this study aims to examine the effect of scd on postural stability . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 13 . 1 this 2 study 2 study 3 aims 3 aims 4 to 3 aims 5 examine 4 to 5 examine 5 examine 7 effect 5 examine 10 on 6 the 7 effect 7 effect 8 of 8 of 9 scd 10 on 12 stability 11 postural 12 stability scottish country dancers ( n = 20 ) were compared with physically active controls ( n = 33 ) for static postural sway measured on a force platform . 0 ###LEFT-WALL### 3 dancers 0 ###LEFT-WALL### 10 compared 0 ###LEFT-WALL### 29 . 1 scottish 2 country 2 country 3 dancers 3 dancers 6 = 3 dancers 9 were 4 ( 6 = 5 n 6 = 6 = 7 20 6 = 8 ) 9 were 10 compared 10 compared 11 with 10 compared 20 for 11 with 14 controls 12 physically 13 active 13 active 14 controls 14 controls 17 = 15 ( 17 = 16 n 17 = 17 = 18 33 17 = 19 ) 20 for 23 sway 21 static 23 sway 22 postural 23 sway 23 sway 24 measured 24 measured 25 on 25 on 28 platform 26 a 27 force 26 a 28 platform 27 force 28 platform the romberg and tandem stances were used under ['] eyes open ['] and ['] eyes closed ['] conditions . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 19 . 1 the 2 romberg 2 romberg 3 and 3 and 5 stances 3 and 13 and 4 tandem 5 stances 6 were 7 used 6 were 13 and 7 used 8 under 7 used 11 open 8 under 10 eyes 13 and 15 eyes 15 eyes 18 conditions 16 closed 18 conditions ninety - five percent ellipse area and sway velocity were calculated from the center of pressure displacement . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 11 calculated 0 ###LEFT-WALL### 18 . 1 ninety 2 - 2 - 3 five 2 - 4 percent 4 percent 5 ellipse 5 ellipse 6 area 6 area 7 and 7 and 9 velocity 7 and 10 were 8 sway 9 velocity 10 were 11 calculated 11 calculated 12 from 12 from 14 center 13 the 14 center 14 center 15 of 15 of 17 displacement 16 pressure 17 displacement ninety - five percent ellipse area was the same for both groups in all tests . 0 ###LEFT-WALL### 6 area 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 16 . 1 ninety 2 - 2 - 3 five 2 - 4 percent 4 percent 6 area 5 ellipse 6 area 6 area 7 was 7 was 9 same 8 the 9 same 9 same 10 for 10 for 12 groups 11 both 12 groups 12 groups 13 in 13 in 15 tests 14 all 15 tests the control group had greater sway velocity for all tests ( [p] < [.] 01 ) except tandem eyes closed . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 21 . 1 the 3 group 2 control 3 group 3 group 4 had 4 had 7 velocity 4 had 17 except 4 had 20 closed 5 greater 7 velocity 6 sway 7 velocity 7 velocity 8 for 8 for 10 tests 9 all 10 tests 10 tests 15 01 11 ( 15 01 13 < 15 01 15 01 16 ) 17 except 19 eyes 18 tandem 19 eyes scd participation resulted in similar postural sway as participation in other physical activities , however nondancers may need a greater amount of regulatory activity to maintain balance . 0 ###LEFT-WALL### 2 participation 0 ###LEFT-WALL### 3 resulted 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 28 . 1 scd 2 participation 2 participation 3 resulted 3 resulted 4 in 3 resulted 8 as 3 resulted 10 in 4 in 7 sway 5 similar 7 sway 6 postural 7 sway 8 as 9 participation 10 in 13 activities 11 other 13 activities 12 physical 13 activities 14 , 16 nondancers 14 , 18 need 15 however 16 nondancers 16 nondancers 17 may 17 may 18 need 18 need 24 activity 18 need 25 to 18 need 26 maintain 19 a 21 amount 20 greater 21 amount 21 amount 22 of 21 amount 24 activity 22 of 24 activity 23 regulatory 24 activity 25 to 26 maintain 26 maintain 27 balance background : physical activity is important for maintaining independence and quality of life in older people living in care homes . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 1 background 2 : 2 : 3 physical 2 : 18 in 3 physical 17 living 4 activity 5 is 5 is 6 important 6 important 7 for 7 for 8 maintaining 8 maintaining 10 and 8 maintaining 17 living 9 independence 10 and 10 and 11 quality 10 and 12 of 10 and 17 living 12 of 13 life 13 life 14 in 14 in 16 people 15 older 16 people 18 in 20 homes 19 care 20 homes little is known about patterns of physical activity or sedentary behavior in this population . 0 ###LEFT-WALL### 1 little 0 ###LEFT-WALL### 3 known 0 ###LEFT-WALL### 15 . 1 little 2 is 2 is 3 known 3 known 4 about 3 known 12 in 4 about 5 patterns 5 patterns 6 of 6 of 9 or 7 physical 8 activity 8 activity 9 or 9 or 11 behavior 10 sedentary 11 behavior 12 in 14 population 13 this 14 population methods : thirty - three care home residents ( 82.6 ± 9.2 years ) wore an actigraph gtx3 accelerometer for seven days , which provided minutes of sedentary behavior and low , light , and moderate - to [-] vigorous physical activity . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 43 . 1 methods 2 : 2 : 4 - 3 thirty 4 - 4 - 5 three 4 - 8 residents 4 - 15 wore 6 care 7 home 7 home 8 residents 8 residents 13 years 8 residents 15 wore 9 ( 13 years 10 82.6 13 years 11 ± 13 years 12 9.2 13 years 13 years 14 ) 15 wore 19 accelerometer 15 wore 20 for 15 wore 38 to 16 an 19 accelerometer 17 actigraph 18 gtx3 18 gtx3 19 accelerometer 20 for 22 days 21 seven 22 days 22 days 24 which 23 , 24 which 24 which 35 and 24 which 37 - 25 provided 30 and 25 provided 35 and 26 minutes 27 of 26 minutes 30 and 27 of 29 behavior 28 sedentary 29 behavior 30 and 33 light 30 and 34 , 31 low 32 , 31 low 33 light 34 , 35 and 35 and 36 moderate 38 to 42 activity 40 vigorous 42 activity 41 physical 42 activity participants undertook the mini - mental state examination and care staff reported activities of daily living ( barthel [index] ) and functional ambulation classification ( fac ) for each participant . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 undertook 0 ###LEFT-WALL### 5 - 1 participants 2 undertook 2 undertook 4 mini 3 the 4 mini 5 - 9 and 5 - 12 reported 5 - 31 . 6 mental 7 state 7 state 8 examination 8 examination 9 and 9 and 11 staff 9 and 12 reported 10 care 11 staff 12 reported 21 and 12 reported 28 for 13 activities 14 of 13 activities 21 and 14 of 16 living 15 daily 16 living 16 living 18 barthel 17 ( 18 barthel 18 barthel 20 ) 21 and 24 classification 21 and 26 fac 22 functional 23 ambulation 23 ambulation 24 classification 25 ( 26 fac 26 fac 27 ) 28 for 30 participant 29 each 30 participant results : participants spent on average 79 % of their day sedentary , 14 % in low , 6 % in light , and 1 % in moderate - to [-] vigorous physical activity . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 3 participants 2 : 4 spent 3 participants 4 spent 4 spent 6 average 4 spent 8 % 4 spent 30 to 5 on 6 average 7 79 8 % 8 % 9 of 9 of 17 low 10 their 17 low 11 day 17 low 12 sedentary 13 , 12 sedentary 17 low 14 14 16 in 15 % 16 in 16 in 17 low 17 low 24 and 18 , 24 and 19 6 21 in 20 % 21 in 21 in 22 light 22 light 24 and 23 , 24 and 24 and 28 moderate 24 and 29 - 25 1 27 in 26 % 27 in 27 in 28 moderate 30 to 34 activity 32 vigorous 34 activity 33 physical 34 activity activity levels did not significantly differ between days or hours of the day ( p > [.] 05 ) . 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 6 differ 0 ###LEFT-WALL### 20 . 1 activity 2 levels 2 levels 3 did 3 did 4 not 3 did 6 differ 5 significantly 6 differ 6 differ 7 between 7 between 9 or 8 days 9 or 9 or 10 hours 9 or 19 ) 10 hours 11 of 11 of 13 day 12 the 13 day 13 day 16 > 14 ( 16 > 15 p 16 > 16 > 18 05 conclusion : levels of physical activity were very low and time being sedentary was high . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 levels 2 : 7 were 2 : 10 and 2 : 16 . 3 levels 4 of 3 levels 7 were 4 of 6 activity 5 physical 6 activity 7 were 9 low 8 very 9 low 10 and 11 time 10 and 14 was 11 time 12 being 11 time 14 was 12 being 13 sedentary 14 was 15 high this study can inform physical activity and sedentary behavior interventions for care homes ' residents . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 inform 0 ###LEFT-WALL### 16 . 1 this 2 study 2 study 3 can 3 can 4 inform 4 inform 7 and 5 physical 6 activity 6 activity 7 and 7 and 10 interventions 7 and 11 for 8 sedentary 9 behavior 9 behavior 10 interventions 11 for 15 residents 12 care 13 homes 13 homes 14 ' 14 ' 15 residents increased proportion [of] [non] - contractile elements can be observed during aging by enhanced skeletal muscle echo intensity [(] ei ) . 0 ###LEFT-WALL### 2 proportion 0 ###LEFT-WALL### 10 observed 0 ###LEFT-WALL### 22 . 1 increased 2 proportion 5 - 10 observed 6 contractile 7 elements 6 contractile 9 be 6 contractile 10 observed 7 elements 8 can 8 can 9 be 10 observed 11 during 10 observed 13 by 10 observed 21 ) 11 during 12 aging 13 by 20 ei 14 enhanced 16 muscle 15 skeletal 16 muscle 16 muscle 18 intensity 17 echo 18 intensity 18 intensity 20 ei studies have demonstrated that an increase in rectus femoris ei may affect physical performance . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 15 . 1 studies 2 have 2 have 3 demonstrated 3 demonstrated 4 that 4 that 6 increase 4 that 12 affect 5 an 6 increase 6 increase 7 in 6 increase 11 may 7 in 10 ei 8 rectus 9 femoris 9 femoris 10 ei 11 may 12 affect 12 affect 14 performance 13 physical 14 performance however , it is still unknown whether the whole quadriceps femoris ei ( qei ) influences strength , power , and functional capacity of an older population . 0 ###LEFT-WALL### 3 it 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 28 . 1 however 2 , 1 however 3 it 3 it 4 is 4 is 5 still 4 is 6 unknown 6 unknown 7 whether 7 whether 9 whole 7 whether 10 quadriceps 8 the 9 whole 9 whole 10 quadriceps 10 quadriceps 11 femoris 11 femoris 14 qei 11 femoris 16 influences 12 ei 14 qei 13 ( 14 qei 14 qei 15 ) 14 qei 16 influences 16 influences 21 and 17 strength 18 , 18 , 19 power 18 , 21 and 20 , 21 and 21 and 23 capacity 21 and 24 of 22 functional 23 capacity 24 of 27 population 25 an 27 population 26 older 27 population therefore , the aim of the present study was to determine the correlation between qei , the four individual quadriceps portions ei , and muscular performance of older men . 0 ###LEFT-WALL### 4 aim 0 ###LEFT-WALL### 30 . 1 therefore 2 , 1 therefore 4 aim 3 the 4 aim 4 aim 5 of 4 aim 9 was 5 of 8 study 6 the 8 study 7 present 8 study 9 was 10 to 9 was 11 determine 10 to 11 determine 11 determine 13 correlation 11 determine 14 between 12 the 13 correlation 14 between 24 and 15 qei 16 , 16 , 22 ei 16 , 24 and 17 the 21 portions 18 four 19 individual 19 individual 21 portions 20 quadriceps 21 portions 21 portions 22 ei 23 , 24 and 24 and 26 performance 24 and 27 of 25 muscular 26 performance 27 of 29 men 28 older 29 men fifty sedentary healthy men ( 66.1 ± 4.5 years [,] 1.75 ± 0.06 m , 80.2 ± [11.0] kg ) volunteered for the present study . 0 ###LEFT-WALL### 4 men 0 ###LEFT-WALL### 21 volunteered 0 ###LEFT-WALL### 26 . 1 fifty 4 men 2 sedentary 4 men 3 healthy 4 men 4 men 9 years 4 men 19 kg 4 men 21 volunteered 5 ( 9 years 6 66.1 9 years 7 ± 9 years 8 4.5 9 years 9 years 11 1.75 9 years 12 ± 9 years 15 , 11 1.75 12 ± 12 ± 14 m 13 0.06 14 m 15 , 19 kg 16 80.2 19 kg 17 ± 19 kg 19 kg 20 ) 21 volunteered 22 for 22 for 25 study 23 the 25 study 24 present 25 study the qei and ei of the four quadriceps portions were calculated by ultrasound imaging . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 15 . 1 the 2 qei 2 qei 3 and 3 and 4 ei 3 and 5 of 3 and 9 portions 3 and 14 imaging 5 of 8 quadriceps 6 the 7 four 7 four 8 quadriceps 9 portions 10 were 10 were 11 calculated 11 calculated 12 by 12 by 13 ultrasound 13 ultrasound 14 imaging knee [extension] one repetition maximum ( 1rm ) , isometric peak torque ( pt ) , and rate [of] torque development ( rtd ) were obtained as measures of muscular strength . 0 ###LEFT-WALL### 1 knee 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 32 . 1 knee 12 torque 3 one 12 torque 4 repetition 12 torque 5 maximum 7 1rm 5 maximum 9 , 5 maximum 11 peak 6 ( 7 1rm 7 1rm 8 ) 10 isometric 11 peak 11 peak 12 torque 12 torque 14 pt 13 ( 14 pt 14 pt 15 ) 16 , 17 and 17 and 21 development 17 and 26 obtained 18 rate 21 development 20 torque 21 development 21 development 23 rtd 21 development 25 were 22 ( 23 rtd 23 rtd 24 ) 25 were 26 obtained 26 obtained 27 as 27 as 28 measures 28 measures 29 of 29 of 31 strength 30 muscular 31 strength muscular power was determined by knee extension with 60 % of 1rm and countermovement jump ( cmj ) . 0 ###LEFT-WALL### 2 power 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 19 . 1 muscular 2 power 2 power 3 was 3 was 4 determined 4 determined 5 by 4 determined 8 with 5 by 7 extension 6 knee 7 extension 8 with 10 % 9 60 10 % 10 % 11 of 11 of 13 and 12 1rm 13 and 13 and 15 jump 13 and 17 cmj 14 countermovement 15 jump 16 ( 17 cmj 17 cmj 18 ) the 30 [-] s sit - to [-] stand [test] was evaluated as a functional capacity parameter . 0 ###LEFT-WALL### 4 s 0 ###LEFT-WALL### 5 sit 0 ###LEFT-WALL### 6 - 1 the 4 s 2 30 4 s 4 s 5 sit 6 - 7 to 6 - 12 evaluated 6 - 18 . 7 to 9 stand 7 to 11 was 11 was 12 evaluated 12 evaluated 13 as 13 as 17 parameter 14 a 15 functional 14 a 17 parameter 15 functional 16 capacity 16 capacity 17 parameter qei and all individual ei were correlated to functional capacity and power during cmj ( [p] ≤ 0.05 ) , but rectus femoris ei was not related to knee extension average power ( p > 0.05 ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 11 and 1 qei 2 and 2 and 5 ei 2 and 6 were 3 all 5 ei 4 individual 5 ei 6 were 11 and 7 correlated 8 to 7 correlated 11 and 8 to 10 capacity 9 functional 10 capacity 11 and 12 power 11 and 13 during 11 and 21 but 13 during 14 cmj 14 cmj 17 ≤ 15 ( 17 ≤ 17 ≤ 18 0.05 17 ≤ 19 ) 20 , 21 but 21 but 23 femoris 21 but 38 . 22 rectus 23 femoris 23 femoris 24 ei 23 femoris 29 knee 23 femoris 35 > 24 ei 25 was 25 was 26 not 25 was 28 to 25 was 29 knee 26 not 27 related 28 to 29 knee 29 knee 32 power 30 extension 32 power 31 average 32 power 33 ( 35 > 34 p 35 > 35 > 36 0.05 35 > 37 ) there were significant correlations between all ei variables , 1rm , pt , and rtd at 0.2 s ( [p] ≤ 0.05 ) , but only vastus medialis ei and qei were correlated to rtd at 0.05 s ( [p] ≤ 0.05 ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 25 but 0 ###LEFT-WALL### 44 . 1 there 2 were 2 were 4 correlations 3 significant 4 correlations 4 correlations 5 between 4 correlations 10 1rm 4 correlations 14 and 5 between 8 variables 6 all 8 variables 7 ei 8 variables 9 , 10 1rm 10 1rm 11 , 11 , 14 and 12 pt 14 and 13 , 14 and 14 and 15 rtd 14 and 16 at 14 and 21 ≤ 14 and 24 , 16 at 18 s 17 0.2 18 s 19 ( 21 ≤ 21 ≤ 22 0.05 21 ≤ 23 ) 25 but 26 only 25 but 28 medialis 25 but 33 correlated 27 vastus 28 medialis 28 medialis 31 qei 28 medialis 32 were 28 medialis 33 correlated 29 ei 30 and 30 and 31 qei 31 qei 32 were 33 correlated 34 to 34 to 35 rtd 35 rtd 36 at 35 rtd 41 ≤ 36 at 38 s 37 0.05 38 s 39 ( 41 ≤ 41 ≤ 42 0.05 41 ≤ 43 ) the results of the present study suggest that qei is related to muscular power and functional capacity of older subjects , but the ei of some individual quadriceps portions may underestimate the correlations with muscular performance . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 22 but 0 ###LEFT-WALL### 37 . 1 the 2 results 2 results 3 of 2 results 22 but 3 of 6 study 4 the 6 study 5 present 6 study 7 suggest 8 that 7 suggest 22 but 8 that 9 qei 8 that 11 related 9 qei 10 is 10 is 11 related 11 related 12 to 12 to 15 and 13 muscular 14 power 14 power 15 and 15 and 17 capacity 15 and 21 , 16 functional 17 capacity 17 capacity 18 of 18 of 20 subjects 19 older 20 subjects 21 , 22 but 22 but 31 underestimate 23 the 24 ei 24 ei 25 of 24 ei 30 may 25 of 29 portions 26 some 29 portions 27 individual 29 portions 28 quadriceps 29 portions 30 may 31 underestimate 31 underestimate 33 correlations 31 underestimate 34 with 32 the 33 correlations 34 with 36 performance 35 muscular 36 performance few long - [term] follow - up data are available on thyroid dysfunction ( td ) in multiple sclerosis ( [ms] [ )(patients treated with glatiramer [acetate] ( ga ) or with interferon [-] beta ( ifnb ) . 0 ###LEFT-WALL### 1 few 0 ###LEFT-WALL### 2 long 0 ###LEFT-WALL### 3 - 1 few 2 long 3 - 5 follow 3 - 6 - 6 - 7 up 6 - 9 are 6 - 39 . 7 up 9 are 8 data 9 are 9 are 10 available 10 available 11 on 10 available 17 in 11 on 13 dysfunction 12 thyroid 13 dysfunction 13 dysfunction 15 td 14 ( 15 td 15 td 16 ) 17 in 19 sclerosis 18 multiple 19 sclerosis 19 sclerosis 23 )(patients 20 ( 23 )(patients 23 )(patients 24 treated 23 )(patients 37 ifnb 23 )(patients 38 ) 24 treated 31 or 25 with 26 glatiramer 25 with 31 or 26 glatiramer 29 ga 28 ( 29 ga 29 ga 30 ) 31 or 32 with 32 with 35 beta 33 interferon 35 beta 36 ( 37 ifnb 37 ifnb 38 ) in a cohort of 787 relapsing - remitting ms ( rrms ) patients [whom] were followed up for 8 years , [we] observed an increased prevalence of td and thyroid autoimmunity ( ta ) within the first year of ifnb treatment , [regardless] of the dose or frequency of administration , [while] no change was observed with ga treatment . 1 in 3 cohort 1 in 6 relapsing 2 a 3 cohort 4 of 5 787 4 of 6 relapsing 6 relapsing 8 remitting 6 relapsing 15 were 7 - 8 remitting 8 remitting 13 patients 9 ms 11 rrms 10 ( 11 rrms 11 rrms 12 ) 11 rrms 13 patients 15 were 21 , 16 followed 17 up 16 followed 18 for 16 followed 21 , 18 for 20 years 19 8 20 years 21 , 23 observed 23 observed 26 prevalence 24 an 26 prevalence 25 increased 26 prevalence 26 prevalence 27 of 26 prevalence 35 within 27 of 29 and 28 td 29 and 29 and 31 autoimmunity 29 and 33 ta 30 thyroid 31 autoimmunity 32 ( 33 ta 33 ta 34 ) 35 within 38 year 36 the 38 year 37 first 38 year 38 year 39 of 39 of 41 treatment 40 ifnb 41 treatment 41 treatment 44 of 42 , 44 of 44 of 47 or 44 of 51 , 45 the 46 dose 46 dose 47 or 47 or 48 frequency 47 or 49 of 49 of 50 administration 51 , 56 observed 53 no 54 change 54 change 55 was 55 was 56 observed 56 observed 57 with 56 observed 60 . 57 with 59 treatment 58 ga 59 treatment the increased prevalence of td and ta within the first year of ifnb treatment suggested the need for close monitoring of thyroid function [and] autoimmunity , [though] only during the first year of ifnb treatment . 0 ###LEFT-WALL### 3 prevalence 0 ###LEFT-WALL### 15 suggested 1 the 3 prevalence 2 increased 3 prevalence 3 prevalence 4 of 3 prevalence 15 suggested 4 of 7 ta 5 td 6 and 6 and 7 ta 7 ta 8 within 7 ta 12 of 8 within 11 year 9 the 10 first 9 the 11 year 12 of 14 treatment 13 ifnb 14 treatment 15 suggested 17 need 15 suggested 18 for 15 suggested 29 during 16 the 17 need 18 for 20 monitoring 19 close 20 monitoring 20 monitoring 21 of 21 of 25 autoimmunity 22 thyroid 25 autoimmunity 23 function 25 autoimmunity 26 , 28 only 26 , 29 during 29 during 32 year 29 during 36 . 30 the 31 first 30 the 32 year 32 year 33 of 33 of 35 treatment 34 ifnb 35 treatment the aim of this study is to provide normative data for a phonological alternating task ( fat ) , a semantic alternating task ( sat ) and an excluded letter task ( elt ) . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 35 . 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 provide 7 to 8 provide 8 provide 27 and 9 normative 10 data 10 data 11 for 10 data 27 and 11 for 15 task 12 a 13 phonological 12 a 15 task 13 phonological 15 task 14 alternating 15 task 15 task 17 fat 15 task 23 task 16 ( 17 fat 17 fat 18 ) 19 , 23 task 20 a 21 semantic 20 a 23 task 21 semantic 23 task 22 alternating 23 task 23 task 25 sat 23 task 26 ) 24 ( 25 sat 25 sat 26 ) 27 and 31 task 27 and 33 elt 28 an 31 task 29 excluded 30 letter 30 letter 31 task 32 ( 33 elt 33 elt 34 ) the tasks were administered to 146 flemish - speaking , cognitively healthy [elderly] . 0 ###LEFT-WALL### 2 tasks 0 ###LEFT-WALL### 4 administered 0 ###LEFT-WALL### 14 . 1 the 2 tasks 2 tasks 3 were 3 were 4 administered 4 administered 5 to 4 administered 10 , 4 administered 12 healthy 5 to 7 flemish 6 146 7 flemish 7 flemish 9 speaking 8 - 9 speaking 9 speaking 10 , 11 cognitively 12 healthy data from 102 were used and were classified according to the significant variables . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 14 . 1 data 2 from 1 data 4 were 2 from 3 102 4 were 6 and 5 used 6 and 6 and 7 were 6 and 10 to 7 were 8 classified 9 according 10 to 10 to 13 variables 11 the 13 variables 12 significant 13 variables subsequently , these tasks were administered to seven patients diagnosed with mild neurocognitive impairment ( mild cognitive impairment , mci ) [and] seven patients with onset dementia of the alzheimer type ( dat ) . 0 ###LEFT-WALL### 4 tasks 0 ###LEFT-WALL### 6 administered 0 ###LEFT-WALL### 35 . 1 subsequently 2 , 1 subsequently 4 tasks 3 these 4 tasks 4 tasks 5 were 5 were 6 administered 6 administered 7 to 6 administered 11 with 7 to 9 patients 8 seven 9 patients 9 patients 10 diagnosed 11 with 14 impairment 11 with 24 patients 12 mild 14 impairment 13 neurocognitive 14 impairment 14 impairment 18 impairment 14 impairment 20 mci 15 ( 18 impairment 16 mild 18 impairment 17 cognitive 18 impairment 18 impairment 19 , 19 , 20 mci 20 mci 21 ) 23 seven 24 patients 24 patients 25 with 24 patients 28 of 25 with 27 dementia 26 onset 27 dementia 28 of 31 type 29 the 31 type 30 alzheimer 31 type 31 type 33 dat 32 ( 33 dat 33 dat 34 ) results of the standard study show that the level of education is a significant variable for all complex vft and age for the sat and the elt , while age related deterioration is [highest] for the elt . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 28 , 0 ###LEFT-WALL### 38 . 1 results 2 of 1 results 20 and 2 of 6 show 3 the 6 show 4 standard 5 study 5 study 6 show 6 show 7 that 6 show 18 complex 7 that 9 level 7 that 12 is 8 the 9 level 9 level 10 of 9 level 12 is 10 of 11 education 12 is 15 variable 12 is 16 for 13 a 15 variable 14 significant 15 variable 16 for 17 all 17 all 18 complex 18 complex 19 vft 20 and 21 age 20 and 22 for 22 for 25 and 23 the 24 sat 24 sat 25 and 25 and 27 elt 26 the 27 elt 28 , 32 deterioration 28 , 33 is 29 while 30 age 29 while 32 deterioration 31 related 32 deterioration 32 deterioration 33 is 33 is 35 for 35 for 37 elt 36 the 37 elt the error rate is [highest] for the elt and [lowest] for the sat . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 14 . 1 the 3 rate 2 error 3 rate 3 rate 4 is 4 is 9 and 6 for 8 elt 6 for 9 and 7 the 8 elt 9 and 11 for 11 for 13 sat 12 the 13 sat analysis of the time duration shows that data should be collected for at least 2 min . 0 ###LEFT-WALL### 1 analysis 0 ###LEFT-WALL### 6 shows 0 ###LEFT-WALL### 17 . 1 analysis 2 of 1 analysis 6 shows 2 of 5 duration 3 the 5 duration 4 time 5 duration 6 shows 7 that 7 that 8 data 7 that 10 be 8 data 9 should 9 should 10 be 10 be 11 collected 11 collected 12 for 12 for 16 min 13 at 14 least 14 least 15 2 15 2 16 min the patients scored significantly lower than the normgroup of healthy adults . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 scored 0 ###LEFT-WALL### 12 . 1 the 2 patients 2 patients 3 scored 3 scored 5 lower 4 significantly 5 lower 5 lower 6 than 6 than 8 normgroup 7 the 8 normgroup 8 normgroup 9 of 9 of 11 adults 10 healthy 11 adults the error rate is [highest] for the sat and [lowest] for the elt . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 14 . 1 the 3 rate 2 error 3 rate 3 rate 4 is 4 is 9 and 6 for 8 sat 6 for 9 and 7 the 8 sat 9 and 11 for 11 for 13 elt 12 the 13 elt hydrogen peroxide , the nonradical [2] - electron reduction product of oxygen , is a normal aerobic metabolite occurring at about 10 nm intracellular concentration . 0 ###LEFT-WALL### 2 peroxide 0 ###LEFT-WALL### 14 is 0 ###LEFT-WALL### 26 . 1 hydrogen 2 peroxide 2 peroxide 10 product 2 peroxide 14 is 3 , 10 product 4 the 10 product 5 nonradical 7 - 5 nonradical 8 electron 8 electron 10 product 9 reduction 10 product 10 product 11 of 10 product 13 , 11 of 12 oxygen 14 is 18 metabolite 15 a 16 normal 15 a 18 metabolite 16 normal 18 metabolite 17 aerobic 18 metabolite 18 metabolite 19 occurring 19 occurring 20 at 20 at 25 concentration 21 about 22 10 22 10 23 nm 23 nm 25 concentration 24 intracellular 25 concentration in liver , it is produced at 50 nmol/min/g of tissue , which is about 2 % of total oxygen uptake [at] steady [state] . 0 ###LEFT-WALL### 4 it 0 ###LEFT-WALL### 6 produced 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 25 . 1 in 2 liver 1 in 3 , 1 in 4 it 4 it 5 is 5 is 6 produced 6 produced 7 at 7 at 9 nmol/min/g 8 50 9 nmol/min/g 9 nmol/min/g 10 of 10 of 11 tissue 12 , 13 which 12 , 23 steady 13 which 14 is 13 which 23 steady 14 is 17 % 14 is 23 steady 15 about 16 2 16 2 17 % 17 % 18 of 18 of 21 uptake 19 total 21 uptake 20 oxygen 21 uptake metabolically generated h2o2 emerged from recent research as a central hub in redox signaling and oxidative stress . 0 ###LEFT-WALL### 3 h2o2 0 ###LEFT-WALL### 4 emerged 0 ###LEFT-WALL### 18 . 1 metabolically 2 generated 2 generated 3 h2o2 3 h2o2 4 emerged 4 emerged 5 from 4 emerged 8 as 5 from 7 research 6 recent 7 research 8 as 15 and 9 a 10 central 9 a 11 hub 10 central 11 hub 11 hub 12 in 11 hub 15 and 12 in 13 redox 13 redox 14 signaling 15 and 17 stress 16 oxidative 17 stress upon generation by major sources , the nadph oxidases or complex iii of the mitochondrial respiratory chain , h2o2 is under sophisticated fine control of peroxiredoxins and glutathione peroxidases with their backup systems as well [as] [by] [catalase] . 0 ###LEFT-WALL### 19 h2o2 0 ###LEFT-WALL### 20 is 0 ###LEFT-WALL### 39 . 1 upon 10 or 1 upon 18 , 1 upon 19 h2o2 2 generation 3 by 2 generation 6 , 3 by 5 sources 4 major 5 sources 6 , 9 oxidases 6 , 10 or 7 the 9 oxidases 8 nadph 9 oxidases 10 or 11 complex 10 or 13 of 11 complex 12 iii 13 of 17 chain 14 the 17 chain 15 mitochondrial 17 chain 16 respiratory 17 chain 19 h2o2 20 is 20 is 21 under 20 is 30 with 20 is 34 as 21 under 27 and 22 sophisticated 24 control 23 fine 24 control 24 control 25 of 24 control 27 and 25 of 26 peroxiredoxins 27 and 29 peroxidases 28 glutathione 29 peroxidases 30 with 33 systems 31 their 33 systems 32 backup 33 systems 34 as 35 well [of] note , h2o2 is a second messenger in insulin signaling and [in] several growth factor - induced signaling cascades . 0 ###LEFT-WALL### 2 note 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 21 . 3 , 4 h2o2 3 , 5 is 4 h2o2 5 is 5 is 8 messenger 5 is 19 signaling 6 a 8 messenger 7 second 8 messenger 8 messenger 9 in 8 messenger 18 induced 9 in 12 and 10 insulin 11 signaling 10 insulin 12 and 12 and 16 factor 12 and 17 - 14 several 15 growth 15 growth 16 factor 19 signaling 20 cascades h2o2 transport across membranes is facilitated by aquaporins , denoted as peroxiporins . 0 ###LEFT-WALL### 2 transport 0 ###LEFT-WALL### 6 facilitated 0 ###LEFT-WALL### 13 . 1 h2o2 2 transport 2 transport 3 across 2 transport 5 is 3 across 4 membranes 5 is 6 facilitated 6 facilitated 7 by 6 facilitated 11 as 7 by 9 , 8 aquaporins 9 , 9 , 10 denoted 11 as 12 peroxiporins [specialized] protein cysteines operate as redox switches using h2o2 as thiol oxidant , making this reactive oxygen species essential for poising the set point of the redox proteome . 0 ###LEFT-WALL### 3 cysteines 0 ###LEFT-WALL### 4 operate 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 29 . 2 protein 3 cysteines 3 cysteines 4 operate 4 operate 7 switches 4 operate 10 as 5 as 6 redox 6 redox 7 switches 7 switches 8 using 8 using 9 h2o2 10 as 12 oxidant 11 thiol 12 oxidant 13 , 18 species 13 , 28 proteome 14 making 18 species 15 this 16 reactive 16 reactive 17 oxygen 17 oxygen 18 species 18 species 19 essential 18 species 28 proteome 19 essential 20 for 20 for 21 poising 21 poising 24 point 22 the 24 point 23 set 24 point 24 point 25 of 25 of 27 redox 26 the 27 redox major processes including proliferation , differentiation , tissue repair , inflammation , circadian rhythm , and aging use this low molecular weight oxygen metabolite as signaling compound . 0 ###LEFT-WALL### 4 proliferation 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 28 . 1 major 4 proliferation 2 processes 4 proliferation 3 including 4 proliferation 5 , 16 and 6 differentiation 7 , 7 , 9 repair 7 , 10 , 8 tissue 9 repair 10 , 11 inflammation 10 , 12 , 12 , 14 rhythm 12 , 16 and 13 circadian 14 rhythm 15 , 16 and 16 and 23 oxygen 16 and 24 metabolite 17 aging 18 use 18 use 23 oxygen 19 this 20 low 20 low 22 weight 21 molecular 22 weight 22 weight 23 oxygen 24 metabolite 25 as 25 as 27 compound 26 signaling 27 compound it should be recognized that children are not small adults , hence dosing in children should not be a ['] small adult dose ['] . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 recognized 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 25 . 1 it 2 should 2 should 3 be 3 be 4 recognized 4 recognized 5 that 5 that 6 children 5 that 7 are 6 children 7 are 7 are 8 not 7 are 10 adults 9 small 10 adults 11 , 13 dosing 11 , 18 be 12 hence 13 dosing 13 dosing 14 in 13 dosing 16 should 14 in 15 children 16 should 17 not 16 should 18 be 18 be 23 dose 19 a 23 dose 21 small 22 adult 22 adult 23 dose a mean population dose in all age groups is just an average dose and not necessarily the best [or] [the] correct [dose] for a given patient . 0 ###LEFT-WALL### 4 dose 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 15 not 0 ###LEFT-WALL### 27 . 1 a 2 mean 1 a 4 dose 2 mean 3 population 3 population 4 dose 4 dose 5 in 4 dose 9 is 5 in 8 groups 6 all 8 groups 7 age 8 groups 9 is 10 just 9 is 13 dose 11 an 12 average 11 an 13 dose 12 average 13 dose 14 and 15 not 15 not 16 necessarily 15 not 18 best 15 not 21 correct 17 the 18 best 18 best 21 correct 21 correct 23 for 23 for 26 patient 24 a 26 patient 25 given 26 patient the dose [of] a drug varies from patient to patient and individual adjustment of the dose is always ideal but is not always practical . 0 ###LEFT-WALL### 2 dose 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 25 . 1 the 2 dose 2 dose 5 drug 2 dose 7 from 2 dose 8 patient 2 dose 20 but 4 a 5 drug 5 drug 6 varies 6 varies 7 from 8 patient 9 to 9 to 13 adjustment 10 patient 11 and 11 and 12 individual 11 and 13 adjustment 13 adjustment 14 of 14 of 16 dose 15 the 16 dose 17 is 18 always 17 is 19 ideal 17 is 20 but 20 but 21 is 21 is 22 not 21 is 23 always 21 is 24 practical theoretically , dose selection in paediatric drug development or clinical settings can be done by using either body weight or the clearance of a drug . 0 ###LEFT-WALL### 9 or 0 ###LEFT-WALL### 13 be 0 ###LEFT-WALL### 26 . 1 theoretically 2 , 1 theoretically 9 or 3 dose 4 selection 4 selection 5 in 4 selection 9 or 5 in 8 development 6 paediatric 8 development 7 drug 8 development 9 or 11 settings 9 or 12 can 10 clinical 11 settings 12 can 13 be 13 be 14 done 14 done 15 by 15 by 16 using 16 using 20 or 17 either 19 weight 18 body 19 weight 19 weight 20 or 20 or 22 clearance 20 or 23 of 21 the 22 clearance 23 of 25 drug 24 a 25 drug over the years , a lot of approaches have been suggested for the prediction of drug clearance or dose in paediatrics . 0 ###LEFT-WALL### 8 approaches 0 ###LEFT-WALL### 11 suggested 0 ###LEFT-WALL### 22 . 1 over 3 years 1 over 4 , 1 over 8 approaches 2 the 3 years 5 a 6 lot 6 lot 7 of 6 lot 8 approaches 7 of 8 approaches 8 approaches 9 have 9 have 10 been 10 been 11 suggested 11 suggested 12 for 11 suggested 20 in 12 for 14 prediction 13 the 14 prediction 14 prediction 15 of 15 of 18 or 16 drug 17 clearance 17 clearance 18 or 18 or 19 dose 20 in 21 paediatrics although some proposed methods are useful for the prediction of clearance or dose in children [,] there remains a high degree of uncertainty in the prediction of drug clearance or dose in children . 0 ###LEFT-WALL### 12 or 0 ###LEFT-WALL### 30 or 0 ###LEFT-WALL### 34 . 1 although 2 some 1 although 12 or 2 some 4 methods 2 some 10 of 3 proposed 4 methods 4 methods 5 are 5 are 6 useful 6 useful 7 for 7 for 9 prediction 8 the 9 prediction 9 prediction 10 of 11 clearance 12 or 12 or 13 dose 12 or 14 in 12 or 17 there 12 or 30 or 14 in 15 children 18 remains 23 uncertainty 18 remains 24 in 18 remains 30 or 19 a 21 degree 20 high 21 degree 21 degree 22 of 21 degree 23 uncertainty 22 of 23 uncertainty 24 in 26 prediction 25 the 26 prediction 26 prediction 27 of 27 of 29 clearance 28 drug 29 clearance 30 or 31 dose 30 or 32 in 32 in 33 children in particular , the prediction of clearance or dose in an individual patient remains highly erratic . 0 ###LEFT-WALL### 5 prediction 0 ###LEFT-WALL### 14 remains 0 ###LEFT-WALL### 17 . 1 in 2 particular 2 particular 3 , 2 particular 5 prediction 4 the 5 prediction 5 prediction 6 of 5 prediction 14 remains 6 of 8 or 7 clearance 8 or 8 or 9 dose 8 or 10 in 10 in 13 patient 11 an 12 individual 11 an 13 patient 12 individual 13 patient 14 remains 15 highly 14 remains 16 erratic this review takes a critical look at these approaches and highlights the application and limitations of these proposed methods . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 20 . 1 this 2 review 2 review 10 and 2 review 14 and 3 takes 6 look 3 takes 7 at 3 takes 10 and 4 a 6 look 5 critical 6 look 7 at 9 approaches 8 these 9 approaches 10 and 11 highlights 10 and 13 application 12 the 13 application 14 and 15 limitations 14 and 16 of 16 of 19 methods 17 these 19 methods 18 proposed 19 methods purpose : the objectives of this study were to evaluate the factors that contribute to aging in the lower eyelids and periorbital changes in asians and to analyze the contribution of different anatomic factors before surgery . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 4 objectives 2 : 26 and 2 : 37 . 3 the 4 objectives 4 objectives 5 of 4 objectives 26 and 5 of 7 study 6 this 7 study 8 were 9 to 8 were 10 evaluate 8 were 26 and 9 to 10 evaluate 10 evaluate 12 factors 11 the 12 factors 12 factors 13 that 12 factors 14 contribute 13 that 14 contribute 14 contribute 15 to 14 contribute 24 in 15 to 16 aging 16 aging 17 in 17 in 23 changes 18 the 20 eyelids 19 lower 20 eyelids 20 eyelids 21 and 21 and 22 periorbital 21 and 23 changes 24 in 25 asians 26 and 27 to 26 and 28 analyze 26 and 35 before 27 to 28 analyze 28 analyze 30 contribution 29 the 30 contribution 30 contribution 31 of 31 of 34 factors 32 different 34 factors 33 anatomic 34 factors 35 before 36 surgery methods : we analyzed photographs and examination findings of 108 patients older than 80 years who had consultations for lower eyelid blepharoplasty . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 we 2 : 4 analyzed 3 we 4 analyzed 4 analyzed 6 and 5 photographs 6 and 6 and 8 findings 6 and 9 of 6 and 12 older 6 and 16 who 6 and 17 had 7 examination 8 findings 9 of 11 patients 10 108 11 patients 12 older 13 than 13 than 15 years 14 80 15 years 16 who 17 had 17 had 18 consultations 17 had 19 for 19 for 22 blepharoplasty 20 lower 22 blepharoplasty 21 eyelid 22 blepharoplasty structural changes were categorized to 7 anatomical categories , and each category was scored from 0 to 3 base d on severity . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 4 categorized 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 23 . 1 structural 2 changes 2 changes 3 were 3 were 4 categorized 4 categorized 5 to 5 to 8 categories 6 7 8 categories 7 anatomical 8 categories 9 , 10 and 10 and 12 category 10 and 14 scored 11 each 12 category 12 category 13 was 13 was 14 scored 14 scored 15 from 15 from 20 d 16 0 17 to 17 to 18 3 17 to 20 d 19 base 20 d 20 d 21 on 21 on 22 severity the total point for each category for all patients was divided by the 456 total possible points and was considered a cumulative contribution score for that category . 0 ###LEFT-WALL### 3 point 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 28 . 1 the 3 point 2 total 3 point 3 point 4 for 3 point 18 and 4 for 6 category 5 each 6 category 6 category 7 for 7 for 9 patients 8 all 9 patients 10 was 11 divided 10 was 18 and 11 divided 12 by 12 by 17 points 13 the 14 456 14 456 17 points 15 total 17 points 16 possible 17 points 18 and 19 was 18 and 24 score 19 was 20 considered 21 a 22 cumulative 21 a 24 score 22 cumulative 23 contribution 23 contribution 24 score 24 score 25 for 25 for 27 category 26 that 27 category " a uniqueness score " for each patient was calculated as the maximum score in 1 category divided by the patient 's total score to reflect the percentage contribution of the patient 's most severe anatomic problem . 0 ###LEFT-WALL### 1 " 0 ###LEFT-WALL### 4 score 0 ###LEFT-WALL### 10 calculated 0 ###LEFT-WALL### 38 . 2 a 4 score 3 uniqueness 4 score 4 score 5 " 4 score 6 for 4 score 9 was 6 for 8 patient 7 each 8 patient 9 was 10 calculated 10 calculated 11 as 11 as 14 score 12 the 14 score 13 maximum 14 score 14 score 15 in 14 score 18 divided 15 in 17 category 16 1 17 category 18 divided 19 by 18 divided 25 to 19 by 24 score 20 the 21 patient 21 patient 22 's 22 's 24 score 23 total 24 score 25 to 26 reflect 26 reflect 29 contribution 27 the 29 contribution 28 percentage 29 contribution 29 contribution 30 of 30 of 37 problem 31 the 32 patient 32 patient 33 's 33 's 37 problem 34 most 35 severe 35 severe 37 problem 36 anatomic 37 problem results : a total of 108 cases ( 51 male and 57 female patients ) were evaluated . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 total 2 : 17 evaluated 2 : 18 . 3 a 4 total 4 total 5 of 4 total 16 were 5 of 7 cases 6 108 7 cases 7 cases 14 patients 8 ( 14 patients 9 51 14 patients 10 male 11 and 11 and 13 female 11 and 14 patients 12 57 13 female 14 patients 15 ) 16 were 17 evaluated the mean age was 57 ± 11 years ( age range , 30 - 75 years ) . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 18 . 1 the 3 age 2 mean 3 age 3 age 4 was 4 was 8 years 5 57 8 years 6 ± 8 years 7 11 8 years 8 years 11 range 8 years 14 - 9 ( 11 range 10 age 11 range 11 range 12 , 12 , 14 - 13 30 14 - 14 - 16 years 14 - 17 ) 15 75 16 years the cumulative contribution score for each category was [as] follows : orbital fat [prolapse] 33.8 ( [medial] 15.3 , [central] 11.7 , [lateral] 6.8 ) [,] skin [laxity] 22.3 % , [periorbital] hollow 20.8 ( tear trough 15.5 , lateral orbital rim 5.3 [ )(, septal confluence 9.5 , orbicularis oculi muscle hypertrophy 3.6 , triangular malar mound 3.4 , and eyelid fluid 0.5 . 0 ###LEFT-WALL### 4 score 0 ###LEFT-WALL### 10 follows 0 ###LEFT-WALL### 11 : 1 the 4 score 2 cumulative 3 contribution 3 contribution 4 score 4 score 5 for 4 score 10 follows 5 for 6 each 6 each 7 category 6 each 8 was 7 category 8 was 11 : 13 fat 11 : 19 , 12 orbital 13 fat 13 fat 15 33.8 13 fat 18 15.3 16 ( 18 15.3 18 15.3 19 , 19 , 21 11.7 19 , 27 skin 19 , 31 , 21 11.7 24 6.8 21 11.7 27 skin 22 , 24 6.8 24 6.8 25 ) 27 skin 30 % 29 22.3 30 % 31 , 33 hollow 31 , 39 , 33 hollow 34 20.8 34 20.8 37 trough 35 ( 37 trough 36 tear 37 trough 37 trough 38 15.5 37 trough 39 , 39 , 50 orbicularis 40 lateral 49 , 40 lateral 50 orbicularis 41 orbital 42 rim 42 rim 43 5.3 42 rim 47 confluence 45 )(, 47 confluence 46 septal 47 confluence 47 confluence 48 9.5 47 confluence 49 , 50 orbicularis 51 oculi 50 orbicularis 52 muscle 50 orbicularis 53 hypertrophy 51 oculi 52 muscle 53 hypertrophy 54 3.6 54 3.6 63 fluid 55 , 63 fluid 56 triangular 58 mound 57 malar 58 mound 58 mound 59 3.4 58 mound 61 and 60 , 61 and 61 and 62 eyelid 61 and 63 fluid 63 fluid 64 0.5 63 fluid 65 . the average uniqueness score was 40.1 % , and skin laxity and orbital fat [prolapse] had the highest average uniqueness score , but no single category played a dominant role in most patients . 0 ###LEFT-WALL### 4 score 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 34 . 1 the 4 score 2 average 3 uniqueness 3 uniqueness 4 score 4 score 5 was 5 was 7 % 6 40.1 7 % 8 , 9 and 8 , 21 score 8 , 23 but 9 and 12 and 9 and 16 had 10 skin 11 laxity 11 laxity 12 and 12 and 14 fat 12 and 16 had 13 orbital 14 fat 16 had 20 uniqueness 16 had 21 score 17 the 18 highest 17 the 20 uniqueness 19 average 20 uniqueness 22 , 23 but 23 but 26 category 23 but 27 played 24 no 26 category 25 single 26 category 26 category 27 played 27 played 30 role 27 played 31 in 28 a 29 dominant 28 a 30 role 29 dominant 30 role 31 in 33 patients 32 most 33 patients medial orbital fat [prolapse] and skin laxity had the highest proportion of grade 3 scores of 9.5 [%] and 6.7 % , respectively . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 13 grade 1 medial 3 fat 2 orbital 3 fat 3 fat 5 and 5 and 6 skin 5 and 7 laxity 5 and 12 of 5 and 13 grade 7 laxity 8 had 8 had 11 proportion 9 the 10 highest 9 the 11 proportion 11 proportion 12 of 13 grade 15 scores 13 grade 23 respectively 14 3 15 scores 15 scores 16 of 16 of 21 % 17 9.5 19 and 19 and 20 6.7 19 and 21 % 22 , 23 respectively 23 respectively 24 . when the patients were grouped according to age , [either] younger than 50 years or older than 50 years [,] there was a prominent difference in orbital fat prolapse and skin laxity between the 2 groups . 0 ###LEFT-WALL### 1 when 0 ###LEFT-WALL### 12 than 0 ###LEFT-WALL### 37 . 2 the 3 patients 3 patients 4 were 4 were 5 grouped 5 grouped 7 to 5 grouped 9 , 5 grouped 11 younger 6 according 7 to 7 to 8 age 11 younger 12 than 12 than 19 years 12 than 30 and 13 50 14 years 14 years 15 or 15 or 16 older 15 or 19 years 16 older 17 than 18 50 19 years 19 years 21 there 19 years 22 was 19 years 30 and 21 there 22 was 22 was 25 difference 23 a 25 difference 24 prominent 25 difference 25 difference 26 in 26 in 28 fat 27 orbital 28 fat 29 prolapse 30 and 30 and 31 skin 31 skin 32 laxity 32 laxity 33 between 33 between 36 groups 34 the 36 groups 35 2 36 groups conclusions : various anatomic factors were related to periorbital changes in asian patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 factors 2 : 7 related 2 : 14 . 3 various 5 factors 4 anatomic 5 factors 5 factors 6 were 6 were 7 related 7 related 8 to 7 related 11 in 8 to 10 changes 9 periorbital 10 changes 11 in 13 patients 12 asian 13 patients understanding of the complex factors that contribute to periorbital changes during the aging process may allow for adequate and customized surgery for each patient and help in prevention of postoperative complications . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 17 for 0 ###LEFT-WALL### 32 . 1 understanding 2 of 1 understanding 11 during 1 understanding 15 may 2 of 5 factors 3 the 5 factors 4 complex 5 factors 5 factors 6 that 5 factors 7 contribute 6 that 7 contribute 7 contribute 8 to 8 to 10 changes 9 periorbital 10 changes 11 during 14 process 12 the 14 process 13 aging 14 process 15 may 17 for 16 allow 17 for 17 for 19 and 17 for 22 for 17 for 27 in 18 adequate 19 and 19 and 21 surgery 20 customized 21 surgery 22 for 25 and 23 each 24 patient 24 patient 25 and 25 and 26 help 27 in 28 prevention 28 prevention 29 of 29 of 31 complications 30 postoperative 31 complications importance : alzheimer disease ( ad ) is a neurodegenerative disorder with no effective therapies . 0 ###LEFT-WALL### 1 importance 0 ###LEFT-WALL### 2 : 2 : 4 disease 2 : 8 is 2 : 16 . 3 alzheimer 4 disease 4 disease 6 ad 4 disease 8 is 5 ( 6 ad 6 ad 7 ) 8 is 11 disorder 9 a 10 neurodegenerative 9 a 11 disorder 10 neurodegenerative 11 disorder 11 disorder 12 with 12 with 15 therapies 13 no 15 therapies 14 effective 15 therapies in 1984 , the national institute on aging created the first 5 ad centers ( adcs ) in an effort to coordinate research efforts into the pathology and treatment of the disease . 0 ###LEFT-WALL### 6 institute 0 ###LEFT-WALL### 9 created 0 ###LEFT-WALL### 33 . 1 in 2 1984 1 in 3 , 1 in 6 institute 4 the 6 institute 5 national 6 institute 6 institute 7 on 6 institute 9 created 7 on 8 aging 9 created 14 centers 9 created 18 in 9 created 21 to 10 the 11 first 10 the 12 5 12 5 14 centers 13 ad 14 centers 14 centers 16 adcs 15 ( 16 adcs 16 adcs 17 ) 18 in 20 effort 19 an 20 effort 21 to 24 efforts 22 coordinate 24 efforts 23 research 24 efforts 24 efforts 25 into 24 efforts 30 of 25 into 28 and 26 the 27 pathology 27 pathology 28 and 28 and 29 treatment 30 of 32 disease 31 the 32 disease since that time , the adc program has expanded to include 27 centers in major medical schools throughout the united states . 0 ###LEFT-WALL### 7 program 0 ###LEFT-WALL### 9 expanded 0 ###LEFT-WALL### 22 . 1 since 3 time 1 since 4 , 1 since 7 program 2 that 3 time 5 the 7 program 6 adc 7 program 7 program 8 has 8 has 9 expanded 9 expanded 10 to 10 to 11 include 11 include 13 centers 11 include 14 in 11 include 18 throughout 12 27 13 centers 14 in 17 schools 15 major 17 schools 16 medical 17 schools 18 throughout 21 states 19 the 21 states 20 united 21 states a major aim of adcs is to develop shared resources , such as tissue samples and patient populations , and thereby promote large - scale [,] high - impact studies that go beyond the capabilities of any single investigator or institution working in isolation . 0 ###LEFT-WALL### 3 aim 0 ###LEFT-WALL### 45 . 1 a 2 major 1 a 3 aim 2 major 3 aim 3 aim 4 of 3 aim 6 is 4 of 5 adcs 6 is 7 to 6 is 20 and 7 to 20 and 8 develop 10 resources 8 develop 20 and 9 shared 10 resources 10 resources 13 as 11 , 13 as 12 such 13 as 13 as 16 and 13 as 19 , 14 tissue 15 samples 15 samples 16 and 16 and 18 populations 17 patient 18 populations 19 , 20 and 20 and 22 promote 20 and 33 beyond 21 thereby 22 promote 22 promote 30 studies 23 large 24 - 23 large 30 studies 25 scale 30 studies 27 high 28 - 27 high 29 impact 29 impact 30 studies 30 studies 31 that 30 studies 32 go 31 that 32 go 33 beyond 40 or 34 the 35 capabilities 35 capabilities 36 of 35 capabilities 40 or 36 of 39 investigator 37 any 39 investigator 38 single 39 investigator 40 or 41 institution 40 or 42 working 42 working 43 in 43 in 44 isolation objective : to quantitatively evaluate the performance of the adc program over the past 25 years . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 5 evaluate 2 : 17 . 3 to 5 evaluate 4 quantitatively 5 evaluate 5 evaluate 7 performance 5 evaluate 12 over 6 the 7 performance 7 performance 8 of 8 of 11 program 9 the 11 program 10 adc 11 program 12 over 16 years 13 the 14 past 13 the 15 25 15 25 16 years design and setting : we systematically harvested every article published by adc investigators and used social network analysis to analyze copublication networks . 0 ###LEFT-WALL### 3 setting 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 23 . 1 design 2 and 2 and 3 setting 4 : 5 we 4 : 14 and 5 we 14 and 6 systematically 7 harvested 7 harvested 9 article 7 harvested 14 and 8 every 9 article 9 article 10 published 10 published 11 by 11 by 13 investigators 12 adc 13 investigators 14 and 15 used 15 used 18 analysis 15 used 19 to 15 used 20 analyze 16 social 17 network 17 network 18 analysis 19 to 20 analyze 20 analyze 22 networks 21 copublication 22 networks results : a total of 12170 adc papers were published from 1985 through 2012 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 total 2 : 10 published 2 : 15 . 3 a 4 total 4 total 5 of 4 total 9 were 5 of 8 papers 6 12170 8 papers 7 adc 8 papers 9 were 10 published 10 published 11 from 10 published 13 through 11 from 12 1985 13 through 14 2012 the frequency of collaborations has increased greatly from the time that the adcs were started until the present , even after the expansion of adcs and the recruitment of new investigators plateaued . 0 ###LEFT-WALL### 2 frequency 0 ###LEFT-WALL### 6 increased 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 33 . 1 the 2 frequency 2 frequency 3 of 2 frequency 5 has 3 of 4 collaborations 5 has 6 increased 6 increased 7 greatly 6 increased 8 from 6 increased 16 until 8 from 10 time 9 the 10 time 10 time 11 that 11 that 13 adcs 11 that 15 started 12 the 13 adcs 13 adcs 14 were 14 were 15 started 16 until 18 present 17 the 18 present 19 , 20 even 20 even 21 after 21 after 26 and 22 the 23 expansion 23 expansion 24 of 23 expansion 26 and 24 of 25 adcs 26 and 28 recruitment 26 and 29 of 27 the 28 recruitment 29 of 31 investigators 30 new 31 investigators 31 investigators 32 plateaued moreover , the collaborations established within the context of the adc program are increasingly interinstitutional , [consistent] with the overall goal of the program to catalyze multicenter research teams . 0 ###LEFT-WALL### 4 collaborations 0 ###LEFT-WALL### 13 are 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 30 . 1 moreover 2 , 1 moreover 4 collaborations 3 the 4 collaborations 4 collaborations 5 established 4 collaborations 13 are 5 established 6 within 6 within 8 context 7 the 8 context 8 context 9 of 9 of 12 program 10 the 12 program 11 adc 12 program 13 are 14 increasingly 13 are 15 interinstitutional 16 , 28 research 16 , 29 teams 18 with 21 goal 18 with 28 research 19 the 21 goal 20 overall 21 goal 21 goal 22 of 22 of 24 program 23 the 24 program 24 program 25 to 24 program 26 catalyze 25 to 26 catalyze 26 catalyze 27 multicenter 28 research 29 teams most important , we determined that collaborative multi - adc research articles are consistently of higher impact than ad articles as a whole . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 determined 0 ###LEFT-WALL### 24 . 1 most 2 important 2 important 3 , 2 important 4 we 4 we 5 determined 5 determined 10 adc 5 determined 18 than 6 that 7 collaborative 7 collaborative 10 adc 8 multi 9 - 8 multi 10 adc 10 adc 12 articles 10 adc 13 are 10 adc 15 of 11 research 12 articles 12 articles 13 are 13 are 14 consistently 15 of 17 impact 16 higher 17 impact 18 than 19 ad 18 than 20 articles 19 ad 20 articles 20 articles 21 as 21 as 23 whole 22 a 23 whole conclusions and relevance : the adc program has successfully fostered high - impact , multiuniversity collaborations ; we suggest that its structural and administrative features could be replicated in other fields of patient - oriented research . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 4 : 1 conclusions 2 and 2 and 3 relevance 4 : 7 program 4 : 10 fostered 4 : 14 , 4 : 19 suggest 4 : 37 . 5 the 7 program 6 adc 7 program 7 program 8 has 8 has 10 fostered 9 successfully 10 fostered 10 fostered 13 impact 11 high 12 - 11 high 13 impact 14 , 16 collaborations 14 , 17 ; 15 multiuniversity 16 collaborations 17 ; 18 we 18 we 19 suggest 19 suggest 20 that 20 that 25 features 20 that 28 replicated 21 its 25 features 22 structural 23 and 23 and 24 administrative 23 and 25 features 25 features 26 could 26 could 27 be 27 be 28 replicated 28 replicated 29 in 29 in 31 fields 30 other 31 fields 31 fields 32 of 32 of 36 research 33 patient 34 - 33 patient 36 research 35 oriented 36 research importance : parkinsonian motor signs are common in the aging population and [are] [associated] with adverse health outcomes . 0 ###LEFT-WALL### 1 importance 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 5 signs 2 : 6 are 3 parkinsonian 4 motor 4 motor 5 signs 5 signs 6 are 6 are 7 common 7 common 12 and 8 in 11 population 8 in 12 and 9 the 11 population 10 aging 11 population 12 and 15 with 15 with 18 outcomes 16 adverse 18 outcomes 17 health 18 outcomes compared with parkinson disease ( pd ) , potential genetic risk factors for mild parkinsonian signs have been largely unexplored . 0 ###LEFT-WALL### 12 factors 0 ###LEFT-WALL### 18 been 0 ###LEFT-WALL### 21 . 1 compared 2 with 1 compared 8 , 1 compared 12 factors 2 with 4 disease 3 parkinson 4 disease 4 disease 6 pd 5 ( 6 pd 6 pd 7 ) 9 potential 12 factors 10 genetic 12 factors 11 risk 12 factors 12 factors 13 for 12 factors 17 have 13 for 16 signs 14 mild 16 signs 15 parkinsonian 16 signs 17 have 18 been 18 been 20 unexplored 19 largely 20 unexplored objective : to determine whether pd susceptibility loci are associated with parkinsonism or substantia nigra pathology in a large community [-] based cohort of older persons . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 to 2 : 4 determine 3 to 4 determine 4 determine 5 whether 4 determine 11 with 5 whether 8 loci 5 whether 10 associated 6 pd 7 susceptibility 7 susceptibility 8 loci 8 loci 9 are 9 are 10 associated 11 with 16 pathology 12 parkinsonism 13 or 13 or 14 substantia 13 or 16 pathology 15 nigra 16 pathology 16 pathology 17 in 17 in 23 cohort 18 a 19 large 18 a 23 cohort 19 large 23 cohort 20 community 22 based 22 based 23 cohort 23 cohort 24 of 24 of 26 persons 25 older 26 persons design , setting , and participants : eighteen candidate single - nucleotide polymorphisms from pd [genome] - wide association studies were evaluated in a joint clinicopathologic cohort . 0 ###LEFT-WALL### 6 participants 0 ###LEFT-WALL### 7 : 1 design 3 setting 2 , 3 setting 3 setting 4 , 3 setting 5 and 5 and 6 participants 7 : 20 studies 7 : 22 evaluated 7 : 28 . 8 eighteen 9 candidate 9 candidate 20 studies 10 single 13 polymorphisms 10 single 19 association 11 - 13 polymorphisms 12 nucleotide 13 polymorphisms 13 polymorphisms 14 from 13 polymorphisms 17 - 14 from 15 pd 18 wide 19 association 19 association 20 studies 20 studies 21 were 21 were 22 evaluated 22 evaluated 23 in 23 in 27 cohort 24 a 25 joint 24 a 27 cohort 25 joint 27 cohort 26 clinicopathologic 27 cohort participants included 1698 individuals and a [nested] autopsy collection of 821 brains from the religious orders study and the rush memory and aging project , 2 prospective community - based studies . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 25 , 1 participants 2 included 2 included 5 and 2 included 13 from 3 1698 5 and 4 individuals 5 and 5 and 9 collection 6 a 9 collection 8 autopsy 9 collection 9 collection 10 of 10 of 12 brains 11 821 12 brains 13 from 22 and 14 the 17 study 15 religious 16 orders 16 orders 17 study 17 study 18 and 18 and 21 memory 18 and 22 and 19 the 21 memory 20 rush 21 memory 22 and 24 project 23 aging 24 project 25 , 28 community 25 , 29 - 26 2 28 community 27 prospective 28 community 29 - 31 studies 29 - 32 . 30 based 31 studies main outcomes and measures : the primary outcomes were a quantitative measure of global parkinsonism or component measures of bradykinesia , rigidity , tremor , and gait impairment that were based on the motor unified parkinson 's disease rating scale . 0 ###LEFT-WALL### 4 measures 0 ###LEFT-WALL### 5 : 1 main 2 outcomes 2 outcomes 3 and 3 and 4 measures 5 : 8 outcomes 5 : 9 were 5 : 41 . 6 the 8 outcomes 7 primary 8 outcomes 8 outcomes 9 were 9 were 26 and 10 a 11 quantitative 10 a 12 measure 11 quantitative 12 measure 12 measure 13 of 12 measure 19 of 12 measure 23 , 13 of 18 measures 14 global 18 measures 15 parkinsonism 16 or 16 or 17 component 16 or 18 measures 19 of 22 rigidity 20 bradykinesia 21 , 20 bradykinesia 22 rigidity 23 , 24 tremor 23 , 26 and 25 , 26 and 26 and 28 impairment 26 and 29 that 26 and 30 were 27 gait 28 impairment 29 that 30 were 30 were 31 based 31 based 32 on 32 on 40 scale 33 the 34 motor 34 motor 36 parkinson 35 unified 36 parkinson 36 parkinson 37 's 37 's 40 scale 38 disease 39 rating 39 rating 40 scale in secondary analyses , we examined associations with additional quantitative motor traits and postmortem indices , including substantia nigra lewy bodies and neuronal loss . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 examined 0 ###LEFT-WALL### 25 . 1 in 3 analyses 1 in 4 , 1 in 5 we 2 secondary 3 analyses 5 we 6 examined 6 examined 7 associations 6 examined 8 with 8 with 22 and 9 additional 12 traits 10 quantitative 11 motor 11 motor 12 traits 12 traits 13 and 13 and 15 indices 13 and 16 , 13 and 17 including 13 and 22 and 14 postmortem 15 indices 17 including 21 bodies 18 substantia 19 nigra 19 nigra 21 bodies 20 lewy 21 bodies 22 and 24 loss 23 neuronal 24 loss results : parkinson disease risk alleles in the mapt ( rs2942168 [;] p = .0006[!] ) and ccdc62 ( rs12817488 [;] p = .004[!] ) loci were associated with global parkinsonism , and these associations remained after exclusion of patients with a pd diagnosis . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 45 . 1 results 2 : 2 : 17 and 3 parkinson 6 alleles 4 disease 6 alleles 5 risk 6 alleles 6 alleles 7 in 6 alleles 17 and 7 in 9 mapt 8 the 9 mapt 9 mapt 11 rs2942168 10 ( 11 rs2942168 11 rs2942168 14 = 11 rs2942168 16 ) 13 p 14 = 14 = 15 .0006[!] 17 and 18 ccdc62 17 and 26 loci 17 and 27 were 17 and 28 associated 18 ccdc62 20 rs12817488 19 ( 20 rs12817488 20 rs12817488 23 = 20 rs12817488 25 ) 22 p 23 = 23 = 24 .004[!] 26 loci 27 were 28 associated 29 with 28 associated 37 after 29 with 33 and 30 global 31 parkinsonism 31 parkinsonism 33 and 32 , 33 and 33 and 34 these 33 and 35 associations 33 and 36 remained 35 associations 36 remained 37 after 38 exclusion 38 exclusion 39 of 39 of 40 patients 40 patients 41 with 41 with 44 diagnosis 42 a 44 diagnosis 43 pd 44 diagnosis in the autopsy cohort , only nmd3 ( rs34016896 [;] p = .03[!] ) was related to nigral neuronal loss , and no associations were detected with lewy bodies . 0 ###LEFT-WALL### 6 only 0 ###LEFT-WALL### 16 related 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 30 . 1 in 4 cohort 1 in 5 , 1 in 6 only 2 the 4 cohort 3 autopsy 4 cohort 6 only 7 nmd3 7 nmd3 9 rs34016896 7 nmd3 15 was 8 ( 9 rs34016896 9 rs34016896 12 = 9 rs34016896 14 ) 11 p 12 = 12 = 13 .03[!] 15 was 16 related 16 related 17 to 17 to 20 loss 18 nigral 20 loss 19 neuronal 20 loss 21 , 22 and 22 and 24 associations 22 and 26 detected 23 no 24 associations 24 associations 25 were 25 were 26 detected 26 detected 27 with 27 with 29 bodies 28 lewy 29 bodies conclusions and relevance : in addition to the established link to pd susceptibility , our results support a broader role for several loci in the development of parkinsonian motor signs and nigral pathology in older persons . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 37 . 1 conclusions 2 and 2 and 3 relevance 4 : 16 results 4 : 17 support 5 in 6 addition 5 in 14 , 5 in 16 results 6 addition 7 to 7 to 10 link 8 the 10 link 9 established 10 link 10 link 11 to 11 to 13 susceptibility 12 pd 13 susceptibility 15 our 16 results 16 results 17 support 17 support 31 and 18 a 20 role 19 broader 20 role 20 role 21 for 20 role 24 in 20 role 31 and 21 for 23 loci 22 several 23 loci 24 in 26 development 25 the 26 development 26 development 27 of 27 of 30 signs 28 parkinsonian 30 signs 29 motor 30 signs 31 and 33 pathology 31 and 34 in 32 nigral 33 pathology 34 in 36 persons 35 older 36 persons anorexia nervosa ( an ) is a complex and heritable eating disorder characterized by dangerously low body weight . 0 ###LEFT-WALL### 2 nervosa 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 19 . 1 anorexia 2 nervosa 2 nervosa 4 an 2 nervosa 6 is 3 ( 4 an 4 an 5 ) 6 is 9 and 6 is 14 by 7 a 8 complex 8 complex 9 and 9 and 12 disorder 9 and 13 characterized 10 heritable 12 disorder 11 eating 12 disorder 14 by 18 weight 15 dangerously 16 low 16 low 17 body 17 body 18 weight neither candidate gene studies nor an initial genome - wide association study ( gwas ) have yielded significant and replicated results . 0 ###LEFT-WALL### 5 nor 0 ###LEFT-WALL### 9 - 1 neither 5 nor 2 candidate 4 studies 3 gene 4 studies 4 studies 5 nor 5 nor 8 genome 6 an 7 initial 6 an 8 genome 7 initial 8 genome 9 - 12 study 9 - 19 and 9 - 22 . 10 wide 11 association 11 association 12 study 12 study 14 gwas 12 study 19 and 13 ( 14 gwas 14 gwas 15 ) 16 have 17 yielded 16 have 19 and 17 yielded 18 significant 19 and 20 replicated 20 replicated 21 results we performed a gwas in 2907 cases with an from 14 countries ( 15 sites ) and 14 860 ancestrally matched controls as part of the genetic consortium for an ( gcan ) and the wellcome trust case control consortium 3 ( wtccc3 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 45 . 1 we 2 performed 2 performed 4 gwas 2 performed 8 with 2 performed 23 as 3 a 4 gwas 4 gwas 5 in 5 in 7 cases 6 2907 7 cases 8 with 17 and 9 an 10 from 9 an 17 and 10 from 12 countries 11 14 12 countries 12 countries 15 sites 13 ( 15 sites 14 15 15 sites 15 sites 16 ) 17 and 22 controls 18 14 22 controls 19 860 22 controls 20 ancestrally 21 matched 21 matched 22 controls 23 as 34 and 24 part 25 of 24 part 34 and 25 of 28 consortium 26 the 28 consortium 27 genetic 28 consortium 28 consortium 29 for 29 for 32 gcan 30 an 32 gcan 31 ( 32 gcan 32 gcan 33 ) 34 and 40 consortium 34 and 43 wtccc3 35 the 40 consortium 36 wellcome 37 trust 37 trust 38 case 38 case 39 control 39 control 40 consortium 40 consortium 41 3 42 ( 43 wtccc3 43 wtccc3 44 ) individual association analyses were conducted in each stratum and meta - analyzed across all 15 discovery data sets . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 5 conducted 1 individual 2 association 2 association 3 analyses 3 analyses 4 were 4 were 5 conducted 5 conducted 6 in 6 in 9 and 7 each 8 stratum 8 stratum 9 and 9 and 10 meta 9 and 12 analyzed 11 - 12 analyzed 12 analyzed 13 across 12 analyzed 19 . 13 across 18 sets 14 all 15 15 15 15 18 sets 16 discovery 17 data 17 data 18 sets seventy - six ( 72 independent ) single nucleotide polymorphisms were taken forward for in silico ( two data sets ) or de novo [(] 13 data sets [ )(replication genotyping in 2677 independent an cases and 8629 european ancestry controls along with 458 an cases and 421 controls from japan . 0 ###LEFT-WALL### 1 seventy 0 ###LEFT-WALL### 2 - 2 - 3 six 2 - 22 or 3 six 5 72 4 ( 5 72 5 72 10 polymorphisms 5 72 14 for 5 72 15 in 5 72 20 sets 5 72 21 ) 6 independent 7 ) 6 independent 10 polymorphisms 8 single 10 polymorphisms 9 nucleotide 10 polymorphisms 10 polymorphisms 11 were 11 were 12 taken 12 taken 13 forward 12 taken 14 for 15 in 16 silico 17 ( 20 sets 18 two 20 sets 19 data 20 sets 20 sets 21 ) 22 or 27 data 22 or 28 sets 23 de 24 novo 24 novo 27 data 26 13 27 data 27 data 28 sets 28 sets 37 and 28 sets 43 with 30 )(replication 31 genotyping 31 genotyping 32 in 31 genotyping 37 and 32 in 33 2677 33 2677 35 an 33 2677 36 cases 34 independent 35 an 35 an 36 cases 37 and 41 controls 38 8629 41 controls 39 european 41 controls 40 ancestry 41 controls 42 along 43 with 43 with 47 and 44 458 46 cases 45 an 46 cases 46 cases 47 and 47 and 49 controls 47 and 52 . 48 421 49 controls 49 controls 50 from 50 from 51 japan the final global meta - analysis across discovery and replication data sets comprised 5551 an cases and 21 080 controls . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 13 comprised 0 ###LEFT-WALL### 21 . 1 the 6 analysis 2 final 6 analysis 3 global 6 analysis 4 meta 5 - 4 meta 6 analysis 6 analysis 7 across 6 analysis 9 and 7 across 8 discovery 9 and 12 sets 9 and 13 comprised 10 replication 11 data 11 data 12 sets 13 comprised 17 and 14 5551 17 and 15 an 16 cases 16 cases 17 and 17 and 20 controls 18 21 20 controls 19 080 20 controls an [subtype] analyses ( 1606 an restricting [;] 1445 an [binge] - purge [ )(were performed . 0 ###LEFT-WALL### 1 an 0 ###LEFT-WALL### 16 performed 0 ###LEFT-WALL### 17 . 1 an 3 analyses 1 an 13 purge 1 an 15 )(were 3 analyses 6 an 3 analyses 13 purge 4 ( 6 an 5 1606 6 an 6 an 7 restricting 6 an 12 - 7 restricting 10 an 9 1445 10 an 15 )(were 16 performed no findings reached genome - wide significance . 0 ###LEFT-WALL### 1 no 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 8 . 1 no 4 genome 2 findings 3 reached 3 reached 4 genome 5 - 7 significance 6 wide 7 significance two intronic variants were suggestively associated [:] rs9839776 ( p=3.01 × 10 ( - 7 ) ) in sox2ot and rs17030795 ( p=5.84 × 10 ( - 6 ) ) in ppp3ca . 0 ###LEFT-WALL### 3 variants 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 33 . 1 two 3 variants 2 intronic 3 variants 3 variants 4 were 4 were 8 rs9839776 4 were 18 in 4 were 31 in 5 suggestively 6 associated 6 associated 8 rs9839776 8 rs9839776 11 × 9 ( 11 × 10 p=3.01 11 × 11 × 12 10 11 × 15 7 11 × 17 ) 13 ( 15 7 14 - 15 7 15 7 16 ) 18 in 20 and 19 sox2ot 20 and 20 and 21 rs17030795 20 and 24 × 22 ( 24 × 23 p=5.84 24 × 24 × 25 10 24 × 28 6 24 × 30 ) 26 ( 28 6 27 - 28 6 28 6 29 ) 31 in 32 ppp3ca two additional signals were specific to europeans [:] rs1523921 ( p=5.76 × 10 ( - [ )( 6 ) ) between cul3 and fam124b and rs1886797 ( p=8.05 × 10 ( - [ )( 6 ) ) near spata13 . 0 ###LEFT-WALL### 3 signals 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 40 . 1 two 3 signals 2 additional 3 signals 3 signals 4 were 4 were 5 specific 5 specific 6 to 5 specific 21 between 5 specific 38 near 6 to 9 rs1523921 7 europeans 9 rs1523921 9 rs1523921 12 × 10 ( 12 × 11 p=5.76 12 × 12 × 13 10 12 × 18 6 12 × 20 ) 14 ( 18 6 15 - 18 6 18 6 19 ) 21 between 25 and 22 cul3 23 and 23 and 24 fam124b 23 and 25 and 25 and 26 rs1886797 25 and 29 × 27 ( 29 × 28 p=8.05 29 × 29 × 30 10 29 × 35 6 29 × 37 ) 31 ( 35 6 32 - 35 6 35 6 36 ) 38 near 39 spata13 comparing discovery with replication results , 76 % of the effects were in the same direction , an observation highly unlikely to be due to chance ( p=4 × 10 ( - 6 ) ) , strongly suggesting that true findings exist but our sample , the largest yet reported , was underpowered for their detection . 0 ###LEFT-WALL### 8 % 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 36 , 0 ###LEFT-WALL### 57 . 1 comparing 2 discovery 1 comparing 3 with 1 comparing 6 , 1 comparing 8 % 3 with 5 results 4 replication 5 results 7 76 8 % 8 % 9 of 8 % 12 were 9 of 11 effects 10 the 11 effects 12 were 13 in 13 in 16 direction 14 the 15 same 14 the 16 direction 16 direction 19 observation 17 , 19 observation 18 an 19 observation 19 observation 21 unlikely 19 observation 29 × 19 observation 35 ) 20 highly 21 unlikely 21 unlikely 22 to 21 unlikely 26 chance 22 to 23 be 23 be 24 due 24 due 25 to 24 due 26 chance 25 to 26 chance 27 ( 29 × 28 p=4 29 × 29 × 30 10 29 × 33 6 29 × 34 ) 31 ( 33 6 32 - 33 6 33 6 34 ) 36 , 38 suggesting 36 , 52 was 37 strongly 38 suggesting 38 suggesting 41 findings 38 suggesting 42 exist 38 suggesting 52 was 39 that 40 true 40 true 41 findings 42 exist 43 but 43 but 45 sample 44 our 45 sample 46 , 50 reported 47 the 48 largest 48 largest 50 reported 49 yet 50 reported 50 reported 51 , 50 reported 52 was 52 was 53 underpowered 53 underpowered 54 for 54 for 56 detection 55 their 56 detection the accrual [of] large genotyped an case - control samples should be an immediate priority for the field . 0 ###LEFT-WALL### 7 case 0 ###LEFT-WALL### 8 - 1 the 7 case 2 accrual 7 case 4 large 7 case 5 genotyped 7 case 6 an 7 case 8 - 10 samples 8 - 12 be 8 - 19 . 9 control 10 samples 10 samples 11 should 11 should 12 be 12 be 15 priority 13 an 14 immediate 13 an 15 priority 14 immediate 15 priority 15 priority 16 for 16 for 18 field 17 the 18 field although there are many studies demonstrating a high percentage of adult athletes who start exercise in suboptimal hydration state [,] limited data concerning hydration levels in athletic youth exist . 0 ###LEFT-WALL### 22 data 0 ###LEFT-WALL### 30 . 1 although 2 there 1 although 3 are 1 although 22 data 2 there 3 are 3 are 5 studies 4 many 5 studies 5 studies 6 demonstrating 5 studies 13 who 5 studies 14 start 6 demonstrating 9 percentage 7 a 9 percentage 8 high 9 percentage 9 percentage 10 of 10 of 12 athletes 11 adult 12 athletes 13 who 14 start 14 start 15 exercise 14 start 16 in 17 suboptimal 19 state 18 hydration 19 state 19 state 22 data 21 limited 22 data 22 data 23 concerning 22 data 29 exist 23 concerning 25 levels 24 hydration 25 levels 25 levels 26 in 26 in 28 youth 27 athletic 28 youth the purpose of this study was to identify the hydration status of elite young athletes of different sports , during a typical day of training . 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 status 9 the 11 status 10 hydration 11 status 11 status 12 of 12 of 15 athletes 13 elite 15 athletes 14 young 15 athletes 15 athletes 16 of 16 of 18 sports 17 different 18 sports 18 sports 20 during 19 , 20 during 20 during 23 day 20 during 26 . 21 a 23 day 22 typical 23 day 23 day 24 of 24 of 25 training fifty - nine young elite male athletes from different sports ( basketball , gymnastics , swimming , running , and canoeing ) participated in the study ( age [:] 15.2 ± 1.3 years [;] years of training : 7.7 ± 2.0 ) . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 23 participated 0 ###LEFT-WALL### 43 . 1 fifty 2 - 2 - 3 nine 2 - 7 athletes 4 young 7 athletes 5 elite 7 athletes 6 male 7 athletes 7 athletes 8 from 7 athletes 20 and 8 from 10 sports 9 different 10 sports 10 sports 12 basketball 10 sports 14 gymnastics 10 sports 16 swimming 11 ( 12 basketball 12 basketball 13 , 13 , 14 gymnastics 14 gymnastics 15 , 15 , 16 swimming 16 swimming 18 running 16 swimming 19 , 17 , 18 running 18 running 19 , 19 , 20 and 20 and 21 canoeing 20 and 22 ) 20 and 23 participated 23 participated 24 in 24 in 26 study 25 the 26 study 26 study 35 years 27 ( 35 years 28 age 35 years 30 15.2 31 ± 31 ± 35 years 32 1.3 33 years 33 years 35 years 35 years 36 of 35 years 38 : 35 years 42 ) 36 of 37 training 38 : 39 7.7 38 : 40 ± 39 7.7 40 ± 40 ± 41 2.0 hydration status was assessed in the morning [,] before and immediately after practice . 0 ###LEFT-WALL### 2 status 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 14 . 1 hydration 2 status 2 status 3 was 3 was 4 assessed 4 assessed 5 in 5 in 7 morning 6 the 7 morning 7 morning 10 and 9 before 10 and 10 and 11 immediately 10 and 12 after 12 after 13 practice data [collection] took place at the same time of the day , with mean environmental temperature and humidity at the time of the measurements at 27.6 ± 0.9 ° c and 58 ± 8 % , respectively . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 took 0 ###LEFT-WALL### 38 . 1 data 3 took 3 took 4 place 3 took 5 at 3 took 13 with 3 took 37 respectively 5 at 8 time 6 the 7 same 7 same 8 time 8 time 9 of 9 of 11 day 10 the 11 day 12 , 13 with 13 with 17 and 13 with 36 , 14 mean 16 temperature 15 environmental 16 temperature 16 temperature 17 and 17 and 18 humidity 17 and 19 at 19 at 21 time 20 the 21 time 21 time 22 of 21 time 25 at 21 time 31 and 21 time 33 ± 22 of 24 measurements 23 the 24 measurements 25 at 27 ± 26 27.6 27 ± 28 0.9 29 ° 28 0.9 31 and 29 ° 30 c 31 and 32 58 31 and 33 ± 33 ± 35 % 34 8 35 % all athletes trained for approximately 90 minutes , and they were consuming fluids ad libitum throughout their practice . 0 ###LEFT-WALL### 2 athletes 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 19 . 1 all 2 athletes 2 athletes 3 trained 2 athletes 11 were 3 trained 4 for 4 for 9 and 5 approximately 6 90 6 90 7 minutes 7 minutes 9 and 8 , 9 and 9 and 10 they 11 were 12 consuming 12 consuming 13 fluids 12 consuming 15 libitum 12 consuming 16 throughout 14 ad 15 libitum 16 throughout 18 practice 17 their 18 practice over 89 % of the athletes [were] hypohydrated ( urine specific gravity [ usg ] ≥1.020 mg·dl [ )(based on their first morning urine sample . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 16 ≥1.020 0 ###LEFT-WALL### 26 . 1 over 2 89 2 89 3 % 3 % 4 of 3 % 16 ≥1.020 4 of 6 athletes 5 the 6 athletes 6 athletes 8 hypohydrated 6 athletes 12 gravity 9 ( 12 gravity 10 urine 12 gravity 11 specific 12 gravity 12 gravity 14 usg 12 gravity 15 ] 13 [ 14 usg 14 usg 15 ] 16 ≥1.020 17 mg·dl 16 ≥1.020 20 on 17 mg·dl 19 )(based 20 on 25 sample 21 their 25 sample 22 first 23 morning 23 morning 25 sample 24 urine 25 sample pretraining urine samples revealed that 76.3 % of the athletes were hypohydrated , whereas a significant high percent remained hypohydrated even after training according to usg values ≥1.020 mg·dl ( 74.5 % ) and urine color scale : 5 - 6 ( 76.3 % ) . 0 ###LEFT-WALL### 1 pretraining 0 ###LEFT-WALL### 46 . 1 pretraining 2 urine 1 pretraining 14 whereas 1 pretraining 22 after 1 pretraining 38 : 2 urine 12 hypohydrated 3 samples 4 revealed 4 revealed 5 that 5 that 7 % 5 that 12 hypohydrated 6 76.3 7 % 7 % 8 of 7 % 11 were 8 of 10 athletes 9 the 10 athletes 11 were 12 hypohydrated 12 hypohydrated 13 , 14 whereas 17 high 14 whereas 20 hypohydrated 15 a 16 significant 15 a 17 high 16 significant 17 high 17 high 18 percent 17 high 19 remained 17 high 20 hypohydrated 18 percent 19 remained 20 hypohydrated 21 even 22 after 34 and 23 training 24 according 23 training 34 and 24 according 25 to 24 according 29 mg·dl 25 to 27 values 26 usg 27 values 28 ≥1.020 29 mg·dl 29 mg·dl 32 % 30 ( 32 % 31 74.5 32 % 32 % 33 ) 34 and 37 scale 35 urine 36 color 36 color 37 scale 38 : 39 5 39 5 41 6 40 - 41 6 41 6 44 % 41 6 45 ) 42 ( 44 % 43 76.3 44 % 44 % 45 ) mean body weight loss during training was - 1.1 ± 0.07 % . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 8 - 1 mean 7 was 2 body 4 loss 3 weight 4 loss 4 loss 5 during 4 loss 7 was 5 during 6 training 8 - 9 1.1 8 - 10 ± 8 - 13 . 9 1.1 10 ± 10 ± 12 % 11 0.07 12 % we concluded that the prevalence of hypohydration among elite young athletes is very high , as indicated by the usg and urine color values . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 17 indicated 0 ###LEFT-WALL### 25 . 1 we 2 concluded 2 concluded 3 that 3 that 5 prevalence 3 that 12 is 4 the 5 prevalence 5 prevalence 6 of 5 prevalence 12 is 6 of 7 hypohydration 7 hypohydration 8 among 8 among 11 athletes 9 elite 11 athletes 10 young 11 athletes 12 is 14 high 12 is 16 as 13 very 14 high 15 , 16 as 16 as 17 indicated 17 indicated 18 by 17 indicated 24 values 18 by 21 and 19 the 20 usg 20 usg 21 and 21 and 22 urine 23 color 24 values the majority of the athletes was hypohydrated throughout the day and dehydrated even more during practice despite fluid availability . 0 ###LEFT-WALL### 2 majority 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 20 . 1 the 2 majority 2 majority 3 of 2 majority 6 was 3 of 5 athletes 4 the 5 athletes 6 was 11 and 7 hypohydrated 8 throughout 7 hypohydrated 11 and 8 throughout 10 day 9 the 10 day 11 and 12 dehydrated 11 and 14 more 11 and 15 during 11 and 17 despite 13 even 14 more 15 during 16 practice 17 despite 19 availability 18 fluid 19 availability adults older than 65 years of age with vision impairment are more likely to have difficulty managing medications compared with people having normal vision . 0 ###LEFT-WALL### 1 adults 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 25 . 1 adults 2 older 1 adults 6 of 1 adults 11 are 2 older 3 than 3 than 5 years 4 65 5 years 6 of 7 age 7 age 8 with 8 with 10 impairment 9 vision 10 impairment 11 are 13 likely 12 more 13 likely 13 likely 14 to 13 likely 15 have 14 to 15 have 15 have 16 difficulty 15 have 20 with 16 difficulty 17 managing 17 managing 18 medications 18 medications 19 compared 20 with 21 people 21 people 22 having 22 having 24 vision 23 normal 24 vision this patient population has difficulty reading medication information and may take the wrong medication or incorrect doses of medication , resulting in serious consequences , including overdose or inadequate treatment of health problems . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 34 . 1 this 3 population 2 patient 3 population 3 population 9 and 4 has 8 information 4 has 9 and 5 difficulty 8 information 6 reading 8 information 7 medication 8 information 9 and 10 may 9 and 22 in 10 may 11 take 11 take 15 or 12 the 14 medication 13 wrong 14 medication 14 medication 15 or 15 or 17 doses 15 or 20 , 15 or 21 resulting 16 incorrect 17 doses 17 doses 18 of 18 of 19 medication 22 in 28 or 23 serious 24 consequences 24 consequences 25 , 25 , 27 overdose 25 , 28 or 26 including 27 overdose 28 or 30 treatment 28 or 31 of 29 inadequate 30 treatment 31 of 33 problems 32 health 33 problems visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information . 0 ###LEFT-WALL### 3 patients 0 ###LEFT-WALL### 4 report 0 ###LEFT-WALL### 21 . 1 visually 2 impaired 2 impaired 3 patients 3 patients 4 report 4 report 6 anxiety 5 increased 6 anxiety 6 anxiety 11 and 6 anxiety 16 to 6 anxiety 17 obtain 7 related 8 to 7 related 11 and 8 to 10 management 9 medication 10 management 11 and 12 must 12 must 13 rely 13 rely 14 on 14 on 15 others 16 to 17 obtain 17 obtain 20 information 18 necessary 19 drug 19 drug 20 information pharmacists have a unique opportunity to pursue accurate medication [adherence] in this special population . 0 ###LEFT-WALL### 1 pharmacists 0 ###LEFT-WALL### 2 have 0 ###LEFT-WALL### 15 . 1 pharmacists 2 have 2 have 5 opportunity 3 a 5 opportunity 4 unique 5 opportunity 5 opportunity 6 to 5 opportunity 7 pursue 6 to 7 pursue 7 pursue 9 medication 7 pursue 11 in 8 accurate 9 medication 11 in 14 population 12 this 13 special 13 special 14 population this article reviews literature illustrating [how] severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population . 0 ###LEFT-WALL### 4 literature 0 ###LEFT-WALL### 11 occur 0 ###LEFT-WALL### 35 . 1 this 4 literature 2 article 4 literature 3 reviews 4 literature 4 literature 5 illustrating 4 literature 10 can 5 illustrating 9 mismanagement 7 severe 8 medication 8 medication 9 mismanagement 10 can 11 occur 11 occur 12 in 11 occur 22 for 11 occur 24 to 11 occur 25 take 12 in 20 and 13 the 19 resources 14 visually 15 impaired 15 impaired 19 resources 16 elderly 17 and 17 and 18 presents 17 and 19 resources 19 resources 20 and 20 and 21 solutions 22 for 23 pharmacists 24 to 25 take 25 take 28 role 25 take 29 in 25 take 32 in 26 a 28 role 27 larger 28 role 29 in 31 management 30 adherence 31 management 32 in 34 population 33 this 34 population changes in body weight can affect the overall health of an older patient and should [not] be considered a normal part of the aging process . 0 ###LEFT-WALL### 1 changes 0 ###LEFT-WALL### 18 considered 0 ###LEFT-WALL### 26 . 1 changes 2 in 1 changes 18 considered 2 in 4 weight 3 body 4 weight 4 weight 14 and 5 can 6 affect 5 can 14 and 6 affect 9 health 7 the 9 health 8 overall 9 health 9 health 10 of 10 of 13 patient 11 an 13 patient 12 older 13 patient 14 and 15 should 15 should 17 be 18 considered 21 part 19 a 20 normal 19 a 21 part 20 normal 21 part 21 part 22 of 22 of 25 process 23 the 25 process 24 aging 25 process in particular , weight loss can lead to numerous adverse health outcomes affecting daily activities , loss of functional status , and increased mortality . 0 ###LEFT-WALL### 5 loss 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 25 . 1 in 4 weight 1 in 5 loss 2 particular 3 , 2 particular 4 weight 5 loss 22 and 6 can 7 lead 6 can 22 and 7 lead 8 to 8 to 12 outcomes 9 numerous 11 health 10 adverse 11 health 11 health 12 outcomes 12 outcomes 13 affecting 12 outcomes 17 loss 13 affecting 15 activities 14 daily 15 activities 16 , 17 loss 17 loss 18 of 17 loss 21 , 18 of 20 status 19 functional 20 status 21 , 22 and 22 and 23 increased 23 increased 24 mortality approximately 15 % to 20 % of older adults experience unintentional weight loss and require intervention to maintain quality of life . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 22 . 1 approximately 2 15 2 15 3 % 3 % 4 to 3 % 14 and 4 to 6 % 5 20 6 % 6 % 7 of 7 of 9 adults 8 older 9 adults 10 experience 13 loss 10 experience 14 and 11 unintentional 12 weight 12 weight 13 loss 14 and 15 require 15 require 16 intervention 15 require 17 to 15 require 18 maintain 17 to 18 maintain 18 maintain 19 quality 19 quality 20 of 20 of 21 life currently , there are no pharmacologic agents indicated to treat unintentional weight loss in older adults ; however , several medications may aid by stimulating appetite [and/or] promoting weight gain . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 31 . 1 currently 2 , 1 currently 3 there 3 there 4 are 4 are 7 agents 5 no 7 agents 6 pharmacologic 7 agents 7 agents 8 indicated 7 agents 14 in 8 indicated 9 to 9 to 10 treat 10 treat 13 loss 11 unintentional 12 weight 12 weight 13 loss 14 in 16 adults 15 older 16 adults 17 ; 20 several 17 ; 30 gain 18 however 19 , 18 however 20 several 20 several 21 medications 20 several 23 aid 20 several 30 gain 21 medications 22 may 22 may 23 aid 23 aid 24 by 24 by 26 appetite 25 stimulating 26 appetite 26 appetite 28 promoting 28 promoting 29 weight in recent years , mirtazapine has gained attention [not] only for its antidepressant effects , but also for its potential benefits in underweight patients . 0 ###LEFT-WALL### 5 mirtazapine 0 ###LEFT-WALL### 7 gained 0 ###LEFT-WALL### 25 . 1 in 3 years 1 in 4 , 1 in 5 mirtazapine 2 recent 3 years 5 mirtazapine 6 has 6 has 7 gained 7 gained 8 attention 7 gained 10 only 7 gained 22 in 10 only 16 but 11 for 14 effects 11 for 16 but 12 its 14 effects 13 antidepressant 14 effects 15 , 16 but 16 but 17 also 16 but 18 for 18 for 21 benefits 19 its 21 benefits 20 potential 21 benefits 22 in 24 patients 23 underweight 24 patients this agent has been found to increase appetite and weight in adults compared with placebo [and] other antidepressants , but further clinical investigation is necessary to determine the role of mirtazapine in the older underweight population . 0 ###LEFT-WALL### 2 agent 0 ###LEFT-WALL### 5 found 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 37 . 1 this 2 agent 2 agent 3 has 3 has 4 been 4 been 5 found 5 found 6 to 6 to 7 increase 7 increase 8 appetite 9 and 10 weight 9 and 24 is 10 weight 11 in 10 weight 24 is 11 in 12 adults 12 adults 13 compared 13 compared 14 with 14 with 23 investigation 15 placebo 23 investigation 17 other 18 antidepressants 18 antidepressants 20 but 19 , 20 but 20 but 21 further 20 but 23 investigation 22 clinical 23 investigation 24 is 25 necessary 25 necessary 26 to 25 necessary 27 determine 26 to 27 determine 27 determine 29 role 27 determine 32 in 28 the 29 role 29 role 30 of 30 of 31 mirtazapine 32 in 36 population 33 the 36 population 34 older 36 population 35 underweight 36 population highly active antiretroviral therapy ( haart ) changed the natural history of pediatric hiv infection . 0 ###LEFT-WALL### 4 therapy 0 ###LEFT-WALL### 8 changed 0 ###LEFT-WALL### 16 . 1 highly 2 active 2 active 4 therapy 3 antiretroviral 4 therapy 4 therapy 6 haart 4 therapy 8 changed 5 ( 6 haart 6 haart 7 ) 8 changed 11 history 9 the 11 history 10 natural 11 history 11 history 12 of 12 of 15 infection 13 pediatric 15 infection 14 hiv 15 infection this review focuses on trends of hiv - associated cancers in childhood in the haart era and analyses potential pathogenetic mechanisms . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 focuses 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 22 . 1 this 2 review 2 review 3 focuses 3 focuses 4 on 4 on 5 trends 5 trends 6 of 6 of 7 hiv 8 - 17 and 9 associated 10 cancers 9 associated 11 in 9 associated 17 and 11 in 12 childhood 12 childhood 13 in 13 in 16 era 14 the 16 era 15 haart 16 era 17 and 18 analyses 18 analyses 21 mechanisms 19 potential 21 mechanisms 20 pathogenetic 21 mechanisms haart reduced aids - defined - malignancies ( adm ) , but incidence [of] several [non] - adm is increasing . 0 ###LEFT-WALL### 1 haart 0 ###LEFT-WALL### 2 reduced 0 ###LEFT-WALL### 17 - 1 haart 2 reduced 2 reduced 3 aids 2 reduced 12 but 3 aids 5 defined 3 aids 7 malignancies 4 - 5 defined 5 defined 6 - 6 - 7 malignancies 7 malignancies 9 adm 7 malignancies 11 , 8 ( 9 adm 9 adm 10 ) 12 but 13 incidence 13 incidence 15 several 17 - 18 adm 17 - 19 is 17 - 21 . 18 adm 19 is 19 is 20 increasing hiv - associated immune activation and inflammation , promoting tumorigenesis , can only partially be reduced by haart . 0 ###LEFT-WALL### 1 hiv 0 ###LEFT-WALL### 16 reduced 0 ###LEFT-WALL### 19 . 1 hiv 6 and 1 hiv 12 can 2 - 6 and 3 associated 5 activation 4 immune 5 activation 5 activation 6 and 6 and 7 inflammation 6 and 9 promoting 6 and 11 , 8 , 9 promoting 9 promoting 10 tumorigenesis 9 promoting 11 , 12 can 15 be 13 only 15 be 14 partially 15 be 15 be 16 reduced 16 reduced 17 by 17 by 18 haart in addition , hiv - infected children may undergo accelerated immune senescence that favors cancer development . 0 ###LEFT-WALL### 7 children 0 ###LEFT-WALL### 9 undergo 0 ###LEFT-WALL### 17 . 1 in 2 addition 1 in 7 children 2 addition 4 hiv 3 , 4 hiv 4 hiv 5 - 6 infected 7 children 7 children 8 may 8 may 9 undergo 9 undergo 12 senescence 10 accelerated 12 senescence 11 immune 12 senescence 12 senescence 13 that 12 senescence 14 favors 13 that 14 favors 14 favors 16 development 15 cancer 16 development how haart affects this condition is an open question . 0 ###LEFT-WALL### 1 how 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 10 . 1 how 2 haart 1 how 3 affects 1 how 6 is 2 haart 3 affects 3 affects 5 condition 4 this 5 condition 6 is 9 question 7 an 8 open 7 an 9 question 8 open 9 question lastly , there is no evidence that prenatal exposure to haart increases the risk of cancer in childhood , but long - term studies are needed . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 27 . 1 lastly 2 , 1 lastly 3 there 3 there 4 is 4 is 6 evidence 5 no 6 evidence 6 evidence 7 that 7 that 9 exposure 7 that 12 increases 8 prenatal 9 exposure 9 exposure 10 to 9 exposure 12 increases 10 to 11 haart 12 increases 14 risk 13 the 14 risk 14 risk 15 of 14 risk 17 in 15 of 16 cancer 17 in 18 childhood 19 , 20 but 20 but 24 studies 20 but 26 needed 21 long 22 - 21 long 24 studies 23 term 24 studies 24 studies 25 are 25 are 26 needed objective : the role of sedentary behaviour in metabolically healthy obesity is unknown . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 role 2 : 12 is 2 : 14 . 3 the 4 role 4 role 5 of 4 role 12 is 5 of 7 behaviour 6 sedentary 7 behaviour 7 behaviour 8 in 8 in 11 obesity 9 metabolically 10 healthy 10 healthy 11 obesity 12 is 13 unknown we examined cross [-] sectional differences in television viewing time across metabolic and obesity phenotypes , hypothesizing that healthy obese individuals spend less time viewing television than their unhealthy counterparts . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 1 we 2 examined 2 examined 6 differences 3 cross 6 differences 5 sectional 6 differences 6 differences 7 in 6 differences 9 viewing 6 differences 15 phenotypes 7 in 8 television 9 viewing 10 time 9 viewing 11 across 9 viewing 15 phenotypes 11 across 13 and 12 metabolic 13 and 13 and 14 obesity 15 phenotypes 17 hypothesizing 16 , 17 hypothesizing 17 hypothesizing 18 that 17 hypothesizing 31 . 18 that 21 individuals 18 that 22 spend 19 healthy 21 individuals 20 obese 21 individuals 21 individuals 22 spend 22 spend 24 time 22 spend 27 than 23 less 24 time 24 time 25 viewing 25 viewing 26 television 27 than 30 counterparts 28 their 30 counterparts 29 unhealthy 30 counterparts methods : a nationally representative sample of 4931 older adults in england ( mean age 65.1 [;] sd=8.9 years ) was drawn from the 2008/9 wave of the english longitudinal study of ageing . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 sample 2 : 22 drawn 2 : 34 . 3 a 4 nationally 3 a 6 sample 4 nationally 5 representative 5 representative 6 sample 6 sample 7 of 6 sample 21 was 7 of 10 adults 8 4931 10 adults 9 older 10 adults 10 adults 11 in 11 in 12 england 12 england 19 years 13 ( 19 years 14 mean 15 age 15 age 19 years 16 65.1 19 years 18 sd=8.9 19 years 19 years 20 ) 21 was 22 drawn 22 drawn 23 from 23 from 26 wave 24 the 26 wave 25 2008/9 26 wave 26 wave 27 of 27 of 31 study 28 the 29 english 29 english 31 study 30 longitudinal 31 study 31 study 32 of 32 of 33 ageing average weekly television viewing time was derived from two questions about weekday [and] weekend viewing . 0 ###LEFT-WALL### 3 television 0 ###LEFT-WALL### 7 derived 0 ###LEFT-WALL### 16 . 1 average 3 television 2 weekly 3 television 3 television 4 viewing 3 television 6 was 4 viewing 5 time 6 was 7 derived 7 derived 8 from 7 derived 11 about 8 from 10 questions 9 two 10 questions 11 about 15 viewing 12 weekday 14 weekend 14 weekend 15 viewing conclusions : a common type of leisure - time sedentary behaviour varies across metabolic and obesity [phenotypes] . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 18 . 1 conclusions 2 : 2 : 7 leisure 3 a 4 common 3 a 5 type 4 common 5 type 5 type 6 of 5 type 7 leisure 6 of 7 leisure 8 - 9 time 9 time 11 behaviour 9 time 12 varies 10 sedentary 11 behaviour 11 behaviour 12 varies 12 varies 13 across 13 across 15 and 14 metabolic 15 and 15 and 16 obesity however , healthy obesity is not explained through differences in leisure - time sedentary behaviour . 0 ###LEFT-WALL### 4 obesity 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 12 - 1 however 2 , 1 however 4 obesity 3 healthy 4 obesity 4 obesity 5 is 5 is 6 not 5 is 8 through 5 is 10 in 6 not 7 explained 8 through 9 differences 10 in 11 leisure 12 - 13 time 12 - 16 . 13 time 15 behaviour 14 sedentary 15 behaviour diabetes mellitus and prostate cancer are 2 of the most important public health concerns , especially in the elderly population . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 are 1 diabetes 2 mellitus 2 mellitus 3 and 3 and 5 cancer 3 and 6 are 4 prostate 5 cancer 6 are 7 2 7 2 8 of 8 of 14 concerns 9 the 10 most 10 most 14 concerns 11 important 14 concerns 12 public 14 concerns 13 health 14 concerns 14 concerns 17 in 15 , 16 especially 15 , 17 in 17 in 20 population 17 in 21 . 18 the 20 population 19 elderly 20 population although diabetes has been recognized as a potent risk factor for many types of cancers , there is a large amount of evidence that shows that it has a protective role against prostate cancer . 0 ###LEFT-WALL### 17 there 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 35 . 1 although 2 diabetes 1 although 5 recognized 1 although 16 , 1 although 17 there 2 diabetes 3 has 3 has 4 been 4 been 5 recognized 5 recognized 6 as 6 as 10 factor 7 a 8 potent 7 a 10 factor 8 potent 10 factor 9 risk 10 factor 10 factor 11 for 11 for 14 of 12 many 14 of 13 types 14 of 14 of 15 cancers 17 there 18 is 18 is 21 amount 18 is 32 against 19 a 20 large 19 a 21 amount 20 large 21 amount 21 amount 22 of 21 amount 26 that 22 of 23 evidence 23 evidence 25 shows 24 that 25 shows 26 that 27 it 26 that 28 has 27 it 28 has 28 has 31 role 29 a 30 protective 29 a 31 role 30 protective 31 role 32 against 34 cancer 33 prostate 34 cancer the underlying cause of this protective role is not fully understood , however , some mechanisms have been proposed in this area . 0 ###LEFT-WALL### 3 cause 0 ###LEFT-WALL### 11 understood 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 23 . 1 the 3 cause 2 underlying 3 cause 3 cause 4 of 3 cause 8 is 4 of 7 role 5 this 7 role 6 protective 7 role 8 is 9 not 8 is 11 understood 10 fully 11 understood 11 understood 13 however 12 , 13 however 13 however 14 , 14 , 16 mechanisms 14 , 19 proposed 15 some 16 mechanisms 16 mechanisms 17 have 17 have 18 been 18 been 19 proposed 19 proposed 20 in 20 in 22 area 21 this 22 area in the present study we have reviewed these mechanisms and some new mechanisms are also proposed . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 14 are 0 ###LEFT-WALL### 17 . 1 in 4 study 1 in 14 are 2 the 4 study 3 present 4 study 4 study 5 we 4 study 7 reviewed 5 we 6 have 6 have 7 reviewed 8 these 9 mechanisms 9 mechanisms 10 and 10 and 13 mechanisms 10 and 14 are 11 some 13 mechanisms 12 new 13 mechanisms 14 are 16 proposed 15 also 16 proposed nearly half of people living with hiv experience cognitive deficits that may impact instrumental activities of daily living . 0 ###LEFT-WALL### 2 half 0 ###LEFT-WALL### 8 experience 0 ###LEFT-WALL### 19 . 1 nearly 2 half 2 half 3 of 2 half 6 with 2 half 8 experience 3 of 4 people 4 people 5 living 6 with 7 hiv 8 experience 10 deficits 9 cognitive 10 deficits 10 deficits 11 that 10 deficits 12 may 11 that 12 may 12 may 13 impact 13 impact 15 activities 14 instrumental 15 activities 15 activities 16 of 16 of 18 living 17 daily 18 living as the number of people aging with hiv increases , concerns mount that disease - related cognitive deficits may be compounded by age - related deficits , which may further compromise everyday functions such as driving . 0 ###LEFT-WALL### 11 concerns 0 ###LEFT-WALL### 12 mount 0 ###LEFT-WALL### 15 - 1 as 3 number 1 as 9 increases 1 as 10 , 1 as 11 concerns 2 the 3 number 3 number 4 of 3 number 9 increases 4 of 5 people 5 people 6 aging 6 aging 7 with 7 with 8 hiv 11 concerns 12 mount 12 mount 14 disease 13 that 14 disease 15 - 18 deficits 15 - 21 compounded 15 - 25 related 15 - 27 , 15 - 37 . 16 related 18 deficits 17 cognitive 18 deficits 18 deficits 19 may 19 may 20 be 20 be 21 compounded 21 compounded 22 by 22 by 23 age 24 - 25 related 25 related 26 deficits 25 related 27 , 27 , 28 which 27 , 31 compromise 28 which 29 may 29 may 31 compromise 30 further 31 compromise 31 compromise 33 functions 31 compromise 35 as 32 everyday 33 functions 34 such 35 as 35 as 36 driving in this cross - sectional pilot study , during [a] 2.5 - hour visit , 26 middle - aged and older adults ( 40 + years ) were administered demographic , health , psychosocial , and driving habits questionnaires ; cognitive assessments [;] and driving simulator tests . 0 ###LEFT-WALL### 3 cross 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 48 . 1 in 2 this 1 in 3 cross 4 - 7 study 4 - 12 - 5 sectional 6 pilot 6 pilot 7 study 7 study 9 during 8 , 9 during 9 during 11 2.5 9 during 12 - 12 - 14 visit 12 - 15 , 13 hour 14 visit 15 , 17 middle 15 , 18 - 16 26 17 middle 18 - 22 adults 18 - 28 were 18 - 40 ; 19 aged 20 and 20 and 21 older 20 and 22 adults 22 adults 25 + 22 adults 28 were 23 ( 25 + 24 40 25 + 25 + 26 years 25 + 27 ) 28 were 36 and 29 administered 32 health 30 demographic 31 , 30 demographic 32 health 32 health 33 , 33 , 34 psychosocial 33 , 36 and 35 , 36 and 36 and 39 questionnaires 37 driving 38 habits 38 habits 39 questionnaires 40 ; 44 and 41 cognitive 42 assessments 42 assessments 44 and 44 and 47 tests 45 driving 46 simulator 46 simulator 47 tests although cd4+ t [lymphocyte] [count] and viral load were unrelated to driving performance , older age was related to poorer driving . 0 ###LEFT-WALL### 16 age 0 ###LEFT-WALL### 18 related 0 ###LEFT-WALL### 22 . 1 although 6 and 1 although 9 were 1 although 14 , 1 although 16 age 2 cd4+ 3 t 2 cd4+ 6 and 6 and 8 load 6 and 9 were 7 viral 8 load 9 were 10 unrelated 10 unrelated 11 to 11 to 12 driving 12 driving 13 performance 15 older 16 age 16 age 17 was 17 was 18 related 18 related 19 to 19 to 21 driving 20 poorer 21 driving furthermore , poorer visual speed of processing performance ( i.e [.] , useful field [of] view ) was related to poorer driving performance ( e.g [.] , average gross reaction time ) . 0 ###LEFT-WALL### 5 speed 0 ###LEFT-WALL### 33 . 1 furthermore 2 , 1 furthermore 5 speed 3 poorer 5 speed 4 visual 5 speed 5 speed 6 of 5 speed 10 i.e 5 speed 16 view 5 speed 18 was 6 of 7 processing 7 processing 8 performance 9 ( 10 i.e 10 i.e 12 , 12 , 16 view 13 useful 14 field 14 field 16 view 16 view 17 ) 18 was 19 related 19 related 20 to 20 to 23 performance 21 poorer 23 performance 22 driving 23 performance 23 performance 25 e.g 23 performance 31 time 24 ( 25 e.g 25 e.g 27 , 27 , 31 time 28 average 31 time 29 gross 30 reaction 30 reaction 31 time 31 time 32 ) mixed findings were observed between driving performance and cognitive function [on] self - reported driving habits of participants . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 observed 0 ###LEFT-WALL### 14 reported 0 ###LEFT-WALL### 19 . 1 mixed 2 findings 2 findings 3 were 3 were 4 observed 4 observed 5 between 5 between 8 and 6 driving 7 performance 7 performance 8 and 8 and 12 self 9 cognitive 10 function 10 function 12 self 13 - 14 reported 14 reported 15 driving 15 driving 16 habits 16 habits 17 of 17 of 18 participants implications for these findings on nursing practice and research are posited . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 posited 0 ###LEFT-WALL### 12 . 1 implications 2 for 1 implications 8 and 2 for 4 findings 3 these 4 findings 4 findings 5 on 5 on 6 nursing 6 nursing 7 practice 8 and 9 research 8 and 10 are 10 are 11 posited background : long - term longitudinal studies of lung function [from] childhood to adulthood are important in linking our understanding of childhood risk factors to adult disease . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 background 2 : 2 : 3 long 4 - 7 studies 4 - 15 are 4 - 28 . 5 term 7 studies 6 longitudinal 7 studies 7 studies 8 of 7 studies 15 are 8 of 12 childhood 9 lung 10 function 10 function 12 childhood 12 childhood 13 to 13 to 14 adulthood 15 are 16 important 16 important 17 in 16 important 25 to 17 in 18 linking 18 linking 20 understanding 19 our 20 understanding 20 understanding 21 of 21 of 24 factors 22 childhood 24 factors 23 risk 24 factors 25 to 27 disease 26 adult 27 disease airway hyperresponsiveness has been shown to independently affect lung function growth in studies of adolescence . 0 ###LEFT-WALL### 2 hyperresponsiveness 0 ###LEFT-WALL### 5 shown 0 ###LEFT-WALL### 16 . 1 airway 2 hyperresponsiveness 2 hyperresponsiveness 3 has 3 has 4 been 4 been 5 shown 5 shown 6 to 6 to 8 affect 7 independently 8 affect 8 affect 11 growth 8 affect 12 in 9 lung 11 growth 10 function 11 growth 12 in 13 studies 13 studies 14 of 14 of 15 adolescence the objective of the study was to test the hypothesis that airway hyperresponsiveness has an independent deleterious effect [on] lung function in adolescence that extends into adulthood . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 28 . 1 the 2 objective 2 objective 3 of 2 objective 6 was 3 of 5 study 4 the 5 study 6 was 7 to 6 was 8 test 7 to 8 test 8 test 10 hypothesis 8 test 22 in 8 test 26 into 9 the 10 hypothesis 10 hypothesis 11 that 11 that 13 hyperresponsiveness 11 that 14 has 12 airway 13 hyperresponsiveness 13 hyperresponsiveness 14 has 14 has 21 function 15 an 16 independent 15 an 21 function 16 independent 21 function 17 deleterious 21 function 18 effect 21 function 20 lung 21 function 22 in 23 adolescence 23 adolescence 24 that 23 adolescence 25 extends 24 that 25 extends 26 into 27 adulthood methods : a random population sample ( n = 983 ) aged 7 - 17 from copenhagen [was] followed longitudinally for 20 years with four examinations . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 sample 2 : 12 aged 2 : 27 . 3 a 6 sample 4 random 5 population 5 population 6 sample 6 sample 9 = 6 sample 12 aged 7 ( 9 = 8 n 9 = 9 = 10 983 9 = 11 ) 12 aged 14 - 12 aged 16 from 12 aged 20 longitudinally 12 aged 21 for 12 aged 24 with 13 7 14 - 14 - 15 17 16 from 17 copenhagen 17 copenhagen 19 followed 21 for 23 years 22 20 23 years 24 with 26 examinations 25 four 26 examinations results : a total of 780 ( 79.3 % ) subjects contributed with lung function measurements and bronchial provocation testing . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 4 total 3 a 4 total 4 total 5 of 4 total 11 subjects 4 total 12 contributed 5 of 6 780 6 780 9 % 7 ( 9 % 8 79.3 9 % 9 % 10 ) 11 subjects 12 contributed 12 contributed 13 with 13 with 17 and 14 lung 16 measurements 15 function 16 measurements 16 measurements 17 and 17 and 20 testing 18 bronchial 19 provocation 19 provocation 20 testing among these , 170 ( 21.8 % ) had airway hyperresponsiveness at one examination or more during the study period . 0 ###LEFT-WALL### 4 170 0 ###LEFT-WALL### 9 had 0 ###LEFT-WALL### 21 . 1 among 2 these 1 among 3 , 1 among 4 170 4 170 7 % 4 170 9 had 5 ( 7 % 6 21.8 7 % 7 % 8 ) 9 had 11 hyperresponsiveness 9 had 12 at 10 airway 11 hyperresponsiveness 12 at 13 one 13 one 15 or 14 examination 15 or 15 or 16 more 15 or 17 during 17 during 20 period 18 the 20 period 19 study 20 period there was no difference in initial fev1 levels between subjects [with] and without airway hyperresponsiveness . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 16 . 1 there 2 was 2 was 4 difference 3 no 4 difference 4 difference 12 and 5 in 8 levels 5 in 12 and 6 initial 8 levels 7 fev1 8 levels 8 levels 9 between 9 between 10 subjects 12 and 13 without 13 without 15 hyperresponsiveness 14 airway 15 hyperresponsiveness in a repeated measures regression model with adjustment for asthma and smoking , airway hyperresponsiveness was independently associated with reduced rates of growth in lung function [in] [both] sexes of 23 ml/year . 0 ###LEFT-WALL### 15 hyperresponsiveness 0 ###LEFT-WALL### 18 associated 0 ###LEFT-WALL### 33 . 1 in 6 model 1 in 13 , 1 in 15 hyperresponsiveness 2 a 6 model 3 repeated 4 measures 4 measures 5 regression 5 regression 6 model 6 model 7 with 6 model 9 for 7 with 8 adjustment 9 for 11 and 10 asthma 11 and 11 and 12 smoking 14 airway 15 hyperresponsiveness 15 hyperresponsiveness 16 was 16 was 17 independently 16 was 18 associated 18 associated 19 with 18 associated 24 in 18 associated 32 ml/year 19 with 21 rates 20 reduced 21 rates 21 rates 22 of 22 of 23 growth 24 in 29 sexes 25 lung 29 sexes 26 function 29 sexes 29 sexes 30 of 30 of 31 23 reduced growth rates resulted in deficits in maximal attained level of lung function [at] age 18 , which persisted throughout [the] [follow] - up until the last examination at age 27 - 37 years . 0 ###LEFT-WALL### 3 rates 0 ###LEFT-WALL### 4 resulted 0 ###LEFT-WALL### 35 . 1 reduced 2 growth 2 growth 3 rates 3 rates 4 resulted 4 resulted 5 in 4 resulted 7 in 4 resulted 24 up 5 in 6 deficits 7 in 10 level 8 maximal 10 level 9 attained 10 level 10 level 11 of 11 of 15 age 12 lung 13 function 13 function 15 age 15 age 16 18 15 age 18 which 17 , 18 which 18 which 19 persisted 18 which 23 - 19 persisted 20 throughout 24 up 25 until 25 until 28 examination 26 the 28 examination 27 last 28 examination 28 examination 29 at 29 at 34 years 30 age 34 years 31 27 32 - 32 - 33 37 32 - 34 years conclusion : airway hyperresponsiveness has an independent deleterious effect on lung function development from 7 to 37 years resulting in a lower maximal attained lung function and persistent deficits in lung function [in] adulthood . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 27 and 3 airway 19 resulting 4 hyperresponsiveness 5 has 5 has 9 effect 5 has 10 on 5 has 16 to 6 an 9 effect 7 independent 9 effect 8 deleterious 9 effect 10 on 13 development 11 lung 13 development 12 function 13 development 14 from 16 to 15 7 16 to 16 to 17 37 17 37 18 years 18 years 19 resulting 19 resulting 20 in 19 resulting 27 and 20 in 26 function 21 a 26 function 22 lower 25 lung 23 maximal 25 lung 24 attained 25 lung 25 lung 26 function 27 and 29 deficits 27 and 30 in 28 persistent 29 deficits 30 in 34 adulthood 31 lung 32 function 32 function 34 adulthood despite the advances in cancer medicine and the resultant 20 % decline in cancer death rates for americans since 1991 , there remain distinct cancer health disparities among african americans , hispanics , native americans , and [the] those living in poverty . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 23 remain 0 ###LEFT-WALL### 43 . 1 despite 3 advances 1 despite 7 and 2 the 3 advances 3 advances 4 in 4 in 5 cancer 6 medicine 7 and 7 and 12 decline 7 and 21 , 7 and 22 there 7 and 23 remain 8 the 12 decline 9 resultant 12 decline 10 20 11 % 11 % 12 decline 12 decline 13 in 12 decline 19 since 13 in 16 rates 14 cancer 15 death 15 death 16 rates 16 rates 17 for 17 for 18 americans 19 since 20 1991 23 remain 27 disparities 23 remain 28 among 23 remain 41 in 24 distinct 25 cancer 25 cancer 26 health 26 health 27 disparities 28 among 37 and 29 african 30 americans 30 americans 31 , 31 , 32 hispanics 31 , 33 , 33 , 35 americans 33 , 37 and 34 native 35 americans 36 , 37 and 37 and 39 those 37 and 40 living 41 in 42 poverty minorities and the poor continue to bear the disproportionate burden of cancer , especially in terms of [stage] at diagnosis , incidence , and mortality . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 continue 1 minorities 2 and 2 and 4 poor 2 and 5 continue 3 the 4 poor 5 continue 6 to 5 continue 7 bear 6 to 7 bear 7 bear 10 burden 8 the 10 burden 9 disproportionate 10 burden 10 burden 11 of 11 of 12 cancer 12 cancer 15 in 13 , 14 especially 13 , 15 in 15 in 16 terms 15 in 26 . 16 terms 17 of 17 of 19 at 19 at 24 and 20 diagnosis 21 , 21 , 22 incidence 21 , 24 and 23 , 24 and 24 and 25 mortality cancer health disparities are persistent reminders that state - of [-] the [-] art cancer prevention , diagnosis , and treatment are not equally effective [for] and accessible to all americans . 0 ###LEFT-WALL### 3 disparities 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 32 . 1 cancer 3 disparities 2 health 3 disparities 3 disparities 4 are 4 are 6 reminders 5 persistent 6 reminders 6 reminders 7 that 6 reminders 8 state 7 that 8 state 8 state 20 and 8 state 22 are 9 - 10 of 10 of 16 prevention 10 of 17 , 10 of 20 and 12 the 16 prevention 14 art 16 prevention 15 cancer 16 prevention 18 diagnosis 20 and 19 , 20 and 20 and 21 treatment 20 and 22 are 22 are 23 not 22 are 24 equally 22 are 27 and 23 not 24 equally 25 effective 27 and 27 and 28 accessible 28 accessible 29 to 29 to 31 americans 30 all 31 americans the cancer prevention model must take into account the phenotype of accelerated aging associated with health disparities as well as the important interplay of biological and sociocultural factors that lead to disparate health outcomes . 0 ###LEFT-WALL### 4 model 0 ###LEFT-WALL### 6 take 0 ###LEFT-WALL### 35 . 1 the 4 model 2 cancer 4 model 3 prevention 4 model 4 model 5 must 5 must 6 take 6 take 8 account 6 take 10 phenotype 7 into 8 account 9 the 10 phenotype 10 phenotype 11 of 10 phenotype 24 of 11 of 13 aging 12 accelerated 13 aging 13 aging 14 associated 13 aging 15 with 13 aging 20 as 15 with 17 disparities 16 health 17 disparities 18 as 19 well 19 well 20 as 20 as 23 interplay 21 the 23 interplay 22 important 23 interplay 24 of 26 and 25 biological 26 and 26 and 28 factors 26 and 29 that 26 and 30 lead 27 sociocultural 28 factors 29 that 30 lead 30 lead 31 to 31 to 34 outcomes 32 disparate 34 outcomes 33 health 34 outcomes the building blocks of this prevention model will include interdisciplinary prevention modalities that encourage partnerships across medical and nonmedical entities , community - based participatory research , development of ethnically [and] racially diverse research cohorts , and full actualization of the prevention benefits outlined in the 2010 patient protection and affordable care act . 0 ###LEFT-WALL### 3 blocks 0 ###LEFT-WALL### 9 include 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 44 outlined 0 ###LEFT-WALL### 54 . 1 the 3 blocks 2 building 3 blocks 3 blocks 4 of 3 blocks 9 include 4 of 8 will 5 this 8 will 6 prevention 7 model 7 model 8 will 9 include 12 modalities 10 interdisciplinary 12 modalities 11 prevention 12 modalities 12 modalities 13 that 12 modalities 14 encourage 13 that 14 encourage 14 encourage 15 partnerships 14 encourage 16 across 16 across 20 entities 17 medical 18 and 18 and 19 nonmedical 18 and 20 entities 21 , 22 community 21 , 23 - 23 - 37 and 24 based 26 research 25 participatory 26 research 26 research 27 , 27 , 28 development 27 , 37 and 28 development 29 of 29 of 35 cohorts 30 ethnically 33 diverse 32 racially 33 diverse 33 diverse 34 research 34 research 35 cohorts 36 , 37 and 37 and 39 actualization 37 and 40 of 38 full 39 actualization 40 of 42 prevention 41 the 42 prevention 42 prevention 43 benefits 42 prevention 44 outlined 43 benefits 44 outlined 44 outlined 45 in 45 in 53 act 46 the 53 act 47 2010 48 patient 48 patient 49 protection 49 protection 50 and 50 and 51 affordable 51 affordable 52 care 52 care 53 act this paper provides highlights from a cdc - hosted meeting on opportunities for cancer prevention during midlife ( roughly ages 45 - 64 years ) . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 26 . 1 this 2 paper 2 paper 3 provides 3 provides 4 highlights 4 highlights 5 from 5 from 7 cdc 6 a 7 cdc 8 - 10 meeting 9 hosted 10 meeting 10 meeting 11 on 11 on 12 opportunities 12 opportunities 13 for 13 for 15 prevention 14 cancer 15 prevention 15 prevention 16 during 16 during 17 midlife 17 midlife 20 ages 17 midlife 24 years 18 ( 20 ages 19 roughly 20 ages 20 ages 21 45 20 ages 22 - 22 - 24 years 23 64 24 years 24 years 25 ) positive changes during this phase of life have the potential to prevent cancer [incidence] later in life , making this phase an opportune time for targeted prevention efforts to facilitate healthy aging and increased longevity . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 8 have 1 positive 2 changes 2 changes 3 during 2 changes 6 of 2 changes 8 have 3 during 5 phase 4 this 5 phase 6 of 7 life 8 have 10 potential 8 have 11 to 8 have 16 in 9 the 10 potential 11 to 12 prevent 12 prevent 13 cancer 12 prevent 15 later 16 in 17 life 17 life 19 making 18 , 19 making 19 making 21 phase 19 making 24 time 19 making 25 for 19 making 36 . 20 this 21 phase 22 an 23 opportune 22 an 24 time 23 opportune 24 time 25 for 33 and 26 targeted 28 efforts 26 targeted 29 to 26 targeted 33 and 27 prevention 28 efforts 29 to 30 facilitate 30 facilitate 32 aging 31 healthy 32 aging 33 and 34 increased 34 increased 35 longevity risk and protective factors discussed during the meeting included exposure to radiation from medical imaging procedures , circadian disruption , chemical exposures , dietary factors , alcohol consumption , obesity , physical activity , diabetes , and the human microbiome . 0 ###LEFT-WALL### 37 and 0 ###LEFT-WALL### 41 . 1 risk 2 and 2 and 4 factors 2 and 5 discussed 2 and 11 to 2 and 37 and 3 protective 4 factors 5 discussed 6 during 6 during 10 exposure 7 the 10 exposure 8 meeting 9 included 9 included 10 exposure 11 to 12 radiation 12 radiation 13 from 12 radiation 22 exposures 13 from 16 procedures 14 medical 16 procedures 15 imaging 16 procedures 16 procedures 19 disruption 17 , 19 disruption 18 circadian 19 disruption 19 disruption 20 , 20 , 22 exposures 21 chemical 22 exposures 22 exposures 25 factors 22 exposures 36 , 23 , 25 factors 24 dietary 25 factors 25 factors 28 consumption 25 factors 35 diabetes 25 factors 36 , 26 , 28 consumption 27 alcohol 28 consumption 28 consumption 30 obesity 28 consumption 33 activity 28 consumption 34 , 29 , 30 obesity 30 obesity 31 , 31 , 33 activity 32 physical 33 activity 33 activity 34 , 34 , 35 diabetes 35 diabetes 36 , 37 and 40 microbiome 38 the 40 microbiome 39 human 40 microbiome although many of these factors are well recognized as being related to cancer [incidence] , others are not as widely recognized or have emerged as growing areas of research . 0 ###LEFT-WALL### 16 others 0 ###LEFT-WALL### 22 or 0 ###LEFT-WALL### 30 . 1 although 5 factors 1 although 6 are 1 although 16 others 2 many 3 of 2 many 5 factors 3 of 5 factors 4 these 5 factors 5 factors 6 are 6 are 7 well 6 are 8 recognized 9 as 10 being 9 as 11 related 9 as 15 , 9 as 16 others 10 being 11 related 11 related 12 to 12 to 13 cancer 16 others 17 are 17 are 18 not 17 are 22 or 19 as 20 widely 20 widely 21 recognized 21 recognized 22 or 22 or 23 have 23 have 24 emerged 24 emerged 27 areas 25 as 26 growing 26 growing 27 areas 27 areas 28 of 28 of 29 research meeting participants discussed promising strategies for cancer prevention targeting this age group . 0 ###LEFT-WALL### 1 meeting 0 ###LEFT-WALL### 3 discussed 0 ###LEFT-WALL### 13 . 1 meeting 2 participants 1 meeting 3 discussed 3 discussed 4 promising 4 promising 5 strategies 4 promising 12 group 5 strategies 6 for 5 strategies 12 group 6 for 8 prevention 7 cancer 8 prevention 8 prevention 9 targeting 9 targeting 11 age 10 this 11 age just as there are multiple determinants of cancer risk , there are likely multiple solutions . 0 ###LEFT-WALL### 11 there 0 ###LEFT-WALL### 12 are 0 ###LEFT-WALL### 16 . 1 just 2 as 2 as 3 there 2 as 4 are 2 as 10 , 2 as 11 there 3 there 4 are 4 are 6 determinants 5 multiple 6 determinants 6 determinants 7 of 7 of 9 risk 8 cancer 9 risk 11 there 12 are 12 are 15 solutions 13 likely 15 solutions 14 multiple 15 solutions changes to social and physical environments may facilitate healthy behaviors and minimize harmful exposures . 0 ###LEFT-WALL### 1 changes 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 15 . 1 changes 2 to 1 changes 11 and 2 to 6 environments 3 social 4 and 4 and 5 physical 4 and 6 environments 7 may 8 facilitate 7 may 11 and 8 facilitate 10 behaviors 9 healthy 10 behaviors 11 and 12 minimize 12 minimize 14 exposures 13 harmful 14 exposures information shared during the meeting about health disparities in the u.s [.] highlighted the need to go beyond traditional approaches to cancer prevention to truly reach vulnerable populations . 0 ###LEFT-WALL### 1 information 0 ###LEFT-WALL### 13 highlighted 0 ###LEFT-WALL### 29 . 1 information 2 shared 1 information 6 about 1 information 13 highlighted 2 shared 3 during 3 during 5 meeting 4 the 5 meeting 6 about 8 disparities 7 health 8 disparities 8 disparities 9 in 9 in 11 u.s 10 the 11 u.s 13 highlighted 15 need 13 highlighted 16 to 14 the 15 need 16 to 17 go 17 go 18 beyond 17 go 21 to 17 go 24 to 18 beyond 20 approaches 19 traditional 20 approaches 21 to 23 prevention 22 cancer 23 prevention 24 to 26 reach 25 truly 26 reach 26 reach 28 populations 27 vulnerable 28 populations partnerships are also a key component to prevention efforts ; community - [based] and nonprofit organizations , the healthcare system , research institutions , state health departments , and federal agencies were all noted as important partners in prevention efforts . 0 ###LEFT-WALL### 1 partnerships 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 41 . 1 partnerships 2 are 2 are 3 also 2 are 6 component 2 are 7 to 4 a 6 component 5 key 6 component 7 to 9 efforts 8 prevention 9 efforts 10 ; 11 community 10 ; 14 and 12 - 14 and 14 and 16 organizations 14 and 25 state 15 nonprofit 16 organizations 16 organizations 20 system 16 organizations 25 state 17 , 20 system 18 the 20 system 19 healthcare 20 system 20 system 23 institutions 20 system 24 , 21 , 23 institutions 22 research 23 institutions 23 institutions 24 , 25 state 26 health 25 state 34 noted 26 health 29 and 26 health 32 were 26 health 34 noted 27 departments 29 and 28 , 29 and 29 and 31 agencies 29 and 32 were 30 federal 31 agencies 33 all 34 noted 34 noted 37 partners 34 noted 38 in 35 as 36 important 36 important 37 partners 38 in 40 efforts 39 prevention 40 efforts coordinated , multi - disciplinary efforts across multiple chronic diseases may provide opportunities for synergistic effects . 0 ###LEFT-WALL### 6 efforts 0 ###LEFT-WALL### 12 provide 0 ###LEFT-WALL### 17 . 1 coordinated 2 , 1 coordinated 6 efforts 3 multi 4 - 3 multi 6 efforts 5 disciplinary 6 efforts 6 efforts 7 across 6 efforts 11 may 7 across 10 diseases 8 multiple 10 diseases 9 chronic 10 diseases 11 may 12 provide 12 provide 13 opportunities 13 opportunities 14 for 14 for 16 effects 15 synergistic 16 effects further , leveraging key partnerships and existing communication channels can maximize success and facilitate timely translation of research findings into public health practice . 0 ###LEFT-WALL### 3 leveraging 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 . 1 further 2 , 1 further 3 leveraging 3 leveraging 6 and 3 leveraging 10 can 4 key 5 partnerships 5 partnerships 6 and 6 and 9 channels 7 existing 8 communication 8 communication 9 channels 10 can 13 and 11 maximize 12 success 11 maximize 13 and 13 and 14 facilitate 13 and 20 into 13 and 23 practice 14 facilitate 16 translation 15 timely 16 translation 16 translation 17 of 17 of 19 findings 18 research 19 findings 20 into 22 health 21 public 22 health this article challenges the idea that cancer cannot be prevented among older adults by examining different aspects of the relationship between age and cancer . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 challenges 0 ###LEFT-WALL### 25 . 1 this 2 article 2 article 3 challenges 3 challenges 5 idea 4 the 5 idea 5 idea 6 that 6 that 7 cancer 6 that 10 prevented 7 cancer 8 cannot 8 cannot 9 be 9 be 10 prevented 10 prevented 11 among 10 prevented 14 by 11 among 13 adults 12 older 13 adults 14 by 15 examining 15 examining 17 aspects 15 examining 21 between 16 different 17 aspects 17 aspects 18 of 18 of 20 relationship 19 the 20 relationship 21 between 23 and 22 age 23 and 23 and 24 cancer although the sequential patterns of aging cannot be changed , several age - related factors that contribute to disease risk can be . 0 ###LEFT-WALL### 12 age 0 ###LEFT-WALL### 22 be 0 ###LEFT-WALL### 23 . 1 although 4 patterns 1 although 9 changed 1 although 10 , 1 although 12 age 2 the 4 patterns 3 sequential 4 patterns 4 patterns 5 of 4 patterns 7 cannot 5 of 6 aging 7 cannot 8 be 8 be 9 changed 9 changed 10 , 11 several 12 age 12 age 21 can 13 - 14 related 14 related 15 factors 14 related 18 to 14 related 21 can 15 factors 16 that 15 factors 17 contribute 16 that 17 contribute 18 to 20 risk 19 disease 20 risk 21 can 22 be for most adults , age is coincidentally associated with preventable chronic conditions , avoidable exposures , and modifiable risk behaviors that are causally associated with cancer . 0 ###LEFT-WALL### 5 age 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 27 . 1 for 3 adults 1 for 4 , 1 for 5 age 2 most 3 adults 5 age 6 is 6 is 8 associated 7 coincidentally 8 associated 8 associated 9 with 9 with 12 conditions 10 preventable 12 conditions 11 chronic 12 conditions 13 , 17 and 14 avoidable 15 exposures 15 exposures 17 and 16 , 17 and 17 and 20 behaviors 17 and 21 that 17 and 22 are 18 modifiable 20 behaviors 19 risk 20 behaviors 21 that 22 are 22 are 24 associated 23 causally 24 associated 24 associated 25 with 25 with 26 cancer midlife is a period of life when the prevalence of multiple cancer risk factors is high and incidence rates begin to increase for many types of cancer . 0 ###LEFT-WALL### 1 midlife 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 28 . 1 midlife 2 is 2 is 4 period 3 a 4 period 4 period 5 of 4 period 7 when 5 of 6 life 7 when 9 prevalence 7 when 15 is 8 the 9 prevalence 9 prevalence 10 of 9 prevalence 13 risk 9 prevalence 14 factors 9 prevalence 15 is 10 of 12 cancer 11 multiple 12 cancer 13 risk 14 factors 15 is 16 high 17 and 19 rates 17 and 20 begin 18 incidence 19 rates 19 rates 20 begin 20 begin 21 to 20 begin 22 increase 21 to 22 increase 22 increase 23 for 23 for 26 of 24 many 26 of 25 types 26 of 26 of 27 cancer however , current evidence suggests that for most adults , cancer does not have to be an inevitable consequence of growing older . 0 ###LEFT-WALL### 4 evidence 0 ###LEFT-WALL### 5 suggests 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 23 . 1 however 2 , 1 however 4 evidence 3 current 4 evidence 4 evidence 5 suggests 5 suggests 6 that 5 suggests 7 for 7 for 9 adults 8 most 9 adults 10 , 11 cancer 10 , 14 have 11 cancer 12 does 12 does 13 not 12 does 14 have 14 have 15 to 14 have 16 be 15 to 16 be 16 be 19 consequence 17 an 19 consequence 18 inevitable 19 consequence 19 consequence 20 of 20 of 21 growing 21 growing 22 older interventions that support healthy environments , help people manage chronic conditions , and promote healthy behaviors may help people make a healthier transition from midlife to older age and reduce the likelihood of developing cancer . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 36 . 1 interventions 2 that 1 interventions 6 , 1 interventions 29 and 2 that 6 , 3 support 5 environments 3 support 6 , 4 healthy 5 environments 6 , 13 and 7 help 8 people 7 help 9 manage 7 help 13 and 9 manage 11 conditions 10 chronic 11 conditions 12 , 13 and 13 and 14 promote 14 promote 16 behaviors 15 healthy 16 behaviors 17 may 18 help 17 may 29 and 18 help 19 people 18 help 20 make 20 make 23 transition 21 a 23 transition 22 healthier 23 transition 23 transition 24 from 23 transition 26 to 24 from 25 midlife 26 to 28 age 27 older 28 age 29 and 30 reduce 29 and 32 likelihood 31 the 32 likelihood 32 likelihood 33 of 33 of 34 developing 34 developing 35 cancer because the number of adults reaching older ages is increasing rapidly , the number of new cancer cases will also increase if current incidence rates remain unchanged . 0 ###LEFT-WALL### 18 cases 0 ###LEFT-WALL### 21 increase 0 ###LEFT-WALL### 28 . 1 because 3 number 1 because 9 is 1 because 12 , 1 because 18 cases 2 the 3 number 3 number 4 of 3 number 6 reaching 3 number 9 is 4 of 5 adults 6 reaching 8 ages 7 older 8 ages 9 is 10 increasing 10 increasing 11 rapidly 13 the 14 number 14 number 15 of 14 number 18 cases 15 of 18 cases 16 new 17 cancer 17 cancer 18 cases 18 cases 19 will 19 will 21 increase 20 also 21 increase 21 increase 22 if 22 if 25 rates 22 if 26 remain 23 current 24 incidence 24 incidence 25 rates 25 rates 26 remain 26 remain 27 unchanged thus , the need to translate the available research into practice to promote cancer prevention , especially for adults at midlife , has never been greater . 0 ###LEFT-WALL### 4 need 0 ###LEFT-WALL### 25 been 0 ###LEFT-WALL### 27 . 1 thus 2 , 1 thus 4 need 3 the 4 need 4 need 5 to 4 need 6 translate 4 need 23 has 5 to 6 translate 6 translate 9 research 6 translate 10 into 6 translate 12 to 7 the 9 research 8 available 9 research 10 into 11 practice 12 to 13 promote 13 promote 15 prevention 14 cancer 15 prevention 15 prevention 18 for 16 , 17 especially 16 , 18 for 18 for 19 adults 18 for 22 , 19 adults 20 at 20 at 21 midlife 23 has 25 been 24 never 25 been 25 been 26 greater background : the workplace is an important domain for adults , and many effective interventions targeting physical activity and weight reduction have been implemented in the workplace . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 workplace 2 : 5 is 2 : 12 and 2 : 28 . 3 the 4 workplace 4 workplace 5 is 5 is 8 domain 6 an 7 important 6 an 8 domain 7 important 8 domain 8 domain 9 for 9 for 10 adults 11 , 12 and 12 and 19 and 12 and 24 implemented 13 many 15 interventions 14 effective 15 interventions 15 interventions 16 targeting 15 interventions 19 and 16 targeting 18 activity 17 physical 18 activity 19 and 21 reduction 19 and 22 have 20 weight 21 reduction 22 have 23 been 23 been 24 implemented 24 implemented 25 in 25 in 27 workplace 26 the 27 workplace however , the u.s [.] workforce is aging , and few studies have examined the relationship of bmi , physical activity , and age as they relate to workplace characteristics . 0 ###LEFT-WALL### 6 workforce 0 ###LEFT-WALL### 14 examined 0 ###LEFT-WALL### 27 relate 0 ###LEFT-WALL### 31 . 1 however 2 , 1 however 6 workforce 3 the 6 workforce 4 u.s 6 workforce 6 workforce 7 is 7 is 10 and 8 aging 10 and 9 , 10 and 10 and 11 few 12 studies 13 have 13 have 14 examined 14 examined 16 relationship 14 examined 25 as 15 the 16 relationship 16 relationship 17 of 17 of 23 and 18 bmi 21 activity 18 bmi 23 and 19 , 21 activity 20 physical 21 activity 21 activity 22 , 23 and 24 age 25 as 26 they 25 as 27 relate 26 they 27 relate 27 relate 28 to 28 to 30 characteristics 29 workplace 30 characteristics purpose : this paper reports on the distribution of physical activity and bmi by age in a population of hospital [-] based healthcare workers and investigates the relationships among workplace characteristics , physical activity , and bmi . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 4 paper 2 : 25 and 2 : 38 . 3 this 4 paper 4 paper 25 and 5 reports 6 on 5 reports 14 by 5 reports 25 and 6 on 12 and 7 the 8 distribution 8 distribution 9 of 8 distribution 12 and 9 of 11 activity 10 physical 11 activity 12 and 13 bmi 14 by 15 age 15 age 16 in 15 age 19 of 16 in 18 population 17 a 18 population 19 of 24 workers 20 hospital 22 based 22 based 24 workers 23 healthcare 24 workers 25 and 26 investigates 25 and 29 among 26 investigates 28 relationships 27 the 28 relationships 29 among 36 and 30 workplace 31 characteristics 31 characteristics 32 , 32 , 34 activity 32 , 36 and 33 physical 34 activity 35 , 36 and 36 and 37 bmi methods : data from a survey of patient care workers in two large academic hospitals in the boston area were collected in late 2009 and analyzed in early 2013 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 25 and 2 : 30 . 3 data 4 from 3 data 7 of 3 data 25 and 4 from 6 survey 5 a 6 survey 7 of 10 workers 8 patient 9 care 9 care 10 workers 10 workers 11 in 11 in 15 hospitals 12 two 15 hospitals 13 large 14 academic 14 academic 15 hospitals 15 hospitals 16 in 16 in 19 area 17 the 19 area 18 boston 19 area 20 were 21 collected 20 were 25 and 21 collected 22 in 22 in 24 2009 23 late 24 2009 25 and 26 analyzed 25 and 27 in 27 in 29 2013 28 early 29 2013 results : in multivariate models , workers reporting greater decision latitude ( or=1.02 , 95 % ci=1.01 , 1.03 ) and job flexibility ( or=1.05 , 95 % ci=1.01 , 1.10 ) reported greater physical activity . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 37 . 1 results 2 : 2 : 3 in 3 in 5 models 4 multivariate 5 models 5 models 7 workers 6 , 7 workers 7 workers 8 reporting 7 workers 13 or=1.02 7 workers 17 ci=1.01 7 workers 20 ) 8 reporting 11 latitude 9 greater 11 latitude 10 decision 11 latitude 12 ( 13 or=1.02 13 or=1.02 14 , 14 , 17 ci=1.01 15 95 17 ci=1.01 16 % 17 ci=1.01 17 ci=1.01 19 1.03 17 ci=1.01 20 ) 18 , 19 1.03 19 1.03 20 ) 21 and 23 flexibility 21 and 33 reported 22 job 23 flexibility 23 flexibility 25 or=1.05 23 flexibility 31 1.10 23 flexibility 33 reported 24 ( 25 or=1.05 25 or=1.05 29 ci=1.01 25 or=1.05 30 , 26 , 29 ci=1.01 27 95 29 ci=1.01 28 % 29 ci=1.01 29 ci=1.01 30 , 30 , 31 1.10 31 1.10 32 ) 33 reported 36 activity 34 greater 36 activity 35 physical 36 activity overweight and obesity increased with age ( p<0.01 ) , even after adjusting for workplace characteristics . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 17 . 1 overweight 2 and 2 and 3 obesity 2 and 10 , 4 increased 5 with 4 increased 10 , 5 with 6 age 6 age 8 p<0.01 7 ( 8 p<0.01 8 p<0.01 9 ) 10 , 11 even 11 even 12 after 12 after 13 adjusting 13 adjusting 14 for 14 for 16 characteristics 15 workplace 16 characteristics sleep deficiency ( or=1.56 , 95 % ci=1.15 , 2.12 ) and workplace harassment ( or=1.62 , 95 % ci=1.20 , 2.18 ) were also associated with obesity . 0 ###LEFT-WALL### 2 deficiency 0 ###LEFT-WALL### 26 associated 0 ###LEFT-WALL### 29 . 1 sleep 2 deficiency 2 deficiency 4 or=1.56 2 deficiency 14 harassment 2 deficiency 24 were 3 ( 4 or=1.56 4 or=1.56 5 , 5 , 14 harassment 6 95 7 % 7 % 14 harassment 8 ci=1.15 10 2.12 8 ci=1.15 12 and 9 , 10 2.12 10 2.12 11 ) 12 and 13 workplace 12 and 14 harassment 14 harassment 16 or=1.62 14 harassment 20 ci=1.20 14 harassment 22 2.18 14 harassment 23 ) 15 ( 16 or=1.62 16 or=1.62 17 , 17 , 20 ci=1.20 18 95 20 ci=1.20 19 % 20 ci=1.20 20 ci=1.20 21 , 21 , 22 2.18 22 2.18 23 ) 24 were 26 associated 25 also 26 associated 26 associated 27 with 27 with 28 obesity conclusions : these findings underscore the persistent impact of the work environment for workers of all ages . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 5 underscore 2 : 18 . 3 these 4 findings 4 findings 5 underscore 5 underscore 8 impact 6 the 8 impact 7 persistent 8 impact 8 impact 9 of 9 of 12 environment 10 the 12 environment 11 work 12 environment 12 environment 13 for 13 for 14 workers 14 workers 15 of 15 of 17 ages 16 all 17 ages based on these results , programs or policies aimed at improving the work environment , especially decision latitude , job flexibility , and workplace harassment should be included in the design of worksite - based health promotion interventions targeting physical activity or obesity . 0 ###LEFT-WALL### 7 or 0 ###LEFT-WALL### 9 aimed 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 44 . 1 based 2 on 1 based 5 , 1 based 7 or 2 on 4 results 3 these 4 results 6 programs 7 or 7 or 8 policies 7 or 9 aimed 9 aimed 10 at 10 at 11 improving 11 improving 14 environment 12 the 14 environment 13 work 14 environment 14 environment 18 latitude 15 , 16 especially 15 , 18 latitude 17 decision 18 latitude 18 latitude 21 flexibility 18 latitude 22 , 19 , 21 flexibility 20 job 21 flexibility 21 flexibility 22 , 23 and 25 harassment 23 and 28 included 24 workplace 25 harassment 25 harassment 26 should 26 should 27 be 27 be 28 included 28 included 29 in 29 in 42 or 30 the 31 design 31 design 32 of 31 design 42 or 32 of 38 interventions 33 worksite 34 - 33 worksite 38 interventions 35 based 36 health 36 health 38 interventions 37 promotion 38 interventions 38 interventions 39 targeting 39 targeting 41 activity 40 physical 41 activity 42 or 43 obesity though frailty status has recently been linked to poorer quality of life , the impact of income on this relationship has not previously been investigated . 0 ###LEFT-WALL### 15 impact 0 ###LEFT-WALL### 25 investigated 0 ###LEFT-WALL### 26 . 1 though 3 status 1 though 7 linked 1 though 13 , 1 though 15 impact 2 frailty 3 status 3 status 4 has 4 has 6 been 5 recently 6 been 6 been 7 linked 7 linked 8 to 8 to 10 quality 9 poorer 10 quality 10 quality 11 of 11 of 12 life 14 the 15 impact 15 impact 16 of 15 impact 21 has 16 of 17 income 17 income 18 on 18 on 20 relationship 19 this 20 relationship 21 has 22 not 21 has 24 been 23 previously 24 been 24 been 25 investigated data from a population - based panel study , the english longitudinal study of aging , on 3225 participants aged 65 - 79 years were analyzed cross [-] sectionally . 0 ###LEFT-WALL### 19 participants 0 ###LEFT-WALL### 20 aged 0 ###LEFT-WALL### 30 . 1 data 19 participants 2 from 4 population 2 from 16 , 2 from 19 participants 3 a 4 population 4 population 8 study 5 - 8 study 6 based 7 panel 7 panel 8 study 8 study 13 study 8 study 16 , 9 , 13 study 10 the 13 study 11 english 13 study 12 longitudinal 13 study 13 study 14 of 13 study 16 , 14 of 15 aging 17 on 18 3225 17 on 19 participants 19 participants 20 aged 20 aged 22 - 20 aged 29 sectionally 21 65 22 - 22 - 23 79 23 79 24 years 24 years 25 were 25 were 26 analyzed 27 cross 29 sectionally subjective well - being was assessed using the casp - 19 instrument , and levels of financial resources quantified using a range of questions about assets and income from a range of sources . 0 ###LEFT-WALL### 2 well 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 34 . 1 subjective 2 well 3 - 4 being 3 - 6 assessed 3 - 14 and 4 being 5 was 5 was 6 assessed 6 assessed 7 using 7 using 9 casp 8 the 9 casp 9 casp 11 19 9 casp 12 instrument 10 - 11 19 11 19 12 instrument 13 , 14 and 14 and 15 levels 14 and 19 quantified 15 levels 16 of 15 levels 19 quantified 16 of 18 resources 17 financial 18 resources 19 quantified 20 using 19 quantified 27 and 20 using 22 range 20 using 25 about 21 a 22 range 22 range 23 of 23 of 24 questions 26 assets 27 and 27 and 28 income 27 and 29 from 27 and 32 of 29 from 31 range 30 a 31 range 32 of 33 sources linear regression models were used to assess the relationship between frailty and well - being . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 14 - 1 linear 3 models 2 regression 3 models 3 models 12 and 4 were 5 used 4 were 12 and 5 used 6 to 5 used 7 assess 6 to 7 assess 7 assess 9 relationship 7 assess 10 between 8 the 9 relationship 10 between 11 frailty 12 and 13 well 14 - 15 being 14 - 16 . there was a significant negative correlation between frailty and well - being ; the correlation coefficient between fi and casp - 19 scores was - 0.58 . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 11 - 1 there 2 was 2 was 6 correlation 3 a 4 significant 3 a 6 correlation 4 significant 6 correlation 5 negative 6 correlation 6 correlation 7 between 7 between 9 and 8 frailty 9 and 9 and 10 well 11 - 12 being 11 - 13 ; 11 - 27 . 13 ; 16 coefficient 13 ; 24 was 14 the 16 coefficient 15 correlation 16 coefficient 16 coefficient 17 between 16 coefficient 24 was 17 between 23 scores 18 fi 19 and 19 and 20 casp 19 and 21 - 19 and 23 scores 22 19 23 scores 24 was 26 0.58 25 - 26 0.58 the relationship was robust to adjustment for sex , age , and relevant health behaviors ( smoking and physical activity ) and persisted when participants with depressive symptoms were excluded from analysis . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 33 . 1 the 2 relationship 2 relationship 22 and 3 was 4 robust 3 was 22 and 4 robust 5 to 4 robust 7 for 5 to 6 adjustment 7 for 12 and 8 sex 9 , 9 , 10 age 9 , 12 and 11 , 12 and 12 and 15 behaviors 12 and 18 and 13 relevant 14 health 14 health 15 behaviors 16 ( 18 and 17 smoking 18 and 18 and 20 activity 18 and 21 ) 19 physical 20 activity 22 and 23 persisted 22 and 24 when 24 when 25 participants 24 when 30 excluded 25 participants 26 with 25 participants 29 were 26 with 28 symptoms 27 depressive 28 symptoms 29 were 30 excluded 30 excluded 31 from 31 from 32 analysis those with greater financial resources reported better subjective well - being with evidence of a " dose - response " effect . 0 ###LEFT-WALL### 1 those 0 ###LEFT-WALL### 6 reported 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 22 . 1 those 2 with 1 those 6 reported 2 with 5 resources 3 greater 5 resources 4 financial 5 resources 6 reported 9 well 7 better 9 well 8 subjective 9 well 9 well 11 being 10 - 11 being 11 being 12 with 11 being 18 - 12 with 13 evidence 13 evidence 14 of 14 of 17 dose 15 a 16 " 15 a 17 dose 18 - 21 effect 19 response 20 " 19 response 21 effect the poorest participants in each frailty category had similar well - being to the most well - off [with] worse frailty status . 0 ###LEFT-WALL### 3 participants 0 ###LEFT-WALL### 8 had 0 ###LEFT-WALL### 23 . 1 the 2 poorest 1 the 3 participants 3 participants 4 in 3 participants 8 had 4 in 7 category 5 each 7 category 6 frailty 7 category 8 had 10 well 8 had 18 off 9 similar 10 well 10 well 12 being 11 - 12 being 12 being 13 to 12 being 17 - 13 to 16 well 14 the 15 most 15 most 16 well 18 off 22 status 20 worse 21 frailty 21 frailty 22 status hence , while the association between frailty and poorer subjective well - being is not significantly impacted by higher levels of wealth and income , financial resources may provide a partial buffer against the detrimental psychological effects of frailty . 0 ###LEFT-WALL### 13 being 0 ###LEFT-WALL### 17 impacted 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 40 . 1 hence 13 being 2 , 3 while 3 while 5 association 3 while 12 - 3 while 13 being 4 the 5 association 5 association 6 between 6 between 8 and 7 frailty 8 and 8 and 11 well 9 poorer 11 well 10 subjective 11 well 13 being 14 is 14 is 15 not 14 is 17 impacted 16 significantly 17 impacted 17 impacted 18 by 18 by 20 levels 19 higher 20 levels 20 levels 21 of 21 of 23 and 22 wealth 23 and 23 and 24 income 25 , 27 resources 25 , 29 provide 26 financial 27 resources 27 resources 28 may 28 may 29 provide 29 provide 32 buffer 29 provide 33 against 30 a 32 buffer 31 partial 32 buffer 33 against 37 effects 34 the 37 effects 35 detrimental 37 effects 36 psychological 37 effects 37 effects 38 of 38 of 39 frailty the impact of aging and physical capacity on coenzyme q10 ( q10 ) levels in human blood is unknown . 0 ###LEFT-WALL### 17 blood 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 20 . 1 the 2 impact 2 impact 3 of 2 impact 5 and 3 of 4 aging 5 and 7 capacity 5 and 8 on 5 and 10 q10 5 and 14 levels 5 and 17 blood 6 physical 7 capacity 8 on 9 coenzyme 10 q10 12 q10 10 q10 14 levels 11 ( 12 q10 12 q10 13 ) 14 levels 15 in 16 human 17 blood 17 blood 18 is 18 is 19 unknown plasma q10 is an important factor in cardiovascular diseases . 0 ###LEFT-WALL### 2 q10 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 10 . 1 plasma 2 q10 2 q10 3 is 3 is 6 factor 4 an 5 important 4 an 6 factor 5 important 6 factor 6 factor 7 in 7 in 9 diseases 8 cardiovascular 9 diseases to understand how physical activity in the elderly affects endogenous q10 levels in blood plasma , we studied a cohort of healthy [community] - dwelling people . 0 ###LEFT-WALL### 17 we 0 ###LEFT-WALL### 18 studied 0 ###LEFT-WALL### 27 . 1 to 2 understand 1 to 16 , 1 to 17 we 2 understand 3 how 3 how 5 activity 3 how 9 affects 4 physical 5 activity 5 activity 6 in 5 activity 9 affects 6 in 8 elderly 7 the 8 elderly 9 affects 12 levels 9 affects 13 in 10 endogenous 12 levels 11 q10 12 levels 13 in 15 plasma 14 blood 15 plasma 17 we 18 studied 18 studied 20 cohort 19 a 20 cohort 20 cohort 21 of 21 of 26 people 22 healthy 24 - 22 healthy 25 dwelling 25 dwelling 26 people volunteers were subjected to different tests of the functional fitness test battery including handgrip strength , six - minute walk , 30 s chair to stand , and time up and [go] tests . 0 ###LEFT-WALL### 1 volunteers 0 ###LEFT-WALL### 3 subjected 0 ###LEFT-WALL### 16 , 1 volunteers 2 were 2 were 3 subjected 3 subjected 4 to 4 to 6 tests 5 different 6 tests 6 tests 7 of 7 of 12 battery 8 the 12 battery 9 functional 10 fitness 10 fitness 11 test 11 test 12 battery 12 battery 13 including 13 including 15 strength 14 handgrip 15 strength 16 , 17 six 16 , 18 - 18 - 20 walk 18 - 21 , 18 - 34 . 19 minute 20 walk 21 , 23 s 21 , 24 chair 22 30 23 s 23 s 24 chair 24 chair 25 to 24 chair 31 and 25 to 28 and 26 stand 28 and 27 , 28 and 28 and 29 time 30 up 31 and 31 and 33 tests anthropometric characteristics , plasma q10 and lipid peroxidation ( mda ) levels were determined . 0 ###LEFT-WALL### 2 characteristics 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 15 . 1 anthropometric 2 characteristics 3 , 12 levels 3 , 13 were 4 plasma 12 levels 5 q10 6 and 6 and 8 peroxidation 6 and 10 mda 6 and 12 levels 7 lipid 8 peroxidation 9 ( 10 mda 10 mda 11 ) 12 levels 13 were 13 were 14 determined population was divided according to gender and fitness . 0 ###LEFT-WALL### 1 population 0 ###LEFT-WALL### 3 divided 0 ###LEFT-WALL### 9 . 1 population 2 was 2 was 3 divided 3 divided 5 to 4 according 5 to 5 to 7 and 6 gender 7 and 7 and 8 fitness we found that people showing higher levels of functional capacity presented lower levels of cholesterol and lipid peroxidation accompanied by higher levels of q10 in plasma . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 27 . 1 we 2 found 2 found 3 that 3 that 4 people 3 that 11 presented 4 people 5 showing 4 people 8 of 4 people 11 presented 5 showing 7 levels 6 higher 7 levels 8 of 10 capacity 9 functional 10 capacity 11 presented 16 and 11 presented 20 by 11 presented 25 in 12 lower 13 levels 13 levels 14 of 13 levels 16 and 14 of 15 cholesterol 16 and 18 peroxidation 16 and 19 accompanied 17 lipid 18 peroxidation 20 by 22 levels 21 higher 22 levels 22 levels 23 of 23 of 24 q10 25 in 26 plasma the ratio q10/cholesterol and q10/ldl increased in these people . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 10 . 1 the 2 ratio 2 ratio 3 q10/cholesterol 3 q10/cholesterol 4 and 4 and 5 q10/ldl 4 and 6 increased 6 increased 7 in 7 in 9 people 8 these 9 people no relationship was found when correlated to muscle strength or agility . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 12 . 1 no 2 relationship 2 relationship 3 was 3 was 4 found 4 found 5 when 5 when 6 correlated 6 correlated 7 to 7 to 10 or 8 muscle 9 strength 9 strength 10 or 10 or 11 agility on the other hand , obesity was related to lower q10 and higher mda levels in plasma affecting women more significantly . 0 ###LEFT-WALL### 6 obesity 0 ###LEFT-WALL### 10 lower 0 ###LEFT-WALL### 22 . 1 on 4 hand 1 on 5 , 1 on 6 obesity 2 the 3 other 3 other 4 hand 6 obesity 7 was 7 was 8 related 8 related 9 to 9 to 10 lower 10 lower 15 levels 11 q10 12 and 12 and 13 higher 12 and 15 levels 14 mda 15 levels 15 levels 16 in 16 in 17 plasma 17 plasma 18 affecting 18 affecting 19 women 18 affecting 21 significantly 20 more 21 significantly our data demonstrate for the first time that physical activity at advanced age can increase the levels of q10 and lower the levels of lipid peroxidation in plasma , probably reducing the progression of cardiovascular diseases . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 20 and 1 our 2 data 2 data 20 and 3 demonstrate 4 for 3 demonstrate 8 that 3 demonstrate 20 and 4 for 7 time 5 the 6 first 5 the 7 time 8 that 10 activity 8 that 15 increase 9 physical 10 activity 10 activity 11 at 10 activity 14 can 11 at 13 age 12 advanced 13 age 14 can 15 increase 15 increase 17 levels 16 the 17 levels 17 levels 18 of 18 of 19 q10 20 and 21 lower 21 lower 23 levels 21 lower 27 in 21 lower 31 reducing 22 the 23 levels 23 levels 24 of 24 of 26 peroxidation 25 lipid 26 peroxidation 27 in 28 plasma 29 , 31 reducing 30 probably 31 reducing 31 reducing 33 progression 31 reducing 37 . 32 the 33 progression 33 progression 34 of 34 of 36 diseases 35 cardiovascular 36 diseases cerebral ischemia caused by loss of blood supply to the brain during cardiac arrest or stroke are major causes of death and disability . 0 ###LEFT-WALL### 2 ischemia 0 ###LEFT-WALL### 17 are 0 ###LEFT-WALL### 24 . 1 cerebral 2 ischemia 2 ischemia 3 caused 2 ischemia 17 are 3 caused 4 by 3 caused 12 during 4 by 5 loss 5 loss 6 of 6 of 8 supply 7 blood 8 supply 8 supply 9 to 9 to 11 brain 10 the 11 brain 12 during 15 or 13 cardiac 14 arrest 14 arrest 15 or 15 or 16 stroke 17 are 19 causes 18 major 19 causes 19 causes 20 of 20 of 22 and 21 death 22 and 22 and 23 disability biological sex is an important factor in predicting vulnerability of the brain to an ischemic insult , with males being at higher risk for cardio - cerebrovascular events than females of the same age . 0 ###LEFT-WALL### 2 sex 0 ###LEFT-WALL### 3 is 1 biological 2 sex 2 sex 3 is 3 is 6 factor 4 an 6 factor 5 important 6 factor 6 factor 7 in 6 factor 18 with 7 in 8 predicting 8 predicting 9 vulnerability 9 vulnerability 10 of 9 vulnerability 13 to 10 of 12 brain 11 the 12 brain 13 to 16 insult 14 an 15 ischemic 14 an 16 insult 15 ischemic 16 insult 17 , 18 with 18 with 19 males 18 with 35 . 19 males 20 being 19 males 31 of 20 being 21 at 20 being 29 than 21 at 23 risk 22 higher 23 risk 23 risk 24 for 24 for 28 events 25 cardio 26 - 25 cardio 28 events 27 cerebrovascular 28 events 29 than 30 females 31 of 34 age 32 the 33 same 33 same 34 age however , relative incidence [of] stroke [between] [the] genders [appears] to normalize [at] advanced ages . 0 ###LEFT-WALL### 9 genders 0 ###LEFT-WALL### 14 advanced 0 ###LEFT-WALL### 16 . 1 however 2 , 1 however 9 genders 3 relative 4 incidence 4 incidence 9 genders 6 stroke 9 genders 9 genders 11 to 9 genders 12 normalize 9 genders 14 advanced 11 to 12 normalize 14 advanced 15 ages therefore , many scientists have focused on the mechanisms of sex differences in outcome following brain ischemic injury , with a particular emphasis on the role of sex steroids . 0 ###LEFT-WALL### 4 scientists 0 ###LEFT-WALL### 6 focused 1 therefore 2 , 1 therefore 4 scientists 3 many 4 scientists 4 scientists 5 have 5 have 6 focused 6 focused 7 on 6 focused 13 in 7 on 9 mechanisms 8 the 9 mechanisms 9 mechanisms 10 of 10 of 12 differences 11 sex 12 differences 13 in 18 injury 14 outcome 15 following 15 following 16 brain 16 brain 18 injury 17 ischemic 18 injury 18 injury 20 with 19 , 20 with 20 with 23 emphasis 20 with 30 . 21 a 22 particular 21 a 23 emphasis 22 particular 23 emphasis 23 emphasis 24 on 23 emphasis 27 of 24 on 26 role 25 the 26 role 27 of 29 steroids 28 sex 29 steroids the majority of studies indicate that female sex steroids , such as estrogen and progesterone , play important roles in the relative neuroprotection following cerebral ischemia observed in females . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 indicate 0 ###LEFT-WALL### 30 . 1 the 2 majority 2 majority 3 of 2 majority 4 studies 3 of 4 studies 4 studies 5 indicate 5 indicate 9 steroids 5 indicate 17 play 6 that 7 female 7 female 9 steroids 8 sex 9 steroids 9 steroids 12 as 9 steroids 17 play 10 , 12 as 11 such 12 as 12 as 14 and 12 as 16 , 13 estrogen 14 and 14 and 15 progesterone 17 play 19 roles 18 important 19 roles 19 roles 20 in 19 roles 24 following 19 roles 27 observed 19 roles 28 in 20 in 23 neuroprotection 21 the 23 neuroprotection 22 relative 23 neuroprotection 24 following 26 ischemia 25 cerebral 26 ischemia 28 in 29 females however , less is known about male sex steroids and brain damage . 0 ###LEFT-WALL### 3 less 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 13 . 1 however 2 , 1 however 3 less 3 less 4 is 4 is 5 known 5 known 6 about 6 about 10 and 7 male 8 sex 8 sex 9 steroids 9 steroids 10 and 10 and 12 damage 11 brain 12 damage this review describes the state of our knowledge of androgen - related contributions to neurological injury and recovery following cerebral ischemia that occurs following stroke . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 describes 0 ###LEFT-WALL### 11 - 1 this 2 review 2 review 3 describes 3 describes 5 state 4 the 5 state 5 state 6 of 6 of 8 knowledge 7 our 8 knowledge 8 knowledge 9 of 9 of 10 androgen 11 - 25 stroke 11 - 26 . 12 related 13 contributions 13 contributions 14 to 13 contributions 17 and 14 to 16 injury 15 neurological 16 injury 17 and 18 recovery 17 and 19 following 17 and 25 stroke 19 following 21 ischemia 20 cerebral 21 ischemia 21 ischemia 22 that 21 ischemia 23 occurs 22 that 23 occurs 24 following 25 stroke experimental studies examining the effects of castration , androgenic agonists and antagonists and aging provide valuable insights into the role of androgens in clinical outcome following cerebrovascular events . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 15 provide 0 ###LEFT-WALL### 29 . 1 experimental 2 studies 2 studies 3 examining 2 studies 6 of 2 studies 15 provide 3 examining 5 effects 4 the 5 effects 6 of 13 and 7 castration 8 , 8 , 10 agonists 8 , 11 and 9 androgenic 10 agonists 11 and 12 antagonists 11 and 13 and 13 and 14 aging 15 provide 17 insights 15 provide 18 into 15 provide 23 in 16 valuable 17 insights 18 into 20 role 19 the 20 role 20 role 21 of 21 of 22 androgens 23 in 28 events 24 clinical 25 outcome 25 outcome 26 following 26 following 28 events 27 cerebrovascular 28 events aging is marked by changes that affect organs and resident stem cell function . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 3 marked 0 ###LEFT-WALL### 14 . 1 aging 2 is 2 is 3 marked 3 marked 4 by 4 by 5 changes 5 changes 6 that 5 changes 7 affect 6 that 7 affect 7 affect 9 and 8 organs 9 and 9 and 13 function 10 resident 11 stem 11 stem 13 function 12 cell 13 function shorting of telomeres , dna damage , oxidative stress , deregulation of genes and proteins , impaired cell - cell communication , and an altered systemic environment cause the eventual demise of cells . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 16 , 1 shorting 2 of 1 shorting 4 , 2 of 3 telomeres 4 , 6 damage 4 , 7 , 5 dna 6 damage 7 , 9 stress 7 , 10 , 8 oxidative 9 stress 10 , 11 deregulation 10 , 14 and 11 deregulation 12 of 12 of 13 genes 14 and 15 proteins 16 , 18 cell 16 , 19 - 17 impaired 18 cell 19 - 23 and 19 - 28 cause 19 - 34 . 20 cell 21 communication 21 communication 23 and 22 , 23 and 23 and 27 environment 23 and 28 cause 24 an 27 environment 25 altered 27 environment 26 systemic 27 environment 28 cause 31 demise 29 the 31 demise 30 eventual 31 demise 31 demise 32 of 32 of 33 cells at the same time , reparative activities also decline . 0 ###LEFT-WALL### 7 activities 0 ###LEFT-WALL### 9 decline 0 ###LEFT-WALL### 10 . 1 at 4 time 1 at 5 , 1 at 7 activities 2 the 3 same 3 same 4 time 6 reparative 7 activities 7 activities 9 decline 8 also 9 decline it is intriguing to correlate aging with the decline of regenerative abilities . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 13 . 1 it 2 is 2 is 3 intriguing 3 intriguing 4 to 4 to 5 correlate 5 correlate 6 aging 5 correlate 7 with 7 with 9 decline 8 the 9 decline 9 decline 10 of 10 of 12 abilities 11 regenerative 12 abilities animal models with strong regenerative capabilities imply that aging processes might not be affecting regeneration . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 7 imply 0 ###LEFT-WALL### 16 . 1 animal 2 models 2 models 3 with 2 models 7 imply 3 with 6 capabilities 4 strong 6 capabilities 5 regenerative 6 capabilities 7 imply 8 that 8 that 9 aging 8 that 13 be 9 aging 10 processes 9 aging 11 might 11 might 12 not 11 might 13 be 13 be 14 affecting 14 affecting 15 regeneration in this review , we selectively present age - dependent changes in stem/progenitor cells that are vital for tissue homeostasis and repair . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 7 present 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 23 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 7 present 6 selectively 7 present 7 present 8 age 9 - 11 changes 10 dependent 11 changes 11 changes 12 in 12 in 14 cells 13 stem/progenitor 14 cells 14 cells 15 that 14 cells 16 are 15 that 16 are 16 are 17 vital 17 vital 18 for 18 for 21 and 19 tissue 20 homeostasis 20 homeostasis 21 and 21 and 22 repair in addition , the aging effect on regeneration following injury in organs such as lung [,] skeletal muscle , heart , nervous system , cochlear hair , lens , and liver are discussed . 0 ###LEFT-WALL### 30 and 0 ###LEFT-WALL### 33 discussed 0 ###LEFT-WALL### 34 . 1 in 2 addition 1 in 19 , 1 in 30 and 2 addition 6 effect 3 , 6 effect 4 the 6 effect 5 aging 6 effect 6 effect 7 on 6 effect 9 following 6 effect 19 , 7 on 8 regeneration 9 following 10 injury 9 following 11 in 11 in 12 organs 12 organs 14 as 13 such 14 as 14 as 18 muscle 15 lung 18 muscle 17 skeletal 18 muscle 20 heart 21 , 21 , 23 system 21 , 24 , 22 nervous 23 system 24 , 26 hair 24 , 27 , 25 cochlear 26 hair 27 , 28 lens 27 , 30 and 29 , 30 and 30 and 31 liver 30 and 32 are 32 are 33 discussed these tissues are also known for diseases such as heart attack , stroke , cognitive impairment , cataract , and hearing loss that occur mostly during aging in humans . 0 ###LEFT-WALL### 2 tissues 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 30 . 1 these 2 tissues 2 tissues 3 are 3 are 5 known 4 also 5 known 5 known 6 for 6 for 7 diseases 7 diseases 9 as 8 such 9 as 9 as 20 and 10 heart 11 attack 11 attack 12 , 12 , 13 stroke 12 , 14 , 14 , 16 impairment 14 , 17 , 15 cognitive 16 impairment 17 , 18 cataract 17 , 20 and 19 , 20 and 20 and 22 loss 20 and 23 that 20 and 24 occur 21 hearing 22 loss 23 that 24 occur 24 occur 25 mostly 24 occur 28 in 25 mostly 26 during 26 during 27 aging 28 in 29 humans conclusively , vertebrate regeneration declines with age with the loss [of] stem/progenitor cell function . 0 ###LEFT-WALL### 4 regeneration 0 ###LEFT-WALL### 5 declines 0 ###LEFT-WALL### 15 . 1 conclusively 2 , 1 conclusively 4 regeneration 3 vertebrate 4 regeneration 4 regeneration 5 declines 5 declines 6 with 5 declines 8 with 6 with 7 age 8 with 14 function 9 the 14 function 10 loss 14 function 12 stem/progenitor 14 function 13 cell 14 function future studies on improving the function of stem cells , along with studies in fish and amphibians where regeneration does not decline with age , will undoubtedly provide insights into both processes . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 28 provide 0 ###LEFT-WALL### 33 . 1 future 2 studies 2 studies 3 on 2 studies 26 will 3 on 4 improving 4 improving 6 function 5 the 6 function 6 function 7 of 6 function 12 with 7 of 9 cells 8 stem 9 cells 10 , 12 with 11 along 12 with 12 with 13 studies 12 with 25 , 13 studies 14 in 13 studies 18 where 14 in 16 and 15 fish 16 and 16 and 17 amphibians 18 where 19 regeneration 18 where 22 decline 19 regeneration 20 does 20 does 21 not 20 does 22 decline 22 decline 23 with 23 with 24 age 26 will 28 provide 27 undoubtedly 28 provide 28 provide 29 insights 28 provide 30 into 30 into 32 processes 31 both 32 processes objective : near - infrared spectroscopy ( nirs ) is commonly used to investigate continuous changes of brain activation and has excellent time [resolution] . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 3 near 2 : 4 - 4 - 6 spectroscopy 4 - 20 and 5 infrared 6 spectroscopy 6 spectroscopy 8 nirs 6 spectroscopy 20 and 7 ( 8 nirs 8 nirs 9 ) 10 is 12 used 10 is 20 and 11 commonly 12 used 12 used 13 to 12 used 14 investigate 13 to 14 investigate 14 investigate 16 changes 15 continuous 16 changes 16 changes 17 of 17 of 19 activation 18 brain 19 activation 20 and 21 has 20 and 23 time 22 excellent 23 time verbal fluency [task] ( vft ) is widely used as a neuropsychological test [of] frontal lobe function . 0 ###LEFT-WALL### 2 fluency 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 18 . 1 verbal 2 fluency 2 fluency 5 vft 2 fluency 7 is 4 ( 5 vft 5 vft 6 ) 7 is 8 widely 7 is 9 used 9 used 10 as 10 as 17 function 11 a 12 neuropsychological 11 a 17 function 12 neuropsychological 13 test 13 test 17 function 15 frontal 16 lobe 16 lobe 17 function the aim of this study was to investigate normal developmental change in frontal lobe function [during] vft performance using multi - channel nirs , specifically focusing on oxygenation hemoglobin ( oxyhb ) changes . 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 investigate 7 to 8 investigate 8 investigate 11 change 8 investigate 12 in 8 investigate 19 using 9 normal 11 change 10 developmental 11 change 12 in 18 performance 13 frontal 14 lobe 14 lobe 15 function 15 function 18 performance 17 vft 18 performance 19 using 23 nirs 19 using 26 focusing 20 multi 21 - 20 multi 23 nirs 22 channel 23 nirs 24 , 26 focusing 25 specifically 26 focusing 26 focusing 27 on 26 focusing 34 . 27 on 29 hemoglobin 28 oxygenation 29 hemoglobin 29 hemoglobin 33 changes 30 ( 33 changes 31 oxyhb 32 ) 31 oxyhb 33 changes 33 changes 34 . methods : the subjects were 9 adults and 37 childrens who were all healthy right - handed volunteers . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 subjects 2 : 5 were 3 the 4 subjects 4 subjects 5 were 5 were 8 and 6 9 8 and 7 adults 8 and 8 and 10 childrens 8 and 11 who 8 and 12 were 9 37 10 childrens 11 who 12 were 12 were 15 right 13 all 15 right 14 healthy 15 right 15 right 17 handed 16 - 17 handed 17 handed 18 volunteers 17 handed 19 . children were divided into four age groups ( group a , 6 - 8 years ; group b , 9 - 11 years ; group c , 12 - 14 years ; group d , 15 - 18 years ) . 0 ###LEFT-WALL### 1 children 0 ###LEFT-WALL### 3 divided 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 41 . 1 children 2 were 2 were 3 divided 3 divided 4 into 4 into 7 groups 5 four 7 groups 6 age 7 groups 7 groups 9 group 8 ( 9 group 9 group 10 a 9 group 12 6 9 group 13 - 11 , 12 6 12 6 13 - 13 - 15 years 13 - 16 ; 14 8 15 years 16 ; 17 group 16 ; 24 ; 17 group 18 b 17 group 21 - 19 , 21 - 20 9 21 - 21 - 23 years 21 - 24 ; 22 11 23 years 24 ; 25 group 24 ; 32 ; 25 group 26 c 25 group 29 - 27 , 29 - 28 12 29 - 29 - 31 years 29 - 32 ; 30 14 31 years 32 ; 33 group 33 group 34 d 33 group 37 - 35 , 37 - 36 15 37 - 37 - 39 years 37 - 40 ) 38 18 39 years the [[] oxyhb ] changes were measured with 22 channels of nirs during vft . 0 ###LEFT-WALL### 5 changes 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 15 . 1 the 5 changes 3 oxyhb 4 ] 3 oxyhb 5 changes 5 changes 6 were 6 were 7 measured 7 measured 8 with 7 measured 13 during 8 with 10 channels 9 22 10 channels 10 channels 11 of 11 of 12 nirs 13 during 14 vft we defined the frontopolar region as the region of interest for analysis , and calculated [the] z - score to compare the data between groups . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 18 - 1 we 14 and 2 defined 5 region 2 defined 6 as 2 defined 14 and 3 the 5 region 4 frontopolar 5 region 6 as 8 region 7 the 8 region 8 region 9 of 9 of 10 interest 10 interest 11 for 11 for 12 analysis 13 , 14 and 14 and 15 calculated 15 calculated 17 z 18 - 19 score 18 - 26 . 19 score 20 to 20 to 21 compare 21 compare 23 data 21 compare 24 between 22 the 23 data 24 between 25 groups results : the task performance changed with age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 . 1 results 2 : 2 : 5 performance 3 the 5 performance 4 task 5 performance 5 performance 6 changed 6 changed 7 with 7 with 8 age there were significant differences between group a and other groups . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 11 . 1 there 2 were 2 were 4 differences 3 significant 4 differences 4 differences 5 between 5 between 8 and 6 group 7 a 6 group 8 and 8 and 10 groups 9 other 10 groups [the] z - score [of] [ [oxyhb] []] also significantly increased with age , when comparing adults to groups a and b ..y the task performances decreased with time in all groups . 0 ###LEFT-WALL### 2 z 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 33 . 2 z 3 - 3 - 4 score 4 score 11 increased 4 score 15 when 6 [ 9 also 6 [ 11 increased 10 significantly 11 increased 11 increased 12 with 11 increased 14 , 12 with 13 age 15 when 16 comparing 16 comparing 17 adults 16 comparing 18 to 18 to 19 groups 19 groups 20 a 21 and 22 b 21 and 23 ..y 22 b 23 ..y 23 ..y 26 performances 24 the 26 performances 25 task 26 performances 26 performances 27 decreased 27 decreased 28 with 28 with 29 time 29 time 30 in 30 in 32 groups 31 all 32 groups in contrast [,] [ oxyhb ] only continued to increase in the adult group . 0 ###LEFT-WALL### 2 contrast 0 ###LEFT-WALL### 8 continued 0 ###LEFT-WALL### 15 . 1 in 2 contrast 2 contrast 5 oxyhb 2 contrast 8 continued 4 [ 5 oxyhb 5 oxyhb 6 ] 7 only 8 continued 8 continued 9 to 8 continued 10 increase 9 to 10 increase 10 increase 11 in 11 in 14 group 12 the 14 group 13 adult 14 group conclusion : the verbal retrieval functions begin to mature in early adolescence and continue to grow up to adulthood . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 6 functions 2 : 13 and 2 : 20 . 3 the 6 functions 4 verbal 5 retrieval 5 retrieval 6 functions 6 functions 13 and 7 begin 8 to 7 begin 9 mature 7 begin 13 and 8 to 9 mature 9 mature 10 in 10 in 12 adolescence 11 early 12 adolescence 13 and 14 continue 13 and 18 to 14 continue 15 to 14 continue 16 grow 15 to 16 grow 16 grow 17 up 18 to 19 adulthood the present study focuses on the role of frequency bias and expected value on the learning processes driving performance on the iowa gambling task ( igt ) in individuals between 5 and 89 years of age . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 37 . 1 the 3 study 2 present 3 study 3 study 11 and 4 focuses 5 on 4 focuses 11 and 5 on 7 role 6 the 7 role 7 role 8 of 8 of 10 bias 9 frequency 10 bias 11 and 12 expected 11 and 20 on 12 expected 13 value 13 value 14 on 13 value 18 driving 14 on 17 processes 15 the 17 processes 16 learning 17 processes 18 driving 19 performance 20 on 32 and 21 the 22 iowa 22 iowa 23 gambling 23 gambling 24 task 24 task 26 igt 25 ( 26 igt 26 igt 27 ) 26 igt 28 in 26 igt 30 between 26 igt 32 and 28 in 29 individuals 30 between 31 5 32 and 34 years 32 and 35 of 33 89 34 years 35 of 36 age as in previous studies , children performed poorly on the igt , were increasingly influenced by frequency of losses during learning , and constantly changed their decisions . 0 ###LEFT-WALL### 6 children 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 28 . 1 as 2 in 1 as 5 , 1 as 6 children 2 in 4 studies 3 previous 4 studies 6 children 12 , 7 performed 8 poorly 7 performed 9 on 7 performed 12 , 9 on 11 igt 10 the 11 igt 12 , 23 and 13 were 15 influenced 13 were 23 and 14 increasingly 15 influenced 15 influenced 16 by 15 influenced 20 during 16 by 17 frequency 17 frequency 18 of 18 of 19 losses 20 during 21 learning 22 , 23 and 23 and 25 changed 24 constantly 25 changed 25 changed 27 decisions 26 their 27 decisions [decision] - making strategies changed after childhood from erratic behavior to more consistent strategies that promoted expected value of deck choices . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 5 changed 0 ###LEFT-WALL### 22 . 2 - 3 making 3 making 4 strategies 3 making 5 changed 5 changed 6 after 5 changed 8 from 5 changed 11 to 6 after 7 childhood 8 from 10 behavior 9 erratic 10 behavior 11 to 14 strategies 12 more 13 consistent 13 consistent 14 strategies 14 strategies 15 that 14 strategies 16 promoted 15 that 16 promoted 16 promoted 18 value 17 expected 18 value 18 value 19 of 19 of 21 choices 20 deck 21 choices performance deficits as well as a loss frequency bias were found in older adults . 0 ###LEFT-WALL### 2 deficits 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 15 . 1 performance 2 deficits 2 deficits 5 as 2 deficits 10 were 3 as 4 well 4 well 5 as 5 as 9 bias 6 a 7 loss 6 a 9 bias 7 loss 9 bias 8 frequency 9 bias 10 were 11 found 11 found 12 in 12 in 14 adults 13 older 14 adults however , age - related deficits were distinct between children and older adults . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 14 . 1 however 2 , 1 however 3 age 3 age 7 were 4 - 5 related 5 related 6 deficits 5 related 7 were 7 were 8 distinct 8 distinct 9 between 9 between 11 and 10 children 11 and 11 and 13 adults 12 older 13 adults cognitive modeling analysis indicated that older adults were more likely to forget about recent outcomes and were more consistent than children when selecting decks . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 . 1 cognitive 2 modeling 1 cognitive 16 and 2 modeling 3 analysis 4 indicated 5 that 4 indicated 16 and 5 that 7 adults 5 that 8 were 6 older 7 adults 7 adults 8 were 8 were 9 more 8 were 10 likely 10 likely 11 to 10 likely 13 about 11 to 12 forget 13 about 15 outcomes 14 recent 15 outcomes 16 and 17 were 16 and 22 when 17 were 18 more 17 were 19 consistent 19 consistent 20 than 20 than 21 children 22 when 23 selecting 23 selecting 24 decks cognitive ability was associated with a modeling parameter for memory as well as igt performance , suggesting the involvement of a cognitive component in young and middle - aged adult decision making . 0 ###LEFT-WALL### 2 ability 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 33 . 1 cognitive 2 ability 2 ability 3 was 3 was 4 associated 4 associated 5 with 5 with 8 parameter 6 a 7 modeling 6 a 8 parameter 7 modeling 8 parameter 8 parameter 9 for 9 for 10 memory 10 memory 13 as 11 as 12 well 12 well 13 as 13 as 15 performance 14 igt 15 performance 16 , 17 suggesting 16 , 29 aged 17 suggesting 19 involvement 17 suggesting 29 aged 18 the 19 involvement 19 involvement 20 of 20 of 23 component 21 a 22 cognitive 21 a 23 component 22 cognitive 23 component 23 component 24 in 24 in 26 and 25 young 26 and 26 and 27 middle 26 and 28 - 29 aged 32 making 30 adult 32 making 31 decision 32 making the interactions of modeling parameters suggested that cognitive changes were the cause of lowered performance in older adults . 0 ###LEFT-WALL### 2 interactions 0 ###LEFT-WALL### 14 lowered 0 ###LEFT-WALL### 19 . 1 the 2 interactions 2 interactions 3 of 2 interactions 7 that 2 interactions 13 of 2 interactions 14 lowered 3 of 4 modeling 4 modeling 5 parameters 5 parameters 6 suggested 7 that 9 changes 7 that 10 were 8 cognitive 9 changes 9 changes 10 were 10 were 12 cause 11 the 12 cause 12 cause 13 of 14 lowered 15 performance 14 lowered 16 in 16 in 18 adults 17 older 18 adults these analyses suggest critical developments in decision processes during the adolescent years and decline in a cognitive process leading [to] decision - making deficits after age 60 . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 13 and 1 these 2 analyses 2 analyses 13 and 3 suggest 5 developments 3 suggest 6 in 3 suggest 9 during 3 suggest 13 and 4 critical 5 developments 6 in 8 processes 7 decision 8 processes 9 during 12 years 10 the 12 years 11 adolescent 12 years 13 and 14 decline 14 decline 15 in 14 decline 23 making 15 in 21 decision 16 a 17 cognitive 16 a 21 decision 17 cognitive 21 decision 18 process 19 leading 19 leading 21 decision 22 - 23 making 23 making 24 deficits 23 making 25 after 23 making 28 . 25 after 26 age 26 age 27 60 platelets have a dynamic functional repertoire that mediates hemostatic and inflammatory responses . 0 ###LEFT-WALL### 1 platelets 0 ###LEFT-WALL### 2 have 0 ###LEFT-WALL### 13 . 1 platelets 2 have 2 have 6 repertoire 3 a 4 dynamic 3 a 6 repertoire 4 dynamic 6 repertoire 5 functional 6 repertoire 6 repertoire 7 that 6 repertoire 8 mediates 7 that 8 mediates 8 mediates 12 responses 9 hemostatic 10 and 10 and 11 inflammatory 10 and 12 responses many of these functions are altered in older adults , promoting a prothrombotic , proinflammatory milieu and contributing to risk of adverse clinical events . 0 ###LEFT-WALL### 4 functions 0 ###LEFT-WALL### 6 altered 1 many 2 of 1 many 4 functions 2 of 4 functions 3 these 4 functions 4 functions 5 are 5 are 6 altered 6 altered 7 in 7 in 9 adults 8 older 9 adults 9 adults 11 promoting 10 , 11 promoting 11 promoting 17 and 11 promoting 19 to 11 promoting 25 . 12 a 13 prothrombotic 12 a 16 milieu 13 prothrombotic 14 , 13 prothrombotic 16 milieu 15 proinflammatory 16 milieu 16 milieu 17 and 17 and 18 contributing 19 to 20 risk 20 risk 21 of 21 of 24 events 22 adverse 24 events 23 clinical 24 events drawing primarily from human studies , this review summarizes important aspects of aging - related changes in platelets . 0 ###LEFT-WALL### 8 review 0 ###LEFT-WALL### 9 summarizes 0 ###LEFT-WALL### 15 related 1 drawing 2 primarily 1 drawing 6 , 1 drawing 8 review 2 primarily 3 from 3 from 5 studies 4 human 5 studies 7 this 8 review 8 review 9 summarizes 9 summarizes 11 aspects 10 important 11 aspects 11 aspects 12 of 12 of 13 aging 14 - 15 related 15 related 16 changes 15 related 17 in 15 related 19 . 17 in 18 platelets the relationship between altered platelet functions and thrombotic and inflammatory disorders in older adults is highlighted . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 16 highlighted 0 ###LEFT-WALL### 17 . 1 the 2 relationship 2 relationship 3 between 2 relationship 15 is 3 between 7 and 4 altered 6 functions 5 platelet 6 functions 6 functions 7 and 7 and 11 disorders 7 and 12 in 8 thrombotic 9 and 9 and 10 inflammatory 9 and 11 disorders 12 in 14 adults 13 older 14 adults 15 is 16 highlighted established [and] developing antiplatelet therapies for the treatment of thrombotic and inflammatory disorders are also discussed in light of these data . 0 ###LEFT-WALL### 5 therapies 0 ###LEFT-WALL### 16 discussed 0 ###LEFT-WALL### 22 . 1 established 5 therapies 3 developing 5 therapies 4 antiplatelet 5 therapies 5 therapies 6 for 5 therapies 9 of 5 therapies 14 are 6 for 8 treatment 7 the 8 treatment 9 of 13 disorders 10 thrombotic 11 and 11 and 12 inflammatory 11 and 13 disorders 14 are 16 discussed 15 also 16 discussed 16 discussed 17 in 17 in 18 light 18 light 19 of 19 of 21 data 20 these 21 data the current study investigated [how] night - to [-] night variations in sleep duration relate to affective well - being the next morning as well as [how] the relationship varies for people of different ages . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 19 - 1 the 3 study 2 current 3 study 3 study 4 investigated 4 investigated 6 night 4 investigated 8 to 7 - 8 to 8 to 10 night 8 to 19 - 10 night 11 variations 10 night 15 relate 11 variations 12 in 11 variations 15 relate 12 in 14 duration 13 sleep 14 duration 15 relate 16 to 16 to 18 well 17 affective 18 well 19 - 20 being 19 - 30 varies 19 - 36 . 20 being 23 morning 20 being 26 as 20 being 30 varies 21 the 22 next 22 next 23 morning 24 as 25 well 25 well 26 as 26 as 29 relationship 28 the 29 relationship 30 varies 31 for 31 for 32 people 32 people 33 of 33 of 35 ages 34 different 35 ages using an experience sampling approach , 397 participants aged 12 to 88 years reported their sleep duration and their momentary affect on 9 mornings , on average . 0 ###LEFT-WALL### 8 participants 0 ###LEFT-WALL### 9 aged 1 using 5 approach 1 using 6 , 1 using 8 participants 2 an 5 approach 3 experience 4 sampling 4 sampling 5 approach 7 397 8 participants 8 participants 9 aged 9 aged 11 to 9 aged 22 on 10 12 11 to 11 to 12 88 12 88 13 years 13 years 14 reported 14 reported 16 sleep 15 their 16 sleep 16 sleep 18 and 16 sleep 21 affect 17 duration 18 and 18 and 20 momentary 18 and 21 affect 19 their 20 momentary 22 on 24 mornings 23 9 24 mornings 24 mornings 27 average 25 , 27 average 26 on 27 average 27 average 28 . associations between sleep duration during the previous night and morning affect differed depending on the participants ' age . 0 ###LEFT-WALL### 1 associations 0 ###LEFT-WALL### 12 differed 0 ###LEFT-WALL### 19 . 1 associations 2 between 1 associations 12 differed 2 between 3 sleep 3 sleep 9 and 3 sleep 11 affect 4 duration 5 during 4 duration 9 and 5 during 8 night 6 the 8 night 7 previous 8 night 9 and 10 morning 9 and 11 affect 12 differed 13 depending 12 differed 14 on 14 on 18 age 15 the 16 participants 16 participants 17 ' 17 ' 18 age for adolescents , for example , affective well - being in the morning [was] worse [the] shorter participants had slept the previous night . 0 ###LEFT-WALL### 10 being 0 ###LEFT-WALL### 24 . 1 for 8 well 1 for 9 - 1 for 10 being 2 adolescents 8 well 3 , 5 example 4 for 5 example 5 example 6 , 5 example 7 affective 7 affective 8 well 10 being 11 in 10 being 19 had 11 in 18 participants 12 the 18 participants 13 morning 18 participants 15 worse 18 participants 17 shorter 18 participants 19 had 20 slept 20 slept 23 night 21 the 22 previous 22 previous 23 night for adults aged over 20 years , however , affective well - being was worse following nights with shorter or longer than average sleep duration . 0 ###LEFT-WALL### 13 being 0 ###LEFT-WALL### 14 was 0 ###LEFT-WALL### 26 . 1 for 2 adults 1 for 12 - 1 for 13 being 2 adults 3 aged 2 adults 11 well 3 aged 4 over 3 aged 8 however 4 over 6 years 5 20 6 years 7 , 8 however 8 however 9 , 9 , 11 well 10 affective 11 well 11 well 12 - 13 being 14 was 14 was 17 nights 15 worse 16 following 16 following 17 nights 17 nights 18 with 18 with 25 duration 19 shorter 20 or 20 or 21 longer 20 or 25 duration 21 longer 22 than 22 than 24 sleep 23 average 24 sleep this effect [was] more pronounced the older [the] participants were . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 11 . 1 this 2 effect 2 effect 4 more 2 effect 5 pronounced 2 effect 10 were 4 more 5 pronounced 5 pronounced 9 participants 6 the 9 participants 7 older 9 participants the findings demonstrate that the importance of sleep duration for daily affective [well] - being is better understood when considering the age of the sleeper . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 26 . 1 the 2 findings 2 findings 3 demonstrate 3 demonstrate 4 that 4 that 6 importance 4 that 18 understood 5 the 6 importance 6 importance 7 of 6 importance 16 is 7 of 9 duration 8 sleep 9 duration 9 duration 10 for 10 for 15 being 11 daily 15 being 12 affective 14 - 12 affective 15 being 16 is 18 understood 17 better 18 understood 18 understood 19 when 19 when 20 considering 20 considering 22 age 21 the 22 age 22 age 23 of 23 of 25 sleeper 24 the 25 sleeper in adults , but not adolescents , not only sleeping less but also sleeping more than one 's average can be associated with lower affective well - being . 0 ###LEFT-WALL### 19 average 0 ###LEFT-WALL### 22 associated 0 ###LEFT-WALL### 27 - 1 in 2 adults 1 in 19 average 2 adults 4 but 3 , 4 but 4 but 5 not 4 but 6 adolescents 4 but 7 , 8 not 10 sleeping 8 not 19 average 9 only 10 sleeping 10 sleeping 11 less 10 sleeping 12 but 12 but 14 sleeping 13 also 14 sleeping 15 more 16 than 16 than 17 one 17 one 18 's 18 's 19 average 19 average 20 can 20 can 21 be 21 be 22 associated 22 associated 23 with 23 with 26 well 24 lower 26 well 25 affective 26 well 27 - 28 being 27 - 29 . primary care providers are expected to address the sexual health concerns of older adults . 0 ###LEFT-WALL### 3 providers 0 ###LEFT-WALL### 5 expected 0 ###LEFT-WALL### 15 . 1 primary 2 care 2 care 3 providers 3 providers 4 are 4 are 5 expected 5 expected 6 to 5 expected 7 address 6 to 7 address 7 address 11 concerns 8 the 11 concerns 9 sexual 10 health 10 health 11 concerns 11 concerns 12 of 12 of 14 adults 13 older 14 adults this study aimed to assess knowledge of aging sexuality and adequacy of formal sexual health education in a sample of u.s . physicians and nurse practitioners in primary care . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 aimed 0 ###LEFT-WALL### 22 . 1 this 2 study 2 study 3 aimed 3 aimed 4 to 3 aimed 5 assess 4 to 5 assess 5 assess 6 knowledge 5 assess 17 in 6 knowledge 7 of 6 knowledge 12 of 7 of 10 and 8 aging 9 sexuality 9 sexuality 10 and 10 and 11 adequacy 12 of 16 education 13 formal 15 health 14 sexual 15 health 15 health 16 education 17 in 19 sample 18 a 19 sample 19 sample 20 of 20 of 21 u.s 22 . 24 and 22 . 30 . 23 physicians 24 and 24 and 26 practitioners 24 and 27 in 25 nurse 26 practitioners 27 in 29 care 28 primary 29 care response [rate] was 24.9 % ( n = 278 ) . 0 ###LEFT-WALL### 1 response 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 11 . 1 response 3 was 3 was 5 % 4 24.9 5 % 5 % 8 = 6 ( 8 = 7 n 8 = 8 = 9 278 8 = 10 ) knowledge scores reflected good knowledge ; however , only 3 % of the sample felt that they had adequate knowledge of older adult sexuality . 0 ###LEFT-WALL### 1 knowledge 0 ###LEFT-WALL### 2 scores 0 ###LEFT-WALL### 6 ; 0 ###LEFT-WALL### 25 . 1 knowledge 2 scores 2 scores 5 knowledge 3 reflected 5 knowledge 4 good 5 knowledge 6 ; 11 % 6 ; 15 felt 7 however 8 , 7 however 11 % 9 only 10 3 10 3 11 % 11 % 12 of 11 % 15 felt 12 of 14 sample 13 the 14 sample 15 felt 16 that 16 that 17 they 16 that 18 had 17 they 18 had 18 had 20 knowledge 19 adequate 20 knowledge 20 knowledge 21 of 21 of 24 sexuality 22 older 23 adult 23 adult 24 sexuality training was found to be adequate for 11 % of the sample . 0 ###LEFT-WALL### 1 training 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 13 . 1 training 2 was 2 was 3 found 3 found 4 to 4 to 5 be 5 be 6 adequate 6 adequate 7 for 7 for 9 % 8 11 9 % 9 % 10 of 10 of 12 sample 11 the 12 sample u.s . providers in primary care are interested in learning more about aging sexuality but feel ill - prepared for it . 0 ###LEFT-WALL### 1 u.s 0 ###LEFT-WALL### 2 . 2 . 3 providers 2 . 15 but 3 providers 4 in 3 providers 7 are 4 in 6 care 5 primary 6 care 7 are 15 but 8 interested 9 in 8 interested 11 more 8 interested 12 about 8 interested 14 sexuality 8 interested 15 but 9 in 10 learning 12 about 13 aging 15 but 16 feel 16 feel 17 ill 17 ill 19 prepared 18 - 19 prepared 19 prepared 20 for 19 prepared 22 . 20 for 21 it although the number of older adults is rapidly expanding , the number of healthcare professionals trained in geriatrics is small and declining . 0 ###LEFT-WALL### 12 number 0 ###LEFT-WALL### 19 is 0 ###LEFT-WALL### 23 . 1 although 3 number 1 although 9 expanding 1 although 12 number 2 the 3 number 3 number 4 of 3 number 7 is 4 of 6 adults 5 older 6 adults 7 is 9 expanding 8 rapidly 9 expanding 9 expanding 10 , 11 the 12 number 12 number 13 of 12 number 16 trained 12 number 19 is 13 of 15 professionals 14 healthcare 15 professionals 16 trained 17 in 17 in 18 geriatrics 19 is 21 and 20 small 21 and 21 and 22 declining the reasons are multifaceted , but because responsibility for training such professionals resides largely in academic health centers ( ahcs ) , their support for geriatrics is critical . 0 ###LEFT-WALL### 2 reasons 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 6 but 0 ###LEFT-WALL### 29 . 1 the 2 reasons 2 reasons 3 are 3 are 4 multifaceted 5 , 6 but 6 but 24 support 6 but 27 is 7 because 8 responsibility 7 because 13 resides 7 because 22 , 7 because 24 support 8 responsibility 9 for 8 responsibility 13 resides 9 for 10 training 10 training 12 professionals 11 such 12 professionals 13 resides 14 largely 14 largely 15 in 15 in 18 centers 16 academic 17 health 17 health 18 centers 18 centers 20 ahcs 19 ( 20 ahcs 20 ahcs 21 ) 23 their 24 support 24 support 25 for 24 support 27 is 25 for 26 geriatrics 27 is 28 critical as ahcs face increasing financial pressure , many are seeking metrics to measure productivity and the relative value unit ( rvu ) may be the one most commonly selected . 0 ###LEFT-WALL### 8 many 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 30 . 1 as 6 pressure 1 as 7 , 1 as 8 many 2 ahcs 4 increasing 3 face 4 increasing 4 increasing 6 pressure 5 financial 6 pressure 8 many 9 are 9 are 10 seeking 10 seeking 11 metrics 11 metrics 12 to 12 to 14 productivity 13 measure 14 productivity 15 and 21 rvu 15 and 24 be 16 the 21 rvu 17 relative 18 value 18 value 19 unit 19 unit 21 rvu 20 ( 21 rvu 21 rvu 22 ) 21 rvu 23 may 23 may 24 be 24 be 26 one 25 the 26 one 26 one 27 most 26 one 29 selected 27 most 29 selected 28 commonly 29 selected yet little is known about the rvu 's effect on geriatric programs . 0 ###LEFT-WALL### 1 yet 0 ###LEFT-WALL### 4 known 0 ###LEFT-WALL### 13 . 1 yet 2 little 2 little 3 is 3 is 4 known 4 known 5 about 4 known 10 on 5 about 9 effect 6 the 7 rvu 7 rvu 8 's 8 's 9 effect 10 on 12 programs 11 geriatric 12 programs review of the literature and a survey of the leaders of the association of directors of geriatric academic programs suggest that the advantages of an rvu [-] based metric are likely eclipsed by its negative impact on the care of older adults , the ability of academic geriatrics to accomplish its mission , and even the survival of geriatrics . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 20 suggest 0 ###LEFT-WALL### 60 . 1 review 2 of 1 review 5 and 2 of 4 literature 3 the 4 literature 5 and 7 survey 5 and 8 of 5 and 14 of 5 and 20 suggest 6 a 7 survey 8 of 10 leaders 9 the 10 leaders 10 leaders 11 of 11 of 13 association 12 the 13 association 14 of 19 programs 15 directors 16 of 15 directors 18 academic 16 of 17 geriatric 18 academic 19 programs 20 suggest 21 that 21 that 23 advantages 21 that 30 are 22 the 23 advantages 23 advantages 24 of 23 advantages 30 are 24 of 26 rvu 25 an 26 rvu 26 rvu 28 based 28 based 29 metric 30 are 54 and 31 likely 32 eclipsed 31 likely 54 and 32 eclipsed 33 by 33 by 36 impact 34 its 36 impact 35 negative 36 impact 36 impact 37 on 36 impact 40 of 37 on 39 care 38 the 39 care 40 of 42 adults 41 older 42 adults 42 adults 45 ability 43 , 45 ability 44 the 45 ability 45 ability 46 of 45 ability 49 to 45 ability 50 accomplish 45 ability 53 , 46 of 48 geriatrics 47 academic 48 geriatrics 49 to 50 accomplish 50 accomplish 52 mission 51 its 52 mission 54 and 55 even 54 and 57 survival 56 the 57 survival 57 survival 58 of 58 of 59 geriatrics if the rvu is to continue to be used as the index of productivity , it should be modified -- by reweighting its codes ( [or] by adding new ones ) -- and complemented by interventions to ensure patient access , care quality , and efficiency . 0 ###LEFT-WALL### 16 it 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 41 , 0 ###LEFT-WALL### 47 . 1 if 3 rvu 1 if 9 used 1 if 16 it 2 the 3 rvu 3 rvu 4 is 4 is 5 to 4 is 9 used 5 to 6 continue 6 continue 7 to 6 continue 8 be 7 to 8 be 10 as 12 index 10 as 15 , 10 as 16 it 11 the 12 index 12 index 13 of 13 of 14 productivity 16 it 33 and 17 should 18 be 17 should 33 and 18 be 19 modified 19 modified 21 by 20 -- 21 by 21 by 22 reweighting 21 by 32 -- 22 reweighting 24 codes 22 reweighting 27 by 23 its 24 codes 25 ( 27 by 27 by 28 adding 27 by 31 ) 28 adding 30 ones 29 new 30 ones 32 -- 33 and 33 and 34 complemented 33 and 35 by 33 and 40 access 35 by 36 interventions 36 interventions 37 to 36 interventions 38 ensure 37 to 38 ensure 39 patient 40 access 41 , 45 and 42 care 43 quality 43 quality 45 and 44 , 45 and 45 and 46 efficiency because an alternative [metric] , such as a patient - based value unit may be preferable , this article describes the principles on which one might be based . 0 ###LEFT-WALL### 13 unit 0 ###LEFT-WALL### 15 be 0 ###LEFT-WALL### 17 , 1 because 3 alternative 1 because 11 based 1 because 13 unit 2 an 3 alternative 3 alternative 7 as 3 alternative 11 based 5 , 7 as 6 such 7 as 7 as 9 patient 7 as 10 - 8 a 9 patient 11 based 12 value 13 unit 14 may 14 may 15 be 15 be 16 preferable 17 , 19 article 17 , 20 describes 18 this 19 article 19 article 20 describes 20 describes 22 principles 21 the 22 principles 22 principles 23 on 23 on 24 which 23 on 25 one 23 on 28 based 25 one 26 might 26 might 27 be 27 be 28 based 28 based 29 . regardless , urgent action is required by all stakeholders to address this issue . 0 ###LEFT-WALL### 4 action 0 ###LEFT-WALL### 6 required 0 ###LEFT-WALL### 14 . 1 regardless 2 , 1 regardless 4 action 3 urgent 4 action 4 action 5 is 5 is 6 required 6 required 7 by 6 required 10 to 6 required 11 address 7 by 9 stakeholders 8 all 9 stakeholders 10 to 11 address 11 address 13 issue 12 this 13 issue without it , the future of academic geriatrics -- and [with] it the innovative care models , research , and training the nation needs to improve care and bend the cost curve -- will be [difficult] [if] not impossible to sustain . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 32 curve 0 ###LEFT-WALL### 33 -- 1 without 10 and 1 without 20 and 2 it 3 , 3 , 5 future 3 , 10 and 4 the 5 future 5 future 6 of 6 of 8 geriatrics 7 academic 8 geriatrics 9 -- 10 and 10 and 12 it 13 the 16 models 14 innovative 15 care 15 care 16 models 16 models 17 , 17 , 18 research 17 , 20 and 19 , 20 and 20 and 21 training 20 and 23 nation 20 and 28 and 20 and 32 curve 22 the 23 nation 23 nation 24 needs 24 needs 25 to 24 needs 28 and 25 to 28 and 26 improve 27 care 26 improve 28 and 28 and 29 bend 29 bend 31 cost 30 the 31 cost 33 -- 34 will 33 -- 35 be 33 -- 42 . 34 will 35 be 35 be 38 not 35 be 39 impossible 38 not 39 impossible 39 impossible 40 to 39 impossible 41 sustain 40 to 41 sustain significance : aging is a multi - factorial process that may be associated with several functional and structural deficits which can evolve into degenerative diseases . 0 ###LEFT-WALL### 1 significance 0 ###LEFT-WALL### 2 : 2 : 3 aging 2 : 4 is 2 : 26 . 3 aging 4 is 4 is 9 process 4 is 14 with 5 a 6 multi 5 a 9 process 6 multi 7 - 6 multi 9 process 8 factorial 9 process 9 process 10 that 9 process 11 may 10 that 11 may 11 may 12 be 12 be 13 associated 14 with 19 deficits 15 several 19 deficits 16 functional 17 and 17 and 18 structural 17 and 19 deficits 19 deficits 20 which 19 deficits 21 can 20 which 21 can 21 can 22 evolve 22 evolve 23 into 23 into 25 diseases 24 degenerative 25 diseases in this review , we present data that may depict an expanded view of molecular aging theories , beginning with the idea that reactive oxygen species ( ros ) are the major effectors in this process . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 present 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 37 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 present 6 present 7 data 7 data 8 that 7 data 9 may 8 that 9 may 9 may 10 depict 10 depict 13 view 11 an 13 view 12 expanded 13 view 13 view 14 of 14 of 17 theories 15 molecular 17 theories 16 aging 17 theories 18 , 19 beginning 18 , 30 are 19 beginning 20 with 19 beginning 30 are 20 with 22 idea 20 with 26 species 21 the 22 idea 23 that 24 reactive 24 reactive 25 oxygen 25 oxygen 26 species 26 species 28 ros 27 ( 28 ros 28 ros 29 ) 30 are 33 effectors 31 the 33 effectors 32 major 33 effectors 33 effectors 34 in 34 in 36 process 35 this 36 process in addition , we have correlated the importance of autophagy as a neuroprotective mechanism and discussed a link between age - related molecules , ca ( 2+ ) signaling , and oxidative stress . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 22 related 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 34 . 1 in 2 addition 1 in 3 , 1 in 4 we 4 we 15 and 5 have 6 correlated 5 have 15 and 6 correlated 8 importance 6 correlated 11 as 7 the 8 importance 8 importance 9 of 9 of 10 autophagy 11 as 14 mechanism 12 a 13 neuroprotective 12 a 14 mechanism 13 neuroprotective 14 mechanism 15 and 16 discussed 15 and 19 between 16 discussed 18 link 17 a 18 link 19 between 20 age 21 - 22 related 22 related 23 molecules 24 , 31 and 25 ca 27 2+ 25 ca 29 signaling 25 ca 31 and 26 ( 27 2+ 27 2+ 28 ) 30 , 31 and 31 and 33 stress 32 oxidative 33 stress recent advances : there is evidence suggesting that alterations in ca ( 2+ ) homeostasis , including mitochondrial ca ( 2+ ) overload and alterations in electron transport chain ( etc ) complexes , which increase cell vulnerability , are linked to oxidative stress in aging . 0 ###LEFT-WALL### 2 advances 0 ###LEFT-WALL### 3 : 1 recent 2 advances 3 : 4 there 3 : 5 is 3 : 24 and 3 : 47 . 4 there 5 is 5 is 7 suggesting 6 evidence 7 suggesting 7 suggesting 8 that 7 suggesting 23 overload 8 that 9 alterations 8 that 23 overload 9 alterations 10 in 9 alterations 23 overload 10 in 11 ca 11 ca 15 homeostasis 12 ( 15 homeostasis 13 2+ 14 ) 13 2+ 15 homeostasis 15 homeostasis 17 including 15 homeostasis 22 ) 16 , 17 including 17 including 19 ca 17 including 22 ) 18 mitochondrial 19 ca 19 ca 21 2+ 20 ( 21 2+ 21 2+ 22 ) 24 and 25 alterations 24 and 41 linked 25 alterations 26 in 25 alterations 29 chain 25 alterations 33 complexes 25 alterations 35 which 25 alterations 40 are 26 in 28 transport 27 electron 28 transport 29 chain 31 etc 29 chain 33 complexes 30 ( 31 etc 31 etc 32 ) 34 , 35 which 35 which 36 increase 35 which 39 , 36 increase 38 vulnerability 37 cell 38 vulnerability 40 are 41 linked 41 linked 42 to 41 linked 45 in 42 to 44 stress 43 oxidative 44 stress 45 in 46 aging as much as ca ( 2+ ) signaling is altered in aged cells , excess ros can be produced due to an ineffective coupling of mitochondrial respiration . 0 ###LEFT-WALL### 16 ros 0 ###LEFT-WALL### 19 produced 0 ###LEFT-WALL### 28 . 1 as 2 much 1 as 10 altered 1 as 16 ros 2 much 3 as 2 much 8 signaling 2 much 9 is 3 as 4 ca 4 ca 6 2+ 5 ( 6 2+ 6 2+ 7 ) 9 is 10 altered 10 altered 11 in 10 altered 14 , 10 altered 15 excess 11 in 13 cells 12 aged 13 cells 16 ros 17 can 17 can 18 be 18 be 19 produced 19 produced 21 to 20 due 21 to 21 to 24 coupling 22 an 24 coupling 23 ineffective 24 coupling 24 coupling 25 of 25 of 27 respiration 26 mitochondrial 27 respiration damaged mitochondria might not be removed by the macroautophagic system , which is hampered in aging by lipofuscin accumulation , boosting ros generation , damaging dna , and , ultimately , leading to apoptosis . 0 ###LEFT-WALL### 2 mitochondria 0 ###LEFT-WALL### 6 removed 1 damaged 2 mitochondria 2 mitochondria 3 might 3 might 4 not 3 might 5 be 5 be 6 removed 6 removed 7 by 6 removed 21 boosting 6 removed 25 damaging 7 by 10 system 8 the 10 system 9 macroautophagic 10 system 10 system 12 which 11 , 12 which 12 which 13 is 12 which 20 , 13 is 14 hampered 14 hampered 15 in 15 in 16 aging 16 aging 17 by 17 by 19 accumulation 18 lipofuscin 19 accumulation 20 , 21 boosting 21 boosting 23 generation 21 boosting 24 , 22 ros 23 generation 24 , 25 damaging 25 damaging 28 and 25 damaging 33 to 25 damaging 35 . 26 dna 28 and 27 , 28 and 28 and 30 ultimately 28 and 32 leading 29 , 30 ultimately 30 ultimately 31 , 33 to 34 apoptosis critical issues : this process can lead to altered protein expression ( such as p53 , sirt1 , and igf - 1 ) and progress to cell death . 0 ###LEFT-WALL### 2 issues 0 ###LEFT-WALL### 3 : 1 critical 2 issues 3 : 24 and 3 : 29 . 4 this 7 lead 5 process 6 can 6 can 7 lead 7 lead 8 to 7 lead 19 and 8 to 11 expression 9 altered 10 protein 10 protein 11 expression 11 expression 14 as 12 ( 14 as 13 such 14 as 14 as 15 p53 14 as 18 , 15 p53 17 sirt1 16 , 17 sirt1 17 sirt1 18 , 18 , 19 and 19 and 20 igf 19 and 22 1 19 and 24 and 21 - 22 1 22 1 23 ) 24 and 25 progress 24 and 26 to 26 to 28 death 27 cell 28 death this cycle can lead to increased cell vulnerability in aging and contribute to an increased susceptibility to degenerative processes . 0 ###LEFT-WALL### 2 cycle 0 ###LEFT-WALL### 4 lead 0 ###LEFT-WALL### 20 . 1 this 2 cycle 2 cycle 3 can 3 can 4 lead 4 lead 5 to 5 to 11 and 6 increased 8 vulnerability 6 increased 9 in 6 increased 11 and 7 cell 8 vulnerability 9 in 10 aging 11 and 12 contribute 12 contribute 13 to 12 contribute 17 to 13 to 16 susceptibility 14 an 16 susceptibility 15 increased 16 susceptibility 17 to 19 processes 18 degenerative 19 processes future directions : a better understanding of ca ( 2+ ) signaling and molecular aging alterations is important for preventing apoptosis in age - related diseases . 0 ###LEFT-WALL### 2 directions 0 ###LEFT-WALL### 20 preventing 0 ###LEFT-WALL### 25 related 1 future 2 directions 2 directions 3 : 3 : 6 understanding 4 a 6 understanding 5 better 6 understanding 6 understanding 7 of 6 understanding 15 aging 6 understanding 20 preventing 7 of 13 and 8 ca 10 2+ 8 ca 12 signaling 8 ca 13 and 9 ( 10 2+ 10 2+ 11 ) 13 and 14 molecular 15 aging 16 alterations 15 aging 17 is 17 is 18 important 18 important 19 for 19 for 20 preventing 20 preventing 21 apoptosis 20 preventing 22 in 22 in 23 age 24 - 25 related 25 related 26 diseases 25 related 27 . in addition , caloric restriction , resveratrol and autophagy modulation appear to be predominantly cytoprotective , and further studies of this process are promising in age - related disease therapeutics . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 appear 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 31 . 1 in 2 addition 1 in 3 , 1 in 8 and 4 caloric 5 restriction 5 restriction 6 , 6 , 7 resveratrol 6 , 8 and 8 and 10 modulation 8 and 11 appear 9 autophagy 10 modulation 11 appear 12 to 12 to 13 be 13 be 15 cytoprotective 14 predominantly 15 cytoprotective 16 , 17 and 17 and 19 studies 17 and 23 are 18 further 19 studies 19 studies 20 of 19 studies 23 are 20 of 22 process 21 this 22 process 23 are 24 promising 24 promising 29 disease 24 promising 30 therapeutics 25 in 26 age 25 in 27 - 25 in 29 disease 28 related 29 disease 29 disease 30 therapeutics objectives : to estimate the rate of restricting fatigue in community [-] living older adults and to determine whether the rates differ according to age , sex , race , physical frailty , and depression . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 3 to 2 : 16 and 2 : 30 , 3 to 16 and 4 estimate 6 rate 4 estimate 10 in 4 estimate 16 and 5 the 6 rate 6 rate 7 of 7 of 8 restricting 8 restricting 9 fatigue 10 in 15 adults 11 community 13 living 13 living 15 adults 14 older 15 adults 16 and 17 to 16 and 18 determine 17 to 18 determine 18 determine 19 whether 19 whether 21 rates 19 whether 22 differ 20 the 21 rates 21 rates 22 differ 22 differ 24 to 23 according 24 to 24 to 25 age 25 age 27 sex 26 , 27 sex 27 sex 29 race 27 sex 30 , 28 , 29 race 29 race 30 , 30 , 34 and 31 physical 32 frailty 32 frailty 34 and 33 , 34 and 34 and 35 depression design : prospective cohort study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 . 1 design 2 : 2 : 5 study 3 prospective 4 cohort 4 cohort 5 study setting : greater new haven , connecticut . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 8 . 1 setting 2 : 2 : 5 haven 3 greater 5 haven 4 new 5 haven 6 , 7 connecticut participants : nondisabled [community] - living older men and women aged 70 and older ( n = 754 ) . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 participants 2 : 2 : 3 nondisabled 3 nondisabled 6 living 5 - 6 living 6 living 13 and 6 living 19 ) 7 older 8 men 8 men 9 and 9 and 10 women 9 and 11 aged 9 and 13 and 11 aged 12 70 13 and 14 older 14 older 17 = 15 ( 17 = 16 n 17 = 17 = 18 754 17 = 19 ) measurements : restricting fatigue was defined as staying in bed for at least half the day and/or cutting down on one 's usual activities because of fatigue for 3 consecutive months or longer . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 2 : 3 restricting 2 : 22 's 2 : 34 . 3 restricting 4 fatigue 3 restricting 5 was 5 was 6 defined 6 defined 7 as 6 defined 17 and/or 7 as 8 staying 8 staying 10 bed 8 staying 11 for 9 in 10 bed 11 for 14 half 12 at 13 least 13 least 14 half 14 half 15 the 14 half 16 day 15 the 16 day 17 and/or 18 cutting 18 cutting 19 down 18 cutting 22 's 19 down 20 on 20 on 21 one 22 's 24 activities 22 's 25 because 22 's 28 for 22 's 32 or 23 usual 24 activities 25 because 26 of 26 of 27 fatigue 28 for 29 3 30 consecutive 31 months 31 months 32 or 32 or 33 longer physical frailty was defined on the basis of slow gait speed , and depression was assessed using the center for epidemiologic studies depression scale . 0 ###LEFT-WALL### 2 frailty 0 ###LEFT-WALL### 4 defined 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 25 . 1 physical 2 frailty 2 frailty 3 was 3 was 4 defined 4 defined 5 on 5 on 7 basis 6 the 7 basis 7 basis 8 of 8 of 11 speed 9 slow 10 gait 10 gait 11 speed 12 , 13 and 13 and 14 depression 13 and 16 assessed 14 depression 15 was 15 was 16 assessed 16 assessed 17 using 17 using 19 center 18 the 19 center 19 center 20 for 20 for 24 scale 21 epidemiologic 22 studies 22 studies 23 depression 23 depression 24 scale results : during a median follow - up of 111 months , the cumulative incidence of restricting fatigue was 31.1 % for men and 42.1 % [for] women . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 follow 2 : 7 - 3 during 5 median 3 during 6 follow 4 a 5 median 7 - 15 incidence 7 - 19 was 7 - 29 . 8 up 15 incidence 9 of 11 months 9 of 12 , 9 of 15 incidence 10 111 11 months 13 the 15 incidence 14 cumulative 15 incidence 15 incidence 16 of 15 incidence 19 was 16 of 17 restricting 17 restricting 18 fatigue 19 was 21 % 20 31.1 21 % 21 % 22 for 22 for 24 and 23 men 24 and 24 and 28 women 25 42.1 28 women 26 % 28 women the overall incidence rate of restricting fatigue was 6.7 per 1,000 person - months ( 7.8 for women and [4.4] for men , p < [.] 001 ) , which did not differ according to race . 0 ###LEFT-WALL### 4 rate 0 ###LEFT-WALL### 8 was 1 the 4 rate 2 overall 4 rate 3 incidence 4 rate 4 rate 5 of 4 rate 8 was 5 of 6 restricting 6 restricting 7 fatigue 8 was 9 6.7 9 6.7 10 per 9 6.7 14 months 10 per 12 person 11 1,000 12 person 13 - 14 months 14 months 16 7.8 14 months 25 < 14 months 30 which 14 months 37 . 15 ( 16 7.8 16 7.8 19 and 16 7.8 23 , 17 for 18 women 17 for 19 and 19 and 21 for 21 for 22 men 23 , 25 < 24 p 25 < 25 < 27 001 25 < 28 ) 29 , 30 which 30 which 31 did 30 which 37 . 31 did 32 not 31 did 33 differ 33 differ 35 to 34 according 35 to 35 to 36 race of the 459 episodes of restricting fatigue , the median duration was 3 months , which did not differ according to age , sex , race , physical frailty , or depression . 0 ###LEFT-WALL### 11 duration 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 33 . 1 of 4 episodes 1 of 11 duration 2 the 3 459 3 459 4 episodes 5 of 6 restricting 5 of 8 , 5 of 11 duration 6 restricting 7 fatigue 9 the 11 duration 10 median 11 duration 11 duration 12 was 12 was 31 or 13 3 14 months 14 months 16 which 14 months 24 sex 14 months 29 frailty 14 months 31 or 15 , 16 which 16 which 17 did 16 which 23 , 17 did 18 not 17 did 19 differ 19 differ 21 to 20 according 21 to 21 to 22 age 23 , 24 sex 24 sex 26 race 24 sex 27 , 25 , 26 race 26 race 27 , 27 , 29 frailty 28 physical 29 frailty 29 frailty 30 , 30 , 31 or 31 or 32 depression conclusion : restricting fatigue is common in community [-] living older adults . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 restricting 2 : 5 is 2 : 13 . 3 restricting 4 fatigue 3 restricting 5 is 5 is 6 common 6 common 7 in 7 in 12 adults 8 community 10 living 10 living 12 adults 11 older 12 adults women , individuals aged 75 to 84 , and individuals with physical frailty or depression had higher rates of restricting fatigue than their respective counterparts . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 16 had 0 ###LEFT-WALL### 26 . 1 women 3 individuals 1 women 9 and 2 , 3 individuals 3 individuals 4 aged 3 individuals 8 , 4 aged 6 to 5 75 6 to 6 to 7 84 8 , 9 and 9 and 10 individuals 9 and 11 with 9 and 16 had 11 with 14 or 12 physical 13 frailty 13 frailty 14 or 14 or 15 depression 16 had 18 rates 17 higher 18 rates 18 rates 19 of 19 of 20 restricting 20 restricting 21 fatigue 20 restricting 22 than 22 than 25 counterparts 23 their 25 counterparts 24 respective 25 counterparts objectives : to compare [chart] - and interview - based methods for identification of delirium . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 7 and 2 : 9 - 2 : 16 . 3 to 7 and 4 compare 7 and 6 - 7 and 7 and 8 interview 9 - 11 methods 10 based 11 methods 11 methods 12 for 12 for 13 identification 13 identification 14 of 14 of 15 delirium design : prospective cohort study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 . 1 design 2 : 2 : 5 study 3 prospective 4 cohort 4 cohort 5 study setting : two academic medical centers . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 . 1 setting 2 : 2 : 6 centers 3 two 6 centers 4 academic 6 centers 5 medical 6 centers participants : individuals aged 70 and older undergoing major elective surgery ( n = 300 ) ( majority orthopedic surgery ) . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 participants 2 : 2 : 11 surgery 3 individuals 11 surgery 4 aged 5 70 4 aged 6 and 6 and 7 older 6 and 9 major 8 undergoing 9 major 9 major 11 surgery 10 elective 11 surgery 11 surgery 14 = 11 surgery 20 surgery 12 ( 14 = 13 n 14 = 14 = 15 300 14 = 16 ) 17 ( 20 surgery 18 majority 20 surgery 19 orthopedic 20 surgery 20 surgery 21 ) measurements : participants were interviewed daily during hospitalization for delirium using the confusion assessment method ( cam [;] interview - based method ) , and their medical charts were reviewed for delirium using a validated chart - review method ( chart [-] based method ) . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 46 . 2 : 3 participants 2 : 30 reviewed 3 participants 4 were 4 were 5 interviewed 5 interviewed 6 daily 5 interviewed 7 during 5 interviewed 9 for 7 during 8 hospitalization 9 for 25 and 10 delirium 11 using 10 delirium 25 and 11 using 19 interview 12 the 19 interview 13 confusion 14 assessment 14 assessment 15 method 15 method 17 cam 16 ( 17 cam 17 cam 19 interview 19 interview 22 method 20 - 22 method 21 based 22 method 22 method 23 ) 24 , 25 and 25 and 28 charts 25 and 29 were 26 their 28 charts 27 medical 28 charts 29 were 30 reviewed 30 reviewed 31 for 30 reviewed 33 using 31 for 32 delirium 33 using 36 chart 34 a 36 chart 35 validated 36 chart 36 chart 39 method 37 - 39 method 38 review 39 method 39 method 44 method 39 method 45 ) 40 ( 44 method 41 chart 43 based 43 based 44 method 44 method 45 ) rate of agreement of the two methods and characteristics of those identified using each approach were examined . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 17 examined 0 ###LEFT-WALL### 18 . 1 rate 2 of 1 rate 4 of 1 rate 8 and 2 of 3 agreement 4 of 7 methods 5 the 6 two 6 two 7 methods 8 and 9 characteristics 8 and 10 of 8 and 16 were 10 of 11 those 11 those 12 identified 11 those 13 using 13 using 15 approach 14 each 15 approach 16 were 17 examined predictive validity for clinical outcomes ( length of stay [,] postoperative complications , discharge disposition ) was compared . 0 ###LEFT-WALL### 2 validity 0 ###LEFT-WALL### 18 compared 0 ###LEFT-WALL### 19 . 1 predictive 2 validity 2 validity 3 for 2 validity 17 was 3 for 5 outcomes 4 clinical 5 outcomes 5 outcomes 7 length 5 outcomes 15 disposition 6 ( 7 length 7 length 8 of 7 length 13 , 8 of 12 complications 9 stay 12 complications 11 postoperative 12 complications 13 , 15 disposition 14 discharge 15 disposition 15 disposition 16 ) 17 was 18 compared in the absence of a criterion standard , predictive value could not be calculated . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 13 be 0 ###LEFT-WALL### 15 . 1 in 3 absence 1 in 13 be 2 the 3 absence 3 absence 4 of 4 of 6 criterion 5 a 6 criterion 7 standard 8 , 7 standard 10 value 9 predictive 10 value 10 value 11 could 11 could 12 not 11 could 13 be 13 be 14 calculated results : the cumulative incidence of delirium was 23 % ( n = 68 [ )(according to the interview [-] based method , 12 % ( n = 35 ) according to the chart - based method , [and] 27 % ( n = 82 [ )(according to the combined approach . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 incidence 2 : 8 was 3 the 5 incidence 4 cumulative 5 incidence 5 incidence 6 of 5 incidence 8 was 6 of 7 delirium 8 was 10 % 9 23 10 % 10 % 13 = 11 ( 13 = 12 n 13 = 13 = 14 68 14 68 16 )(according 14 68 21 based 16 )(according 17 to 16 )(according 21 based 17 to 19 interview 18 the 19 interview 21 based 22 method 21 based 32 to 22 method 25 % 23 , 25 % 24 12 25 % 25 % 28 = 25 % 30 ) 26 ( 28 = 27 n 28 = 28 = 29 35 28 = 30 ) 31 according 32 to 32 to 34 chart 33 the 34 chart 34 chart 37 method 34 chart 41 % 35 - 37 method 36 based 37 method 37 method 38 , 38 , 41 % 40 27 41 % 41 % 44 = 41 % 52 . 42 ( 44 = 43 n 44 = 44 = 47 )(according 45 82 47 )(according 47 )(according 48 to 48 to 51 approach 49 the 51 approach 50 combined 51 approach overall agreement was 80 % ; kappa was 0.30 . 0 ###LEFT-WALL### 2 agreement 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 6 ; 0 ###LEFT-WALL### 10 . 1 overall 2 agreement 2 agreement 3 was 3 was 5 % 4 80 5 % 6 ; 7 kappa 6 ; 8 was 7 kappa 8 was 8 was 9 0.30 the methods differed in detection of psychomotor features and time [of] onset . 0 ###LEFT-WALL### 2 methods 0 ###LEFT-WALL### 3 differed 0 ###LEFT-WALL### 13 . 1 the 2 methods 2 methods 3 differed 3 differed 4 in 4 in 5 detection 5 detection 6 of 6 of 9 and 7 psychomotor 8 features 8 features 9 and 9 and 12 onset 10 time 12 onset the chart - based method missed delirium in individuals that the cam identified who were lacking features of psychomotor agitation or inappropriate behavior . 0 ###LEFT-WALL### 2 chart 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 24 . 1 the 2 chart 3 - 5 method 3 - 6 missed 4 based 5 method 5 method 6 missed 6 missed 7 delirium 7 delirium 8 in 7 delirium 18 of 8 in 9 individuals 9 individuals 10 that 9 individuals 17 features 10 that 12 cam 10 that 17 features 11 the 12 cam 12 cam 13 identified 12 cam 14 who 12 cam 15 were 12 cam 17 features 14 who 15 were 15 were 16 lacking 18 of 21 or 19 psychomotor 20 agitation 20 agitation 21 or 21 or 23 behavior 22 inappropriate 23 behavior the cam - based method missed chart - identified cases occurring during the night shift . 0 ###LEFT-WALL### 2 cam 0 ###LEFT-WALL### 3 - 1 the 2 cam 3 - 7 chart 3 - 8 - 4 based 5 method 5 method 6 missed 6 missed 7 chart 8 - 10 cases 8 - 15 shift 8 - 16 . 9 identified 10 cases 10 cases 11 occurring 10 cases 15 shift 11 occurring 12 during 12 during 14 night 13 the 14 night the combined method had high predictive validity for all clinical outcomes . 0 ###LEFT-WALL### 3 method 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 12 . 1 the 3 method 2 combined 3 method 3 method 4 had 4 had 7 validity 5 high 7 validity 6 predictive 7 validity 7 validity 8 for 8 for 11 outcomes 9 all 11 outcomes 10 clinical 11 outcomes conclusions : interview - and chart - based methods have specific strengths for identification of delirium . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 7 - 1 conclusions 2 : 2 : 5 and 3 interview 5 and 4 - 5 and 5 and 6 chart 7 - 9 methods 7 - 10 have 7 - 17 . 8 based 9 methods 9 methods 10 have 10 have 12 strengths 11 specific 12 strengths 12 strengths 13 for 13 for 14 identification 14 identification 15 of 15 of 16 delirium a combined approach captures the largest [number] and broadest range of delirium cases . 0 ###LEFT-WALL### 3 approach 0 ###LEFT-WALL### 4 captures 0 ###LEFT-WALL### 14 . 1 a 3 approach 2 combined 3 approach 3 approach 4 captures 4 captures 10 range 5 the 8 and 5 the 10 range 6 largest 8 and 8 and 9 broadest 10 range 11 of 11 of 13 cases 12 delirium 13 cases objectives : sleep deprivation can physically affect skin appearance [,] e.g . increase the cutaneous signs of aging . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 . 1 objectives 2 : 2 : 3 sleep 3 sleep 4 deprivation 3 sleep 7 affect 4 deprivation 5 can 5 can 7 affect 6 physically 7 affect 7 affect 11 e.g 8 skin 11 e.g 9 appearance 11 e.g 12 . 13 increase 12 . 19 . 13 increase 16 signs 14 the 16 signs 15 cutaneous 16 signs 16 signs 17 of 17 of 18 aging there are no studies of sleep disorders and subjective ratings of skin [appearance] or cutaneous body image ( cbi ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 21 . 1 there 2 are 2 are 8 and 3 no 4 studies 4 studies 5 of 4 studies 8 and 5 of 7 disorders 6 sleep 7 disorders 8 and 10 ratings 8 and 11 of 9 subjective 10 ratings 11 of 14 or 12 skin 14 or 14 or 17 image 14 or 19 cbi 15 cutaneous 16 body 16 body 17 image 18 ( 19 cbi 19 cbi 20 ) cbi is an important consideration in the treatment of cosmetically disfiguring dermatologic disorders . 0 ###LEFT-WALL### 1 cbi 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 14 . 1 cbi 2 is 2 is 5 consideration 3 an 4 important 3 an 5 consideration 4 important 5 consideration 5 consideration 6 in 6 in 8 treatment 7 the 8 treatment 8 treatment 9 of 9 of 11 disfiguring 10 cosmetically 11 disfiguring 11 disfiguring 13 disorders 12 dermatologic 13 disorders we examined the association of insomnia and cbi . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 9 . 1 we 2 examined 2 examined 4 association 3 the 4 association 4 association 5 of 5 of 7 and 6 insomnia 7 and 7 and 8 cbi methods : as part of a larger study , community - based [non] - clinical participants completed ratings of insomnia and cbi ( also measured [4] - weeks post - baseline ) using the cutaneous body image scale ( cbis ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 42 . 1 methods 2 : 2 : 3 as 3 as 4 part 4 part 5 of 5 of 8 study 6 a 8 study 7 larger 8 study 9 , 10 community 9 , 11 - 11 - 16 participants 11 - 17 completed 12 based 14 - 12 based 16 participants 15 clinical 16 participants 16 participants 17 completed 17 completed 18 ratings 18 ratings 19 of 19 of 21 and 20 insomnia 21 and 21 and 22 cbi 22 cbi 31 baseline 22 cbi 33 using 23 ( 24 also 23 ( 31 baseline 25 measured 29 post 25 measured 30 - 25 measured 31 baseline 27 - 29 post 28 weeks 29 post 29 post 30 - 31 baseline 32 ) 33 using 38 scale 34 the 38 scale 35 cutaneous 36 body 36 body 37 image 37 image 38 scale 38 scale 40 cbis 39 ( 40 cbis 40 cbis 41 ) results : 301/311 adults ( 238 women ; mean ± sd age 38.6 ± 14.7 years ; 54.5 % married ; 94.2 % " white " ) completed insomnia and cbi ratings at baseline ; 243/301 completed cbi ratings 4 - weeks post - baseline . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 ; 1 results 2 : 2 : 4 adults 3 301/311 4 adults 4 adults 7 women 5 ( 7 women 6 238 7 women 7 women 8 ; 8 ; 9 mean 8 ; 17 ; 9 mean 16 years 10 ± 12 age 11 sd 12 age 12 age 16 years 13 38.6 16 years 14 ± 16 years 15 14.7 16 years 17 ; 19 % 17 ; 20 married 17 ; 21 ; 18 54.5 19 % 19 % 20 married 21 ; 30 and 21 ; 35 ; 22 94.2 23 % 23 % 24 " 23 % 29 insomnia 25 white 26 " 25 white 27 ) 25 white 29 insomnia 28 completed 29 insomnia 29 insomnia 30 and 30 and 32 ratings 30 and 33 at 31 cbi 32 ratings 33 at 34 baseline 35 ; 36 243/301 35 ; 37 completed 36 243/301 37 completed 37 completed 39 ratings 38 cbi 39 ratings 39 ratings 40 4 39 ratings 43 post 39 ratings 45 baseline 41 - 43 post 42 weeks 43 post 43 post 44 - 44 - 45 baseline 45 baseline 46 . a low cbis score denotes greater dissatisfaction with cbi . 0 ###LEFT-WALL### 4 score 0 ###LEFT-WALL### 5 denotes 0 ###LEFT-WALL### 10 . 1 a 4 score 2 low 4 score 3 cbis 4 score 4 score 5 denotes 5 denotes 7 dissatisfaction 5 denotes 8 with 6 greater 7 dissatisfaction 8 with 9 cbi a similar relationship was observed for cbi ratings 4 - weeks post - baseline . 0 ###LEFT-WALL### 3 relationship 0 ###LEFT-WALL### 5 observed 0 ###LEFT-WALL### 13 - 1 a 2 similar 1 a 3 relationship 2 similar 3 relationship 3 relationship 4 was 4 was 5 observed 5 observed 6 for 6 for 8 ratings 7 cbi 8 ratings 8 ratings 9 4 8 ratings 12 post 10 - 12 post 11 weeks 12 post 12 post 13 - 13 - 14 baseline 13 - 15 . conclusions : cbi dissatisfaction was positively related to insomnia severity , especially among women . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 dissatisfaction 2 : 7 related 3 cbi 4 dissatisfaction 4 dissatisfaction 5 was 5 was 6 positively 5 was 7 related 7 related 8 to 8 to 10 severity 9 insomnia 10 severity 10 severity 13 among 11 , 12 especially 11 , 13 among 13 among 14 women 13 among 15 . underlying insomnia may confound an individual 's self - assessment of their cbi , a finding that has important treatment implications in dermatology . 0 ###LEFT-WALL### 1 underlying 0 ###LEFT-WALL### 4 confound 1 underlying 2 insomnia 1 underlying 3 may 3 may 4 confound 4 confound 8 self 5 an 6 individual 6 individual 7 's 7 's 8 self 8 self 10 assessment 8 self 16 finding 9 - 10 assessment 10 assessment 11 of 10 assessment 14 , 11 of 13 cbi 12 their 13 cbi 14 , 16 finding 15 a 16 finding 16 finding 17 that 16 finding 18 has 16 finding 24 . 17 that 18 has 18 has 21 implications 18 has 22 in 19 important 20 treatment 20 treatment 21 implications 22 in 23 dermatology alzheimer 's disease ( ad ) affects approximately 5.3 million americans . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 7 affects 0 ###LEFT-WALL### 12 . 1 alzheimer 2 's 2 's 3 disease 3 disease 5 ad 3 disease 7 affects 4 ( 5 ad 5 ad 6 ) 7 affects 11 americans 8 approximately 10 million 9 5.3 10 million 10 million 11 americans use by primary care physicians of these new clinical criteria coupled with the understanding of the role of biomarkers will help you to make accurate diagnoses earlier in the disease process when intervention can be most beneficial . 0 ###LEFT-WALL### 1 use 0 ###LEFT-WALL### 21 help 0 ###LEFT-WALL### 38 . 1 use 2 by 1 use 5 physicians 1 use 11 coupled 1 use 20 will 2 by 4 care 3 primary 4 care 5 physicians 6 of 5 physicians 11 coupled 6 of 10 criteria 7 these 10 criteria 8 new 10 criteria 9 clinical 10 criteria 11 coupled 12 with 12 with 14 understanding 13 the 14 understanding 14 understanding 15 of 14 understanding 18 of 15 of 17 role 16 the 17 role 18 of 19 biomarkers 20 will 21 help 21 help 22 you 21 help 23 to 21 help 24 make 23 to 24 make 24 make 26 diagnoses 24 make 27 earlier 24 make 28 in 24 make 37 beneficial 25 accurate 26 diagnoses 28 in 31 process 29 the 31 process 30 disease 31 process 31 process 32 when 32 when 33 intervention 32 when 35 be 33 intervention 34 can 34 can 35 be 36 most 37 beneficial none none arterial health may influence muscle function in older adults . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 8 function 0 ###LEFT-WALL### 12 . 1 none 4 health 1 none 6 influence 1 none 8 function 2 none 3 arterial 3 arterial 4 health 4 health 5 may 5 may 6 influence 6 influence 7 muscle 8 function 9 in 9 in 11 adults 10 older 11 adults study purpose was to determine whether arterial elasticity is related to strength , central and peripheral fatigue , fatigue at rest , and treadmill endurance . 0 ###LEFT-WALL### 1 study 0 ###LEFT-WALL### 5 determine 2 purpose 3 was 3 was 4 to 3 was 5 determine 4 to 5 determine 5 determine 6 whether 5 determine 11 to 5 determine 26 . 6 whether 8 elasticity 6 whether 10 related 7 arterial 8 elasticity 8 elasticity 9 is 9 is 10 related 11 to 23 and 12 strength 13 , 13 , 14 central 13 , 15 and 15 and 17 fatigue 15 and 19 fatigue 15 and 23 and 16 peripheral 17 fatigue 18 , 19 fatigue 19 fatigue 20 at 19 fatigue 22 , 20 at 21 rest 22 , 23 and 23 and 25 endurance 24 treadmill 25 endurance subjects were 91 healthy women aged >60 . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 8 . 1 subjects 2 were 2 were 5 women 3 91 5 women 4 healthy 5 women 5 women 6 aged 6 aged 7 >60 treadmill endurance and maximal oxygen uptake ( vo2 [max] ) were measured . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 13 . 1 treadmill 2 endurance 2 endurance 3 and 3 and 6 uptake 3 and 8 vo2 3 and 11 were 4 maximal 6 uptake 5 oxygen 6 uptake 7 ( 8 vo2 8 vo2 10 ) 11 were 12 measured peripheral and central fatigue for the knee extensors were evaluated using two isometric fatigue tests ( one voluntary and one adding electrical stimulation ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 25 . 1 peripheral 2 and 2 and 4 fatigue 2 and 5 for 2 and 8 extensors 2 and 9 were 2 and 10 evaluated 3 central 4 fatigue 5 for 7 knee 6 the 7 knee 8 extensors 9 were 10 evaluated 11 using 11 using 15 tests 12 two 15 tests 13 isometric 14 fatigue 14 fatigue 15 tests 15 tests 19 and 16 ( 19 and 17 one 18 voluntary 18 voluntary 19 and 19 and 20 one 19 and 21 adding 19 and 24 ) 21 adding 23 stimulation 22 electrical 23 stimulation arterial elasticity was determined using radial artery pulse wave analysis . 0 ###LEFT-WALL### 2 elasticity 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 11 . 1 arterial 2 elasticity 2 elasticity 3 was 3 was 4 determined 4 determined 5 using 5 using 10 analysis 6 radial 7 artery 7 artery 10 analysis 8 pulse 10 analysis 9 wave 10 analysis linear multiple regression was used in statistical analysis . 0 ###LEFT-WALL### 3 regression 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 9 . 1 linear 3 regression 2 multiple 3 regression 3 regression 4 was 4 was 5 used 5 used 6 in 6 in 8 analysis 7 statistical 8 analysis large artery elasticity was associated with central fatigue ( p < 0.01 ) [and] treadmill endurance ( p < 0.02 ) after adjusting for vo2 max and knee extension strength . 0 ###LEFT-WALL### 3 elasticity 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 31 . 1 large 2 artery 2 artery 3 elasticity 3 elasticity 4 was 4 was 5 associated 5 associated 6 with 5 associated 19 < 5 associated 22 after 6 with 8 fatigue 6 with 16 endurance 7 central 8 fatigue 8 fatigue 11 < 9 ( 11 < 10 p 11 < 11 < 12 0.01 11 < 13 ) 15 treadmill 16 endurance 17 ( 19 < 18 p 19 < 19 < 20 0.02 19 < 21 ) 22 after 23 adjusting 23 adjusting 24 for 23 adjusting 30 strength 24 for 25 vo2 26 max 27 and 27 and 28 knee 27 and 30 strength 29 extension 30 strength subjective fatigue at rest was related to large artery elasticity after adjusting for ethnic origin ( < 0.02 ) . 0 ###LEFT-WALL### 2 fatigue 0 ###LEFT-WALL### 6 related 0 ###LEFT-WALL### 20 . 1 subjective 2 fatigue 2 fatigue 3 at 2 fatigue 5 was 3 at 4 rest 5 was 6 related 6 related 7 to 6 related 11 after 7 to 10 elasticity 8 large 9 artery 9 artery 10 elasticity 11 after 12 adjusting 12 adjusting 13 for 13 for 15 origin 14 ethnic 15 origin 15 origin 18 0.02 16 ( 18 0.02 17 < 18 0.02 18 0.02 19 ) strength was significantly related to small artery elasticity after adjusting for ethnic origin , leg lean tissue , age , and blood pressure . 0 ###LEFT-WALL### 1 strength 0 ###LEFT-WALL### 4 related 0 ###LEFT-WALL### 24 . 1 strength 2 was 2 was 4 related 3 significantly 4 related 4 related 5 to 4 related 9 after 5 to 8 elasticity 6 small 7 artery 7 artery 8 elasticity 9 after 10 adjusting 10 adjusting 11 for 11 for 21 and 12 ethnic 13 origin 13 origin 14 , 14 , 17 tissue 14 , 18 , 15 leg 17 tissue 16 lean 17 tissue 18 , 19 age 18 , 21 and 20 , 21 and 21 and 23 pressure 22 blood 23 pressure arterial elasticity is independently related to strength and fatigue in older women , especially in the central nervous system where arterial elasticity is independently related to perceptions of fatigue at rest and central fatigue . 0 ###LEFT-WALL### 2 elasticity 0 ###LEFT-WALL### 5 related 0 ###LEFT-WALL### 35 . 1 arterial 2 elasticity 2 elasticity 3 is 3 is 4 independently 3 is 5 related 5 related 6 to 5 related 14 especially 5 related 20 where 5 related 26 to 5 related 30 at 6 to 8 and 7 strength 8 and 8 and 9 fatigue 8 and 13 , 9 fatigue 10 in 10 in 12 women 11 older 12 women 14 especially 15 in 15 in 19 system 16 the 19 system 17 central 19 system 18 nervous 19 system 20 where 22 elasticity 20 where 25 related 21 arterial 22 elasticity 22 elasticity 23 is 23 is 24 independently 23 is 25 related 26 to 27 perceptions 27 perceptions 28 of 28 of 29 fatigue 30 at 32 and 31 rest 32 and 32 and 34 fatigue 33 central 34 fatigue these results suggest that arterial health may be involved with the ability of the central nervous system to activate muscle in older women . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 24 . 1 these 2 results 2 results 3 suggest 3 suggest 4 that 4 that 6 health 4 that 9 involved 5 arterial 6 health 6 health 7 may 7 may 8 be 8 be 9 involved 9 involved 10 with 10 with 12 ability 11 the 12 ability 12 ability 13 of 12 ability 18 to 12 ability 19 activate 13 of 17 system 14 the 17 system 15 central 17 system 16 nervous 17 system 18 to 19 activate 19 activate 20 muscle 19 activate 21 in 21 in 23 women 22 older 23 women kidney damage is a common sequela of several chronic pathologic conditions . 0 ###LEFT-WALL### 2 damage 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 12 . 1 kidney 2 damage 2 damage 3 is 3 is 6 sequela 4 a 5 common 4 a 6 sequela 5 common 6 sequela 6 sequela 7 of 7 of 11 conditions 8 several 11 conditions 9 chronic 11 conditions 10 pathologic 11 conditions whether biomarkers of kidney damage are prognostic for more severe outcomes is unknown . 0 ###LEFT-WALL### 1 whether 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 14 . 1 whether 2 biomarkers 1 whether 6 are 1 whether 12 is 2 biomarkers 3 of 2 biomarkers 6 are 3 of 5 damage 4 kidney 5 damage 6 are 7 prognostic 7 prognostic 8 for 8 for 11 outcomes 9 more 10 severe 10 severe 11 outcomes 12 is 13 unknown we measured three urinary biomarkers ( kidney injury molecule - 1 [ kim - 1 ] , il - 18 , and albumin [ )(in 3010 individuals enrolled in the health , aging and body composition ( health abc ) study and used cox proportional hazards models to investigate the associations of urinary kim - 1/creatinine ( cr ) , il - 18/cr , and albumin/cr [(] acr ) with all - cause mortality and cardiovascular disease ( cvd ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 10 - 1 we 2 measured 2 measured 5 biomarkers 3 three 5 biomarkers 4 urinary 5 biomarkers 5 biomarkers 9 molecule 6 ( 9 molecule 7 kidney 9 molecule 8 injury 9 molecule 9 molecule 10 - 10 - 11 1 10 - 17 , 11 1 13 kim 11 1 15 1 12 [ 13 kim 13 kim 14 - 14 - 15 1 15 1 16 ] 17 , 22 and 18 il 20 18 19 - 20 18 20 18 21 , 21 , 22 and 22 and 34 and 23 albumin 25 )(in 23 albumin 32 , 25 )(in 26 3010 26 3010 27 individuals 26 3010 28 enrolled 27 individuals 28 enrolled 28 enrolled 29 in 29 in 31 health 30 the 31 health 32 , 33 aging 32 , 34 and 34 and 36 composition 34 and 39 abc 34 and 42 and 35 body 36 composition 37 ( 39 abc 38 health 39 abc 39 abc 40 ) 41 study 42 and 42 and 43 used 43 used 47 models 43 used 48 to 43 used 49 investigate 44 cox 47 models 45 proportional 47 models 46 hazards 47 models 48 to 49 investigate 49 investigate 51 associations 50 the 51 associations 51 associations 52 of 52 of 61 il 53 urinary 60 , 53 urinary 61 il 54 kim 56 1/creatinine 55 - 56 1/creatinine 56 1/creatinine 58 cr 56 1/creatinine 60 , 57 ( 58 cr 58 cr 59 ) 61 il 72 - 62 - 72 - 63 18/cr 65 and 64 , 65 and 65 and 68 acr 65 and 69 ) 65 and 70 with 65 and 72 - 66 albumin/cr 68 acr 70 with 71 all 72 - 75 and 72 - 81 . 73 cause 74 mortality 74 mortality 75 and 75 and 77 disease 75 and 79 cvd 76 cardiovascular 77 disease 78 ( 79 cvd 79 cvd 80 ) multivariable models adjusted for demographics , traditional cvd risk factors , and egfr . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 3 adjusted 0 ###LEFT-WALL### 14 . 1 multivariable 2 models 2 models 3 adjusted 3 adjusted 4 for 4 for 12 and 5 demographics 6 , 6 , 10 factors 6 , 12 and 7 traditional 10 factors 8 cvd 10 factors 9 risk 10 factors 11 , 12 and 12 and 13 egfr mean age of participants was 74 years , 49 % of participants were men , and 41 % of participants were black . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 23 . 1 mean 2 age 1 mean 5 was 2 age 3 of 2 age 5 was 3 of 4 participants 5 was 7 years 6 74 7 years 8 , 10 % 8 , 13 were 8 , 16 and 9 49 10 % 10 % 11 of 10 % 13 were 11 of 12 participants 13 were 14 men 15 , 16 and 16 and 18 % 16 and 21 were 17 41 18 % 18 % 19 of 18 % 21 were 19 of 20 participants 21 were 22 black during the median 12.4 years of [follow] - up , 1450 deaths and 797 cvd outcomes occurred . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 17 occurred 0 ###LEFT-WALL### 18 . 1 during 3 median 1 during 13 and 2 the 3 median 3 median 4 12.4 5 years 6 of 5 years 10 , 6 of 9 up 8 - 9 up 10 , 12 deaths 10 , 13 and 11 1450 12 deaths 13 and 16 outcomes 13 and 17 occurred 14 797 16 outcomes 15 cvd 16 outcomes in similar analyses , only acr quartiles associated with cvd [:] ( [1.19] [;] 0.95 to 1.48 ) , [(] 1.35 ; 1.08 [to] 1.67 [ )(, [and] [(] 1.54 ; 1.24 [to] 1.91 [ )( 0 ###LEFT-WALL### 5 only 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 36 )( 1 in 3 analyses 1 in 4 , 1 in 5 only 2 similar 3 analyses 5 only 7 quartiles 6 acr 7 quartiles 7 quartiles 8 associated 8 associated 9 with 9 with 10 cvd 10 cvd 16 to 12 ( 16 to 15 0.95 16 to 16 to 17 1.48 16 to 18 ) 19 , 21 1.35 19 , 22 ; 22 ; 23 1.08 22 ; 27 )(, 23 1.08 25 1.67 27 )(, 30 1.54 27 )(, 31 ; 31 ; 32 1.24 32 1.24 34 1.91 urinary kim - 1 had a modest association with all - cause mortality but did not associate with cvd , and urinary il - 18 did not associate with either outcome . 0 ###LEFT-WALL### 2 kim 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 28 associate 0 ###LEFT-WALL### 32 . 1 urinary 2 kim 3 - 4 1 3 - 5 had 3 - 11 - 4 1 5 had 5 had 8 association 6 a 7 modest 6 a 8 association 7 modest 8 association 8 association 9 with 9 with 10 all 11 - 14 but 12 cause 13 mortality 12 cause 14 but 14 but 15 did 15 did 16 not 15 did 17 associate 17 associate 18 with 18 with 21 and 19 cvd 21 and 20 , 21 and 21 and 23 il 21 and 25 18 21 and 28 associate 22 urinary 23 il 24 - 25 18 25 18 26 did 26 did 27 not 26 did 28 associate 28 associate 29 with 29 with 31 outcome 30 either 31 outcome in contrast , albuminuria strongly associated with all - cause mortality and cvd . 0 ###LEFT-WALL### 4 albuminuria 0 ###LEFT-WALL### 6 associated 0 ###LEFT-WALL### 9 - 1 in 2 contrast 1 in 3 , 1 in 4 albuminuria 4 albuminuria 6 associated 5 strongly 6 associated 6 associated 7 with 7 with 8 all 9 - 12 and 9 - 14 . 10 cause 11 mortality 11 mortality 12 and 12 and 13 cvd future studies should evaluate reasons for these differences in the prognostic importance of individual kidney injury markers . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 evaluate 0 ###LEFT-WALL### 18 . 1 future 2 studies 2 studies 3 should 3 should 4 evaluate 4 evaluate 5 reasons 4 evaluate 9 in 5 reasons 6 for 6 for 8 differences 7 these 8 differences 9 in 12 importance 10 the 12 importance 11 prognostic 12 importance 12 importance 13 of 13 of 17 markers 14 individual 15 kidney 15 kidney 17 markers 16 injury 17 markers [the] prevalence of ckd and [of] renal failure vary worldwide , yet parallel increases in leading risk factors explain only part of the differential prevalence . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 26 . 2 prevalence 3 of 2 prevalence 5 and 3 of 4 ckd 5 and 8 failure 5 and 11 , 7 renal 8 failure 9 vary 10 worldwide 9 vary 11 , 11 , 13 parallel 12 yet 13 parallel 13 parallel 14 increases 13 parallel 15 in 15 in 17 risk 16 leading 17 risk 17 risk 18 factors 17 risk 19 explain 18 factors 19 explain 19 explain 20 only 19 explain 21 part 21 part 22 of 22 of 25 prevalence 23 the 25 prevalence 24 differential 25 prevalence we measured ckd prevalence and egfr , and their relationship with traditional and additional risk factors , in a sardinian founder population cohort . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 measured 0 ###LEFT-WALL### 24 . 1 we 2 measured 2 measured 8 and 3 ckd 4 prevalence 4 prevalence 5 and 5 and 6 egfr 5 and 8 and 7 , 8 and 8 and 10 relationship 8 and 17 , 8 and 18 in 9 their 10 relationship 10 relationship 11 with 11 with 16 factors 12 traditional 13 and 13 and 14 additional 13 and 16 factors 15 risk 16 factors 18 in 23 cohort 19 a 20 sardinian 19 a 23 cohort 20 sardinian 22 population 21 founder 22 population 22 population 23 cohort the egfr was calculated using equations from the ckd epidemiology collaboration and modification of diet in renal disease studies . 0 ###LEFT-WALL### 2 egfr 0 ###LEFT-WALL### 4 calculated 0 ###LEFT-WALL### 20 . 1 the 2 egfr 2 egfr 3 was 3 was 4 calculated 4 calculated 5 using 4 calculated 16 in 5 using 6 equations 5 using 7 from 7 from 13 modification 8 the 13 modification 9 ckd 10 epidemiology 10 epidemiology 11 collaboration 11 collaboration 12 and 12 and 13 modification 13 modification 14 of 14 of 15 diet 16 in 19 studies 17 renal 18 disease 18 disease 19 studies a genetic score was generated from 13 reported egfr - and ckd - related loci , and univariable and multivariable analyses were applied to assess the relationship between clinical , ultrasonographic , and genetic variables with three outcomes : ckd , change in egfr , and fast egfr decline . 0 ###LEFT-WALL### 3 score 0 ###LEFT-WALL### 5 generated 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 50 . 1 a 3 score 2 genetic 3 score 3 score 4 was 4 was 5 generated 5 generated 6 from 5 generated 9 egfr 6 from 7 13 7 13 8 reported 10 - 11 and 10 - 25 assess 10 - 39 : 10 - 42 change 11 and 21 analyses 11 and 23 applied 12 ckd 13 - 12 ckd 21 analyses 14 related 21 analyses 15 loci 17 and 16 , 17 and 17 and 18 univariable 17 and 19 and 19 and 20 multivariable 19 and 21 analyses 21 analyses 22 were 22 were 23 applied 23 applied 24 to 24 to 25 assess 25 assess 27 relationship 25 assess 28 between 25 assess 36 with 26 the 27 relationship 28 between 35 variables 29 clinical 30 , 30 , 31 ultrasonographic 30 , 33 and 32 , 33 and 33 and 34 genetic 33 and 35 variables 36 with 38 outcomes 37 three 38 outcomes 39 : 40 ckd 40 ckd 41 , 40 ckd 42 change 42 change 43 in 43 in 46 and 44 egfr 46 and 45 , 46 and 46 and 49 decline 47 fast 49 decline 48 egfr 49 decline genetic risk score , older age , and female sex independently correlated with each outcome . 0 ###LEFT-WALL### 3 score 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 16 . 1 genetic 3 score 2 risk 3 score 4 , 8 and 5 older 6 age 6 age 8 and 7 , 8 and 8 and 10 sex 8 and 12 correlated 9 female 10 sex 11 independently 12 correlated 12 correlated 13 with 13 with 15 outcome 14 each 15 outcome diabetes was associated with ckd prevalence , [whereas] hypertension and hyperuricemia correlated more strongly with fast egfr decline . 0 ###LEFT-WALL### 1 diabetes 0 ###LEFT-WALL### 3 associated 0 ###LEFT-WALL### 19 . 1 diabetes 2 was 2 was 3 associated 3 associated 4 with 4 with 5 ckd 5 ckd 10 and 5 ckd 18 decline 6 prevalence 7 , 7 , 9 hypertension 7 , 10 and 10 and 11 hyperuricemia 10 and 12 correlated 10 and 18 decline 12 correlated 14 strongly 12 correlated 15 with 13 more 14 strongly 15 with 17 egfr 16 fast 17 egfr diabetes , hypertension , hyperuricemia , and high baseline egfr were associated with a decline of egfr . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 12 associated 0 ###LEFT-WALL### 18 . 1 diabetes 2 , 2 , 3 hypertension 2 , 4 , 4 , 5 hyperuricemia 4 , 7 and 6 , 7 and 7 and 10 egfr 7 and 11 were 8 high 9 baseline 9 baseline 10 egfr 11 were 12 associated 12 associated 13 with 13 with 15 decline 14 a 15 decline 15 decline 16 of 16 of 17 egfr along with differential health practices , population [variations] in this spectrum of risk factors probably contributes to the variable ckd prevalence worldwide . 0 ###LEFT-WALL### 7 population 0 ###LEFT-WALL### 16 contributes 0 ###LEFT-WALL### 23 . 1 along 2 with 2 with 5 practices 2 with 6 , 2 with 7 population 3 differential 4 health 4 health 5 practices 7 population 9 in 7 population 16 contributes 9 in 11 spectrum 10 this 11 spectrum 11 spectrum 12 of 12 of 14 factors 13 risk 14 factors 15 probably 16 contributes 16 contributes 17 to 16 contributes 22 worldwide 17 to 21 prevalence 18 the 21 prevalence 19 variable 21 prevalence 20 ckd 21 prevalence background : eukaryotic elongation factor 1 alpha - 2 ( eef1a2 ) has been recently shown to be a putative oncogene of lung cancer . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 25 . 2 : 5 factor 3 eukaryotic 5 factor 4 elongation 5 factor 5 factor 6 1 5 factor 7 alpha 5 factor 16 shown 7 alpha 9 2 7 alpha 13 has 8 - 9 2 9 2 11 eef1a2 9 2 12 ) 10 ( 11 eef1a2 11 eef1a2 12 ) 13 has 14 been 14 been 16 shown 15 recently 16 shown 16 shown 17 to 17 to 18 be 18 be 21 oncogene 19 a 20 putative 19 a 21 oncogene 20 putative 21 oncogene 21 oncogene 22 of 22 of 24 cancer 23 lung 24 cancer materials and methods : we analyzed the expression and prognostic significance of eef1a2 in 69 primary [non] - small cell lung cancer ( nsclc ) cases . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 27 . 1 materials 2 and 2 and 3 methods 4 : 5 we 4 : 6 analyzed 5 we 6 analyzed 6 analyzed 9 and 6 analyzed 14 in 7 the 8 expression 8 expression 9 and 9 and 11 significance 9 and 12 of 10 prognostic 11 significance 12 of 13 eef1a2 14 in 26 cases 15 69 26 cases 16 primary 22 cancer 16 primary 26 cases 18 - 22 cancer 19 small 20 cell 20 cell 21 lung 21 lung 22 cancer 22 cancer 24 nsclc 22 cancer 25 ) 23 ( 24 nsclc 24 nsclc 25 ) we also suppressed eef1a2 expression using rna interference and then analyzed cell proliferation , migration and invasion of five adenocarcinoma cell lines . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 suppressed 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 23 . 1 we 3 suppressed 2 also 3 suppressed 3 suppressed 5 expression 3 suppressed 6 using 4 eef1a2 5 expression 6 using 9 and 7 rna 8 interference 8 interference 9 and 9 and 10 then 9 and 13 proliferation 9 and 14 , 11 analyzed 12 cell 12 cell 13 proliferation 14 , 16 and 15 migration 16 and 16 and 17 invasion 16 and 18 of 18 of 22 lines 19 five 22 lines 20 adenocarcinoma 22 lines 21 cell 22 lines results : eef1a2 protein expression was positive in 84.1 % . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 expression 2 : 6 was 2 : 11 . 3 eef1a2 5 expression 4 protein 5 expression 5 expression 6 was 6 was 7 positive 7 positive 8 in 8 in 10 % 9 84.1 10 % negative immunostaining for eef1a2 was shown to be an independent prognostic factor and significantly correlated with lymph node metastasis . 0 ###LEFT-WALL### 2 immunostaining 0 ###LEFT-WALL### 6 shown 0 ###LEFT-WALL### 20 . 1 negative 2 immunostaining 2 immunostaining 3 for 2 immunostaining 5 was 3 for 4 eef1a2 5 was 6 shown 6 shown 7 to 6 shown 16 with 7 to 13 and 8 be 12 factor 8 be 13 and 9 an 10 independent 9 an 12 factor 10 independent 12 factor 11 prognostic 12 factor 13 and 15 correlated 14 significantly 15 correlated 16 with 19 metastasis 17 lymph 18 node 18 node 19 metastasis there was no significant correlation between eef1a2 protein and mrna expression levels . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 13 . 1 there 2 was 2 was 5 correlation 2 was 6 between 3 no 5 correlation 4 significant 5 correlation 6 between 9 and 7 eef1a2 8 protein 8 protein 9 and 9 and 12 levels 10 mrna 11 expression 11 expression 12 levels among the five examined cell lines , transfection of eef1a2 sirna inhibited cell migration in only one cell line while it did [not] change [cell] [proliferation] and invasion . 0 ###LEFT-WALL### 8 transfection 0 ###LEFT-WALL### 12 inhibited 0 ###LEFT-WALL### 29 . 1 among 6 lines 1 among 7 , 1 among 8 transfection 2 the 3 five 3 five 6 lines 4 examined 5 cell 5 cell 6 lines 8 transfection 9 of 8 transfection 12 inhibited 9 of 11 sirna 10 eef1a2 11 sirna 12 inhibited 14 migration 12 inhibited 20 while 13 cell 14 migration 14 migration 15 in 15 in 19 line 16 only 17 one 17 one 19 line 18 cell 19 line 20 while 21 it 20 while 22 did 21 it 22 did 22 did 27 and 24 change 27 and 27 and 28 invasion conclusion : negative immunostaining of eef1a2 predicted for poor prognosis [of] nsclc . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 . 1 conclusion 2 : 2 : 4 immunostaining 3 negative 4 immunostaining 4 immunostaining 5 of 5 of 6 eef1a2 6 eef1a2 7 predicted 7 predicted 8 for 8 for 12 nsclc 9 poor 10 prognosis 10 prognosis 12 nsclc the mechanism of this result could not be elucidated by cell proliferation [,] migration and invasion assays . 0 ###LEFT-WALL### 2 mechanism 0 ###LEFT-WALL### 9 elucidated 0 ###LEFT-WALL### 18 . 1 the 2 mechanism 2 mechanism 3 of 2 mechanism 6 could 3 of 5 result 4 this 5 result 6 could 7 not 6 could 8 be 8 be 9 elucidated 9 elucidated 10 by 10 by 15 and 11 cell 14 migration 12 proliferation 14 migration 14 migration 15 and 15 and 17 assays 16 invasion 17 assays background : smoking is a major cause of morbidity and mortality . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 smoking 2 : 4 is 2 : 12 . 3 smoking 4 is 4 is 10 and 5 a 6 major 5 a 7 cause 6 major 7 cause 7 cause 8 of 7 cause 10 and 8 of 9 morbidity 10 and 11 mortality smoking - related epigenetic biomarkers may open new avenues to better quantify the adverse health effects of smoking , and to better understanding of the underlying mechanisms . 0 ###LEFT-WALL### 1 smoking 0 ###LEFT-WALL### 7 open 0 ###LEFT-WALL### 28 . 1 smoking 6 may 2 - 3 related 3 related 5 biomarkers 3 related 6 may 4 epigenetic 5 biomarkers 6 may 7 open 7 open 9 avenues 7 open 10 to 8 new 9 avenues 10 to 20 and 11 better 12 quantify 12 quantify 16 effects 12 quantify 20 and 13 the 16 effects 14 adverse 15 health 15 health 16 effects 16 effects 17 of 17 of 18 smoking 19 , 20 and 20 and 21 to 20 and 22 better 21 to 22 better 22 better 23 understanding 23 understanding 24 of 24 of 27 mechanisms 25 the 27 mechanisms 26 underlying 27 mechanisms we aimed to evaluate the clinical implications of f2rl3 methylation , a novel epigenetic biomarker of smoking exposure disclosed by recent [genome] - wide methylation studies . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 19 disclosed 0 ###LEFT-WALL### 27 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 evaluate 3 to 4 evaluate 4 evaluate 7 implications 5 the 7 implications 6 clinical 7 implications 7 implications 8 of 8 of 10 methylation 9 f2rl3 10 methylation 11 , 19 disclosed 12 a 13 novel 12 a 15 biomarker 13 novel 15 biomarker 14 epigenetic 15 biomarker 15 biomarker 16 of 15 biomarker 19 disclosed 16 of 18 exposure 17 smoking 18 exposure 19 disclosed 20 by 20 by 26 studies 21 recent 23 - 21 recent 25 methylation 24 wide 25 methylation 25 methylation 26 studies methods : blood dna methylation at f2rl3 ( also known as par - 4 ) was quantified in baseline samples of 3588 participants aged 50 - 75 years in a large population - based prospective cohort study by maldi - tof mass spectrometry . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 3 blood 0 ###LEFT-WALL### 44 . 1 methods 2 : 2 : 3 blood 3 blood 4 dna 3 blood 38 by 4 dna 5 methylation 4 dna 16 was 4 dna 17 quantified 5 methylation 6 at 5 methylation 14 4 5 methylation 16 was 6 at 7 f2rl3 7 f2rl3 10 known 8 ( 10 known 9 also 10 known 10 known 11 as 10 known 13 - 11 as 12 par 13 - 14 4 14 4 15 ) 17 quantified 18 in 18 in 20 samples 19 baseline 20 samples 20 samples 21 of 21 of 23 participants 22 3588 23 participants 23 participants 24 aged 23 participants 25 50 23 participants 34 based 25 50 28 years 25 50 34 based 26 - 28 years 27 75 28 years 28 years 29 in 28 years 33 - 29 in 32 population 30 a 32 population 31 large 32 population 34 based 37 study 35 prospective 36 cohort 36 cohort 37 study 38 by 43 spectrometry 39 maldi 41 tof 40 - 41 tof 41 tof 42 mass 42 mass 43 spectrometry deaths [were] recorded during a median follow - up [of] 10.1 years . 0 ###LEFT-WALL### 1 deaths 0 ###LEFT-WALL### 7 follow 0 ###LEFT-WALL### 8 - 1 deaths 3 recorded 1 deaths 7 follow 3 recorded 4 during 4 during 6 median 5 a 6 median 8 - 9 up 8 - 13 . 9 up 12 years 11 10.1 12 years the associations of methylation [intensity] and [of] smoking with all - cause , cardiovascular , cancer and other mortality were assessed by cox 's proportional hazards regression , controlling for potential confounding factors . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 21 assessed 1 the 12 cause 2 associations 3 of 2 associations 6 and 3 of 4 methylation 6 and 8 smoking 6 and 11 - 6 and 12 cause 8 smoking 9 with 9 with 10 all 12 cause 13 , 13 , 16 cancer 13 , 17 and 14 cardiovascular 15 , 14 cardiovascular 16 cancer 17 and 19 mortality 17 and 20 were 18 other 19 mortality 20 were 21 assessed 21 assessed 22 by 22 by 27 regression 23 cox 24 's 24 's 27 regression 25 proportional 26 hazards 26 hazards 27 regression 27 regression 29 controlling 28 , 29 controlling 29 controlling 30 for 29 controlling 33 factors 29 controlling 34 . 30 for 31 potential 32 confounding 33 factors results : lower methylation [intensity] at f2rl3 was strongly associated with mortality . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 methylation 2 : 10 associated 2 : 13 . 3 lower 4 methylation 4 methylation 6 at 4 methylation 8 was 6 at 7 f2rl3 8 was 10 associated 9 strongly 10 associated 10 associated 11 with 11 with 12 mortality the associations with mortality outcomes were much stronger among men than among women . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 14 . 1 the 2 associations 2 associations 3 with 2 associations 6 were 3 with 5 outcomes 4 mortality 5 outcomes 6 were 8 stronger 7 much 8 stronger 8 stronger 9 among 8 stronger 11 than 9 among 10 men 11 than 12 among 12 among 13 women in addition , strong positive associations of smoking with each of the outcomes were substantially weakened , and almost disappeared when controlling for f2rl3 methylation [intensity] . 0 ###LEFT-WALL### 6 associations 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 27 . 1 in 2 addition 1 in 3 , 1 in 6 associations 4 strong 6 associations 5 positive 6 associations 6 associations 7 of 6 associations 14 were 7 of 8 smoking 8 smoking 9 with 9 with 13 outcomes 10 each 11 of 10 each 13 outcomes 11 of 13 outcomes 12 the 13 outcomes 14 were 18 and 15 substantially 16 weakened 16 weakened 18 and 17 , 18 and 18 and 20 disappeared 18 and 21 when 19 almost 20 disappeared 21 when 22 controlling 22 controlling 23 for 22 controlling 25 methylation 23 for 24 f2rl3 conclusions : f2rl3 methylation is a strong predictor of mortality , including all - cause , cardiovascular , cancer and other mortality . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 methylation 2 : 5 is 2 : 14 - 3 f2rl3 4 methylation 4 methylation 5 is 5 is 8 predictor 6 a 7 strong 6 a 8 predictor 7 strong 8 predictor 8 predictor 9 of 8 predictor 12 including 9 of 10 mortality 11 , 12 including 12 including 13 all 12 including 14 - 14 - 15 cause 14 - 16 , 14 - 23 . 16 , 20 and 17 cardiovascular 18 , 17 cardiovascular 19 cancer 19 cancer 20 and 20 and 22 mortality 21 other 22 mortality systemic adverse effects of smoking may be mediated by pathways associated with f2rl3 methylation . 0 ###LEFT-WALL### 3 effects 0 ###LEFT-WALL### 8 mediated 0 ###LEFT-WALL### 15 . 1 systemic 3 effects 2 adverse 3 effects 3 effects 4 of 3 effects 6 may 4 of 5 smoking 6 may 7 be 7 be 8 mediated 8 mediated 9 by 9 by 10 pathways 10 pathways 11 associated 10 pathways 12 with 12 with 14 methylation 13 f2rl3 14 methylation the decrease of tcr diversity with aging has never been studied by direct methods . 0 ###LEFT-WALL### 2 decrease 0 ###LEFT-WALL### 11 studied 0 ###LEFT-WALL### 15 . 1 the 2 decrease 2 decrease 3 of 2 decrease 8 has 3 of 5 diversity 4 tcr 5 diversity 5 diversity 6 with 6 with 7 aging 8 has 10 been 9 never 10 been 10 been 11 studied 11 studied 12 by 12 by 14 methods 13 direct 14 methods in this study , we combined high - throughput illumina sequencing with unique cdna molecular identifier technology to achieve deep and precisely normalized profiling of tcr β repertoires in 39 healthy donors aged 6 - 90 y . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 35 - 0 ###LEFT-WALL### 38 . 1 in 2 this 1 in 21 and 3 study 4 , 4 , 10 illumina 4 , 21 and 5 we 9 throughput 6 combined 9 throughput 7 high 8 - 7 high 9 throughput 9 throughput 10 illumina 10 illumina 11 sequencing 11 sequencing 12 with 11 sequencing 17 technology 11 sequencing 20 deep 12 with 14 cdna 13 unique 14 cdna 15 molecular 17 technology 16 identifier 17 technology 17 technology 18 to 17 technology 19 achieve 18 to 19 achieve 21 and 24 profiling 21 and 27 β 22 precisely 23 normalized 23 normalized 24 profiling 24 profiling 25 of 25 of 26 tcr 27 β 28 repertoires 28 repertoires 29 in 28 repertoires 33 aged 29 in 32 donors 30 39 32 donors 31 healthy 32 donors 33 aged 34 6 34 6 35 - 35 - 36 90 36 90 37 y we demonstrate that tcr β diversity [per] 10 [(] 6 [ )(t cells decreases roughly linearly with age , with significant reduction already apparent by age 40 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 demonstrate 1 we 2 demonstrate 2 demonstrate 3 that 3 that 4 tcr 3 that 5 β 4 tcr 5 β 5 β 14 decreases 5 β 15 roughly 5 β 16 linearly 5 β 17 with 6 diversity 14 decreases 8 10 14 decreases 10 6 12 )(t 12 )(t 14 decreases 13 cells 14 decreases 17 with 18 age 18 age 20 with 19 , 20 with 20 with 22 reduction 20 with 23 already 20 with 24 apparent 20 with 28 . 21 significant 22 reduction 24 apparent 25 by 25 by 26 age 26 age 27 40 the percentage of naive [t] cells showed a strong correlation with measured tcr diversity and decreased linearly up to age 70 . 0 ###LEFT-WALL### 2 percentage 0 ###LEFT-WALL### 7 showed 0 ###LEFT-WALL### 22 . 1 the 2 percentage 2 percentage 3 of 2 percentage 7 showed 3 of 6 cells 4 naive 6 cells 7 showed 10 correlation 7 showed 11 with 7 showed 17 linearly 7 showed 18 up 7 showed 19 to 8 a 9 strong 8 a 10 correlation 9 strong 10 correlation 11 with 15 and 12 measured 14 diversity 12 measured 15 and 13 tcr 14 diversity 15 and 16 decreased 19 to 20 age 20 age 21 70 remarkably , the oldest group ( average age 82 [y] ) was characterized by a higher percentage of naive [cd4] ( [+] [ )(t [cells] , lower abundance of expanded clones , and increased tcr diversity compared with the previous age group ( average age 62 [y] ) , suggesting the influence of age selection and association of these three related parameters with longevity . 1 remarkably 2 , 1 remarkably 5 group 3 the 4 oldest 3 the 5 group 5 group 8 age 5 group 12 was 6 ( 8 age 7 average 8 age 8 age 9 82 8 age 11 ) 12 was 13 characterized 13 characterized 14 by 14 by 17 percentage 15 a 17 percentage 16 higher 17 percentage 17 percentage 18 of 17 percentage 29 of 18 of 28 abundance 19 naive 24 )(t 19 naive 28 abundance 21 ( 24 )(t 24 )(t 26 , 27 lower 28 abundance 29 of 33 and 30 expanded 31 clones 31 clones 33 and 32 , 33 and 33 and 36 diversity 33 and 37 compared 33 and 38 with 34 increased 36 diversity 35 tcr 36 diversity 38 with 42 group 39 the 42 group 40 previous 41 age 41 age 42 group 42 group 45 age 42 group 50 suggesting 43 ( 45 age 44 average 45 age 45 age 46 62 45 age 48 ) 49 , 50 suggesting 50 suggesting 56 and 51 the 52 influence 52 influence 53 of 52 influence 56 and 53 of 55 selection 54 age 55 selection 56 and 57 association 56 and 65 . 57 association 58 of 58 of 62 parameters 59 these 60 three 60 three 62 parameters 61 related 62 parameters 62 parameters 63 with 63 with 64 longevity interestingly , cross - analysis of individual tcr β repertoires revealed a set >10,000 of the most representative public tcr β clonotypes , whose abundance among the top 100,000 clones correlated with tcr diversity and decreased with aging . 0 ###LEFT-WALL### 3 cross 0 ###LEFT-WALL### 4 - 1 interestingly 2 , 1 interestingly 3 cross 4 - 5 analysis 4 - 11 revealed 5 analysis 6 of 5 analysis 11 revealed 6 of 10 repertoires 7 individual 10 repertoires 8 tcr 9 β 9 β 10 repertoires 11 revealed 14 >10,000 12 a 14 >10,000 13 set 14 >10,000 14 >10,000 15 of 15 of 20 tcr 16 the 17 most 17 most 20 tcr 18 representative 19 public 19 public 20 tcr 20 tcr 21 β 20 tcr 22 clonotypes 20 tcr 24 whose 21 β 22 clonotypes 23 , 24 whose 24 whose 25 abundance 24 whose 39 . 25 abundance 26 among 25 abundance 30 clones 25 abundance 36 decreased 25 abundance 38 aging 26 among 29 100,000 27 the 28 top 27 the 29 100,000 30 clones 35 and 31 correlated 32 with 31 correlated 35 and 32 with 34 diversity 33 tcr 34 diversity 35 and 36 decreased 36 decreased 37 with 37 with 38 aging mutations in leucine - rich repeat kinase 2 ( lrrk2 ) cause inherited parkinson disease ( pd ) , and common variants around lrrk2 are a risk factor for sporadic pd . 0 ###LEFT-WALL### 1 mutations 0 ###LEFT-WALL### 12 cause 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 32 . 1 mutations 2 in 1 mutations 12 cause 2 in 3 leucine 3 leucine 7 kinase 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 cause 15 disease 13 inherited 15 disease 14 parkinson 15 disease 15 disease 17 pd 16 ( 17 pd 17 pd 18 ) 19 , 20 and 20 and 22 variants 20 and 25 are 21 common 22 variants 22 variants 23 around 22 variants 25 are 23 around 24 lrrk2 25 are 28 factor 26 a 28 factor 27 risk 28 factor 28 factor 29 for 29 for 31 pd 30 sporadic 31 pd using protein - protein interaction arrays , we identified bcl2 - associated athanogene 5 , rab7l1 ( rab7 , member ras oncogene family - like 1 ) , and cyclin - g - associated kinase as binding partners of lrrk2 . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 9 identified 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 41 . 1 using 2 protein 1 using 7 , 1 using 8 we 2 protein 6 arrays 3 - 6 arrays 4 protein 6 arrays 5 interaction 6 arrays 6 arrays 7 , 8 we 9 identified 9 identified 10 bcl2 10 bcl2 13 athanogene 11 - 13 athanogene 12 associated 13 athanogene 13 athanogene 14 5 13 athanogene 15 , 15 , 16 rab7l1 15 , 34 associated 16 rab7l1 31 - 16 rab7l1 34 associated 17 ( 31 - 18 rab7 23 family 18 rab7 29 and 19 , 23 family 20 member 23 family 21 ras 23 family 22 oncogene 23 family 23 family 25 like 23 family 28 , 24 - 25 like 25 like 26 1 25 like 27 ) 28 , 29 and 29 and 30 cyclin 29 and 31 - 31 - 32 g 31 - 33 - 34 associated 38 partners 35 kinase 38 partners 36 as 37 binding 37 binding 38 partners 38 partners 39 of 39 of 40 lrrk2 the latter two genes are candidate genes for risk for sporadic pd identified by genome [-] wide association studies . 0 ###LEFT-WALL### 4 genes 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 20 . 1 the 4 genes 2 latter 4 genes 3 two 4 genes 4 genes 5 are 5 are 7 genes 6 candidate 7 genes 7 genes 8 for 8 for 9 risk 9 risk 10 for 10 for 12 pd 11 sporadic 12 pd 12 pd 13 identified 13 identified 14 by 14 by 19 studies 15 genome 19 studies 17 wide 18 association 18 association 19 studies these proteins form a complex that promotes clearance of golgi - derived vesicles through the autophagy - lysosome [system] both in vitro and in vivo . 0 ###LEFT-WALL### 2 proteins 0 ###LEFT-WALL### 3 form 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 18 lysosome 0 ###LEFT-WALL### 26 . 1 these 2 proteins 2 proteins 3 form 3 form 5 complex 4 a 5 complex 5 complex 6 that 5 complex 7 promotes 6 that 7 promotes 7 promotes 8 clearance 8 clearance 9 of 9 of 10 golgi 11 - 13 vesicles 11 - 17 - 12 derived 13 vesicles 13 vesicles 14 through 14 through 16 autophagy 15 the 16 autophagy 17 - 18 lysosome 18 lysosome 20 both 18 lysosome 23 and 21 in 22 vitro 22 vitro 23 and 23 and 25 vivo 24 in 25 vivo we propose that three different genes for pd have a common biological function . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 propose 0 ###LEFT-WALL### 14 . 1 we 2 propose 2 propose 3 that 3 that 6 genes 3 that 9 have 4 three 6 genes 5 different 6 genes 6 genes 7 for 6 genes 9 have 7 for 8 pd 9 have 13 function 10 a 11 common 10 a 13 function 11 common 13 function 12 biological 13 function more generally , data integration from multiple unbiased screens can provide insight into human disease mechanisms . 0 ###LEFT-WALL### 5 integration 0 ###LEFT-WALL### 11 provide 0 ###LEFT-WALL### 17 . 1 more 2 generally 2 generally 3 , 2 generally 5 integration 4 data 5 integration 5 integration 6 from 5 integration 10 can 6 from 9 screens 7 multiple 9 screens 8 unbiased 9 screens 10 can 11 provide 11 provide 12 insight 11 provide 13 into 13 into 16 mechanisms 14 human 15 disease 15 disease 16 mechanisms angiogenesis , the sprouting of new capillaries from existing blood vessels [,] accompanies clinical and experimental stroke and is focused particularly in the salvageable ischemic border zone . 0 ###LEFT-WALL### 1 angiogenesis 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 28 . 2 , 4 sprouting 2 , 18 and 3 the 4 sprouting 4 sprouting 5 of 4 sprouting 8 from 4 sprouting 18 and 5 of 7 capillaries 6 new 7 capillaries 8 from 11 vessels 9 existing 10 blood 10 blood 11 vessels 13 accompanies 15 and 13 accompanies 18 and 14 clinical 15 and 15 and 17 stroke 16 experimental 17 stroke 18 and 19 is 18 and 21 particularly 19 is 20 focused 21 particularly 22 in 22 in 27 zone 23 the 27 zone 24 salvageable 26 border 25 ischemic 26 border 26 border 27 zone as this endogenous angiogenic response correlates positively with clinical [prognosis] , a more complete understanding of the underlying molecular mechanisms and timing of these events may help in the design of novel therapies for vascular regeneration [after] [stroke] . 0 ###LEFT-WALL### 25 events 0 ###LEFT-WALL### 27 help 0 ###LEFT-WALL### 39 . 1 as 5 response 1 as 6 correlates 1 as 25 events 2 this 5 response 3 endogenous 5 response 4 angiogenic 5 response 5 response 6 correlates 6 correlates 7 positively 6 correlates 8 with 8 with 21 and 9 clinical 11 , 11 , 15 understanding 11 , 21 and 12 a 15 understanding 13 more 15 understanding 14 complete 15 understanding 15 understanding 16 of 16 of 20 mechanisms 17 the 20 mechanisms 18 underlying 20 mechanisms 19 molecular 20 mechanisms 21 and 22 timing 21 and 23 of 23 of 24 these 25 events 26 may 26 may 27 help 27 help 28 in 28 in 30 design 29 the 30 design 30 design 31 of 31 of 33 therapies 32 novel 33 therapies 33 therapies 34 for 34 for 36 regeneration 35 vascular 36 regeneration in this review we discuss endogenous protective mechanisms , including angiogenesis and vasculogenesis , and underlying molecular mechanisms . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 discuss 1 in 3 review 1 in 4 we 2 this 3 review 4 we 5 discuss 5 discuss 8 mechanisms 5 discuss 10 including 6 endogenous 8 mechanisms 7 protective 8 mechanisms 9 , 10 including 10 including 15 and 10 including 19 . 11 angiogenesis 12 and 12 and 13 vasculogenesis 12 and 15 and 14 , 15 and 15 and 18 mechanisms 16 underlying 18 mechanisms 17 molecular 18 mechanisms we also consider the feasibility of angiogenic therapy for [stroke] [and] its optimal timing . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 consider 0 ###LEFT-WALL### 15 . 1 we 3 consider 2 also 3 consider 3 consider 5 feasibility 4 the 5 feasibility 5 feasibility 6 of 6 of 8 therapy 7 angiogenic 8 therapy 8 therapy 9 for 9 for 14 timing 12 its 14 timing 13 optimal 14 timing precise detection and quantification of white matter hyperintensities ( wmh ) observed in t2 - weighted fluid attenuated inversion recovery ( flair ) magnetic resonance images ( mri ) is of substantial interest in aging , and age - related neurological disorders such as alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 matter 0 ###LEFT-WALL### 12 observed 0 ###LEFT-WALL### 15 - 1 precise 2 detection 2 detection 3 and 3 and 4 quantification 3 and 5 of 3 and 7 matter 5 of 6 white 8 hyperintensities 10 wmh 8 hyperintensities 12 observed 9 ( 10 wmh 10 wmh 11 ) 12 observed 13 in 12 observed 15 - 13 in 14 t2 15 - 28 mri 15 - 30 is 15 - 40 related 15 - 51 . 16 weighted 28 mri 17 fluid 18 attenuated 18 attenuated 19 inversion 19 inversion 20 recovery 20 recovery 22 flair 21 ( 22 flair 22 flair 23 ) 22 flair 24 magnetic 24 magnetic 25 resonance 25 resonance 26 images 26 images 28 mri 27 ( 28 mri 28 mri 29 ) 28 mri 30 is 30 is 31 of 31 of 33 interest 32 substantial 33 interest 33 interest 34 in 34 in 37 and 35 aging 37 and 36 , 37 and 37 and 38 age 39 - 40 related 40 related 42 disorders 40 related 44 as 40 related 50 ) 41 neurological 42 disorders 43 such 44 as 44 as 47 disease 45 alzheimer 46 's 46 's 47 disease 47 disease 49 ad 48 ( 49 ad 49 ad 50 ) this is mainly because wmh may reflect co - morbid neural injury or cerebral vascular disease burden . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 18 . 1 this 2 is 2 is 3 mainly 2 is 4 because 4 because 5 wmh 4 because 7 reflect 5 wmh 6 may 6 may 7 reflect 7 reflect 13 or 8 co 9 - 8 co 12 injury 10 morbid 12 injury 11 neural 12 injury 12 injury 13 or 13 or 17 burden 14 cerebral 16 disease 15 vascular 16 disease 16 disease 17 burden wmh in the older population may be small , diffuse , and irregular in shape , and sufficiently heterogeneous within [and] [across] subjects . 0 ###LEFT-WALL### 1 wmh 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 24 . 1 wmh 2 in 1 wmh 6 may 2 in 5 population 3 the 5 population 4 older 5 population 6 may 7 be 7 be 12 and 8 small 9 , 9 , 10 diffuse 9 , 12 and 11 , 12 and 12 and 17 and 13 irregular 14 in 13 irregular 17 and 14 in 15 shape 16 , 17 and 17 and 19 heterogeneous 18 sufficiently 19 heterogeneous 19 heterogeneous 20 within 20 within 23 subjects here , we pose hyperintensity detection as a supervised inference problem and adapt two learning models , specifically , support vector machines and random forests , for this task . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 30 . 1 here 2 , 1 here 3 we 3 we 12 and 4 pose 6 detection 4 pose 12 and 5 hyperintensity 6 detection 6 detection 7 as 7 as 11 problem 8 a 11 problem 9 supervised 10 inference 10 inference 11 problem 12 and 13 adapt 13 adapt 14 two 13 adapt 27 for 14 two 15 learning 14 two 23 and 15 learning 16 models 15 learning 18 specifically 17 , 18 specifically 18 specifically 19 , 19 , 23 and 20 support 21 vector 21 vector 22 machines 22 machines 23 and 23 and 25 forests 23 and 26 , 24 random 25 forests 27 for 29 task 28 this 29 task using texture features engineered by texton filter banks , we provide a suite of effective segmentation methods for this problem . 0 ###LEFT-WALL### 10 we 0 ###LEFT-WALL### 11 provide 0 ###LEFT-WALL### 21 . 1 using 3 features 1 using 9 , 1 using 10 we 2 texture 3 features 3 features 4 engineered 4 engineered 5 by 5 by 8 banks 6 texton 8 banks 7 filter 8 banks 10 we 11 provide 11 provide 13 suite 12 a 13 suite 13 suite 14 of 14 of 17 methods 15 effective 16 segmentation 16 segmentation 17 methods 17 methods 18 for 18 for 20 problem 19 this 20 problem through extensive evaluations on healthy [middle] - aged and older adults who vary in ad risk , we show that our methods are reliable and robust in segmenting hyperintense regions . 0 ###LEFT-WALL### 18 we 0 ###LEFT-WALL### 19 show 0 ###LEFT-WALL### 31 . 1 through 3 evaluations 1 through 18 we 2 extensive 3 evaluations 3 evaluations 4 on 3 evaluations 12 who 3 evaluations 13 vary 4 on 11 adults 5 healthy 7 - 5 healthy 11 adults 8 aged 9 and 9 and 10 older 9 and 11 adults 12 who 13 vary 14 in 16 risk 14 in 17 , 14 in 18 we 15 ad 16 risk 18 we 19 show 19 show 20 that 19 show 22 methods 19 show 23 are 21 our 22 methods 22 methods 23 are 23 are 25 and 24 reliable 25 and 25 and 26 robust 26 robust 27 in 27 in 28 segmenting 28 segmenting 30 regions 29 hyperintense 30 regions a measure of hyperintensity accumulation , referred to as normalized effective wmh volume , is shown to be associated with dementia in older adults and parental family history in cognitively normal subjects . 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 33 . 1 a 2 measure 2 measure 3 of 2 measure 5 accumulation 3 of 5 accumulation 4 hyperintensity 5 accumulation 5 accumulation 8 to 5 accumulation 15 is 6 , 8 to 7 referred 8 to 8 to 9 as 8 to 14 , 9 as 13 volume 10 normalized 13 volume 11 effective 13 volume 12 wmh 13 volume 15 is 16 shown 16 shown 17 to 17 to 18 be 18 be 19 associated 19 associated 20 with 19 associated 22 in 20 with 21 dementia 22 in 25 and 23 older 24 adults 24 adults 25 and 25 and 28 history 25 and 29 in 26 parental 27 family 27 family 28 history 29 in 32 subjects 30 cognitively 31 normal 31 normal 32 subjects we provide an open source library for hyperintensity detection and accumulation ( interfaced with existing neuroimaging tools ) , that can be adapted for segmentation problems in other neuroimaging studies . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 provide 0 ###LEFT-WALL### 31 . 1 we 2 provide 2 provide 6 library 2 provide 24 for 2 provide 27 in 3 an 4 open 3 an 6 library 4 open 5 source 5 source 6 library 6 library 7 for 6 library 20 that 6 library 21 can 7 for 10 and 8 hyperintensity 9 detection 9 detection 10 and 10 and 11 accumulation 10 and 13 interfaced 12 ( 13 interfaced 13 interfaced 14 with 13 interfaced 18 ) 14 with 17 tools 15 existing 17 tools 16 neuroimaging 17 tools 19 , 20 that 20 that 21 can 21 can 22 be 22 be 23 adapted 24 for 26 problems 25 segmentation 26 problems 27 in 30 studies 28 other 30 studies 29 neuroimaging 30 studies migration of hiv infected cells into the cns is associated with a spectrum of neurological disorders , ranging from milder forms of hiv - associated neurocognitive disorders ( hand ) to hiv - associated dementia ( had ) . 0 ###LEFT-WALL### 1 migration 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 39 . 1 migration 2 of 1 migration 9 is 2 of 5 cells 3 hiv 4 infected 4 infected 5 cells 5 cells 6 into 6 into 8 cns 7 the 8 cns 9 is 10 associated 10 associated 11 with 11 with 13 spectrum 12 a 13 spectrum 13 spectrum 14 of 14 of 16 disorders 15 neurological 16 disorders 16 disorders 18 ranging 17 , 18 ranging 18 ranging 19 from 18 ranging 31 to 18 ranging 38 ) 19 from 21 forms 20 milder 21 forms 21 forms 22 of 22 of 23 hiv 23 hiv 27 disorders 24 - 27 disorders 25 associated 27 disorders 26 neurocognitive 27 disorders 27 disorders 29 hand 27 disorders 30 ) 28 ( 29 hand 29 hand 30 ) 31 to 32 hiv 32 hiv 35 dementia 33 - 35 dementia 34 associated 35 dementia 35 dementia 37 had 35 dementia 38 ) 36 ( 37 had 37 had 38 ) these neuro - psychiatric syndromes are related to the neurodegenerative pathology triggered by the release of hiv proteins and cytokine/chemokines from monocytes/macrophages into the cns - a condition known as hiv encephalitis ( hive ) . 0 ###LEFT-WALL### 5 syndromes 0 ###LEFT-WALL### 7 related 0 ###LEFT-WALL### 36 . 1 these 5 syndromes 2 neuro 3 - 2 neuro 5 syndromes 4 psychiatric 5 syndromes 5 syndromes 6 are 6 are 7 related 7 related 8 to 7 related 13 by 7 related 21 from 8 to 11 pathology 9 the 11 pathology 10 neurodegenerative 11 pathology 11 pathology 12 triggered 13 by 19 and 14 the 15 release 15 release 16 of 15 release 19 and 16 of 18 proteins 17 hiv 18 proteins 19 and 20 cytokine/chemokines 21 from 22 monocytes/macrophages 22 monocytes/macrophages 23 into 22 monocytes/macrophages 28 condition 23 into 25 cns 24 the 25 cns 26 - 28 condition 27 a 28 condition 28 condition 29 known 28 condition 35 ) 29 known 30 as 30 as 32 encephalitis 31 hiv 32 encephalitis 32 encephalitis 34 hive 33 ( 34 hive 34 hive 35 ) as a result of more effective combined anti - retroviral therapy patients with hiv are living longer and thus the frequency of hand has increased considerably , resulting in an overlap between the neurodegenerative pathology associated with hiv and that related to aging . 0 ###LEFT-WALL### 12 patients 0 ###LEFT-WALL### 15 are 0 ###LEFT-WALL### 18 and 1 as 3 result 1 as 12 patients 2 a 3 result 4 of 11 therapy 4 of 12 patients 5 more 6 effective 6 effective 11 therapy 7 combined 11 therapy 8 anti 9 - 8 anti 11 therapy 10 retroviral 11 therapy 12 patients 13 with 12 patients 15 are 13 with 14 hiv 15 are 16 living 16 living 17 longer 18 and 19 thus 18 and 21 frequency 18 and 25 increased 20 the 21 frequency 21 frequency 22 of 21 frequency 24 has 22 of 23 hand 24 has 25 increased 25 increased 26 considerably 25 increased 28 resulting 27 , 28 resulting 28 resulting 29 in 28 resulting 44 . 29 in 39 and 30 an 31 overlap 31 overlap 32 between 31 overlap 37 with 31 overlap 39 and 32 between 35 pathology 33 the 35 pathology 34 neurodegenerative 35 pathology 35 pathology 36 associated 37 with 38 hiv 39 and 40 that 39 and 41 related 39 and 42 to 42 to 43 aging in fact , hiv infection is believed to hasten the aging process . 0 ###LEFT-WALL### 5 infection 0 ###LEFT-WALL### 7 believed 0 ###LEFT-WALL### 13 . 1 in 2 fact 2 fact 3 , 2 fact 5 infection 4 hiv 5 infection 5 infection 6 is 6 is 7 believed 7 believed 8 to 7 believed 9 hasten 8 to 9 hasten 9 hasten 12 process 10 the 12 process 11 aging 12 process the mechanisms through which hiv and aging lead to neurodegeneration include [:] abnormal calcium flux , excitotoxicity , signaling abnormalities , oxidative stress and autophagy defects . 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 11 include 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 27 . 1 the 2 mechanisms 2 mechanisms 3 through 2 mechanisms 11 include 3 through 4 which 3 through 6 and 3 through 8 lead 5 hiv 6 and 6 and 7 aging 6 and 8 lead 8 lead 9 to 9 to 10 neurodegeneration 11 include 15 flux 11 include 19 signaling 13 abnormal 15 flux 14 calcium 15 flux 15 flux 17 excitotoxicity 16 , 17 excitotoxicity 17 excitotoxicity 18 , 18 , 19 signaling 19 signaling 20 abnormalities 19 signaling 21 , 21 , 26 defects 22 oxidative 23 stress 23 stress 24 and 24 and 25 autophagy 24 and 26 defects moreover , recent studies have shown that defects in the processing and transport of neurotrophic factors such as fibroblast growth factors ( fgfs ) , neural growth [factor] ( ngf ) and brain - derived growth [factor] ( bdnf ) might also play a role . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 34 - 1 moreover 2 , 1 moreover 4 studies 3 recent 4 studies 4 studies 32 and 5 have 6 shown 5 have 32 and 6 shown 12 and 6 shown 18 as 6 shown 21 factors 7 that 12 and 8 defects 9 in 8 defects 12 and 9 in 11 processing 10 the 11 processing 12 and 13 transport 12 and 14 of 14 of 16 factors 15 neurotrophic 16 factors 17 such 18 as 18 as 20 growth 19 fibroblast 20 growth 21 factors 23 fgfs 21 factors 27 growth 22 ( 23 fgfs 23 fgfs 24 ) 25 , 27 growth 26 neural 27 growth 27 growth 30 ngf 27 growth 31 ) 29 ( 30 ngf 30 ngf 31 ) 32 and 33 brain 34 - 36 growth 34 - 43 play 34 - 46 . 35 derived 36 growth 36 growth 39 bdnf 36 growth 41 might 38 ( 39 bdnf 39 bdnf 40 ) 41 might 43 play 42 also 43 play 43 play 45 role 44 a 45 role recent evidence implicates alterations in neurotrophins in the pathogenesis of neurodegeneration associated with hand in the context of aging . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 3 implicates 0 ###LEFT-WALL### 20 . 1 recent 2 evidence 2 evidence 3 implicates 3 implicates 4 alterations 4 alterations 5 in 4 alterations 12 associated 4 alterations 18 of 5 in 6 neurotrophins 6 neurotrophins 7 in 6 neurotrophins 10 of 7 in 9 pathogenesis 8 the 9 pathogenesis 10 of 11 neurodegeneration 12 associated 13 with 12 associated 15 in 13 with 14 hand 15 in 17 context 16 the 17 context 18 of 19 aging here , we report fgf overexpression curtails gp120 - induced neurotoxicity in a double transgenic mouse model . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 report 0 ###LEFT-WALL### 18 . 1 here 2 , 1 here 3 we 3 we 4 report 4 report 6 overexpression 4 report 7 curtails 5 fgf 6 overexpression 6 overexpression 7 curtails 7 curtails 11 neurotoxicity 7 curtails 12 in 8 gp120 9 - 8 gp120 11 neurotoxicity 10 induced 11 neurotoxicity 12 in 17 model 13 a 14 double 13 a 17 model 14 double 16 mouse 15 transgenic 16 mouse 16 mouse 17 model furthermore , our data show disparities in brain neurotrophic factor levels may be exacerbated in hiv patients over 50 years of age . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 5 show 0 ###LEFT-WALL### 23 . 1 furthermore 2 , 1 furthermore 4 data 3 our 4 data 4 data 5 show 5 show 6 disparities 5 show 7 in 5 show 11 levels 5 show 14 exacerbated 7 in 8 brain 9 neurotrophic 10 factor 10 factor 11 levels 11 levels 12 may 12 may 13 be 13 be 14 exacerbated 14 exacerbated 15 in 14 exacerbated 18 over 15 in 17 patients 16 hiv 17 patients 18 over 20 years 19 50 20 years 20 years 21 of 21 of 22 age in this review , we discuss the most recent findings on neurotrophins and hand in the context of developing new therapies to combat hiv infection in the aging population . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 discuss 0 ###LEFT-WALL### 30 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 discuss 6 discuss 10 findings 7 the 10 findings 8 most 9 recent 9 recent 10 findings 10 findings 11 on 11 on 13 and 12 neurotrophins 13 and 13 and 14 hand 13 and 15 in 13 and 22 to 15 in 17 context 16 the 17 context 17 context 18 of 18 of 19 developing 19 developing 21 therapies 20 new 21 therapies 22 to 25 infection 23 combat 25 infection 24 hiv 25 infection 25 infection 26 in 26 in 29 population 27 the 29 population 28 aging 29 population objective : the aim of this study was to evaluate the safety and tolerability of sitagliptin 100 mg / [day] in elderly patients with type 2 diabetes . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 4 aim 3 the 4 aim 4 aim 5 of 4 aim 7 study 4 aim 19 / 5 of 6 this 7 study 8 was 8 was 9 to 8 was 19 / 9 to 10 evaluate 10 evaluate 13 and 11 the 13 and 12 safety 13 and 13 and 14 tolerability 13 and 15 of 15 of 16 sitagliptin 17 100 18 mg 18 mg 19 / 19 / 21 in 19 / 24 with 21 in 23 patients 22 elderly 23 patients 24 with 25 type 24 with 27 diabetes 25 type 26 2 design : a post [hoc] pooled analysis of 25 randomized , double - blind , parallel group clinical studies with results available as of 1 december 2011 . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 28 . 1 design 2 : 2 : 7 analysis 3 a 4 post 3 a 7 analysis 4 post 6 pooled 6 pooled 7 analysis 7 analysis 8 of 8 of 9 25 9 25 10 randomized 10 randomized 11 , 10 randomized 12 double 13 - 19 studies 14 blind 15 , 14 blind 17 group 16 parallel 17 group 17 group 19 studies 18 clinical 19 studies 19 studies 20 with 20 with 21 results 21 results 22 available 22 available 23 as 23 as 24 of 24 of 26 december 25 1 26 december 26 december 27 2011 setting : multicenter , international clinical trials . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 8 . 1 setting 2 : 2 : 3 multicenter 4 , 7 trials 5 international 7 trials 6 clinical 7 trials subjects : patients with type 2 diabetes aged 65 years or older . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 . 1 subjects 2 : 2 : 3 patients 3 patients 4 with 3 patients 7 diabetes 3 patients 8 aged 4 with 5 type 5 type 6 2 7 diabetes 8 aged 8 aged 11 or 9 65 10 years 10 years 11 or 11 or 12 older interventions : patients [were] randomized to sitagliptin 100 mg/day ( n = 1,261 ) or a comparator ( n = 1,185 ) for 12 weeks to 2 years . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 1 interventions 2 : 2 : 15 or 2 : 23 for 3 patients 5 randomized 3 patients 15 or 5 randomized 6 to 6 to 7 sitagliptin 7 sitagliptin 12 = 8 100 9 mg/day 9 mg/day 12 = 10 ( 12 = 11 n 12 = 12 = 13 1,261 12 = 14 ) 15 or 17 comparator 15 or 20 = 16 a 17 comparator 18 ( 20 = 19 n 20 = 20 = 21 1,185 20 = 22 ) 23 for 26 to 24 12 25 weeks 25 weeks 26 to 26 to 28 years 27 2 28 years main outcome measures : in each study , investigators reported [serious] and [non] - serious adverse events that occurred during the study , and serious adverse events occurring within 14 days following the last dose of study drug . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 10 reported 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 38 drug 0 ###LEFT-WALL### 39 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 5 in 5 in 7 study 6 each 7 study 8 , 10 reported 9 investigators 10 reported 12 and 14 - 12 and 19 occurred 14 - 17 events 15 serious 17 events 16 adverse 17 events 18 that 19 occurred 19 occurred 20 during 19 occurred 29 within 20 during 24 and 21 the 22 study 22 study 24 and 23 , 24 and 24 and 27 events 24 and 28 occurring 25 serious 27 events 26 adverse 27 events 29 within 30 14 30 14 31 days 30 14 38 drug 31 days 32 following 31 days 36 of 31 days 38 drug 32 following 35 dose 33 the 35 dose 34 last 35 dose 36 of 37 study this analysis used patient - level data from each study to assess the exposure [-] adjusted incidence rates of specific adverse events that occurred following initiation of study drug . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 3 used 0 ###LEFT-WALL### 30 . 1 this 2 analysis 2 analysis 3 used 3 used 7 data 3 used 8 from 3 used 11 to 3 used 12 assess 4 patient 5 - 4 patient 7 data 6 level 7 data 8 from 10 study 9 each 10 study 11 to 12 assess 12 assess 14 exposure 13 the 14 exposure 14 exposure 16 adjusted 14 exposure 18 rates 14 exposure 29 drug 17 incidence 18 rates 18 rates 19 of 18 rates 25 following 18 rates 29 drug 19 of 22 events 20 specific 22 events 21 adverse 22 events 22 events 23 that 22 events 24 occurred 23 that 24 occurred 25 following 26 initiation 26 initiation 27 of 27 of 28 study results : summary measures of adverse events overall were similar between the sitagliptin and [non] [-] exposed [(] active comparator or placebo ) groups , except for higher incidences of deaths and drug - related adverse events in the [non] [-] exposed group . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 measures 2 : 9 were 3 summary 4 measures 4 measures 5 of 4 measures 9 were 5 of 7 events 6 adverse 7 events 8 overall 9 were 9 were 14 and 10 similar 11 between 10 similar 14 and 11 between 13 sitagliptin 12 the 13 sitagliptin 14 and 24 groups 14 and 25 , 14 and 26 except 17 exposed 20 comparator 19 active 20 comparator 20 comparator 21 or 21 or 22 placebo 21 or 23 ) 21 or 24 groups 26 except 27 for 27 for 29 incidences 28 higher 29 incidences 29 incidences 30 of 30 of 32 and 31 deaths 32 and 32 and 33 drug 32 and 37 events 34 - 37 events 35 related 37 events 36 adverse 37 events 37 events 38 in 37 events 44 . 38 in 43 group 39 the 43 group 42 exposed 43 group incidence rates of specific adverse events were generally similar between the two groups , with the exception of hypoglycemia . 0 ###LEFT-WALL### 2 rates 0 ###LEFT-WALL### 7 were 1 incidence 2 rates 2 rates 3 of 2 rates 7 were 3 of 6 events 4 specific 6 events 5 adverse 6 events 7 were 8 generally 7 were 9 similar 9 similar 10 between 10 between 13 groups 11 the 12 two 12 two 13 groups 13 groups 15 with 14 , 15 with 15 with 17 exception 15 with 20 . 16 the 17 exception 17 exception 18 of 18 of 19 hypoglycemia a lower incidence rate of hypoglycemia was observed in the sitagliptin group compared with the [non] [-] exposed group [ 7.0 vs [.] 14.3 per 100 patient - years [;] difference [-] 7.6 [(] 95 % ci - 11.2 [to] - 4.3 ] ) , primarily due to greater use of sulfonylureas in the [non] [-] exposed group . 0 ###LEFT-WALL### 4 rate 0 ###LEFT-WALL### 8 observed 1 a 4 rate 2 lower 4 rate 3 incidence 4 rate 4 rate 5 of 4 rate 7 was 5 of 6 hypoglycemia 7 was 8 observed 8 observed 9 in 9 in 12 group 10 the 12 group 11 sitagliptin 12 group 12 group 13 compared 13 compared 14 with 14 with 19 group 15 the 19 group 18 exposed 19 group 19 group 28 - 20 [ 28 - 21 7.0 22 vs 21 7.0 28 - 22 vs 24 14.3 24 14.3 25 per 25 per 27 patient 26 100 27 patient 28 - 37 ci 29 years 37 ci 31 difference 37 ci 33 7.6 37 ci 35 95 37 ci 36 % 37 ci 37 ci 39 11.2 37 ci 47 due 38 - 39 11.2 39 11.2 42 4.3 39 11.2 44 ) 41 - 42 4.3 42 4.3 43 ] 45 , 46 primarily 45 , 47 due 47 due 48 to 47 due 53 in 47 due 59 . 48 to 50 use 49 greater 50 use 50 use 51 of 51 of 52 sulfonylureas 53 in 58 group 54 the 58 group 57 exposed 58 group conclusions : in this pooled safety analysis of elderly patients with type 2 diabetes , treatment with sitagliptin 100 [mg/day] was generally well tolerated for up to 2 years . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 30 . 1 conclusions 2 : 2 : 3 in 2 : 11 with 3 in 7 analysis 4 this 7 analysis 5 pooled 7 analysis 6 safety 7 analysis 7 analysis 8 of 8 of 10 patients 9 elderly 10 patients 11 with 12 type 11 with 14 diabetes 12 type 13 2 15 , 16 treatment 15 , 21 was 16 treatment 17 with 16 treatment 21 was 17 with 18 sitagliptin 18 sitagliptin 19 100 21 was 22 generally 21 was 23 well 23 well 24 tolerated 24 tolerated 25 for 25 for 29 years 26 up 27 to 27 to 28 2 28 2 29 years during mammalian development , migration , proliferation and survival of primordial germ cells can give rise [to] germ stem cells . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 15 give 0 ###LEFT-WALL### 21 . 1 during 3 development 1 during 4 , 1 during 8 and 2 mammalian 3 development 5 migration 6 , 6 , 7 proliferation 6 , 8 and 8 and 9 survival 8 and 10 of 8 and 14 can 10 of 13 cells 11 primordial 12 germ 12 germ 13 cells 14 can 15 give 15 give 20 cells 16 rise 20 cells 18 germ 20 cells 19 stem 20 cells there [are] evidences that stem cells also exist in adult gonad , and can maintain the renewal of germ cells and decelerate aging process . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 25 . 1 there 21 and 3 evidences 5 stem 3 evidences 21 and 4 that 5 stem 5 stem 6 cells 5 stem 13 and 6 cells 13 and 7 also 8 exist 8 exist 9 in 8 exist 13 and 9 in 11 gonad 10 adult 11 gonad 12 , 13 and 13 and 14 can 14 can 15 maintain 15 maintain 17 renewal 16 the 17 renewal 17 renewal 18 of 18 of 20 cells 19 germ 20 cells 21 and 22 decelerate 22 decelerate 24 process 23 aging 24 process therefore , germ stem cells play a pivotal role in rejuvenation of adult tissues as well as regeneration of damaged organs . 0 ###LEFT-WALL### 5 cells 0 ###LEFT-WALL### 6 play 0 ###LEFT-WALL### 22 . 1 therefore 2 , 1 therefore 5 cells 3 germ 5 cells 4 stem 5 cells 5 cells 6 play 6 play 9 role 6 play 10 in 7 a 8 pivotal 7 a 9 role 8 pivotal 9 role 10 in 11 rejuvenation 11 rejuvenation 12 of 11 rejuvenation 17 as 12 of 14 tissues 13 adult 14 tissues 15 as 16 well 16 well 17 as 17 as 18 regeneration 18 regeneration 19 of 19 of 21 organs 20 damaged 21 organs such cells have provided a potential resource for stem cell therapy and regenerative medicine . 0 ###LEFT-WALL### 2 cells 0 ###LEFT-WALL### 4 provided 0 ###LEFT-WALL### 15 . 1 such 2 cells 2 cells 3 have 3 have 4 provided 4 provided 7 resource 5 a 6 potential 5 a 7 resource 6 potential 7 resource 7 resource 8 for 8 for 12 and 9 stem 11 therapy 10 cell 11 therapy 11 therapy 12 and 12 and 14 medicine 13 regenerative 14 medicine objective : to assess the safety and tolerability of high - dose creatine , the feasibility of enrolling premanifest and 50 % [at] [-] risk subjects in a prevention trial , and the potential of cognitive , imaging , and blood markers . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 assess 3 to 4 assess 4 assess 7 and 5 the 7 and 6 safety 7 and 7 and 8 tolerability 7 and 9 of 9 of 20 and 10 high 11 - 10 high 13 creatine 12 dose 13 creatine 13 creatine 14 , 14 , 16 feasibility 14 , 20 and 15 the 16 feasibility 16 feasibility 17 of 17 of 18 enrolling 18 enrolling 19 premanifest 20 and 26 subjects 20 and 27 in 21 50 22 % 22 % 26 subjects 25 risk 26 subjects 27 in 32 and 28 a 29 prevention 28 a 30 trial 29 prevention 30 trial 30 trial 32 and 31 , 32 and 32 and 34 potential 33 the 34 potential 34 potential 35 of 35 of 40 and 36 cognitive 37 , 37 , 38 imaging 37 , 40 and 39 , 40 and 40 and 42 markers 40 and 43 . 41 blood 42 markers methods : sixty - four eligible consenting participants were randomly allocated [(] 1:1 [ )(to 15 g twice daily [of] creatine monohydrate or placebo for [a] 6 - month double - blind phase followed by [a] 12 - month open - label extension . 1 methods 2 : 2 : 3 sixty 3 sixty 8 participants 3 sixty 9 were 3 sixty 11 allocated 4 - 5 four 5 four 8 participants 6 eligible 8 participants 7 consenting 8 participants 8 participants 9 were 9 were 10 randomly 11 allocated 15 )(to 13 1:1 15 )(to 15 )(to 16 15 16 15 17 g 17 g 22 monohydrate 18 twice 19 daily 19 daily 21 creatine 21 creatine 22 monohydrate 22 monohydrate 23 or 23 or 24 placebo 23 or 25 for 23 or 30 double 23 or 33 phase 25 for 27 6 28 - 30 double 29 month 30 double 30 double 31 - 32 blind 33 phase 33 phase 34 followed 34 followed 35 by 34 followed 37 12 37 12 43 extension 38 - 43 extension 39 month 43 extension 40 open 41 - 40 open 43 extension 42 label 43 extension 43 extension 44 . subjects included premanifest ( tested ) [and] at [-] risk ( not tested ) individuals without clinical symptoms or signs of huntington disease ( hd ) . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 27 . 1 subjects 2 included 2 included 3 premanifest 2 included 5 tested 2 included 8 at 4 ( 5 tested 5 tested 6 ) 8 at 10 risk 10 risk 15 individuals 11 ( 12 not 11 ( 15 individuals 12 not 13 tested 13 tested 14 ) 15 individuals 16 without 15 individuals 21 of 15 individuals 25 hd 15 individuals 26 ) 16 without 19 or 17 clinical 18 symptoms 18 symptoms 19 or 19 or 20 signs 21 of 23 disease 22 huntington 23 disease 24 ( 25 hd 25 hd 26 ) primary outcomes were safety and tolerability . 0 ###LEFT-WALL### 2 outcomes 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 7 . 1 primary 2 outcomes 2 outcomes 3 were 3 were 5 and 4 safety 5 and 5 and 6 tolerability exploratory endpoints included fine motor , visuospatial , and memory performance ; structural and diffusion mri ; [and] selected blood markers . 0 ###LEFT-WALL### 2 endpoints 0 ###LEFT-WALL### 5 motor 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 22 . 1 exploratory 2 endpoints 2 endpoints 3 included 2 endpoints 5 motor 3 included 4 fine 6 , 9 and 6 , 12 ; 7 visuospatial 9 and 8 , 9 and 9 and 11 performance 10 memory 11 performance 12 ; 14 and 12 ; 17 ; 13 structural 14 and 14 and 16 mri 15 diffusion 16 mri 17 ; 21 markers 19 selected 20 blood 20 blood 21 markers results : forty - seven hd carriers and 17 [non] - hd controls were enrolled . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 14 were 0 ###LEFT-WALL### 16 . 1 results 2 : 2 : 7 carriers 3 forty 4 - 4 - 5 seven 4 - 7 carriers 6 hd 7 carriers 8 and 9 17 8 and 11 - 9 17 11 - 11 - 13 controls 12 hd 13 controls 13 controls 14 were 14 were 15 enrolled fifteen discontinued treatment ( 2 assigned [to] [placebo] ) ; all were followed for the entire study period . 0 ###LEFT-WALL### 1 fifteen 0 ###LEFT-WALL### 2 discontinued 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 19 . 1 fifteen 2 discontinued 2 discontinued 3 treatment 3 treatment 5 2 4 ( 5 2 5 2 6 assigned 5 2 9 ) 10 ; 11 all 10 ; 13 followed 11 all 12 were 12 were 13 followed 13 followed 14 for 14 for 18 period 15 the 18 period 16 entire 17 study 17 study 18 period primary analysis was by intent to treat . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 8 . 1 primary 2 analysis 2 analysis 3 was 3 was 4 by 4 by 5 intent 5 intent 6 to 5 intent 7 treat 6 to 7 treat the most common adverse events were gastrointestinal . 0 ###LEFT-WALL### 5 events 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 8 . 1 the 2 most 2 most 5 events 3 common 5 events 4 adverse 5 events 5 events 6 were 6 were 7 gastrointestinal neuroimaging demonstrated treatment - related slowing of cortical and striatal atrophy at 6 and 18 months . 0 ###LEFT-WALL### 1 neuroimaging 0 ###LEFT-WALL### 2 demonstrated 0 ###LEFT-WALL### 5 related 1 neuroimaging 2 demonstrated 2 demonstrated 3 treatment 4 - 5 related 5 related 6 slowing 5 related 12 at 5 related 17 . 6 slowing 7 of 7 of 11 atrophy 8 cortical 9 and 9 and 10 striatal 9 and 11 atrophy 12 at 16 months 13 6 14 and 14 and 15 18 14 and 16 months conclusion : we describe a design that preserves the autonomy of subjects not wanting genetic testing while including controls for assessing the specificity of treatment effects . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 describe 2 : 27 . 3 we 4 describe 4 describe 6 design 5 a 6 design 6 design 7 that 6 design 8 preserves 7 that 8 preserves 8 preserves 10 autonomy 8 preserves 17 while 9 the 10 autonomy 10 autonomy 11 of 11 of 12 subjects 12 subjects 13 not 13 not 14 wanting 14 wanting 16 testing 15 genetic 16 testing 17 while 18 including 18 including 19 controls 19 controls 20 for 19 controls 24 of 20 for 21 assessing 21 assessing 23 specificity 22 the 23 specificity 24 of 26 effects 25 treatment 26 effects our results demonstrate the feasibility of prevention trials for hd and the safety of high - dose creatine , provide possible evidence of disease modification , support future studies of creatine , and illustrate the value of prodromal biomarkers . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 40 . 1 our 2 results 2 results 3 demonstrate 3 demonstrate 5 feasibility 3 demonstrate 9 for 4 the 5 feasibility 5 feasibility 6 of 6 of 8 trials 7 prevention 8 trials 9 for 11 and 10 hd 11 and 11 and 13 safety 11 and 14 of 12 the 13 safety 14 of 18 creatine 15 high 16 - 15 high 17 dose 17 dose 18 creatine 19 , 26 , 20 provide 22 evidence 20 provide 26 , 21 possible 22 evidence 22 evidence 23 of 23 of 25 modification 24 disease 25 modification 26 , 33 and 27 support 29 studies 27 support 33 and 28 future 29 studies 29 studies 30 of 30 of 31 creatine 32 , 33 and 33 and 34 illustrate 34 illustrate 36 value 35 the 36 value 36 value 37 of 37 of 39 biomarkers 38 prodromal 39 biomarkers classification of evidence : this study provides class i evidence that high - dose creatine is safe and tolerable . 0 ###LEFT-WALL### 3 evidence 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 20 . 1 classification 2 of 2 of 3 evidence 4 : 6 study 4 : 10 evidence 4 : 13 - 5 this 6 study 6 study 7 provides 7 provides 8 class 8 class 9 i 8 class 10 evidence 9 i 10 evidence 10 evidence 12 high 11 that 12 high 13 - 15 creatine 13 - 16 is 14 dose 15 creatine 15 creatine 16 is 16 is 18 and 17 safe 18 and 18 and 19 tolerable none background [:] electrocardiography has been considered an important tool in the management of chagas disease ( chd ) patients , although its value in elderly infected patients is unknown . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 29 is 0 ###LEFT-WALL### 31 . 1 none 4 electrocardiography 1 none 6 been 1 none 7 considered 2 background 4 electrocardiography 4 electrocardiography 5 has 5 has 6 been 7 considered 10 tool 7 considered 20 patients 7 considered 22 although 8 an 10 tool 9 important 10 tool 10 tool 11 in 10 tool 18 chd 11 in 13 management 12 the 13 management 13 management 14 of 14 of 16 disease 15 chagas 16 disease 17 ( 18 chd 18 chd 19 ) 21 , 22 although 22 although 24 value 23 its 24 value 24 value 25 in 24 value 29 is 25 in 28 patients 26 elderly 28 patients 27 infected 28 patients 29 is 30 unknown this study was designed to investigate the prevalence and prognostic value of electrocardiographic abnormalities in trypanosoma cruzi infected and noninfected older adults . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 designed 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 23 . 1 this 2 study 2 study 3 was 3 was 4 designed 4 designed 5 to 4 designed 6 investigate 5 to 6 investigate 6 investigate 8 prevalence 7 the 8 prevalence 9 and 11 value 9 and 19 and 10 prognostic 11 value 11 value 12 of 11 value 19 and 12 of 14 abnormalities 13 electrocardiographic 14 abnormalities 14 abnormalities 15 in 15 in 17 cruzi 16 trypanosoma 17 cruzi 18 infected 19 and 19 and 20 noninfected 19 and 22 adults 21 older 22 adults methods and results : we studied 1462 participants in bambuí city , brazil , with electrocardiogram [(] ecg ) records classified by the minnesota code . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 21 classified 0 ###LEFT-WALL### 26 . 1 methods 2 and 2 and 3 results 4 : 5 we 4 : 6 studied 5 we 6 studied 6 studied 8 participants 7 1462 8 participants 8 participants 9 in 8 participants 20 records 8 participants 21 classified 9 in 11 city 10 bambuí 11 city 11 city 13 brazil 12 , 13 brazil 13 brazil 15 with 13 brazil 19 ) 14 , 15 with 15 with 18 ecg 15 with 19 ) 16 electrocardiogram 18 ecg 20 records 21 classified 21 classified 22 by 22 by 25 code 23 the 25 code 24 minnesota 25 code follow - up time was 10 years ; the endpoint was mortality . 0 ###LEFT-WALL### 1 follow 0 ###LEFT-WALL### 2 - 2 - 4 time 2 - 5 was 2 - 8 ; 2 - 13 . 3 up 4 time 4 time 5 was 5 was 7 years 6 10 7 years 8 ; 10 endpoint 8 ; 11 was 9 the 10 endpoint 10 endpoint 11 was 11 was 12 mortality adjustment for potential confounding variables included age , gender , conventional risk factors , and [b] [-] type natriuretic peptide ( bnp ) . 0 ###LEFT-WALL### 1 adjustment 0 ###LEFT-WALL### 6 included 0 ###LEFT-WALL### 24 . 1 adjustment 2 for 1 adjustment 6 included 2 for 3 potential 3 potential 4 confounding 4 confounding 5 variables 6 included 15 and 7 age 8 , 8 , 9 gender 8 , 10 , 10 , 13 factors 10 , 15 and 11 conventional 13 factors 12 risk 13 factors 14 , 15 and 15 and 20 peptide 15 and 22 bnp 18 type 20 peptide 19 natriuretic 20 peptide 21 ( 22 bnp 22 bnp 23 ) the mean age was 69 years ( 60.9 % women ) . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 12 . 1 the 3 age 2 mean 3 age 3 age 4 was 4 was 6 years 5 69 6 years 6 years 10 women 7 ( 10 women 8 60.9 10 women 9 % 10 women 10 women 11 ) the prevalence of chd was 38.1 % ( n=557 ) . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 11 . 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 5 was 3 of 4 chd 5 was 7 % 6 38.1 7 % 7 % 9 n=557 8 ( 9 n=557 9 n=557 10 ) ecg abnormalities were more frequent in chd patients ( 87.6 % versus 77.7 % , p<0.001 ) . 0 ###LEFT-WALL### 2 abnormalities 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 18 . 1 ecg 2 abnormalities 2 abnormalities 3 were 3 were 5 frequent 4 more 5 frequent 5 frequent 6 in 6 in 8 patients 7 chd 8 patients 8 patients 11 % 8 patients 16 p<0.001 9 ( 11 % 10 87.6 11 % 11 % 12 versus 11 % 15 , 12 versus 14 % 13 77.7 14 % 15 , 16 p<0.001 16 p<0.001 17 ) right bundle branch block ( rbbb [ )(with left anterior hemiblock ( lah ) [was] strongly related to chd ( or [:] 11.99 [ 5.60 to 25.69 ] ) . 0 ###LEFT-WALL### 4 block 0 ###LEFT-WALL### 17 related 0 ###LEFT-WALL### 30 . 1 right 3 branch 2 bundle 3 branch 3 branch 4 block 5 ( 17 related 6 rbbb 8 )(with 6 rbbb 17 related 8 )(with 11 hemiblock 9 left 11 hemiblock 10 anterior 11 hemiblock 11 hemiblock 13 lah 12 ( 13 lah 13 lah 14 ) 16 strongly 17 related 17 related 18 to 18 to 19 chd 19 chd 21 or 20 ( 21 or 21 or 23 11.99 21 or 26 to 21 or 29 ) 24 [ 26 to 25 5.60 26 to 26 to 27 25.69 26 to 28 ] during the mean follow - up time of 8.7 years , 556 participants died ( 253 with chd ) , and only 89 were lost to follow - up . 0 ###LEFT-WALL### 21 and 1 during 3 mean 1 during 21 and 2 the 3 mean 4 follow 6 up 4 follow 21 and 5 - 6 up 6 up 7 time 6 up 20 , 7 time 13 participants 7 time 14 died 7 time 16 253 8 of 10 years 8 of 11 , 8 of 13 participants 9 8.7 10 years 12 556 13 participants 13 participants 14 died 15 ( 16 253 16 253 17 with 16 253 19 ) 17 with 18 chd 21 and 27 follow 22 only 23 89 23 89 24 were 24 were 25 lost 25 lost 26 to 26 to 27 follow 27 follow 29 up 28 - 29 up 29 up 30 . ecg variables of independent prognostic value for death in chd included absence [of] sinus rhythm , frequent [ventricular] and supraventricular premature beats , atrial fibrillation , rbbb , old and possible old myocardial infarction , and left [ventricular] hypertrophy . 0 ###LEFT-WALL### 2 variables 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 40 . 1 ecg 2 variables 2 variables 3 of 2 variables 16 , 3 of 6 value 4 independent 6 value 5 prognostic 6 value 6 value 7 for 6 value 9 in 7 for 8 death 9 in 10 chd 11 included 15 rhythm 11 included 16 , 12 absence 15 rhythm 14 sinus 15 rhythm 16 , 17 frequent 19 and 36 and 19 and 39 hypertrophy 20 supraventricular 22 beats 21 premature 22 beats 22 beats 23 , 23 , 25 fibrillation 23 , 26 , 24 atrial 25 fibrillation 26 , 27 rbbb 26 , 28 , 28 , 29 old 28 , 30 and 30 and 34 infarction 30 and 36 and 31 possible 34 infarction 32 old 34 infarction 33 myocardial 34 infarction 35 , 36 and 36 and 37 left 36 and 39 hypertrophy the presence of any major ecg abnormalities doubled the risk of death in chd patients [(] hr : 2.18 [ 1.35 to 3.53 []] ) [,] [but] [it] also increased the risk in [non] [-] chd subjects [(] hr [:] 1.50 [ 1.07 to 2.10 []] ) [;] [the] risk of death increased with the number of major abnormalities in the same patient [.] 0 ###LEFT-WALL### 2 presence 0 ###LEFT-WALL### 8 doubled 1 the 2 presence 2 presence 3 of 2 presence 8 doubled 3 of 7 abnormalities 4 any 7 abnormalities 5 major 7 abnormalities 6 ecg 7 abnormalities 8 doubled 10 risk 9 the 10 risk 10 risk 11 of 10 risk 18 : 11 of 12 death 12 death 13 in 13 in 17 hr 14 chd 15 patients 15 patients 17 hr 18 : 19 2.18 18 : 30 increased 19 2.18 21 1.35 19 2.18 30 increased 20 [ 21 1.35 21 1.35 22 to 21 1.35 25 ) 22 to 23 3.53 29 also 30 increased 30 increased 32 risk 31 the 32 risk 32 risk 33 in 33 in 39 hr 36 chd 37 subjects 37 subjects 39 hr 39 hr 41 1.50 39 hr 50 risk 39 hr 51 of 41 1.50 44 to 41 1.50 50 risk 42 [ 44 to 43 1.07 44 to 44 to 45 2.10 44 to 47 ) 51 of 52 death 52 death 53 increased 52 death 60 in 53 increased 54 with 54 with 59 abnormalities 55 the 56 number 56 number 57 of 56 number 59 abnormalities 57 of 59 abnormalities 58 major 59 abnormalities 60 in 63 patient 61 the 62 same 62 same 63 patient conclusion : ecg abnormalities are more common among elderly chagas disease patients and strongly [predict] adverse outcomes . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 2 : 4 abnormalities 2 : 5 are 3 ecg 4 abnormalities 4 abnormalities 5 are 5 are 17 outcomes 6 more 17 outcomes 7 common 8 among 7 common 13 and 8 among 12 patients 9 elderly 12 patients 10 chagas 12 patients 11 disease 12 patients 13 and 16 adverse 13 and 17 outcomes 14 strongly 16 adverse estradiol effects on memory depend on hormone levels and the interaction of different estrogen receptors within neural circuits . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 5 depend 0 ###LEFT-WALL### 19 . 1 estradiol 2 effects 2 effects 3 on 2 effects 5 depend 3 on 4 memory 5 depend 6 on 5 depend 16 within 6 on 9 and 7 hormone 8 levels 8 levels 9 and 9 and 11 interaction 9 and 12 of 10 the 11 interaction 12 of 15 receptors 13 different 15 receptors 14 estrogen 15 receptors 16 within 18 circuits 17 neural 18 circuits estradiol induces gene transcription and rapid membrane signaling mediated by estrogen receptor - alpha ( erα ) , estrogen receptor - beta ( erβ ) , [and] [a] recently characterized [g] - protein coupled estrogen receptor , each with distinct distributions and ability to influence estradiol - dependent signaling . 0 ###LEFT-WALL### 1 estradiol 0 ###LEFT-WALL### 2 induces 0 ###LEFT-WALL### 5 and 1 estradiol 2 induces 2 induces 4 transcription 3 gene 4 transcription 5 and 7 membrane 5 and 9 mediated 6 rapid 7 membrane 7 membrane 8 signaling 7 membrane 9 mediated 9 mediated 10 by 9 mediated 20 receptor 10 by 12 receptor 11 estrogen 12 receptor 12 receptor 14 alpha 13 - 14 alpha 14 alpha 16 erα 14 alpha 18 , 15 ( 16 erα 16 erα 17 ) 19 estrogen 20 receptor 20 receptor 32 - 21 - 32 - 22 beta 24 erβ 22 beta 30 characterized 22 beta 32 - 23 ( 24 erβ 24 erβ 25 ) 26 , 30 characterized 29 recently 30 characterized 32 - 42 and 33 protein 34 coupled 34 coupled 36 receptor 35 estrogen 36 receptor 36 receptor 37 , 37 , 38 each 37 , 42 and 38 each 39 with 39 with 41 distributions 40 distinct 41 distributions 42 and 43 ability 42 and 44 to 42 and 45 influence 42 and 48 dependent 44 to 45 influence 45 influence 46 estradiol 47 - 48 dependent 48 dependent 49 signaling 48 dependent 50 . investigations using receptor specific agonists suggest that all three receptors rapidly activate kinase [-] signaling and have complex [dose] - dependent influences on memory . 0 ###LEFT-WALL### 1 investigations 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 . 1 investigations 2 using 1 investigations 6 suggest 2 using 5 agonists 3 receptor 5 agonists 4 specific 5 agonists 6 suggest 7 that 7 that 10 receptors 7 that 16 and 8 all 9 three 9 three 10 receptors 11 rapidly 12 activate 12 activate 15 signaling 12 activate 16 and 13 kinase 15 signaling 16 and 17 have 17 have 22 influences 17 have 23 on 18 complex 20 - 18 complex 22 influences 21 dependent 22 influences 23 on 24 memory research employing receptor knockout mice demonstrate that erα maintains transcription and memory as estradiol levels decline . 0 ###LEFT-WALL### 5 mice 0 ###LEFT-WALL### 6 demonstrate 0 ###LEFT-WALL### 17 . 1 research 3 receptor 2 employing 3 receptor 3 receptor 5 mice 4 knockout 5 mice 5 mice 6 demonstrate 6 demonstrate 7 that 7 that 8 erα 7 that 9 maintains 8 erα 9 maintains 9 maintains 11 and 9 maintains 16 decline 10 transcription 11 and 11 and 12 memory 11 and 13 as 11 and 16 decline 13 as 15 levels 14 estradiol 15 levels this work indicates a regulatory role of erβ in transcription and cognition , which depends on estradiol levels and the function of erα . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 3 indicates 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 24 . 1 this 2 work 2 work 3 indicates 3 indicates 6 role 3 indicates 9 in 4 a 5 regulatory 4 a 6 role 5 regulatory 6 role 6 role 7 of 7 of 8 erβ 9 in 11 and 10 transcription 11 and 11 and 12 cognition 13 , 14 which 13 , 15 depends 14 which 15 depends 15 depends 16 on 16 on 19 and 17 estradiol 18 levels 18 levels 19 and 19 and 21 function 19 and 22 of 20 the 21 function 22 of 23 erα the regulatory role of erβ is due in part to erβ acting as a negative regulator of erα - mediated transcription . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 22 . 1 the 3 role 2 regulatory 3 role 3 role 4 of 3 role 6 is 4 of 5 erβ 6 is 7 due 7 due 9 part 7 due 13 as 8 in 9 part 9 part 10 to 10 to 11 erβ 11 erβ 12 acting 13 as 16 regulator 14 a 15 negative 14 a 16 regulator 15 negative 16 regulator 16 regulator 17 of 17 of 18 erα 19 - 21 transcription 20 mediated 21 transcription vector - mediated expression of estrogen receptors in the hippocampus provides an innovative research approach and suggests that memory depends on the relative expression of erα and erβ interacting with estradiol levels . 0 ###LEFT-WALL### 4 expression 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 33 . 1 vector 2 - 1 vector 4 expression 3 mediated 4 expression 4 expression 5 of 4 expression 16 and 5 of 7 receptors 6 estrogen 7 receptors 7 receptors 8 in 8 in 10 hippocampus 9 the 10 hippocampus 11 provides 15 approach 11 provides 16 and 12 an 13 innovative 12 an 15 approach 13 innovative 14 research 14 research 15 approach 16 and 17 suggests 16 and 21 on 16 and 30 with 17 suggests 18 that 18 that 19 memory 18 that 20 depends 19 memory 20 depends 21 on 24 expression 22 the 24 expression 23 relative 24 expression 24 expression 25 of 24 expression 29 interacting 25 of 28 erβ 26 erα 27 and 27 and 28 erβ 30 with 32 levels 31 estradiol 32 levels notably , the ability of estradiol to improve cognition declines with advanced age along with decreased expression of estrogen receptors . 0 ###LEFT-WALL### 4 ability 0 ###LEFT-WALL### 10 declines 0 ###LEFT-WALL### 21 . 1 notably 2 , 1 notably 4 ability 3 the 4 ability 4 ability 5 of 4 ability 7 to 4 ability 8 improve 4 ability 10 declines 5 of 6 estradiol 7 to 8 improve 8 improve 9 cognition 10 declines 11 with 10 declines 15 with 11 with 13 age 12 advanced 13 age 14 along 15 with 15 with 17 expression 16 decreased 17 expression 17 expression 18 of 18 of 20 receptors 19 estrogen 20 receptors thus , it will be important for future research to determine the mechanisms that regulate estrogen receptor expression during aging . 0 ###LEFT-WALL### 3 it 0 ###LEFT-WALL### 5 be 0 ###LEFT-WALL### 21 . 1 thus 2 , 1 thus 3 it 3 it 4 will 4 will 5 be 5 be 6 important 6 important 7 for 6 important 10 to 6 important 11 determine 7 for 9 research 8 future 9 research 10 to 11 determine 11 determine 13 mechanisms 12 the 13 mechanisms 13 mechanisms 14 that 13 mechanisms 15 regulate 14 that 15 regulate 15 regulate 18 expression 15 regulate 19 during 16 estrogen 17 receptor 17 receptor 18 expression 19 during 20 aging the ww domain - containing oxidoreductase ( wwox ) [gene] , encodes a tumor suppressor located on 16q23.1 , spanning fra16d , one of the most active common fragile sites in the human genome , that is altered in numerous types of cancer . 0 ###LEFT-WALL### 3 domain 0 ###LEFT-WALL### 12 encodes 0 ###LEFT-WALL### 35 , 0 ###LEFT-WALL### 44 . 1 the 3 domain 2 ww 3 domain 3 domain 5 containing 3 domain 12 encodes 4 - 5 containing 5 containing 6 oxidoreductase 5 containing 11 , 6 oxidoreductase 8 wwox 7 ( 8 wwox 8 wwox 9 ) 12 encodes 15 suppressor 12 encodes 20 spanning 13 a 15 suppressor 14 tumor 15 suppressor 15 suppressor 16 located 16 located 17 on 17 on 18 16q23.1 19 , 20 spanning 20 spanning 21 fra16d 20 spanning 35 , 21 fra16d 23 one 22 , 23 one 23 one 24 of 23 one 31 in 23 one 35 , 24 of 30 sites 25 the 30 sites 26 most 27 active 27 active 30 sites 28 common 30 sites 29 fragile 30 sites 31 in 34 genome 32 the 34 genome 33 human 34 genome 35 , 36 that 35 , 38 altered 36 that 37 is 37 is 38 altered 38 altered 39 in 39 in 43 cancer 40 numerous 41 types 41 types 42 of 41 types 43 cancer 42 of 43 cancer wwox 's alteration in these myriad cancers is due to disparate mechanisms including loss of heterozygosity , homozygous deletion and epigenetic changes . 0 ###LEFT-WALL### 3 alteration 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 23 . 1 wwox 2 's 2 's 3 alteration 3 alteration 4 in 3 alteration 8 is 4 in 7 cancers 5 these 7 cancers 6 myriad 7 cancers 8 is 10 to 8 is 13 including 9 due 10 to 10 to 12 mechanisms 11 disparate 12 mechanisms 13 including 20 and 14 loss 15 of 14 loss 17 , 15 of 16 heterozygosity 17 , 19 deletion 17 , 20 and 18 homozygous 19 deletion 20 and 22 changes 21 epigenetic 22 changes in vitro , wwox has been found to be reduced or absent in numerous cancer cell lines and wwox restoration has been found to inhibit tumor cell growth and invasion . 0 ###LEFT-WALL### 4 wwox 0 ###LEFT-WALL### 11 or 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 25 inhibit 0 ###LEFT-WALL### 31 . 1 in 2 vitro 2 vitro 3 , 2 vitro 4 wwox 4 wwox 5 has 5 has 6 been 6 been 7 found 7 found 8 to 8 to 9 be 9 be 11 or 10 reduced 11 or 11 or 12 absent 11 or 13 in 11 or 17 lines 13 in 15 cancer 14 numerous 15 cancer 16 cell 17 lines 18 and 20 restoration 18 and 23 found 19 wwox 20 restoration 20 restoration 21 has 21 has 22 been 22 been 23 found 23 found 24 to 24 to 25 inhibit 25 inhibit 29 and 26 tumor 28 growth 27 cell 28 growth 28 growth 29 and 29 and 30 invasion wwox knockout mice developed femoral focal lesions resembling osteosarcomas within one month of their life and aging wwox heterozygous mice have an increased incidence of spontaneous lung and mammary tumors as well as b - cell lymphomas . 0 ###LEFT-WALL### 3 mice 0 ###LEFT-WALL### 4 developed 0 ###LEFT-WALL### 38 . 1 wwox 3 mice 2 knockout 3 mice 3 mice 4 developed 4 developed 37 lymphomas 5 femoral 7 lesions 6 focal 7 lesions 7 lesions 8 resembling 7 lesions 10 within 7 lesions 28 and 8 resembling 9 osteosarcomas 10 within 12 month 11 one 12 month 12 month 13 of 13 of 27 lung 14 their 27 lung 15 life 16 and 16 and 18 wwox 16 and 20 mice 16 and 25 of 16 and 27 lung 17 aging 18 wwox 19 heterozygous 20 mice 20 mice 21 have 21 have 24 incidence 22 an 24 incidence 23 increased 24 incidence 24 incidence 25 of 26 spontaneous 27 lung 28 and 30 tumors 28 and 35 - 28 and 36 cell 29 mammary 30 tumors 30 tumors 33 as 31 as 32 well 32 well 33 as 33 as 34 b 36 cell 37 lymphomas we herein review wwox 's role that has been unearthed thus far in different types of malignancies , its clinical significance and future implications . 0 ###LEFT-WALL### 6 role 0 ###LEFT-WALL### 10 unearthed 0 ###LEFT-WALL### 25 . 1 we 3 review 2 herein 3 review 3 review 4 wwox 4 wwox 5 's 5 's 6 role 6 role 7 that 6 role 9 been 6 role 10 unearthed 7 that 8 has 8 has 9 been 10 unearthed 12 far 10 unearthed 13 in 10 unearthed 24 implications 11 thus 12 far 13 in 15 types 14 different 15 types 15 types 16 of 16 of 22 and 17 malignancies 18 , 18 , 21 significance 18 , 22 and 19 its 21 significance 20 clinical 21 significance 22 and 23 future background : the harmful relationship of sedentary behavior to health may reflect an exchange of sedentary activity for moderate - to [-] vigorous physical activity ( mvpa ) , or sedentary behavior may be a separate risk factor . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 relationship 2 : 34 be 2 : 39 . 3 the 5 relationship 4 harmful 5 relationship 5 relationship 6 of 5 relationship 9 to 5 relationship 11 may 6 of 8 behavior 7 sedentary 8 behavior 9 to 10 health 11 may 12 reflect 12 reflect 14 exchange 12 reflect 18 for 13 an 14 exchange 14 exchange 15 of 15 of 17 activity 16 sedentary 17 activity 18 for 32 behavior 19 moderate 21 to 19 moderate 30 or 20 - 21 to 21 to 25 activity 21 to 29 , 23 vigorous 25 activity 24 physical 25 activity 25 activity 27 mvpa 26 ( 27 mvpa 27 mvpa 28 ) 29 , 30 or 30 or 31 sedentary 30 or 32 behavior 32 behavior 33 may 33 may 34 be 34 be 38 factor 35 a 36 separate 35 a 38 factor 36 separate 38 factor 37 risk 38 factor we examined whether time spent in sedentary behavior is related to disability in activities of daily living ( adl ) , independent [of] time spent in mvpa in older adults . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 1 we 2 examined 2 examined 3 whether 2 examined 13 in 3 whether 4 time 3 whether 10 related 4 time 5 spent 4 time 9 is 5 spent 6 in 6 in 8 behavior 7 sedentary 8 behavior 9 is 10 related 10 related 11 to 11 to 12 disability 13 in 14 activities 14 activities 15 of 14 activities 19 adl 14 activities 24 time 15 of 17 living 16 daily 17 living 18 ( 19 adl 19 adl 20 ) 21 , 24 time 22 independent 24 time 24 time 25 spent 24 time 31 . 25 spent 26 in 26 in 27 mvpa 27 mvpa 28 in 28 in 30 adults 29 older 30 adults methods : the nationally representative [2003] - 2006 national health and nutrition examinations surveys ( nhanes ) included 2286 adults aged 60 years and older in whom physical activity was assessed by accelerometer . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 11 and 3 the 10 health 4 nationally 5 representative 5 representative 7 - 5 representative 10 health 8 2006 9 national 9 national 10 health 10 health 11 and 11 and 16 nhanes 11 and 17 ) 11 and 18 included 11 and 20 adults 11 and 21 aged 11 and 26 in 12 nutrition 13 examinations 13 examinations 14 surveys 14 surveys 16 nhanes 15 ( 16 nhanes 16 nhanes 17 ) 19 2286 20 adults 20 adults 21 aged 21 aged 24 and 22 60 23 years 23 years 24 and 24 and 25 older 26 in 27 whom 26 in 29 activity 26 in 31 assessed 28 physical 29 activity 29 activity 30 was 30 was 31 assessed 31 assessed 32 by 32 by 33 accelerometer the association between adl task disability and the daily percentage of sedentary time was evaluated by multiple logistic regression . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 15 evaluated 0 ###LEFT-WALL### 20 . 1 the 2 association 2 association 3 between 2 association 14 was 3 between 7 and 4 adl 6 disability 5 task 6 disability 6 disability 7 and 7 and 10 percentage 7 and 11 of 8 the 10 percentage 9 daily 10 percentage 11 of 13 time 12 sedentary 13 time 14 was 15 evaluated 15 evaluated 16 by 16 by 19 regression 17 multiple 19 regression 18 logistic 19 regression results : these adults on average spent 9 h / [d] being sedentary during waking hours and 4.5 % reported adl disability . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 adults 2 : 7 spent 2 : 17 and 2 : 23 . 3 these 4 adults 4 adults 6 average 4 adults 7 spent 5 on 6 average 7 spent 10 / 8 9 9 h 9 h 10 / 10 / 12 being 12 being 13 sedentary 13 sedentary 14 during 14 during 16 hours 15 waking 16 hours 17 and 19 % 17 and 20 reported 18 4.5 19 % 19 % 20 reported 20 reported 22 disability 21 adl 22 disability the odds of adl disability were 46 % greater ( odds ratio [,] 1.46 [;] 95 % confidence interval [,] 1.07 - 1.98 ) for each daily hour spent in sedentary behavior , adjusted for mvpa and socioeconomic and health factors . 0 ###LEFT-WALL### 2 odds 0 ###LEFT-WALL### 33 , 0 ###LEFT-WALL### 42 . 1 the 2 odds 2 odds 3 of 2 odds 33 , 3 of 5 disability 4 adl 5 disability 6 were 8 % 6 were 33 , 7 46 8 % 8 % 9 greater 9 greater 22 - 9 greater 25 for 10 ( 22 - 11 odds 12 ratio 12 ratio 18 confidence 14 1.46 18 confidence 16 95 17 % 17 % 18 confidence 18 confidence 19 interval 19 interval 21 1.07 19 interval 22 - 22 - 23 1.98 22 - 24 ) 25 for 28 hour 26 each 28 hour 27 daily 28 hour 28 hour 29 spent 29 spent 30 in 30 in 32 behavior 31 sedentary 32 behavior 33 , 34 adjusted 33 , 35 for 33 , 41 factors 35 for 39 and 36 mvpa 37 and 37 and 38 socioeconomic 37 and 39 and 39 and 40 health conclusion : these us national data show a strong relationship between greater time spent in sedentary behavior and the presence of adl disability , independent [of] time spent in moderate or vigorous activity . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 6 data 2 : 7 show 2 : 24 , 2 : 34 . 3 these 6 data 4 us 6 data 5 national 6 data 6 data 7 show 7 show 10 relationship 7 show 18 and 8 a 10 relationship 9 strong 10 relationship 10 relationship 11 between 10 relationship 14 spent 11 between 13 time 12 greater 13 time 14 spent 15 in 15 in 17 behavior 16 sedentary 17 behavior 18 and 20 presence 18 and 23 disability 19 the 20 presence 20 presence 21 of 21 of 22 adl 24 , 27 time 24 , 28 spent 25 independent 27 time 27 time 28 spent 28 spent 29 in 28 spent 33 activity 29 in 31 or 30 moderate 31 or 31 or 32 vigorous these findings support programs encouraging older adults to decrease sedentary behavior regardless of their engagement in moderate or vigorous activity . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 21 . 1 these 2 findings 2 findings 3 support 3 support 4 programs 4 programs 5 encouraging 4 programs 13 of 5 encouraging 7 adults 5 encouraging 8 to 5 encouraging 9 decrease 6 older 7 adults 8 to 9 decrease 9 decrease 11 behavior 9 decrease 12 regardless 10 sedentary 11 behavior 13 of 15 engagement 14 their 15 engagement 15 engagement 16 in 16 in 20 activity 17 moderate 18 or 18 or 19 vigorous 18 or 20 activity background : clinical and biochemical predictors of extreme longevity would be useful in geriatric practice but have still not been clearly defined . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 defined 0 ###LEFT-WALL### 23 . 2 : 6 predictors 2 : 16 but 3 clinical 4 and 4 and 5 biochemical 4 and 6 predictors 6 predictors 7 of 6 predictors 10 would 7 of 9 longevity 8 extreme 9 longevity 10 would 16 but 11 be 12 useful 11 be 16 but 12 useful 13 in 13 in 15 practice 14 geriatric 15 practice 16 but 17 have 17 have 19 not 17 have 20 been 18 still 19 not 20 been 22 defined 21 clearly 22 defined methods : to identify the best nongenetic predictors of survival in centenarians , we examined 340 individuals aged 100+ years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 14 we 2 : 15 examined 2 : 21 . 3 to 4 identify 3 to 13 , 3 to 14 we 4 identify 8 predictors 4 identify 11 in 5 the 6 best 5 the 8 predictors 7 nongenetic 8 predictors 8 predictors 9 of 9 of 10 survival 11 in 12 centenarians 14 we 15 examined 15 examined 17 individuals 15 examined 18 aged 16 340 17 individuals 17 individuals 18 aged 18 aged 20 years 19 100+ 20 years a detailed questionnaire was completed , and comprehensive geriatric assessment and blood analyses were performed . 0 ###LEFT-WALL### 3 questionnaire 0 ###LEFT-WALL### 5 completed 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 16 . 1 a 2 detailed 1 a 3 questionnaire 2 detailed 3 questionnaire 3 questionnaire 4 was 4 was 5 completed 6 , 7 and 7 and 11 and 7 and 15 performed 8 comprehensive 10 assessment 9 geriatric 10 assessment 10 assessment 11 and 11 and 13 analyses 11 and 14 were 12 blood 13 analyses 14 were 15 performed survival of study participants was checked annually over the period of 10 years . 0 ###LEFT-WALL### 1 survival 0 ###LEFT-WALL### 6 checked 0 ###LEFT-WALL### 14 . 1 survival 2 of 1 survival 5 was 2 of 4 participants 3 study 4 participants 5 was 6 checked 6 checked 7 annually 6 checked 8 over 8 over 10 period 9 the 10 period 10 period 11 of 11 of 13 years 12 10 13 years results : in the univariate cox proportional hazards model , a longer survival of centenarians was correlated with a higher adjusted mini [-] mental state examination ( mmse ( adj ) ) [score] ( p < [.] 000001 [ )( higher activities of daily living ( adl ) and adjusted instrumental activities of daily living ( iadl ( adj ) ) scores ( p < [.] 000001 [and] p = [.] 00008 , respectively [ )( [and] younger age at the time of testing ( p = [.] 005 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 , 1 results 2 : 2 : 3 in 3 in 9 model 4 the 9 model 5 univariate 9 model 6 cox 9 model 7 proportional 9 model 8 hazards 9 model 10 , 13 survival 10 , 17 correlated 11 a 13 survival 12 longer 13 survival 13 survival 14 of 13 survival 16 was 14 of 15 centenarians 16 was 17 correlated 17 correlated 18 with 18 with 22 mini 18 with 26 examination 19 a 22 mini 20 higher 22 mini 21 adjusted 22 mini 24 mental 25 state 25 state 26 examination 26 examination 28 mmse 26 examination 36 < 27 ( 28 mmse 28 mmse 30 adj 28 mmse 32 ) 29 ( 30 adj 30 adj 31 ) 34 ( 36 < 35 p 36 < 36 < 42 activities 38 000001 42 activities 41 higher 42 activities 42 activities 43 of 43 of 49 and 44 daily 45 living 45 living 47 adl 46 ( 47 adl 47 adl 48 ) 47 adl 49 and 49 and 52 activities 49 and 53 of 50 adjusted 52 activities 51 instrumental 52 activities 53 of 54 daily 54 daily 55 living 54 daily 62 scores 54 daily 65 < 55 living 57 iadl 55 living 62 scores 56 ( 57 iadl 57 iadl 59 adj 57 iadl 61 ) 58 ( 59 adj 59 adj 60 ) 63 ( 65 < 64 p 65 < 65 < 67 000001 67 000001 70 = 67 000001 79 age 69 p 70 = 70 = 72 00008 70 = 73 , 73 , 74 respectively 73 , 79 age 78 younger 79 age 79 age 80 at 79 age 83 of 79 age 87 = 79 age 91 . 80 at 82 time 81 the 82 time 83 of 84 testing 85 ( 87 = 86 p 87 = 87 = 89 005 87 = 90 ) blood pressure , lipid profile , and c - reactive protein and hemoglobin concentrations were not associated with survival . 0 ###LEFT-WALL### 1 blood 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 were 0 ###LEFT-WALL### 20 . 1 blood 2 pressure 2 pressure 5 profile 3 , 5 profile 4 lipid 5 profile 5 profile 6 , 6 , 7 and 7 and 8 c 7 and 9 - 8 c 9 - 9 - 12 and 10 reactive 11 protein 11 protein 12 and 12 and 14 concentrations 12 and 15 were 13 hemoglobin 14 concentrations 15 were 16 not 15 were 18 with 16 not 17 associated 18 with 19 survival in multivariate analysis with the adl score substituted by the iadl ( adj ) score [,] the only predictor of survival [was] mmse [(] adj ) [(] hr = 0.973 per [each] mmse ( adj ) point , 95 % ci : 0.958 - 0.988 , p = [.] 0006 ) . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 8 substituted 1 in 2 multivariate 1 in 3 analysis 3 analysis 4 with 3 analysis 8 substituted 4 with 7 score 5 the 7 score 6 adl 7 score 8 substituted 9 by 8 substituted 19 predictor 9 by 15 score 10 the 15 score 11 iadl 13 adj 11 iadl 15 score 12 ( 13 adj 13 adj 14 ) 17 the 18 only 17 the 19 predictor 19 predictor 20 of 20 of 28 hr 21 survival 28 hr 23 mmse 28 hr 25 adj 26 ) 25 adj 28 hr 28 hr 30 0.973 28 hr 37 point 28 hr 40 % 29 = 30 0.973 30 0.973 31 per 30 0.973 35 adj 30 0.973 37 point 31 per 33 mmse 34 ( 35 adj 35 adj 36 ) 38 , 40 % 39 95 40 % 40 % 41 ci 40 % 42 : 40 % 52 . 41 ci 42 : 42 : 48 = 43 0.958 44 - 44 - 45 0.988 44 - 48 = 46 , 48 = 47 p 48 = 48 = 50 0006 48 = 51 ) conclusions : cognitive and functional performances are predictors of survival in centenarians . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 performances 2 : 7 are 2 : 13 . 3 cognitive 4 and 4 and 5 functional 4 and 6 performances 6 performances 7 are 7 are 8 predictors 8 predictors 9 of 9 of 10 survival 10 survival 11 in 11 in 12 centenarians reversal of the visible signs of facial aging with the use of injectable products as an alternative to surgery has become more popular , with nearly 5 million procedures performed in the united states in 2012 . 0 ###LEFT-WALL### 1 reversal 0 ###LEFT-WALL### 21 become 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 37 . 1 reversal 2 of 1 reversal 20 has 2 of 5 signs 3 the 5 signs 4 visible 5 signs 5 signs 6 of 6 of 8 aging 7 facial 8 aging 8 aging 9 with 8 aging 15 as 9 with 11 use 10 the 11 use 11 use 12 of 12 of 14 products 13 injectable 14 products 15 as 17 alternative 16 an 17 alternative 17 alternative 18 to 18 to 19 surgery 20 has 21 become 21 become 23 popular 22 more 23 popular 24 , 29 procedures 24 , 30 performed 25 with 28 million 25 with 29 procedures 26 nearly 28 million 27 5 28 million 29 procedures 30 performed 30 performed 31 in 30 performed 35 in 31 in 34 states 32 the 34 states 33 united 34 states 35 in 36 2012 volume augmentation products , such as hyaluronic acid ( ha ) , calcium hydroxylapatite ( caha ) , [and] [poly] - l - lactic acid ( plla ) , are often used [in] [combination] with one another and with neurotoxins for facial rejuvenation because of the complementary modes of action . 0 ###LEFT-WALL### 3 products 0 ###LEFT-WALL### 32 used 0 ###LEFT-WALL### 51 . 1 volume 3 products 2 augmentation 3 products 3 products 8 acid 3 products 30 are 4 , 8 acid 5 such 8 acid 6 as 7 hyaluronic 7 hyaluronic 8 acid 8 acid 10 ha 8 acid 14 hydroxylapatite 8 acid 23 - 8 acid 29 , 9 ( 10 ha 10 ha 11 ) 12 , 14 hydroxylapatite 13 calcium 14 hydroxylapatite 14 hydroxylapatite 16 caha 14 hydroxylapatite 18 , 15 ( 16 caha 16 caha 17 ) 21 - 23 - 22 l 23 - 23 - 25 acid 23 - 29 , 24 lactic 25 acid 25 acid 27 plla 26 ( 27 plla 27 plla 28 ) 30 are 31 often 30 are 32 used 32 used 38 and 32 used 44 because 35 with 37 another 35 with 38 and 36 one 37 another 38 and 39 with 39 with 40 neurotoxins 40 neurotoxins 41 for 41 for 43 rejuvenation 42 facial 43 rejuvenation 44 because 45 of 45 of 48 modes 46 the 48 modes 47 complementary 48 modes 48 modes 49 of 49 of 50 action this article presents 2 case reports involving patientspecific combinations of 2 different ha products , injectable plla , and caha with incobotulinumtoxina or abobotulinumtoxina . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 presents 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 25 . 1 this 2 article 2 article 3 presents 3 presents 6 reports 4 2 6 reports 5 case 6 reports 6 reports 7 involving 6 reports 10 of 7 involving 9 combinations 8 patientspecific 9 combinations 10 of 14 products 11 2 14 products 12 different 14 products 13 ha 14 products 15 , 19 and 16 injectable 17 plla 17 plla 19 and 18 , 19 and 19 and 20 caha 19 and 21 with 21 with 23 or 22 incobotulinumtoxina 23 or 23 or 24 abobotulinumtoxina the combination of ha , caha , plla , and neurotoxins has resulted in outstanding outcomes for many patients , with no clinical evidence of increased adverse events secondary to combination therapy . 0 ###LEFT-WALL### 2 combination 0 ###LEFT-WALL### 13 resulted 1 the 2 combination 2 combination 3 of 2 combination 12 has 3 of 10 and 4 ha 5 , 5 , 8 plla 5 , 10 and 6 caha 8 plla 7 , 8 plla 8 plla 9 , 9 , 10 and 10 and 11 neurotoxins 12 has 13 resulted 13 resulted 14 in 13 resulted 17 for 14 in 16 outcomes 15 outstanding 16 outcomes 17 for 19 patients 18 many 19 patients 19 patients 21 with 20 , 21 with 21 with 24 evidence 21 with 33 . 22 no 24 evidence 23 clinical 24 evidence 24 evidence 25 of 25 of 28 events 26 increased 28 events 27 adverse 28 events 28 events 29 secondary 29 secondary 30 to 30 to 32 therapy 31 combination 32 therapy background : radiofrequency - induced heating of dermal and subdermal tissue promotes skin contracture ; however , the temperature threshold for inducing an epidermal burn is lower than the therapeutic temperature thresholds required for collagen remodeling , and therefore , there is the possibility [of] epidermal burn . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 48 . 1 background 2 : 2 : 3 radiofrequency 4 - 6 heating 4 - 12 promotes 4 - 15 ; 4 - 38 and 5 induced 6 heating 6 heating 7 of 6 heating 12 promotes 7 of 11 tissue 8 dermal 9 and 9 and 10 subdermal 9 and 11 tissue 12 promotes 14 contracture 13 skin 14 contracture 15 ; 20 threshold 15 ; 26 is 15 ; 28 than 16 however 17 , 16 however 20 threshold 18 the 20 threshold 19 temperature 20 threshold 20 threshold 21 for 20 threshold 26 is 21 for 22 inducing 22 inducing 25 burn 23 an 25 burn 24 epidermal 25 burn 26 is 27 lower 28 than 32 thresholds 28 than 33 required 29 the 32 thresholds 30 therapeutic 31 temperature 31 temperature 32 thresholds 32 thresholds 33 required 33 required 34 for 33 required 36 remodeling 34 for 35 collagen 37 , 38 and 38 and 41 there 38 and 42 is 39 therefore 40 , 39 therefore 41 there 41 there 42 is 42 is 47 burn 43 the 47 burn 44 possibility 47 burn 46 epidermal 47 burn herein , we evaluate a radiofrequency treatment that provides novel real - time subdermal and epidermal temperature monitoring . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 evaluate 0 ###LEFT-WALL### 19 . 1 herein 2 , 1 herein 3 we 3 we 4 evaluate 4 evaluate 7 treatment 5 a 7 treatment 6 radiofrequency 7 treatment 7 treatment 8 that 7 treatment 9 provides 8 that 9 provides 9 provides 13 time 9 provides 15 and 10 novel 13 time 11 real 12 - 11 real 13 time 14 subdermal 15 and 15 and 18 monitoring 16 epidermal 17 temperature 17 temperature 18 monitoring methods : a retrospective chart review of 18 subjects undergoing thermistor - controlled subdermal skin tightening via percutaneous radiofrequency was conducted . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 - 1 methods 2 : 2 : 11 thermistor 3 a 4 retrospective 3 a 11 thermistor 4 retrospective 5 chart 5 chart 6 review 6 review 7 of 6 review 9 subjects 7 of 8 18 9 subjects 10 undergoing 12 - 15 skin 12 - 20 was 12 - 22 . 13 controlled 15 skin 14 subdermal 15 skin 15 skin 16 tightening 15 skin 20 was 16 tightening 17 via 17 via 19 radiofrequency 18 percutaneous 19 radiofrequency 20 was 21 conducted during the treatment , epidermal temperature was concurrently monitored by a handheld infrared laser thermometer and a forward looking infrared camera system and peak temperatures readings were reported and evaluated . 0 ###LEFT-WALL### 6 temperature 0 ###LEFT-WALL### 9 monitored 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 31 . 1 during 3 treatment 1 during 4 , 1 during 6 temperature 2 the 3 treatment 5 epidermal 6 temperature 6 temperature 7 was 7 was 9 monitored 8 concurrently 9 monitored 9 monitored 10 by 10 by 16 and 11 a 12 handheld 11 a 15 thermometer 12 handheld 14 laser 13 infrared 14 laser 14 laser 15 thermometer 15 thermometer 16 and 16 and 22 system 17 a 22 system 18 forward 22 system 19 looking 22 system 20 infrared 21 camera 21 camera 22 system 23 and 26 readings 23 and 27 were 24 peak 26 readings 25 temperatures 26 readings 26 readings 27 were 27 were 29 and 28 reported 29 and 29 and 30 evaluated results : mean temperatures of 43.6 and 38.2 °c were reported for the infrared camera and infrared thermometer . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 mean 0 ###LEFT-WALL### 19 . 1 results 2 : 2 : 3 mean 3 mean 4 temperatures 3 mean 11 reported 4 temperatures 5 of 4 temperatures 10 were 5 of 9 °c 6 43.6 7 and 7 and 8 38.2 7 and 9 °c 10 were 11 reported 11 reported 12 for 12 for 16 and 13 the 15 camera 14 infrared 15 camera 15 camera 16 and 16 and 18 thermometer 17 infrared 18 thermometer the bland - altman plot analysis reported a bias of 5.38 °c and 95 % limits of agreement between 0.60 and 10.15 °c . additionally , the mean difference or bias of 5.38 °c was statistically significant [(] p<0.0001 . 0 ###LEFT-WALL### 2 bland 0 ###LEFT-WALL### 3 - 1 the 2 bland 3 - 6 analysis 3 - 7 reported 3 - 24 . 4 altman 6 analysis 5 plot 6 analysis 6 analysis 7 reported 7 reported 13 and 7 reported 19 between 8 a 9 bias 9 bias 10 of 9 bias 13 and 10 of 12 °c 11 5.38 12 °c 13 and 16 limits 13 and 17 of 14 95 16 limits 15 % 16 limits 17 of 18 agreement 19 between 23 °c 20 0.60 21 and 21 and 22 10.15 21 and 23 °c 24 . 30 or 24 . 35 was 24 . 40 . 25 additionally 26 , 25 additionally 30 or 27 the 29 difference 28 mean 29 difference 29 difference 30 or 30 or 31 bias 30 or 32 of 30 or 35 was 32 of 34 °c 33 5.38 34 °c 35 was 36 statistically 35 was 39 p<0.0001 37 significant 39 p<0.0001 conclusion : our preliminary data supports a superior form of thermoregulation for the purposes of skin tightening that integrates continuous subsurface and epidermal temperature monitoring . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 data 2 : 6 supports 2 : 26 . 3 our 5 data 4 preliminary 5 data 5 data 6 supports 6 supports 9 form 7 a 8 superior 7 a 9 form 8 superior 9 form 9 form 10 of 9 form 17 tightening 9 form 25 monitoring 10 of 11 thermoregulation 11 thermoregulation 12 for 11 thermoregulation 15 of 12 for 14 purposes 13 the 14 purposes 15 of 16 skin 17 tightening 18 that 17 tightening 19 integrates 19 integrates 24 temperature 20 continuous 24 temperature 21 subsurface 22 and 22 and 23 epidermal 22 and 24 temperature 24 temperature 25 monitoring background : imiquimod 3.75 % and 2.5 % creams were studied for the treatment of actinic keratosis ( ak ) of the full face or balding scalp , to determine comparable efficacy and tolerability to imiquimod 5 % cream . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 5 % 2 : 6 and 3 imiquimod 4 3.75 3 imiquimod 5 % 6 and 9 creams 6 and 28 , 7 2.5 9 creams 8 % 9 creams 9 creams 28 , 10 were 11 studied 10 were 28 , 11 studied 12 for 12 for 25 or 13 the 14 treatment 14 treatment 15 of 14 treatment 21 of 14 treatment 25 or 15 of 17 keratosis 16 actinic 17 keratosis 17 keratosis 19 ak 18 ( 19 ak 19 ak 20 ) 21 of 24 face 22 the 24 face 23 full 24 face 25 or 27 scalp 26 balding 27 scalp 28 , 29 to 28 , 30 determine 29 to 30 determine 30 determine 33 and 30 determine 35 to 31 comparable 32 efficacy 32 efficacy 33 and 33 and 34 tolerability 35 to 39 cream 36 imiquimod 39 cream 37 5 38 % 38 % 39 cream methods : in two identical multicenter , randomized , double - blind , placebo controlled studies . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 17 . 1 methods 2 : 2 : 3 in 2 : 10 double 3 in 6 multicenter 4 two 6 multicenter 5 identical 6 multicenter 6 multicenter 8 randomized 7 , 8 randomized 8 randomized 9 , 11 - 16 studies 12 blind 13 , 12 blind 16 studies 14 placebo 15 controlled 15 controlled 16 studies adult subjects with 5 to 20 visible lesions , or palpable aks in an area that exceeded 25 cm² on either the face or balding scalp were randomized to [imiquimod] 3.75 % , 2.5 % [or] vehicle cream ( 1:1:1 ) applied once daily for two 2 - week treatment cycles , with a 2 [-] week , no [-] treatment interval between cycles . 1 adult 2 subjects 2 subjects 3 with 2 subjects 12 aks 3 with 4 5 3 with 5 to 5 to 10 or 6 20 8 lesions 7 visible 8 lesions 8 lesions 10 or 9 , 10 or 10 or 11 palpable 12 aks 13 in 12 aks 16 that 12 aks 17 exceeded 13 in 15 area 14 an 15 area 16 that 17 exceeded 17 exceeded 29 to 18 25 19 cm² 18 25 29 to 19 cm² 20 on 19 cm² 27 were 20 on 24 or 21 either 24 or 22 the 23 face 23 face 24 or 24 or 26 scalp 25 balding 26 scalp 27 were 28 randomized 29 to 31 3.75 31 3.75 32 % 32 % 38 cream 32 % 42 applied 33 , 38 cream 34 2.5 38 cream 35 % 37 vehicle 37 vehicle 38 cream 38 cream 40 1:1:1 38 cream 41 ) 39 ( 40 1:1:1 40 1:1:1 41 ) 42 applied 43 once 42 applied 44 daily 42 applied 45 for 42 applied 47 2 42 applied 53 with 45 for 46 two 47 2 51 cycles 48 - 51 cycles 49 week 51 cycles 50 treatment 51 cycles 51 cycles 52 , 53 with 57 week 54 a 57 week 55 2 57 week 57 week 62 interval 58 , 62 interval 59 no 62 interval 61 treatment 62 interval 62 interval 63 between 62 interval 65 . 63 between 64 cycles efficacy was assessed 8 weeks posttreatment ( end of study visit [ eos ] ) . 0 ###LEFT-WALL### 1 efficacy 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 16 . 1 efficacy 2 was 2 was 6 posttreatment 3 assessed 6 posttreatment 4 8 5 weeks 5 weeks 6 posttreatment 6 posttreatment 8 end 7 ( 8 end 8 end 9 of 8 end 15 ) 9 of 13 eos 10 study 11 visit 11 visit 13 eos 12 [ 13 eos 13 eos 14 ] primary efficacy was [rate] of complete clearance of ak lesions . 0 ###LEFT-WALL### 2 efficacy 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 11 . 1 primary 2 efficacy 2 efficacy 3 was 3 was 5 of 5 of 7 clearance 6 complete 7 clearance 7 clearance 8 of 8 of 10 lesions 9 ak 10 lesions secondary efficacy endpoints were rate [of] partial clearance at eos ( ≥ 75 % reduction in number [of] ak lesions compared to baseline ) and median percent decrease [from] baseline lesion count . 0 ###LEFT-WALL### 3 endpoints 0 ###LEFT-WALL### 33 . 1 secondary 2 efficacy 2 efficacy 3 endpoints 3 endpoints 4 were 4 were 5 rate 5 rate 25 and 7 partial 8 clearance 8 clearance 9 at 8 clearance 25 and 9 at 10 eos 10 eos 15 reduction 11 ( 15 reduction 12 ≥ 15 reduction 13 75 14 % 14 % 15 reduction 15 reduction 16 in 15 reduction 21 compared 15 reduction 24 ) 16 in 20 lesions 17 number 20 lesions 19 ak 20 lesions 21 compared 22 to 22 to 23 baseline 25 and 32 count 26 median 28 decrease 27 percent 28 decrease 28 decrease 32 count 30 baseline 32 count 31 lesion 32 count safety assessments included visual assessment of local skin reactions ( lsrs ) , number and duration of study treatment rest periods required due to intolerant lsrs , adverse events ( aes ) and clinical laboratory tests . 0 ###LEFT-WALL### 2 assessments 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 37 . 1 safety 2 assessments 2 assessments 3 included 3 included 5 assessment 4 visual 5 assessment 5 assessment 6 of 6 of 9 reactions 7 local 9 reactions 8 skin 9 reactions 9 reactions 11 lsrs 10 ( 11 lsrs 11 lsrs 12 ) 13 , 15 and 14 number 15 and 15 and 16 duration 15 and 17 of 17 of 33 and 18 study 20 rest 19 treatment 20 rest 20 rest 21 periods 21 periods 22 required 21 periods 24 to 21 periods 33 and 23 due 24 to 24 to 26 lsrs 25 intolerant 26 lsrs 26 lsrs 29 events 27 , 29 events 28 adverse 29 events 29 events 31 aes 29 events 32 ) 30 ( 31 aes 31 aes 32 ) 33 and 36 tests 34 clinical 35 laboratory 35 laboratory 36 tests results : overall 479 patients [were] randomized to imiquimod 3.75 % , 2.5 % , or vehicle . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 results 2 : 2 : 3 overall 2 : 16 or 4 479 5 patients 5 patients 7 randomized 5 patients 16 or 7 randomized 8 to 8 to 9 imiquimod 9 imiquimod 11 % 10 3.75 11 % 11 % 14 % 12 , 14 % 13 2.5 14 % 14 % 15 , 15 , 16 or 16 or 17 vehicle complete clearance rates were 35.6 % , 30.6 % , [and] 6.3 % [respectively] ( both p<.001 [versus] [vehicle] ) . 0 ###LEFT-WALL### 3 rates 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 21 . 1 complete 2 clearance 2 clearance 3 rates 3 rates 4 were 4 were 6 % 5 35.6 6 % 6 % 9 % 6 % 13 % 7 , 9 % 8 30.6 9 % 9 % 10 , 10 , 13 % 12 6.3 13 % 13 % 17 p<.001 13 % 20 ) 15 ( 17 p<.001 16 both 17 p<.001 17 p<.001 20 ) the difference in complete clearance rates ( imiquimod [minus] [vehicle] ) was 29.3 [%] and 24.3 % , respectively . 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 12 was 1 the 2 difference 2 difference 3 in 2 difference 12 was 3 in 6 rates 4 complete 5 clearance 5 clearance 6 rates 6 rates 8 imiquimod 7 ( 8 imiquimod 8 imiquimod 11 ) 12 was 17 % 12 was 19 respectively 13 29.3 15 and 15 and 16 24.3 15 and 17 % 18 , 19 respectively 19 respectively 20 . partial clearance rates were 59.4 % , 48.1 % , [and] 22.6 % [respectively] ( both p<.001 [versus] [vehicle] ) . 0 ###LEFT-WALL### 3 rates 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 21 . 1 partial 2 clearance 2 clearance 3 rates 3 rates 4 were 4 were 6 % 5 59.4 6 % 6 % 9 % 6 % 13 % 7 , 9 % 8 48.1 9 % 9 % 10 , 10 , 13 % 12 22.6 13 % 13 % 17 p<.001 13 % 20 ) 15 ( 17 p<.001 16 both 17 p<.001 17 p<.001 20 ) median % reductions in ak lesions were 81.8 % , 71.8 % , [and] 25.0 % [respectively] ( p<.001 [versus] [vehicle] ) . 0 ###LEFT-WALL### 3 reductions 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 23 . 1 median 3 reductions 2 % 3 reductions 3 reductions 4 in 3 reductions 7 were 4 in 6 lesions 5 ak 6 lesions 7 were 9 % 8 81.8 9 % 9 % 12 % 9 % 16 % 10 , 12 % 11 71.8 12 % 12 % 13 , 13 , 16 % 15 25.0 16 % 16 % 19 p<.001 16 % 22 ) 18 ( 19 p<.001 19 p<.001 22 ) all primary and secondary efficacy endpoints were greater in study 1 . 0 ###LEFT-WALL### 6 endpoints 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 12 . 1 all 6 endpoints 2 primary 3 and 3 and 4 secondary 3 and 5 efficacy 5 efficacy 6 endpoints 6 endpoints 7 were 7 were 8 greater 8 greater 9 in 9 in 10 study 10 study 11 1 photodamage in the treatment area was ['] much improved ['] with imiquimod 3.75 % . 0 ###LEFT-WALL### 1 photodamage 0 ###LEFT-WALL### 15 . 1 photodamage 2 in 1 photodamage 8 much 2 in 4 treatment 3 the 4 treatment 4 treatment 5 area 4 treatment 6 was 5 area 6 was 8 much 9 improved 9 improved 11 with 11 with 12 imiquimod 11 with 14 % 13 3.75 14 % both active creams were well tolerated with few treatment - related discontinuations . 0 ###LEFT-WALL### 3 creams 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 11 related 1 both 3 creams 2 active 3 creams 3 creams 4 were 4 were 5 well 5 well 6 tolerated 6 tolerated 7 with 7 with 8 few 7 with 9 treatment 10 - 11 related 11 related 12 discontinuations 11 related 13 . conclusions : in two well - controlled phase 3 studies , both imiquimod 3.75 % and 2.5 % creams were more effective than vehicle and well tolerated when administered daily as a 2 [-] week on/off/on regimen to treat ak . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 8 phase 2 : 10 studies 2 : 11 , 2 : 39 treat 2 : 41 . 3 in 4 two 3 in 8 phase 5 well 6 - 5 well 8 phase 7 controlled 8 phase 8 phase 9 3 8 phase 10 studies 11 , 12 both 11 , 13 imiquimod 11 , 16 and 12 both 13 imiquimod 13 imiquimod 15 % 14 3.75 15 % 16 and 19 creams 16 and 25 and 17 2.5 19 creams 18 % 19 creams 19 creams 25 and 20 were 22 effective 20 were 25 and 21 more 22 effective 22 effective 23 than 23 than 24 vehicle 25 and 27 tolerated 25 and 28 when 26 well 27 tolerated 28 when 29 administered 29 administered 30 daily 30 daily 31 as 30 daily 38 to 31 as 37 regimen 32 a 37 regimen 33 2 35 week 35 week 36 on/off/on 36 on/off/on 37 regimen 38 to 39 treat 39 treat 40 ak reduction in ak lesions was comparable to that reported with imiquimod 5 % with fewer local aes . 0 ###LEFT-WALL### 1 reduction 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 18 . 1 reduction 2 in 1 reduction 5 was 2 in 4 lesions 3 ak 4 lesions 5 was 6 comparable 6 comparable 7 to 7 to 8 that 8 that 9 reported 9 reported 10 with 9 reported 14 with 10 with 11 imiquimod 10 with 13 % 12 5 13 % 14 with 17 aes 15 fewer 17 aes 16 local 17 aes the human circadian clock ensures that biochemical and physiological processes occur at the optimal time of day . 0 ###LEFT-WALL### 4 clock 0 ###LEFT-WALL### 5 ensures 0 ###LEFT-WALL### 18 . 1 the 4 clock 2 human 4 clock 3 circadian 4 clock 4 clock 5 ensures 5 ensures 6 that 6 that 10 processes 6 that 11 occur 7 biochemical 8 and 8 and 9 physiological 8 and 10 processes 10 processes 11 occur 11 occur 12 at 12 at 15 time 13 the 15 time 14 optimal 15 time 15 time 16 of 16 of 17 day in addition to a central pacemaker in the body , recent evidence suggests that peripheral mammalian tissues also possess autonomous circadian oscillators , which are regulated by genes linked to distinct tissue - specific functions . 0 ###LEFT-WALL### 12 evidence 0 ###LEFT-WALL### 13 suggests 0 ###LEFT-WALL### 33 - 1 in 2 addition 1 in 10 , 1 in 12 evidence 2 addition 3 to 3 to 6 pacemaker 4 a 5 central 4 a 6 pacemaker 5 central 6 pacemaker 6 pacemaker 7 in 7 in 9 body 8 the 9 body 11 recent 12 evidence 12 evidence 13 suggests 13 suggests 14 that 14 that 17 tissues 14 that 19 possess 15 peripheral 17 tissues 16 mammalian 17 tissues 18 also 19 possess 19 possess 22 oscillators 20 autonomous 22 oscillators 21 circadian 22 oscillators 22 oscillators 24 which 23 , 24 which 24 which 25 are 24 which 33 - 25 are 26 regulated 26 regulated 27 by 27 by 28 genes 28 genes 29 linked 29 linked 30 to 30 to 32 tissue 31 distinct 32 tissue 33 - 35 functions 33 - 36 . 34 specific 35 functions the skin is situated in a position naturally exposed to diurnal environmental changes . 0 ###LEFT-WALL### 2 skin 0 ###LEFT-WALL### 4 situated 0 ###LEFT-WALL### 14 . 1 the 2 skin 2 skin 3 is 3 is 4 situated 4 situated 5 in 5 in 7 position 6 a 7 position 7 position 9 exposed 8 naturally 9 exposed 9 exposed 10 to 10 to 13 changes 11 diurnal 13 changes 12 environmental 13 changes the skin 's chronobiological functioning influences skin aging , cell repair and development of skin cancers , as well as optimal timing of drug delivery to the skin . 0 ###LEFT-WALL### 12 and 1 the 2 skin 2 skin 3 's 3 's 7 skin 4 chronobiological 7 skin 5 functioning 7 skin 6 influences 7 skin 7 skin 8 aging 7 skin 9 , 9 , 11 repair 9 , 12 and 10 cell 11 repair 12 and 13 development 12 and 14 of 12 and 20 as 14 of 16 cancers 15 skin 16 cancers 17 , 20 as 18 as 19 well 19 well 20 as 20 as 22 timing 20 as 29 . 21 optimal 22 timing 22 timing 23 of 23 of 25 delivery 24 drug 25 delivery 25 delivery 26 to 26 to 28 skin 27 the 28 skin an understanding of circadian skin [-] related functions and the impact of their disruption allow clinicians to improve therapeutic [decision] - making and maximize the effectiveness of prescribed treatments . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 30 . 1 an 2 understanding 1 an 3 of 1 an 9 and 3 of 8 functions 4 circadian 5 skin 5 skin 7 related 7 related 8 functions 9 and 11 impact 9 and 12 of 9 and 23 and 10 the 11 impact 12 of 14 disruption 13 their 14 disruption 15 allow 16 clinicians 15 allow 17 to 15 allow 18 improve 15 allow 23 and 17 to 18 improve 18 improve 22 making 19 therapeutic 21 - 19 therapeutic 22 making 23 and 24 maximize 24 maximize 26 effectiveness 25 the 26 effectiveness 26 effectiveness 27 of 27 of 29 treatments 28 prescribed 29 treatments urinary incontinence is a common complaint in older people , and is associated with significant impact on the individual , their carers and the wider healthcare system . 0 ###LEFT-WALL### 2 incontinence 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 28 . 1 urinary 2 incontinence 2 incontinence 11 and 3 is 6 complaint 3 is 7 in 3 is 11 and 4 a 5 common 4 a 6 complaint 5 common 6 complaint 7 in 9 people 8 older 9 people 10 , 11 and 11 and 12 is 11 and 14 with 11 and 17 on 12 is 13 associated 14 with 16 impact 15 significant 16 impact 17 on 23 and 18 the 19 individual 19 individual 20 , 20 , 22 carers 20 , 23 and 21 their 22 carers 23 and 27 system 24 the 27 system 25 wider 27 system 26 healthcare 27 system as the numbers of frail elderly people increase , so will [the] burden [of] incontinence . 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 16 . 1 as 7 people 1 as 9 , 2 the 3 numbers 3 numbers 4 of 3 numbers 7 people 4 of 7 people 5 frail 7 people 6 elderly 7 people 8 increase 9 , 9 , 11 will 10 so 11 will 11 will 13 burden 13 burden 15 incontinence this review examines recent developments in research into the aetiology , physiology , pathology and treatment of urinary incontinence [and] lower urinary tract symptoms in older people , and explores potential future developments which might reduce or ameliorate both urinary incontinence and its effects on frail older people . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 49 . 1 this 2 review 2 review 3 examines 3 examines 15 and 3 examines 29 and 4 recent 5 developments 5 developments 6 in 5 developments 15 and 6 in 7 research 7 research 8 into 8 into 14 pathology 9 the 14 pathology 10 aetiology 12 physiology 10 aetiology 13 , 10 aetiology 14 pathology 11 , 12 physiology 12 physiology 13 , 15 and 16 treatment 15 and 29 and 16 treatment 17 of 17 of 19 incontinence 18 urinary 19 incontinence 21 lower 24 symptoms 21 lower 25 in 21 lower 29 and 22 urinary 23 tract 23 tract 24 symptoms 25 in 27 people 26 older 27 people 28 , 29 and 29 and 37 or 30 explores 31 potential 30 explores 37 or 31 potential 33 developments 31 potential 36 reduce 32 future 33 developments 33 developments 34 which 33 developments 35 might 33 developments 36 reduce 34 which 35 might 37 or 38 ameliorate 38 ameliorate 42 and 38 ameliorate 45 on 39 both 42 and 40 urinary 41 incontinence 41 incontinence 42 and 42 and 44 effects 43 its 44 effects 45 on 48 people 46 frail 48 people 47 older 48 people these include increasing understanding of the importance of central control of continence , the role of the urothelium as a sensory organ , novel targets for pharmacological treatments and surgical and invasive interventions . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 34 . 1 these 2 include 2 include 4 understanding 3 increasing 4 understanding 4 understanding 5 of 4 understanding 8 of 4 understanding 11 of 5 of 7 importance 6 the 7 importance 8 of 10 control 9 central 10 control 11 of 12 continence 13 , 29 and 14 the 15 role 15 role 16 of 15 role 23 , 16 of 18 urothelium 17 the 18 urothelium 18 urothelium 19 as 19 as 22 organ 20 a 22 organ 21 sensory 22 organ 23 , 25 targets 23 , 29 and 24 novel 25 targets 25 targets 26 for 26 for 28 treatments 27 pharmacological 28 treatments 29 and 33 interventions 30 surgical 31 and 31 and 32 invasive 31 and 33 interventions background : this study investigated the differences in exercise self [-] efficacy , compliance , and effectiveness of home - based exercise in individuals [with] and [without] metabolic syndrome ( mets ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 based 0 ###LEFT-WALL### 33 . 2 : 4 study 2 : 5 investigated 3 this 4 study 4 study 5 investigated 5 investigated 7 differences 5 investigated 8 in 6 the 7 differences 8 in 9 exercise 9 exercise 12 efficacy 9 exercise 21 based 10 self 12 efficacy 12 efficacy 16 and 12 efficacy 21 based 13 , 16 and 14 compliance 16 and 15 , 16 and 16 and 17 effectiveness 16 and 18 of 16 and 20 - 18 of 19 home 21 based 22 exercise 21 based 23 in 23 in 26 and 24 individuals 26 and 26 and 29 syndrome 26 and 31 mets 28 metabolic 29 syndrome 30 ( 31 mets 31 mets 32 ) methods : one hundred and ten individuals at risk for diabetes participated in this study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 7 individuals 2 : 12 participated 2 : 16 . 3 one 4 hundred 4 hundred 5 and 5 and 6 ten 6 ten 7 individuals 7 individuals 8 at 7 individuals 12 participated 8 at 9 risk 9 risk 10 for 10 for 11 diabetes 12 participated 13 in 13 in 15 study 14 this 15 study subjects were categorized into individuals with mets and individuals without mets . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 3 categorized 0 ###LEFT-WALL### 12 . 1 subjects 2 were 2 were 3 categorized 3 categorized 4 into 3 categorized 6 with 3 categorized 10 without 4 into 5 individuals 6 with 8 and 7 mets 8 and 8 and 9 individuals 10 without 11 mets metabolic risk factors and exercise self - efficacy were evaluated for all subjects before and after 3 months of home - based exercise . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 24 . 1 metabolic 3 factors 2 risk 3 factors 3 factors 4 and 4 and 6 self 5 exercise 6 self 7 - 8 efficacy 7 - 10 evaluated 7 - 21 - 8 efficacy 9 were 9 were 10 evaluated 10 evaluated 11 for 11 for 13 subjects 12 all 13 subjects 13 subjects 15 and 13 subjects 19 of 14 before 15 and 15 and 16 after 16 after 18 months 17 3 18 months 19 of 20 home 21 - 23 exercise 22 based 23 exercise univariate analysis of variance was used to compare the effectiveness of a home [-] based exercise program between individuals [with] and without mets . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 24 . 1 univariate 2 analysis 2 analysis 3 of 2 analysis 5 was 3 of 4 variance 5 was 6 used 6 used 7 to 6 used 8 compare 7 to 8 compare 8 compare 10 effectiveness 9 the 10 effectiveness 10 effectiveness 11 of 10 effectiveness 21 and 11 of 17 program 12 a 17 program 13 home 15 based 15 based 16 exercise 16 exercise 17 program 18 between 19 individuals 18 between 21 and 21 and 22 without 22 without 23 mets results : the home - based exercise program improved body mass index [and] lipid profile in individuals at risk for diabetes , regardless of mets status at baseline . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 1 results 2 : 2 : 4 home 2 : 24 of 2 : 27 at 3 the 4 home 4 home 15 profile 5 - 15 profile 6 based 10 body 7 exercise 9 improved 8 program 9 improved 9 improved 10 body 10 body 15 profile 11 mass 15 profile 12 index 15 profile 14 lipid 15 profile 15 profile 16 in 15 profile 18 at 15 profile 20 for 15 profile 22 , 16 in 17 individuals 18 at 19 risk 20 for 21 diabetes 23 regardless 24 of 24 of 26 status 25 mets 26 status 27 at 28 baseline individuals without mets had higher exercise self [-] efficacy at baseline and performed greater exercise volume compared with individuals with mets during the intervention . 0 ###LEFT-WALL### 1 individuals 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 25 . 1 individuals 2 without 1 individuals 4 had 2 without 3 mets 4 had 9 efficacy 4 had 10 at 5 higher 6 exercise 6 exercise 7 self 7 self 9 efficacy 10 at 12 and 11 baseline 12 and 12 and 16 volume 12 and 17 compared 12 and 18 with 13 performed 15 exercise 14 greater 15 exercise 15 exercise 16 volume 18 with 19 individuals 19 individuals 20 with 19 individuals 22 during 20 with 21 mets 22 during 24 intervention 23 the 24 intervention the increased exercise volume in individuals without mets may contribute to their better control of insulin resistance than individuals with mets . 0 ###LEFT-WALL### 4 volume 0 ###LEFT-WALL### 10 contribute 0 ###LEFT-WALL### 22 . 1 the 4 volume 2 increased 3 exercise 3 exercise 4 volume 4 volume 5 in 4 volume 9 may 5 in 6 individuals 6 individuals 7 without 7 without 8 mets 9 may 10 contribute 10 contribute 11 to 10 contribute 18 than 10 contribute 20 with 11 to 14 control 12 their 14 control 13 better 14 control 14 control 15 of 15 of 17 resistance 16 insulin 17 resistance 18 than 19 individuals 20 with 21 mets furthermore , baseline exercise self [-] efficacy was correlated with exercise volume executed by subjects at home . 0 ###LEFT-WALL### 7 efficacy 0 ###LEFT-WALL### 9 correlated 0 ###LEFT-WALL### 18 . 1 furthermore 2 , 1 furthermore 7 efficacy 3 baseline 7 efficacy 4 exercise 7 efficacy 5 self 7 efficacy 7 efficacy 8 was 8 was 9 correlated 9 correlated 10 with 9 correlated 14 by 9 correlated 16 at 10 with 12 volume 11 exercise 12 volume 12 volume 13 executed 14 by 15 subjects 16 at 17 home conclusions : we conclude that home - based exercise programs are beneficial for individuals at risk for diabetes . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 conclude 2 : 7 - 3 we 4 conclude 4 conclude 5 that 4 conclude 6 home 7 - 10 programs 7 - 11 are 7 - 19 . 8 based 9 exercise 9 exercise 10 programs 10 programs 11 are 11 are 12 beneficial 12 beneficial 13 for 12 beneficial 15 at 13 for 14 individuals 15 at 16 risk 16 risk 17 for 17 for 18 diabetes however , more intensive [and/or] supervised exercise intervention may be needed for those with mets . 0 ###LEFT-WALL### 8 intervention 0 ###LEFT-WALL### 11 needed 0 ###LEFT-WALL### 16 . 1 however 2 , 1 however 8 intervention 3 more 4 intensive 4 intensive 7 exercise 6 supervised 7 exercise 7 exercise 8 intervention 8 intervention 9 may 9 may 10 be 10 be 11 needed 11 needed 12 for 11 needed 14 with 12 for 13 those 14 with 15 mets repair of dna double - strand breaks via homologous recombination can produce double holliday junctions ( dhjs ) that require enzymatic separation . 0 ###LEFT-WALL### 4 double 0 ###LEFT-WALL### 5 - 1 repair 2 of 1 repair 4 double 2 of 3 dna 5 - 6 strand 5 - 23 . 6 strand 7 breaks 7 breaks 8 via 7 breaks 19 that 7 breaks 20 require 8 via 15 junctions 9 homologous 10 recombination 10 recombination 15 junctions 11 can 15 junctions 12 produce 15 junctions 13 double 15 junctions 14 holliday 15 junctions 15 junctions 17 dhjs 16 ( 17 dhjs 17 dhjs 18 ) 19 that 20 require 20 require 22 separation 21 enzymatic 22 separation topoisomerase iiiα ( topiiiα ) together [with] rmi1 disentangles the final hemicatenane intermediate obtained once dhjs have converged . 0 ###LEFT-WALL### 8 rmi1 0 ###LEFT-WALL### 9 disentangles 0 ###LEFT-WALL### 19 . 1 topoisomerase 8 rmi1 2 iiiα 8 rmi1 3 ( 4 topiiiα 4 topiiiα 5 ) 4 topiiiα 8 rmi1 6 together 8 rmi1 8 rmi1 9 disentangles 9 disentangles 13 intermediate 10 the 13 intermediate 11 final 13 intermediate 12 hemicatenane 13 intermediate 13 intermediate 14 obtained 14 obtained 15 once 15 once 16 dhjs 15 once 18 converged 16 dhjs 17 have 17 have 18 converged how binding of rmi1 to topiiiα influences it to behave as a hemicatenane dissolvase , rather than as an enzyme that relaxes dna topology , is unknown . 0 ###LEFT-WALL### 1 how 0 ###LEFT-WALL### 26 is 0 ###LEFT-WALL### 28 . 1 how 2 binding 1 how 7 influences 1 how 26 is 2 binding 3 of 2 binding 7 influences 3 of 4 rmi1 4 rmi1 5 to 5 to 6 topiiiα 7 influences 8 it 7 influences 9 to 9 to 10 behave 10 behave 11 as 10 behave 17 than 11 as 14 dissolvase 12 a 14 dissolvase 13 hemicatenane 14 dissolvase 15 , 17 than 16 rather 17 than 17 than 18 as 17 than 25 , 18 as 20 enzyme 19 an 20 enzyme 20 enzyme 21 that 20 enzyme 22 relaxes 21 that 22 relaxes 22 relaxes 24 topology 23 dna 24 topology 26 is 27 unknown here , we present the crystal structure of human topiiiα complexed to the first oligonucleotide [-] binding domain ( ob [fold] ) of rmi1 . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 present 0 ###LEFT-WALL### 25 . 1 here 2 , 1 here 3 we 3 we 4 present 4 present 7 structure 5 the 7 structure 6 crystal 7 structure 7 structure 8 of 7 structure 11 complexed 8 of 10 topiiiα 9 human 10 topiiiα 11 complexed 12 to 12 to 18 domain 13 the 14 first 13 the 18 domain 15 oligonucleotide 17 binding 17 binding 18 domain 18 domain 20 ob 18 domain 23 of 19 ( 20 ob 20 ob 22 ) 23 of 24 rmi1 topiii assumes a toroidal type 1 a topoisomerase fold . 0 ###LEFT-WALL### 1 topiii 0 ###LEFT-WALL### 2 assumes 0 ###LEFT-WALL### 10 . 1 topiii 2 assumes 2 assumes 9 fold 3 a 4 toroidal 3 a 9 fold 4 toroidal 5 type 5 type 9 fold 6 1 7 a 7 a 9 fold 8 topoisomerase 9 fold rmi1 attaches to the edge of the gate in topiiiα through which dna passes . 0 ###LEFT-WALL### 1 rmi1 0 ###LEFT-WALL### 2 attaches 0 ###LEFT-WALL### 15 . 1 rmi1 2 attaches 2 attaches 3 to 2 attaches 9 in 3 to 5 edge 4 the 5 edge 5 edge 6 of 6 of 8 gate 7 the 8 gate 9 in 10 topiiiα 10 topiiiα 11 through 11 through 12 which 11 through 13 dna 11 through 14 passes 13 dna 14 passes rmi1 projects a 23 [-] residue [loop] into the topiiiα gate , thereby influencing the dynamics of its opening and closing . 0 ###LEFT-WALL### 1 rmi1 0 ###LEFT-WALL### 2 projects 1 rmi1 2 projects 2 projects 6 residue 2 projects 14 influencing 3 a 6 residue 4 23 6 residue 6 residue 8 into 8 into 11 gate 9 the 11 gate 10 topiiiα 11 gate 12 , 14 influencing 13 thereby 14 influencing 14 influencing 16 dynamics 14 influencing 22 . 15 the 16 dynamics 16 dynamics 17 of 17 of 20 and 18 its 19 opening 19 opening 20 and 20 and 21 closing our results provide a mechanistic rationale for [how] rmi1 stabilizes topiiiα - gate opening to [enable] dissolution and [illustrate] how binding partners modulate topoisomerase function . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 10 stabilizes 0 ###LEFT-WALL### 12 - 1 our 2 results 2 results 3 provide 3 provide 6 rationale 3 provide 7 for 4 a 6 rationale 5 mechanistic 6 rationale 7 for 9 rmi1 9 rmi1 10 stabilizes 10 stabilizes 11 topiiiα 12 - 25 function 12 - 26 . 13 gate 14 opening 14 opening 15 to 14 opening 18 and 15 to 17 dissolution 18 and 20 how 18 and 21 binding 18 and 22 partners 18 and 23 modulate 18 and 25 function 22 partners 23 modulate 23 modulate 24 topoisomerase background data : the pelvic incidence ( pi ) was recognized as the key factor of the sagittal balance of the spine . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 : 1 background 2 data 3 : 6 incidence 3 : 11 recognized 3 : 23 . 4 the 6 incidence 5 pelvic 6 incidence 6 incidence 8 pi 6 incidence 10 was 7 ( 8 pi 8 pi 9 ) 10 was 11 recognized 11 recognized 12 as 12 as 15 factor 13 the 15 factor 14 key 15 factor 15 factor 16 of 16 of 19 balance 17 the 19 balance 18 sagittal 19 balance 19 balance 20 of 20 of 22 spine 21 the 22 spine its value was described [own] for each individual and unchanged during adulthood . 0 ###LEFT-WALL### 2 value 0 ###LEFT-WALL### 4 described 0 ###LEFT-WALL### 13 . 1 its 2 value 2 value 3 was 3 was 4 described 4 described 6 for 6 for 7 each 7 each 9 and 8 individual 9 and 9 and 10 unchanged 10 unchanged 11 during 11 during 12 adulthood purpose : to bring out the effect of the age and [of] a sagittal imbalance in the variability of the value of pi . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 3 to 2 : 4 bring 3 to 4 bring 4 bring 5 out 4 bring 7 effect 4 bring 16 in 6 the 7 effect 7 effect 8 of 8 of 11 and 9 the 10 age 10 age 11 and 11 and 15 imbalance 13 a 14 sagittal 13 a 15 imbalance 14 sagittal 15 imbalance 16 in 18 variability 17 the 18 variability 18 variability 19 of 18 variability 22 of 19 of 21 value 20 the 21 value 22 of 23 pi materials and methods : 200 subjects with chronic low back pain due to sagittal imbalance were compared to 89 normal subjects . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 materials 2 and 2 and 3 methods 4 : 6 subjects 4 : 17 compared 4 : 22 . 5 200 6 subjects 6 subjects 7 with 6 subjects 13 to 6 subjects 16 were 7 with 11 pain 8 chronic 9 low 9 low 10 back 10 back 11 pain 12 due 13 to 13 to 15 imbalance 14 sagittal 15 imbalance 16 were 17 compared 17 compared 18 to 18 to 21 subjects 19 89 21 subjects 20 normal 21 subjects for each groups , the cases were divided according to the age ( 19 - 40 , 6 - 40 years , over 60 years ) . 0 ###LEFT-WALL### 1 for 0 ###LEFT-WALL### 3 groups 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 27 . 1 for 2 each 2 each 3 groups 4 , 6 cases 4 , 8 divided 5 the 6 cases 6 cases 7 were 7 were 8 divided 8 divided 10 to 9 according 10 to 10 to 12 age 11 the 12 age 12 age 15 - 12 age 21 years 13 ( 15 - 14 19 15 - 15 - 16 40 15 - 17 , 17 , 21 years 18 6 19 - 19 - 20 40 19 - 21 years 21 years 25 years 21 years 26 ) 22 , 25 years 23 over 24 60 24 60 25 years 25 years 26 ) the pi and the sagittal positional parameters were measured on large [radiographs] in standardized standing position . 0 ###LEFT-WALL### 16 position 0 ###LEFT-WALL### 17 . 1 the 2 pi 2 pi 3 and 3 and 5 sagittal 3 and 7 parameters 3 and 10 on 3 and 11 large 3 and 16 position 4 the 5 sagittal 6 positional 7 parameters 7 parameters 8 were 8 were 9 measured 9 measured 10 on 11 large 13 in 13 in 15 standing 14 standardized 15 standing results : the correlation between age and pi was [observed] significant only for the >60 years cases . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 correlation 2 : 9 was 2 : 18 . 3 the 4 correlation 4 correlation 5 between 4 correlation 9 was 5 between 7 and 6 age 7 and 7 and 8 pi 9 was 11 significant 11 significant 12 only 12 only 13 for 13 for 17 cases 14 the 17 cases 15 >60 17 cases 16 years 17 cases the mean values of pi were significantly greater for these cases . 0 ###LEFT-WALL### 3 values 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 12 . 1 the 3 values 2 mean 3 values 3 values 4 of 3 values 6 were 4 of 5 pi 6 were 8 greater 7 significantly 8 greater 8 greater 9 for 9 for 11 cases 10 these 11 cases discussion : an increase of the value of pi was attributable to a twisting mobilization within the sacroiliac joint . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 4 increase 2 : 10 was 2 : 20 . 3 an 4 increase 4 increase 5 of 4 increase 10 was 5 of 7 value 6 the 7 value 7 value 8 of 8 of 9 pi 10 was 11 attributable 11 attributable 12 to 11 attributable 16 within 12 to 15 mobilization 13 a 15 mobilization 14 twisting 15 mobilization 16 within 19 joint 17 the 19 joint 18 sacroiliac 19 joint it results from a forward projection of the gravity due to a sagittal disturbance and a pelvic compensatory [backward] rotation . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 21 . 1 it 2 results 2 results 3 from 2 results 11 to 3 from 6 projection 4 a 6 projection 5 forward 6 projection 6 projection 7 of 7 of 9 gravity 8 the 9 gravity 10 due 11 to 11 to 15 and 12 a 13 sagittal 12 a 14 disturbance 13 sagittal 14 disturbance 14 disturbance 15 and 15 and 20 rotation 16 a 17 pelvic 16 a 20 rotation 17 pelvic 20 rotation 18 compensatory 20 rotation this twisting into the sacroiliac joint was incriminated in the origin of chronic low back pain . 0 ###LEFT-WALL### 2 twisting 0 ###LEFT-WALL### 8 incriminated 0 ###LEFT-WALL### 17 . 1 this 2 twisting 2 twisting 3 into 2 twisting 7 was 3 into 6 joint 4 the 6 joint 5 sacroiliac 6 joint 7 was 8 incriminated 8 incriminated 9 in 9 in 11 origin 10 the 11 origin 11 origin 12 of 12 of 16 pain 13 chronic 14 low 14 low 16 pain 15 back 16 pain conclusion : the sagittal pelvi - spinal imbalance may be incriminated in the increasing of the value of pi by a painful destabilization sacro - iliac , with leads to an increasing of the value of pi . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 5 pelvi 2 : 6 - 3 the 5 pelvi 4 sagittal 5 pelvi 6 - 8 imbalance 6 - 11 incriminated 7 spinal 8 imbalance 8 imbalance 9 may 9 may 10 be 10 be 11 incriminated 11 incriminated 12 in 11 incriminated 28 with 11 incriminated 30 to 12 in 14 increasing 13 the 14 increasing 14 increasing 15 of 14 increasing 18 of 14 increasing 26 iliac 15 of 17 value 16 the 17 value 18 of 19 pi 19 pi 20 by 20 by 24 sacro 21 a 24 sacro 22 painful 23 destabilization 23 destabilization 24 sacro 25 - 26 iliac 26 iliac 27 , 28 with 29 leads 30 to 32 increasing 31 an 32 increasing 32 increasing 33 of 32 increasing 36 of 33 of 35 value 34 the 35 value 36 of 37 pi background : assisted living ( al ) is a growing and operationally diverse option in our nation 's long - term care system . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 living 2 : 8 is 2 : 24 . 3 assisted 4 living 4 living 6 al 4 living 8 is 5 ( 6 al 6 al 7 ) 8 is 14 option 9 a 14 option 10 growing 11 and 11 and 13 diverse 11 and 14 option 12 operationally 13 diverse 14 option 15 in 15 in 23 system 16 our 17 nation 17 nation 18 's 18 's 23 system 19 long 20 - 19 long 21 term 21 term 23 system 22 care 23 system many consumers view al communities as a viable option to receive needed services and age in place . 0 ###LEFT-WALL### 2 consumers 0 ###LEFT-WALL### 3 view 0 ###LEFT-WALL### 12 needed 0 ###LEFT-WALL### 18 . 1 many 2 consumers 2 consumers 3 view 3 view 5 communities 3 view 6 as 4 al 5 communities 6 as 9 option 6 as 12 needed 7 a 8 viable 7 a 9 option 8 viable 9 option 9 option 10 to 9 option 11 receive 9 option 12 needed 10 to 11 receive 12 needed 14 and 12 needed 16 in 13 services 14 and 14 and 15 age 16 in 17 place however , little is [known] about the factors that influence residents ' ability to age in place when experiencing cognitive [decline] . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 3 little 3 little 4 is 4 is 6 about 4 is 20 cognitive 6 about 8 factors 7 the 8 factors 8 factors 9 that 8 factors 10 influence 9 that 10 influence 10 influence 13 ability 11 residents 12 ' 12 ' 13 ability 13 ability 14 to 13 ability 19 experiencing 14 to 15 age 15 age 16 in 15 age 18 when 16 in 17 place 18 when 19 experiencing objective : to estimate the association of resident and site characteristics to length [of] stay , reason for leaving and destination for residents with dementia in assisted living . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 3 to 2 : 4 estimate 3 to 4 estimate 4 estimate 6 association 4 estimate 27 assisted 5 the 6 association 6 association 7 of 6 association 27 assisted 7 of 9 and 8 resident 9 and 9 and 10 site 9 and 11 characteristics 9 and 16 , 11 characteristics 12 to 11 characteristics 16 , 12 to 13 length 15 stay 16 , 16 , 17 reason 16 , 26 in 17 reason 18 for 17 reason 22 for 17 reason 24 with 17 reason 26 in 18 for 20 and 19 leaving 20 and 20 and 21 destination 22 for 23 residents 24 with 25 dementia 27 assisted 28 living in particular , this study sought to assess the impact of an ['] enhanced ['] program intended to facilitate aging in place . 0 ###LEFT-WALL### 5 study 0 ###LEFT-WALL### 6 sought 0 ###LEFT-WALL### 23 . 1 in 2 particular 2 particular 3 , 2 particular 5 study 4 this 5 study 5 study 6 sought 6 sought 7 to 6 sought 8 assess 7 to 8 assess 8 assess 10 impact 8 assess 17 intended 9 the 10 impact 10 impact 11 of 10 impact 17 intended 11 of 16 program 12 an 16 program 14 enhanced 16 program 17 intended 18 to 17 intended 19 facilitate 18 to 19 facilitate 19 facilitate 20 aging 19 facilitate 21 in 21 in 22 place method : data were gathered from a retrospective evaluation of residents ' clinical records ( n=312 ) in five dementia - specific als ( 3 with robust enhanced programs ) in the northeastern united states . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 5 gathered 2 : 36 . 3 data 4 were 4 were 5 gathered 5 gathered 6 from 5 gathered 18 in 5 gathered 31 in 6 from 9 evaluation 7 a 8 retrospective 7 a 9 evaluation 8 retrospective 9 evaluation 9 evaluation 10 of 10 of 14 records 11 residents 12 ' 12 ' 14 records 13 clinical 14 records 14 records 16 n=312 15 ( 16 n=312 16 n=312 17 ) 18 in 23 als 19 five 23 als 20 dementia 21 - 20 dementia 23 als 22 specific 23 als 23 als 25 3 24 ( 25 3 25 3 26 with 25 3 30 ) 26 with 29 programs 27 robust 29 programs 28 enhanced 29 programs 31 in 35 states 32 the 35 states 33 northeastern 34 united 34 united 35 states results : the time to 50 % survival for the full cohort ( n=312 ) was 20.2 months . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 1 results 2 : 2 : 4 time 3 the 4 time 4 time 8 survival 4 time 16 was 5 to 7 % 5 to 8 survival 6 50 7 % 8 survival 9 for 8 survival 16 was 9 for 12 cohort 10 the 12 cohort 11 full 12 cohort 12 cohort 14 n=312 13 ( 14 n=312 14 n=312 15 ) 16 was 18 months 17 20.2 18 months both age at [move] - in and gender were statistically significant predictors of length [of] [stay] . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 17 . 1 both 7 and 2 age 3 at 2 age 7 and 3 at 6 in 5 - 6 in 7 and 8 gender 7 and 9 were 9 were 10 statistically 9 were 12 predictors 11 significant 12 predictors 12 predictors 13 of 13 of 14 length sites with robust support for aging in place exhibited a statistically significant longer length of stay compared [to] sites with limited support . 0 ###LEFT-WALL### 1 sites 0 ###LEFT-WALL### 9 exhibited 0 ###LEFT-WALL### 23 . 1 sites 2 with 1 sites 5 for 1 sites 9 exhibited 2 with 4 support 3 robust 4 support 5 for 6 aging 6 aging 8 place 7 in 8 place 9 exhibited 14 length 10 a 11 statistically 10 a 14 length 11 statistically 12 significant 12 significant 14 length 13 longer 14 length 14 length 15 of 15 of 19 sites 16 stay 17 compared 17 compared 19 sites 19 sites 20 with 20 with 22 support 21 limited 22 support of the residents who left or died ( n=165 ) nearly one quarter ( 24 % ) were able to stay until the end of their lives , while 52 % moved to a nursing home , primarily because of family , financial , or medical concerns . 0 ###LEFT-WALL### 13 quarter 0 ###LEFT-WALL### 18 were 0 ###LEFT-WALL### 48 . 1 of 3 residents 1 of 13 quarter 2 the 3 residents 3 residents 4 who 3 residents 6 or 3 residents 9 n=165 4 who 6 or 5 left 6 or 6 or 7 died 8 ( 9 n=165 9 n=165 10 ) 11 nearly 13 quarter 12 one 13 quarter 13 quarter 16 % 13 quarter 18 were 14 ( 16 % 15 24 16 % 16 % 17 ) 18 were 19 able 19 able 20 to 19 able 21 stay 20 to 21 stay 21 stay 22 until 21 stay 29 while 21 stay 38 primarily 22 until 24 end 23 the 24 end 24 end 25 of 25 of 27 lives 26 their 27 lives 28 , 29 while 29 while 31 % 29 while 32 moved 29 while 37 , 30 52 31 % 31 % 32 moved 32 moved 33 to 33 to 36 home 34 a 35 nursing 34 a 36 home 35 nursing 36 home 38 primarily 39 because 39 because 40 of 40 of 45 or 41 family 42 , 42 , 43 financial 42 , 45 or 44 , 45 or 45 or 47 concerns 46 medical 47 concerns few residents left these settings because of behavioral problems . 0 ###LEFT-WALL### 2 residents 0 ###LEFT-WALL### 3 left 0 ###LEFT-WALL### 10 . 1 few 2 residents 2 residents 3 left 3 left 5 settings 3 left 6 because 4 these 5 settings 6 because 7 of 7 of 9 problems 8 behavioral 9 problems conclusion : al sites with a more robust commitment to an aging in place model and a willingness to provide palliative care demonstrated a significantly longer length [of] stay . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 30 . 1 conclusion 2 : 2 : 3 al 3 al 4 sites 3 al 15 model 4 sites 5 with 4 sites 10 to 4 sites 15 model 5 with 9 commitment 6 a 9 commitment 7 more 8 robust 8 robust 9 commitment 10 to 14 place 11 an 13 in 12 aging 13 in 13 in 14 place 16 and 18 willingness 16 and 23 demonstrated 17 a 18 willingness 18 willingness 19 to 18 willingness 20 provide 18 willingness 23 demonstrated 19 to 20 provide 20 provide 22 care 21 palliative 22 care 23 demonstrated 29 stay 24 a 29 stay 25 significantly 26 longer 26 longer 27 length 27 length 29 stay study design : observational population - based study . 0 ###LEFT-WALL### 2 design 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 9 . 1 study 2 design 2 design 3 : 3 : 5 population 4 observational 5 population 6 - 8 study 7 based 8 study objective : to determine the prevalence of radiographical scheuermann disease in a dutch population and evaluate the consistency of diagnostic criteria . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 15 and 2 : 22 . 3 to 15 and 4 determine 6 prevalence 4 determine 11 in 4 determine 15 and 5 the 6 prevalence 6 prevalence 7 of 7 of 10 disease 8 radiographical 10 disease 9 scheuermann 10 disease 11 in 14 population 12 a 13 dutch 12 a 14 population 13 dutch 14 population 15 and 16 evaluate 16 evaluate 18 consistency 17 the 18 consistency 18 consistency 19 of 19 of 21 criteria 20 diagnostic 21 criteria summary of background data : scheuermann disease is a form of osteochondrosis characterized by increased posterior rounding of the thoracic spine with structural vertebral deformity . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 5 : 1 summary 2 of 2 of 3 background 3 background 4 data 5 : 7 disease 5 : 8 is 5 : 26 . 6 scheuermann 7 disease 7 disease 8 is 8 is 10 form 9 a 10 form 10 form 11 of 10 form 13 characterized 11 of 12 osteochondrosis 13 characterized 14 by 14 by 17 rounding 15 increased 17 rounding 16 posterior 17 rounding 17 rounding 18 of 17 rounding 22 with 18 of 21 spine 19 the 21 spine 20 thoracic 21 spine 22 with 25 deformity 23 structural 25 deformity 24 vertebral 25 deformity different expert opinion [-] based radiological criteria exist , yet these have not been validated . 0 ###LEFT-WALL### 7 criteria 0 ###LEFT-WALL### 15 validated 0 ###LEFT-WALL### 16 . 1 different 2 expert 2 expert 5 based 3 opinion 5 based 5 based 7 criteria 6 radiological 7 criteria 7 criteria 8 exist 8 exist 10 yet 9 , 10 yet 10 yet 11 these 11 these 12 have 12 have 13 not 12 have 14 been 14 been 15 validated the prevalence in the general population reported ranged from 1 % to 10 % . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 8 ranged 0 ###LEFT-WALL### 15 . 1 the 2 prevalence 2 prevalence 3 in 2 prevalence 8 ranged 3 in 6 population 4 the 6 population 5 general 6 population 6 population 7 reported 8 ranged 9 from 8 ranged 12 to 9 from 11 % 10 1 11 % 12 to 14 % 13 10 14 % methods : lateral spine [radiographs] [of] 2753 rotterdam study participants ( aged 45 - 89 yr ) were assessed for scheuermann disease using sørensen and sachs ' radiographical criteria in 2 phases . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 1 methods 2 : 2 : 4 spine 3 lateral 4 spine 4 spine 7 2753 4 spine 9 study 4 spine 19 assessed 8 rotterdam 9 study 9 study 10 participants 9 study 18 were 9 study 19 assessed 10 participants 12 aged 10 participants 16 yr 10 participants 18 were 11 ( 12 aged 12 aged 13 45 12 aged 14 - 14 - 16 yr 15 89 16 yr 16 yr 17 ) 19 assessed 20 for 19 assessed 23 using 20 for 22 disease 21 scheuermann 22 disease 23 using 29 criteria 23 using 30 in 24 sørensen 25 and 25 and 26 sachs 26 sachs 27 ' 27 ' 29 criteria 28 radiographical 29 criteria 30 in 32 phases 31 2 32 phases cohen κ statistics were calculated for interrater agreement . 0 ###LEFT-WALL### 3 statistics 0 ###LEFT-WALL### 5 calculated 0 ###LEFT-WALL### 9 . 1 cohen 3 statistics 2 κ 3 statistics 3 statistics 4 were 4 were 5 calculated 5 calculated 6 for 6 for 8 agreement 7 interrater 8 agreement prevalence estimates were calculated and sex differences were tested with pearson χ [test] . 0 ###LEFT-WALL### 2 estimates 0 ###LEFT-WALL### 4 calculated 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 14 . 1 prevalence 2 estimates 2 estimates 3 were 3 were 4 calculated 5 and 7 differences 5 and 9 tested 6 sex 7 differences 7 differences 8 were 8 were 9 tested 9 tested 10 with 10 with 11 pearson 10 with 12 χ we evaluated whether varying the kyphosis angle criterion would change the prevalence estimate . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 evaluated 0 ###LEFT-WALL### 14 . 1 we 2 evaluated 2 evaluated 3 whether 3 whether 4 varying 3 whether 10 change 4 varying 8 criterion 4 varying 9 would 5 the 8 criterion 6 kyphosis 8 criterion 7 angle 8 criterion 9 would 10 change 10 change 13 estimate 11 the 13 estimate 12 prevalence 13 estimate results : a total of 677 ( 24.6 % ) individuals had endplate irregularities and 140 ( 5.1 % ) [individuals] had vertebral wedging . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 25 . 1 results 2 : 2 : 4 total 3 a 4 total 4 total 5 of 4 total 11 individuals 4 total 12 had 5 of 6 677 6 677 9 % 7 ( 9 % 8 24.6 9 % 9 % 10 ) 11 individuals 12 had 12 had 13 endplate 13 endplate 14 irregularities 15 and 16 140 15 and 22 had 16 140 19 % 16 140 22 had 17 ( 19 % 18 5.1 19 % 19 % 20 ) 22 had 24 wedging 23 vertebral 24 wedging abnormalities were significantly more prevalent among males ( p < 0.05 ) . 0 ###LEFT-WALL### 1 abnormalities 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 13 . 1 abnormalities 2 were 2 were 5 prevalent 3 significantly 4 more 4 more 5 prevalent 5 prevalent 6 among 6 among 7 males 7 males 10 < 8 ( 10 < 9 p 10 < 10 < 11 0.05 10 < 12 ) the interrater agreement κ statistics were 78.8 % for vertebral wedging and 79.4 % [for] endplate irregularity . 0 ###LEFT-WALL### 5 statistics 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 18 . 1 the 5 statistics 2 interrater 3 agreement 3 agreement 5 statistics 4 κ 5 statistics 5 statistics 6 were 6 were 8 % 7 78.8 8 % 8 % 9 for 9 for 12 and 10 vertebral 11 wedging 11 wedging 12 and 12 and 17 irregularity 13 79.4 14 % 14 % 17 irregularity 16 endplate 17 irregularity a total of 127 individuals had both criteria , of which 111 had a kyphosis angle greater than 45 ° , resulting in a prevalence of 4.0 % ( 95 % confidence [interval] [ ci ] : 3.3 % - 4.7 % ) . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 44 . 1 a 2 total 2 total 3 of 2 total 6 had 3 of 5 individuals 4 127 5 individuals 6 had 8 criteria 7 both 8 criteria 9 , 12 111 9 , 13 had 9 , 37 : 10 of 11 which 10 of 12 111 12 111 13 had 13 had 16 angle 14 a 16 angle 15 kyphosis 16 angle 16 angle 17 greater 17 greater 18 than 17 greater 22 resulting 18 than 20 ° 19 45 20 ° 21 , 22 resulting 22 resulting 23 in 22 resulting 36 ] 23 in 25 prevalence 24 a 25 prevalence 25 prevalence 26 of 26 of 28 % 27 4.0 28 % 28 % 32 confidence 29 ( 32 confidence 30 95 31 % 31 % 32 confidence 32 confidence 35 ci 32 confidence 36 ] 34 [ 35 ci 35 ci 36 ] 37 : 39 % 38 3.3 39 % 39 % 42 % 40 - 42 % 41 4.7 42 % 42 % 43 ) the disease prevalence was 4.5 % in males versus 3.6 % in females , yet this difference was not statistically significant ( p = 0.23 ) . 0 ###LEFT-WALL### 3 prevalence 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 27 . 1 the 3 prevalence 2 disease 3 prevalence 3 prevalence 4 was 4 was 8 males 5 4.5 7 in 6 % 7 in 7 in 8 males 8 males 9 versus 9 versus 13 females 10 3.6 12 in 11 % 12 in 12 in 13 females 14 , 15 yet 14 , 18 was 15 yet 17 difference 16 this 17 difference 17 difference 18 was 18 was 19 not 18 was 21 significant 20 statistically 21 significant 21 significant 24 = 22 ( 24 = 23 p 24 = 24 = 25 0.23 24 = 26 ) adjustment of the kyphosis angle criterion from 45 ° to 40 ° or 35 ° increased the number of cases marginally [,] corresponding to prevalence estimates not significantly different from the estimates using original criteria ( 4.2 % [ 95 % [ci] : 3.3 % - 4.7 % ] and 4.4 % [ 95 % ci : 3.6 % - 5.2 % []] ) . 0 ###LEFT-WALL### 1 adjustment 0 ###LEFT-WALL### 16 increased 0 ###LEFT-WALL### 57 : 0 ###LEFT-WALL### 65 . 1 adjustment 2 of 1 adjustment 7 from 1 adjustment 16 increased 2 of 6 criterion 3 the 6 criterion 4 kyphosis 6 criterion 5 angle 6 criterion 7 from 9 ° 8 45 9 ° 9 ° 10 to 10 to 13 or 11 40 12 ° 12 ° 13 or 13 or 15 ° 14 35 15 ° 16 increased 18 number 17 the 18 number 18 number 19 of 18 number 27 not 19 of 20 cases 20 cases 23 corresponding 21 marginally 23 corresponding 23 corresponding 24 to 24 to 26 estimates 25 prevalence 26 estimates 27 not 29 different 28 significantly 29 different 29 different 30 from 29 different 33 using 30 from 32 estimates 31 the 32 estimates 33 using 35 criteria 34 original 35 criteria 35 criteria 38 % 36 ( 38 % 37 4.2 38 % 38 % 52 % 38 % 57 : 39 [ 52 % 40 95 41 % 40 95 50 and 41 % 43 : 43 : 45 % 44 3.3 45 % 45 % 48 % 46 - 48 % 47 4.7 48 % 48 % 49 ] 50 and 51 4.4 50 and 52 % 52 % 56 ci 52 % 57 : 53 [ 56 ci 54 95 56 ci 55 % 56 ci 56 ci 57 : 57 : 59 % 58 3.6 59 % 59 % 62 % 60 - 62 % 61 5.2 62 % 62 % 64 ) conclusion : our results revealed a prevalence of 4.0 % of radiographical scheuermann disease in dutch individuals aged 45 years and older . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 revealed 2 : 23 . 3 our 4 results 4 results 5 revealed 5 revealed 7 prevalence 5 revealed 18 aged 6 a 7 prevalence 7 prevalence 8 of 7 prevalence 11 of 7 prevalence 18 aged 8 of 10 % 9 4.0 10 % 11 of 14 disease 12 radiographical 14 disease 13 scheuermann 14 disease 14 disease 15 in 15 in 17 individuals 16 dutch 17 individuals 18 aged 21 and 19 45 20 years 20 years 21 and 21 and 22 older although there is no current " gold standard " for the radiographical definition , standardized scoring of independent features resulted in substantial interobserver agreement , and different applications of diagnostic criteria did not significantly alter the classification . 0 ###LEFT-WALL### 16 scoring 0 ###LEFT-WALL### 20 resulted 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 38 . 1 although 2 there 1 although 3 is 1 although 14 , 1 although 16 scoring 2 there 3 is 3 is 7 gold 4 no 7 gold 5 current 6 " 5 current 7 gold 7 gold 8 standard 8 standard 9 " 8 standard 10 for 10 for 13 definition 11 the 13 definition 12 radiographical 13 definition 15 standardized 16 scoring 16 scoring 17 of 16 scoring 20 resulted 17 of 19 features 18 independent 19 features 20 resulted 21 in 21 in 24 agreement 22 substantial 24 agreement 23 interobserver 24 agreement 25 , 26 and 26 and 28 applications 26 and 35 alter 27 different 28 applications 28 applications 29 of 28 applications 32 did 29 of 31 criteria 30 diagnostic 31 criteria 32 did 33 not 32 did 35 alter 34 significantly 35 alter 35 alter 37 classification 36 the 37 classification age - related defects of the immune system are responsible for [t] cell unresponsiveness to cancer vaccination at older age . 0 ###LEFT-WALL### 4 defects 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 21 . 1 age 2 - 1 age 4 defects 3 related 4 defects 4 defects 5 of 4 defects 9 are 5 of 8 system 6 the 8 system 7 immune 8 system 9 are 10 responsible 10 responsible 11 for 10 responsible 15 to 10 responsible 18 at 11 for 14 unresponsiveness 13 cell 14 unresponsiveness 15 to 17 vaccination 16 cancer 17 vaccination 18 at 20 age 19 older 20 age major immune defects at older age are lack of naive [t] cells , impaired activation pathways of t [cells] and antigen - presenting cells ( apcs ) , and age - related changes in the tumor microenvironment ( tme ) . 1 major 3 defects 2 immune 3 defects 3 defects 4 at 3 defects 7 are 4 at 6 age 5 older 6 age 7 are 29 and 8 lack 9 of 8 lack 13 , 9 of 12 cells 10 naive 12 cells 13 , 16 pathways 13 , 20 and 14 impaired 16 pathways 15 activation 16 pathways 16 pathways 17 of 17 of 18 t 20 and 21 antigen 20 and 23 presenting 20 and 29 and 22 - 23 presenting 23 presenting 24 cells 23 presenting 28 , 24 cells 26 apcs 25 ( 26 apcs 26 apcs 27 ) 29 and 30 age 29 and 33 changes 31 - 33 changes 32 related 33 changes 33 changes 34 in 33 changes 41 . 34 in 37 microenvironment 35 the 37 microenvironment 36 tumor 37 microenvironment 37 microenvironment 39 tme 38 ( 39 tme 39 tme 40 ) this raises the question whether cancer vaccination is feasible at older age . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 raises 0 ###LEFT-WALL### 13 . 1 this 2 raises 2 raises 4 question 2 raises 5 whether 3 the 4 question 5 whether 7 vaccination 5 whether 8 is 6 cancer 7 vaccination 7 vaccination 8 is 8 is 9 feasible 9 feasible 10 at 10 at 12 age 11 older 12 age we compared various cancer vaccine studies at young and old age , thereby focusing on the importance of both innate and adaptive immune responses for cancer immunotherapy . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 6 studies 0 ###LEFT-WALL### 28 . 1 we 2 compared 2 compared 4 cancer 3 various 4 cancer 4 cancer 5 vaccine 4 cancer 6 studies 5 vaccine 6 studies 6 studies 7 at 6 studies 25 for 7 at 9 and 8 young 9 and 9 and 11 age 9 and 12 , 9 and 14 focusing 9 and 18 of 10 old 11 age 13 thereby 14 focusing 14 focusing 15 on 15 on 17 importance 16 the 17 importance 18 of 24 responses 19 both 24 responses 20 innate 21 and 21 and 22 adaptive 21 and 24 responses 23 immune 24 responses 25 for 27 immunotherapy 26 cancer 27 immunotherapy these analyses suggest that creating an immune - stimulating environment with help of the innate immune system may improve [t] cell responses in cancer vaccination at older age . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 29 . 1 these 2 analyses 2 analyses 3 suggest 3 suggest 4 that 4 that 5 creating 4 that 19 improve 5 creating 10 environment 5 creating 11 with 5 creating 18 may 6 an 7 immune 6 an 10 environment 7 immune 8 - 7 immune 10 environment 9 stimulating 10 environment 11 with 12 help 12 help 13 of 13 of 17 system 14 the 17 system 15 innate 17 system 16 immune 17 system 18 may 19 improve 19 improve 22 responses 19 improve 23 in 19 improve 26 at 21 cell 22 responses 23 in 25 vaccination 24 cancer 25 vaccination 26 at 28 age 27 older 28 age the purpose of this study was to examine the effects of anatabine supplementation in conjunction with unilateral , maximal eccentric isokinetic muscle actions on serum markers of muscle damage and pro - inflammatory cytokines in humans . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 32 - 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 examine 7 to 8 examine 8 examine 10 effects 8 examine 16 with 9 the 10 effects 10 effects 11 of 11 of 13 supplementation 12 anatabine 13 supplementation 14 in 15 conjunction 15 conjunction 16 with 16 with 23 actions 17 unilateral 18 , 17 unilateral 22 muscle 19 maximal 22 muscle 20 eccentric 22 muscle 21 isokinetic 22 muscle 22 muscle 23 actions 23 actions 24 on 24 on 26 markers 25 serum 26 markers 26 markers 27 of 27 of 30 and 28 muscle 29 damage 29 damage 30 and 30 and 31 pro 32 - 34 cytokines 33 inflammatory 34 cytokines 34 cytokines 35 in 35 in 36 humans seventeen men ( mean ± s.d [.] age = 22.4 ± [3.2] [yrs] ) participated in this double - blinded , [placebo] - controlled , crossover study . 0 ###LEFT-WALL### 2 men 0 ###LEFT-WALL### 15 participated 1 seventeen 2 men 2 men 8 age 2 men 15 participated 3 ( 8 age 4 mean 5 ± 5 ± 8 age 6 s.d 8 age 8 age 10 22.4 8 age 11 ± 8 age 14 ) 9 = 10 22.4 10 22.4 11 ± 15 participated 16 in 16 in 18 double 17 this 18 double 18 double 20 blinded 18 double 24 controlled 18 double 27 study 19 - 20 blinded 20 blinded 21 , 23 - 24 controlled 24 controlled 25 , 25 , 27 study 26 crossover 27 study 27 study 28 . participants were randomly assigned to two 10 - day conditions ( anatabine and placebo ) separated by a 2 - 4 week washout period . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 4 assigned 0 ###LEFT-WALL### 25 . 1 participants 2 were 2 were 3 randomly 2 were 4 assigned 4 assigned 5 to 5 to 6 two 6 two 7 10 6 two 16 separated 7 10 10 conditions 7 10 16 separated 8 - 10 conditions 9 day 10 conditions 10 conditions 13 and 10 conditions 15 ) 11 ( 13 and 12 anatabine 13 and 13 and 14 placebo 13 and 15 ) 16 separated 17 by 17 by 24 period 18 a 24 period 19 2 20 - 20 - 21 4 20 - 24 period 22 week 24 period 23 washout 24 period after seven days of supplementation , blood was sampled immediately prior to pre , immediately following post , [and] 24 , 48 , and 72 h after 6 sets of 10 repetitions of unilateral , maximal eccentric isokinetic forearm flexion exercise . 0 ###LEFT-WALL### 41 exercise 0 ###LEFT-WALL### 42 . 1 after 3 days 1 after 41 exercise 2 seven 3 days 3 days 7 blood 3 days 9 sampled 4 of 5 supplementation 4 of 6 , 4 of 7 blood 7 blood 8 was 8 was 9 sampled 9 sampled 10 immediately 9 sampled 11 prior 11 prior 24 and 12 to 13 pre 12 to 24 and 13 pre 16 following 14 , 16 following 15 immediately 16 following 16 following 17 post 16 following 23 , 17 post 20 24 18 , 20 24 20 24 22 48 20 24 23 , 21 , 22 48 22 48 23 , 23 , 24 and 24 and 27 after 25 72 26 h 26 h 27 after 27 after 29 sets 28 6 29 sets 29 sets 30 of 30 of 32 repetitions 31 10 32 repetitions 32 repetitions 33 of 33 of 40 flexion 34 unilateral 35 , 34 unilateral 37 eccentric 36 maximal 37 eccentric 37 eccentric 40 flexion 38 isokinetic 39 forearm 39 forearm 40 flexion concentrations [of] serum creatine kinase , lactate dehydrogenase [,] myoglobin , high sensitivity [c] - reactive protein , and tnf - α were measured . 0 ###LEFT-WALL### 5 kinase 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 25 . 1 concentrations 3 serum 3 serum 5 kinase 4 creatine 5 kinase 6 , 7 lactate 6 , 19 and 7 lactate 10 myoglobin 8 dehydrogenase 10 myoglobin 10 myoglobin 13 sensitivity 11 , 13 sensitivity 12 high 13 sensitivity 13 sensitivity 17 protein 13 sensitivity 18 , 15 - 17 protein 16 reactive 17 protein 17 protein 18 , 19 and 22 α 19 and 23 were 20 tnf 21 - 20 tnf 22 α 22 α 23 were 23 were 24 measured creatine kinase , myoglobin , and [lactate] dehydrogenase increased ( p<0.05 ) , while high sensitivity [c] - reactive protein and tnf - α did [not] change ( p>0.05 ) after the eccentric exercise during both conditions . 0 ###LEFT-WALL### 2 kinase 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 38 . 1 creatine 2 kinase 3 , 6 and 3 , 13 , 4 myoglobin 6 and 5 , 6 and 6 and 8 dehydrogenase 6 and 9 increased 6 and 11 p<0.05 10 ( 11 p<0.05 11 p<0.05 12 ) 13 , 24 α 13 , 25 did 14 while 16 sensitivity 14 while 24 α 15 high 16 sensitivity 16 sensitivity 21 and 18 - 21 and 19 reactive 20 protein 20 protein 21 and 21 and 22 tnf 21 and 23 - 24 α 25 did 25 did 27 change 25 did 31 after 25 did 35 during 27 change 29 p>0.05 28 ( 29 p>0.05 29 p>0.05 30 ) 31 after 34 exercise 32 the 34 exercise 33 eccentric 34 exercise 35 during 37 conditions 36 both 37 conditions lactate dehydrogenase [was] higher [(] p<0.05 [ )(during the anatabine condition . 0 ###LEFT-WALL### 1 lactate 0 ###LEFT-WALL### 12 . 1 lactate 6 p<0.05 1 lactate 8 )(during 2 dehydrogenase 6 p<0.05 4 higher 6 p<0.05 8 )(during 11 condition 9 the 11 condition 10 anatabine 11 condition the primary findings of this study were two - fold : [(] a [ )(anatabine had no beneficial effects on traditional markers of muscle damage ( creatine kinase , [lactate] dehydrogenase , and myoglobin ) compared to placebo after the eccentric exercise protocol , and [(] [b] [ )(the eccentric exercise protocol did not elicit increase in the pro - inflammatory cytokines ( c - reactive protein and tnf - α ) . 0 ###LEFT-WALL### 2 primary 0 ###LEFT-WALL### 9 - 1 the 2 primary 2 primary 3 findings 2 primary 6 study 2 primary 7 were 3 findings 4 of 3 findings 6 study 4 of 5 this 7 were 8 two 9 - 10 fold 9 - 11 : 9 - 16 had 11 : 15 )(anatabine 13 a 15 )(anatabine 15 )(anatabine 16 had 16 had 19 effects 16 had 20 on 17 no 19 effects 18 beneficial 19 effects 20 on 22 markers 21 traditional 22 markers 22 markers 23 of 23 of 33 and 24 muscle 33 and 25 damage 28 kinase 25 damage 31 dehydrogenase 26 ( 28 kinase 27 creatine 28 kinase 28 kinase 29 , 29 , 31 dehydrogenase 31 dehydrogenase 32 , 32 , 33 and 33 and 34 myoglobin 33 and 35 ) 33 and 36 compared 33 and 39 after 36 compared 37 to 37 to 38 placebo 39 after 45 and 40 the 43 protocol 41 eccentric 43 protocol 42 exercise 43 protocol 43 protocol 45 and 44 , 45 and 45 and 50 eccentric 45 and 52 protocol 45 and 55 elicit 49 )(the 50 eccentric 51 exercise 52 protocol 52 protocol 53 did 53 did 54 not 53 did 55 elicit 55 elicit 56 increase 56 increase 57 in 57 in 59 pro 58 the 59 pro 59 pro 62 cytokines 60 - 62 cytokines 61 inflammatory 62 cytokines 62 cytokines 65 - 62 cytokines 73 . 63 ( 65 - 64 c 65 - 65 - 68 and 65 - 73 . 66 reactive 67 protein 67 protein 68 and 68 and 69 tnf 68 and 73 . 69 tnf 71 α 70 - 71 α 71 α 72 ) future studies are needed to examine the effects of anatabine on naturally [-] occurring inflammation that is common with aging or obesity . 0 ###LEFT-WALL### 1 future 0 ###LEFT-WALL### 4 needed 0 ###LEFT-WALL### 23 . 1 future 2 studies 1 future 3 are 1 future 4 needed 2 studies 3 are 4 needed 5 to 4 needed 15 inflammation 5 to 6 examine 6 examine 8 effects 6 examine 11 on 7 the 8 effects 8 effects 9 of 9 of 10 anatabine 11 on 14 occurring 12 naturally 14 occurring 15 inflammation 16 that 15 inflammation 17 is 16 that 17 is 17 is 21 or 18 common 19 with 18 common 21 or 19 with 20 aging 21 or 22 obesity furthermore , additional research is needed to examine the relationship between muscle damage and inflammation after eccentric exercises of different modes , durations , and intensities . 0 ###LEFT-WALL### 4 research 0 ###LEFT-WALL### 6 needed 0 ###LEFT-WALL### 27 . 1 furthermore 2 , 1 furthermore 4 research 3 additional 4 research 4 research 5 is 5 is 6 needed 6 needed 7 to 6 needed 11 between 6 needed 16 after 7 to 8 examine 8 examine 10 relationship 9 the 10 relationship 11 between 14 and 12 muscle 13 damage 13 damage 14 and 14 and 15 inflammation 16 after 18 exercises 17 eccentric 18 exercises 18 exercises 19 of 19 of 25 and 20 different 21 modes 21 modes 22 , 22 , 23 durations 22 , 25 and 24 , 25 and 25 and 26 intensities introduction : sarcopenia is currently best described as an age [-] related decline in skeletal muscle [mass] and function . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 3 sarcopenia 2 : 7 described 2 : 20 . 3 sarcopenia 4 is 4 is 5 currently 4 is 7 described 6 best 7 described 7 described 8 as 7 described 14 in 8 as 13 decline 9 an 10 age 9 an 13 decline 10 age 12 related 12 related 13 decline 14 in 18 and 15 skeletal 16 muscle 16 muscle 18 and 18 and 19 function however , no consensus exists as to how to best quantify muscle [function] in older adults . 0 ###LEFT-WALL### 4 consensus 0 ###LEFT-WALL### 5 exists 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 4 consensus 3 no 4 consensus 4 consensus 5 exists 5 exists 7 to 6 as 7 to 7 to 8 how 8 how 9 to 8 how 11 quantify 9 to 11 quantify 10 best 11 quantify 11 quantify 12 muscle 11 quantify 14 in 14 in 16 adults 15 older 16 adults the muscle quality index ( mqi ) was recently recommended as an ideal evidence [-] based assessment of functional status in older adults . 0 ###LEFT-WALL### 4 index 0 ###LEFT-WALL### 10 recommended 0 ###LEFT-WALL### 24 . 1 the 4 index 2 muscle 4 index 3 quality 4 index 4 index 6 mqi 4 index 8 was 5 ( 6 mqi 6 mqi 7 ) 8 was 9 recently 8 was 10 recommended 10 recommended 11 as 10 recommended 21 in 11 as 17 assessment 12 an 13 ideal 12 an 17 assessment 13 ideal 17 assessment 14 evidence 16 based 16 based 17 assessment 17 assessment 18 of 18 of 20 status 19 functional 20 status 21 in 23 adults 22 older 23 adults nevertheless , the usefulness of mqi to assess [physical] function is limited [by] whether it is [reflective] of muscle qualitative changes to an intervention . 0 ###LEFT-WALL### 4 usefulness 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 25 . 1 nevertheless 2 , 1 nevertheless 4 usefulness 3 the 4 usefulness 4 usefulness 5 of 4 usefulness 11 is 5 of 6 mqi 6 mqi 7 to 6 mqi 10 function 7 to 8 assess 8 assess 10 function 11 is 12 limited 12 limited 14 whether 12 limited 22 to 14 whether 15 it 14 whether 16 is 15 it 16 is 16 is 18 of 18 of 21 changes 19 muscle 21 changes 20 qualitative 21 changes 22 to 24 intervention 23 an 24 intervention thus , the purpose of this investigation was to determine whether mqi changes in response to resistance exercise training and detraining and how such changes correspond to other recommended measures of physical function proposed by suggested definitions of sarcopenia . 0 ###LEFT-WALL### 4 purpose 0 ###LEFT-WALL### 34 proposed 0 ###LEFT-WALL### 40 . 1 thus 2 , 1 thus 4 purpose 3 the 4 purpose 4 purpose 5 of 4 purpose 8 was 5 of 7 investigation 6 this 7 investigation 8 was 9 to 8 was 10 determine 9 to 10 determine 10 determine 11 whether 10 determine 16 to 11 whether 12 mqi 11 whether 13 changes 12 mqi 13 changes 14 in 15 response 15 response 16 to 16 to 17 resistance 18 exercise 19 training 19 training 20 and 20 and 33 function 20 and 34 proposed 21 detraining 22 and 22 and 23 how 22 and 25 changes 22 and 31 of 22 and 33 function 24 such 25 changes 25 changes 26 correspond 26 correspond 27 to 27 to 30 measures 28 other 30 measures 29 recommended 30 measures 30 measures 31 of 32 physical 33 function 34 proposed 35 by 35 by 37 definitions 36 suggested 37 definitions 37 definitions 38 of 38 of 39 sarcopenia methods : twenty - five older adults ( 70.6±6.1y ; bmi=28.1±5.4kg·m ( - 2 [ )( (completed a 6 [-] week resistance training program in a wait - [list] controlled , cross - over design . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 ; 1 methods 2 : 2 : 7 adults 3 twenty 4 - 4 - 5 five 4 - 7 adults 6 older 7 adults 7 adults 9 70.6±6.1y 8 ( 9 70.6±6.1y 9 70.6±6.1y 10 ; 10 ; 11 bmi=28.1±5.4kg·m 10 ; 17 (completed 10 ; 31 , 11 bmi=28.1±5.4kg·m 14 2 11 bmi=28.1±5.4kg·m 17 (completed 12 ( 14 2 13 - 14 2 14 2 16 )( 17 (completed 24 program 17 (completed 25 in 17 (completed 30 controlled 18 a 24 program 19 6 22 resistance 21 week 22 resistance 22 resistance 23 training 23 training 24 program 25 in 27 wait 26 a 27 wait 28 - 30 controlled 30 controlled 31 , 31 , 32 cross 32 cross 34 over 33 - 34 over 34 over 35 design 34 over 36 . mqi was determined as power output [from] timed [sit] to stand ( sts ) , body mass , and leg length . 0 ###LEFT-WALL### 1 mqi 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 22 . 1 mqi 2 was 2 was 19 and 3 determined 4 as 3 determined 15 , 4 as 6 output 5 power 6 output 6 output 8 timed 6 output 13 sts 8 timed 10 to 10 to 11 stand 12 ( 13 sts 13 sts 14 ) 15 , 17 mass 15 , 19 and 16 body 17 mass 18 , 19 and 19 and 21 length 20 leg 21 length gait speed , hand grip strength , get - up - and - go and lean body mass [(] lbm [ )( evaluated before and after exercise training and detraining . 0 ###LEFT-WALL### 2 speed 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 31 . 1 gait 2 speed 3 , 7 , 4 hand 6 strength 4 hand 7 , 5 grip 6 strength 7 , 12 and 8 get 10 up 8 get 12 and 9 - 10 up 11 - 12 and 12 and 15 and 13 - 15 and 14 go 15 and 15 and 16 lean 16 lean 20 lbm 16 lean 25 and 17 body 18 mass 18 mass 20 lbm 20 lbm 23 evaluated 24 before 25 and 25 and 26 after 26 after 29 and 27 exercise 28 training 28 training 29 and 29 and 30 detraining mqi and functional changes to training and detraining were evaluated with repeated measures anova and clinical interpretations of magnitude based inferences . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 10 evaluated 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 22 . 1 mqi 2 and 2 and 4 changes 2 and 9 were 3 functional 4 changes 4 changes 5 to 5 to 7 and 6 training 7 and 7 and 8 detraining 9 were 10 evaluated 10 evaluated 11 with 11 with 13 measures 11 with 14 anova 12 repeated 13 measures 15 and 17 interpretations 15 and 20 based 16 clinical 17 interpretations 17 interpretations 18 of 17 interpretations 20 based 18 of 19 magnitude 20 based 21 inferences results : short term resistance training significantly and clinically improved mqi ( 203.4±64.31 to 244.3±82.92w ) , gait time ( 1.85±0.36 to 1.66±0.27s ) and sit to stand performance ( 13.21±2.51 to 11.05±1.58s ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 35 . 1 results 2 : 2 : 8 and 3 short 6 training 3 short 7 significantly 3 short 8 and 4 term 6 training 5 resistance 6 training 8 and 25 and 8 and 27 to 9 clinically 10 improved 10 improved 11 mqi 10 improved 25 and 11 mqi 13 203.4±64.31 11 mqi 19 time 12 ( 13 203.4±64.31 13 203.4±64.31 14 to 13 203.4±64.31 16 ) 14 to 15 244.3±82.92w 17 , 19 time 18 gait 19 time 19 time 21 1.85±0.36 19 time 24 ) 20 ( 21 1.85±0.36 21 1.85±0.36 22 to 21 1.85±0.36 24 ) 22 to 23 1.66±0.27s 25 and 26 sit 27 to 29 performance 28 stand 29 performance 29 performance 31 13.21±2.51 30 ( 31 13.21±2.51 31 13.21±2.51 32 to 31 13.21±2.51 34 ) 32 to 33 11.05±1.58s changes in lbm and hand grip strength were not significant or clinically meaningful . 0 ###LEFT-WALL### 1 changes 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 14 . 1 changes 2 in 1 changes 8 were 2 in 4 and 3 lbm 4 and 4 and 7 strength 5 hand 7 strength 6 grip 7 strength 8 were 9 not 8 were 11 or 10 significant 11 or 11 or 13 meaningful 12 clinically 13 meaningful [de] - training for 6 [-] weeks did not result in significant changes in any measure from post - training performance . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 10 result 2 - 3 training 3 training 4 for 3 training 8 did 4 for 7 weeks 5 6 7 weeks 8 did 9 not 8 did 10 result 10 result 11 in 10 result 14 in 11 in 13 changes 12 significant 13 changes 14 in 16 measure 15 any 16 measure 16 measure 17 from 16 measure 20 training 17 from 18 post 19 - 20 training 20 training 21 performance 20 training 22 . cognitive decline , alzheimer 's disease ( ad ) and other causes are major public health problems worldwide . 0 ###LEFT-WALL### 2 decline 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 19 . 1 cognitive 2 decline 3 , 4 alzheimer 3 , 5 's 3 , 10 and 4 alzheimer 5 's 5 's 6 disease 6 disease 8 ad 7 ( 8 ad 8 ad 9 ) 10 and 12 causes 10 and 13 are 11 other 12 causes 12 causes 13 are 13 are 17 problems 13 are 18 worldwide 14 major 15 public 15 public 17 problems 16 health 17 problems with changing demographics , the number of persons with dementia will increase rapidly . 0 ###LEFT-WALL### 8 persons 0 ###LEFT-WALL### 12 increase 0 ###LEFT-WALL### 14 . 1 with 2 changing 1 with 4 , 1 with 8 persons 2 changing 3 demographics 5 the 6 number 6 number 7 of 6 number 8 persons 7 of 8 persons 8 persons 9 with 8 persons 11 will 9 with 10 dementia 11 will 12 increase 12 increase 13 rapidly the treatment and prevention of ad and other dementias , therefore , is an urgent unmet need . 0 ###LEFT-WALL### 2 treatment 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 18 . 1 the 2 treatment 3 and 4 prevention 3 and 13 is 4 prevention 5 of 4 prevention 13 is 5 of 7 and 6 ad 7 and 7 and 9 dementias 8 other 9 dementias 10 , 11 therefore 11 therefore 12 , 11 therefore 13 is 13 is 17 need 14 an 15 urgent 14 an 17 need 15 urgent 16 unmet 16 unmet 17 need there have been considerable advances in understanding the biology of [many] age - related disorders that cause dementia . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 3 been 0 ###LEFT-WALL### 14 related 1 there 2 have 2 have 3 been 3 been 5 advances 4 considerable 5 advances 5 advances 6 in 5 advances 10 of 6 in 7 understanding 7 understanding 9 biology 8 the 9 biology 10 of 12 age 13 - 14 related 14 related 15 disorders 14 related 19 . 15 disorders 16 that 15 disorders 17 cause 16 that 17 cause 17 cause 18 dementia gains in understanding ad have led to the development of ante [-] [mortem] biomarkers of traditional neuropathology and the conduct of several phase iii interventions in the amyloid - β cascade early in the disease process . 0 ###LEFT-WALL### 1 gains 0 ###LEFT-WALL### 6 led 0 ###LEFT-WALL### 37 . 1 gains 2 in 1 gains 5 have 2 in 3 understanding 3 understanding 4 ad 5 have 6 led 6 led 7 to 6 led 25 interventions 6 led 26 in 7 to 18 and 8 the 9 development 9 development 10 of 9 development 18 and 10 of 14 biomarkers 11 ante 14 biomarkers 14 biomarkers 15 of 15 of 17 neuropathology 16 traditional 17 neuropathology 18 and 20 conduct 19 the 20 conduct 20 conduct 21 of 21 of 23 phase 22 several 23 phase 23 phase 24 iii 26 in 31 cascade 27 the 31 cascade 28 amyloid 29 - 28 amyloid 31 cascade 30 β 31 cascade 31 cascade 32 early 32 early 33 in 33 in 36 process 34 the 36 process 35 disease 36 process many other intervention strategies are in various stages of development . 0 ###LEFT-WALL### 4 strategies 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 11 . 1 many 2 other 2 other 4 strategies 3 intervention 4 strategies 4 strategies 5 are 5 are 6 in 6 in 8 stages 7 various 8 stages 8 stages 9 of 9 of 10 development however , efforts to date have met with limited success . 0 ###LEFT-WALL### 3 efforts 0 ###LEFT-WALL### 7 met 0 ###LEFT-WALL### 11 . 1 however 2 , 1 however 3 efforts 3 efforts 4 to 3 efforts 5 date 3 efforts 6 have 4 to 5 date 6 have 7 met 7 met 8 with 8 with 10 success 9 limited 10 success a recent national institute on aging research summit led to a number of requests for applications . 0 ###LEFT-WALL### 4 institute 0 ###LEFT-WALL### 9 led 0 ###LEFT-WALL### 17 . 1 a 2 recent 1 a 4 institute 2 recent 4 institute 3 national 4 institute 4 institute 5 on 4 institute 9 led 5 on 8 summit 6 aging 7 research 7 research 8 summit 9 led 10 to 10 to 14 requests 11 a 12 number 12 number 13 of 12 number 14 requests 13 of 14 requests 14 requests 15 for 15 for 16 applications one was to establish multi - disciplinary teams of investigators who use systems biology approaches and stem cell technology to identify a new generation of ad targets . 0 ###LEFT-WALL### 1 one 0 ###LEFT-WALL### 21 identify 0 ###LEFT-WALL### 28 . 1 one 2 was 2 was 3 to 2 was 16 and 3 to 16 and 4 establish 8 teams 4 establish 16 and 5 multi 6 - 5 multi 8 teams 7 disciplinary 8 teams 8 teams 9 of 9 of 10 investigators 10 investigators 11 who 10 investigators 12 use 11 who 12 use 12 use 13 systems 13 systems 14 biology 13 systems 15 approaches 14 biology 15 approaches 16 and 17 stem 16 and 20 to 17 stem 19 technology 18 cell 19 technology 20 to 21 identify 21 identify 24 generation 22 a 23 new 22 a 24 generation 23 new 24 generation 24 generation 25 of 25 of 27 targets 26 ad 27 targets we were recently awarded one of three such grants to build a pipeline that integrates epidemiology , systems biology , and stem cell technology to discover and validate novel therapeutic targets and lead compounds for ad treatment and prevention . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 40 . 1 we 2 were 2 were 3 recently 2 were 4 awarded 4 awarded 5 one 4 awarded 10 to 5 one 6 of 6 of 9 grants 7 three 8 such 8 such 9 grants 10 to 21 and 11 build 13 pipeline 11 build 21 and 12 a 13 pipeline 13 pipeline 14 that 13 pipeline 15 integrates 14 that 15 integrates 15 integrates 16 epidemiology 16 epidemiology 19 biology 17 , 19 biology 18 systems 19 biology 19 biology 20 , 21 and 27 and 22 stem 24 technology 22 stem 27 and 23 cell 24 technology 24 technology 25 to 24 technology 26 discover 25 to 26 discover 27 and 32 and 28 validate 31 targets 28 validate 32 and 29 novel 31 targets 30 therapeutic 31 targets 32 and 33 lead 33 lead 34 compounds 33 lead 35 for 35 for 38 and 36 ad 37 treatment 37 treatment 38 and 38 and 39 prevention here we describe the two cohorts that provide the data and biospecimens being exploited for our pipeline and describe the available unique datasets . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 describe 0 ###LEFT-WALL### 24 . 1 here 2 we 2 we 3 describe 3 describe 6 cohorts 4 the 5 two 5 two 6 cohorts 6 cohorts 7 that 6 cohorts 18 and 7 that 18 and 8 provide 11 and 8 provide 18 and 9 the 10 data 10 data 11 and 11 and 12 biospecimens 11 and 13 being 13 being 14 exploited 14 exploited 15 for 15 for 17 pipeline 16 our 17 pipeline 18 and 19 describe 19 describe 23 datasets 20 the 23 datasets 21 available 23 datasets 22 unique 23 datasets second , we present evidence in support of a chronic disease model of ad that informs our choice of [phenotypes] as the target outcome . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 present 0 ###LEFT-WALL### 25 . 1 second 2 , 1 second 3 we 3 we 4 present 4 present 5 evidence 5 evidence 6 in 5 evidence 8 of 5 evidence 13 of 6 in 7 support 8 of 12 model 9 a 10 chronic 9 a 12 model 10 chronic 11 disease 11 disease 12 model 13 of 14 ad 14 ad 15 that 14 ad 16 informs 15 that 16 informs 16 informs 18 choice 17 our 18 choice 18 choice 19 of 19 of 21 as 21 as 24 outcome 22 the 24 outcome 23 target 24 outcome third , we provide an overview of our approach . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 10 . 1 third 2 , 1 third 3 we 3 we 4 provide 4 provide 6 overview 5 an 6 overview 6 overview 7 of 7 of 9 approach 8 our 9 approach finally , we present the details of our planned drug discovery pipeline . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 present 0 ###LEFT-WALL### 13 . 1 finally 2 , 1 finally 3 we 3 we 4 present 4 present 6 details 5 the 6 details 6 details 7 of 7 of 12 pipeline 8 our 12 pipeline 9 planned 10 drug 10 drug 12 pipeline 11 discovery 12 pipeline background : interventions in primary health care settings have been effective in increasing physical fitness . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 interventions 2 : 10 been 2 : 16 . 3 interventions 4 in 3 interventions 9 have 4 in 8 settings 5 primary 7 care 6 health 7 care 7 care 8 settings 9 have 10 been 10 been 11 effective 11 effective 12 in 12 in 13 increasing 13 increasing 15 fitness 14 physical 15 fitness in 2001 , the programa de exercício físico em unidades de saúde ( physical exercise in health primary care program - pehpcp ) was launched in rio claro city , brazil . 0 ###LEFT-WALL### 12 saúde 0 ###LEFT-WALL### 25 launched 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 32 . 1 in 2 2001 1 in 3 , 1 in 12 saúde 4 the 9 em 5 programa 6 de 6 de 7 exercício 7 exercício 8 físico 8 físico 9 em 9 em 12 saúde 10 unidades 11 de 11 de 12 saúde 12 saúde 15 exercise 12 saúde 24 was 13 ( 15 exercise 14 physical 15 exercise 15 exercise 16 in 15 exercise 23 ) 16 in 22 pehpcp 17 health 18 primary 18 primary 19 care 19 care 20 program 20 program 22 pehpcp 21 - 22 pehpcp 24 was 25 launched 25 launched 26 in 26 in 29 city 27 rio 28 claro 28 claro 29 city 30 , 31 brazil the intervention consisted of biweekly , 60 - minute group sessions in all primary health care settings in the city . 0 ###LEFT-WALL### 2 intervention 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 21 . 1 the 2 intervention 2 intervention 3 consisted 3 consisted 4 of 4 of 11 sessions 5 biweekly 7 60 5 biweekly 10 group 6 , 7 60 7 60 8 - 9 minute 10 group 10 group 11 sessions 11 sessions 12 in 12 in 17 settings 13 all 17 settings 14 primary 17 settings 15 health 17 settings 16 care 17 settings 17 settings 18 in 18 in 20 city 19 the 20 city this study evaluated the effect of pehpcp on physical fitness and on the aging process after a decade of ongoing implementation . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 evaluated 0 ###LEFT-WALL### 22 . 1 this 2 study 2 study 3 evaluated 3 evaluated 5 effect 3 evaluated 16 after 4 the 5 effect 5 effect 6 of 6 of 7 pehpcp 7 pehpcp 11 and 8 on 10 fitness 8 on 11 and 9 physical 10 fitness 11 and 12 on 12 on 15 process 13 the 15 process 14 aging 15 process 16 after 18 decade 17 a 18 decade 18 decade 19 of 19 of 21 implementation 20 ongoing 21 implementation every 4 months , participants completed the american alliance for health , physical education , recreation and dance standardized tests . 0 ###LEFT-WALL### 5 participants 0 ###LEFT-WALL### 6 completed 0 ###LEFT-WALL### 21 . 1 every 3 months 1 every 4 , 1 every 5 participants 2 4 3 months 5 participants 6 completed 6 completed 8 american 7 the 8 american 8 american 9 alliance 8 american 19 standardized 9 alliance 10 for 9 alliance 19 standardized 10 for 17 and 11 health 12 , 12 , 14 education 12 , 15 , 13 physical 14 education 15 , 16 recreation 15 , 17 and 17 and 18 dance 19 standardized 20 tests results : program participation was associated with a reduced effect , compared with baseline , of the natural decline of physical fitness caused by aging , as represented by changes in the following measures [:] coordination test time , - 0.44 seconds [;] agility and dynamic balance test time [;] - 1.81 seconds [;] aerobic capacity test time , 3.57 seconds [;] and muscle strength exercises , +0.60 repetitions . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 3 program 2 : 7 with 3 program 4 participation 3 program 5 was 3 program 6 associated 4 participation 5 was 7 with 10 effect 8 a 10 effect 9 reduced 10 effect 10 effect 12 compared 10 effect 16 of 11 , 12 compared 12 compared 13 with 12 compared 15 , 13 with 14 baseline 16 of 19 decline 17 the 19 decline 18 natural 19 decline 19 decline 20 of 19 decline 23 caused 20 of 22 fitness 21 physical 22 fitness 23 caused 24 by 23 caused 29 by 24 by 25 aging 25 aging 28 represented 26 , 28 represented 27 as 28 represented 29 by 30 changes 30 changes 31 in 31 in 36 coordination 32 the 36 coordination 33 following 36 coordination 34 measures 36 coordination 36 coordination 45 and 36 coordination 48 test 37 test 38 time 38 time 39 , 39 , 44 agility 39 , 45 and 40 - 41 0.44 41 0.44 42 seconds 42 seconds 44 agility 45 and 47 balance 45 and 48 test 46 dynamic 47 balance 48 test 49 time 48 test 58 time 51 - 52 1.81 52 1.81 53 seconds 53 seconds 58 time 55 aerobic 58 time 56 capacity 58 time 57 test 58 time 58 time 63 and 59 , 63 and 60 3.57 61 seconds 61 seconds 63 and 63 and 66 exercises 63 and 69 repetitions 63 and 70 . 64 muscle 65 strength 65 strength 66 exercises 67 , 69 repetitions 68 +0.60 69 repetitions 69 repetitions 70 . no significant effect on flexibility was found . 0 ###LEFT-WALL### 3 effect 0 ###LEFT-WALL### 7 found 0 ###LEFT-WALL### 8 . 1 no 3 effect 2 significant 3 effect 3 effect 4 on 3 effect 6 was 4 on 5 flexibility 6 was 7 found conclusions : the pehpcp showed potential in improving muscle strength , coordination , aerobic capacity , and agility and dynamic balance in participants and in maintaining flexibility in participants . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 balance 0 ###LEFT-WALL### 30 . 2 : 4 pehpcp 2 : 5 showed 3 the 4 pehpcp 4 pehpcp 5 showed 5 showed 6 potential 5 showed 9 muscle 6 potential 7 in 7 in 8 improving 9 muscle 19 and 9 muscle 21 balance 10 strength 11 , 11 , 12 coordination 11 , 13 , 13 , 15 capacity 13 , 17 and 14 aerobic 15 capacity 16 , 17 and 17 and 18 agility 17 and 19 and 19 and 20 dynamic 19 and 21 balance 21 balance 24 and 22 in 23 participants 22 in 24 and 24 and 25 in 25 in 26 maintaining 26 maintaining 27 flexibility 26 maintaining 28 in 28 in 29 participants there are two ways to picture white matter : as a grid of electrical wires or a network of roads . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 21 . 1 there 2 are 2 are 4 ways 3 two 4 ways 4 ways 5 to 4 ways 6 picture 5 to 6 picture 6 picture 7 white 7 white 8 matter 7 white 9 : 8 matter 9 : 9 : 10 as 10 as 16 or 11 a 12 grid 12 grid 13 of 12 grid 16 or 13 of 15 wires 14 electrical 15 wires 16 or 18 network 16 or 19 of 17 a 18 network 19 of 20 roads the first metaphor captures the classical function of an axon as [conductor] of action potentials ( and information ) from one brain region to another . 0 ###LEFT-WALL### 3 metaphor 0 ###LEFT-WALL### 4 captures 0 ###LEFT-WALL### 26 . 1 the 3 metaphor 2 first 3 metaphor 3 metaphor 4 captures 4 captures 7 function 4 captures 11 as 4 captures 24 to 5 the 7 function 6 classical 7 function 7 function 8 of 8 of 10 axon 9 an 10 axon 11 as 13 of 13 of 17 and 14 action 15 potentials 15 potentials 17 and 16 ( 17 and 17 and 18 information 17 and 19 ) 17 and 20 from 20 from 23 region 21 one 23 region 22 brain 23 region 24 to 25 another the second one points to the important role of axons in a bi - directional transport of biological molecules and organelles between the cell body and synapse . 0 ###LEFT-WALL### 2 second 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 28 . 1 the 2 second 2 second 3 one 2 second 9 of 2 second 20 and 3 one 4 points 4 points 5 to 5 to 8 role 6 the 8 role 7 important 8 role 8 role 9 of 10 axons 11 in 10 axons 20 and 11 in 16 transport 12 a 13 bi 12 a 16 transport 13 bi 14 - 13 bi 16 transport 15 directional 16 transport 16 transport 17 of 17 of 19 molecules 18 biological 19 molecules 20 and 26 and 21 organelles 22 between 21 organelles 26 and 22 between 25 body 23 the 25 body 24 cell 25 body 26 and 27 synapse given the wide variety of such cargoes , a well - functioning axonal transport is critical for a number of processes , including neurotransmission , metabolism and viability of neurons . 0 ###LEFT-WALL### 14 transport 0 ###LEFT-WALL### 15 is 0 ###LEFT-WALL### 31 . 1 given 4 variety 1 given 11 - 1 given 14 transport 2 the 4 variety 3 wide 4 variety 4 variety 5 of 5 of 7 cargoes 6 such 7 cargoes 7 cargoes 10 well 8 , 10 well 9 a 10 well 10 well 11 - 12 functioning 14 transport 13 axonal 14 transport 14 transport 15 is 15 is 16 critical 16 critical 17 for 17 for 27 and 18 a 19 number 19 number 20 of 19 number 22 , 20 of 21 processes 22 , 24 neurotransmission 22 , 25 , 23 including 24 neurotransmission 25 , 26 metabolism 25 , 27 and 27 and 28 viability 27 and 29 of 29 of 30 neurons this selective review will emphasize the need for considering axonal transport when interpreting functional consequences [of] inter - individual variations in the structural properties of white matter . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 5 emphasize 0 ###LEFT-WALL### 18 - 1 this 2 selective 2 selective 3 review 3 review 4 will 4 will 5 emphasize 5 emphasize 7 need 6 the 7 need 7 need 8 for 7 need 15 consequences 7 need 17 inter 8 for 9 considering 9 considering 11 transport 9 considering 12 when 10 axonal 11 transport 12 when 13 interpreting 14 functional 15 consequences 15 consequences 17 inter 18 - 20 variations 18 - 27 matter 18 - 28 . 19 individual 20 variations 20 variations 21 in 20 variations 27 matter 21 in 24 properties 22 the 24 properties 23 structural 24 properties 24 properties 25 of 25 of 26 white we start by describing the space occupied by white matter and techniques used in vivo for its characterization . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 start 0 ###LEFT-WALL### 19 . 1 we 2 start 2 start 3 by 2 start 8 by 3 by 4 describing 4 describing 6 space 5 the 6 space 6 space 7 occupied 8 by 11 and 9 white 10 matter 10 matter 11 and 11 and 12 techniques 12 techniques 13 used 12 techniques 16 for 13 used 15 vivo 14 in 15 vivo 16 for 18 characterization 17 its 18 characterization we then provide examples of key features of maturation and aging of white matter , as well as some of the common abnormalities observed in neurodevelopmental and neurodegenerative disorders . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 24 observed 0 ###LEFT-WALL### 30 . 1 we 3 provide 2 then 3 provide 3 provide 10 and 3 provide 17 well 3 provide 18 as 4 examples 5 of 4 examples 10 and 5 of 7 features 6 key 7 features 7 features 8 of 8 of 9 maturation 10 and 11 aging 10 and 15 , 11 aging 12 of 12 of 14 matter 13 white 14 matter 16 as 17 well 18 as 23 abnormalities 18 as 24 observed 19 some 20 of 19 some 23 abnormalities 20 of 23 abnormalities 21 the 23 abnormalities 22 common 23 abnormalities 23 abnormalities 24 observed 24 observed 25 in 25 in 29 disorders 26 neurodevelopmental 27 and 27 and 28 neurodegenerative 27 and 29 disorders next , we review work that motivated our focus [on] axonal diameter , and explain the relationships between transport and cytoskeleton within the axon . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 next 2 , 1 next 3 we 3 we 14 and 4 review 5 work 4 review 14 and 5 work 6 that 5 work 7 motivated 6 that 7 motivated 7 motivated 12 diameter 8 our 12 diameter 9 focus 12 diameter 11 axonal 12 diameter 13 , 14 and 14 and 15 explain 15 explain 17 relationships 15 explain 18 between 15 explain 22 within 16 the 17 relationships 18 between 20 and 19 transport 20 and 20 and 21 cytoskeleton 22 within 24 axon 23 the 24 axon we will conclude by describing molecular machinery of axonal transport and genes that may contribute to inter - individual variations in axonal [diameter] and axonal transport . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 conclude 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 27 . 1 we 2 will 2 will 3 conclude 3 conclude 4 by 3 conclude 7 machinery 4 by 5 describing 6 molecular 7 machinery 7 machinery 8 of 7 machinery 13 that 7 machinery 17 inter 8 of 11 and 9 axonal 10 transport 10 transport 11 and 11 and 12 genes 13 that 14 may 14 may 15 contribute 15 contribute 16 to 16 to 17 inter 18 - 20 variations 19 individual 20 variations 20 variations 21 in 21 in 26 transport 22 axonal 24 and 24 and 25 axonal 24 and 26 transport it is accepted widely that fast - twitch muscle fibers are preferentially impacted in aging muscle , yet we hypothesize that this is not valid when aging muscle atrophy becomes severe . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 accepted 1 it 2 is 2 is 3 accepted 3 accepted 4 widely 3 accepted 5 that 5 that 10 fibers 5 that 13 impacted 6 fast 7 - 6 fast 8 twitch 8 twitch 10 fibers 9 muscle 10 fibers 10 fibers 11 are 11 are 12 preferentially 11 are 13 impacted 13 impacted 14 in 14 in 15 aging 15 aging 16 muscle 16 muscle 25 valid 17 , 25 valid 18 yet 25 valid 19 we 20 hypothesize 20 hypothesize 21 that 21 that 22 this 21 that 23 is 22 this 23 is 23 is 24 not 24 not 25 valid 25 valid 26 when 25 valid 32 . 26 when 27 aging 26 when 30 becomes 27 aging 29 atrophy 27 aging 30 becomes 28 muscle 29 atrophy 30 becomes 31 severe in this review , we summarize the evidence of fiber type [-] specific effect in aging muscle and the potential confounding roles of fibers coexpressing multiple myosin heavy - chain isoforms and their histochemical identification . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 summarize 0 ###LEFT-WALL### 36 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 summarize 6 summarize 8 evidence 6 summarize 15 in 7 the 8 evidence 8 evidence 9 of 9 of 14 effect 10 fiber 14 effect 11 type 14 effect 13 specific 14 effect 15 in 18 and 16 aging 17 muscle 17 muscle 18 and 18 and 20 potential 19 the 20 potential 20 potential 21 confounding 20 potential 23 of 21 confounding 22 roles 23 of 24 fibers 24 fibers 25 coexpressing 25 coexpressing 32 and 26 multiple 31 isoforms 27 myosin 31 isoforms 28 heavy 29 - 28 heavy 30 chain 30 chain 31 isoforms 31 isoforms 32 and 32 and 35 identification 33 their 35 identification 34 histochemical 35 identification current dogma suggests that aerobic exercise training has minimal effects on skeletal muscle size . 0 ###LEFT-WALL### 2 dogma 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 15 . 1 current 2 dogma 2 dogma 3 suggests 3 suggests 7 training 3 suggests 8 has 4 that 5 aerobic 5 aerobic 6 exercise 6 exercise 7 training 7 training 8 has 8 has 10 effects 8 has 11 on 9 minimal 10 effects 11 on 14 size 12 skeletal 13 muscle 13 muscle 14 size we and others have demonstrated that aerobic exercise acutely and [chronically] alters protein metabolism and induces skeletal muscle hypertrophy . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 19 hypertrophy 0 ###LEFT-WALL### 20 . 1 we 2 and 2 and 3 others 2 and 10 and 2 and 19 hypertrophy 4 have 5 demonstrated 4 have 10 and 5 demonstrated 8 exercise 5 demonstrated 9 acutely 6 that 7 aerobic 7 aerobic 8 exercise 10 and 15 and 12 alters 14 metabolism 12 alters 15 and 13 protein 14 metabolism 15 and 16 induces 15 and 18 muscle 17 skeletal 18 muscle these findings promote [an] antithesis to the status quo by providing novel perspective on skeletal muscle mass regulation and insight into exercise countermeasures for populations prone to muscle loss . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 28 muscle 0 ###LEFT-WALL### 30 . 1 these 2 findings 2 findings 3 promote 3 promote 5 antithesis 3 promote 6 to 3 promote 10 by 3 promote 21 into 6 to 9 quo 7 the 9 quo 8 status 9 quo 10 by 11 providing 11 providing 13 perspective 11 providing 14 on 12 novel 13 perspective 14 on 19 and 15 skeletal 16 muscle 16 muscle 17 mass 17 mass 18 regulation 18 regulation 19 and 19 and 20 insight 21 into 23 countermeasures 22 exercise 23 countermeasures 23 countermeasures 24 for 24 for 25 populations 25 populations 26 prone 26 prone 27 to 27 to 28 muscle 28 muscle 29 loss in this review , we summarize current evidence for a direct effect of vitamin d on skeletal muscle . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 summarize 0 ###LEFT-WALL### 19 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 summarize 6 summarize 8 evidence 6 summarize 16 on 7 current 8 evidence 8 evidence 9 for 9 for 12 effect 10 a 11 direct 10 a 12 effect 11 direct 12 effect 12 effect 13 of 13 of 14 vitamin 14 vitamin 15 d 16 on 18 muscle 17 skeletal 18 muscle a number of studies identify the receptor for 1,25 - dihydroxyvitamin - d3 ( vitamin d [receptor] ( vdr ) ) and the enzyme cyp27b1 ( 1 - α - hydroxylase ) in muscle . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 identify 0 ###LEFT-WALL### 35 . 1 a 2 number 2 number 3 of 2 number 4 studies 3 of 4 studies 4 studies 5 identify 5 identify 22 and 5 identify 28 - 5 identify 33 in 6 the 7 receptor 7 receptor 8 for 7 receptor 22 and 8 for 9 1,25 9 1,25 11 dihydroxyvitamin 9 1,25 13 d3 10 - 11 dihydroxyvitamin 11 dihydroxyvitamin 12 - 12 - 13 d3 13 d3 15 vitamin 13 d3 21 ) 14 ( 15 vitamin 15 vitamin 16 d 15 vitamin 19 vdr 15 vitamin 20 ) 18 ( 19 vdr 19 vdr 20 ) 22 and 25 cyp27b1 23 the 24 enzyme 24 enzyme 25 cyp27b1 26 ( 28 - 27 1 28 - 28 - 29 α 28 - 32 ) 29 α 31 hydroxylase 30 - 31 hydroxylase 31 hydroxylase 32 ) 33 in 34 muscle we hypothesize that vitamin d acts on myocytes via the vdr , and we examine proposed effects on myocyte proliferation [,] differentiation , growth , and inflammation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesize 0 ###LEFT-WALL### 28 . 1 we 2 hypothesize 2 hypothesize 3 that 3 that 6 acts 3 that 15 examine 4 vitamin 5 d 4 vitamin 6 acts 6 acts 7 on 6 acts 9 via 6 acts 15 examine 7 on 8 myocytes 9 via 13 and 10 the 11 vdr 11 vdr 13 and 12 , 13 and 13 and 14 we 15 examine 17 effects 15 examine 18 on 16 proposed 17 effects 18 on 26 and 19 myocyte 22 differentiation 20 proliferation 22 differentiation 22 differentiation 23 , 23 , 24 growth 23 , 26 and 25 , 26 and 26 and 27 inflammation telomerase is the ribonucleoprotein ( rnp ) reverse transcriptase responsible for synthesizing the 3 ['] ends of linear chromosomes . 0 ###LEFT-WALL### 1 telomerase 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 20 . 1 telomerase 2 is 2 is 4 ribonucleoprotein 2 is 9 transcriptase 3 the 4 ribonucleoprotein 4 ribonucleoprotein 6 rnp 5 ( 6 rnp 6 rnp 7 ) 8 reverse 9 transcriptase 9 transcriptase 10 responsible 10 responsible 11 for 11 for 12 synthesizing 12 synthesizing 16 ends 13 the 14 3 14 3 16 ends 16 ends 17 of 17 of 19 chromosomes 18 linear 19 chromosomes it plays critical roles in tumorigenesis , cellular aging , and stem cell renewal . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 plays 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 15 . 1 it 2 plays 2 plays 4 roles 2 plays 5 in 3 critical 4 roles 5 in 6 tumorigenesis 7 , 11 and 8 cellular 9 aging 8 cellular 11 and 10 , 11 and 11 and 14 renewal 12 stem 14 renewal 13 cell 14 renewal the past two years have seen exciting progress in determining telomerase holoenzyme architecture and the structural basis of telomerase activity . 0 ###LEFT-WALL### 4 years 0 ###LEFT-WALL### 12 holoenzyme 0 ###LEFT-WALL### 21 . 1 the 2 past 1 the 3 two 3 two 4 years 4 years 5 have 5 have 6 seen 6 seen 8 progress 6 seen 9 in 6 seen 12 holoenzyme 7 exciting 8 progress 9 in 10 determining 10 determining 11 telomerase 12 holoenzyme 14 and 13 architecture 14 and 14 and 17 basis 14 and 18 of 15 the 17 basis 16 structural 17 basis 18 of 20 activity 19 telomerase 20 activity notably , the first electron microscopy structures of telomerase were reported , of the tetrahymena thermophila telomerase holoenzyme and a human telomerase dimer . 0 ###LEFT-WALL### 7 structures 0 ###LEFT-WALL### 11 reported 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 24 . 1 notably 2 , 1 notably 7 structures 3 the 7 structures 4 first 7 structures 5 electron 7 structures 6 microscopy 7 structures 7 structures 8 of 7 structures 10 were 8 of 9 telomerase 10 were 11 reported 12 , 19 and 12 , 23 dimer 13 of 15 tetrahymena 13 of 19 and 14 the 15 tetrahymena 16 thermophila 17 telomerase 17 telomerase 18 holoenzyme 18 holoenzyme 19 and 19 and 22 telomerase 19 and 23 dimer 20 a 21 human 20 a 22 telomerase 21 human 22 telomerase in addition to new structures of tert and ter domains , the first structures of telomerase protein domains beyond tert , and their complexes with ter or telomeric single - stranded dna , were reported . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 30 - 0 ###LEFT-WALL### 36 . 1 in 2 addition 2 addition 3 to 2 addition 6 of 2 addition 22 and 3 to 5 structures 4 new 5 structures 6 of 10 domains 7 tert 8 and 8 and 9 ter 9 ter 10 domains 10 domains 14 structures 11 , 14 structures 12 the 13 first 12 the 14 structures 14 structures 15 of 14 structures 21 , 15 of 18 domains 16 telomerase 18 domains 17 protein 18 domains 18 domains 19 beyond 19 beyond 20 tert 21 , 22 and 22 and 24 complexes 22 and 25 with 23 their 24 complexes 25 with 27 or 26 ter 27 or 27 or 29 single 28 telomeric 29 single 30 - 33 , 31 stranded 32 dna 31 stranded 33 , 33 , 34 were 34 were 35 reported together these studies provide the first glimpse into the organization of the proteins and rna in the telomerase rnp . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 20 . 1 together 3 studies 2 these 3 studies 3 studies 4 provide 4 provide 7 glimpse 4 provide 8 into 4 provide 16 in 5 the 7 glimpse 6 first 7 glimpse 8 into 10 organization 9 the 10 organization 10 organization 11 of 11 of 14 and 12 the 13 proteins 13 proteins 14 and 14 and 15 rna 16 in 19 rnp 17 the 18 telomerase 18 telomerase 19 rnp the mammalian target of rapamycin ( mtor ) signaling [pathway] is a master regulator of cell growth and metabolism . 0 ###LEFT-WALL### 3 target 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 20 . 1 the 3 target 2 mammalian 3 target 3 target 4 of 3 target 9 signaling 3 target 11 is 4 of 5 rapamycin 5 rapamycin 7 mtor 6 ( 7 mtor 7 mtor 8 ) 11 is 14 regulator 12 a 14 regulator 13 master 14 regulator 14 regulator 15 of 15 of 18 and 16 cell 17 growth 17 growth 18 and 18 and 19 metabolism deregulation of the mtor pathway has been implicated in a number of human diseases such as cancer , diabetes , obesity , neurological diseases , and genetic disorders . 0 ###LEFT-WALL### 1 deregulation 0 ###LEFT-WALL### 8 implicated 0 ###LEFT-WALL### 29 . 1 deregulation 2 of 1 deregulation 6 has 2 of 5 pathway 3 the 5 pathway 4 mtor 5 pathway 6 has 7 been 7 been 8 implicated 8 implicated 9 in 9 in 14 diseases 10 a 11 number 11 number 12 of 11 number 14 diseases 12 of 14 diseases 13 human 14 diseases 14 diseases 16 as 15 such 16 as 16 as 26 and 17 cancer 18 , 18 , 19 diabetes 18 , 20 , 20 , 21 obesity 20 , 22 , 22 , 24 diseases 22 , 26 and 23 neurological 24 diseases 25 , 26 and 26 and 28 disorders 27 genetic 28 disorders rapamycin , a specific inhibitor of mtor , has been shown to be useful in the treatment of certain diseases . 0 ###LEFT-WALL### 1 rapamycin 0 ###LEFT-WALL### 11 shown 0 ###LEFT-WALL### 21 . 1 rapamycin 5 inhibitor 1 rapamycin 9 has 2 , 5 inhibitor 3 a 4 specific 3 a 5 inhibitor 4 specific 5 inhibitor 5 inhibitor 6 of 5 inhibitor 8 , 6 of 7 mtor 9 has 10 been 10 been 11 shown 11 shown 12 to 12 to 13 be 13 be 14 useful 14 useful 15 in 15 in 17 treatment 16 the 17 treatment 17 treatment 18 of 18 of 20 diseases 19 certain 20 diseases here we discuss its mechanism of action and highlight recent findings regarding the effects and limitations of rapamycin monotherapy and the potential utility of combination therapy with rapamycin . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 29 . 1 here 2 we 2 we 8 and 3 discuss 5 mechanism 3 discuss 8 and 4 its 5 mechanism 5 mechanism 6 of 6 of 7 action 8 and 9 highlight 8 and 27 with 9 highlight 20 and 10 recent 11 findings 11 findings 12 regarding 11 findings 15 and 12 regarding 14 effects 13 the 14 effects 15 and 16 limitations 15 and 17 of 15 and 20 and 17 of 19 monotherapy 18 rapamycin 19 monotherapy 20 and 23 utility 20 and 24 of 21 the 23 utility 22 potential 23 utility 24 of 26 therapy 25 combination 26 therapy 27 with 28 rapamycin very frail elderly patients living in the community , present complex needs and [have] a higher rate of hospital admissions with emergency [department] ( ed ) visits . 0 ###LEFT-WALL### 27 visits 0 ###LEFT-WALL### 28 . 1 very 2 frail 2 frail 4 patients 3 elderly 4 patients 4 patients 5 living 4 patients 9 , 5 living 6 in 6 in 8 community 7 the 8 community 9 , 12 needs 9 , 13 and 10 present 12 needs 11 complex 12 needs 13 and 17 rate 13 and 18 of 13 and 25 ed 13 and 27 visits 15 a 17 rate 16 higher 17 rate 18 of 20 admissions 19 hospital 20 admissions 20 admissions 21 with 21 with 22 emergency 24 ( 25 ed 25 ed 26 ) here , we evaluated the impact on hospital admissions of the copa model ( co - ordination personnes agées ) , which provides integrated primary care with intensive case management for community [-] dwelling , very frail elderly patients . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 40 . 1 here 2 , 1 here 3 we 3 we 4 evaluated 4 evaluated 6 impact 4 evaluated 7 on 5 the 6 impact 7 on 9 admissions 8 hospital 9 admissions 9 admissions 10 of 9 admissions 15 co 10 of 13 model 11 the 13 model 12 copa 13 model 14 ( 15 co 15 co 19 agées 15 co 21 , 16 - 19 agées 17 ordination 19 agées 18 personnes 19 agées 19 agées 20 ) 21 , 22 which 21 , 23 provides 21 , 35 , 22 which 23 provides 23 provides 26 care 23 provides 27 with 23 provides 31 for 24 integrated 26 care 25 primary 26 care 27 with 30 management 28 intensive 29 case 29 case 30 management 31 for 34 dwelling 32 community 34 dwelling 35 , 39 patients 36 very 37 frail 37 frail 39 patients 38 elderly 39 patients we used [a] quasi - experimental study in an urban district of paris with four hundred twenty - eight very frail patients ( 105 in the intervention group and 323 in [the] control group ) with one [-] year follow - up . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 0 ###LEFT-WALL### 43 . 1 we 2 used 2 used 4 quasi 2 used 42 up 4 quasi 7 study 5 - 7 study 6 experimental 7 study 7 study 8 in 7 study 41 - 8 in 11 district 9 an 11 district 10 urban 11 district 11 district 12 of 11 district 14 with 11 district 22 patients 12 of 13 paris 14 with 17 twenty 15 four 16 hundred 16 hundred 17 twenty 18 - 22 patients 19 eight 22 patients 20 very 21 frail 21 frail 22 patients 22 patients 24 105 22 patients 41 - 23 ( 24 105 24 105 25 in 24 105 41 - 25 in 27 intervention 26 the 27 intervention 27 intervention 29 and 27 intervention 40 follow 28 group 29 and 29 and 34 group 29 and 35 ) 29 and 36 with 29 and 40 follow 30 323 31 in 31 in 34 group 33 control 34 group 36 with 39 year 37 one 39 year the primary outcome measures were the presence of any unplanned hospitalization ( via the ed ) , any planned hospitalizations ( direct admission , no ed visit ) and any hospitalization overall . 0 ###LEFT-WALL### 4 measures 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 33 . 1 the 4 measures 2 primary 3 outcome 3 outcome 4 measures 4 measures 5 were 5 were 29 and 6 the 7 presence 7 presence 8 of 7 presence 29 and 8 of 11 hospitalization 9 any 11 hospitalization 10 unplanned 11 hospitalization 11 hospitalization 13 via 11 hospitalization 20 hospitalizations 12 ( 13 via 13 via 15 ed 13 via 16 ) 14 the 15 ed 17 , 20 hospitalizations 18 any 20 hospitalizations 19 planned 20 hospitalizations 20 hospitalizations 23 admission 20 hospitalizations 27 visit 20 hospitalizations 28 ) 21 ( 23 admission 22 direct 23 admission 23 admission 24 , 24 , 27 visit 25 no 27 visit 26 ed 27 visit 27 visit 28 ) 29 and 32 overall 30 any 32 overall 31 hospitalization 32 overall secondary outcome measures included health parameters assessed with the rai - hc ( resident assessment instrument - home care ) . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 included 0 ###LEFT-WALL### 21 . 1 secondary 3 measures 2 outcome 3 measures 3 measures 4 included 4 included 6 parameters 5 health 6 parameters 6 parameters 7 assessed 6 parameters 8 with 6 parameters 19 care 8 with 10 rai 9 the 10 rai 10 rai 12 hc 11 - 12 hc 12 hc 16 instrument 12 hc 17 - 13 ( 16 instrument 14 resident 15 assessment 15 assessment 16 instrument 16 instrument 17 - 17 - 19 care 18 home 19 care 19 care 20 ) comparing the intervention group with the control group , the risk of having at least one unplanned hospital admission decreased at one year and the planned hospital admissions rate increased , without a significant change in total hospital admissions . 0 ###LEFT-WALL### 11 risk 0 ###LEFT-WALL### 20 decreased 1 comparing 4 group 1 comparing 5 with 1 comparing 9 , 1 comparing 11 risk 2 the 4 group 3 intervention 4 group 5 with 8 group 6 the 8 group 7 control 8 group 10 the 11 risk 11 risk 12 of 11 risk 20 decreased 12 of 13 having 13 having 19 admission 14 at 15 least 15 least 16 one 16 one 19 admission 17 unplanned 19 admission 18 hospital 19 admission 20 decreased 21 at 20 decreased 32 without 21 at 24 and 22 one 23 year 23 year 24 and 24 and 29 rate 24 and 30 increased 25 the 29 rate 26 planned 27 hospital 27 hospital 29 rate 28 admissions 29 rate 31 , 32 without 32 without 35 change 32 without 40 . 33 a 34 significant 33 a 35 change 34 significant 35 change 35 change 36 in 36 in 39 admissions 37 total 39 admissions 38 hospital 39 admissions among patients in the intervention group , there was less risk of depression and dyspnea . 0 ###LEFT-WALL### 8 there 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 16 . 1 among 2 patients 1 among 7 , 1 among 8 there 2 patients 3 in 3 in 6 group 4 the 6 group 5 intervention 6 group 8 there 9 was 9 was 11 risk 10 less 11 risk 11 risk 12 of 12 of 14 and 13 depression 14 and 14 and 15 dyspnea the copa model improves the quality of care provided to very frail elderly patients by reducing unplanned hospitalizations [and] improving some health parameters . 0 ###LEFT-WALL### 3 model 0 ###LEFT-WALL### 4 improves 0 ###LEFT-WALL### 24 . 1 the 3 model 2 copa 3 model 3 model 4 improves 4 improves 6 quality 4 improves 10 to 4 improves 15 by 5 the 6 quality 6 quality 7 of 7 of 8 care 8 care 9 provided 10 to 14 patients 11 very 12 frail 12 frail 14 patients 13 elderly 14 patients 15 by 16 reducing 16 reducing 18 hospitalizations 17 unplanned 18 hospitalizations 18 hospitalizations 20 improving 20 improving 23 parameters 21 some 23 parameters 22 health 23 parameters objectives : decision aids are effective to improve [decision] - making , yet they are rarely tested in nursing homes ( nhs ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 aids 2 : 17 tested 2 : 24 . 3 decision 4 aids 4 aids 5 are 5 are 6 effective 6 effective 7 to 6 effective 8 improve 7 to 8 improve 8 improve 11 making 8 improve 13 yet 10 - 11 making 11 making 12 , 13 yet 14 they 14 they 15 are 15 are 17 tested 16 rarely 17 tested 17 tested 18 in 18 in 19 nursing 19 nursing 20 homes 20 homes 22 nhs 21 ( 22 nhs 22 nhs 23 ) study objectives [were] [to] ( 1 ) examine the feasibility [of] [a] goals of care ( goc ) [decision] aid for surrogate [decision] - makers ( sdms ) of persons with dementia [;] [and] ( 2 ) to test its effect on quality of communication and decision - making . 0 ###LEFT-WALL### 2 objectives 0 ###LEFT-WALL### 8 examine 1 study 2 objectives 2 objectives 6 1 2 objectives 8 examine 5 ( 6 1 6 1 7 ) 8 examine 10 feasibility 9 the 10 feasibility 10 feasibility 13 goals 10 feasibility 20 aid 13 goals 14 of 13 goals 20 aid 14 of 15 care 15 care 17 goc 16 ( 17 goc 17 goc 18 ) 20 aid 21 for 21 for 22 surrogate 22 surrogate 25 makers 22 surrogate 29 of 24 - 25 makers 25 makers 27 sdms 25 makers 28 ) 26 ( 27 sdms 27 sdms 28 ) 29 of 30 persons 30 persons 31 with 30 persons 38 to 30 persons 39 test 31 with 32 dementia 32 dementia 36 2 35 ( 36 2 36 2 37 ) 38 to 39 test 39 test 41 effect 39 test 42 on 39 test 49 making 40 its 41 effect 42 on 43 quality 43 quality 44 of 44 of 46 and 45 communication 46 and 46 and 47 decision 48 - 49 making 49 making 50 . design : pre - post intervention to test a goc decision aid intervention for sdms for persons with dementia in nhs . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 design 2 : 2 : 3 pre 4 - 5 post 4 - 22 . 5 post 6 intervention 5 post 7 to 5 post 20 in 7 to 8 test 8 test 13 intervention 8 test 16 for 9 a 13 intervention 10 goc 13 intervention 11 decision 12 aid 12 aid 13 intervention 13 intervention 14 for 14 for 15 sdms 16 for 17 persons 17 persons 18 with 18 with 19 dementia 20 in 21 nhs investigators collected data from reviews of resident health records and interviews with sdms at baseline and 3 [-] month follow - up . 0 ###LEFT-WALL### 1 investigators 0 ###LEFT-WALL### 2 collected 0 ###LEFT-WALL### 16 and 1 investigators 2 collected 2 collected 3 data 2 collected 14 at 3 data 4 from 3 data 6 of 4 from 5 reviews 6 of 8 health 7 resident 8 health 8 health 10 and 9 records 10 and 10 and 11 interviews 10 and 12 with 12 with 13 sdms 14 at 15 baseline 16 and 19 month 16 and 20 follow 17 3 19 month 19 month 20 follow 20 follow 22 up 21 - 22 up 22 up 23 . setting : two nhs in north carolina . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 . 1 setting 2 : 2 : 7 carolina 3 two 7 carolina 4 nhs 5 in 4 nhs 7 carolina 5 in 6 north participants : eighteen residents who were over 65 years of age , had moderate to severe dementia on the global deterioration scale ( 5 , 6 [,] or 7 ) , and an english - speaking surrogate decision - maker . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 2 : 4 residents 2 : 39 - 3 eighteen 4 residents 4 residents 5 who 4 residents 12 , 5 who 12 , 6 were 7 over 6 were 12 , 7 over 9 years 8 65 9 years 9 years 10 of 10 of 11 age 12 , 13 had 13 had 32 and 14 moderate 15 to 14 moderate 18 on 14 moderate 32 and 15 to 17 dementia 16 severe 17 dementia 18 on 22 scale 19 the 22 scale 20 global 22 scale 21 deterioration 22 scale 22 scale 24 5 23 ( 24 5 24 5 28 or 24 5 31 , 25 , 28 or 26 6 28 or 28 or 29 7 28 or 30 ) 31 , 32 and 32 and 38 decision 33 an 34 english 33 an 38 decision 34 english 35 - 34 english 37 surrogate 36 speaking 37 surrogate 37 surrogate 38 decision 39 - 40 maker 39 - 41 . intervention [:] ( 1 ) goc decision aid video viewed by the sdm [and] ( 2 ) a structured care plan meeting between the sdm and interdisciplinary nh team . 0 ###LEFT-WALL### 9 video 0 ###LEFT-WALL### 10 viewed 0 ###LEFT-WALL### 30 . 1 intervention 4 1 1 intervention 9 video 3 ( 4 1 4 1 5 ) 6 goc 8 aid 7 decision 8 aid 8 aid 9 video 9 video 10 viewed 10 viewed 11 by 10 viewed 21 plan 10 viewed 23 between 11 by 13 sdm 12 the 13 sdm 13 sdm 16 2 15 ( 16 2 16 2 17 ) 18 a 21 plan 19 structured 20 care 20 care 21 plan 21 plan 22 meeting 23 between 26 and 24 the 25 sdm 25 sdm 26 and 26 and 29 team 27 interdisciplinary 28 nh 28 nh 29 team measurements : surrogate knowledge , quality of communication with health care providers , surrogate - provider concordance on goals of care , and palliative care domains addressed in the care plan . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 , 1 measurements 2 : 2 : 4 knowledge 3 surrogate 4 knowledge 4 knowledge 6 quality 5 , 6 quality 6 quality 7 of 6 quality 9 with 6 quality 13 , 7 of 8 communication 9 with 12 providers 10 health 12 providers 11 care 12 providers 13 , 14 surrogate 13 , 15 - 15 - 23 and 15 - 31 plan 15 - 32 . 16 provider 17 concordance 17 concordance 18 on 17 concordance 23 and 18 on 19 goals 19 goals 20 of 20 of 21 care 22 , 23 and 23 and 26 domains 23 and 27 addressed 23 and 31 plan 24 palliative 25 care 25 care 26 domains 27 addressed 28 in 28 in 30 care 29 the 30 care results : eighty - nine percent of the sdms thought the decision aid was relevant to their needs . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 1 results 2 : 2 : 6 percent 2 : 16 to 3 eighty 4 - 4 - 5 nine 4 - 6 percent 6 percent 7 of 7 of 9 sdms 8 the 9 sdms 9 sdms 10 thought 10 thought 13 aid 10 thought 14 was 11 the 13 aid 12 decision 13 aid 13 aid 14 was 14 was 15 relevant 16 to 18 needs 17 their 18 needs after viewing the video decision aid , sdms increased the number of correct responses on knowledge - based questions ( 12.5 vs 14.2 ; p < . 001 [ )( 0 ###LEFT-WALL### 6 aid 0 ###LEFT-WALL### 18 based 0 ###LEFT-WALL### 24 ; 0 ###LEFT-WALL### 27 . 1 after 2 viewing 1 after 6 aid 2 viewing 4 video 3 the 4 video 5 decision 6 aid 6 aid 9 increased 6 aid 18 based 7 , 9 increased 8 sdms 9 increased 9 increased 14 responses 9 increased 17 - 10 the 11 number 11 number 12 of 11 number 14 responses 12 of 14 responses 13 correct 14 responses 14 responses 15 on 15 on 16 knowledge 18 based 19 questions 19 questions 21 12.5 20 ( 21 12.5 21 12.5 22 vs 21 12.5 24 ; 22 vs 23 14.2 24 ; 25 p 24 ; 26 < 25 p 26 < 27 . 28 001 27 . 30 )( at 3 months , they reported improved quality of communication scores ( 6.1 vs 6.8 [;] p = [.] 01 ) and improved concordance on primary goal [of] care with nh [team] ( 50 % vs 78 % ; p = . 003 [ )( 0 ###LEFT-WALL### 5 they 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 39 ; 0 ###LEFT-WALL### 42 . 1 at 3 months 1 at 4 , 1 at 5 they 2 3 3 months 5 they 22 and 6 reported 8 quality 6 reported 22 and 7 improved 8 quality 8 quality 9 of 9 of 11 scores 10 communication 11 scores 11 scores 13 6.1 12 ( 13 6.1 13 6.1 14 vs 13 6.1 18 = 13 6.1 21 ) 14 vs 15 6.8 17 p 18 = 18 = 20 01 22 and 23 improved 23 improved 24 concordance 24 concordance 25 on 24 concordance 30 with 25 on 29 care 26 primary 29 care 27 goal 29 care 30 with 31 nh 31 nh 35 % 33 ( 35 % 34 50 35 % 35 % 36 vs 35 % 39 ; 36 vs 38 % 37 78 38 % 39 ; 40 p 39 ; 41 = 40 p 41 = 42 . 43 003 42 . 45 )( the number of palliative care domains addressed [in] the care plan increased ( 1.8 vs 4.3 ; p < . 001 [ )( 0 ###LEFT-WALL### 6 domains 0 ###LEFT-WALL### 7 addressed 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 20 . 1 the 2 number 2 number 3 of 2 number 6 domains 3 of 6 domains 4 palliative 6 domains 5 care 6 domains 6 domains 7 addressed 7 addressed 11 plan 9 the 11 plan 10 care 11 plan 11 plan 12 increased 11 plan 14 1.8 13 ( 14 1.8 14 1.8 15 vs 14 1.8 17 ; 15 vs 16 4.3 17 ; 18 p 17 ; 19 < 18 p 19 < 20 . 21 001 20 . 23 )( conclusions : the decision - support intervention piloted in this study was feasible and relevant for surrogate decision [-] makers of persons with advanced dementia in nhs , and it improved quality of communication between sdm and nh providers . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 40 . 1 conclusions 2 : 2 : 4 decision 3 the 4 decision 4 decision 7 intervention 5 - 7 intervention 6 support 7 intervention 7 intervention 8 piloted 7 intervention 11 study 7 intervention 12 was 7 intervention 23 with 7 intervention 28 , 8 piloted 9 in 9 in 10 this 11 study 12 was 12 was 14 and 12 was 16 for 13 feasible 14 and 14 and 15 relevant 16 for 20 makers 17 surrogate 20 makers 18 decision 20 makers 20 makers 21 of 21 of 22 persons 23 with 25 dementia 24 advanced 25 dementia 25 dementia 26 in 26 in 27 nhs 29 and 30 it 29 and 31 improved 30 it 31 improved 31 improved 32 quality 31 improved 35 between 32 quality 33 of 33 of 34 communication 35 between 37 and 36 sdm 37 and 37 and 39 providers 38 nh 39 providers a larger randomized clinical trial is underway to provide further evidence of the effects of this decision aid intervention . 0 ###LEFT-WALL### 5 trial 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 20 . 1 a 5 trial 2 larger 5 trial 3 randomized 5 trial 4 clinical 5 trial 5 trial 6 is 6 is 7 underway 7 underway 8 to 7 underway 9 provide 8 to 9 provide 9 provide 11 evidence 10 further 11 evidence 11 evidence 12 of 12 of 14 effects 13 the 14 effects 14 effects 15 of 15 of 19 intervention 16 this 19 intervention 17 decision 19 intervention 18 aid 19 intervention apolipoprotein e ( apoe ) [ε] [genotype] has previously been significantly associated with cognitive , brain imaging , and alzheimer 's disease - related [phenotypes] ( e.g [.] , age [of] [onset] ) . 0 ###LEFT-WALL### 4 apoe 0 ###LEFT-WALL### 12 associated 0 ###LEFT-WALL### 34 . 1 apolipoprotein 2 e 1 apolipoprotein 4 apoe 3 ( 4 apoe 4 apoe 5 ) 4 apoe 8 has 8 has 10 been 9 previously 10 been 10 been 12 associated 11 significantly 12 associated 12 associated 13 with 13 with 19 and 14 cognitive 15 , 14 cognitive 16 brain 16 brain 17 imaging 17 imaging 19 and 18 , 19 and 19 and 22 disease 19 and 23 - 19 and 24 related 19 and 30 age 20 alzheimer 21 's 21 's 22 disease 26 ( 30 age 27 e.g 29 , 27 e.g 30 age 30 age 33 ) in the tomm40 gene , the rs10524523 ( " 523 " ) variable length [poly] [-] t repeat polymorphism has more recently been associated with similar ph/enotypes , although the allelic directions of these associations have varied between initial reports . 0 ###LEFT-WALL### 19 polymorphism 0 ###LEFT-WALL### 37 varied 0 ###LEFT-WALL### 41 . 1 in 4 gene 1 in 5 , 1 in 19 polymorphism 2 the 4 gene 3 tomm40 4 gene 6 the 19 polymorphism 7 rs10524523 10 523 7 rs10524523 12 ) 7 rs10524523 14 length 8 ( 9 " 8 ( 10 523 10 523 11 " 10 523 12 ) 13 variable 14 length 14 length 17 t 14 length 19 polymorphism 18 repeat 19 polymorphism 19 polymorphism 20 has 20 has 23 been 21 more 22 recently 22 recently 23 been 23 been 24 associated 24 associated 25 with 24 associated 29 although 25 with 27 ph/enotypes 26 similar 27 ph/enotypes 28 , 29 although 29 although 32 directions 30 the 32 directions 31 allelic 32 directions 32 directions 33 of 32 directions 36 have 33 of 35 associations 34 these 35 associations 36 have 37 varied 37 varied 38 between 38 between 40 reports 39 initial 40 reports using diffusion magnetic resonance imaging tractography , the present study aimed to investigate whether there are independent effects of apolipoprotein e ( apoe ) [and] tomm40 genotypes on human brain white matter integrity in a community - dwelling sample of older adults [,] the lothian birth cohort 1936 [(] mean age = 72.70 years , standard deviation [=] 0.74 , n [approximately] = 640 - 650 [;] for most analyses [ )( 1 using 6 tractography 1 using 7 , 1 using 10 study 2 diffusion 6 tractography 3 magnetic 4 resonance 4 resonance 6 tractography 5 imaging 6 tractography 8 the 10 study 9 present 10 study 10 study 11 aimed 10 study 12 to 10 study 13 investigate 10 study 16 are 12 to 13 investigate 13 investigate 14 whether 14 whether 15 there 16 are 18 effects 17 independent 18 effects 18 effects 19 of 18 effects 26 tomm40 18 effects 27 genotypes 19 of 20 apolipoprotein 20 apolipoprotein 21 e 20 apolipoprotein 23 apoe 22 ( 23 apoe 23 apoe 24 ) 26 tomm40 27 genotypes 27 genotypes 28 on 27 genotypes 38 dwelling 28 on 33 integrity 29 human 30 brain 30 brain 31 white 31 white 33 integrity 32 matter 33 integrity 33 integrity 34 in 34 in 36 community 35 a 36 community 37 - 38 dwelling 38 dwelling 39 sample 39 sample 40 of 40 of 42 adults 41 older 42 adults 42 adults 51 age 42 adults 52 = 44 the 51 age 45 lothian 51 age 46 birth 47 cohort 47 cohort 48 1936 47 cohort 51 age 50 mean 51 age 51 age 52 = 52 = 63 = 53 72.70 54 years 54 years 57 deviation 55 , 57 deviation 56 standard 57 deviation 57 deviation 59 0.74 57 deviation 60 , 60 , 63 = 61 n 63 = 63 = 64 640 64 640 66 650 65 - 66 650 66 650 68 for 66 650 72 )( 68 for 70 analyses 69 most 70 analyses some nominally significant effects were observed [(] i.e . , covariate - adjusted differences [between] genotype groups [at] p < 0.05 ) . 0 ###LEFT-WALL### 4 effects 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 9 . 1 some 4 effects 2 nominally 3 significant 3 significant 4 effects 4 effects 5 were 5 were 8 i.e 6 observed 8 i.e 9 . 14 differences 9 . 16 genotype 9 . 23 . 10 , 11 covariate 11 covariate 12 - 11 covariate 14 differences 13 adjusted 14 differences 14 differences 16 genotype 16 genotype 17 groups 17 groups 20 < 19 p 20 < 20 < 21 0.05 20 < 22 ) for apoe , deleterious effects of ε4 " risk " allele presence [(] vs [.] [absence] [ )(were found in the right ventral cingulum and left inferior longitudinal fasciculus . 0 ###LEFT-WALL### 5 effects 0 ###LEFT-WALL### 11 allele 0 ###LEFT-WALL### 30 . 1 for 2 apoe 1 for 3 , 1 for 5 effects 4 deleterious 5 effects 5 effects 6 of 5 effects 11 allele 6 of 9 risk 7 ε4 8 " 7 ε4 9 risk 9 risk 10 " 11 allele 12 presence 12 presence 14 vs 14 vs 25 and 18 )(were 19 found 18 )(were 25 and 19 found 20 in 20 in 24 cingulum 21 the 24 cingulum 22 right 24 cingulum 23 ventral 24 cingulum 25 and 26 left 26 left 29 fasciculus 27 inferior 29 fasciculus 28 longitudinal 29 fasciculus to test for biologically independent effects of the tomm40 523 repeat , participants were stratified into apoe [genotype] subgroups , so that any significant effects could not be attributed to apoe variation . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 12 , 1 to 2 test 2 test 3 for 2 test 10 523 2 test 11 repeat 3 for 6 effects 4 biologically 5 independent 5 independent 6 effects 6 effects 7 of 7 of 9 tomm40 8 the 9 tomm40 10 523 11 repeat 12 , 13 participants 12 , 15 stratified 13 participants 14 were 14 were 15 stratified 15 stratified 16 into 15 stratified 22 that 16 into 19 subgroups 17 apoe 19 subgroups 20 , 22 that 21 so 22 that 22 that 25 effects 22 that 29 attributed 22 that 33 . 23 any 25 effects 24 significant 25 effects 25 effects 26 could 26 could 27 not 26 could 28 be 28 be 29 attributed 29 attributed 30 to 30 to 32 variation 31 apoe 32 variation in participants with the apoe ε3/ε4 [genotype] , effects of tomm40 523 status were found in the left uncinate fasciculus , left rostral cingulum , left ventral cingulum , and a general factor of white matter integrity . 0 ###LEFT-WALL### 9 effects 0 ###LEFT-WALL### 15 found 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 38 . 1 in 2 participants 1 in 9 effects 2 participants 3 with 3 with 5 apoe 4 the 5 apoe 6 ε3/ε4 8 , 6 ε3/ε4 9 effects 9 effects 10 of 9 effects 14 were 10 of 13 status 11 tomm40 12 523 11 tomm40 13 status 14 were 15 found 15 found 16 in 16 in 20 fasciculus 17 the 20 fasciculus 18 left 20 fasciculus 19 uncinate 20 fasciculus 21 , 30 and 22 left 24 cingulum 23 rostral 24 cingulum 24 cingulum 25 , 25 , 28 cingulum 25 , 30 and 26 left 28 cingulum 27 ventral 28 cingulum 29 , 30 and 30 and 33 factor 31 a 33 factor 32 general 33 factor 33 factor 34 of 34 of 37 integrity 35 white 37 integrity 36 matter 37 integrity in all 4 of these tractography measures , carriers of the tomm40 523 " short " allele showed lower white matter integrity when compared with carriers of the " long " and " very [-] long " alleles . 0 ###LEFT-WALL### 9 carriers 0 ###LEFT-WALL### 20 white 0 ###LEFT-WALL### 39 . 1 in 3 4 1 in 8 , 1 in 9 carriers 2 all 3 4 3 4 4 of 4 of 7 measures 5 these 7 measures 6 tractography 7 measures 9 carriers 10 of 9 carriers 17 allele 9 carriers 18 showed 9 carriers 20 white 10 of 12 tomm40 11 the 12 tomm40 12 tomm40 13 523 13 523 14 " 15 short 16 " 15 short 17 allele 17 allele 18 showed 18 showed 19 lower 20 white 22 integrity 20 white 23 when 20 white 25 with 21 matter 22 integrity 23 when 24 compared 25 with 26 carriers 26 carriers 27 of 27 of 38 alleles 28 the 29 " 28 the 38 alleles 30 long 31 " 30 long 32 and 32 and 33 " 32 and 36 long 32 and 38 alleles 34 very 36 long 36 long 37 " most of these effects survived correction for childhood intelligence test scores and vascular disease history , though only the effect of tomm40 523 on the left ventral cingulum integrity survived correction for false discovery rate . 0 ###LEFT-WALL### 4 effects 0 ###LEFT-WALL### 5 survived 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 36 . 1 most 2 of 1 most 4 effects 2 of 4 effects 3 these 4 effects 4 effects 5 survived 5 survived 6 correction 6 correction 7 for 7 for 12 and 8 childhood 11 scores 9 intelligence 11 scores 10 test 11 scores 11 scores 12 and 12 and 15 history 13 vascular 14 disease 14 disease 15 history 16 , 35 rate 17 though 18 only 17 though 30 survived 17 though 35 rate 18 only 20 effect 19 the 20 effect 20 effect 21 of 20 effect 30 survived 21 of 22 tomm40 22 tomm40 23 523 22 tomm40 24 on 24 on 29 integrity 25 the 29 integrity 26 left 29 integrity 27 ventral 28 cingulum 28 cingulum 29 integrity 30 survived 31 correction 30 survived 32 for 32 for 34 discovery 33 false 34 discovery the effects of apoe in this older population are more specific and restricted compared [with] those reported in previous studies , and the effects of tomm40 on white matter integrity appear to be novel , [although] [replication] is required in large independent samples . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 39 required 0 ###LEFT-WALL### 44 . 1 the 2 effects 2 effects 3 of 2 effects 9 are 3 of 4 apoe 4 apoe 5 in 5 in 8 population 6 this 8 population 7 older 8 population 9 are 11 specific 10 more 11 specific 12 and 30 integrity 12 and 35 , 13 restricted 29 matter 14 compared 29 matter 16 those 17 reported 16 those 22 and 17 reported 18 in 18 in 20 studies 19 previous 20 studies 21 , 22 and 22 and 24 effects 22 and 25 of 22 and 29 matter 23 the 24 effects 25 of 26 tomm40 26 tomm40 27 on 27 on 28 white 29 matter 30 integrity 30 integrity 35 , 31 appear 32 to 31 appear 33 be 31 appear 35 , 32 to 33 be 33 be 34 novel 35 , 38 is 38 is 39 required 39 required 40 in 40 in 43 samples 41 large 43 samples 42 independent 43 samples background : appearance - based education shows promise in promoting sunscreen use although [resource] - intensive methods used in prior studies preclude wide dissemination . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 22 preclude 0 ###LEFT-WALL### 25 . 1 background 2 : 2 : 3 appearance 4 - 7 shows 4 - 8 promise 5 based 6 education 6 education 7 shows 7 shows 8 promise 8 promise 9 in 9 in 10 promoting 10 promoting 12 use 10 promoting 13 although 11 sunscreen 12 use 13 although 15 - 15 - 17 methods 16 intensive 17 methods 17 methods 18 used 17 methods 22 preclude 18 used 19 in 19 in 21 studies 20 prior 21 studies 22 preclude 24 dissemination 23 wide 24 dissemination appearance - based video education can be made easily accessible . 0 ###LEFT-WALL### 5 education 0 ###LEFT-WALL### 8 made 0 ###LEFT-WALL### 11 . 1 appearance 2 - 1 appearance 5 education 3 based 4 video 4 video 5 education 5 education 6 can 6 can 7 be 7 be 8 made 8 made 9 easily 8 made 10 accessible objective : we sought to compare the effectiveness [of] appearance - based video education with that of health - based video education in improving sunscreen use and knowledge . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 sought 2 : 29 . 3 we 4 sought 4 sought 5 to 4 sought 22 education 4 sought 23 in 5 to 6 compare 6 compare 10 appearance 7 the 10 appearance 8 effectiveness 10 appearance 10 appearance 14 education 11 - 14 education 12 based 13 video 13 video 14 education 14 education 15 with 14 education 17 of 14 education 19 - 15 with 16 that 17 of 18 health 20 based 21 video 21 video 22 education 23 in 24 improving 24 improving 27 and 25 sunscreen 26 use 26 use 27 and 27 and 28 knowledge design : in a randomized controlled trial , participants viewed either an appearance - based video on ultraviolet - induced premature aging or [a] health - based video emphasizing ultraviolet exposure and skin cancer risk . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 1 design 2 : 2 : 3 in 3 in 7 trial 4 a 7 trial 5 randomized 7 trial 6 controlled 7 trial 8 , 9 participants 8 , 10 viewed 8 , 26 - 9 participants 10 viewed 10 viewed 11 either 10 viewed 13 appearance 12 an 13 appearance 13 appearance 23 or 14 - 23 or 15 based 16 video 16 video 17 on 16 video 23 or 17 on 22 aging 18 ultraviolet 19 - 18 ultraviolet 22 aging 20 induced 22 aging 21 premature 22 aging 23 or 25 health 23 or 26 - 26 - 32 and 26 - 36 . 27 based 28 video 27 based 32 and 28 video 29 emphasizing 29 emphasizing 31 exposure 30 ultraviolet 31 exposure 32 and 33 skin 33 skin 35 risk 34 cancer 35 risk results : fifty high - school students participated in the study , conducted from february through march 2012 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 7 students 2 : 12 , 3 fifty 7 students 4 high 5 - 4 high 7 students 6 school 7 students 7 students 12 , 8 participated 9 in 8 participated 12 , 9 in 11 study 10 the 11 study 12 , 13 conducted 12 , 16 through 13 conducted 14 from 14 from 15 february 16 through 17 march 17 march 18 2012 the health [-] based group had a nonstatistically significant increase in sunscreen use [(] 0.9 ± 1.9 d / [wk] , p = [.] 096 ) , [whereas] the appearance - based group demonstrated a statistically significant [increase] in sunscreen use ( 2.8 ± 2.2 , p < [.] 001 ) . 0 ###LEFT-WALL### 5 group 0 ###LEFT-WALL### 6 had 1 the 5 group 2 health 4 based 4 based 5 group 5 group 6 had 6 had 10 increase 6 had 11 in 6 had 16 ± 7 a 10 increase 8 nonstatistically 9 significant 9 significant 10 increase 11 in 13 use 12 sunscreen 13 use 13 use 15 0.9 16 ± 19 / 17 1.9 18 d 18 d 19 / 19 / 23 = 19 / 31 - 21 , 23 = 22 p 23 = 23 = 25 096 23 = 26 ) 27 , 31 - 29 the 30 appearance 30 appearance 31 - 31 - 41 use 32 based 41 use 33 group 34 demonstrated 34 demonstrated 41 use 35 a 39 in 36 statistically 37 significant 37 significant 39 in 39 in 40 sunscreen 40 sunscreen 41 use 41 use 44 ± 42 ( 44 ± 43 2.8 44 ± 44 ± 45 2.2 44 ± 48 < 44 ± 52 . 46 , 48 < 47 p 48 < 48 < 50 001 48 < 51 ) [between] - group comparisons revealed that the appearance - based group applied sunscreen at significantly greater frequencies compared with the health - based group [(] 2.2 ± 1.4 vs 0.2 ± 0.6 , p < [.] 001 ) . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 5 revealed 0 ###LEFT-WALL### 39 . 2 - 4 comparisons 3 group 4 comparisons 4 comparisons 5 revealed 5 revealed 6 that 6 that 8 appearance 6 that 23 based 7 the 8 appearance 8 appearance 13 sunscreen 8 appearance 23 based 9 - 13 sunscreen 10 based 13 sunscreen 11 group 12 applied 12 applied 13 sunscreen 13 sunscreen 14 at 13 sunscreen 22 - 14 at 17 frequencies 15 significantly 16 greater 16 greater 17 frequencies 17 frequencies 18 compared 18 compared 19 with 19 with 21 health 20 the 21 health 23 based 27 ± 24 group 27 ± 26 2.2 27 ± 27 ± 28 1.4 27 ± 29 vs 29 vs 31 ± 30 0.2 31 ± 31 ± 35 < 32 0.6 35 < 33 , 35 < 34 p 35 < 35 < 37 001 35 < 38 ) knowledge scores significantly improved in both study groups . 0 ###LEFT-WALL### 2 scores 0 ###LEFT-WALL### 7 study 0 ###LEFT-WALL### 9 . 1 knowledge 2 scores 2 scores 4 improved 2 scores 7 study 3 significantly 4 improved 4 improved 5 in 5 in 6 both 7 study 8 groups the difference in knowledge scores between the study groups was not significant . 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 13 . 1 the 2 difference 2 difference 3 in 2 difference 10 was 3 in 5 scores 4 knowledge 5 scores 5 scores 6 between 6 between 9 groups 7 the 9 groups 8 study 9 groups 10 was 11 not 10 was 12 significant 11 not 12 significant limitations : the study population may not reflect the general population . 0 ###LEFT-WALL### 1 limitations 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 . 1 limitations 2 : 2 : 4 study 3 the 4 study 4 study 5 population 4 study 8 reflect 5 population 6 may 6 may 7 not 6 may 8 reflect 8 reflect 11 population 9 the 11 population 10 general 11 population conclusion : appearance - based video education appears to be effective in promoting sunscreen use and knowledge in adolescents . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 20 . 1 conclusion 2 : 2 : 3 appearance 4 - 6 video 5 based 6 video 6 video 7 education 6 video 13 promoting 7 education 8 appears 8 appears 9 to 8 appears 10 be 9 to 10 be 10 be 11 effective 11 effective 12 in 12 in 13 promoting 13 promoting 16 and 13 promoting 18 in 14 sunscreen 15 use 15 use 16 and 16 and 17 knowledge 18 in 19 adolescents the present study investigated the effects of a single intravenous ( i.v [.] ) dose of vitamin c ( ascorbate , asc ) on spatial memory in app/psen1 mice , an alzheimer 's disease model . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 36 . 1 the 3 study 2 present 3 study 3 study 4 investigated 4 investigated 6 effects 4 investigated 24 on 4 investigated 27 in 5 the 6 effects 6 effects 7 of 6 effects 16 of 7 of 15 dose 8 a 15 dose 9 single 15 dose 10 intravenous 12 i.v 10 intravenous 15 dose 11 ( 12 i.v 12 i.v 14 ) 16 of 17 vitamin 17 vitamin 18 c 17 vitamin 20 ascorbate 19 ( 20 ascorbate 20 ascorbate 22 asc 20 ascorbate 23 ) 21 , 22 asc 22 asc 23 ) 24 on 26 memory 25 spatial 26 memory 27 in 29 mice 28 app/psen1 29 mice 30 , 35 model 31 an 32 alzheimer 32 alzheimer 33 's 33 's 35 model 34 disease 35 model first , we confirmed the uptake time course in asc - depleted gulo [(] - [/] - [ )(mice , which cannot synthesize asc . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 confirmed 0 ###LEFT-WALL### 25 . 1 first 2 , 1 first 3 we 3 we 4 confirmed 4 confirmed 8 course 5 the 8 course 6 uptake 8 course 7 time 8 course 8 course 9 in 8 course 21 which 8 course 22 cannot 9 in 10 asc 10 asc 13 gulo 10 asc 19 )(mice 11 - 13 gulo 12 depleted 13 gulo 13 gulo 15 - 17 - 19 )(mice 19 )(mice 20 , 21 which 22 cannot 22 cannot 23 synthesize 23 synthesize 24 asc differential tissue uptake was seen based on asc transporter distribution . 0 ###LEFT-WALL### 2 tissue 0 ###LEFT-WALL### 6 based 0 ###LEFT-WALL### 11 . 1 differential 2 tissue 2 tissue 3 uptake 2 tissue 4 was 2 tissue 5 seen 2 tissue 6 based 3 uptake 4 was 6 based 7 on 6 based 10 distribution 7 on 8 asc 9 transporter 10 distribution liver ( svct1 and svct2 ) asc was elevated at 30 , 60 and 120 min post - treatment ( 125 mg/kg , i.v . [ )(, whereas spleen ( svct2 ) asc increased at 60 and 120 min . 0 ###LEFT-WALL### 7 asc 0 ###LEFT-WALL### 9 elevated 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 24 i.v 0 ###LEFT-WALL### 25 . 1 liver 5 svct2 1 liver 7 asc 2 ( 5 svct2 3 svct1 4 and 4 and 5 svct2 5 svct2 6 ) 7 asc 8 was 8 was 9 elevated 9 elevated 10 at 10 at 11 30 11 30 17 post 11 30 19 treatment 12 , 17 post 13 60 14 and 14 and 15 120 14 and 16 min 16 min 17 post 17 post 18 - 18 - 19 treatment 19 treatment 22 mg/kg 19 treatment 23 , 20 ( 22 mg/kg 21 125 22 mg/kg 22 mg/kg 23 , 23 , 24 i.v 25 . 33 asc 25 . 34 increased 27 )(, 28 whereas 28 whereas 29 spleen 28 whereas 32 ) 28 whereas 33 asc 29 spleen 31 svct2 30 ( 31 svct2 31 svct2 32 ) 33 asc 34 increased 34 increased 35 at 35 at 39 min 36 60 37 and 37 and 38 120 37 and 39 min 39 min 40 . there was no detectable change in cortical ( svct2 at choroid plexus , and neurons ) asc within the 2 - h interval , although the cortex preferentially retained asc . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 1 there 2 was 2 was 5 change 2 was 6 in 2 was 18 within 2 was 25 although 3 no 5 change 4 detectable 5 change 6 in 17 asc 7 cortical 9 svct2 7 cortical 16 ) 7 cortical 17 asc 8 ( 9 svct2 9 svct2 10 at 9 svct2 16 ) 10 at 14 and 11 choroid 12 plexus 12 plexus 14 and 13 , 14 and 14 and 15 neurons 18 within 23 interval 19 the 23 interval 20 2 21 - 21 - 22 h 21 - 23 interval 24 , 25 although 25 although 27 cortex 25 although 29 retained 25 although 31 . 26 the 27 cortex 27 cortex 29 retained 28 preferentially 29 retained 29 retained 30 asc memory declined with age and asc treatment improved performance in 9 - [month] - old app/psen1 and wt mice . 0 ###LEFT-WALL### 1 memory 0 ###LEFT-WALL### 2 declined 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 20 . 1 memory 2 declined 2 declined 3 with 3 with 4 age 5 and 7 treatment 5 and 8 improved 6 asc 7 treatment 7 treatment 8 improved 8 improved 9 performance 8 improved 10 in 10 in 12 - 11 9 12 - 12 - 14 - 14 - 19 mice 15 old 19 mice 16 app/psen1 17 and 17 and 18 wt 18 wt 19 mice app/psen1 mice displayed no behavioral impairment relative to wt controls . 0 ###LEFT-WALL### 2 mice 0 ###LEFT-WALL### 3 displayed 0 ###LEFT-WALL### 11 . 1 app/psen1 2 mice 2 mice 3 displayed 3 displayed 6 impairment 4 no 6 impairment 5 behavioral 6 impairment 6 impairment 7 relative 7 relative 8 to 8 to 10 controls 9 wt 10 controls although dopamine and metabolite dopac decreased in the nucleus accumbens with age , and improved spatial memory was correlated with increased dopamine in saline treated mice , acute asc treatment did not alter monoamine levels in the nucleus accumbens . 0 ###LEFT-WALL### 27 , 0 ###LEFT-WALL### 40 . 1 although 3 and 1 although 19 correlated 1 although 27 , 2 dopamine 3 and 3 and 4 metabolite 3 and 5 dopac 3 and 18 was 3 and 19 correlated 5 dopac 6 decreased 5 dopac 11 with 5 dopac 18 was 6 decreased 7 in 7 in 10 accumbens 8 the 10 accumbens 9 nucleus 10 accumbens 11 with 14 and 12 age 14 and 13 , 14 and 14 and 17 memory 15 improved 17 memory 16 spatial 17 memory 19 correlated 20 with 19 correlated 23 in 20 with 22 dopamine 21 increased 22 dopamine 23 in 24 saline 25 treated 26 mice 25 treated 27 , 27 , 33 alter 28 acute 30 treatment 29 asc 30 treatment 30 treatment 31 did 31 did 32 not 31 did 33 alter 33 alter 35 levels 34 monoamine 35 levels 35 levels 36 in 36 in 39 accumbens 37 the 39 accumbens 38 nucleus 39 accumbens these data show that the modified y [-] maze is sensitive to age - related deficits , but not additional memory deficits due to amyloid pathology in app/psen1 mice . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 30 . 1 these 2 data 2 data 3 show 3 show 4 that 4 that 9 maze 4 that 10 is 5 the 9 maze 6 modified 7 y 6 modified 9 maze 9 maze 10 is 10 is 11 sensitive 11 sensitive 12 to 11 sensitive 18 but 11 sensitive 24 to 11 sensitive 27 in 12 to 13 age 13 age 16 deficits 14 - 16 deficits 15 related 16 deficits 16 deficits 17 , 18 but 19 not 18 but 22 deficits 19 not 20 additional 20 additional 21 memory 21 memory 22 deficits 23 due 24 to 24 to 26 pathology 25 amyloid 26 pathology 27 in 29 mice 28 app/psen1 29 mice they also suggest improvements in short - term spatial memory were not due to changes in the neuropathological features of ad or monoamine signaling . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 25 . 1 they 3 suggest 2 also 3 suggest 3 suggest 4 improvements 3 suggest 11 were 4 improvements 5 in 4 improvements 11 were 5 in 10 memory 6 short 7 - 6 short 8 term 8 term 10 memory 9 spatial 10 memory 11 were 12 not 11 were 14 to 11 were 16 in 13 due 14 to 14 to 15 changes 16 in 19 features 17 the 19 features 18 neuropathological 19 features 19 features 20 of 19 features 24 signaling 20 of 22 or 21 ad 22 or 22 or 23 monoamine advances in treatment have transformed human immunodeficiency virus ( hiv ) [infection] from an inexorable march to severe morbidity and premature death to a manageable chronic condition , often marked by good health . 0 ###LEFT-WALL### 1 advances 0 ###LEFT-WALL### 28 , 0 ###LEFT-WALL### 34 . 1 advances 2 in 1 advances 28 , 2 in 3 treatment 4 have 5 transformed 4 have 28 , 5 transformed 8 virus 5 transformed 13 from 6 human 7 immunodeficiency 7 immunodeficiency 8 virus 8 virus 10 hiv 9 ( 10 hiv 10 hiv 11 ) 13 from 20 and 14 an 15 inexorable 14 an 16 march 15 inexorable 16 march 16 march 17 to 16 march 20 and 17 to 19 morbidity 18 severe 19 morbidity 20 and 22 death 20 and 23 to 21 premature 22 death 23 to 27 condition 24 a 27 condition 25 manageable 27 condition 26 chronic 27 condition 28 , 30 marked 29 often 30 marked 30 marked 31 by 30 marked 33 health 32 good 33 health thus , infected [individuals] [are] living long enough [that] there is a potential for interaction with normal senescence effects on various organ systems , including the brain . 1 thus 2 , 1 thus 6 living 3 infected 6 living 6 living 7 long 6 living 11 is 7 long 8 enough 7 long 10 there 11 is 13 potential 11 is 16 with 12 a 13 potential 13 potential 14 for 14 for 15 interaction 16 with 19 effects 17 normal 18 senescence 18 senescence 19 effects 19 effects 20 on 20 on 23 systems 21 various 22 organ 22 organ 23 systems 23 systems 25 including 24 , 25 including 25 including 27 brain 25 including 28 . 26 the 27 brain to examine this interaction , the brains of 51 individuals with hiv infection and 65 uninfected controls were studied using 351 magnetic resonance imaging and a battery of neuropsychological tests collected 2 or more times [over] follow - up periods ranging from 6 months to 8 years . 0 ###LEFT-WALL### 7 brains 0 ###LEFT-WALL### 19 studied 0 ###LEFT-WALL### 33 or 1 to 2 examine 1 to 5 , 1 to 7 brains 2 examine 4 interaction 3 this 4 interaction 6 the 7 brains 7 brains 8 of 7 brains 18 were 8 of 14 and 9 51 10 individuals 10 individuals 11 with 10 individuals 14 and 11 with 13 infection 12 hiv 13 infection 14 and 17 controls 15 65 17 controls 16 uninfected 17 controls 18 were 19 studied 19 studied 20 using 20 using 21 351 21 351 25 and 21 351 31 collected 22 magnetic 24 imaging 23 resonance 24 imaging 24 imaging 25 and 25 and 27 battery 25 and 28 of 25 and 31 collected 26 a 27 battery 28 of 30 tests 29 neuropsychological 30 tests 31 collected 32 2 33 or 34 more 33 or 35 times 33 or 37 follow 35 times 37 follow 37 follow 39 up 38 - 39 up 39 up 40 periods 39 up 48 . 40 periods 41 ranging 40 periods 42 from 42 from 45 to 43 6 44 months 44 months 45 to 45 to 47 years 46 8 47 years brain tissue regions of interest showed expected age - related decrease in volume ; cerebrospinal fluid - filled spaces showed [increase] in volume for both groups . 0 ###LEFT-WALL### 3 regions 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 10 related 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 27 . 1 brain 2 tissue 2 tissue 3 regions 3 regions 4 of 3 regions 6 showed 4 of 5 interest 6 showed 8 age 7 expected 8 age 9 - 10 related 10 related 11 decrease 10 related 12 in 10 related 14 ; 12 in 13 volume 14 ; 19 spaces 14 ; 20 showed 15 cerebrospinal 19 spaces 16 fluid 17 - 16 fluid 19 spaces 18 filled 19 spaces 19 spaces 20 showed 20 showed 22 in 20 showed 23 volume 20 showed 24 for 24 for 26 groups 25 both 26 groups although hiv - infected individuals were in good general health , and free of clinically [-] detectable dementia , several brain regions supporting higher - order cognition and integration of functions showed acceleration of the normal aging trajectory , including neocortex , which extended from the frontal and temporal poles to the parietal lobe , and the thalamus . 0 ###LEFT-WALL### 5 individuals 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 11 , 1 although 2 hiv 1 although 3 - 1 although 5 individuals 4 infected 5 individuals 5 individuals 6 were 6 were 7 in 7 in 10 health 8 good 9 general 9 general 10 health 11 , 12 and 12 and 22 regions 13 free 14 of 13 free 19 , 13 free 22 regions 14 of 18 dementia 15 clinically 17 detectable 17 detectable 18 dementia 20 several 22 regions 21 brain 22 regions 22 regions 23 supporting 22 regions 30 of 22 regions 32 showed 23 supporting 28 and 24 higher 25 - 24 higher 27 cognition 26 order 27 cognition 27 cognition 28 and 28 and 29 integration 30 of 31 functions 32 showed 33 acceleration 32 showed 40 including 32 showed 43 which 33 acceleration 34 of 34 of 38 trajectory 35 the 38 trajectory 36 normal 38 trajectory 37 aging 38 trajectory 39 , 40 including 40 including 41 neocortex 40 including 42 , 43 which 44 extended 44 extended 45 from 44 extended 50 poles 44 extended 51 to 45 from 48 and 46 the 47 frontal 47 frontal 48 and 48 and 49 temporal 51 to 56 and 52 the 54 lobe 53 parietal 54 lobe 54 lobe 56 and 55 , 56 and 56 and 58 thalamus 56 and 59 . 57 the 58 thalamus beyond an anticipated increase in lateral ventricle [and] sylvian fissure volumes and decrease in tissue volumes ( specifically , the frontal and sensorimotor neocortices , thalamus , and hippocampus ) with longer duration of illness , most regions also showed accelerated disease progression . 0 ###LEFT-WALL### 38 regions 0 ###LEFT-WALL### 40 showed 0 ###LEFT-WALL### 44 . 1 beyond 12 and 1 beyond 30 ) 1 beyond 38 regions 2 an 4 increase 3 anticipated 4 increase 4 increase 5 in 4 increase 12 and 5 in 11 volumes 6 lateral 7 ventricle 7 ventricle 10 fissure 9 sylvian 10 fissure 10 fissure 11 volumes 12 and 13 decrease 12 and 14 in 12 and 28 and 14 in 16 volumes 15 tissue 16 volumes 17 ( 18 specifically 17 ( 28 and 18 specifically 19 , 20 the 21 frontal 21 frontal 22 and 22 and 24 neocortices 22 and 25 , 23 sensorimotor 24 neocortices 25 , 26 thalamus 25 , 28 and 27 , 28 and 28 and 29 hippocampus 28 and 30 ) 31 with 33 duration 31 with 36 , 31 with 38 regions 32 longer 33 duration 33 duration 34 of 34 of 35 illness 37 most 38 regions 38 regions 40 showed 39 also 40 showed 40 showed 43 progression 41 accelerated 42 disease 42 disease 43 progression this accelerated loss of cortical tissue may represent a risk factor for premature cognitive and motor compromise [if] [not] dementia . 0 ###LEFT-WALL### 3 loss 0 ###LEFT-WALL### 8 represent 0 ###LEFT-WALL### 21 . 1 this 3 loss 2 accelerated 3 loss 3 loss 4 of 3 loss 7 may 4 of 6 tissue 5 cortical 6 tissue 7 may 8 represent 8 represent 11 factor 8 represent 12 for 9 a 11 factor 10 risk 11 factor 12 for 20 dementia 13 premature 20 dementia 14 cognitive 15 and 15 and 17 compromise 15 and 20 dementia 16 motor 17 compromise on a more promising note , hiv - infected patients with increasing cd4 counts exhibited slower expansion of sylvian fissure volume and slower declines of frontal and temporoparietal cortices , insula , and hippocampus tissue volumes . 0 ###LEFT-WALL### 10 patients 0 ###LEFT-WALL### 15 exhibited 0 ###LEFT-WALL### 37 . 1 on 5 note 1 on 8 - 1 on 10 patients 2 a 5 note 3 more 4 promising 4 promising 5 note 5 note 7 hiv 6 , 7 hiv 7 hiv 8 - 9 infected 10 patients 10 patients 11 with 10 patients 13 cd4 10 patients 14 counts 10 patients 15 exhibited 11 with 12 increasing 13 cd4 14 counts 15 exhibited 33 and 16 slower 17 expansion 17 expansion 18 of 17 expansion 22 and 18 of 21 volume 19 sylvian 21 volume 20 fissure 21 volume 22 and 24 declines 22 and 25 of 22 and 31 insula 22 and 33 and 23 slower 24 declines 25 of 29 cortices 26 frontal 27 and 27 and 28 temporoparietal 27 and 29 cortices 30 , 31 insula 31 insula 32 , 33 and 36 volumes 34 hippocampus 36 volumes 35 tissue 36 volumes thus , attenuated shrinkage of these brain regions , likely with adequate pharmacologic treatment and control of further infection , has the potential of abating decline in associated higher - order functions , notably [,] explicit memory , executive functions , self - regulation , and visuospatial abilities . 0 ###LEFT-WALL### 4 shrinkage 0 ###LEFT-WALL### 21 has 0 ###LEFT-WALL### 41 , 1 thus 2 , 1 thus 4 shrinkage 3 attenuated 4 shrinkage 4 shrinkage 5 of 4 shrinkage 10 likely 4 shrinkage 21 has 5 of 8 regions 6 these 8 regions 7 brain 8 regions 9 , 10 likely 10 likely 11 with 10 likely 20 , 11 with 15 and 12 adequate 14 treatment 13 pharmacologic 14 treatment 14 treatment 15 and 15 and 16 control 16 control 17 of 17 of 19 infection 18 further 19 infection 21 has 23 potential 21 has 26 decline 22 the 23 potential 23 potential 24 of 24 of 25 abating 26 decline 27 in 27 in 32 functions 28 associated 32 functions 29 higher 30 - 29 higher 32 functions 31 order 32 functions 32 functions 37 memory 33 , 37 memory 34 notably 36 explicit 36 explicit 37 memory 37 memory 40 functions 37 memory 41 , 38 , 40 functions 39 executive 40 functions 40 functions 41 , 41 , 42 self 41 , 43 - 43 - 46 and 43 - 49 . 44 regulation 46 and 45 , 46 and 46 and 48 abilities 47 visuospatial 48 abilities low carotenoid status ( especially of the xanthophylls , lutein [ l ] , [and] zeaxanthin [ z ] ) is common in older adults and has been associated with a number of degenerative diseases of the central nervous system ranging from retina [(] e.g [.] , macular degeneration ) to brain ( e.g [.] , alzheimer 's disease ) . 0 ###LEFT-WALL### 3 status 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 61 . 1 low 3 status 2 carotenoid 3 status 3 status 6 of 3 status 10 lutein 3 status 16 zeaxanthin 3 status 26 and 4 ( 5 especially 4 ( 6 of 6 of 8 xanthophylls 6 of 9 , 7 the 8 xanthophylls 9 , 10 lutein 10 lutein 12 l 10 lutein 14 , 11 [ 12 l 12 l 13 ] 14 , 16 zeaxanthin 16 zeaxanthin 18 z 16 zeaxanthin 20 ) 17 [ 18 z 18 z 19 ] 21 is 22 common 21 is 26 and 22 common 23 in 23 in 25 adults 24 older 25 adults 26 and 27 has 26 and 30 with 27 has 28 been 28 been 29 associated 30 with 35 diseases 31 a 32 number 32 number 33 of 32 number 35 diseases 33 of 35 diseases 34 degenerative 35 diseases 35 diseases 36 of 36 of 40 system 37 the 40 system 38 central 40 system 39 nervous 40 system 40 system 41 ranging 40 system 54 e.g 41 ranging 42 from 41 ranging 51 to 42 from 45 e.g 43 retina 45 e.g 45 e.g 49 degeneration 47 , 49 degeneration 48 macular 49 degeneration 49 degeneration 50 ) 51 to 52 brain 53 ( 54 e.g 54 e.g 59 disease 54 e.g 60 ) 56 , 59 disease 57 alzheimer 58 's 58 's 59 disease 59 disease 60 ) in this study , we tested whether retinal measures of l + z [(] macular pigment optical density [ mpod ] [ )(, used as a surrogate for brain l + z levels , were related to [cognitive] function when comparing healthy older adults with mildly cognitively impaired older adults . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 tested 0 ###LEFT-WALL### 51 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 tested 6 tested 7 whether 7 whether 9 measures 7 whether 36 related 8 retinal 9 measures 9 measures 10 of 9 measures 35 were 10 of 18 density 11 l 12 + 12 + 13 z 12 + 18 density 15 macular 16 pigment 16 pigment 18 density 17 optical 18 density 18 density 20 mpod 18 density 24 used 19 [ 20 mpod 20 mpod 21 ] 23 )(, 24 used 24 used 25 as 24 used 28 for 24 used 34 , 25 as 27 surrogate 26 a 27 surrogate 28 for 33 levels 29 brain 33 levels 30 l 31 + 31 + 32 z 31 + 33 levels 35 were 36 related 36 related 37 to 36 related 40 when 36 related 45 with 37 to 39 function 40 when 41 comparing 41 comparing 44 adults 42 healthy 44 adults 43 older 44 adults 45 with 50 adults 46 mildly 48 impaired 47 cognitively 48 impaired 48 impaired 50 adults 49 older 50 adults twenty - four subjects with mild cognitive impairment were compared with 24 matched controls . 0 ###LEFT-WALL### 4 subjects 0 ###LEFT-WALL### 10 compared 0 ###LEFT-WALL### 15 . 1 twenty 2 - 2 - 3 four 2 - 4 subjects 4 subjects 5 with 4 subjects 9 were 5 with 8 impairment 6 mild 8 impairment 7 cognitive 8 impairment 9 were 10 compared 10 compared 11 with 11 with 14 controls 12 24 14 controls 13 matched 14 controls subjects were matched with respect to age , body mass index , ethnicity , sex , and smoking status . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 3 matched 0 ###LEFT-WALL### 20 . 1 subjects 2 were 2 were 3 matched 3 matched 4 with 3 matched 6 to 4 with 5 respect 6 to 17 and 7 age 8 , 8 , 11 index 8 , 12 , 9 body 11 index 10 mass 11 index 12 , 13 ethnicity 12 , 14 , 14 , 15 sex 14 , 17 and 16 , 17 and 17 and 19 status 18 smoking 19 status degree of cognitive impairment and cognitive ability was determined [via] structured clinical interview . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 13 interview 0 ###LEFT-WALL### 14 . 1 degree 2 of 1 degree 5 and 2 of 4 impairment 3 cognitive 4 impairment 5 and 6 cognitive 5 and 7 ability 5 and 8 was 5 and 9 determined 5 and 11 structured 5 and 13 interview 7 ability 8 was 11 structured 12 clinical mpod was measured psychophysically . 0 ###LEFT-WALL### 1 mpod 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 5 . 1 mpod 2 was 2 was 3 measured 3 measured 4 psychophysically in healthy older adults , mpod was only related to visual - spatial and constructional abilities ( p = 0.04 ) . 0 ###LEFT-WALL### 6 mpod 0 ###LEFT-WALL### 9 related 0 ###LEFT-WALL### 22 . 1 in 4 adults 1 in 5 , 1 in 6 mpod 2 healthy 4 adults 3 older 4 adults 6 mpod 7 was 7 was 9 related 8 only 9 related 9 related 10 to 10 to 16 abilities 11 visual 12 - 11 visual 16 abilities 13 spatial 14 and 14 and 15 constructional 14 and 16 abilities 16 abilities 19 = 17 ( 19 = 18 p 19 = 19 = 20 0.04 19 = 21 ) for subjects with mild cognitive impairment ( mci ) , however , mpod was broadly related to cognition including the composite score on the mini - mental state examination ( p = 0.02 ) , visual - spatial and constructional abilities ( p = 0.04 ) , language ability ( p = 0.05 ) , attention ( p = 0.03 ) , and the total scale on the repeatable battery for the assessment of neuropsychological status ( p = 0.03 ) . 0 ###LEFT-WALL### 13 mpod 0 ###LEFT-WALL### 16 related 0 ###LEFT-WALL### 35 , 0 ###LEFT-WALL### 82 . 1 for 2 subjects 1 for 13 mpod 2 subjects 3 with 3 with 6 impairment 4 mild 6 impairment 5 cognitive 6 impairment 6 impairment 8 mci 7 ( 8 mci 8 mci 9 ) 10 , 11 however 11 however 12 , 11 however 13 mpod 13 mpod 14 was 14 was 15 broadly 14 was 16 related 16 related 17 to 16 related 23 on 17 to 18 cognition 18 cognition 19 including 19 including 22 score 20 the 22 score 21 composite 22 score 23 on 29 examination 24 the 29 examination 25 mini 26 - 25 mini 28 state 27 mental 28 state 28 state 29 examination 29 examination 32 = 30 ( 32 = 31 p 32 = 32 = 33 0.02 32 = 34 ) 35 , 63 and 35 , 66 scale 36 visual 37 - 36 visual 63 and 38 spatial 39 and 39 and 41 abilities 39 and 44 = 39 and 49 ability 39 and 63 and 40 constructional 41 abilities 42 ( 44 = 43 p 44 = 44 = 45 0.04 44 = 46 ) 47 , 49 ability 48 language 49 ability 49 ability 52 = 49 ability 56 attention 49 ability 62 , 50 ( 52 = 51 p 52 = 52 = 53 0.05 52 = 54 ) 55 , 56 attention 56 attention 59 = 56 attention 61 ) 57 ( 59 = 58 p 59 = 59 = 60 0.03 62 , 63 and 63 and 65 total 63 and 66 scale 64 the 65 total 66 scale 67 on 66 scale 70 battery 66 scale 71 for 66 scale 79 = 68 the 70 battery 69 repeatable 70 battery 71 for 73 assessment 72 the 73 assessment 73 assessment 74 of 74 of 76 status 75 neuropsychological 76 status 77 ( 79 = 78 p 79 = 79 = 80 0.03 79 = 81 ) it is possible that l/z status may be more strongly related to cognition when individuals are considered [with] established [onset] [of] cognitive [decline] . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 24 . 1 it 2 is 2 is 3 possible 3 possible 4 that 4 that 6 status 4 that 11 related 5 l/z 6 status 6 status 7 may 7 may 8 be 8 be 10 strongly 8 be 11 related 9 more 10 strongly 11 related 12 to 11 related 14 when 11 related 22 cognitive 12 to 13 cognition 14 when 15 individuals 14 when 17 considered 15 individuals 16 are 16 are 17 considered 17 considered 19 established deficiency in energy metabolisms is perhaps the earliest modifiable defect in brain aging and sporadic alzheimer 's disease [(] [sad] ) . 0 ###LEFT-WALL### 1 deficiency 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 22 . 1 deficiency 2 in 1 deficiency 5 is 2 in 4 metabolisms 3 energy 4 metabolisms 5 is 6 perhaps 5 is 10 defect 7 the 8 earliest 7 the 10 defect 9 modifiable 10 defect 10 defect 11 in 11 in 14 and 12 brain 13 aging 12 brain 14 and 14 and 18 disease 14 and 21 ) 15 sporadic 16 alzheimer 16 alzheimer 17 's 17 's 18 disease several high - energy compounds ( hecs [ )(such as atp , phosphoenolpyruvate , phosphocreatine and acetyl coenzyme a have been shown to exhibit neuroprotective effects . 0 ###LEFT-WALL### 5 compounds 0 ###LEFT-WALL### 13 phosphoenolpyruvate 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 27 . 1 several 5 compounds 2 high 3 - 2 high 4 energy 4 energy 5 compounds 5 compounds 7 hecs 5 compounds 13 phosphoenolpyruvate 6 ( 7 hecs 7 hecs 10 as 7 hecs 12 , 9 )(such 10 as 10 as 11 atp 14 , 16 and 14 , 22 shown 15 phosphocreatine 16 and 16 and 18 coenzyme 16 and 20 have 17 acetyl 18 coenzyme 18 coenzyme 19 a 20 have 21 been 21 been 22 shown 22 shown 23 to 23 to 24 exhibit 24 exhibit 26 effects 25 neuroprotective 26 effects to understand their mechanism of actions , we tested the effects of these hecs on intracellular ca ( 2+ ) , a central regulator [in] brain function . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 understand 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 28 . 1 to 2 understand 2 understand 4 mechanism 3 their 4 mechanism 4 mechanism 5 of 5 of 6 actions 7 , 8 we 7 , 9 tested 7 , 21 , 8 we 9 tested 9 tested 11 effects 9 tested 15 on 10 the 11 effects 11 effects 12 of 12 of 14 hecs 13 these 14 hecs 15 on 17 ca 16 intracellular 17 ca 17 ca 19 2+ 18 ( 19 2+ 19 2+ 20 ) 21 , 27 function 22 a 23 central 22 a 27 function 23 central 24 regulator 24 regulator 27 function 26 brain 27 function our data showed that the hecs robustly and dose - dependently [mobilized] intracellular ca ( 2+ ) in cultured sh - sy5y cells , and the actions were sensitive to intracellular ca ( 2+ ) chelator bapta - am or energy metabolism blocker rotenone . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 10 - 1 our 2 data 2 data 8 and 3 showed 4 that 3 showed 6 hecs 3 showed 7 robustly 3 showed 8 and 5 the 6 hecs 8 and 9 dose 10 - 13 intracellular 10 - 28 were 10 - 38 - 11 dependently 13 intracellular 13 intracellular 28 were 14 ca 16 2+ 14 ca 18 in 14 ca 25 and 15 ( 16 2+ 16 2+ 17 ) 18 in 20 sh 19 cultured 20 sh 20 sh 23 cells 21 - 23 cells 22 sy5y 23 cells 23 cells 24 , 24 , 25 and 25 and 27 actions 25 and 28 were 26 the 27 actions 28 were 29 sensitive 29 sensitive 30 to 30 to 37 bapta 31 intracellular 36 chelator 32 ca 34 2+ 32 ca 36 chelator 33 ( 34 2+ 34 2+ 35 ) 36 chelator 37 bapta 38 - 40 or 39 am 40 or 40 or 44 rotenone 40 or 45 . 41 energy 43 blocker 42 metabolism 43 blocker 43 blocker 44 rotenone the ca ( 2+ ) influx triggered by the hecs was from both extracellular medium and intracellular stores and the hecs also induced repetitive ca ( 2+ ) oscillations . 0 ###LEFT-WALL### 6 influx 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 19 and 1 the 6 influx 2 ca 4 2+ 2 ca 6 influx 3 ( 4 2+ 4 2+ 5 ) 6 influx 7 triggered 6 influx 11 was 7 triggered 8 by 8 by 10 hecs 9 the 10 hecs 11 was 12 from 12 from 18 stores 13 both 18 stores 14 extracellular 18 stores 15 medium 16 and 16 and 17 intracellular 16 and 18 stores 19 and 21 hecs 19 and 23 induced 20 the 21 hecs 21 hecs 23 induced 22 also 23 induced 23 induced 25 ca 24 repetitive 25 ca 25 ca 29 oscillations 26 ( 29 oscillations 27 2+ 28 ) 27 2+ 29 oscillations 29 oscillations 30 . as these actions were similar to those of classical ca ( 2+ ) agonists , the hecs may be viewed as a new group of physiological ca ( 2+ ) agonists . 1 as 3 actions 1 as 4 were 1 as 15 , 1 as 17 hecs 2 these 3 actions 3 actions 4 were 4 were 5 similar 5 similar 6 to 6 to 7 those 7 those 8 of 7 those 14 agonists 8 of 10 ca 9 classical 10 ca 11 ( 14 agonists 12 2+ 13 ) 12 2+ 14 agonists 14 agonists 15 , 16 the 17 hecs 17 hecs 18 may 18 may 19 be 19 be 20 viewed 20 viewed 21 as 21 as 27 ca 22 a 24 group 23 new 24 group 24 group 25 of 24 group 27 ca 25 of 27 ca 26 physiological 27 ca 27 ca 31 agonists 28 ( 31 agonists 29 2+ 30 ) 29 2+ 31 agonists 31 agonists 32 . we also found that the hecs promoted the intracellular activity of calpain , a ca ( 2+ ) - dependent protease , and the enzyme activity fluctuated in concert with cellular energy levels , suggesting that calpain activity may also be energy - [driven] or energy - dependent . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 19 - 1 we 3 found 2 also 3 found 3 found 4 that 4 that 6 hecs 4 that 7 promoted 5 the 6 hecs 6 hecs 7 promoted 7 promoted 10 activity 8 the 10 activity 9 intracellular 10 activity 10 activity 11 of 11 of 12 calpain 12 calpain 15 ca 13 , 15 ca 14 a 15 ca 15 ca 17 2+ 15 ca 18 ) 16 ( 17 2+ 17 2+ 18 ) 19 - 26 activity 19 - 27 fluctuated 19 - 34 , 19 - 41 be 19 - 47 - 20 dependent 26 activity 21 protease 23 and 22 , 23 and 23 and 25 enzyme 23 and 26 activity 24 the 25 enzyme 26 activity 27 fluctuated 27 fluctuated 29 concert 27 fluctuated 30 with 28 in 29 concert 30 with 33 levels 31 cellular 32 energy 32 energy 33 levels 34 , 41 be 35 suggesting 38 activity 35 suggesting 39 may 36 that 38 activity 37 calpain 38 activity 39 may 41 be 40 also 41 be 41 be 45 or 42 energy 45 or 43 - 45 or 45 or 46 energy 47 - 48 dependent 47 - 49 . these findings may add to current knowledge for the regulatory mechanisms of ca ( 2+ ) and calpain . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 add 0 ###LEFT-WALL### 19 . 1 these 2 findings 2 findings 3 may 3 may 4 add 4 add 5 to 5 to 7 knowledge 6 current 7 knowledge 7 knowledge 8 for 8 for 11 mechanisms 9 the 11 mechanisms 10 regulatory 11 mechanisms 11 mechanisms 12 of 12 of 17 and 13 ca 15 2+ 13 ca 17 and 14 ( 15 2+ 15 2+ 16 ) 17 and 18 calpain since ca ( 2+ ) and calpain undergo critical dysfunction in brain aging but the underlying mechanisms remain elusive , our work may provide a new perspective for clarifying some controversies . 0 ###LEFT-WALL### 8 undergo 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 32 . 1 since 6 and 1 since 8 undergo 2 ca 4 2+ 2 ca 6 and 3 ( 4 2+ 4 2+ 5 ) 6 and 7 calpain 8 undergo 10 dysfunction 8 undergo 11 in 9 critical 10 dysfunction 11 in 12 brain 12 brain 13 aging 14 but 17 mechanisms 14 but 20 , 15 the 17 mechanisms 16 underlying 17 mechanisms 17 mechanisms 20 , 18 remain 19 elusive 18 remain 20 , 20 , 24 provide 21 our 22 work 22 work 23 may 23 may 24 provide 24 provide 27 perspective 25 a 26 new 25 a 27 perspective 26 new 27 perspective 27 perspective 28 for 28 for 29 clarifying 29 clarifying 31 controversies 30 some 31 controversies more importantly , the hecs , as key intermediates in glucose catabolism , the primary source of energy supply in the brain , may be used as potential drugs for rational prevention [of] [sad] . 0 ###LEFT-WALL### 5 hecs 0 ###LEFT-WALL### 25 be 0 ###LEFT-WALL### 35 . 1 more 2 importantly 2 importantly 3 , 2 importantly 5 hecs 4 the 5 hecs 5 hecs 7 as 5 hecs 16 source 5 hecs 24 may 6 , 7 as 7 as 9 intermediates 7 as 13 , 8 key 9 intermediates 9 intermediates 10 in 10 in 12 catabolism 11 glucose 12 catabolism 13 , 16 source 14 the 16 source 15 primary 16 source 16 source 17 of 16 source 20 in 16 source 23 , 17 of 19 supply 18 energy 19 supply 20 in 22 brain 21 the 22 brain 24 may 25 be 25 be 29 drugs 26 used 29 drugs 27 as 28 potential 28 potential 29 drugs 29 drugs 30 for 30 for 32 prevention 31 rational 32 prevention few research papers in economics have examined the extent , causes or consequences of physical stature decline in aging populations . 0 ###LEFT-WALL### 3 papers 0 ###LEFT-WALL### 7 examined 0 ###LEFT-WALL### 21 . 1 few 3 papers 2 research 3 papers 3 papers 4 in 3 papers 6 have 4 in 5 economics 6 have 7 examined 7 examined 12 or 7 examined 17 decline 8 the 9 extent 9 extent 10 , 10 , 11 causes 10 , 12 or 12 or 13 consequences 12 or 14 of 12 or 17 decline 14 of 16 stature 15 physical 16 stature 17 decline 18 in 18 in 19 aging 19 aging 20 populations using repeated observations on objectively measured data from the english longitudinal study of aging ( elsa ) , we document that reduction in height is an important phenomenon among respondents aged 50 [and] [over] . 0 ###LEFT-WALL### 19 we 0 ###LEFT-WALL### 20 document 0 ###LEFT-WALL### 35 . 1 using 3 observations 1 using 18 , 1 using 19 we 2 repeated 3 observations 3 observations 4 on 3 observations 8 from 3 observations 13 of 4 on 7 data 5 objectively 6 measured 6 measured 7 data 8 from 12 study 9 the 12 study 10 english 12 study 11 longitudinal 12 study 13 of 14 aging 14 aging 16 elsa 15 ( 16 elsa 16 elsa 17 ) 19 we 20 document 20 document 22 reduction 20 document 25 is 21 that 22 reduction 22 reduction 23 in 22 reduction 25 is 23 in 24 height 25 is 28 phenomenon 26 an 27 important 26 an 28 phenomenon 27 important 28 phenomenon 28 phenomenon 29 among 29 among 30 respondents 30 respondents 31 aged 31 aged 32 50 on average , physical stature [decline] occurs at an annual rate of between 0.08 [%] and 0.10 % for males , [and] 0.12 [%] and 0.14 % for females - which approximately translates into a 2 - 4 cm reduction in height over the life course . 0 ###LEFT-WALL### 5 stature 0 ###LEFT-WALL### 7 occurs 0 ###LEFT-WALL### 47 . 1 on 2 average 2 average 3 , 2 average 5 stature 4 physical 5 stature 5 stature 7 occurs 7 occurs 8 at 7 occurs 43 over 8 at 11 rate 9 an 10 annual 9 an 11 rate 10 annual 11 rate 11 rate 12 of 12 of 18 % 13 between 16 and 14 0.08 16 and 16 and 17 0.10 16 and 18 % 18 % 19 for 18 % 31 which 18 % 33 translates 19 for 20 males 20 males 27 % 21 , 27 % 23 0.12 25 and 25 and 26 0.14 25 and 27 % 27 % 28 for 27 % 30 - 28 for 29 females 31 which 33 translates 32 approximately 33 translates 33 translates 34 into 33 translates 41 in 34 into 40 reduction 35 a 40 reduction 36 2 37 - 37 - 38 4 37 - 39 cm 39 cm 40 reduction 41 in 42 height 43 over 46 course 44 the 46 course 45 life 46 course since height is commonly used as a measure of long - run health , our results demonstrate that failing to take age - related height loss into account substantially overstates the health advantage of older birth cohorts relative to their younger counterparts . 0 ###LEFT-WALL### 16 results 0 ###LEFT-WALL### 17 demonstrate 0 ###LEFT-WALL### 43 . 1 since 2 height 1 since 3 is 1 since 16 results 2 height 3 is 3 is 4 commonly 3 is 5 used 6 as 13 health 6 as 14 , 6 as 16 results 7 a 8 measure 8 measure 9 of 8 measure 13 health 9 of 13 health 10 long 11 - 10 long 13 health 12 run 13 health 15 our 16 results 16 results 17 demonstrate 17 demonstrate 18 that 18 that 19 failing 18 that 30 overstates 19 failing 20 to 19 failing 21 take 19 failing 30 overstates 20 to 21 take 21 take 22 age 23 - 24 related 24 related 26 loss 24 related 28 account 24 related 29 substantially 24 related 30 overstates 25 height 26 loss 27 into 28 account 30 overstates 33 advantage 31 the 33 advantage 32 health 33 advantage 33 advantage 34 of 34 of 37 cohorts 35 older 36 birth 36 birth 37 cohorts 37 cohorts 38 relative 38 relative 39 to 39 to 42 counterparts 40 their 42 counterparts 41 younger 42 counterparts we also show that there is an absence of consistent predictors of physical stature [decline] at the individual level . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 20 . 1 we 3 show 2 also 3 show 3 show 4 that 4 that 5 there 4 that 6 is 5 there 6 is 6 is 8 absence 6 is 16 at 7 an 8 absence 8 absence 9 of 8 absence 12 of 9 of 11 predictors 10 consistent 11 predictors 12 of 14 stature 13 physical 14 stature 16 at 19 level 17 the 19 level 18 individual 19 level however , we demonstrate how deteriorating health and reductions in height occur simultaneously . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 demonstrate 0 ###LEFT-WALL### 14 . 1 however 2 , 1 however 3 we 3 we 4 demonstrate 4 demonstrate 5 how 5 how 8 and 5 how 12 occur 6 deteriorating 7 health 7 health 8 and 8 and 9 reductions 8 and 10 in 8 and 12 occur 10 in 11 height 12 occur 13 simultaneously we document that declines in muscle mass and bone density [are] likely to be the mechanism through which these effects are operating . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 14 be 0 ###LEFT-WALL### 23 . 1 we 8 and 2 document 3 that 2 document 8 and 3 that 4 declines 3 that 7 mass 4 declines 5 in 4 declines 7 mass 5 in 6 muscle 8 and 9 bone 9 bone 10 density 10 density 12 likely 12 likely 13 to 13 to 14 be 14 be 16 mechanism 15 the 16 mechanism 16 mechanism 17 through 17 through 18 which 17 through 20 effects 17 through 21 are 19 these 20 effects 20 effects 21 are 21 are 22 operating if this physical stature decline is determined by deteriorating health in adulthood , the coefficient [on] measured height when used as an input in a typical empirical health production function will be affected by reverse causality . 0 ###LEFT-WALL### 15 coefficient 0 ###LEFT-WALL### 17 measured 0 ###LEFT-WALL### 37 . 1 if 5 decline 1 if 7 determined 1 if 13 , 1 if 15 coefficient 2 this 5 decline 3 physical 4 stature 4 stature 5 decline 5 decline 6 is 6 is 7 determined 7 determined 8 by 7 determined 11 in 8 by 10 health 9 deteriorating 10 health 11 in 12 adulthood 14 the 15 coefficient 15 coefficient 17 measured 17 measured 18 height 17 measured 19 when 17 measured 21 as 17 measured 24 in 19 when 20 used 21 as 23 input 22 an 23 input 24 in 36 causality 25 a 26 typical 25 a 36 causality 26 typical 28 health 27 empirical 28 health 28 health 29 production 29 production 31 will 30 function 31 will 31 will 32 be 32 be 33 affected 33 affected 34 by 34 by 35 reverse while our analysis details the inherent difficulties associated with measuring height in older populations , we do not find that significant bias arises in typical empirical health production functions from the use of height which has not been adjusted for physical stature decline . 0 ###LEFT-WALL### 7 difficulties 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 43 decline 0 ###LEFT-WALL### 44 . 1 while 4 details 1 while 7 difficulties 2 our 4 details 3 analysis 4 details 5 the 7 difficulties 6 inherent 7 difficulties 7 difficulties 8 associated 8 associated 9 with 9 with 10 measuring 10 measuring 11 height 10 measuring 12 in 12 in 14 populations 13 older 14 populations 15 , 16 we 15 , 19 find 16 we 17 do 17 do 18 not 17 do 19 find 19 find 20 that 20 that 22 bias 20 that 23 arises 21 significant 22 bias 22 bias 23 arises 23 arises 24 in 24 in 27 health 25 typical 27 health 26 empirical 27 health 27 health 29 functions 27 health 43 decline 28 production 29 functions 29 functions 30 from 29 functions 33 of 29 functions 43 decline 30 from 32 use 31 the 32 use 33 of 34 height 34 height 35 which 34 height 36 has 35 which 36 has 36 has 37 not 36 has 38 been 38 been 39 adjusted 39 adjusted 40 for 40 for 42 stature 41 physical 42 stature therefore , our results validate the use of height among the population aged over 50 . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 validate 0 ###LEFT-WALL### 16 . 1 therefore 2 , 1 therefore 4 results 3 our 4 results 4 results 5 validate 5 validate 7 use 5 validate 10 among 6 the 7 use 7 use 8 of 8 of 9 height 10 among 12 population 11 the 12 population 12 population 13 aged 13 aged 14 over 14 over 15 50 none clinical trials with new drugs for chronic obstructive pulmonary disease ( copd ) have been performed . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 17 performed 0 ###LEFT-WALL### 18 . 1 none 3 trials 1 none 16 been 1 none 17 performed 2 clinical 3 trials 3 trials 4 with 3 trials 15 have 4 with 6 drugs 5 new 6 drugs 6 drugs 7 for 7 for 11 disease 8 chronic 11 disease 9 obstructive 11 disease 10 pulmonary 11 disease 11 disease 13 copd 12 ( 13 copd 13 copd 14 ) 15 have 16 been viruses exacerbate copd and bacteria may play a part in severe copd ; therefore , antibiotic and antiviral approaches have a sound rationale . 0 ###LEFT-WALL### 1 viruses 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 24 . 1 viruses 4 and 2 exacerbate 3 copd 2 exacerbate 4 and 4 and 7 play 4 and 10 in 5 bacteria 6 may 6 may 7 play 7 play 9 part 8 a 9 part 10 in 12 copd 11 severe 12 copd 13 ; 19 approaches 13 ; 20 have 14 therefore 15 , 14 therefore 19 approaches 16 antibiotic 17 and 17 and 18 antiviral 17 and 19 approaches 19 approaches 20 have 20 have 23 rationale 21 a 22 sound 21 a 23 rationale 22 sound 23 rationale antiinflammatory approaches have been studied . 0 ###LEFT-WALL### 2 approaches 0 ###LEFT-WALL### 5 studied 0 ###LEFT-WALL### 6 . 1 antiinflammatory 2 approaches 2 approaches 3 have 3 have 4 been 4 been 5 studied advances in understanding the molecular basis of other processes have resulted in novel drugs to target reactive oxidant species , mucus , proteases , fibrosis , cachexia , and muscle wasting , and accelerated aging . 0 ###LEFT-WALL### 1 advances 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 36 . 1 advances 2 in 1 advances 7 of 1 advances 33 and 2 in 3 understanding 3 understanding 6 basis 4 the 6 basis 5 molecular 6 basis 7 of 9 processes 8 other 9 processes 10 have 11 resulted 10 have 33 and 11 resulted 12 in 12 in 14 drugs 13 novel 14 drugs 14 drugs 15 to 15 to 29 and 16 target 19 species 17 reactive 18 oxidant 18 oxidant 19 species 19 species 20 , 20 , 21 mucus 20 , 22 , 22 , 23 proteases 22 , 24 , 24 , 25 fibrosis 24 , 26 , 26 , 27 cachexia 26 , 29 and 28 , 29 and 29 and 31 wasting 29 and 32 , 30 muscle 31 wasting 32 , 33 and 33 and 34 accelerated 34 accelerated 35 aging studies with monoclonal antibodies have been disappointing , highlighting the tendency for infections and malignancies during treatment . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 6 been 1 studies 2 with 1 studies 5 have 2 with 4 antibodies 3 monoclonal 4 antibodies 5 have 6 been 6 been 7 disappointing 7 disappointing 9 highlighting 8 , 9 highlighting 9 highlighting 11 tendency 9 highlighting 16 during 9 highlighting 18 . 10 the 11 tendency 11 tendency 12 for 12 for 14 and 13 infections 14 and 14 and 15 malignancies 16 during 17 treatment promising future directions are lung regeneration with retinoids and stem cells . 0 ###LEFT-WALL### 3 directions 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 12 . 1 promising 3 directions 2 future 3 directions 3 directions 4 are 4 are 9 and 5 lung 6 regeneration 6 regeneration 7 with 6 regeneration 9 and 7 with 8 retinoids 9 and 11 cells 10 stem 11 cells low - frequency coding dna sequence variants in the proprotein convertase subtilisin/kexin type 9 gene ( pcsk9 ) lower plasma low - density lipoprotein cholesterol ( ldl - c ) , protect against risk of coronary heart disease ( chd ) , and have prompted the development of a new class of therapeutics . 0 ###LEFT-WALL### 7 variants 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 54 . 1 low 2 - 1 low 3 frequency 3 frequency 4 coding 4 coding 7 variants 5 dna 6 sequence 6 sequence 7 variants 7 variants 8 in 7 variants 31 , 8 in 15 gene 9 the 15 gene 10 proprotein 11 convertase 11 convertase 15 gene 12 subtilisin/kexin 15 gene 13 type 15 gene 14 9 15 gene 15 gene 17 pcsk9 16 ( 17 pcsk9 17 pcsk9 18 ) 19 lower 25 cholesterol 19 lower 31 , 20 plasma 25 cholesterol 21 low 22 - 21 low 23 density 23 density 25 cholesterol 24 lipoprotein 25 cholesterol 25 cholesterol 28 - 26 ( 28 - 27 ldl 28 - 28 - 29 c 28 - 30 ) 31 , 43 and 32 protect 33 against 32 protect 38 disease 32 protect 43 and 33 against 34 risk 34 risk 35 of 35 of 37 heart 36 coronary 37 heart 38 disease 40 chd 39 ( 40 chd 40 chd 41 ) 42 , 43 and 43 and 44 have 44 have 45 prompted 45 prompted 47 development 46 the 47 development 47 development 48 of 47 development 52 of 48 of 51 class 49 a 50 new 49 a 51 class 50 new 51 class 52 of 53 therapeutics it is uncertain whether the pcsk9 example represents a paradigm or an isolated exception . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 15 . 1 it 2 is 2 is 3 uncertain 3 uncertain 4 whether 4 whether 7 example 4 whether 8 represents 5 the 7 example 6 pcsk9 7 example 7 example 8 represents 8 represents 11 or 9 a 10 paradigm 10 paradigm 11 or 11 or 14 exception 12 an 13 isolated 12 an 14 exception 13 isolated 14 exception we used the " exome array " to genotype >200,000 low - frequency and rare coding sequence variants across the genome in 56,538 individuals [(] 42,208 european ancestry [[] ea []] and 14,330 african ancestry [ aa ] [ )( tested these variants for association with ldl [-] c , high - density lipoprotein cholesterol ( hdl - c ) , [and] triglycerides . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 1 we 2 used 2 used 6 array 2 used 8 to 2 used 9 genotype 3 the 4 " 3 the 6 array 5 exome 6 array 6 array 7 " 8 to 9 genotype 9 genotype 10 >200,000 9 genotype 19 across 10 >200,000 14 and 10 >200,000 17 sequence 11 low 12 - 11 low 13 frequency 13 frequency 14 and 14 and 15 rare 14 and 16 coding 14 and 17 sequence 17 sequence 18 variants 19 across 21 genome 20 the 21 genome 21 genome 22 in 22 in 32 and 23 56,538 30 ea 24 individuals 27 european 26 42,208 27 european 27 european 30 ea 28 ancestry 30 ea 30 ea 32 and 32 and 34 african 32 and 35 ancestry 32 and 41 tested 33 14,330 34 african 35 ancestry 37 aa 35 ancestry 41 tested 36 [ 37 aa 37 aa 38 ] 41 tested 43 variants 42 these 43 variants 43 variants 44 for 43 variants 46 with 43 variants 55 cholesterol 44 for 45 association 46 with 47 ldl 47 ldl 49 c 50 , 55 cholesterol 51 high 52 - 51 high 54 lipoprotein 53 density 54 lipoprotein 54 lipoprotein 55 cholesterol 55 cholesterol 58 - 55 cholesterol 63 triglycerides 55 cholesterol 64 . 56 ( 58 - 57 hdl 58 - 58 - 59 c 58 - 60 ) 61 , 63 triglycerides 63 triglycerides 64 . [although] we did not identify new genes associated with ldl - c , we did identify four low - frequency [(] frequencies between 0.1 % and 2 % [ )(variants [(] angptl8 rs145464906 [ c.361c>t [;] p.gln121* ] , pafah1b2 rs186808413 [[] c.482c>t [;] p.ser161leu []] , col18a1 rs114139997 [ c.331g>a [;] p.gly111arg []] , and pcsk7 rs142953140 [ c.1511g>a [;] p.arg504his ] ) [with] large effects on hdl - [c] [and/or] triglycerides . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 5 identify 0 ###LEFT-WALL### 11 - 2 we 3 did 3 did 4 not 3 did 5 identify 5 identify 7 genes 6 new 7 genes 7 genes 8 associated 8 associated 9 with 9 with 10 ldl 11 - 12 c 11 - 13 , 13 , 14 we 13 , 19 - 14 we 15 did 15 did 16 identify 16 identify 17 four 16 identify 18 low 19 - 22 frequencies 20 frequency 22 frequencies 22 frequencies 26 and 23 between 26 and 24 0.1 25 % 24 0.1 26 and 26 and 27 2 27 2 28 % 28 % 30 )(variants 30 )(variants 41 rs186808413 32 angptl8 41 rs186808413 33 rs145464906 37 p.gln121* 33 rs145464906 39 , 33 rs145464906 41 rs186808413 34 [ 37 p.gln121* 35 c.361c>t 37 p.gln121* 37 p.gln121* 38 ] 40 pafah1b2 41 rs186808413 41 rs186808413 45 p.ser161leu 43 c.482c>t 45 p.ser161leu 45 p.ser161leu 47 , 47 , 48 col18a1 47 , 56 and 49 rs114139997 53 p.gly111arg 50 [ 53 p.gly111arg 51 c.331g>a 53 p.gly111arg 53 p.gly111arg 55 , 55 , 56 and 56 and 57 pcsk7 56 and 67 effects 58 rs142953140 62 p.arg504his 58 rs142953140 64 ) 58 rs142953140 67 effects 59 [ 62 p.arg504his 60 c.1511g>a 62 p.arg504his 62 p.arg504his 63 ] 66 large 67 effects 67 effects 68 on 67 effects 73 triglycerides 68 on 69 hdl 70 - 73 triglycerides 73 triglycerides 74 . none of these four variants was associated with risk for chd , suggesting that examples of low - frequency coding variants with robust effects on both lipids and chd will be limited . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 33 . 1 none 2 of 1 none 6 was 2 of 5 variants 3 these 4 four 4 four 5 variants 6 was 7 associated 7 associated 8 with 7 associated 10 for 8 with 9 risk 10 for 11 chd 12 , 13 suggesting 12 , 31 be 13 suggesting 14 that 13 suggesting 31 be 14 that 28 and 14 that 30 will 15 examples 16 of 15 examples 20 coding 15 examples 25 on 15 examples 28 and 16 of 19 frequency 17 low 18 - 17 low 19 frequency 20 coding 21 variants 21 variants 22 with 22 with 24 effects 23 robust 24 effects 25 on 27 lipids 26 both 27 lipids 28 and 29 chd 28 and 30 will 31 be 32 limited this chapter will serve as a guide for the diagnosis of multiple sclerosis [(] [ms] [ )( 0 ###LEFT-WALL### 2 chapter 0 ###LEFT-WALL### 4 serve 0 ###LEFT-WALL### 17 )( 1 this 2 chapter 2 chapter 3 will 3 will 4 serve 4 serve 5 as 5 as 7 guide 6 a 7 guide 7 guide 8 for 8 for 10 diagnosis 9 the 10 diagnosis 10 diagnosis 11 of 11 of 13 sclerosis 12 multiple 13 sclerosis primary aims include a review of both the common and atypical clinical manifestations [of] [ms] , a detailed discussion of the alternative diagnoses which can mimic [ms] , as well as a review of the current established diagnostic criteria and a history of their development . 0 ###LEFT-WALL### 2 aims 0 ###LEFT-WALL### 3 include 1 primary 2 aims 2 aims 3 include 3 include 10 and 4 a 5 review 5 review 6 of 5 review 10 and 6 of 7 both 7 both 8 the 7 both 9 common 8 the 9 common 10 and 13 manifestations 10 and 19 discussion 11 atypical 13 manifestations 12 clinical 13 manifestations 16 , 19 discussion 17 a 18 detailed 17 a 19 discussion 18 detailed 19 discussion 19 discussion 20 of 19 discussion 23 diagnoses 19 discussion 26 mimic 19 discussion 28 , 20 of 22 alternative 21 the 22 alternative 23 diagnoses 24 which 23 diagnoses 25 can 23 diagnoses 26 mimic 24 which 25 can 28 , 29 as 29 as 30 well 29 as 37 established 30 well 31 as 30 well 34 of 30 well 37 established 31 as 33 review 32 a 33 review 34 of 36 current 35 the 36 current 37 established 40 and 38 diagnostic 39 criteria 39 criteria 40 and 40 and 42 history 40 and 46 . 41 a 42 history 42 history 43 of 43 of 45 development 44 their 45 development it will also review the distinct disease courses and [ms] variants . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 12 . 1 it 2 will 2 will 4 review 3 also 4 review 4 review 9 and 5 the 8 courses 6 distinct 7 disease 7 disease 8 courses 8 courses 9 and 9 and 11 variants the goal of the chapter is to facilitate the diagnostic process for clinicians so that they may expedite early diagnosis and treatment in an effort to alter disease outcomes and ultimately improve patients ' quality of life . 0 ###LEFT-WALL### 2 goal 0 ###LEFT-WALL### 30 and 0 ###LEFT-WALL### 38 . 1 the 2 goal 2 goal 3 of 2 goal 6 is 3 of 5 chapter 4 the 5 chapter 6 is 7 to 6 is 8 facilitate 7 to 8 facilitate 8 facilitate 11 process 8 facilitate 12 for 8 facilitate 15 that 8 facilitate 26 to 9 the 11 process 10 diagnostic 11 process 12 for 13 clinicians 14 so 15 that 15 that 16 they 15 that 18 expedite 16 they 17 may 17 may 18 expedite 18 expedite 21 and 18 expedite 23 in 19 early 20 diagnosis 20 diagnosis 21 and 21 and 22 treatment 23 in 25 effort 24 an 25 effort 26 to 30 and 27 alter 29 outcomes 27 alter 30 and 28 disease 29 outcomes 30 and 32 improve 31 ultimately 32 improve 32 improve 35 quality 33 patients 34 ' 34 ' 35 quality 35 quality 36 of 36 of 37 life background : behavioral and psychological symptoms of dementia ( bpsd ) are often considered to be the greatest challenge in dementia care , leading to increased healthcare costs , caregiver burden , and placement into care facilities . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 38 . 1 background 2 : 2 : 3 behavioral 4 and 6 symptoms 4 and 14 considered 5 psychological 6 symptoms 6 symptoms 7 of 6 symptoms 10 bpsd 6 symptoms 12 are 7 of 8 dementia 9 ( 10 bpsd 10 bpsd 11 ) 12 are 13 often 12 are 14 considered 14 considered 15 to 14 considered 20 in 14 considered 24 leading 14 considered 33 and 14 considered 35 into 15 to 16 be 16 be 19 challenge 17 the 18 greatest 17 the 19 challenge 20 in 22 care 21 dementia 22 care 23 , 24 leading 24 leading 25 to 24 leading 29 , 25 to 28 costs 26 increased 28 costs 27 healthcare 28 costs 30 caregiver 31 burden 31 burden 33 and 32 , 33 and 33 and 34 placement 35 into 37 facilities 36 care 37 facilities with potential for pharmacological intervention to exacerbate behaviors or even lead to mortality , the development and rigorous testing of [non] [-] pharmacological interventions is vital . 0 ###LEFT-WALL### 6 to 0 ###LEFT-WALL### 25 is 0 ###LEFT-WALL### 27 . 1 with 2 potential 1 with 3 for 1 with 6 to 3 for 5 intervention 4 pharmacological 5 intervention 6 to 9 or 6 to 25 is 7 exacerbate 8 behaviors 7 exacerbate 9 or 9 or 11 lead 10 even 11 lead 11 lead 12 to 12 to 17 and 13 mortality 14 , 14 , 16 development 14 , 17 and 15 the 16 development 17 and 19 testing 17 and 20 of 18 rigorous 19 testing 20 of 24 interventions 23 pharmacological 24 interventions 25 is 26 vital a pilot of the tailored activities program ( tap ) for reducing problem behaviors in people with dementia was conducted in the united states with promising results . 0 ###LEFT-WALL### 2 pilot 0 ###LEFT-WALL### 20 conducted 0 ###LEFT-WALL### 28 . 1 a 2 pilot 2 pilot 3 of 2 pilot 11 for 2 pilot 19 was 3 of 9 tap 4 the 9 tap 5 tailored 6 activities 6 activities 7 program 7 program 9 tap 8 ( 9 tap 9 tap 10 ) 11 for 12 reducing 12 reducing 14 behaviors 12 reducing 15 in 12 reducing 17 with 13 problem 14 behaviors 15 in 16 people 17 with 18 dementia 19 was 20 conducted 20 conducted 21 in 21 in 24 states 22 the 24 states 23 united 24 states 24 states 25 with 25 with 27 results 26 promising 27 results this randomized trial will investigate the effectiveness of tap for reducing the burden of bpsd on persons with dementia and family caregivers within an australian population . 0 ###LEFT-WALL### 3 trial 0 ###LEFT-WALL### 5 investigate 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 27 . 1 this 3 trial 2 randomized 3 trial 3 trial 4 will 4 will 5 investigate 5 investigate 7 effectiveness 6 the 7 effectiveness 7 effectiveness 8 of 8 of 9 tap 9 tap 10 for 10 for 11 reducing 11 reducing 13 burden 11 reducing 16 on 11 reducing 18 with 12 the 13 burden 13 burden 14 of 14 of 15 bpsd 16 on 17 persons 18 with 19 dementia 20 and 21 family 20 and 22 caregivers 21 family 22 caregivers 22 caregivers 23 within 23 within 26 population 24 an 25 australian 24 an 26 population 25 australian 26 population this trial will also examine the cost - effectiveness and willingness to pay for tap compared with a control group . 0 ###LEFT-WALL### 2 trial 0 ###LEFT-WALL### 5 examine 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 21 . 1 this 2 trial 2 trial 3 will 3 will 5 examine 4 also 5 examine 5 examine 7 cost 6 the 7 cost 8 - 10 and 8 - 20 group 9 effectiveness 10 and 10 and 11 willingness 10 and 12 to 10 and 14 for 10 and 16 compared 10 and 20 group 12 to 13 pay 14 for 15 tap 16 compared 17 with 17 with 19 control 18 a 19 control methods : this randomized trial aims to recruit 180 participant dyads of a person with dementia and their caregivers . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 3 this 2 : 4 randomized 3 this 4 randomized 4 randomized 6 aims 4 randomized 7 to 5 trial 6 aims 7 to 8 recruit 8 recruit 11 dyads 8 recruit 15 with 9 180 11 dyads 10 participant 11 dyads 11 dyads 12 of 12 of 14 person 13 a 14 person 15 with 17 and 16 dementia 17 and 17 and 19 caregivers 18 their 19 caregivers participants will have a diagnosis of dementia , exhibit behaviors as scored by the neuropsychiatric inventory , and the caregiver must have at least 7 h per week contact . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 12 scored 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 30 . 1 participants 2 will 2 will 8 , 3 have 5 diagnosis 3 have 8 , 4 a 5 diagnosis 5 diagnosis 6 of 6 of 7 dementia 8 , 9 exhibit 9 exhibit 10 behaviors 9 exhibit 11 as 11 as 12 scored 12 scored 13 by 13 by 16 inventory 14 the 16 inventory 15 neuropsychiatric 16 inventory 17 , 18 and 18 and 20 caregiver 18 and 22 have 19 the 20 caregiver 20 caregiver 21 must 21 must 22 have 22 have 26 h 23 at 24 least 24 least 25 7 25 7 26 h 26 h 27 per 27 per 29 contact 28 week 29 contact participants will be randomly allocated to intervention ( tap ) or control ( phone [-] based education sessions ) groups , both provided by a trained occupational therapist . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 5 allocated 0 ###LEFT-WALL### 11 or 0 ###LEFT-WALL### 29 . 1 participants 2 will 2 will 3 be 3 be 5 allocated 4 randomly 5 allocated 5 allocated 6 to 6 to 7 intervention 7 intervention 9 tap 8 ( 9 tap 9 tap 10 ) 11 or 12 control 11 or 21 , 12 control 18 sessions 12 control 21 , 13 ( 18 sessions 14 phone 16 based 16 based 17 education 17 education 18 sessions 18 sessions 19 ) 20 groups 21 , 21 , 23 provided 22 both 23 provided 23 provided 24 by 24 by 28 therapist 25 a 28 therapist 26 trained 28 therapist 27 occupational 28 therapist primary outcome measure will be the revised neuropsychiatric inventory - clinician rating [scale] ( npi - c ) to measure bpsd exhibited by the person with dementia . 0 ###LEFT-WALL### 4 will 0 ###LEFT-WALL### 5 be 1 primary 4 will 2 outcome 4 will 3 measure 4 will 4 will 5 be 5 be 9 inventory 6 the 9 inventory 7 revised 9 inventory 8 neuropsychiatric 9 inventory 9 inventory 11 clinician 10 - 11 clinician 11 clinician 12 rating 11 clinician 28 . 12 rating 16 - 12 rating 19 to 14 ( 16 - 15 npi 16 - 16 - 17 c 16 - 18 ) 19 to 20 measure 20 measure 21 bpsd 21 bpsd 22 exhibited 21 bpsd 26 with 22 exhibited 23 by 23 by 25 person 24 the 25 person 26 with 27 dementia conclusions : this trial investigates the effectiveness and cost - effectiveness of tap within an australian population . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 18 . 1 conclusions 2 : 2 : 4 trial 3 this 4 trial 4 trial 8 and 5 investigates 7 effectiveness 5 investigates 8 and 6 the 7 effectiveness 8 and 9 cost 10 - 11 effectiveness 11 effectiveness 12 of 12 of 13 tap 13 tap 14 within 14 within 17 population 15 an 16 australian 15 an 17 population 16 australian 17 population results will address a significant gap in the current australian community - support base for people living with dementia and their caregivers . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 address 1 results 2 will 2 will 3 address 3 address 6 gap 3 address 7 in 4 a 5 significant 4 a 6 gap 5 significant 6 gap 7 in 11 community 8 the 11 community 9 current 10 australian 10 australian 11 community 11 community 13 support 12 - 13 support 13 support 14 base 13 support 23 . 14 base 15 for 14 base 18 with 15 for 16 people 16 people 17 living 18 with 20 and 19 dementia 20 and 20 and 22 caregivers 21 their 22 caregivers background : chronic stress negatively affects health and well - being . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 . 2 : 4 stress 2 : 6 affects 2 : 10 - 3 chronic 4 stress 4 stress 6 affects 5 negatively 6 affects 6 affects 8 and 7 health 8 and 8 and 9 well 10 - 11 being a growing population of informal dementia caregivers experience chronic stress associated with extraordinary demands of caring for a relative with dementia . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 7 caregivers 0 ###LEFT-WALL### 22 . 1 a 3 population 2 growing 3 population 3 population 4 of 3 population 7 caregivers 4 of 6 dementia 5 informal 6 dementia 7 caregivers 8 experience 8 experience 10 stress 8 experience 11 associated 9 chronic 10 stress 10 stress 11 associated 11 associated 12 with 12 with 14 demands 13 extraordinary 14 demands 14 demands 15 of 15 of 16 caring 16 caring 17 for 16 caring 20 with 17 for 19 relative 18 a 19 relative 20 with 21 dementia this review summarizes physiological and functional changes due to chronic dementia caregiver stress . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 summarizes 0 ###LEFT-WALL### 14 . 1 this 2 review 2 review 3 summarizes 3 summarizes 7 changes 3 summarizes 9 to 4 physiological 5 and 5 and 6 functional 5 and 7 changes 8 due 9 to 9 to 13 stress 10 chronic 13 stress 11 dementia 13 stress 12 caregiver 13 stress methods : a literature search for papers assessing effects of dementia caregiving was conducted focusing on publications evaluating differences between caregivers and [non] [-] caregivers in objective measures of health and cognition . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 22 and 3 a 5 search 4 literature 5 search 5 search 6 for 5 search 8 assessing 5 search 22 and 6 for 7 papers 8 assessing 9 effects 8 assessing 20 between 9 effects 10 of 9 effects 14 conducted 9 effects 15 focusing 10 of 11 dementia 11 dementia 12 caregiving 11 dementia 13 was 12 caregiving 13 was 15 focusing 16 on 16 on 17 publications 17 publications 18 evaluating 18 evaluating 19 differences 20 between 21 caregivers 22 and 25 caregivers 22 and 26 in 22 and 29 of 26 in 28 measures 27 objective 28 measures 29 of 31 and 30 health 31 and 31 and 32 cognition results : the review identified 37 studies describing data from 4,145 participants including 749 dementia caregivers and 3,396 [non] - caregiver peers . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 review 2 : 5 identified 2 : 17 and 2 : 23 . 3 the 4 review 4 review 5 identified 5 identified 7 studies 6 37 7 studies 7 studies 8 describing 8 describing 9 data 9 data 10 from 9 data 13 including 10 from 12 participants 11 4,145 12 participants 13 including 16 caregivers 14 749 16 caregivers 15 dementia 16 caregivers 17 and 18 3,396 17 and 20 - 18 3,396 20 - 20 - 22 peers 21 caregiver 22 peers objective outcome measures affected in dementia caregivers included markers of dyscoagulation , inflammation , and cell aging as well as measures of immune [function] , sleep , and cognition . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 8 included 0 ###LEFT-WALL### 30 . 1 objective 3 measures 2 outcome 3 measures 3 measures 4 affected 3 measures 8 included 4 affected 5 in 5 in 7 caregivers 6 dementia 7 caregivers 8 included 15 and 9 markers 10 of 9 markers 12 , 10 of 11 dyscoagulation 12 , 13 inflammation 12 , 15 and 14 , 15 and 15 and 16 cell 15 and 17 aging 15 and 20 as 18 as 19 well 19 well 20 as 20 as 28 and 21 measures 22 of 21 measures 28 and 22 of 26 sleep 23 immune 25 , 23 immune 26 sleep 27 , 28 and 28 and 29 cognition though diverse in designs , samples , and study quality , the majority of the studies indicated increased vulnerability of dementia caregivers to detrimental changes in health and cognition . 0 ###LEFT-WALL### 16 studies 0 ###LEFT-WALL### 17 indicated 0 ###LEFT-WALL### 30 . 1 though 16 studies 2 diverse 3 in 2 diverse 11 , 2 diverse 16 studies 3 in 8 and 4 designs 5 , 5 , 6 samples 5 , 8 and 7 , 8 and 8 and 10 quality 9 study 10 quality 12 the 13 majority 13 majority 14 of 13 majority 16 studies 14 of 16 studies 15 the 16 studies 16 studies 17 indicated 17 indicated 19 vulnerability 17 indicated 22 caregivers 18 increased 19 vulnerability 19 vulnerability 20 of 19 vulnerability 22 caregivers 20 of 21 dementia 22 caregivers 23 to 23 to 25 changes 24 detrimental 25 changes 25 changes 26 in 26 in 28 and 27 health 28 and 28 and 29 cognition demographic and personality characteristics moderating or mediating effects of chronic stress in caregivers were also reviewed . 0 ###LEFT-WALL### 6 or 0 ###LEFT-WALL### 16 reviewed 0 ###LEFT-WALL### 17 . 1 demographic 2 and 2 and 4 characteristics 2 and 5 moderating 2 and 6 or 3 personality 4 characteristics 6 or 8 effects 6 or 9 of 6 or 14 were 7 mediating 8 effects 9 of 11 stress 10 chronic 11 stress 11 stress 12 in 12 in 13 caregivers 14 were 15 also 14 were 16 reviewed conclusions : there is accumulating evidence that chronic dementia caregiver stress increases their vulnerability to disease and diminishes their ability to provide optimal care . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 17 and 3 there 17 and 4 is 5 accumulating 4 is 17 and 5 accumulating 6 evidence 5 accumulating 15 to 6 evidence 7 that 7 that 11 stress 7 that 12 increases 8 chronic 9 dementia 9 dementia 11 stress 10 caregiver 11 stress 11 stress 12 increases 12 increases 14 vulnerability 13 their 14 vulnerability 15 to 16 disease 17 and 18 diminishes 18 diminishes 20 ability 19 their 20 ability 20 ability 21 to 20 ability 22 provide 21 to 22 provide 22 provide 24 care 23 optimal 24 care clinicians and society need to appreciate the extent of deleterious effects of chronic stress on dementia caregiver health . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 need 0 ###LEFT-WALL### 19 . 1 clinicians 2 and 2 and 3 society 2 and 4 need 4 need 5 to 4 need 6 appreciate 5 to 6 appreciate 6 appreciate 8 extent 6 appreciate 15 on 7 the 8 extent 8 extent 9 of 8 extent 12 of 9 of 11 effects 10 deleterious 11 effects 12 of 14 stress 13 chronic 14 stress 15 on 18 health 16 dementia 18 health 17 caregiver 18 health background : over the past few decades , new care models that are more resident - oriented and directed [toward] small - scale and homelike environments have been developed worldwide . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 31 . 1 background 2 : 2 : 3 over 3 over 18 and 4 the 5 past 4 the 6 few 6 few 7 decades 7 decades 11 models 7 decades 17 oriented 7 decades 18 and 8 , 11 models 9 new 10 care 10 care 11 models 11 models 12 that 11 models 13 are 11 models 16 - 12 that 13 are 13 are 15 resident 14 more 15 resident 18 and 23 scale 19 directed 23 scale 21 small 22 - 21 small 23 scale 24 and 26 environments 24 and 29 developed 25 homelike 26 environments 26 environments 27 have 27 have 28 been 28 been 29 developed 29 developed 30 worldwide the impact of these care models on the quality of life of residents has been studied . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 16 studied 0 ###LEFT-WALL### 17 . 1 the 2 impact 2 impact 3 of 2 impact 14 has 3 of 6 models 4 these 6 models 5 care 6 models 6 models 7 on 7 on 9 quality 8 the 9 quality 9 quality 10 of 10 of 11 life 11 life 12 of 12 of 13 residents 14 has 15 been 15 been 16 studied however , little research has been conducted to gain insight into how these new care models influence healthcare staff 's work environment . 0 ###LEFT-WALL### 4 research 0 ###LEFT-WALL### 7 conducted 0 ###LEFT-WALL### 23 . 1 however 2 , 1 however 4 research 3 little 4 research 4 research 5 has 5 has 6 been 6 been 7 conducted 7 conducted 8 to 8 to 9 gain 9 gain 10 insight 9 gain 11 into 11 into 12 how 12 how 16 models 12 how 17 influence 13 these 16 models 14 new 15 care 15 care 16 models 16 models 17 influence 17 influence 22 environment 18 healthcare 19 staff 19 staff 20 's 20 's 22 environment 21 work 22 environment this study focuses on the consequences of small - scale care on staff 's perceived job characteristics . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 focuses 0 ###LEFT-WALL### 18 . 1 this 2 study 2 study 3 focuses 3 focuses 4 on 3 focuses 12 on 4 on 6 consequences 5 the 6 consequences 6 consequences 7 of 7 of 11 care 8 small 9 - 8 small 10 scale 10 scale 11 care 12 on 17 characteristics 13 staff 14 's 14 's 17 characteristics 15 perceived 16 job 16 job 17 characteristics methods : data were derived from a sample of 136 dutch living arrangements providing nursing home care for people with dementia ( 2008/2009 ) , in which 1,327 residents and 1,147 staff participated . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 home 2 : 3 data 2 : 5 derived 3 data 4 were 4 were 5 derived 5 derived 6 from 6 from 8 sample 7 a 8 sample 8 sample 9 of 8 sample 13 arrangements 8 sample 16 home 9 of 11 dutch 10 136 11 dutch 11 dutch 12 living 13 arrangements 14 providing 13 arrangements 16 home 14 providing 15 nursing 16 home 17 care 17 care 18 for 17 care 20 with 17 care 26 in 18 for 19 people 20 with 21 dementia 21 dementia 23 2008/2009 22 ( 23 2008/2009 23 2008/2009 24 ) 25 , 26 in 26 in 27 which 26 in 30 and 26 in 33 participated 26 in 34 . 28 1,327 29 residents 29 residents 30 and 30 and 32 staff 30 and 33 participated 31 1,147 32 staff the relationship between two indicators of small - scale care ( small - scale care characteristics and total number of residents with dementia in facility ) and staff 's job characteristics ( job demands , decision authority , coworker and supervisor support ) were studied with multilevel regression analyses . 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 35 , 0 ###LEFT-WALL### 50 . 1 the 2 relationship 2 relationship 3 between 2 relationship 6 of 2 relationship 27 and 3 between 5 indicators 4 two 5 indicators 6 of 10 care 7 small 8 - 7 small 10 care 9 scale 10 care 10 care 17 and 11 ( 17 and 12 small 13 - 12 small 16 characteristics 14 scale 16 characteristics 15 care 16 characteristics 16 characteristics 17 and 17 and 19 number 17 and 20 of 17 and 22 with 17 and 26 ) 18 total 19 number 20 of 21 residents 22 with 23 dementia 23 dementia 24 in 24 in 25 facility 27 and 31 characteristics 27 and 34 demands 28 staff 29 's 29 's 31 characteristics 30 job 31 characteristics 32 ( 34 demands 33 job 34 demands 34 demands 35 , 35 , 40 and 35 , 49 analyses 36 decision 37 authority 37 authority 38 , 38 , 39 coworker 38 , 40 and 40 and 42 support 40 and 43 ) 40 and 44 were 41 supervisor 42 support 44 were 45 studied 45 studied 46 with 46 with 47 multilevel 47 multilevel 48 regression 47 multilevel 49 analyses 48 regression 49 analyses all analyses were adjusted for staff , resident , and living arrangement characteristics when needed . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 4 adjusted 0 ###LEFT-WALL### 16 . 1 all 2 analyses 2 analyses 3 were 3 were 4 adjusted 4 adjusted 5 for 4 adjusted 14 when 5 for 10 and 6 staff 7 , 7 , 8 resident 7 , 10 and 9 , 10 and 10 and 13 characteristics 11 living 13 characteristics 12 arrangement 13 characteristics 14 when 15 needed results : both indicators of small - scale care were associated with job demands ; staff perceived less time and work pressure as more characteristics of small - scale care were integrated and the facility had less residents with dementia in total . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 indicators 2 : 11 associated 2 : 15 ; 2 : 43 . 3 both 4 indicators 4 indicators 5 of 4 indicators 10 were 5 of 9 care 6 small 7 - 6 small 8 scale 8 scale 9 care 10 were 11 associated 11 associated 12 with 12 with 14 demands 13 job 14 demands 15 ; 33 and 16 staff 17 perceived 16 staff 20 and 17 perceived 19 time 18 less 19 time 20 and 22 pressure 20 and 32 integrated 20 and 33 and 21 work 22 pressure 23 as 25 characteristics 23 as 32 integrated 24 more 25 characteristics 25 characteristics 26 of 25 characteristics 31 were 26 of 30 care 27 small 28 - 27 small 29 scale 29 scale 30 care 31 were 32 integrated 33 and 35 facility 33 and 36 had 34 the 35 facility 36 had 37 less 36 had 38 residents 36 had 42 total 38 residents 39 with 39 with 40 dementia 41 in 42 total only one indicator was associated with decision authority . 0 ###LEFT-WALL### 3 indicator 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 9 . 1 only 2 one 2 one 3 indicator 3 indicator 4 was 4 was 5 associated 5 associated 6 with 6 with 8 authority 7 decision 8 authority as more characteristics of small - scale care were integrated , staff 's perceived decision authority was higher . 0 ###LEFT-WALL### 12 staff 0 ###LEFT-WALL### 13 's 0 ###LEFT-WALL### 19 . 1 as 3 characteristics 1 as 10 integrated 1 as 12 staff 2 more 3 characteristics 3 characteristics 4 of 3 characteristics 9 were 4 of 8 care 5 small 6 - 5 small 7 scale 7 scale 8 care 9 were 10 integrated 10 integrated 11 , 12 staff 13 's 13 's 14 perceived 14 perceived 16 authority 14 perceived 17 was 15 decision 16 authority 16 authority 17 was 17 was 18 higher no relationship was found with coworker and supervisor social support . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 11 . 1 no 2 relationship 2 relationship 3 was 3 was 4 found 4 found 5 with 5 with 7 and 6 coworker 7 and 7 and 10 support 8 supervisor 10 support 9 social 10 support conclusions : knowing that job demands and decision authority are important predictors of job appraisal and well - being , our findings show that small - scale care could have a beneficial impact on healthcare staff 's work environment . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 - 1 conclusions 2 : 2 : 3 knowing 2 : 16 and 4 that 15 appraisal 5 job 15 appraisal 6 demands 7 and 7 and 8 decision 7 and 9 authority 7 and 13 of 7 and 15 appraisal 9 authority 10 are 10 are 12 predictors 11 important 12 predictors 12 predictors 13 of 14 job 15 appraisal 15 appraisal 16 and 16 and 17 well 18 - 19 being 18 - 20 , 18 - 40 . 20 , 22 findings 20 , 23 show 21 our 22 findings 22 findings 23 show 23 show 27 scale 23 show 33 impact 23 show 34 on 24 that 27 scale 25 small 26 - 25 small 27 scale 27 scale 28 care 27 scale 30 have 28 care 29 could 29 could 30 have 31 a 33 impact 32 beneficial 33 impact 34 on 39 environment 35 healthcare 36 staff 36 staff 37 's 37 's 39 environment 38 work 39 environment increasing evidence suggests that subjective cognitive decline ( scd ) is a potential predictor of future cognitive decline [or] dementia . 0 ###LEFT-WALL### 1 increasing 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 21 . 1 increasing 2 evidence 1 increasing 3 suggests 3 suggests 7 decline 3 suggests 11 is 4 that 7 decline 5 subjective 7 decline 6 cognitive 7 decline 7 decline 9 scd 7 decline 11 is 8 ( 9 scd 9 scd 10 ) 11 is 14 predictor 12 a 14 predictor 13 potential 14 predictor 14 predictor 15 of 15 of 20 dementia 16 future 20 dementia 17 cognitive 18 decline 18 decline 20 dementia we investigated whether scd in patients with parkinson 's disease ( pd ) is a predictor [of] future cognitive decline . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 21 . 1 we 2 investigated 2 investigated 3 whether 3 whether 4 scd 3 whether 14 is 4 scd 5 in 4 scd 14 is 5 in 6 patients 6 patients 7 with 7 with 10 disease 8 parkinson 9 's 9 's 10 disease 10 disease 12 pd 11 ( 12 pd 12 pd 13 ) 14 is 20 decline 15 a 20 decline 16 predictor 20 decline 18 future 20 decline 19 cognitive 20 decline forty - six cognitively normal patients with pd were selected using comprehensive neuropsychological tests , and classified depending on the presence ( pd - scd [(] [+] ) , n = 25 ) or absence of scd ( pd - scd [(] - ) , n = 21 ) . 0 ###LEFT-WALL### 1 forty 0 ###LEFT-WALL### 2 - 2 - 6 patients 2 - 10 selected 2 - 50 . 3 six 6 patients 4 cognitively 5 normal 5 normal 6 patients 6 patients 7 with 6 patients 9 were 7 with 8 pd 9 were 10 selected 10 selected 11 using 11 using 34 or 12 comprehensive 14 tests 13 neuropsychological 14 tests 14 tests 16 and 15 , 16 and 16 and 17 classified 16 and 18 depending 16 and 34 or 18 depending 19 on 18 depending 31 = 19 on 21 presence 20 the 21 presence 21 presence 23 pd 22 ( 23 pd 23 pd 25 scd 23 pd 29 , 24 - 25 scd 25 scd 28 ) 30 n 31 = 31 = 32 25 31 = 33 ) 34 or 35 absence 34 or 36 of 34 or 39 pd 34 or 47 = 36 of 37 scd 38 ( 39 pd 39 pd 41 scd 39 pd 44 ) 40 - 41 scd 41 scd 43 - 45 , 47 = 46 n 47 = 47 = 48 21 47 = 49 ) after a mean follow - up of 2.4 years , we repeated the cognitive assessments with the same subjects . 0 ###LEFT-WALL### 4 follow 0 ###LEFT-WALL### 5 - 1 after 3 mean 1 after 4 follow 2 a 3 mean 5 - 11 we 5 - 12 repeated 5 - 20 . 6 up 11 we 7 of 9 years 7 of 10 , 7 of 11 we 8 2.4 9 years 11 we 12 repeated 12 repeated 15 assessments 12 repeated 16 with 13 the 15 assessments 14 cognitive 15 assessments 16 with 19 subjects 17 the 18 same 18 same 19 subjects the clinical characteristics and cognitive performance of the 2 groups did not differ at baseline . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 13 differ 0 ###LEFT-WALL### 16 . 1 the 3 characteristics 2 clinical 3 characteristics 3 characteristics 4 and 4 and 6 performance 4 and 7 of 4 and 11 did 5 cognitive 6 performance 7 of 10 groups 8 the 9 2 9 2 10 groups 11 did 12 not 11 did 13 differ 13 differ 14 at 14 at 15 baseline [at] [the] follow - up assessment , 11 patients in the pd - scd ( + [ )( [(] 44.0 % ) and [2] in the pd - scd ( - [ )( [(] 9.5 % ) were diagnosed with mild cognitive impairment ( mci [ )(, and the pd - scd [(] [+] ) patients showed more rapid decline in semantic fluency and visuospatial memory tasks than those in the pd - scd [(] - [ )(group [.] 0 ###LEFT-WALL### 3 follow 0 ###LEFT-WALL### 4 - 4 - 5 up 4 - 13 - 5 up 6 assessment 6 assessment 9 patients 7 , 9 patients 8 11 9 patients 9 patients 10 in 9 patients 13 - 10 in 12 pd 11 the 12 pd 13 - 14 scd 13 - 23 and 14 scd 21 % 15 ( 21 % 16 + 20 44.0 20 44.0 21 % 21 % 22 ) 23 and 29 scd 25 in 27 pd 25 in 28 - 25 in 29 scd 26 the 27 pd 29 scd 36 % 29 scd 38 were 30 ( 36 % 31 - 35 9.5 35 9.5 36 % 36 % 37 ) 38 were 39 diagnosed 39 diagnosed 40 with 40 with 48 and 41 mild 48 and 42 cognitive 43 impairment 43 impairment 45 mci 44 ( 45 mci 45 mci 47 )(, 47 )(, 48 and 48 and 52 scd 48 and 56 patients 48 and 57 showed 49 the 52 scd 50 pd 52 scd 51 - 52 scd 52 scd 55 ) 56 patients 57 showed 57 showed 60 decline 57 showed 61 in 57 showed 68 than 58 more 59 rapid 59 rapid 60 decline 61 in 64 and 62 semantic 63 fluency 63 fluency 64 and 64 and 67 tasks 65 visuospatial 66 memory 66 memory 67 tasks 68 than 69 those 69 those 70 in 70 in 78 )(group 71 the 78 )(group 72 pd 74 scd 73 - 74 scd 74 scd 76 - 74 scd 78 )(group present results demonstrate that scd in cognitively normal patients with pd is an independent risk factor for incident mci and acts as a predictor [for] future cognitive decline . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 29 . 1 present 2 results 2 results 3 demonstrate 3 demonstrate 5 scd 3 demonstrate 20 and 4 that 5 scd 5 scd 6 in 5 scd 20 and 6 in 9 patients 7 cognitively 8 normal 8 normal 9 patients 9 patients 10 with 10 with 11 pd 12 is 16 factor 12 is 20 and 13 an 14 independent 13 an 16 factor 14 independent 16 factor 15 risk 16 factor 16 factor 17 for 17 for 18 incident 18 incident 19 mci 20 and 21 acts 20 and 22 as 22 as 28 decline 23 a 28 decline 24 predictor 28 decline 26 future 28 decline 27 cognitive 28 decline background : dementia is an emerging health priority in australian aboriginal communities , but substantial gaps remain in our understanding of this issue , particularly for the large urban section of the population . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 dementia 2 : 4 is 2 : 14 but 3 dementia 4 is 4 is 8 priority 5 an 8 priority 6 emerging 7 health 7 health 8 priority 8 priority 9 in 9 in 12 communities 10 australian 12 communities 11 aboriginal 12 communities 13 , 14 but 14 but 16 gaps 14 but 17 remain 15 substantial 16 gaps 16 gaps 17 remain 17 remain 18 in 17 remain 26 for 18 in 20 understanding 19 our 20 understanding 20 understanding 21 of 21 of 23 issue 22 this 23 issue 24 , 25 particularly 24 , 26 for 26 for 30 section 26 for 34 . 27 the 30 section 28 large 30 section 29 urban 30 section 30 section 31 of 31 of 33 population 32 the 33 population in remote aboriginal communities , high prevalence rates of dementia at relatively young ages have been reported . 0 ###LEFT-WALL### 8 rates 0 ###LEFT-WALL### 17 reported 0 ###LEFT-WALL### 18 . 1 in 4 communities 1 in 5 , 1 in 8 rates 2 remote 4 communities 3 aboriginal 4 communities 6 high 7 prevalence 7 prevalence 8 rates 8 rates 9 of 8 rates 15 have 9 of 10 dementia 10 dementia 11 at 11 at 14 ages 12 relatively 13 young 13 young 14 ages 15 have 16 been 16 been 17 reported the current study is investigating aging , cognitive decline , and dementia in older urban/regional aboriginal australians . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 18 . 1 the 3 study 2 current 3 study 3 study 4 is 4 is 5 investigating 5 investigating 11 and 5 investigating 13 in 6 aging 7 , 7 , 9 decline 7 , 11 and 8 cognitive 9 decline 10 , 11 and 11 and 12 dementia 13 in 17 australians 14 older 17 australians 15 urban/regional 17 australians 16 aboriginal 17 australians methods : we partnered with five aboriginal communities across the eastern australian state of new south wales , to undertake a census of all aboriginal men and women aged 60 years [and] over residing in these communities . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 3 we 2 : 4 partnered 2 : 18 , 3 we 4 partnered 4 partnered 5 with 4 partnered 8 communities 4 partnered 9 across 5 with 6 five 7 aboriginal 8 communities 9 across 13 state 10 the 13 state 11 eastern 12 australian 12 australian 13 state 13 state 14 of 14 of 17 wales 15 new 16 south 16 south 17 wales 18 , 19 to 18 , 20 undertake 18 , 27 and 19 to 20 undertake 20 undertake 22 census 21 a 22 census 22 census 23 of 23 of 26 men 24 all 26 men 25 aboriginal 26 men 27 and 28 women 27 and 29 aged 28 women 29 aged 29 aged 33 over 29 aged 35 in 30 60 31 years 31 years 33 over 33 over 34 residing 35 in 37 communities 36 these 37 communities this was followed by a survey of the health , well - being , and life history of all consenting participants . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 followed 0 ###LEFT-WALL### 12 - 1 this 2 was 2 was 3 followed 3 followed 4 by 3 followed 11 well 4 by 6 survey 5 a 6 survey 6 survey 7 of 7 of 9 health 8 the 9 health 10 , 11 well 11 well 12 - 12 - 15 and 12 - 22 . 13 being 15 and 14 , 15 and 15 and 17 history 15 and 18 of 16 life 17 history 18 of 21 participants 19 all 21 participants 20 consenting 21 participants participants were also screened using three cognitive instruments . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 4 screened 0 ###LEFT-WALL### 9 . 1 participants 2 were 2 were 4 screened 3 also 4 screened 4 screened 5 using 5 using 8 instruments 6 three 8 instruments 7 cognitive 8 instruments those scoring below designated cut - offs , and a 20 % random sample of those scoring above ( i.e [.] ["] normal " range ) [,] completed a contact person interview [(] with a nominated family member [ )(and medical assessment ( blind to initial screening results ) , which formed the basis of " gold standard " clinical consensus determinations of cognitive impairment and dementia . 0 ###LEFT-WALL### 1 those 0 ###LEFT-WALL### 4 designated 1 those 2 scoring 1 those 3 below 1 those 4 designated 4 designated 5 cut 4 designated 9 and 5 cut 7 offs 6 - 7 offs 7 offs 8 , 9 and 14 sample 10 a 14 sample 11 20 12 % 12 % 14 sample 13 random 14 sample 14 sample 15 of 15 of 16 those 16 those 17 scoring 16 those 28 completed 17 scoring 18 above 17 scoring 25 range 17 scoring 28 completed 19 ( 25 range 20 i.e 25 range 23 normal 24 " 23 normal 25 range 25 range 26 ) 28 completed 40 )(and 29 a 32 interview 30 contact 32 interview 31 person 32 interview 32 interview 34 with 32 interview 40 )(and 34 with 38 member 35 a 38 member 36 nominated 38 member 37 family 38 member 40 )(and 42 assessment 40 )(and 44 blind 40 )(and 51 which 41 medical 42 assessment 43 ( 44 blind 44 blind 45 to 44 blind 49 ) 45 to 48 results 46 initial 48 results 47 screening 48 results 50 , 51 which 51 which 52 formed 52 formed 54 basis 53 the 54 basis 54 basis 55 of 55 of 56 " 55 of 66 and 57 gold 62 determinations 58 standard 59 " 58 standard 62 determinations 60 clinical 62 determinations 61 consensus 62 determinations 62 determinations 63 of 62 determinations 66 and 63 of 65 impairment 64 cognitive 65 impairment 66 and 67 dementia 66 and 68 . conclusion : this paper details our protocol for a population - based study in collaboration with local aboriginal community organizations . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 paper 2 : 5 details 2 : 11 - 2 : 21 . 3 this 4 paper 4 paper 5 details 5 details 7 protocol 5 details 8 for 6 our 7 protocol 8 for 10 population 9 a 10 population 11 - 13 study 12 based 13 study 13 study 14 in 14 in 15 collaboration 15 collaboration 16 with 16 with 20 organizations 17 local 20 organizations 18 aboriginal 20 organizations 19 community 20 organizations the study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban aboriginal people , [across] city and rural communities , where the majority of aboriginal australians live . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 37 . 1 the 2 study 2 study 3 will 3 will 4 provide 4 provide 9 rates 4 provide 15 in 5 the 9 rates 6 first 8 prevalence 7 available 8 prevalence 8 prevalence 9 rates 9 rates 10 for 10 for 12 and 11 dementia 12 and 12 and 14 impairment 13 cognitive 14 impairment 15 in 18 sample 16 a 18 sample 17 representative 18 sample 18 sample 19 of 19 of 26 and 20 urban 22 people 21 aboriginal 22 people 22 people 23 , 23 , 25 city 23 , 26 and 26 and 28 communities 26 and 29 , 26 and 30 where 27 rural 28 communities 30 where 32 majority 30 where 36 live 31 the 32 majority 32 majority 33 of 32 majority 36 live 33 of 35 australians 34 aboriginal 35 australians it will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging , of international significance . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 contribute 1 it 2 will 2 will 4 contribute 3 also 4 contribute 4 contribute 13 and 5 to 7 assessment 5 to 13 and 6 improved 7 assessment 7 assessment 8 of 8 of 12 impairment 9 dementia 10 and 10 and 11 cognitive 10 and 12 impairment 13 and 14 to 14 to 16 understanding 15 the 16 understanding 16 understanding 17 of 16 understanding 20 of 17 of 19 determinants 18 social 19 determinants 20 of 22 aging 21 successful 22 aging 22 aging 24 of 23 , 24 of 24 of 26 significance 24 of 27 . 25 international 26 significance sirtuins are nicotinamide adenine dinucleotide ( nad+ ) - dependent deacylases that have traditionally been linked with calorie restriction and aging in mammals . 0 ###LEFT-WALL### 1 sirtuins 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 24 . 1 sirtuins 2 are 2 are 5 dinucleotide 3 nicotinamide 5 dinucleotide 4 adenine 5 dinucleotide 5 dinucleotide 7 nad+ 6 ( 7 nad+ 7 nad+ 8 ) 9 - 11 deacylases 10 dependent 11 deacylases 11 deacylases 12 that 11 deacylases 13 have 12 that 13 have 13 have 15 been 14 traditionally 15 been 15 been 16 linked 16 linked 17 with 16 linked 22 in 17 with 20 and 18 calorie 19 restriction 19 restriction 20 and 20 and 21 aging 22 in 23 mammals these proteins also play an important role in maintaining neuronal health during aging . 0 ###LEFT-WALL### 2 proteins 0 ###LEFT-WALL### 4 play 0 ###LEFT-WALL### 14 . 1 these 2 proteins 2 proteins 4 play 3 also 4 play 4 play 7 role 4 play 8 in 5 an 6 important 5 an 7 role 6 important 7 role 8 in 9 maintaining 9 maintaining 11 health 9 maintaining 12 during 10 neuronal 11 health 12 during 13 aging during neuronal development , the sir2 ortholog sirt1 is structurally important , promoting axonal elongation , neurite outgrowth , and dendritic branching . 0 ###LEFT-WALL### 8 sirt1 0 ###LEFT-WALL### 9 is 1 during 3 development 1 during 4 , 1 during 8 sirt1 2 neuronal 3 development 5 the 7 ortholog 6 sir2 7 ortholog 7 ortholog 8 sirt1 8 sirt1 9 is 9 is 11 important 10 structurally 11 important 11 important 13 promoting 12 , 13 promoting 13 promoting 20 and 13 promoting 23 . 14 axonal 15 elongation 15 elongation 16 , 16 , 18 outgrowth 16 , 20 and 17 neurite 18 outgrowth 19 , 20 and 20 and 21 dendritic 20 and 22 branching this sirtuin also plays a role in memory formation by modulating synaptic plasticity . 0 ###LEFT-WALL### 2 sirtuin 0 ###LEFT-WALL### 4 plays 0 ###LEFT-WALL### 14 . 1 this 2 sirtuin 2 sirtuin 4 plays 3 also 4 plays 4 plays 6 role 4 plays 7 in 4 plays 10 by 5 a 6 role 7 in 9 formation 8 memory 9 formation 10 by 13 plasticity 11 modulating 13 plasticity 12 synaptic 13 plasticity hypothalamic functions that affect feeding behavior , endocrine function , and circadian rhythmicity are all regulated by sirt1 . 0 ###LEFT-WALL### 2 functions 0 ###LEFT-WALL### 16 regulated 0 ###LEFT-WALL### 19 . 1 hypothalamic 2 functions 2 functions 3 that 2 functions 4 affect 2 functions 14 are 3 that 4 affect 4 affect 11 and 5 feeding 6 behavior 6 behavior 7 , 7 , 9 function 7 , 11 and 8 endocrine 9 function 10 , 11 and 11 and 13 rhythmicity 12 circadian 13 rhythmicity 14 are 16 regulated 15 all 16 regulated 16 regulated 17 by 17 by 18 sirt1 finally , sirt1 plays protective roles in several neurodegenerative diseases including alzheimer 's , parkinson 's , and motor neuron diseases , which may relate to its functions in metabolism , stress resistance , and genomic stability . 0 ###LEFT-WALL### 3 sirt1 0 ###LEFT-WALL### 4 plays 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 38 . 1 finally 2 , 1 finally 3 sirt1 3 sirt1 4 plays 4 plays 6 roles 4 plays 7 in 5 protective 6 roles 7 in 10 diseases 8 several 10 diseases 9 neurodegenerative 10 diseases 10 diseases 11 including 10 diseases 16 's 11 including 13 's 12 alzheimer 13 's 14 , 16 's 15 parkinson 16 's 16 's 17 , 18 and 21 diseases 18 and 32 stress 19 motor 20 neuron 20 neuron 21 diseases 21 diseases 23 which 21 diseases 32 stress 22 , 23 which 23 which 24 may 23 which 31 , 24 may 25 relate 25 relate 26 to 25 relate 29 in 26 to 28 functions 27 its 28 functions 29 in 30 metabolism 32 stress 35 and 33 resistance 35 and 34 , 35 and 35 and 37 stability 36 genomic 37 stability drugs that activate sirt1 may offer a promising approach to treat these disorders . 0 ###LEFT-WALL### 1 drugs 0 ###LEFT-WALL### 6 offer 0 ###LEFT-WALL### 14 . 1 drugs 2 that 1 drugs 3 activate 1 drugs 5 may 2 that 3 activate 3 activate 4 sirt1 5 may 6 offer 6 offer 9 approach 6 offer 10 to 7 a 8 promising 7 a 9 approach 8 promising 9 approach 10 to 11 treat 11 treat 13 disorders 12 these 13 disorders drawing upon interviews and participant observation conducted with hundreds of middle - aged and elderly chinese women in rural and urban neighborhoods in beijing municipality between 1993 and 2012 , this paper explores the emergence of revolutionary new narratives of self [-] compassion among older women in reform - era beijing . 0 ###LEFT-WALL### 11 middle 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 52 . 1 drawing 2 upon 1 drawing 4 and 2 upon 3 interviews 4 and 5 participant 4 and 6 observation 4 and 10 of 4 and 11 middle 6 observation 7 conducted 7 conducted 8 with 8 with 9 hundreds 9 hundreds 10 of 12 - 17 women 12 - 30 , 13 aged 14 and 14 and 15 elderly 14 and 17 women 16 chinese 17 women 17 women 18 in 17 women 23 in 18 in 22 neighborhoods 19 rural 20 and 20 and 21 urban 20 and 22 neighborhoods 23 in 25 municipality 24 beijing 25 municipality 25 municipality 28 and 26 between 28 and 27 1993 28 and 28 and 29 2012 30 , 32 paper 30 , 33 explores 30 , 49 - 31 this 32 paper 32 paper 33 explores 33 explores 35 emergence 34 the 35 emergence 35 emergence 36 of 35 emergence 40 of 35 emergence 47 in 36 of 39 narratives 37 revolutionary 39 narratives 38 new 39 narratives 40 of 43 compassion 41 self 43 compassion 43 compassion 44 among 44 among 46 women 45 older 46 women 47 in 48 reform 49 - 51 beijing 50 era 51 beijing taught before 1949 that [they] should first and [foremost] serve their families [and] after 1949 that they should put their own individual needs aside and serve the party and the masses , many older chinese women in beijing - [after] the seeds of market reform were sown in the late 1970s - slowly [began] to focus more attention than before on themselves , their past and present experiences , sources [of] and solutions to past and present distress , and their own personal enjoyment of everyday life . 0 ###LEFT-WALL### 8 and 1 taught 2 before 1 taught 7 first 1 taught 8 and 2 before 3 1949 3 1949 4 that 3 1949 6 should 4 that 6 should 8 and 10 serve 10 serve 12 families 10 serve 14 after 11 their 12 families 14 after 15 1949 15 1949 16 that 15 1949 25 and 16 that 17 they 16 that 25 and 17 they 25 and 18 should 19 put 18 should 25 and 19 put 23 needs 19 put 24 aside 20 their 21 own 20 their 23 needs 22 individual 23 needs 25 and 26 serve 26 serve 29 and 27 the 29 and 28 party 29 and 29 and 31 masses 29 and 39 - 30 the 31 masses 32 , 39 - 33 many 36 women 34 older 36 women 35 chinese 36 women 36 women 37 in 36 women 39 - 37 in 38 beijing 39 - 42 seeds 41 the 42 seeds 42 seeds 43 of 42 seeds 47 sown 43 of 44 market 44 market 45 reform 44 market 46 were 45 reform 46 were 47 sown 48 in 47 sown 55 to 48 in 51 1970s 49 the 51 1970s 50 late 51 1970s 52 - 55 to 53 slowly 55 to 55 to 56 focus 56 focus 68 experiences 57 more 58 attention 58 attention 59 than 58 attention 60 before 58 attention 61 on 58 attention 63 , 61 on 62 themselves 63 , 65 past 63 , 66 and 64 their 65 past 66 and 67 present 66 and 68 experiences 68 experiences 80 and 69 , 80 and 70 sources 72 and 72 and 73 solutions 72 and 74 to 72 and 76 and 74 to 75 past 76 and 78 distress 76 and 79 , 76 and 80 and 77 present 78 distress 80 and 84 enjoyment 80 and 85 of 80 and 88 . 81 their 82 own 81 their 84 enjoyment 83 personal 84 enjoyment 85 of 87 life 86 everyday 87 life the analysis shows how western theories of both gero - transcendence and individualization as modernization are insufficient to account for the complex cultural formations of self [-] care that have developed among older women in the first decades of post - mao china . 1 the 2 analysis 2 analysis 3 shows 3 shows 4 how 4 how 6 theories 4 how 19 account 5 western 6 theories 6 theories 7 of 6 theories 12 and 6 theories 18 to 6 theories 19 account 7 of 8 both 9 gero 10 - 9 gero 11 transcendence 11 transcendence 12 and 12 and 13 individualization 12 and 14 as 12 and 16 are 14 as 15 modernization 16 are 17 insufficient 17 insufficient 18 to 19 account 20 for 19 account 32 among 20 for 24 formations 21 the 24 formations 22 complex 24 formations 23 cultural 24 formations 24 formations 25 of 24 formations 29 that 24 formations 30 have 25 of 28 care 26 self 28 care 29 that 30 have 30 have 31 developed 32 among 34 women 33 older 34 women 34 women 35 in 34 women 39 of 34 women 43 china 35 in 38 decades 36 the 37 first 36 the 38 decades 39 of 40 post 41 - 43 china 42 mao 43 china 43 china 44 . background : there is growing evidence for the ongoing structural and functional adaptation of the skin after birth . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 is 2 : 19 . 3 there 4 is 4 is 6 evidence 5 growing 6 evidence 6 evidence 7 for 6 evidence 14 of 7 for 13 adaptation 8 the 13 adaptation 9 ongoing 13 adaptation 10 structural 11 and 11 and 12 functional 11 and 13 adaptation 14 of 16 skin 15 the 16 skin 16 skin 17 after 17 after 18 birth objectives : the aim of this study was the definition of scanning electron microscopy markers of skin maturation in different age groups ( birth to adulthood ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 8 was 2 : 28 . 3 the 4 aim 4 aim 5 of 4 aim 8 was 5 of 7 study 6 this 7 study 8 was 10 definition 9 the 10 definition 10 definition 11 of 11 of 12 scanning 12 scanning 15 markers 12 scanning 19 in 13 electron 15 markers 14 microscopy 15 markers 15 markers 16 of 16 of 18 maturation 17 skin 18 maturation 19 in 22 groups 20 different 21 age 21 age 22 groups 22 groups 24 birth 23 ( 24 birth 24 birth 25 to 24 birth 27 ) 25 to 26 adulthood we propose a semiquantitative score to analyse the maturation of the skin surface and a complementary evaluation of the distribution of corneodesmosin and corneodesmosomes . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 25 . 1 we 23 and 2 propose 5 score 2 propose 6 to 2 propose 23 and 3 a 4 semiquantitative 3 a 5 score 4 semiquantitative 5 score 6 to 7 analyse 7 analyse 9 maturation 8 the 9 maturation 9 maturation 10 of 9 maturation 18 of 10 of 14 and 11 the 13 surface 12 skin 13 surface 13 surface 14 and 14 and 17 evaluation 15 a 16 complementary 15 a 17 evaluation 16 complementary 17 evaluation 18 of 20 distribution 19 the 20 distribution 20 distribution 21 of 21 of 22 corneodesmosin 23 and 24 corneodesmosomes material and methods : an electron microscopy isotropy ( e.m.i [.] ) score was performed in six age - groups to include fullterm neonates , babies , children and adults . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 material 2 and 2 and 3 methods 4 : 13 score 4 : 15 performed 4 : 25 , 4 : 31 . 5 an 13 score 6 electron 13 score 7 microscopy 13 score 8 isotropy 10 e.m.i 8 isotropy 12 ) 8 isotropy 13 score 9 ( 10 e.m.i 10 e.m.i 12 ) 13 score 14 was 14 was 15 performed 15 performed 16 in 16 in 18 age 17 six 18 age 18 age 20 groups 19 - 20 groups 20 groups 21 to 20 groups 22 include 20 groups 25 , 21 to 22 include 22 include 24 neonates 23 fullterm 24 neonates 25 , 29 and 26 babies 27 , 27 , 28 children 27 , 29 and 29 and 30 adults the distribution of corneodesmosome remnants was analysed by corneodesmosin distribution with immunocytochemical corneocyte labelling . 0 ###LEFT-WALL### 2 distribution 0 ###LEFT-WALL### 7 analysed 0 ###LEFT-WALL### 15 . 1 the 2 distribution 2 distribution 3 of 2 distribution 6 was 3 of 5 remnants 4 corneodesmosome 5 remnants 6 was 7 analysed 7 analysed 8 by 7 analysed 11 with 8 by 10 distribution 9 corneodesmosin 10 distribution 11 with 14 labelling 12 immunocytochemical 14 labelling 13 corneocyte 14 labelling results : the e.m.i . score [showed] the highest anisotropy in neonates . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 . 1 results 2 : 2 : 4 e.m.i 3 the 4 e.m.i 5 . 6 score 5 . 13 . 6 score 10 anisotropy 6 score 11 in 8 the 9 highest 8 the 10 anisotropy 11 in 12 neonates the youngest groups displayed irregular and thick cell clusters composed of poorly individualized cells . 0 ###LEFT-WALL### 3 groups 0 ###LEFT-WALL### 4 displayed 0 ###LEFT-WALL### 15 . 1 the 2 youngest 1 the 3 groups 3 groups 4 displayed 4 displayed 9 clusters 5 irregular 6 and 6 and 7 thick 6 and 8 cell 8 cell 9 clusters 9 clusters 11 of 10 composed 11 of 11 of 14 cells 12 poorly 13 individualized 13 individualized 14 cells in the older groups , the distribution of superficial corneocytes was more regular . 0 ###LEFT-WALL### 7 distribution 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 14 . 1 in 4 groups 1 in 5 , 1 in 7 distribution 2 the 4 groups 3 older 4 groups 6 the 7 distribution 7 distribution 8 of 7 distribution 11 was 8 of 10 corneocytes 9 superficial 10 corneocytes 11 was 13 regular 12 more 13 regular the cells evenly covered the surface and displayed easily visualized single cell outlines . 0 ###LEFT-WALL### 2 cells 0 ###LEFT-WALL### 10 visualized 0 ###LEFT-WALL### 14 . 1 the 2 cells 2 cells 7 and 2 cells 10 visualized 3 evenly 4 covered 4 covered 6 surface 4 covered 7 and 5 the 6 surface 7 and 8 displayed 9 easily 10 visualized 10 visualized 13 outlines 11 single 12 cell 12 cell 13 outlines the distribution of immune - labelled corneodesmosome remnants and the corneocyte projected area showed a correlation between age and structural maturation . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 14 showed 0 ###LEFT-WALL### 22 . 1 the 2 distribution 2 distribution 3 of 2 distribution 9 and 3 of 8 remnants 4 immune 5 - 4 immune 8 remnants 6 labelled 8 remnants 7 corneodesmosome 8 remnants 9 and 13 area 9 and 14 showed 10 the 13 area 11 corneocyte 13 area 12 projected 13 area 14 showed 16 correlation 14 showed 19 and 15 a 16 correlation 16 correlation 17 between 17 between 18 age 19 and 21 maturation 20 structural 21 maturation the observed evolution indicated a poorly controlled process of corneocyte desquamation in infants and confirmed the relative immaturity of the epidermal barrier up to 1 - 2 years after birth under basal conditions . 0 ###LEFT-WALL### 3 evolution 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 34 . 1 the 3 evolution 2 observed 3 evolution 3 evolution 14 and 4 indicated 8 process 4 indicated 14 and 5 a 8 process 6 poorly 7 controlled 7 controlled 8 process 8 process 9 of 8 process 12 in 9 of 11 desquamation 10 corneocyte 11 desquamation 12 in 13 infants 14 and 15 confirmed 14 and 29 after 14 and 31 under 15 confirmed 18 immaturity 16 the 18 immaturity 17 relative 18 immaturity 18 immaturity 19 of 18 immaturity 23 up 19 of 22 barrier 20 the 22 barrier 21 epidermal 22 barrier 23 up 24 to 24 to 28 years 25 1 26 - 26 - 27 2 26 - 28 years 29 after 30 birth 31 under 33 conditions 32 basal 33 conditions conclusion : our study is the first attempt [at] semiquantitative evaluation of the micromorphology maturation of the epidermal surface at the ultrastructural level . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 is 2 : 24 . 3 our 4 study 4 study 5 is 5 is 11 evaluation 6 the 7 first 6 the 11 evaluation 8 attempt 11 evaluation 10 semiquantitative 11 evaluation 11 evaluation 12 of 12 of 15 maturation 13 the 15 maturation 14 micromorphology 15 maturation 15 maturation 16 of 16 of 19 surface 17 the 19 surface 18 epidermal 19 surface 19 surface 20 at 20 at 23 level 21 the 23 level 22 ultrastructural 23 level the e.m.i . score and the associated pattern of corneodesmosome breakdown may be used as markers of the stratum corneum maturation . 0 ###LEFT-WALL### 2 e.m.i 0 ###LEFT-WALL### 3 . 1 the 2 e.m.i 3 . 4 score 3 . 5 and 3 . 22 . 5 and 8 pattern 5 and 14 used 6 the 8 pattern 7 associated 8 pattern 8 pattern 9 of 8 pattern 12 may 9 of 11 breakdown 10 corneodesmosome 11 breakdown 12 may 13 be 13 be 14 used 14 used 15 as 15 as 16 markers 16 markers 17 of 17 of 21 maturation 18 the 21 maturation 19 stratum 21 maturation 20 corneum 21 maturation objectives : to assess the differences in antipsychotic drug prescription rates in residents with dementia in dementia special care units ( scus ) of dutch nursing homes , considering the differences in patient characteristics . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 assess 3 to 4 assess 4 assess 6 differences 4 assess 7 in 4 assess 12 in 4 assess 29 considering 5 the 6 differences 7 in 11 rates 8 antipsychotic 9 drug 9 drug 11 rates 10 prescription 11 rates 12 in 13 residents 13 residents 14 with 13 residents 16 in 13 residents 24 of 14 with 15 dementia 16 in 20 units 17 dementia 20 units 18 special 20 units 19 care 20 units 20 units 22 scus 21 ( 22 scus 22 scus 23 ) 24 of 27 homes 25 dutch 27 homes 26 nursing 27 homes 28 , 29 considering 29 considering 31 differences 29 considering 32 in 29 considering 35 . 30 the 31 differences 32 in 34 characteristics 33 patient 34 characteristics method : as part of the waalbed - [ii] study , the data on antipsychotic drug use in 290 patients were collected and the global deterioration scale ( gds [ )(stage , type of dementia and behaviour ( cohen - mansfield agitation inventory ( cmai [ )( ( [measured] in 14 scus in nine nursing homes . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 13 data 3 as 4 part 3 as 13 data 4 part 5 of 5 of 7 waalbed 6 the 7 waalbed 7 waalbed 10 study 8 - 10 study 10 study 11 , 12 the 13 data 13 data 14 on 13 data 21 were 14 on 17 use 15 antipsychotic 17 use 16 drug 17 use 17 use 18 in 18 in 20 patients 19 290 20 patients 21 were 23 and 22 collected 23 and 23 and 33 type 24 the 33 type 25 global 26 deterioration 26 deterioration 27 scale 27 scale 31 )(stage 27 scale 33 type 28 ( 31 )(stage 29 gds 31 )(stage 31 )(stage 32 , 33 type 34 of 34 of 36 and 35 dementia 36 and 36 and 37 behaviour 36 and 39 cohen 36 and 45 cmai 38 ( 39 cohen 39 cohen 40 - 40 - 45 cmai 41 mansfield 42 agitation 42 agitation 43 inventory 43 inventory 45 cmai 44 ( 45 cmai 45 cmai 47 )( 45 cmai 50 in 45 cmai 57 . 50 in 52 scus 51 14 52 scus 52 scus 53 in 52 scus 55 nursing 53 in 54 nine 55 nursing 56 homes a multilevel logistic regression model was used to assess the difference in antipsychotic drug prescription rates between dementia scus adjusted for age , gender , gds stage , type of dementia and cmai factor scores . 0 ###LEFT-WALL### 5 model 0 ###LEFT-WALL### 36 . 1 a 5 model 2 multilevel 3 logistic 3 logistic 4 regression 4 regression 5 model 5 model 6 was 6 was 7 used 7 used 8 to 7 used 9 assess 8 to 9 assess 9 assess 11 difference 9 assess 34 factor 10 the 11 difference 11 difference 12 in 11 difference 16 rates 12 in 15 prescription 13 antipsychotic 14 drug 14 drug 15 prescription 16 rates 17 between 17 between 18 dementia 18 dementia 32 and 18 dementia 34 factor 19 scus 20 adjusted 19 scus 23 , 20 adjusted 21 for 21 for 22 age 23 , 24 gender 23 , 25 , 25 , 27 stage 25 , 28 , 26 gds 27 stage 28 , 30 of 28 , 32 and 29 type 30 of 30 of 31 dementia 32 and 33 cmai 32 and 34 factor 34 factor 35 scores results : two hundred and ninety residents met the inclusion criteria . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 7 residents 2 : 8 met 2 : 12 . 3 two 4 hundred 4 hundred 5 and 5 and 6 ninety 6 ninety 7 residents 7 residents 8 met 8 met 11 criteria 9 the 11 criteria 10 inclusion 11 criteria thirty - two per cent were prescribed an antipsychotic drug . 0 ###LEFT-WALL### 1 thirty 0 ###LEFT-WALL### 7 prescribed 0 ###LEFT-WALL### 11 . 1 thirty 3 two 1 thirty 6 were 1 thirty 7 prescribed 2 - 3 two 3 two 6 were 4 per 5 cent 5 cent 6 were 7 prescribed 10 drug 8 an 9 antipsychotic 8 an 10 drug 9 antipsychotic 10 drug antipsychotic drugs were more often prescribed in patients with physically aggressive [and] [non] - aggressive behaviour and in patients with mixed dementia ( vascular/alzheimer's ) than in patients with other types of dementia . 0 ###LEFT-WALL### 2 drugs 0 ###LEFT-WALL### 6 prescribed 0 ###LEFT-WALL### 34 . 1 antipsychotic 2 drugs 2 drugs 3 were 3 were 5 often 3 were 6 prescribed 4 more 5 often 6 prescribed 7 in 6 prescribed 17 and 6 prescribed 20 with 6 prescribed 26 than 7 in 8 patients 9 with 16 behaviour 9 with 17 and 10 physically 11 aggressive 11 aggressive 14 - 11 aggressive 16 behaviour 15 aggressive 16 behaviour 17 and 18 in 18 in 19 patients 20 with 22 dementia 21 mixed 22 dementia 22 dementia 24 vascular/alzheimer's 23 ( 24 vascular/alzheimer's 24 vascular/alzheimer's 25 ) 26 than 27 in 27 in 28 patients 28 patients 29 with 29 with 31 types 30 other 31 types 31 types 32 of 32 of 33 dementia antipsychotic drug prescriptions significantly differed among the dementia scus . 0 ###LEFT-WALL### 3 prescriptions 0 ###LEFT-WALL### 5 differed 0 ###LEFT-WALL### 10 . 1 antipsychotic 2 drug 2 drug 3 prescriptions 3 prescriptions 5 differed 4 significantly 5 differed 5 differed 6 among 6 among 9 scus 7 the 8 dementia 8 dementia 9 scus the odds of antipsychotic drug use for patients in the scu with the highest prevalence of drug use were 2.76 ( 95 % confidence interval ( [ci] [ )(1.14 - 6.69 ) times as high as for the scu with the lowest prevalence of drug use , taking the patient characteristics into account . 1 the 2 odds 2 odds 3 of 2 odds 19 were 3 of 6 use 4 antipsychotic 5 drug 5 drug 6 use 6 use 7 for 6 use 12 with 6 use 16 of 7 for 8 patients 8 patients 9 in 9 in 11 scu 10 the 11 scu 12 with 15 prevalence 13 the 14 highest 13 the 15 prevalence 16 of 18 use 17 drug 18 use 19 were 20 2.76 20 2.76 33 times 21 ( 33 times 22 95 33 times 23 % 24 confidence 24 confidence 33 times 25 interval 33 times 26 ( 30 - 29 )(1.14 30 - 30 - 31 6.69 30 - 32 ) 30 - 33 times 33 times 35 high 33 times 54 . 34 as 35 high 35 high 36 as 35 high 40 with 36 as 37 for 37 for 39 scu 38 the 39 scu 40 with 43 prevalence 41 the 42 lowest 41 the 43 prevalence 43 prevalence 44 of 43 prevalence 48 taking 44 of 46 use 45 drug 46 use 47 , 48 taking 48 taking 51 characteristics 48 taking 53 account 48 taking 54 . 49 the 51 characteristics 50 patient 51 characteristics 52 into 53 account conclusion : antipsychotic drug use in nursing home residents with dementia is not only predicted by the type of dementia and patient behaviour , but it is independently associated with the dementia scu at which the patient resides . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 but 0 ###LEFT-WALL### 39 . 1 conclusion 2 : 2 : 3 antipsychotic 2 : 16 by 3 antipsychotic 5 use 3 antipsychotic 12 is 3 antipsychotic 15 predicted 4 drug 5 use 5 use 6 in 5 use 12 is 6 in 7 nursing 7 nursing 8 home 7 nursing 9 residents 9 residents 10 with 10 with 11 dementia 12 is 13 not 14 only 15 predicted 16 by 21 and 17 the 19 of 18 type 19 of 19 of 20 dementia 19 of 21 and 21 and 23 behaviour 22 patient 23 behaviour 24 , 25 but 25 but 26 it 25 but 29 associated 26 it 27 is 27 is 29 associated 28 independently 29 associated 29 associated 30 with 30 with 32 dementia 30 with 33 scu 31 the 32 dementia 33 scu 34 at 34 at 35 which 34 at 37 patient 34 at 38 resides 36 the 37 patient 37 patient 38 resides this result indicates that antipsychotic drugs are not only prescribed for their clinical indications ( agitation/aggression ) but [are] associated with environmental factors that may reflect a specific nursing home prescribing culture . 0 ###LEFT-WALL### 2 result 0 ###LEFT-WALL### 18 but 0 ###LEFT-WALL### 33 . 1 this 2 result 2 result 18 but 3 indicates 4 that 3 indicates 18 but 4 that 6 drugs 4 that 10 prescribed 5 antipsychotic 6 drugs 6 drugs 7 are 7 are 8 not 7 are 9 only 7 are 10 prescribed 10 prescribed 11 for 11 for 14 indications 12 their 14 indications 13 clinical 14 indications 14 indications 16 agitation/aggression 15 ( 16 agitation/aggression 16 agitation/aggression 17 ) 18 but 20 associated 20 associated 21 with 21 with 23 factors 22 environmental 23 factors 23 factors 24 that 23 factors 25 may 23 factors 31 prescribing 24 that 25 may 25 may 26 reflect 26 reflect 30 home 27 a 28 specific 27 a 30 home 28 specific 29 nursing 29 nursing 30 home 31 prescribing 32 culture background : currently , there is not enough echocardiographic information regarding aging - associated changes in the octogenarian population . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 5 there 2 : 6 is 2 : 13 - 3 currently 4 , 3 currently 5 there 5 there 6 is 6 is 7 not 6 is 11 regarding 8 enough 11 regarding 9 echocardiographic 10 information 10 information 11 regarding 11 regarding 12 aging 13 - 15 changes 14 associated 15 changes 15 changes 16 in 16 in 19 population 17 the 19 population 18 octogenarian 19 population we aimed to characterize echocardiographic measures of structure and function among a group of healthy octogenarians . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 17 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 characterize 3 to 4 characterize 4 characterize 6 measures 4 characterize 11 among 5 echocardiographic 6 measures 6 measures 7 of 7 of 9 and 8 structure 9 and 9 and 10 function 11 among 16 octogenarians 12 a 13 group 13 group 14 of 13 group 16 octogenarians 14 of 16 octogenarians 15 healthy 16 octogenarians methods : approximately 350 octogenarians , residing in nursing homes , were screened in ankara , turkey . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 octogenarians 2 : 13 screened 2 : 16 , 2 : 18 . 3 approximately 4 350 4 350 5 octogenarians 5 octogenarians 7 residing 5 octogenarians 12 were 6 , 7 residing 7 residing 8 in 7 residing 11 , 8 in 9 nursing 9 nursing 10 homes 12 were 13 screened 13 screened 14 in 14 in 15 ankara 16 , 17 turkey according to inclusion criteria , 40 octogenarians were enrolled . 0 ###LEFT-WALL### 7 octogenarians 0 ###LEFT-WALL### 9 enrolled 0 ###LEFT-WALL### 10 . 1 according 2 to 2 to 4 criteria 2 to 5 , 2 to 7 octogenarians 3 inclusion 4 criteria 6 40 7 octogenarians 7 octogenarians 8 were 8 were 9 enrolled these subjects underwent conventional and tissue doppler echocardiography according to the guidelines of the american society of echocardiography ( ase ) . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 22 . 1 these 2 subjects 2 subjects 3 underwent 3 underwent 5 and 3 underwent 10 to 4 conventional 5 and 5 and 8 echocardiography 6 tissue 8 echocardiography 7 doppler 8 echocardiography 9 according 10 to 10 to 12 guidelines 11 the 12 guidelines 12 guidelines 13 of 12 guidelines 17 of 13 of 16 society 14 the 16 society 15 american 16 society 17 of 20 ase 18 echocardiography 20 ase 19 ( 20 ase 20 ase 21 ) the population [was] also separated into various groups according to gender , body mass index [(] bmi , < 25 vs [.] 25 - 29.9 ) , and blood pressure ( < 80/120 mmhg vs [.] 80 - 89/120 - 139 mmhg ) . 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 44 . 1 the 2 population 2 population 5 separated 2 population 28 and 4 also 5 separated 5 separated 6 into 5 separated 10 to 6 into 8 groups 7 various 8 groups 9 according 10 to 10 to 11 gender 11 gender 17 bmi 11 gender 20 25 12 , 17 bmi 13 body 14 mass 14 mass 15 index 15 index 17 bmi 17 bmi 18 , 18 , 20 25 19 < 20 25 20 25 21 vs 20 25 26 ) 21 vs 24 - 23 25 24 - 24 - 25 29.9 27 , 28 and 28 and 30 pressure 28 and 40 - 29 blood 30 pressure 31 ( 40 - 32 < 34 mmhg 33 80/120 34 mmhg 34 mmhg 35 vs 34 mmhg 40 - 35 vs 38 - 37 80 38 - 38 - 39 89/120 40 - 42 mmhg 40 - 43 ) 41 139 42 mmhg all measurements were indexed by dividing to body surface area ( bsa ) for standardization . 0 ###LEFT-WALL### 2 measurements 0 ###LEFT-WALL### 4 indexed 0 ###LEFT-WALL### 16 . 1 all 2 measurements 2 measurements 3 were 3 were 4 indexed 4 indexed 5 by 4 indexed 7 to 4 indexed 14 for 5 by 6 dividing 7 to 10 area 8 body 10 area 9 surface 10 area 10 area 12 bsa 11 ( 12 bsa 12 bsa 13 ) 14 for 15 standardization results : left [ventricular] [mass] ( lvm ) , posterior wall thickness , right [ventricular] diameter , tricuspid e/a ratio , and septal [e] ['] - wave velocity were significantly higher in men , which lost significance after adjusting for bsa . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 1 results 2 : 2 : 3 left 3 left 7 lvm 6 ( 7 lvm 7 lvm 8 ) 9 , 12 thickness 9 , 13 , 10 posterior 12 thickness 11 wall 12 thickness 13 , 22 and 14 right 22 and 16 diameter 17 , 17 , 20 ratio 17 , 22 and 18 tricuspid 20 ratio 19 e/a 20 ratio 21 , 22 and 22 and 28 velocity 22 and 29 were 23 septal 26 - 23 septal 28 velocity 27 wave 28 velocity 29 were 31 higher 29 were 32 in 30 significantly 31 higher 32 in 33 men 33 men 35 which 34 , 35 which 35 which 36 lost 35 which 42 . 36 lost 37 significance 37 significance 38 after 38 after 39 adjusting 39 adjusting 40 for 40 for 41 bsa there was no significant difference between groups formed by bmi and blood pressure . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 14 . 1 there 2 was 2 was 5 difference 2 was 6 between 2 was 9 by 3 no 5 difference 4 significant 5 difference 6 between 7 groups 7 groups 8 formed 9 by 11 and 10 bmi 11 and 11 and 13 pressure 12 blood 13 pressure moreover , mild global left and right [ventricular] dysfunction including a prominent diastolic counterpart , however , with normal ejection [fraction] was revealed using conventional and tissue doppler techniques . 0 ###LEFT-WALL### 9 dysfunction 0 ###LEFT-WALL### 23 revealed 0 ###LEFT-WALL### 30 . 1 moreover 2 , 1 moreover 9 dysfunction 3 mild 9 dysfunction 4 global 9 dysfunction 5 left 6 and 6 and 7 right 6 and 9 dysfunction 9 dysfunction 10 including 9 dysfunction 22 was 10 including 14 counterpart 10 including 16 however 10 including 18 with 11 a 12 prominent 11 a 14 counterpart 12 prominent 14 counterpart 13 diastolic 14 counterpart 15 , 16 however 16 however 17 , 18 with 20 ejection 19 normal 20 ejection 22 was 23 revealed 23 revealed 24 using 24 using 26 and 25 conventional 26 and 26 and 29 techniques 27 tissue 29 techniques 28 doppler 29 techniques finally , we checked our results with the current reference values of the ase and observed the following differences : [ventricular] septum , relative wall thickness , lvm , and mass index values were above ase reference range , posterior wall measurements were close to upper range . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 20 : 0 ###LEFT-WALL### 48 . 1 finally 2 , 1 finally 3 we 3 we 15 and 4 checked 6 results 4 checked 15 and 5 our 6 results 6 results 7 with 6 results 10 reference 6 results 11 values 6 results 12 of 7 with 9 current 8 the 9 current 10 reference 11 values 12 of 14 ase 13 the 14 ase 15 and 16 observed 16 observed 19 differences 17 the 18 following 17 the 19 differences 20 : 30 and 20 : 39 , 22 septum 23 , 23 , 26 thickness 23 , 27 , 24 relative 25 wall 25 wall 26 thickness 27 , 28 lvm 27 , 30 and 29 , 30 and 30 and 32 index 30 and 33 values 30 and 34 were 30 and 35 above 31 mass 32 index 33 values 34 were 35 above 38 range 36 ase 37 reference 37 reference 38 range 39 , 40 posterior 39 , 43 were 40 posterior 43 were 41 wall 42 measurements 42 measurements 43 were 43 were 44 close 44 close 45 to 45 to 47 range 46 upper 47 range on the contrary , left [ventricular] diameters and volumes were below ase reference range . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 15 . 1 on 3 contrary 1 on 4 , 1 on 8 and 2 the 3 contrary 5 left 7 diameters 7 diameters 8 and 8 and 9 volumes 8 and 10 were 10 were 11 below 11 below 14 range 12 ase 14 range 13 reference 14 range conclusions : we described echocardiographic measures of structure and function in a group of healthy octogenarians . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 3 we 2 : 4 described 3 we 4 described 4 described 6 measures 4 described 11 in 5 echocardiographic 6 measures 6 measures 7 of 7 of 9 and 8 structure 9 and 9 and 10 function 11 in 16 octogenarians 12 a 13 group 13 group 14 of 13 group 16 octogenarians 14 of 16 octogenarians 15 healthy 16 octogenarians aim : the present study evaluated the association between changes in physical functioning and a variety of factors in an older population in taiwan . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 5 study 2 : 6 evaluated 3 the 5 study 4 present 5 study 5 study 6 evaluated 6 evaluated 8 association 6 evaluated 9 between 6 evaluated 11 in 7 the 8 association 9 between 10 changes 11 in 14 and 12 physical 13 functioning 13 functioning 14 and 14 and 16 variety 14 and 17 of 14 and 23 in 15 a 16 variety 17 of 18 factors 18 factors 19 in 19 in 22 population 20 an 22 population 21 older 22 population 23 in 24 taiwan methods : the data of 907 participants were derived from a three [-] wave cohort study of aging , the functioning and aging study in taipei , with a study period from 2005 to 2009 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 data 2 : 9 derived 2 : 19 , 3 the 4 data 4 data 5 of 4 data 8 were 5 of 7 participants 6 907 7 participants 8 were 9 derived 9 derived 10 from 10 from 16 study 11 a 16 study 12 three 16 study 14 wave 15 cohort 15 cohort 16 study 16 study 17 of 17 of 18 aging 19 , 22 and 20 the 21 functioning 21 functioning 22 and 22 and 24 study 22 and 25 in 22 and 28 with 23 aging 24 study 25 in 26 taipei 27 , 28 with 28 with 30 study 28 with 31 period 28 with 36 . 29 a 30 study 31 period 34 to 32 from 34 to 33 2005 34 to 34 to 35 2009 functional status was assessed using activities of daily living , instrumental activities of daily living and mobility tasks , and classified as being normal , with mild disability , moderate disability , and severe disability . 0 ###LEFT-WALL### 1 functional 0 ###LEFT-WALL### 36 . 1 functional 3 was 1 functional 5 using 1 functional 22 as 2 status 3 was 3 was 4 assessed 5 using 20 and 6 activities 7 of 6 activities 10 , 7 of 9 living 8 daily 9 living 10 , 12 activities 10 , 16 and 11 instrumental 12 activities 12 activities 13 of 13 of 15 living 14 daily 15 living 16 and 18 tasks 16 and 20 and 17 mobility 18 tasks 19 , 20 and 20 and 21 classified 22 as 35 disability 23 being 35 disability 24 normal 26 with 24 normal 33 and 25 , 26 with 26 with 28 disability 26 with 32 , 27 mild 28 disability 28 disability 31 disability 29 , 31 disability 30 moderate 31 disability 31 disability 32 , 32 , 33 and 33 and 34 severe 33 and 35 disability all potential factors were allocated into five groups including demography , chronic diseases , geriatric conditions , lifestyle and physical assessments . 0 ###LEFT-WALL### 3 factors 0 ###LEFT-WALL### 5 allocated 0 ###LEFT-WALL### 22 . 1 all 3 factors 2 potential 3 factors 3 factors 4 were 4 were 5 allocated 5 allocated 6 into 6 into 19 and 7 five 8 groups 8 groups 9 including 8 groups 11 , 9 including 10 demography 11 , 13 diseases 11 , 14 , 12 chronic 13 diseases 14 , 16 conditions 14 , 17 , 15 geriatric 16 conditions 17 , 18 lifestyle 17 , 19 and 19 and 21 assessments 20 physical 21 assessments generalized estimating equations and generalized linear [mixed] - effects models were used to identify factors responsible for changes in physical functioning across different waves of data . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 27 . 1 generalized 3 equations 1 generalized 4 and 2 estimating 3 equations 4 and 5 generalized 5 generalized 9 effects 5 generalized 19 in 5 generalized 22 across 6 linear 8 - 6 linear 9 effects 9 effects 10 models 9 effects 14 identify 10 models 11 were 11 were 12 used 12 used 13 to 12 used 14 identify 13 to 14 identify 14 identify 15 factors 15 factors 16 responsible 16 responsible 17 for 17 for 18 changes 19 in 21 functioning 20 physical 21 functioning 22 across 24 waves 23 different 24 waves 24 waves 25 of 25 of 26 data results : the proportion of elderly participants with normal function decreased [with] time throughout the study period . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 results 2 : 2 : 4 proportion 2 : 8 with 2 : 14 throughout 3 the 4 proportion 4 proportion 5 of 5 of 7 participants 6 elderly 7 participants 8 with 13 time 9 normal 10 function 10 function 11 decreased 11 decreased 13 time 14 throughout 17 period 15 the 17 period 16 study 17 period the results of generalized estimating equations and mixed effects models showed nearly identical sets of factors . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 17 . 1 the 2 results 2 results 3 of 2 results 7 and 3 of 4 generalized 4 generalized 5 estimating 5 estimating 6 equations 7 and 9 effects 7 and 10 models 7 and 11 showed 8 mixed 9 effects 10 models 11 showed 11 showed 14 sets 12 nearly 13 identical 13 identical 14 sets 14 sets 15 of 15 of 16 factors these included age , living arrangements , social support , self - rated health , stroke , diabetes , parkinson 's disease , osteoporosis , depression , cognition , vision , history [of] fracture and [falls] [,] incontinence of urine and feces , physical activity , body mass index , and short physical performance battery . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 21 's 1 these 2 included 2 included 3 age 2 included 5 living 4 , 5 living 5 living 6 arrangements 5 living 7 , 7 , 9 support 7 , 10 , 8 social 9 support 10 , 11 self 10 , 12 - 12 - 15 , 12 - 17 , 13 rated 14 health 13 rated 15 , 15 , 16 stroke 17 , 18 diabetes 17 , 19 , 19 , 20 parkinson 19 , 21 's 20 parkinson 21 's 21 's 35 and 22 disease 23 , 23 , 24 osteoporosis 23 , 25 , 25 , 26 depression 25 , 27 , 27 , 28 cognition 27 , 29 , 29 , 30 vision 29 , 31 , 31 , 34 fracture 31 , 35 and 32 history 34 fracture 35 and 38 incontinence 35 and 39 of 39 of 51 and 40 urine 41 and 41 and 42 feces 41 and 43 , 43 , 45 activity 43 , 46 , 44 physical 45 activity 46 , 49 index 46 , 51 and 47 body 48 mass 48 mass 49 index 50 , 51 and 51 and 55 battery 51 and 56 . 52 short 55 battery 53 physical 55 battery 54 performance 55 battery conclusions : older persons with stroke [,] parkinson 's disease , diabetes , osteoporosis , geriatric conditions and poor short physical performance battery score should be considered as the target of prevention [against] functional [decline] . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 36 . 1 conclusions 2 : 2 : 4 persons 3 older 4 persons 4 persons 5 with 4 persons 12 diabetes 4 persons 14 osteoporosis 5 with 10 disease 6 stroke 8 parkinson 8 parkinson 9 's 9 's 10 disease 11 , 12 diabetes 12 diabetes 13 , 13 , 14 osteoporosis 14 osteoporosis 15 , 15 , 18 and 15 , 27 considered 16 geriatric 17 conditions 17 conditions 18 and 18 and 24 score 18 and 25 should 19 poor 24 score 20 short 24 score 21 physical 24 score 22 performance 23 battery 23 battery 24 score 25 should 26 be 26 be 27 considered 27 considered 28 as 27 considered 34 functional 28 as 30 target 29 the 30 target 30 target 31 of 31 of 32 prevention those not living with spouses , with poor self [-] rated health , with low social support , being underweight or obese [and] with a sedentary lifestyle might also require major attention . 0 ###LEFT-WALL### 1 those 0 ###LEFT-WALL### 2 not 0 ###LEFT-WALL### 33 . 2 not 19 being 2 not 30 require 3 living 4 with 3 living 6 , 3 living 19 being 4 with 5 spouses 6 , 7 with 7 with 12 health 7 with 18 , 7 with 19 being 8 poor 9 self 9 self 12 health 11 rated 12 health 12 health 14 with 13 , 14 with 14 with 17 support 14 with 18 , 15 low 16 social 16 social 17 support 19 being 21 or 19 being 28 might 20 underweight 21 or 21 or 22 obese 22 obese 24 with 24 with 27 lifestyle 25 a 27 lifestyle 26 sedentary 27 lifestyle 28 might 30 require 29 also 30 require 30 require 32 attention 31 major 32 attention purpose : to evaluate the relationship between corneal hysteresis ( ch ) and corneal resistance factor ( crf [ )(with age , central corneal thickness ( cct ) , corneal curvature ( km ) , corneal volume ( cv ) , and refractive error in naïve eyes . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 48 . 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 42 and 4 evaluate 45 in 5 the 6 relationship 6 relationship 7 between 6 relationship 13 and 7 between 9 hysteresis 8 corneal 9 hysteresis 9 hysteresis 11 ch 10 ( 11 ch 11 ch 12 ) 13 and 16 factor 13 and 18 crf 13 and 42 and 14 corneal 15 resistance 15 resistance 16 factor 17 ( 18 crf 18 crf 20 )(with 18 crf 31 curvature 18 crf 40 ) 20 )(with 21 age 21 age 25 thickness 22 , 25 thickness 23 central 25 thickness 24 corneal 25 thickness 25 thickness 27 cct 25 thickness 29 , 26 ( 27 cct 27 cct 28 ) 29 , 31 curvature 30 corneal 31 curvature 31 curvature 33 km 31 curvature 37 volume 31 curvature 40 ) 32 ( 33 km 33 km 34 ) 35 , 37 volume 36 corneal 37 volume 37 volume 39 cv 37 volume 40 ) 38 ( 39 cv 39 cv 40 ) 41 , 42 and 42 and 44 error 43 refractive 44 error 45 in 47 eyes 46 naïve 47 eyes methods : 105 healthy subjects ( 58 male and 47 female ) were included in this study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 1 methods 2 : 2 : 5 subjects 3 105 5 subjects 4 healthy 5 subjects 5 subjects 7 58 6 ( 7 58 7 58 9 and 7 58 13 were 7 58 14 included 7 58 18 . 8 male 9 and 9 and 11 female 9 and 12 ) 9 and 13 were 10 47 11 female 14 included 15 in 15 in 17 study 16 this 17 study the ages ranged from 19 to 82 years ( mean 43.1 ± 15.4 years ) and refraction between - 11 d and +6 d ( mean - 0.79 ± [2.95] d ) . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 33 . 1 the 2 ages 2 ages 3 ranged 2 ages 4 from 2 ages 16 and 4 from 8 years 5 19 6 to 6 to 7 82 6 to 8 years 8 years 14 years 9 ( 14 years 10 mean 12 ± 11 43.1 12 ± 12 ± 14 years 13 15.4 14 years 14 years 15 ) 16 and 17 refraction 16 and 18 between 16 and 22 and 18 between 21 d 19 - 20 11 20 11 21 d 22 and 23 +6 22 and 29 ± 23 +6 24 d 25 ( 29 ± 26 mean 27 - 26 mean 29 ± 28 0.79 29 ± 29 ± 31 d 29 ± 32 ) ch and crf obtained with the ocular response analyzer ( ora ) were correlated with age , refractive error , goldmann applanation tonometry ( gat ) , and with cct , km , cv obtained with the pentacam , and with corneal - compensated intraocular pressure ( iopcc ) and goldmann - correlated intraocular pressure measurement ( iopg ) obtained with ora . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 63 . 1 ch 2 and 2 and 3 crf 2 and 4 obtained 2 and 5 with 2 and 14 correlated 5 with 7 ocular 6 the 7 ocular 7 ocular 9 analyzer 7 ocular 13 were 8 response 9 analyzer 9 analyzer 11 ora 9 analyzer 13 were 10 ( 11 ora 11 ora 12 ) 14 correlated 28 and 14 correlated 40 and 15 with 16 age 15 with 28 and 16 age 19 error 16 age 25 gat 17 , 19 error 18 refractive 19 error 19 error 20 , 20 , 25 gat 21 goldmann 22 applanation 22 applanation 23 tonometry 23 tonometry 25 gat 24 ( 25 gat 25 gat 26 ) 27 , 28 and 28 and 29 with 29 with 34 cv 30 cct 32 km 31 , 32 km 32 km 33 , 32 km 34 cv 34 cv 35 obtained 36 with 38 pentacam 36 with 40 and 37 the 38 pentacam 39 , 40 and 40 and 41 with 41 with 50 and 42 corneal 46 pressure 42 corneal 50 and 43 - 46 pressure 44 compensated 46 pressure 45 intraocular 46 pressure 46 pressure 48 iopcc 46 pressure 49 ) 47 ( 48 iopcc 48 iopcc 49 ) 50 and 51 goldmann 51 goldmann 56 measurement 51 goldmann 60 obtained 51 goldmann 61 with 52 - 56 measurement 53 correlated 55 pressure 54 intraocular 55 pressure 55 pressure 56 measurement 56 measurement 58 iopg 56 measurement 59 ) 57 ( 58 iopg 58 iopg 59 ) 61 with 62 ora a multivariable mixed effect model was used to evaluate associations among these parameters . 0 ###LEFT-WALL### 5 model 0 ###LEFT-WALL### 7 used 0 ###LEFT-WALL### 14 . 1 a 2 multivariable 1 a 5 model 2 multivariable 4 effect 3 mixed 4 effect 4 effect 5 model 5 model 6 was 6 was 7 used 7 used 8 to 7 used 9 evaluate 8 to 9 evaluate 9 evaluate 10 associations 9 evaluate 11 among 11 among 13 parameters 12 these 13 parameters results : ch ranged from 6.9 to 14.6 mmhg ( mean 10.26 ± 1.49 [mmhg] ) ; crf ranged from 5.8 to 17 mmhg ( mean 10.38 ± 1.64 [mmhg] ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 32 . 1 results 2 : 2 : 3 ch 3 ch 4 ranged 3 ch 13 ± 4 ranged 5 from 5 from 6 6.9 6 6.9 7 to 7 to 9 mmhg 8 14.6 9 mmhg 10 ( 13 ± 11 mean 13 ± 12 10.26 13 ± 13 ± 14 1.49 13 ± 16 ) 17 ; 18 crf 17 ; 19 ranged 18 crf 19 ranged 19 ranged 20 from 20 from 21 5.8 21 5.8 22 to 21 5.8 28 ± 22 to 24 mmhg 23 17 24 mmhg 25 ( 28 ± 26 mean 28 ± 27 10.38 28 ± 28 ± 29 1.64 28 ± 31 ) multivariate analysis showed a statistically significant correlation between ch with cct ( p < 0.001 ) , and km ( p < 0.001 ) , [and] between crf with cct ( p < 0.001 ) and gat ( p < 0.001 ) . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 43 . 1 multivariate 2 analysis 2 analysis 3 showed 3 showed 7 correlation 3 showed 22 < 3 showed 27 between 4 a 7 correlation 5 statistically 6 significant 6 significant 7 correlation 7 correlation 8 between 7 correlation 10 with 8 between 9 ch 10 with 18 and 11 cct 14 < 11 cct 18 and 12 ( 14 < 13 p 14 < 14 < 15 0.001 14 < 16 ) 17 , 18 and 18 and 19 km 20 ( 22 < 21 p 22 < 22 < 23 0.001 22 < 24 ) 25 , 27 between 27 between 36 and 27 between 42 ) 28 crf 29 with 28 crf 36 and 29 with 30 cct 30 cct 33 < 31 ( 33 < 32 p 33 < 33 < 34 0.001 33 < 35 ) 36 and 37 gat 36 and 40 < 38 ( 40 < 39 p 40 < 40 < 41 0.001 conclusions : our findings support the hypothesis that ch and crf are related to the corneal shape and thickness , and show a decrease of ch with age . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 21 and 2 : 29 . 3 our 4 findings 4 findings 21 and 5 support 7 hypothesis 5 support 21 and 6 the 7 hypothesis 7 hypothesis 8 that 8 that 10 and 8 that 13 related 9 ch 10 and 10 and 11 crf 10 and 12 are 12 are 13 related 13 related 14 to 14 to 18 and 15 the 17 shape 16 corneal 17 shape 17 shape 18 and 18 and 19 thickness 20 , 21 and 21 and 22 show 22 show 24 decrease 22 show 27 with 23 a 24 decrease 24 decrease 25 of 25 of 26 ch 27 with 28 age background and purpose : the aim of this study was to explore whether hearing loss is associated with the risk of parkinson 's disease in the elderly in taiwan . 0 ###LEFT-WALL### 3 purpose 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 23 's 0 ###LEFT-WALL### 30 . 1 background 2 and 2 and 3 purpose 4 : 6 aim 4 : 23 's 5 the 6 aim 6 aim 7 of 6 aim 10 was 7 of 9 study 8 this 9 study 10 was 11 to 10 was 12 explore 11 to 12 explore 13 whether 14 hearing 13 whether 17 associated 13 whether 23 's 14 hearing 15 loss 14 hearing 16 is 16 is 17 associated 17 associated 18 with 18 with 20 risk 19 the 20 risk 20 risk 21 of 21 of 22 parkinson 23 's 24 disease 23 's 25 in 23 's 28 in 25 in 27 elderly 26 the 27 elderly 28 in 29 taiwan the incidence of parkinson 's disease by the end of 2010 and the associated risk factors were investigated . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 19 . 1 the 2 incidence 2 incidence 3 of 2 incidence 7 by 2 incidence 12 and 3 of 6 disease 4 parkinson 5 's 5 's 6 disease 7 by 9 end 8 the 9 end 9 end 10 of 10 of 11 2010 12 and 16 factors 12 and 17 were 13 the 16 factors 14 associated 16 factors 15 risk 16 factors 17 were 18 investigated results : the incidence of parkinson 's disease in the hearing loss group was 1.77 - fold higher than that in the [non] [-] hearing - loss group [(] 3.11 vs [.] 1.76 per 1000 person - years ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 4 incidence 2 : 14 was 2 : 16 - 3 the 4 incidence 4 incidence 5 of 4 incidence 14 was 5 of 8 disease 6 parkinson 7 's 7 's 8 disease 8 disease 9 in 9 in 13 group 10 the 13 group 11 hearing 12 loss 12 loss 13 group 14 was 15 1.77 16 - 17 fold 17 fold 18 higher 17 fold 19 than 19 than 20 that 19 than 21 in 21 in 25 hearing 22 the 25 hearing 25 hearing 28 group 26 - 28 group 27 loss 28 group 28 group 30 3.11 28 group 31 vs 28 group 38 years 28 group 39 ) 31 vs 33 1.76 33 1.76 34 per 34 per 36 person 35 1000 36 person 37 - 38 years 38 years 39 ) after controlling for confounding factors , the adjusted hazard ratio ( hr ) of parkinson 's disease was 1.53 ( 95 % ci 1.17 , 1.99 ) for the hearing loss group compared with the [non] [-] hearing - loss group . 0 ###LEFT-WALL### 17 disease 0 ###LEFT-WALL### 18 was 0 ###LEFT-WALL### 39 - 0 ###LEFT-WALL### 42 . 1 after 2 controlling 1 after 17 disease 2 controlling 3 for 2 controlling 14 of 3 for 4 confounding 4 confounding 5 factors 5 factors 10 ratio 6 , 10 ratio 7 the 10 ratio 8 adjusted 9 hazard 9 hazard 10 ratio 10 ratio 12 hr 10 ratio 13 ) 11 ( 12 hr 12 hr 13 ) 14 of 16 's 15 parkinson 16 's 17 disease 18 was 18 was 19 1.53 18 was 28 for 19 1.53 23 ci 19 1.53 26 1.99 20 ( 23 ci 21 95 23 ci 22 % 23 ci 23 ci 24 1.17 23 ci 25 , 25 , 26 1.99 26 1.99 27 ) 28 for 32 group 29 the 32 group 30 hearing 31 loss 31 loss 32 group 32 group 33 compared 33 compared 34 with 34 with 38 hearing 35 the 38 hearing 39 - 41 group 40 loss 41 group male sex [(] hr = 1.33 , 95 % ci 1.02 , 1.74 [ )(, age ( for each year , hr = 1.06 , 95 % ci 1.04 , 1.09 ) , hypertension [(] hr = 1.70 , 95 % ci [1.26] , 2.30 ) and cerebrovascular disease ( hr [=] 1.78 , 95 % ci 1.37 , 2.32 ) were also significantly associated [with] the risk of parkinson 's disease . 0 ###LEFT-WALL### 4 hr 0 ###LEFT-WALL### 5 = 0 ###LEFT-WALL### 12 , 1 male 2 sex 2 sex 4 hr 4 hr 5 = 5 = 6 1.33 6 1.33 10 ci 7 , 10 ci 8 95 10 ci 9 % 10 ci 10 ci 11 1.02 10 ci 12 , 12 , 13 1.74 12 , 15 )(, 15 )(, 16 age 15 )(, 21 , 16 age 18 for 17 ( 18 for 18 for 20 year 18 for 21 , 19 each 20 year 21 , 22 hr 21 , 23 = 21 , 33 , 22 hr 23 = 23 = 24 1.06 24 1.06 28 ci 25 , 28 ci 26 95 28 ci 27 % 28 ci 28 ci 29 1.04 28 ci 31 1.09 28 ci 32 ) 30 , 31 1.09 31 1.09 32 ) 33 , 36 hr 34 hypertension 36 hr 36 hr 37 = 37 = 38 1.70 38 1.70 49 disease 39 , 49 disease 40 95 49 disease 41 % 49 disease 42 ci 45 2.30 42 ci 47 and 44 , 45 2.30 45 2.30 46 ) 47 and 48 cerebrovascular 47 and 49 disease 49 disease 51 hr 49 disease 54 , 50 ( 51 hr 51 hr 53 1.78 51 hr 54 , 54 , 65 associated 55 95 56 % 56 % 57 ci 56 % 62 were 56 % 65 associated 57 ci 58 1.37 57 ci 60 2.32 57 ci 62 were 59 , 60 2.32 60 2.32 61 ) 62 were 63 also 62 were 64 significantly 65 associated 68 risk 65 associated 73 . 67 the 68 risk 68 risk 69 of 69 of 72 disease 70 parkinson 71 's 71 's 72 disease conclusions : hearing loss correlates with an increased risk of parkinson 's disease in the elderly . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 1 conclusions 2 : 2 : 3 hearing 3 hearing 4 loss 3 hearing 5 correlates 4 loss 5 correlates 5 correlates 6 with 5 correlates 14 in 6 with 9 risk 7 an 9 risk 8 increased 9 risk 9 risk 10 of 10 of 13 disease 11 parkinson 12 's 12 's 13 disease 14 in 16 elderly 15 the 16 elderly further studies are needed to confirm whether hearing loss could be a [non] [-] motor feature of parkinson 's disease . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 needed 0 ###LEFT-WALL### 21 . 1 further 2 studies 2 studies 3 are 3 are 4 needed 4 needed 5 to 5 to 6 confirm 6 confirm 7 whether 6 confirm 19 's 7 whether 8 hearing 7 whether 11 be 7 whether 19 's 8 hearing 9 loss 8 hearing 10 could 10 could 11 be 11 be 16 feature 12 a 16 feature 15 motor 16 feature 16 feature 17 of 17 of 18 parkinson 19 's 20 disease the apolipoprotein e ( apoe ) ε4 allele is a major genetic risk factor for sporadic alzheimer 's disease and has been associated with structural and functional brain alterations across the adult life span . 0 ###LEFT-WALL### 8 allele 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 35 . 1 the 8 allele 2 apolipoprotein 3 e 2 apolipoprotein 5 apoe 2 apolipoprotein 8 allele 4 ( 5 apoe 5 apoe 6 ) 7 ε4 8 allele 8 allele 20 and 9 is 14 factor 9 is 20 and 10 a 14 factor 11 major 14 factor 12 genetic 14 factor 13 risk 14 factor 14 factor 15 for 15 for 19 disease 16 sporadic 17 alzheimer 17 alzheimer 18 's 18 's 19 disease 20 and 21 has 20 and 24 with 21 has 22 been 22 been 23 associated 24 with 29 alterations 24 with 30 across 25 structural 26 and 26 and 27 functional 26 and 29 alterations 28 brain 29 alterations 30 across 34 span 31 the 34 span 32 adult 33 life 33 life 34 span recent studies have presented evidence that ε4 affects microstructural properties of brain white matter ( wm ) in [non] - demented carriers of the ε4 allele , but conflicting evidence has been presented as well . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 36 . 1 recent 2 studies 2 studies 3 have 3 have 5 evidence 3 have 13 white 4 presented 5 evidence 5 evidence 6 that 6 that 7 ε4 6 that 8 affects 7 ε4 8 affects 8 affects 10 properties 9 microstructural 10 properties 10 properties 11 of 11 of 12 brain 13 white 14 matter 13 white 18 in 14 matter 16 wm 15 ( 16 wm 16 wm 17 ) 20 - 22 carriers 20 - 27 , 21 demented 22 carriers 22 carriers 23 of 23 of 26 allele 24 the 26 allele 25 ε4 26 allele 27 , 30 evidence 27 , 33 presented 28 but 29 conflicting 28 but 30 evidence 30 evidence 31 has 31 has 32 been 32 been 33 presented 33 presented 34 as 34 as 35 well the main purpose of the present study was therefore to examine apoe effects on wm in a large sample [of] middle - aged and older adults ( n = 273 ) . 0 ###LEFT-WALL### 3 purpose 0 ###LEFT-WALL### 32 . 1 the 3 purpose 2 main 3 purpose 3 purpose 4 of 3 purpose 8 was 4 of 7 study 5 the 7 study 6 present 7 study 8 was 9 therefore 8 was 10 to 8 was 11 examine 10 to 11 examine 11 examine 13 effects 12 apoe 13 effects 13 effects 14 on 14 on 15 wm 15 wm 16 in 16 in 21 middle 17 a 18 large 17 a 21 middle 18 large 19 sample 19 sample 21 middle 21 middle 26 adults 22 - 26 adults 23 aged 24 and 24 and 25 older 24 and 26 adults 26 adults 29 = 26 adults 31 ) 27 ( 29 = 28 n 29 = 29 = 30 273 diffusion tensor [imaging] ( dti ) data [was] acquired , and tract - based as well as voxel - wise analyses were conducted . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 22 were 0 ###LEFT-WALL### 24 . 1 diffusion 11 and 2 tensor 5 dti 2 tensor 7 data 4 ( 5 dti 5 dti 6 ) 7 data 9 acquired 7 data 11 and 10 , 11 and 11 and 12 tract 11 and 13 - 11 and 14 based 11 and 17 as 11 and 22 were 15 as 16 well 16 well 17 as 17 as 21 analyses 18 voxel 19 - 18 voxel 21 analyses 20 wise 21 analyses 22 were 23 conducted the tract - based analyses revealed no significant apoe effects , and no significant interactions [between] genotype and age were observed . 0 ###LEFT-WALL### 2 tract 0 ###LEFT-WALL### 3 - 1 the 2 tract 3 - 5 analyses 3 - 6 revealed 3 - 18 and 3 - 22 . 4 based 5 analyses 5 analyses 6 revealed 6 revealed 9 apoe 7 no 9 apoe 8 significant 9 apoe 9 apoe 12 and 9 apoe 17 genotype 10 effects 12 and 11 , 12 and 12 and 15 interactions 12 and 17 genotype 13 no 15 interactions 14 significant 15 interactions 18 and 19 age 18 and 21 observed 19 age 20 were 20 were 21 observed taken together , the findings of the present study suggest that apoe effects on white - matter microstructure are less abundant than has been suggested in some previous studies . 0 ###LEFT-WALL### 5 findings 0 ###LEFT-WALL### 10 suggest 0 ###LEFT-WALL### 30 . 1 taken 2 together 1 taken 3 , 1 taken 5 findings 4 the 5 findings 5 findings 6 of 5 findings 10 suggest 6 of 9 study 7 the 9 study 8 present 9 study 10 suggest 11 that 11 that 13 effects 11 that 19 are 12 apoe 13 effects 13 effects 14 on 13 effects 19 are 14 on 18 microstructure 15 white 16 - 15 white 17 matter 17 matter 18 microstructure 19 are 21 abundant 20 less 21 abundant 21 abundant 22 than 22 than 23 has 22 than 25 suggested 22 than 26 in 23 has 24 been 24 been 25 suggested 26 in 29 studies 27 some 29 studies 28 previous 29 studies background/purpose : increased interest in antiaging methods , mandates a development of reliable noninvasive technique to assess skin aging . 0 ###LEFT-WALL### 1 background/purpose 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 20 . 1 background/purpose 2 : 2 : 8 , 3 increased 4 interest 3 increased 5 in 3 increased 8 , 5 in 7 methods 6 antiaging 7 methods 8 , 9 mandates 9 mandates 11 development 9 mandates 16 to 10 a 11 development 11 development 12 of 12 of 15 technique 13 reliable 15 technique 14 noninvasive 15 technique 16 to 17 assess 17 assess 18 skin 18 skin 19 aging in this study , we aimed to determine the effects of photoaging at histopathologic resolution [by] means of reflectance confocal microscopy . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 aimed 0 ###LEFT-WALL### 22 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 aimed 6 aimed 7 to 6 aimed 8 determine 7 to 8 determine 8 determine 10 effects 8 determine 13 at 9 the 10 effects 10 effects 11 of 11 of 12 photoaging 13 at 17 means 14 histopathologic 15 resolution 15 resolution 17 means 17 means 18 of 18 of 21 microscopy 19 reflectance 21 microscopy 20 confocal 21 microscopy method : the sun - exposed malar area , the anterior aspect [of] ear lobule , and the sun - protected posterior aspect of ear lobule had been evaluated in 120 volunteers from different age groups over 10 previously reported and new confocal parameters for skin aging . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 4 sun 2 : 9 , 3 the 4 sun 4 sun 8 area 5 - 8 area 6 exposed 8 area 7 malar 8 area 8 area 9 , 9 , 17 and 10 the 15 lobule 11 anterior 12 aspect 12 aspect 15 lobule 14 ear 15 lobule 15 lobule 17 and 16 , 17 and 17 and 19 sun 17 and 20 - 17 and 21 protected 17 and 23 aspect 17 and 28 been 17 and 29 evaluated 18 the 19 sun 22 posterior 23 aspect 23 aspect 24 of 23 aspect 27 had 24 of 26 lobule 25 ear 26 lobule 27 had 28 been 29 evaluated 30 in 30 in 32 volunteers 31 120 32 volunteers 32 volunteers 33 from 33 from 41 and 34 different 36 groups 35 age 36 groups 36 groups 37 over 36 groups 41 and 37 over 38 10 38 10 40 reported 39 previously 40 reported 41 and 44 parameters 41 and 48 . 42 new 44 parameters 43 confocal 44 parameters 44 parameters 45 for 45 for 47 aging 46 skin 47 aging result : the sun - exposed areas revealed more frequent irregular honeycomb pattern , polycylic papillary contours , coarse collagen , huddled collagen , curled bright structures with higher epidermal thickness , and furrow depth values . 0 ###LEFT-WALL### 1 result 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 37 . 1 result 2 : 2 : 4 sun 3 the 4 sun 5 - 13 pattern 5 - 14 , 5 - 24 , 6 exposed 7 areas 7 areas 8 revealed 8 revealed 12 honeycomb 9 more 10 frequent 10 frequent 12 honeycomb 11 irregular 12 honeycomb 12 honeycomb 13 pattern 14 , 17 contours 14 , 22 huddled 15 polycylic 16 papillary 16 papillary 17 contours 17 contours 20 collagen 17 contours 22 huddled 18 , 20 collagen 19 coarse 20 collagen 20 collagen 21 , 22 huddled 23 collagen 24 , 33 and 25 curled 27 structures 26 bright 27 structures 27 structures 28 with 27 structures 33 and 28 with 31 thickness 29 higher 31 thickness 30 epidermal 31 thickness 32 , 33 and 33 and 36 values 34 furrow 35 depth 35 depth 36 values however , the incidence of thin reticulated collagen and the number of dermal papillae were statistically higher on the sun [-] protected posterior aspect of ear lobule . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 15 were 0 ###LEFT-WALL### 28 . 1 however 2 , 1 however 9 and 3 the 4 incidence 4 incidence 5 of 4 incidence 9 and 5 of 8 collagen 6 thin 8 collagen 7 reticulated 8 collagen 9 and 11 number 9 and 12 of 9 and 15 were 10 the 11 number 12 of 14 papillae 13 dermal 14 papillae 15 were 16 statistically 15 were 17 higher 17 higher 18 on 18 on 24 aspect 19 the 24 aspect 20 sun 22 protected 22 protected 24 aspect 23 posterior 24 aspect 24 aspect 25 of 25 of 27 lobule 26 ear 27 lobule conclusion : reflectance confocal microscopy is a reliable diagnostic technique for evaluation [of] skin photoaging with objective criteria . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 3 reflectance 3 reflectance 5 microscopy 3 reflectance 15 photoaging 4 confocal 5 microscopy 5 microscopy 6 is 6 is 10 technique 7 a 8 reliable 7 a 10 technique 8 reliable 9 diagnostic 9 diagnostic 10 technique 10 technique 11 for 11 for 14 skin 12 evaluation 14 skin 14 skin 15 photoaging 15 photoaging 16 with 16 with 18 criteria 17 objective 18 criteria with the new emerging compact models it is possible to scan even the least accessible body parts with no discomfort to the patient , which offers the possibility to assess the effect of antiaging applications and to identify early signs of solar damage in cosmetically sensitive areas . 0 ###LEFT-WALL### 1 with 0 ###LEFT-WALL### 8 is 1 with 6 models 1 with 8 is 2 the 6 models 3 new 6 models 4 emerging 6 models 5 compact 6 models 7 it 8 is 8 is 9 possible 9 possible 10 to 9 possible 11 scan 10 to 11 scan 11 scan 12 even 11 scan 17 parts 11 scan 18 with 12 even 14 least 13 the 14 least 15 accessible 16 body 16 body 17 parts 18 with 20 discomfort 19 no 20 discomfort 20 discomfort 21 to 20 discomfort 25 which 21 to 23 patient 22 the 23 patient 24 , 25 which 25 which 26 offers 25 which 48 . 26 offers 28 possibility 26 offers 43 damage 27 the 28 possibility 28 possibility 29 to 28 possibility 41 of 29 to 36 and 30 assess 32 effect 30 assess 36 and 31 the 32 effect 32 effect 33 of 33 of 35 applications 34 antiaging 35 applications 36 and 37 to 36 and 38 identify 37 to 38 identify 38 identify 40 signs 39 early 40 signs 40 signs 41 of 42 solar 43 damage 43 damage 44 in 44 in 47 areas 45 cosmetically 46 sensitive 46 sensitive 47 areas background : helicobacter pylori [(] h . pylori [ )(- related diseases are responsible for a tremendous amount of morbidity and mortality in japan . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 . 0 ###LEFT-WALL### 25 . 1 background 2 : 2 : 4 pylori 3 helicobacter 4 pylori 4 pylori 6 h 7 . 8 pylori 7 . 13 are 8 pylori 13 are 10 )(- 11 related 11 related 12 diseases 11 related 13 are 13 are 14 responsible 14 responsible 15 for 14 responsible 23 in 15 for 21 and 16 a 17 tremendous 16 a 18 amount 17 tremendous 18 amount 18 amount 19 of 18 amount 21 and 19 of 20 morbidity 21 and 22 mortality 23 in 24 japan we estimated the prevalence of h . pylori infection by sex , birth [year] , and geographic area among japanese adults . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 estimated 0 ###LEFT-WALL### 7 . 1 we 2 estimated 2 estimated 4 prevalence 3 the 4 prevalence 4 prevalence 5 of 5 of 6 h 7 . 16 and 7 . 22 . 8 pylori 9 infection 9 infection 10 by 9 infection 12 , 10 by 11 sex 12 , 13 birth 12 , 16 and 15 , 16 and 16 and 18 area 16 and 19 among 17 geographic 18 area 19 among 21 adults 20 japanese 21 adults materials and methods : this cross - sectional study included 14,716 subjects aged 20 years or more who underwent a health checkup between may 1997 and march 2013 in seven geographic areas throughout japan . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 7 - 1 materials 2 and 2 and 3 methods 3 methods 4 : 4 : 6 cross 5 this 6 cross 7 - 9 study 7 - 10 included 7 - 35 . 8 sectional 9 study 9 study 10 included 10 included 12 subjects 11 14,716 12 subjects 12 subjects 13 aged 12 subjects 18 who 12 subjects 19 underwent 13 aged 16 or 14 20 15 years 15 years 16 or 16 or 17 more 18 who 19 underwent 19 underwent 22 checkup 19 underwent 33 throughout 20 a 21 health 20 a 22 checkup 21 health 22 checkup 22 checkup 23 between 22 checkup 29 in 23 between 26 and 24 may 25 1997 24 may 26 and 26 and 27 march 27 march 28 2013 29 in 32 areas 30 seven 32 areas 31 geographic 32 areas 33 throughout 34 japan relevant information on the demographics and status of h . pylori infection was retrieved from the electronic database . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 . 1 relevant 2 information 2 information 3 on 2 information 6 and 3 on 5 demographics 4 the 5 demographics 6 and 7 status 6 and 8 of 8 of 9 h 10 . 12 infection 10 . 14 retrieved 10 . 19 . 11 pylori 12 infection 12 infection 13 was 13 was 14 retrieved 14 retrieved 15 from 15 from 18 database 16 the 18 database 17 electronic 18 database the univariate [log] - binominal regression model was used to estimate the prevalence of h . pylori infection , taking birth year [into] consideration . 0 ###LEFT-WALL### 7 model 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 16 . 1 the 7 model 2 univariate 4 - 2 univariate 6 regression 5 binominal 6 regression 6 regression 7 model 7 model 8 was 8 was 9 used 9 used 10 to 9 used 11 estimate 10 to 11 estimate 11 estimate 13 prevalence 12 the 13 prevalence 13 prevalence 14 of 14 of 15 h 16 . 18 infection 16 . 19 , 16 . 25 . 17 pylori 18 infection 19 , 24 consideration 20 taking 24 consideration 21 birth 24 consideration 22 year 24 consideration the multivariate log [-] binominal regression model was used to compare the prevalence of h . pylori infection [between] seven geographic areas . 0 ###LEFT-WALL### 7 model 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 16 . 0 ###LEFT-WALL### 23 . 1 the 7 model 2 multivariate 7 model 3 log 7 model 5 binominal 6 regression 6 regression 7 model 7 model 8 was 8 was 9 used 9 used 10 to 9 used 11 compare 10 to 11 compare 11 compare 13 prevalence 12 the 13 prevalence 13 prevalence 14 of 14 of 15 h 16 . 22 areas 17 pylori 22 areas 18 infection 22 areas 20 seven 22 areas 21 geographic 22 areas results : the overall prevalence of h . pylori infection was 37.6 % in women and 43.2 % in men . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 . 1 results 2 : 2 : 5 prevalence 3 the 5 prevalence 4 overall 5 prevalence 5 prevalence 6 of 6 of 7 h 8 . 10 infection 8 . 11 was 8 . 21 . 9 pylori 10 infection 10 infection 11 was 11 was 13 % 12 37.6 13 % 13 % 14 in 14 in 16 and 15 women 16 and 16 and 20 men 17 43.2 19 in 18 % 19 in 19 in 20 men among seven geographic areas , hokkaido showed the lowest prevalence ( 29.4 % ) , while yamagata prefecture represented the highest ( 54.5 % ) . 0 ###LEFT-WALL### 6 hokkaido 0 ###LEFT-WALL### 7 showed 0 ###LEFT-WALL### 26 . 1 among 4 areas 1 among 5 , 1 among 6 hokkaido 2 seven 4 areas 3 geographic 4 areas 6 hokkaido 7 showed 7 showed 10 prevalence 7 showed 16 while 8 the 9 lowest 8 the 10 prevalence 10 prevalence 13 % 11 ( 13 % 12 29.4 13 % 13 % 14 ) 15 , 16 while 16 while 18 prefecture 16 while 19 represented 16 while 25 ) 17 yamagata 18 prefecture 18 prefecture 19 represented 19 represented 21 highest 20 the 21 highest 21 highest 24 % 22 ( 24 % 23 54.5 24 % 24 % 25 ) the prevalence of [h] [.] pylori infection was [highest] in the 1940 - 1949 birth cohort [and] then decreased in the ensuing birth cohorts [;] the risk ratio [(] [rr] [ )(was [0.85] ( 95 % confidence interval ( ci ) [0.84] - 0.87 [ )(for changes in the 10 - year birth cohort . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 8 was 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 8 was 3 of 7 infection 6 pylori 7 infection 8 was 10 in 10 in 16 cohort 11 the 16 cohort 12 1940 13 - 13 - 14 1949 13 - 16 cohort 15 birth 16 cohort 16 cohort 19 decreased 18 then 19 decreased 19 decreased 20 in 20 in 24 cohorts 21 the 24 cohorts 22 ensuing 24 cohorts 23 birth 24 cohorts 24 cohorts 28 ratio 24 cohorts 32 )(was 26 the 28 ratio 27 risk 28 ratio 28 ratio 32 )(was 32 )(was 43 - 34 ( 43 - 35 95 36 % 36 % 37 confidence 37 confidence 38 interval 38 interval 40 ci 38 interval 43 - 39 ( 40 ci 40 ci 41 ) 43 - 44 0.87 43 - 55 . 44 0.87 46 )(for 44 0.87 48 in 46 )(for 47 changes 48 in 50 10 49 the 50 10 50 10 54 cohort 51 - 54 cohort 52 year 53 birth 53 birth 54 cohort 54 cohort 55 . individuals in yamagata prefecture had the highest [rr] of [acquiring] h . pylori infection in all three birth cohorts ( [rr] = 1.53 for 1940 , [rr] = 1.69 for 1950 , [and] [rr] = 1.85 for 1960 ) when compared with those in hokkaido . 0 ###LEFT-WALL### 4 prefecture 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 12 . 0 ###LEFT-WALL### 46 . 1 individuals 2 in 1 individuals 4 prefecture 2 in 3 yamagata 4 prefecture 5 had 5 had 7 highest 6 the 7 highest 7 highest 9 of 9 of 11 h 12 . 14 infection 12 . 28 = 13 pylori 14 infection 14 infection 15 in 14 infection 28 = 15 in 19 cohorts 16 all 17 three 17 three 19 cohorts 18 birth 19 cohorts 19 cohorts 23 1.53 20 ( 23 1.53 22 = 23 1.53 23 1.53 24 for 23 1.53 26 , 24 for 25 1940 28 = 29 1.69 28 = 30 for 28 = 40 when 30 for 31 1950 31 1950 36 1.85 32 , 36 1.85 35 = 36 1.85 36 1.85 37 for 36 1.85 39 ) 37 for 38 1960 40 when 41 compared 41 compared 42 with 41 compared 44 in 42 with 43 those 44 in 45 hokkaido conclusions : the prevalence of h . pylori infection increases with age and exhibits geographic variation in japan . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 . 1 conclusions 2 : 2 : 4 prevalence 3 the 4 prevalence 4 prevalence 5 of 5 of 6 h 7 . 9 infection 7 . 13 and 7 . 19 . 8 pylori 9 infection 9 infection 13 and 10 increases 11 with 10 increases 13 and 11 with 12 age 13 and 14 exhibits 13 and 17 in 14 exhibits 16 variation 15 geographic 16 variation 17 in 18 japan there has been a striking decrease in the prevalence of h . pylori infection , especially [in] [younger] japanese populations . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 3 been 0 ###LEFT-WALL### 12 . 1 there 2 has 2 has 3 been 3 been 6 decrease 4 a 5 striking 4 a 6 decrease 5 striking 6 decrease 6 decrease 7 in 7 in 9 prevalence 8 the 9 prevalence 9 prevalence 10 of 10 of 11 h 12 . 14 infection 12 . 15 , 12 . 21 . 13 pylori 14 infection 15 , 20 populations 16 especially 19 japanese 19 japanese 20 populations purpose : to investigate the macular sensitivity of healthy eyes of a wide age range as determined by macular integrity assessment ( maia ) , and to [investigate] factors affecting macular sensitivity . 0 ###LEFT-WALL### 17 determined 1 purpose 2 : 2 : 3 to 2 : 17 determined 3 to 4 investigate 4 investigate 7 sensitivity 4 investigate 16 as 5 the 7 sensitivity 6 macular 7 sensitivity 7 sensitivity 8 of 7 sensitivity 11 of 8 of 10 eyes 9 healthy 10 eyes 11 of 15 range 12 a 15 range 13 wide 14 age 14 age 15 range 16 as 17 determined 17 determined 26 and 17 determined 33 . 18 by 21 assessment 18 by 26 and 19 macular 21 assessment 20 integrity 21 assessment 21 assessment 23 maia 22 ( 23 maia 23 maia 24 ) 25 , 26 and 26 and 27 to 27 to 29 factors 29 factors 30 affecting 30 affecting 32 sensitivity 31 macular 32 sensitivity macular sensitivity was examined by a standard grid , a 37 [-] stimuli grid covering the central 10 degrees of the retina including one centering point . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 4 examined 1 macular 2 sensitivity 2 sensitivity 3 was 3 was 4 examined 4 examined 5 by 5 by 8 grid 6 a 7 standard 6 a 8 grid 7 standard 8 grid 8 grid 14 grid 9 , 14 grid 10 a 14 grid 11 37 13 stimuli 13 stimuli 14 grid 14 grid 15 covering 14 grid 20 of 14 grid 23 including 14 grid 27 . 15 covering 19 degrees 16 the 19 degrees 17 central 19 degrees 18 10 19 degrees 20 of 22 retina 21 the 22 retina 23 including 26 point 24 one 26 point 25 centering 26 point results : the central sensitivity ( cs ) was 28.9 db for subjects under 20 years , 27.2 db [for] subjects between 20 to 60 years , and 24.5 db [for] subjects over 60 years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 5 sensitivity 2 : 9 was 2 : 17 , 3 the 5 sensitivity 4 central 5 sensitivity 5 sensitivity 7 cs 5 sensitivity 9 was 6 ( 7 cs 7 cs 8 ) 9 was 11 db 10 28.9 11 db 11 db 12 for 12 for 13 subjects 13 subjects 14 under 14 under 16 years 15 20 16 years 17 , 28 and 18 27.2 19 db 19 db 21 subjects 21 subjects 22 between 21 subjects 28 and 22 between 26 years 23 20 24 to 24 to 25 60 24 to 26 years 27 , 28 and 28 and 32 subjects 29 24.5 30 db 30 db 32 subjects 32 subjects 33 over 33 over 35 years 34 60 35 years the average sensitivity ( as ) was 29.6 db for subjects under 20 years , and after that the sensitivity was 28.7 db and 26.3 db . 0 ###LEFT-WALL### 3 sensitivity 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 27 . 1 the 3 sensitivity 2 average 3 sensitivity 3 sensitivity 5 as 3 sensitivity 7 was 4 ( 5 as 5 as 6 ) 7 was 9 db 8 29.6 9 db 9 db 10 for 10 for 11 subjects 11 subjects 12 under 12 under 14 years 13 20 14 years 15 , 16 and 16 and 20 sensitivity 16 and 21 was 17 after 18 that 17 after 20 sensitivity 19 the 20 sensitivity 20 sensitivity 21 was 21 was 24 and 22 28.7 23 db 23 db 24 and 24 and 26 db 25 26.3 26 db both cs and as in subjects over 60 years exhibited a significantly lower sensitivity than in subjects under the age of 20 ( p = 0.01 ) . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 10 exhibited 0 ###LEFT-WALL### 28 . 1 both 3 and 2 cs 3 and 3 and 4 as 3 and 5 in 3 and 10 exhibited 5 in 6 subjects 6 subjects 7 over 7 over 9 years 8 60 9 years 10 exhibited 14 sensitivity 10 exhibited 15 than 10 exhibited 18 under 10 exhibited 25 = 11 a 14 sensitivity 12 significantly 13 lower 13 lower 14 sensitivity 15 than 16 in 16 in 17 subjects 18 under 20 age 19 the 20 age 20 age 21 of 21 of 22 20 23 ( 25 = 24 p 25 = 25 = 26 0.01 25 = 27 ) regression analysis results indicated that the sensitivity gradually decreased by approximately 0.6 db every 10 years ( p = 0.01 ) . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 indicated 0 ###LEFT-WALL### 22 . 1 regression 3 results 2 analysis 3 results 3 results 4 indicated 4 indicated 5 that 5 that 7 sensitivity 5 that 9 decreased 6 the 7 sensitivity 7 sensitivity 9 decreased 8 gradually 9 decreased 9 decreased 10 by 9 decreased 14 every 9 decreased 19 = 10 by 13 db 11 approximately 12 0.6 12 0.6 13 db 14 every 16 years 15 10 16 years 17 ( 19 = 18 p 19 = 19 = 20 0.01 19 = 21 ) the age and development of axial length were statistically significant factors influencing the decline in sensitivity ( p = 0.01 ) . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 22 . 1 the 2 age 2 age 3 and 3 and 4 development 3 and 5 of 3 and 8 were 5 of 7 length 6 axial 7 length 8 were 9 statistically 8 were 11 factors 10 significant 11 factors 11 factors 12 influencing 12 influencing 14 decline 12 influencing 15 in 13 the 14 decline 15 in 16 sensitivity 16 sensitivity 19 = 17 ( 19 = 18 p 19 = 19 = 20 0.01 19 = 21 ) when each stimulus position was investigated , the center ( 0 degrees ) was significantly lower [(] 26.4 db ) than surrounding stimulus positions [(] 1 degree : 28.9 db , 3 degrees : 28.7 db , 5 degrees : 27.8 [db] [ )(( p = 0.01 ) . 0 ###LEFT-WALL### 22 surrounding 0 ###LEFT-WALL### 24 positions 0 ###LEFT-WALL### 28 : 0 ###LEFT-WALL### 49 . 1 when 4 position 1 when 7 , 1 when 20 ) 1 when 22 surrounding 2 each 4 position 3 stimulus 4 position 4 position 5 was 5 was 7 , 6 investigated 7 , 7 , 16 lower 8 the 9 center 9 center 12 degrees 9 center 14 was 10 ( 12 degrees 11 0 12 degrees 12 degrees 13 ) 14 was 16 lower 15 significantly 16 lower 16 lower 19 db 18 26.4 19 db 21 than 22 surrounding 22 surrounding 23 stimulus 22 surrounding 24 positions 24 positions 27 degree 26 1 27 degree 28 : 30 db 28 : 31 , 29 28.9 30 db 31 , 33 degrees 31 , 34 : 32 3 33 degrees 34 : 36 db 34 : 37 , 35 28.7 36 db 37 , 39 degrees 37 , 40 : 38 5 39 degrees 40 : 41 27.8 41 27.8 46 = 44 )(( 46 = 45 p 46 = 46 = 47 0.01 46 = 48 ) conclusion : the macular sensitivity in healthy japanese subjects calculated by maia exhibited a significantly low value with aging , and sensitivity decreased with the advance in the development of axial length . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 33 . 1 conclusion 2 : 2 : 5 sensitivity 3 the 5 sensitivity 4 macular 5 sensitivity 5 sensitivity 6 in 5 sensitivity 18 with 6 in 8 japanese 7 healthy 8 japanese 8 japanese 9 subjects 8 japanese 13 exhibited 9 subjects 10 calculated 9 subjects 13 exhibited 10 calculated 11 by 11 by 12 maia 13 exhibited 17 value 14 a 17 value 15 significantly 16 low 16 low 17 value 18 with 19 aging 20 , 21 and 21 and 22 sensitivity 21 and 23 decreased 22 sensitivity 23 decreased 23 decreased 24 with 23 decreased 27 in 24 with 26 advance 25 the 26 advance 27 in 29 development 28 the 29 development 29 development 30 of 30 of 32 length 31 axial 32 length the sensitivity of surrounding stimulus positions was higher than in the center ( 0 degrees ) . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 17 . 1 the 2 sensitivity 2 sensitivity 3 of 2 sensitivity 7 was 3 of 4 surrounding 4 surrounding 6 positions 5 stimulus 6 positions 7 was 8 higher 8 higher 9 than 9 than 10 in 10 in 12 center 11 the 12 center 12 center 15 degrees 13 ( 15 degrees 14 0 15 degrees 15 degrees 16 ) alzheimer 's disease is a degenerative , progressive and irreversible condition , which affects cognitive functions . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 17 . 1 alzheimer 2 's 2 's 3 disease 3 disease 4 is 4 is 11 condition 5 a 11 condition 6 degenerative 7 , 7 , 8 progressive 7 , 9 and 9 and 10 irreversible 9 and 11 condition 12 , 13 which 12 , 14 affects 13 which 14 affects 14 affects 16 functions 15 cognitive 16 functions it was first described in 1907 , by the german physician alois alzheimer . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 described 1 it 2 was 2 was 4 described 3 first 4 described 4 described 5 in 5 in 6 1907 6 1907 8 by 7 , 8 by 8 by 13 alzheimer 8 by 14 . 9 the 11 physician 10 german 11 physician 11 physician 13 alzheimer 12 alois 13 alzheimer although at the time , it was considered a rare disease , in 2010 in the world were [estimated] 35.6 million cases of dementia , most of these with the diagnosis of alzheimer 's disease . 0 ###LEFT-WALL### 17 world 0 ###LEFT-WALL### 18 were 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 34 's 0 ###LEFT-WALL### 36 . 1 although 6 it 1 although 8 considered 1 although 12 , 1 although 17 world 2 at 4 time 2 at 5 , 2 at 6 it 3 the 4 time 6 it 7 was 7 was 8 considered 8 considered 11 disease 9 a 10 rare 9 a 11 disease 10 rare 11 disease 13 in 15 in 13 in 17 world 14 2010 15 in 16 the 17 world 17 world 18 were 18 were 22 cases 20 35.6 21 million 21 million 22 cases 22 cases 23 of 23 of 24 dementia 25 , 26 most 25 , 34 's 26 most 27 of 26 most 29 with 26 most 34 's 27 of 28 these 29 with 31 diagnosis 30 the 31 diagnosis 31 diagnosis 32 of 32 of 33 alzheimer 34 's 35 disease typical neuropathologic lesions are represented by the amyloid plaques , neurofibrilar tangles and synapses and neurons losses . 0 ###LEFT-WALL### 3 lesions 0 ###LEFT-WALL### 5 represented 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 18 . 1 typical 3 lesions 2 neuropathologic 3 lesions 3 lesions 4 are 4 are 5 represented 5 represented 6 by 6 by 9 plaques 7 the 9 plaques 8 amyloid 9 plaques 10 , 15 and 11 neurofibrilar 13 and 11 neurofibrilar 15 and 12 tangles 13 and 13 and 14 synapses 15 and 17 losses 16 neurons 17 losses it was hypothesized that the amyloid protein has prion - like properties . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 hypothesized 1 it 2 was 2 was 3 hypothesized 3 hypothesized 4 that 4 that 7 protein 4 that 8 has 5 the 7 protein 6 amyloid 7 protein 7 protein 8 has 8 has 9 prion 9 prion 11 like 10 - 11 like 11 like 12 properties 11 like 13 . even from the first descriptions of the disease , atypical features were observed - the second case described by the physician alois alzheimer , had only plaques , the tangles were missing . 0 ###LEFT-WALL### 11 features 0 ###LEFT-WALL### 13 observed 0 ###LEFT-WALL### 14 - 1 even 2 from 1 even 9 , 1 even 11 features 2 from 5 descriptions 3 the 4 first 3 the 5 descriptions 5 descriptions 6 of 6 of 8 disease 7 the 8 disease 10 atypical 11 features 11 features 12 were 12 were 13 observed 14 - 17 case 14 - 24 , 14 - 28 , 14 - 33 . 15 the 17 case 16 second 17 case 17 case 24 , 18 described 19 by 18 described 23 alzheimer 18 described 24 , 19 by 21 physician 20 the 21 physician 22 alois 23 alzheimer 24 , 25 had 25 had 26 only 25 had 27 plaques 28 , 30 tangles 28 , 31 were 29 the 30 tangles 30 tangles 31 were 31 were 32 missing about 19 % of the healthy old subjects present in the brain the same lesions as alzheimer 's cases , while in 10 % of the cases of disease , [in] [necropsy] are present only the plaques or only the tangles . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 15 lesions 0 ###LEFT-WALL### 42 . 1 about 2 19 2 19 3 % 3 % 4 of 3 % 15 lesions 4 of 7 old 5 the 7 old 6 healthy 7 old 7 old 8 subjects 7 old 9 present 8 subjects 9 present 9 present 10 in 9 present 14 same 10 in 12 brain 11 the 12 brain 13 the 14 same 15 lesions 16 as 15 lesions 38 or 16 as 19 cases 16 as 33 are 17 alzheimer 18 's 18 's 19 cases 19 cases 33 are 20 , 21 while 21 while 22 in 21 while 30 , 21 while 33 are 22 in 24 % 23 10 24 % 24 % 25 of 24 % 28 of 25 of 27 cases 26 the 27 cases 28 of 29 disease 33 are 34 present 34 present 35 only 36 the 37 plaques 37 plaques 38 or 38 or 39 only 38 or 41 tangles 40 the 41 tangles these aspects are even more paradoxical , as the certain diagnosis is established only [at] [necropsy] , on anatomopathological lesions . 0 ###LEFT-WALL### 2 aspects 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 7 , 1 these 2 aspects 2 aspects 3 are 3 are 6 paradoxical 4 even 5 more 5 more 6 paradoxical 7 , 11 diagnosis 7 , 13 established 8 as 10 certain 8 as 11 diagnosis 9 the 10 certain 11 diagnosis 12 is 12 is 13 established 13 established 14 only 13 established 18 on 17 , 18 on 18 on 20 lesions 18 on 21 . 19 anatomopathological 20 lesions even so , the international diagnosis criteria , based on clinical aspects , can establish a certain , probable or [a] possible diagnosis . 0 ###LEFT-WALL### 7 criteria 0 ###LEFT-WALL### 15 establish 0 ###LEFT-WALL### 24 . 1 even 2 so 1 even 3 , 1 even 7 criteria 2 so 3 , 4 the 7 criteria 5 international 7 criteria 6 diagnosis 7 criteria 7 criteria 9 based 7 criteria 14 can 8 , 9 based 9 based 10 on 9 based 13 , 10 on 12 aspects 11 clinical 12 aspects 14 can 15 establish 15 establish 23 diagnosis 16 a 23 diagnosis 17 certain 18 , 18 , 19 probable 18 , 20 or 20 or 22 possible 20 or 23 diagnosis [it] exist an early - onset form , as well as a late - onset form of disease ( which appears after 80 - 85 years of life ) ; genes are involved in the genesis of the disease . 0 ###LEFT-WALL### 2 exist 0 ###LEFT-WALL### 30 ; 0 ###LEFT-WALL### 40 . 2 exist 7 form 3 an 4 early 3 an 7 form 4 early 5 - 4 early 6 onset 6 onset 7 form 7 form 11 as 8 , 11 as 9 as 10 well 10 well 11 as 11 as 16 form 11 as 29 ) 12 a 13 late 12 a 16 form 13 late 14 - 13 late 15 onset 15 onset 16 form 16 form 17 of 17 of 18 disease 18 disease 20 which 19 ( 20 which 20 which 21 appears 20 which 29 ) 21 appears 22 after 22 after 26 years 23 80 24 - 24 - 25 85 24 - 26 years 26 years 27 of 27 of 28 life 30 ; 31 genes 30 ; 33 involved 31 genes 32 are 32 are 33 involved 33 involved 34 in 34 in 36 genesis 35 the 36 genesis 36 genesis 37 of 37 of 39 disease 38 the 39 disease a lot of money [are] spent to find an efficient medication in the treatment of the disease ( tramiprosate -- an amyloid - antagonist , dimebon , gamma - secretase inhibitors or a vaccine -- a synthetic form of the amyloid protein ) ; for the moment the used medication may at its best only to [temporary] improve the symptoms . 0 ###LEFT-WALL### 32 or 0 ###LEFT-WALL### 44 ; 0 ###LEFT-WALL### 61 . 1 a 2 lot 2 lot 3 of 2 lot 4 money 3 of 4 money 4 money 6 spent 4 money 32 or 6 spent 7 to 7 to 8 find 8 find 11 medication 8 find 31 inhibitors 9 an 10 efficient 9 an 11 medication 10 efficient 11 medication 11 medication 12 in 11 medication 15 of 11 medication 19 tramiprosate 11 medication 24 antagonist 12 in 14 treatment 13 the 14 treatment 15 of 17 disease 16 the 17 disease 18 ( 19 tramiprosate 19 tramiprosate 20 -- 20 -- 24 antagonist 21 an 22 amyloid 21 an 24 antagonist 22 amyloid 23 - 22 amyloid 24 antagonist 24 antagonist 26 dimebon 24 antagonist 28 gamma 24 antagonist 29 - 25 , 26 dimebon 26 dimebon 27 , 27 , 28 gamma 28 gamma 29 - 30 secretase 31 inhibitors 32 or 34 vaccine 32 or 38 form 33 a 34 vaccine 35 -- 38 form 36 a 37 synthetic 36 a 38 form 37 synthetic 38 form 38 form 39 of 38 form 43 ) 39 of 42 protein 40 the 42 protein 41 amyloid 42 protein 44 ; 45 for 44 ; 58 improve 45 for 55 only 46 the 47 moment 47 moment 50 medication 47 moment 51 may 47 moment 55 only 48 the 50 medication 49 used 50 medication 50 medication 51 may 52 at 54 best 52 at 55 only 53 its 54 best 55 only 56 to 56 to 58 improve 58 improve 60 symptoms 59 the 60 symptoms some scientists believe that approx . 0 ###LEFT-WALL### 2 scientists 0 ###LEFT-WALL### 3 believe 0 ###LEFT-WALL### 6 . 1 some 2 scientists 2 scientists 3 believe 3 believe 4 that 3 believe 5 approx 4 that 5 approx network representation of brain connectivity has provided a novel means of investigating brain changes arising from pathology , development or aging . 0 ###LEFT-WALL### 2 representation 0 ###LEFT-WALL### 7 provided 0 ###LEFT-WALL### 22 . 1 network 2 representation 2 representation 3 of 2 representation 7 provided 3 of 4 brain 4 brain 5 connectivity 4 brain 6 has 5 connectivity 6 has 7 provided 10 means 7 provided 16 from 8 a 9 novel 8 a 10 means 9 novel 10 means 10 means 11 of 11 of 12 investigating 12 investigating 14 changes 13 brain 14 changes 14 changes 15 arising 16 from 20 or 17 pathology 18 , 18 , 19 development 18 , 20 or 20 or 21 aging the high dimensionality of these networks demands methods that are not only able to extract the patterns that highlight these sources of variation , [but] describe them individually . 0 ###LEFT-WALL### 3 dimensionality 0 ###LEFT-WALL### 7 demands 0 ###LEFT-WALL### 29 . 1 the 3 dimensionality 2 high 3 dimensionality 3 dimensionality 4 of 3 dimensionality 7 demands 4 of 6 networks 5 these 6 networks 7 demands 8 methods 8 methods 9 that 8 methods 10 are 9 that 10 are 10 are 11 not 10 are 12 only 10 are 13 able 13 able 14 to 13 able 15 extract 14 to 15 extract 15 extract 17 patterns 15 extract 28 individually 16 the 17 patterns 17 patterns 18 that 17 patterns 24 , 18 that 24 , 19 highlight 21 sources 19 highlight 24 , 20 these 21 sources 21 sources 22 of 22 of 23 variation 24 , 26 describe 26 describe 27 them in this paper , we present a unified framework for learning subnetwork patterns of connectivity by their projective [non] - negative decomposition into a reconstructive basis set , as well as [,] additional basis sets representing development and group discrimination . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 27 set 1 in 3 paper 1 in 4 , 1 in 5 we 2 this 3 paper 5 we 6 present 6 present 9 framework 6 present 10 for 7 a 9 framework 8 unified 9 framework 10 for 11 learning 11 learning 13 patterns 11 learning 16 by 11 learning 27 set 12 subnetwork 13 patterns 13 patterns 14 of 14 of 15 connectivity 16 by 22 decomposition 17 their 22 decomposition 18 projective 20 - 18 projective 22 decomposition 21 negative 22 decomposition 22 decomposition 23 into 23 into 26 basis 24 a 26 basis 25 reconstructive 26 basis 27 set 31 as 28 , 31 as 29 as 30 well 30 well 31 as 31 as 40 discrimination 31 as 41 . 33 additional 37 development 34 basis 35 sets 35 sets 37 development 36 representing 37 development 37 development 38 and 38 and 39 group 38 and 40 discrimination in order to obtain these components , we exploit the geometrical distribution of the population in the connectivity space by using a graph [-] theoretical scheme that imposes locality - preserving properties . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 9 exploit 1 in 2 order 1 in 7 , 1 in 8 we 2 order 3 to 2 order 4 obtain 3 to 4 obtain 4 obtain 6 components 5 these 6 components 8 we 9 exploit 9 exploit 12 distribution 9 exploit 16 in 9 exploit 31 preserving 10 the 12 distribution 11 geometrical 12 distribution 12 distribution 13 of 13 of 15 population 14 the 15 population 16 in 19 space 17 the 19 space 18 connectivity 19 space 19 space 20 by 19 space 27 that 19 space 28 imposes 20 by 21 using 21 using 26 scheme 22 a 26 scheme 23 graph 26 scheme 25 theoretical 26 scheme 27 that 28 imposes 28 imposes 29 locality 30 - 31 preserving 31 preserving 32 properties 31 preserving 33 . in addition , the projection of the subject networks into the basis set provides a low dimensional representation of it , that teases [apart] the different sources of variation in the sample , facilitating variation - specific statistical analysis . 0 ###LEFT-WALL### 5 projection 0 ###LEFT-WALL### 14 provides 0 ###LEFT-WALL### 21 , 1 in 2 addition 1 in 3 , 1 in 5 projection 4 the 5 projection 5 projection 6 of 5 projection 14 provides 6 of 9 networks 7 the 9 networks 8 subject 9 networks 9 networks 10 into 9 networks 13 set 10 into 12 basis 11 the 12 basis 14 provides 18 representation 15 a 18 representation 16 low 18 representation 17 dimensional 18 representation 18 representation 19 of 19 of 20 it 21 , 22 that 21 , 23 teases 22 that 23 teases 23 teases 27 sources 23 teases 30 in 23 teases 34 facilitating 25 the 27 sources 26 different 27 sources 27 sources 28 of 28 of 29 variation 30 in 32 sample 31 the 32 sample 33 , 34 facilitating 34 facilitating 35 variation 34 facilitating 40 . 35 variation 39 analysis 36 - 39 analysis 37 specific 39 analysis 38 statistical 39 analysis 39 analysis 40 . the proposed framework is applied to a study of diffusion - based connectivity in subjects with autism . 0 ###LEFT-WALL### 3 framework 0 ###LEFT-WALL### 5 applied 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 18 . 1 the 3 framework 2 proposed 3 framework 3 framework 4 is 4 is 5 applied 5 applied 6 to 6 to 8 study 7 a 8 study 8 study 9 of 9 of 10 diffusion 11 - 13 connectivity 12 based 13 connectivity 13 connectivity 14 in 14 in 15 subjects 15 subjects 16 with 16 with 17 autism a valid , time - efficient and easy - [to] - use instrument is important for busy clinical settings , large scale surveys , or community screening use . 0 ###LEFT-WALL### 13 instrument 0 ###LEFT-WALL### 14 is 0 ###LEFT-WALL### 29 . 1 a 2 valid 1 a 13 instrument 2 valid 4 time 2 valid 13 instrument 3 , 4 time 4 time 7 and 4 time 11 - 5 - 7 and 6 efficient 7 and 7 and 8 easy 7 and 9 - 12 use 13 instrument 13 instrument 14 is 14 is 15 important 15 important 16 for 16 for 25 or 17 busy 19 settings 18 clinical 19 settings 19 settings 20 , 20 , 23 surveys 20 , 25 or 21 large 22 scale 22 scale 23 surveys 24 , 25 or 25 or 26 community 25 or 27 screening 27 screening 28 use the purpose of this study was to validate the mobility hierarchical disability categorization model ( an abbreviated model ) by investigating its concurrent validity with the multidimensional hierarchical disability categorization model ( a comprehensive model ) and triangulating both models with physical performance measures in older adults . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 37 and 0 ###LEFT-WALL### 48 . 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 validate 7 to 8 validate 8 validate 14 model 8 validate 20 by 8 validate 25 with 9 the 14 model 10 mobility 13 categorization 11 hierarchical 12 disability 12 disability 13 categorization 13 categorization 14 model 14 model 18 model 15 ( 18 model 16 an 18 model 17 abbreviated 18 model 18 model 19 ) 20 by 21 investigating 21 investigating 24 validity 22 its 24 validity 23 concurrent 24 validity 25 with 31 model 26 the 31 model 27 multidimensional 29 disability 28 hierarchical 29 disability 29 disability 31 model 30 categorization 31 model 31 model 35 model 32 ( 35 model 33 a 34 comprehensive 33 a 35 model 34 comprehensive 35 model 35 model 36 ) 37 and 38 triangulating 37 and 40 models 38 triangulating 39 both 38 triangulating 40 models 40 models 41 with 40 models 44 measures 40 models 45 in 41 with 43 performance 42 physical 43 performance 45 in 47 adults 46 older 47 adults self - reported function [on] mobility , instrumental activities of daily living ( iadl ) and activities of daily living ( adl ) domains were recorded and then the disability status determined based on both the multidimensional hierarchical categorization model and the mobility hierarchical categorization model . 0 ###LEFT-WALL### 24 domains 0 ###LEFT-WALL### 25 were 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 47 . 1 self 6 mobility 1 self 16 and 2 - 6 mobility 3 reported 4 function 4 function 6 mobility 6 mobility 9 activities 6 mobility 15 ) 7 , 9 activities 8 instrumental 9 activities 9 activities 10 of 9 activities 14 iadl 9 activities 15 ) 10 of 12 living 11 daily 12 living 13 ( 14 iadl 14 iadl 15 ) 16 and 17 activities 16 and 18 of 16 and 22 adl 16 and 24 domains 18 of 20 living 19 daily 20 living 21 ( 22 adl 22 adl 23 ) 24 domains 25 were 25 were 26 recorded 27 and 28 then 27 and 31 status 27 and 33 based 29 the 31 status 30 disability 31 status 31 status 32 determined 31 status 33 based 33 based 34 on 33 based 41 and 34 on 35 both 36 the 40 model 37 multidimensional 39 categorization 38 hierarchical 39 categorization 39 categorization 40 model 40 model 41 and 41 and 46 model 42 the 46 model 43 mobility 46 model 44 hierarchical 45 categorization 45 categorization 46 model the physical performance measures , consisting of grip strength and usual and fastest gait speeds ( ugs , fgs ) , were collected on the same day . 0 ###LEFT-WALL### 4 measures 0 ###LEFT-WALL### 23 collected 0 ###LEFT-WALL### 28 . 1 the 4 measures 2 physical 3 performance 3 performance 4 measures 4 measures 6 consisting 4 measures 22 were 5 , 6 consisting 6 consisting 7 of 6 consisting 21 , 7 of 10 and 8 grip 9 strength 9 strength 10 and 10 and 15 speeds 10 and 19 fgs 11 usual 12 and 12 and 13 fastest 12 and 14 gait 14 gait 15 speeds 16 ( 19 fgs 17 ugs 19 fgs 18 , 19 fgs 19 fgs 20 ) 19 fgs 21 , 22 were 23 collected 23 collected 24 on 24 on 27 day 25 the 26 same 25 the 27 day both categorization models showed high correlation [(] [γs] [=] 0.92 , p < 0.001 ) and agreement ( kappa [=] 0.61 , p < 0.0001 ) . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 27 . 1 both 3 models 2 categorization 3 models 3 models 4 showed 4 showed 6 correlation 4 showed 16 and 5 high 6 correlation 6 correlation 10 0.92 6 correlation 13 < 11 , 13 < 12 p 13 < 13 < 14 0.001 13 < 15 ) 16 and 17 agreement 17 agreement 19 kappa 17 agreement 24 < 18 ( 19 kappa 19 kappa 21 0.61 19 kappa 22 , 22 , 24 < 23 p 24 < 24 < 25 0.0001 24 < 26 ) physical performance measures demonstrated significant different group means among the disability subgroups based on both categorization models . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 demonstrated 0 ###LEFT-WALL### 18 . 1 physical 2 performance 2 performance 3 measures 3 measures 4 demonstrated 4 demonstrated 8 means 5 significant 7 group 6 different 7 group 7 group 8 means 8 means 9 among 8 means 13 based 9 among 12 subgroups 10 the 12 subgroups 11 disability 12 subgroups 13 based 14 on 14 on 17 models 15 both 17 models 16 categorization 17 models the results of multiple regression analysis indicated that both models individually explain similar amount of variance on all physical performances , with adjustments for age , sex , and number of comorbidities . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 7 indicated 0 ###LEFT-WALL### 33 . 1 the 2 results 2 results 3 of 2 results 7 indicated 3 of 6 analysis 4 multiple 6 analysis 5 regression 6 analysis 7 indicated 8 that 8 that 10 models 8 that 12 explain 9 both 10 models 10 models 12 explain 11 individually 12 explain 12 explain 29 and 13 similar 14 amount 14 amount 15 of 14 amount 29 and 15 of 16 variance 16 variance 17 on 16 variance 22 with 17 on 20 performances 18 all 20 performances 19 physical 20 performances 21 , 22 with 22 with 23 adjustments 22 with 28 , 23 adjustments 24 for 23 adjustments 27 sex 24 for 25 age 26 , 27 sex 27 sex 28 , 28 , 29 and 29 and 30 number 29 and 31 of 31 of 32 comorbidities our results found that the mobility hierarchical disability categorization model is a valid and time efficient tool [for] large survey or screening use . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 24 . 1 our 2 results 2 results 3 found 3 found 4 that 4 that 10 model 4 that 11 is 5 the 10 model 6 mobility 10 model 7 hierarchical 8 disability 8 disability 10 model 9 categorization 10 model 10 model 11 is 11 is 23 use 12 a 23 use 13 valid 14 and 14 and 20 survey 14 and 21 or 15 time 20 survey 16 efficient 17 tool 17 tool 20 survey 19 large 20 survey 21 or 22 screening 21 or 23 use background : anti - oxidant capacity is crucial defence against environmental or endogenous oxidative stress . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 6 capacity 2 : 7 is 3 anti 4 - 3 anti 6 capacity 5 oxidant 6 capacity 6 capacity 7 is 7 is 9 defence 8 crucial 9 defence 9 defence 10 against 10 against 15 stress 11 environmental 12 or 12 or 13 endogenous 12 or 15 stress 14 oxidative 15 stress nuclear factor [erythroid] 2 - related factor 2 ( nrf2 ) is a redox - sensitive transcription factor that plays a key defensive role against oxidative and cytotoxic stress and cellular senescence . 0 ###LEFT-WALL### 2 factor 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 33 . 1 nuclear 2 factor 2 factor 4 2 2 factor 12 is 5 - 6 related 6 related 7 factor 6 related 11 ) 6 related 12 is 7 factor 8 2 7 factor 10 nrf2 9 ( 10 nrf2 10 nrf2 11 ) 12 is 18 factor 13 a 14 redox 13 a 18 factor 14 redox 15 - 14 redox 17 transcription 16 sensitive 17 transcription 17 transcription 18 factor 18 factor 19 that 18 factor 20 plays 19 that 20 plays 20 plays 24 role 21 a 24 role 22 key 24 role 23 defensive 24 role 24 role 25 against 25 against 30 and 26 oxidative 27 and 27 and 29 stress 27 and 30 and 28 cytotoxic 29 stress 30 and 32 senescence 31 cellular 32 senescence however , nrf2 signalling is impaired in several aging - related diseases , such as chronic pulmonary obstructive disease ( copd ) , cancer , and neurodegenerative diseases . 0 ###LEFT-WALL### 3 nrf2 0 ###LEFT-WALL### 6 impaired 0 ###LEFT-WALL### 11 related 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 29 . 1 however 2 , 1 however 3 nrf2 3 nrf2 4 signalling 3 nrf2 5 is 5 is 6 impaired 6 impaired 7 in 6 impaired 9 aging 7 in 8 several 10 - 11 related 11 related 12 diseases 11 related 15 as 11 related 22 ) 13 , 15 as 14 such 15 as 15 as 19 disease 15 as 22 ) 16 chronic 19 disease 17 pulmonary 19 disease 18 obstructive 19 disease 19 disease 21 copd 20 ( 21 copd 21 copd 22 ) 23 , 26 and 24 cancer 26 and 25 , 26 and 26 and 28 diseases 27 neurodegenerative 28 diseases thus , novel therapeutics that enhance nrf2 signalling are an attractive approach to treat these diseases . 0 ###LEFT-WALL### 4 therapeutics 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 17 . 1 thus 2 , 1 thus 4 therapeutics 3 novel 4 therapeutics 4 therapeutics 5 that 4 therapeutics 6 enhance 4 therapeutics 9 are 5 that 6 enhance 6 enhance 7 nrf2 7 nrf2 8 signalling 9 are 12 approach 9 are 13 to 10 an 11 attractive 10 an 12 approach 11 attractive 12 approach 13 to 14 treat 14 treat 16 diseases 15 these 16 diseases methodology/principal findings : nrf2 was stabilized by ski - ii ( 2 - ( p - hydroxyanilino ) - 4 - [(] p - chlorophenyl ) thiazole [ )(, which is a known sphingosine kinase inhibitor [,] in human bronchial epithelial cell line , beas2b , and in primary human bronchial epithelial cells , leading to enhancement of anti - oxidant proteins , such as ho - 1 , nqo1 and gclm . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 methodology/principal 2 findings 3 : 4 nrf2 3 : 6 stabilized 3 : 9 - 4 nrf2 5 was 5 was 6 stabilized 6 stabilized 7 by 7 by 8 ski 9 - 10 ii 9 - 19 - 10 ii 12 2 10 ii 16 - 11 ( 12 2 12 2 13 - 14 ( 16 - 15 p 16 - 16 - 17 hydroxyanilino 16 - 18 ) 19 - 20 4 19 - 27 thiazole 19 - 29 )(, 19 - 31 is 20 4 24 - 20 4 27 thiazole 21 - 24 - 23 p 24 - 24 - 25 chlorophenyl 24 - 26 ) 29 )(, 30 which 30 which 31 is 31 is 36 inhibitor 32 a 36 inhibitor 33 known 36 inhibitor 34 sphingosine 36 inhibitor 35 kinase 36 inhibitor 36 inhibitor 47 and 38 in 43 line 38 in 47 and 39 human 43 line 40 bronchial 43 line 41 epithelial 43 line 42 cell 43 line 43 line 45 beas2b 44 , 45 beas2b 45 beas2b 46 , 46 , 47 and 47 and 48 in 48 in 53 cells 49 primary 50 human 50 human 53 cells 51 bronchial 53 cells 52 epithelial 53 cells 53 cells 55 leading 54 , 55 leading 55 leading 56 to 55 leading 62 proteins 55 leading 65 as 56 to 57 enhancement 57 enhancement 58 of 58 of 61 oxidant 59 anti 60 - 59 anti 61 oxidant 63 , 65 as 64 such 65 as 65 as 66 ho 65 as 73 . 66 ho 68 1 66 ho 72 gclm 67 - 68 1 68 1 69 , 69 , 72 gclm 70 nqo1 71 and 71 and 72 gclm 72 gclm 73 . the activation of nrf2 was achieved by the generation of inactive dimerized form of keap1 , a negative regulator of nrf2 expression , which was independent of sphingosine kinase inhibition . 0 ###LEFT-WALL### 2 activation 0 ###LEFT-WALL### 6 achieved 0 ###LEFT-WALL### 31 . 1 the 2 activation 2 activation 3 of 2 activation 5 was 3 of 4 nrf2 5 was 6 achieved 6 achieved 7 by 7 by 9 generation 8 the 9 generation 9 generation 10 of 10 of 13 form 11 inactive 13 form 12 dimerized 13 form 13 form 14 of 13 form 24 which 13 form 25 was 13 form 27 of 14 of 15 keap1 15 keap1 19 regulator 16 , 19 regulator 17 a 18 negative 17 a 19 regulator 18 negative 19 regulator 19 regulator 20 of 19 regulator 23 , 20 of 22 expression 21 nrf2 22 expression 24 which 25 was 25 was 26 independent 27 of 30 inhibition 28 sphingosine 30 inhibition 29 kinase 30 inhibition using mice that were exposed to cigarette smoke , ski - ii induced nrf2 expression together with ho - 1 in their lungs . 0 ###LEFT-WALL### 12 ii 0 ###LEFT-WALL### 13 induced 0 ###LEFT-WALL### 24 . 1 using 2 mice 1 using 11 - 1 using 12 ii 2 mice 3 that 2 mice 4 were 3 that 4 were 4 were 5 exposed 5 exposed 6 to 6 to 8 smoke 7 cigarette 8 smoke 8 smoke 10 ski 9 , 10 ski 10 ski 11 - 12 ii 13 induced 13 induced 15 expression 13 induced 16 together 13 induced 17 with 14 nrf2 15 expression 17 with 18 ho 17 with 20 1 19 - 20 1 20 1 21 in 21 in 23 lungs 22 their 23 lungs in addition , ski - ii reduced cigarette smoke mediated oxidative stress , macrophages and neutrophil infiltration and markers of inflammation in mice . 0 ###LEFT-WALL### 6 ii 0 ###LEFT-WALL### 7 reduced 0 ###LEFT-WALL### 24 . 1 in 2 addition 1 in 6 ii 2 addition 4 ski 3 , 4 ski 4 ski 5 - 6 ii 7 reduced 7 reduced 18 and 7 reduced 22 in 8 cigarette 10 mediated 9 smoke 10 mediated 10 mediated 12 stress 11 oxidative 12 stress 12 stress 13 , 13 , 14 macrophages 13 , 15 and 15 and 17 infiltration 15 and 18 and 16 neutrophil 17 infiltration 18 and 19 markers 18 and 20 of 20 of 21 inflammation 22 in 23 mice conclusions/significance : ski - ii appears to be a novel activator of nrf2 signalling via the inactivation of keap1 . 0 ###LEFT-WALL### 1 conclusions/significance 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 20 . 1 conclusions/significance 2 : 2 : 3 ski 4 - 5 ii 4 - 6 appears 5 ii 6 appears 6 appears 7 to 6 appears 8 be 7 to 8 be 8 be 11 activator 9 a 11 activator 10 novel 11 activator 11 activator 12 of 11 activator 14 signalling 12 of 13 nrf2 14 signalling 15 via 15 via 17 inactivation 16 the 17 inactivation 17 inactivation 18 of 18 of 19 keap1 background : frailty is related to adverse outcomes in the elderly . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 frailty 2 : 5 related 2 : 12 . 3 frailty 4 is 4 is 5 related 5 related 6 to 5 related 9 in 6 to 8 outcomes 7 adverse 8 outcomes 9 in 11 elderly 10 the 11 elderly however , current status and clinical significance of frailty have not been evaluated for the korean elderly population . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 13 evaluated 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 5 and 3 current 4 status 4 status 5 and 5 and 7 significance 5 and 8 of 5 and 10 have 6 clinical 7 significance 8 of 9 frailty 10 have 11 not 10 have 12 been 12 been 13 evaluated 13 evaluated 14 for 14 for 18 population 15 the 18 population 16 korean 18 population 17 elderly 18 population we aimed to investigate the usefulness of established frailty criteria for community [-] dwelling korean [elderly] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 17 . 1 we 2 aimed 2 aimed 3 to 2 aimed 11 for 3 to 4 investigate 4 investigate 6 usefulness 5 the 6 usefulness 6 usefulness 7 of 7 of 10 criteria 8 established 9 frailty 9 frailty 10 criteria 11 for 15 korean 12 community 14 dwelling 14 dwelling 15 korean we also tried to develop and validate a new frailty index based on a multidimensional model . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 17 . 1 we 6 and 2 also 3 tried 3 tried 4 to 3 tried 5 develop 3 tried 6 and 4 to 5 develop 6 and 7 validate 7 validate 11 index 7 validate 13 on 8 a 9 new 8 a 11 index 9 new 10 frailty 10 frailty 11 index 11 index 12 based 13 on 16 model 14 a 15 multidimensional 14 a 16 model 15 multidimensional 16 model methods : we studied 693 participants of the korean longitudinal study on health and aging ( klosha ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 studied 2 : 19 . 3 we 4 studied 4 studied 6 participants 4 studied 12 on 5 693 6 participants 6 participants 7 of 7 of 11 study 8 the 9 korean 9 korean 11 study 10 longitudinal 11 study 12 on 14 and 13 health 14 and 14 and 15 aging 15 aging 17 klosha 16 ( 17 klosha 17 klosha 18 ) we developed a new frailty index ( klosha frailty index , kfi ) and compared predictability of it with the established frailty indexes from the cardiovascular health study ( chs ) and study of osteoporotic fracture ( sof ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 developed 0 ###LEFT-WALL### 40 . 1 we 2 developed 2 developed 6 index 3 a 6 index 4 new 5 frailty 5 frailty 6 index 6 index 14 and 7 ( 14 and 8 klosha 9 frailty 9 frailty 10 index 10 index 12 kfi 11 , 12 kfi 12 kfi 13 ) 12 kfi 14 and 14 and 16 predictability 14 and 17 of 14 and 19 with 14 and 39 ) 15 compared 16 predictability 17 of 18 it 19 with 23 indexes 20 the 23 indexes 21 established 22 frailty 22 frailty 23 indexes 23 indexes 24 from 23 indexes 34 of 24 from 33 study 25 the 33 study 26 cardiovascular 27 health 27 health 28 study 28 study 30 chs 29 ( 30 chs 30 chs 31 ) 30 chs 32 and 32 and 33 study 34 of 38 sof 35 osteoporotic 36 fracture 36 fracture 38 sof 37 ( 38 sof mortality , hospitalization , and functional decline were evaluated . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 evaluated 0 ###LEFT-WALL### 10 . 1 mortality 2 , 2 , 3 hospitalization 2 , 5 and 4 , 5 and 5 and 7 decline 5 and 8 were 6 functional 7 decline 8 were 9 evaluated results : the prevalence of frailty was 9.2 % ( sof [index] ) , 13.2 % ( chs [index] ) , [and] 15.6 % ( kfi ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 prevalence 2 : 7 was 2 : 28 . 3 the 4 prevalence 4 prevalence 5 of 4 prevalence 7 was 5 of 6 frailty 7 was 9 % 8 9.2 9 % 9 % 11 sof 9 % 16 % 9 % 24 % 10 ( 11 sof 11 sof 13 ) 14 , 16 % 15 13.2 16 % 16 % 18 chs 16 % 21 , 17 ( 18 chs 18 chs 20 ) 21 , 24 % 23 15.6 24 % 24 % 26 kfi 24 % 27 ) 25 ( 26 kfi 26 kfi 27 ) the criteria from chs and kfi correlated with each other , but sof did not correlate with kfi . 0 ###LEFT-WALL### 2 criteria 0 ###LEFT-WALL### 12 but 0 ###LEFT-WALL### 19 . 1 the 2 criteria 2 criteria 3 from 2 criteria 12 but 3 from 5 and 4 chs 5 and 5 and 6 kfi 7 correlated 8 with 7 correlated 12 but 8 with 10 other 9 each 10 other 11 , 12 but 12 but 16 correlate 13 sof 14 did 14 did 15 not 14 did 16 correlate 16 correlate 17 with 17 with 18 kfi during the [follow] [-] up period ( 5.6 ± 0.9 years ) , 97 participants ( 14.0 % ) died . 0 ###LEFT-WALL### 15 participants 0 ###LEFT-WALL### 20 died 0 ###LEFT-WALL### 21 . 1 during 6 period 1 during 13 , 1 during 15 participants 2 the 6 period 5 up 6 period 6 period 11 years 7 ( 11 years 8 5.6 11 years 9 ± 11 years 10 0.9 11 years 11 years 12 ) 14 97 15 participants 15 participants 18 % 15 participants 20 died 16 ( 18 % 17 14.0 18 % 18 % 19 ) frailty defined by kfi predicted mortality better than chs index ( c - index [:] 0.713 and 0.596 , respectively ; p<0.001 , [better] for kfi ) . 0 ###LEFT-WALL### 1 frailty 0 ###LEFT-WALL### 5 predicted 0 ###LEFT-WALL### 21 ; 0 ###LEFT-WALL### 22 p<0.001 0 ###LEFT-WALL### 28 . 1 frailty 2 defined 1 frailty 5 predicted 2 defined 3 by 3 by 4 kfi 5 predicted 6 mortality 6 mortality 7 better 7 better 8 than 7 better 13 - 7 better 20 respectively 8 than 10 index 9 chs 10 index 11 ( 13 - 12 c 13 - 13 - 14 index 13 - 19 , 14 index 17 and 16 0.713 17 and 17 and 18 0.596 19 , 20 respectively 20 respectively 21 ; 21 ; 22 p<0.001 22 p<0.001 25 for 23 , 25 for 25 for 26 kfi 25 for 27 ) in contrast , frailty by sof [index] was not related to mortality . 0 ###LEFT-WALL### 4 frailty 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 13 . 1 in 2 contrast 1 in 3 , 1 in 4 frailty 4 frailty 5 by 4 frailty 8 was 5 by 6 sof 8 was 9 not 8 was 11 to 9 not 10 related 11 to 12 mortality the kfi showed better predictability for following functional decline than chs index ( area under the receiver - operating characteristic curve was 0.937 for kfi [and] 0.704 for chs index , p = 0.001 [ )( 0 ###LEFT-WALL### 2 kfi 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 10 than 1 the 2 kfi 2 kfi 3 showed 3 showed 4 better 3 showed 5 predictability 3 showed 6 for 6 for 7 following 7 following 9 decline 7 following 10 than 8 functional 9 decline 10 than 12 index 10 than 22 was 11 chs 12 index 12 index 18 - 12 index 22 was 13 ( 18 - 14 area 15 under 14 area 18 - 15 under 17 receiver 16 the 17 receiver 18 - 21 curve 19 operating 21 curve 20 characteristic 21 curve 22 was 23 0.937 23 0.937 24 for 23 0.937 27 0.704 23 0.937 30 index 24 for 25 kfi 27 0.704 28 for 27 0.704 30 index 28 for 29 chs 30 index 33 = 31 , 33 = 32 p 33 = 33 = 34 0.001 33 = 36 )( however , the sof index could not [predict] [subsequent] [functional] decline . 0 ###LEFT-WALL### 5 index 0 ###LEFT-WALL### 11 decline 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 5 index 3 the 5 index 4 sof 5 index 5 index 6 could 6 could 7 not 6 could 11 decline frailty by the kfi ( or = 2.13 , 95 % ci 1.04 - 4.35 [ )(and chs index ( or = 2.24 , 95 % ci 1.05 - 4.76 ) were associated with hospitalization . 0 ###LEFT-WALL### 1 frailty 0 ###LEFT-WALL### 7 = 1 frailty 2 by 1 frailty 7 = 2 by 6 or 3 the 6 or 4 kfi 6 or 5 ( 6 or 7 = 8 2.13 8 2.13 11 % 9 , 11 % 10 95 11 % 11 % 17 )(and 11 % 19 index 11 % 21 or 11 % 36 . 12 ci 14 - 12 ci 17 )(and 13 1.04 14 - 14 - 15 4.35 17 )(and 18 chs 17 )(and 19 index 20 ( 21 or 21 or 23 2.24 21 or 32 were 21 or 33 associated 21 or 34 with 21 or 36 . 22 = 23 2.24 23 2.24 27 ci 23 2.24 32 were 24 , 27 ci 25 95 27 ci 26 % 27 ci 27 ci 29 - 27 ci 31 ) 28 1.05 29 - 29 - 30 4.76 34 with 35 hospitalization in contrast , frailty by the sof index was not correlated with hospitalization ( or [=] 1.43 , 95 % ci 0.68 - 3.01 ) . 0 ###LEFT-WALL### 4 frailty 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 26 . 1 in 2 contrast 1 in 3 , 1 in 4 frailty 4 frailty 5 by 4 frailty 9 was 5 by 8 index 6 the 8 index 7 sof 8 index 9 was 10 not 9 was 12 with 10 not 11 correlated 12 with 13 hospitalization 13 hospitalization 15 or 13 hospitalization 21 ci 14 ( 15 or 15 or 17 1.43 15 or 18 , 18 , 21 ci 19 95 21 ci 20 % 21 ci 21 ci 23 - 21 ci 25 ) 22 0.68 23 - 23 - 24 3.01 conclusion : prevalence of frailty was higher in korea compared to previous studies in other countries . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 prevalence 2 : 6 was 2 : 17 . 3 prevalence 4 of 3 prevalence 6 was 4 of 5 frailty 6 was 7 higher 7 higher 8 in 8 in 9 korea 9 korea 10 compared 10 compared 11 to 10 compared 14 in 11 to 13 studies 12 previous 13 studies 14 in 16 countries 15 other 16 countries a novel frailty index ( kfi ) , which includes domains of comprehensive geriatric assessment , is a valid criterion for the evaluation and prediction of frailty in the korean elderly population . 0 ###LEFT-WALL### 4 index 0 ###LEFT-WALL### 17 is 0 ###LEFT-WALL### 33 . 1 a 2 novel 1 a 4 index 2 novel 3 frailty 3 frailty 4 index 4 index 6 kfi 4 index 9 which 4 index 17 is 5 ( 6 kfi 6 kfi 7 ) 8 , 9 which 9 which 10 includes 9 which 16 , 10 includes 11 domains 11 domains 12 of 12 of 15 assessment 13 comprehensive 15 assessment 14 geriatric 15 assessment 17 is 20 criterion 18 a 20 criterion 19 valid 20 criterion 20 criterion 21 for 20 criterion 26 of 20 criterion 28 in 21 for 24 and 22 the 23 evaluation 23 evaluation 24 and 24 and 25 prediction 26 of 27 frailty 28 in 32 population 29 the 32 population 30 korean 32 population 31 elderly 32 population breast cancer is a heterogeneous disease whose molecular diversity is not well reflected in clinical and pathological markers used for prognosis [and] treatment selection . 0 ###LEFT-WALL### 2 cancer 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 11 not 0 ###LEFT-WALL### 25 . 1 breast 2 cancer 2 cancer 3 is 3 is 6 disease 4 a 6 disease 5 heterogeneous 6 disease 6 disease 7 whose 7 whose 9 diversity 8 molecular 9 diversity 9 diversity 10 is 11 not 12 well 11 not 19 used 12 well 13 reflected 12 well 14 in 12 well 19 used 14 in 18 markers 15 clinical 16 and 16 and 17 pathological 16 and 18 markers 19 used 20 for 19 used 24 selection 20 for 23 treatment 21 prognosis 23 treatment as tumor cells secrete proteins into the extracellular environment , some of these proteins reach circulation and could become suitable biomarkers for improving diagnosis or monitoring response to treatment . 0 ###LEFT-WALL### 14 proteins 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 30 . 1 as 3 cells 1 as 4 secrete 1 as 10 , 1 as 14 proteins 2 tumor 3 cells 3 cells 4 secrete 4 secrete 5 proteins 4 secrete 6 into 6 into 9 environment 7 the 9 environment 8 extracellular 9 environment 11 some 12 of 11 some 14 proteins 12 of 14 proteins 13 these 14 proteins 14 proteins 17 and 15 reach 16 circulation 15 reach 17 and 17 and 18 could 18 could 19 become 19 become 21 biomarkers 19 become 22 for 19 become 28 to 20 suitable 21 biomarkers 22 for 25 or 23 improving 24 diagnosis 24 diagnosis 25 or 25 or 27 response 26 monitoring 27 response 28 to 29 treatment as many signaling pathways and interaction networks are altered in cancerous tissues by protein phosphorylation , changes in the secretory phosphoproteome of cancer tissues could reflect both disease progression and subtype . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 32 . 1 as 2 many 1 as 5 and 2 many 3 signaling 4 pathways 5 and 5 and 7 networks 5 and 8 are 6 interaction 7 networks 8 are 16 , 9 altered 10 in 9 altered 13 by 9 altered 16 , 10 in 12 tissues 11 cancerous 12 tissues 13 by 15 phosphorylation 14 protein 15 phosphorylation 16 , 30 and 17 changes 18 in 17 changes 29 progression 17 changes 30 and 18 in 21 phosphoproteome 19 the 21 phosphoproteome 20 secretory 21 phosphoproteome 21 phosphoproteome 22 of 22 of 23 cancer 23 cancer 24 tissues 23 cancer 26 reflect 24 tissues 25 could 25 could 26 reflect 26 reflect 27 both 28 disease 29 progression 30 and 31 subtype to test this hypothesis , we compared the phosphopeptide - enriched fractions obtained from proteins secreted into conditioned media ( cm ) derived from five luminal and five basal type breast cancer cell lines using label - free quantitative mass spectrometry . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 compared 0 ###LEFT-WALL### 10 - 1 to 2 test 1 to 5 , 1 to 6 we 2 test 4 hypothesis 3 this 4 hypothesis 6 we 7 compared 7 compared 9 phosphopeptide 8 the 9 phosphopeptide 10 - 27 and 10 - 37 - 11 enriched 12 fractions 12 fractions 13 obtained 12 fractions 27 and 13 obtained 14 from 13 obtained 26 luminal 14 from 15 proteins 15 proteins 16 secreted 15 proteins 23 derived 15 proteins 24 from 16 secreted 17 into 17 into 19 media 18 conditioned 19 media 19 media 21 cm 20 ( 21 cm 21 cm 22 ) 24 from 25 five 27 and 36 label 28 five 29 basal 29 basal 34 lines 30 type 32 cancer 31 breast 32 cancer 32 cancer 34 lines 33 cell 34 lines 34 lines 36 label 35 using 36 label 37 - 38 free 37 - 42 . 38 free 41 spectrometry 39 quantitative 40 mass 40 mass 41 spectrometry altogether over 5000 phosphosites derived from 1756 phosphoproteins were identified , several of which have the potential to qualify as phosphopeptide plasma biomarker candidates for the more aggressive basal and also the luminal - type breast cancers . 0 ###LEFT-WALL### 4 phosphosites 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 19 qualify 0 ###LEFT-WALL### 38 . 1 altogether 4 phosphosites 2 over 3 5000 3 5000 4 phosphosites 4 phosphosites 5 derived 4 phosphosites 9 were 5 derived 6 from 6 from 8 phosphoproteins 7 1756 8 phosphoproteins 9 were 10 identified 11 , 12 several 11 , 15 have 12 several 13 of 12 several 15 have 13 of 14 which 15 have 17 potential 15 have 18 to 16 the 17 potential 18 to 19 qualify 19 qualify 20 as 19 qualify 30 and 20 as 21 phosphopeptide 22 plasma 24 candidates 23 biomarker 24 candidates 24 candidates 25 for 24 candidates 30 and 25 for 29 basal 26 the 29 basal 27 more 28 aggressive 28 aggressive 29 basal 30 and 31 also 30 and 37 cancers 32 the 37 cancers 33 luminal 34 - 33 luminal 37 cancers 35 type 37 cancers 36 breast 37 cancers the analysis of phosphopeptides from breast cancer patient plasma and controls allowed us to construct a discovery list of phosphosites under rigorous collection conditions , and second to qualify discovery candidates generated from the cm studies . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 12 allowed 0 ###LEFT-WALL### 37 . 1 the 2 analysis 2 analysis 3 of 2 analysis 10 and 3 of 4 phosphopeptides 4 phosphopeptides 5 from 5 from 9 plasma 6 breast 7 cancer 7 cancer 9 plasma 8 patient 9 plasma 10 and 11 controls 10 and 12 allowed 12 allowed 13 us 12 allowed 14 to 12 allowed 26 and 14 to 26 and 15 construct 18 list 15 construct 21 under 15 construct 26 and 16 a 18 list 17 discovery 18 list 18 list 19 of 19 of 20 phosphosites 21 under 24 conditions 22 rigorous 23 collection 23 collection 24 conditions 25 , 26 and 26 and 27 second 26 and 36 studies 27 second 28 to 27 second 31 candidates 28 to 29 qualify 29 qualify 30 discovery 31 candidates 32 generated 32 generated 33 from 33 from 35 cm 34 the 35 cm indeed , a set of basal - specific phosphorylation cm site candidates derived from ibp3 , cd44 , opn , fstl3 , lamb1 , and stc2 , and luminal - specific candidates derived from cytc and ibp5 were selected and [,] based on their presence in plasma , quantified across all cell line cm samples using skyline ms1 intensity data . 0 ###LEFT-WALL### 4 set 0 ###LEFT-WALL### 13 derived 1 indeed 2 , 1 indeed 4 set 3 a 4 set 4 set 5 of 4 set 13 derived 5 of 12 candidates 6 basal 7 - 6 basal 12 candidates 8 specific 12 candidates 9 phosphorylation 12 candidates 10 cm 11 site 11 site 12 candidates 13 derived 14 from 13 derived 19 opn 14 from 15 ibp3 15 ibp3 17 cd44 16 , 17 cd44 17 cd44 18 , 19 opn 28 and 20 , 28 and 21 fstl3 25 and 21 fstl3 28 and 22 , 25 and 23 lamb1 25 and 24 , 25 and 25 and 26 stc2 25 and 27 , 28 and 32 candidates 28 and 33 derived 28 and 34 from 28 and 40 and 28 and 61 . 29 luminal 30 - 29 luminal 32 candidates 31 specific 32 candidates 34 from 36 and 35 cytc 36 and 36 and 37 ibp5 38 were 39 selected 38 were 40 and 40 and 42 based 40 and 43 on 40 and 45 presence 40 and 46 in 44 their 45 presence 46 in 47 plasma 47 plasma 49 quantified 48 , 49 quantified 49 quantified 50 across 49 quantified 61 . 50 across 55 samples 51 all 55 samples 52 cell 53 line 53 line 55 samples 54 cm 55 samples 55 samples 56 using 56 using 60 data 57 skyline 58 ms1 58 ms1 60 data 59 intensity 60 data together , this approach allowed us to assemble a set of novel cancer [subtype] specific phosphopeptide candidates for subsequent biomarker verification and clinical validation . 0 ###LEFT-WALL### 4 approach 0 ###LEFT-WALL### 5 allowed 0 ###LEFT-WALL### 25 . 1 together 2 , 1 together 4 approach 3 this 4 approach 4 approach 5 allowed 5 allowed 6 us 5 allowed 7 to 5 allowed 8 assemble 7 to 8 assemble 8 assemble 10 set 8 assemble 18 for 9 a 10 set 10 set 11 of 11 of 17 candidates 12 novel 13 cancer 13 cancer 17 candidates 15 specific 16 phosphopeptide 16 phosphopeptide 17 candidates 18 for 22 and 19 subsequent 20 biomarker 20 biomarker 21 verification 21 verification 22 and 22 and 24 validation 23 clinical 24 validation the aim of the present study was to test the hypothesis that the age [-] associated decrease of tendon stiffness would necessitate greater muscle fascicle strains to produce similar levels of force during isometric contraction . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 26 strains 0 ###LEFT-WALL### 36 . 1 the 2 aim 2 aim 3 of 2 aim 6 study 2 aim 9 test 2 aim 21 would 3 of 5 present 4 the 5 present 6 study 7 was 7 was 8 to 7 was 9 test 8 to 9 test 9 test 11 hypothesis 10 the 11 hypothesis 11 hypothesis 12 that 12 that 14 age 12 that 16 associated 13 the 14 age 14 age 16 associated 16 associated 17 decrease 17 decrease 18 of 18 of 20 stiffness 19 tendon 20 stiffness 21 would 22 necessitate 22 necessitate 24 muscle 23 greater 24 muscle 24 muscle 25 fascicle 24 muscle 26 strains 25 fascicle 26 strains 26 strains 27 to 27 to 28 produce 28 produce 30 levels 28 produce 33 during 29 similar 30 levels 30 levels 31 of 31 of 32 force 33 during 35 contraction 34 isometric 35 contraction greater fascicle strains could force sarcomeres to operate in less advantageous regions of their force - length and force - velocity relationships , thus impairing the capacity to generate strong and explosive contractions . 0 ###LEFT-WALL### 3 strains 0 ###LEFT-WALL### 34 . 1 greater 3 strains 2 fascicle 3 strains 3 strains 4 could 4 could 5 force 5 force 6 sarcomeres 5 force 7 to 5 force 8 operate 7 to 8 operate 8 operate 9 in 9 in 12 regions 10 less 11 advantageous 11 advantageous 12 regions 12 regions 13 of 12 regions 25 impairing 13 of 15 force 14 their 15 force 15 force 18 and 16 - 18 and 17 length 18 and 18 and 19 force 18 and 22 relationships 18 and 23 , 20 - 22 relationships 21 velocity 22 relationships 22 relationships 23 , 24 thus 25 impairing 25 impairing 27 capacity 26 the 27 capacity 27 capacity 28 to 27 capacity 29 generate 28 to 29 generate 29 generate 33 contractions 30 strong 31 and 31 and 32 explosive 31 and 33 contractions to test this hypothesis , sagittal - plane dynamic velocity - encoded phase - contrast magnetic resonance images of the gastrocnemius medialis ( gm ) muscle and achilles tendon ( at ) were acquired in six young [(] yw [;] 26.1 ± 2.3 [yr] [ )(and six senior ( sw [;] 76.7 ± 8.3 [yr] ) women during submaximal isometric contraction ( 35 % maximum voluntary isometric contraction [ )(of the plantar flexor muscles . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 5 , 1 to 2 test 2 test 4 hypothesis 3 this 4 hypothesis 5 , 8 plane 5 , 11 - 6 sagittal 7 - 6 sagittal 8 plane 8 plane 10 velocity 9 dynamic 10 velocity 11 - 13 phase 11 - 14 - 12 encoded 13 phase 14 - 15 contrast 15 contrast 27 and 16 magnetic 18 images 17 resonance 18 images 18 images 19 of 18 images 27 and 19 of 21 gastrocnemius 20 the 21 gastrocnemius 21 gastrocnemius 22 medialis 21 gastrocnemius 26 muscle 22 medialis 24 gm 22 medialis 26 muscle 23 ( 24 gm 24 gm 25 ) 27 and 28 achilles 27 and 29 tendon 27 and 33 were 27 and 34 acquired 29 tendon 31 at 29 tendon 33 were 30 ( 31 at 31 at 32 ) 34 acquired 35 in 35 in 46 )(and 36 six 42 ± 37 young 42 ± 39 yw 41 26.1 39 yw 42 ± 42 ± 43 2.3 42 ± 46 )(and 46 )(and 57 women 46 )(and 58 during 47 six 57 women 48 senior 53 ± 48 senior 56 ) 48 senior 57 women 49 ( 53 ± 50 sw 53 ± 52 76.7 53 ± 53 ± 54 8.3 53 ± 56 ) 58 during 61 contraction 59 submaximal 61 contraction 60 isometric 61 contraction 61 contraction 64 % 62 ( 64 % 63 35 64 % 64 % 68 contraction 64 % 74 muscles 64 % 75 . 65 maximum 68 contraction 66 voluntary 68 contraction 67 isometric 68 contraction 68 contraction 70 )(of 68 contraction 74 muscles 70 )(of 73 flexor 71 the 73 flexor 72 plantar 73 flexor multiple gm fascicle lengths were continuously determined by automatically tracking regions of interest coinciding with the end points of muscle fascicles evenly distributed along the muscle 's proximo - distal length . 0 ###LEFT-WALL### 4 lengths 0 ###LEFT-WALL### 7 determined 0 ###LEFT-WALL### 32 . 1 multiple 4 lengths 2 gm 4 lengths 3 fascicle 4 lengths 4 lengths 5 were 5 were 6 continuously 5 were 7 determined 7 determined 8 by 8 by 10 tracking 9 automatically 10 tracking 10 tracking 11 regions 11 regions 12 of 12 of 13 interest 13 interest 14 coinciding 13 interest 15 with 13 interest 18 points 13 interest 23 distributed 15 with 17 end 16 the 17 end 18 points 19 of 18 points 23 distributed 19 of 21 fascicles 20 muscle 21 fascicles 22 evenly 23 distributed 23 distributed 24 along 24 along 31 length 25 the 26 muscle 26 muscle 27 's 27 's 31 length 28 proximo 29 - 28 proximo 31 length 30 distal 31 length at stiffness and young 's modulus were measured as the slopes of the tendon 's force - elongation and stress - strain curves , respectively . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 26 . 1 at 2 stiffness 2 stiffness 3 and 3 and 6 modulus 3 and 7 were 4 young 5 's 5 's 6 modulus 7 were 8 measured 8 measured 9 as 8 measured 25 respectively 9 as 11 slopes 10 the 11 slopes 11 slopes 12 of 11 slopes 19 and 12 of 16 force 13 the 14 tendon 14 tendon 15 's 15 's 16 force 17 - 19 and 18 elongation 19 and 19 and 20 stress 19 and 23 curves 19 and 24 , 21 - 23 curves 22 strain 23 curves 23 curves 24 , [despite] significantly lower at stiffness at older age ( yw : 120.2 ± 52.3 n/mm [vs] . sw : 53.9 ± 44.4 n/mm , p = 0.040 ) , contraction - induced changes in gm fascicle lengths were similar in both age groups at equal levels of absolute muscular force ( 4 - 5 % fascicle shortening in both groups [ )(, and even significantly larger in yw [(] yw : 11 - 12 % vs [.] sw : 6 - 8 % fascicle shortening [ )(at equal percentage of maximum voluntary contraction . 0 ###LEFT-WALL### 3 lower 0 ###LEFT-WALL### 11 : 2 significantly 3 lower 3 lower 5 stiffness 4 at 5 stiffness 5 stiffness 6 at 6 at 8 age 7 older 8 age 8 age 10 yw 9 ( 10 yw 10 yw 11 : 11 : 12 120.2 11 : 17 . 12 120.2 13 ± 13 ± 15 n/mm 14 52.3 15 n/mm 17 . 18 sw 17 . 19 : 17 . 21 ± 19 : 20 53.9 20 53.9 21 ± 21 ± 23 n/mm 21 ± 31 - 22 44.4 23 n/mm 23 n/mm 26 = 24 , 26 = 25 p 26 = 26 = 27 0.040 26 = 28 ) 29 , 31 - 30 contraction 31 - 31 - 33 changes 32 induced 33 changes 33 changes 34 in 33 changes 39 similar 33 changes 42 age 33 changes 43 groups 34 in 35 gm 35 gm 37 lengths 35 gm 38 were 36 fascicle 37 lengths 37 lengths 38 were 39 similar 40 in 40 in 41 both 42 age 43 groups 43 groups 44 at 44 at 45 equal 45 equal 46 levels 45 equal 56 fascicle 46 levels 47 of 46 levels 56 fascicle 47 of 50 force 48 absolute 50 force 49 muscular 50 force 50 force 53 - 51 ( 53 - 52 4 53 - 53 - 55 % 54 5 55 % 56 fascicle 63 and 56 fascicle 67 in 57 shortening 58 in 57 shortening 63 and 58 in 60 groups 59 both 60 groups 62 )(, 63 and 63 and 64 even 63 and 66 larger 65 significantly 66 larger 67 in 68 yw 68 yw 70 yw 68 yw 71 : 70 yw 71 : 71 : 73 - 72 11 73 - 73 - 74 12 74 12 75 % 75 % 76 vs 75 % 79 : 76 vs 78 sw 79 : 80 6 80 6 85 shortening 81 - 85 shortening 82 8 85 shortening 83 % 84 fascicle 84 fascicle 85 shortening 85 shortening 87 )(at 85 shortening 90 of 85 shortening 94 . 87 )(at 89 percentage 88 equal 89 percentage 90 of 93 contraction 91 maximum 93 contraction 92 voluntary 93 contraction these results suggest that factors other than at stiffness , such as age - associated changes in muscle composition or fascicle slack , might serve as compensatory adaptations , limiting the degree of fascicle strains upon contraction . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 38 . 1 these 2 results 2 results 3 suggest 3 suggest 4 that 3 suggest 5 factors 4 that 5 factors 5 factors 7 than 5 factors 9 stiffness 5 factors 12 as 6 other 7 than 7 than 8 at 10 , 12 as 11 such 12 as 12 as 13 age 12 as 14 - 14 - 23 , 14 - 29 , 15 associated 16 changes 15 associated 17 in 15 associated 23 , 17 in 20 or 18 muscle 19 composition 19 composition 20 or 20 or 22 slack 21 fascicle 22 slack 23 , 24 might 24 might 25 serve 25 serve 28 adaptations 26 as 27 compensatory 27 compensatory 28 adaptations 29 , 30 limiting 29 , 35 strains 30 limiting 34 fascicle 30 limiting 35 strains 31 the 32 degree 32 degree 33 of 32 degree 34 fascicle 33 of 34 fascicle 35 strains 36 upon 36 upon 37 contraction this article explores mutual caregiving between older spouses aging with physical disabilities . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 explores 0 ###LEFT-WALL### 13 . 1 this 2 article 2 article 3 explores 3 explores 5 caregiving 3 explores 6 between 4 mutual 5 caregiving 6 between 8 spouses 7 older 8 spouses 8 spouses 9 aging 9 aging 10 with 10 with 12 disabilities 11 physical 12 disabilities nine older couples , where both partners had lived long lives with physical disabilities , were interviewed as dyads about mutual caregiving . 0 ###LEFT-WALL### 3 couples 0 ###LEFT-WALL### 17 interviewed 0 ###LEFT-WALL### 23 . 1 nine 3 couples 2 older 3 couples 3 couples 5 where 3 couples 16 were 4 , 5 where 5 where 7 partners 5 where 9 lived 5 where 15 , 6 both 7 partners 7 partners 8 had 8 had 9 lived 9 lived 11 lives 9 lived 12 with 10 long 11 lives 12 with 14 disabilities 13 physical 14 disabilities 16 were 17 interviewed 17 interviewed 18 as 17 interviewed 20 about 18 as 19 dyads 20 about 22 caregiving 21 mutual 22 caregiving the couples not only had access to different kinds and degrees of formal support but also provided mutual care to each other in a variety of ways . 0 ###LEFT-WALL### 2 couples 0 ###LEFT-WALL### 16 also 0 ###LEFT-WALL### 28 . 1 the 2 couples 2 couples 16 also 3 not 4 only 4 only 16 also 5 had 6 access 5 had 7 to 5 had 16 also 7 to 10 and 8 different 9 kinds 9 kinds 10 and 10 and 14 support 11 degrees 12 of 11 degrees 14 support 12 of 14 support 13 formal 14 support 15 but 16 also 16 also 17 provided 17 provided 19 care 17 provided 20 to 17 provided 23 in 18 mutual 19 care 20 to 22 other 21 each 22 other 23 in 25 variety 24 a 25 variety 25 variety 26 of 26 of 27 ways interview coding using grounded theory led to two overarching categories from which motivation for mutual caregiving could be understood . 0 ###LEFT-WALL### 1 interview 0 ###LEFT-WALL### 6 led 1 interview 2 coding 1 interview 3 using 1 interview 6 led 3 using 5 theory 4 grounded 5 theory 6 led 7 to 6 led 10 categories 7 to 8 two 8 two 9 overarching 10 categories 11 from 11 from 12 which 11 from 13 motivation 11 from 19 understood 13 motivation 14 for 13 motivation 17 could 14 for 16 caregiving 15 mutual 16 caregiving 17 could 18 be 18 be 19 understood 19 understood 20 . these categories were [mutual] [care] as freedom and mutual care as imperative . 0 ###LEFT-WALL### 2 categories 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 13 . 1 these 2 categories 2 categories 3 were 3 were 6 as 3 were 12 imperative 6 as 8 and 7 freedom 8 and 8 and 10 care 9 mutual 10 care 11 as 12 imperative the results extend understanding about how older couples with disabilities attached meaning to their mutual caregiving , and why mutual care was sometimes preferable , despite the availability of other sources of help and [despite] practical difficulties of providing this help . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 18 and 1 the 2 results 2 results 3 extend 3 extend 4 understanding 3 extend 5 about 5 about 6 how 6 how 8 couples 6 how 11 attached 7 older 8 couples 8 couples 9 with 8 couples 11 attached 9 with 10 disabilities 11 attached 12 meaning 11 attached 13 to 13 to 16 caregiving 14 their 16 caregiving 15 mutual 16 caregiving 17 , 18 and 18 and 21 care 18 and 22 was 19 why 21 care 20 mutual 21 care 21 care 22 was 22 was 23 sometimes 22 was 24 preferable 24 preferable 26 despite 25 , 26 despite 26 despite 34 and 26 despite 42 . 27 the 28 availability 28 availability 29 of 28 availability 34 and 29 of 31 sources 30 other 31 sources 31 sources 32 of 32 of 33 help 34 and 37 difficulties 34 and 42 . 36 practical 37 difficulties 37 difficulties 38 of 38 of 39 providing 39 providing 41 help 40 this 41 help these findings suggest that health care professionals need to be sensitive to the dynamics of the couple relationship and carefully explore the couple 's preferences for how formal support can best be provided in ways that honor and sustain the integrity of the couple relationship . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 38 and 0 ###LEFT-WALL### 46 . 1 these 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 7 professionals 4 that 8 need 5 health 6 care 6 care 7 professionals 8 need 9 to 8 need 19 and 9 to 19 and 10 be 11 sensitive 10 be 19 and 11 sensitive 12 to 12 to 14 dynamics 13 the 14 dynamics 14 dynamics 15 of 15 of 18 relationship 16 the 18 relationship 17 couple 18 relationship 19 and 21 explore 20 carefully 21 explore 21 explore 25 preferences 21 explore 26 for 22 the 23 couple 23 couple 24 's 24 's 25 preferences 26 for 27 how 27 how 28 formal 28 formal 29 support 29 support 30 can 30 can 32 be 31 best 32 be 32 be 38 and 33 provided 34 in 33 provided 37 honor 33 provided 38 and 34 in 35 ways 36 that 37 honor 38 and 39 sustain 39 sustain 41 integrity 40 the 41 integrity 41 integrity 42 of 42 of 45 relationship 43 the 45 relationship 44 couple 45 relationship objective : to analyze similarities among factors associated with the components of frailty [in] elderly . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 3 to 2 : 4 analyze 3 to 4 analyze 4 analyze 5 similarities 4 analyze 6 among 6 among 7 factors 7 factors 8 associated 8 associated 9 with 8 associated 15 elderly 9 with 11 components 10 the 11 components 11 components 12 of 12 of 13 frailty method : we studied 1,413 elderly from the second wave of the sabe study in 2006 . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 studied 2 : 17 . 3 we 4 studied 4 studied 5 1,413 5 1,413 6 elderly 6 elderly 7 from 6 elderly 15 in 7 from 10 wave 8 the 9 second 8 the 10 wave 10 wave 11 of 11 of 14 study 12 the 14 study 13 sabe 14 study 15 in 16 2006 each of the five components of the frailty phenotype was considered a dependent variable in the hierarchical logistic regression models . 0 ###LEFT-WALL### 1 each 0 ###LEFT-WALL### 11 considered 0 ###LEFT-WALL### 21 . 1 each 2 of 1 each 10 was 2 of 5 components 3 the 4 five 4 five 5 components 5 components 6 of 6 of 9 phenotype 7 the 9 phenotype 8 frailty 9 phenotype 10 was 11 considered 11 considered 14 variable 11 considered 15 in 12 a 13 dependent 12 a 14 variable 13 dependent 14 variable 15 in 20 models 16 the 20 models 17 hierarchical 19 regression 18 logistic 19 regression 19 regression 20 models results : in both genders , age , schooling , sedentary lifestyle , and screening positive for depression were associated similarly with more than one component of frailty . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 29 . 1 results 2 : 2 : 3 in 3 in 5 genders 4 both 5 genders 5 genders 7 age 5 genders 9 schooling 6 , 7 age 7 age 8 , 8 , 9 schooling 9 schooling 10 , 10 , 14 and 10 , 20 associated 11 sedentary 12 lifestyle 12 lifestyle 14 and 13 , 14 and 14 and 15 screening 14 and 16 positive 14 and 19 were 16 positive 17 for 17 for 18 depression 19 were 20 associated 20 associated 21 similarly 21 similarly 22 with 22 with 26 component 23 more 24 than 24 than 25 one 25 one 26 component 26 component 27 of 27 of 28 frailty other similarities were also observed with stroke [and] screening positive for cognitive decline [in] men , and number of diseases and gait speed in women . 0 ###LEFT-WALL### 2 similarities 0 ###LEFT-WALL### 5 observed 0 ###LEFT-WALL### 26 . 1 other 2 similarities 2 similarities 3 were 3 were 5 observed 4 also 5 observed 5 observed 6 with 6 with 21 and 7 stroke 9 screening 9 screening 10 positive 9 screening 17 and 10 positive 11 for 11 for 15 men 12 cognitive 13 decline 13 decline 15 men 16 , 17 and 17 and 18 number 17 and 19 of 17 and 21 and 19 of 20 diseases 21 and 23 speed 21 and 24 in 22 gait 23 speed 24 in 25 women the most similar associations happened between weakness and slowness ; weakness , slowness , and lpal [;] or weakness , slowness , and exhaustion . 0 ###LEFT-WALL### 4 associations 0 ###LEFT-WALL### 5 happened 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 25 . 1 the 4 associations 2 most 3 similar 3 similar 4 associations 4 associations 5 happened 5 happened 6 between 6 between 8 and 7 weakness 8 and 8 and 9 slowness 10 ; 23 and 11 weakness 12 , 12 , 13 slowness 12 , 15 and 14 , 15 and 15 and 16 lpal 15 and 18 or 18 or 19 weakness 18 or 21 slowness 18 or 23 and 20 , 21 slowness 21 slowness 22 , 23 and 24 exhaustion discussion : encouraging physical activity , screening for [and] treating depression and treating both diseases of the central nervous system and chronic diseases must be the focus of strategies to avoid , delay , or even remedy frailty . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 1 discussion 2 : 2 : 3 encouraging 3 encouraging 5 activity 3 encouraging 7 screening 4 physical 5 activity 6 , 7 screening 7 screening 8 for 7 screening 12 and 7 screening 39 . 8 for 10 treating 11 depression 12 and 12 and 13 treating 12 and 21 and 12 and 25 be 14 both 21 and 15 diseases 16 of 15 diseases 21 and 16 of 20 system 17 the 20 system 18 central 20 system 19 nervous 20 system 21 and 23 diseases 21 and 24 must 22 chronic 23 diseases 24 must 25 be 25 be 35 or 26 the 27 focus 27 focus 28 of 27 focus 35 or 28 of 29 strategies 29 strategies 30 to 29 strategies 31 avoid 29 strategies 33 delay 30 to 31 avoid 32 , 33 delay 33 delay 34 , 34 , 35 or 35 or 36 even 35 or 38 frailty 37 remedy 38 frailty cardiomyocyte [hypertrophy] is an adaptive response of the heart to various types of stress . 0 ###LEFT-WALL### 1 cardiomyocyte 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 15 . 1 cardiomyocyte 3 is 3 is 6 response 4 an 5 adaptive 4 an 6 response 5 adaptive 6 response 6 response 7 of 7 of 9 heart 8 the 9 heart 9 heart 10 to 10 to 14 stress 11 various 12 types 12 types 13 of 12 types 14 stress 13 of 14 stress during the period of stress accumulation , the [transition] [from] physiological hypertrophy to pathological [hypertrophy] results in the promotion of heart failure . 0 ###LEFT-WALL### 11 physiological 0 ###LEFT-WALL### 12 hypertrophy 0 ###LEFT-WALL### 23 . 1 during 3 period 1 during 7 , 1 during 11 physiological 2 the 3 period 3 period 4 of 4 of 6 accumulation 5 stress 6 accumulation 8 the 11 physiological 11 physiological 12 hypertrophy 12 hypertrophy 13 to 12 hypertrophy 17 in 13 to 16 results 14 pathological 16 results 17 in 19 promotion 18 the 19 promotion 19 promotion 20 of 20 of 22 failure 21 heart 22 failure gelsolin ( gsn ) is a member of the actin - binding proteins , which regulate dynamic actin filament organization by severing and capping . 0 ###LEFT-WALL### 3 gsn 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 25 . 1 gelsolin 3 gsn 2 ( 3 gsn 3 gsn 4 ) 3 gsn 5 is 5 is 7 member 5 is 12 binding 6 a 7 member 7 member 8 of 8 of 10 actin 9 the 10 actin 11 - 12 binding 12 binding 13 proteins 12 binding 14 , 14 , 15 which 14 , 16 regulate 15 which 16 regulate 16 regulate 23 and 17 dynamic 18 actin 18 actin 20 organization 19 filament 20 organization 20 organization 21 by 20 organization 23 and 21 by 22 severing 23 and 24 capping moreover , gsn also regulates cell morphology , differentiation , movement , and apoptosis . 0 ###LEFT-WALL### 3 gsn 0 ###LEFT-WALL### 5 regulates 0 ###LEFT-WALL### 15 . 1 moreover 2 , 1 moreover 3 gsn 3 gsn 5 regulates 4 also 5 regulates 5 regulates 13 and 6 cell 7 morphology 7 morphology 8 , 8 , 9 differentiation 8 , 10 , 10 , 11 movement 10 , 13 and 12 , 13 and 13 and 14 apoptosis in this study , we used h9c2 and h9c2 - gsn stable clones in an attempt to understand the mechanisms of gsn overexpression in cardiomyocytes . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 26 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 used 6 used 13 clones 6 used 14 in 7 h9c2 8 and 8 and 9 h9c2 9 h9c2 11 gsn 10 - 11 gsn 11 gsn 13 clones 12 stable 13 clones 14 in 16 attempt 15 an 16 attempt 16 attempt 17 to 16 attempt 18 understand 17 to 18 understand 18 understand 20 mechanisms 18 understand 24 in 19 the 20 mechanisms 20 mechanisms 21 of 21 of 23 overexpression 22 gsn 23 overexpression 24 in 25 cardiomyocytes these data showed that the overexpression of gsn in h9c2 - induced [cardiac] [hypertrophy] and increased the pathological [hypertrophy] markers atrial natriuretic peptide brain natriuretic peptide . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 27 . 1 these 2 data 2 data 3 showed 3 showed 4 that 3 showed 6 overexpression 3 showed 9 in 5 the 6 overexpression 6 overexpression 7 of 7 of 8 gsn 9 in 10 h9c2 11 - 15 and 12 induced 15 and 15 and 16 increased 16 increased 26 peptide 17 the 26 peptide 18 pathological 20 markers 20 markers 24 brain 21 atrial 23 peptide 22 natriuretic 23 peptide 23 peptide 24 brain 24 brain 26 peptide 25 natriuretic 26 peptide furthermore , we found that [e] - cadherin expression decreased with the overexpression of gsn in h9c2 , but β - catenin expression increased . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 7 - 1 furthermore 2 , 1 furthermore 3 we 3 we 4 found 4 found 5 that 7 - 9 expression 7 - 10 decreased 7 - 19 but 7 - 25 . 8 cadherin 9 expression 9 expression 10 decreased 10 decreased 11 with 10 decreased 16 in 11 with 13 overexpression 12 the 13 overexpression 13 overexpression 14 of 14 of 15 gsn 16 in 17 h9c2 18 , 19 but 19 but 23 expression 19 but 24 increased 20 β 21 - 20 β 22 catenin 22 catenin 23 expression 23 expression 24 increased these data presume that the cytoskeleton is loose . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 presume 0 ###LEFT-WALL### 9 . 1 these 2 data 2 data 3 presume 3 presume 4 that 4 that 6 cytoskeleton 4 that 7 is 5 the 6 cytoskeleton 6 cytoskeleton 7 is 7 is 8 loose further , previous studies show that the mitogen - activated protein kinase pathway can [induce] [cardiac] hypertrophy . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 show 0 ###LEFT-WALL### 18 . 1 further 2 , 1 further 4 studies 3 previous 4 studies 4 studies 5 show 5 show 6 that 6 that 13 pathway 6 that 17 hypertrophy 7 the 13 pathway 8 mitogen 9 - 8 mitogen 11 protein 10 activated 11 protein 11 protein 13 pathway 12 kinase 13 pathway 13 pathway 14 can 14 can 17 hypertrophy moreover , we used both the p38 [inhibitor] ( sb203580 ) and gsn sirna to confirm our conjecture . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 19 . 1 moreover 2 , 1 moreover 3 we 3 we 12 and 4 used 5 both 4 used 12 and 5 both 6 the 5 both 7 p38 6 the 7 p38 7 p38 10 sb203580 9 ( 10 sb203580 10 sb203580 11 ) 12 and 16 confirm 13 gsn 14 sirna 14 sirna 15 to 15 to 16 confirm 16 confirm 18 conjecture 17 our 18 conjecture we found that both of these factors significantly suppressed gelsolin - induced cardiac [hypertrophy] through p38/gata4 signaling pathway . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 11 - 1 we 2 found 2 found 3 that 3 that 4 both 3 that 9 suppressed 4 both 5 of 4 both 9 suppressed 5 of 7 factors 6 these 7 factors 8 significantly 9 suppressed 9 suppressed 10 gelsolin 11 - 18 pathway 11 - 19 . 12 induced 16 p38/gata4 13 cardiac 16 p38/gata4 15 through 16 p38/gata4 16 p38/gata4 18 pathway 17 signaling 18 pathway therefore , we predict that the gene silencing of gsn and/or the downstream blocking of gsn along the p38 pathway could be applied to [ameliorate] [pathological] [cardiac] hypertrophy in the future . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 23 applied 0 ###LEFT-WALL### 32 . 1 therefore 2 , 1 therefore 3 we 3 we 4 predict 4 predict 8 silencing 4 predict 11 and/or 5 that 8 silencing 6 the 8 silencing 7 gene 8 silencing 8 silencing 9 of 9 of 10 gsn 11 and/or 14 blocking 12 the 14 blocking 13 downstream 14 blocking 14 blocking 15 of 14 blocking 21 could 15 of 16 gsn 16 gsn 17 along 17 along 20 pathway 18 the 20 pathway 19 p38 20 pathway 21 could 22 be 22 be 23 applied 23 applied 24 to 24 to 28 hypertrophy 28 hypertrophy 29 in 29 in 31 future 30 the 31 future cornelia de lange [syndrome] ( cdls ) is the prototype for the cohesinopathy disorders that have mutations in genes associated with the cohesin subunit in all cells . 0 ###LEFT-WALL### 3 lange 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 28 . 1 cornelia 2 de 2 de 3 lange 3 lange 6 cdls 3 lange 8 is 5 ( 6 cdls 6 cdls 7 ) 8 is 10 prototype 8 is 11 for 8 is 18 in 8 is 21 with 9 the 10 prototype 11 for 14 disorders 12 the 14 disorders 13 cohesinopathy 14 disorders 14 disorders 15 that 14 disorders 16 have 15 that 16 have 16 have 17 mutations 18 in 19 genes 19 genes 20 associated 21 with 23 cohesin 22 the 23 cohesin 23 cohesin 24 subunit 24 subunit 25 in 25 in 27 cells 26 all 27 cells roberts [syndrome] is the next most common cohesinopathy . 0 ###LEFT-WALL### 1 roberts 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 9 . 1 roberts 3 is 3 is 5 next 3 is 8 cohesinopathy 4 the 5 next 6 most 7 common 7 common 8 cohesinopathy in addition to the developmental implications of cohesin biology , there is much translational and basic research , with progress towards potential treatment for these conditions . 0 ###LEFT-WALL### 11 there 0 ###LEFT-WALL### 12 is 1 in 2 addition 1 in 11 there 3 to 6 implications 3 to 10 , 3 to 11 there 4 the 6 implications 5 developmental 6 implications 6 implications 7 of 7 of 9 biology 8 cohesin 9 biology 11 there 12 is 12 is 17 research 12 is 19 with 13 much 17 research 14 translational 15 and 15 and 16 basic 15 and 17 research 18 , 19 with 19 with 20 progress 19 with 27 . 20 progress 21 towards 20 progress 24 for 21 towards 23 treatment 22 potential 23 treatment 24 for 26 conditions 25 these 26 conditions clinically , there are many issues in cdls faced by the individual , parents and caretakers , professionals , and schools . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 22 . 1 clinically 2 , 1 clinically 3 there 3 there 4 are 4 are 6 issues 5 many 6 issues 6 issues 7 in 6 issues 9 faced 6 issues 10 by 7 in 8 cdls 10 by 20 and 11 the 14 parents 12 individual 13 , 12 individual 14 parents 14 parents 15 and 15 and 16 caretakers 15 and 18 professionals 15 and 20 and 17 , 18 professionals 18 professionals 19 , 20 and 21 schools the following abstracts are presentations from the 5th cornelia de lange syndrome scientific and educational symposium on june 20 - 21 , 2012 , in conjunction with the cornelia de lange syndrome foundation national meeting , lincolnshire , il . 0 ###LEFT-WALL### 3 abstracts 0 ###LEFT-WALL### 4 are 1 the 2 following 1 the 3 abstracts 3 abstracts 4 are 4 are 5 presentations 5 presentations 6 from 5 presentations 17 on 5 presentations 21 21 6 from 16 symposium 7 the 16 symposium 8 5th 9 cornelia 9 cornelia 10 de 10 de 11 lange 11 lange 12 syndrome 12 syndrome 13 scientific 13 scientific 14 and 14 and 15 educational 15 educational 16 symposium 17 on 18 june 18 june 19 20 20 - 21 21 21 21 23 2012 22 , 23 2012 23 2012 27 with 24 , 27 with 25 in 26 conjunction 26 conjunction 27 with 27 with 35 meeting 28 the 35 meeting 29 cornelia 30 de 30 de 31 lange 31 lange 32 syndrome 32 syndrome 33 foundation 33 foundation 34 national 34 national 35 meeting 35 meeting 39 il 36 , 39 il 37 lincolnshire 39 il 38 , 39 il 39 il 40 . the research committee of the cdls foundation organizes the meeting , reviews and accepts abstracts and subsequently disseminates the information to the families . 0 ###LEFT-WALL### 3 committee 0 ###LEFT-WALL### 8 organizes 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 24 . 1 the 3 committee 2 research 3 committee 3 committee 4 of 3 committee 8 organizes 4 of 7 foundation 5 the 7 foundation 6 cdls 7 foundation 8 organizes 10 meeting 9 the 10 meeting 11 , 13 and 12 reviews 13 and 13 and 16 and 14 accepts 15 abstracts 14 accepts 16 and 16 and 18 disseminates 17 subsequently 18 disseminates 18 disseminates 20 information 18 disseminates 21 to 19 the 20 information 21 to 23 families 22 the 23 families in addition to the basic science and clinical discussions , there were educationally - focused talks related to practical aspects of management at home and in school . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 17 related 1 in 2 addition 1 in 12 were 2 addition 3 to 3 to 5 basic 4 the 5 basic 6 science 7 and 7 and 9 discussions 7 and 10 , 7 and 11 there 7 and 12 were 8 clinical 9 discussions 12 were 13 educationally 14 - 17 related 15 focused 16 talks 16 talks 17 related 17 related 18 to 17 related 28 . 18 to 20 aspects 19 practical 20 aspects 20 aspects 21 of 21 of 22 management 22 management 25 and 23 at 24 home 23 at 25 and 25 and 26 in 26 in 27 school ama cme credits were provided by greater baltimore medical center , baltimore , md . 0 ###LEFT-WALL### 3 credits 0 ###LEFT-WALL### 5 provided 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 15 . 1 ama 2 cme 2 cme 3 credits 3 credits 4 were 4 were 5 provided 5 provided 6 by 6 by 10 center 7 greater 8 baltimore 8 baltimore 9 medical 9 medical 10 center 10 center 12 baltimore 11 , 12 baltimore 12 baltimore 13 , 13 , 14 md a common feature of many neurodegenerative diseases is the deposition of β - sheet - rich amyloid aggregates formed by proteins specific to these diseases . 0 ###LEFT-WALL### 3 feature 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 26 . 1 a 2 common 1 a 3 feature 2 common 3 feature 3 feature 4 of 3 feature 8 is 4 of 7 diseases 5 many 7 diseases 6 neurodegenerative 7 diseases 8 is 10 deposition 9 the 10 deposition 10 deposition 11 of 10 deposition 19 formed 10 deposition 22 specific 11 of 18 aggregates 12 β 14 sheet 12 β 15 - 12 β 17 amyloid 13 - 14 sheet 14 sheet 15 - 16 rich 17 amyloid 17 amyloid 18 aggregates 19 formed 20 by 20 by 21 proteins 22 specific 23 to 23 to 25 diseases 24 these 25 diseases these protein aggregates are thought to cause neuronal dysfunction [,] directly or indirectly . 0 ###LEFT-WALL### 3 aggregates 0 ###LEFT-WALL### 5 thought 0 ###LEFT-WALL### 14 . 1 these 3 aggregates 2 protein 3 aggregates 3 aggregates 4 are 4 are 5 thought 5 thought 6 to 6 to 7 cause 7 cause 9 dysfunction 7 cause 12 or 8 neuronal 9 dysfunction 11 directly 12 or 12 or 13 indirectly recent studies have strongly implicated cell [-] [to] [-] cell transmission of misfolded proteins as a common mechanism for the onset and progression of various neurodegenerative disorders . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 5 implicated 0 ###LEFT-WALL### 28 . 1 recent 2 studies 2 studies 3 have 3 have 5 implicated 4 strongly 5 implicated 5 implicated 11 transmission 5 implicated 15 as 6 cell 11 transmission 10 cell 11 transmission 11 transmission 12 of 12 of 14 proteins 13 misfolded 14 proteins 15 as 18 mechanism 16 a 17 common 16 a 18 mechanism 17 common 18 mechanism 18 mechanism 19 for 18 mechanism 24 of 19 for 22 and 20 the 21 onset 21 onset 22 and 22 and 23 progression 24 of 27 disorders 25 various 27 disorders 26 neurodegenerative 27 disorders emerging evidence also suggests the presence of conformationally diverse ['] strains ' of each type of disease protein , which may be another shared feature of amyloid aggregates , accounting for the tremendous heterogeneity within each type of neurodegenerative disease . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 4 suggests 0 ###LEFT-WALL### 41 . 1 emerging 2 evidence 2 evidence 4 suggests 3 also 4 suggests 4 suggests 6 presence 5 the 6 presence 6 presence 7 of 6 presence 13 of 7 of 12 ' 8 conformationally 9 diverse 9 diverse 11 strains 11 strains 12 ' 13 of 15 type 14 each 15 type 15 type 16 of 15 type 30 accounting 16 of 18 protein 17 disease 18 protein 18 protein 20 which 19 , 20 which 20 which 21 may 20 which 29 , 21 may 22 be 22 be 25 feature 23 another 25 feature 24 shared 25 feature 25 feature 26 of 26 of 28 aggregates 27 amyloid 28 aggregates 30 accounting 31 for 30 accounting 35 within 31 for 34 heterogeneity 32 the 34 heterogeneity 33 tremendous 34 heterogeneity 35 within 40 disease 36 each 37 type 37 type 38 of 37 type 40 disease 38 of 40 disease 39 neurodegenerative 40 disease although there are many more questions to be answered , these studies have opened up new avenues for therapeutic interventions in neurodegenerative disorders . 0 ###LEFT-WALL### 12 studies 0 ###LEFT-WALL### 14 opened 0 ###LEFT-WALL### 24 . 1 although 2 there 1 although 3 are 1 although 12 studies 2 there 3 are 3 are 6 questions 4 many 5 more 5 more 6 questions 7 to 8 be 7 to 10 , 7 to 12 studies 8 be 9 answered 11 these 12 studies 12 studies 13 have 13 have 14 opened 14 opened 15 up 14 opened 17 avenues 14 opened 18 for 14 opened 21 in 16 new 17 avenues 18 for 20 interventions 19 therapeutic 20 interventions 21 in 23 disorders 22 neurodegenerative 23 disorders objective : to examine the associations of combined lifestyle factors and physical conditions with cerebrovascular diseases ( cbvd ) mortality , after accounting for competing risk events , including death from cardiovascular diseases , cancers and other diseases . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 examine 3 to 4 examine 4 examine 20 mortality 4 examine 29 including 5 the 20 mortality 6 associations 7 of 6 associations 11 and 7 of 10 factors 8 combined 9 lifestyle 9 lifestyle 10 factors 11 and 13 conditions 11 and 14 with 11 and 18 cbvd 11 and 20 mortality 12 physical 13 conditions 14 with 16 diseases 15 cerebrovascular 16 diseases 17 ( 18 cbvd 18 cbvd 19 ) 20 mortality 22 after 21 , 22 after 22 after 23 accounting 22 after 28 , 23 accounting 24 for 24 for 27 events 25 competing 27 events 26 risk 27 events 28 , 29 including 29 including 30 death 29 including 31 from 29 including 39 . 31 from 36 and 32 cardiovascular 33 diseases 33 diseases 34 , 34 , 35 cancers 34 , 36 and 36 and 38 diseases 37 other 38 diseases methods : data on 2010 subjects aged over 55 years were finally analyzed using competing risk models . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 methods 2 : 2 : 3 data 3 data 4 on 3 data 7 aged 3 data 14 using 4 on 6 subjects 5 2010 6 subjects 7 aged 8 over 7 aged 13 analyzed 8 over 9 55 9 55 10 years 9 55 11 were 10 years 11 were 12 finally 13 analyzed 14 using 17 models 15 competing 17 models 16 risk 17 models all the subjects were interviewed by the beijing longitudinal study of aging ( blsa ) , in china , between 1 january 1992 and 30 august 2009 . 0 ###LEFT-WALL### 1 all 0 ###LEFT-WALL### 5 interviewed 0 ###LEFT-WALL### 28 . 1 all 2 the 1 all 3 subjects 1 all 4 were 2 the 3 subjects 4 were 5 interviewed 5 interviewed 6 by 5 interviewed 20 between 5 interviewed 26 august 6 by 10 study 7 the 10 study 8 beijing 9 longitudinal 9 longitudinal 10 study 10 study 11 of 11 of 14 blsa 12 aging 14 blsa 13 ( 14 blsa 14 blsa 15 ) 14 blsa 17 in 16 , 17 in 17 in 18 china 17 in 19 , 20 between 22 january 21 1 22 january 23 1992 24 and 24 and 25 30 24 and 26 august 26 august 27 2009 results : elderly females were at a lower risk of death from cbvd than elderly males ( hr [=] 0.639 , 95 % ci = 0.457 - 0.895 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 1 results 2 : 2 : 3 elderly 3 elderly 4 females 3 elderly 5 were 3 elderly 18 hr 4 females 5 were 5 were 6 at 5 were 12 from 5 were 14 than 6 at 9 risk 7 a 9 risk 8 lower 9 risk 9 risk 10 of 10 of 11 death 12 from 13 cbvd 14 than 16 males 15 elderly 16 males 17 ( 18 hr 18 hr 20 0.639 18 hr 23 % 18 hr 29 ) 21 , 23 % 22 95 23 % 23 % 24 ci 23 % 25 = 23 % 29 ) 24 ci 25 = 25 = 27 - 26 0.457 27 - 27 - 28 0.895 increasing age [(] hr = 1.543 , 95 % ci = 1.013 - 2.349 ) , poor self - rated health ( [hr] = 1.652 , 95 % ci = 1.198 - 2.277 ) , hypertension [(] hr = 2.201 , 95 % ci = 1.524 - 3.178 ) and overweight [(] hr = 1.473 , 95 % ci = 1.013 - 2.142 [ )(or obesity ( hr [=] 1.711 , 95 % ci = 1.1754 - 2.490 [ )(was associated [with] higher cbvd mortality risk . 0 ###LEFT-WALL### 1 increasing 0 ###LEFT-WALL### 5 = 0 ###LEFT-WALL### 7 , 1 increasing 4 hr 1 increasing 5 = 2 age 4 hr 5 = 6 1.543 7 , 10 ci 7 , 16 , 8 95 10 ci 9 % 10 ci 10 ci 11 = 11 = 12 1.013 12 1.013 14 2.349 13 - 14 2.349 14 2.349 15 ) 16 , 18 self 16 , 19 - 17 poor 18 self 19 - 21 health 19 - 26 , 20 rated 21 health 21 health 25 1.652 22 ( 25 1.652 24 = 25 1.652 25 1.652 26 , 26 , 29 ci 26 , 35 , 27 95 29 ci 28 % 29 ci 29 ci 30 = 30 = 31 1.198 31 1.198 33 2.277 32 - 33 2.277 33 2.277 34 ) 35 , 38 hr 35 , 41 , 36 hypertension 38 hr 38 hr 39 = 39 = 40 2.201 41 , 44 ci 41 , 45 = 41 , 50 and 42 95 44 ci 43 % 44 ci 44 ci 45 = 45 = 46 1.524 46 1.524 48 3.178 47 - 48 3.178 48 3.178 49 ) 50 and 53 hr 50 and 54 = 51 overweight 53 hr 53 hr 54 = 54 = 55 1.473 55 1.473 65 )(or 56 , 65 )(or 57 95 59 ci 58 % 59 ci 59 ci 62 - 59 ci 65 )(or 60 = 61 1.013 61 1.013 62 - 62 - 63 2.142 65 )(or 66 obesity 65 )(or 68 hr 65 )(or 71 , 67 ( 68 hr 68 hr 70 1.711 68 hr 71 , 71 , 81 associated 72 95 73 % 73 % 74 ci 73 % 80 )(was 73 % 81 associated 74 ci 77 - 74 ci 80 )(was 75 = 76 1.1754 76 1.1754 77 - 77 - 78 2.490 81 associated 86 risk 81 associated 87 . 83 higher 86 risk 84 cbvd 85 mortality 85 mortality 86 risk normal cognition function [(] hr = 0.650 , 95 % ci = 0.434 - 0.973 ) and living in urban [(] hr [=] 0.456 , 95 % ci = 0.286 - 0.727 ) was associated with lower cbvd mortality risk . 0 ###LEFT-WALL### 5 hr 0 ###LEFT-WALL### 6 = 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 41 . 1 normal 5 hr 2 cognition 3 function 3 function 5 hr 5 hr 6 = 6 = 7 0.650 8 , 11 ci 8 , 12 = 8 , 17 and 9 95 11 ci 10 % 11 ci 11 ci 12 = 12 = 13 0.434 13 0.434 15 0.973 14 - 15 0.973 15 0.973 16 ) 17 and 18 living 17 and 35 associated 18 living 19 in 18 living 34 was 19 in 22 hr 20 urban 22 hr 22 hr 24 0.456 22 hr 28 ci 25 , 28 ci 26 95 28 ci 27 % 28 ci 28 ci 31 - 28 ci 33 ) 29 = 30 0.286 30 0.286 31 - 31 - 32 0.727 34 was 35 associated 35 associated 36 with 36 with 40 risk 37 lower 40 risk 38 cbvd 40 risk 39 mortality 40 risk conclusions : cbvd mortality was associated with gender , age , blood pressure , residence , bmi , cognitive function , nutrition and the result [of] self - rated health assessment in the elderly in beijing , china . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 cbvd 2 : 6 associated 2 : 14 , 3 cbvd 4 mortality 3 cbvd 5 was 3 cbvd 6 associated 4 mortality 5 was 6 associated 7 with 7 with 8 gender 8 gender 10 age 9 , 10 age 10 age 13 pressure 10 age 14 , 11 , 13 pressure 12 blood 13 pressure 13 pressure 14 , 14 , 15 residence 14 , 29 rated 15 residence 23 and 15 residence 29 rated 16 , 23 and 17 bmi 18 , 18 , 20 function 18 , 21 , 19 cognitive 20 function 21 , 22 nutrition 21 , 23 and 23 and 27 self 23 and 28 - 24 the 27 self 25 result 27 self 29 rated 31 assessment 29 rated 32 in 29 rated 35 in 30 health 31 assessment 32 in 34 elderly 33 the 34 elderly 35 in 36 beijing 36 beijing 38 china 37 , 38 china 38 china 39 . background : some premature features of immunosenescence have been associated with persistent viral infections and altered populations of t cells . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 1 background 2 : 2 : 5 features 3 some 5 features 4 premature 5 features 5 features 6 of 6 of 7 immunosenescence 7 immunosenescence 15 and 8 have 9 been 8 have 15 and 9 been 10 associated 10 associated 11 with 11 with 14 infections 12 persistent 14 infections 13 viral 14 infections 15 and 16 altered 15 and 20 cells 16 altered 17 populations 17 populations 18 of 18 of 19 t in particular , the inverted [t] cd4:cd8 ratio has been correlated with increased morbidity and mortality across different age groups . 0 ###LEFT-WALL### 8 ratio 0 ###LEFT-WALL### 11 correlated 0 ###LEFT-WALL### 21 . 1 in 2 particular 2 particular 3 , 2 particular 8 ratio 4 the 8 ratio 5 inverted 8 ratio 7 cd4:cd8 8 ratio 8 ratio 9 has 9 has 10 been 10 been 11 correlated 11 correlated 12 with 11 correlated 17 across 12 with 15 and 13 increased 14 morbidity 14 morbidity 15 and 15 and 16 mortality 17 across 20 groups 18 different 19 age 19 age 20 groups objective : here , we investigated the role of persistent viral infections , cognitive and functional states as predictors of inverted cd4:cd8 [ratio] of older adults in a developing country . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 31 . 1 objective 2 : 2 : 3 here 4 , 5 we 4 , 6 investigated 4 , 13 , 5 we 6 investigated 6 investigated 8 role 7 the 8 role 8 role 9 of 9 of 12 infections 10 persistent 12 infections 11 viral 12 infections 13 , 15 and 14 cognitive 15 and 15 and 17 states 15 and 18 as 16 functional 17 states 18 as 19 predictors 19 predictors 20 of 20 of 22 cd4:cd8 21 inverted 22 cd4:cd8 22 cd4:cd8 24 of 24 of 26 adults 25 older 26 adults 26 adults 27 in 27 in 30 country 28 a 30 country 29 developing 30 country methods : three hundred and sixty [community] - dwelling older adults ( aged 60 - 103 years ) were recruited . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 - 1 methods 2 : 2 : 6 sixty 3 three 4 hundred 4 hundred 5 and 5 and 6 sixty 8 - 11 adults 8 - 20 recruited 8 - 21 . 9 dwelling 11 adults 10 older 11 adults 11 adults 13 aged 11 adults 17 years 11 adults 19 were 12 ( 13 aged 13 aged 14 60 13 aged 15 - 15 - 17 years 16 103 17 years 17 years 18 ) 19 were 20 recruited cognitive [function] was evaluated by the instrument of brief neuropsychological assessment and mini - mental state examination inventory . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 19 . 1 cognitive 3 was 3 was 4 evaluated 4 evaluated 5 by 5 by 7 instrument 6 the 7 instrument 7 instrument 8 of 8 of 12 and 9 brief 10 neuropsychological 10 neuropsychological 11 assessment 11 assessment 12 and 12 and 13 mini 14 - 18 inventory 15 mental 16 state 16 state 17 examination 17 examination 18 inventory functional activities questionnaire was used to determine activities of daily living . 0 ###LEFT-WALL### 3 questionnaire 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 12 . 1 functional 2 activities 2 activities 3 questionnaire 3 questionnaire 4 was 4 was 5 used 5 used 6 to 5 used 7 determine 6 to 7 determine 7 determine 8 activities 8 activities 9 of 9 of 11 living 10 daily 11 living cytomegalovirus ( cmv ) and epstein - barr virus ( ebv ) serologies were determined by elisas . 0 ###LEFT-WALL### 13 serologies 0 ###LEFT-WALL### 14 were 0 ###LEFT-WALL### 18 . 1 cytomegalovirus 3 cmv 1 cytomegalovirus 5 and 2 ( 3 cmv 3 cmv 4 ) 5 and 6 epstein 5 and 13 serologies 6 epstein 9 virus 7 - 9 virus 8 barr 9 virus 9 virus 11 ebv 9 virus 12 ) 10 ( 11 ebv 11 ebv 12 ) 13 serologies 14 were 14 were 15 determined 15 determined 16 by 16 by 17 elisas peripheral blood was assessed for lymphocyte subsets by flow cytometry ( cd4+ , cd8+ , nk , nkt , [b] and cd8+cd28 - ) . 0 ###LEFT-WALL### 2 blood 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 25 . 1 peripheral 2 blood 2 blood 3 was 3 was 4 assessed 4 assessed 5 for 5 for 7 subsets 6 lymphocyte 7 subsets 7 subsets 8 by 8 by 10 cytometry 9 flow 10 cytometry 10 cytometry 21 and 11 ( 21 and 12 cd4+ 13 , 12 cd4+ 14 cd8+ 14 cd8+ 15 , 15 , 16 nk 15 , 17 , 17 , 18 nkt 17 , 21 and 19 , 21 and 21 and 22 cd8+cd28 21 and 23 - 21 and 24 ) results : fifty - nine individuals were identified with cd4:cd8 ratio [<] 1 , and had increased igg titers to cmv ( p < 0.01 ) , but not to ebv , compared to subjects with cd4:cd8 ratio >1 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 40 . 1 results 2 : 2 : 3 fifty 4 - 6 individuals 4 - 15 and 5 nine 6 individuals 6 individuals 15 and 7 were 8 identified 7 were 15 and 8 identified 9 with 9 with 11 ratio 10 cd4:cd8 11 ratio 11 ratio 13 1 14 , 15 and 15 and 32 , 15 and 34 to 15 and 36 with 16 had 17 increased 16 had 32 , 17 increased 19 titers 18 igg 19 titers 19 titers 28 but 20 to 21 cmv 20 to 28 but 21 cmv 24 < 22 ( 24 < 23 p 24 < 24 < 25 0.01 24 < 26 ) 27 , 28 but 28 but 29 not 28 but 30 to 30 to 31 ebv 32 , 33 compared 34 to 35 subjects 36 with 37 cd4:cd8 36 with 39 >1 38 ratio 39 >1 the older adults with inverted cd4:cd8 [ratio] had impairments in some cognitive dimensions and had more functional disability and dependency ( p = 0.01 ) than subjects with cd4:cd8 ratio >1 . 0 ###LEFT-WALL### 3 adults 0 ###LEFT-WALL### 15 had 0 ###LEFT-WALL### 32 . 1 the 3 adults 2 older 3 adults 3 adults 4 with 3 adults 8 had 4 with 6 cd4:cd8 5 inverted 6 cd4:cd8 8 had 14 and 9 impairments 10 in 9 impairments 14 and 10 in 13 dimensions 11 some 13 dimensions 12 cognitive 13 dimensions 14 and 15 had 15 had 19 and 15 had 26 than 15 had 28 with 16 more 17 functional 17 functional 18 disability 18 disability 19 and 19 and 20 dependency 19 and 23 = 21 ( 23 = 22 p 23 = 23 = 24 0.01 23 = 25 ) 26 than 27 subjects 28 with 31 >1 29 cd4:cd8 31 >1 30 ratio 31 >1 the lymphocyte subsets did not vary between groups . 0 ###LEFT-WALL### 3 subsets 0 ###LEFT-WALL### 6 vary 0 ###LEFT-WALL### 9 . 1 the 3 subsets 2 lymphocyte 3 subsets 3 subsets 4 did 4 did 5 not 4 did 6 vary 6 vary 7 between 7 between 8 groups [the] increased [cmv] - igg titers alone contributed to 8× higher chance to invert cd4:cd8 t cell ratio [(] or 8.12 , 95 % ci 1.74 - 37.88 , p < 0.01 ) . 0 ###LEFT-WALL### 6 titers 0 ###LEFT-WALL### 14 invert 0 ###LEFT-WALL### 34 . 2 increased 4 - 2 increased 6 titers 5 igg 6 titers 6 titers 8 contributed 6 titers 9 to 6 titers 13 to 6 titers 14 invert 7 alone 8 contributed 9 to 10 8× 10 8× 12 chance 10 8× 13 to 11 higher 12 chance 14 invert 20 or 15 cd4:cd8 16 t 15 cd4:cd8 17 cell 17 cell 20 or 18 ratio 20 or 20 or 21 8.12 20 or 25 ci 22 , 25 ci 23 95 25 ci 24 % 25 ci 25 ci 31 < 25 ci 33 ) 26 1.74 27 - 27 - 28 37.88 27 - 31 < 29 , 31 < 30 p 31 < 31 < 32 0.01 conclusion : our data further indicate the role of cmv on circulating [t] cells , poor cognition and functional disability/dependency during aging . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 4 data 2 : 6 indicate 3 our 4 data 4 data 6 indicate 5 further 6 indicate 6 indicate 8 role 6 indicate 11 on 7 the 8 role 8 role 9 of 9 of 10 cmv 11 on 12 circulating 12 circulating 18 and 12 circulating 21 during 14 cells 15 , 15 , 17 cognition 15 , 18 and 16 poor 17 cognition 18 and 20 disability/dependency 19 functional 20 disability/dependency 21 during 22 aging this study investigated the effect of 7,8 - dihydroxyflavone ( dhf ) on the expression and activity of heme oxygenase - 1 ( ho - 1 ) , an enzyme with potent antioxidant properties , as well as the molecular mechanisms involved . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 43 . 1 this 2 study 2 study 3 investigated 3 investigated 5 effect 3 investigated 13 on 3 investigated 38 as 4 the 5 effect 5 effect 6 of 6 of 7 7,8 7 7,8 9 dihydroxyflavone 8 - 9 dihydroxyflavone 9 dihydroxyflavone 11 dhf 9 dihydroxyflavone 12 ) 10 ( 11 dhf 11 dhf 12 ) 13 on 16 and 14 the 15 expression 15 expression 16 and 16 and 17 activity 16 and 18 of 16 and 22 1 16 and 30 enzyme 18 of 20 oxygenase 19 heme 20 oxygenase 21 - 22 1 22 1 24 ho 22 1 28 , 23 ( 24 ho 24 ho 26 1 24 ho 27 ) 25 - 26 1 26 1 27 ) 28 , 30 enzyme 29 an 30 enzyme 30 enzyme 31 with 30 enzyme 35 , 31 with 34 properties 32 potent 33 antioxidant 33 antioxidant 34 properties 36 as 37 well 37 well 38 as 38 as 41 mechanisms 39 the 41 mechanisms 40 molecular 41 mechanisms 41 mechanisms 42 involved dhf markedly upregulated ho - 1 mrna and protein expression in human keratinocytes ( hacat cells ) , resulting in increased ho - 1 activity . 0 ###LEFT-WALL### 1 dhf 0 ###LEFT-WALL### 3 upregulated 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 26 . 1 dhf 3 upregulated 2 markedly 3 upregulated 3 upregulated 4 ho 4 ho 8 and 5 - 8 and 6 1 7 mrna 7 mrna 8 and 8 and 10 expression 8 and 11 in 8 and 23 - 9 protein 10 expression 11 in 13 keratinocytes 12 human 13 keratinocytes 13 keratinocytes 16 cells 13 keratinocytes 19 resulting 14 ( 16 cells 15 hacat 16 cells 16 cells 17 ) 18 , 19 resulting 19 resulting 20 in 19 resulting 23 - 20 in 22 ho 21 increased 22 ho 23 - 25 activity 24 1 25 activity dhf also increased the protein level of transcription factor nuclear factor erythroid [2] - related factor 2 ( nrf2 ) , which regulates ho - 1 expression by binding to the antioxidant response element ( are ) within the ho - 1 gene promoter , in a time - dependent manner . 0 ###LEFT-WALL### 1 dhf 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 52 . 1 dhf 3 increased 2 also 3 increased 3 increased 6 level 4 the 6 level 5 protein 6 level 6 level 7 of 6 level 19 nrf2 7 of 16 factor 8 transcription 11 factor 9 factor 11 factor 10 nuclear 11 factor 11 factor 16 factor 12 erythroid 14 - 12 erythroid 16 factor 15 related 16 factor 16 factor 17 2 18 ( 19 nrf2 19 nrf2 20 ) 21 , 22 which 21 , 23 regulates 21 , 25 - 22 which 23 regulates 23 regulates 24 ho 25 - 27 expression 26 1 27 expression 27 expression 28 by 27 expression 38 within 28 by 29 binding 29 binding 30 to 30 to 34 element 31 the 34 element 32 antioxidant 33 response 33 response 34 element 34 element 36 are 35 ( 36 are 36 are 37 ) 38 within 51 manner 39 the 51 manner 40 ho 44 promoter 40 ho 46 in 40 ho 51 manner 41 - 44 promoter 42 1 44 promoter 43 gene 44 promoter 44 promoter 45 , 45 , 46 in 46 in 48 time 46 in 49 - 47 a 48 time 50 dependent 51 manner moreover , dhf decreased the expression of kelch - like ech - associated protein 1 , a repressor of nrf2 activity , and induced the translocation of nrf2 from the cytosol into the nucleus , thereby allowing its association with the are site . 0 ###LEFT-WALL### 3 dhf 0 ###LEFT-WALL### 23 and 1 moreover 2 , 1 moreover 3 dhf 3 dhf 23 and 4 decreased 6 expression 4 decreased 10 like 4 decreased 23 and 5 the 6 expression 6 expression 7 of 7 of 8 kelch 9 - 10 like 10 like 11 ech 10 like 22 , 11 ech 14 protein 12 - 14 protein 13 associated 14 protein 14 protein 15 1 14 protein 18 repressor 14 protein 22 , 16 , 18 repressor 17 a 18 repressor 18 repressor 19 of 18 repressor 22 , 19 of 21 activity 20 nrf2 21 activity 22 , 23 and 23 and 24 induced 23 and 37 allowing 24 induced 26 translocation 24 induced 29 from 25 the 26 translocation 26 translocation 27 of 27 of 28 nrf2 29 from 31 cytosol 30 the 31 cytosol 31 cytosol 32 into 32 into 34 nucleus 33 the 34 nucleus 35 , 37 allowing 36 thereby 37 allowing 37 allowing 39 association 37 allowing 40 with 37 allowing 44 . 38 its 39 association 40 with 43 site 41 the 43 site 42 are 43 site dhf activated extracellular - regulated kinase [(] erk [ )(and protein kinase b ( pkb , akt ) in keratinocytes , while the erk and akt inhibitors attenuated dhf - enhanced nrf2 and ho - 1 expression . 0 ###LEFT-WALL### 1 dhf 0 ###LEFT-WALL### 2 activated 1 dhf 2 activated 2 activated 12 kinase 2 activated 19 in 2 activated 22 while 3 extracellular 4 - 3 extracellular 6 kinase 5 regulated 6 kinase 6 kinase 8 erk 8 erk 10 )(and 10 )(and 11 protein 10 )(and 12 kinase 12 kinase 13 b 12 kinase 15 pkb 12 kinase 17 akt 14 ( 15 pkb 15 pkb 16 , 16 , 17 akt 17 akt 18 ) 19 in 20 keratinocytes 21 , 22 while 22 while 25 and 22 while 28 attenuated 22 while 38 . 23 the 24 erk 24 erk 25 and 25 and 27 inhibitors 25 and 28 attenuated 26 akt 27 inhibitors 28 attenuated 29 dhf 29 dhf 33 and 30 - 33 and 31 enhanced 32 nrf2 32 nrf2 33 and 33 and 34 ho 33 and 37 expression 33 and 38 . 35 - 37 expression 36 1 37 expression 37 expression 38 . dhf also protected the keratinocytes against hydrogen peroxide - and ultraviolet [b] - induced oxidative damage , while ho - 1 , erk and akt inhibitors markedly suppressed dhf - mediated cytoprotection . 0 ###LEFT-WALL### 1 dhf 0 ###LEFT-WALL### 3 protected 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 33 . 1 dhf 3 protected 2 also 3 protected 3 protected 5 keratinocytes 3 protected 6 against 4 the 5 keratinocytes 6 against 10 and 7 hydrogen 8 peroxide 8 peroxide 10 and 9 - 10 and 10 and 11 ultraviolet 10 and 16 damage 13 - 16 damage 14 induced 16 damage 15 oxidative 16 damage 16 damage 17 , 17 , 26 inhibitors 17 , 28 suppressed 17 , 30 - 18 while 19 ho 18 while 26 inhibitors 19 ho 21 1 20 - 21 1 21 1 22 , 23 erk 24 and 24 and 25 akt 25 akt 26 inhibitors 26 inhibitors 28 suppressed 27 markedly 28 suppressed 28 suppressed 29 dhf 30 - 32 cytoprotection 31 mediated 32 cytoprotection taken together , the results suggested that dhf activates erk - and akt - nrf2 signaling cascades in hacat cells , leading to the upregulation of ho - 1 and cytoprotection against oxidative stress . 0 ###LEFT-WALL### 5 results 0 ###LEFT-WALL### 6 suggested 0 ###LEFT-WALL### 35 . 1 taken 2 together 1 taken 3 , 1 taken 5 results 4 the 5 results 5 results 6 suggested 6 suggested 7 that 7 that 8 dhf 7 that 9 activates 8 dhf 9 activates 9 activates 30 and 9 activates 32 against 10 erk 12 and 11 - 12 and 12 and 13 akt 12 and 30 and 13 akt 15 nrf2 13 akt 22 leading 14 - 15 nrf2 15 nrf2 16 signaling 15 nrf2 21 , 16 signaling 17 cascades 17 cascades 18 in 18 in 20 cells 19 hacat 20 cells 22 leading 23 to 22 leading 29 1 23 to 25 upregulation 24 the 25 upregulation 25 upregulation 26 of 26 of 27 ho 28 - 29 1 30 and 31 cytoprotection 32 against 34 stress 33 oxidative 34 stress background and aim : dilated perivascular spaces ( dpvs ) have previously been associated with aging and hypertension - related cerebral microangiopathy . 0 ###LEFT-WALL### 3 aim 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 aim 4 : 7 spaces 4 : 14 associated 4 : 20 related 5 dilated 7 spaces 6 perivascular 7 spaces 7 spaces 9 dpvs 7 spaces 11 have 8 ( 9 dpvs 9 dpvs 10 ) 11 have 13 been 12 previously 13 been 13 been 14 associated 14 associated 15 with 15 with 17 and 16 aging 17 and 17 and 18 hypertension 19 - 20 related 20 related 22 microangiopathy 20 related 23 . 21 cerebral 22 microangiopathy however , their risk factors , radiological features and clinical relevance have been poorly evaluated in cadasil ( cerebral autosomal - dominant arteriopathy with subcortical [infarcts] and leukoencephalopathy ) , a unique model to investigate the pathophysiology of ischemic small - vessel disease . 0 ###LEFT-WALL### 4 risk 0 ###LEFT-WALL### 15 evaluated 0 ###LEFT-WALL### 44 . 1 however 2 , 1 however 4 risk 3 their 4 risk 4 risk 9 and 4 risk 13 been 4 risk 15 evaluated 5 factors 6 , 6 , 8 features 6 , 9 and 7 radiological 8 features 9 and 11 relevance 9 and 12 have 10 clinical 11 relevance 12 have 13 been 13 been 14 poorly 15 evaluated 16 in 15 evaluated 33 model 15 evaluated 34 to 16 in 17 cadasil 17 cadasil 23 arteriopathy 18 ( 23 arteriopathy 19 cerebral 23 arteriopathy 20 autosomal 21 - 20 autosomal 23 arteriopathy 22 dominant 23 arteriopathy 23 arteriopathy 24 with 23 arteriopathy 30 , 24 with 27 and 25 subcortical 27 and 27 and 28 leukoencephalopathy 27 and 29 ) 31 a 33 model 32 unique 33 model 34 to 35 investigate 35 investigate 37 pathophysiology 36 the 37 pathophysiology 37 pathophysiology 38 of 38 of 43 disease 39 ischemic 42 vessel 40 small 41 - 40 small 42 vessel 42 vessel 43 disease the purpose of this study was to investigate these different aspects in a large cohort of patients with this disorder . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 21 . 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 investigate 7 to 8 investigate 8 investigate 11 aspects 8 investigate 12 in 8 investigate 18 with 9 these 11 aspects 10 different 11 aspects 12 in 15 cohort 13 a 14 large 13 a 15 cohort 14 large 15 cohort 15 cohort 16 of 16 of 17 patients 18 with 20 disorder 19 this 20 disorder methods : demographic and mri data of 344 patients from a prospective cohort study were analyzed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 4 and 2 : 15 were 3 demographic 4 and 4 and 5 mri 4 and 6 data 4 and 14 study 4 and 15 were 6 data 7 of 6 data 14 study 7 of 9 patients 8 344 9 patients 9 patients 10 from 10 from 13 cohort 11 a 12 prospective 11 a 13 cohort 12 prospective 13 cohort 15 were 16 analyzed the severity of dpvs was evaluated separately in the anterior temporal lobes , subinsular areas , basal ganglia and white matter , using validated semiquantitative scales . 0 ###LEFT-WALL### 2 severity 0 ###LEFT-WALL### 6 evaluated 0 ###LEFT-WALL### 27 . 1 the 2 severity 2 severity 3 of 2 severity 5 was 3 of 4 dpvs 5 was 6 evaluated 6 evaluated 7 separately 6 evaluated 8 in 6 evaluated 23 using 8 in 12 lobes 9 the 12 lobes 10 anterior 12 lobes 11 temporal 12 lobes 12 lobes 15 areas 13 , 15 areas 14 subinsular 15 areas 15 areas 21 matter 15 areas 22 , 16 , 21 matter 17 basal 21 matter 18 ganglia 19 and 19 and 20 white 19 and 21 matter 21 matter 22 , 23 using 26 scales 24 validated 26 scales 25 semiquantitative 26 scales results : the severity of dpvs was found to increase with age regardless of cerebral area ( p<0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 severity 2 : 8 found 2 : 20 . 3 the 4 severity 4 severity 5 of 4 severity 7 was 5 of 6 dpvs 7 was 8 found 8 found 9 to 9 to 10 increase 10 increase 11 with 10 increase 14 of 11 with 12 age 13 regardless 14 of 14 of 16 area 15 cerebral 16 area 16 area 18 p<0.001 17 ( 18 p<0.001 18 p<0.001 19 ) in contrast with dpvs in other locations , the severity of dpvs in the temporal lobes or subinsular areas was also found strongly and specifically related to the extent of wmh ( p<0.001 ) . 0 ###LEFT-WALL### 10 severity 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 35 . 1 in 2 contrast 1 in 10 severity 3 with 4 dpvs 3 with 8 , 3 with 10 severity 4 dpvs 5 in 5 in 7 locations 6 other 7 locations 9 the 10 severity 10 severity 11 of 10 severity 24 and 11 of 19 areas 12 dpvs 13 in 12 dpvs 17 or 13 in 16 lobes 14 the 16 lobes 15 temporal 16 lobes 17 or 18 subinsular 17 or 19 areas 20 was 22 found 20 was 24 and 21 also 22 found 22 found 23 strongly 24 and 26 related 24 and 27 to 25 specifically 26 related 27 to 29 extent 28 the 29 extent 29 extent 30 of 30 of 31 wmh 31 wmh 33 p<0.001 32 ( 33 p<0.001 33 p<0.001 34 ) conversely , no significant association was detected with lacunar volume , number of microbleeds or bpf . 0 ###LEFT-WALL### 5 association 0 ###LEFT-WALL### 7 detected 0 ###LEFT-WALL### 17 . 1 conversely 2 , 1 conversely 5 association 3 no 5 association 4 significant 5 association 5 association 6 was 6 was 7 detected 7 detected 8 with 8 with 15 or 9 lacunar 10 volume 10 volume 11 , 11 , 12 number 11 , 15 or 12 number 13 of 13 of 14 microbleeds 15 or 16 bpf a high degree of dpvs in the white matter was associated with lower cognitive performances independently of age and other mri markers of the disease including bpf ( p≤0.04 ) . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 31 . 1 a 2 high 1 a 3 degree 2 high 3 degree 3 degree 4 of 3 degree 5 dpvs 4 of 5 dpvs 5 dpvs 6 in 5 dpvs 11 associated 5 dpvs 19 and 6 in 8 white 7 the 8 white 8 white 9 matter 8 white 10 was 9 matter 10 was 11 associated 12 with 11 associated 16 independently 12 with 15 performances 13 lower 15 performances 14 cognitive 15 performances 16 independently 17 of 17 of 18 age 19 and 22 markers 19 and 23 of 20 other 22 markers 21 mri 22 markers 23 of 25 disease 24 the 25 disease 25 disease 26 including 25 disease 29 p≤0.04 26 including 27 bpf 28 ( 29 p≤0.04 29 p≤0.04 30 ) conclusions : in cadasil , the progression of the hereditary microangiopathy with aging may promote the dilation of perivascular spaces throughout the whole brain but with variable extent according [to] cerebral [location] . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 33 . 1 conclusions 2 : 2 : 3 in 3 in 4 cadasil 5 , 7 progression 5 , 15 promote 6 the 7 progression 7 progression 8 of 7 progression 14 may 8 of 11 microangiopathy 9 the 11 microangiopathy 10 hereditary 11 microangiopathy 11 microangiopathy 12 with 12 with 13 aging 14 may 15 promote 15 promote 17 dilation 15 promote 21 throughout 15 promote 25 but 16 the 17 dilation 17 dilation 18 of 18 of 20 spaces 19 perivascular 20 spaces 21 throughout 24 brain 22 the 24 brain 23 whole 24 brain 25 but 26 with 26 with 29 according 26 with 31 cerebral 27 variable 29 according 28 extent 29 according hazardous organic wastes from industrial , military , and commercial activities represent one of the greatest challenges to human beings . 0 ###LEFT-WALL### 3 wastes 0 ###LEFT-WALL### 12 represent 0 ###LEFT-WALL### 21 . 1 hazardous 3 wastes 2 organic 3 wastes 3 wastes 4 from 3 wastes 12 represent 4 from 11 activities 5 industrial 6 , 6 , 7 military 6 , 9 and 8 , 9 and 9 and 10 commercial 9 and 11 activities 12 represent 13 one 12 represent 18 to 13 one 14 of 14 of 17 challenges 15 the 16 greatest 15 the 17 challenges 18 to 20 beings 19 human 20 beings advanced oxidation processes ( aops ) are alternatives to the degradation of those organic wastes . 0 ###LEFT-WALL### 3 processes 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 16 . 1 advanced 2 oxidation 2 oxidation 3 processes 3 processes 5 aops 3 processes 7 are 4 ( 5 aops 5 aops 6 ) 7 are 8 alternatives 8 alternatives 9 to 9 to 11 degradation 10 the 11 degradation 11 degradation 12 of 12 of 15 wastes 13 those 15 wastes 14 organic 15 wastes however , the knowledge about the exact mechanisms of aops is still incomplete . 0 ###LEFT-WALL### 4 knowledge 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 14 . 1 however 2 , 1 however 4 knowledge 3 the 4 knowledge 4 knowledge 5 about 4 knowledge 11 is 5 about 8 mechanisms 6 the 8 mechanisms 7 exact 8 mechanisms 8 mechanisms 9 of 9 of 10 aops 11 is 12 still 11 is 13 incomplete 12 still 13 incomplete here we report a phenomenon in the aops : induced effects , which is a common property of combustion reaction . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 report 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 21 . 1 here 2 we 2 we 3 report 3 report 5 phenomenon 3 report 10 induced 4 a 5 phenomenon 5 phenomenon 6 in 5 phenomenon 9 : 6 in 8 aops 7 the 8 aops 9 : 10 induced 10 induced 11 effects 10 induced 12 , 12 , 13 which 12 , 14 is 13 which 14 is 14 is 17 property 15 a 16 common 15 a 17 property 16 common 17 property 17 property 18 of 18 of 20 reaction 19 combustion 20 reaction through analysis edta oxidation processes by fenton and uv - fenton system , the results indicate that , just like combustion , aops are typical induction reactions . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 10 - 1 through 2 analysis 2 analysis 5 processes 3 edta 5 processes 4 oxidation 5 processes 5 processes 6 by 5 processes 8 and 6 by 7 fenton 8 and 9 uv 10 - 12 system 10 - 13 , 10 - 28 . 11 fenton 12 system 13 , 15 results 13 , 16 indicate 14 the 15 results 15 results 16 indicate 16 indicate 17 that 17 that 23 aops 17 that 24 are 18 , 19 just 18 , 20 like 20 like 21 combustion 20 like 22 , 20 like 23 aops 23 aops 24 are 24 are 27 reactions 25 typical 26 induction 26 induction 27 reactions one [most] compelling example is that pre - feeding easily oxidizable organic matter can promote the oxidation of refractory organic compound when it was treated by aops . 0 ###LEFT-WALL### 4 example 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 8 - 1 one 4 example 3 compelling 4 example 4 example 5 is 5 is 7 pre 6 that 7 pre 8 - 9 feeding 8 - 15 promote 8 - 28 . 9 feeding 10 easily 9 feeding 13 matter 9 feeding 14 can 11 oxidizable 13 matter 12 organic 13 matter 14 can 15 promote 15 promote 17 oxidation 15 promote 22 when 16 the 17 oxidation 17 oxidation 18 of 18 of 21 compound 19 refractory 21 compound 20 organic 21 compound 22 when 23 it 22 when 25 treated 23 it 24 was 24 was 25 treated 25 treated 26 by 26 by 27 aops connecting aops to combustion , it is possible to achieve some helpful enlightenment from combustion to analyze , [predict] and understand aops . 0 ###LEFT-WALL### 6 it 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 23 . 1 connecting 2 aops 1 connecting 3 to 1 connecting 5 , 1 connecting 6 it 3 to 4 combustion 6 it 7 is 7 is 8 possible 8 possible 9 to 8 possible 20 and 9 to 20 and 10 achieve 13 enlightenment 10 achieve 20 and 11 some 13 enlightenment 12 helpful 13 enlightenment 13 enlightenment 14 from 14 from 15 combustion 15 combustion 16 to 15 combustion 17 analyze 16 to 17 analyze 18 , 20 and 20 and 21 understand 21 understand 22 aops in addition , we assume that [maybe] other oxidation reactions also have induced effects , such as corrosion , aging and passivation . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 assume 1 in 2 addition 1 in 3 , 1 in 4 we 4 we 5 assume 5 assume 6 that 6 that 10 reactions 6 that 13 induced 8 other 10 reactions 9 oxidation 10 reactions 10 reactions 12 have 11 also 12 have 12 have 13 induced 13 induced 14 effects 14 effects 17 as 14 effects 21 and 15 , 17 as 16 such 17 as 17 as 18 corrosion 17 as 19 , 19 , 21 and 20 aging 21 and 21 and 22 passivation 21 and 23 . muchmore research is necessary to reveal the possibilities of induced effects in those fields . 0 ###LEFT-WALL### 1 muchmore 0 ###LEFT-WALL### 10 induced 0 ###LEFT-WALL### 15 . 1 muchmore 2 research 1 muchmore 9 of 1 muchmore 10 induced 2 research 3 is 3 is 4 necessary 4 necessary 5 to 4 necessary 6 reveal 5 to 6 reveal 6 reveal 8 possibilities 7 the 8 possibilities 8 possibilities 9 of 10 induced 11 effects 10 induced 12 in 12 in 14 fields 13 those 14 fields histopathological studies in alzheimer 's disease ( ad ) suggest severe and region - specific neurodegeneration of the basal forebrain cholinergic system ( bfcs ) . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 10 suggest 0 ###LEFT-WALL### 26 . 1 histopathological 2 studies 2 studies 3 in 2 studies 10 suggest 3 in 6 disease 4 alzheimer 5 's 5 's 6 disease 6 disease 8 ad 7 ( 8 ad 8 ad 9 ) 10 suggest 12 and 11 severe 12 and 12 and 13 region 12 and 16 neurodegeneration 14 - 16 neurodegeneration 15 specific 16 neurodegeneration 16 neurodegeneration 17 of 16 neurodegeneration 25 ) 17 of 22 system 18 the 22 system 19 basal 20 forebrain 20 forebrain 22 system 21 cholinergic 22 system 22 system 24 bfcs 23 ( 24 bfcs 24 bfcs 25 ) the ad group showed significant volume reductions of all subregions of the bfcs , which were most pronounced in the posterior nucleus basalis meynert ( nbm ) . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 28 . 1 the 3 group 2 ad 3 group 3 group 4 showed 4 showed 6 volume 4 showed 7 reductions 5 significant 6 volume 7 reductions 8 of 7 reductions 15 which 8 of 10 subregions 9 all 10 subregions 10 subregions 11 of 11 of 13 bfcs 12 the 13 bfcs 14 , 15 which 15 which 16 were 15 which 27 ) 16 were 17 most 17 most 18 pronounced 18 pronounced 19 in 19 in 24 meynert 20 the 23 basalis 21 posterior 23 basalis 22 nucleus 23 basalis 23 basalis 24 meynert 24 meynert 26 nbm 25 ( 26 nbm 26 nbm 27 ) the mild cognitive impairment - ad [group] showed pronounced volume reductions in the posterior nbm , but preserved volumes of anterior - medial regions . 0 ###LEFT-WALL### 4 impairment 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 25 . 1 the 4 impairment 2 mild 4 impairment 3 cognitive 4 impairment 5 - 6 ad 5 - 17 but 6 ad 17 but 8 showed 11 reductions 8 showed 15 nbm 8 showed 17 but 9 pronounced 10 volume 10 volume 11 reductions 11 reductions 12 in 12 in 14 posterior 13 the 14 posterior 16 , 17 but 17 but 18 preserved 18 preserved 24 regions 19 volumes 20 of 19 volumes 24 regions 20 of 24 regions 21 anterior 22 - 21 anterior 24 regions 23 medial 24 regions diagnostic accuracy of posterior nbm volume was superior to hippocampus volume in both groups , despite higher multicenter variability of the bfcs measurements . 0 ###LEFT-WALL### 2 accuracy 0 ###LEFT-WALL### 7 was 1 diagnostic 2 accuracy 2 accuracy 3 of 2 accuracy 7 was 3 of 6 volume 4 posterior 6 volume 5 nbm 6 volume 7 was 8 superior 8 superior 9 to 8 superior 12 in 8 superior 16 despite 9 to 11 volume 10 hippocampus 11 volume 12 in 14 groups 13 both 14 groups 15 , 16 despite 16 despite 19 variability 16 despite 24 . 17 higher 18 multicenter 18 multicenter 19 variability 19 variability 20 of 20 of 23 measurements 21 the 23 measurements 22 bfcs 23 measurements the data of our study suggest that bfcs morphometry may provide an emerging biomarker in ad . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 6 suggest 0 ###LEFT-WALL### 17 . 1 the 2 data 2 data 3 of 2 data 6 suggest 3 of 5 study 4 our 5 study 6 suggest 7 that 7 that 9 morphometry 7 that 11 provide 8 bfcs 9 morphometry 9 morphometry 10 may 10 may 11 provide 11 provide 14 biomarker 12 an 14 biomarker 13 emerging 14 biomarker 14 biomarker 15 in 15 in 16 ad amyloid - β [peptide] ( aβ ) , the cerebral accumulation of which is thought to cause alzheimer 's disease ( ad ) , is produced throughout life . 0 ###LEFT-WALL### 3 β 0 ###LEFT-WALL### 26 produced 0 ###LEFT-WALL### 29 . 1 amyloid 2 - 1 amyloid 3 β 3 β 6 aβ 3 β 11 accumulation 3 β 25 is 5 ( 6 aβ 6 aβ 7 ) 8 , 11 accumulation 9 the 11 accumulation 10 cerebral 11 accumulation 11 accumulation 12 of 11 accumulation 24 , 12 of 13 which 12 of 14 is 13 which 14 is 14 is 15 thought 14 is 16 to 16 to 17 cause 17 cause 20 disease 18 alzheimer 19 's 19 's 20 disease 20 disease 22 ad 21 ( 22 ad 22 ad 23 ) 25 is 26 produced 26 produced 27 throughout 27 throughout 28 life the level of insoluble aβ rises with age and is further increased in ad . 0 ###LEFT-WALL### 2 level 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 15 . 1 the 2 level 2 level 3 of 2 level 9 and 3 of 5 aβ 4 insoluble 5 aβ 6 rises 7 with 6 rises 9 and 7 with 8 age 9 and 10 is 10 is 12 increased 11 further 12 increased 12 increased 13 in 13 in 14 ad in contrast , we showed previously that [in] mid - frontal cortex in a cohort without neurological disease , soluble aβ declined progressively between 16 and 95 [y] . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 29 . 1 in 2 contrast 1 in 3 , 1 in 4 we 4 we 5 showed 5 showed 6 previously 5 showed 12 cortex 5 showed 13 in 5 showed 16 without 7 that 12 cortex 9 mid 10 - 9 mid 12 cortex 11 frontal 12 cortex 13 in 15 cohort 14 a 15 cohort 16 without 18 disease 17 neurological 18 disease 19 , 21 aβ 19 , 22 declined 20 soluble 21 aβ 21 aβ 22 declined 22 declined 23 progressively 22 declined 24 between 24 between 26 and 25 16 26 and 26 and 27 95 we speculated that the divergent changes in the levels of soluble and insoluble aβ with age might reflect an increasing tendency to favor the production or retention within the brain of aβ42 over aβ40 , leading to elevation of aβ ( 42:40 ) even as total soluble aβ decreased . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 23 favor 0 ###LEFT-WALL### 50 . 1 we 2 speculated 2 speculated 3 that 3 that 6 changes 3 that 18 reflect 4 the 6 changes 5 divergent 6 changes 6 changes 7 in 6 changes 17 might 7 in 9 levels 8 the 9 levels 9 levels 10 of 10 of 14 aβ 11 soluble 12 and 12 and 13 insoluble 12 and 14 aβ 14 aβ 15 with 15 with 16 age 17 might 18 reflect 18 reflect 21 tendency 18 reflect 22 to 19 an 21 tendency 20 increasing 21 tendency 22 to 23 favor 23 favor 26 or 24 the 25 production 25 production 26 or 26 or 27 retention 26 or 31 of 27 retention 28 within 28 within 30 brain 29 the 30 brain 31 of 32 aβ42 32 aβ42 33 over 32 aβ42 44 even 33 over 34 aβ40 34 aβ40 36 leading 35 , 36 leading 36 leading 37 to 36 leading 43 ) 37 to 38 elevation 38 elevation 39 of 39 of 40 aβ 40 aβ 42 42:40 41 ( 42 42:40 42 42:40 43 ) 44 even 45 as 45 as 48 aβ 46 total 48 aβ 47 soluble 48 aβ 48 aβ 49 decreased we have now measured aβ40 and aβ42 in soluble and insoluble ( guanidine - extractable ) fractions of human postmortem brain tissue from the same cohort studied previously . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 measured 0 ###LEFT-WALL### 29 . 1 we 2 have 2 have 4 measured 3 now 4 measured 4 measured 7 aβ42 4 measured 8 in 4 measured 28 previously 5 aβ40 6 and 6 and 7 aβ42 8 in 10 and 9 soluble 10 and 10 and 17 fractions 10 and 18 of 11 insoluble 13 guanidine 11 insoluble 14 - 11 insoluble 17 fractions 12 ( 13 guanidine 13 guanidine 14 - 15 extractable 16 ) 15 extractable 17 fractions 18 of 22 tissue 19 human 20 postmortem 20 postmortem 22 tissue 21 brain 22 tissue 22 tissue 23 from 23 from 26 cohort 24 the 25 same 25 same 26 cohort 26 cohort 27 studied insoluble aβ42 increased progressively with age . 0 ###LEFT-WALL### 2 aβ42 0 ###LEFT-WALL### 3 increased 0 ###LEFT-WALL### 7 . 1 insoluble 2 aβ42 2 aβ42 3 increased 3 increased 4 progressively 3 increased 5 with 5 with 6 age differential production or retention of aβ40 and aβ42 in the over [-] 50 [s] is likely to contribute to the influence of age on the risk of sporadic ad . 0 ###LEFT-WALL### 3 or 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 30 . 1 differential 2 production 2 production 3 or 3 or 4 retention 3 or 5 of 5 of 6 aβ40 7 and 8 aβ42 7 and 15 is 8 aβ42 9 in 8 aβ42 15 is 9 in 13 50 10 the 13 50 11 over 13 50 15 is 16 likely 16 likely 17 to 16 likely 18 contribute 17 to 18 contribute 18 contribute 19 to 18 contribute 24 on 19 to 21 influence 20 the 21 influence 21 influence 22 of 22 of 23 age 24 on 26 risk 25 the 26 risk 26 risk 27 of 27 of 29 ad 28 sporadic 29 ad no disease - modifying therapies are currently available for alzheimer 's disease ( ad ) , a neurodegenerative disorder that affects more than 36 million people worldwide . 0 ###LEFT-WALL### 1 no 0 ###LEFT-WALL### 3 - 1 no 2 disease 3 - 5 therapies 3 - 6 are 4 modifying 5 therapies 5 therapies 6 are 6 are 7 currently 6 are 8 available 8 available 9 for 9 for 12 disease 10 alzheimer 11 's 11 's 12 disease 12 disease 14 ad 12 disease 19 disorder 13 ( 14 ad 14 ad 15 ) 16 , 19 disorder 17 a 19 disorder 18 neurodegenerative 19 disorder 19 disorder 20 that 19 disorder 21 affects 19 disorder 28 . 20 that 21 affects 21 affects 26 people 21 affects 27 worldwide 22 more 23 than 23 than 25 million 24 36 25 million 25 million 26 people although cardiovascular risk factors such as hypertension [and] diabetes are increasingly implicated as contributing to the development of ad , the mechanisms [whereby] these factors influence pathological processes in the ad brain have not been defined . 0 ###LEFT-WALL### 22 mechanisms 0 ###LEFT-WALL### 36 defined 0 ###LEFT-WALL### 37 . 1 although 4 factors 1 although 10 are 1 although 22 mechanisms 2 cardiovascular 4 factors 3 risk 4 factors 4 factors 6 as 4 factors 10 are 5 such 6 as 6 as 9 diabetes 7 hypertension 9 diabetes 10 are 11 increasingly 10 are 12 implicated 13 as 14 contributing 13 as 22 mechanisms 15 to 17 development 15 to 20 , 15 to 22 mechanisms 16 the 17 development 17 development 18 of 18 of 19 ad 21 the 22 mechanisms 22 mechanisms 25 factors 22 mechanisms 26 influence 22 mechanisms 33 have 24 these 25 factors 25 factors 26 influence 26 influence 28 processes 26 influence 29 in 27 pathological 28 processes 29 in 32 brain 30 the 32 brain 31 ad 32 brain 33 have 34 not 33 have 35 been 35 been 36 defined here we propose , for the first time , vascular activation as a relevant mechanism in ad pathogenesis . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 propose 0 ###LEFT-WALL### 19 . 1 here 2 we 2 we 3 propose 3 propose 5 for 3 propose 11 activation 3 propose 12 as 3 propose 16 in 4 , 5 for 5 for 8 time 5 for 9 , 6 the 8 time 7 first 8 time 10 vascular 11 activation 12 as 15 mechanism 13 a 14 relevant 13 a 15 mechanism 14 relevant 15 mechanism 16 in 18 pathogenesis 17 ad 18 pathogenesis we explore this hypothesis in two transgenic ad animal models : ad2576appswe ( ad2576 ) and laferla 3xtg ( 3xtgad ) mice using the vascular activation inhibitor sunitinib . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 explore 0 ###LEFT-WALL### 11 : 1 we 2 explore 2 explore 4 hypothesis 2 explore 5 in 3 this 4 hypothesis 5 in 10 models 6 two 10 models 7 transgenic 10 models 8 ad 10 models 9 animal 10 models 11 : 16 and 11 : 29 . 12 ad2576appswe 14 ad2576 12 ad2576appswe 16 and 13 ( 14 ad2576 14 ad2576 15 ) 16 and 17 laferla 16 and 22 mice 16 and 28 sunitinib 18 3xtg 20 3xtgad 18 3xtg 21 ) 18 3xtg 22 mice 19 ( 20 3xtgad 20 3xtgad 21 ) 22 mice 23 using 22 mice 28 sunitinib 23 using 27 inhibitor 24 the 27 inhibitor 25 vascular 26 activation 26 activation 27 inhibitor our data show that in both ad animal models , the cerebrovasculature is activated and overexpresses amyloid beta , thrombin , tumor necrosis factor alpha , interleukin - 1 beta , interleukin [-] 6 , and matrix metalloproteinase 9 . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 40 . 1 our 2 data 2 data 3 show 3 show 4 that 4 that 12 cerebrovasculature 4 that 13 is 5 in 9 models 5 in 10 , 5 in 12 cerebrovasculature 6 both 9 models 7 ad 8 animal 8 animal 9 models 11 the 12 cerebrovasculature 12 cerebrovasculature 13 is 13 is 15 and 14 activated 15 and 15 and 16 overexpresses 15 and 30 beta 16 overexpresses 18 beta 17 amyloid 18 beta 18 beta 20 thrombin 19 , 20 thrombin 20 thrombin 25 alpha 20 thrombin 27 interleukin 20 thrombin 28 - 21 , 25 alpha 22 tumor 24 factor 23 necrosis 24 factor 24 factor 25 alpha 25 alpha 26 , 26 , 27 interleukin 27 interleukin 28 - 29 1 30 beta 31 , 36 and 32 interleukin 34 6 32 interleukin 36 and 35 , 36 and 36 and 38 metalloproteinase 37 matrix 38 metalloproteinase 38 metalloproteinase 39 9 oral administration of sunitinib significantly reduces vascular expression of these proteins . 0 ###LEFT-WALL### 2 administration 0 ###LEFT-WALL### 6 reduces 0 ###LEFT-WALL### 12 . 1 oral 2 administration 2 administration 3 of 2 administration 6 reduces 3 of 4 sunitinib 5 significantly 6 reduces 6 reduces 8 expression 7 vascular 8 expression 8 expression 9 of 9 of 11 proteins 10 these 11 proteins furthermore , sunitinib improves cognitive [function] , as assessed [by] several behavioral paradigms , in both ad animal models . 0 ###LEFT-WALL### 3 sunitinib 0 ###LEFT-WALL### 4 improves 1 furthermore 2 , 1 furthermore 3 sunitinib 3 sunitinib 4 improves 4 improves 13 paradigms 5 cognitive 7 , 5 cognitive 13 paradigms 8 as 9 assessed 9 assessed 13 paradigms 11 several 13 paradigms 12 behavioral 13 paradigms 13 paradigms 15 in 14 , 15 in 15 in 19 models 15 in 20 . 16 both 19 models 17 ad 19 models 18 animal 19 models finally , oxidant injury of brain endothelial cells in culture , resulting in expression of inflammatory proteins , is mitigated by sunitinib . 0 ###LEFT-WALL### 4 injury 0 ###LEFT-WALL### 20 mitigated 0 ###LEFT-WALL### 23 . 1 finally 2 , 1 finally 4 injury 3 oxidant 4 injury 4 injury 5 of 4 injury 19 is 5 of 8 cells 6 brain 8 cells 7 endothelial 8 cells 8 cells 9 in 9 in 10 culture 10 culture 12 resulting 11 , 12 resulting 12 resulting 13 in 12 resulting 18 , 13 in 14 expression 14 expression 15 of 15 of 17 proteins 16 inflammatory 17 proteins 19 is 20 mitigated 20 mitigated 21 by 21 by 22 sunitinib the current data , as well as published studies showing cerebrovascular activation in human ad , support further exploration of vascular - based mechanisms in ad pathogenesis . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 17 support 0 ###LEFT-WALL### 28 . 1 the 3 data 2 current 3 data 3 data 7 as 3 data 17 support 4 , 7 as 5 as 6 well 6 well 7 as 7 as 9 studies 7 as 16 , 8 published 9 studies 9 studies 10 showing 10 showing 12 activation 10 showing 13 in 11 cerebrovascular 12 activation 13 in 15 ad 14 human 15 ad 17 support 19 exploration 17 support 25 in 18 further 19 exploration 19 exploration 20 of 20 of 24 mechanisms 21 vascular 22 - 21 vascular 24 mechanisms 23 based 24 mechanisms 25 in 27 pathogenesis 26 ad 27 pathogenesis new thinking about ad pathogenesis and novel , effective treatments are urgently needed . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 14 . 1 new 2 thinking 1 new 6 and 2 thinking 3 about 3 about 5 pathogenesis 4 ad 5 pathogenesis 6 and 10 treatments 6 and 11 are 7 novel 8 , 7 novel 10 treatments 9 effective 10 treatments 11 are 12 urgently 11 are 13 needed identification of " vascular activation " as a heretofore unexplored target could stimulate translational investigations in this newly defined area , leading to innovative therapeutic approaches for the treatment of this devastating disease . 0 ###LEFT-WALL### 1 identification 0 ###LEFT-WALL### 13 stimulate 1 identification 2 of 1 identification 12 could 2 of 3 " 2 of 5 activation 4 vascular 5 activation 5 activation 6 " 5 activation 7 as 7 as 11 target 8 a 9 heretofore 8 a 11 target 9 heretofore 10 unexplored 10 unexplored 11 target 12 could 13 stimulate 13 stimulate 15 investigations 13 stimulate 16 in 14 translational 15 investigations 16 in 20 area 17 this 20 area 18 newly 19 defined 19 defined 20 area 20 area 22 leading 21 , 22 leading 22 leading 23 to 22 leading 34 . 23 to 26 approaches 24 innovative 26 approaches 25 therapeutic 26 approaches 26 approaches 27 for 26 approaches 30 of 27 for 29 treatment 28 the 29 treatment 30 of 33 disease 31 this 33 disease 32 devastating 33 disease [none] objective : fibroblast growth factor 10 ( fgf 10 ) [signaling] [pathway] is crucial to lung development and epithelial reconstruction . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 22 . 3 : 6 factor 3 : 14 is 4 fibroblast 5 growth 5 growth 6 factor 6 factor 7 10 6 factor 9 fgf 6 factor 14 is 8 ( 9 fgf 9 fgf 10 10 9 fgf 11 ) 14 is 15 crucial 15 crucial 16 to 16 to 19 and 17 lung 18 development 18 development 19 and 19 and 21 reconstruction 20 epithelial 21 reconstruction the aim of this study was to investigate the relationship between gene polymorphisms in fgf 10 and susceptibility to chronic obstructive pulmonary disease ( copd ) in a han population of north china . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 34 . 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 investigate 7 to 8 investigate 8 investigate 10 relationship 8 investigate 19 to 8 investigate 27 in 9 the 10 relationship 10 relationship 11 between 11 between 17 and 12 gene 13 polymorphisms 13 polymorphisms 14 in 13 polymorphisms 17 and 14 in 15 fgf 15 fgf 16 10 17 and 18 susceptibility 19 to 23 disease 20 chronic 23 disease 21 obstructive 23 disease 22 pulmonary 23 disease 23 disease 25 copd 24 ( 25 copd 25 copd 26 ) 27 in 30 population 28 a 30 population 29 han 30 population 30 population 31 of 31 of 33 china 32 north 33 china methods : the subjects included 220 patients with copd ( copd [group] ) and 285 healthy controls ( control [group] ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 subjects 2 : 5 included 2 : 22 . 3 the 4 subjects 4 subjects 5 included 5 included 7 patients 5 included 8 with 6 220 7 patients 8 with 14 and 9 copd 11 copd 10 ( 11 copd 11 copd 13 ) 11 copd 14 and 14 and 17 controls 14 and 19 control 15 285 17 controls 16 healthy 17 controls 18 ( 19 control 19 control 21 ) the copd patients , admitted to our hospital from june 2007 to may 2012 because of acute exacerbation , included 142 males and 78 females , aging from 43 to 93 years [ mean [(] 74 ± 10 ) ] . 0 ###LEFT-WALL### 3 patients 0 ###LEFT-WALL### 20 included 0 ###LEFT-WALL### 41 . 1 the 3 patients 2 copd 3 patients 3 patients 5 admitted 3 patients 20 included 4 , 5 admitted 5 admitted 6 to 5 admitted 12 to 5 admitted 15 because 5 admitted 19 , 6 to 8 hospital 7 our 8 hospital 8 hospital 9 from 9 from 10 june 10 june 11 2007 12 to 13 may 13 may 14 2012 15 because 16 of 16 of 18 exacerbation 17 acute 18 exacerbation 20 included 23 and 21 142 23 and 22 males 23 and 23 and 25 females 23 and 27 aging 24 78 25 females 26 , 27 aging 27 aging 32 years 27 aging 40 ] 28 from 30 to 29 43 30 to 30 to 31 93 30 to 32 years 32 years 37 ± 33 [ 37 ± 34 mean 37 ± 36 74 37 ± 37 ± 38 10 37 ± 39 ) the control group included 183 males and 102 females , aging from 44 to 97 years [ mean [(] 72 ± 9 ) ] . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 included 0 ###LEFT-WALL### 25 . 1 the 3 group 2 control 3 group 3 group 4 included 4 included 7 and 4 included 11 aging 5 183 7 and 6 males 7 and 7 and 9 females 8 102 9 females 10 , 11 aging 11 aging 16 years 11 aging 24 ] 12 from 14 to 13 44 14 to 14 to 15 97 14 to 16 years 16 years 21 ± 17 [ 21 ± 18 mean 21 ± 20 72 21 ± 21 ± 22 9 21 ± 23 ) according to results of lung function testing , patients with copd [were] divided into mild ( 8 cases ) , moderate [(] 62 cases ) , and severe ( 48 cases ) and very severe groups ( 102 cases ) . 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 41 . 1 according 2 to 1 according 27 and 2 to 3 results 3 results 4 of 4 of 7 testing 5 lung 6 function 6 function 7 testing 7 testing 9 patients 8 , 9 patients 9 patients 10 with 9 patients 25 ) 10 with 11 copd 11 copd 13 divided 11 copd 14 into 14 into 24 cases 15 mild 18 cases 15 mild 20 , 15 mild 21 moderate 16 ( 18 cases 17 8 18 cases 18 cases 19 ) 21 moderate 24 cases 23 62 24 cases 26 , 27 and 27 and 28 severe 27 and 31 cases 27 and 33 and 29 ( 31 cases 30 48 31 cases 31 cases 32 ) 33 and 36 groups 33 and 39 cases 34 very 35 severe 35 severe 36 groups 37 ( 39 cases 38 102 39 cases 39 cases 40 ) [the] genotype frequencies of fgf 10 gene single nucleotide polymorphisms ( rs10473352 , rs16873956 , rs2973644 , rs1011814 , rs10402070 and rs723166 ) were genotyped by rflp pcr - restriction fragment length polymorphism method and micro - sequencing ( snapshot ) technology assay . 0 ###LEFT-WALL### 2 genotype 0 ###LEFT-WALL### 13 , 2 genotype 3 frequencies 3 frequencies 4 of 3 frequencies 12 rs10473352 4 of 10 polymorphisms 5 fgf 6 10 5 fgf 10 polymorphisms 7 gene 10 polymorphisms 8 single 9 nucleotide 9 nucleotide 10 polymorphisms 11 ( 12 rs10473352 12 rs10473352 13 , 13 , 21 and 13 , 25 genotyped 13 , 29 - 14 rs16873956 15 , 15 , 16 rs2973644 15 , 17 , 17 , 20 rs10402070 17 , 21 and 18 rs1011814 19 , 18 rs1011814 20 rs10402070 21 and 22 rs723166 21 and 23 ) 21 and 24 were 24 were 25 genotyped 25 genotyped 26 by 26 by 28 pcr 27 rflp 28 pcr 29 - 43 assay 29 - 44 . 30 restriction 33 polymorphism 31 fragment 32 length 32 length 33 polymorphism 33 polymorphism 34 method 34 method 35 and 35 and 38 sequencing 35 and 40 snapshot 35 and 43 assay 36 micro 37 - 36 micro 38 sequencing 39 ( 40 snapshot 40 snapshot 41 ) 42 technology 43 assay chi [-] [square] [test] was used to perform the hardy - weinberg equilibrium test . 0 ###LEFT-WALL### 1 chi 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 15 . 1 chi 5 was 5 was 6 used 6 used 7 to 6 used 8 perform 7 to 8 perform 8 perform 10 hardy 9 the 10 hardy 11 - 14 test 12 weinberg 14 test 13 equilibrium 14 test unconditional [logistic] of regression [model] [was] used to calculate odds [ratio] ( or ) and 95%ci . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 17 . 1 unconditional 3 of 1 unconditional 7 used 1 unconditional 15 and 3 of 4 regression 7 used 8 to 7 used 9 calculate 8 to 9 calculate 9 calculate 10 odds 10 odds 13 or 12 ( 13 or 13 or 14 ) 15 and 16 95%ci the 2 groups were compared using [t] - test . 0 ###LEFT-WALL### 3 groups 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 8 - 1 the 2 2 2 2 3 groups 3 groups 4 were 4 were 6 using 5 compared 6 using 8 - 9 test 8 - 10 . results : the rs2973644 locus aa , ga and gg genotype frequencies in the copd group and the control group were 108/220 , 92/220 , 20/220 and 167/285 , 104/285 , 14/285 , respectively [;] while the frequencies of allele a [and] [g] were 308/440 , 132/440 and 438/570 , 132/570 , respectively . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 54 . 2 : 9 and 2 : 11 genotype 2 : 17 and 3 the 5 locus 4 rs2973644 5 locus 5 locus 6 aa 6 aa 7 , 7 , 8 ga 7 , 9 and 9 and 10 gg 9 and 11 genotype 11 genotype 12 frequencies 11 genotype 13 in 13 in 16 group 14 the 16 group 15 copd 16 group 17 and 20 group 17 and 21 were 18 the 20 group 19 control 20 group 20 group 21 were 21 were 22 108/220 21 were 34 respectively 21 were 36 while 22 108/220 24 92/220 22 108/220 27 and 23 , 24 92/220 24 92/220 25 , 25 , 27 and 26 20/220 27 and 27 and 28 167/285 27 and 30 104/285 27 and 32 14/285 27 and 33 , 29 , 30 104/285 30 104/285 31 , 31 , 32 14/285 32 14/285 33 , 36 while 38 frequencies 36 while 44 were 37 the 38 frequencies 38 frequencies 39 of 38 frequencies 44 were 39 of 40 allele 40 allele 41 a 44 were 45 308/440 44 were 53 respectively 45 308/440 48 and 46 , 48 and 47 132/440 48 and 48 and 49 438/570 48 and 51 132/570 48 and 52 , 50 , 51 132/570 51 132/570 52 , the rs10473352 locus tt , tc and [cc] [genotype] frequencies in the copd group and the control group were 142/220 , 72/220 , 6/220 and 202/285 , 82/285 , 1/285 , respectively , the differences being statistically significant ( χ ( 2 ) value were 6.021 - 6.213 , p < 0.05 ) . 0 ###LEFT-WALL### 3 locus 0 ###LEFT-WALL### 19 were 0 ###LEFT-WALL### 33 , 0 ###LEFT-WALL### 54 . 1 the 3 locus 2 rs10473352 3 locus 3 locus 7 and 3 locus 18 group 3 locus 19 were 4 tt 6 tc 5 , 6 tc 6 tc 7 and 7 and 10 frequencies 7 and 11 in 7 and 18 group 11 in 15 and 12 the 14 group 13 copd 14 group 14 group 15 and 15 and 17 control 16 the 17 control 19 were 20 142/220 19 were 32 respectively 20 142/220 22 72/220 21 , 22 72/220 22 72/220 25 and 22 72/220 28 82/285 22 72/220 30 1/285 22 72/220 31 , 23 , 25 and 24 6/220 25 and 25 and 26 202/285 25 and 27 , 27 , 28 82/285 28 82/285 29 , 29 , 30 1/285 30 1/285 31 , 31 , 32 respectively 32 respectively 33 , 33 , 35 differences 33 , 45 were 34 the 35 differences 35 differences 36 being 35 differences 45 were 36 being 37 statistically 36 being 44 value 38 significant 40 χ 38 significant 43 ) 38 significant 44 value 39 ( 40 χ 40 χ 42 2 40 χ 43 ) 41 ( 42 2 42 2 43 ) 45 were 51 < 46 6.021 47 - 47 - 48 6.213 47 - 51 < 49 , 51 < 50 p 51 < 51 < 52 0.05 51 < 53 ) the rs10473352 allele t and [c] frequencies were [356/440] , 84/440 and 486/570 , 84/570 , respectively [,] the differences being not statistically significant ( χ ( 2 ) = 3.395 , p > 0.05 ) . 0 ###LEFT-WALL### 3 allele 0 ###LEFT-WALL### 30 = 0 ###LEFT-WALL### 37 . 1 the 3 allele 2 rs10473352 3 allele 3 allele 5 and 3 allele 8 were 3 allele 12 and 3 allele 15 84/570 3 allele 30 = 4 t 5 and 5 and 7 frequencies 5 and 8 were 10 , 12 and 11 84/440 12 and 12 and 13 486/570 12 and 14 , 14 , 15 84/570 15 84/570 20 differences 15 84/570 29 ) 16 , 17 respectively 16 , 20 differences 19 the 20 differences 20 differences 21 being 20 differences 26 χ 20 differences 29 ) 21 being 22 not 21 being 23 statistically 21 being 24 significant 25 ( 26 χ 26 χ 28 2 26 χ 29 ) 27 ( 28 2 28 2 29 ) 30 = 31 3.395 30 = 34 > 32 , 34 > 33 p 34 > 34 > 35 0.05 34 > 36 ) the remaining 5 tsnp ( rs10473352 , rs16873956 , rs2973644 , rs10402070 and rs723166 ) genotype distribution and allele frequencies were not significantly different [(] or value were 0.606 - 1.357 , p > 0.05 ) . 0 ###LEFT-WALL### 3 5 0 ###LEFT-WALL### 21 were 1 the 2 remaining 1 the 3 5 3 5 13 and 3 5 16 genotype 3 5 21 were 4 tsnp 6 rs10473352 4 tsnp 8 rs16873956 5 ( 6 rs10473352 6 rs10473352 7 , 8 rs16873956 9 , 9 , 12 rs10402070 9 , 13 and 10 rs2973644 11 , 10 rs2973644 12 rs10402070 13 and 14 rs723166 13 and 15 ) 13 and 16 genotype 16 genotype 18 and 17 distribution 18 and 18 and 20 frequencies 19 allele 20 frequencies 21 were 22 not 21 were 29 0.606 22 not 23 significantly 23 significantly 24 different 24 different 28 were 26 or 27 value 27 value 28 were 29 0.606 31 1.357 30 - 31 1.357 31 1.357 34 > 31 1.357 37 . 32 , 34 > 33 p 34 > 34 > 35 0.05 34 > 36 ) conclusions : fgf 10 gene snp sites rs2973644 and rs10473352 polymorphisms may be associated with susceptibility to copd in han population of north china . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 25 . 1 conclusions 2 : 2 : 8 rs2973644 3 fgf 4 10 3 fgf 8 rs2973644 5 gene 8 rs2973644 6 snp 8 rs2973644 7 sites 8 rs2973644 9 and 11 polymorphisms 9 and 14 associated 10 rs10473352 11 polymorphisms 11 polymorphisms 12 may 12 may 13 be 13 be 14 associated 14 associated 15 with 15 with 16 susceptibility 15 with 17 to 17 to 18 copd 18 copd 19 in 19 in 21 population 20 han 21 population 21 population 22 of 22 of 24 china 23 north 24 china the snp in rs1011814 may be associated with severity of copd . 0 ###LEFT-WALL### 2 snp 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 12 . 1 the 2 snp 2 snp 3 in 2 snp 5 may 3 in 4 rs1011814 5 may 6 be 6 be 7 associated 7 associated 8 with 8 with 9 severity 9 severity 10 of 10 of 11 copd gastroesophageal [reflux] disease is a common disorder in all patients but a particular problem in the elderly , for whom the disease often presents with advanced mucosal damage and other complications . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 4 is 1 gastroesophageal 3 disease 3 disease 4 is 4 is 7 disorder 5 a 6 common 5 a 7 disorder 6 common 7 disorder 7 disorder 8 in 7 disorder 11 but 7 disorder 19 for 8 in 10 patients 9 all 10 patients 11 but 14 problem 12 a 14 problem 13 particular 14 problem 14 problem 15 in 15 in 17 elderly 16 the 17 elderly 18 , 19 for 19 for 20 whom 19 for 22 disease 19 for 24 presents 19 for 32 . 21 the 22 disease 22 disease 24 presents 23 often 24 presents 24 presents 25 with 24 presents 31 complications 25 with 29 and 26 advanced 28 damage 27 mucosal 28 damage 28 damage 29 and 29 and 30 other symptoms are also not as reliable an indication of disease severity in older patients . 0 ###LEFT-WALL### 1 symptoms 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 15 . 1 symptoms 2 are 2 are 3 also 2 are 4 not 2 are 8 indication 5 as 6 reliable 5 as 7 an 6 reliable 7 an 7 an 8 indication 8 indication 9 of 9 of 11 severity 10 disease 11 severity 11 severity 12 in 12 in 14 patients 13 older 14 patients likewise , therapy is more difficult because of potential side effects and drug interactions . 0 ###LEFT-WALL### 3 therapy 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 15 . 1 likewise 2 , 1 likewise 3 therapy 3 therapy 4 is 4 is 6 difficult 5 more 6 difficult 6 difficult 7 because 7 because 8 of 8 of 12 and 9 potential 10 side 10 side 11 effects 11 effects 12 and 12 and 14 interactions 13 drug 14 interactions unlabelled : ( 99 m [ c] - trodat - 1 is the first clinical routine ( 99 [m] [ c] radiopharmaceutical to evaluate dopamine neurons loss in parkinson 's disease ( pd ) . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 trodat 0 ###LEFT-WALL### 33 pd 1 unlabelled 2 : 2 : 7 c] 3 ( 7 c] 4 99 5 m 5 m 7 c] 7 c] 8 - 7 c] 9 trodat 9 trodat 10 - 9 trodat 11 1 10 - 11 1 11 1 15 clinical 12 is 13 the 12 is 15 clinical 14 first 15 clinical 15 clinical 17 ( 16 routine 17 ( 17 ( 20 [ 17 ( 31 disease 17 ( 32 ( 20 [ 21 c] 20 [ 22 radiopharmaceutical 21 c] 22 radiopharmaceutical 22 radiopharmaceutical 23 to 22 radiopharmaceutical 24 evaluate 23 to 24 evaluate 24 evaluate 25 dopamine 24 evaluate 26 neurons 26 neurons 29 parkinson 27 loss 28 in 28 in 29 parkinson 30 's 31 disease 31 disease 32 ( [(] 18 )f - av - [133] is a novel pet radiotracer targeting the vesicular monoamine transporter type 2 ( vmat2 ) to detect monoaminergic terminal reduction in pd patients . 0 ###LEFT-WALL### 5 av 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 31 . 2 18 5 av 3 )f 4 - 3 )f 5 av 6 - 8 is 8 is 12 radiotracer 8 is 18 type 8 is 23 to 9 a 12 radiotracer 10 novel 12 radiotracer 11 pet 12 radiotracer 12 radiotracer 13 targeting 13 targeting 17 transporter 14 the 17 transporter 15 vesicular 16 monoamine 16 monoamine 17 transporter 18 type 19 2 18 type 21 vmat2 20 ( 21 vmat2 21 vmat2 22 ) 23 to 24 detect 24 detect 27 reduction 24 detect 28 in 25 monoaminergic 26 terminal 26 terminal 27 reduction 28 in 30 patients 29 pd 30 patients the aim of this study is to compare both images in the same health control ( hc ) and pd subjects . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 22 . 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 compare 7 to 8 compare 8 compare 19 and 9 both 10 images 10 images 11 in 10 images 19 and 11 in 15 control 12 the 13 same 13 same 15 control 14 health 15 control 15 control 17 hc 16 ( 17 hc 17 hc 18 ) 19 and 21 subjects 20 pd 21 subjects methods : eighteen subjects ( 8 hc and 10 pd ) were recruited for ( 99 m [ c] - trodat - 1 spect , ( 18 )f - av - 133 pet and mri scans within two weeks . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 subjects 2 : 13 recruited 2 : 30 av 3 eighteen 4 subjects 4 subjects 8 and 4 subjects 12 were 5 ( 8 and 6 8 7 hc 7 hc 8 and 8 and 10 pd 8 and 11 ) 9 10 10 pd 12 were 13 recruited 13 recruited 14 for 13 recruited 19 c] 14 for 15 ( 15 ( 19 c] 16 99 17 m 17 m 19 c] 19 c] 20 - 19 c] 30 av 20 - 23 1 20 - 27 18 20 - 29 - 21 trodat 23 1 22 - 23 1 23 1 24 spect 25 , 27 18 26 ( 27 18 27 18 28 )f 28 )f 29 - 29 - 30 av 30 av 34 and 30 av 35 mri 30 av 39 weeks 31 - 34 and 32 133 33 pet 33 pet 34 and 34 and 35 mri 35 mri 36 scans 36 scans 38 two 37 within 38 two the spect images were performed at 4 - h post - injection for 45 min , and the pet images were performed at 90 min post - injection for 10 min . 0 ###LEFT-WALL### 3 images 0 ###LEFT-WALL### 5 performed 0 ###LEFT-WALL### 17 and 1 the 3 images 2 spect 3 images 3 images 4 were 4 were 5 performed 5 performed 6 at 6 at 10 post 7 4 8 - 8 - 9 h 8 - 10 post 10 post 12 injection 11 - 12 injection 12 injection 13 for 12 injection 16 , 13 for 15 min 14 45 15 min 16 , 17 and 17 and 19 pet 17 and 22 performed 18 the 19 pet 19 pet 20 images 19 pet 21 were 19 pet 22 performed 20 images 21 were 22 performed 23 at 23 at 26 post 24 90 25 min 25 min 26 post 26 post 28 injection 27 - 28 injection 28 injection 29 for 29 for 31 min 30 10 31 min 31 min 32 . each pet and spect image was normalized into montreal neurological institute [template] aided from individual mri for comparison . 0 ###LEFT-WALL### 5 image 0 ###LEFT-WALL### 7 normalized 0 ###LEFT-WALL### 19 . 1 each 5 image 2 pet 3 and 3 and 4 spect 4 spect 5 image 5 image 6 was 6 was 7 normalized 7 normalized 8 into 8 into 11 institute 9 montreal 10 neurological 10 neurological 11 institute 11 institute 13 aided 11 institute 14 from 14 from 16 mri 15 individual 16 mri 16 mri 17 for 17 for 18 comparison for regional analysis , volume of interest ( vois ) of bilateral caudate nuclei , anterior , posterior putamen and occipital cortex ( as reference [region] ) were delineated from the normalized mri . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 29 delineated 0 ###LEFT-WALL### 34 . 1 for 3 analysis 1 for 15 , 1 for 20 and 2 regional 3 analysis 3 analysis 5 volume 4 , 5 volume 5 volume 6 of 5 volume 11 of 5 volume 15 , 6 of 7 interest 7 interest 9 vois 8 ( 9 vois 9 vois 10 ) 11 of 14 nuclei 12 bilateral 14 nuclei 13 caudate 14 nuclei 16 anterior 17 , 16 anterior 18 posterior 18 posterior 19 putamen 19 putamen 20 and 20 and 22 cortex 20 and 24 as 20 and 28 were 21 occipital 22 cortex 23 ( 24 as 24 as 25 reference 24 as 27 ) 28 were 29 delineated 29 delineated 30 from 30 from 33 mri 31 the 33 mri 32 normalized 33 mri the specific uptake ratio ( sur ) was calculated as [(] regional mean counts/reference mean counts - 1 ) . 0 ###LEFT-WALL### 4 ratio 0 ###LEFT-WALL### 9 calculated 0 ###LEFT-WALL### 20 . 1 the 4 ratio 2 specific 3 uptake 3 uptake 4 ratio 4 ratio 6 sur 4 ratio 8 was 5 ( 6 sur 6 sur 7 ) 8 was 9 calculated 9 calculated 10 as 10 as 16 counts 12 regional 13 mean 13 mean 16 counts 14 counts/reference 16 counts 15 mean 16 counts 16 counts 18 1 17 - 18 1 18 1 19 ) the nonparametric mann [-] whitney [u] test was used to evaluate the power of differentiating control from pd subjects for both image modalities . 0 ###LEFT-WALL### 7 test 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 24 . 1 the 7 test 2 nonparametric 7 test 3 mann 5 whitney 5 whitney 7 test 7 test 8 was 8 was 9 used 9 used 10 to 9 used 11 evaluate 10 to 11 evaluate 11 evaluate 13 power 11 evaluate 17 from 11 evaluate 20 for 12 the 13 power 13 power 14 of 14 of 16 control 15 differentiating 16 control 17 from 19 subjects 18 pd 19 subjects 20 for 23 modalities 21 both 23 modalities 22 image 23 modalities the correlations of the surs to the clinical parameters were examined . 0 ###LEFT-WALL### 2 correlations 0 ###LEFT-WALL### 11 examined 0 ###LEFT-WALL### 12 . 1 the 2 correlations 2 correlations 3 of 2 correlations 10 were 3 of 5 surs 4 the 5 surs 5 surs 6 to 6 to 9 parameters 7 the 9 parameters 8 clinical 9 parameters 10 were 11 examined for voxelwise analysis , two - [sample] t - test [for] group comparison between hc and pd was computed in both image modalities . 0 ###LEFT-WALL### 13 comparison 0 ###LEFT-WALL### 19 computed 0 ###LEFT-WALL### 24 . 1 for 3 analysis 1 for 13 comparison 2 voxelwise 3 analysis 3 analysis 6 - 4 , 6 - 5 two 6 - 6 - 8 t 6 - 9 - 10 test 13 comparison 12 group 13 comparison 13 comparison 14 between 13 comparison 18 was 14 between 17 pd 15 hc 16 and 16 and 17 pd 18 was 19 computed 19 computed 20 in 20 in 23 modalities 21 both 23 modalities 22 image 23 modalities results : the surs of caudate nucleus and putamen correlated well between two image modalities ( r = 0.81 , p<0.001 ) , and showed significant different between hc and pd subjects . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 33 . 1 results 2 : 2 : 4 surs 3 the 4 surs 4 surs 5 of 5 of 7 nucleus 6 caudate 7 nucleus 8 and 9 putamen 8 and 24 and 9 putamen 24 and 10 correlated 11 well 10 correlated 12 between 10 correlated 24 and 12 between 15 modalities 13 two 14 image 14 image 15 modalities 15 modalities 18 = 15 modalities 21 p<0.001 16 ( 18 = 17 r 18 = 18 = 19 0.81 18 = 20 , 20 , 21 p<0.001 21 p<0.001 22 ) 23 , 24 and 24 and 25 showed 25 showed 30 and 26 significant 27 different 26 significant 30 and 27 different 28 between 28 between 29 hc 30 and 32 subjects 31 pd 32 subjects of note , the [(] 18 )f - av - 133 sur displayed a better correlation to pd clinical laterality index as compared [to] ( 99 m [ c] - trodat - 1 ( r = 0.73 [vs] [.] r = 0.33 ) . 0 ###LEFT-WALL### 6 18 0 ###LEFT-WALL### 8 - 1 of 2 note 1 of 3 , 1 of 6 18 4 the 6 18 6 18 7 )f 8 - 9 av 8 - 10 - 10 - 12 sur 10 - 13 displayed 11 133 12 sur 12 sur 13 displayed 13 displayed 16 correlation 13 displayed 17 to 14 a 16 correlation 15 better 16 correlation 17 to 21 index 18 pd 21 index 19 clinical 21 index 20 laterality 21 index 21 index 23 compared 21 index 27 m 21 index 31 trodat 22 as 23 compared 25 ( 27 m 26 99 27 m 27 m 29 c] 29 c] 31 trodat 30 - 31 trodat 31 trodat 32 - 31 trodat 43 ) 32 - 35 r 33 1 35 r 34 ( 35 r 35 r 36 = 36 = 40 r 39 [.] 40 r 40 r 41 = 40 r 42 0.33 voxelwise analysis showed more lesions for pd subjects from [(] 18 )f - av - 133 image [as] compared to ( 99 m [ c] - trodat - 1 [especially] at the substantia nigra region . 1 voxelwise 2 analysis 2 analysis 3 showed 3 showed 5 lesions 3 showed 6 for 3 showed 8 subjects 3 showed 12 )f 4 more 5 lesions 6 for 7 pd 8 subjects 9 from 8 subjects 12 )f 9 from 11 18 12 )f 15 - 13 - 15 - 14 av 15 - 15 - 16 133 16 133 17 image 16 133 20 to 16 133 23 m 16 133 26 - 17 image 19 compared 19 compared 20 to 21 ( 23 m 22 99 23 m 23 m 25 c] 25 c] 26 - 26 - 28 - 26 - 35 region 27 trodat 28 - 28 - 30 [especially] 28 - 35 region 30 [especially] 34 nigra 31 at 34 nigra 32 the 33 substantia 33 substantia 34 nigra conclusion : ( 18 )f - av - 133 pet demonstrated similar performance in differentiation pd from control , and a better correlation to clinical characteristics than that of [(] 99 m [ c] - trodat - 1 spect . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 c] 1 conclusion 2 : 2 : 6 - 3 ( 6 - 4 18 5 )f 5 )f 6 - 6 - 7 av 6 - 34 c] 7 av 10 pet 7 av 11 demonstrated 8 - 9 133 9 133 10 pet 10 pet 11 demonstrated 11 demonstrated 13 performance 11 demonstrated 14 in 11 demonstrated 17 from 11 demonstrated 27 than 12 similar 13 performance 14 in 16 pd 15 differentiation 16 pd 17 from 20 and 18 control 20 and 19 , 20 and 20 and 23 correlation 20 and 24 to 21 a 23 correlation 22 better 23 correlation 24 to 26 characteristics 25 clinical 26 characteristics 27 than 28 that 27 than 29 of 29 of 32 m 31 99 32 m 34 c] 35 - 34 c] 36 trodat 36 trodat 38 1 36 trodat 39 spect 37 - 38 1 [(] 18 )f - av - 133 pet also showed additional information in substantia nigra integrity in pd subjects by voxelwise analysis . 0 ###LEFT-WALL### 8 pet 0 ###LEFT-WALL### 10 showed 0 ###LEFT-WALL### 23 . 2 18 8 pet 3 )f 5 av 3 )f 6 - 3 )f 8 pet 4 - 5 av 5 av 6 - 7 133 8 pet 8 pet 10 showed 9 also 10 showed 10 showed 12 information 10 showed 17 in 10 showed 20 by 11 additional 12 information 12 information 13 in 13 in 16 integrity 14 substantia 16 integrity 15 nigra 16 integrity 17 in 19 subjects 18 pd 19 subjects 20 by 22 analysis 21 voxelwise 22 analysis collectively , ( [18] )f - av - 133 could be a promising and better tracer for clinical use to detect monoaminergic terminal reduction in pd patients . 0 ###LEFT-WALL### 9 133 0 ###LEFT-WALL### 11 be 0 ###LEFT-WALL### 28 . 1 collectively 2 , 1 collectively 9 133 3 ( 5 )f 5 )f 6 - 5 )f 9 133 6 - 7 av 7 av 8 - 7 av 9 133 9 133 10 could 10 could 11 be 11 be 16 tracer 11 be 17 for 11 be 20 to 12 a 16 tracer 13 promising 14 and 14 and 15 better 14 and 16 tracer 17 for 19 use 18 clinical 19 use 20 to 21 detect 21 detect 24 reduction 21 detect 25 in 22 monoaminergic 24 reduction 23 terminal 24 reduction 25 in 27 patients 26 pd 27 patients aging nurse faculty members are vital human resources who serve as educators , researchers , and leaders within baccalaureate nursing ( bsn ) programs . 0 ###LEFT-WALL### 4 members 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 25 . 1 aging 2 nurse 2 nurse 4 members 3 faculty 4 members 4 members 5 are 5 are 8 resources 6 vital 7 human 7 human 8 resources 8 resources 9 who 8 resources 10 serve 9 who 10 serve 10 serve 11 as 10 serve 18 within 10 serve 24 programs 11 as 16 and 12 educators 13 , 13 , 14 researchers 13 , 16 and 15 , 16 and 16 and 17 leaders 18 within 20 nursing 19 baccalaureate 20 nursing 20 nursing 22 bsn 21 ( 22 bsn 22 bsn 23 ) on average , aging nurse faculty members are over 50 years of age and face key retirement decisions over the next decade . 0 ###LEFT-WALL### 1 on 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 23 . 1 on 7 members 1 on 8 are 2 average 3 , 2 average 5 nurse 4 aging 5 nurse 5 nurse 7 members 6 faculty 7 members 8 are 14 and 9 over 10 50 10 50 11 years 11 years 12 of 11 years 14 and 12 of 13 age 14 and 18 decisions 15 face 17 retirement 16 key 17 retirement 17 retirement 18 decisions 18 decisions 19 over 19 over 22 decade 20 the 21 next 20 the 22 decade the purpose of this study was to begin to build substantive theory about academic nurse leaders ' perceptions of extending the academic working life of aging nurse faculty members . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 10 build 0 ###LEFT-WALL### 30 . 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 begin 7 to 8 begin 8 begin 9 to 9 to 10 build 10 build 12 theory 10 build 13 about 11 substantive 12 theory 13 about 18 perceptions 14 academic 15 nurse 15 nurse 16 leaders 16 leaders 17 ' 17 ' 18 perceptions 18 perceptions 19 of 19 of 20 extending 20 extending 22 academic 21 the 22 academic 22 academic 23 working 23 working 24 life 24 life 25 of 25 of 26 aging 26 aging 29 members 27 nurse 28 faculty 28 faculty 29 members nine academic nurse leaders from bsn programs nationwide were interviewed in this grounded theory study . 0 ###LEFT-WALL### 4 leaders 0 ###LEFT-WALL### 10 interviewed 0 ###LEFT-WALL### 16 . 1 nine 4 leaders 2 academic 4 leaders 3 nurse 4 leaders 4 leaders 5 from 4 leaders 9 were 5 from 7 programs 6 bsn 7 programs 8 nationwide 9 were 9 were 10 interviewed 10 interviewed 11 in 11 in 15 study 12 this 13 grounded 13 grounded 15 study 14 theory 15 study data were analyzed using constant comparative 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 constant 7 analysis 6 comparative 7 analysis four categories emerged : valuing aging nurse faculty , enduring environmental challenges , recognizing stakeholder incongruence , and readjusting . 0 ###LEFT-WALL### 2 categories 0 ###LEFT-WALL### 3 emerged 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 20 . 1 four 2 categories 2 categories 3 emerged 4 : 8 faculty 4 : 9 , 5 valuing 6 aging 6 aging 7 nurse 7 nurse 8 faculty 9 , 12 challenges 9 , 13 , 10 enduring 12 challenges 11 environmental 12 challenges 13 , 18 and 14 recognizing 16 incongruence 15 stakeholder 16 incongruence 16 incongruence 18 and 17 , 18 and 18 and 19 readjusting findings reveal that aging nurse faculty members are highly valued by academic nurse leaders , bringing wisdom , experience , and institutional , historical , and cultural awareness to their many roles . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 reveal 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 33 . 1 findings 2 reveal 2 reveal 7 members 2 reveal 10 valued 3 that 4 aging 4 aging 5 nurse 5 nurse 7 members 6 faculty 7 members 7 members 8 are 8 are 10 valued 9 highly 10 valued 10 valued 11 by 10 valued 16 bringing 11 by 14 leaders 12 academic 14 leaders 13 nurse 14 leaders 15 , 16 bringing 16 bringing 17 wisdom 16 bringing 18 , 18 , 21 and 19 experience 21 and 20 , 21 and 21 and 28 awareness 21 and 29 to 22 institutional 23 , 22 institutional 28 awareness 24 historical 26 and 25 , 26 and 26 and 27 cultural 26 and 28 awareness 29 to 32 roles 30 their 31 many 31 many 32 roles yet , some aging [nurse] [faculty] fail to keep knowledge , skills , and teaching modes current , which is problematic given the multiple environmental challenges that academic nurse leaders face . 0 ###LEFT-WALL### 3 some 0 ###LEFT-WALL### 7 fail 0 ###LEFT-WALL### 32 . 1 yet 2 , 1 yet 3 some 3 some 4 aging 3 some 7 fail 7 fail 8 to 7 fail 26 challenges 8 to 9 keep 9 keep 14 and 10 knowledge 11 , 11 , 12 skills 11 , 14 and 13 , 14 and 14 and 17 current 14 and 18 , 14 and 19 which 14 and 20 is 14 and 22 given 15 teaching 16 modes 16 modes 17 current 19 which 20 is 20 is 21 problematic 22 given 24 multiple 23 the 24 multiple 25 environmental 26 challenges 26 challenges 27 that 26 challenges 31 face 27 that 30 leaders 27 that 31 face 28 academic 29 nurse 29 nurse 30 leaders 30 leaders 31 face stakeholder incongruence arises as [a] [mismatch] between the needs of the bsn program and the skills and contributions of aging nurse faculty members . 0 ###LEFT-WALL### 2 incongruence 0 ###LEFT-WALL### 3 arises 0 ###LEFT-WALL### 24 . 1 stakeholder 2 incongruence 2 incongruence 3 arises 3 arises 4 as 4 as 7 between 7 between 9 needs 8 the 9 needs 9 needs 10 of 10 of 17 and 11 the 13 program 12 bsn 13 program 13 program 14 and 14 and 16 skills 14 and 17 and 15 the 16 skills 17 and 18 contributions 17 and 19 of 19 of 20 aging 20 aging 23 members 21 nurse 23 members 22 faculty 23 members bsn programs , program leaders , and aging nurse faculty members can lessen incongruence by readjusting to address the pressures , tensions , and ongoing change . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 27 . 1 bsn 2 programs 2 programs 3 , 3 , 5 leaders 3 , 7 and 4 program 5 leaders 6 , 7 and 7 and 9 nurse 7 and 11 members 7 and 16 readjusting 8 aging 9 nurse 10 faculty 11 members 11 members 12 can 12 can 13 lessen 13 lessen 14 incongruence 13 lessen 15 by 15 by 16 readjusting 16 readjusting 17 to 17 to 18 address 18 address 20 pressures 19 the 20 pressures 21 , 24 and 22 tensions 24 and 23 , 24 and 24 and 26 change 25 ongoing 26 change progressive supranuclear palsy is a rare parkinsonian disorder with characteristic neurofibrillary pathology consisting of hyperphosphorylated tau protein . 0 ###LEFT-WALL### 3 palsy 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 18 . 1 progressive 3 palsy 2 supranuclear 3 palsy 3 palsy 4 is 4 is 8 disorder 5 a 8 disorder 6 rare 7 parkinsonian 7 parkinsonian 8 disorder 8 disorder 9 with 8 disorder 13 consisting 9 with 12 pathology 10 characteristic 12 pathology 11 neurofibrillary 12 pathology 13 consisting 14 of 14 of 17 protein 15 hyperphosphorylated 16 tau 16 tau 17 protein common [variation] defining the microtubule associated protein tau gene ( mapt ) h1 haplotype strongly contributes to disease risk . 0 ###LEFT-WALL### 14 haplotype 0 ###LEFT-WALL### 16 contributes 0 ###LEFT-WALL### 20 . 1 common 14 haplotype 3 defining 9 gene 3 defining 12 ) 3 defining 14 haplotype 4 the 9 gene 5 microtubule 9 gene 6 associated 9 gene 7 protein 9 gene 8 tau 9 gene 9 gene 11 mapt 10 ( 11 mapt 11 mapt 12 ) 13 h1 14 haplotype 14 haplotype 16 contributes 15 strongly 16 contributes 16 contributes 17 to 17 to 19 risk 18 disease 19 risk a recent genome - wide association study ( gwas ) revealed 3 novel risk loci on chromosomes 1 , 2 , [and] 3 that primarily implicate stx6 , eif2ak3 , and mobp , respectively . 0 ###LEFT-WALL### 3 genome 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 35 . 1 a 2 recent 1 a 3 genome 2 recent 3 genome 4 - 7 study 4 - 11 revealed 5 wide 6 association 6 association 7 study 7 study 9 gwas 7 study 11 revealed 8 ( 9 gwas 9 gwas 10 ) 11 revealed 15 loci 11 revealed 34 respectively 12 3 15 loci 13 novel 15 loci 14 risk 15 loci 15 loci 16 on 15 loci 20 2 15 loci 23 3 16 on 17 chromosomes 17 chromosomes 18 1 19 , 20 2 20 2 21 , 21 , 23 3 23 3 24 that 23 3 26 implicate 23 3 31 and 23 3 33 , 24 that 26 implicate 25 primarily 26 implicate 26 implicate 27 stx6 28 , 31 and 29 eif2ak3 31 and 30 , 31 and 31 and 32 mobp 31 and 33 , genetic associations , however , rarely lead to direct identification of the relevant functional allele . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 7 lead 0 ###LEFT-WALL### 16 . 1 genetic 2 associations 2 associations 7 lead 3 , 4 however 4 however 5 , 4 however 7 lead 6 rarely 7 lead 7 lead 8 to 8 to 9 direct 9 direct 10 identification 10 identification 11 of 11 of 15 allele 12 the 15 allele 13 relevant 15 allele 14 functional 15 allele more often , they are in linkage disequilibrium with the causative polymorphism ( [s] [ )(that could be a coding change or affect gene expression regulatory motifs . 0 ###LEFT-WALL### 4 they 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 28 . 1 more 2 often 2 often 3 , 2 often 4 they 4 they 5 are 5 are 6 in 5 are 9 with 6 in 8 disequilibrium 7 linkage 8 disequilibrium 9 with 12 polymorphism 10 the 12 polymorphism 11 causative 12 polymorphism 12 polymorphism 16 )(that 12 polymorphism 17 could 13 ( 16 )(that 16 )(that 17 could 17 could 22 or 18 be 21 change 18 be 22 or 19 a 21 change 20 coding 21 change 22 or 23 affect 23 affect 27 motifs 24 gene 27 motifs 25 expression 27 motifs 26 regulatory 27 motifs to identify [any] such changes , we sequenced all coding exons of those genes directly implicated by the associations in progressive supranuclear palsy cases and analyzed regional gene expression data from control brains to identify expression quantitative trait loci within 1 mb of the risk loci . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 identify 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 47 . 1 to 2 identify 2 identify 5 changes 4 such 5 changes 6 , 7 we 6 , 8 sequenced 7 we 8 sequenced 8 sequenced 11 exons 9 all 11 exons 10 coding 11 exons 11 exons 12 of 11 exons 17 by 11 exons 20 in 11 exons 25 and 12 of 14 genes 13 those 14 genes 14 genes 16 implicated 15 directly 16 implicated 17 by 19 associations 18 the 19 associations 20 in 23 palsy 21 progressive 23 palsy 22 supranuclear 23 palsy 24 cases 25 and 25 and 26 analyzed 25 and 30 data 25 and 34 to 26 analyzed 29 expression 27 regional 29 expression 28 gene 29 expression 30 data 31 from 31 from 33 brains 32 control 33 brains 34 to 35 identify 35 identify 39 loci 36 expression 38 trait 37 quantitative 38 trait 38 trait 39 loci 39 loci 40 within 39 loci 43 of 40 within 42 mb 41 1 42 mb 43 of 46 loci 44 the 46 loci 45 risk 46 loci although we did not find any coding variants underlying the associations , gwas - associated single - nucleotide polymorphisms at these loci are in complete linkage disequilibrium with haplotypes that completely overlap with the respective genes . 0 ###LEFT-WALL### 19 polymorphisms 0 ###LEFT-WALL### 23 are 0 ###LEFT-WALL### 37 . 1 although 2 we 1 although 5 find 1 although 19 polymorphisms 2 we 3 did 3 did 4 not 3 did 5 find 5 find 8 variants 5 find 15 associated 6 any 8 variants 7 coding 8 variants 8 variants 9 underlying 8 variants 13 gwas 8 variants 15 associated 9 underlying 11 associations 10 the 11 associations 12 , 13 gwas 13 gwas 14 - 16 single 17 - 16 single 18 nucleotide 18 nucleotide 19 polymorphisms 19 polymorphisms 20 at 19 polymorphisms 23 are 20 at 22 loci 21 these 22 loci 23 are 24 in 24 in 27 disequilibrium 25 complete 27 disequilibrium 26 linkage 27 disequilibrium 27 disequilibrium 28 with 27 disequilibrium 33 with 28 with 29 haplotypes 29 haplotypes 30 that 29 haplotypes 32 overlap 30 that 32 overlap 31 completely 32 overlap 33 with 36 genes 34 the 36 genes 35 respective 36 genes although implication of eif2ak3 and mobp could not be fully assessed , we show that the gwas single - nucleotide polymorphism rs1411478 ( stx6 ) is a strong expression quantitative trait locus with significantly lower expression of stx6 in white matter in carriers of the risk allele . 0 ###LEFT-WALL### 13 we 0 ###LEFT-WALL### 14 show 0 ###LEFT-WALL### 48 . 1 although 5 and 1 although 11 assessed 1 although 13 we 2 implication 3 of 2 implication 5 and 3 of 4 eif2ak3 5 and 6 mobp 5 and 7 could 7 could 8 not 7 could 9 be 9 be 11 assessed 10 fully 11 assessed 11 assessed 12 , 13 we 14 show 14 show 15 that 15 that 18 single 15 that 26 is 16 the 18 single 17 gwas 18 single 18 single 22 rs1411478 18 single 26 is 19 - 22 rs1411478 20 nucleotide 21 polymorphism 21 polymorphism 22 rs1411478 22 rs1411478 24 stx6 22 rs1411478 25 ) 23 ( 24 stx6 24 stx6 25 ) 26 is 32 locus 26 is 33 with 26 is 39 in 26 is 42 in 27 a 32 locus 28 strong 29 expression 29 expression 32 locus 30 quantitative 31 trait 31 trait 32 locus 33 with 36 expression 34 significantly 35 lower 35 lower 36 expression 36 expression 37 of 37 of 38 stx6 39 in 41 matter 40 white 41 matter 42 in 43 carriers 43 carriers 44 of 44 of 47 allele 45 the 47 allele 46 risk 47 allele frontotemporal dementia with parkinsonism linked to chromosome 17 ( ftdp - 17 ) is a neurodegenerative tauopathy caused by mutations in the tau gene ( mapt ) . 0 ###LEFT-WALL### 1 frontotemporal 0 ###LEFT-WALL### 14 is 0 ###LEFT-WALL### 28 . 1 frontotemporal 2 dementia 1 frontotemporal 5 linked 1 frontotemporal 10 ftdp 1 frontotemporal 14 is 2 dementia 3 with 3 with 4 parkinsonism 5 linked 6 to 6 to 7 chromosome 7 chromosome 8 17 9 ( 10 ftdp 10 ftdp 12 17 10 ftdp 13 ) 11 - 12 17 12 17 13 ) 14 is 17 tauopathy 15 a 16 neurodegenerative 15 a 17 tauopathy 16 neurodegenerative 17 tauopathy 17 tauopathy 18 caused 17 tauopathy 26 mapt 18 caused 19 by 19 by 20 mutations 20 mutations 21 in 21 in 24 gene 22 the 24 gene 23 tau 24 gene 25 ( 26 mapt 26 mapt 27 ) individuals with ftdp - 17 have deficits in learning , memory , and language , in addition to personality and behavioral changes that are often characterized by a lack of social inhibition . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 33 . 1 individuals 2 with 1 individuals 13 and 2 with 3 ftdp 3 ftdp 5 17 3 ftdp 9 learning 3 ftdp 11 memory 4 - 5 17 5 17 6 have 6 have 7 deficits 6 have 8 in 8 in 9 learning 10 , 11 memory 11 memory 12 , 13 and 14 language 13 and 15 , 13 and 16 in 16 in 20 and 17 addition 18 to 17 addition 20 and 18 to 19 personality 20 and 22 changes 20 and 23 that 20 and 24 are 21 behavioral 22 changes 23 that 24 are 24 are 25 often 24 are 26 characterized 26 characterized 27 by 27 by 29 lack 28 a 29 lack 29 lack 30 of 30 of 32 inhibition 31 social 32 inhibition several transgenic mouse models expressing tau mutations have been tested extensively for memory or motor impairments , though reports of amygdala - dependent behaviors are lacking . 0 ###LEFT-WALL### 4 models 0 ###LEFT-WALL### 10 tested 0 ###LEFT-WALL### 27 . 1 several 4 models 2 transgenic 3 mouse 3 mouse 4 models 4 models 5 expressing 4 models 8 have 5 expressing 7 mutations 6 tau 7 mutations 8 have 9 been 9 been 10 tested 10 tested 11 extensively 10 tested 12 for 10 tested 18 though 12 for 14 or 13 memory 14 or 14 or 16 impairments 14 or 17 , 15 motor 16 impairments 18 though 19 reports 18 though 25 are 19 reports 20 of 19 reports 25 are 20 of 24 behaviors 21 amygdala 22 - 21 amygdala 23 dependent 23 dependent 24 behaviors 25 are 26 lacking to this end , we tested the rtg4510 mouse model on a behavioral battery that included amygdala - dependent tasks of exploration . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 tested 0 ###LEFT-WALL### 23 . 1 to 3 end 1 to 4 , 1 to 5 we 2 this 3 end 5 we 6 tested 6 tested 10 model 6 tested 11 on 7 the 10 model 8 rtg4510 10 model 9 mouse 10 model 11 on 14 battery 12 a 13 behavioral 12 a 14 battery 13 behavioral 14 battery 14 battery 15 that 14 battery 16 included 15 that 16 included 16 included 20 tasks 17 amygdala 18 - 17 amygdala 19 dependent 19 dependent 20 tasks 20 tasks 21 of 21 of 22 exploration as expected , rtg4510 mice exhibit profound impairments in hippocampal - dependent learning and memory tests , including contextual fear conditioning . 0 ###LEFT-WALL### 5 mice 0 ###LEFT-WALL### 6 exhibit 1 as 2 expected 1 as 3 , 1 as 5 mice 2 expected 3 , 4 rtg4510 5 mice 5 mice 6 exhibit 6 exhibit 8 impairments 6 exhibit 9 in 7 profound 8 impairments 9 in 14 and 10 hippocampal 11 - 10 hippocampal 12 dependent 12 dependent 13 learning 13 learning 14 and 14 and 16 tests 14 and 18 including 15 memory 16 tests 17 , 18 including 18 including 21 conditioning 18 including 22 . 19 contextual 21 conditioning 20 fear 21 conditioning however , rtg4510 mice also display an abnormal hyperexploratory phenotype in the open - field assay , elevated plus maze , light - dark exploration , and cued fear conditioning , indicative [of] amygdala dysfunction . 0 ###LEFT-WALL### 4 mice 0 ###LEFT-WALL### 6 display 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 36 . 1 however 2 , 1 however 4 mice 3 rtg4510 4 mice 4 mice 6 display 5 also 6 display 6 display 10 phenotype 6 display 11 in 7 an 10 phenotype 8 abnormal 10 phenotype 9 hyperexploratory 10 phenotype 11 in 27 and 12 the 16 assay 13 open 14 - 13 open 15 field 15 field 16 assay 16 assay 17 , 17 , 20 maze 17 , 21 , 18 elevated 20 maze 19 plus 20 maze 21 , 25 exploration 21 , 27 and 22 light 23 - 22 light 25 exploration 24 dark 25 exploration 26 , 27 and 27 and 30 conditioning 28 cued 30 conditioning 29 fear 30 conditioning 31 , 35 dysfunction 32 indicative 35 dysfunction 34 amygdala 35 dysfunction furthermore , significant tau burden is detected in the amygdala of both rtg4510 mice and human ftdp - 17 patients , suggesting that the rtg4510 mouse model recapitulates the behavioral disturbances and neurodegeneration of the amygdala characteristic of ftdp - 17 . 0 ###LEFT-WALL### 4 tau 0 ###LEFT-WALL### 7 detected 0 ###LEFT-WALL### 40 - 1 furthermore 2 , 1 furthermore 4 tau 3 significant 4 tau 4 tau 5 burden 4 tau 6 is 4 tau 7 detected 5 burden 6 is 7 detected 8 in 7 detected 17 ftdp 7 detected 22 suggesting 8 in 10 amygdala 9 the 10 amygdala 10 amygdala 11 of 11 of 15 and 12 both 15 and 13 rtg4510 14 mice 14 mice 15 and 15 and 16 human 17 ftdp 20 patients 18 - 20 patients 19 17 20 patients 20 patients 21 , 21 , 22 suggesting 22 suggesting 23 that 22 suggesting 40 - 23 that 27 model 23 that 28 recapitulates 24 the 27 model 25 rtg4510 26 mouse 26 mouse 27 model 27 model 28 recapitulates 28 recapitulates 32 and 29 the 31 disturbances 30 behavioral 31 disturbances 31 disturbances 32 and 32 and 33 neurodegeneration 32 and 34 of 32 and 38 of 34 of 37 characteristic 35 the 37 characteristic 36 amygdala 37 characteristic 38 of 39 ftdp 40 - 41 17 40 - 42 . respiratory infections are among the most important causes of morbidity and mortality from infectious diseases worldwide . 0 ###LEFT-WALL### 2 infections 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 17 . 1 respiratory 2 infections 2 infections 3 are 3 are 4 among 3 are 16 worldwide 4 among 8 causes 5 the 8 causes 6 most 7 important 7 important 8 causes 8 causes 9 of 9 of 11 and 10 morbidity 11 and 11 and 12 mortality 11 and 13 from 13 from 15 diseases 14 infectious 15 diseases the most common causative bacterium , streptococcus pneumoniae , frequently colonises the upper respiratory tract , where it resides mostly asymptomatically . 0 ###LEFT-WALL### 5 bacterium 0 ###LEFT-WALL### 11 colonises 1 the 2 most 2 most 5 bacterium 3 common 5 bacterium 4 causative 5 bacterium 5 bacterium 8 pneumoniae 5 bacterium 11 colonises 6 , 8 pneumoniae 7 streptococcus 8 pneumoniae 8 pneumoniae 9 , 10 frequently 11 colonises 11 colonises 15 tract 12 the 15 tract 13 upper 15 tract 14 respiratory 15 tract 15 tract 17 where 16 , 17 where 17 where 18 it 17 where 19 resides 17 where 22 . 18 it 19 resides 19 resides 20 mostly 20 mostly 21 asymptomatically occasionally , however , s [pneumoniae] can cause severe disease such as pneumonia . 0 ###LEFT-WALL### 5 s 0 ###LEFT-WALL### 8 cause 0 ###LEFT-WALL### 14 . 1 occasionally 2 , 1 occasionally 5 s 2 , 3 however 3 however 4 , 3 however 5 s 5 s 7 can 7 can 8 cause 8 cause 10 disease 9 severe 10 disease 10 disease 12 as 11 such 12 as 12 as 13 pneumonia local host immunity is essential to control colonising pathogens by preventing overgrowth , spread , and invasion . 0 ###LEFT-WALL### 3 immunity 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 18 . 1 local 3 immunity 2 host 3 immunity 3 immunity 4 is 4 is 5 essential 5 essential 6 to 5 essential 10 by 6 to 7 control 7 control 8 colonising 8 colonising 9 pathogens 10 by 11 preventing 11 preventing 16 and 12 overgrowth 13 , 13 , 14 spread 13 , 16 and 15 , 16 and 16 and 17 invasion however , age - related immune deficits in elderly people , known as immunosenescence , might contribute to increased disease burden . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 17 contribute 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 3 age 3 age 16 might 4 - 5 related 5 related 7 deficits 5 related 8 in 5 related 15 , 5 related 16 might 6 immune 7 deficits 8 in 10 people 9 elderly 10 people 10 people 12 known 11 , 12 known 12 known 13 as 12 known 15 , 13 as 14 immunosenescence 16 might 17 contribute 17 contribute 18 to 18 to 21 burden 19 increased 20 disease 20 disease 21 burden we review present knowledge about immunosenescence in the respiratory tract against gram - positive bacteria , particularly s [pneumoniae] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 review 1 we 2 review 2 review 4 knowledge 2 review 5 about 2 review 7 in 2 review 11 against 3 present 4 knowledge 5 about 6 immunosenescence 7 in 10 tract 8 the 10 tract 9 respiratory 10 tract 11 against 12 gram 12 gram 15 bacteria 12 gram 18 s 13 - 15 bacteria 14 positive 15 bacteria 15 bacteria 16 , 16 , 17 particularly 16 , 18 s 18 s 20 . we discuss the possible underdetection of pneumococcal colonisation in elderly people , and suggest changes to present surveillance methods to improve understanding of the relation between colonisation and disease . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 30 . 1 we 13 and 2 discuss 5 underdetection 2 discuss 9 in 2 discuss 13 and 3 the 5 underdetection 4 possible 5 underdetection 5 underdetection 6 of 6 of 8 colonisation 7 pneumococcal 8 colonisation 9 in 11 people 10 elderly 11 people 12 , 13 and 13 and 14 suggest 13 and 16 to 13 and 20 to 14 suggest 15 changes 16 to 17 present 17 present 19 methods 18 surveillance 19 methods 20 to 21 improve 21 improve 22 understanding 22 understanding 23 of 22 understanding 26 between 23 of 25 relation 24 the 25 relation 26 between 28 and 27 colonisation 28 and 28 and 29 disease we conclude that present knowledge about alteration of host [-] pathogen interactions by immunosenescence in the respiratory tract is insufficient , and that research is needed to enable improved measures for prevention . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 33 . 1 we 22 and 2 conclude 3 that 2 conclude 22 and 3 that 5 knowledge 3 that 19 is 4 present 5 knowledge 5 knowledge 6 about 5 knowledge 13 by 5 knowledge 19 is 6 about 7 alteration 7 alteration 8 of 8 of 12 interactions 9 host 11 pathogen 11 pathogen 12 interactions 13 by 14 immunosenescence 14 immunosenescence 15 in 15 in 18 tract 16 the 18 tract 17 respiratory 18 tract 19 is 20 insufficient 21 , 22 and 22 and 28 enable 23 that 24 research 24 research 25 is 25 is 26 needed 26 needed 27 to 27 to 28 enable 28 enable 30 measures 29 improved 30 measures 30 measures 31 for 31 for 32 prevention background : surgery for elderly patients with primary lung neoplasms has become relatively common as populations age ; however , the high frequency of postoperative complications has prevented its broad application . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 surgery 2 : 12 become 2 : 18 ; 2 : 32 . 3 surgery 4 for 3 surgery 7 with 3 surgery 11 has 4 for 6 patients 5 elderly 6 patients 7 with 10 neoplasms 8 primary 9 lung 9 lung 10 neoplasms 11 has 12 become 12 become 14 common 13 relatively 14 common 14 common 15 as 15 as 17 age 16 populations 17 age 18 ; 23 frequency 18 ; 28 prevented 19 however 20 , 19 however 23 frequency 21 the 23 frequency 22 high 23 frequency 23 frequency 24 of 23 frequency 27 has 24 of 26 complications 25 postoperative 26 complications 27 has 28 prevented 28 prevented 31 application 29 its 31 application 30 broad 31 application recently , the japanese respiratory society proposed lung age ( la ) as an index [of] lung function , but reports on the association between la and the risk factors for postoperative complications [with] [non] - small cell lung cancer ( nsclc ) [surgery] have been limited . 0 ###LEFT-WALL### 6 society 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 48 . 1 recently 2 , 1 recently 6 society 3 the 6 society 4 japanese 6 society 5 respiratory 6 society 6 society 20 but 7 proposed 9 age 7 proposed 13 as 7 proposed 20 but 8 lung 9 age 9 age 11 la 10 ( 11 la 11 la 12 ) 13 as 18 function 14 an 18 function 15 index 18 function 17 lung 18 function 19 , 20 but 20 but 21 reports 21 reports 22 on 21 reports 25 between 22 on 24 association 23 the 24 association 25 between 26 la 27 and 30 factors 27 and 46 been 28 the 30 factors 29 risk 30 factors 30 factors 31 for 30 factors 40 cancer 30 factors 45 have 31 for 33 complications 32 postoperative 33 complications 36 - 40 cancer 37 small 38 cell 38 cell 39 lung 39 lung 40 cancer 40 cancer 42 nsclc 40 cancer 43 ) 41 ( 42 nsclc 42 nsclc 43 ) 45 have 46 been 46 been 47 limited in this study , we analyzed the clinical applicability of la for elderly patients with nsclc . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 analyzed 0 ###LEFT-WALL### 17 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 analyzed 6 analyzed 9 applicability 6 analyzed 15 with 7 the 9 applicability 8 clinical 9 applicability 9 applicability 10 of 10 of 11 la 11 la 12 for 12 for 14 patients 13 elderly 14 patients 15 with 16 nsclc materials and methods : we [studied] 320 patients aged >70 [y] underwent curative resections for nsclc . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 17 . 1 materials 2 and 2 and 3 methods 4 : 8 patients 4 : 12 underwent 5 we 7 320 7 320 8 patients 8 patients 9 aged 8 patients 12 underwent 9 aged 10 >70 12 underwent 14 resections 13 curative 14 resections 14 resections 15 for 15 for 16 nsclc the categorical data were compared among the four groups . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 5 compared 0 ###LEFT-WALL### 10 . 1 the 3 data 2 categorical 3 data 3 data 4 were 4 were 5 compared 5 compared 6 among 6 among 9 groups 7 the 8 four 8 four 9 groups results : the numbers of patients in groups a [,] [b] , [c] [,] [and] [d] were 80 , 77 , 79 [,] and 84 , respectively . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 28 . 1 results 2 : 2 : 6 patients 3 the 4 numbers 4 numbers 5 of 4 numbers 6 patients 5 of 6 patients 6 patients 7 in 7 in 8 groups 8 groups 9 a 12 , 17 were 17 were 18 80 17 were 27 respectively 18 80 20 77 18 80 24 and 19 , 20 77 20 77 21 , 21 , 24 and 22 79 24 and 24 and 25 84 24 and 26 , for the univariate analysis , the preoperative factors for postoperative complications were gender , ag , and smoking ( p < 0.05 ) . 0 ###LEFT-WALL### 8 factors 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 24 . 1 for 4 analysis 1 for 5 , 1 for 8 factors 2 the 4 analysis 3 univariate 4 analysis 6 the 8 factors 7 preoperative 8 factors 8 factors 9 for 8 factors 12 were 9 for 11 complications 10 postoperative 11 complications 12 were 13 gender 13 gender 17 and 14 , 17 and 15 ag 17 and 16 , 17 and 17 and 18 smoking 17 and 21 < 17 and 23 ) 19 ( 21 < 20 p 21 < 21 < 22 0.05 21 < 23 ) in a multivariate analysis , ag proved to be an independent factor . 0 ###LEFT-WALL### 6 ag 0 ###LEFT-WALL### 7 proved 0 ###LEFT-WALL### 13 . 1 in 4 analysis 1 in 5 , 1 in 6 ag 2 a 3 multivariate 2 a 4 analysis 3 multivariate 4 analysis 6 ag 7 proved 7 proved 8 to 7 proved 9 be 8 to 9 be 9 be 12 factor 10 an 11 independent 10 an 12 factor 11 independent 12 factor although we found no significant differences , there was a tendency for the prognosis to worsen with an increase in the ag ( p = 0.06 ) . 0 ###LEFT-WALL### 8 there 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 28 . 1 although 2 we 1 although 3 found 1 although 7 , 1 although 8 there 2 we 3 found 3 found 6 differences 4 no 6 differences 5 significant 6 differences 8 there 9 was 9 was 11 tendency 10 a 11 tendency 11 tendency 12 for 11 tendency 15 to 11 tendency 16 worsen 11 tendency 25 = 12 for 14 prognosis 13 the 14 prognosis 15 to 16 worsen 16 worsen 17 with 16 worsen 20 in 17 with 19 increase 18 an 19 increase 20 in 22 ag 21 the 22 ag 23 ( 25 = 24 p 25 = 25 = 26 0.06 25 = 27 ) conclusions : the ag was significantly associated with [and] an independent predictive factor for postoperative complications . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 ag 2 : 7 associated 2 : 17 . 3 the 4 ag 4 ag 5 was 5 was 6 significantly 5 was 7 associated 7 associated 8 with 8 with 13 factor 10 an 11 independent 10 an 13 factor 11 independent 13 factor 12 predictive 13 factor 13 factor 14 for 14 for 16 complications 15 postoperative 16 complications we conclude that la and ag are useful factors for predicting the risk of postoperative complications . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 17 . 1 we 2 conclude 2 conclude 3 that 3 that 5 and 3 that 7 are 4 la 5 and 5 and 6 ag 5 and 7 are 7 are 9 factors 8 useful 9 factors 9 factors 10 for 10 for 11 predicting 11 predicting 13 risk 12 the 13 risk 13 risk 14 of 14 of 16 complications 15 postoperative 16 complications healthy longevity is a tangible possibility for many individuals and populations , with nutritional and other lifestyle factors playing a key role in modulating the likelihood of healthy ageing . 0 ###LEFT-WALL### 2 longevity 0 ###LEFT-WALL### 3 is 1 healthy 2 longevity 2 longevity 3 is 3 is 6 possibility 4 a 6 possibility 5 tangible 6 possibility 6 possibility 7 for 6 possibility 13 with 7 for 10 and 8 many 9 individuals 9 individuals 10 and 10 and 11 populations 12 , 13 with 13 with 15 and 13 with 26 likelihood 13 with 30 . 14 nutritional 15 and 15 and 18 factors 15 and 19 playing 16 other 18 factors 17 lifestyle 18 factors 19 playing 22 role 20 a 22 role 21 key 22 role 22 role 23 in 23 in 24 modulating 25 the 26 likelihood 26 likelihood 27 of 27 of 29 ageing 28 healthy 29 ageing nevertheless , studies of effects of nutrients or single foods on ageing often show inconsistent results and ignore the overall framework of dietary habits . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 25 . 1 nevertheless 2 , 1 nevertheless 3 studies 3 studies 4 of 3 studies 6 of 3 studies 17 and 4 of 5 effects 6 of 8 or 7 nutrients 8 or 8 or 10 foods 8 or 11 on 9 single 10 foods 11 on 12 ageing 13 often 14 show 14 show 16 results 14 show 17 and 15 inconsistent 16 results 17 and 18 ignore 18 ignore 21 framework 19 the 21 framework 20 overall 21 framework 21 framework 22 of 22 of 24 habits 23 dietary 24 habits therefore , the use of dietary patterns ( [e.g] [.] a mediterranean dietary pattern ) and the specific dietary recommendations [(] e.g . dietary approaches to stop [hypertension] , polymeal and the american healthy eating index ) are becoming more widespread in promoting lifelong health . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 22 e.g 0 ###LEFT-WALL### 23 . 1 therefore 2 , 1 therefore 16 and 3 the 4 use 4 use 5 of 4 use 16 and 5 of 7 patterns 6 dietary 7 patterns 7 patterns 14 pattern 8 ( 14 pattern 11 a 14 pattern 12 mediterranean 14 pattern 13 dietary 14 pattern 14 pattern 15 ) 16 and 20 recommendations 16 and 22 e.g 17 the 20 recommendations 18 specific 20 recommendations 19 dietary 20 recommendations 23 . 25 approaches 23 . 38 are 23 . 46 . 24 dietary 25 approaches 25 approaches 26 to 25 approaches 27 stop 25 approaches 31 and 25 approaches 38 are 26 to 27 stop 29 , 31 and 30 polymeal 31 and 31 and 36 index 31 and 37 ) 32 the 33 american 33 american 36 index 34 healthy 35 eating 35 eating 36 index 38 are 39 becoming 39 becoming 41 widespread 40 more 41 widespread 41 widespread 42 in 42 in 43 promoting 43 promoting 45 health 44 lifelong 45 health a posteriori defined dietary patterns are described frequently in relation to age - related diseases but their generalisability is often a challenge since these are developed specifically for the population under study . 0 ###LEFT-WALL### 5 patterns 0 ###LEFT-WALL### 7 described 0 ###LEFT-WALL### 14 related 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 33 . 1 a 2 posteriori 2 posteriori 5 patterns 3 defined 5 patterns 4 dietary 5 patterns 5 patterns 6 are 6 are 7 described 7 described 8 frequently 7 described 11 to 9 in 10 relation 10 relation 11 to 11 to 12 age 13 - 14 related 14 related 15 diseases 16 but 18 generalisability 16 but 19 is 17 their 18 generalisability 18 generalisability 19 is 19 is 20 often 19 is 22 challenge 19 is 23 since 21 a 22 challenge 23 since 24 these 23 since 26 developed 24 these 25 are 25 are 26 developed 26 developed 27 specifically 26 developed 28 for 26 developed 31 under 28 for 30 population 29 the 30 population 31 under 32 study conversely , the dietary guidelines are often developed [based] on prevention of disease or nutrient deficiency , but often less attention is paid to [how] well these dietary guidelines promote health outcomes . 0 ###LEFT-WALL### 5 guidelines 0 ###LEFT-WALL### 8 developed 0 ###LEFT-WALL### 33 . 1 conversely 2 , 1 conversely 5 guidelines 3 the 5 guidelines 4 dietary 5 guidelines 5 guidelines 6 are 6 are 7 often 6 are 8 developed 8 developed 10 on 10 on 14 or 11 prevention 12 of 11 prevention 14 or 12 of 13 disease 14 or 15 nutrient 14 or 21 attention 14 or 23 paid 16 deficiency 18 but 17 , 18 but 18 but 19 often 18 but 20 less 18 but 21 attention 21 attention 22 is 22 is 23 paid 23 paid 24 to 24 to 26 well 26 well 29 guidelines 26 well 30 promote 27 these 29 guidelines 28 dietary 29 guidelines 29 guidelines 30 promote 30 promote 32 outcomes 31 health 32 outcomes in the present paper , we provide an overview of the state of the art of dietary patterns and dietary recommendations in relation to life expectancy and the risk of age - related disorders ( with emphasis on cardiometabolic diseases and cognitive outcomes ) . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 provide 0 ###LEFT-WALL### 33 related 0 ###LEFT-WALL### 45 . 1 in 4 paper 1 in 5 , 1 in 6 we 2 the 4 paper 3 present 4 paper 6 we 7 provide 7 provide 9 overview 7 provide 24 to 8 an 9 overview 9 overview 10 of 10 of 19 and 11 the 12 state 12 state 13 of 12 state 19 and 13 of 15 art 14 the 15 art 15 art 16 of 16 of 18 patterns 17 dietary 18 patterns 19 and 21 recommendations 20 dietary 21 recommendations 22 in 23 relation 23 relation 24 to 24 to 27 and 25 life 26 expectancy 26 expectancy 27 and 27 and 29 risk 27 and 30 of 28 the 29 risk 30 of 31 age 32 - 33 related 33 related 34 disorders 33 related 44 ) 34 disorders 36 with 35 ( 36 with 36 with 41 and 36 with 44 ) 37 emphasis 38 on 37 emphasis 41 and 38 on 40 diseases 39 cardiometabolic 40 diseases 41 and 43 outcomes 42 cognitive 43 outcomes according to both a posteriori [and] a priori dietary patterns , some key ['] ingredients ' can be identified that [are] associated consistently with longevity and better cardiometabolic and cognitive health . 0 ###LEFT-WALL### 17 can 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 32 . 1 according 2 to 2 to 10 patterns 2 to 11 , 2 to 17 can 3 both 10 patterns 4 a 5 posteriori 5 posteriori 10 patterns 7 a 8 priori 8 priori 10 patterns 9 dietary 10 patterns 12 some 15 ingredients 13 key 15 ingredients 15 ingredients 16 ' 16 ' 17 can 17 can 18 be 18 be 31 health 19 identified 31 health 20 that 22 associated 20 that 24 with 20 that 26 and 22 associated 23 consistently 24 with 25 longevity 26 and 27 better 26 and 31 health 28 cardiometabolic 29 and 29 and 30 cognitive 29 and 31 health these include high intake of fruit , vegetables , fish , ( whole ) grains and legumes/pulses and potatoes , whereas dietary patterns rich in red meat and sugar - rich foods have been associated with an increased risk of mortality and cardiometabolic outcomes . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 45 . 1 these 2 include 2 include 4 intake 3 high 4 intake 4 intake 5 of 5 of 6 fruit 6 fruit 8 vegetables 6 fruit 10 fish 6 fruit 18 and 7 , 8 vegetables 8 vegetables 9 , 9 , 10 fish 10 fish 11 , 12 ( 18 and 13 whole 14 ) 13 whole 15 grains 15 grains 16 and 16 and 17 legumes/pulses 16 and 18 and 18 and 19 potatoes 18 and 20 , 20 , 32 foods 20 , 35 associated 21 whereas 23 patterns 21 whereas 30 - 21 whereas 32 foods 22 dietary 23 patterns 23 patterns 24 rich 24 rich 25 in 25 in 28 and 26 red 27 meat 27 meat 28 and 28 and 29 sugar 31 rich 32 foods 32 foods 33 have 33 have 34 been 34 been 35 associated 35 associated 36 with 36 with 39 risk 36 with 44 outcomes 37 an 39 risk 38 increased 39 risk 39 risk 40 of 40 of 42 and 41 mortality 42 and 42 and 43 cardiometabolic the objective of this study was to evaluate the performance of the established anti - cyclic citrullinated peptide ( anti - ccp ) enzyme - linked immunosorbent [assay] ( elisa ) compared to rheumatoid factor - immunoglobulin m ( rf - igm ) and [c] [-] reactive protein ( crp ) . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 32 compared 0 ###LEFT-WALL### 52 . 1 the 2 objective 2 objective 3 of 2 objective 5 study 2 objective 8 evaluate 2 objective 32 compared 3 of 4 this 5 study 6 was 6 was 7 to 6 was 8 evaluate 7 to 8 evaluate 8 evaluate 10 performance 9 the 10 performance 10 performance 11 of 11 of 18 peptide 12 the 18 peptide 13 established 18 peptide 14 anti 15 - 14 anti 18 peptide 16 cyclic 18 peptide 17 citrullinated 18 peptide 18 peptide 24 enzyme 18 peptide 27 immunosorbent 19 ( 24 enzyme 20 anti 22 ccp 20 anti 23 ) 20 anti 24 enzyme 21 - 22 ccp 22 ccp 23 ) 24 enzyme 25 - 25 - 27 immunosorbent 26 linked 27 immunosorbent 27 immunosorbent 30 elisa 27 immunosorbent 31 ) 29 ( 30 elisa 30 elisa 31 ) 32 compared 33 to 32 compared 44 and 33 to 34 rheumatoid 35 factor 42 igm 35 factor 44 and 36 - 42 igm 37 immunoglobulin 38 m 37 immunoglobulin 40 rf 39 ( 40 rf 40 rf 41 - 40 rf 42 igm 42 igm 43 ) 44 and 48 protein 44 and 50 crp 47 reactive 48 protein 49 ( 50 crp 50 crp 51 ) serum samples of 176 patients were analyzed with the anti - ccp elisa assay method established in our laboratory . 0 ###LEFT-WALL### 2 samples 0 ###LEFT-WALL### 7 analyzed 0 ###LEFT-WALL### 20 . 1 serum 2 samples 2 samples 3 of 2 samples 6 were 3 of 5 patients 4 176 5 patients 6 were 7 analyzed 7 analyzed 8 with 8 with 15 method 9 the 15 method 10 anti 11 - 10 anti 15 method 12 ccp 13 elisa 13 elisa 15 method 14 assay 15 method 15 method 16 established 15 method 17 in 17 in 19 laboratory 18 our 19 laboratory the results of rheumatoid arthritis ( [ra] [ )(patients , the other inflammatory patients , and healthy controls were compared using medcalc ( version 7.0 ) . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 20 compared 0 ###LEFT-WALL### 27 . 1 the 2 results 2 results 3 of 2 results 16 and 3 of 5 arthritis 4 rheumatoid 5 arthritis 5 arthritis 9 )(patients 5 arthritis 14 patients 6 ( 9 )(patients 9 )(patients 10 , 10 , 14 patients 11 the 12 other 12 other 14 patients 13 inflammatory 14 patients 14 patients 15 , 15 , 16 and 16 and 18 controls 16 and 19 were 17 healthy 18 controls 19 were 20 compared 20 compared 21 using 21 using 22 medcalc 22 medcalc 24 version 23 ( 24 version 24 version 25 7.0 24 version 26 ) the anti - ccp assay results were compared with rf - igm and crp concentration analyzed in catholic university . 0 ###LEFT-WALL### 6 results 0 ###LEFT-WALL### 8 compared 1 the 6 results 2 anti 3 - 2 anti 6 results 4 ccp 6 results 5 assay 6 results 6 results 7 were 7 were 8 compared 8 compared 9 with 9 with 10 rf 10 rf 15 concentration 11 - 15 concentration 12 igm 13 and 13 and 14 crp 14 crp 15 concentration 15 concentration 16 analyzed 15 concentration 17 in 15 concentration 20 . 17 in 19 university 18 catholic 19 university the specificity of elisa test results of [ra] patients showed 91 % and 87 % , when healthy controls or osteoarthritis patients were considered as negative . 0 ###LEFT-WALL### 2 specificity 0 ###LEFT-WALL### 10 showed 1 the 2 specificity 2 specificity 3 of 2 specificity 10 showed 3 of 6 results 4 elisa 6 results 5 test 6 results 6 results 7 of 7 of 9 patients 10 showed 12 % 10 showed 13 and 10 showed 17 when 11 91 12 % 13 and 15 % 14 87 15 % 16 , 17 when 17 when 20 or 17 when 24 considered 17 when 27 . 18 healthy 19 controls 19 controls 20 or 20 or 22 patients 20 or 23 were 21 osteoarthritis 22 patients 23 were 24 considered 24 considered 26 negative 25 as 26 negative thus , the established elisa method was [ra] specific , but its sensitivity was low . 0 ###LEFT-WALL### 6 method 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 16 . 1 thus 2 , 1 thus 6 method 3 the 6 method 4 established 6 method 5 elisa 6 method 6 method 7 was 7 was 9 specific 10 , 11 but 11 but 13 sensitivity 11 but 14 was 12 its 13 sensitivity 13 sensitivity 14 was 14 was 15 low to see the low sensitivity [may] from aging effect , the concentration of anti - ccp was analyzed for different aging [group] . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 see 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 23 . 1 to 2 see 2 see 5 sensitivity 3 the 5 sensitivity 4 low 5 sensitivity 5 sensitivity 7 from 7 from 8 aging 8 aging 9 effect 10 , 12 concentration 10 , 18 analyzed 11 the 12 concentration 12 concentration 13 of 12 concentration 17 was 13 of 16 ccp 14 anti 15 - 14 anti 16 ccp 17 was 18 analyzed 18 analyzed 19 for 19 for 21 aging 20 different 21 aging we tested 110 healthy controls ' sera using the same method . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 tested 0 ###LEFT-WALL### 12 . 1 we 2 tested 2 tested 7 sera 3 110 5 controls 4 healthy 5 controls 5 controls 6 ' 6 ' 7 sera 7 sera 8 using 8 using 11 method 9 the 10 same 10 same 11 method the statistical results of young subjects ( < 45 years old ) showed significantly lower anti - ccp concentrations than those of older subjects ( >65 years old , p<0.0001 ) . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 13 showed 0 ###LEFT-WALL### 32 . 1 the 3 results 2 statistical 3 results 3 results 4 of 3 results 11 old 3 results 13 showed 4 of 6 subjects 5 young 6 subjects 7 ( 11 old 8 < 9 45 9 45 10 years 10 years 11 old 11 old 12 ) 13 showed 18 ccp 13 showed 19 concentrations 13 showed 20 than 14 significantly 15 lower 15 lower 18 ccp 16 anti 17 - 16 anti 18 ccp 20 than 21 those 21 those 22 of 22 of 24 subjects 23 older 24 subjects 24 subjects 26 >65 24 subjects 30 p<0.0001 25 ( 26 >65 26 >65 28 old 26 >65 29 , 27 years 28 old 29 , 30 p<0.0001 30 p<0.0001 31 ) the citrullination might also be occurring during aging process in healthy populations . 0 ###LEFT-WALL### 2 citrullination 0 ###LEFT-WALL### 5 be 0 ###LEFT-WALL### 13 . 1 the 2 citrullination 2 citrullination 3 might 3 might 5 be 4 also 5 be 5 be 6 occurring 6 occurring 7 during 6 occurring 10 in 7 during 9 process 8 aging 9 process 10 in 12 populations 11 healthy 12 populations the validation results imply that the established method could be used as a clinical diagnostic [for] [ra] together with rf - igm . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 imply 0 ###LEFT-WALL### 21 - 1 the 3 results 2 validation 3 results 3 results 4 imply 4 imply 5 that 5 that 8 method 5 that 11 used 6 the 8 method 7 established 8 method 8 method 9 could 9 could 10 be 10 be 11 used 11 used 12 as 11 used 19 with 12 as 15 diagnostic 13 a 14 clinical 13 a 15 diagnostic 14 clinical 15 diagnostic 18 together 19 with 19 with 20 rf 21 - 22 igm 21 - 23 . objective : reductions on the clearance from plasma of chylomicrons are associated with atherosclerosis . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 reductions 2 : 12 associated 2 : 15 . 3 reductions 4 on 3 reductions 11 are 4 on 6 clearance 5 the 6 clearance 6 clearance 7 from 7 from 8 plasma 8 plasma 9 of 9 of 10 chylomicrons 11 are 12 associated 12 associated 13 with 13 with 14 atherosclerosis statins improve the removal from plasma of chylomicrons in a dose dependent manner . 0 ###LEFT-WALL### 1 statins 0 ###LEFT-WALL### 2 improve 0 ###LEFT-WALL### 14 . 1 statins 2 improve 2 improve 4 removal 2 improve 9 in 3 the 4 removal 4 removal 5 from 5 from 6 plasma 6 plasma 7 of 7 of 8 chylomicrons 9 in 13 manner 10 a 13 manner 11 dose 13 manner 12 dependent 13 manner there is controversy whether ezetimibe modifies the plasma clearance of chylomicrons . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 12 . 1 there 2 is 2 is 3 controversy 2 is 4 whether 4 whether 5 ezetimibe 4 whether 6 modifies 5 ezetimibe 6 modifies 6 modifies 9 clearance 7 the 9 clearance 8 plasma 9 clearance 9 clearance 10 of 10 of 11 chylomicrons effects of [ezetimibe] alone or [in] combination with simvastatin were compared with low and high dose of the latter , upon the kinetics of a chylomicron - like emulsion in coronary heart disease ( chd ) patients . 0 ###LEFT-WALL### 5 or 0 ###LEFT-WALL### 38 . 1 effects 2 of 1 effects 5 or 2 of 4 alone 5 or 7 combination 5 or 8 with 5 or 10 were 8 with 9 simvastatin 10 were 11 compared 11 compared 12 with 12 with 14 and 12 with 37 patients 13 low 14 and 14 and 16 dose 14 and 17 of 14 and 28 like 14 and 30 in 15 high 16 dose 17 of 19 latter 18 the 19 latter 19 latter 21 upon 20 , 21 upon 21 upon 23 kinetics 21 upon 27 - 22 the 23 kinetics 23 kinetics 24 of 24 of 26 chylomicron 25 a 26 chylomicron 28 like 29 emulsion 30 in 33 disease 31 coronary 32 heart 32 heart 33 disease 33 disease 35 chd 34 ( 35 chd 35 chd 36 ) methods : 25 chd patients were randomized for treatment with ezetimibe 10 [mg] ( group 1 ) or simvastatin 20 [mg] ( group 2 ) with progression to ezetimibe + [simvastatin] 10/20 mg or [simvastatin] 80 mg , respectively . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 29 ezetimibe 3 25 5 patients 4 chd 5 patients 5 patients 6 were 6 were 7 randomized 7 randomized 8 for 7 randomized 26 with 7 randomized 28 to 8 for 18 or 9 treatment 10 with 9 treatment 18 or 10 with 11 ezetimibe 11 ezetimibe 12 10 11 ezetimibe 15 group 14 ( 15 group 15 group 16 1 15 group 17 ) 18 or 19 simvastatin 18 or 23 group 19 simvastatin 20 20 22 ( 23 group 23 group 24 2 23 group 25 ) 26 with 27 progression 28 to 29 ezetimibe 29 ezetimibe 34 or 29 ezetimibe 39 respectively 30 + 32 10/20 32 10/20 33 mg 33 mg 34 or 34 or 37 mg 36 80 37 mg 38 , 39 respectively 39 respectively 40 . kinetic studies were performed at baseline and after each treatment period of 6 weeks . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 performed 0 ###LEFT-WALL### 15 . 1 kinetic 2 studies 2 studies 3 were 3 were 4 performed 4 performed 7 and 5 at 6 baseline 5 at 7 and 7 and 8 after 8 after 11 period 9 each 11 period 10 treatment 11 period 11 period 12 of 12 of 14 weeks 13 6 14 weeks the fractional catabolic rates ( fcr [ )(of the emulsion labeled with [(] 14 )c - ce and [(] 3 )h - tg , that represent respectively chylomicron remnant [and] triglyceride removal , were calculated . 0 ###LEFT-WALL### 4 rates 0 ###LEFT-WALL### 34 were 0 ###LEFT-WALL### 36 . 1 the 4 rates 2 fractional 4 rates 3 catabolic 4 rates 4 rates 18 and 4 rates 34 were 5 ( 18 and 6 fcr 8 )(of 6 fcr 12 with 6 fcr 18 and 8 )(of 10 emulsion 9 the 10 emulsion 10 emulsion 11 labeled 12 with 17 ce 14 14 17 ce 15 )c 16 - 15 )c 17 ce 18 and 23 tg 18 and 24 , 18 and 25 that 18 and 26 represent 18 and 33 , 20 3 23 tg 21 )h 22 - 21 )h 23 tg 24 , 25 that 25 that 26 represent 26 represent 27 respectively 26 represent 32 removal 28 chylomicron 32 removal 29 remnant 31 triglyceride 31 triglyceride 32 removal 34 were 35 calculated comparisons were made by anova . 0 ###LEFT-WALL### 1 comparisons 0 ###LEFT-WALL### 3 made 0 ###LEFT-WALL### 6 . 1 comparisons 2 were 2 were 3 made 3 made 4 by 4 by 5 anova the [(] 3 )h - tg - fcr in group 1 were 0.017 ± 0.011 , 0.024 ± 0.011 and 0.042 ± 0.013 min ( - 1 ) [and] in group 2 were 0.016 ± 0.009 , 0.022 ± 0.009 and 0.037 ± 0.012 min ( - 1 ) [at] baseline , after 6 and 12 weeks ( p < 0.05 vs [.] baseline , [and] 6 vs [.] 12 weeks [ )( 0 ###LEFT-WALL### 3 3 0 ###LEFT-WALL### 4 )h 0 ###LEFT-WALL### 5 - 1 the 3 3 3 3 4 )h 5 - 6 tg 5 - 7 - 7 - 8 fcr 7 - 12 were 7 - 16 , 8 fcr 9 in 8 fcr 12 were 9 in 10 group 10 group 11 1 12 were 14 ± 13 0.017 14 ± 14 ± 15 0.011 16 , 17 0.024 16 , 18 ± 16 , 20 and 17 0.024 18 ± 18 ± 19 0.011 20 and 31 group 21 0.042 31 group 22 ± 31 group 23 0.013 30 in 24 min 27 1 24 min 30 in 25 ( 27 1 26 - 27 1 27 1 28 ) 30 in 31 group 31 group 32 2 31 group 33 were 33 were 41 and 34 0.016 35 ± 35 ± 36 0.009 35 ± 37 , 37 , 39 ± 37 , 41 and 38 0.022 39 ± 39 ± 40 0.009 41 and 51 baseline 41 and 52 , 41 and 53 after 42 0.037 43 ± 43 ± 51 baseline 44 0.012 51 baseline 45 min 48 1 45 min 49 ) 45 min 51 baseline 46 ( 48 1 47 - 48 1 48 1 49 ) 53 after 57 weeks 54 6 55 and 55 and 56 12 55 and 57 weeks 57 weeks 60 < 58 ( 60 < 59 p 60 < 60 < 61 0.05 61 0.05 62 vs 61 0.05 67 6 62 vs 64 baseline 65 , 67 6 67 6 68 vs 67 6 73 )( 68 vs 71 weeks 70 12 71 weeks there were no differences between groups in time . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 9 . 1 there 2 were 2 were 4 differences 3 no 4 differences 4 differences 5 between 5 between 6 groups 6 groups 7 in 7 in 8 time conclusion : both treatments increased similarly the removal from plasma of chylomicron [and] remnants in chd patients . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 treatments 2 : 5 increased 2 : 18 . 3 both 4 treatments 4 treatments 5 increased 5 increased 6 similarly 5 increased 8 removal 5 increased 15 in 7 the 8 removal 8 removal 9 from 9 from 10 plasma 10 plasma 11 of 11 of 14 remnants 12 chylomicron 14 remnants 15 in 17 patients 16 chd 17 patients frailty is an increasingly recognized syndrome resulting in age - related decline [in] function [and] reserve across multiple physiologic systems . 0 ###LEFT-WALL### 1 frailty 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 11 related 1 frailty 2 is 2 is 6 syndrome 3 an 6 syndrome 4 increasingly 5 recognized 5 recognized 6 syndrome 6 syndrome 7 resulting 7 resulting 8 in 8 in 9 age 10 - 11 related 11 related 16 reserve 11 related 17 across 11 related 21 . 12 decline 16 reserve 14 function 16 reserve 17 across 20 systems 18 multiple 20 systems 19 physiologic 20 systems it presents [as] a hyperinflammable state , characterized by high vulnerability for adverse health outcomes , such as disability , falls , hospitalization , institutionalization , and mortality . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 29 . 1 it 20 , 2 presents 6 state 2 presents 18 as 2 presents 20 , 4 a 5 hyperinflammable 4 a 6 state 5 hyperinflammable 6 state 6 state 8 characterized 7 , 8 characterized 8 characterized 9 by 8 characterized 12 for 8 characterized 16 , 9 by 11 vulnerability 10 high 11 vulnerability 12 for 15 outcomes 13 adverse 14 health 14 health 15 outcomes 17 such 18 as 18 as 19 disability 20 , 21 falls 22 , 27 and 23 hospitalization 24 , 24 , 25 institutionalization 24 , 27 and 26 , 27 and 27 and 28 mortality the prevalence of frailty syndrome ( fs ) is of potentially enormous significance , as it potentially affects 20 - 30 % of adults older than 75 . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 9 is 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 9 is 3 of 5 syndrome 4 frailty 5 syndrome 5 syndrome 7 fs 6 ( 7 fs 7 fs 8 ) 9 is 10 of 10 of 13 significance 11 potentially 12 enormous 12 enormous 13 significance 13 significance 22 % 14 , 22 % 15 as 16 it 15 as 18 affects 16 it 18 affects 17 potentially 18 affects 18 affects 20 - 19 20 20 - 20 - 21 30 21 30 22 % 22 % 23 of 22 % 28 . 23 of 24 adults 24 adults 25 older 25 older 26 than 26 than 27 75 cellular and molecular basis [of] frailty has not been elucidated . 0 ###LEFT-WALL### 6 frailty 0 ###LEFT-WALL### 10 elucidated 0 ###LEFT-WALL### 11 . 1 cellular 2 and 2 and 3 molecular 2 and 4 basis 4 basis 6 frailty 6 frailty 7 has 7 has 8 not 7 has 9 been 9 been 10 elucidated despite a massive research effort to elucidate alzheimer 's disease ( ad ) in recent decades , effective treatment remains elusive . 0 ###LEFT-WALL### 19 treatment 0 ###LEFT-WALL### 20 remains 0 ###LEFT-WALL### 22 . 1 despite 5 effort 1 despite 17 , 1 despite 19 treatment 2 a 3 massive 2 a 5 effort 3 massive 4 research 4 research 5 effort 5 effort 6 to 5 effort 7 elucidate 6 to 7 elucidate 7 elucidate 10 disease 7 elucidate 14 in 8 alzheimer 9 's 9 's 10 disease 10 disease 12 ad 11 ( 12 ad 12 ad 13 ) 14 in 16 decades 15 recent 16 decades 18 effective 19 treatment 19 treatment 20 remains 20 remains 21 elusive this failure may relate to an oversimplification of the pathogenic processes underlying ad and also lack of understanding of ad progression during its long latent stages . 0 ###LEFT-WALL### 2 failure 0 ###LEFT-WALL### 4 relate 0 ###LEFT-WALL### 27 . 1 this 2 failure 2 failure 3 may 3 may 4 relate 4 relate 5 to 4 relate 22 during 5 to 7 oversimplification 6 an 7 oversimplification 7 oversimplification 8 of 7 oversimplification 17 of 7 oversimplification 19 of 8 of 11 processes 9 the 11 processes 10 pathogenic 11 processes 11 processes 12 underlying 12 underlying 14 and 13 ad 14 and 14 and 15 also 14 and 16 lack 17 of 18 understanding 19 of 21 progression 20 ad 21 progression 22 during 26 stages 23 its 26 stages 24 long 26 stages 25 latent 26 stages although evidence shows that the two specific neuropathological hallmarks in ad ( neuronal loss and protein accumulation ) , which are opposite in nature , do not progress [in] parallel , the great majority of studies have focused on only one of these aspects . 0 ###LEFT-WALL### 34 majority 0 ###LEFT-WALL### 45 . 1 although 2 evidence 1 although 3 shows 1 although 34 majority 2 evidence 3 shows 3 shows 4 that 4 that 9 hallmarks 4 that 28 progress 5 the 6 two 6 two 9 hallmarks 7 specific 9 hallmarks 8 neuropathological 9 hallmarks 9 hallmarks 10 in 9 hallmarks 26 do 10 in 11 ad 11 ad 15 and 12 ( 15 and 13 neuronal 14 loss 14 loss 15 and 15 and 17 accumulation 15 and 18 ) 15 and 20 which 15 and 25 , 16 protein 17 accumulation 19 , 20 which 20 which 21 are 20 which 25 , 21 are 22 opposite 22 opposite 23 in 23 in 24 nature 26 do 27 not 26 do 28 progress 30 parallel 31 , 30 parallel 34 majority 32 the 34 majority 33 great 34 majority 34 majority 35 of 34 majority 37 have 35 of 36 studies 37 have 38 focused 38 focused 39 on 39 on 41 one 40 only 41 one 41 one 42 of 42 of 44 aspects 43 these 44 aspects furthermore , research focusing on single structures is likely to render an incomplete picture of ad pathogenesis because as ad involves complete brain networks , potential compensatory mechanisms within the network may ameliorate impairment of the system to a certain extent . 0 ###LEFT-WALL### 3 research 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 42 . 1 furthermore 2 , 1 furthermore 3 research 3 research 4 focusing 3 research 8 is 4 focusing 5 on 5 on 7 structures 6 single 7 structures 8 is 9 likely 9 likely 10 to 9 likely 11 render 10 to 11 render 11 render 14 picture 11 render 18 because 11 render 38 to 12 an 13 incomplete 12 an 14 picture 13 incomplete 14 picture 14 picture 15 of 15 of 17 pathogenesis 16 ad 17 pathogenesis 18 because 28 mechanisms 18 because 33 ameliorate 19 as 20 ad 19 as 21 involves 19 as 25 , 19 as 28 mechanisms 20 ad 21 involves 21 involves 24 networks 22 complete 23 brain 23 brain 24 networks 26 potential 28 mechanisms 27 compensatory 28 mechanisms 28 mechanisms 29 within 28 mechanisms 32 may 29 within 31 network 30 the 31 network 32 may 33 ameliorate 33 ameliorate 34 impairment 34 impairment 35 of 35 of 37 system 36 the 37 system 38 to 41 extent 39 a 40 certain 39 a 41 extent 40 certain 41 extent here , we describe an approach for enabling integrative analysis of the dual - nature lesions , simultaneously , in all components of one of the brain networks most vulnerable to ad . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 describe 0 ###LEFT-WALL### 33 . 1 here 2 , 1 here 3 we 3 we 4 describe 4 describe 6 approach 5 an 6 approach 6 approach 7 for 7 for 8 enabling 8 enabling 10 analysis 8 enabling 18 simultaneously 8 enabling 20 in 9 integrative 10 analysis 10 analysis 11 of 11 of 16 lesions 12 the 16 lesions 13 dual 14 - 13 dual 15 nature 15 nature 16 lesions 17 , 18 simultaneously 18 simultaneously 19 , 20 in 22 components 21 all 22 components 22 components 23 of 22 components 25 of 23 of 24 one 25 of 28 networks 26 the 28 networks 27 brain 28 networks 28 networks 30 vulnerable 29 most 30 vulnerable 30 vulnerable 31 to 31 to 32 ad this approach is based on significant development of methods previously described mainly by our group that were optimized and complemented for this study . 0 ###LEFT-WALL### 2 approach 0 ###LEFT-WALL### 4 based 0 ###LEFT-WALL### 24 . 1 this 2 approach 2 approach 3 is 3 is 4 based 4 based 5 on 4 based 21 for 5 on 7 development 6 significant 7 development 7 development 8 of 8 of 9 methods 9 methods 11 described 10 previously 11 described 11 described 12 mainly 12 mainly 13 by 13 by 15 group 14 our 15 group 15 group 16 that 15 group 19 and 16 that 19 and 17 were 18 optimized 17 were 19 and 19 and 20 complemented 21 for 23 study 22 this 23 study it combines unbiased stereology with immunohistochemistry and immunofluorescence , making use of advanced graphics computing for three - dimensional ( 3 d ) volume reconstructions . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 combines 0 ###LEFT-WALL### 26 . 1 it 2 combines 2 combines 4 stereology 2 combines 5 with 3 unbiased 4 stereology 5 with 7 and 5 with 25 reconstructions 6 immunohistochemistry 7 and 7 and 8 immunofluorescence 7 and 10 making 9 , 10 making 10 making 11 use 10 making 18 - 11 use 12 of 12 of 14 graphics 13 advanced 14 graphics 14 graphics 15 computing 15 computing 16 for 16 for 17 three 19 dimensional 22 d 19 dimensional 24 volume 20 ( 22 d 21 3 22 d 22 d 23 ) 24 volume 25 reconstructions although this study was performed in human brainstem and focused in ad , it may be applied to the study of any neurological disease characterized by dual - nature lesions , in humans and animal models . 0 ###LEFT-WALL### 14 it 0 ###LEFT-WALL### 17 applied 1 although 3 study 1 although 4 was 1 although 14 it 2 this 3 study 3 study 4 was 4 was 9 and 5 performed 6 in 5 performed 9 and 6 in 8 brainstem 7 human 8 brainstem 9 and 10 focused 11 in 12 ad 11 in 13 , 11 in 14 it 14 it 15 may 15 may 16 be 16 be 17 applied 17 applied 18 to 17 applied 26 by 18 to 20 study 19 the 20 study 20 study 21 of 21 of 24 disease 22 any 24 disease 23 neurological 24 disease 24 disease 25 characterized 26 by 30 lesions 27 dual 28 - 27 dual 29 nature 29 nature 30 lesions 30 lesions 32 in 31 , 32 in 32 in 36 models 32 in 37 . 33 humans 34 and 34 and 35 animal 34 and 36 models this approach does not require a high level of investment in new equipment and a significant number of specimens can be processed and analyzed within a funding cycle . 0 ###LEFT-WALL### 2 approach 0 ###LEFT-WALL### 5 require 0 ###LEFT-WALL### 29 . 1 this 2 approach 2 approach 3 does 3 does 4 not 3 does 5 require 5 require 8 level 5 require 11 in 5 require 25 within 6 a 7 high 6 a 8 level 7 high 8 level 8 level 9 of 9 of 10 investment 11 in 14 and 12 new 13 equipment 13 equipment 14 and 14 and 17 number 14 and 18 of 15 a 16 significant 15 a 17 number 16 significant 17 number 18 of 19 specimens 19 specimens 23 and 20 can 21 be 20 can 23 and 21 be 22 processed 23 and 24 analyzed 25 within 28 cycle 26 a 28 cycle 27 funding 28 cycle the transcription factor nrf2 is a key regulator of the cellular stress response , and pharmacological nrf2 activation is a promising strategy for skin protection and cancer prevention . 0 ###LEFT-WALL### 4 nrf2 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 29 . 1 the 3 factor 2 transcription 3 factor 3 factor 4 nrf2 4 nrf2 5 is 5 is 8 regulator 6 a 8 regulator 7 key 8 regulator 8 regulator 9 of 9 of 13 response 10 the 13 response 11 cellular 12 stress 12 stress 13 response 14 , 15 and 15 and 18 activation 15 and 19 is 16 pharmacological 18 activation 17 nrf2 18 activation 18 activation 19 is 19 is 22 strategy 20 a 21 promising 20 a 22 strategy 21 promising 22 strategy 22 strategy 23 for 23 for 26 and 24 skin 25 protection 25 protection 26 and 26 and 28 prevention 27 cancer 28 prevention we show here that prolonged nrf2 activation in keratinocytes causes sebaceous gland enlargement and seborrhea in mice due to upregulation of the growth factor epigen , which we identified as a novel nrf2 target . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 show 1 we 2 show 2 show 3 here 2 show 4 that 4 that 7 activation 4 that 10 causes 5 prolonged 7 activation 6 nrf2 7 activation 7 activation 8 in 7 activation 10 causes 8 in 9 keratinocytes 10 causes 14 and 11 sebaceous 13 enlargement 12 gland 13 enlargement 13 enlargement 14 and 14 and 15 seborrhea 14 and 21 of 15 seborrhea 16 in 16 in 17 mice 17 mice 19 to 18 due 19 to 19 to 20 upregulation 21 of 25 epigen 22 the 25 epigen 23 growth 25 epigen 24 factor 25 epigen 25 epigen 27 which 26 , 27 which 27 which 29 identified 27 which 35 . 28 we 29 identified 29 identified 30 as 30 as 34 target 31 a 34 target 32 novel 34 target 33 nrf2 34 target this was accompanied by thickening and hyperkeratosis of hair follicle infundibula . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 accompanied 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 12 . 1 this 2 was 2 was 3 accompanied 3 accompanied 4 by 4 by 5 thickening 6 and 7 hyperkeratosis 6 and 10 follicle 7 hyperkeratosis 8 of 7 hyperkeratosis 10 follicle 8 of 9 hair 10 follicle 11 infundibula these abnormalities caused dilatation of infundibula , hair loss , and cyst development upon aging . 0 ###LEFT-WALL### 2 abnormalities 0 ###LEFT-WALL### 3 caused 0 ###LEFT-WALL### 16 . 1 these 2 abnormalities 2 abnormalities 3 caused 3 caused 4 dilatation 3 caused 14 upon 4 dilatation 5 of 5 of 11 and 6 infundibula 7 , 7 , 9 loss 7 , 11 and 8 hair 9 loss 10 , 11 and 11 and 13 development 12 cyst 13 development 14 upon 15 aging upregulation of epigen , secretory leukocyte peptidase [inhibitor] ( slpi ) , and small proline - rich protein 2 [d] ( sprr2d [ )(in hair follicles [was] identified as the likely cause of infundibular acanthosis , hyperkeratosis , and cyst formation . 0 ###LEFT-WALL### 39 and 0 ###LEFT-WALL### 42 . 1 upregulation 2 of 1 upregulation 13 and 2 of 3 epigen 3 epigen 7 peptidase 4 , 7 peptidase 5 secretory 7 peptidase 6 leukocyte 7 peptidase 7 peptidase 10 slpi 7 peptidase 12 , 9 ( 10 slpi 10 slpi 11 ) 13 and 18 protein 13 and 22 sprr2d 13 and 39 and 14 small 18 protein 15 proline 16 - 15 proline 18 protein 17 rich 18 protein 18 protein 19 2 21 ( 22 sprr2d 22 sprr2d 24 )(in 22 sprr2d 28 identified 22 sprr2d 33 of 22 sprr2d 37 hyperkeratosis 22 sprr2d 38 , 24 )(in 26 follicles 25 hair 26 follicles 28 identified 29 as 29 as 32 cause 30 the 32 cause 31 likely 32 cause 33 of 35 acanthosis 34 infundibular 35 acanthosis 36 , 37 hyperkeratosis 37 hyperkeratosis 38 , 38 , 39 and 39 and 41 formation 40 cyst 41 formation these alterations were highly reminiscent to the phenotype of chloracne/"metabolizing acquired dioxin - induced skin hamartomas " ( madish ) [patients] . 0 ###LEFT-WALL### 2 alterations 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 22 . 1 these 2 alterations 2 alterations 3 were 3 were 4 highly 3 were 5 reminiscent 5 reminiscent 6 to 6 to 8 phenotype 7 the 8 phenotype 8 phenotype 9 of 9 of 12 dioxin 10 chloracne/"metabolizing 11 acquired 11 acquired 12 dioxin 12 dioxin 16 hamartomas 13 - 16 hamartomas 14 induced 15 skin 15 skin 16 hamartomas 16 hamartomas 17 " 16 hamartomas 19 madish 16 hamartomas 20 ) 18 ( 19 madish 19 madish 20 ) indeed , slpi , sprr2 , and epigen were strongly expressed in cysts of madish patients and upregulated by dioxin in human keratinocytes in an nrf2 - dependent manner . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 9 were 1 indeed 2 , 1 indeed 7 and 3 slpi 4 , 4 , 5 sprr2 4 , 7 and 6 , 7 and 7 and 8 epigen 7 and 9 were 9 were 17 and 10 strongly 11 expressed 11 expressed 12 in 11 expressed 17 and 12 in 13 cysts 13 cysts 14 of 14 of 16 patients 15 madish 16 patients 17 and 18 upregulated 17 and 19 by 17 and 20 dioxin 17 and 21 in 17 and 24 in 21 in 23 keratinocytes 22 human 23 keratinocytes 24 in 26 nrf2 25 an 26 nrf2 26 nrf2 29 manner 27 - 29 manner 28 dependent 29 manner 29 manner 30 . these results identify novel nrf2 activities in the pilosebaceous unit and point to a role of nrf2 in madish pathogenesis . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 21 . 1 these 2 results 2 results 11 and 3 identify 6 activities 3 identify 7 in 3 identify 11 and 4 novel 6 activities 5 nrf2 6 activities 7 in 10 unit 8 the 10 unit 9 pilosebaceous 10 unit 11 and 12 point 11 and 20 pathogenesis 12 point 13 to 12 point 18 in 13 to 15 role 14 a 15 role 15 role 16 of 16 of 17 nrf2 18 in 19 madish as the second most common age related neurodegenerative disease after alzheimer 's disease , the health , social and economic impact resulting from parkinson 's disease will continue to increase alongside the longevity of the population . 0 ###LEFT-WALL### 6 age 0 ###LEFT-WALL### 7 related 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 30 increase 0 ###LEFT-WALL### 37 . 1 as 3 second 1 as 6 age 2 the 3 second 4 most 5 common 5 common 6 age 6 age 7 related 7 related 9 disease 7 related 10 after 8 neurodegenerative 9 disease 10 after 13 disease 11 alzheimer 12 's 12 's 13 disease 14 , 19 and 14 , 28 continue 15 the 16 health 16 health 17 , 17 , 18 social 17 , 19 and 19 and 21 impact 19 and 22 resulting 19 and 23 from 19 and 28 continue 20 economic 21 impact 23 from 27 will 24 parkinson 25 's 25 's 27 will 26 disease 27 will 28 continue 29 to 29 to 30 increase 30 increase 31 alongside 31 alongside 33 longevity 32 the 33 longevity 33 longevity 34 of 34 of 36 population 35 the 36 population ageing remains the biggest risk factor for developing idiopathic parkinson 's disease . 0 ###LEFT-WALL### 1 ageing 0 ###LEFT-WALL### 2 remains 0 ###LEFT-WALL### 13 . 1 ageing 2 remains 2 remains 6 factor 3 the 4 biggest 3 the 6 factor 5 risk 6 factor 6 factor 7 for 7 for 8 developing 8 developing 12 disease 9 idiopathic 10 parkinson 10 parkinson 11 's 11 's 12 disease although research into the mechanisms leading to cell death in parkinson 's disease has shed light on many aspects of the pathogenesis of this disorder , we still cannot answer the fundamental question , what specific age related factors predispose some individuals to develop this common neurodegenerative disease . 0 ###LEFT-WALL### 6 leading 0 ###LEFT-WALL### 14 has 0 ###LEFT-WALL### 26 , 1 although 2 research 1 although 6 leading 3 into 5 mechanisms 3 into 6 leading 4 the 5 mechanisms 6 leading 7 to 6 leading 14 has 7 to 9 death 8 cell 9 death 9 death 10 in 10 in 13 disease 11 parkinson 12 's 12 's 13 disease 14 has 16 light 14 has 17 on 15 shed 16 light 17 on 19 aspects 18 many 19 aspects 19 aspects 20 of 19 aspects 23 of 20 of 22 pathogenesis 21 the 22 pathogenesis 23 of 25 disorder 24 this 25 disorder 26 , 27 we 26 , 30 answer 27 we 29 cannot 28 still 29 cannot 29 cannot 30 answer 30 answer 33 question 31 the 33 question 32 fundamental 33 question 33 question 35 what 34 , 35 what 35 what 39 factors 35 what 40 predispose 35 what 49 . 36 specific 39 factors 37 age 38 related 38 related 39 factors 39 factors 40 predispose 40 predispose 42 individuals 40 predispose 43 to 41 some 42 individuals 43 to 44 develop 44 develop 48 disease 45 this 48 disease 46 common 48 disease 47 neurodegenerative 48 disease in this review we focus specifically on the neuronal population associated with the motor symptoms of parkinson 's disease , the dopaminergic neurons of the substantia nigra , and try to understand how ageing puts these neurons at risk to the extent that a slight change in protein metabolism or mitochondrial function can push the cells over the edge leading to catastrophic cell death [and] many of the symptoms seen in parkinson 's disease . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 focus 0 ###LEFT-WALL### 75 . 1 in 3 review 1 in 4 we 2 this 3 review 4 we 5 focus 5 focus 6 specifically 5 focus 7 on 5 focus 12 with 5 focus 31 to 7 on 10 population 8 the 10 population 9 neuronal 10 population 10 population 11 associated 12 with 15 symptoms 13 the 15 symptoms 14 motor 15 symptoms 15 symptoms 16 of 16 of 29 and 17 parkinson 18 's 18 's 19 disease 19 disease 20 , 20 , 23 neurons 20 , 29 and 21 the 23 neurons 22 dopaminergic 23 neurons 23 neurons 24 of 24 of 27 nigra 25 the 27 nigra 26 substantia 27 nigra 28 , 29 and 29 and 30 try 31 to 32 understand 32 understand 33 how 33 how 34 ageing 33 how 35 puts 34 ageing 35 puts 35 puts 37 neurons 35 puts 38 at 35 puts 71 in 36 these 37 neurons 38 at 39 risk 39 risk 40 to 39 risk 43 that 40 to 42 extent 41 the 42 extent 43 that 46 change 43 that 54 push 44 a 46 change 45 slight 46 change 46 change 47 in 46 change 53 can 47 in 50 or 48 protein 49 metabolism 49 metabolism 50 or 50 or 52 function 51 mitochondrial 52 function 53 can 54 push 54 push 56 cells 54 push 57 over 55 the 56 cells 57 over 59 edge 58 the 59 edge 59 edge 60 leading 59 edge 67 of 60 leading 61 to 60 leading 66 many 61 to 64 death 62 catastrophic 63 cell 63 cell 64 death 67 of 69 symptoms 68 the 69 symptoms 69 symptoms 70 seen 71 in 74 disease 72 parkinson 73 's 73 's 74 disease we review the evidence that ageing is important for the development of parkinson 's disease and how age related decline leads to the loss of neurons within this disease , before describing exactly how advancing age may lead to substantia nigra neuronal loss and parkinson 's disease in some individuals . 0 ###LEFT-WALL### 40 substantia 0 ###LEFT-WALL### 44 and 0 ###LEFT-WALL### 46 's 0 ###LEFT-WALL### 51 . 1 we 2 review 2 review 4 evidence 2 review 31 before 2 review 39 to 3 the 4 evidence 4 evidence 5 that 4 evidence 19 related 5 that 6 ageing 5 that 19 related 6 ageing 7 is 7 is 8 important 8 important 9 for 9 for 16 and 10 the 11 development 11 development 12 of 11 development 16 and 12 of 15 disease 13 parkinson 14 's 14 's 15 disease 16 and 17 how 18 age 19 related 19 related 21 leads 19 related 30 , 20 decline 21 leads 21 leads 22 to 21 leads 25 of 22 to 24 loss 23 the 24 loss 25 of 26 neurons 26 neurons 27 within 27 within 29 disease 28 this 29 disease 31 before 32 describing 32 describing 34 how 33 exactly 34 how 34 how 35 advancing 35 advancing 36 age 36 age 37 may 37 may 38 lead 39 to 40 substantia 40 substantia 43 loss 41 nigra 43 loss 42 neuronal 43 loss 44 and 45 parkinson 44 and 46 's 45 parkinson 46 's 46 's 47 disease 46 's 48 in 48 in 50 individuals 49 some 50 individuals as aging is a complex phenomenon characterized by intraindividual and interindividual diversities in the maintenance of the homeostatic condition of cells and tissues , changes [in] renal function are not [uniform] [and] depend on associated diseases and environmental factors . 0 ###LEFT-WALL### 12 diversities 0 ###LEFT-WALL### 33 depend 0 ###LEFT-WALL### 40 . 1 as 2 aging 1 as 3 is 1 as 12 diversities 2 aging 3 is 3 is 6 phenomenon 3 is 8 by 4 a 6 phenomenon 5 complex 6 phenomenon 6 phenomenon 7 characterized 8 by 10 and 9 intraindividual 10 and 10 and 11 interindividual 12 diversities 13 in 12 diversities 16 of 12 diversities 29 are 13 in 15 maintenance 14 the 15 maintenance 16 of 28 function 17 the 28 function 18 homeostatic 19 condition 19 condition 20 of 19 condition 22 and 20 of 21 cells 22 and 23 tissues 22 and 24 , 22 and 28 function 25 changes 28 function 27 renal 28 function 29 are 30 not 29 are 33 depend 33 depend 34 on 34 on 37 and 35 associated 36 diseases 36 diseases 37 and 37 and 39 factors 38 environmental 39 factors multiple studies have investigated the possible underlying mechanisms of age - related decline [in] kidney function . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 11 - 1 multiple 2 studies 2 studies 3 have 3 have 4 investigated 4 investigated 8 mechanisms 5 the 8 mechanisms 6 possible 8 mechanisms 7 underlying 8 mechanisms 8 mechanisms 9 of 9 of 10 age 11 - 16 function 11 - 17 . 12 related 13 decline 13 decline 16 function 15 kidney 16 function evolutionary , molecular , cellular and systemic theories have been postulated to explain the primary disease independent age - related changes and adaptive responses . 0 ###LEFT-WALL### 8 theories 0 ###LEFT-WALL### 11 postulated 0 ###LEFT-WALL### 20 related 1 evolutionary 2 , 1 evolutionary 8 theories 3 molecular 4 , 4 , 5 cellular 4 , 6 and 6 and 7 systemic 6 and 8 theories 8 theories 9 have 9 have 10 been 10 been 11 postulated 11 postulated 12 to 12 to 13 explain 13 explain 18 age 14 the 18 age 15 primary 16 disease 16 disease 18 age 17 independent 18 age 19 - 20 related 20 related 22 and 20 related 25 . 21 changes 22 and 22 and 24 responses 23 adaptive 24 responses as peroxisome proliferator - activated receptors ( ppars ) are involved in a broad spectrum of biological processes , ppar activation might have an effect on the prevention of cell senescence . 0 ###LEFT-WALL### 3 proliferator 0 ###LEFT-WALL### 4 - 1 as 2 peroxisome 2 peroxisome 3 proliferator 4 - 6 receptors 4 - 11 involved 4 - 19 , 4 - 32 . 5 activated 6 receptors 6 receptors 8 ppars 6 receptors 10 are 7 ( 8 ppars 8 ppars 9 ) 10 are 11 involved 11 involved 12 in 12 in 15 spectrum 13 a 14 broad 13 a 15 spectrum 14 broad 15 spectrum 15 spectrum 16 of 16 of 18 processes 17 biological 18 processes 19 , 21 activation 19 , 23 have 20 ppar 21 activation 21 activation 22 might 22 might 23 have 23 have 25 effect 23 have 26 on 24 an 25 effect 26 on 28 prevention 27 the 28 prevention 28 prevention 29 of 29 of 31 senescence 30 cell 31 senescence in this review , we will focus on the experimental and clinical evidence of ppar agonists in a battle against the aging kidney . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 7 focus 0 ###LEFT-WALL### 24 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 will 6 will 7 focus 7 focus 8 on 7 focus 17 in 7 focus 20 against 8 on 13 evidence 9 the 13 evidence 10 experimental 11 and 11 and 12 clinical 11 and 13 evidence 13 evidence 14 of 14 of 16 agonists 15 ppar 16 agonists 17 in 19 battle 18 a 19 battle 20 against 23 kidney 21 the 23 kidney 22 aging 23 kidney in this paper we review the effects of aging on sensory systems and their impact on posture , balance and gait . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 review 0 ###LEFT-WALL### 22 . 1 in 3 paper 1 in 4 we 2 this 3 paper 4 we 5 review 5 review 7 effects 5 review 10 on 5 review 16 on 6 the 7 effects 7 effects 8 of 8 of 9 aging 10 on 13 and 11 sensory 12 systems 12 systems 13 and 13 and 15 impact 14 their 15 impact 16 on 20 and 17 posture 18 , 18 , 19 balance 18 , 20 and 20 and 21 gait we also address cognitive aging and attempt to specify [which] altered cognitive functions negatively impact balance [and] walking . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 19 . 1 we 6 and 2 also 3 address 3 address 5 aging 3 address 6 and 4 cognitive 5 aging 6 and 7 attempt 6 and 16 balance 7 attempt 8 to 7 attempt 9 specify 8 to 9 specify 9 specify 13 functions 9 specify 14 negatively 11 altered 13 functions 12 cognitive 13 functions 15 impact 16 balance 16 balance 18 walking the role of cognition in postural control is tested with dual - task experiments . 0 ###LEFT-WALL### 2 role 0 ###LEFT-WALL### 9 tested 0 ###LEFT-WALL### 15 . 1 the 2 role 2 role 3 of 2 role 8 is 3 of 4 cognition 4 cognition 5 in 5 in 7 control 6 postural 7 control 8 is 9 tested 9 tested 10 with 10 with 14 experiments 11 dual 12 - 11 dual 13 task 13 task 14 experiments this situation results in deleterious effects due to [an] [attentional] overload . 0 ###LEFT-WALL### 2 situation 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 12 . 1 this 2 situation 2 situation 3 results 3 results 4 in 4 in 6 effects 5 deleterious 6 effects 6 effects 7 due 7 due 8 to 7 due 11 overload 8 to 11 overload given the human cognitive system [has] limited capacities , we propose that simultaneously performing two tasks depends on the capacity of each individual to perform these tasks on a [continuum] [between] automatic execution to highly controlled performance . 0 ###LEFT-WALL### 10 we 0 ###LEFT-WALL### 11 propose 0 ###LEFT-WALL### 38 . 1 given 8 capacities 1 given 9 , 1 given 10 we 2 the 8 capacities 3 human 8 capacities 4 cognitive 8 capacities 5 system 7 limited 7 limited 8 capacities 10 we 11 propose 11 propose 14 performing 11 propose 17 depends 12 that 13 simultaneously 13 simultaneously 14 performing 14 performing 16 tasks 14 performing 17 depends 15 two 16 tasks 17 depends 18 on 17 depends 24 to 18 on 20 capacity 19 the 20 capacity 20 capacity 21 of 21 of 23 individual 22 each 23 individual 24 to 25 perform 25 perform 27 tasks 25 perform 34 to 26 these 27 tasks 27 tasks 28 on 28 on 33 execution 29 a 33 execution 32 automatic 33 execution 34 to 37 performance 35 highly 36 controlled 36 controlled 37 performance a level of maximum control exceeds the subject 's attentional capacity , which makes it impossible to perform both tasks simultaneously . 0 ###LEFT-WALL### 2 level 0 ###LEFT-WALL### 6 exceeds 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 22 . 1 a 2 level 2 level 3 of 2 level 6 exceeds 3 of 5 control 4 maximum 5 control 6 exceeds 11 capacity 7 the 8 subject 8 subject 9 's 9 's 11 capacity 10 attentional 11 capacity 12 , 13 which 12 , 14 makes 13 which 14 makes 14 makes 15 it 14 makes 16 impossible 16 impossible 17 to 16 impossible 18 perform 17 to 18 perform 18 perform 20 tasks 18 perform 21 simultaneously 19 both 20 tasks the subject therefore prioritizes one of the tasks . 0 ###LEFT-WALL### 2 subject 0 ###LEFT-WALL### 4 prioritizes 0 ###LEFT-WALL### 9 . 1 the 2 subject 2 subject 4 prioritizes 3 therefore 4 prioritizes 4 prioritizes 5 one 5 one 6 of 6 of 8 tasks 7 the 8 tasks we use representative dual - task studies from the literature to illustrate the relationship between the different cognitive components and their impact on the control of posture and gait in elderly subjects with altered cognitive capacities and with elderly subjects who are fallers or who have altered sensory - motor capacities . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 44 or 0 ###LEFT-WALL### 52 . 1 we 2 use 2 use 7 studies 2 use 8 from 2 use 11 to 2 use 12 illustrate 3 representative 6 task 4 dual 5 - 4 dual 6 task 6 task 7 studies 8 from 10 literature 9 the 10 literature 11 to 12 illustrate 12 illustrate 14 relationship 12 illustrate 15 between 12 illustrate 23 on 13 the 14 relationship 15 between 20 and 16 the 19 components 17 different 19 components 18 cognitive 19 components 19 components 20 and 20 and 22 impact 21 their 22 impact 23 on 28 and 24 the 25 control 25 control 26 of 25 control 28 and 26 of 27 posture 28 and 29 gait 28 and 37 and 30 in 32 subjects 30 in 37 and 31 elderly 32 subjects 32 subjects 33 with 33 with 36 capacities 34 altered 36 capacities 35 cognitive 36 capacities 37 and 38 with 38 with 40 subjects 39 elderly 40 subjects 40 subjects 41 who 40 subjects 42 are 41 who 42 are 42 are 43 fallers 44 or 45 who 44 or 46 have 45 who 46 have 46 have 51 capacities 47 altered 50 motor 48 sensory 49 - 48 sensory 50 motor 50 motor 51 capacities recently this postural - cognitive relationship was addressed with a new approach . 0 ###LEFT-WALL### 6 relationship 0 ###LEFT-WALL### 8 addressed 0 ###LEFT-WALL### 13 . 1 recently 6 relationship 2 this 6 relationship 3 postural 4 - 3 postural 6 relationship 5 cognitive 6 relationship 6 relationship 7 was 7 was 8 addressed 8 addressed 9 with 9 with 12 approach 10 a 11 new 10 a 12 approach 11 new 12 approach we report [how] cognitive training can improve dual - task management and we attempt to define the cognitive mechanisms that may be responsible for better postural balance . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 report 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 28 . 1 we 2 report 2 report 5 training 2 report 7 improve 4 cognitive 5 training 5 training 6 can 6 can 7 improve 7 improve 11 management 8 dual 9 - 8 dual 10 task 10 task 11 management 12 and 13 we 12 and 14 attempt 13 we 14 attempt 14 attempt 15 to 14 attempt 16 define 15 to 16 define 16 define 19 mechanisms 17 the 19 mechanisms 18 cognitive 19 mechanisms 19 mechanisms 20 that 19 mechanisms 22 be 19 mechanisms 23 responsible 20 that 21 may 21 may 22 be 23 responsible 24 for 24 for 27 balance 25 better 27 balance 26 postural 27 balance objective : multimodal perception raises the issue of sensory integration . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 perception 2 : 5 raises 2 : 11 . 3 multimodal 4 perception 4 perception 5 raises 5 raises 7 issue 6 the 7 issue 7 issue 8 of 8 of 10 integration 9 sensory 10 integration the aim of this study is to assess whether the visuo - haptic subjective vertical could be predicted from the visual and haptic unimodal performances , according to a bayesian model , which optimizes the reliability of the multimodal estimate . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 32 , 0 ###LEFT-WALL### 41 . 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 assess 7 to 8 assess 8 assess 9 whether 8 assess 28 to 9 whether 15 vertical 9 whether 18 predicted 10 the 15 vertical 11 visuo 12 - 11 visuo 15 vertical 13 haptic 15 vertical 14 subjective 15 vertical 15 vertical 16 could 16 could 17 be 17 be 18 predicted 18 predicted 19 from 19 from 25 performances 20 the 25 performances 21 visual 22 and 22 and 23 haptic 22 and 25 performances 24 unimodal 25 performances 26 , 28 to 27 according 28 to 28 to 31 model 28 to 32 , 29 a 31 model 30 bayesian 31 model 32 , 33 which 32 , 34 optimizes 33 which 34 optimizes 34 optimizes 36 reliability 35 the 36 reliability 36 reliability 37 of 37 of 40 estimate 38 the 40 estimate 39 multimodal 40 estimate the limits of the model were assessed by evaluating the impact of aging , cerebral damage and spatial deficits . 0 ###LEFT-WALL### 2 limits 0 ###LEFT-WALL### 7 assessed 0 ###LEFT-WALL### 20 . 1 the 2 limits 2 limits 3 of 2 limits 6 were 3 of 5 model 4 the 5 model 6 were 7 assessed 7 assessed 8 by 8 by 9 evaluating 9 evaluating 17 and 10 the 11 impact 11 impact 12 of 11 impact 14 , 12 of 13 aging 14 , 16 damage 14 , 17 and 15 cerebral 16 damage 17 and 19 deficits 18 spatial 19 deficits method : young and older healthy participants , as well as patients with a right hemisphere lesion , suffering from spatial neglect [or] [not] , had to align a rod with the gravitational vertical in the visual , haptic and visuo - haptic modalities . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 45 . 1 method 2 : 2 : 3 young 4 and 7 participants 4 and 26 had 5 older 7 participants 6 healthy 7 participants 7 participants 11 as 7 participants 26 had 8 , 11 as 9 as 10 well 10 well 11 as 11 as 12 patients 11 as 25 , 12 patients 13 with 13 with 17 lesion 14 a 17 lesion 15 right 17 lesion 16 hemisphere 17 lesion 17 lesion 19 suffering 18 , 19 suffering 19 suffering 20 from 19 suffering 25 , 20 from 22 neglect 21 spatial 22 neglect 26 had 27 to 27 to 28 align 28 align 40 and 29 a 30 rod 30 rod 31 with 30 rod 38 , 31 with 34 vertical 32 the 34 vertical 33 gravitational 34 vertical 34 vertical 35 in 35 in 37 visual 36 the 37 visual 38 , 39 haptic 38 , 40 and 40 and 44 modalities 41 visuo 42 - 41 visuo 44 modalities 43 haptic 44 modalities results : visuo - [haptic] [subjective] vertical [was] correctly [predicted] by the model in healthy participants , as well as in patients in spite of different performances . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 visuo 3 visuo 7 vertical 4 - 7 vertical 7 vertical 9 correctly 7 vertical 11 by 7 vertical 14 in 7 vertical 18 as 7 vertical 28 . 11 by 13 model 12 the 13 model 14 in 16 participants 15 healthy 16 participants 17 , 18 as 18 as 19 well 18 as 28 . 19 well 20 as 19 well 25 of 20 as 21 in 21 in 22 patients 22 patients 23 in 23 in 24 spite 25 of 27 performances 26 different 27 performances [an] anticlockwise deviation of the subjective vertical was observed in the neglect group whatever the experimental conditions . 0 ###LEFT-WALL### 3 deviation 0 ###LEFT-WALL### 9 observed 0 ###LEFT-WALL### 18 . 2 anticlockwise 3 deviation 3 deviation 4 of 3 deviation 8 was 4 of 7 vertical 5 the 7 vertical 6 subjective 7 vertical 8 was 9 observed 9 observed 10 in 9 observed 14 whatever 10 in 13 group 11 the 13 group 12 neglect 13 group 14 whatever 15 the 14 whatever 17 conditions 15 the 17 conditions 16 experimental 17 conditions by contrast , no deviation was observed in both [non] - neglect and healthy groups , for the visual and the visuo - haptic modalities . 0 ###LEFT-WALL### 5 deviation 0 ###LEFT-WALL### 7 observed 0 ###LEFT-WALL### 11 - 1 by 2 contrast 1 by 3 , 1 by 5 deviation 4 no 5 deviation 5 deviation 6 was 6 was 7 observed 7 observed 8 in 8 in 9 both 11 - 15 groups 11 - 23 - 12 neglect 13 and 13 and 14 healthy 13 and 15 groups 15 groups 17 for 16 , 17 for 17 for 20 and 17 for 23 - 18 the 19 visual 19 visual 20 and 20 and 22 visuo 21 the 22 visuo 23 - 25 modalities 23 - 26 . 24 haptic 25 modalities nevertheless , the haptic subjective vertical [was] deviated [,] anticlockwise in the [non] [-] neglect patients and older healthy adults , and [clockwise] in the young healthy adults . 0 ###LEFT-WALL### 6 vertical 0 ###LEFT-WALL### 8 deviated 0 ###LEFT-WALL### 29 . 1 nevertheless 2 , 1 nevertheless 6 vertical 3 the 6 vertical 4 haptic 6 vertical 5 subjective 6 vertical 6 vertical 8 deviated 8 deviated 10 anticlockwise 8 deviated 22 and 11 in 17 and 11 in 22 and 12 the 16 patients 15 neglect 16 patients 16 patients 17 and 17 and 20 adults 18 older 20 adults 19 healthy 20 adults 21 , 22 and 22 and 24 in 24 in 28 adults 25 the 28 adults 26 young 28 adults 27 healthy 28 adults moreover , the variance was the smallest in the bimodal condition . 0 ###LEFT-WALL### 4 variance 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 12 . 1 moreover 2 , 1 moreover 4 variance 3 the 4 variance 4 variance 5 was 5 was 7 smallest 6 the 7 smallest 7 smallest 8 in 8 in 11 condition 9 the 11 condition 10 bimodal 11 condition conclusion : the integration of visual and haptic signals appeared to obey a bayesian model optimizing the reliability of the multimodal estimate . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 integration 2 : 10 appeared 2 : 23 . 3 the 4 integration 4 integration 5 of 4 integration 10 appeared 5 of 9 signals 6 visual 7 and 7 and 8 haptic 7 and 9 signals 10 appeared 11 to 10 appeared 12 obey 11 to 12 obey 12 obey 15 model 13 a 15 model 14 bayesian 15 model 15 model 16 optimizing 16 optimizing 18 reliability 17 the 18 reliability 18 reliability 19 of 19 of 22 estimate 20 the 22 estimate 21 multimodal 22 estimate this holds true [despite] of aging , brain damage or visuospatial disorders . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 holds 0 ###LEFT-WALL### 13 . 1 this 2 holds 2 holds 10 or 3 true 5 of 3 true 7 , 5 of 6 aging 7 , 9 damage 7 , 10 or 8 brain 9 damage 10 or 12 disorders 11 visuospatial 12 disorders regarding the perception of the vertical , multisensory integration does not seem thus to depend only on right posterior cortical areas . 0 ###LEFT-WALL### 1 regarding 0 ###LEFT-WALL### 12 seem 0 ###LEFT-WALL### 22 . 1 regarding 3 perception 1 regarding 10 does 2 the 3 perception 3 perception 4 of 4 of 9 integration 5 the 9 integration 6 vertical 7 , 6 vertical 9 integration 8 multisensory 9 integration 10 does 11 not 10 does 12 seem 12 seem 14 to 12 seem 15 depend 13 thus 14 to 14 to 15 depend 15 depend 16 only 16 only 17 on 17 on 21 areas 18 right 21 areas 19 posterior 21 areas 20 cortical 21 areas objective : to determine whether men with klinefelter [syndrome] ( ks ) have the same phenotype as men with mosaic ks . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 determine 2 : 22 . 3 to 4 determine 4 determine 5 whether 5 whether 6 men 5 whether 13 have 6 men 7 with 6 men 11 ks 6 men 13 have 7 with 8 klinefelter 10 ( 11 ks 11 ks 12 ) 13 have 16 phenotype 13 have 17 as 13 have 19 with 14 the 15 same 15 same 16 phenotype 17 as 18 men 19 with 21 ks 20 mosaic 21 ks design : subject identification via prospectively collected database . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 3 subject 0 ###LEFT-WALL### 9 . 1 design 2 : 2 : 3 subject 3 subject 4 identification 3 subject 5 via 5 via 8 database 6 prospectively 7 collected 7 collected 8 database setting : male infertility specialty clinic . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 2 : 6 clinic 2 : 7 . 3 male 4 infertility 4 infertility 6 clinic 5 specialty 6 clinic patient ( s ) : men undergoing a fertility evaluation from 2005 to 2012 at a single male infertility specialty clinic and having [a] karyotype demonstrating ks ( mosaic or [non] [-] mosaic ) . 0 ###LEFT-WALL### 1 patient 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 35 . 1 patient 3 s 1 patient 5 : 2 ( 3 s 3 s 4 ) 5 : 6 men 6 men 7 undergoing 7 undergoing 10 evaluation 8 a 10 evaluation 9 fertility 10 evaluation 10 evaluation 13 to 10 evaluation 25 karyotype 10 evaluation 26 demonstrating 11 from 13 to 12 2005 13 to 13 to 14 2012 13 to 15 at 13 to 25 karyotype 15 at 22 and 16 a 17 single 16 a 21 clinic 17 single 18 male 18 male 21 clinic 19 infertility 21 clinic 20 specialty 21 clinic 21 clinic 22 and 22 and 23 having 26 demonstrating 27 ks 27 ks 30 or 28 ( 30 or 29 mosaic 30 or 30 or 33 mosaic 30 or 34 ) intervention ( s ) : none . 0 ###LEFT-WALL### 1 intervention 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 7 . 1 intervention 3 s 1 intervention 5 : 2 ( 3 s 3 s 4 ) 5 : 6 none main outcome measure ( s ) : testicular size , and semen and hormone parameters , genetic evaluation , and signs of testosterone ( t ) deficiency using validated questionnaires . 0 ###LEFT-WALL### 3 measure 0 ###LEFT-WALL### 7 : 0 ###LEFT-WALL### 31 . 1 main 2 outcome 2 outcome 3 measure 3 measure 5 s 3 measure 7 : 4 ( 5 s 5 s 6 ) 7 : 20 and 7 : 28 using 8 testicular 9 size 9 size 11 and 10 , 11 and 11 and 12 semen 11 and 13 and 13 and 15 parameters 13 and 16 , 14 hormone 15 parameters 16 , 18 evaluation 16 , 20 and 17 genetic 18 evaluation 19 , 20 and 20 and 21 signs 21 signs 22 of 22 of 27 deficiency 23 testosterone 25 t 23 testosterone 27 deficiency 24 ( 25 t 25 t 26 ) 28 using 30 questionnaires 29 validated 30 questionnaires result ( s ) : of 86 men identified with ks , 6 ( 6.7 % ) were mosaic ks , and 80 ( 93.3 % ) were [non] [-] mosaic ks . 0 ###LEFT-WALL### 1 result 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 33 . 1 result 3 s 1 result 5 : 2 ( 3 s 3 s 4 ) 5 : 6 of 5 : 10 with 6 of 8 men 7 86 8 men 8 men 9 identified 10 with 11 ks 12 , 13 6 12 , 18 were 12 , 22 and 13 6 16 % 13 6 18 were 14 ( 16 % 15 6.7 16 % 16 % 17 ) 18 were 20 ks 19 mosaic 20 ks 21 , 22 and 22 and 23 80 22 and 28 were 23 80 26 % 23 80 28 were 24 ( 26 % 25 93.3 26 % 26 % 27 ) 28 were 32 ks 31 mosaic 32 ks a higher proportion of men with mosaic ks had sperm in the [ejaculate] [:] 3 ( 50 % ) of 6 versus 3 ( 3.75 % ) of 80 . 0 ###LEFT-WALL### 3 proportion 0 ###LEFT-WALL### 9 had 0 ###LEFT-WALL### 30 . 1 a 3 proportion 2 higher 3 proportion 3 proportion 4 of 3 proportion 9 had 4 of 5 men 5 men 6 with 6 with 8 ks 7 mosaic 8 ks 9 had 10 sperm 10 sperm 11 in 10 sperm 20 of 11 in 15 3 12 the 15 3 15 3 18 % 16 ( 18 % 17 50 18 % 18 % 19 ) 20 of 21 6 21 6 22 versus 21 6 28 of 22 versus 23 3 23 3 26 % 24 ( 26 % 25 3.75 26 % 26 % 27 ) 28 of 29 80 the sexual health inventory for men ( shim ) and androgen deficiency in the aging male ( adam ) questionnaire scores were not different between groups . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 22 were 0 ###LEFT-WALL### 27 . 1 the 8 shim 2 sexual 3 health 3 health 4 inventory 4 inventory 5 for 4 inventory 8 shim 5 for 6 men 7 ( 8 shim 8 shim 9 ) 8 shim 10 and 10 and 12 deficiency 10 and 13 in 10 and 22 were 11 androgen 12 deficiency 13 in 21 scores 14 the 21 scores 15 aging 16 male 16 male 18 adam 17 ( 18 adam 18 adam 19 ) 18 adam 21 scores 20 questionnaire 21 scores 22 were 23 not 22 were 24 different 24 different 25 between 25 between 26 groups conclusion ( s ) : men with mosaic ks [seem] to be more well androgenized than their [non] [-] mosaic ks counterparts , both with respect to hormones and sperm [in] [the] ejaculate . 0 ###LEFT-WALL### 12 be 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 34 . 1 conclusion 3 s 1 conclusion 5 : 2 ( 3 s 3 s 4 ) 5 : 6 men 5 : 7 with 5 : 11 to 7 with 9 ks 8 mosaic 9 ks 11 to 12 be 12 be 14 well 12 be 15 androgenized 13 more 14 well 15 androgenized 16 than 16 than 22 counterparts 17 their 22 counterparts 20 mosaic 22 counterparts 21 ks 22 counterparts 23 , 24 both 23 , 33 ejaculate 24 both 25 with 24 both 33 ejaculate 25 with 29 and 26 respect 27 to 26 respect 29 and 27 to 28 hormones 29 and 30 sperm objective : encouraging physical activity is an important public health measure to reduce disability prevalence in the aged . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 5 activity 2 : 6 is 3 encouraging 5 activity 4 physical 5 activity 5 activity 6 is 6 is 11 measure 6 is 12 to 7 an 11 measure 8 important 9 public 9 public 11 measure 10 health 11 measure 12 to 13 reduce 13 reduce 15 prevalence 13 reduce 16 in 14 disability 15 prevalence 16 in 18 aged 17 the 18 aged the aims of this study were to determine the association between midlife physical activity and late - life disability and to investigate gender - specific differences . 0 ###LEFT-WALL### 2 aims 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 24 - 1 the 2 aims 2 aims 3 of 2 aims 20 and 3 of 5 study 4 this 5 study 6 were 7 to 6 were 8 determine 6 were 20 and 7 to 8 determine 8 determine 10 association 8 determine 11 between 9 the 10 association 11 between 15 and 12 midlife 14 activity 13 physical 14 activity 14 activity 15 and 15 and 19 disability 16 late 17 - 16 late 18 life 18 life 19 disability 20 and 21 to 20 and 22 investigate 21 to 22 investigate 22 investigate 23 gender 24 - 26 differences 24 - 27 . 25 specific 26 differences method : this data originates from the kora - age cohort , [a] follow - up in 2008 of the monica ( multinational monitoring of trends and determinants in cardiovascular diseases )/kora ( cooperative health research in the region of augsburg [ )(s1 - s4 surveys ( 1984 - 2001 ) situated in augsburg , a city in southern germany . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 4 data 2 : 9 - 3 this 4 data 4 data 5 originates 5 originates 6 from 6 from 8 kora 7 the 8 kora 9 - 11 cohort 9 - 12 , 9 - 15 - 10 age 11 cohort 12 , 14 follow 15 - 27 and 16 up 27 and 17 in 18 2008 17 in 27 and 19 of 21 monica 19 of 27 and 20 the 21 monica 22 ( 23 multinational 23 multinational 27 and 24 monitoring 25 of 24 monitoring 27 and 25 of 26 trends 27 and 28 determinants 27 and 29 in 27 and 32 )/kora 29 in 31 diseases 30 cardiovascular 31 diseases 32 )/kora 44 - 33 ( 44 - 34 cooperative 35 health 35 health 36 research 36 research 37 in 36 research 40 of 36 research 44 - 37 in 39 region 38 the 39 region 40 of 43 )(s1 41 augsburg 43 )(s1 44 - 45 s4 45 s4 46 surveys 45 s4 52 situated 45 s4 57 city 46 surveys 49 - 46 surveys 52 situated 47 ( 49 - 48 1984 49 - 49 - 50 2001 49 - 51 ) 52 situated 53 in 53 in 54 augsburg 55 , 57 city 56 a 57 city 57 city 58 in 57 city 61 . 58 in 60 germany 59 southern 60 germany we applied a multivariable hurdle model to investigate the association of physical activity and disability . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 applied 0 ###LEFT-WALL### 16 . 1 we 2 applied 2 applied 6 model 2 applied 7 to 3 a 4 multivariable 3 a 6 model 4 multivariable 5 hurdle 5 hurdle 6 model 7 to 8 investigate 8 investigate 10 association 9 the 10 association 10 association 11 of 11 of 14 and 12 physical 13 activity 13 activity 14 and 14 and 15 disability results : we analysed 3333 persons with a mean follow - up [of] 18±5.5 years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 analysed 2 : 11 - 3 we 4 analysed 4 analysed 6 persons 4 analysed 10 follow 5 3333 6 persons 6 persons 7 with 6 persons 10 follow 7 with 9 mean 8 a 9 mean 11 - 12 up 11 - 16 . 12 up 15 years 14 18±5.5 15 years using hurdle models , moderate activity and high activity had a protective effect on the occurrence of disability ( or ( odds ratio )=0.80 [and] 0.73 ) , but not on severity ( i.e [.] number [of] limitations ) . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 10 had 0 ###LEFT-WALL### 40 . 1 using 3 models 1 using 4 , 1 using 7 and 2 hurdle 3 models 5 moderate 6 activity 6 activity 7 and 7 and 9 activity 7 and 10 had 8 high 9 activity 10 had 13 effect 10 had 14 on 10 had 29 but 10 had 31 on 11 a 12 protective 11 a 13 effect 12 protective 13 effect 14 on 16 occurrence 15 the 16 occurrence 16 occurrence 17 of 16 occurrence 20 or 17 of 18 disability 19 ( 20 or 20 or 24 )=0.80 20 or 28 , 21 ( 24 )=0.80 22 odds 23 ratio 23 ratio 24 )=0.80 24 )=0.80 26 0.73 24 )=0.80 27 ) 29 but 30 not 31 on 32 severity 32 severity 38 limitations 33 ( 38 limitations 34 i.e 36 number 36 number 38 limitations 38 limitations 39 ) we observed a strong gender - specific [difference] in this association , with men benefitting more from exercise . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 observed 0 ###LEFT-WALL### 19 . 1 we 2 observed 2 observed 5 gender 2 observed 13 with 3 a 4 strong 3 a 5 gender 4 strong 5 gender 5 gender 7 specific 6 - 7 specific 7 specific 9 in 7 specific 12 , 9 in 11 association 10 this 11 association 13 with 14 men 14 men 15 benefitting 15 benefitting 16 more 15 benefitting 17 from 17 from 18 exercise conclusion : elevated physical activity reduces the risk of becoming disabled and postpones the onset of disability by several years , but we could not show an effect on the severity of disability . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 but 0 ###LEFT-WALL### 34 . 1 conclusion 2 : 2 : 5 activity 3 elevated 5 activity 4 physical 5 activity 5 activity 12 and 5 activity 16 of 5 activity 18 by 6 reduces 8 risk 6 reduces 12 and 7 the 8 risk 8 risk 9 of 9 of 10 becoming 10 becoming 11 disabled 12 and 13 postpones 12 and 15 onset 14 the 15 onset 16 of 17 disability 18 by 20 years 19 several 20 years 21 , 22 but 22 but 23 we 22 but 26 show 23 we 24 could 24 could 25 not 24 could 26 show 26 show 28 effect 26 show 29 on 27 an 28 effect 29 on 31 severity 30 the 31 severity 31 severity 32 of 32 of 33 disability in addition , men seem to benefit more from leisure [-] time physical activity than women . 0 ###LEFT-WALL### 4 men 0 ###LEFT-WALL### 5 seem 0 ###LEFT-WALL### 17 . 1 in 2 addition 1 in 3 , 1 in 4 men 4 men 5 seem 5 seem 6 to 5 seem 7 benefit 6 to 7 benefit 7 benefit 8 more 7 benefit 9 from 7 benefit 15 than 9 from 14 activity 10 leisure 14 activity 12 time 14 activity 13 physical 14 activity 15 than 16 women objective : to evaluate the temporal association between depression symptoms and cognitive function in older adults over a 4 [-] year period . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 7 association 5 the 7 association 6 temporal 7 association 7 association 8 between 7 association 14 in 8 between 11 and 9 depression 10 symptoms 10 symptoms 11 and 11 and 13 function 12 cognitive 13 function 14 in 16 adults 15 older 16 adults 16 adults 17 over 17 over 22 period 18 a 22 period 19 4 21 year 21 year 22 period methods : using a longitudinal , cross [-] lagged , population - based design , we studied depression symptoms and cognitive domains ( including processing speed , verbal fluency , face and word recognition , episodic memory , and simple and choice reaction time ) in 896 community - dwelling adults aged 70 - 97 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 using 2 : 10 , 3 using 7 cross 3 using 9 lagged 4 a 7 cross 5 longitudinal 6 , 5 longitudinal 7 cross 10 , 11 population 10 , 12 - 12 - 14 design 12 - 15 , 12 - 17 studied 13 based 14 design 15 , 16 we 16 we 17 studied 17 studied 20 and 18 depression 19 symptoms 19 symptoms 20 and 20 and 21 cognitive 20 and 22 domains 20 and 32 and 22 domains 24 including 22 domains 32 and 23 ( 24 including 24 including 26 speed 24 including 30 , 25 processing 26 speed 26 speed 29 fluency 27 , 29 fluency 28 verbal 29 fluency 29 fluency 30 , 31 face 32 and 32 and 33 word 33 word 39 and 34 recognition 35 , 35 , 37 memory 35 , 39 and 36 episodic 37 memory 38 , 39 and 39 and 44 time 39 and 45 ) 39 and 46 in 39 and 51 adults 40 simple 41 and 41 and 42 choice 41 and 44 time 43 reaction 44 time 46 in 48 community 47 896 48 community 49 - 51 adults 50 dwelling 51 adults 51 adults 52 aged 51 adults 56 years 51 adults 57 . 52 aged 53 70 54 - 56 years 55 97 56 years 56 years 57 . results : cross - lagged structural equation models suggested that initial depression symptoms affected subsequent processing speed and simple and choice reaction time but that cognition did not predict depression symptoms over time . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 cross 0 ###LEFT-WALL### 4 - 1 results 2 : 2 : 3 cross 4 - 18 and 4 - 34 . 5 lagged 8 models 5 lagged 18 and 6 structural 7 equation 7 equation 8 models 8 models 9 suggested 8 models 10 that 8 models 11 initial 10 that 11 initial 11 initial 13 symptoms 12 depression 13 symptoms 13 symptoms 14 affected 13 symptoms 16 processing 14 affected 15 subsequent 16 processing 17 speed 18 and 29 predict 19 simple 20 and 20 and 21 choice 20 and 26 cognition 21 choice 23 time 21 choice 24 but 22 reaction 23 time 24 but 25 that 26 cognition 27 did 27 did 28 not 27 did 29 predict 29 predict 31 symptoms 29 predict 32 over 30 depression 31 symptoms 32 over 33 time the associations between depression and cognitive variables were attenuated when the models were adjusted for sensory impairment , physical health , and locus of control . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 attenuated 0 ###LEFT-WALL### 26 . 1 the 2 associations 2 associations 3 between 2 associations 5 and 3 between 4 depression 5 and 7 variables 5 and 8 were 6 cognitive 7 variables 8 were 9 attenuated 9 attenuated 10 when 10 when 12 models 10 when 14 adjusted 11 the 12 models 12 models 13 were 13 were 14 adjusted 14 adjusted 15 for 15 for 22 and 16 sensory 17 impairment 17 impairment 18 , 18 , 20 health 18 , 22 and 19 physical 20 health 21 , 22 and 22 and 23 locus 22 and 24 of 24 of 25 control conclusion : the findings suggest that , causally , depression precedes cognitive impairment in this age group and that the association is related to physical health and perceptions of a lack of control . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 related 0 ###LEFT-WALL### 34 . 2 : 4 findings 2 : 5 suggest 2 : 7 , 3 the 4 findings 4 findings 5 suggest 5 suggest 6 that 7 , 10 depression 7 , 11 precedes 8 causally 9 , 8 causally 10 depression 10 depression 11 precedes 11 precedes 13 impairment 11 precedes 14 in 12 cognitive 13 impairment 14 in 16 age 15 this 16 age 16 age 18 and 16 age 23 related 17 group 18 and 18 and 19 that 18 and 21 association 18 and 22 is 18 and 23 related 20 the 21 association 21 association 22 is 23 related 24 to 24 to 27 and 25 physical 26 health 26 health 27 and 27 and 28 perceptions 27 and 29 of 29 of 31 lack 30 a 31 lack 31 lack 32 of 32 of 33 control habitual consumption of dairy products has been shown to play an important role in the prevention of several chronic diseases . 0 ###LEFT-WALL### 2 consumption 0 ###LEFT-WALL### 8 shown 0 ###LEFT-WALL### 21 . 1 habitual 2 consumption 2 consumption 3 of 2 consumption 6 has 3 of 5 products 4 dairy 5 products 6 has 7 been 7 been 8 shown 8 shown 9 to 9 to 10 play 10 play 13 role 10 play 14 in 11 an 12 important 11 an 13 role 12 important 13 role 14 in 16 prevention 15 the 16 prevention 16 prevention 17 of 17 of 20 diseases 18 several 20 diseases 19 chronic 20 diseases we aimed to prospectively assess the relationship between the change in dairy product consumption ( both regular fat and low/reduced fat ) and the 15 [-] year incidence of age - related macular degeneration ( amd ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 32 related 1 we 2 aimed 2 aimed 3 to 2 aimed 5 assess 3 to 5 assess 4 prospectively 5 assess 5 assess 7 relationship 5 assess 11 in 6 the 7 relationship 7 relationship 8 between 8 between 10 change 9 the 10 change 11 in 14 consumption 12 dairy 14 consumption 13 product 14 consumption 14 consumption 23 and 15 ( 23 and 16 both 23 and 17 regular 18 fat 18 fat 19 and 19 and 21 fat 19 and 22 ) 19 and 23 and 20 low/reduced 21 fat 23 and 28 incidence 23 and 29 of 23 and 31 - 24 the 28 incidence 25 15 27 year 27 year 28 incidence 29 of 30 age 31 - 32 related 32 related 34 degeneration 32 related 38 . 33 macular 34 degeneration 34 degeneration 36 amd 35 ( 36 amd 36 amd 37 ) in the blue mountains eye study , 2037 participants aged 49 years [or] above at baseline were [re] - examined at [follow] - up in 1997 - 9 , 2002 - 4 and/or 2007 - 9 . 0 ###LEFT-WALL### 9 participants 0 ###LEFT-WALL### 35 - 0 ###LEFT-WALL### 37 . 1 in 6 study 1 in 7 , 1 in 9 participants 2 the 6 study 3 blue 4 mountains 4 mountains 5 eye 5 eye 6 study 8 2037 9 participants 9 participants 10 aged 9 participants 17 were 10 aged 14 above 10 aged 15 at 11 49 12 years 12 years 14 above 15 at 16 baseline 17 were 20 examined 17 were 31 - 17 were 33 and/or 19 - 20 examined 20 examined 21 at 20 examined 25 in 20 examined 29 , 21 at 24 up 23 - 24 up 25 in 27 - 26 1997 27 - 27 - 28 9 30 2002 31 - 31 - 32 4 33 and/or 34 2007 34 2007 35 - 35 - 36 9 amd was assessed from retinal photographs . 0 ###LEFT-WALL### 1 amd 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 7 . 1 amd 2 was 2 was 3 assessed 3 assessed 4 from 4 from 6 photographs 5 retinal 6 photographs dietary data were collected using a semi - quantitative ffq , and servings of dairy product consumption calculated . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 collected 0 ###LEFT-WALL### 19 . 1 dietary 2 data 2 data 3 were 3 were 4 collected 4 collected 5 using 4 collected 18 calculated 5 using 12 and 6 a 7 semi 6 a 10 ffq 7 semi 8 - 7 semi 10 ffq 9 quantitative 10 ffq 10 ffq 12 and 11 , 12 and 12 and 13 servings 12 and 14 of 14 of 17 consumption 15 dairy 17 consumption 16 product 17 consumption over the 15 - [year] follow - up , there were 352 , 268 and eighty - four incident cases of any , early and late amd , respectively . 0 ###LEFT-WALL### 6 follow 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 30 . 1 over 3 15 1 over 4 - 1 over 6 follow 2 the 3 15 6 follow 8 up 7 - 8 up 8 up 9 , 9 , 10 there 9 , 11 were 10 there 11 were 11 were 12 352 11 were 29 respectively 12 352 15 and 12 352 20 cases 12 352 27 amd 13 , 15 and 14 268 15 and 15 and 16 eighty 15 and 17 - 17 - 20 cases 18 four 20 cases 19 incident 20 cases 20 cases 21 of 20 cases 23 , 21 of 22 any 23 , 27 amd 24 early 25 and 25 and 26 late 25 and 27 amd 27 amd 28 , after adjusting [for] age , sex , current smoking , white cell count and fish consumption , a significant linear trend [(] p for trend = 0·003 [ )(was observed with decreasing consumption of total dairy foods and the 15 [-] year incidence of late amd , comparing the lowest [v] [.] highest quintile of intake ( or 2·80 , 95 % ci 1·21 , 3·04 ) . 0 ###LEFT-WALL### 4 age 0 ###LEFT-WALL### 5 , 1 after 2 adjusting 1 after 4 age 5 , 6 sex 5 , 7 , 7 , 9 smoking 7 , 10 , 8 current 9 smoking 10 , 14 and 10 , 17 , 11 white 13 count 12 cell 13 count 13 count 14 and 14 and 16 consumption 15 fish 16 consumption 17 , 27 0·003 18 a 19 significant 18 a 27 0·003 19 significant 21 trend 20 linear 21 trend 21 trend 23 p 21 trend 24 for 21 trend 26 = 24 for 25 trend 27 0·003 29 )(was 29 )(was 30 observed 30 observed 31 with 31 with 38 and 32 decreasing 33 consumption 33 consumption 34 of 33 consumption 38 and 34 of 37 foods 35 total 37 foods 36 dairy 37 foods 38 and 43 incidence 38 and 48 comparing 39 the 43 incidence 40 15 43 incidence 42 year 43 incidence 43 incidence 44 of 44 of 46 amd 45 late 46 amd 47 , 48 comparing 48 comparing 53 highest 49 the 50 lowest 49 the 53 highest 53 highest 64 1·21 54 quintile 55 of 55 of 56 intake 56 intake 59 2·80 57 ( 59 2·80 58 or 59 2·80 59 2·80 60 , 60 , 64 1·21 61 95 62 % 62 % 64 1·21 63 ci 64 1·21 64 1·21 66 3·04 64 1·21 68 . 65 , 66 3·04 66 3·04 67 ) over the 15 years , decreased consumption of reduced [-] fat dairy foods was associated with an increased risk of incident late amd , comparing the lowest [to] highest quintile of intake ( or 3·10 , 95 % ci 1·18 , 8·14 [,] p for trend = 0·04 [ )( 1 over 4 years 1 over 7 consumption 2 the 4 years 3 15 4 years 4 years 6 decreased 5 , 6 decreased 7 consumption 8 of 7 consumption 14 was 8 of 13 foods 9 reduced 11 fat 11 fat 13 foods 12 dairy 13 foods 14 was 15 associated 15 associated 16 with 16 with 19 risk 17 an 19 risk 18 increased 19 risk 19 risk 20 of 19 risk 25 comparing 20 of 23 amd 21 incident 23 amd 22 late 23 amd 24 , 25 comparing 25 comparing 30 quintile 26 the 27 lowest 26 the 29 highest 26 the 30 quintile 30 quintile 31 of 30 quintile 35 3·10 30 quintile 39 ci 31 of 32 intake 33 ( 35 3·10 34 or 35 3·10 35 3·10 36 , 36 , 39 ci 37 95 39 ci 38 % 39 ci 39 ci 42 8·14 39 ci 48 0·04 39 ci 50 )( 40 1·18 41 , 40 1·18 42 8·14 42 8·14 44 p 42 8·14 45 for 42 8·14 47 = 45 for 46 trend 47 = 48 0·04 decreasing total dietary ca intake over the 15 years was also associated with an increased risk of developing incident late amd ( multivariable - adjusted [p] for trend [=] 0·03 ) . 0 ###LEFT-WALL### 1 decreasing 0 ###LEFT-WALL### 12 associated 1 decreasing 5 intake 1 decreasing 10 was 2 total 5 intake 3 dietary 5 intake 4 ca 5 intake 5 intake 6 over 6 over 9 years 7 the 8 15 8 15 9 years 10 was 11 also 10 was 12 associated 12 associated 13 with 13 with 16 risk 14 an 16 risk 15 increased 16 risk 16 risk 17 of 17 of 18 developing 18 developing 21 amd 19 incident 21 amd 20 late 21 amd 21 amd 23 multivariable 22 ( 23 multivariable 23 multivariable 25 adjusted 23 multivariable 32 . 24 - 25 adjusted 25 adjusted 27 for 25 adjusted 31 ) 27 for 30 0·03 28 trend 30 0·03 [a] lower consumption of dairy products ( regular and low fat ) and ca was independently associated with a higher risk of developing incident late amd in the long term . 0 ###LEFT-WALL### 2 lower 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 31 . 2 lower 3 consumption 3 consumption 4 of 3 consumption 11 fat 4 of 6 products 5 dairy 6 products 7 ( 11 fat 8 regular 9 and 9 and 10 low 9 and 11 fat 11 fat 12 ) 13 and 14 ca 13 and 17 associated 14 ca 15 was 15 was 17 associated 16 independently 17 associated 17 associated 18 with 18 with 21 risk 19 a 21 risk 20 higher 21 risk 21 risk 22 of 22 of 23 developing 23 developing 26 amd 23 developing 27 in 24 incident 26 amd 25 late 26 amd 27 in 30 term 28 the 30 term 29 long 30 term additional cohort studies are needed to confirm these findings . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 5 needed 0 ###LEFT-WALL### 10 . 1 additional 2 cohort 2 cohort 3 studies 3 studies 4 are 4 are 5 needed 5 needed 6 to 6 to 7 confirm 7 confirm 9 findings 8 these 9 findings objective : this research uses the quality - adjusted life expectancy ( qale ) [method] to assess the qale changes of rural residents before and after introducing telemedicine health services . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 research 2 : 5 uses 2 : 31 . 3 this 4 research 4 research 5 uses 5 uses 7 quality 5 uses 16 to 5 uses 25 and 6 the 7 quality 7 quality 11 expectancy 8 - 11 expectancy 9 adjusted 11 expectancy 10 life 11 expectancy 11 expectancy 13 qale 11 expectancy 14 ) 12 ( 13 qale 13 qale 14 ) 16 to 17 assess 17 assess 20 changes 18 the 20 changes 19 qale 20 changes 20 changes 21 of 21 of 23 residents 22 rural 23 residents 24 before 25 and 25 and 26 after 26 after 27 introducing 27 introducing 30 services 28 telemedicine 30 services 29 health 30 services materials and methods : based on taiwan 's experiences of telemedicine provision over the period 1995 - 2004 , this representative of a national sample is composed of 85 cases for people living in penghu county , a remote area in taiwan . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 5 based 0 ###LEFT-WALL### 19 , 1 materials 2 and 2 and 3 methods 3 methods 4 : 4 : 5 based 5 based 6 on 5 based 13 over 5 based 17 - 6 on 9 experiences 7 taiwan 8 's 8 's 9 experiences 9 experiences 10 of 10 of 12 provision 11 telemedicine 12 provision 13 over 15 period 14 the 15 period 16 1995 17 - 17 - 18 2004 19 , 21 representative 19 , 27 composed 20 this 21 representative 21 representative 22 of 21 representative 26 is 22 of 25 sample 23 a 24 national 23 a 25 sample 24 national 25 sample 26 is 27 composed 27 composed 28 of 28 of 30 cases 29 85 30 cases 30 cases 31 for 30 cases 33 living 30 cases 40 area 31 for 32 people 33 living 34 in 34 in 36 county 35 penghu 36 county 37 , 40 area 38 a 39 remote 38 a 40 area 39 remote 40 area 40 area 41 in 40 area 43 . 41 in 42 taiwan cases were evaluated using persons with life expectancy at birth from 85 to 0 years . 0 ###LEFT-WALL### 1 cases 0 ###LEFT-WALL### 3 evaluated 0 ###LEFT-WALL### 16 . 1 cases 2 were 2 were 3 evaluated 3 evaluated 4 using 3 evaluated 6 with 3 evaluated 9 at 4 using 5 persons 6 with 8 expectancy 7 life 8 expectancy 9 at 15 years 10 birth 13 to 10 birth 15 years 11 from 13 to 12 85 13 to 13 to 14 0 results : the provision of telemedicine health services increased rural population qale by 2.91 quality - adjusted life years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 provision 2 : 9 increased 3 the 4 provision 4 provision 5 of 4 provision 9 increased 5 of 8 services 6 telemedicine 8 services 7 health 8 services 9 increased 12 qale 9 increased 13 by 10 rural 11 population 11 population 12 qale 13 by 15 quality 14 2.91 15 quality 15 quality 19 years 16 - 19 years 17 adjusted 18 life 18 life 19 years 19 years 20 . telemedicine provision does improve rural residents ' health status . 0 ###LEFT-WALL### 2 provision 0 ###LEFT-WALL### 4 improve 0 ###LEFT-WALL### 10 . 1 telemedicine 2 provision 2 provision 3 does 3 does 4 improve 4 improve 9 status 5 rural 6 residents 6 residents 7 ' 7 ' 9 status 8 health 9 status relative to the index population living in taipei , the capital of taiwan , the survival ratios of the population of concern >65 years decreased faster and were less than those of the index population >65 years by at least 7 [%] and 3 % , respectively , before and after introducing telemedicine health services . 0 ###LEFT-WALL### 17 ratios 0 ###LEFT-WALL### 23 >65 0 ###LEFT-WALL### 56 . 1 relative 2 to 1 relative 7 in 1 relative 14 , 1 relative 17 ratios 2 to 5 population 3 the 5 population 4 index 5 population 5 population 6 living 7 in 8 taipei 8 taipei 11 capital 9 , 11 capital 10 the 11 capital 11 capital 12 of 11 capital 14 , 12 of 13 taiwan 15 the 17 ratios 16 survival 17 ratios 17 ratios 18 of 17 ratios 23 >65 18 of 20 population 19 the 20 population 20 population 21 of 21 of 22 concern 23 >65 24 years 23 >65 50 and 24 years 27 and 25 decreased 26 faster 25 decreased 27 and 27 and 28 were 27 and 37 years 27 and 47 respectively 28 were 29 less 28 were 30 than 30 than 31 those 31 those 32 of 32 of 36 >65 33 the 36 >65 34 index 35 population 35 population 36 >65 37 years 38 by 38 by 45 % 39 at 40 least 40 least 43 and 41 7 43 and 43 and 44 3 43 and 45 % 46 , 47 respectively 47 respectively 48 , 49 before 50 and 50 and 51 after 51 after 52 introducing 52 introducing 55 services 53 telemedicine 55 services 54 health 55 services conclusions : it appears that the needs for telemedicine health services increased along with the aging of our society in rural and underserved regions . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 it 2 : 4 appears 2 : 25 . 3 it 4 appears 4 appears 5 that 5 that 7 needs 5 that 12 increased 6 the 7 needs 7 needs 8 for 7 needs 12 increased 8 for 11 services 9 telemedicine 11 services 10 health 11 services 12 increased 14 with 12 increased 20 in 13 along 14 with 14 with 16 aging 15 the 16 aging 16 aging 17 of 17 of 19 society 18 our 19 society 20 in 24 regions 21 rural 22 and 22 and 23 underserved 22 and 24 regions aging is the strongest risk factor [for] cognitive decline . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 10 . 1 aging 2 is 2 is 9 decline 3 the 4 strongest 3 the 9 decline 5 risk 9 decline 6 factor 9 decline 8 cognitive 9 decline the perimenopausal period puts women in a more vulnerable state in regard to certain functions such as memory . 0 ###LEFT-WALL### 3 period 0 ###LEFT-WALL### 4 puts 0 ###LEFT-WALL### 19 . 1 the 3 period 2 perimenopausal 3 period 3 period 4 puts 4 puts 5 women 4 puts 6 in 4 puts 11 in 4 puts 13 to 6 in 10 state 7 a 10 state 8 more 9 vulnerable 9 vulnerable 10 state 11 in 12 regard 13 to 15 functions 14 certain 15 functions 15 functions 17 as 16 such 17 as 17 as 18 memory also , the women 's health initiative memory study ( whims ) pointed at some cognitive adverse effects of postmenopausal hormone therapy , but these results were not relevant for the peri - and early menopause since whims recruited women above the age of 65 years . 0 ###LEFT-WALL### 1 also 0 ###LEFT-WALL### 14 at 0 ###LEFT-WALL### 24 but 0 ###LEFT-WALL### 47 . 1 also 2 , 1 also 9 study 1 also 14 at 3 the 4 women 4 women 5 's 5 's 9 study 6 health 7 initiative 7 initiative 8 memory 8 memory 9 study 9 study 11 whims 9 study 14 at 10 ( 11 whims 11 whims 12 ) 13 pointed 14 at 14 at 18 effects 15 some 18 effects 16 cognitive 18 effects 17 adverse 18 effects 18 effects 19 of 19 of 22 therapy 20 postmenopausal 21 hormone 21 hormone 22 therapy 23 , 24 but 24 but 26 results 24 but 27 were 25 these 26 results 26 results 27 were 27 were 28 not 27 were 29 relevant 28 not 29 relevant 29 relevant 30 for 29 relevant 37 since 29 relevant 41 above 30 for 34 and 31 the 32 peri 32 peri 34 and 33 - 34 and 34 and 36 menopause 35 early 36 menopause 37 since 38 whims 37 since 39 recruited 38 whims 39 recruited 39 recruited 40 women 41 above 43 age 42 the 43 age 43 age 44 of 44 of 46 years 45 65 46 years the ['] window of opportunity ['] theory , pointing at potential protective effects of postmenopausal hormone therapy in the early menopause , mainly applies to coronary artery disease , but clinical data on neuroprotection by estrogen are not consistent . 0 ###LEFT-WALL### 3 window 0 ###LEFT-WALL### 24 applies 0 ###LEFT-WALL### 30 but 0 ###LEFT-WALL### 40 . 1 the 3 window 3 window 4 of 3 window 9 pointing 3 window 24 applies 4 of 7 theory 5 opportunity 7 theory 8 , 9 pointing 9 pointing 10 at 9 pointing 18 in 9 pointing 22 , 10 at 13 effects 11 potential 13 effects 12 protective 13 effects 13 effects 14 of 14 of 17 therapy 15 postmenopausal 16 hormone 16 hormone 17 therapy 18 in 21 menopause 19 the 21 menopause 20 early 21 menopause 23 mainly 24 applies 24 applies 25 to 25 to 28 disease 26 coronary 27 artery 27 artery 28 disease 29 , 30 but 30 but 32 data 30 but 37 are 31 clinical 32 data 32 data 33 on 32 data 35 by 32 data 37 are 33 on 34 neuroprotection 35 by 36 estrogen 37 are 38 not 37 are 39 consistent in view of a recent publication , the following article discusses the issue [of] menopause and cognitive decline , with a focus on possible associations [with] surgical [menopause] . 0 ###LEFT-WALL### 10 article 0 ###LEFT-WALL### 11 discusses 1 in 2 view 1 in 7 , 1 in 10 article 2 view 3 of 3 of 6 publication 4 a 5 recent 4 a 6 publication 5 recent 6 publication 8 the 9 following 8 the 10 article 10 article 11 discusses 11 discusses 16 and 11 discusses 20 with 12 the 15 menopause 13 issue 15 menopause 15 menopause 16 and 16 and 18 decline 17 cognitive 18 decline 19 , 20 with 20 with 22 focus 20 with 27 surgical 20 with 29 . 21 a 22 focus 22 focus 23 on 23 on 25 associations 24 possible 25 associations purpose : this study explored the risk factors , cut - off points , sensitivity , specificity , positive predictive values , and negative predictive values of physical performance testing among community [-] dwelling frail elderly people in taiwan . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 8 factors 0 ###LEFT-WALL### 40 . 1 purpose 2 : 2 : 4 study 3 this 4 study 4 study 5 explored 4 study 7 risk 4 study 8 factors 6 the 7 risk 7 risk 8 factors 8 factors 10 cut 8 factors 12 off 8 factors 31 among 9 , 10 cut 10 cut 11 - 12 off 23 and 13 points 14 , 14 , 15 sensitivity 14 , 16 , 16 , 17 specificity 16 , 18 , 18 , 21 values 18 , 23 and 19 positive 21 values 20 predictive 21 values 22 , 23 and 23 and 26 values 24 negative 26 values 25 predictive 26 values 26 values 27 of 27 of 30 testing 28 physical 30 testing 29 performance 30 testing 31 among 37 people 32 community 34 dwelling 34 dwelling 37 people 35 frail 37 people 36 elderly 37 people 37 people 38 in 38 in 39 taiwan organizing construct : the empirical measurement of frailty is based on the following five indicators : weight loss , weakness , exhaustion , slow responses , and minimal physical activity . 0 ###LEFT-WALL### 2 construct 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 31 . 1 organizing 2 construct 3 : 6 measurement 3 : 10 based 3 : 16 : 3 : 21 , 4 the 6 measurement 5 empirical 6 measurement 6 measurement 7 of 6 measurement 9 is 7 of 8 frailty 9 is 10 based 10 based 11 on 11 on 15 indicators 12 the 13 following 12 the 14 five 14 five 15 indicators 16 : 17 weight 16 : 19 , 17 weight 18 loss 19 , 20 weakness 21 , 27 and 22 exhaustion 23 , 23 , 25 responses 23 , 27 and 24 slow 25 responses 26 , 27 and 27 and 30 activity 28 minimal 30 activity 29 physical 30 activity the frail phenotype is considered present if three [or] more of the indicators are observed . 0 ###LEFT-WALL### 3 phenotype 0 ###LEFT-WALL### 5 considered 0 ###LEFT-WALL### 16 . 1 the 3 phenotype 2 frail 3 phenotype 3 phenotype 4 is 4 is 5 considered 5 considered 6 present 6 present 7 if 7 if 10 more 7 if 15 observed 8 three 10 more 10 more 11 of 10 more 14 are 11 of 13 indicators 12 the 13 indicators 14 are 15 observed meanwhile , a short battery of physical performance tests was conducted to assess the balance , mobility , and flexibility among elderly people . 0 ###LEFT-WALL### 5 battery 0 ###LEFT-WALL### 11 conducted 0 ###LEFT-WALL### 24 . 1 meanwhile 2 , 1 meanwhile 5 battery 3 a 4 short 3 a 5 battery 4 short 5 battery 5 battery 6 of 5 battery 10 was 6 of 9 tests 7 physical 8 performance 8 performance 9 tests 10 was 11 conducted 11 conducted 12 to 11 conducted 21 among 12 to 13 assess 13 assess 19 and 14 the 15 balance 15 balance 16 , 16 , 17 mobility 16 , 19 and 18 , 19 and 19 and 20 flexibility 21 among 23 people 22 elderly 23 people methods : a cross - sectional research design was executed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 1 methods 2 : 2 : 4 cross 3 a 4 cross 5 - 8 design 5 - 10 executed 5 - 11 . 6 sectional 7 research 7 research 8 design 8 design 9 was 9 was 10 executed participants were evaluated using a short battery of physical performance tests to assess their physical performance . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 evaluated 0 ###LEFT-WALL### 17 . 1 participants 2 were 2 were 3 evaluated 3 evaluated 4 using 4 using 7 battery 4 using 12 to 4 using 13 assess 5 a 7 battery 6 short 7 battery 7 battery 8 of 8 of 11 tests 9 physical 10 performance 10 performance 11 tests 12 to 13 assess 13 assess 16 performance 14 their 16 performance 15 physical 16 performance multivariate logistic regression and receiver operating characteristic ( roc ) analyses were performed . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 14 . 1 multivariate 3 regression 2 logistic 3 regression 3 regression 4 and 4 and 5 receiver 4 and 6 operating 4 and 12 were 6 operating 11 analyses 7 characteristic 9 roc 7 characteristic 11 analyses 8 ( 9 roc 9 roc 10 ) 12 were 13 performed findings : the logistic regression results showed that the factors significantly correlated to frailty included falls in the previous year , smoking , hypertension , and bone and joint disease . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 4 logistic 2 : 16 falls 2 : 21 , 3 the 4 logistic 4 logistic 6 results 4 logistic 12 correlated 4 logistic 16 falls 5 regression 6 results 6 results 7 showed 7 showed 8 that 8 that 10 factors 8 that 12 correlated 9 the 10 factors 10 factors 12 correlated 11 significantly 12 correlated 12 correlated 13 to 13 to 14 frailty 14 frailty 15 included 16 falls 17 in 16 falls 20 year 18 the 19 previous 19 previous 20 year 21 , 28 and 22 smoking 23 , 23 , 24 hypertension 23 , 26 and 25 , 26 and 26 and 27 bone 26 and 28 and 28 and 30 disease 29 joint 30 disease physical performance test scores were analyzed using the roc curves to discriminate frailty statuses . 0 ###LEFT-WALL### 2 performance 0 ###LEFT-WALL### 6 analyzed 0 ###LEFT-WALL### 15 . 1 physical 2 performance 2 performance 4 scores 2 performance 5 were 2 performance 6 analyzed 3 test 4 scores 4 scores 5 were 6 analyzed 7 using 6 analyzed 13 frailty 6 analyzed 14 statuses 7 using 10 curves 7 using 11 to 7 using 12 discriminate 8 the 10 curves 9 roc 10 curves 11 to 12 discriminate 13 frailty 14 statuses conclusions : the research findings suggest that physical performance variables can be used to effectively screen elderly people at risk for frailty in the community . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 findings 2 : 6 suggest 2 : 26 . 3 the 5 findings 4 research 5 findings 5 findings 6 suggest 6 suggest 10 variables 6 suggest 13 used 7 that 8 physical 8 physical 9 performance 9 performance 10 variables 10 variables 11 can 11 can 12 be 12 be 13 used 13 used 14 to 13 used 16 screen 14 to 16 screen 15 effectively 16 screen 16 screen 18 people 16 screen 21 for 17 elderly 18 people 18 people 19 at 19 at 20 risk 21 for 22 frailty 22 frailty 23 in 23 in 25 community 24 the 25 community clinical relevance : the findings offer reference values for physical performance tests specific to community [-] dwelling frail elderly people . 0 ###LEFT-WALL### 2 relevance 0 ###LEFT-WALL### 3 : 1 clinical 2 relevance 3 : 5 findings 3 : 6 offer 3 : 21 . 4 the 5 findings 5 findings 6 offer 6 offer 8 values 6 offer 9 for 6 offer 12 tests 7 reference 8 values 9 for 11 performance 10 physical 11 performance 12 tests 13 specific 13 specific 14 to 14 to 20 people 15 community 17 dwelling 17 dwelling 20 people 18 frail 20 people 19 elderly 20 people the information can enable health practitioners to achieve early identification of frailty among elderly people with anthropometric characteristics similar to those associated with people in asian countries . 0 ###LEFT-WALL### 2 information 0 ###LEFT-WALL### 4 enable 0 ###LEFT-WALL### 28 . 1 the 2 information 2 information 3 can 3 can 4 enable 4 enable 6 practitioners 4 enable 7 to 4 enable 8 achieve 5 health 6 practitioners 7 to 8 achieve 8 achieve 10 identification 8 achieve 13 among 8 achieve 16 with 8 achieve 25 in 9 early 10 identification 10 identification 11 of 11 of 12 frailty 13 among 15 people 14 elderly 15 people 16 with 18 characteristics 17 anthropometric 18 characteristics 18 characteristics 19 similar 19 similar 20 to 20 to 21 those 21 those 22 associated 22 associated 23 with 23 with 24 people 25 in 27 countries 26 asian 27 countries nitric oxide ( no ) , generated by no synthase ( nos ) [enzymes] , is an important bioactive molecule involved in the regulation of several biological phenomena that are crucial for organogenesis , including gene expression , cell growth , matrix remolding , proliferation , differentiation and apoptosis . 0 ###LEFT-WALL### 2 oxide 0 ###LEFT-WALL### 16 is 0 ###LEFT-WALL### 50 . 1 nitric 2 oxide 2 oxide 4 no 2 oxide 7 generated 2 oxide 16 is 3 ( 4 no 4 no 5 ) 6 , 7 generated 7 generated 8 by 7 generated 15 , 8 by 10 synthase 9 no 10 synthase 10 synthase 12 nos 11 ( 12 nos 12 nos 13 ) 16 is 48 and 17 an 18 important 17 an 20 molecule 18 important 20 molecule 19 bioactive 20 molecule 20 molecule 21 involved 20 molecule 25 of 20 molecule 32 for 20 molecule 34 , 21 involved 22 in 22 in 24 regulation 23 the 24 regulation 25 of 28 phenomena 26 several 28 phenomena 27 biological 28 phenomena 28 phenomena 29 that 28 phenomena 30 are 29 that 30 are 30 are 31 crucial 32 for 33 organogenesis 34 , 37 expression 34 , 38 , 35 including 36 gene 36 gene 37 expression 38 , 40 growth 38 , 41 , 39 cell 40 growth 41 , 43 remolding 41 , 44 , 42 matrix 43 remolding 44 , 45 proliferation 44 , 46 , 46 , 47 differentiation 46 , 48 and 48 and 49 apoptosis the expression of nos isoforms in embryonic tissues is temporally and spatially regulated , and disruption of endogenous no can lead to developmental defects . 0 ###LEFT-WALL### 2 expression 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 25 . 1 the 2 expression 2 expression 3 of 2 expression 11 and 3 of 5 isoforms 4 nos 5 isoforms 5 isoforms 6 in 6 in 8 tissues 7 embryonic 8 tissues 9 is 10 temporally 9 is 11 and 11 and 13 regulated 12 spatially 13 regulated 14 , 15 and 15 and 16 disruption 15 and 21 lead 16 disruption 17 of 16 disruption 20 can 17 of 19 no 18 endogenous 19 no 20 can 21 lead 21 lead 22 to 22 to 24 defects 23 developmental 24 defects maternal treatment with pan nos inhibitors during early organogenesis caused severe malformations of the axial skeleton . 0 ###LEFT-WALL### 2 treatment 0 ###LEFT-WALL### 10 caused 0 ###LEFT-WALL### 17 . 1 maternal 2 treatment 2 treatment 3 with 2 treatment 10 caused 3 with 6 inhibitors 4 pan 6 inhibitors 5 nos 6 inhibitors 6 inhibitors 7 during 7 during 9 organogenesis 8 early 9 organogenesis 10 caused 12 malformations 11 severe 12 malformations 12 malformations 13 of 13 of 16 skeleton 14 the 16 skeleton 15 axial 16 skeleton in [utero] exposure during the fetal period induced limb reduction defects of vascular origin . 0 ###LEFT-WALL### 3 exposure 0 ###LEFT-WALL### 8 induced 0 ###LEFT-WALL### 15 . 1 in 3 exposure 3 exposure 4 during 3 exposure 8 induced 4 during 7 period 5 the 7 period 6 fetal 7 period 8 induced 11 defects 9 limb 11 defects 10 reduction 11 defects 11 defects 12 of 12 of 14 origin 13 vascular 14 origin knock - out mice have been used to define the role of the various nos isoforms on the origin of the abnormal development . 0 ###LEFT-WALL### 4 mice 0 ###LEFT-WALL### 7 used 0 ###LEFT-WALL### 24 . 1 knock 2 - 1 knock 4 mice 3 out 4 mice 4 mice 5 have 5 have 6 been 6 been 7 used 7 used 8 to 7 used 9 define 8 to 9 define 9 define 11 role 9 define 17 on 10 the 11 role 11 role 12 of 12 of 16 isoforms 13 the 16 isoforms 14 various 16 isoforms 15 nos 16 isoforms 17 on 19 origin 18 the 19 origin 19 origin 20 of 20 of 23 development 21 the 23 development 22 abnormal 23 development cardiovascular malformations , limb reduction defects , reduced growth and reduced survival have been observed in knock [-] out mice with targeted disruption of endothelial nos ( enos ) . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 15 observed 0 ###LEFT-WALL### 30 . 1 cardiovascular 2 malformations 2 malformations 3 , 3 , 6 defects 3 , 7 , 4 limb 5 reduction 5 reduction 6 defects 7 , 9 growth 7 , 10 and 8 reduced 9 growth 10 and 12 survival 10 and 13 have 11 reduced 12 survival 13 have 14 been 14 been 15 observed 15 observed 16 in 16 in 20 mice 17 knock 20 mice 19 out 20 mice 20 mice 21 with 20 mice 24 of 20 mice 28 enos 21 with 23 disruption 22 targeted 23 disruption 24 of 26 nos 25 endothelial 26 nos 27 ( 28 enos 28 enos 29 ) limited morphological changes were observed in mice lacking inducible nos ( inos ) or neuronal nos [n] ( nos ) . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 5 observed 0 ###LEFT-WALL### 21 . 1 limited 3 changes 2 morphological 3 changes 3 changes 4 were 4 were 5 observed 5 observed 6 in 6 in 14 or 7 mice 8 lacking 7 mice 14 or 8 lacking 10 nos 9 inducible 10 nos 10 nos 12 inos 11 ( 12 inos 12 inos 13 ) 14 or 16 nos 14 or 19 nos 15 neuronal 16 nos 18 ( 19 nos 19 nos 20 ) results obtained [with] in vitro [studies] suggest that optimal levels of no are required for neural tube closure . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 7 suggest 0 ###LEFT-WALL### 19 . 1 results 2 obtained 1 results 7 suggest 4 in 5 vitro 5 vitro 7 suggest 7 suggest 8 that 8 that 10 levels 8 that 14 required 9 optimal 10 levels 10 levels 11 of 10 levels 13 are 11 of 12 no 13 are 14 required 14 required 15 for 15 for 18 closure 16 neural 17 tube 17 tube 18 closure disregulation of no production was also recently proposed as a contributing mechanism in the origin of malformations associated with exposure to known environmental teratogens , such as valproic acid , thalidomide , copper deficiency , and diabetes . 0 ###LEFT-WALL### 1 disregulation 0 ###LEFT-WALL### 8 proposed 0 ###LEFT-WALL### 38 . 1 disregulation 2 of 1 disregulation 5 was 2 of 4 production 3 no 4 production 5 was 6 also 5 was 8 proposed 7 recently 8 proposed 8 proposed 9 as 8 proposed 21 to 9 as 12 mechanism 9 as 19 with 10 a 12 mechanism 11 contributing 12 mechanism 12 mechanism 13 in 13 in 15 origin 14 the 15 origin 15 origin 16 of 15 origin 18 associated 16 of 17 malformations 19 with 20 exposure 21 to 36 and 22 known 24 teratogens 23 environmental 24 teratogens 24 teratogens 25 , 25 , 34 deficiency 25 , 36 and 26 such 34 deficiency 27 as 28 valproic 28 valproic 33 copper 29 acid 31 thalidomide 29 acid 32 , 29 acid 33 copper 30 , 31 thalidomide 31 thalidomide 32 , 33 copper 34 deficiency 35 , 36 and 36 and 37 diabetes [none] thrombotic events occurring in either arteries or veins are the primary causes of fatal perioperative cardiovascular events . 0 ###LEFT-WALL### 3 events 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 19 . 2 thrombotic 3 events 3 events 4 occurring 3 events 10 are 4 occurring 5 in 5 in 8 or 6 either 8 or 7 arteries 8 or 8 or 9 veins 10 are 13 causes 11 the 13 causes 12 primary 13 causes 13 causes 14 of 14 of 18 events 15 fatal 18 events 16 perioperative 18 events 17 cardiovascular 18 events risk factors for deep vein thrombosis , several of which are evidently associated with specific surgical procedures , are quite different from those for arterial thrombosis ( e.g [.] , aging or atherosclerotic diseases ) . 0 ###LEFT-WALL### 2 factors 0 ###LEFT-WALL### 19 are 0 ###LEFT-WALL### 36 . 1 risk 2 factors 2 factors 3 for 2 factors 8 several 2 factors 19 are 3 for 6 thrombosis 4 deep 5 vein 5 vein 6 thrombosis 7 , 8 several 8 several 9 of 8 several 18 , 9 of 10 which 9 of 11 are 10 which 11 are 11 are 12 evidently 11 are 14 with 12 evidently 13 associated 14 with 17 procedures 15 specific 17 procedures 16 surgical 17 procedures 19 are 21 different 20 quite 21 different 21 different 22 from 22 from 32 or 23 those 24 for 23 those 31 aging 23 those 32 or 24 for 26 thrombosis 25 arterial 26 thrombosis 26 thrombosis 28 e.g 27 ( 28 e.g 28 e.g 30 , 32 or 34 diseases 32 or 35 ) 33 atherosclerotic 34 diseases thrombus formed in arteries consists mainly of platelets coated with fibrin ( i.e [.] , white thrombus ) , while venous thrombus formed at relatively lower [shear] stress consists of all blood components including erythrocytes as well as leukocytes infiltrated with fibrin ( red thrombus ) . 0 ###LEFT-WALL### 1 thrombus 0 ###LEFT-WALL### 5 consists 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 47 . 1 thrombus 2 formed 1 thrombus 5 consists 2 formed 3 in 3 in 4 arteries 5 consists 6 mainly 5 consists 7 of 7 of 8 platelets 8 platelets 9 coated 9 coated 10 with 10 with 11 fibrin 11 fibrin 13 i.e 11 fibrin 17 thrombus 12 ( 13 i.e 13 i.e 15 , 15 , 17 thrombus 16 white 17 thrombus 17 thrombus 18 ) 19 , 32 blood 20 while 22 thrombus 20 while 29 consists 20 while 32 blood 21 venous 22 thrombus 22 thrombus 23 formed 22 thrombus 29 consists 23 formed 24 at 24 at 28 stress 25 relatively 26 lower 26 lower 28 stress 29 consists 30 of 30 of 31 all 32 blood 33 components 32 blood 38 as 33 components 34 including 34 including 35 erythrocytes 36 as 37 well 37 well 38 as 38 as 39 leukocytes 39 leukocytes 40 infiltrated 39 leukocytes 45 thrombus 40 infiltrated 41 with 41 with 42 fibrin 43 ( 45 thrombus 44 red 45 thrombus 45 thrombus 46 ) clinical evidence indicates beneficial roles of neuraxial anesthesia/analgesia in the prevention of vte for patients undergoing high risk surgical procedures . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 3 indicates 0 ###LEFT-WALL### 21 . 1 clinical 2 evidence 2 evidence 3 indicates 3 indicates 5 roles 3 indicates 9 in 3 indicates 14 for 4 beneficial 5 roles 5 roles 6 of 6 of 8 anesthesia/analgesia 7 neuraxial 8 anesthesia/analgesia 9 in 11 prevention 10 the 11 prevention 11 prevention 12 of 12 of 13 vte 14 for 15 patients 15 patients 16 undergoing 16 undergoing 20 procedures 17 high 20 procedures 18 risk 20 procedures 19 surgical 20 procedures to date , mechanisms of action of drugs used for neuraxial anesthesia/analgesia to prevent venous thrombosis are uncertain . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 date 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 19 . 1 to 2 date 3 , 4 mechanisms 3 , 17 are 4 mechanisms 5 of 4 mechanisms 17 are 5 of 6 action 6 action 7 of 7 of 8 drugs 8 drugs 9 used 9 used 10 for 9 used 13 to 9 used 14 prevent 10 for 12 anesthesia/analgesia 11 neuraxial 12 anesthesia/analgesia 13 to 14 prevent 14 prevent 16 thrombosis 15 venous 16 thrombosis 17 are 18 uncertain however , accumulation of clinical as well as experimental findings points to the involvement of immune cells ( especially monocytes ) in red thrombus generation and to the interaction of anesthetics with these cells . 0 ###LEFT-WALL### 3 accumulation 0 ###LEFT-WALL### 11 points 0 ###LEFT-WALL### 35 . 1 however 2 , 1 however 3 accumulation 3 accumulation 4 of 3 accumulation 11 points 4 of 10 findings 5 clinical 10 findings 6 as 7 well 7 well 9 experimental 8 as 9 experimental 9 experimental 10 findings 11 points 12 to 11 points 32 with 12 to 14 involvement 13 the 14 involvement 14 involvement 15 of 14 involvement 26 and 15 of 17 cells 16 immune 17 cells 17 cells 20 monocytes 18 ( 19 especially 18 ( 20 monocytes 20 monocytes 21 ) 22 in 25 generation 22 in 26 and 23 red 24 thrombus 24 thrombus 25 generation 26 and 27 to 27 to 29 interaction 28 the 29 interaction 29 interaction 30 of 30 of 31 anesthetics 32 with 34 cells 33 these 34 cells local anesthetics and nk1r antagonists are candidate drugs that may possess the capability to prevent venous thrombotic disorders in perioperative settings . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 22 . 1 local 2 anesthetics 2 anesthetics 3 and 3 and 5 antagonists 3 and 6 are 4 nk1r 5 antagonists 6 are 8 drugs 7 candidate 8 drugs 8 drugs 9 that 8 drugs 15 prevent 9 that 10 may 10 may 11 possess 11 possess 13 capability 11 possess 14 to 12 the 13 capability 14 to 15 prevent 15 prevent 18 disorders 15 prevent 19 in 16 venous 18 disorders 17 thrombotic 18 disorders 19 in 21 settings 20 perioperative 21 settings none age of patients and brain oxidative stress may contribute to pathogenesis of alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 15 's 0 ###LEFT-WALL### 20 . 1 none 2 age 1 none 10 contribute 1 none 15 's 2 age 3 of 2 age 9 may 3 of 5 and 4 patients 5 and 5 and 8 stress 6 brain 8 stress 7 oxidative 8 stress 9 may 10 contribute 10 contribute 11 to 11 to 12 pathogenesis 12 pathogenesis 13 of 13 of 14 alzheimer 15 's 16 disease 16 disease 18 ad 17 ( 18 ad 18 ad 19 ) erythrocytes ( red blood cells , rbc ) are considered as passive " reporter cells " for the oxidative status of the whole organism and [are] not well studied in ad . 0 ###LEFT-WALL### 1 erythrocytes 0 ###LEFT-WALL### 10 considered 0 ###LEFT-WALL### 32 . 1 erythrocytes 5 cells 1 erythrocytes 7 rbc 1 erythrocytes 9 are 2 ( 5 cells 3 red 4 blood 4 blood 5 cells 5 cells 6 , 6 , 7 rbc 7 rbc 8 ) 9 are 10 considered 10 considered 25 and 10 considered 30 in 11 as 12 passive 12 passive 13 " 12 passive 14 reporter 14 reporter 15 cells 15 cells 16 " 15 cells 17 for 15 cells 25 and 17 for 20 status 18 the 20 status 19 oxidative 20 status 20 status 21 of 21 of 24 organism 22 the 24 organism 23 whole 24 organism 25 and 27 not 25 and 28 well 28 well 29 studied 30 in 31 ad the aim of this work was to assess whether the antioxidant status of rbc changes in aging and ad . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 20 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 work 4 this 5 work 6 was 7 to 6 was 8 assess 7 to 8 assess 8 assess 9 whether 9 whether 12 status 9 whether 15 changes 10 the 12 status 11 antioxidant 12 status 12 status 13 of 12 status 15 changes 13 of 14 rbc 15 changes 16 in 16 in 18 and 17 aging 18 and 18 and 19 ad blood was taken from ad [and] [non] - alzheimer 's dementia patients , aged - matched and younger controls . 0 ###LEFT-WALL### 1 blood 0 ###LEFT-WALL### 3 taken 0 ###LEFT-WALL### 20 . 1 blood 2 was 2 was 3 taken 3 taken 4 from 4 from 19 controls 5 ad 12 patients 5 ad 16 matched 5 ad 17 and 8 - 12 patients 9 alzheimer 10 's 10 's 12 patients 11 dementia 12 patients 12 patients 14 aged 12 patients 15 - 13 , 14 aged 14 aged 15 - 17 and 18 younger 17 and 19 controls in vivo antioxidant status was assessed in each of the study subjects by measuring rbc levels of h202 , organic hydroperoxides , glutathione ( gsh ) and glutathione [disulfide] ( gssg ) , activities of superoxide dismutase , [catalase] [,] glutathione peroxidase , glutathione reductase , glutathione s - transferase , and glucose - 6 - phosphate dehydrogenase . 0 ###LEFT-WALL### 3 antioxidant 1 in 2 vivo 2 vivo 3 antioxidant 3 antioxidant 5 was 3 antioxidant 7 in 3 antioxidant 13 by 4 status 5 was 5 was 6 assessed 7 in 8 each 8 each 9 of 9 of 12 subjects 10 the 12 subjects 11 study 12 subjects 13 by 14 measuring 14 measuring 16 levels 15 rbc 16 levels 16 levels 17 of 17 of 27 and 18 h202 21 hydroperoxides 18 h202 27 and 19 , 21 hydroperoxides 20 organic 21 hydroperoxides 21 hydroperoxides 23 glutathione 21 hydroperoxides 26 ) 22 , 23 glutathione 23 glutathione 25 gsh 23 glutathione 26 ) 24 ( 25 gsh 25 gsh 26 ) 27 and 34 activities 27 and 35 of 28 glutathione 31 gssg 28 glutathione 33 , 28 glutathione 34 activities 30 ( 31 gssg 31 gssg 32 ) 35 of 37 dismutase 36 superoxide 37 dismutase 37 dismutase 42 peroxidase 37 dismutase 47 glutathione 38 , 42 peroxidase 41 glutathione 42 peroxidase 42 peroxidase 45 reductase 42 peroxidase 46 , 43 , 45 reductase 44 glutathione 45 reductase 45 reductase 46 , 46 , 47 glutathione 47 glutathione 48 s 47 glutathione 52 and 47 glutathione 59 . 49 - 52 and 50 transferase 52 and 51 , 52 and 52 and 53 glucose 52 and 56 - 52 and 59 . 54 - 56 - 55 6 56 - 56 - 58 dehydrogenase 56 - 59 . 57 phosphate 58 dehydrogenase in both aging and dementia , oxidative stress in rbc was shown to increase and to be expressed in elevated concentrations of h202 and organic hydroperoxides , decreased the gsh/gssg ratio and glutathione s - transferase activity . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 38 . 1 in 3 aging 1 in 4 and 2 both 3 aging 4 and 5 dementia 6 , 8 stress 6 , 12 shown 7 oxidative 8 stress 8 stress 9 in 8 stress 11 was 9 in 10 rbc 11 was 12 shown 12 shown 13 to 13 to 15 and 14 increase 15 and 15 and 16 to 15 and 18 expressed 15 and 19 in 16 to 17 be 19 in 27 , 20 elevated 24 and 20 elevated 27 , 21 concentrations 22 of 21 concentrations 24 and 22 of 23 h202 24 and 26 hydroperoxides 25 organic 26 hydroperoxides 27 , 28 decreased 28 decreased 37 activity 29 the 31 ratio 30 gsh/gssg 31 ratio 31 ratio 32 and 32 and 33 glutathione 32 and 35 - 32 and 36 transferase 33 glutathione 34 s 36 transferase 37 activity decreased glutathione peroxidase activity in rbc may be considered as a new peripheral marker for alzheimer 's disease while alterations of other parameters of oxidative stress reflect age - related events . 0 ###LEFT-WALL### 4 activity 0 ###LEFT-WALL### 9 considered 0 ###LEFT-WALL### 30 related 0 ###LEFT-WALL### 32 . 1 decreased 3 peroxidase 2 glutathione 3 peroxidase 3 peroxidase 4 activity 4 activity 5 in 4 activity 7 may 5 in 6 rbc 7 may 8 be 8 be 9 considered 9 considered 10 as 9 considered 15 for 9 considered 19 while 10 as 14 marker 11 a 14 marker 12 new 14 marker 13 peripheral 14 marker 15 for 18 disease 16 alzheimer 17 's 17 's 18 disease 19 while 20 alterations 19 while 27 reflect 20 alterations 21 of 20 alterations 24 of 20 alterations 27 reflect 21 of 23 parameters 22 other 23 parameters 24 of 26 stress 25 oxidative 26 stress 27 reflect 28 age 29 - 30 related 30 related 31 events introduction : controversial results on the relationship between the left - handedness and neurotic disturbances have been obtained in so far investigations . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 . 1 introduction 2 : 2 : 4 results 3 controversial 4 results 4 results 5 on 5 on 7 relationship 6 the 7 relationship 7 relationship 8 between 8 between 12 handedness 9 the 12 handedness 10 left 11 - 10 left 12 handedness 13 and 15 disturbances 13 and 18 obtained 14 neurotic 15 disturbances 15 disturbances 16 have 16 have 17 been 17 been 18 obtained 18 obtained 19 in 19 in 22 investigations 20 so 21 far 21 far 22 investigations objective : the aim of this study was to investigate the link between the left - handedness and neurotic disturbances in an adult urban population . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 8 was 2 : 26 . 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 investigate 10 investigate 12 link 10 investigate 13 between 11 the 12 link 13 between 18 and 14 the 17 handedness 15 left 16 - 15 left 17 handedness 17 handedness 18 and 18 and 20 disturbances 19 neurotic 20 disturbances 20 disturbances 21 in 21 in 25 population 22 an 25 population 23 adult 25 population 24 urban 25 population methods : a cross - sectional study was performed on 1,202 adult residents of the stari grad municipality in belgrade , out of [which] 401 were males ( 33.4 % ) and 801 were females ( 66.6 % ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 40 . 1 methods 2 : 2 : 4 cross 3 a 4 cross 5 - 7 study 5 - 9 performed 5 - 21 , 5 - 26 were 5 - 32 and 6 sectional 7 study 7 study 8 was 8 was 9 performed 9 performed 10 on 9 performed 19 in 10 on 13 residents 11 1,202 13 residents 12 adult 13 residents 13 residents 14 of 14 of 18 municipality 15 the 18 municipality 16 stari 18 municipality 17 grad 18 municipality 19 in 20 belgrade 21 , 23 of 21 , 26 were 22 out 23 of 23 of 25 401 23 of 26 were 26 were 27 males 27 males 30 % 28 ( 30 % 29 33.4 30 % 30 % 31 ) 32 and 33 801 32 and 34 were 33 801 34 were 34 were 35 females 35 females 38 % 36 ( 38 % 37 66.6 38 % 38 % 39 ) a questionnaire was used as an investigation instrument , with questions concerning age , gender , writing hand and neurotic disturbances : tension , agressiveness , anger , nervousness , weepiness and seclusion . 0 ###LEFT-WALL### 2 questionnaire 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 22 : 0 ###LEFT-WALL### 34 . 1 a 2 questionnaire 2 questionnaire 3 was 3 was 4 used 4 used 5 as 5 as 8 instrument 6 an 7 investigation 6 an 8 instrument 7 investigation 8 instrument 8 instrument 10 with 8 instrument 19 and 9 , 10 with 10 with 11 questions 10 with 14 , 11 questions 12 concerning 12 concerning 13 age 14 , 19 and 15 gender 16 , 16 , 18 hand 16 , 19 and 17 writing 18 hand 19 and 21 disturbances 19 and 22 : 20 neurotic 21 disturbances 22 : 32 and 23 tension 24 , 24 , 29 nervousness 24 , 30 , 25 agressiveness 27 anger 25 agressiveness 28 , 25 agressiveness 29 nervousness 26 , 27 anger 27 anger 28 , 30 , 31 weepiness 30 , 32 and 32 and 33 seclusion results : left - handedness was found in 60 subjects ( 5 % ) and it was statistically more frequent in males ( 7.7 % [ )(compared to females ( 3.6 % ) ( p = 0.003 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 handedness 2 : 7 found 2 : 15 and 2 : 39 . 3 left 4 - 3 left 5 handedness 5 handedness 6 was 6 was 7 found 7 found 8 in 8 in 10 subjects 9 60 10 subjects 10 subjects 13 % 11 ( 13 % 12 5 13 % 13 % 14 ) 15 and 16 it 15 and 17 was 16 it 17 was 17 was 18 statistically 17 was 19 more 17 was 20 frequent 20 frequent 21 in 21 in 22 males 22 males 25 % 22 males 36 = 23 ( 25 % 24 7.7 25 % 25 % 27 )(compared 25 % 33 ) 27 )(compared 28 to 28 to 29 females 29 females 32 % 30 ( 32 % 31 3.6 32 % 32 % 33 ) 34 ( 36 = 35 p 36 = 36 = 37 0.003 36 = 38 ) a decreasing trend of proportion of left - [handed] males was found in relation to aging . 0 ###LEFT-WALL### 3 trend 0 ###LEFT-WALL### 12 found 0 ###LEFT-WALL### 17 . 1 a 3 trend 2 decreasing 3 trend 3 trend 4 of 3 trend 11 was 4 of 5 proportion 5 proportion 6 of 6 of 10 males 7 left 8 - 7 left 10 males 11 was 12 found 12 found 15 to 13 in 14 relation 14 relation 15 to 15 to 16 aging in the age group 18 to 39 years , agressiveness , as a specific neurotic disturbance , was significantly more frequent in left - [handed] males in comparison to right - handers ( p = 0.035 ) . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 18 was 0 ###LEFT-WALL### 38 . 1 in 3 age 1 in 4 group 2 the 3 age 4 group 5 18 4 group 6 to 4 group 12 as 4 group 18 was 6 to 8 years 7 39 8 years 8 years 10 agressiveness 9 , 10 agressiveness 10 agressiveness 11 , 11 , 12 as 12 as 16 disturbance 12 as 17 , 13 a 14 specific 13 a 16 disturbance 14 specific 15 neurotic 15 neurotic 16 disturbance 18 was 19 significantly 18 was 21 frequent 20 more 21 frequent 21 frequent 22 in 21 frequent 27 in 21 frequent 29 to 22 in 26 males 23 left 24 - 23 left 26 males 27 in 28 comparison 29 to 32 handers 30 right 31 - 30 right 32 handers 32 handers 35 = 33 ( 35 = 34 p 35 = 35 = 36 0.035 35 = 37 ) in the age group 40 to 59 years , neurotic disturbances were more common among left - [handed] males compared to right - handers ( p = 0.030 ).there were no significant diferences in the proportion of neurotic disturbances between the left - handed and the right - handed females . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 9 , 1 in 3 age 1 in 4 group 2 the 3 age 4 group 6 to 4 group 8 years 5 40 6 to 6 to 7 59 7 59 8 years 9 , 11 disturbances 9 , 17 - 10 neurotic 11 disturbances 11 disturbances 12 were 12 were 14 common 13 more 14 common 14 common 15 among 15 among 16 left 17 - 19 males 17 - 20 compared 17 - 23 - 19 males 20 compared 20 compared 21 to 21 to 22 right 23 - 24 handers 23 - 30 were 24 handers 27 = 24 handers 30 were 25 ( 27 = 26 p 27 = 27 = 29 ).there 28 0.030 29 ).there 30 were 33 diferences 30 were 34 in 31 no 33 diferences 32 significant 33 diferences 34 in 45 and 35 the 36 proportion 36 proportion 37 of 36 proportion 40 between 36 proportion 45 and 37 of 39 disturbances 38 neurotic 39 disturbances 40 between 42 left 41 the 42 left 42 left 44 handed 43 - 44 handed 45 and 47 right 45 and 49 handed 46 the 47 right 48 - 49 handed 49 handed 50 females 49 handed 51 . conclusion : from a public health point of view , left - handed men may be regarded as a relatively vulnerable population category concerning mental health . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 14 men 2 : 17 regarded 2 : 27 . 3 from 7 point 3 from 14 men 4 a 5 public 4 a 7 point 5 public 6 health 6 health 7 point 7 point 8 of 7 point 13 handed 8 of 9 view 9 view 11 left 10 , 11 left 11 left 12 - 14 men 15 may 15 may 16 be 16 be 17 regarded 17 regarded 18 as 18 as 23 category 19 a 20 relatively 19 a 23 category 20 relatively 21 vulnerable 21 vulnerable 22 population 22 population 23 category 23 category 24 concerning 24 concerning 26 health 25 mental 26 health the purpose of this paper is to analyze the self - perception of weight in relation with the body mass index and the body composition of three working groups composed of physically untrained young students , young athletes and patients diagnosed with chronic diseases . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 6 is 1 the 2 purpose 2 purpose 3 of 2 purpose 6 is 3 of 5 paper 4 this 5 paper 6 is 7 to 7 to 8 analyze 8 analyze 10 self 9 the 10 self 10 self 12 perception 11 - 12 perception 12 perception 13 of 12 perception 15 in 12 perception 17 with 12 perception 26 of 12 perception 45 . 13 of 14 weight 15 in 16 relation 17 with 22 and 18 the 21 index 19 body 20 mass 20 mass 21 index 21 index 22 and 22 and 25 composition 23 the 25 composition 24 body 25 composition 26 of 29 groups 27 three 29 groups 28 working 29 groups 29 groups 31 of 30 composed 31 of 31 of 39 and 31 of 42 with 32 physically 33 untrained 33 untrained 35 students 34 young 35 students 35 students 36 , 36 , 38 athletes 36 , 39 and 37 young 38 athletes 39 and 40 patients 39 and 41 diagnosed 42 with 44 diseases 43 chronic 44 diseases the working groups consisted of 110 participants : untrained students , athletes and dialysed patients ; 50.9 % women and 49.1 % men [;] with an average age of 26.03 . 0 ###LEFT-WALL### 3 groups 0 ###LEFT-WALL### 4 consisted 0 ###LEFT-WALL### 8 : 0 ###LEFT-WALL### 31 . 1 the 3 groups 2 working 3 groups 3 groups 4 consisted 4 consisted 5 of 5 of 7 participants 6 110 7 participants 8 : 10 students 8 : 16 ; 9 untrained 10 students 10 students 13 and 11 , 13 and 12 athletes 13 and 13 and 15 patients 13 and 16 ; 14 dialysed 15 patients 16 ; 20 and 17 50.9 19 women 18 % 19 women 19 women 20 and 20 and 23 men 20 and 29 of 21 49.1 23 men 22 % 23 men 23 men 25 with 25 with 28 age 26 an 28 age 27 average 28 age 29 of 30 26.03 the bmi of the patients is significantly higher than the bmi of the athletes and untrained students . 0 ###LEFT-WALL### 2 bmi 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 18 . 1 the 2 bmi 2 bmi 3 of 2 bmi 6 is 3 of 5 patients 4 the 5 patients 6 is 7 significantly 6 is 8 higher 8 higher 9 than 9 than 11 bmi 9 than 12 of 10 the 11 bmi 12 of 15 and 13 the 14 athletes 14 athletes 15 and 15 and 17 students 16 untrained 17 students no significant differences were found between groups in terms of self [-] perception of weight . 0 ###LEFT-WALL### 3 differences 0 ###LEFT-WALL### 5 found 0 ###LEFT-WALL### 16 . 1 no 3 differences 2 significant 3 differences 3 differences 4 were 4 were 5 found 5 found 6 between 5 found 8 in 6 between 7 groups 8 in 9 terms 9 terms 10 of 10 of 13 perception 11 self 13 perception 13 perception 14 of 14 of 15 weight compared to the physically untrained students and patients , the athletes have a significantly higher level of muscle tissue . 0 ###LEFT-WALL### 11 athletes 0 ###LEFT-WALL### 12 have 0 ###LEFT-WALL### 20 . 1 compared 2 to 1 compared 9 , 1 compared 11 athletes 2 to 7 and 3 the 6 students 4 physically 5 untrained 5 untrained 6 students 6 students 7 and 7 and 8 patients 10 the 11 athletes 11 athletes 12 have 12 have 16 level 13 a 16 level 14 significantly 15 higher 15 higher 16 level 16 level 17 of 17 of 19 tissue 18 muscle 19 tissue the athletes also have a significantly lower adipose tissue than that of the physically untrained students and patients . 0 ###LEFT-WALL### 2 athletes 0 ###LEFT-WALL### 4 have 0 ###LEFT-WALL### 19 . 1 the 2 athletes 2 athletes 4 have 3 also 4 have 4 have 9 tissue 4 have 10 than 5 a 9 tissue 6 significantly 7 lower 7 lower 8 adipose 8 adipose 9 tissue 10 than 11 that 10 than 12 of 12 of 17 and 13 the 16 students 14 physically 15 untrained 15 untrained 16 students 16 students 17 and 17 and 18 patients ageing is inevitably associated with a decline in physiologic reserves . 0 ###LEFT-WALL### 1 ageing 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 11 . 1 ageing 2 is 2 is 4 associated 3 inevitably 4 associated 4 associated 5 with 4 associated 8 in 5 with 7 decline 6 a 7 decline 8 in 10 reserves 9 physiologic 10 reserves frailty results from reaching a threshold of [decline] across multiple organ systems . 0 ###LEFT-WALL### 1 frailty 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 13 . 1 frailty 2 results 2 results 3 from 3 from 4 reaching 4 reaching 6 threshold 5 a 6 threshold 6 threshold 7 of 7 of 9 across 9 across 12 systems 10 multiple 11 organ 11 organ 12 systems [by] consequence , it is associated with a high vulnerability and reduced ability to maintain homeostasis . 0 ###LEFT-WALL### 2 consequence 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 17 . 3 , 4 it 3 , 11 and 4 it 11 and 5 is 6 associated 5 is 11 and 6 associated 7 with 7 with 10 vulnerability 8 a 9 high 8 a 10 vulnerability 9 high 10 vulnerability 11 and 12 reduced 11 and 13 ability 13 ability 14 to 13 ability 15 maintain 14 to 15 maintain 15 maintain 16 homeostasis this vulnerability is not only age - related , but also related to disability and comorbidity , as illustrated by three clinical cases . 0 ###LEFT-WALL### 2 vulnerability 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 24 . 1 this 2 vulnerability 2 vulnerability 10 but 3 is 4 not 3 is 5 only 3 is 6 age 3 is 8 related 3 is 10 but 7 - 8 related 8 related 9 , 10 but 12 related 11 also 12 related 12 related 13 to 12 related 20 by 13 to 15 and 14 disability 15 and 15 and 16 comorbidity 15 and 19 illustrated 17 , 19 illustrated 18 as 19 illustrated 20 by 23 cases 21 three 23 cases 22 clinical 23 cases sarcopenia , which is defined as age - related loss of muscle [mass] , is considered to be a central manifestation of frailty . 0 ###LEFT-WALL### 1 sarcopenia 0 ###LEFT-WALL### 16 considered 0 ###LEFT-WALL### 24 . 1 sarcopenia 3 which 1 sarcopenia 15 is 2 , 3 which 3 which 4 is 3 which 8 - 4 is 5 defined 5 defined 6 as 6 as 7 age 8 - 9 related 9 related 10 loss 9 related 14 , 9 related 15 is 10 loss 11 of 11 of 12 muscle 15 is 16 considered 16 considered 17 to 16 considered 18 be 17 to 18 be 18 be 21 manifestation 19 a 21 manifestation 20 central 21 manifestation 21 manifestation 22 of 22 of 23 frailty in addition to being highly prevalent in elderly population , frailty also exerts a substantial impact on quality of life . 0 ###LEFT-WALL### 11 frailty 0 ###LEFT-WALL### 13 exerts 0 ###LEFT-WALL### 21 . 1 in 2 addition 1 in 10 , 1 in 11 frailty 2 addition 3 to 3 to 4 being 4 being 6 prevalent 5 highly 6 prevalent 6 prevalent 7 in 7 in 9 population 8 elderly 9 population 11 frailty 13 exerts 12 also 13 exerts 13 exerts 16 impact 13 exerts 17 on 14 a 15 substantial 14 a 16 impact 15 substantial 16 impact 17 on 18 quality 18 quality 19 of 19 of 20 life as it is extremely challenging by defying conventional medication and involving new [therapeutically] approaches , frailty fully qualifies as a new geriatric syndrome . 0 ###LEFT-WALL### 16 frailty 0 ###LEFT-WALL### 24 . 1 as 2 it 1 as 3 is 1 as 15 , 1 as 16 frailty 2 it 3 is 3 is 5 challenging 4 extremely 5 challenging 5 challenging 6 by 6 by 10 and 7 defying 9 medication 8 conventional 9 medication 9 medication 10 and 10 and 14 approaches 10 and 15 , 11 involving 14 approaches 12 new 14 approaches 16 frailty 18 qualifies 17 fully 18 qualifies 18 qualifies 19 as 19 as 23 syndrome 20 a 21 new 20 a 23 syndrome 21 new 23 syndrome 22 geriatric 23 syndrome aim : the aim of this research is to contribute new data related to the incidence [of] essential hypertension in elderly patients [with] metabolic [syndrome] . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 13 related 2 : 26 . 3 the 4 aim 4 aim 5 of 4 aim 8 is 5 of 7 research 6 this 7 research 8 is 9 to 8 is 13 related 9 to 10 contribute 10 contribute 12 data 11 new 12 data 13 related 14 to 13 related 20 in 13 related 24 metabolic 14 to 19 hypertension 15 the 19 hypertension 16 incidence 19 hypertension 18 essential 19 hypertension 20 in 22 patients 21 elderly 22 patients material and methods : the current study was conducted on a number of 1,832 patients hospitalized in the cardiovascular rehabilitation clinic of rehabilitation hospital iasi , in the period [october] 2010 - july 2012 . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 35 . 1 material 2 and 2 and 3 methods 4 : 6 current 4 : 9 conducted 5 the 6 current 6 current 7 study 6 current 8 was 6 current 9 conducted 7 study 8 was 9 conducted 10 on 9 conducted 17 in 9 conducted 33 july 10 on 15 patients 11 a 12 number 12 number 13 of 12 number 15 patients 13 of 15 patients 14 1,832 15 patients 15 patients 16 hospitalized 17 in 25 iasi 18 the 25 iasi 19 cardiovascular 20 rehabilitation 20 rehabilitation 21 clinic 21 clinic 22 of 21 clinic 24 hospital 22 of 23 rehabilitation 24 hospital 25 iasi 25 iasi 27 in 26 , 27 in 27 in 29 period 27 in 32 - 28 the 29 period 29 period 31 2010 33 july 34 2012 of these patients we selected the ones who were 65 years of age or more and who fulfilled at least three of the five criteria that define the metabolic syndrome , using the criteria recommended by aha/nhlbi . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 selected 0 ###LEFT-WALL### 16 and 1 of 3 patients 1 of 4 we 2 these 3 patients 4 we 5 selected 5 selected 7 ones 6 the 7 ones 7 ones 8 who 7 ones 9 were 8 who 9 were 9 were 14 or 10 65 11 years 11 years 12 of 11 years 14 or 12 of 13 age 14 or 15 more 16 and 17 who 16 and 18 fulfilled 17 who 18 fulfilled 18 fulfilled 21 three 19 at 20 least 20 least 21 three 21 three 22 of 21 three 26 that 21 three 27 define 22 of 25 criteria 23 the 25 criteria 24 five 25 criteria 26 that 27 define 27 define 30 syndrome 27 define 32 using 28 the 30 syndrome 29 metabolic 30 syndrome 31 , 32 using 32 using 34 criteria 32 using 38 . 33 the 34 criteria 34 criteria 35 recommended 35 recommended 36 by 36 by 37 aha/nhlbi results : the data obtained revealed an increased incidence of the cardiometabolic syndrome in patients over 65 years of age , in a percentage of 73 % . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 data 2 : 6 revealed 3 the 4 data 4 data 5 obtained 4 data 6 revealed 6 revealed 9 incidence 6 revealed 14 in 6 revealed 16 over 7 an 9 incidence 8 increased 9 incidence 9 incidence 10 of 10 of 13 syndrome 11 the 13 syndrome 12 cardiometabolic 13 syndrome 14 in 15 patients 16 over 18 years 17 65 18 years 18 years 19 of 19 of 20 age 20 age 22 in 21 , 22 in 22 in 24 percentage 22 in 28 . 23 a 24 percentage 24 percentage 25 of 25 of 27 % 26 73 27 % the gender [repartition] revealed a higher frequency in the case of female patients ( 66 % ) . 0 ###LEFT-WALL### 2 gender 0 ###LEFT-WALL### 4 revealed 0 ###LEFT-WALL### 18 . 1 the 2 gender 2 gender 4 revealed 4 revealed 7 frequency 4 revealed 8 in 5 a 7 frequency 6 higher 7 frequency 8 in 10 case 9 the 10 case 10 case 11 of 11 of 13 patients 12 female 13 patients 13 patients 16 % 14 ( 16 % 15 66 16 % 16 % 17 ) of the metabolic syndrome criteria , the highest incidence was registered for the essential hypertension . 0 ###LEFT-WALL### 9 incidence 0 ###LEFT-WALL### 11 registered 0 ###LEFT-WALL### 16 . 1 of 5 criteria 1 of 6 , 1 of 9 incidence 2 the 5 criteria 3 metabolic 4 syndrome 4 syndrome 5 criteria 7 the 8 highest 7 the 9 incidence 9 incidence 10 was 10 was 11 registered 11 registered 12 for 12 for 15 hypertension 13 the 15 hypertension 14 essential 15 hypertension most of the hypertensive patients were diagnosed with essential hypertension grade 3 ( 55 % ) , while the rest had grade 2 ( 29 % ) and grade 1 [respectively] ( 16 % ) . 0 ###LEFT-WALL### 5 patients 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 36 . 1 most 2 of 1 most 5 patients 2 of 5 patients 3 the 5 patients 4 hypertensive 5 patients 5 patients 28 and 6 were 7 diagnosed 6 were 28 and 7 diagnosed 8 with 7 diagnosed 18 while 8 with 11 grade 9 essential 10 hypertension 10 hypertension 11 grade 11 grade 12 3 11 grade 15 % 13 ( 15 % 14 55 15 % 15 % 16 ) 17 , 18 while 18 while 20 rest 18 while 21 had 18 while 27 ) 19 the 20 rest 20 rest 21 had 21 had 22 grade 22 grade 23 2 22 grade 26 % 24 ( 26 % 25 29 26 % 26 % 27 ) 28 and 29 grade 29 grade 30 1 30 1 34 % 32 ( 34 % 33 16 34 % 34 % 35 ) conclusion : eht has a significant occurrence in elderly patients . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 eht 2 : 4 has 2 : 11 . 3 eht 4 has 4 has 7 occurrence 4 has 8 in 5 a 6 significant 5 a 7 occurrence 6 significant 7 occurrence 8 in 10 patients 9 elderly 10 patients [it] [seems] that hypertension of the elderly has a higher occurrence in the case of female patients , due to the lack of hormonal protection . 0 ###LEFT-WALL### 4 hypertension 0 ###LEFT-WALL### 8 has 3 that 4 hypertension 4 hypertension 5 of 4 hypertension 8 has 5 of 7 elderly 6 the 7 elderly 8 has 11 occurrence 8 has 12 in 9 a 11 occurrence 10 higher 11 occurrence 12 in 14 case 13 the 14 case 14 case 15 of 15 of 17 patients 16 female 17 patients 17 patients 20 to 18 , 20 to 19 due 20 to 20 to 22 lack 20 to 26 . 21 the 22 lack 22 lack 23 of 23 of 25 protection 24 hormonal 25 protection the association with the other risk factors related to the metabolic syndrome makes the elderly more prone to the occurrence and development of cardiovascular diseases . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 13 makes 0 ###LEFT-WALL### 26 . 1 the 2 association 2 association 3 with 2 association 13 makes 3 with 7 factors 4 the 5 other 5 other 7 factors 6 risk 7 factors 7 factors 8 related 8 related 9 to 9 to 12 syndrome 10 the 12 syndrome 11 metabolic 12 syndrome 13 makes 15 elderly 13 makes 17 prone 14 the 15 elderly 16 more 17 prone 17 prone 18 to 18 to 21 and 19 the 20 occurrence 20 occurrence 21 and 21 and 22 development 21 and 23 of 23 of 25 diseases 24 cardiovascular 25 diseases keywords : essential hypertension , elderly people , objective : to observe the occurrence condition of endoleak after endovascular aneurysm repair ( evar ) [operation] for abdominal aortic aneurysm ( aaa ) , and to analyze the factors of the endoleak . 0 ###LEFT-WALL### 1 keywords 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 42 . 1 keywords 2 : 2 : 4 hypertension 3 essential 4 hypertension 5 , 6 elderly 5 , 34 and 6 elderly 9 objective 6 elderly 11 to 6 elderly 34 and 7 people 9 objective 8 , 9 objective 9 objective 10 : 10 : 11 to 12 observe 15 condition 12 observe 18 after 12 observe 26 for 12 observe 34 and 13 the 15 condition 14 occurrence 15 condition 15 condition 16 of 16 of 17 endoleak 18 after 21 repair 19 endovascular 20 aneurysm 20 aneurysm 21 repair 21 repair 23 evar 22 ( 23 evar 23 evar 24 ) 26 for 29 aneurysm 27 abdominal 29 aneurysm 28 aortic 29 aneurysm 29 aneurysm 31 aaa 30 ( 31 aaa 31 aaa 32 ) 33 , 34 and 34 and 35 to 34 and 36 analyze 35 to 36 analyze 36 analyze 38 factors 37 the 38 factors 38 factors 39 of 39 of 41 endoleak 40 the 41 endoleak methods : between july 2005 and june 2013 , 210 cases of aaa were treated with evar . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 18 . 1 methods 2 : 2 : 3 between 3 between 6 and 4 july 5 2005 4 july 6 and 6 and 7 june 7 june 8 2013 9 , 11 cases 9 , 15 treated 10 210 11 cases 11 cases 12 of 11 cases 14 were 12 of 13 aaa 14 were 15 treated 15 treated 16 with 16 with 17 evar of 210 patients , 175 were male and 35 were female , aging 42 - 89 years ( mean , 65.7 years ) . 0 ###LEFT-WALL### 5 175 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 24 . 1 of 3 patients 1 of 4 , 1 of 5 175 2 210 3 patients 5 175 6 were 6 were 7 male 8 and 9 35 8 and 10 were 9 35 10 were 10 were 17 years 11 female 12 , 11 female 17 years 13 aging 17 years 14 42 15 - 15 - 16 89 15 - 17 years 17 years 22 years 18 ( 22 years 19 mean 20 , 19 mean 22 years 21 65.7 22 years 22 years 23 ) the patients were all proved to have infrarenal aaa by computed tomography angiography ( cta ) . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 5 proved 0 ###LEFT-WALL### 17 . 1 the 2 patients 2 patients 3 were 3 were 5 proved 4 all 5 proved 5 proved 6 to 5 proved 7 have 6 to 7 have 7 have 9 aaa 7 have 10 by 8 infrarenal 9 aaa 10 by 13 angiography 11 computed 12 tomography 12 tomography 13 angiography 13 angiography 15 cta 14 ( 15 cta 15 cta 16 ) the disease duration ranged from 1 week to 2 years ( median , 11.3 weeks ) . 0 ###LEFT-WALL### 3 duration 0 ###LEFT-WALL### 4 ranged 0 ###LEFT-WALL### 17 . 1 the 3 duration 2 disease 3 duration 3 duration 4 ranged 4 ranged 5 from 5 from 8 to 6 1 7 week 7 week 8 to 8 to 10 years 8 to 15 weeks 9 2 10 years 11 ( 15 weeks 12 median 13 , 12 median 15 weeks 14 11.3 15 weeks 15 weeks 16 ) the maximum diameter of the aneurysms was 44 - 72 mm [(] [mean] , 57.3 mm ) . 0 ###LEFT-WALL### 3 diameter 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 18 . 1 the 3 diameter 2 maximum 3 diameter 3 diameter 4 of 3 diameter 7 was 4 of 6 aneurysms 5 the 6 aneurysms 7 was 8 44 8 44 11 mm 8 44 16 mm 9 - 11 mm 10 72 11 mm 11 mm 14 , 14 , 16 mm 15 57.3 16 mm 16 mm 17 ) the proximal landing zone was longer than 1.5 cm . 0 ###LEFT-WALL### 4 zone 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 10 . 1 the 4 zone 2 proximal 3 landing 3 landing 4 zone 4 zone 5 was 5 was 6 longer 6 longer 7 than 7 than 9 cm 8 1.5 9 cm cta was performed routinely at 2 months after operation to detect the endoleak of contrast agent . 0 ###LEFT-WALL### 1 cta 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 17 . 1 cta 2 was 2 was 3 performed 3 performed 4 routinely 3 performed 5 at 3 performed 8 after 3 performed 10 to 5 at 7 months 6 2 7 months 8 after 9 operation 10 to 11 detect 11 detect 13 endoleak 12 the 13 endoleak 13 endoleak 14 of 14 of 16 agent 15 contrast 16 agent if endoleak was found , cta was performed again at 6 months . 0 ###LEFT-WALL### 6 cta 0 ###LEFT-WALL### 8 performed 0 ###LEFT-WALL### 13 . 1 if 2 endoleak 1 if 4 found 1 if 5 , 1 if 6 cta 2 endoleak 3 was 3 was 4 found 6 cta 7 was 7 was 8 performed 8 performed 9 again 8 performed 10 at 10 at 12 months 11 6 12 months if obvious endoleak still existed , digital subtraction angiography ( dsa ) would be performed to clarify the character and the degree of the endoleak , and evar should be done if necessary . 0 ###LEFT-WALL### 9 angiography 0 ###LEFT-WALL### 15 performed 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 34 . 1 if 3 endoleak 1 if 5 existed 1 if 6 , 1 if 9 angiography 2 obvious 3 endoleak 3 endoleak 5 existed 4 still 5 existed 7 digital 8 subtraction 8 subtraction 9 angiography 9 angiography 11 dsa 9 angiography 13 would 10 ( 11 dsa 11 dsa 12 ) 13 would 14 be 14 be 15 performed 15 performed 16 to 16 to 17 clarify 17 clarify 19 character 18 the 19 character 20 and 27 and 20 and 30 be 21 the 22 degree 22 degree 23 of 22 degree 27 and 23 of 27 and 24 the 25 endoleak 25 endoleak 27 and 26 , 27 and 27 and 28 evar 27 and 29 should 29 should 30 be 30 be 31 done 31 done 33 necessary 32 if 33 necessary the patients were followed up 2 - 8 months ( mean , 3.1 months ) . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 4 followed 0 ###LEFT-WALL### 16 . 1 the 2 patients 2 patients 3 were 3 were 4 followed 4 followed 5 up 5 up 9 months 6 2 7 - 7 - 8 8 7 - 9 months 9 months 14 months 10 ( 14 months 11 mean 12 , 11 mean 14 months 13 3.1 14 months 14 months 15 ) at 2 months after operation , contrast agent endoleak was found in the remnant aneurysm cavity of 12 cases ( 5.7 % ) . 0 ###LEFT-WALL### 9 endoleak 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 24 . 1 at 3 months 1 at 6 , 1 at 9 endoleak 2 2 3 months 3 months 4 after 4 after 5 operation 7 contrast 9 endoleak 8 agent 9 endoleak 9 endoleak 10 was 10 was 11 found 11 found 12 in 12 in 16 cavity 13 the 16 cavity 14 remnant 16 cavity 15 aneurysm 16 cavity 16 cavity 17 of 17 of 19 cases 18 12 19 cases 19 cases 22 % 20 ( 22 % 21 5.7 22 % 22 % 23 ) at 6 months after eperation , contrast agent endoleak was found in 10 cases ( 4.8 % ) by cta . 0 ###LEFT-WALL### 9 endoleak 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 21 . 1 at 3 months 1 at 6 , 1 at 9 endoleak 2 6 3 months 3 months 4 after 4 after 5 eperation 7 contrast 9 endoleak 8 agent 9 endoleak 9 endoleak 10 was 10 was 11 found 11 found 12 in 11 found 19 by 12 in 14 cases 13 10 14 cases 14 cases 17 % 15 ( 17 % 16 4.8 17 % 17 % 18 ) 19 by 20 cta in 8 patients receiving dsa , there were 4 cases of type i endoleak ( 3 cases of type ia and 1 case of type ib ) , 3 cases of type ii endoleak , and 1 case of type iii ( type iiib ) endoleak . 0 ###LEFT-WALL### 7 there 0 ###LEFT-WALL### 8 were 1 in 5 dsa 1 in 6 , 1 in 7 there 2 8 5 dsa 3 patients 5 dsa 4 receiving 5 dsa 7 there 8 were 8 were 9 4 9 4 10 cases 9 4 14 endoleak 9 4 17 cases 10 cases 11 of 10 cases 14 endoleak 11 of 12 type 12 type 13 i 15 ( 17 cases 16 3 17 cases 17 cases 18 of 17 cases 47 . 18 of 21 and 19 type 20 ia 20 ia 21 and 21 and 23 case 21 and 27 ) 21 and 30 cases 22 1 23 case 23 case 24 of 24 of 26 ib 25 type 26 ib 28 , 30 cases 29 3 30 cases 30 cases 31 of 30 cases 36 and 30 cases 46 endoleak 30 cases 47 . 31 of 32 type 32 type 33 ii 34 endoleak 36 and 35 , 36 and 36 and 38 case 36 and 39 of 36 and 44 iiib 36 and 46 endoleak 37 1 38 case 39 of 40 type 40 type 41 iii 42 ( 44 iiib 43 type 44 iiib 44 iiib 45 ) in 5 patients having type i and type iii endoleak , collateral movement of stent graft was observed in different degree ; after increased stent graft was implanted , the endoleak disappeared after 2 - 4 months . 0 ###LEFT-WALL### 21 degree 0 ###LEFT-WALL### 22 ; 0 ###LEFT-WALL### 38 . 1 in 3 patients 2 5 3 patients 3 patients 4 having 3 patients 7 and 4 having 5 type 5 type 6 i 7 and 8 type 7 and 13 movement 7 and 19 in 7 and 21 degree 8 type 9 iii 10 endoleak 11 , 10 endoleak 12 collateral 12 collateral 13 movement 13 movement 14 of 13 movement 17 was 14 of 16 graft 15 stent 16 graft 17 was 18 observed 18 observed 19 in 20 different 21 degree 22 ; 31 endoleak 22 ; 32 disappeared 23 after 26 graft 23 after 27 was 23 after 29 , 23 after 31 endoleak 24 increased 26 graft 25 stent 26 graft 26 graft 27 was 27 was 28 implanted 30 the 31 endoleak 31 endoleak 32 disappeared 32 disappeared 33 after 33 after 37 months 34 2 35 - 35 - 36 4 35 - 37 months the patients having type ii endoleak were not given special treatment , endoleak still existed at 2 months after reexamination of cta , but the maximum diameter of aaa had no enlargement . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 33 . 1 the 2 patients 2 patients 3 having 2 patients 7 were 3 having 4 type 3 having 6 endoleak 4 type 5 ii 7 were 8 not 7 were 11 treatment 8 not 9 given 9 given 11 treatment 10 special 11 treatment 12 , 13 endoleak 12 , 15 existed 12 , 24 but 13 endoleak 15 existed 14 still 15 existed 15 existed 16 at 16 at 18 months 17 2 18 months 18 months 19 after 19 after 20 reexamination 20 reexamination 21 of 21 of 22 cta 23 , 24 but 24 but 27 diameter 24 but 30 had 25 the 27 diameter 26 maximum 27 diameter 27 diameter 28 of 27 diameter 30 had 28 of 29 aaa 30 had 32 enlargement 31 no 32 enlargement conclusion : the collateral movement of stent graft is a very important factor to cause type i and type iii endoleak in the patients of aaa after evar , and endoleak can be plugged by evar again . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 5 movement 2 : 9 is 3 the 5 movement 4 collateral 5 movement 5 movement 6 of 5 movement 9 is 6 of 8 graft 7 stent 8 graft 9 is 18 and 10 a 11 very 10 a 13 factor 11 very 12 important 12 important 13 factor 13 factor 14 to 13 factor 18 and 14 to 16 type 15 cause 16 type 16 type 17 i 18 and 19 type 19 type 20 iii 19 type 21 endoleak 21 endoleak 22 in 21 endoleak 27 after 21 endoleak 37 again 22 in 24 patients 23 the 24 patients 24 patients 25 of 25 of 26 aaa 27 after 30 and 27 after 34 plugged 28 evar 30 and 29 , 30 and 30 and 31 endoleak 30 and 32 can 32 can 33 be 33 be 34 plugged 34 plugged 35 by 35 by 36 evar comparative neuroimaging can identify unique features of the human brain and teach us about human brain evolution . 0 ###LEFT-WALL### 2 neuroimaging 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 18 . 1 comparative 2 neuroimaging 2 neuroimaging 3 can 3 can 11 and 4 identify 6 features 4 identify 11 and 5 unique 6 features 6 features 7 of 7 of 10 brain 8 the 10 brain 9 human 10 brain 11 and 12 teach 11 and 17 evolution 12 teach 13 us 12 teach 14 about 14 about 16 brain 15 human 16 brain comparisons with chimpanzees , our closest living primate relative , are critical in this [endeavor] . 0 ###LEFT-WALL### 1 comparisons 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 16 . 1 comparisons 2 with 1 comparisons 11 are 2 with 3 chimpanzees 3 chimpanzees 9 relative 4 , 9 relative 5 our 6 closest 5 our 9 relative 7 living 9 relative 8 primate 9 relative 9 relative 10 , 11 are 12 critical 12 critical 13 in 13 in 14 this structural magnetic resonance imaging ( mri ) has been used to compare brain size development , brain structure proportions and brain aging . 0 ###LEFT-WALL### 4 imaging 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 23 . 1 structural 3 resonance 2 magnetic 3 resonance 3 resonance 4 imaging 4 imaging 6 mri 4 imaging 8 has 5 ( 6 mri 6 mri 7 ) 8 has 9 been 9 been 10 used 10 used 11 to 11 to 16 , 12 compare 15 development 12 compare 16 , 13 brain 15 development 14 size 15 development 16 , 17 brain 16 , 20 and 18 structure 19 proportions 19 proportions 20 and 20 and 21 brain 20 and 22 aging positron emission tomography ( pet ) imaging has been used to compare resting brain glucose metabolism . 0 ###LEFT-WALL### 2 emission 0 ###LEFT-WALL### 10 used 0 ###LEFT-WALL### 17 . 1 positron 2 emission 2 emission 7 imaging 2 emission 9 been 2 emission 10 used 3 tomography 5 pet 3 tomography 6 ) 3 tomography 7 imaging 4 ( 5 pet 5 pet 6 ) 7 imaging 8 has 8 has 9 been 10 used 11 to 10 used 12 compare 11 to 12 compare 12 compare 16 metabolism 13 resting 14 brain 14 brain 16 metabolism 15 glucose 16 metabolism functional mri ( fmri ) has been used to compare auditory and visual system pathways , as well as resting - state networks of connectivity . 0 ###LEFT-WALL### 1 functional 0 ###LEFT-WALL### 10 compare 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 26 . 1 functional 7 been 1 functional 9 to 2 mri 4 fmri 2 mri 6 has 3 ( 4 fmri 4 fmri 5 ) 6 has 7 been 7 been 8 used 9 to 10 compare 10 compare 15 pathways 11 auditory 12 and 12 and 13 visual 12 and 15 pathways 14 system 15 pathways 16 , 22 state 17 as 18 well 17 as 22 state 18 well 20 resting 19 as 20 resting 20 resting 21 - 22 state 23 networks 23 networks 24 of 24 of 25 connectivity finally , diffusion [-] weighted imaging ( dwi ) has been used to compare structural connectivity . 0 ###LEFT-WALL### 6 imaging 0 ###LEFT-WALL### 12 used 0 ###LEFT-WALL### 17 . 1 finally 2 , 1 finally 6 imaging 3 diffusion 5 weighted 5 weighted 6 imaging 6 imaging 8 dwi 6 imaging 10 has 7 ( 8 dwi 8 dwi 9 ) 10 has 11 been 11 been 12 used 12 used 13 to 12 used 14 compare 13 to 14 compare 14 compare 16 connectivity 15 structural 16 connectivity collectively , these methods have revealed human brain specializations with respect to development , cortical organization , connectivity , and aging . 0 ###LEFT-WALL### 4 methods 0 ###LEFT-WALL### 6 revealed 0 ###LEFT-WALL### 22 . 1 collectively 2 , 1 collectively 4 methods 3 these 4 methods 4 methods 5 have 5 have 6 revealed 6 revealed 9 specializations 6 revealed 10 with 6 revealed 12 to 7 human 9 specializations 8 brain 9 specializations 10 with 11 respect 12 to 20 and 13 development 14 , 14 , 16 organization 14 , 17 , 15 cortical 16 organization 17 , 18 connectivity 17 , 20 and 19 , 20 and 20 and 21 aging these findings inform our knowledge of the evolutionary changes responsible for the special features of the modern human mind . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 inform 0 ###LEFT-WALL### 20 . 1 these 2 findings 2 findings 3 inform 3 inform 5 knowledge 4 our 5 knowledge 5 knowledge 6 of 6 of 9 changes 7 the 9 changes 8 evolutionary 9 changes 9 changes 10 responsible 10 responsible 11 for 11 for 14 features 12 the 14 features 13 special 14 features 14 features 15 of 15 of 19 mind 16 the 19 mind 17 modern 19 mind 18 human 19 mind objectives : we explore whether spousal caregiving is associated with enhanced well - being for older husbands and wives . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 explore 3 we 4 explore 4 explore 5 whether 5 whether 7 caregiving 5 whether 9 associated 6 spousal 7 caregiving 7 caregiving 8 is 8 is 9 associated 9 associated 10 with 10 with 12 well 11 enhanced 12 well 12 well 14 being 13 - 14 being 14 being 15 for 14 being 20 . 15 for 18 and 16 older 17 husbands 17 husbands 18 and 18 and 19 wives method : we use time diary data from the 2009 panel study of income dynamics and disability and use of time supplement . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 we 2 : 4 use 3 we 4 use 4 use 7 data 4 use 8 from 5 time 7 data 6 diary 7 data 8 from 12 study 9 the 12 study 10 2009 11 panel 11 panel 12 study 12 study 13 of 12 study 18 and 12 study 22 supplement 13 of 14 income 15 dynamics 16 and 16 and 17 disability 16 and 18 and 18 and 19 use 18 and 20 of 18 and 22 supplement 20 of 21 time we measure experienced well - being as ratings of happiness and frustration during activities recalled for the previous day . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 measure 0 ###LEFT-WALL### 5 - 1 we 2 measure 2 measure 4 well 3 experienced 4 well 5 - 6 being 5 - 15 recalled 5 - 20 . 7 as 11 and 7 as 15 recalled 8 ratings 9 of 8 ratings 11 and 9 of 10 happiness 11 and 12 frustration 11 and 13 during 11 and 15 recalled 13 during 14 activities 15 recalled 16 for 16 for 19 day 17 the 18 previous 17 the 19 day we estimate separately for husbands and wives 3 distinct effects on experienced well - being : having a spouse with a disability [;] doing household or personal care tasks ( " chores " ) for someone other than a spouse with a disability [;] and doing such tasks for a spouse with a disability ( " care " ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 estimate 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 17 having 0 ###LEFT-WALL### 60 . 1 we 2 estimate 2 estimate 3 separately 2 estimate 4 for 2 estimate 10 effects 2 estimate 11 on 4 for 6 and 5 husbands 6 and 6 and 7 wives 8 3 10 effects 9 distinct 10 effects 11 on 13 well 12 experienced 13 well 14 - 15 being 14 - 16 : 15 being 16 : 16 : 17 having 17 having 19 spouse 17 having 38 than 17 having 41 with 18 a 19 spouse 19 spouse 20 with 19 spouse 35 for 20 with 26 or 21 a 25 household 22 disability 25 household 24 doing 25 household 25 household 26 or 26 or 29 tasks 26 or 32 chores 27 personal 28 care 28 care 29 tasks 30 ( 31 " 30 ( 32 chores 32 chores 33 " 32 chores 34 ) 35 for 36 someone 37 other 38 than 38 than 40 spouse 39 a 40 spouse 41 with 45 and 41 with 48 tasks 42 a 43 disability 43 disability 45 and 45 and 46 doing 47 such 48 tasks 48 tasks 49 for 49 for 51 spouse 50 a 51 spouse 51 spouse 52 with 51 spouse 57 care 52 with 54 disability 53 a 54 disability 55 ( 56 " 55 ( 57 care 57 care 58 " 57 care 59 ) results : for husbands , neither care status nor spouse ['s] disability status are associated with experienced well - being . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 1 results 2 : 2 : 3 for 3 for 4 husbands 5 , 9 nor 5 , 15 associated 5 , 19 - 6 neither 9 nor 7 care 8 status 8 status 9 nor 9 nor 13 status 9 nor 14 are 10 spouse 13 status 12 disability 13 status 14 are 15 associated 15 associated 16 with 16 with 18 well 17 experienced 18 well 19 - 20 being 19 - 21 . in contrast , for wives , carrying out chores [is] associated with lower reports of happiness compared with other activities and providing care to one 's husband is associated with greater reports of happiness than carrying out chores . 0 ###LEFT-WALL### 9 chores 0 ###LEFT-WALL### 11 associated 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 39 . 1 in 2 contrast 1 in 6 , 1 in 9 chores 2 contrast 4 for 3 , 4 for 4 for 5 wives 4 for 6 , 7 carrying 9 chores 8 out 9 chores 9 chores 11 associated 11 associated 12 with 12 with 14 reports 13 lower 14 reports 14 reports 15 of 15 of 16 happiness 16 happiness 17 compared 16 happiness 18 with 18 with 20 activities 19 other 20 activities 21 and 22 providing 21 and 29 associated 22 providing 23 care 22 providing 28 is 23 care 24 to 24 to 27 husband 25 one 26 's 26 's 27 husband 28 is 29 associated 29 associated 30 with 30 with 32 reports 30 with 35 than 30 with 36 carrying 31 greater 32 reports 32 reports 33 of 33 of 34 happiness 36 carrying 37 out 36 carrying 38 chores discussion : for women , chores such as meal preparation , laundry , and cleaning -- but not caregiving per se -- are associated with worse experienced well - being than other activities . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 1 discussion 2 : 2 : 3 for 3 for 4 women 5 , 14 and 5 , 24 associated 6 chores 8 as 6 chores 11 , 7 such 8 as 8 as 10 preparation 9 meal 10 preparation 11 , 12 laundry 11 , 14 and 13 , 14 and 14 and 15 cleaning 14 and 17 but 14 and 23 are 16 -- 17 but 17 but 18 not 17 but 22 -- 18 not 19 caregiving 19 caregiving 21 se 20 per 21 se 23 are 24 associated 24 associated 25 with 25 with 28 well 26 worse 28 well 27 experienced 28 well 28 well 30 being 29 - 30 being 30 being 31 than 30 being 33 activities 30 being 34 . 32 other 33 activities findings [underscore] that there are positive aspects of spousal caregiving for older wives [that] offset the innately unpleasant nature of household tasks . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 15 offset 0 ###LEFT-WALL### 23 . 1 findings 3 that 1 findings 15 offset 3 that 4 there 3 that 5 are 4 there 5 are 5 are 7 aspects 6 positive 7 aspects 7 aspects 8 of 8 of 10 caregiving 9 spousal 10 caregiving 10 caregiving 11 for 11 for 13 wives 12 older 13 wives 15 offset 19 nature 16 the 19 nature 17 innately 18 unpleasant 18 unpleasant 19 nature 19 nature 20 of 20 of 22 tasks 21 household 22 tasks the impact of [intrinsic] aging upon human peripheral blood t cell subsets remains incompletely quantified and understood . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 18 . 1 the 2 impact 2 impact 3 of 2 impact 16 and 3 of 5 aging 5 aging 6 upon 5 aging 12 subsets 6 upon 9 blood 7 human 9 blood 8 peripheral 9 blood 9 blood 10 t 11 cell 12 subsets 13 remains 15 quantified 13 remains 16 and 14 incompletely 15 quantified 16 and 17 understood this impact must be distinguished from the influence of latent persistent microorganisms , particularly cmv , which has been associated with age - related changes in the [t] cell pool . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 5 distinguished 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 31 . 1 this 2 impact 2 impact 3 must 3 must 4 be 4 be 5 distinguished 5 distinguished 6 from 6 from 8 influence 7 the 8 influence 8 influence 9 of 9 of 12 microorganisms 10 latent 12 microorganisms 11 persistent 12 microorganisms 13 , 15 cmv 13 , 24 related 14 particularly 15 cmv 15 cmv 17 which 15 cmv 24 related 16 , 17 which 17 which 18 has 17 which 23 - 18 has 19 been 19 been 20 associated 20 associated 21 with 21 with 22 age 24 related 25 changes 24 related 26 in 26 in 30 pool 27 the 30 pool 29 cell 30 pool [in] a cross - sectional cohort of 152 cmv - negative individuals , aged 21 - 101 y , we found that aging correlated [strictly] to an absolute loss of naive cd8 , but not cd4 , [t] cells [but] , contrary to many reports , [did] not lead to an increase in memory t cell numbers . 0 ###LEFT-WALL### 3 cross 0 ###LEFT-WALL### 4 - 2 a 3 cross 4 - 6 cohort 4 - 16 - 5 sectional 6 cohort 6 cohort 7 of 6 cohort 14 aged 7 of 8 152 9 cmv 12 individuals 10 - 12 individuals 11 negative 12 individuals 12 individuals 13 , 13 , 14 aged 14 aged 15 21 14 aged 16 - 16 - 17 101 16 - 19 , 17 101 18 y 19 , 20 we 20 we 21 found 21 found 23 aging 21 found 26 to 22 that 23 aging 23 aging 24 correlated 26 to 29 loss 27 an 29 loss 28 absolute 29 loss 29 loss 30 of 30 of 42 contrary 31 naive 42 contrary 32 cd8 34 but 32 cd8 39 cells 32 cd8 42 contrary 33 , 34 but 34 but 35 not 34 but 36 cd4 34 but 37 , 37 , 39 cells 39 cells 41 , 42 contrary 43 to 43 to 45 reports 44 many 45 reports 45 reports 49 lead 46 , 48 not 46 , 49 lead 49 lead 50 to 49 lead 53 in 49 lead 56 cell 49 lead 57 numbers 49 lead 58 . 50 to 52 increase 51 an 52 increase 53 in 54 memory 54 memory 55 t 56 cell 57 numbers the loss of naive cd8 t cells was not altered by cmv in 239 subjects ( range 21 - 96 [y] ) , but the decline in cd4 [(] [+] ) naive cells showed significance in cmv ( [+] [ )(individuals . 0 ###LEFT-WALL### 2 loss 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 23 , 1 the 2 loss 2 loss 3 of 2 loss 8 was 3 of 7 cells 4 naive 7 cells 5 cd8 6 t 5 cd8 7 cells 8 was 9 not 8 was 11 by 8 was 13 in 9 not 10 altered 11 by 12 cmv 13 in 15 subjects 14 239 15 subjects 15 subjects 17 range 16 ( 17 range 17 range 19 - 17 range 22 ) 18 21 19 - 19 - 20 96 23 , 33 cells 23 , 34 showed 24 but 26 decline 24 but 33 cells 25 the 26 decline 27 in 28 cd4 27 in 31 ) 27 in 33 cells 32 naive 33 cells 33 cells 34 showed 34 showed 35 significance 34 showed 36 in 36 in 37 cmv 37 cmv 41 )(individuals 38 ( 41 )(individuals 41 )(individuals 42 . these individuals also exhibited an absolute increase in the effector/effector memory cd4 ( [+] [ )(and cd8 [(] [+] ) cells with age . 0 ###LEFT-WALL### 2 individuals 0 ###LEFT-WALL### 4 exhibited 0 ###LEFT-WALL### 24 . 1 these 2 individuals 2 individuals 4 exhibited 3 also 4 exhibited 4 exhibited 7 increase 4 exhibited 8 in 4 exhibited 22 with 5 an 6 absolute 5 an 7 increase 6 absolute 7 increase 8 in 21 cells 9 the 21 cells 10 effector/effector 21 cells 11 memory 21 cells 12 cd4 16 )(and 13 ( 16 )(and 16 )(and 17 cd8 16 )(and 20 ) 16 )(and 21 cells 22 with 23 age that increase was seen mainly , [if] not exclusively , in older subjects with elevated anti - [cmv] ab titers , suggesting that efficacy of viral control over time may determine the magnitude of cmv impact upon [t] cell memory , and perhaps upon immune defense . 0 ###LEFT-WALL### 2 increase 0 ###LEFT-WALL### 4 seen 0 ###LEFT-WALL### 47 . 1 that 2 increase 2 increase 3 was 3 was 4 seen 4 seen 5 mainly 4 seen 11 in 4 seen 14 with 5 mainly 9 exclusively 6 , 8 not 6 , 9 exclusively 9 exclusively 10 , 11 in 13 subjects 12 older 13 subjects 14 with 22 suggesting 14 with 36 impact 15 elevated 22 suggesting 16 anti 20 titers 16 anti 21 , 16 anti 22 suggesting 17 - 20 titers 19 ab 20 titers 20 titers 21 , 22 suggesting 23 that 22 suggesting 31 determine 23 that 24 efficacy 23 that 31 determine 24 efficacy 25 of 24 efficacy 30 may 25 of 27 control 26 viral 27 control 27 control 28 over 28 over 29 time 30 may 31 determine 31 determine 33 magnitude 32 the 33 magnitude 33 magnitude 34 of 34 of 35 cmv 36 impact 42 and 37 upon 40 memory 37 upon 42 and 39 cell 40 memory 41 , 42 and 42 and 43 perhaps 42 and 44 upon 44 upon 46 defense 45 immune 46 defense these findings provide important new insights into the age - related changes in the peripheral blood pool of older adults , demonstrating that aging and [cmv] exert both distinct and joint influence upon blood t cell homeostasis in humans . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 40 . 1 these 2 findings 2 findings 25 and 3 provide 6 insights 3 provide 7 into 3 provide 25 and 4 important 6 insights 5 new 6 insights 7 into 9 age 8 the 9 age 9 age 22 demonstrating 9 age 24 aging 10 - 11 related 11 related 12 changes 11 related 13 in 11 related 21 , 11 related 22 demonstrating 13 in 17 pool 14 the 17 pool 15 peripheral 16 blood 16 blood 17 pool 17 pool 18 of 18 of 20 adults 19 older 20 adults 22 demonstrating 23 that 22 demonstrating 24 aging 23 that 24 aging 25 and 27 exert 25 and 37 homeostasis 27 exert 30 and 27 exert 33 upon 28 both 30 and 29 distinct 30 and 30 and 32 influence 31 joint 32 influence 33 upon 34 blood 34 blood 35 t 36 cell 37 homeostasis 37 homeostasis 38 in 38 in 39 humans in addition to positive and negative symptoms , cognitive deficits are increasingly being recognized as a core feature of schizophrenia . 0 ###LEFT-WALL### 10 deficits 0 ###LEFT-WALL### 21 . 1 in 2 addition 1 in 8 , 1 in 10 deficits 2 addition 3 to 3 to 7 symptoms 4 positive 5 and 5 and 6 negative 5 and 7 symptoms 9 cognitive 10 deficits 10 deficits 11 are 11 are 13 being 12 increasingly 13 being 13 being 14 recognized 14 recognized 15 as 15 as 18 feature 16 a 18 feature 17 core 18 feature 18 feature 19 of 19 of 20 schizophrenia neurocognitive impairments are strongly associated with functional outcomes ; thus , the treatment of cognitive impairments is of central importance . 0 ###LEFT-WALL### 2 impairments 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 9 ; 0 ###LEFT-WALL### 21 . 1 neurocognitive 2 impairments 2 impairments 3 are 3 are 4 strongly 3 are 5 associated 5 associated 6 with 6 with 8 outcomes 7 functional 8 outcomes 9 ; 13 treatment 9 ; 17 is 10 thus 11 , 10 thus 13 treatment 12 the 13 treatment 13 treatment 14 of 13 treatment 17 is 14 of 16 impairments 15 cognitive 16 impairments 17 is 18 of 18 of 20 importance 19 central 20 importance a large body of evidence suggests that the [serotonin] 6 ( 5 - ht6 ) [receptors] may be potential targets for cognitive improvement . 0 ###LEFT-WALL### 3 body 0 ###LEFT-WALL### 6 suggests 0 ###LEFT-WALL### 24 . 1 a 2 large 1 a 3 body 2 large 3 body 3 body 4 of 3 body 6 suggests 4 of 5 evidence 6 suggests 7 that 7 that 10 6 7 that 18 be 8 the 10 6 10 6 13 - 10 6 17 may 11 ( 13 - 12 5 13 - 13 - 14 ht6 13 - 15 ) 17 may 18 be 18 be 20 targets 19 potential 20 targets 20 targets 21 for 21 for 23 improvement 22 cognitive 23 improvement clinical and preclinical studies have supported the notion that using 5 [-] ht6 receptor antagonists is a promising component in the treatment of cognitive dysfunctions associated with aging and alzheimer 's disease . 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 33 . 1 clinical 2 and 2 and 3 preclinical 2 and 4 studies 2 and 6 supported 2 and 29 and 4 studies 5 have 5 have 6 supported 6 supported 8 notion 7 the 8 notion 8 notion 9 that 9 that 10 using 9 that 16 is 10 using 15 antagonists 10 using 16 is 11 5 15 antagonists 13 ht6 15 antagonists 14 receptor 15 antagonists 16 is 19 component 16 is 20 in 17 a 18 promising 17 a 19 component 18 promising 19 component 20 in 22 treatment 21 the 22 treatment 22 treatment 23 of 23 of 25 dysfunctions 24 cognitive 25 dysfunctions 25 dysfunctions 26 associated 26 associated 27 with 27 with 28 aging 29 and 32 disease 30 alzheimer 31 's 31 's 32 disease however , less is known about the efficacy of this strategy in the treatment of schizophrenia - like cognitive disturbances . 0 ###LEFT-WALL### 3 less 0 ###LEFT-WALL### 5 known 1 however 2 , 1 however 3 less 3 less 4 is 4 is 5 known 5 known 6 about 5 known 12 in 6 about 8 efficacy 7 the 8 efficacy 8 efficacy 9 of 9 of 11 strategy 10 this 11 strategy 12 in 14 treatment 13 the 14 treatment 14 treatment 15 of 15 of 16 schizophrenia 16 schizophrenia 18 like 17 - 18 like 18 like 20 disturbances 18 like 21 . 19 cognitive 20 disturbances the purpose of this review is to summarize existing data on the effects of 5 - ht6 receptor antagonists in animal experiments , utilizing tasks that assess cognitive domains that are relevant to the cognitive deficits characterizing schizophrenia . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 39 . 1 the 2 purpose 2 purpose 3 of 2 purpose 6 is 3 of 5 review 4 this 5 review 6 is 7 to 6 is 8 summarize 7 to 8 summarize 8 summarize 10 data 8 summarize 11 on 8 summarize 33 to 9 existing 10 data 11 on 13 effects 12 the 13 effects 13 effects 14 of 13 effects 24 utilizing 13 effects 26 that 13 effects 27 assess 14 of 15 5 15 5 19 antagonists 16 - 19 antagonists 17 ht6 18 receptor 18 receptor 19 antagonists 19 antagonists 20 in 19 antagonists 23 , 20 in 22 experiments 21 animal 22 experiments 24 utilizing 25 tasks 26 that 27 assess 27 assess 29 domains 28 cognitive 29 domains 29 domains 30 that 29 domains 31 are 30 that 31 are 31 are 32 relevant 33 to 36 deficits 34 the 36 deficits 35 cognitive 36 deficits 36 deficits 37 characterizing 37 characterizing 38 schizophrenia this review focuses primarily on animal models of schizophrenia that are based on the blockade of n - methyl - d - aspartate receptors ; however , [when] relevant , data obtained in other models are also discussed . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 focuses 0 ###LEFT-WALL### 25 ; 0 ###LEFT-WALL### 39 . 1 this 2 review 2 review 3 focuses 3 focuses 4 primarily 4 primarily 5 on 5 on 7 models 6 animal 7 models 7 models 8 of 7 models 10 that 7 models 11 are 8 of 9 schizophrenia 10 that 11 are 11 are 12 based 12 based 13 on 13 on 15 blockade 14 the 15 blockade 15 blockade 16 of 15 blockade 19 methyl 15 blockade 22 - 16 of 17 n 18 - 19 methyl 19 methyl 20 - 20 - 22 - 21 d 22 - 22 - 24 receptors 22 - 25 ; 23 aspartate 24 receptors 25 ; 31 data 25 ; 36 are 26 however 31 data 27 , 29 relevant 29 relevant 30 , 29 relevant 31 data 31 data 32 obtained 31 data 36 are 32 obtained 33 in 33 in 35 models 34 other 35 models 36 are 37 also 36 are 38 discussed the putative procognitive actions of 5 [-] ht6 agonists are also reviewed . 0 ###LEFT-WALL### 4 actions 0 ###LEFT-WALL### 12 reviewed 0 ###LEFT-WALL### 13 . 1 the 4 actions 2 putative 4 actions 3 procognitive 4 actions 4 actions 5 of 4 actions 10 are 5 of 9 agonists 6 5 9 agonists 8 ht6 9 agonists 10 are 12 reviewed 11 also 12 reviewed finally , the mechanisms that are putatively responsible for the procognitive effects of 5 [-] ht6 [receptor] ligands are briefly discussed . 0 ###LEFT-WALL### 4 mechanisms 0 ###LEFT-WALL### 21 discussed 0 ###LEFT-WALL### 22 . 1 finally 2 , 1 finally 4 mechanisms 3 the 4 mechanisms 4 mechanisms 5 that 4 mechanisms 6 are 4 mechanisms 19 are 5 that 6 are 6 are 7 putatively 6 are 8 responsible 8 responsible 9 for 9 for 12 effects 10 the 12 effects 11 procognitive 12 effects 12 effects 13 of 13 of 14 5 14 5 16 ht6 14 5 18 ligands 16 ht6 18 ligands 19 are 20 briefly 19 are 21 discussed heme oxygenase ( ho ) was regarded as an enzyme to degrade heme in aging red blood cells ; recent studies suggested ho might have other functions such as neuroprotection . 0 ###LEFT-WALL### 2 oxygenase 0 ###LEFT-WALL### 19 ; 0 ###LEFT-WALL### 31 . 1 heme 2 oxygenase 2 oxygenase 4 ho 2 oxygenase 6 was 3 ( 4 ho 4 ho 5 ) 6 was 7 regarded 7 regarded 8 as 8 as 10 enzyme 9 an 10 enzyme 10 enzyme 11 to 10 enzyme 12 degrade 11 to 12 degrade 12 degrade 13 heme 12 degrade 14 in 14 in 15 aging 15 aging 18 cells 16 red 17 blood 17 blood 18 cells 19 ; 21 studies 19 ; 22 suggested 20 recent 21 studies 21 studies 22 suggested 22 suggested 23 ho 22 suggested 25 have 23 ho 24 might 24 might 25 have 25 have 27 functions 26 other 27 functions 27 functions 29 as 28 such 29 as 29 as 30 neuroprotection ho degrades heme to produce carbon monoxide ( co ) , iron ( fe²⁺ ) and biliverdin , which is rapidly converted to bilirubin ( br ) . 0 ###LEFT-WALL### 1 ho 0 ###LEFT-WALL### 2 degrades 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 28 . 1 ho 2 degrades 2 degrades 16 and 3 heme 4 to 3 heme 16 and 4 to 7 monoxide 5 produce 7 monoxide 6 carbon 7 monoxide 7 monoxide 9 co 7 monoxide 12 iron 8 ( 9 co 9 co 10 ) 11 , 12 iron 12 iron 14 fe²⁺ 12 iron 15 ) 13 ( 14 fe²⁺ 14 fe²⁺ 15 ) 16 and 17 biliverdin 18 , 19 which 18 , 22 converted 19 which 20 is 20 is 22 converted 21 rapidly 22 converted 22 converted 23 to 23 to 24 bilirubin 24 bilirubin 26 br 25 ( 26 br 26 br 27 ) three isoforms of ho were identified in the brain : inducible form ( ho - 1 ) and constitutive forms ( ho - 2 and ho - 3 ) . 0 ###LEFT-WALL### 2 isoforms 0 ###LEFT-WALL### 6 identified 0 ###LEFT-WALL### 10 : 0 ###LEFT-WALL### 30 . 1 three 2 isoforms 2 isoforms 3 of 2 isoforms 5 were 3 of 4 ho 5 were 6 identified 6 identified 7 in 7 in 9 brain 8 the 9 brain 10 : 12 form 11 inducible 12 form 12 form 18 and 12 form 26 ho 13 ( 18 and 14 ho 16 1 14 ho 18 and 15 - 16 1 16 1 17 ) 18 and 20 forms 18 and 22 ho 18 and 23 - 19 constitutive 20 forms 21 ( 22 ho 22 ho 23 - 23 - 26 ho 24 2 25 and 25 and 26 ho 26 ho 28 3 26 ho 29 ) 27 - 28 3 28 3 29 ) ho - 1 and ho - 2 may have different mechanisms to protect neurons from oxidative stress . 0 ###LEFT-WALL### 1 ho 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 18 . 2 - 3 1 2 - 4 and 4 and 7 2 4 and 9 have 5 ho 6 - 5 ho 7 2 7 2 8 may 8 may 9 have 9 have 11 mechanisms 9 have 12 to 10 different 11 mechanisms 12 to 13 protect 13 protect 14 neurons 14 neurons 15 from 15 from 17 stress 16 oxidative 17 stress ho - 1 is normally barely detectable in the brain . 0 ###LEFT-WALL### 3 1 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 11 . 1 ho 2 - 1 ho 3 1 3 1 4 is 4 is 5 normally 4 is 7 detectable 6 barely 7 detectable 7 detectable 8 in 8 in 10 brain 9 the 10 brain ho - 1 can be induced mainly in microglia and astrocytes by oxidative stimulus rapidly . 0 ###LEFT-WALL### 4 can 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 16 . 1 ho 2 - 1 ho 4 can 3 1 4 can 4 can 10 and 5 be 6 induced 5 be 10 and 6 induced 7 mainly 7 mainly 8 in 8 in 9 microglia 10 and 11 astrocytes 10 and 12 by 10 and 15 rapidly 12 by 14 stimulus 13 oxidative 14 stimulus ho - 1 might function as an emerging molecule to protect neurons against acute insults mediated by facilitating iron [efflux] from cells under stress conditions . 0 ###LEFT-WALL### 1 ho 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 26 . 2 - 3 1 2 - 5 function 3 1 4 might 4 might 5 function 5 function 6 as 5 function 13 against 6 as 9 molecule 7 an 9 molecule 8 emerging 9 molecule 9 molecule 10 to 9 molecule 11 protect 10 to 11 protect 11 protect 12 neurons 13 against 15 insults 14 acute 15 insults 15 insults 16 mediated 15 insults 23 under 16 mediated 17 by 17 by 18 facilitating 18 facilitating 19 iron 19 iron 21 from 21 from 22 cells 23 under 25 conditions 24 stress 25 conditions up - regulation of ho - 1 was also found in brain glial cells in the aging and neurodegenerative diseases . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 21 . 1 up 2 - 1 up 3 regulation 3 regulation 4 of 3 regulation 18 and 4 of 5 ho 5 ho 7 1 5 ho 10 found 6 - 7 1 7 1 8 was 8 was 10 found 9 also 10 found 10 found 11 in 10 found 15 in 11 in 14 cells 12 brain 14 cells 13 glial 14 cells 15 in 17 aging 16 the 17 aging 18 and 20 diseases 19 neurodegenerative 20 diseases this may lead to iron deposition and oxidative mitochondrial injury . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 lead 0 ###LEFT-WALL### 11 . 1 this 2 may 2 may 3 lead 3 lead 4 to 4 to 7 and 5 iron 6 deposition 6 deposition 7 and 7 and 10 injury 8 oxidative 10 injury 9 mitochondrial 10 injury ho - 1 may confer neuroprotection or neurotoxic effect because of the balance between beneficial and toxic effects of heme and heme products . 0 ###LEFT-WALL### 3 1 0 ###LEFT-WALL### 5 confer 0 ###LEFT-WALL### 24 . 1 ho 2 - 1 ho 3 1 3 1 4 may 4 may 5 confer 5 confer 7 or 5 confer 10 because 6 neuroprotection 7 or 7 or 9 effect 8 neurotoxic 9 effect 10 because 11 of 11 of 21 and 12 the 13 balance 13 balance 14 between 13 balance 19 of 13 balance 21 and 14 between 18 effects 15 beneficial 16 and 16 and 17 toxic 16 and 18 effects 19 of 20 heme 21 and 23 products 22 heme 23 products pharmacological modulation of [ho] - 1 induction represents a therapeutic strategy for several nervous system disorders . 0 ###LEFT-WALL### 2 modulation 0 ###LEFT-WALL### 8 represents 0 ###LEFT-WALL### 17 . 1 pharmacological 2 modulation 2 modulation 3 of 2 modulation 8 represents 3 of 7 induction 5 - 6 1 6 1 7 induction 8 represents 11 strategy 9 a 10 therapeutic 9 a 11 strategy 10 therapeutic 11 strategy 11 strategy 12 for 12 for 16 disorders 13 several 16 disorders 14 nervous 15 system 15 system 16 disorders ho - 2 predominantly expressed in neurons . 0 ###LEFT-WALL### 1 ho 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 8 . 2 - 7 neurons 3 2 6 in 4 predominantly 5 expressed 5 expressed 6 in 6 in 7 neurons bilirubin has been demonstrated to protect neurons from oxidative stress in vivo and in vitro . 0 ###LEFT-WALL### 1 bilirubin 0 ###LEFT-WALL### 4 demonstrated 0 ###LEFT-WALL### 16 . 1 bilirubin 2 has 2 has 3 been 3 been 4 demonstrated 4 demonstrated 5 to 5 to 6 protect 6 protect 7 neurons 6 protect 13 and 7 neurons 8 from 8 from 10 stress 9 oxidative 10 stress 11 in 12 vivo 12 vivo 13 and 13 and 15 vitro 14 in 15 vitro bilirubin can be oxidized to biliverdin by scavenging peroxyl radicals . 0 ###LEFT-WALL### 1 bilirubin 0 ###LEFT-WALL### 4 oxidized 0 ###LEFT-WALL### 11 . 1 bilirubin 2 can 2 can 3 be 3 be 4 oxidized 4 oxidized 5 to 4 oxidized 7 by 5 to 6 biliverdin 7 by 10 radicals 8 scavenging 9 peroxyl 9 peroxyl 10 radicals ho - 2 could protect neurons through bilirubin [pathway] . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 5 protect 0 ###LEFT-WALL### 10 . 1 ho 2 - 1 ho 3 2 3 2 4 could 4 could 5 protect 5 protect 6 neurons 5 protect 7 through 7 through 8 bilirubin ho - 2 might also promote neuronal survival through the co - cgmp - mapk pathway . 0 ###LEFT-WALL### 3 2 0 ###LEFT-WALL### 6 promote 0 ###LEFT-WALL### 14 - 1 ho 2 - 1 ho 3 2 3 2 4 might 4 might 6 promote 5 also 6 promote 6 promote 8 survival 6 promote 9 through 7 neuronal 8 survival 9 through 11 co 10 the 11 co 11 co 13 cgmp 12 - 13 cgmp 13 cgmp 14 - 14 - 16 pathway 14 - 17 . 15 mapk 16 pathway biliverdin/bilirubin may be possible therapeutic candidates to treat nervous system disease related with oxidative damage . 0 ###LEFT-WALL### 1 biliverdin/bilirubin 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 16 . 1 biliverdin/bilirubin 2 may 2 may 3 be 3 be 6 candidates 4 possible 6 candidates 5 therapeutic 6 candidates 6 candidates 7 to 7 to 11 disease 8 treat 11 disease 9 nervous 10 system 10 system 11 disease 11 disease 12 related 12 related 13 with 13 with 15 damage 14 oxidative 15 damage the transcription factor signal transducer and activator of transcription ( stat )3 has been considered as a potential anticancer target since its first description as an oncogene in 1999 , recently leading to stat3 inhibitors [been] brought to [clinical] trial for the treatment of solid tumors . 0 ###LEFT-WALL### 3 factor 0 ###LEFT-WALL### 15 considered 1 the 3 factor 2 transcription 3 factor 3 factor 6 and 3 factor 12 )3 3 factor 13 has 4 signal 5 transducer 5 transducer 6 and 6 and 7 activator 6 and 8 of 6 and 12 )3 8 of 11 stat 9 transcription 11 stat 10 ( 11 stat 13 has 14 been 14 been 15 considered 15 considered 16 as 15 considered 21 since 15 considered 28 in 16 as 20 target 17 a 18 potential 17 a 20 target 18 potential 19 anticancer 19 anticancer 20 target 21 since 24 description 22 its 23 first 22 its 24 description 24 description 25 as 25 as 27 oncogene 26 an 27 oncogene 28 in 29 1999 29 1999 32 leading 30 , 32 leading 31 recently 32 leading 32 leading 33 to 32 leading 35 inhibitors 32 leading 41 for 32 leading 47 . 33 to 34 stat3 35 inhibitors 37 brought 37 brought 40 trial 38 to 40 trial 41 for 43 treatment 42 the 43 treatment 43 treatment 44 of 44 of 46 tumors 45 solid 46 tumors however , the past 14 years of intense basic research have uncovered novel stat3 - mediated pathways that could affect the outcome of the designed therapies while at the same time help designing function - specific inhibitors . 0 ###LEFT-WALL### 5 14 0 ###LEFT-WALL### 12 uncovered 0 ###LEFT-WALL### 35 - 1 however 2 , 1 however 5 14 3 the 4 past 3 the 5 14 5 14 6 years 5 14 11 have 5 14 12 uncovered 6 years 7 of 6 years 11 have 7 of 10 research 8 intense 10 research 9 basic 10 research 12 uncovered 14 stat3 13 novel 14 stat3 14 stat3 17 pathways 15 - 17 pathways 16 mediated 17 pathways 17 pathways 18 that 17 pathways 19 could 17 pathways 35 - 18 that 19 could 19 could 20 affect 20 affect 22 outcome 20 affect 27 while 21 the 22 outcome 22 outcome 23 of 23 of 26 therapies 24 the 26 therapies 25 designed 26 therapies 27 while 28 at 28 at 34 function 29 the 30 same 30 same 34 function 31 time 34 function 32 help 34 function 33 designing 34 function 35 - 37 inhibitors 35 - 38 . 36 specific 37 inhibitors particularly intriguing are the recent findings that suggest profound implications of stat3 with the regulation of cellular metabolism in both canonical , that is transcriptional , and [non] [-] canonical ways . 0 ###LEFT-WALL### 2 intriguing 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 32 . 1 particularly 2 intriguing 2 intriguing 3 are 3 are 6 findings 4 the 6 findings 5 recent 6 findings 6 findings 7 that 6 findings 8 suggest 7 that 8 suggest 8 suggest 10 implications 8 suggest 13 with 9 profound 10 implications 10 implications 11 of 11 of 12 stat3 13 with 15 regulation 13 with 21 canonical 14 the 15 regulation 15 regulation 16 of 16 of 18 metabolism 17 cellular 18 metabolism 18 metabolism 19 in 19 in 20 both 22 , 23 that 22 , 24 is 23 that 24 is 24 is 27 and 25 transcriptional 27 and 26 , 27 and 27 and 30 canonical 30 canonical 31 ways here , after a short description of the main known features of stat3 signaling and function , we review the recent literature on the role of stat3 in regulating cellular metabolism and discuss the potential consequences on the therapeutic approaches currently under clinical experimentation . 0 ###LEFT-WALL### 18 we 0 ###LEFT-WALL### 32 and 0 ###LEFT-WALL### 45 . 1 here 18 we 2 , 3 after 3 after 6 description 3 after 17 , 3 after 18 we 4 a 6 description 5 short 6 description 6 description 7 of 6 description 12 of 7 of 11 features 8 the 11 features 9 main 10 known 10 known 11 features 12 of 15 and 13 stat3 14 signaling 13 stat3 15 and 15 and 16 function 18 we 32 and 19 review 22 literature 19 review 23 on 19 review 28 in 19 review 32 and 20 the 22 literature 21 recent 22 literature 23 on 25 role 24 the 25 role 25 role 26 of 26 of 27 stat3 28 in 29 regulating 29 regulating 31 metabolism 30 cellular 31 metabolism 32 and 33 discuss 32 and 41 currently 32 and 42 under 33 discuss 36 consequences 33 discuss 37 on 34 the 36 consequences 35 potential 36 consequences 37 on 40 approaches 38 the 40 approaches 39 therapeutic 40 approaches 42 under 44 experimentation 43 clinical 44 experimentation because of the combination of population growth and population aging , increases in the incidence of chronic neurodegenerative disorders have become a societal concern , both in terms of decreased quality of life and increased financial burden . 0 ###LEFT-WALL### 12 increases 0 ###LEFT-WALL### 21 become 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 38 . 1 because 2 of 1 because 12 increases 2 of 4 combination 3 the 4 combination 4 combination 5 of 5 of 8 and 6 population 7 growth 7 growth 8 and 8 and 9 population 10 aging 11 , 10 aging 12 increases 12 increases 13 in 12 increases 20 have 13 in 15 incidence 14 the 15 incidence 15 incidence 16 of 16 of 19 disorders 17 chronic 19 disorders 18 neurodegenerative 19 disorders 20 have 21 become 21 become 24 concern 22 a 24 concern 23 societal 24 concern 25 , 34 and 26 both 27 in 26 both 34 and 27 in 28 terms 28 terms 29 of 28 terms 32 of 29 of 31 quality 30 decreased 31 quality 32 of 33 life 34 and 37 burden 35 increased 37 burden 36 financial 37 burden clinical [manifestation] of many of these disorders takes years , with the initiation of mild cognitive symptoms leading to behavioral problems , dementia and loss of motor functions , the need for assisted living , and eventual death . 0 ###LEFT-WALL### 1 clinical 0 ###LEFT-WALL### 8 takes 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 39 . 1 clinical 3 of 1 clinical 8 takes 3 of 7 disorders 4 many 5 of 4 many 7 disorders 5 of 7 disorders 6 these 7 disorders 8 takes 9 years 9 years 11 with 10 , 11 with 11 with 13 initiation 11 with 22 , 12 the 13 initiation 13 initiation 14 of 14 of 17 symptoms 15 mild 17 symptoms 16 cognitive 17 symptoms 17 symptoms 18 leading 18 leading 19 to 19 to 21 problems 20 behavioral 21 problems 22 , 36 and 23 dementia 24 and 24 and 25 loss 24 and 26 of 24 and 31 need 24 and 36 and 26 of 28 functions 27 motor 28 functions 29 , 31 need 30 the 31 need 31 need 32 for 31 need 35 , 32 for 34 living 33 assisted 34 living 35 , 36 and 36 and 38 death 37 eventual 38 death lifestyle factors greatly affect the progression [of] cognitive decline , with high - risk behaviors including unhealthy diet , lack of exercise , smoking , and exposure to environmental toxins leading to enhanced oxidative stress and inflammation . 0 ###LEFT-WALL### 2 factors 0 ###LEFT-WALL### 4 affect 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 38 . 1 lifestyle 2 factors 2 factors 4 affect 3 greatly 4 affect 4 affect 9 decline 5 the 9 decline 6 progression 9 decline 8 cognitive 9 decline 10 , 18 diet 10 , 19 , 11 with 16 including 11 with 17 unhealthy 11 with 18 diet 12 high 13 - 12 high 15 behaviors 14 risk 15 behaviors 15 behaviors 16 including 19 , 26 and 20 lack 21 of 20 lack 23 , 21 of 22 exercise 23 , 24 smoking 23 , 26 and 25 , 26 and 26 and 27 exposure 26 and 28 to 26 and 31 leading 28 to 30 toxins 29 environmental 30 toxins 31 leading 32 to 32 to 36 and 33 enhanced 35 stress 34 oxidative 35 stress 35 stress 36 and 36 and 37 inflammation [although] there exists an urgent need to develop effective treatments for age - related cognitive [decline] and neurodegenerative disease , prevention strategies have been underdeveloped . 0 ###LEFT-WALL### 2 there 0 ###LEFT-WALL### 3 exists 0 ###LEFT-WALL### 14 related 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 26 . 2 there 3 exists 3 exists 6 need 4 an 6 need 5 urgent 6 need 6 need 7 to 6 need 8 develop 7 to 8 develop 8 develop 10 treatments 8 develop 11 for 9 effective 10 treatments 11 for 12 age 13 - 14 related 14 related 19 disease 15 cognitive 17 and 17 and 18 neurodegenerative 17 and 19 disease 20 , 22 strategies 20 , 24 been 21 prevention 22 strategies 22 strategies 23 have 23 have 24 been 24 been 25 underdeveloped primary prevention in many of these neurodegenerative diseases could be achieved earlier in life by consuming a healthy diet , rich in antioxidant and anti - inflammatory phytochemicals , which offers one of the most effective and least expensive ways to address the crisis . 0 ###LEFT-WALL### 2 prevention 0 ###LEFT-WALL### 11 achieved 0 ###LEFT-WALL### 45 . 1 primary 2 prevention 2 prevention 3 in 2 prevention 5 of 2 prevention 9 could 3 in 4 many 5 of 8 diseases 6 these 8 diseases 7 neurodegenerative 8 diseases 9 could 10 be 10 be 11 achieved 11 achieved 12 earlier 11 achieved 13 in 11 achieved 20 , 11 achieved 21 rich 13 in 14 life 14 life 15 by 15 by 16 consuming 16 consuming 19 diet 17 a 18 healthy 17 a 19 diet 18 healthy 19 diet 21 rich 22 in 21 rich 40 ways 22 in 24 and 23 antioxidant 24 and 24 and 28 phytochemicals 24 and 29 , 24 and 30 which 24 and 31 offers 25 anti 26 - 25 anti 28 phytochemicals 27 inflammatory 28 phytochemicals 30 which 31 offers 31 offers 32 one 32 one 33 of 33 of 35 most 34 the 35 most 36 effective 37 and 37 and 39 expensive 37 and 40 ways 38 least 39 expensive 40 ways 41 to 40 ways 42 address 41 to 42 address 42 address 44 crisis 43 the 44 crisis english walnuts ( juglans regia l [.] ) are rich in numerous phytochemicals , including high amounts of polyunsaturated fatty acids , and offer potential benefits to brain health . 0 ###LEFT-WALL### 2 walnuts 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 28 brain 0 ###LEFT-WALL### 30 . 1 english 2 walnuts 2 walnuts 5 regia 2 walnuts 9 are 3 ( 5 regia 4 juglans 5 regia 5 regia 6 l 5 regia 8 ) 9 are 10 rich 10 rich 11 in 10 rich 15 including 11 in 13 phytochemicals 12 numerous 13 phytochemicals 14 , 15 including 15 including 17 amounts 15 including 22 , 16 high 17 amounts 17 amounts 18 of 18 of 21 acids 19 polyunsaturated 21 acids 20 fatty 21 acids 22 , 23 and 23 and 25 potential 23 and 26 benefits 24 offer 25 potential 25 potential 26 benefits 26 benefits 27 to 27 to 28 brain 28 brain 29 health polyphenolic compounds found in walnuts not only reduce the oxidant and inflammatory load on brain cells but also improve interneuronal signaling , increase neurogenesis , and enhance sequestration of insoluble toxic protein aggregates . 0 ###LEFT-WALL### 2 compounds 0 ###LEFT-WALL### 18 also 0 ###LEFT-WALL### 34 . 1 polyphenolic 2 compounds 2 compounds 3 found 2 compounds 18 also 3 found 4 in 4 in 5 walnuts 6 not 7 only 7 only 18 also 8 reduce 11 and 8 reduce 14 on 8 reduce 18 also 9 the 11 and 10 oxidant 11 and 11 and 13 load 12 inflammatory 13 load 14 on 16 cells 15 brain 16 cells 17 but 18 also 18 also 26 and 19 improve 21 signaling 19 improve 26 and 20 interneuronal 21 signaling 21 signaling 24 neurogenesis 22 , 24 neurogenesis 23 increase 24 neurogenesis 24 neurogenesis 25 , 25 , 26 and 26 and 27 enhance 27 enhance 28 sequestration 28 sequestration 29 of 29 of 33 aggregates 30 insoluble 32 protein 31 toxic 32 protein 32 protein 33 aggregates evidence for the beneficial effects of consuming a walnut [-] rich diet is reviewed in this article . 0 ###LEFT-WALL### 1 evidence 0 ###LEFT-WALL### 14 reviewed 0 ###LEFT-WALL### 18 . 1 evidence 2 for 1 evidence 13 is 2 for 5 effects 3 the 5 effects 4 beneficial 5 effects 5 effects 6 of 6 of 7 consuming 7 consuming 12 diet 8 a 9 walnut 8 a 12 diet 9 walnut 12 diet 11 rich 12 diet 13 is 14 reviewed 14 reviewed 15 in 15 in 17 article 16 this 17 article importance : morphometric assessment has emerged as a strong predictor of postoperative morbidity and mortality . 0 ###LEFT-WALL### 1 importance 0 ###LEFT-WALL### 2 : 2 : 3 morphometric 2 : 6 emerged 2 : 16 . 3 morphometric 4 assessment 3 morphometric 5 has 3 morphometric 6 emerged 4 assessment 5 has 6 emerged 7 as 7 as 10 predictor 8 a 9 strong 8 a 10 predictor 9 strong 10 predictor 10 predictor 11 of 11 of 14 and 12 postoperative 13 morbidity 13 morbidity 14 and 14 and 15 mortality however , a gap exists in translating this knowledge to bedside decision making . 0 ###LEFT-WALL### 4 gap 0 ###LEFT-WALL### 5 exists 0 ###LEFT-WALL### 14 . 1 however 2 , 1 however 4 gap 3 a 4 gap 4 gap 5 exists 5 exists 6 in 6 in 7 translating 7 translating 9 knowledge 7 translating 10 to 8 this 9 knowledge 10 to 13 making 11 bedside 13 making 12 decision 13 making we introduced a novel measure of patient - centered surgical risk assessment : morphometric age . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 introduced 0 ###LEFT-WALL### 13 : 0 ###LEFT-WALL### 16 . 1 we 2 introduced 2 introduced 12 assessment 3 a 4 novel 3 a 5 measure 4 novel 5 measure 5 measure 6 of 5 measure 12 assessment 6 of 12 assessment 7 patient 8 - 7 patient 12 assessment 9 centered 12 assessment 10 surgical 12 assessment 11 risk 12 assessment 13 : 15 age 14 morphometric 15 age objective : to investigate the relationship between morphometric age and posttransplant survival . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 investigate 2 : 13 . 3 to 4 investigate 4 investigate 6 relationship 4 investigate 7 between 5 the 6 relationship 7 between 10 and 8 morphometric 9 age 9 age 10 and 10 and 12 survival 11 posttransplant 12 survival data sources : medical records of recipients of deceased - donor liver transplants ( study population [ )(and kidney donors/trauma patients ( morphometric age control population ) . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 9 deceased 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 28 . 1 data 2 sources 1 data 8 of 1 data 9 deceased 2 sources 3 : 3 : 5 records 4 medical 5 records 5 records 6 of 6 of 7 recipients 7 recipients 8 of 10 - 13 transplants 11 donor 12 liver 12 liver 13 transplants 13 transplants 18 )(and 14 ( 18 )(and 15 study 16 population 16 population 18 )(and 18 )(and 21 patients 18 )(and 26 population 18 )(and 27 ) 19 kidney 21 patients 20 donors/trauma 21 patients 22 ( 26 population 23 morphometric 24 age 24 age 26 population 25 control 26 population 26 population 27 ) study selection : a retrospective cohort study of 348 liver transplant patients and 3313 control patients . 0 ###LEFT-WALL### 2 selection 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 17 . 1 study 2 selection 2 selection 3 : 3 : 7 study 4 a 5 retrospective 4 a 7 study 5 retrospective 6 cohort 6 cohort 7 study 7 study 8 of 8 of 13 and 9 348 12 patients 10 liver 12 patients 11 transplant 12 patients 12 patients 13 and 13 and 16 patients 14 3313 16 patients 15 control 16 patients we assessed medical records for validated morphometric characteristics of aging ( psoas area , psoas density , and abdominal aortic calcification ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 assessed 0 ###LEFT-WALL### 23 . 1 we 2 assessed 2 assessed 4 records 2 assessed 5 for 3 medical 4 records 5 for 8 characteristics 6 validated 8 characteristics 7 morphometric 8 characteristics 8 characteristics 9 of 8 characteristics 18 and 9 of 10 aging 11 ( 18 and 12 psoas 13 area 13 area 14 , 14 , 16 density 14 , 18 and 15 psoas 16 density 17 , 18 and 18 and 21 calcification 18 and 22 ) 19 abdominal 21 calcification 20 aortic 21 calcification we created a model ( stratified by sex ) for a morphometric age equation , which we then calculated for the control population using multivariate linear regression modeling ( covariates ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 created 0 ###LEFT-WALL### 32 . 1 we 2 created 2 created 4 model 2 created 10 for 3 a 4 model 4 model 6 stratified 5 ( 6 stratified 6 stratified 7 by 6 stratified 9 ) 7 by 8 sex 10 for 14 equation 11 a 12 morphometric 11 a 14 equation 12 morphometric 13 age 13 age 14 equation 14 equation 16 which 15 , 16 which 16 which 19 calculated 16 which 31 ) 17 we 19 calculated 18 then 19 calculated 19 calculated 20 for 20 for 23 population 21 the 23 population 22 control 23 population 23 population 24 using 24 using 28 modeling 25 multivariate 27 regression 26 linear 27 regression 27 regression 28 modeling 28 modeling 30 covariates 29 ( 30 covariates 30 covariates 31 ) these models were then applied to the study population to determine each patient 's morphometric age . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 5 applied 0 ###LEFT-WALL### 17 . 1 these 2 models 2 models 3 were 3 were 5 applied 4 then 5 applied 5 applied 6 to 5 applied 10 to 6 to 9 population 7 the 9 population 8 study 9 population 10 to 11 determine 11 determine 16 age 12 each 13 patient 13 patient 14 's 14 's 16 age 15 morphometric 16 age data extraction and synthesis : all analytic steps related to measuring morphometric characteristics were obtained via custom algorithms programmed into commercially available software . 0 ###LEFT-WALL### 4 synthesis 0 ###LEFT-WALL### 5 : 1 data 2 extraction 2 extraction 3 and 3 and 4 synthesis 5 : 6 all 5 : 15 obtained 5 : 24 . 6 all 8 steps 6 all 11 measuring 6 all 14 were 7 analytic 8 steps 8 steps 9 related 9 related 10 to 10 to 11 measuring 11 measuring 13 characteristics 12 morphometric 13 characteristics 14 were 15 obtained 15 obtained 16 via 16 via 18 algorithms 17 custom 18 algorithms 18 algorithms 19 programmed 18 algorithms 20 into 20 into 23 software 21 commercially 22 available 22 available 23 software an independent observer confirmed [all] algorithm [outputs] . 0 ###LEFT-WALL### 6 algorithm 0 ###LEFT-WALL### 8 . 1 an 2 independent 1 an 6 algorithm 2 independent 3 observer 3 observer 4 confirmed 4 confirmed 6 algorithm trained assistants performed medical record review to obtain patient characteristics . 0 ###LEFT-WALL### 2 assistants 0 ###LEFT-WALL### 5 record 0 ###LEFT-WALL### 11 . 1 trained 2 assistants 2 assistants 3 performed 2 assistants 5 record 3 performed 4 medical 5 record 6 review 5 record 7 to 7 to 8 obtain 8 obtain 10 characteristics 9 patient 10 characteristics results : cox proportional hazards regression [model] showed that morphometric age was a significant independent predictor of overall mortality ( hazard ratio [,] 1.03 per morphometric year [ 95 % ci , 1.02 - 1.04 [;] p < .001[!] ] ) after liver transplant . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 45 . 2 : 5 hazards 2 : 44 transplant 3 cox 5 hazards 4 proportional 5 hazards 5 hazards 6 regression 5 hazards 8 showed 5 hazards 44 transplant 6 regression 8 showed 8 showed 9 that 9 that 11 age 9 that 12 was 10 morphometric 11 age 11 age 12 was 12 was 16 predictor 12 was 34 - 12 was 42 after 13 a 14 significant 13 a 16 predictor 14 significant 16 predictor 15 independent 16 predictor 16 predictor 17 of 16 predictor 22 ratio 17 of 19 mortality 18 overall 19 mortality 20 ( 22 ratio 21 hazard 22 ratio 22 ratio 24 1.03 22 ratio 25 per 22 ratio 31 ci 22 ratio 32 , 25 per 27 year 26 morphometric 27 year 28 [ 31 ci 29 95 31 ci 30 % 31 ci 31 ci 32 , 32 , 34 - 33 1.02 34 - 34 - 35 1.04 34 - 41 ) 35 1.04 38 < 37 p 38 < 38 < 39 .001[!] 38 < 40 ] 42 after 43 liver chronologic age was not a significant covariate for survival ( hazard ratio [,] 1.02 per year [ 95 % ci , 0.99 - 1.04 [;] p = .21[!] ] ) . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 31 . 1 chronologic 2 age 2 age 3 was 3 was 4 not 3 was 7 covariate 5 a 7 covariate 6 significant 7 covariate 7 covariate 8 for 7 covariate 23 - 8 for 9 survival 9 survival 12 ratio 10 ( 12 ratio 11 hazard 12 ratio 12 ratio 14 1.02 12 ratio 15 per 12 ratio 20 ci 12 ratio 21 , 15 per 16 year 17 [ 20 ci 18 95 20 ci 19 % 20 ci 20 ci 21 , 21 , 23 - 22 0.99 23 - 23 - 24 1.04 23 - 27 = 23 - 30 ) 26 p 27 = 27 = 28 .21[!] 27 = 29 ] morphometric age stratified patients at high and low risk for mortality . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 3 stratified 0 ###LEFT-WALL### 12 . 1 morphometric 2 age 2 age 3 stratified 3 stratified 4 patients 3 stratified 5 at 5 at 9 risk 6 high 7 and 7 and 8 low 7 and 9 risk 9 risk 10 for 10 for 11 mortality for example , patients in the middle chronologic age tertile who jumped to the oldest morphometric tertile have worse outcomes than those who jumped to the youngest morphometric tertile ( 74.4 % vs 93.2 % survival at 1 year [ p = .03[!] ] [;] 45.2 % vs 75.0 % at 5 years [ p = .03[!] []] ) . 0 ###LEFT-WALL### 4 patients 0 ###LEFT-WALL### 18 have 0 ###LEFT-WALL### 60 . 1 for 2 example 2 example 3 , 2 example 4 patients 4 patients 5 in 4 patients 13 to 4 patients 18 have 5 in 10 tertile 6 the 10 tertile 7 middle 10 tertile 8 chronologic 9 age 9 age 10 tertile 10 tertile 11 who 10 tertile 12 jumped 11 who 12 jumped 13 to 17 tertile 14 the 15 oldest 14 the 17 tertile 16 morphometric 17 tertile 18 have 20 outcomes 18 have 21 than 18 have 51 at 18 have 56 = 19 worse 20 outcomes 21 than 22 those 22 those 23 who 22 those 24 jumped 23 who 24 jumped 24 jumped 25 to 24 jumped 47 % 25 to 29 tertile 26 the 27 youngest 26 the 29 tertile 28 morphometric 29 tertile 29 tertile 32 % 30 ( 32 % 31 74.4 32 % 32 % 33 vs 32 % 42 = 32 % 44 ] 33 vs 36 survival 34 93.2 35 % 35 % 36 survival 36 survival 37 at 37 at 39 year 38 1 39 year 40 [ 42 = 41 p 42 = 42 = 43 .03[!] 42 = 44 ] 46 45.2 47 % 47 % 48 vs 48 vs 50 % 49 75.0 50 % 51 at 53 years 52 5 53 years 54 [ 56 = 55 p 56 = 56 = 57 .03[!] 56 = 59 ) conclusions and relevance : morphometric age correlated with mortality after liver [transplant] with better discrimination than chronologic age . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 19 . 1 conclusions 2 and 2 and 3 relevance 3 relevance 4 : 4 : 6 age 4 : 10 after 4 : 13 with 4 : 16 than 5 morphometric 6 age 6 age 7 correlated 6 age 8 with 8 with 9 mortality 10 after 11 liver 13 with 15 discrimination 14 better 15 discrimination 16 than 18 age 17 chronologic 18 age assigning a morphometric age to potential liver transplant recipients could improve prediction of postoperative mortality risk . 0 ###LEFT-WALL### 1 assigning 0 ###LEFT-WALL### 11 improve 0 ###LEFT-WALL### 17 . 1 assigning 4 age 1 assigning 5 to 1 assigning 10 could 2 a 3 morphometric 2 a 4 age 3 morphometric 4 age 5 to 9 recipients 6 potential 7 liver 7 liver 9 recipients 8 transplant 9 recipients 10 could 11 improve 11 improve 12 prediction 12 prediction 13 of 13 of 16 risk 14 postoperative 15 mortality 15 mortality 16 risk resveratrol is a [naturally] occurring polyphenol that provides a number of anti - aging health benefits including improved metabolism , cardioprotection , and cancer prevention . 0 ###LEFT-WALL### 1 resveratrol 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 26 . 1 resveratrol 2 is 2 is 6 polyphenol 2 is 17 including 3 a 6 polyphenol 5 occurring 6 polyphenol 6 polyphenol 7 that 6 polyphenol 8 provides 7 that 8 provides 8 provides 16 benefits 9 a 10 number 10 number 11 of 10 number 16 benefits 11 of 16 benefits 12 anti 13 - 12 anti 16 benefits 14 aging 16 benefits 15 health 16 benefits 17 including 25 prevention 18 improved 19 metabolism 19 metabolism 20 , 20 , 21 cardioprotection 20 , 23 and 22 , 23 and 23 and 24 cancer 23 and 25 prevention much of the work on resveratrol and cancer comes from in [vitro] studies looking at resveratrol actions on cancer cells and pathways . 0 ###LEFT-WALL### 4 work 0 ###LEFT-WALL### 9 comes 0 ###LEFT-WALL### 23 . 1 much 2 of 1 much 4 work 2 of 4 work 3 the 4 work 4 work 5 on 4 work 9 comes 5 on 7 and 6 resveratrol 7 and 7 and 8 cancer 9 comes 10 from 10 from 11 in 11 in 13 studies 13 studies 14 looking 14 looking 15 at 14 looking 18 on 15 at 17 actions 16 resveratrol 17 actions 18 on 21 and 19 cancer 20 cells 20 cells 21 and 21 and 22 pathways there are , however , comparatively fewer studies that have investigated resveratrol treatment and cancer outcomes in vivo , perhaps limited by its poor bioavailability when taken orally . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 29 . 1 there 2 are 2 are 4 however 2 are 6 comparatively 2 are 8 studies 3 , 4 however 4 however 5 , 7 fewer 8 studies 8 studies 9 that 8 studies 10 have 9 that 10 have 10 have 11 investigated 11 investigated 14 and 11 investigated 18 vivo 12 resveratrol 13 treatment 13 treatment 14 and 14 and 16 outcomes 15 cancer 16 outcomes 17 in 18 vivo 19 , 20 perhaps 19 , 21 limited 20 perhaps 21 limited 21 limited 22 by 21 limited 26 when 22 by 25 bioavailability 23 its 25 bioavailability 24 poor 25 bioavailability 26 when 27 taken 27 taken 28 orally although research in cell culture has shown promising and positive effects of resveratrol , evidence from rodents and humans is inconsistent . 0 ###LEFT-WALL### 15 evidence 0 ###LEFT-WALL### 20 is 0 ###LEFT-WALL### 22 . 1 although 2 research 1 although 7 shown 1 although 14 , 1 although 15 evidence 2 research 3 in 2 research 6 has 3 in 5 culture 4 cell 5 culture 6 has 7 shown 7 shown 11 effects 8 promising 9 and 9 and 10 positive 9 and 11 effects 11 effects 12 of 12 of 13 resveratrol 15 evidence 16 from 15 evidence 20 is 16 from 18 and 17 rodents 18 and 18 and 19 humans 20 is 21 inconsistent this review highlights [the] in vivo effects of resveratrol treatment on breast [,] colorectal , liver , pancreatic , and prostate cancers . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 highlights 0 ###LEFT-WALL### 23 . 1 this 2 review 2 review 3 highlights 3 highlights 6 vivo 3 highlights 7 effects 3 highlights 11 on 5 in 6 vivo 7 effects 8 of 8 of 10 treatment 9 resveratrol 10 treatment 11 on 20 and 12 breast 16 liver 14 colorectal 15 , 14 colorectal 16 liver 16 liver 17 , 17 , 18 pancreatic 17 , 20 and 19 , 20 and 20 and 22 cancers 21 prostate 22 cancers resveratrol supplementation in animal models of cancer has shown positive , neutral as well as negative outcomes depending on resveratrol [route] of administration , dose , tumor model , species , and other factors . 0 ###LEFT-WALL### 2 supplementation 0 ###LEFT-WALL### 9 shown 0 ###LEFT-WALL### 35 . 1 resveratrol 2 supplementation 2 supplementation 3 in 2 supplementation 8 has 3 in 5 models 4 animal 5 models 5 models 6 of 6 of 7 cancer 8 has 9 shown 9 shown 17 outcomes 9 shown 19 on 10 positive 11 , 10 positive 17 outcomes 12 neutral 17 outcomes 13 as 14 well 14 well 16 negative 15 as 16 negative 16 negative 17 outcomes 17 outcomes 18 depending 19 on 32 and 20 resveratrol 22 of 20 resveratrol 24 , 22 of 23 administration 24 , 25 dose 24 , 26 , 26 , 28 model 26 , 29 , 27 tumor 28 model 29 , 30 species 29 , 32 and 31 , 32 and 32 and 34 factors 33 other 34 factors within a specific cancer type , there is variability between studies with respect to strain , age , and sex of animal used [,] timing and method of resveratrol supplementation , and dose of resveratrol used to study cancer endpoints . 0 ###LEFT-WALL### 5 type 0 ###LEFT-WALL### 6 , 1 within 4 cancer 1 within 5 type 2 a 4 cancer 3 specific 4 cancer 6 , 7 there 6 , 8 is 7 there 8 is 8 is 9 variability 9 variability 10 between 9 variability 12 with 9 variability 19 and 10 between 11 studies 12 with 13 respect 13 respect 14 to 13 respect 15 strain 14 to 15 strain 16 , 19 and 17 age 19 and 18 , 19 and 19 and 20 sex 19 and 28 of 19 and 41 . 20 sex 21 of 21 of 26 and 22 animal 23 used 23 used 25 timing 25 timing 26 and 26 and 27 method 28 of 40 endpoints 29 resveratrol 30 supplementation 30 supplementation 32 and 31 , 32 and 32 and 33 dose 32 and 34 of 32 and 36 used 32 and 39 cancer 34 of 35 resveratrol 36 used 37 to 37 to 38 study 39 cancer 40 endpoints together , the data suggest that many factors need to be considered before resveratrol can be used for human cancer prevention or therapy . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 5 suggest 0 ###LEFT-WALL### 24 . 1 together 2 , 1 together 4 data 3 the 4 data 4 data 5 suggest 5 suggest 8 factors 5 suggest 9 need 6 that 7 many 7 many 8 factors 8 factors 9 need 9 need 10 to 9 need 12 considered 10 to 11 be 11 be 12 considered 12 considered 13 before 13 before 14 resveratrol 13 before 17 used 14 resveratrol 15 can 15 can 16 be 16 be 17 used 17 used 18 for 18 for 22 or 19 human 20 cancer 20 cancer 21 prevention 21 prevention 22 or 22 or 23 therapy none epidemiological studies reveal that children born with a solitary functioning kidney ( sfk ) have a greater predisposition to develop renal insufficiency and hypertension in early adulthood . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 4 reveal 0 ###LEFT-WALL### 29 . 1 none 2 epidemiological 1 none 3 studies 1 none 4 reveal 2 epidemiological 3 studies 4 reveal 5 that 5 that 6 children 5 that 16 have 6 children 7 born 6 children 16 have 7 born 8 with 8 with 12 kidney 9 a 10 solitary 9 a 12 kidney 10 solitary 12 kidney 11 functioning 12 kidney 12 kidney 14 sfk 13 ( 14 sfk 14 sfk 15 ) 16 have 19 predisposition 16 have 20 to 16 have 26 in 17 a 19 predisposition 18 greater 19 predisposition 20 to 21 develop 21 develop 24 and 22 renal 23 insufficiency 23 insufficiency 24 and 24 and 25 hypertension 26 in 28 adulthood 27 early 28 adulthood a congenital sfk is present in patients with unilateral renal agenesis or unilateral multicystic kidney dysplasia , leading to both structural and functional adaptations in the remaining kidney , which act to mitigate the reductions in glomerular filtration [rate] and sodium excretion that would otherwise ensue . 0 ###LEFT-WALL### 3 sfk 0 ###LEFT-WALL### 4 is 1 a 3 sfk 2 congenital 3 sfk 3 sfk 4 is 4 is 5 present 5 present 6 in 5 present 18 leading 6 in 12 or 7 patients 8 with 7 patients 12 or 8 with 11 agenesis 9 unilateral 11 agenesis 10 renal 11 agenesis 12 or 16 dysplasia 13 unilateral 15 kidney 14 multicystic 15 kidney 15 kidney 16 dysplasia 17 , 18 leading 18 leading 19 to 18 leading 25 in 18 leading 47 . 19 to 24 adaptations 20 both 24 adaptations 21 structural 22 and 22 and 23 functional 22 and 24 adaptations 25 in 28 kidney 26 the 27 remaining 26 the 28 kidney 28 kidney 30 which 29 , 30 which 30 which 31 act 30 which 47 . 31 act 32 to 32 to 33 mitigate 33 mitigate 40 and 34 the 35 reductions 35 reductions 36 in 35 reductions 40 and 36 in 38 filtration 37 glomerular 38 filtration 40 and 42 excretion 40 and 43 that 40 and 44 would 41 sodium 42 excretion 43 that 44 would 44 would 46 ensue 45 otherwise 46 ensue to understand the mechanisms underlying the early development of renal insufficiency in children born with a sfk , we established a model of fetal uninephrectomy ( uni - x ) in sheep , a species that similar to humans complete nephrogenesis before birth . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 understand 0 ###LEFT-WALL### 18 , 1 to 2 understand 2 understand 4 mechanisms 2 understand 12 in 3 the 4 mechanisms 4 mechanisms 5 underlying 5 underlying 8 development 6 the 8 development 7 early 8 development 8 development 9 of 9 of 11 insufficiency 10 renal 11 insufficiency 12 in 13 children 13 children 14 born 14 born 15 with 15 with 17 sfk 16 a 17 sfk 18 , 19 we 18 , 20 established 19 we 20 established 20 established 22 model 20 established 31 in 21 a 22 model 22 model 23 of 22 model 29 x 23 of 25 uninephrectomy 24 fetal 25 uninephrectomy 25 uninephrectomy 27 uni 26 ( 27 uni 27 uni 28 - 28 - 29 x 29 x 30 ) 31 in 32 sheep 32 sheep 35 species 33 , 35 species 34 a 35 species 35 species 37 similar 35 species 44 . 36 that 37 similar 37 similar 38 to 37 similar 42 before 38 to 41 nephrogenesis 39 humans 41 nephrogenesis 40 complete 41 nephrogenesis 42 before 43 birth this model results in a 30 % [reduction] in nephron number rather than 50 % , due to compensatory nephrogenesis in the remaining kidney . 0 ###LEFT-WALL### 2 model 0 ###LEFT-WALL### 3 results 1 this 2 model 2 model 3 results 3 results 4 in 3 results 13 than 4 in 11 number 5 a 11 number 6 30 9 in 7 % 9 in 9 in 11 number 10 nephron 11 number 12 rather 13 than 13 than 15 % 14 50 15 % 15 % 18 to 16 , 18 to 17 due 18 to 18 to 20 nephrogenesis 18 to 25 . 19 compensatory 20 nephrogenesis 20 nephrogenesis 21 in 21 in 24 kidney 22 the 23 remaining 22 the 24 kidney similar to children with a congenital sfk , uni - x sheep demonstrate a progressive increase in arterial pressure and a loss [of] renal function with aging . 0 ###LEFT-WALL### 12 sheep 0 ###LEFT-WALL### 13 demonstrate 0 ###LEFT-WALL### 28 . 1 similar 2 to 1 similar 10 - 1 similar 12 sheep 2 to 3 children 3 children 4 with 4 with 7 sfk 5 a 6 congenital 5 a 7 sfk 6 congenital 7 sfk 7 sfk 9 uni 8 , 9 uni 9 uni 10 - 11 x 12 sheep 12 sheep 13 demonstrate 13 demonstrate 16 increase 13 demonstrate 17 in 13 demonstrate 26 with 14 a 16 increase 15 progressive 16 increase 17 in 20 and 18 arterial 19 pressure 19 pressure 20 and 20 and 25 function 21 a 22 loss 21 a 25 function 22 loss 25 function 24 renal 25 function 26 with 27 aging this review summarizes the compensatory changes in renal hemodynamics and tubular sodium handling that drive impairments in renal function and highlights the existence of sex differences in the functional adaptations following the loss of a kidney during fetal life . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 40 . 1 this 2 review 2 review 20 and 3 summarizes 19 function 3 summarizes 20 and 4 the 19 function 5 compensatory 6 changes 6 changes 7 in 6 changes 10 and 7 in 9 hemodynamics 8 renal 9 hemodynamics 10 and 13 handling 10 and 14 that 10 and 15 drive 10 and 19 function 11 tubular 12 sodium 12 sodium 13 handling 14 that 15 drive 15 drive 16 impairments 15 drive 17 in 18 renal 19 function 20 and 21 highlights 20 and 37 during 21 highlights 23 existence 21 highlights 27 in 22 the 23 existence 23 existence 24 of 24 of 26 differences 25 sex 26 differences 27 in 30 adaptations 28 the 30 adaptations 29 functional 30 adaptations 30 adaptations 31 following 30 adaptations 34 of 31 following 33 loss 32 the 33 loss 34 of 36 kidney 35 a 36 kidney 37 during 39 life 38 fetal 39 life purpose : the purpose of this research is to study the effects of aging and combined training ( [sprint] and strength ) on catecholamine responses [ adrenaline ( [a] [ )(and noradrenaline [(] [na] ) ] . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 4 purpose 2 : 15 and 3 the 4 purpose 4 purpose 5 of 4 purpose 15 and 5 of 7 research 6 this 7 research 8 is 9 to 8 is 10 study 8 is 15 and 9 to 10 study 10 study 12 effects 11 the 12 effects 12 effects 13 of 13 of 14 aging 15 and 16 combined 15 and 20 and 17 training 20 and 18 ( 20 and 20 and 21 strength 20 and 22 ) 20 and 23 on 20 and 31 )(and 23 on 25 responses 24 catecholamine 25 responses 26 [ 31 )(and 27 adrenaline 31 )(and 28 ( 31 )(and 31 )(and 32 noradrenaline 31 )(and 35 ) 31 )(and 36 ] methods : thirty - two male subjects voluntarily participated in this study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 7 subjects 2 : 9 participated 2 : 13 . 3 thirty 4 - 4 - 5 two 4 - 7 subjects 6 male 7 subjects 7 subjects 9 participated 8 voluntarily 9 participated 9 participated 10 in 10 in 12 study 11 this 12 study yt and at participated in a high intensity sprint and strength training program ( hisst ) for 13 weeks . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 participated 0 ###LEFT-WALL### 20 . 1 yt 2 and 2 and 3 at 2 and 4 participated 4 participated 5 in 4 participated 17 for 5 in 10 and 6 a 7 high 6 a 9 sprint 7 high 8 intensity 8 intensity 9 sprint 9 sprint 10 and 10 and 13 program 10 and 15 hisst 11 strength 13 program 12 training 13 program 14 ( 15 hisst 15 hisst 16 ) 17 for 19 weeks 18 13 19 weeks all the participants realized the wingate [-] test before ( p1 ) [and] after [(] p2 [ )(hisst . 0 ###LEFT-WALL### 1 all 0 ###LEFT-WALL### 4 realized 0 ###LEFT-WALL### 19 . 1 all 2 the 1 all 3 participants 1 all 4 realized 2 the 3 participants 4 realized 8 test 4 realized 14 after 5 the 8 test 6 wingate 8 test 8 test 9 before 8 test 11 p1 10 ( 11 p1 11 p1 12 ) 14 after 18 )(hisst 16 p2 18 )(hisst plasma a and na concentrations were determined at rest ( [a] 0 , na0 ) and at the end of exercise ( a max , namax ) . 0 ###LEFT-WALL### 5 concentrations 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 28 . 1 plasma 2 a 1 plasma 3 and 3 and 4 na 4 na 5 concentrations 5 concentrations 6 were 6 were 7 determined 7 determined 16 and 8 at 9 rest 8 at 16 and 9 rest 12 0 9 rest 14 na0 10 ( 12 0 12 0 13 , 13 , 14 na0 14 na0 15 ) 16 and 17 at 17 at 19 end 18 the 19 end 19 end 20 of 20 of 21 exercise 21 exercise 26 namax 22 ( 26 namax 23 a 26 namax 24 max 25 , 24 max 26 namax 26 namax 27 ) results : at p1 , a significant difference ( p < 0.05 [ )(in terms of age was observed for na0 [and] [a] 0 between yt and at and between control groups yc and ac . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 32 groups 0 ###LEFT-WALL### 36 . 1 results 2 : 2 : 3 at 3 at 4 p1 5 , 8 difference 5 , 18 was 6 a 8 difference 7 significant 8 difference 8 difference 11 < 8 difference 18 was 9 ( 11 < 10 p 11 < 11 < 15 terms 12 0.05 14 )(in 14 )(in 15 terms 15 terms 16 of 16 of 17 age 18 was 19 observed 18 was 20 for 20 for 21 na0 21 na0 24 0 21 na0 29 and 21 na0 32 groups 25 between 28 at 25 between 29 and 26 yt 27 and 27 and 28 at 29 and 30 between 30 between 31 control 32 groups 35 ac 33 yc 34 and 34 and 35 ac this age effect disappeared after training when compared yt and at . 0 ###LEFT-WALL### 3 effect 0 ###LEFT-WALL### 4 disappeared 0 ###LEFT-WALL### 12 . 1 this 3 effect 2 age 3 effect 3 effect 4 disappeared 4 disappeared 5 after 5 after 6 training 6 training 7 when 6 training 11 at 7 when 8 compared 9 yt 10 and 10 and 11 at [after] hisst , [a] max increased significantly ( p < 0.05 ) in yt and at ( from 3.08 ± 0.17 to 3.23 ± 0.34 nmol l [(] - 1 [ )(in yt and from 3.23 ± 0.52 to 4.59 ± [0.10] nmol l ( - 1 ) in at ) . 0 ###LEFT-WALL### 2 hisst 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 52 . 3 , 15 and 5 max 6 increased 5 max 13 in 5 max 15 and 6 increased 7 significantly 6 increased 10 < 8 ( 10 < 9 p 10 < 10 < 11 0.05 10 < 12 ) 13 in 14 yt 15 and 16 at 15 and 18 from 17 ( 18 from 18 from 19 3.08 18 from 51 ) 19 3.08 20 ± 19 3.08 24 ± 20 ± 22 to 21 0.17 22 to 22 to 23 3.23 24 ± 29 - 24 ± 34 and 24 ± 49 in 25 0.34 26 nmol 25 0.34 29 - 26 nmol 27 l 29 - 30 1 32 )(in 33 yt 32 )(in 34 and 34 and 35 from 35 from 37 ± 36 3.23 37 ± 37 ± 39 to 37 ± 47 1 38 0.52 39 to 39 to 40 4.59 40 4.59 43 nmol 41 ± 43 nmol 43 nmol 44 l 45 ( 47 1 46 - 47 1 47 1 48 ) 49 in 50 at however , namax increased significantly ( p < 0.05 ) in at only ( from 3.34 ± 0.31 to 3.75 ± [0.60] nmol l ( - 1 ) ) . 0 ###LEFT-WALL### 3 namax 0 ###LEFT-WALL### 4 increased 0 ###LEFT-WALL### 30 . 1 however 2 , 1 however 3 namax 3 namax 4 increased 4 increased 5 significantly 4 increased 8 < 4 increased 11 in 4 increased 13 only 4 increased 15 from 6 ( 8 < 7 p 8 < 8 < 9 0.05 8 < 10 ) 11 in 12 at 14 ( 15 from 15 from 16 3.34 15 from 29 ) 16 3.34 17 ± 16 3.34 27 1 17 ± 19 to 18 0.31 19 to 19 to 20 3.75 20 3.75 23 nmol 21 ± 23 nmol 23 nmol 24 l 25 ( 27 1 26 - 27 1 27 1 28 ) a max [was] highly increased [in] at compared to yt ( 4.59 ± 0.10 vs [.] 3.23 ± 0.34 nmol l [(] - 1 ) [ )(, respectively . 0 ###LEFT-WALL### 7 at 0 ###LEFT-WALL### 8 compared 1 a 2 max 1 a 7 at 2 max 7 at 4 highly 5 increased 5 increased 7 at 7 at 8 compared 8 compared 9 to 8 compared 28 respectively 9 to 10 yt 10 yt 13 ± 11 ( 13 ± 12 4.59 13 ± 13 ± 14 0.10 13 ± 15 vs 13 ± 25 ) 15 vs 17 3.23 17 3.23 18 ± 18 ± 23 - 19 0.34 20 nmol 19 0.34 23 - 20 nmol 21 l 23 - 24 1 27 )(, 28 respectively 28 respectively 29 . conclusion : the combined training ( sprint [and] strength ) appeared to reduce the age effect of the catecholamine response [both] at rest and in response to exercise . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 training 2 : 11 appeared 2 : 29 . 3 the 5 training 4 combined 5 training 5 training 9 strength 5 training 11 appeared 6 ( 9 strength 7 sprint 9 strength 9 strength 10 ) 11 appeared 12 to 11 appeared 13 reduce 12 to 13 reduce 13 reduce 16 effect 13 reduce 24 and 13 reduce 27 to 14 the 16 effect 15 age 16 effect 16 effect 17 of 17 of 20 response 18 the 20 response 19 catecholamine 20 response 22 at 23 rest 22 at 24 and 24 and 26 response 25 in 26 response 27 to 28 exercise none objective : this study estimates national trends and patterns in use of second [-] generation antipsychotics ( sgas ) for adjunctive treatment of nonpsychotic adult depression in office - based practice . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 14 second 0 ###LEFT-WALL### 30 - 0 ###LEFT-WALL### 33 . 1 none 2 objective 1 none 13 of 1 none 14 second 2 objective 3 : 3 : 5 study 3 : 11 in 4 this 5 study 5 study 9 and 6 estimates 8 trends 6 estimates 9 and 7 national 8 trends 9 and 10 patterns 11 in 12 use 12 use 13 of 14 second 17 antipsychotics 14 second 21 for 14 second 29 office 16 generation 17 antipsychotics 17 antipsychotics 19 sgas 18 ( 19 sgas 19 sgas 20 ) 21 for 23 treatment 22 adjunctive 23 treatment 23 treatment 24 of 24 of 27 depression 25 nonpsychotic 26 adult 26 adult 27 depression 28 in 29 office 30 - 32 practice 31 based 32 practice method : twelve consecutive years ( 1999 - 2010 ) of the national ambulatory medical care survey were analyzed to estimate trends and patterns of adjunctive [sga] treatment for adult [(] ≥ 18 years ) nonpsychotic depression in office - based visits . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 40 - 1 method 2 : 2 : 37 depression 2 : 39 office 3 twelve 5 years 4 consecutive 5 years 5 years 7 1999 5 years 9 2010 5 years 11 of 5 years 23 and 6 ( 7 1999 7 1999 8 - 8 - 9 2010 9 2010 10 ) 11 of 14 ambulatory 12 the 14 ambulatory 13 national 14 ambulatory 14 ambulatory 16 care 14 ambulatory 19 analyzed 15 medical 16 care 16 care 17 survey 16 care 18 were 16 care 19 analyzed 17 survey 18 were 19 analyzed 20 to 20 to 21 estimate 21 estimate 22 trends 23 and 24 patterns 23 and 35 ) 23 and 37 depression 24 patterns 25 of 25 of 28 treatment 26 adjunctive 28 treatment 28 treatment 29 for 29 for 34 years 30 adult 34 years 32 ≥ 34 years 33 18 34 years 36 nonpsychotic 37 depression 38 in 39 office 40 - 42 visits 40 - 43 . 41 based 42 visits results : from 1999 to 2010 , 8.6 % of adult depression visits included [an] sga . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 5 to 3 from 5 to 4 1999 5 to 5 to 6 2010 5 to 9 % 7 , 9 % 8 8.6 9 % 9 % 10 of 9 % 17 . 10 of 13 visits 11 adult 13 visits 12 depression 13 visits 13 visits 14 included 14 included 16 sga [sga] use rates increased from 4.6 % in 1999 - 2000 to 12.5 % in 2009 - 2010 , with an adjusted odds ratio ( aor ) for time [trend] of 2.78 ( 95 % ci , 1.84 - 4.20 ) . 0 ###LEFT-WALL### 3 rates 0 ###LEFT-WALL### 4 increased 0 ###LEFT-WALL### 42 . 2 use 3 rates 3 rates 4 increased 4 increased 10 - 4 increased 12 to 4 increased 15 in 4 increased 39 - 5 from 10 - 6 4.6 8 in 6 4.6 10 - 7 % 8 in 8 in 9 1999 10 - 11 2000 12 to 14 % 13 12.5 14 % 15 in 16 2009 16 2009 18 2010 17 - 18 2010 18 2010 20 with 18 2010 37 , 19 , 20 with 20 with 24 ratio 20 with 28 for 20 with 37 , 21 an 24 ratio 22 adjusted 23 odds 23 odds 24 ratio 24 ratio 26 aor 25 ( 26 aor 26 aor 27 ) 28 for 29 time 29 time 31 of 29 time 36 ci 31 of 32 2.78 33 ( 36 ci 34 95 36 ci 35 % 36 ci 36 ci 37 , 37 , 39 - 38 1.84 39 - 39 - 40 4.20 39 - 41 ) the increase in [sga] augmentation was broad - based , with no significant differences in time trends between demographic and clinical subgroups . 0 ###LEFT-WALL### 2 increase 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 23 . 1 the 2 increase 2 increase 3 in 2 increase 6 was 3 in 5 augmentation 6 was 7 broad 7 broad 9 based 7 broad 11 with 7 broad 15 in 7 broad 18 between 8 - 9 based 9 based 10 , 11 with 14 differences 12 no 14 differences 13 significant 14 differences 15 in 17 trends 16 time 17 trends 18 between 22 subgroups 19 demographic 20 and 20 and 21 clinical 20 and 22 subgroups conclusions : between 1999 and 2010 , sgas were increasingly accepted in the outpatient treatment of adult nonpsychotic depression . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 20 . 1 conclusions 2 : 2 : 3 between 3 between 5 and 4 1999 5 and 5 and 6 2010 7 , 8 sgas 7 , 11 accepted 8 sgas 9 were 9 were 11 accepted 10 increasingly 11 accepted 11 accepted 12 in 12 in 15 treatment 13 the 15 treatment 14 outpatient 15 treatment 15 treatment 16 of 16 of 19 depression 17 adult 19 depression 18 nonpsychotic 19 depression objective : healthcare and mortality costs of secondhand smoke ( shs ) exposure at home [among] [non] - smokers in california were estimated for the year 2009 . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 - 1 objective 2 : 2 : 13 exposure 3 healthcare 4 and 4 and 6 costs 4 and 7 of 4 and 13 exposure 5 mortality 6 costs 7 of 9 smoke 8 secondhand 9 smoke 9 smoke 11 shs 10 ( 11 shs 11 shs 12 ) 13 exposure 14 at 14 at 15 home 18 - 19 smokers 18 - 23 estimated 18 - 28 . 19 smokers 20 in 19 smokers 22 were 20 in 21 california 22 were 23 estimated 23 estimated 24 for 24 for 26 year 25 the 26 year 26 year 27 2009 methods : costs were estimated with an epidemiological model using california shs home exposure rates and published relative risks . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 methods 2 : 2 : 3 costs 3 costs 16 and 4 were 5 estimated 4 were 16 and 5 estimated 6 with 6 with 9 model 7 an 8 epidemiological 7 an 9 model 8 epidemiological 9 model 9 model 10 using 9 model 15 rates 10 using 14 exposure 10 using 15 rates 11 california 12 shs 12 shs 14 exposure 13 home 14 exposure 16 and 17 published 16 and 19 risks 18 relative 19 risks healthcare costs included nine conditions , and mortality was estimated for four perinatal and three adult conditions . 0 ###LEFT-WALL### 2 costs 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 18 . 1 healthcare 2 costs 2 costs 3 included 3 included 5 conditions 4 nine 5 conditions 6 , 7 and 7 and 8 mortality 7 and 10 estimated 8 mortality 9 was 9 was 10 estimated 10 estimated 11 for 11 for 17 conditions 12 four 17 conditions 13 perinatal 14 and 14 and 16 adult 14 and 17 conditions 15 three 16 adult three mortality - related measures were estimated : deaths , years of potential life lost ( ypll ) and the value of lost productivity . 0 ###LEFT-WALL### 2 mortality 0 ###LEFT-WALL### 7 estimated 0 ###LEFT-WALL### 8 : 1 three 2 mortality 2 mortality 6 were 3 - 4 related 4 related 5 measures 4 related 6 were 6 were 7 estimated 8 : 19 and 8 : 25 . 9 deaths 10 , 10 , 11 years 10 , 19 and 11 years 12 of 11 years 14 life 11 years 15 lost 11 years 17 ypll 12 of 13 potential 14 life 15 lost 16 ( 17 ypll 17 ypll 18 ) 19 and 21 value 19 and 22 of 20 the 21 value 22 of 24 productivity 23 lost 24 productivity results : shs - attributable healthcare costs totalled over $ 241 million . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 results 2 : 2 : 3 shs 4 - 7 costs 4 - 8 totalled 4 - 13 . 5 attributable 7 costs 6 healthcare 7 costs 7 costs 8 totalled 8 totalled 9 over 8 totalled 10 $ 10 $ 12 million 11 241 12 million the most costly conditions for children and adolescents were attention deficit hyperactivity disorder ( $ 7.8 million ) and middle ear disease ( $ 5.6 million ) . 0 ###LEFT-WALL### 4 conditions 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 28 . 1 the 2 most 2 most 4 conditions 3 costly 4 conditions 4 conditions 5 for 4 conditions 19 and 5 for 7 and 6 children 7 and 7 and 8 adolescents 9 were 13 disorder 9 were 19 and 10 attention 13 disorder 11 deficit 13 disorder 12 hyperactivity 13 disorder 13 disorder 15 $ 14 ( 15 $ 15 $ 17 million 15 $ 18 ) 16 7.8 17 million 19 and 20 middle 20 middle 22 disease 21 ear 22 disease 22 disease 24 $ 23 ( 24 $ 24 $ 26 million 24 $ 27 ) 25 5.6 26 million for adults , the most costly conditions were ischaemic heart disease ( ihd ) ( $ 130.0 million [ )(and asthma ( $ 67.4 million ) . 0 ###LEFT-WALL### 7 conditions 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 27 . 1 for 2 adults 1 for 3 , 1 for 7 conditions 4 the 5 most 5 most 7 conditions 6 costly 7 conditions 7 conditions 8 were 8 were 11 disease 9 ischaemic 10 heart 10 heart 11 disease 11 disease 13 ihd 11 disease 20 )(and 12 ( 13 ihd 13 ihd 14 ) 15 ( 20 )(and 16 $ 18 million 16 $ 20 )(and 17 130.0 18 million 20 )(and 21 asthma 20 )(and 23 $ 20 )(and 26 ) 22 ( 23 $ 23 $ 25 million 23 $ 26 ) 24 67.4 25 million deaths of 821 californians were attributable to shs exposure in the home , including 27 infants whose mothers smoked while pregnant and 700 adults who died from ihd . 0 ###LEFT-WALL### 1 deaths 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 29 . 1 deaths 2 of 1 deaths 5 were 2 of 4 californians 3 821 4 californians 5 were 6 attributable 6 attributable 7 to 6 attributable 10 in 7 to 9 exposure 8 shs 9 exposure 10 in 12 home 11 the 12 home 13 , 22 and 14 including 16 infants 15 27 16 infants 16 infants 17 whose 16 infants 22 and 17 whose 18 mothers 18 mothers 19 smoked 19 smoked 20 while 20 while 21 pregnant 22 and 24 adults 22 and 25 who 22 and 26 died 23 700 24 adults 25 who 26 died 26 died 27 from 27 from 28 ihd these deaths represented a loss of over 13 000 ypll and $ 119 million in lost productivity . 0 ###LEFT-WALL### 2 deaths 0 ###LEFT-WALL### 3 represented 0 ###LEFT-WALL### 18 . 1 these 2 deaths 2 deaths 3 represented 3 represented 5 loss 3 represented 15 in 4 a 5 loss 5 loss 6 of 6 of 7 over 7 over 11 and 8 13 10 ypll 9 000 10 ypll 10 ypll 11 and 11 and 12 $ 12 $ 14 million 13 119 14 million 15 in 17 productivity 16 lost 17 productivity conclusions : the economic impact of shs exposure in the home totalled $ 360 million in california in 2009 . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 impact 2 : 12 totalled 2 : 20 . 3 the 5 impact 4 economic 5 impact 5 impact 6 of 5 impact 12 totalled 6 of 8 exposure 7 shs 8 exposure 8 exposure 9 in 9 in 11 home 10 the 11 home 12 totalled 13 $ 12 totalled 16 in 12 totalled 18 in 13 $ 15 million 14 360 15 million 16 in 17 california 18 in 19 2009 policies that reduce exposure to shs at home have great potential for reducing healthcare and mortality costs . 0 ###LEFT-WALL### 1 policies 0 ###LEFT-WALL### 9 have 0 ###LEFT-WALL### 18 . 1 policies 2 that 1 policies 3 reduce 1 policies 9 have 2 that 3 reduce 3 reduce 4 exposure 3 reduce 5 to 3 reduce 7 at 5 to 6 shs 7 at 8 home 9 have 11 potential 9 have 12 for 10 great 11 potential 12 for 13 reducing 13 reducing 15 and 14 healthcare 15 and 15 and 17 costs 16 mortality 17 costs background : there is a loss [of] lean body mass ( lbm ) with increasing age . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 is 2 : 17 . 3 there 4 is 4 is 10 mass 4 is 14 with 5 a 6 loss 5 a 10 mass 6 loss 10 mass 8 lean 9 body 9 body 10 mass 10 mass 12 lbm 11 ( 12 lbm 12 lbm 13 ) 14 with 15 increasing 15 increasing 16 age a low lbm has been associated with increased adverse effects from prescribed medications such as chemotherapy . 0 ###LEFT-WALL### 2 low 0 ###LEFT-WALL### 8 increased 0 ###LEFT-WALL### 17 . 1 a 2 low 2 low 3 lbm 2 low 7 with 2 low 8 increased 3 lbm 4 has 4 has 5 been 5 been 6 associated 6 associated 7 with 8 increased 10 effects 9 adverse 10 effects 10 effects 11 from 11 from 13 medications 12 prescribed 13 medications 13 medications 15 as 14 such 15 as 15 as 16 chemotherapy accurate assessment of lbm may allow for more accurate drug prescribing . 0 ###LEFT-WALL### 2 assessment 0 ###LEFT-WALL### 7 for 0 ###LEFT-WALL### 12 . 1 accurate 2 assessment 2 assessment 3 of 2 assessment 5 may 3 of 4 lbm 5 may 7 for 6 allow 7 for 7 for 11 prescribing 8 more 11 prescribing 9 accurate 10 drug 10 drug 11 prescribing the aims of this study were to develop new prediction equations ( pes ) for lbm with anthropometric and biochemical variables from a development cohort and then validate the best performing pes in validation cohorts . 0 ###LEFT-WALL### 2 aims 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 36 . 1 the 2 aims 2 aims 3 of 2 aims 26 and 3 of 5 study 4 this 5 study 6 were 7 to 6 were 8 develop 6 were 26 and 7 to 8 develop 8 develop 11 equations 8 develop 15 for 8 develop 17 with 9 new 11 equations 10 prediction 11 equations 11 equations 13 pes 12 ( 13 pes 13 pes 14 ) 15 for 16 lbm 17 with 21 variables 18 anthropometric 19 and 19 and 20 biochemical 19 and 21 variables 21 variables 22 from 22 from 25 cohort 23 a 24 development 23 a 25 cohort 24 development 25 cohort 26 and 28 validate 26 and 33 in 27 then 28 validate 28 validate 30 best 29 the 30 best 30 best 31 performing 31 performing 32 pes 33 in 35 cohorts 34 validation 35 cohorts methods : pes were developed in a cohort of 188 healthy subjects and then validated in a convenience cohort of 52 healthy subjects . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 1 methods 2 : 2 : 3 pes 3 pes 13 and 4 were 5 developed 4 were 13 and 5 developed 6 in 6 in 8 cohort 7 a 8 cohort 8 cohort 9 of 9 of 12 subjects 10 188 12 subjects 11 healthy 12 subjects 13 and 15 validated 13 and 16 in 14 then 15 validated 16 in 19 cohort 17 a 19 cohort 18 convenience 19 cohort 19 cohort 20 of 20 of 23 subjects 21 52 23 subjects 22 healthy 23 subjects the best performing anthropometric pe was then compared to published anthropometric pes in an older [(] age≥50 [years] ) cohort of 2287 people . 0 ###LEFT-WALL### 2 best 0 ###LEFT-WALL### 8 compared 0 ###LEFT-WALL### 24 . 1 the 2 best 2 best 3 performing 2 best 6 was 3 performing 5 pe 4 anthropometric 5 pe 6 was 8 compared 7 then 8 compared 8 compared 9 to 8 compared 13 in 9 to 12 pes 10 published 12 pes 11 anthropometric 12 pes 13 in 20 cohort 14 an 20 cohort 15 older 20 cohort 17 age≥50 19 ) 17 age≥50 20 cohort 20 cohort 21 of 21 of 23 people 22 2287 23 people best subset regression analysis was used to derive pes . 0 ###LEFT-WALL### 1 best 0 ###LEFT-WALL### 10 . 1 best 3 regression 2 subset 3 regression 3 regression 4 analysis 3 regression 5 was 3 regression 6 used 4 analysis 5 was 6 used 7 to 6 used 8 derive 7 to 8 derive 8 derive 9 pes correlation , bland - altman and sheiner & beal methods were used to validate and [compare] the pes against [dual] x - ray absorptiometry ( dxa ) - derived lbm . 0 ###LEFT-WALL### 1 correlation 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 31 . 2 , 15 and 2 , 29 derived 3 bland 4 - 3 bland 15 and 5 altman 6 and 6 and 9 beal 6 and 10 methods 6 and 14 validate 6 and 15 and 7 sheiner 8 & 8 & 9 beal 10 methods 11 were 11 were 12 used 12 used 13 to 12 used 14 validate 13 to 14 validate 15 and 18 pes 15 and 24 absorptiometry 15 and 29 derived 17 the 18 pes 18 pes 19 against 19 against 21 x 22 - 24 absorptiometry 23 ray 24 absorptiometry 24 absorptiometry 26 dxa 24 absorptiometry 28 - 25 ( 26 dxa 26 dxa 27 ) 29 derived 30 lbm results : the pe which included biochemistry variables performed only marginally better than the anthropometric pe . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 1 results 2 : 2 : 4 pe 3 the 4 pe 4 pe 5 which 4 pe 6 included 5 which 6 included 6 included 8 variables 7 biochemistry 8 variables 8 variables 9 performed 9 performed 10 only 9 performed 12 better 11 marginally 12 better 12 better 13 than 13 than 16 pe 14 the 16 pe 15 anthropometric 16 pe the anthropometric pe on average [over] [-] estimated lbm by 0.74 kg in the combined cohort . 0 ###LEFT-WALL### 3 pe 0 ###LEFT-WALL### 8 estimated 0 ###LEFT-WALL### 17 . 1 the 3 pe 2 anthropometric 3 pe 3 pe 5 average 3 pe 8 estimated 4 on 5 average 8 estimated 9 lbm 8 estimated 10 by 8 estimated 13 in 10 by 12 kg 11 0.74 12 kg 13 in 16 cohort 14 the 16 cohort 15 combined 16 cohort across gender ( male vs [.] female ) , body mass index ( < 22 , 22 - < 27 , 27 - < 30 [and] ≥30 kg/m2 ) [and] age groups ( 50 - 64 , 65 - 79 [and] ≥80 years ) , the maximum mean over [-] estimation of the anthropometric pe [was] 1.36 [kg] . 1 across 2 gender 1 across 9 , 1 across 10 body 2 gender 4 male 3 ( 4 male 4 male 5 vs 4 male 8 ) 5 vs 7 female 10 body 17 22 10 body 19 < 11 mass 12 index 12 index 15 22 13 ( 15 22 14 < 15 22 15 22 16 , 16 , 17 22 17 22 18 - 19 < 20 27 20 27 31 age 20 27 32 groups 21 , 23 - 22 27 23 - 23 - 28 kg/m2 23 - 29 ) 23 - 31 age 24 < 25 30 25 30 28 kg/m2 27 ≥30 28 kg/m2 31 age 32 groups 32 groups 35 - 33 ( 35 - 34 50 35 - 35 - 36 64 36 64 39 - 36 64 47 maximum 37 , 39 - 38 65 39 - 39 - 43 years 39 - 44 ) 40 79 43 years 42 ≥80 43 years 45 , 47 maximum 46 the 47 maximum 47 maximum 48 mean 47 maximum 52 of 47 maximum 59 . 48 mean 49 over 49 over 51 estimation 52 of 55 pe 53 the 55 pe 54 anthropometric 55 pe 55 pe 57 1.36 conclusions : a new anthropometric pe has been developed [that] offers an alternative for clinicians when access to dxa is limited . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 pe 2 : 8 been 2 : 22 . 3 a 4 new 3 a 6 pe 4 new 6 pe 5 anthropometric 6 pe 6 pe 7 has 7 has 8 been 8 been 11 offers 9 developed 11 offers 11 offers 13 alternative 11 offers 21 limited 12 an 13 alternative 13 alternative 14 for 13 alternative 21 limited 14 for 15 clinicians 15 clinicians 16 when 16 when 17 access 16 when 20 is 17 access 18 to 17 access 20 is 18 to 19 dxa further research is required to determine the clinical utility [and] if it will improve the safety of medication use . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 required 0 ###LEFT-WALL### 20 . 1 further 2 research 2 research 3 is 3 is 4 required 4 required 5 to 4 required 6 determine 5 to 6 determine 6 determine 9 utility 6 determine 11 if 7 the 9 utility 8 clinical 9 utility 11 if 12 it 11 if 14 improve 12 it 13 will 13 will 14 improve 14 improve 16 safety 15 the 16 safety 16 safety 17 of 17 of 19 use 18 medication 19 use introduction : the advent of tyrosine kinase inhibitors has produced 5 - year survival of 90 [+] % for chronic myelocytic leukemia ( cml ) [patients] in clinical trials . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 4 advent 2 : 10 produced 2 : 30 . 3 the 4 advent 4 advent 5 of 4 advent 9 has 5 of 8 inhibitors 6 tyrosine 8 inhibitors 7 kinase 8 inhibitors 9 has 10 produced 10 produced 11 5 10 produced 27 in 11 5 14 survival 12 - 14 survival 13 year 14 survival 14 survival 15 of 14 survival 25 ) 15 of 18 % 16 90 18 % 18 % 19 for 19 for 22 leukemia 20 chronic 22 leukemia 21 myelocytic 22 leukemia 22 leukemia 24 cml 23 ( 24 cml 24 cml 25 ) 27 in 29 trials 28 clinical 29 trials however , population level survival has been lower , especially in older patients . 0 ###LEFT-WALL### 5 survival 0 ###LEFT-WALL### 7 been 1 however 2 , 1 however 5 survival 3 population 5 survival 4 level 5 survival 5 survival 6 has 6 has 7 been 7 been 8 lower 8 lower 11 in 9 , 10 especially 9 , 11 in 11 in 13 patients 11 in 14 . 12 older 13 patients here , we examine survival of patients with cml in germany and compare it to survival of patients in the united states ( us ) . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 26 . 1 here 2 , 1 here 3 we 3 we 12 and 4 examine 5 survival 4 examine 8 with 4 examine 10 in 4 examine 12 and 5 survival 6 of 6 of 7 patients 8 with 9 cml 10 in 11 germany 12 and 13 compare 12 and 19 in 13 compare 14 it 13 compare 15 to 15 to 16 survival 16 survival 17 of 17 of 18 patients 19 in 22 states 20 the 22 states 21 united 22 states 22 states 24 us 23 ( 24 us 24 us 25 ) methods : data were extracted from the surveillance , epidemiology , and end results database in the us and 11 cancer registries in germany . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 5 extracted 2 : 25 . 3 data 4 were 4 were 5 extracted 5 extracted 6 from 5 extracted 16 in 5 extracted 23 in 6 from 12 and 7 the 8 surveillance 8 surveillance 9 , 9 , 10 epidemiology 9 , 12 and 11 , 12 and 12 and 15 database 13 end 15 database 14 results 15 database 16 in 19 and 17 the 18 us 18 us 19 and 19 and 22 registries 20 11 22 registries 21 cancer 22 registries 23 in 24 germany patients 15 - 69 years old diagnosed with cml were included in the analysis . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 11 included 0 ###LEFT-WALL### 15 . 1 patients 2 15 1 patients 6 old 1 patients 7 diagnosed 1 patients 10 were 3 - 4 69 4 69 5 years 5 years 6 old 7 diagnosed 8 with 8 with 9 cml 10 were 11 included 11 included 12 in 12 in 14 analysis 13 the 14 analysis period analysis for 2002 - 2006 was used to provide the most up - to [-] date possible estimates of five - year relative survival . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 8 used 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 26 . 1 period 2 analysis 2 analysis 3 for 2 analysis 7 was 3 for 5 - 4 2002 5 - 5 - 6 2006 7 was 8 used 8 used 9 to 8 used 10 provide 9 to 10 provide 10 provide 12 most 10 provide 13 up 10 provide 15 to 11 the 12 most 14 - 15 to 15 to 17 date 15 to 22 - 17 date 19 estimates 18 possible 19 estimates 19 estimates 20 of 20 of 21 five 22 - 25 survival 23 year 25 survival 24 relative 25 survival results : five - year relative survival was 68.7 % overall in germany [and] 72.7 % in the us . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 five 2 : 4 - 4 - 7 survival 4 - 8 was 4 - 20 . 5 year 7 survival 6 relative 7 survival 7 survival 8 was 8 was 10 % 8 was 11 overall 8 was 12 in 8 was 17 in 9 68.7 10 % 12 in 16 % 13 germany 15 72.7 13 germany 16 % 17 in 19 us 18 the 19 us survival was higher in the us for all age groups except for ages 15 - 39 years , but the difference was only statistically significant for ages 50 - 59 years ( at 67.5 % vs 77.7 % in germany and the us , respectively ) . 0 ###LEFT-WALL### 1 survival 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 19 but 0 ###LEFT-WALL### 47 . 1 survival 2 was 2 was 3 higher 3 higher 4 in 3 higher 7 for 4 in 6 us 5 the 6 us 7 for 10 groups 8 all 10 groups 9 age 10 groups 10 groups 11 except 10 groups 17 years 11 except 12 for 12 for 13 ages 13 ages 14 15 15 - 17 years 16 39 17 years 17 years 18 , 19 but 21 difference 19 but 22 was 20 the 21 difference 21 difference 22 was 22 was 23 only 22 was 25 significant 24 statistically 25 significant 25 significant 26 for 25 significant 45 respectively 26 for 27 ages 27 ages 28 50 27 ages 31 years 29 - 31 years 30 59 31 years 31 years 33 at 31 years 44 , 32 ( 33 at 33 at 35 % 33 at 44 , 34 67.5 35 % 35 % 36 vs 36 vs 38 % 37 77.7 38 % 38 % 39 in 39 in 41 and 40 germany 41 and 41 and 43 us 41 and 44 , 42 the 43 us 44 , 45 respectively 45 respectively 46 ) survival decreased with age , ranging from 83.1 [%] and 81.9 % , respectively , in germany and the us for patients 15 - 39 years old to 54.2 [%] and 54.5 % , respectively , in patients 65 - 69 years old . 0 ###LEFT-WALL### 1 survival 0 ###LEFT-WALL### 2 decreased 0 ###LEFT-WALL### 44 . 1 survival 2 decreased 2 decreased 3 with 2 decreased 6 ranging 2 decreased 16 in 3 with 4 age 5 , 6 ranging 6 ranging 12 % 6 ranging 14 respectively 6 ranging 15 , 7 from 10 and 8 83.1 10 and 10 and 11 81.9 10 and 12 % 13 , 14 respectively 14 respectively 15 , 16 in 18 and 17 germany 18 and 18 and 20 us 18 and 21 for 18 and 27 old 19 the 20 us 21 for 26 years 22 patients 26 years 23 15 24 - 24 - 25 39 24 - 26 years 27 old 28 to 27 old 35 respectively 27 old 37 in 28 to 33 % 29 54.2 31 and 31 and 32 54.5 31 and 33 % 34 , 35 respectively 35 respectively 36 , 37 in 38 patients 38 patients 39 65 38 patients 43 old 40 - 41 69 41 69 42 years 42 years 43 old survival increased between 2002 and 2006 by 12.0 % points in germany and 17.1 % points in the us . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 20 . 1 survival 2 increased 1 survival 13 and 2 increased 3 between 2 increased 7 by 2 increased 11 in 3 between 5 and 4 2002 5 and 5 and 6 2006 7 by 10 points 8 12.0 10 points 9 % 10 points 11 in 12 germany 13 and 16 points 13 and 17 in 14 17.1 16 points 15 % 16 points 17 in 19 us 18 the 19 us conclusions : five - year survival estimates were higher in the us than in germany overall , but the difference was only significant for ages 50 - 59 years . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 30 . 1 conclusions 2 : 2 : 3 five 4 - 7 estimates 4 - 8 were 4 - 18 but 4 - 27 - 5 year 7 estimates 6 survival 7 estimates 7 estimates 8 were 8 were 9 higher 9 higher 10 in 9 higher 13 than 9 higher 16 overall 10 in 12 us 11 the 12 us 13 than 14 in 14 in 15 germany 17 , 18 but 18 but 20 difference 18 but 21 was 19 the 20 difference 20 difference 21 was 21 was 22 only 21 was 23 significant 23 significant 24 for 24 for 25 ages 25 ages 26 50 27 - 29 years 28 59 29 years survival did not equal that seen in clinical trials for either country , but strong improvement in survival was seen between 2002 and 2006 . 0 ###LEFT-WALL### 1 survival 0 ###LEFT-WALL### 4 equal 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 25 . 1 survival 2 did 2 did 3 not 2 did 4 equal 4 equal 5 that 5 that 6 seen 6 seen 7 in 7 in 9 trials 8 clinical 9 trials 9 trials 10 for 10 for 12 country 11 either 12 country 13 , 14 but 14 but 16 improvement 14 but 20 seen 15 strong 16 improvement 16 improvement 17 in 16 improvement 19 was 17 in 18 survival 19 was 20 seen 20 seen 21 between 21 between 23 and 22 2002 23 and 23 and 24 2006 objectives : unmet mental health care needs of older people ( aged 65 [and] [over] ) have been identified as a serious problem internationally , particularly in rural areas . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 7 needs 2 : 19 identified 3 unmet 7 needs 4 mental 5 health 5 health 7 needs 6 care 7 needs 7 needs 8 of 7 needs 12 aged 7 needs 17 have 8 of 10 people 9 older 10 people 11 ( 12 aged 12 aged 13 65 12 aged 16 ) 17 have 18 been 18 been 19 identified 19 identified 20 as 19 identified 24 internationally 19 identified 27 in 20 as 23 problem 21 a 23 problem 22 serious 23 problem 25 , 26 particularly 25 , 27 in 27 in 29 areas 27 in 30 . 28 rural 29 areas in this study we explored the views of health and social care providers of the barriers to effective mental health care for older people in a rural region in australia . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 explored 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 31 . 1 in 3 study 1 in 4 we 2 this 3 study 4 we 5 explored 5 explored 7 views 6 the 7 views 7 views 8 of 8 of 9 health 10 and 13 providers 10 and 21 care 11 social 12 care 12 care 13 providers 13 providers 14 of 13 providers 21 care 14 of 16 barriers 15 the 16 barriers 16 barriers 17 to 17 to 20 health 18 effective 20 health 19 mental 20 health 21 care 22 for 21 care 25 in 21 care 29 in 22 for 24 people 23 older 24 people 25 in 28 region 26 a 27 rural 26 a 28 region 27 rural 28 region 29 in 30 australia method : semi - structured interviews were conducted with 19 participants from 13 organisations providing care and support to older people in a rural region of australia . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 6 interviews 2 : 17 and 3 semi 4 - 3 semi 6 interviews 5 structured 6 interviews 6 interviews 17 and 7 were 8 conducted 7 were 17 and 8 conducted 9 with 9 with 11 participants 10 19 11 participants 11 participants 12 from 12 from 14 organisations 13 13 14 organisations 14 organisations 15 providing 15 providing 16 care 17 and 18 support 17 and 19 to 17 and 22 in 19 to 21 people 20 older 21 people 22 in 25 region 23 a 25 region 24 rural 25 region 25 region 26 of 26 of 27 australia a framework analysis approach was used to thematically analyse the data . 0 ###LEFT-WALL### 4 approach 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 12 . 1 a 4 approach 2 framework 4 approach 3 analysis 4 approach 4 approach 5 was 5 was 6 used 6 used 7 to 6 used 9 analyse 7 to 9 analyse 8 thematically 9 analyse 9 analyse 11 data 10 the 11 data results : two main themes were identified : ['] [recognising] the problem ['] and ['] service availability and access ['] . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 themes 2 : 7 identified 2 : 8 : 2 : 21 . 3 two 5 themes 4 main 5 themes 5 themes 6 were 6 were 7 identified 8 : 18 and 11 the 12 problem 12 problem 14 and 14 and 17 availability 14 and 18 and 16 service 17 availability 18 and 19 access in particular the participants identified the impact of the attitudes of older people and health professionals , as well as service inadequacies and gaps in services , on the provision of mental health care to older people in a rural region . 0 ###LEFT-WALL### 4 participants 0 ###LEFT-WALL### 5 identified 0 ###LEFT-WALL### 42 . 1 in 2 particular 2 particular 4 participants 3 the 4 participants 4 participants 5 identified 5 identified 14 and 5 identified 28 on 6 the 7 impact 7 impact 8 of 7 impact 14 and 8 of 10 attitudes 9 the 10 attitudes 10 attitudes 11 of 11 of 13 people 12 older 13 people 14 and 16 professionals 14 and 18 as 15 health 16 professionals 17 , 18 as 18 as 23 and 18 as 27 , 19 well 20 as 19 well 23 and 20 as 22 inadequacies 21 service 22 inadequacies 23 and 24 gaps 23 and 25 in 25 in 26 services 28 on 30 provision 29 the 30 provision 30 provision 31 of 30 provision 38 in 31 of 34 care 32 mental 33 health 33 health 34 care 34 care 35 to 35 to 37 people 36 older 37 people 38 in 41 region 39 a 41 region 40 rural 41 region conclusion : this study supports previous work on intrinsic and extrinsic barriers to older people with mental health problems accessing mental health services . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 supports 2 : 24 . 3 this 4 study 4 study 5 supports 5 supports 7 work 5 supports 8 on 5 supports 13 to 5 supports 16 with 6 previous 7 work 8 on 12 barriers 9 intrinsic 10 and 10 and 11 extrinsic 10 and 12 barriers 13 to 15 people 14 older 15 people 16 with 19 problems 16 with 20 accessing 17 mental 18 health 18 health 19 problems 20 accessing 23 services 21 mental 23 services 22 health 23 services the study also offers new insight into the difficulties that arise from the separation of physical and mental health systems for older people with multiple needs , and the impact of living in a rural region on unmet mental health care needs of older people . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 offers 0 ###LEFT-WALL### 46 . 1 the 2 study 2 study 4 offers 3 also 4 offers 4 offers 6 insight 4 offers 20 systems 4 offers 28 and 4 offers 33 in 5 new 6 insight 6 insight 7 into 6 insight 15 of 7 into 9 difficulties 8 the 9 difficulties 9 difficulties 10 that 9 difficulties 11 arise 10 that 11 arise 11 arise 12 from 12 from 14 separation 13 the 14 separation 15 of 19 health 16 physical 17 and 17 and 18 mental 17 and 19 health 20 systems 21 for 20 systems 24 with 21 for 23 people 22 older 23 people 24 with 26 needs 25 multiple 26 needs 27 , 28 and 28 and 30 impact 29 the 30 impact 30 impact 31 of 31 of 32 living 33 in 36 region 34 a 35 rural 34 a 36 region 35 rural 36 region 36 region 37 on 36 region 43 of 37 on 38 unmet 38 unmet 41 care 38 unmet 42 needs 39 mental 40 health 40 health 41 care 41 care 42 needs 43 of 45 people 44 older 45 people objectives : this study concerns culturally deaf people in the united kingdom who use british sign language ( bsl ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 concerns 2 : 21 . 3 this 4 study 4 study 5 concerns 5 concerns 6 culturally 5 concerns 8 people 7 deaf 8 people 8 people 9 in 8 people 13 who 8 people 14 use 9 in 12 kingdom 10 the 12 kingdom 11 united 12 kingdom 13 who 14 use 14 use 19 bsl 15 british 19 bsl 16 sign 17 language 17 language 19 bsl 18 ( 19 bsl 19 bsl 20 ) its objective was to explore [how] deaf people 's knowledge about dementia and access to services is mediated by their minoritised cultural - linguistic status . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 18 mediated 0 ###LEFT-WALL### 26 . 1 its 2 objective 2 objective 3 was 3 was 4 to 3 was 18 mediated 4 to 5 explore 5 explore 7 deaf 7 deaf 10 knowledge 7 deaf 17 is 8 people 9 's 9 's 10 knowledge 10 knowledge 11 about 10 knowledge 17 is 11 about 13 and 12 dementia 13 and 13 and 14 access 13 and 15 to 15 to 16 services 18 mediated 19 by 19 by 25 status 20 their 25 status 21 minoritised 25 status 22 cultural 23 - 22 cultural 25 status 24 linguistic 25 status methods : twenty - six members of the deaf community participated in one of three deaf - led focus groups in bsl corresponding with the sample of [:] deaf people over the age of 60 without dementia [;] deaf people aged 18 - 60 working professional roles unconnected with dementia services [;] ordinary members of the deaf community aged 18 - 60 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 methods 2 : 2 : 3 twenty 4 - 6 members 5 six 6 members 6 members 7 of 6 members 11 participated 7 of 10 community 8 the 10 community 9 deaf 10 community 11 participated 12 in 11 participated 21 in 12 in 13 one 13 one 14 of 14 of 20 groups 15 three 20 groups 16 deaf 18 led 16 deaf 19 focus 17 - 18 led 19 focus 20 groups 21 in 22 bsl 22 bsl 23 corresponding 22 bsl 34 of 23 corresponding 24 with 24 with 26 sample 24 with 30 people 25 the 26 sample 26 sample 27 of 27 of 29 deaf 30 people 31 over 31 over 33 age 32 the 33 age 34 of 35 60 35 60 36 without 35 60 40 people 35 60 41 aged 35 60 45 working 36 without 37 dementia 39 deaf 40 people 40 people 41 aged 41 aged 43 - 42 18 43 - 43 - 44 60 45 working 47 roles 46 professional 47 roles 47 roles 48 unconnected 48 unconnected 49 with 49 with 54 members 50 dementia 51 services 51 services 54 members 53 ordinary 54 members 54 members 55 of 55 of 58 community 56 the 58 community 57 deaf 58 community 58 community 59 aged 58 community 62 60 59 aged 60 18 61 - 62 60 62 60 63 . data were subjected to a thematic content analysis . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 subjected 0 ###LEFT-WALL### 9 . 1 data 2 were 2 were 3 subjected 3 subjected 4 to 4 to 8 analysis 5 a 6 thematic 5 a 8 analysis 6 thematic 8 analysis 7 content 8 analysis results : participants ' concerns about their poor levels of knowledge and understanding of dementia were augmented by their awareness that without sustained social contact in bsl opportunities for earlier recognition of dementia would be lost . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 37 . 1 results 2 : 2 : 5 concerns 3 participants 4 ' 4 ' 5 concerns 5 concerns 6 about 6 about 9 levels 7 their 9 levels 8 poor 9 levels 9 levels 10 of 10 of 11 knowledge 12 and 13 understanding 12 and 17 augmented 13 understanding 14 of 13 understanding 16 were 14 of 15 dementia 16 were 17 augmented 17 augmented 18 by 18 by 20 awareness 19 their 20 awareness 20 awareness 21 that 21 that 28 opportunities 21 that 36 lost 22 without 25 contact 22 without 28 opportunities 23 sustained 24 social 24 social 25 contact 25 contact 26 in 26 in 27 bsl 28 opportunities 29 for 28 opportunities 32 of 28 opportunities 34 would 29 for 31 recognition 30 earlier 31 recognition 32 of 33 dementia 34 would 35 be 35 be 36 lost although primary care services were identified as the first port of call for dementia - related concerns , there was widespread mistrust of their effectiveness because of failures in communication and cultural competence . 0 ###LEFT-WALL### 12 call 0 ###LEFT-WALL### 16 related 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 34 . 1 although 3 care 1 although 12 call 2 primary 3 care 3 care 4 services 3 care 11 of 4 services 5 were 5 were 6 identified 6 identified 7 as 7 as 10 port 8 the 10 port 9 first 10 port 10 port 11 of 12 call 13 for 13 for 14 dementia 15 - 16 related 16 related 17 concerns 18 , 19 there 18 , 20 was 19 there 20 was 20 was 22 mistrust 20 was 26 because 21 widespread 22 mistrust 22 mistrust 23 of 23 of 25 effectiveness 24 their 25 effectiveness 26 because 27 of 27 of 31 and 28 failures 29 in 28 failures 31 and 29 in 30 communication 31 and 33 competence 32 cultural 33 competence confirmed diagnosis of dementia was not viewed as a gateway to services and support because deaf organisations , dementia - related organisations and mainstream adult services were perceived to be ill - equipped to respond to the needs of deaf people with dementia . 0 ###LEFT-WALL### 2 diagnosis 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 21 related 0 ###LEFT-WALL### 23 and 1 confirmed 2 diagnosis 2 diagnosis 3 of 2 diagnosis 5 was 3 of 4 dementia 5 was 6 not 5 was 8 as 6 not 7 viewed 8 as 10 gateway 9 a 10 gateway 10 gateway 11 to 10 gateway 14 support 10 gateway 19 dementia 11 to 13 and 12 services 13 and 13 and 14 support 14 support 15 because 15 because 16 deaf 15 because 17 organisations 16 deaf 17 organisations 18 , 19 dementia 19 dementia 20 - 20 - 21 related 21 related 22 organisations 23 and 26 services 23 and 28 perceived 24 mainstream 26 services 25 adult 26 services 26 services 27 were 27 were 28 perceived 28 perceived 29 to 28 perceived 30 be 29 to 30 be 30 be 31 ill 30 be 33 equipped 32 - 33 equipped 33 equipped 34 to 33 equipped 36 to 33 equipped 42 with 33 equipped 44 . 34 to 35 respond 36 to 38 needs 37 the 38 needs 38 needs 39 of 39 of 41 people 40 deaf 41 people 42 with 43 dementia conclusions : locating problems of late diagnosis within the deaf community 's poor awareness and knowledge of dementia fails to recognise the structural barriers deaf people face in timely access to services and accurate recognition of dementia - related changes . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 41 . 1 conclusions 2 : 2 : 3 locating 3 locating 4 problems 3 locating 8 within 4 problems 5 of 5 of 7 diagnosis 6 late 7 diagnosis 8 within 14 awareness 9 the 11 community 10 deaf 11 community 11 community 12 's 12 's 14 awareness 13 poor 14 awareness 15 and 16 knowledge 15 and 19 fails 16 knowledge 17 of 16 knowledge 19 fails 17 of 18 dementia 19 fails 20 to 19 fails 28 in 19 fails 31 to 20 to 21 recognise 21 recognise 27 face 22 the 27 face 23 structural 26 people 24 barriers 26 people 25 deaf 26 people 26 people 27 face 28 in 30 access 29 timely 30 access 31 to 33 and 32 services 33 and 33 and 35 recognition 34 accurate 35 recognition 35 recognition 36 of 36 of 40 changes 37 dementia 38 - 37 dementia 40 changes 39 related 40 changes background : family caregivers of patients with dementia frequently experience psychological stress , depression and disturbed psychophysiological activity , with increased levels of diurnal cortisol secretion . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 10 experience 0 ###LEFT-WALL### 27 . 1 background 2 : 2 : 3 family 3 family 4 caregivers 3 family 10 experience 4 caregivers 5 of 4 caregivers 10 experience 5 of 6 patients 6 patients 7 with 7 with 8 dementia 9 frequently 10 experience 10 experience 12 stress 10 experience 20 with 11 psychological 12 stress 12 stress 15 and 13 , 15 and 14 depression 15 and 15 and 18 activity 15 and 19 , 16 disturbed 18 activity 17 psychophysiological 18 activity 20 with 22 levels 21 increased 22 levels 22 levels 23 of 23 of 26 secretion 24 diurnal 25 cortisol 25 cortisol 26 secretion objectives : to compare the effects of [a] cognitive - behavioural group therapy ( cbt ) to a psychoeducation group programme ( educ ) on cortisol secretion in caregivers of patients with moderate alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 3 to 2 : 4 compare 3 to 4 compare 4 compare 6 effects 4 compare 17 to 4 compare 25 on 5 the 6 effects 6 effects 7 of 6 effects 15 cbt 7 of 13 therapy 9 cognitive 10 - 9 cognitive 13 therapy 11 behavioural 12 group 12 group 13 therapy 14 ( 15 cbt 15 cbt 16 ) 17 to 21 programme 18 a 21 programme 19 psychoeducation 21 programme 20 group 21 programme 21 programme 23 educ 22 ( 23 educ 23 educ 24 ) 25 on 27 secretion 26 cortisol 27 secretion 27 secretion 28 in 27 secretion 30 of 28 in 29 caregivers 30 of 31 patients 31 patients 32 with 31 patients 38 ad 32 with 36 disease 33 moderate 34 alzheimer 34 alzheimer 35 's 35 's 36 disease 37 ( 38 ad 38 ad 39 ) method : caregivers of ad outpatients were semi - randomly allocated to one of two intervention programmes ( cbt or educ ) consisting of eight weekly sessions . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 6 outpatients 2 : 7 were 3 caregivers 4 of 3 caregivers 6 outpatients 4 of 5 ad 6 outpatients 7 were 7 were 8 semi 8 semi 11 allocated 9 - 11 allocated 10 randomly 11 allocated 11 allocated 12 to 11 allocated 28 . 12 to 13 one 13 one 14 of 14 of 17 programmes 15 two 17 programmes 16 intervention 17 programmes 17 programmes 20 or 18 ( 20 or 19 cbt 20 or 20 or 21 educ 20 or 22 ) 20 or 23 consisting 20 or 28 . 23 consisting 24 of 24 of 27 sessions 25 eight 27 sessions 26 weekly 27 sessions twenty - six participants completed the study . 0 ###LEFT-WALL### 4 participants 0 ###LEFT-WALL### 5 completed 0 ###LEFT-WALL### 8 . 1 twenty 2 - 2 - 3 six 2 - 4 participants 4 participants 5 completed 5 completed 7 study 6 the 7 study before and after intervention , salivary cortisol was collected at four different times of the day . 0 ###LEFT-WALL### 7 cortisol 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 17 . 1 before 2 and 2 and 3 after 2 and 5 , 2 and 7 cortisol 3 after 4 intervention 6 salivary 7 cortisol 7 cortisol 8 was 8 was 9 collected 9 collected 10 at 10 at 13 times 11 four 13 times 12 different 13 times 13 times 14 of 14 of 16 day 15 the 16 day effects of the interventions were evaluated with self [-] report psychological scales and questionnaires related to functional abilities and neuropsychiatric symptoms of the ad relative . 0 ###LEFT-WALL### 1 effects 0 ###LEFT-WALL### 6 evaluated 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 26 . 1 effects 2 of 1 effects 5 were 2 of 4 interventions 3 the 4 interventions 5 were 6 evaluated 6 evaluated 7 with 7 with 12 scales 8 self 12 scales 10 report 12 scales 11 psychological 12 scales 13 and 14 questionnaires 13 and 15 related 14 questionnaires 15 related 15 related 16 to 16 to 19 and 17 functional 18 abilities 18 abilities 19 and 19 and 21 symptoms 19 and 22 of 20 neuropsychiatric 21 symptoms 22 of 25 relative 23 the 25 relative 24 ad 25 relative results : only in the cbt group did salivary cortisol levels significantly decrease after intervention , with a large effect size and high achieved power . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 only 2 : 13 decrease 2 : 16 , 2 : 26 . 3 only 4 in 3 only 8 did 4 in 7 group 5 the 7 group 6 cbt 7 group 8 did 11 levels 8 did 13 decrease 9 salivary 10 cortisol 10 cortisol 11 levels 12 significantly 13 decrease 13 decrease 14 after 14 after 15 intervention 16 , 22 and 16 , 24 achieved 17 with 20 effect 17 with 22 and 18 a 19 large 18 a 20 effect 19 large 20 effect 21 size 22 and 22 and 23 high 22 and 24 achieved 24 achieved 25 power both groups reported a reduction of neuropsychiatric symptoms of their ad relative after intervention . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 3 reported 0 ###LEFT-WALL### 15 . 1 both 2 groups 2 groups 3 reported 3 reported 5 reduction 3 reported 13 after 4 a 5 reduction 5 reduction 6 of 6 of 8 symptoms 7 neuropsychiatric 8 symptoms 8 symptoms 9 of 9 of 12 relative 10 their 12 relative 11 ad 12 relative 13 after 14 intervention conclusion : psychoeducation for caregivers may contribute to a reduction of neuropsychiatric symptoms of ad patients while cbt additionally attenuates psychophysiological responses to stressful situations in caregivers , by reducing diurnal cortisol levels . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 psychoeducation 2 : 7 contribute 3 psychoeducation 4 for 3 psychoeducation 6 may 4 for 5 caregivers 6 may 7 contribute 7 contribute 8 to 7 contribute 17 while 7 contribute 23 to 7 contribute 29 by 8 to 10 reduction 9 a 10 reduction 10 reduction 11 of 10 reduction 14 of 11 of 13 symptoms 12 neuropsychiatric 13 symptoms 14 of 16 patients 15 ad 16 patients 17 while 18 cbt 17 while 20 attenuates 18 cbt 20 attenuates 19 additionally 20 attenuates 20 attenuates 22 responses 21 psychophysiological 22 responses 23 to 25 situations 24 stressful 25 situations 25 situations 26 in 26 in 27 caregivers 28 , 29 by 29 by 30 reducing 29 by 34 . 30 reducing 33 levels 31 diurnal 32 cortisol 32 cortisol 33 levels this may lead to a positive impact in the general health of the caregiver , eventually resulting in better care of the ad patient . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 lead 0 ###LEFT-WALL### 25 . 1 this 2 may 2 may 3 lead 3 lead 4 to 3 lead 8 in 3 lead 18 in 4 to 7 impact 5 a 6 positive 5 a 7 impact 6 positive 7 impact 8 in 11 health 9 the 11 health 10 general 11 health 11 health 12 of 12 of 14 caregiver 13 the 14 caregiver 14 caregiver 17 resulting 15 , 17 resulting 16 eventually 17 resulting 18 in 20 care 19 better 20 care 20 care 21 of 21 of 24 patient 22 the 24 patient 23 ad 24 patient this study examined correlates [of] susceptibility to scams in 639 community [-] dwelling older adults without dementia from a cohort study of aging . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 correlates 0 ###LEFT-WALL### 24 . 1 this 2 study 2 study 3 examined 2 study 4 correlates 4 correlates 6 susceptibility 4 correlates 7 to 4 correlates 9 in 4 correlates 18 from 7 to 8 scams 9 in 15 adults 10 639 15 adults 11 community 13 dwelling 13 dwelling 15 adults 14 older 15 adults 15 adults 16 without 16 without 17 dementia 18 from 21 study 19 a 21 study 20 cohort 21 study 21 study 22 of 22 of 23 aging regression models adjusted for age , sex , education , and income were used to examine associations between susceptibility to scams , measured by a five [-] item self - report measure , and a number of potential correlates . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 30 - 1 regression 2 models 2 models 6 , 3 adjusted 4 for 3 adjusted 6 , 4 for 5 age 6 , 16 examine 6 , 18 between 6 , 23 measured 7 sex 8 , 8 , 9 education 8 , 11 and 10 , 11 and 11 and 12 income 11 and 13 were 13 were 14 used 14 used 15 to 15 to 16 examine 16 examine 17 associations 18 between 19 susceptibility 19 susceptibility 20 to 20 to 21 scams 22 , 23 measured 23 measured 24 by 23 measured 30 - 24 by 29 self 25 a 29 self 26 five 28 item 28 item 29 self 30 - 32 measure 30 - 34 and 30 - 40 . 31 report 32 measure 33 , 34 and 34 and 36 number 34 and 39 correlates 35 a 36 number 36 number 37 of 36 number 39 correlates 37 of 38 potential susceptibility was positively associated with age and negatively associated with income , cognition , psychological well - being , social support , and literacy . 0 ###LEFT-WALL### 1 susceptibility 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 17 - 1 susceptibility 2 was 2 was 7 and 3 positively 4 associated 4 associated 5 with 4 associated 7 and 5 with 6 age 7 and 9 associated 8 negatively 9 associated 9 associated 10 with 10 with 11 income 11 income 13 cognition 11 income 16 well 12 , 13 cognition 13 cognition 14 , 14 , 16 well 15 psychological 16 well 16 well 17 - 17 - 18 being 17 - 19 , 17 - 25 . 19 , 23 and 20 social 21 support 21 support 23 and 22 , 23 and 23 and 24 literacy fully adjusted models indicated that older age and lower levels of cognitive [function] , decreased psychological well - being , and lower literacy in particular may be markers of susceptibility to financial victimization in old age . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 4 indicated 0 ###LEFT-WALL### 37 . 1 fully 2 adjusted 2 adjusted 3 models 3 models 4 indicated 4 indicated 5 that 5 that 8 and 5 that 27 be 6 older 7 age 7 age 8 and 8 and 10 levels 8 and 11 of 8 and 26 may 9 lower 10 levels 11 of 23 literacy 12 cognitive 17 well 12 cognitive 23 literacy 14 , 17 well 15 decreased 17 well 16 psychological 17 well 17 well 18 - 19 being 21 and 20 , 21 and 21 and 22 lower 21 and 23 literacy 23 literacy 25 particular 24 in 25 particular 26 may 27 be 27 be 28 markers 28 markers 29 of 28 markers 31 to 29 of 30 susceptibility 31 to 33 victimization 32 financial 33 victimization 33 victimization 34 in 34 in 36 age 35 old 36 age lexical retrieval in production is a competitive process , requiring activation of a target word from semantic input and its selection from [amongst] coactivated items . 0 ###LEFT-WALL### 2 retrieval 0 ###LEFT-WALL### 5 is 1 lexical 2 retrieval 2 retrieval 3 in 2 retrieval 5 is 3 in 4 production 5 is 8 process 5 is 10 requiring 6 a 7 competitive 6 a 8 process 7 competitive 8 process 9 , 10 requiring 10 requiring 11 activation 10 requiring 16 from 10 requiring 26 . 11 activation 12 of 12 of 15 word 13 a 15 word 14 target 15 word 16 from 19 and 17 semantic 18 input 18 input 19 and 19 and 21 selection 19 and 22 from 20 its 21 selection 22 from 25 items 24 coactivated 25 items competitors are automatically primed through spreading activation within the lexicon , [but] competition may be increased by the prior presentation of related items : the semantic interference effect . 0 ###LEFT-WALL### 1 competitors 0 ###LEFT-WALL### 4 primed 0 ###LEFT-WALL### 11 , 1 competitors 2 are 2 are 3 automatically 2 are 4 primed 4 primed 5 through 5 through 6 spreading 6 spreading 7 activation 6 spreading 8 within 8 within 10 lexicon 9 the 10 lexicon 11 , 13 competition 11 , 16 increased 11 , 24 : 13 competition 14 may 14 may 15 be 15 be 16 increased 16 increased 17 by 17 by 20 presentation 18 the 20 presentation 19 prior 20 presentation 20 presentation 21 of 21 of 23 items 22 related 23 items 24 : 28 effect 24 : 29 . 25 the 28 effect 26 semantic 27 interference 27 interference 28 effect this has been demonstrated [in] tasks in which pictures grouped [by] semantic [category] are compared to unrelated pictures ( blocked [naming] ) and [in] tasks involving successive naming of items from the same semantic category [(] continuous naming ) . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 been 0 ###LEFT-WALL### 40 . 1 this 2 has 2 has 3 been 3 been 23 and 4 demonstrated 6 tasks 6 tasks 7 in 6 tasks 23 and 7 in 8 which 7 in 9 pictures 7 in 15 compared 9 pictures 10 grouped 9 pictures 14 are 10 grouped 12 semantic 14 are 15 compared 15 compared 16 to 15 compared 20 blocked 16 to 18 pictures 17 unrelated 18 pictures 19 ( 20 blocked 20 blocked 22 ) 23 and 28 naming 23 and 39 ) 25 tasks 28 naming 26 involving 28 naming 27 successive 28 naming 28 naming 29 of 28 naming 31 from 29 of 30 items 31 from 38 naming 32 the 33 same 32 the 38 naming 34 semantic 35 category 35 category 38 naming 37 continuous 38 naming such highly structured tasks may not be representative of the processes at work under more natural word retrieval conditions . 0 ###LEFT-WALL### 4 tasks 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 20 . 1 such 4 tasks 2 highly 3 structured 3 structured 4 tasks 4 tasks 5 may 5 may 6 not 5 may 7 be 7 be 8 representative 7 be 12 at 7 be 14 under 8 representative 9 of 9 of 11 processes 10 the 11 processes 12 at 13 work 14 under 19 conditions 15 more 16 natural 16 natural 17 word 17 word 19 conditions 18 retrieval 19 conditions therefore , we conducted a retrospective examination of naming latencies from a randomized picture naming task containing a wide variety of items and categories . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 25 . 1 therefore 2 , 1 therefore 3 we 3 we 4 conducted 4 conducted 7 examination 4 conducted 11 from 5 a 6 retrospective 5 a 7 examination 6 retrospective 7 examination 7 examination 8 of 8 of 9 naming 9 naming 10 latencies 11 from 16 task 12 a 16 task 13 randomized 14 picture 14 picture 16 task 15 naming 16 task 16 task 17 containing 16 task 21 of 17 containing 20 variety 18 a 19 wide 18 a 20 variety 19 wide 20 variety 21 of 23 and 22 items 23 and 23 and 24 categories our large sample of adults , ranging in age from 22 to 89 years , also allowed us to test the hypothesis that older adults , who are particularly susceptible to word - retrieval problems , experience increased difficulty resolving competition among lexical items . 0 ###LEFT-WALL### 3 sample 0 ###LEFT-WALL### 17 allowed 0 ###LEFT-WALL### 45 . 1 our 3 sample 2 large 3 sample 3 sample 4 of 3 sample 17 allowed 4 of 5 adults 5 adults 7 ranging 6 , 7 ranging 7 ranging 8 in 7 ranging 15 , 8 in 14 years 9 age 12 to 9 age 14 years 10 from 12 to 11 22 12 to 12 to 13 89 16 also 17 allowed 17 allowed 18 us 17 allowed 19 to 17 allowed 20 test 19 to 20 test 20 test 22 hypothesis 20 test 38 increased 21 the 22 hypothesis 22 hypothesis 23 that 22 hypothesis 37 experience 22 hypothesis 38 increased 23 that 25 adults 23 that 37 experience 24 older 25 adults 25 adults 27 who 25 adults 35 problems 25 adults 37 experience 26 , 27 who 27 who 28 are 27 who 33 - 28 are 30 susceptible 29 particularly 30 susceptible 30 susceptible 31 to 30 susceptible 32 word 31 to 32 word 33 - 35 problems 34 retrieval 35 problems 35 problems 36 , 38 increased 39 difficulty 38 increased 42 among 39 difficulty 40 resolving 40 resolving 41 competition 42 among 44 items 43 lexical 44 items semantic interference effects were evident in the interaction between semantic category [and] order of presentation within a block - miscellaneous items were named more quickly , whereas related items were named more slowly . 0 ###LEFT-WALL### 1 semantic 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 31 named 0 ###LEFT-WALL### 34 . 1 semantic 4 were 2 interference 3 effects 3 effects 4 were 4 were 5 evident 5 evident 6 in 5 evident 9 between 5 evident 16 within 6 in 8 interaction 7 the 8 interaction 9 between 13 order 10 semantic 11 category 11 category 13 order 13 order 14 of 14 of 15 presentation 16 within 18 block 17 a 18 block 19 - 21 items 19 - 23 named 20 miscellaneous 21 items 21 items 22 were 22 were 23 named 23 named 25 quickly 23 named 27 whereas 24 more 25 quickly 26 , 27 whereas 27 whereas 29 items 28 related 29 items 29 items 30 were 30 were 31 named 31 named 33 slowly 32 more 33 slowly this interference effect did not vary with participant age , contrary to the hypothesis that older adults are more susceptible to semantic interference . 0 ###LEFT-WALL### 3 effect 0 ###LEFT-WALL### 6 vary 1 this 3 effect 2 interference 3 effect 3 effect 4 did 4 did 5 not 4 did 6 vary 6 vary 7 with 7 with 9 age 8 participant 9 age 9 age 11 contrary 10 , 11 contrary 11 contrary 12 to 11 contrary 24 . 12 to 14 hypothesis 13 the 14 hypothesis 14 hypothesis 15 that 15 that 17 adults 15 that 18 are 16 older 17 adults 17 adults 18 are 18 are 20 susceptible 19 more 20 susceptible 20 susceptible 21 to 21 to 23 interference 22 semantic 23 interference plant - derived dietary polyphenols may improve some disease states and promote health . 0 ###LEFT-WALL### 5 polyphenols 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 14 . 1 plant 2 - 1 plant 5 polyphenols 3 derived 5 polyphenols 4 dietary 5 polyphenols 5 polyphenols 11 and 6 may 7 improve 6 may 11 and 7 improve 10 states 8 some 10 states 9 disease 10 states 11 and 12 promote 12 promote 13 health experimental evidence suggests that this is partially attributable to changes in gene expression . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 14 . 1 experimental 2 evidence 2 evidence 3 suggests 3 suggests 4 that 4 that 5 this 4 that 6 is 5 this 6 is 6 is 7 partially 6 is 8 attributable 8 attributable 9 to 8 attributable 11 in 9 to 10 changes 11 in 13 expression 12 gene 13 expression the rational use of bioactive food components may therefore present an opportunity to activate or repress selected gene expression pathways [and] , consequently , to manage or prevent disease . 0 ###LEFT-WALL### 3 use 0 ###LEFT-WALL### 15 or 0 ###LEFT-WALL### 30 . 1 the 3 use 2 rational 3 use 3 use 4 of 3 use 8 may 4 of 7 components 5 bioactive 6 food 6 food 7 components 8 may 15 or 9 therefore 10 present 10 present 12 opportunity 10 present 15 or 11 an 12 opportunity 12 opportunity 13 to 12 opportunity 14 activate 13 to 14 activate 15 or 27 or 16 repress 20 pathways 16 repress 27 or 17 selected 18 gene 18 gene 20 pathways 19 expression 20 pathways 20 pathways 25 to 20 pathways 26 manage 22 , 23 consequently 23 consequently 24 , 23 consequently 25 to 25 to 26 manage 27 or 28 prevent 28 prevent 29 disease it remains to be determined whether this use of bioactive food components can be done safely . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 remains 0 ###LEFT-WALL### 17 . 1 it 2 remains 2 remains 3 to 3 to 4 be 4 be 5 determined 5 determined 6 whether 6 whether 8 use 6 whether 14 be 7 this 8 use 8 use 9 of 8 use 13 can 9 of 12 components 10 bioactive 11 food 11 food 12 components 13 can 14 be 14 be 15 done 15 done 16 safely this article reviews the associated controversies and limitations of polyphenol therapy . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 reviews 0 ###LEFT-WALL### 12 . 1 this 2 article 2 article 3 reviews 3 reviews 7 and 4 the 6 controversies 5 associated 6 controversies 6 controversies 7 and 7 and 8 limitations 7 and 9 of 9 of 11 therapy 10 polyphenol 11 therapy there is a paucity of clinical data on the rational use of polyphenols , including a lack of knowledge on effective dosage , actual chemical formulations , bioavailability , distribution in tissues , the effect of genetic variations , differences in gut microflora , the synergistic ( or antagonistic ) effects observed in extracts , and the possible interaction between polyphenols and lipid domains of cell membranes that may alter the function of relevant receptors . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 52 observed 0 ###LEFT-WALL### 76 . 1 there 2 is 2 is 4 paucity 3 a 4 paucity 4 paucity 5 of 4 paucity 12 of 4 paucity 15 including 5 of 7 data 6 clinical 7 data 7 data 8 on 8 on 11 use 9 the 11 use 10 rational 11 use 12 of 13 polyphenols 14 , 15 including 15 including 17 lack 15 including 20 on 15 including 39 , 16 a 17 lack 17 lack 18 of 18 of 19 knowledge 20 on 22 dosage 21 effective 22 dosage 22 dosage 26 formulations 23 , 26 formulations 24 actual 26 formulations 25 chemical 26 formulations 26 formulations 28 bioavailability 26 formulations 30 distribution 26 formulations 35 effect 26 formulations 39 , 27 , 28 bioavailability 28 bioavailability 29 , 29 , 30 distribution 30 distribution 31 in 30 distribution 33 , 31 in 32 tissues 33 , 35 effect 34 the 35 effect 35 effect 36 of 35 effect 39 , 36 of 38 variations 37 genetic 38 variations 39 , 52 observed 40 differences 41 in 40 differences 44 , 41 in 43 microflora 42 gut 43 microflora 44 , 46 synergistic 44 , 48 or 45 the 46 synergistic 47 ( 48 or 48 or 51 effects 48 or 52 observed 49 antagonistic 50 ) 49 antagonistic 51 effects 52 observed 53 in 53 in 56 and 54 extracts 56 and 55 , 56 and 56 and 59 interaction 56 and 60 between 56 and 68 that 56 and 69 may 57 the 59 interaction 58 possible 59 interaction 60 between 62 and 61 polyphenols 62 and 62 and 64 domains 62 and 65 of 63 lipid 64 domains 65 of 67 membranes 66 cell 67 membranes 68 that 69 may 69 may 70 alter 70 alter 72 function 71 the 72 function 72 function 73 of 73 of 75 receptors 74 relevant 75 receptors the seminal question of why plants make substances that benefit humans remains unanswered , and there is still much to learn in terms of correlative [versus] causal effects of human exposure to various nutrients . 0 ###LEFT-WALL### 3 question 0 ###LEFT-WALL### 12 remains 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 35 . 1 the 3 question 2 seminal 3 question 3 question 4 of 3 question 12 remains 4 of 5 why 5 why 6 plants 5 why 7 make 6 plants 7 make 7 make 8 substances 7 make 11 humans 8 substances 9 that 8 substances 10 benefit 9 that 10 benefit 12 remains 13 unanswered 14 , 15 and 15 and 16 there 15 and 17 is 16 there 17 is 17 is 18 still 17 is 19 much 19 much 20 to 19 much 21 learn 20 to 21 learn 21 learn 22 in 21 learn 32 to 22 in 23 terms 23 terms 24 of 24 of 28 effects 25 correlative 28 effects 27 causal 28 effects 28 effects 29 of 29 of 31 exposure 30 human 31 exposure 32 to 34 nutrients 33 various 34 nutrients the available data strongly suggest significant effects at the molecular level that represent interactions with the epigenome . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 5 suggest 0 ###LEFT-WALL### 18 . 1 the 3 data 2 available 3 data 3 data 5 suggest 4 strongly 5 suggest 5 suggest 7 effects 6 significant 7 effects 7 effects 8 at 7 effects 12 that 7 effects 13 represent 8 at 11 level 9 the 11 level 10 molecular 11 level 12 that 13 represent 13 represent 14 interactions 13 represent 15 with 15 with 17 epigenome 16 the 17 epigenome the advent of relatively simple technologies is helping the field of epigenetics progress and facilitating the acquisition of multiple types of data [that] were previously difficult to obtain . 0 ###LEFT-WALL### 2 advent 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 29 . 1 the 2 advent 2 advent 3 of 2 advent 7 is 3 of 6 technologies 4 relatively 5 simple 5 simple 6 technologies 7 is 8 helping 8 helping 10 field 8 helping 13 progress 9 the 10 field 10 field 11 of 11 of 12 epigenetics 14 and 15 facilitating 14 and 24 were 15 facilitating 17 acquisition 15 facilitating 24 were 16 the 17 acquisition 17 acquisition 18 of 18 of 22 data 19 multiple 20 types 20 types 21 of 20 types 22 data 21 of 22 data 24 were 25 previously 24 were 26 difficult 26 difficult 27 to 26 difficult 28 obtain 27 to 28 obtain in this review , we summarize the molecular basis of the epigenetic regulation of gene expression and the epigenetic changes associated with the consumption of polyphenols that illustrate [how] modifications in human nutrition may become relevant to health and disease . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 summarize 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 41 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 summarize 6 summarize 9 basis 7 the 9 basis 8 molecular 9 basis 9 basis 10 of 9 basis 14 of 10 of 13 regulation 11 the 13 regulation 12 epigenetic 13 regulation 14 of 16 expression 15 gene 16 expression 17 and 20 changes 17 and 35 become 18 the 20 changes 19 epigenetic 20 changes 20 changes 21 associated 20 changes 34 may 21 associated 22 with 21 associated 31 in 22 with 24 consumption 23 the 24 consumption 24 consumption 25 of 25 of 26 polyphenols 26 polyphenols 27 that 26 polyphenols 28 illustrate 27 that 28 illustrate 28 illustrate 30 modifications 31 in 33 nutrition 32 human 33 nutrition 34 may 35 become 35 become 36 relevant 36 relevant 37 to 37 to 39 and 38 health 39 and 39 and 40 disease little is known regarding bone marrow ( bm ) cellularity , cd34+ fraction , and cfu - gm colony formation in relation to age and whether healthy children require a reference range distinct from healthy adults . 0 ###LEFT-WALL### 1 little 0 ###LEFT-WALL### 2 is 1 little 2 is 2 is 6 marrow 2 is 15 and 3 known 5 bone 4 regarding 5 bone 5 bone 6 marrow 6 marrow 8 bm 7 ( 8 bm 8 bm 9 ) 10 cellularity 11 , 11 , 13 fraction 11 , 15 and 12 cd34+ 13 fraction 14 , 15 and 15 and 16 cfu 15 and 20 formation 17 - 20 formation 18 gm 19 colony 19 colony 20 formation 20 formation 21 in 20 formation 23 to 20 formation 33 distinct 20 formation 37 . 21 in 22 relation 23 to 25 and 24 age 25 and 25 and 26 whether 25 and 28 children 25 and 32 range 27 healthy 28 children 28 children 29 require 29 require 31 reference 29 require 32 range 30 a 31 reference 33 distinct 34 from 34 from 36 adults 35 healthy 36 adults we therefore analyzed a series of single bm aspirates from 45 healthy children who were evaluated as potential bm donors . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 analyzed 0 ###LEFT-WALL### 21 . 1 we 3 analyzed 2 therefore 3 analyzed 3 analyzed 5 series 3 analyzed 10 from 4 a 5 series 5 series 6 of 6 of 9 aspirates 7 single 9 aspirates 8 bm 9 aspirates 10 from 13 children 11 45 13 children 12 healthy 13 children 13 children 14 who 13 children 15 were 14 who 15 were 15 were 20 donors 16 evaluated 20 donors 17 as 18 potential 18 potential 20 donors 19 bm 20 donors thirty - three of these children subsequently donated bm . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 8 donated 0 ###LEFT-WALL### 10 . 1 thirty 2 - 2 - 3 three 2 - 4 of 2 - 8 donated 4 of 6 children 5 these 6 children 7 subsequently 8 donated 8 donated 9 bm we quantified the nucleated cell count [,] fraction of cd34+ cells , and number of cfu - gm colonies in single aspirates and bm harvests . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 quantified 0 ###LEFT-WALL### 17 - 1 we 2 quantified 2 quantified 8 fraction 3 the 8 fraction 4 nucleated 5 cell 5 cell 6 count 6 count 8 fraction 8 fraction 9 of 8 fraction 15 of 9 of 13 and 10 cd34+ 11 cells 11 cells 13 and 12 , 13 and 13 and 14 number 15 of 16 cfu 17 - 25 harvests 17 - 26 . 18 gm 25 harvests 19 colonies 20 in 19 colonies 23 and 20 in 22 aspirates 21 single 22 aspirates 23 and 24 bm 23 and 25 harvests single aspirates displayed a mean nucleated cell count of 31.3 × 10 ( 6 [ )(cells/ml , a mean fraction of 1.17 % cd34+ cells , and a mean colony forming potential of 66.6 cfu - gm/10 ( 5 ) cells . 0 ###LEFT-WALL### 2 aspirates 0 ###LEFT-WALL### 3 displayed 0 ###LEFT-WALL### 42 . 1 single 2 aspirates 2 aspirates 3 displayed 3 displayed 27 and 4 a 5 mean 4 a 8 count 5 mean 7 cell 6 nucleated 7 cell 7 cell 8 count 8 count 9 of 8 count 27 and 9 of 11 × 10 31.3 11 × 11 × 12 10 11 × 16 )(cells/ml 11 × 20 fraction 13 ( 16 )(cells/ml 14 6 16 )(cells/ml 16 )(cells/ml 17 , 17 , 20 fraction 18 a 20 fraction 19 mean 20 fraction 20 fraction 21 of 20 fraction 26 , 21 of 25 cells 22 1.17 25 cells 23 % 25 cells 24 cd34+ 25 cells 26 , 27 and 27 and 32 potential 27 and 33 of 28 a 32 potential 29 mean 30 colony 30 colony 32 potential 31 forming 32 potential 33 of 41 cells 34 66.6 41 cells 35 cfu 37 gm/10 35 cfu 41 cells 36 - 37 gm/10 37 gm/10 39 5 37 gm/10 40 ) 38 ( 39 5 39 5 40 ) harvests yielded the same number of nucleated cells but increased numbers of cd34+ cells and cfu - gm compared with single aspirates . 0 ###LEFT-WALL### 1 harvests 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 17 - 1 harvests 9 but 2 yielded 5 number 2 yielded 9 but 3 the 4 same 3 the 5 number 5 number 6 of 6 of 8 cells 7 nucleated 8 cells 9 but 10 increased 10 increased 11 numbers 11 numbers 12 of 12 of 15 and 13 cd34+ 14 cells 14 cells 15 and 15 and 16 cfu 17 - 18 gm 17 - 19 compared 17 - 23 . 18 gm 19 compared 19 compared 20 with 20 with 22 aspirates 21 single 22 aspirates the mean nucleated cell count in bm harvests was 31.1 × 10 ( 6 ) [/ml] with a mean fraction of 1.95 % cd34+ cells and a mean of 112.4 cfu - gm colonies/10 ( 5 ) cells . 0 ###LEFT-WALL### 5 count 0 ###LEFT-WALL### 9 was 1 the 5 count 2 mean 5 count 3 nucleated 4 cell 4 cell 5 count 5 count 6 in 5 count 9 was 6 in 8 harvests 7 bm 8 harvests 9 was 11 × 9 was 17 with 10 31.1 11 × 11 × 12 10 11 × 14 6 13 ( 14 6 14 6 15 ) 17 with 20 fraction 18 a 20 fraction 19 mean 20 fraction 20 fraction 21 of 21 of 26 and 22 1.95 23 % 23 % 25 cells 24 cd34+ 25 cells 25 cells 26 and 26 and 28 mean 26 and 29 of 26 and 38 cells 27 a 28 mean 29 of 31 cfu 30 112.4 31 cfu 32 - 38 cells 33 gm 38 cells 34 colonies/10 36 5 34 colonies/10 37 ) 34 colonies/10 38 cells 35 ( 36 5 36 5 37 ) 38 cells 39 . the concentration of nucleated cells [was] elevated compared with reported adult counts , [while] cd34+ percentage and cfu - gm counts were similar . 0 ###LEFT-WALL### 2 concentration 0 ###LEFT-WALL### 8 compared 0 ###LEFT-WALL### 19 - 1 the 2 concentration 2 concentration 3 of 2 concentration 7 elevated 2 concentration 8 compared 3 of 5 cells 4 nucleated 5 cells 8 compared 9 with 9 with 17 and 10 reported 11 adult 11 adult 12 counts 12 counts 13 , 13 , 16 percentage 13 , 17 and 15 cd34+ 16 percentage 17 and 18 cfu 19 - 21 counts 19 - 22 were 19 - 24 . 20 gm 21 counts 21 counts 22 were 22 were 23 similar in this series of healthy children , the fraction of cd34+ cells , cfu - gm colonies , and nucleated cells decreased with age . 0 ###LEFT-WALL### 9 fraction 0 ###LEFT-WALL### 22 decreased 0 ###LEFT-WALL### 25 . 1 in 3 series 1 in 7 , 1 in 9 fraction 2 this 3 series 3 series 4 of 4 of 6 children 5 healthy 6 children 8 the 9 fraction 9 fraction 10 of 9 fraction 22 decreased 10 of 19 and 11 cd34+ 12 cells 12 cells 13 , 13 , 14 cfu 13 , 19 and 14 cfu 17 colonies 15 - 17 colonies 16 gm 17 colonies 17 colonies 18 , 18 , 19 and 19 and 21 cells 20 nucleated 21 cells 22 decreased 23 with 23 with 24 age we did not identify gender specific differences . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 identify 0 ###LEFT-WALL### 8 . 1 we 2 did 2 did 3 not 2 did 4 identify 4 identify 7 differences 5 gender 7 differences 6 specific 7 differences to our knowledge , this represents the first comprehensive study [of] cd34+ cell fraction , cfu - gm counts , and nucleated cell numbers in the bm of healthy children . 0 ###LEFT-WALL### 5 this 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 31 . 1 to 3 knowledge 1 to 4 , 1 to 5 this 2 our 3 knowledge 5 this 21 and 6 represents 14 fraction 6 represents 21 and 7 the 14 fraction 8 first 10 study 9 comprehensive 10 study 10 study 12 cd34+ 12 cd34+ 13 cell 13 cell 14 fraction 14 fraction 16 cfu 15 , 16 cfu 16 cfu 19 counts 16 cfu 20 , 17 - 19 counts 18 gm 19 counts 19 counts 20 , 20 , 21 and 21 and 22 nucleated 21 and 25 in 22 nucleated 24 numbers 23 cell 24 numbers 25 in 27 bm 26 the 27 bm 27 bm 28 of 28 of 30 children 29 healthy 30 children the findings provide valuable information for practical use for bm transplantation and contribute to the understanding of hematopoiesis from birth to adulthood . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 23 . 1 the 2 findings 2 findings 12 and 3 provide 5 information 3 provide 12 and 4 valuable 5 information 5 information 6 for 6 for 8 use 7 practical 8 use 8 use 9 for 9 for 11 transplantation 10 bm 11 transplantation 12 and 13 contribute 13 contribute 14 to 13 contribute 21 to 14 to 16 understanding 15 the 16 understanding 16 understanding 17 of 17 of 18 hematopoiesis 18 hematopoiesis 19 from 19 from 20 birth 21 to 22 adulthood this research examined the relationship between health and life satisfaction in women over 65 years of age in local communities . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 21 . 1 this 2 research 2 research 3 examined 3 examined 5 relationship 3 examined 6 between 3 examined 11 in 3 examined 13 over 4 the 5 relationship 6 between 8 and 7 health 8 and 8 and 10 satisfaction 9 life 10 satisfaction 11 in 12 women 13 over 15 years 14 65 15 years 15 years 16 of 16 of 17 age 17 age 18 in 18 in 20 communities 19 local 20 communities the world health organization 's definition of health as physical , mental , and social well - being was used as the foundation for analyzing the effects of health on life satisfaction . 0 ###LEFT-WALL### 4 organization 0 ###LEFT-WALL### 5 's 0 ###LEFT-WALL### 33 . 1 the 4 organization 2 world 3 health 3 health 4 organization 4 organization 5 's 5 's 6 definition 5 's 9 as 6 definition 7 of 7 of 8 health 9 as 14 and 10 physical 11 , 11 , 12 mental 11 , 14 and 13 , 14 and 14 and 16 well 14 and 17 - 14 and 18 being 14 and 25 analyzing 15 social 16 well 18 being 19 was 19 was 20 used 20 used 21 as 21 as 23 foundation 22 the 23 foundation 23 foundation 24 for 24 for 25 analyzing 25 analyzing 27 effects 25 analyzing 30 on 26 the 27 effects 27 effects 28 of 28 of 29 health 30 on 32 satisfaction 31 life 32 satisfaction the korean longitudinal study of aging was utilized to analyze data from 2,356 women over 65 . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 8 utilized 0 ###LEFT-WALL### 17 . 1 the 2 korean 2 korean 4 study 3 longitudinal 4 study 4 study 5 of 4 study 7 was 5 of 6 aging 7 was 8 utilized 8 utilized 9 to 9 to 10 analyze 10 analyze 11 data 10 analyze 12 from 10 analyze 15 over 12 from 14 women 13 2,356 14 women 15 over 16 65 our results showed that significant influential factors included satisfaction in relationship [with] children , self - rated health , depression , participation in social activities , and number of family members . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 14 , 1 our 2 results 2 results 3 showed 3 showed 4 that 4 that 7 factors 4 that 8 included 5 significant 7 factors 6 influential 7 factors 7 factors 8 included 8 included 9 satisfaction 8 included 10 in 10 in 13 children 11 relationship 13 children 14 , 15 self 14 , 16 - 16 - 27 and 16 - 32 . 17 rated 18 health 18 health 19 , 19 , 20 depression 19 , 21 , 21 , 22 participation 21 , 27 and 22 participation 23 in 23 in 25 activities 24 social 25 activities 26 , 27 and 27 and 28 number 27 and 29 of 29 of 31 members 30 family 31 members our findings suggest [how] older women 's health and life satisfaction can be improved , and give necessary directions for future studies . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 23 . 1 our 2 findings 2 findings 3 suggest 3 suggest 9 and 3 suggest 16 and 5 older 6 women 6 women 7 's 7 's 8 health 8 health 9 and 9 and 11 satisfaction 9 and 16 and 10 life 11 satisfaction 12 can 13 be 12 can 16 and 13 be 14 improved 15 , 16 and 16 and 17 give 16 and 19 directions 18 necessary 19 directions 19 directions 20 for 20 for 22 studies 21 future 22 studies many emergency departments ( ed ) are experiencing ever increasing volumes as they serve as a safety net for patients [without] established access to primary care . 0 ###LEFT-WALL### 3 departments 0 ###LEFT-WALL### 22 established 0 ###LEFT-WALL### 27 . 1 many 2 emergency 2 emergency 3 departments 3 departments 5 ed 3 departments 7 are 4 ( 5 ed 5 ed 6 ) 7 are 8 experiencing 8 experiencing 11 volumes 8 experiencing 12 as 9 ever 10 increasing 10 increasing 11 volumes 12 as 13 they 12 as 14 serve 13 they 14 serve 14 serve 15 as 15 as 17 safety 16 a 17 safety 17 safety 18 net 17 safety 22 established 18 net 19 for 18 net 22 established 19 for 20 patients 22 established 23 access 22 established 24 to 24 to 26 care 25 primary 26 care impending physician shortages , our aging population , and recent changes in national healthcare policy are expected to further exacerbate this situation and worsen ed overcrowding . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 27 . 1 impending 3 shortages 2 physician 3 shortages 3 shortages 4 , 4 , 7 population 4 , 9 and 5 our 7 population 6 aging 7 population 8 , 9 and 9 and 10 recent 9 and 11 changes 9 and 23 and 11 changes 12 in 11 changes 16 are 12 in 15 policy 13 national 15 policy 14 healthcare 15 policy 16 are 17 expected 17 expected 18 to 17 expected 23 and 18 to 23 and 19 further 20 exacerbate 20 exacerbate 22 situation 20 exacerbate 23 and 21 this 22 situation 23 and 24 worsen 23 and 26 overcrowding 24 worsen 25 ed 25 ed 26 overcrowding these conditions could result in a dilution of ed resources and significantly impact the ability of emergency personnel to provide quality care for patients with serious illnesses . 0 ###LEFT-WALL### 2 conditions 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 28 . 1 these 2 conditions 2 conditions 11 and 3 could 4 result 3 could 11 and 4 result 5 in 5 in 7 dilution 6 a 7 dilution 7 dilution 8 of 8 of 10 resources 9 ed 10 resources 11 and 13 impact 12 significantly 13 impact 13 impact 15 ability 14 the 15 ability 15 ability 16 of 15 ability 19 to 15 ability 20 provide 16 of 18 personnel 17 emergency 18 personnel 19 to 20 provide 20 provide 22 care 20 provide 25 with 21 quality 22 care 22 care 23 for 23 for 24 patients 25 with 27 illnesses 26 serious 27 illnesses previous studies have demonstrated that low acuity patients without emergencies can be safely and legally identified in triage and can be sent away from the ed for further outpatient treatment and evaluation . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 33 . 1 previous 2 studies 2 studies 3 have 3 have 19 and 4 demonstrated 5 that 4 demonstrated 19 and 5 that 8 patients 5 that 18 triage 6 low 8 patients 7 acuity 8 patients 8 patients 9 without 8 patients 14 and 8 patients 18 triage 9 without 10 emergencies 11 can 12 be 11 can 14 and 12 be 13 safely 14 and 16 identified 14 and 17 in 15 legally 16 identified 19 and 20 can 20 can 21 be 21 be 22 sent 22 sent 23 away 22 sent 24 from 22 sent 27 for 24 from 26 ed 25 the 26 ed 27 for 31 and 28 further 29 outpatient 29 outpatient 30 treatment 30 treatment 31 and 31 and 32 evaluation however , without a specific designated clinic [follow] up , these patients often fail to get the appropriate care required . 0 ###LEFT-WALL### 12 patients 0 ###LEFT-WALL### 14 fail 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 12 patients 3 without 7 clinic 3 without 12 patients 4 a 5 specific 4 a 7 clinic 5 specific 7 clinic 6 designated 7 clinic 9 up 10 , 9 up 12 patients 11 these 12 patients 12 patients 14 fail 13 often 14 fail 14 fail 15 to 14 fail 16 get 15 to 16 get 16 get 19 care 17 the 19 care 18 appropriate 19 care 19 care 20 required in this study , we couple the ed medical screening exam process with a timely medical referral system to a local federally qualified healthcare clinic ( fqhc ) . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 couple 0 ###LEFT-WALL### 29 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 couple 6 couple 12 process 6 couple 13 with 6 couple 19 to 7 the 12 process 8 ed 12 process 9 medical 11 exam 10 screening 11 exam 11 exam 12 process 13 with 18 system 14 a 15 timely 14 a 18 system 15 timely 17 referral 16 medical 17 referral 17 referral 18 system 19 to 27 fqhc 20 a 27 fqhc 21 local 27 fqhc 22 federally 23 qualified 23 qualified 24 healthcare 24 healthcare 25 clinic 25 clinic 27 fqhc 26 ( 27 fqhc 27 fqhc 28 ) these referred patients were monitored for subsequent success in satisfaction with their primary care needs and their rate of recidivism to the ed . 0 ###LEFT-WALL### 3 patients 0 ###LEFT-WALL### 5 monitored 0 ###LEFT-WALL### 24 . 1 these 3 patients 2 referred 3 patients 3 patients 4 were 4 were 5 monitored 5 monitored 6 for 5 monitored 9 in 5 monitored 11 with 5 monitored 21 to 6 for 8 success 7 subsequent 8 success 9 in 10 satisfaction 11 with 16 and 12 their 15 needs 13 primary 14 care 14 care 15 needs 15 needs 16 and 16 and 18 rate 16 and 19 of 17 their 18 rate 19 of 20 recidivism 21 to 23 ed 22 the 23 ed most of the [non] [-] emergent patients who were judged to be appropriate to refer to the fqhc were satisfied with their medical screening process ( 89 % ) and most elected to attend the same day clinic appointment at the fqhc ( 85 % ) . 0 ###LEFT-WALL### 7 patients 0 ###LEFT-WALL### 20 satisfied 0 ###LEFT-WALL### 47 . 1 most 2 of 1 most 7 patients 2 of 7 patients 3 the 7 patients 6 emergent 7 patients 7 patients 8 who 7 patients 9 were 7 patients 19 were 8 who 9 were 9 were 10 judged 10 judged 11 to 10 judged 13 appropriate 11 to 12 be 13 appropriate 14 to 13 appropriate 15 refer 14 to 15 refer 15 refer 16 to 16 to 18 fqhc 17 the 18 fqhc 19 were 20 satisfied 20 satisfied 21 with 20 satisfied 40 at 21 with 30 and 21 with 32 elected 22 their 23 medical 23 medical 24 screening 23 medical 30 and 24 screening 25 process 25 process 28 % 26 ( 28 % 27 89 28 % 28 % 29 ) 30 and 31 most 32 elected 33 to 32 elected 34 attend 33 to 34 attend 34 attend 39 appointment 35 the 36 same 35 the 39 appointment 37 day 39 appointment 38 clinic 39 appointment 40 at 42 fqhc 41 the 42 fqhc 42 fqhc 45 % 43 ( 45 % 44 85 45 % 45 % 46 ) only 17 % of these patients who were referred out of our ed returned to be seen in our ed within the three - month interval . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 14 returned 0 ###LEFT-WALL### 24 - 1 only 2 17 2 17 3 % 3 % 4 of 3 % 7 who 3 % 8 were 3 % 14 returned 4 of 6 patients 5 these 6 patients 7 who 8 were 8 were 9 referred 9 referred 11 of 10 out 11 of 11 of 13 ed 12 our 13 ed 14 returned 15 to 15 to 16 be 16 be 17 seen 17 seen 18 in 17 seen 21 within 18 in 20 ed 19 our 20 ed 21 within 23 three 22 the 23 three 24 - 26 interval 24 - 27 . 25 month 26 interval we concluded that referring low acuity patients out of the emergency department to a primary care clinic setting provided an opportunity for these patients to establish a medical home for future access to [non] - emergent health care . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 concluded 0 ###LEFT-WALL### 35 - 0 ###LEFT-WALL### 39 . 1 we 2 concluded 2 concluded 3 that 3 that 4 referring 3 that 19 provided 4 referring 7 patients 4 referring 9 of 4 referring 13 to 4 referring 19 provided 5 low 7 patients 6 acuity 7 patients 8 out 9 of 9 of 12 department 10 the 12 department 11 emergency 12 department 13 to 18 setting 14 a 18 setting 15 primary 16 care 16 care 18 setting 17 clinic 18 setting 19 provided 21 opportunity 19 provided 22 for 20 an 21 opportunity 22 for 24 patients 23 these 24 patients 24 patients 25 to 24 patients 33 to 25 to 26 establish 26 establish 29 home 26 establish 33 to 27 a 28 medical 27 a 29 home 28 medical 29 home 29 home 30 for 30 for 32 access 31 future 32 access 35 - 38 care 36 emergent 38 care 37 health 38 care background : tuberculosis is a serious global health problem . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 tuberculosis 2 : 4 is 2 : 10 . 3 tuberculosis 4 is 4 is 9 problem 5 a 6 serious 5 a 9 problem 6 serious 7 global 7 global 9 problem 8 health 9 problem its paradigms are shifting through time , especially in rapidly developing countries such as china . 0 ###LEFT-WALL### 2 paradigms 0 ###LEFT-WALL### 3 are 1 its 2 paradigms 2 paradigms 3 are 3 are 4 shifting 4 shifting 5 through 5 through 6 time 6 time 9 in 7 , 8 especially 7 , 9 in 9 in 11 developing 9 in 16 . 10 rapidly 11 developing 11 developing 12 countries 12 countries 14 as 13 such 14 as 14 as 15 china health providers in china are at the forefront of the battle against tuberculosis ; however , there are few empirical studies on health providers ' perspectives on the challenges they face in tuberculosis control at the county level in china . 0 ###LEFT-WALL### 2 providers 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 41 . 1 health 2 providers 2 providers 3 in 2 providers 5 are 3 in 4 china 5 are 6 at 6 at 8 forefront 7 the 8 forefront 8 forefront 9 of 9 of 11 battle 10 the 11 battle 11 battle 12 against 12 against 13 tuberculosis 14 ; 17 there 14 ; 31 face 15 however 16 , 15 however 17 there 17 there 18 are 18 are 21 studies 19 few 21 studies 20 empirical 21 studies 21 studies 22 on 21 studies 27 on 22 on 26 perspectives 23 health 24 providers 24 providers 25 ' 25 ' 26 perspectives 27 on 29 challenges 28 the 29 challenges 29 challenges 30 they 29 challenges 31 face 30 they 31 face 31 face 32 in 31 face 35 at 31 face 39 in 32 in 34 control 33 tuberculosis 34 control 35 at 38 level 36 the 38 level 37 county 38 level 39 in 40 china this study was conducted among health providers to explore their experiences with tuberculosis control in order to identify bottlenecks and emerging challenges in controlling tuberculosis in rural china . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 29 . 1 this 2 study 2 study 3 was 3 was 4 conducted 4 conducted 5 among 4 conducted 8 to 4 conducted 12 with 5 among 7 providers 6 health 7 providers 8 to 9 explore 9 explore 11 experiences 10 their 11 experiences 12 with 20 and 12 with 23 in 13 tuberculosis 14 control 14 control 15 in 14 control 20 and 15 in 16 order 16 order 17 to 16 order 18 identify 17 to 18 identify 18 identify 19 bottlenecks 20 and 22 challenges 21 emerging 22 challenges 23 in 24 controlling 24 controlling 25 tuberculosis 25 tuberculosis 26 in 26 in 28 china 27 rural 28 china methods : a qualitative approach was used . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 approach 2 : 7 used 2 : 8 . 3 a 4 qualitative 3 a 5 approach 4 qualitative 5 approach 5 approach 6 was 6 was 7 used semi - structured , [in] - depth interviews were conducted with 17 health providers working in various positions within the health system of one rural county ( zjg ) of china . 0 ###LEFT-WALL### 8 interviews 0 ###LEFT-WALL### 10 conducted 0 ###LEFT-WALL### 32 . 1 semi 3 structured 1 semi 6 - 1 semi 8 interviews 2 - 3 structured 3 structured 4 , 7 depth 8 interviews 8 interviews 9 were 9 were 10 conducted 10 conducted 11 with 10 conducted 16 in 11 with 14 providers 12 17 14 providers 13 health 14 providers 14 providers 15 working 16 in 18 positions 17 various 18 positions 18 positions 19 within 18 positions 23 of 19 within 22 system 20 the 22 system 21 health 22 system 23 of 26 county 24 one 26 county 25 rural 26 county 26 county 28 zjg 26 county 30 of 27 ( 28 zjg 28 zjg 29 ) 30 of 31 china data [were] analyzed based on thematic content analysis using maxqda 10 qualitative data analysis software . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 4 based 0 ###LEFT-WALL### 16 . 1 data 3 analyzed 1 data 4 based 4 based 5 on 4 based 8 analysis 4 based 9 using 5 on 7 content 6 thematic 7 content 9 using 15 software 10 maxqda 11 10 10 maxqda 15 software 12 qualitative 13 data 13 data 15 software 14 analysis 15 software results : health providers reported several problems in tuberculosis control in zjg [county] . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 providers 2 : 5 reported 2 : 14 . 3 health 4 providers 4 providers 5 reported 5 reported 7 problems 5 reported 8 in 5 reported 11 in 6 several 7 problems 8 in 10 control 9 tuberculosis 10 control 11 in 12 zjg migrant workers and the elderly were repeatedly documented as the main obstacles in effective tuberculosis control in the county . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 8 documented 0 ###LEFT-WALL### 20 . 1 migrant 2 workers 2 workers 3 and 3 and 5 elderly 3 and 6 were 4 the 5 elderly 6 were 7 repeatedly 6 were 8 documented 8 documented 9 as 9 as 12 obstacles 10 the 11 main 10 the 12 obstacles 12 obstacles 13 in 12 obstacles 17 in 13 in 16 control 14 effective 15 tuberculosis 15 tuberculosis 16 control 17 in 19 county 18 the 19 county at a personal level , doctors showed their frustration with the lack of new drugs for treating tuberculosis patients , and their opinions varied regarding incentives for referring patients . 0 ###LEFT-WALL### 6 doctors 0 ###LEFT-WALL### 7 showed 0 ###LEFT-WALL### 30 . 1 at 4 level 1 at 5 , 1 at 6 doctors 2 a 3 personal 2 a 4 level 3 personal 4 level 6 doctors 7 showed 7 showed 9 frustration 7 showed 21 and 8 their 9 frustration 9 frustration 10 with 9 frustration 13 of 10 with 12 lack 11 the 12 lack 13 of 15 drugs 14 new 15 drugs 15 drugs 16 for 16 for 17 treating 17 treating 19 patients 18 tuberculosis 19 patients 20 , 21 and 21 and 23 opinions 21 and 29 patients 22 their 23 opinions 23 opinions 24 varied 23 opinions 25 regarding 25 regarding 26 incentives 26 incentives 27 for 27 for 28 referring conclusion : the results suggest that several problems still remain for controlling tuberculosis in rural china . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 remain 0 ###LEFT-WALL### 17 . 2 : 4 results 2 : 5 suggest 3 the 4 results 4 results 5 suggest 5 suggest 6 that 6 that 8 problems 6 that 10 remain 7 several 8 problems 9 still 10 remain 10 remain 11 for 11 for 12 controlling 12 controlling 13 tuberculosis 13 tuberculosis 14 in 14 in 16 china 15 rural 16 china tuberculosis control efforts need to make reaching the most vulnerable populations a priority and encourage local health providers to adopt innovative practices in the local context based on national guidelines to achieve the best results . 0 ###LEFT-WALL### 3 efforts 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 36 . 1 tuberculosis 2 control 2 control 3 efforts 3 efforts 14 and 4 need 5 to 4 need 13 priority 4 need 14 and 5 to 6 make 6 make 7 reaching 6 make 11 populations 8 the 11 populations 9 most 10 vulnerable 10 vulnerable 11 populations 12 a 13 priority 14 and 15 encourage 14 and 19 to 14 and 23 in 15 encourage 18 providers 16 local 17 health 17 health 18 providers 19 to 20 adopt 20 adopt 22 practices 21 innovative 22 practices 23 in 26 context 24 the 26 context 25 local 26 context 26 context 27 based 27 based 28 on 27 based 31 to 28 on 30 guidelines 29 national 30 guidelines 31 to 32 achieve 32 achieve 35 results 33 the 34 best 33 the 35 results considerable changes in china 's national tuberculosis control program are needed to tackle these emerging challenges faced by health workers at the county level . 0 ###LEFT-WALL### 2 changes 0 ###LEFT-WALL### 11 needed 0 ###LEFT-WALL### 25 . 1 considerable 2 changes 2 changes 3 in 2 changes 10 are 3 in 9 program 4 china 5 's 5 's 9 program 6 national 7 tuberculosis 7 tuberculosis 8 control 8 control 9 program 10 are 11 needed 11 needed 12 to 12 to 13 tackle 13 tackle 16 challenges 13 tackle 18 by 14 these 16 challenges 15 emerging 16 challenges 16 challenges 17 faced 18 by 20 workers 19 health 20 workers 20 workers 21 at 21 at 24 level 22 the 24 level 23 county 24 level the heart begins to beat before the brain is formed . 0 ###LEFT-WALL### 2 heart 0 ###LEFT-WALL### 3 begins 0 ###LEFT-WALL### 11 . 1 the 2 heart 2 heart 3 begins 3 begins 4 to 3 begins 5 beat 4 to 5 beat 5 beat 6 before 6 before 8 brain 6 before 10 formed 7 the 8 brain 8 brain 9 is 9 is 10 formed whether conventional hierarchical central commands sent by the brain to the heart alone explain all the interplay between these two organs should be reconsidered . 0 ###LEFT-WALL### 15 all 0 ###LEFT-WALL### 24 reconsidered 0 ###LEFT-WALL### 25 . 1 whether 5 commands 1 whether 14 explain 1 whether 15 all 2 conventional 5 commands 3 hierarchical 5 commands 4 central 5 commands 5 commands 6 sent 5 commands 10 to 5 commands 14 explain 6 sent 7 by 7 by 9 brain 8 the 9 brain 10 to 12 heart 11 the 12 heart 13 alone 14 explain 15 all 16 the 15 all 17 interplay 15 all 22 should 16 the 17 interplay 17 interplay 18 between 18 between 21 organs 19 these 20 two 20 two 21 organs 22 should 23 be 23 be 24 reconsidered here , we demonstrate correlations between the signal complexity of brain and cardiac activity . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 demonstrate 0 ###LEFT-WALL### 15 . 1 here 2 , 1 here 3 we 3 we 4 demonstrate 4 demonstrate 5 correlations 4 demonstrate 6 between 6 between 9 complexity 7 the 9 complexity 8 signal 9 complexity 9 complexity 10 of 10 of 12 and 11 brain 12 and 12 and 14 activity 13 cardiac 14 activity eighty - seven geriatric outpatients with healthy hearts and varied cognitive abilities each provided a 24 [-] hour electrocardiography ( ecg ) and a 19 [-] channel eye - closed routine electroencephalography ( eeg ) . 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 36 . 1 eighty 2 - 2 - 3 seven 2 - 5 outpatients 4 geriatric 5 outpatients 5 outpatients 6 with 5 outpatients 9 and 6 with 8 hearts 7 healthy 8 hearts 9 and 12 abilities 9 and 13 each 9 and 14 provided 9 and 21 ecg 9 and 23 and 10 varied 12 abilities 11 cognitive 12 abilities 13 each 14 provided 14 provided 19 electrocardiography 15 a 19 electrocardiography 16 24 18 hour 18 hour 19 electrocardiography 20 ( 21 ecg 21 ecg 22 ) 23 and 28 eye 23 and 29 - 23 and 32 electroencephalography 24 a 28 eye 25 19 28 eye 27 channel 28 eye 29 - 32 electroencephalography 30 closed 31 routine 31 routine 32 electroencephalography 32 electroencephalography 34 eeg 32 electroencephalography 35 ) 33 ( 34 eeg 34 eeg 35 ) the low [-] [to] - high frequency power ( lf/hf ) ratio of rri was calculated to represent sympatho - vagal balance . 0 ###LEFT-WALL### 12 ratio 0 ###LEFT-WALL### 16 calculated 0 ###LEFT-WALL### 23 . 1 the 12 ratio 2 low 8 power 2 low 12 ratio 5 - 8 power 6 high 7 frequency 7 frequency 8 power 8 power 10 lf/hf 8 power 11 ) 9 ( 10 lf/hf 10 lf/hf 11 ) 12 ratio 13 of 12 ratio 15 was 13 of 14 rri 15 was 16 calculated 16 calculated 17 to 17 to 18 represent 18 represent 22 balance 19 sympatho 20 - 19 sympatho 22 balance 21 vagal 22 balance whether these heart [-] brain correlations could be fully explained by the central autonomic network is unknown and needs further exploration . 0 ###LEFT-WALL### 1 whether 0 ###LEFT-WALL### 16 is 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 22 . 1 whether 6 correlations 1 whether 10 explained 1 whether 16 is 2 these 6 correlations 3 heart 6 correlations 5 brain 6 correlations 6 correlations 7 could 7 could 8 be 8 be 9 fully 8 be 10 explained 10 explained 11 by 11 by 15 network 12 the 15 network 13 central 15 network 14 autonomic 15 network 16 is 17 unknown 18 and 19 needs 18 and 20 further 19 needs 20 further 20 further 21 exploration stem cell research can lead to the development of treatments for a wide range of ailments including diabetes , heart disease , aging , neurodegenerative diseases , spinal cord injury , and cancer . 0 ###LEFT-WALL### 3 research 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 34 . 1 stem 2 cell 2 cell 3 research 3 research 4 can 4 can 19 , 5 lead 6 to 5 lead 11 for 5 lead 19 , 6 to 8 development 7 the 8 development 8 development 9 of 9 of 10 treatments 11 for 14 range 12 a 14 range 13 wide 14 range 14 range 15 of 15 of 16 ailments 16 ailments 17 including 17 including 18 diabetes 19 , 20 heart 19 , 23 aging 20 heart 21 disease 22 , 23 aging 23 aging 24 , 24 , 32 and 25 neurodegenerative 26 diseases 26 diseases 27 , 27 , 30 injury 27 , 32 and 28 spinal 29 cord 29 cord 30 injury 31 , 32 and 32 and 33 cancer oct4 is a master regulator of self [-] renewal of undifferentiated embryonic stem cells . 0 ###LEFT-WALL### 1 oct4 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 15 . 1 oct4 2 is 2 is 5 regulator 3 a 5 regulator 4 master 5 regulator 5 regulator 6 of 6 of 9 renewal 7 self 9 renewal 9 renewal 10 of 10 of 14 cells 11 undifferentiated 13 stem 12 embryonic 13 stem 13 stem 14 cells oct4 also plays a crucial role in reprogramming of somatic cells into induced pluripotent [stem] ( ips ) cells . 0 ###LEFT-WALL### 1 oct4 0 ###LEFT-WALL### 3 plays 0 ###LEFT-WALL### 20 . 1 oct4 3 plays 2 also 3 plays 3 plays 6 role 3 plays 7 in 3 plays 12 into 4 a 5 crucial 4 a 6 role 5 crucial 6 role 7 in 8 reprogramming 8 reprogramming 9 of 9 of 11 cells 10 somatic 11 cells 12 into 19 cells 13 induced 19 cells 14 pluripotent 17 ips 14 pluripotent 19 cells 16 ( 17 ips 17 ips 18 ) given known [vivo] reproductive toxicity of cobalt and nickel metals , we examined the effect of these metals on expression of several stem cell factors in embryonic tera - 1 cells , as well as stem cells . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 38 . 1 given 5 toxicity 2 known 5 toxicity 4 reproductive 5 toxicity 5 toxicity 6 of 5 toxicity 8 and 6 of 7 cobalt 8 and 10 metals 9 nickel 10 metals 11 , 12 we 11 , 13 examined 12 we 13 examined 13 examined 15 effect 13 examined 26 in 13 examined 33 as 14 the 15 effect 15 effect 16 of 15 effect 19 on 15 effect 21 of 16 of 18 metals 17 these 18 metals 19 on 20 expression 21 of 25 factors 22 several 25 factors 23 stem 24 cell 24 cell 25 factors 26 in 28 tera 27 embryonic 28 tera 28 tera 31 cells 29 - 31 cells 30 1 31 cells 31 cells 32 , 33 as 34 well 34 well 35 as 35 as 37 cells 36 stem 37 cells cobalt and nickel induced a concentration [-] dependent increase of oct4 and hif - 1α , but not nanog or klf4 . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 induced 0 ###LEFT-WALL### 22 . 1 cobalt 2 and 2 and 3 nickel 2 and 4 induced 4 induced 9 increase 4 induced 17 but 5 a 9 increase 6 concentration 9 increase 8 dependent 9 increase 9 increase 10 of 9 increase 15 1α 10 of 13 hif 11 oct4 12 and 12 and 13 hif 14 - 15 1α 15 1α 16 , 17 but 18 not 17 but 20 or 19 nanog 20 or 20 or 21 klf4 oct4 induced by cobalt and nickel was due primarily to protein stabilization because mg132 stabilized oct4 in cells treated with either metals and [because] neither nickel nor cobalt significantly modulated its steady - state mrna level . 0 ###LEFT-WALL### 1 oct4 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 37 . 1 oct4 2 induced 1 oct4 7 was 2 induced 3 by 3 by 5 and 4 cobalt 5 and 5 and 6 nickel 7 was 8 due 8 due 9 primarily 8 due 13 because 8 due 20 with 9 primarily 10 to 10 to 12 stabilization 11 protein 12 stabilization 13 because 14 mg132 13 because 15 stabilized 14 mg132 15 stabilized 15 stabilized 16 oct4 16 oct4 17 in 16 oct4 19 treated 17 in 18 cells 20 with 21 either 20 with 22 metals 23 and 27 nor 23 and 30 modulated 25 neither 26 nickel 26 nickel 27 nor 27 nor 28 cobalt 27 nor 30 modulated 29 significantly 30 modulated 30 modulated 36 level 31 its 36 level 32 steady 33 - 32 steady 34 state 34 state 35 mrna 35 mrna 36 level oct4 stabilization by cobalt and nickel was mediated largely through reactive oxygen species ( ros ) as co - treatment with ascorbic acid abolished oct4 [increase] . 0 ###LEFT-WALL### 2 stabilization 0 ###LEFT-WALL### 8 mediated 0 ###LEFT-WALL### 19 - 1 oct4 2 stabilization 2 stabilization 3 by 2 stabilization 7 was 3 by 5 and 4 cobalt 5 and 5 and 6 nickel 7 was 8 mediated 8 mediated 9 largely 8 mediated 16 ) 8 mediated 18 co 9 largely 10 through 10 through 13 species 11 reactive 12 oxygen 12 oxygen 13 species 13 species 15 ros 14 ( 15 ros 15 ros 16 ) 17 as 18 co 19 - 20 treatment 19 - 24 abolished 19 - 27 . 20 treatment 21 with 20 treatment 24 abolished 21 with 23 acid 22 ascorbic 23 acid 24 abolished 25 oct4 moreover , nickel and cobalt treatment increased sumoylation and mono - ubiquitination of oct4 and k123 was crucial for mediating these modifications . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 increased 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 23 . 1 moreover 2 , 1 moreover 4 and 3 nickel 4 and 4 and 6 treatment 4 and 7 increased 5 cobalt 6 treatment 7 increased 8 sumoylation 9 and 12 ubiquitination 9 and 17 was 10 mono 11 - 10 mono 12 ubiquitination 12 ubiquitination 13 of 12 ubiquitination 17 was 13 of 15 and 14 oct4 15 and 15 and 16 k123 17 was 18 crucial 18 crucial 19 for 19 for 20 mediating 20 mediating 22 modifications 21 these 22 modifications combined , our observations suggest that nickel and cobalt may exert their reproductive toxicity through perturbing oct4 activity in the stem cell compartment . 0 ###LEFT-WALL### 4 observations 0 ###LEFT-WALL### 5 suggest 0 ###LEFT-WALL### 24 . 1 combined 2 , 1 combined 4 observations 3 our 4 observations 4 observations 5 suggest 5 suggest 6 that 6 that 8 and 6 that 11 exert 7 nickel 8 and 8 and 9 cobalt 8 and 10 may 10 may 11 exert 11 exert 14 toxicity 11 exert 15 through 11 exert 19 in 12 their 14 toxicity 13 reproductive 14 toxicity 15 through 18 activity 16 perturbing 18 activity 17 oct4 18 activity 19 in 23 compartment 20 the 23 compartment 21 stem 23 compartment 22 cell 23 compartment enduring interest in the apolipoprotein e ( apoe ) polymorphism is ensured by its evolutionary - driven uniqueness in humans and its prominent role in geriatrics and gerontology . 0 ###LEFT-WALL### 1 enduring 0 ###LEFT-WALL### 12 ensured 0 ###LEFT-WALL### 29 . 1 enduring 2 interest 1 enduring 3 in 1 enduring 11 is 3 in 10 polymorphism 4 the 10 polymorphism 5 apolipoprotein 6 e 5 apolipoprotein 8 apoe 5 apolipoprotein 10 polymorphism 7 ( 8 apoe 8 apoe 9 ) 11 is 12 ensured 12 ensured 13 by 12 ensured 19 in 12 ensured 25 in 13 by 18 uniqueness 14 its 18 uniqueness 15 evolutionary 16 - 15 evolutionary 18 uniqueness 17 driven 18 uniqueness 19 in 21 and 20 humans 21 and 21 and 24 role 22 its 24 role 23 prominent 24 role 25 in 27 and 26 geriatrics 27 and 27 and 28 gerontology we use large samples of longitudinally followed populations from the framingham heart study ( fhs ) original and offspring cohorts and the long life family study ( llfs ) to investigate gender - specific effects of the apoe4 allele on human survival in a wide range of ages from midlife to extreme old ages , and the sensitivity of these effects to cardiovascular disease ( cvd ) , cancer , and neurodegenerative disorders ( nd ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 33 - 0 ###LEFT-WALL### 77 . 1 we 2 use 2 use 4 samples 2 use 9 from 3 large 4 samples 4 samples 5 of 5 of 8 populations 6 longitudinally 7 followed 7 followed 8 populations 9 from 18 and 10 the 17 original 11 framingham 12 heart 12 heart 13 study 13 study 15 fhs 14 ( 15 fhs 15 fhs 16 ) 15 fhs 17 original 17 original 18 and 18 and 32 gender 18 and 33 - 19 offspring 20 cohorts 20 cohorts 21 and 21 and 28 llfs 21 and 30 to 21 and 31 investigate 21 and 32 gender 22 the 28 llfs 23 long 24 life 24 life 25 family 25 family 26 study 26 study 28 llfs 27 ( 28 llfs 28 llfs 29 ) 30 to 31 investigate 33 - 35 effects 33 - 39 allele 34 specific 35 effects 35 effects 36 of 35 effects 39 allele 36 of 38 apoe4 37 the 38 apoe4 39 allele 40 on 39 allele 43 in 40 on 42 survival 41 human 42 survival 43 in 56 and 44 a 45 wide 44 a 46 range 45 wide 46 range 46 range 47 of 46 range 49 from 46 range 56 and 47 of 48 ages 49 from 50 midlife 50 midlife 51 to 51 to 54 ages 52 extreme 54 ages 53 old 54 ages 55 , 56 and 56 and 58 sensitivity 56 and 62 to 56 and 66 cvd 56 and 71 and 57 the 58 sensitivity 58 sensitivity 59 of 59 of 61 effects 60 these 61 effects 62 to 64 disease 63 cardiovascular 64 disease 65 ( 66 cvd 66 cvd 67 ) 68 , 71 and 69 cancer 71 and 70 , 71 and 71 and 73 disorders 71 and 75 nd 71 and 76 ) 72 neurodegenerative 73 disorders 74 ( 75 nd 75 nd 76 ) the analyses show that women 's lifespan is more sensitive to the e4 allele than men 's in all these populations . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 22 . 1 the 2 analyses 2 analyses 3 show 3 show 4 that 4 that 7 lifespan 4 that 8 is 5 women 6 's 6 's 7 lifespan 7 lifespan 8 is 8 is 10 sensitive 9 more 10 sensitive 10 sensitive 11 to 10 sensitive 15 than 10 sensitive 18 in 11 to 14 allele 12 the 14 allele 13 e4 14 allele 15 than 17 's 16 men 17 's 18 in 19 all 19 all 20 these 19 all 21 populations 20 these 21 populations a highly significant adverse effect of the e4 allele is limited to women with moderate lifespan of about 70 to 95 years in two fhs cohorts and the llfs with relative risk of death [rr] = 1.48 ( p = 3.6 × 10 ( - 6 [ )( (in the fhs cohorts . 0 ###LEFT-WALL### 5 effect 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 53 . 1 a 2 highly 1 a 5 effect 2 highly 3 significant 3 significant 5 effect 4 adverse 5 effect 5 effect 6 of 5 effect 10 is 6 of 9 allele 7 the 9 allele 8 e4 9 allele 10 is 11 limited 11 limited 12 to 11 limited 14 with 11 limited 20 to 11 limited 49 (in 12 to 13 women 14 with 16 lifespan 15 moderate 16 lifespan 16 lifespan 17 of 17 of 19 70 18 about 19 70 20 to 22 years 21 95 22 years 22 years 23 in 22 years 37 1.48 22 years 42 × 23 in 27 and 24 two 26 cohorts 25 fhs 26 cohorts 26 cohorts 27 and 27 and 29 llfs 27 and 30 with 28 the 29 llfs 30 with 32 risk 31 relative 32 risk 32 risk 33 of 33 of 34 death 36 = 37 1.48 37 1.48 40 = 37 1.48 42 × 38 ( 40 = 39 p 40 = 40 = 41 3.6 42 × 43 10 43 10 46 6 44 ( 46 6 45 - 46 6 46 6 48 )( 49 (in 52 cohorts 50 the 52 cohorts 51 fhs 52 cohorts major human diseases including cvd , nd , and cancer , whose risks can be sensitive to the e4 allele , do not mediate the association of this allele with lifespan in large fhs samples . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 36 . 1 major 3 diseases 2 human 3 diseases 3 diseases 4 including 3 diseases 9 and 4 including 5 cvd 5 cvd 7 nd 6 , 7 nd 7 nd 8 , 9 and 10 cancer 9 and 12 whose 11 , 12 whose 12 whose 13 risks 12 whose 21 , 13 risks 14 can 14 can 15 be 15 be 16 sensitive 16 sensitive 17 to 17 to 20 allele 18 the 20 allele 19 e4 20 allele 21 , 22 do 22 do 23 not 22 do 24 mediate 24 mediate 26 association 24 mediate 30 with 24 mediate 32 in 25 the 26 association 26 association 27 of 27 of 29 allele 28 this 29 allele 30 with 31 lifespan 32 in 35 samples 33 large 35 samples 34 fhs 35 samples [non] - skin cancer [non] [-] additively increases mortality of the fhs women with moderate lifespans increasing the risks of death of the e4 carriers with cancer two [-] fold compared to the [non] [-] e4 carriers , i.e [.] , [rr] = 2.07 ( p = 5.0 × 10 ( - 7 ) [ )( 2 - 4 cancer 3 skin 4 cancer 4 cancer 8 increases 7 additively 8 increases 8 increases 9 mortality 8 increases 14 with 9 mortality 10 of 10 of 13 women 11 the 13 women 12 fhs 13 women 14 with 16 lifespans 15 moderate 16 lifespans 16 lifespans 17 increasing 16 lifespans 20 of 17 increasing 19 risks 18 the 19 risks 20 of 21 death 21 death 22 of 21 death 25 carriers 21 death 30 fold 21 death 31 compared 22 of 24 e4 23 the 24 e4 25 carriers 26 with 25 carriers 30 fold 26 with 27 cancer 27 cancer 28 two 31 compared 32 to 32 to 37 carriers 33 the 37 carriers 36 e4 37 carriers 37 carriers 39 i.e 37 carriers 44 2.07 38 , 39 i.e 39 i.e 41 , 41 , 44 2.07 43 = 44 2.07 44 2.07 47 = 44 2.07 56 )( 45 ( 47 = 46 p 47 = 47 = 49 × 48 5.0 49 × 49 × 50 10 49 × 53 7 51 ( 53 7 52 - 53 7 53 7 54 ) the results suggest a pivotal role of [non] [-] sex - specific cancer as a nonlinear modulator of survival in this sample that increases the risk of death of the apoe4 carriers by 150 % ( p = 5.3 × 10 ( - 8 ) ) compared to the [non] [-] carriers . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 53 . 1 the 2 results 2 results 3 suggest 3 suggest 6 role 3 suggest 47 compared 4 a 5 pivotal 4 a 6 role 5 pivotal 6 role 6 role 7 of 6 role 13 cancer 6 role 47 compared 7 of 10 sex 11 - 13 cancer 12 specific 13 cancer 13 cancer 14 as 13 cancer 46 ) 14 as 17 modulator 15 a 16 nonlinear 15 a 17 modulator 16 nonlinear 17 modulator 17 modulator 18 of 18 of 19 survival 19 survival 20 in 19 survival 23 that 19 survival 24 increases 20 in 22 sample 21 this 22 sample 23 that 24 increases 24 increases 26 risk 24 increases 33 by 25 the 26 risk 26 risk 27 of 26 risk 29 of 27 of 28 death 29 of 32 carriers 30 the 32 carriers 31 apoe4 32 carriers 33 by 35 % 34 150 35 % 35 % 38 = 36 ( 38 = 37 p 38 = 38 = 40 × 39 5.3 40 × 40 × 41 10 40 × 44 8 42 ( 44 8 43 - 44 8 44 8 45 ) 47 compared 48 to 48 to 52 carriers 49 the 52 carriers this risk explains the 4.2 year shorter life expectancy of the e4 carriers compared to the [non] [-] carriers in this sample . 0 ###LEFT-WALL### 2 risk 0 ###LEFT-WALL### 3 explains 0 ###LEFT-WALL### 23 . 1 this 2 risk 2 risk 3 explains 3 explains 9 expectancy 3 explains 15 to 3 explains 20 in 4 the 9 expectancy 5 4.2 6 year 6 year 9 expectancy 7 shorter 8 life 8 life 9 expectancy 9 expectancy 10 of 10 of 13 carriers 11 the 13 carriers 12 e4 13 carriers 13 carriers 14 compared 15 to 19 carriers 16 the 19 carriers 20 in 22 sample 21 this 22 sample the analyses suggest the existence of age - and gender - sensitive systemic mechanisms linking the e4 allele to lifespan which can [non] - additively interfere with cancer - related mechanisms . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 30 related 1 the 2 analyses 2 analyses 3 suggest 3 suggest 9 and 3 suggest 26 interfere 4 the 5 existence 5 existence 6 of 5 existence 9 and 6 of 7 age 8 - 9 and 9 and 10 gender 9 and 14 mechanisms 9 and 26 interfere 11 - 14 mechanisms 12 sensitive 14 mechanisms 13 systemic 14 mechanisms 14 mechanisms 15 linking 14 mechanisms 24 - 15 linking 18 allele 15 linking 19 to 16 the 18 allele 17 e4 18 allele 19 to 20 lifespan 20 lifespan 21 which 20 lifespan 22 can 21 which 22 can 25 additively 26 interfere 26 interfere 27 with 27 with 28 cancer 29 - 30 related 30 related 31 mechanisms 30 related 32 . deregulation of the translational machinery is emerging as a critical contributor to cancer development . 0 ###LEFT-WALL### 1 deregulation 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 15 . 1 deregulation 2 of 1 deregulation 6 is 2 of 5 machinery 3 the 5 machinery 4 translational 5 machinery 6 is 7 emerging 7 emerging 8 as 7 emerging 12 to 8 as 11 contributor 9 a 10 critical 9 a 11 contributor 10 critical 11 contributor 12 to 14 development 13 cancer 14 development the contribution of micrornas in translational gene control has been established however [;] the role of micrornas in disrupting the cap [-] dependent translation regulation complex has not been previously described . 0 ###LEFT-WALL### 2 contribution 0 ###LEFT-WALL### 11 established 0 ###LEFT-WALL### 32 . 1 the 2 contribution 2 contribution 3 of 2 contribution 9 has 3 of 4 micrornas 4 micrornas 5 in 5 in 8 control 6 translational 7 gene 7 gene 8 control 9 has 10 been 10 been 11 established 11 established 12 however 12 however 15 role 12 however 31 described 14 the 15 role 15 role 16 of 15 role 18 in 15 role 27 has 16 of 17 micrornas 18 in 19 disrupting 19 disrupting 26 complex 20 the 26 complex 21 cap 25 regulation 23 dependent 25 regulation 24 translation 25 regulation 25 regulation 26 complex 27 has 28 not 27 has 29 been 29 been 31 described 30 previously 31 described here , we established that elevated mir - 520c - 3p represses global translation , cell proliferation and initiates premature senescence in hela and dlbcl cells . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 established 0 ###LEFT-WALL### 27 . 1 here 2 , 1 here 3 we 3 we 4 established 4 established 11 3p 4 established 12 represses 5 that 6 elevated 6 elevated 11 3p 7 mir 9 520c 7 mir 11 3p 8 - 9 520c 9 520c 10 - 11 3p 12 represses 12 represses 21 senescence 12 represses 22 in 13 global 14 translation 14 translation 15 , 15 , 17 proliferation 15 , 18 and 16 cell 17 proliferation 18 and 19 initiates 18 and 21 senescence 20 premature 21 senescence 22 in 26 cells 23 hela 24 and 24 and 25 dlbcl 25 dlbcl 26 cells moreover , we demonstrate that mir - 520c - 3p directly targets translation initiation factor [,] eif4gii mrna and negatively regulates eif4gii protein synthesis . mir - 520c - 3p overexpression diminishes cells colony formation and reduces tumor growth in a human [xenograft] mouse model . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 25 . 1 moreover 2 , 1 moreover 3 we 3 we 19 and 4 demonstrate 5 that 4 demonstrate 19 and 5 that 10 3p 5 that 12 targets 6 mir 8 520c 6 mir 9 - 6 mir 10 3p 7 - 8 520c 8 520c 9 - 10 3p 12 targets 11 directly 12 targets 12 targets 18 mrna 13 translation 14 initiation 14 initiation 17 eif4gii 15 factor 17 eif4gii 17 eif4gii 18 mrna 19 and 21 regulates 20 negatively 21 regulates 21 regulates 24 synthesis 22 eif4gii 23 protein 23 protein 24 synthesis 25 . 31 overexpression 25 . 36 and 25 . 46 . 26 mir 28 520c 26 mir 30 3p 27 - 28 520c 28 520c 29 - 30 3p 31 overexpression 31 overexpression 36 and 32 diminishes 35 formation 32 diminishes 36 and 33 cells 34 colony 34 colony 35 formation 36 and 37 reduces 37 reduces 39 growth 38 tumor 39 growth 39 growth 40 in 40 in 45 model 41 a 45 model 42 human 45 model 44 mouse 45 model consequently , downregulation of eif4gii by sirna decreases translation , cell proliferation and ability to form colonies , as well as induces cellular senescence . 0 ###LEFT-WALL### 3 downregulation 0 ###LEFT-WALL### 8 decreases 1 consequently 2 , 1 consequently 3 downregulation 3 downregulation 4 of 3 downregulation 8 decreases 4 of 5 eif4gii 5 eif4gii 6 by 6 by 7 sirna 8 decreases 13 and 8 decreases 15 to 9 translation 10 , 10 , 12 proliferation 10 , 13 and 11 cell 12 proliferation 13 and 14 ability 15 to 16 form 16 form 17 colonies 16 form 19 as 18 , 19 as 19 as 20 well 19 as 25 . 20 well 22 induces 21 as 22 induces 22 induces 24 senescence 22 induces 25 . 23 cellular 24 senescence in vitro [and] in vivo findings were further validated in patient samples ; dlbcl primary cells demonstrated low mir - 520c - 3p levels with reciprocally up - regulated eif4gii protein expression . 0 ###LEFT-WALL### 6 findings 0 ###LEFT-WALL### 9 validated 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 33 . 1 in 2 vitro 2 vitro 6 findings 4 in 5 vivo 5 vivo 6 findings 6 findings 7 were 7 were 9 validated 8 further 9 validated 9 validated 10 in 10 in 12 samples 11 patient 12 samples 13 ; 16 cells 13 ; 18 low 14 dlbcl 16 cells 15 primary 16 cells 16 cells 17 demonstrated 16 cells 18 low 18 low 24 levels 19 mir 20 - 19 mir 24 levels 21 520c 22 - 21 520c 24 levels 23 3p 24 levels 24 levels 25 with 25 with 32 expression 26 reciprocally 27 up 27 up 28 - 27 up 31 protein 29 regulated 31 protein 30 eif4gii 31 protein 31 protein 32 expression our results provide evidence that the tumor suppressor effect of mir - 520c - 3p is mediated through repression of translation while inducing senescence and that eif4gii is a key effector of this anti - tumor activity . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 38 . 1 our 2 results 2 results 3 provide 3 provide 4 evidence 3 provide 18 through 3 provide 22 while 4 evidence 5 that 5 that 9 effect 5 that 17 mediated 6 the 9 effect 7 tumor 9 effect 8 suppressor 9 effect 9 effect 10 of 9 effect 15 3p 9 effect 16 is 9 effect 17 mediated 10 of 11 mir 11 mir 13 520c 12 - 13 520c 13 520c 14 - 15 3p 16 is 18 through 19 repression 19 repression 20 of 20 of 21 translation 22 while 23 inducing 23 inducing 24 senescence 25 and 27 eif4gii 25 and 28 is 26 that 27 eif4gii 27 eif4gii 28 is 28 is 31 effector 29 a 31 effector 30 key 31 effector 31 effector 32 of 32 of 37 activity 33 this 37 activity 34 anti 35 - 34 anti 36 tumor 36 tumor 37 activity study objectives : evaluate long - term effects of group interventions on sleep and pain outcomes in a primary care population of older adults with osteoarthritis pain and sleep disturbance . 0 ###LEFT-WALL### 2 objectives 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 31 . 1 study 2 objectives 2 objectives 3 : 3 : 14 and 4 evaluate 8 effects 4 evaluate 12 on 4 evaluate 14 and 5 long 6 - 5 long 7 term 7 term 8 effects 8 effects 9 of 9 of 11 interventions 10 group 11 interventions 12 on 13 sleep 14 and 15 pain 14 and 21 population 15 pain 16 outcomes 15 pain 17 in 17 in 19 primary 18 a 19 primary 20 care 21 population 21 population 22 of 22 of 28 and 23 older 24 adults 24 adults 25 with 24 adults 28 and 25 with 27 pain 26 osteoarthritis 27 pain 28 and 30 disturbance 29 sleep 30 disturbance design : double - blind , cluster - randomized controlled trial [with] 18 - [mo] follow - up . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 2 : 7 cluster 2 : 8 - 2 : 14 - 3 double 4 - 3 double 7 cluster 5 blind 6 , 5 blind 7 cluster 8 - 11 trial 9 randomized 11 trial 10 controlled 11 trial 11 trial 13 18 13 18 14 - 14 - 16 follow 16 follow 18 up 17 - 18 up 18 up 19 . setting : group health and university of washington , seattle , wa , from 2009 to 2011 . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 18 . 1 setting 2 : 2 : 3 group 3 group 6 university 3 group 16 to 4 health 5 and 5 and 6 university 6 university 7 of 7 of 8 washington 8 washington 10 seattle 9 , 10 seattle 10 seattle 12 wa 10 seattle 13 , 11 , 12 wa 12 wa 13 , 14 from 16 to 15 2009 16 to 16 to 17 2011 participants : three hundred sixty - seven adults age 60 [y] and older , with osteoarthritis pain and insomnia symptoms . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 1 participants 2 : 2 : 4 hundred 2 : 6 - 2 : 12 and 3 three 4 hundred 5 sixty 6 - 6 - 7 seven 8 adults 9 age 9 age 10 60 9 age 12 and 12 and 13 older 13 older 15 with 14 , 15 with 15 with 18 and 15 with 21 . 16 osteoarthritis 17 pain 17 pain 18 and 18 and 20 symptoms 19 insomnia 20 symptoms interventions : six weekly sessions of group cognitive behavioral therapy for insomnia and pain ( cbt - pi ) , pain alone ( cbt - p [ )(, and education - only control ( eoc ) delivered in patients ' primary care clinics . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 2 : 1 interventions 2 : 2 : 5 sessions 2 : 11 for 2 : 22 alone 2 : 25 - 3 six 4 weekly 4 weekly 5 sessions 5 sessions 6 of 6 of 10 therapy 7 group 10 therapy 8 cognitive 10 therapy 9 behavioral 10 therapy 11 for 21 pain 12 insomnia 13 and 13 and 14 pain 13 and 16 cbt 13 and 21 pain 15 ( 16 cbt 16 cbt 18 pi 16 cbt 20 , 17 - 18 pi 18 pi 19 ) 23 ( 25 - 24 cbt 25 - 25 - 29 and 25 - 44 . 26 p 29 and 28 )(, 29 and 29 and 30 education 29 and 31 - 29 and 32 only 29 and 37 delivered 32 only 33 control 33 control 35 eoc 33 control 37 delivered 34 ( 35 eoc 35 eoc 36 ) 37 delivered 38 in 38 in 43 clinics 39 patients 40 ' 40 ' 43 clinics 41 primary 43 clinics 42 care 43 clinics measurements and results : there were no significant differences between treatment groups in sleep outcomes at 18 mo . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 : 1 measurements 2 and 2 and 3 results 4 : 5 there 4 : 6 were 4 : 19 . 5 there 6 were 6 were 9 differences 7 no 9 differences 8 significant 9 differences 9 differences 10 between 10 between 12 groups 11 treatment 12 groups 12 groups 13 in 12 groups 16 at 13 in 15 outcomes 14 sleep 15 outcomes 16 at 18 mo 17 18 18 mo this is a change [from] published significant 9 - [mo] [follow] - up results for insomnia severity ( insomnia severity index ) and sleep efficiency . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 26 . 1 this 2 is 2 is 4 change 2 is 9 - 3 a 4 change 4 change 6 published 6 published 7 significant 8 9 9 - 9 - 12 - 12 - 23 and 13 up 14 results 14 results 15 for 14 results 23 and 15 for 17 severity 16 insomnia 17 severity 17 severity 21 index 18 ( 21 index 19 insomnia 20 severity 20 severity 21 index 21 index 22 ) 23 and 25 efficiency 24 sleep 25 efficiency there were no significant treatment differences in pain at either [follow] - up . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 14 . 1 there 2 were 2 were 6 differences 3 no 6 differences 4 significant 5 treatment 5 treatment 6 differences 6 differences 7 in 6 differences 9 at 7 in 8 pain 9 at 10 either 12 - 13 up post [hoc] analyses of participants with greater insomnia and pain severity at baseline ( n = 98 ) showed significant ( p = 0.01 ) 18 [-] mo reductions in pain comparing cbt - pi versus cbt [-] p ( adjusted mean difference [ amd ] = - 1.29 [ 95 % confidence interval ( ci ) [:] - 2.24 , - 0.33 ] ) . 0 ###LEFT-WALL### 1 post 0 ###LEFT-WALL### 9 and 1 post 3 analyses 1 post 6 with 3 analyses 4 of 4 of 5 participants 6 with 8 insomnia 7 greater 8 insomnia 9 and 11 severity 9 and 19 showed 10 pain 11 severity 11 severity 12 at 11 severity 16 = 11 severity 19 showed 12 at 13 baseline 14 ( 16 = 15 n 16 = 16 = 17 98 16 = 18 ) 19 showed 29 reductions 19 showed 30 in 20 significant 23 = 20 significant 25 ) 20 significant 29 reductions 21 ( 23 = 22 p 23 = 23 = 24 0.01 26 18 28 mo 28 mo 29 reductions 30 in 37 cbt 31 pain 37 cbt 32 comparing 37 cbt 33 cbt 35 pi 34 - 35 pi 35 pi 36 versus 36 versus 37 cbt 37 cbt 39 p 37 cbt 48 - 40 ( 48 - 41 adjusted 42 mean 42 mean 43 difference 42 mean 47 = 42 mean 48 - 43 difference 45 amd 43 difference 47 = 44 [ 45 amd 45 amd 46 ] 48 - 49 1.29 49 1.29 54 interval 50 [ 54 interval 51 95 52 % 52 % 54 interval 53 confidence 54 interval 54 interval 56 ci 54 interval 60 2.24 54 interval 66 . 55 ( 56 ci 56 ci 57 ) 59 - 60 2.24 60 2.24 63 0.33 60 2.24 65 ) 61 , 63 0.33 62 - 63 0.33 63 0.33 64 ] moderate , albeit nonsignificant , cbt - pi versus eoc treatment effects for insomnia severity ( amd [=] - 1.43 [ 95 % ci : - 4.71 , 1.86 ] ) and sleep efficiency [(] amd = 2.50 [ 95 % ci : - 5.04 , 10.05 ] ) were also observed . 0 ###LEFT-WALL### 1 moderate 0 ###LEFT-WALL### 52 observed 0 ###LEFT-WALL### 53 . 1 moderate 3 albeit 2 , 3 albeit 3 albeit 36 amd 4 nonsignificant 6 cbt 4 nonsignificant 11 treatment 5 , 6 cbt 6 cbt 7 - 8 pi 9 versus 9 versus 10 eoc 10 eoc 11 treatment 11 treatment 12 effects 12 effects 13 for 12 effects 32 and 13 for 15 severity 14 insomnia 15 severity 15 severity 17 amd 15 severity 20 1.43 16 ( 17 amd 17 amd 19 - 19 - 20 1.43 20 1.43 26 - 20 1.43 29 1.86 20 1.43 31 ) 21 [ 26 - 22 95 23 % 23 % 24 ci 23 % 25 : 23 % 26 - 24 ci 25 : 26 - 27 4.71 26 - 28 , 28 , 29 1.86 29 1.86 30 ] 32 and 34 efficiency 32 and 36 amd 33 sleep 34 efficiency 36 amd 38 2.50 36 amd 50 were 36 amd 52 observed 37 = 38 2.50 38 2.50 41 % 38 2.50 50 were 39 [ 41 % 40 95 41 % 41 % 42 ci 41 % 43 : 41 % 45 5.04 41 % 49 ) 42 ci 43 : 44 - 45 5.04 45 5.04 47 10.05 45 5.04 49 ) 46 , 47 10.05 47 10.05 48 ] 50 were 51 also possible trial design and methodological considerations that may have affected results are discussed . 0 ###LEFT-WALL### 3 design 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 14 . 1 possible 2 trial 2 trial 3 design 4 and 6 considerations 4 and 13 discussed 5 methodological 6 considerations 6 considerations 7 that 6 considerations 8 may 6 considerations 12 are 7 that 8 may 8 may 9 have 9 have 10 affected 10 affected 11 results 12 are 13 discussed conclusions : results suggest patients with higher levels of comorbid pain and insomnia may be most likely to experience sustained benefit from cognitive behavioral therapy interventions over time , and inclusion of insomnia treatment may yield more clinically meaningful improvements than cognitive behavioral therapy for pain alone . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 benefit 0 ###LEFT-WALL### 48 . 2 : 3 results 2 : 4 suggest 3 results 4 suggest 4 suggest 5 patients 4 suggest 6 with 6 with 8 levels 7 higher 8 levels 8 levels 9 of 8 levels 16 most 8 levels 21 benefit 9 of 10 comorbid 10 comorbid 12 and 10 comorbid 15 be 11 pain 12 and 12 and 13 insomnia 12 and 14 may 14 may 15 be 16 most 17 likely 16 most 21 benefit 17 likely 18 to 18 to 19 experience 19 experience 20 sustained 21 benefit 22 from 21 benefit 27 over 21 benefit 41 than 21 benefit 45 for 21 benefit 47 alone 22 from 26 interventions 23 cognitive 26 interventions 24 behavioral 26 interventions 25 therapy 26 interventions 27 over 40 improvements 28 time 30 and 29 , 30 and 30 and 31 inclusion 30 and 40 improvements 31 inclusion 32 of 32 of 33 insomnia 33 insomnia 34 treatment 33 insomnia 36 yield 34 treatment 35 may 35 may 36 yield 37 more 38 clinically 38 clinically 39 meaningful 39 meaningful 40 improvements 41 than 44 therapy 42 cognitive 44 therapy 43 behavioral 44 therapy 45 for 46 pain trial registration : clinicaltrials.gov identifier : nct01142349 . 0 ###LEFT-WALL### 2 registration 0 ###LEFT-WALL### 3 : 1 trial 2 registration 3 : 5 identifier 3 : 6 : 4 clinicaltrials.gov 5 identifier 6 : 7 nct01142349 6 : 8 . while the past decade has seen great progress in mapping loci for common diseases , studying how these risk alleles lead to pathology remains a challenge . 0 ###LEFT-WALL### 16 studying 0 ###LEFT-WALL### 24 remains 0 ###LEFT-WALL### 27 . 1 while 4 decade 1 while 6 seen 1 while 15 , 1 while 16 studying 2 the 3 past 2 the 4 decade 4 decade 5 has 5 has 6 seen 6 seen 8 progress 6 seen 9 in 7 great 8 progress 9 in 10 mapping 10 mapping 11 loci 11 loci 12 for 12 for 14 diseases 13 common 14 diseases 16 studying 17 how 16 studying 24 remains 17 how 20 alleles 17 how 21 lead 18 these 20 alleles 19 risk 20 alleles 20 alleles 21 lead 21 lead 22 to 22 to 23 pathology 24 remains 26 challenge 25 a 26 challenge age - related macular degeneration ( amd ) affects 9 million older americans , and is characterized by the loss of the retinal pigment epithelium ( rpe ) . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 29 . 1 age 15 and 2 - 3 related 3 related 5 degeneration 3 related 8 ) 3 related 9 affects 4 macular 5 degeneration 5 degeneration 7 amd 6 ( 7 amd 7 amd 8 ) 9 affects 13 americans 9 affects 15 and 10 9 11 million 11 million 13 americans 12 older 13 americans 14 , 15 and 15 and 16 is 16 is 17 characterized 17 characterized 18 by 18 by 20 loss 19 the 20 loss 20 loss 21 of 20 loss 27 rpe 21 of 25 epithelium 22 the 25 epithelium 23 retinal 24 pigment 24 pigment 25 epithelium 26 ( 27 rpe 27 rpe 28 ) although the closely linked genome - wide association studies arms2/htra1 genes , located at the chromosome 10q26 locus , are strongly associated with the risk of amd , their downstream targets are unknown . 0 ###LEFT-WALL### 31 targets 0 ###LEFT-WALL### 32 are 0 ###LEFT-WALL### 34 . 1 although 5 genome 1 although 28 , 1 although 31 targets 2 the 5 genome 3 closely 4 linked 4 linked 5 genome 5 genome 9 studies 6 - 9 studies 7 wide 8 association 8 association 9 studies 9 studies 10 arms2/htra1 9 studies 22 associated 9 studies 28 , 10 arms2/htra1 11 genes 10 arms2/htra1 20 are 10 arms2/htra1 22 associated 11 genes 13 located 11 genes 20 are 12 , 13 located 13 located 14 at 13 located 19 , 14 at 18 locus 15 the 18 locus 16 chromosome 18 locus 17 10q26 18 locus 21 strongly 22 associated 22 associated 23 with 23 with 25 risk 24 the 25 risk 25 risk 26 of 26 of 27 amd 29 their 31 targets 30 downstream 31 targets 31 targets 32 are 32 are 33 unknown low population frequencies of risk alleles in tissue banks make it impractical to study their function in cells derived from autopsied tissue . 0 ###LEFT-WALL### 3 frequencies 0 ###LEFT-WALL### 10 make 0 ###LEFT-WALL### 23 . 1 low 3 frequencies 2 population 3 frequencies 3 frequencies 4 of 3 frequencies 10 make 4 of 6 alleles 5 risk 6 alleles 6 alleles 7 in 7 in 9 banks 8 tissue 9 banks 10 make 11 it 11 it 12 impractical 12 impractical 13 to 12 impractical 14 study 13 to 14 study 14 study 16 function 14 study 17 in 15 their 16 function 17 in 18 cells 18 cells 19 derived 19 derived 20 from 20 from 22 tissue 21 autopsied 22 tissue moreover , autopsy eyes from end [-] stage amd patients , where age - related rpe atrophy and fibrosis are already present , cannot be used to determine how abnormal arms2/htra1 expression can initiate rpe pathology . 0 ###LEFT-WALL### 3 autopsy 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 37 . 1 moreover 2 , 1 moreover 3 autopsy 3 autopsy 4 eyes 4 eyes 5 from 5 from 10 patients 6 end 8 stage 8 stage 10 patients 9 amd 10 patients 11 , 32 expression 11 , 34 initiate 12 where 13 age 12 where 26 used 12 where 32 expression 13 age 24 cannot 14 - 15 related 15 related 16 rpe 15 related 23 , 15 related 24 cannot 16 rpe 18 and 16 rpe 22 present 17 atrophy 18 and 18 and 19 fibrosis 18 and 20 are 20 are 22 present 21 already 22 present 24 cannot 25 be 25 be 26 used 26 used 27 to 26 used 28 determine 27 to 28 determine 28 determine 29 how 29 how 30 abnormal 31 arms2/htra1 32 expression 32 expression 33 can 33 can 34 initiate 34 initiate 36 pathology 35 rpe 36 pathology instead , induced pluripotent stem [(] ips ) cell [-] derived rpe from patients provides us with earlier stage amd patient - specific cells and allows us to analyze the underlying mechanisms at this critical time point . 0 ###LEFT-WALL### 12 rpe 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 38 . 1 instead 2 , 1 instead 12 rpe 3 induced 4 pluripotent 4 pluripotent 11 derived 5 stem 11 derived 7 ips 8 ) 7 ips 9 cell 9 cell 11 derived 11 derived 12 rpe 12 rpe 13 from 12 rpe 25 and 13 from 14 patients 15 provides 16 us 15 provides 17 with 15 provides 25 and 17 with 24 cells 18 earlier 19 stage 19 stage 24 cells 20 amd 24 cells 21 patient 22 - 21 patient 24 cells 23 specific 24 cells 25 and 26 allows 25 and 33 at 26 allows 27 us 26 allows 28 to 26 allows 29 analyze 28 to 29 analyze 29 analyze 32 mechanisms 30 the 32 mechanisms 31 underlying 32 mechanisms 33 at 37 point 34 this 37 point 35 critical 37 point 36 time 37 point an unbiased proteome screen of a2e - aged patient - specific ips - derived rpe cell lines identified superoxide dismutase 2 ( sod2 ) - mediated antioxidative defense in the genetic allele's susceptibility of amd . 0 ###LEFT-WALL### 4 screen 0 ###LEFT-WALL### 26 mediated 0 ###LEFT-WALL### 36 . 1 an 2 unbiased 1 an 4 screen 2 unbiased 3 proteome 3 proteome 4 screen 4 screen 5 of 4 screen 15 rpe 4 screen 26 mediated 5 of 6 a2e 6 a2e 12 ips 7 - 12 ips 8 aged 12 ips 9 patient 10 - 9 patient 12 ips 11 specific 12 ips 12 ips 13 - 13 - 15 rpe 14 derived 15 rpe 15 rpe 17 lines 15 rpe 18 identified 15 rpe 25 - 16 cell 17 lines 17 lines 18 identified 18 identified 20 dismutase 19 superoxide 20 dismutase 20 dismutase 21 2 20 dismutase 23 sod2 22 ( 23 sod2 23 sod2 24 ) 26 mediated 28 defense 26 mediated 29 in 27 antioxidative 28 defense 29 in 33 susceptibility 30 the 33 susceptibility 31 genetic 32 allele's 32 allele's 33 susceptibility 33 susceptibility 34 of 34 of 35 amd the amd - associated risk haplotype ( t - in/del - a ) impairs the ability of the rpe to defend against aging - related oxidative stress . 0 ###LEFT-WALL### 2 amd 0 ###LEFT-WALL### 25 related 0 ###LEFT-WALL### 28 . 1 the 2 amd 2 amd 5 risk 2 amd 25 related 3 - 5 risk 4 associated 5 risk 5 risk 6 haplotype 5 risk 21 defend 5 risk 24 - 6 haplotype 8 t 6 haplotype 11 - 6 haplotype 14 impairs 7 ( 8 t 8 t 9 - 9 - 11 - 10 in/del 11 - 11 - 12 a 11 - 13 ) 14 impairs 16 ability 15 the 16 ability 16 ability 17 of 16 ability 20 to 16 ability 21 defend 17 of 19 rpe 18 the 19 rpe 20 to 21 defend 21 defend 22 against 22 against 23 aging 25 related 27 stress 26 oxidative 27 stress sod2 defense is impaired in rpe homozygous for the risk haplotype ( t - in/del - a [;] t - in/del - a ) , while the effect was less pronounced in rpe homozygous for the protective haplotype ( g - wt - g ; g - wt - g [ )( 0 ###LEFT-WALL### 1 sod2 0 ###LEFT-WALL### 4 impaired 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 52 )( 1 sod2 2 defense 1 sod2 3 is 1 sod2 4 impaired 2 defense 3 is 4 impaired 5 in 4 impaired 11 haplotype 4 impaired 16 - 4 impaired 22 - 5 in 6 rpe 6 rpe 7 homozygous 7 homozygous 8 for 8 for 10 risk 9 the 10 risk 11 haplotype 13 t 12 ( 13 t 13 t 14 - 14 - 16 - 15 in/del 16 - 16 - 19 t 16 - 20 - 17 a 19 t 20 - 22 - 21 in/del 22 - 22 - 23 a 22 - 24 ) 25 , 30 less 25 , 31 pronounced 25 , 43 - 26 while 28 effect 26 while 29 was 26 while 30 less 27 the 28 effect 28 effect 29 was 30 less 31 pronounced 31 pronounced 32 in 31 pronounced 38 haplotype 32 in 33 rpe 33 rpe 34 homozygous 34 homozygous 35 for 35 for 37 protective 36 the 37 protective 38 haplotype 41 - 39 ( 41 - 40 g 41 - 41 - 42 wt 41 - 43 - 43 - 44 g 43 - 45 ; 45 ; 46 g 45 ; 47 - 45 ; 49 - 46 g 47 - 47 - 48 wt 49 - 50 g arms2/htra1 risk alleles decrease sod2 defense , making rpe more susceptible to oxidative damage and thereby contributing to amd pathogenesis . 0 ###LEFT-WALL### 2 risk 0 ###LEFT-WALL### 3 alleles 1 arms2/htra1 2 risk 2 risk 3 alleles 3 alleles 6 defense 4 decrease 6 defense 5 sod2 6 defense 6 defense 8 making 7 , 8 making 8 making 15 and 8 making 18 to 8 making 21 . 9 rpe 11 susceptible 9 rpe 15 and 10 more 11 susceptible 11 susceptible 12 to 12 to 14 damage 13 oxidative 14 damage 15 and 16 thereby 15 and 17 contributing 18 to 20 pathogenesis 19 amd 20 pathogenesis objective : male hypogonadism is common in the elderly and has been associated with increased risk of mortality . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 hypogonadism 2 : 10 and 2 : 19 . 3 male 4 hypogonadism 4 hypogonadism 10 and 5 is 6 common 5 is 10 and 6 common 7 in 7 in 9 elderly 8 the 9 elderly 10 and 11 has 11 has 12 been 12 been 13 associated 13 associated 14 with 14 with 16 risk 15 increased 16 risk 16 risk 17 of 17 of 18 mortality our objective has been to assess the prevalence of primary and central hypogonadism in elderly male patients admitted to the hospital because of acute illness . 0 ###LEFT-WALL### 18 admitted 1 our 2 objective 2 objective 3 has 3 has 4 been 4 been 5 to 4 been 6 assess 5 to 6 assess 6 assess 8 prevalence 6 assess 18 admitted 7 the 8 prevalence 8 prevalence 9 of 8 prevalence 18 admitted 9 of 13 hypogonadism 10 primary 11 and 11 and 12 central 11 and 13 hypogonadism 13 hypogonadism 14 in 14 in 17 patients 15 elderly 17 patients 16 male 17 patients 18 admitted 19 to 18 admitted 23 of 18 admitted 26 . 19 to 21 hospital 20 the 21 hospital 22 because 23 of 23 of 25 illness 24 acute 25 illness we also evaluated the relationships between gonadal dysfunction and in [-] hospital mortality . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 evaluated 0 ###LEFT-WALL### 14 . 1 we 3 evaluated 2 also 3 evaluated 3 evaluated 5 relationships 4 the 5 relationships 5 relationships 9 and 6 between 8 dysfunction 6 between 9 and 7 gonadal 8 dysfunction 9 and 10 in 10 in 13 mortality 12 hospital 13 mortality patients and methods : 150 patients , aged ≥65 years , admitted during 2010 and 2011 in our geriatric unit , were studied . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 patients 2 and 2 and 3 methods 4 : 6 patients 4 : 22 were 4 : 24 . 5 150 6 patients 6 patients 10 years 6 patients 22 were 7 , 10 years 8 aged 10 years 9 ≥65 10 years 10 years 12 admitted 10 years 21 , 11 , 12 admitted 12 admitted 13 during 12 admitted 17 in 12 admitted 21 , 13 during 15 and 14 2010 15 and 15 and 16 2011 17 in 20 unit 18 our 20 unit 19 geriatric 20 unit 22 were 23 studied serum concentrations total , bioavailable and free testosterone , as well as of follicle - stimulating [hormone] and luteinizing hormone were quantified in every patient . 0 ###LEFT-WALL### 2 concentrations 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 26 . 1 serum 2 concentrations 2 concentrations 6 and 3 total 4 , 3 total 5 bioavailable 3 total 6 and 6 and 7 free 6 and 8 testosterone 9 , 18 and 9 , 22 quantified 10 as 11 well 10 as 15 - 10 as 18 and 11 well 12 as 12 as 13 of 13 of 14 follicle 16 stimulating 18 and 18 and 20 hormone 18 and 21 were 19 luteinizing 20 hormone 21 were 22 quantified 22 quantified 23 in 23 in 25 patient 24 every 25 patient hypogonadism was defined by the presence of serum testosterone levels lower than 200 ng/dl . 0 ###LEFT-WALL### 1 hypogonadism 0 ###LEFT-WALL### 3 defined 0 ###LEFT-WALL### 15 . 1 hypogonadism 2 was 2 was 3 defined 3 defined 4 by 3 defined 11 lower 4 by 6 presence 5 the 6 presence 6 presence 7 of 7 of 10 levels 8 serum 10 levels 9 testosterone 10 levels 11 lower 12 than 12 than 14 ng/dl 13 200 14 ng/dl results : hypogonadism was found in 80 patients ( 53.3 % ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 hypogonadism 2 : 5 found 2 : 13 . 3 hypogonadism 4 was 4 was 5 found 5 found 6 in 6 in 8 patients 7 80 8 patients 8 patients 11 % 9 ( 11 % 10 53.3 11 % 11 % 12 ) serum gonadotropin concentrations were elevated in 43.7 % of these patients , whereas 41.3 % of hypogonadic patients showed normal and 15 % low gonadotropin concentrations . 0 ###LEFT-WALL### 3 concentrations 0 ###LEFT-WALL### 19 showed 0 ###LEFT-WALL### 27 . 1 serum 3 concentrations 2 gonadotropin 3 concentrations 3 concentrations 4 were 4 were 5 elevated 5 elevated 6 in 5 elevated 13 whereas 6 in 8 % 7 43.7 8 % 8 % 9 of 9 of 11 patients 10 these 11 patients 12 , 13 whereas 13 whereas 15 % 14 41.3 15 % 15 % 16 of 15 % 19 showed 16 of 18 patients 17 hypogonadic 18 patients 19 showed 21 and 19 showed 26 concentrations 20 normal 21 and 21 and 24 low 22 15 23 % 23 % 24 low 25 gonadotropin 26 concentrations respiratory tract infection and congestive heart failure were the main causes of hospitalization in hypogonadal men , whereas acute cerebrovascular disease was the main reason for admission in eugonadal patients . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 31 . 1 respiratory 2 tract 2 tract 3 infection 3 infection 4 and 4 and 7 failure 4 and 8 were 5 congestive 6 heart 6 heart 7 failure 8 were 11 causes 9 the 10 main 9 the 11 causes 11 causes 12 of 12 of 13 hospitalization 13 hospitalization 14 in 14 in 16 men 15 hypogonadal 16 men 17 , 25 reason 18 whereas 21 disease 18 whereas 22 was 18 whereas 25 reason 19 acute 21 disease 20 cerebrovascular 21 disease 21 disease 22 was 22 was 24 main 23 the 24 main 25 reason 26 for 25 reason 28 in 26 for 27 admission 28 in 30 patients 29 eugonadal 30 patients of the 13 patients who died during hospitalization , 12 were hypogonadic . 0 ###LEFT-WALL### 10 12 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 13 . 1 of 4 patients 1 of 9 , 1 of 10 12 2 the 3 13 3 13 4 patients 4 patients 5 who 4 patients 6 died 5 who 6 died 6 died 7 during 7 during 8 hospitalization 10 12 11 were 11 were 12 hypogonadic patients who died showed significantly lower serum levels of total , free and bioavailable testosterone than those found in patients who survived . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 16 than 0 ###LEFT-WALL### 23 . 1 patients 2 who 1 patients 3 died 1 patients 4 showed 2 who 3 died 4 showed 7 serum 4 showed 8 levels 4 showed 16 than 5 significantly 6 lower 6 lower 7 serum 8 levels 9 of 9 of 15 testosterone 10 total 11 , 10 total 15 testosterone 12 free 13 and 13 and 14 bioavailable 13 and 15 testosterone 16 than 17 those 16 than 18 found 17 those 18 found 18 found 19 in 18 found 20 patients 20 patients 21 who 20 patients 22 survived 21 who 22 survived conclusion : our results show that about half of patients admitted for acute illness have hypogonadism , mainly [of] [non] - [hypergonadotropic] type . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 show 2 : 17 , 2 : 24 . 3 our 4 results 4 results 5 show 5 show 6 that 6 that 8 half 6 that 15 have 7 about 8 half 8 half 9 of 8 half 15 have 9 of 10 patients 10 patients 11 admitted 11 admitted 12 for 12 for 14 illness 13 acute 14 illness 15 have 16 hypogonadism 17 , 23 type 18 mainly 21 - 18 mainly 23 type gonadal hypofunction is significantly related with [in] [-] hospital mortality . 0 ###LEFT-WALL### 2 hypofunction 0 ###LEFT-WALL### 5 related 0 ###LEFT-WALL### 11 . 1 gonadal 2 hypofunction 2 hypofunction 3 is 3 is 4 significantly 3 is 5 related 5 related 6 with 6 with 10 mortality 9 hospital 10 mortality a low value of serum testosterone may be a predictor for mortality in elderly male patients . 0 ###LEFT-WALL### 3 value 0 ###LEFT-WALL### 8 be 0 ###LEFT-WALL### 17 . 1 a 2 low 1 a 3 value 2 low 3 value 3 value 4 of 3 value 7 may 4 of 6 testosterone 5 serum 6 testosterone 7 may 8 be 8 be 10 predictor 9 a 10 predictor 10 predictor 11 for 10 predictor 13 in 11 for 12 mortality 13 in 16 patients 14 elderly 16 patients 15 male 16 patients objectives : to investigate anti - dementia drugs , associated characteristics of cholinesterase inhibitors ( cheis ) and nmda antagonists , co - medication , and idu in a large population of outpatients with mild ad . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 37 . 1 objectives 2 : 2 : 3 to 2 : 9 , 3 to 9 , 4 investigate 8 drugs 4 investigate 9 , 5 anti 6 - 5 anti 7 dementia 7 dementia 8 drugs 9 , 10 associated 10 associated 26 and 10 associated 28 in 10 associated 34 with 11 characteristics 12 of 11 characteristics 18 and 12 of 14 inhibitors 13 cholinesterase 14 inhibitors 14 inhibitors 16 cheis 15 ( 16 cheis 16 cheis 17 ) 18 and 20 antagonists 18 and 24 medication 18 and 26 and 19 nmda 20 antagonists 21 , 24 medication 22 co 23 - 22 co 24 medication 24 medication 25 , 25 , 26 and 26 and 27 idu 28 in 31 population 29 a 31 population 30 large 31 population 31 population 32 of 32 of 33 outpatients 34 with 36 ad 35 mild 36 ad methods : in this cross - sectional analysis of medication characteristics , we analyzed data from the swedish dementia quality registry ( svedem ) on 5,907 newly diagnosed ad patients who were registered in memory clinics . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 13 we 2 : 14 analyzed 2 : 37 . 3 in 5 cross 3 in 12 , 3 in 13 we 4 this 5 cross 5 cross 8 analysis 6 - 8 analysis 7 sectional 8 analysis 8 analysis 9 of 8 analysis 12 , 9 of 11 characteristics 10 medication 11 characteristics 13 we 14 analyzed 14 analyzed 15 data 14 analyzed 28 diagnosed 15 data 16 from 15 data 25 on 15 data 28 diagnosed 16 from 21 registry 17 the 18 swedish 18 swedish 21 registry 19 dementia 20 quality 20 quality 21 registry 21 registry 23 svedem 22 ( 23 svedem 23 svedem 24 ) 25 on 26 5,907 27 newly 28 diagnosed 28 diagnosed 30 patients 29 ad 30 patients 30 patients 31 who 30 patients 32 were 31 who 32 were 32 were 33 registered 33 registered 34 in 34 in 36 clinics 35 memory 36 clinics svedem is a national quality registry in sweden , which was established [in] 2007 to evaluate and improve dementia [healthcare] . 0 ###LEFT-WALL### 1 svedem 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 21 . 1 svedem 2 is 2 is 6 registry 3 a 4 national 3 a 6 registry 4 national 5 quality 5 quality 6 registry 6 registry 7 in 7 in 8 sweden 9 , 10 which 9 , 17 and 10 which 11 was 11 was 17 and 12 established 14 2007 12 established 17 and 14 2007 15 to 14 2007 16 evaluate 15 to 16 evaluate 17 and 18 improve 18 improve 19 dementia comparisons were performed concerning co - medications , use of ≥3 psychotropic drugs ( idu ) and polypharmacy ( ≥5 drugs ) based on anti - dementia treatment ( cheis or nmda antagonists ) . 0 ###LEFT-WALL### 1 comparisons 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 35 . 1 comparisons 2 were 2 were 5 co 3 performed 5 co 4 concerning 5 co 5 co 7 medications 6 - 7 medications 7 medications 9 use 7 medications 16 ) 8 , 9 use 9 use 10 of 9 use 15 idu 9 use 16 ) 10 of 13 drugs 11 ≥3 13 drugs 12 psychotropic 13 drugs 14 ( 15 idu 15 idu 16 ) 17 and 18 polypharmacy 17 and 23 based 18 polypharmacy 21 drugs 18 polypharmacy 23 based 19 ( 21 drugs 20 ≥5 21 drugs 21 drugs 22 ) 23 based 24 on 23 based 28 treatment 24 on 27 dementia 25 anti 26 - 25 anti 27 dementia 28 treatment 31 or 29 ( 31 or 30 cheis 31 or 31 or 33 antagonists 31 or 34 ) 32 nmda 33 antagonists information on baseline characteristics such as age , sex , living conditions , cognitive evaluation base [d] on the mini - mental state examination ( mmse ) score , and diagnostic work - up was also evaluated . 0 ###LEFT-WALL### 1 information 0 ###LEFT-WALL### 37 evaluated 0 ###LEFT-WALL### 38 . 1 information 2 on 1 information 6 as 1 information 11 living 1 information 35 was 2 on 4 characteristics 3 baseline 4 characteristics 5 such 6 as 6 as 7 age 7 age 9 sex 8 , 9 sex 9 sex 10 , 11 living 30 and 11 living 34 up 12 conditions 13 , 13 , 16 base 13 , 30 and 14 cognitive 15 evaluation 15 evaluation 16 base 16 base 18 on 18 on 28 score 19 the 28 score 20 mini 26 mmse 20 mini 28 score 21 - 26 mmse 22 mental 23 state 23 state 24 examination 24 examination 26 mmse 25 ( 26 mmse 26 mmse 27 ) 29 , 30 and 30 and 32 work 30 and 33 - 31 diagnostic 32 work 35 was 37 evaluated 36 also 37 evaluated results : the majority of the ad patients were in the mild stage of the disease . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 patients 2 : 9 were 2 : 17 . 3 the 4 majority 4 majority 5 of 4 majority 8 patients 5 of 8 patients 6 the 8 patients 7 ad 8 patients 8 patients 9 were 9 were 10 in 10 in 13 stage 11 the 13 stage 12 mild 13 stage 13 stage 14 of 14 of 16 disease 15 the 16 disease overall , 4,342 ( 75.4 % ) patients received any chei , 438 ( 7.6 % ) used an nmda antagonist and 74 ( 1.3 % ) [patients] were treated with both . 0 ###LEFT-WALL### 8 patients 0 ###LEFT-WALL### 9 received 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 33 . 1 overall 3 4,342 1 overall 8 patients 2 , 3 4,342 3 4,342 6 % 3 4,342 7 ) 4 ( 6 % 5 75.4 6 % 6 % 7 ) 8 patients 9 received 9 received 11 chei 10 any 11 chei 12 , 13 438 12 , 18 used 12 , 22 and 13 438 16 % 13 438 18 used 14 ( 16 % 15 7.6 16 % 16 % 17 ) 18 used 21 antagonist 19 an 21 antagonist 20 nmda 21 antagonist 22 and 23 74 22 and 30 treated 23 74 26 % 23 74 29 were 24 ( 26 % 25 1.3 26 % 26 % 27 ) 29 were 30 treated 30 treated 31 with 31 with 32 both however , 907 ( 15.7 % ) [patients] were not treated with any anti - dementia drug . 0 ###LEFT-WALL### 3 907 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 3 907 3 907 6 % 3 907 9 were 4 ( 6 % 5 15.7 6 % 6 % 7 ) 9 were 10 not 9 were 12 with 10 not 11 treated 12 with 17 drug 13 any 17 drug 14 anti 15 - 14 anti 17 drug 16 dementia 17 drug while polypharmacy was seen in 33.5 % of patients , only 2.6 % concurrently used ≥3 psychotropic medications . 0 ###LEFT-WALL### 13 % 0 ###LEFT-WALL### 16 ≥3 0 ###LEFT-WALL### 19 . 1 while 2 polypharmacy 1 while 4 seen 1 while 10 , 1 while 13 % 2 polypharmacy 3 was 3 was 4 seen 4 seen 5 in 5 in 7 % 6 33.5 7 % 7 % 8 of 8 of 9 patients 11 only 12 2.6 12 2.6 13 % 13 % 15 used 13 % 16 ≥3 14 concurrently 15 used 16 ≥3 18 medications 17 psychotropic 18 medications patients on cheis were significantly younger , had a higher mmse score and were treated with a smaller number of medications ( a proxy for overall co - morbidity ) . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 15 treated 0 ###LEFT-WALL### 31 . 1 patients 2 on 1 patients 4 were 2 on 3 cheis 4 were 6 younger 5 significantly 6 younger 7 , 13 and 8 had 11 mmse 8 had 12 score 8 had 13 and 9 a 11 mmse 10 higher 11 mmse 13 and 14 were 14 were 15 treated 15 treated 16 with 16 with 21 medications 17 a 19 number 18 smaller 19 number 19 number 20 of 19 number 21 medications 20 of 21 medications 21 medications 24 proxy 22 ( 24 proxy 23 a 24 proxy 24 proxy 25 for 24 proxy 30 ) 25 for 27 co 26 overall 27 co 27 co 29 morbidity 28 - 29 morbidity 29 morbidity 30 ) [co] - medication with antipsychotics [[] 3.3 vs [.] 7.6 % [;] adjusted odds ratio ( or ) [0.55] ( 95 % ci 0.38 - 0.79 [ )( and [anxiolytics] [[] [5.8] [vs] [.] 10.9 % [;] adjusted or 0.62 ( 95 % ci 0.46 - 0.84 ) ] was significantly lower in the chei+ group than in those with no anti - dementia treatment [.] 2 - 3 medication 3 medication 4 with 3 medication 8 vs 3 medication 13 adjusted 4 with 5 antipsychotics 5 antipsychotics 7 3.3 8 vs 11 % 10 7.6 11 % 13 adjusted 15 ratio 14 odds 15 ratio 15 ratio 17 or 15 ratio 25 - 16 ( 17 or 17 or 18 ) 20 ( 25 - 21 95 23 ci 22 % 23 ci 23 ci 24 0.38 23 ci 25 - 25 - 29 and 26 0.79 29 and 29 and 35 10.9 35 10.9 36 % 36 % 39 or 38 adjusted 39 or 39 or 40 0.62 39 or 44 ci 39 or 50 was 41 ( 44 ci 42 95 44 ci 43 % 44 ci 44 ci 45 0.46 44 ci 47 0.84 44 ci 49 ] 46 - 47 0.84 47 0.84 48 ) 50 was 51 significantly 50 was 52 lower 52 lower 53 in 52 lower 57 than 53 in 56 group 54 the 56 group 55 chei+ 56 group 57 than 58 in 58 in 59 those 59 those 60 with 60 with 65 treatment 61 no 65 treatment 62 anti 63 - 62 anti 65 treatment 64 dementia 65 treatment conclusion : patients taking cheis were treated with less antipsychotics and anxiolytics than those not taking cheis . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 7 treated 2 : 18 . 3 patients 4 taking 3 patients 6 were 4 taking 5 cheis 6 were 7 treated 7 treated 8 with 7 treated 13 than 8 with 9 less 8 with 11 and 10 antipsychotics 11 and 11 and 12 anxiolytics 13 than 14 those 14 those 15 not 15 not 16 taking 16 taking 17 cheis more research is warranted to elucidate whether use of cheis in clinical practice can reduce the need for psychotropic drugs in ad patients . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 warranted 0 ###LEFT-WALL### 24 . 1 more 2 research 2 research 3 is 3 is 4 warranted 4 warranted 5 to 5 to 6 elucidate 6 elucidate 7 whether 6 elucidate 23 patients 7 whether 8 use 7 whether 15 reduce 8 use 9 of 8 use 14 can 9 of 10 cheis 10 cheis 11 in 11 in 13 practice 12 clinical 13 practice 14 can 15 reduce 15 reduce 17 need 15 reduce 21 in 16 the 17 need 17 need 18 for 18 for 20 drugs 19 psychotropic 20 drugs 21 in 22 ad age - related bone loss is in [large] part the consequence of senescence mechanisms that impact bone cell number and function . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 22 . 1 age 6 is 2 - 3 related 3 related 5 loss 3 related 6 is 4 bone 5 loss 6 is 9 part 6 is 11 consequence 7 in 9 part 10 the 11 consequence 11 consequence 12 of 12 of 14 mechanisms 13 senescence 14 mechanisms 14 mechanisms 15 that 14 mechanisms 16 impact 15 that 16 impact 16 impact 20 and 17 bone 19 number 18 cell 19 number 19 number 20 and 20 and 21 function in recent years , progress has been made in the understanding of the molecular mechanisms underlying bone cell senescence that contributes to the alteration of skeletal integrity during aging . 0 ###LEFT-WALL### 5 progress 0 ###LEFT-WALL### 8 made 0 ###LEFT-WALL### 30 . 1 in 3 years 1 in 4 , 1 in 5 progress 2 recent 3 years 5 progress 6 has 6 has 7 been 7 been 8 made 8 made 9 in 8 made 22 to 8 made 28 during 9 in 11 understanding 10 the 11 understanding 11 understanding 12 of 11 understanding 16 underlying 12 of 15 mechanisms 13 the 15 mechanisms 14 molecular 15 mechanisms 16 underlying 19 senescence 17 bone 19 senescence 18 cell 19 senescence 19 senescence 20 that 19 senescence 21 contributes 20 that 21 contributes 22 to 24 alteration 23 the 24 alteration 24 alteration 25 of 25 of 27 integrity 26 skeletal 27 integrity 28 during 29 aging these mechanisms can be classified as intrinsic senescence processes , alterations in endogenous anabolic factors , and changes in local support . 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 4 be 0 ###LEFT-WALL### 22 . 1 these 2 mechanisms 2 mechanisms 3 can 3 can 4 be 4 be 17 and 5 classified 9 processes 5 classified 17 and 6 as 7 intrinsic 7 intrinsic 8 senescence 8 senescence 9 processes 9 processes 11 alterations 10 , 11 alterations 11 alterations 12 in 11 alterations 16 , 12 in 15 factors 13 endogenous 15 factors 14 anabolic 15 factors 17 and 18 changes 18 changes 19 in 19 in 21 support 20 local 21 support intrinsic senescence mechanisms cause cellular dysfunctions that are not tissue specific and include telomere shortening , accumulation of oxidative damage , impaired dna repair , and altered epigenetic mechanisms regulating gene transcription . 0 ###LEFT-WALL### 3 mechanisms 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 33 . 1 intrinsic 2 senescence 2 senescence 3 mechanisms 3 mechanisms 26 and 4 cause 6 dysfunctions 4 cause 26 and 5 cellular 6 dysfunctions 6 dysfunctions 7 that 6 dysfunctions 8 are 7 that 8 are 8 are 9 not 8 are 15 shortening 10 tissue 14 telomere 11 specific 12 and 12 and 13 include 12 and 14 telomere 14 telomere 15 shortening 15 shortening 17 accumulation 16 , 17 accumulation 17 accumulation 18 of 17 accumulation 25 , 18 of 20 damage 19 oxidative 20 damage 20 damage 24 repair 21 , 24 repair 22 impaired 24 repair 23 dna 24 repair 24 repair 25 , 25 , 26 and 26 and 27 altered 26 and 29 mechanisms 28 epigenetic 29 mechanisms 29 mechanisms 30 regulating 30 regulating 32 transcription 31 gene 32 transcription aging mechanisms that are more relevant to the bone microenvironment include alterations in the expression and signaling of local growth factors and altered intercellular communications . 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 11 include 0 ###LEFT-WALL### 26 . 1 aging 2 mechanisms 2 mechanisms 3 that 2 mechanisms 4 are 2 mechanisms 11 include 3 that 4 are 4 are 6 relevant 5 more 6 relevant 6 relevant 7 to 7 to 10 microenvironment 8 the 10 microenvironment 9 bone 10 microenvironment 11 include 12 alterations 11 include 13 in 13 in 22 and 14 the 15 expression 15 expression 16 and 16 and 17 signaling 16 and 22 and 17 signaling 18 of 18 of 21 factors 19 local 20 growth 20 growth 21 factors 22 and 25 communications 23 altered 25 communications 24 intercellular 25 communications this review provides an integrated overview of the current concepts and interacting mechanisms underlying bone cell senescence during aging and how they could be targeted to reduce the negative impact of senescence in the aging skeleton . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 37 . 1 this 2 review 2 review 3 provides 3 provides 6 overview 4 an 6 overview 5 integrated 6 overview 6 overview 7 of 7 of 10 concepts 8 the 10 concepts 9 current 10 concepts 11 and 13 mechanisms 11 and 27 reduce 12 interacting 13 mechanisms 13 mechanisms 14 underlying 13 mechanisms 27 reduce 14 underlying 17 senescence 14 underlying 18 during 15 bone 17 senescence 16 cell 17 senescence 18 during 20 and 19 aging 20 and 20 and 21 how 20 and 22 they 20 and 26 to 22 they 23 could 23 could 24 be 24 be 25 targeted 25 targeted 26 to 27 reduce 30 impact 27 reduce 33 in 28 the 30 impact 29 negative 30 impact 30 impact 31 of 31 of 32 senescence 33 in 36 skeleton 34 the 36 skeleton 35 aging 36 skeleton modern medicine wields the power to treat large numbers of diseases and injuries most of us would have died from just a hundred years ago , yet many of the most devastating diseases of our time are still untreatable . 0 ###LEFT-WALL### 2 medicine 0 ###LEFT-WALL### 3 wields 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 40 . 1 modern 2 medicine 2 medicine 3 wields 3 wields 5 power 3 wields 6 to 4 the 5 power 6 to 7 treat 7 treat 11 diseases 8 large 9 numbers 9 numbers 10 of 9 numbers 11 diseases 10 of 11 diseases 12 and 13 injuries 12 and 37 are 13 injuries 14 most 13 injuries 18 have 13 injuries 19 died 14 most 15 of 14 most 17 would 15 of 16 us 17 would 18 have 19 died 20 from 19 died 25 ago 19 died 27 yet 20 from 23 hundred 21 just 23 hundred 22 a 23 hundred 24 years 25 ago 26 , 27 yet 27 yet 33 diseases 28 many 29 of 28 many 33 diseases 29 of 33 diseases 30 the 31 most 31 most 33 diseases 32 devastating 33 diseases 33 diseases 34 of 33 diseases 37 are 34 of 36 time 35 our 36 time 37 are 38 still 37 are 39 untreatable 38 still 39 untreatable chronic conditions of age such as cardiovascular disease , diabetes , osteoarthritis or alzheimer 's disease turn out to be of a complexity that may require transformative ideas and paradigms to understand and treat them . 0 ###LEFT-WALL### 13 or 0 ###LEFT-WALL### 36 . 1 chronic 2 conditions 2 conditions 3 of 2 conditions 9 , 3 of 4 age 4 age 6 as 5 such 6 as 6 as 8 disease 7 cardiovascular 8 disease 9 , 10 diabetes 9 , 11 , 11 , 12 osteoarthritis 11 , 13 or 13 or 17 turn 13 or 18 out 13 or 21 of 13 or 24 that 13 or 25 may 14 alzheimer 15 's 15 's 17 turn 16 disease 17 turn 18 out 19 to 18 out 20 be 19 to 20 be 21 of 23 complexity 22 a 23 complexity 24 that 25 may 25 may 26 require 26 require 29 and 26 require 31 to 26 require 33 and 27 transformative 28 ideas 28 ideas 29 and 29 and 30 paradigms 31 to 33 and 32 understand 33 and 33 and 34 treat 34 treat 35 them parabiosis , which is characterised by a shared blood supply between two surgically connected animals , may just provide such a transformative experimental paradigm . 0 ###LEFT-WALL### 1 parabiosis 0 ###LEFT-WALL### 19 provide 0 ###LEFT-WALL### 25 . 1 parabiosis 3 which 1 parabiosis 17 may 2 , 3 which 3 which 4 is 3 which 16 , 4 is 5 characterised 5 characterised 6 by 5 characterised 11 between 6 by 10 supply 7 a 10 supply 8 shared 9 blood 9 blood 10 supply 11 between 15 animals 12 two 15 animals 13 surgically 14 connected 14 connected 15 animals 17 may 19 provide 18 just 19 provide 19 provide 24 paradigm 20 such 21 a 21 a 22 transformative 21 a 24 paradigm 22 transformative 24 paradigm 23 experimental 24 paradigm [although] [forgotten] and shunned now in many countries , it has contributed to major breakthroughs in tumour biology , endocrinology and transplantation research in the past century . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 14 major 0 ###LEFT-WALL### 28 . 3 and 10 it 3 and 12 contributed 4 shunned 5 now 4 shunned 6 in 4 shunned 9 , 4 shunned 10 it 6 in 8 countries 7 many 8 countries 10 it 11 has 11 has 12 contributed 12 contributed 13 to 13 to 14 major 14 major 15 breakthroughs 14 major 16 in 14 major 24 in 16 in 21 and 17 tumour 18 biology 18 biology 19 , 19 , 20 endocrinology 19 , 21 and 21 and 23 research 22 transplantation 23 research 24 in 27 century 25 the 26 past 25 the 27 century interestingly , recent studies from the united states and britain are reporting stunning advances in stem cell biology and tissue regeneration using parabiosis between young and old mice , indicating a possible revival of this paradigm . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 37 . 1 interestingly 2 , 1 interestingly 9 and 3 recent 4 studies 4 studies 5 from 4 studies 9 and 5 from 8 states 6 the 8 states 7 united 8 states 9 and 10 britain 9 and 11 are 11 are 12 reporting 12 reporting 14 advances 12 reporting 15 in 12 reporting 22 using 12 reporting 24 between 13 stunning 14 advances 15 in 19 and 16 stem 17 cell 17 cell 18 biology 18 biology 19 and 19 and 21 regeneration 20 tissue 21 regeneration 22 using 23 parabiosis 24 between 26 and 25 young 26 and 26 and 28 mice 26 and 29 , 26 and 30 indicating 26 and 34 of 27 old 28 mice 30 indicating 33 revival 31 a 33 revival 32 possible 33 revival 34 of 36 paradigm 35 this 36 paradigm we review here briefly the history of parabiosis and discuss its utility to study physiological and pathophysiological processes . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 19 . 1 we 9 and 2 review 3 here 2 review 4 briefly 2 review 6 history 2 review 9 and 5 the 6 history 6 history 7 of 7 of 8 parabiosis 9 and 10 discuss 10 discuss 12 utility 10 discuss 13 to 11 its 12 utility 13 to 14 study 14 study 18 processes 15 physiological 16 and 16 and 17 pathophysiological 16 and 18 processes we argue that [parabiosis] is a technique that should enjoy wider acceptance and application , and that policies should be revisited to allow its use in biomedical research . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 argue 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 29 . 1 we 2 argue 2 argue 3 that 2 argue 5 is 3 that 5 is 5 is 7 technique 6 a 7 technique 7 technique 8 that 7 technique 10 enjoy 8 that 9 should 9 should 10 enjoy 10 enjoy 12 acceptance 11 wider 12 acceptance 13 and 16 and 13 and 23 allow 14 application 16 and 15 , 16 and 16 and 17 that 16 and 18 policies 16 and 22 to 16 and 23 allow 18 policies 19 should 19 should 20 be 20 be 21 revisited 21 revisited 22 to 23 allow 25 use 23 allow 26 in 24 its 25 use 26 in 28 research 27 biomedical 28 research ageing is a stochastic process associated with a progressive decline in physiological functions which predispose to the pathogenesis of several neurodegenerative diseases . 0 ###LEFT-WALL### 1 ageing 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 23 . 1 ageing 2 is 2 is 5 process 3 a 4 stochastic 3 a 5 process 4 stochastic 5 process 5 process 6 associated 6 associated 7 with 6 associated 11 in 7 with 10 decline 8 a 9 progressive 8 a 10 decline 9 progressive 10 decline 11 in 13 functions 12 physiological 13 functions 13 functions 14 which 13 functions 15 predispose 14 which 15 predispose 15 predispose 16 to 15 predispose 22 diseases 16 to 18 pathogenesis 17 the 18 pathogenesis 18 pathogenesis 19 of 19 of 20 several 21 neurodegenerative 22 diseases the intrinsic complexity of ageing remains a significant challenge to understand the cause of this natural phenomenon . 0 ###LEFT-WALL### 3 complexity 0 ###LEFT-WALL### 6 remains 0 ###LEFT-WALL### 18 . 1 the 3 complexity 2 intrinsic 3 complexity 3 complexity 4 of 3 complexity 6 remains 4 of 5 ageing 6 remains 9 challenge 6 remains 10 to 7 a 8 significant 7 a 9 challenge 8 significant 9 challenge 10 to 11 understand 11 understand 13 cause 12 the 13 cause 13 cause 14 of 14 of 17 phenomenon 15 this 17 phenomenon 16 natural 17 phenomenon at the molecular level , ageing is thought to be characterized by the accumulation of chronic oxidative damage to lipids , proteins and nucleic acids caused by free radicals . 0 ###LEFT-WALL### 6 ageing 0 ###LEFT-WALL### 8 thought 0 ###LEFT-WALL### 30 . 1 at 4 level 1 at 5 , 1 at 6 ageing 2 the 4 level 3 molecular 4 level 6 ageing 7 is 7 is 8 thought 8 thought 9 to 8 thought 12 by 8 thought 27 by 9 to 10 be 10 be 11 characterized 12 by 14 accumulation 13 the 14 accumulation 14 accumulation 15 of 14 accumulation 26 caused 15 of 18 damage 16 chronic 18 damage 17 oxidative 18 damage 18 damage 19 to 19 to 23 and 20 lipids 21 , 21 , 22 proteins 21 , 23 and 23 and 25 acids 24 nucleic 25 acids 27 by 29 radicals 28 free 29 radicals increased oxidative stress and misfolded protein formations , combined with impaired compensatory mechanisms , may promote neurodegenerative disorders with age . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 21 . 1 increased 3 stress 1 increased 4 and 2 oxidative 3 stress 4 and 16 promote 5 misfolded 6 protein 6 protein 7 formations 7 formations 9 combined 7 formations 15 may 8 , 9 combined 9 combined 10 with 9 combined 14 , 10 with 13 mechanisms 11 impaired 13 mechanisms 12 compensatory 13 mechanisms 15 may 16 promote 16 promote 18 disorders 16 promote 19 with 17 neurodegenerative 18 disorders 19 with 20 age nutritional modulation through calorie restriction has been shown to be effective as an anti - ageing factor , promoting longevity and protecting against neurodegenerative pathology in yeast , nematodes and murine models . 0 ###LEFT-WALL### 5 restriction 0 ###LEFT-WALL### 8 shown 0 ###LEFT-WALL### 33 . 1 nutritional 5 restriction 2 modulation 5 restriction 3 through 4 calorie 4 calorie 5 restriction 5 restriction 6 has 6 has 7 been 7 been 8 shown 8 shown 9 to 8 shown 23 against 8 shown 26 in 9 to 10 be 10 be 11 effective 11 effective 12 as 12 as 21 and 13 an 17 factor 14 anti 15 - 14 anti 16 ageing 16 ageing 17 factor 17 factor 18 , 18 , 20 longevity 18 , 21 and 19 promoting 20 longevity 21 and 22 protecting 23 against 25 pathology 24 neurodegenerative 25 pathology 26 in 30 and 27 yeast 28 , 28 , 29 nematodes 28 , 30 and 30 and 32 models 31 murine 32 models calorie restriction increases the intracellular levels of the essential pyridine nucleotide , nicotinamide adenine dinucleotide ( nad [(] [+] ) ) , a co - substrate for the sirtuin 1 ( sirt1 , [silent] mating - type information regulator 2 homolog 1 ) [activity] and a cofactor for oxidative phosphorylation and atp synthesis . 0 ###LEFT-WALL### 2 restriction 0 ###LEFT-WALL### 3 increases 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 54 . 1 calorie 2 restriction 2 restriction 3 increases 3 increases 6 levels 4 the 6 levels 5 intracellular 6 levels 6 levels 7 of 7 of 11 nucleotide 8 the 11 nucleotide 9 essential 10 pyridine 10 pyridine 11 nucleotide 11 nucleotide 15 dinucleotide 12 , 15 dinucleotide 13 nicotinamide 14 adenine 14 adenine 15 dinucleotide 15 dinucleotide 17 nad 15 dinucleotide 21 ) 16 ( 17 nad 17 nad 20 ) 22 , 45 and 23 a 24 co 23 a 26 substrate 24 co 25 - 24 co 26 substrate 26 substrate 27 for 26 substrate 45 and 27 for 29 sirtuin 28 the 29 sirtuin 29 sirtuin 35 mating 29 sirtuin 41 homolog 30 1 32 sirt1 30 1 35 mating 31 ( 32 sirt1 32 sirt1 33 , 36 - 41 homolog 37 type 41 homolog 38 information 39 regulator 39 regulator 41 homolog 40 2 41 homolog 41 homolog 42 1 41 homolog 43 ) 45 and 47 cofactor 45 and 48 for 46 a 47 cofactor 48 for 51 and 49 oxidative 50 phosphorylation 50 phosphorylation 51 and 51 and 53 synthesis 52 atp 53 synthesis promotion of intracellular nad [(] [+] [ )(anabolism is speculated to induce neuroprotective effects against amyloid - β - peptide [(] aβ ) toxicity in some models for alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 1 promotion 0 ###LEFT-WALL### 10 speculated 0 ###LEFT-WALL### 35 . 1 promotion 2 of 1 promotion 8 )(anabolism 1 promotion 9 is 1 promotion 10 speculated 2 of 4 nad 3 intracellular 4 nad 8 )(anabolism 9 is 10 speculated 11 to 10 speculated 15 against 10 speculated 25 in 11 to 12 induce 12 induce 14 effects 13 neuroprotective 14 effects 15 against 24 toxicity 16 amyloid 18 β 16 amyloid 24 toxicity 17 - 18 β 18 β 22 aβ 18 β 23 ) 19 - 22 aβ 20 peptide 22 aβ 22 aβ 23 ) 25 in 27 models 26 some 27 models 27 models 28 for 28 for 31 disease 29 alzheimer 30 's 30 's 31 disease 31 disease 33 ad 32 ( 33 ad 33 ad 34 ) the nad [(] [+] [ )(- dependent histone deacetylase , sirt1 , has been implicated in the ageing process . 0 ###LEFT-WALL### 2 nad 0 ###LEFT-WALL### 15 implicated 0 ###LEFT-WALL### 20 . 1 the 2 nad 2 nad 9 deacetylase 2 nad 11 sirt1 2 nad 13 has 6 )(- 9 deacetylase 7 dependent 9 deacetylase 8 histone 9 deacetylase 9 deacetylase 10 , 10 , 11 sirt1 11 sirt1 12 , 13 has 14 been 14 been 15 implicated 15 implicated 16 in 16 in 19 process 17 the 19 process 18 ageing 19 process sirt1 serves as a deacetylase for numerous proteins involved in several cellular pathways , including stress response and apoptosis , and plays a protective role in neurodegenerative disorders , such as ad . 0 ###LEFT-WALL### 1 sirt1 0 ###LEFT-WALL### 21 and 1 sirt1 21 and 2 serves 3 as 2 serves 10 in 2 serves 21 and 3 as 5 deacetylase 4 a 5 deacetylase 5 deacetylase 6 for 6 for 8 proteins 7 numerous 8 proteins 8 proteins 9 involved 10 in 18 and 11 several 13 pathways 12 cellular 13 pathways 13 pathways 14 , 14 , 17 response 14 , 18 and 15 including 16 stress 16 stress 17 response 18 and 19 apoptosis 20 , 21 and 21 and 22 plays 21 and 26 in 22 plays 25 role 23 a 24 protective 23 a 25 role 24 protective 25 role 26 in 28 disorders 27 neurodegenerative 28 disorders 28 disorders 31 as 29 , 31 as 30 such 31 as 31 as 32 ad 31 as 33 . importance : single measures of blood pressure ( bp ) levels are associated with the development of atherosclerosis ; however , long - term patterns in bp and their effect on cardiovascular disease risk are poorly characterized . 0 ###LEFT-WALL### 1 importance 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 4 measures 2 : 13 associated 2 : 19 ; 3 single 4 measures 4 measures 5 of 4 measures 12 are 5 of 6 blood 6 blood 7 pressure 6 blood 11 levels 7 pressure 9 bp 7 pressure 11 levels 8 ( 9 bp 9 bp 10 ) 12 are 13 associated 13 associated 14 with 14 with 16 development 15 the 16 development 16 development 17 of 17 of 18 atherosclerosis 19 ; 25 patterns 19 ; 35 are 20 however 21 , 20 however 25 patterns 22 long 23 - 22 long 25 patterns 24 term 25 patterns 25 patterns 26 in 25 patterns 35 are 26 in 28 and 27 bp 28 and 28 and 30 effect 29 their 30 effect 30 effect 31 on 31 on 34 risk 32 cardiovascular 33 disease 33 disease 34 risk 35 are 36 poorly 35 are 37 characterized objectives : to identify common bp trajectories throughout early adulthood and to determine their association with presence of coronary artery calcification ( cac ) during middle age . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 3 to 2 : 11 and 3 to 11 and 4 identify 7 trajectories 4 identify 8 throughout 4 identify 11 and 5 common 7 trajectories 6 bp 7 trajectories 8 throughout 10 adulthood 9 early 10 adulthood 11 and 12 to 11 and 13 determine 11 and 25 during 12 to 13 determine 13 determine 15 association 13 determine 16 with 14 their 15 association 16 with 17 presence 17 presence 18 of 18 of 21 calcification 19 coronary 21 calcification 20 artery 21 calcification 21 calcification 23 cac 22 ( 23 cac 23 cac 24 ) 25 during 27 age 26 middle 27 age design , setting , and participants : prospective cohort data from 4681 participants in the cardia study , who were black and white men and women aged 18 to 30 years at baseline in 1985 - 1986 at 4 urban us sites , collected through 25 years of follow - up ( 2010 - 2011 ) . 0 ###LEFT-WALL### 6 participants 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 57 . 1 design 6 participants 2 , 3 setting 3 setting 4 , 3 setting 6 participants 5 and 6 participants 6 participants 7 : 7 : 10 data 8 prospective 10 data 9 cohort 10 data 10 data 11 from 11 from 13 participants 12 4681 13 participants 13 participants 14 in 14 in 17 study 15 the 17 study 16 cardia 17 study 18 , 19 who 18 , 20 were 19 who 20 were 20 were 22 and 20 were 25 and 20 were 51 up 20 were 54 - 21 black 22 and 22 and 23 white 24 men 25 and 25 and 26 women 25 and 50 - 26 women 27 aged 27 aged 29 to 28 18 29 to 29 to 30 30 30 30 31 years 31 years 32 at 31 years 49 follow 32 at 33 baseline 33 baseline 34 in 33 baseline 37 1986 33 baseline 48 of 34 in 35 1985 36 - 37 1986 37 1986 38 at 37 1986 43 , 38 at 41 us 39 4 41 us 40 urban 41 us 42 sites 43 , 43 , 44 collected 43 , 45 through 43 , 47 years 45 through 46 25 47 years 48 of 52 ( 54 - 53 2010 54 - 54 - 55 2011 54 - 56 ) we examined systolic bp , diastolic bp , and mid - bp ( calculated as [[] sbp+dbp ]/2 , an important marker of coronary heart disease risk among younger populations ) at baseline and years 2 , 5 , 7 , 10 , 15 , 20 , [and] 25 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 37 , 0 ###LEFT-WALL### 50 . 1 we 2 examined 2 examined 4 bp 2 examined 32 at 3 systolic 4 bp 4 bp 9 and 5 , 9 and 6 diastolic 7 bp 7 bp 9 and 8 , 9 and 9 and 10 mid 9 and 12 bp 9 and 22 marker 9 and 31 ) 11 - 12 bp 12 bp 14 calculated 12 bp 19 , 13 ( 14 calculated 14 calculated 15 as 14 calculated 19 , 15 as 18 ]/2 17 sbp+dbp 18 ]/2 19 , 22 marker 20 an 21 important 20 an 22 marker 21 important 22 marker 22 marker 23 of 22 marker 31 ) 23 of 27 risk 24 coronary 25 heart 25 heart 26 disease 26 disease 27 risk 27 risk 28 among 28 among 30 populations 29 younger 30 populations 32 at 34 and 33 baseline 34 and 34 and 35 years 35 years 36 2 37 , 38 5 37 , 39 , 39 , 40 7 39 , 41 , 41 , 42 10 41 , 43 , 43 , 44 15 43 , 45 , 45 , 46 20 45 , 47 , 47 , 49 25 latent mixture modeling was used to identify trajectories in systolic , diastolic , and mid - bp over time . 0 ###LEFT-WALL### 3 modeling 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 20 . 1 latent 3 modeling 2 mixture 3 modeling 3 modeling 4 was 4 was 5 used 5 used 6 to 5 used 7 identify 6 to 7 identify 7 identify 8 trajectories 7 identify 9 in 7 identify 18 over 9 in 14 and 10 systolic 11 , 11 , 12 diastolic 11 , 14 and 13 , 14 and 14 and 17 bp 15 mid 16 - 15 mid 17 bp 18 over 19 time main outcomes and measures : coronary artery calcification greater than or equal to agatston score of 100 hounsfield units ( hu ) at [year] 25 . 0 ###LEFT-WALL### 4 measures 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 26 . 1 main 2 outcomes 2 outcomes 3 and 3 and 4 measures 4 measures 5 : 5 : 6 coronary 5 : 23 at 6 coronary 11 or 6 coronary 15 score 6 coronary 16 of 7 artery 8 calcification 8 calcification 9 greater 8 calcification 11 or 9 greater 10 than 11 or 12 equal 11 or 13 to 11 or 15 score 13 to 14 agatston 16 of 19 units 17 100 19 units 18 hounsfield 19 units 19 units 21 hu 20 ( 21 hu 21 hu 22 ) 23 at 25 25 compared with the low - stable group , trajectories with elevated bp levels had greater odds of having a cac score of 100 hu or greater . 0 ###LEFT-WALL### 9 trajectories 0 ###LEFT-WALL### 18 having 0 ###LEFT-WALL### 27 . 1 compared 2 with 1 compared 8 , 1 compared 9 trajectories 2 with 7 group 3 the 7 group 4 low 5 - 4 low 7 group 6 stable 7 group 9 trajectories 10 with 9 trajectories 14 had 10 with 13 levels 11 elevated 13 levels 12 bp 13 levels 14 had 16 odds 15 greater 16 odds 16 odds 17 of 17 of 18 having 18 having 21 score 18 having 25 or 19 a 21 score 20 cac 21 score 21 score 22 of 22 of 23 100 24 hu 25 or 25 or 26 greater adjusted odds ratios were 1.44 ( 95 % ci , 0.83 - 2.49 ) for moderate - stable , 1.86 ( 95 % ci , 0.91 - 3.82 [ )(for moderate - increasing , 2.28 ( 95 % ci , 1.24 - 4.18 [ )(, for elevated [-] stable , [and] [3.70] ( 95 % ci , 1.66 - 8.20 ) [for] elevated - increasing groups . 1 adjusted 2 odds 2 odds 3 ratios 3 ratios 4 were 4 were 5 1.44 4 were 15 for 5 1.44 9 ci 5 1.44 12 - 6 ( 9 ci 7 95 9 ci 8 % 9 ci 9 ci 10 , 10 , 12 - 11 0.83 12 - 12 - 13 2.49 12 - 14 ) 15 for 18 stable 16 moderate 17 - 16 moderate 18 stable 18 stable 20 1.86 18 stable 27 - 19 , 20 1.86 20 1.86 24 ci 20 1.86 25 , 21 ( 24 ci 22 95 24 ci 23 % 24 ci 24 ci 25 , 25 , 27 - 26 0.91 27 - 27 - 28 3.82 28 3.82 30 )(for 30 )(for 33 increasing 31 moderate 32 - 31 moderate 33 increasing 33 increasing 35 2.28 33 increasing 42 - 34 , 35 2.28 35 2.28 39 ci 35 2.28 40 , 36 ( 39 ci 37 95 39 ci 38 % 39 ci 39 ci 40 , 40 , 42 - 41 1.24 42 - 42 - 43 4.18 43 4.18 46 for 43 4.18 55 % 45 )(, 46 for 46 for 49 stable 46 for 50 , 47 elevated 49 stable 53 ( 55 % 54 95 55 % 55 % 56 ci 55 % 63 elevated 55 % 65 increasing 55 % 67 . 56 ci 59 - 56 ci 63 elevated 57 , 59 - 58 1.66 59 - 59 - 60 8.20 59 - 61 ) 64 - 65 increasing 65 increasing 66 groups 65 increasing 67 . [the] adjusted prevalence of a cac score of 100 hu or higher was 5.8 % in the low - stable group . 0 ###LEFT-WALL### 2 adjusted 0 ###LEFT-WALL### 13 was 0 ###LEFT-WALL### 22 . 2 adjusted 11 or 2 adjusted 13 was 3 prevalence 4 of 3 prevalence 11 or 4 of 7 score 5 a 7 score 6 cac 7 score 7 score 8 of 8 of 10 hu 9 100 10 hu 11 or 12 higher 13 was 15 % 14 5.8 15 % 15 % 16 in 16 in 21 group 17 the 21 group 18 low 19 - 18 low 21 group 20 stable 21 group these odds ratios represent an absolute increase of 2.7 % , 5 % , 6.3 % , and 12.9 % for the prevalence of a cac score of 100 hu or higher for the moderate - stable , moderate - increasing , elevated - stable [and] elevated - increasing groups , respectively , compared with the low - stable group . 0 ###LEFT-WALL### 3 ratios 0 ###LEFT-WALL### 4 represent 1 these 3 ratios 2 odds 3 ratios 3 ratios 4 represent 4 represent 7 increase 5 an 6 absolute 5 an 7 increase 6 absolute 7 increase 7 increase 8 of 8 of 20 % 9 2.7 10 % 9 2.7 18 and 10 % 13 % 11 , 13 % 12 5 13 % 13 % 16 % 13 % 17 , 14 , 16 % 15 6.3 16 % 16 % 17 , 18 and 19 12.9 18 and 20 % 20 % 21 for 20 % 24 of 20 % 28 of 21 for 23 prevalence 22 the 23 prevalence 24 of 27 score 25 a 27 score 26 cac 27 score 28 of 29 100 29 100 31 or 29 100 41 increasing 30 hu 31 or 31 or 32 higher 31 or 33 for 33 for 37 stable 34 the 37 stable 35 moderate 36 - 35 moderate 37 stable 37 stable 39 moderate 38 , 39 moderate 39 moderate 40 - 41 increasing 43 elevated 41 increasing 45 stable 41 increasing 49 increasing 42 , 43 elevated 43 elevated 44 - 45 stable 47 elevated 48 - 49 increasing 49 increasing 50 groups 49 increasing 61 . 50 groups 54 compared 50 groups 55 with 51 , 52 respectively 52 respectively 53 , 52 respectively 54 compared 55 with 60 group 56 the 60 group 57 low 58 - 57 low 60 group 59 stable 60 group associations were not altered after adjustment for baseline and year 25 bp . 0 ###LEFT-WALL### 1 associations 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 13 . 1 associations 2 were 2 were 3 not 2 were 5 after 3 not 4 altered 5 after 6 adjustment 6 adjustment 7 for 7 for 9 and 8 baseline 9 and 9 and 12 bp 10 year 11 25 10 year 12 bp findings were similar for trajectories of isolated systolic bp trajectories but were attenuated for diastolic bp trajectories . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 18 . 1 findings 11 but 2 were 3 similar 2 were 11 but 3 similar 4 for 4 for 5 trajectories 5 trajectories 6 of 6 of 10 trajectories 7 isolated 10 trajectories 8 systolic 10 trajectories 9 bp 10 trajectories 11 but 12 were 12 were 13 attenuated 13 attenuated 14 for 14 for 17 trajectories 15 diastolic 17 trajectories 16 bp 17 trajectories conclusions and relevance : blood pressure trajectories throughout young adulthood vary , and higher bp trajectories were associated with an increased risk of cac in middle age . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 11 vary 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 28 . 1 conclusions 3 relevance 1 conclusions 5 blood 1 conclusions 11 vary 2 and 3 relevance 3 relevance 4 : 4 : 5 blood 5 blood 7 trajectories 5 blood 8 throughout 6 pressure 7 trajectories 8 throughout 10 adulthood 9 young 10 adulthood 12 , 13 and 13 and 16 trajectories 13 and 18 associated 14 higher 16 trajectories 15 bp 16 trajectories 16 trajectories 17 were 17 were 18 associated 18 associated 19 with 18 associated 25 in 19 with 22 risk 20 an 22 risk 21 increased 22 risk 22 risk 23 of 23 of 24 cac 25 in 27 age 26 middle 27 age long - term trajectories in bp may assist in more accurate identification of individuals with subclinical atherosclerosis . 0 ###LEFT-WALL### 4 trajectories 0 ###LEFT-WALL### 8 assist 0 ###LEFT-WALL### 18 . 1 long 2 - 1 long 3 term 3 term 4 trajectories 4 trajectories 5 in 4 trajectories 7 may 5 in 6 bp 7 may 8 assist 8 assist 9 in 8 assist 15 with 9 in 12 identification 10 more 11 accurate 11 accurate 12 identification 12 identification 13 of 13 of 14 individuals 15 with 17 atherosclerosis 16 subclinical 17 atherosclerosis recent advances [are] uncovering more and more of the genetic architecture underlying amyotrophic lateral sclerosis ( als ) , a fatal neurodegenerative condition that affects ~6,000 americans annually . 0 ###LEFT-WALL### 6 and 1 recent 2 advances 2 advances 4 uncovering 2 advances 6 and 4 uncovering 5 more 6 and 11 architecture 6 and 12 underlying 7 more 8 of 7 more 11 architecture 8 of 11 architecture 9 the 11 architecture 10 genetic 11 architecture 12 underlying 15 sclerosis 13 amyotrophic 15 sclerosis 14 lateral 15 sclerosis 15 sclerosis 17 als 15 sclerosis 23 condition 16 ( 17 als 17 als 18 ) 19 , 23 condition 20 a 21 fatal 20 a 23 condition 21 fatal 23 condition 22 neurodegenerative 23 condition 23 condition 24 that 23 condition 25 affects 23 condition 29 . 24 that 25 affects 25 affects 27 americans 25 affects 28 annually 26 ~6,000 27 americans chief among these was the discovery that a large repeat expansion in the c9orf72 gene is responsible for an unprecedented portion of familial and sporadic als cases . 0 ###LEFT-WALL### 1 chief 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 28 . 1 chief 2 among 1 chief 4 was 2 among 3 these 4 was 6 discovery 5 the 6 discovery 6 discovery 7 that 7 that 11 expansion 7 that 16 is 8 a 11 expansion 9 large 10 repeat 10 repeat 11 expansion 11 expansion 12 in 11 expansion 16 is 12 in 15 gene 13 the 15 gene 14 c9orf72 15 gene 16 is 17 responsible 17 responsible 18 for 18 for 21 portion 19 an 21 portion 20 unprecedented 21 portion 21 portion 22 of 22 of 27 cases 23 familial 24 and 24 and 25 sporadic 24 and 27 cases 26 als 27 cases much has been published on how this expansion disrupts neuronal homeostasis and how gene [-] based therapy might be an effective treatment in the future . 0 ###LEFT-WALL### 1 much 0 ###LEFT-WALL### 4 published 0 ###LEFT-WALL### 26 . 1 much 2 has 2 has 3 been 3 been 4 published 4 published 5 on 4 published 23 in 5 on 6 how 6 how 8 expansion 6 how 19 be 7 this 8 expansion 8 expansion 9 disrupts 9 disrupts 12 and 10 neuronal 11 homeostasis 11 homeostasis 12 and 12 and 13 how 12 and 17 therapy 12 and 19 be 14 gene 16 based 16 based 17 therapy 17 therapy 18 might 18 might 19 be 19 be 22 treatment 20 an 21 effective 20 an 22 treatment 21 effective 22 treatment 23 in 25 future 24 the 25 future nevertheless , it is instructive to look back at the origins of this important mutation . 0 ###LEFT-WALL### 3 it 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 16 . 1 nevertheless 2 , 1 nevertheless 3 it 3 it 4 is 4 is 5 instructive 5 instructive 6 to 6 to 7 look 7 look 8 back 8 back 9 at 9 at 11 origins 10 the 11 origins 11 origins 12 of 12 of 15 mutation 13 this 14 important 14 important 15 mutation in this opinion piece , we attempt to answer three key questions concerning c9orf72 . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 attempt 0 ###LEFT-WALL### 15 . 1 in 4 piece 1 in 5 , 1 in 6 we 2 this 4 piece 3 opinion 4 piece 6 we 7 attempt 7 attempt 8 to 7 attempt 9 answer 8 to 9 answer 9 answer 12 questions 10 three 12 questions 11 key 12 questions 12 questions 13 concerning 13 concerning 14 c9orf72 [first] [,] how many times did the expansion occur throughout human history ? 0 ###LEFT-WALL### 3 how 0 ###LEFT-WALL### 9 occur 0 ###LEFT-WALL### 13 ? 3 how 4 many 4 many 5 times 5 times 6 did 6 did 8 expansion 6 did 9 occur 7 the 8 expansion 9 occur 10 throughout 10 throughout 12 history 11 human 12 history [second] [,] how old is the expansion ? 0 ###LEFT-WALL### 3 how 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 8 ? 3 how 4 old 4 old 5 is 5 is 7 expansion 6 the 7 expansion and finally [and] perhaps most importantly [,] [how] did the expansion spread throughout europe ? 0 ###LEFT-WALL### 1 and 0 ###LEFT-WALL### 15 ? 1 and 2 finally 1 and 5 most 1 and 9 did 4 perhaps 5 most 5 most 9 did 6 importantly 9 did 9 did 11 expansion 10 the 11 expansion 11 expansion 12 spread 12 spread 13 throughout 13 throughout 14 europe we speculate that the expansion occurred only once in the past , that [this] event took place in the finnish population and that the vikings and their descendants were responsible for disseminating this mutation throughout the rest of the continent . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 speculate 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 32 disseminating 0 ###LEFT-WALL### 41 . 1 we 2 speculate 2 speculate 3 that 3 that 5 expansion 3 that 6 occurred 4 the 5 expansion 5 expansion 6 occurred 6 occurred 7 only 6 occurred 8 once 8 once 9 in 9 in 11 past 10 the 11 past 12 , 15 event 12 , 17 place 13 that 15 event 15 event 17 place 16 took 17 place 17 place 18 in 18 in 22 and 19 the 21 population 20 finnish 21 population 21 population 22 and 22 and 23 that 22 and 26 and 22 and 32 disseminating 24 the 25 vikings 25 vikings 26 and 26 and 28 descendants 26 and 29 were 27 their 28 descendants 29 were 30 responsible 30 responsible 31 for 31 for 32 disseminating 32 disseminating 34 mutation 32 disseminating 35 throughout 32 disseminating 37 rest 33 this 34 mutation 36 the 37 rest 37 rest 38 of 38 of 40 continent 39 the 40 continent introduction : the objectives of this study were to study the age - specific activation patterns of cerebral areas during motor execution ( me ) and motor imaging ( mi ) of the upper extremities and to discuss the age - related neural mechanisms associated with me or mi . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 50 . 2 : 4 objectives 2 : 8 were 2 : 13 - 3 the 4 objectives 4 objectives 5 of 4 objectives 8 were 5 of 7 study 6 this 7 study 8 were 9 to 9 to 10 study 10 study 12 age 11 the 12 age 13 - 16 patterns 13 - 36 and 14 specific 16 patterns 15 activation 16 patterns 16 patterns 17 of 16 patterns 32 of 17 of 26 and 18 cerebral 19 areas 19 areas 20 during 19 areas 26 and 20 during 22 execution 21 motor 22 execution 22 execution 24 me 23 ( 24 me 24 me 25 ) 26 and 28 imaging 26 and 30 mi 27 motor 28 imaging 29 ( 30 mi 30 mi 31 ) 32 of 35 extremities 33 the 35 extremities 34 upper 35 extremities 36 and 44 mechanisms 36 and 45 associated 37 to 38 discuss 37 to 41 - 37 to 44 mechanisms 38 discuss 40 age 39 the 40 age 42 related 44 mechanisms 43 neural 44 mechanisms 44 mechanisms 45 associated 45 associated 46 with 46 with 48 or 47 me 48 or 48 or 49 mi results : no major differences were identified regarding the activated brain areas during me or mi between the two groups ; however , a minor difference was noted . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 ; 0 ###LEFT-WALL### 29 . 1 results 2 : 2 : 4 major 2 : 13 during 2 : 17 between 3 no 4 major 4 major 5 differences 4 major 6 were 4 major 7 identified 4 major 8 regarding 5 differences 6 were 8 regarding 12 areas 9 the 12 areas 10 activated 11 brain 11 brain 12 areas 13 during 15 or 14 me 15 or 15 or 16 mi 17 between 20 groups 18 the 19 two 19 two 20 groups 21 ; 26 difference 21 ; 27 was 22 however 23 , 22 however 26 difference 24 a 26 difference 25 minor 26 difference 26 difference 27 was 27 was 28 noted the intensity of the activated brain area during me was stronger in the older group than in the younger group , while the results with mi were the opposite . 0 ###LEFT-WALL### 2 intensity 0 ###LEFT-WALL### 10 was 1 the 2 intensity 2 intensity 3 of 2 intensity 10 was 3 of 7 area 4 the 7 area 5 activated 6 brain 6 brain 7 area 7 area 8 during 8 during 9 me 10 was 11 stronger 11 stronger 12 in 11 stronger 16 than 11 stronger 22 while 12 in 15 group 13 the 15 group 14 older 15 group 16 than 17 in 17 in 20 group 18 the 20 group 19 younger 20 group 21 , 22 while 22 while 24 results 22 while 27 were 22 while 30 . 23 the 24 results 24 results 25 with 24 results 27 were 25 with 26 mi 27 were 29 opposite 28 the 29 opposite the posterior central gyrus and supplementary motor area during mi were more active in the younger group than in the older group . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 23 . 1 the 4 gyrus 2 posterior 4 gyrus 3 central 4 gyrus 4 gyrus 5 and 5 and 8 area 5 and 9 during 5 and 11 were 6 supplementary 7 motor 7 motor 8 area 9 during 10 mi 11 were 12 more 11 were 13 active 13 active 14 in 13 active 18 than 14 in 17 group 15 the 17 group 16 younger 17 group 18 than 19 in 19 in 22 group 20 the 22 group 21 older 22 group the putamen , lingual , and so on demonstrated stronger activation during dominant hand mi in the older group . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 demonstrated 0 ###LEFT-WALL### 20 . 1 the 2 putamen 2 putamen 3 , 3 , 4 lingual 3 , 6 and 5 , 6 and 6 and 8 on 6 and 9 demonstrated 7 so 8 on 9 demonstrated 11 activation 9 demonstrated 12 during 9 demonstrated 16 in 10 stronger 11 activation 12 during 15 mi 13 dominant 14 hand 14 hand 15 mi 16 in 19 group 17 the 19 group 18 older 19 group conclusion : the results of this study revealed that the brain structure was altered and that neuronal activity was attenuated with age , and the cerebral cortex and subcortical tissues were found to be over - activated to achieve the same level of me and mi , indicating that the activating effects of the left hemisphere enhanced with age , whereas the inhibitory effects declined during me , and activation of the right hemisphere became more difficult during mi . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 80 . 1 conclusion 2 : 2 : 4 results 3 the 4 results 4 results 5 of 5 of 7 study 6 this 7 study 7 study 8 revealed 7 study 9 that 7 study 14 altered 9 that 11 brain 9 that 14 altered 10 the 11 brain 11 brain 12 structure 11 brain 13 was 11 brain 14 altered 12 structure 13 was 15 and 18 activity 15 and 20 attenuated 16 that 18 activity 17 neuronal 18 activity 18 activity 19 was 19 was 20 attenuated 20 attenuated 21 with 21 with 28 and 21 with 32 found 22 age 24 and 23 , 24 and 24 and 27 cortex 24 and 28 and 25 the 27 cortex 26 cerebral 27 cortex 28 and 29 subcortical 28 and 30 tissues 28 and 31 were 30 tissues 31 were 32 found 33 to 32 found 37 activated 32 found 61 whereas 33 to 34 be 34 be 35 over 36 - 37 activated 37 activated 38 to 37 activated 58 with 37 activated 60 , 38 to 39 achieve 39 achieve 42 level 40 the 41 same 41 same 42 level 42 level 43 of 42 level 48 indicating 42 level 57 enhanced 43 of 45 and 44 me 45 and 45 and 46 mi 45 and 47 , 48 indicating 49 that 49 that 52 effects 49 that 57 enhanced 50 the 52 effects 51 activating 52 effects 52 effects 53 of 52 effects 57 enhanced 53 of 56 hemisphere 54 the 56 hemisphere 55 left 56 hemisphere 58 with 59 age 61 whereas 69 and 61 whereas 75 became 62 the 64 effects 63 inhibitory 64 effects 64 effects 65 declined 64 effects 66 during 64 effects 69 and 66 during 67 me 68 , 69 and 69 and 70 activation 69 and 71 of 69 and 75 became 71 of 74 hemisphere 72 the 74 hemisphere 73 right 74 hemisphere 75 became 77 difficult 76 more 77 difficult 77 difficult 78 during 78 during 79 mi a groundbreaking publication by sinclair and coworkers has illuminated the pseudo - hypoxic state in aging and its reversibility . 0 ###LEFT-WALL### 3 publication 0 ###LEFT-WALL### 9 illuminated 0 ###LEFT-WALL### 20 . 1 a 3 publication 2 groundbreaking 3 publication 3 publication 4 by 3 publication 8 has 4 by 6 and 5 sinclair 6 and 6 and 7 coworkers 8 has 9 illuminated 9 illuminated 17 and 10 the 14 state 11 pseudo 12 - 11 pseudo 14 state 13 hypoxic 14 state 14 state 15 in 14 state 17 and 15 in 16 aging 17 and 19 reversibility 18 its 19 reversibility remarkably , these data also fit the mtor - centered model of aging . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 6 fit 0 ###LEFT-WALL### 14 . 1 remarkably 2 , 1 remarkably 4 data 3 these 4 data 4 data 6 fit 5 also 6 fit 6 fit 11 model 7 the 11 model 8 mtor 9 - 8 mtor 11 model 10 centered 11 model 11 model 12 of 12 of 13 aging here we discuss [that] the mtor pathway can cause cellular pseudo - hypoxic state , manifested by hif - 1 expression and lactate production under normoxia . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 27 . 1 here 2 we 2 we 15 , 3 discuss 14 state 3 discuss 15 , 5 the 14 state 6 mtor 14 state 7 pathway 14 state 8 can 14 state 9 cause 14 state 10 cellular 14 state 11 pseudo 12 - 11 pseudo 14 state 13 hypoxic 14 state 15 , 22 and 15 , 25 under 16 manifested 17 by 16 manifested 21 expression 16 manifested 22 and 17 by 18 hif 19 - 20 1 20 1 21 expression 22 and 23 lactate 23 lactate 24 production 25 under 26 normoxia we found that rapamycin decreased hif - 1 and lactate levels in proliferating and senescent cells in vitro . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 19 . 1 we 9 and 2 found 6 hif 2 found 8 1 2 found 9 and 3 that 6 hif 4 rapamycin 5 decreased 5 decreased 6 hif 7 - 8 1 9 and 10 lactate 10 lactate 14 and 10 lactate 18 vitro 11 levels 12 in 11 levels 14 and 12 in 13 proliferating 14 and 16 cells 15 senescent 16 cells 17 in 18 vitro this reduction was independent from mitochondrial respiration : rapamycin decreased [lactate] production in normoxia , hypoxia , and in the presence of the oxphos inhibitor oligomycin . 0 ###LEFT-WALL### 2 reduction 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 8 : 1 this 2 reduction 2 reduction 3 was 3 was 4 independent 4 independent 5 from 5 from 7 respiration 6 mitochondrial 7 respiration 8 : 9 rapamycin 8 : 10 decreased 8 : 27 . 9 rapamycin 10 decreased 10 decreased 12 production 12 production 18 and 13 in 16 hypoxia 13 in 18 and 14 normoxia 15 , 14 normoxia 16 hypoxia 17 , 18 and 18 and 19 in 19 in 21 presence 20 the 21 presence 21 presence 22 of 22 of 26 oligomycin 23 the 26 oligomycin 24 oxphos 26 oligomycin 25 inhibitor 26 oligomycin we suggest that pseudo - hypoxic state is not necessarily caused by mitochondrial dysfunction , but instead mitochondrial dysfunction may be secondary to mtor - driven hyperfunctions . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 suggest 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 28 . 1 we 2 suggest 2 suggest 7 state 2 suggest 11 caused 3 that 7 state 4 pseudo 5 - 4 pseudo 7 state 6 hypoxic 7 state 7 state 8 is 8 is 9 not 8 is 11 caused 10 necessarily 11 caused 11 caused 12 by 12 by 14 dysfunction 13 mitochondrial 14 dysfunction 15 , 16 but 16 but 17 instead 16 but 19 dysfunction 16 but 21 be 18 mitochondrial 19 dysfunction 19 dysfunction 20 may 20 may 21 be 21 be 22 secondary 22 secondary 23 to 23 to 27 hyperfunctions 24 mtor 25 - 24 mtor 27 hyperfunctions 26 driven 27 hyperfunctions clinical applications of rapamycin for reversing pseudo - hypoxic state [and] [lactate] acidosis are discussed . 0 ###LEFT-WALL### 2 applications 0 ###LEFT-WALL### 15 discussed 0 ###LEFT-WALL### 16 . 1 clinical 2 applications 2 applications 3 of 2 applications 14 are 3 of 4 rapamycin 4 rapamycin 5 for 5 for 6 reversing 6 reversing 13 acidosis 7 pseudo 8 - 7 pseudo 10 state 9 hypoxic 10 state 10 state 13 acidosis 14 are 15 discussed aging is a common risk factor of many disorders . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 10 . 1 aging 2 is 2 is 6 factor 3 a 4 common 3 a 6 factor 4 common 6 factor 5 risk 6 factor 6 factor 7 of 7 of 9 disorders 8 many 9 disorders with age , the level of insoluble extracellular matrix increases leading [to] increased stiffness of a number of tissues . 0 ###LEFT-WALL### 5 level 0 ###LEFT-WALL### 13 increased 0 ###LEFT-WALL### 20 . 1 with 2 age 1 with 3 , 1 with 5 level 4 the 5 level 5 level 6 of 5 level 13 increased 6 of 10 increases 7 insoluble 9 matrix 8 extracellular 9 matrix 9 matrix 10 increases 10 increases 11 leading 13 increased 14 stiffness 14 stiffness 15 of 15 of 19 tissues 16 a 17 number 17 number 18 of 17 number 19 tissues 18 of 19 tissues matrix accumulation can also be observed in fibrotic disorders , such as systemic sclerosis ( ssc ) . 0 ###LEFT-WALL### 2 accumulation 0 ###LEFT-WALL### 6 observed 0 ###LEFT-WALL### 18 . 1 matrix 2 accumulation 2 accumulation 3 can 3 can 5 be 4 also 5 be 5 be 6 observed 6 observed 7 in 7 in 9 disorders 8 fibrotic 9 disorders 9 disorders 12 as 10 , 12 as 11 such 12 as 12 as 14 sclerosis 12 as 17 ) 13 systemic 14 sclerosis 14 sclerosis 16 ssc 15 ( 16 ssc 16 ssc 17 ) although the intrinsic aging process in skin is phenotypically distinct from ssc , here we demonstrate similar behavior of aged and ssc skin fibroblasts in culture . 0 ###LEFT-WALL### 15 we 0 ###LEFT-WALL### 16 demonstrate 0 ###LEFT-WALL### 27 . 1 although 5 process 1 although 8 is 1 although 13 , 1 although 15 we 2 the 5 process 3 intrinsic 5 process 4 aging 5 process 5 process 6 in 5 process 8 is 6 in 7 skin 8 is 9 phenotypically 8 is 10 distinct 10 distinct 11 from 11 from 12 ssc 14 here 15 we 15 we 16 demonstrate 16 demonstrate 18 behavior 17 similar 18 behavior 18 behavior 19 of 18 behavior 25 in 19 of 24 fibroblasts 20 aged 21 and 21 and 22 ssc 21 and 23 skin 23 skin 24 fibroblasts 25 in 26 culture we have used quantitative proteomics to characterize the phenotype of dermal fibroblasts from healthy subjects of various ages and from patients with ssc . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 used 0 ###LEFT-WALL### 24 . 1 we 2 have 2 have 3 used 3 used 5 proteomics 3 used 6 to 3 used 7 characterize 4 quantitative 5 proteomics 6 to 7 characterize 7 characterize 9 phenotype 7 characterize 22 with 8 the 9 phenotype 9 phenotype 10 of 10 of 12 fibroblasts 11 dermal 12 fibroblasts 12 fibroblasts 19 and 13 from 15 subjects 13 from 19 and 14 healthy 15 subjects 15 subjects 16 of 16 of 18 ages 17 various 18 ages 19 and 20 from 20 from 21 patients 22 with 23 ssc our results demonstrate that proteins involved in dna and rna processing decrease with age and in ssc , whereas those involved in mitochondrial and other metabolic processes behave the opposite . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 28 behave 0 ###LEFT-WALL### 31 . 1 our 2 results 2 results 3 demonstrate 3 demonstrate 4 that 4 that 5 proteins 4 that 6 involved 5 proteins 6 involved 6 involved 7 in 6 involved 11 processing 7 in 10 rna 8 dna 9 and 9 and 10 rna 11 processing 12 decrease 11 processing 19 whereas 12 decrease 15 and 13 with 14 age 13 with 15 and 15 and 16 in 16 in 17 ssc 18 , 19 whereas 19 whereas 20 those 20 those 21 involved 20 those 22 in 20 those 28 behave 22 in 24 and 23 mitochondrial 24 and 24 and 27 processes 25 other 27 processes 26 metabolic 27 processes 28 behave 30 opposite 29 the 30 opposite specifically , minichromosome [maintenance] ( mcm ) helicase proteins are less abundant with age and ssc , and they exhibit an altered subcellular distribution . 0 ###LEFT-WALL### 9 proteins 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 25 . 1 specifically 2 , 1 specifically 9 proteins 3 minichromosome 6 mcm 3 minichromosome 8 helicase 5 ( 6 mcm 6 mcm 7 ) 8 helicase 9 proteins 9 proteins 10 are 10 are 12 abundant 11 less 12 abundant 12 abundant 13 with 13 with 15 and 14 age 15 and 15 and 16 ssc 17 , 18 and 18 and 19 they 18 and 20 exhibit 19 they 20 exhibit 20 exhibit 24 distribution 21 an 24 distribution 22 altered 24 distribution 23 subcellular 24 distribution we observed that lower levels of mcm7 correlate with reduced cell proliferation [,] lower autophagic capacity , and higher intracellular protein abundance phenotypes of aged and ssc cells . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 observed 0 ###LEFT-WALL### 29 . 1 we 2 observed 2 observed 3 that 3 that 5 levels 3 that 8 correlate 4 lower 5 levels 5 levels 6 of 5 levels 8 correlate 6 of 7 mcm7 8 correlate 9 with 9 with 21 protein 10 reduced 11 cell 11 cell 16 capacity 12 proliferation 16 capacity 14 lower 16 capacity 15 autophagic 16 capacity 16 capacity 18 and 17 , 18 and 18 and 19 higher 18 and 21 protein 20 intracellular 21 protein 21 protein 22 abundance 21 protein 23 phenotypes 21 protein 24 of 22 abundance 23 phenotypes 24 of 26 and 25 aged 26 and 26 and 28 cells 27 ssc 28 cells in addition , we show that ssc fibroblasts exhibit higher levels of senescence compared with their healthy counterparts , suggesting further similarities between the fibrotic disorder and the aging process . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 show 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 31 . 1 in 2 addition 1 in 3 , 1 in 4 we 4 we 5 show 5 show 6 that 6 that 8 fibroblasts 6 that 9 exhibit 7 ssc 8 fibroblasts 8 fibroblasts 9 exhibit 9 exhibit 11 levels 9 exhibit 15 with 10 higher 11 levels 11 levels 12 of 12 of 13 senescence 13 senescence 14 compared 15 with 18 counterparts 16 their 18 counterparts 17 healthy 18 counterparts 19 , 27 and 20 suggesting 22 similarities 21 further 22 similarities 22 similarities 23 between 22 similarities 27 and 23 between 26 disorder 24 the 26 disorder 25 fibrotic 26 disorder 27 and 30 process 28 the 30 process 29 aging 30 process hence , at the molecular level , ssc fibroblasts exhibit intrinsic characteristics of fibroblasts from aged skin . 0 ###LEFT-WALL### 9 fibroblasts 0 ###LEFT-WALL### 10 exhibit 0 ###LEFT-WALL### 18 . 1 hence 2 , 1 hence 9 fibroblasts 2 , 3 at 3 at 6 level 3 at 7 , 3 at 9 fibroblasts 4 the 6 level 5 molecular 6 level 8 ssc 9 fibroblasts 9 fibroblasts 10 exhibit 10 exhibit 12 characteristics 11 intrinsic 12 characteristics 12 characteristics 13 of 13 of 14 fibroblasts 14 fibroblasts 15 from 15 from 17 skin 16 aged 17 skin purpose of review : there is a growing burden of end - stage cardiovascular disease in the aging western world and a need to improve access to best evidence - based care , including patients located in rural areas . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 11 end 0 ###LEFT-WALL### 12 - 1 purpose 2 of 1 purpose 10 of 1 purpose 11 end 2 of 3 review 2 of 4 : 2 of 6 is 3 review 4 : 4 : 5 there 6 is 9 burden 7 a 9 burden 8 growing 9 burden 9 burden 10 of 12 - 21 and 12 - 28 best 12 - 30 - 12 - 40 . 13 stage 15 disease 14 cardiovascular 15 disease 15 disease 16 in 15 disease 21 and 16 in 20 world 17 the 20 world 18 aging 20 world 19 western 20 world 21 and 23 need 21 and 24 to 21 and 27 to 21 and 28 best 22 a 23 need 24 to 25 improve 25 improve 26 access 25 improve 27 to 28 best 29 evidence 30 - 32 care 30 - 33 , 31 based 32 care 33 , 34 including 33 , 36 located 34 including 35 patients 34 including 36 located 36 located 37 in 37 in 39 areas 38 rural 39 areas recent findings : disparities are evident within rural settings for patients with cardiovascular disease . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 recent 2 findings 3 : 4 disparities 3 : 5 are 3 : 15 . 4 disparities 5 are 5 are 6 evident 6 evident 7 within 6 evident 12 with 7 within 9 settings 8 rural 9 settings 9 settings 10 for 10 for 11 patients 12 with 14 disease 13 cardiovascular 14 disease useful guidelines exist to guide clinical services integration . 0 ###LEFT-WALL### 2 guidelines 0 ###LEFT-WALL### 3 exist 0 ###LEFT-WALL### 9 . 1 useful 2 guidelines 2 guidelines 3 exist 3 exist 4 to 4 to 5 guide 5 guide 8 integration 6 clinical 7 services 7 services 8 integration palliative care and cardiac services need to integrate their services defining the primary care lead with heart failure nurses coordinating . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 need 1 palliative 2 care 2 care 3 and 3 and 5 services 3 and 6 need 4 cardiac 5 services 6 need 7 to 6 need 21 . 7 to 8 integrate 8 integrate 10 services 8 integrate 16 with 9 their 10 services 10 services 11 defining 11 defining 15 lead 12 the 15 lead 13 primary 14 care 14 care 15 lead 16 with 17 heart 17 heart 18 failure 17 heart 19 nurses 18 failure 19 nurses 19 nurses 20 coordinating earlier communication around disease implications , symptom burden and objectives of care feed into the integrated model [for] best and agreed outcomes to be achieved . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 26 . 1 earlier 2 communication 2 communication 3 around 2 communication 6 , 3 around 5 implications 4 disease 5 implications 6 , 8 burden 6 , 9 and 7 symptom 8 burden 9 and 10 objectives 9 and 11 of 9 and 20 and 11 of 12 care 13 feed 14 into 13 feed 19 best 13 feed 20 and 14 into 17 model 15 the 17 model 16 integrated 17 model 20 and 21 agreed 20 and 23 to 21 agreed 22 outcomes 23 to 24 be 24 be 25 achieved telehealth can assist a rural population when it is part of that integrated care model but more research on telemonitoring is required before conclusions can be drawn on the role of this expensive technology . 0 ###LEFT-WALL### 1 telehealth 0 ###LEFT-WALL### 3 assist 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 35 . 1 telehealth 2 can 2 can 3 assist 3 assist 6 population 4 a 5 rural 4 a 6 population 5 rural 6 population 6 population 7 when 6 population 11 of 7 when 8 it 7 when 10 part 8 it 9 is 9 is 10 part 11 of 15 model 12 that 15 model 13 integrated 14 care 14 care 15 model 16 but 18 research 16 but 22 required 17 more 18 research 18 research 19 on 18 research 21 is 19 on 20 telemonitoring 21 is 22 required 22 required 23 before 22 required 28 on 23 before 24 conclusions 23 before 27 drawn 24 conclusions 25 can 25 can 26 be 26 be 27 drawn 28 on 30 role 29 the 30 role 30 role 31 of 31 of 34 technology 32 this 34 technology 33 expensive 34 technology individual care plans can assist all involved . 0 ###LEFT-WALL### 3 plans 0 ###LEFT-WALL### 5 assist 0 ###LEFT-WALL### 8 . 1 individual 2 care 2 care 3 plans 3 plans 4 can 4 can 5 assist 5 assist 6 all 6 all 7 involved subcutaneous furosemide may play a part in keeping a patient at home and with good palliative care the place of death can be the patient 's home , if that is desired . 0 ###LEFT-WALL### 2 furosemide 0 ###LEFT-WALL### 4 play 0 ###LEFT-WALL### 13 and 1 subcutaneous 2 furosemide 2 furosemide 3 may 3 may 4 play 4 play 6 part 5 a 6 part 6 part 7 in 7 in 8 keeping 8 keeping 10 patient 8 keeping 11 at 9 a 10 patient 11 at 12 home 13 and 19 place 13 and 23 be 14 with 17 care 14 with 19 place 15 good 16 palliative 16 palliative 17 care 18 the 19 place 19 place 20 of 19 place 22 can 20 of 21 death 22 can 23 be 23 be 27 home 23 be 29 if 24 the 25 patient 25 patient 26 's 26 's 27 home 28 , 29 if 29 if 30 that 29 if 32 desired 29 if 33 . 30 that 31 is 31 is 32 desired 32 desired 33 . summary : rural patients with end [-] stage heart failure can be well supported at home as long as the model of care is united to support them . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 be 0 ###LEFT-WALL### 29 . 2 : 12 be 3 rural 4 patients 4 patients 5 with 4 patients 11 can 5 with 10 failure 6 end 8 stage 8 stage 9 heart 9 heart 10 failure 11 can 12 be 12 be 13 well 12 be 14 supported 14 supported 15 at 14 supported 18 long 15 at 16 home 17 as 18 long 18 long 19 as 18 long 26 to 18 long 27 support 19 as 21 model 19 as 24 is 19 as 25 united 20 the 21 model 21 model 22 of 21 model 24 is 22 of 23 care 26 to 27 support 27 support 28 them this includes heart failure nurse coordination based in the cardiac team , palliative care and general practice support . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 includes 0 ###LEFT-WALL### 19 . 1 this 2 includes 2 includes 6 coordination 2 includes 8 in 3 heart 6 coordination 4 failure 6 coordination 5 nurse 6 coordination 6 coordination 7 based 8 in 15 and 9 the 11 team 10 cardiac 11 team 11 team 12 , 12 , 14 care 12 , 15 and 13 palliative 14 care 15 and 18 support 16 general 17 practice 17 practice 18 support chronic inflammation and increased oxidative stress are underlying the uremia - associated immune deficiency . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 15 . 1 chronic 2 inflammation 2 inflammation 3 and 3 and 6 stress 3 and 7 are 4 increased 6 stress 5 oxidative 6 stress 7 are 8 underlying 8 underlying 14 deficiency 9 the 14 deficiency 10 uremia 11 - 10 uremia 14 deficiency 12 associated 14 deficiency 13 immune 14 deficiency summary : in this review , the differential impact of uremia on the cellular immune system is summarized . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 19 . 1 summary 2 : 2 : 3 in 3 in 5 review 4 this 5 review 6 , 9 impact 6 , 18 summarized 7 the 9 impact 8 differential 9 impact 9 impact 10 of 9 impact 17 is 10 of 11 uremia 11 uremia 12 on 12 on 16 system 13 the 16 system 14 cellular 16 system 15 immune 16 system 17 is 18 summarized virtually all immune cells studied show a combination of [an] activated status and loss of function . 0 ###LEFT-WALL### 2 all 0 ###LEFT-WALL### 16 function 0 ###LEFT-WALL### 17 . 1 virtually 2 all 2 all 4 cells 2 all 15 of 2 all 16 function 3 immune 4 cells 4 cells 5 studied 4 cells 6 show 6 show 8 combination 7 a 8 combination 8 combination 9 of 9 of 13 and 11 activated 12 status 12 status 13 and 13 and 14 loss 13 and 15 of however , uremia preferentially decreases the number and function of lymphoid cells while myeloid cells show normal [and/or] elevated cell numbers with increased production of inflammatory cytokines and reactive oxygen species . 0 ###LEFT-WALL### 3 uremia 0 ###LEFT-WALL### 5 decreases 0 ###LEFT-WALL### 32 . 1 however 2 , 1 however 3 uremia 3 uremia 5 decreases 4 preferentially 5 decreases 5 decreases 8 and 5 decreases 13 while 6 the 7 number 7 number 8 and 8 and 9 function 8 and 10 of 10 of 12 cells 11 lymphoid 12 cells 13 while 15 cells 13 while 16 show 14 myeloid 15 cells 15 cells 16 show 16 show 21 numbers 16 show 22 with 17 normal 20 cell 19 elevated 20 cell 20 cell 21 numbers 22 with 28 and 23 increased 24 production 24 production 25 of 24 production 28 and 25 of 27 cytokines 26 inflammatory 27 cytokines 28 and 31 species 29 reactive 30 oxygen 30 oxygen 31 species these particular changes are compatible with immunological aging , which is characterized by loss of thymic function [,] attrition of telomeres and an expanded memory t cell population . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 29 . 1 these 3 changes 2 particular 3 changes 3 changes 4 are 4 are 5 compatible 5 compatible 6 with 6 with 8 aging 7 immunological 8 aging 9 , 10 which 9 , 12 characterized 10 which 11 is 11 is 12 characterized 12 characterized 13 by 13 by 22 and 14 loss 15 of 14 loss 22 and 15 of 19 attrition 16 thymic 17 function 17 function 19 attrition 19 attrition 20 of 20 of 21 telomeres 22 and 28 population 23 an 28 population 24 expanded 25 memory 25 memory 26 t 25 memory 28 population 27 cell 28 population similar to aging in healthy individuals , the proinflammatory and potential cardiotoxic subsets of cd28 ( null ) [t] cells and cd16 [(] [+] ) monocytes are increased . 0 ###LEFT-WALL### 13 subsets 0 ###LEFT-WALL### 28 increased 0 ###LEFT-WALL### 29 . 1 similar 2 to 1 similar 7 , 1 similar 13 subsets 2 to 3 aging 3 aging 4 in 4 in 6 individuals 5 healthy 6 individuals 8 the 13 subsets 9 proinflammatory 10 and 10 and 11 potential 10 and 13 subsets 12 cardiotoxic 13 subsets 13 subsets 14 of 13 subsets 27 are 14 of 26 monocytes 15 cd28 21 and 15 cd28 26 monocytes 16 ( 21 and 17 null 18 ) 17 null 20 cells 20 cells 21 and 21 and 22 cd16 21 and 25 ) 27 are 28 increased epigenetically changed hematopoietic stem cells may be involved in immunological aging as specific dna regions become hypermethylated . 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 18 . 1 epigenetically 2 changed 2 changed 5 cells 3 hematopoietic 5 cells 4 stem 5 cells 5 cells 6 may 6 may 7 be 7 be 8 involved 8 involved 9 in 9 in 15 regions 10 immunological 15 regions 11 aging 15 regions 12 as 13 specific 13 specific 15 regions 14 dna 15 regions 15 regions 16 become 15 regions 17 hypermethylated proinflammatory t cells and monocytes persist after kidney transplantation , which constitutes a persistent cardiovascular risk factor . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 persist 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 18 . 1 proinflammatory 2 t 1 proinflammatory 3 cells 3 cells 4 and 4 and 5 monocytes 4 and 6 persist 6 persist 7 after 7 after 9 transplantation 8 kidney 9 transplantation 10 , 11 which 10 , 12 constitutes 11 which 12 constitutes 12 constitutes 17 factor 13 a 14 persistent 13 a 17 factor 14 persistent 17 factor 15 cardiovascular 17 factor 16 risk 17 factor possible therapeutic options to reverse or halt uremia - associated immunological aging are discussed . 0 ###LEFT-WALL### 3 options 0 ###LEFT-WALL### 14 discussed 0 ###LEFT-WALL### 15 . 1 possible 3 options 2 therapeutic 3 options 3 options 4 to 3 options 13 are 4 to 6 or 5 reverse 6 or 6 or 8 uremia 6 or 9 - 6 or 10 associated 6 or 12 aging 7 halt 8 uremia 10 associated 11 immunological 13 are 14 discussed key messages : premature aging of the immune system is a dominant feature in patients with end - stage renal failure , which corresponds to immunological aging in elderly healthy individuals , [which] is characterized by preferential loss of cells belonging to the lymphoid cell lineage , inflammation and expansion of proinflammatory immune cells . 0 ###LEFT-WALL### 2 messages 0 ###LEFT-WALL### 3 : 1 key 2 messages 3 : 4 premature 4 premature 5 aging 4 premature 6 of 4 premature 10 is 6 of 9 system 7 the 9 system 8 immune 9 system 10 is 13 feature 11 a 12 dominant 11 a 13 feature 12 dominant 13 feature 13 feature 14 in 13 feature 21 failure 13 feature 23 which 14 in 15 patients 15 patients 16 with 16 with 17 end 18 - 21 failure 19 stage 21 failure 20 renal 21 failure 21 failure 22 , 22 , 23 which 23 which 32 , 24 corresponds 25 to 24 corresponds 32 , 25 to 27 aging 26 immunological 27 aging 27 aging 28 in 28 in 31 individuals 29 elderly 31 individuals 30 healthy 31 individuals 32 , 34 is 32 , 41 belonging 34 is 35 characterized 35 characterized 36 by 36 by 38 loss 37 preferential 38 loss 38 loss 39 of 39 of 40 cells 41 belonging 42 to 41 belonging 49 and 42 to 46 lineage 43 the 46 lineage 44 lymphoid 45 cell 45 cell 46 lineage 47 , 49 and 48 inflammation 49 and 49 and 50 expansion 49 and 51 of 49 and 55 . 51 of 54 cells 52 proinflammatory 54 cells 53 immune 54 cells objective : this study was designed to examine the age and sex distribution and the effects of [menopause] in a large cohort of participants diagnosed with benign paroxysmal positional vertigo ( bppv ) . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 8 examine 2 : 34 . 3 this 4 study 4 study 5 was 5 was 6 designed 6 designed 7 to 7 to 8 examine 8 examine 14 and 9 the 10 age 10 age 11 and 11 and 13 distribution 11 and 14 and 12 sex 13 distribution 14 and 16 effects 14 and 17 of 15 the 16 effects 17 of 19 in 19 in 22 cohort 20 a 22 cohort 21 large 22 cohort 22 cohort 23 of 23 of 24 participants 24 participants 25 diagnosed 25 diagnosed 26 with 26 with 30 vertigo 27 benign 30 vertigo 28 paroxysmal 30 vertigo 29 positional 30 vertigo 30 vertigo 32 bppv 31 ( 32 bppv 32 bppv 33 ) methods : we analyzed 1,377 bppv patients and surveyed 935 women from this group - all diagnosed at the boys town national research hospital in the last decade . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 diagnosed 0 ###LEFT-WALL### 29 . 2 : 3 we 2 : 8 and 3 we 8 and 4 analyzed 7 patients 4 analyzed 8 and 5 1,377 7 patients 6 bppv 7 patients 8 and 9 surveyed 8 and 12 from 9 surveyed 11 women 10 935 11 women 12 from 14 group 13 this 14 group 14 group 16 all 14 group 17 diagnosed 15 - 16 all 16 all 17 diagnosed 17 diagnosed 18 at 18 at 24 hospital 19 the 24 hospital 20 boys 21 town 21 town 22 national 22 national 23 research 23 research 24 hospital 24 hospital 25 in 25 in 28 decade 26 the 27 last 26 the 28 decade the latter is a novel finding and was confirmed by a direct survey of female bppv patients ( 168 [participated] ) . 0 ###LEFT-WALL### 2 latter 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 22 . 1 the 2 latter 2 latter 7 and 3 is 6 finding 3 is 7 and 4 a 5 novel 4 a 6 finding 5 novel 6 finding 7 and 8 was 7 and 10 by 8 was 9 confirmed 10 by 13 survey 11 a 12 direct 11 a 13 survey 12 direct 13 survey 13 survey 14 of 14 of 17 patients 15 female 17 patients 16 bppv 17 patients 17 patients 19 168 18 ( 19 168 19 168 21 ) in addition , there was a pronounced female preponderance ( 6.8:1 [female] - to [-] male [ratio] ) [in] bppv in the teenage group despite its low prevalence in this age group . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 13 - 1 in 2 addition 1 in 3 , 1 in 4 there 4 there 5 was 5 was 9 preponderance 6 a 9 preponderance 7 pronounced 9 preponderance 8 female 9 preponderance 9 preponderance 11 6.8:1 10 ( 11 6.8:1 11 6.8:1 13 - 13 - 24 group 13 - 33 . 14 to 20 bppv 14 to 24 group 16 male 18 ) 16 male 20 bppv 20 bppv 21 in 21 in 23 teenage 22 the 23 teenage 24 group 25 despite 24 group 28 prevalence 24 group 29 in 25 despite 27 low 26 its 27 low 29 in 32 group 30 this 32 group 31 age 32 group conclusions : data suggest that hormonal fluctuations [(] especially [during] [menopause] [ )(may increase the tendency to develop bppv . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 4 suggest 2 : 20 . 3 data 4 suggest 4 suggest 5 that 5 that 7 fluctuations 5 that 14 increase 6 hormonal 7 fluctuations 7 fluctuations 13 )(may 9 especially 13 )(may 13 )(may 14 increase 14 increase 16 tendency 14 increase 17 to 15 the 16 tendency 17 to 18 develop 18 develop 19 bppv objective : aging induces a shift in circulating hormones in women , accompanied by weight [gain] during the late reproductive , menopausal transition , and postmenopausal years . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 3 aging 2 : 12 , 3 aging 12 , 4 induces 6 shift 4 induces 12 , 5 a 6 shift 6 shift 7 in 7 in 8 circulating 8 circulating 9 hormones 9 hormones 10 in 10 in 11 women 12 , 13 accompanied 12 , 14 by 12 , 17 during 14 by 15 weight 17 during 25 and 18 the 23 transition 19 late 23 transition 20 reproductive 21 , 20 reproductive 23 transition 22 menopausal 23 transition 23 transition 25 and 24 , 25 and 25 and 27 years 26 postmenopausal 27 years exercise has been shown to counter weight [gain] ; however , it might increase circulating androgens . 0 ###LEFT-WALL### 1 exercise 0 ###LEFT-WALL### 4 shown 0 ###LEFT-WALL### 9 ; 0 ###LEFT-WALL### 17 . 1 exercise 2 has 2 has 3 been 3 been 4 shown 4 shown 5 to 5 to 6 counter 6 counter 7 weight 9 ; 12 it 9 ; 14 increase 10 however 11 , 10 however 12 it 12 it 13 might 13 might 14 increase 14 increase 16 androgens 15 circulating 16 androgens a 6 [-] month aerobic and resistance training exercise regimen was implemented to examine interrelationships between circulating sex hormones , body composition , aerobic capacity , insulin sensitivity , and insulin resistance . 0 ###LEFT-WALL### 10 regimen 0 ###LEFT-WALL### 12 implemented 0 ###LEFT-WALL### 33 . 1 a 10 regimen 2 6 4 month 4 month 8 training 5 aerobic 6 and 6 and 7 resistance 6 and 8 training 8 training 9 exercise 9 exercise 10 regimen 10 regimen 11 was 11 was 12 implemented 12 implemented 13 to 12 implemented 16 between 13 to 14 examine 14 examine 15 interrelationships 16 between 30 and 17 circulating 18 sex 18 sex 19 hormones 19 hormones 20 , 20 , 22 composition 20 , 23 , 21 body 22 composition 23 , 25 capacity 23 , 26 , 24 aerobic 25 capacity 26 , 28 sensitivity 26 , 30 and 27 insulin 28 sensitivity 29 , 30 and 30 and 32 resistance 31 insulin 32 resistance methods : twenty - eight women , aged 42 to 52 years , completed the 6 - month intervention study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 women 2 : 14 completed 2 : 17 - 2 : 21 . 3 twenty 4 - 4 - 5 eight 4 - 6 women 6 women 8 aged 6 women 14 completed 7 , 8 aged 8 aged 9 42 8 aged 10 to 8 aged 13 , 10 to 12 years 11 52 12 years 14 completed 16 6 15 the 16 6 17 - 20 study 18 month 20 study 19 intervention 20 study they were randomly assigned to either a control ( con [;] n = 10 ) group - and maintained their sedentary lifestyle - or an exercise intervention ( exe [;] n = 18 ) group . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 4 assigned 1 they 2 were 2 were 3 randomly 2 were 4 assigned 4 assigned 5 to 4 assigned 8 control 5 to 6 either 7 a 8 control 8 control 18 and 9 ( 18 and 10 con 13 = 10 con 16 group 12 n 13 = 13 = 14 10 13 = 15 ) 16 group 18 and 17 - 18 and 18 and 35 group 18 and 36 . 19 maintained 35 group 20 their 22 lifestyle 21 sedentary 22 lifestyle 22 lifestyle 24 or 23 - 24 or 24 or 27 intervention 24 or 29 exe 24 or 35 group 25 an 26 exercise 25 an 27 intervention 26 exercise 27 intervention 28 ( 29 exe 29 exe 32 = 29 exe 34 ) 31 n 32 = 32 = 33 18 the exercise intervention consisted of combined aerobic and resistance workouts scheduled 6 days / [week] for 60 minutes/day . 0 ###LEFT-WALL### 2 exercise 0 ###LEFT-WALL### 6 combined 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 19 . 1 the 2 exercise 2 exercise 3 intervention 2 exercise 5 of 2 exercise 6 combined 3 intervention 4 consisted 4 consisted 5 of 6 combined 7 aerobic 8 and 10 workouts 8 and 11 scheduled 9 resistance 10 workouts 10 workouts 11 scheduled 11 scheduled 14 / 12 6 13 days 13 days 14 / 14 / 16 for 16 for 18 minutes/day 17 60 18 minutes/day body weight , composition , vo2 peak , plasma insulin , glucose , lipid profile , estradiol , testosterone , progesterone , dehydroepiandrosterone , and dehydroepiandrosterone [sulfate] ( dheas ) were measured at baseline and on [month] 6 . 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 31 were 0 ###LEFT-WALL### 39 . 1 body 2 weight 2 weight 3 , 3 , 4 composition 3 , 5 , 5 , 7 peak 5 , 8 , 6 vo2 7 peak 8 , 10 insulin 8 , 11 , 9 plasma 10 insulin 11 , 12 glucose 11 , 13 , 13 , 15 profile 13 , 16 , 14 lipid 15 profile 16 , 17 estradiol 16 , 18 , 18 , 23 dehydroepiandrosterone 18 , 25 and 19 testosterone 20 , 19 testosterone 23 dehydroepiandrosterone 21 progesterone 22 , 21 progesterone 23 dehydroepiandrosterone 24 , 25 and 25 and 26 dehydroepiandrosterone 25 and 29 dheas 25 and 31 were 28 ( 29 dheas 29 dheas 30 ) 31 were 32 measured 32 measured 35 and 33 at 34 baseline 33 at 35 and 35 and 36 on 36 on 38 6 insulin sensitivity was estimated using the insulin sensitivity index and the quantitative insulin sensitivity check index , whereas insulin resistance was estimated using the homeostatic model for insulin resistance . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 4 estimated 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 30 . 1 insulin 2 sensitivity 2 sensitivity 3 was 3 was 4 estimated 4 estimated 5 using 5 using 10 and 6 the 9 index 7 insulin 9 index 8 sensitivity 9 index 9 index 10 and 10 and 16 index 11 the 16 index 12 quantitative 16 index 13 insulin 14 sensitivity 14 sensitivity 16 index 15 check 16 index 17 , 20 resistance 17 , 22 estimated 18 whereas 19 insulin 18 whereas 20 resistance 20 resistance 21 was 21 was 22 estimated 22 estimated 23 using 22 estimated 27 for 23 using 26 model 24 the 26 model 25 homeostatic 26 model 27 for 29 resistance 28 insulin 29 resistance results : there was a trend toward increased dheas in both groups ( p < 0.1 [ )(, but not as a function of the intervention . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 was 2 : 27 . 3 there 4 was 4 was 6 trend 4 was 7 toward 4 was 10 in 4 was 19 but 4 was 21 as 5 a 6 trend 7 toward 9 dheas 8 increased 9 dheas 10 in 12 groups 11 both 12 groups 12 groups 15 < 13 ( 15 < 14 p 15 < 15 < 16 0.1 15 < 18 )(, 19 but 20 not 21 as 23 function 22 a 23 function 23 function 24 of 24 of 26 intervention 25 the 26 intervention insulin sensitivity [index] increased in the exe group compared with the con group ( p < 0.01 ) . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 4 increased 0 ###LEFT-WALL### 19 . 1 insulin 2 sensitivity 2 sensitivity 4 increased 4 increased 5 in 5 in 8 group 6 the 8 group 7 exe 8 group 8 group 9 compared 9 compared 10 with 10 with 13 group 11 the 13 group 12 con 13 group 13 group 16 < 14 ( 16 < 15 p 16 < 16 < 17 0.01 16 < 18 ) multiple linear regression indicated that , at 6 months , dheas was a negative contributor to insulin sensitivity in the exe group , but not in the con group . 0 ###LEFT-WALL### 3 regression 0 ###LEFT-WALL### 4 indicated 0 ###LEFT-WALL### 30 . 1 multiple 3 regression 2 linear 3 regression 3 regression 4 indicated 4 indicated 5 that 5 that 11 dheas 5 that 12 was 6 , 7 at 7 at 9 months 7 at 10 , 7 at 11 dheas 8 6 9 months 11 dheas 12 was 12 was 15 contributor 13 a 15 contributor 14 negative 15 contributor 15 contributor 24 but 16 to 18 sensitivity 16 to 24 but 17 insulin 18 sensitivity 18 sensitivity 19 in 19 in 22 group 20 the 22 group 21 exe 22 group 23 , 24 but 24 but 25 not 24 but 26 in 26 in 29 group 27 the 29 group 28 con 29 group conclusions : in midlife women , an increase in circulating dheas , such as that previously reported during the menopausal transition , is associated with higher insulin resistance , but exercise can mitigate this risk by improving insulin sensitivity , thereby countering the effects of dheas . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 8 increase 2 : 24 associated 2 : 30 but 3 in 5 women 3 in 6 , 3 in 8 increase 4 midlife 5 women 7 an 8 increase 8 increase 9 in 8 increase 23 is 9 in 10 circulating 10 circulating 11 dheas 10 circulating 14 as 12 , 14 as 13 such 14 as 14 as 15 that 14 as 22 , 15 that 17 reported 16 previously 17 reported 17 reported 18 during 18 during 21 transition 19 the 21 transition 20 menopausal 21 transition 23 is 24 associated 24 associated 25 with 25 with 28 resistance 26 higher 27 insulin 27 insulin 28 resistance 29 , 30 but 30 but 31 exercise 30 but 33 mitigate 31 exercise 32 can 32 can 33 mitigate 33 mitigate 35 risk 34 this 35 risk 35 risk 36 by 36 by 37 improving 37 improving 39 sensitivity 38 insulin 39 sensitivity 39 sensitivity 42 countering 40 , 41 thereby 40 , 42 countering 42 countering 44 effects 42 countering 47 . 43 the 44 effects 44 effects 45 of 45 of 46 dheas traumatic brain injury ( tbi ) is the most common form of head injury and is a leading cause of death worldwide . 0 ###LEFT-WALL### 3 injury 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 23 . 1 traumatic 2 brain 2 brain 3 injury 3 injury 5 tbi 3 injury 15 and 4 ( 5 tbi 5 tbi 6 ) 7 is 11 form 7 is 15 and 8 the 9 most 9 most 11 form 10 common 11 form 11 form 12 of 12 of 14 injury 13 head 14 injury 15 and 16 is 15 and 22 worldwide 16 is 19 cause 17 a 19 cause 18 leading 19 cause 19 cause 20 of 20 of 21 death due to the vast variability in the types and severity of trauma , the cellular consequences of head injury are not completely understood . 0 ###LEFT-WALL### 16 consequences 0 ###LEFT-WALL### 23 understood 0 ###LEFT-WALL### 24 . 1 due 2 to 2 to 5 variability 2 to 13 , 2 to 16 consequences 3 the 5 variability 4 vast 5 variability 5 variability 6 in 5 variability 11 of 6 in 9 and 7 the 8 types 8 types 9 and 9 and 10 severity 11 of 12 trauma 14 the 16 consequences 15 cellular 16 consequences 16 consequences 17 of 16 consequences 20 are 17 of 19 injury 18 head 19 injury 20 are 21 not 20 are 23 understood 22 completely 23 understood the development of reliable models of tbi will aid in understanding the molecular consequences of head trauma , and they will assist in identifying biological surrogate markers of the degree of damage and prognosis . 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 35 . 1 the 2 development 2 development 3 of 2 development 33 and 3 of 5 models 4 reliable 5 models 5 models 6 of 6 of 7 tbi 7 tbi 9 aid 7 tbi 22 assist 8 will 9 aid 9 aid 10 in 9 aid 15 of 9 aid 21 will 10 in 11 understanding 11 understanding 14 consequences 12 the 14 consequences 13 molecular 14 consequences 15 of 19 and 16 head 17 trauma 17 trauma 19 and 18 , 19 and 19 and 20 they 21 will 22 assist 22 assist 23 in 23 in 24 identifying 24 identifying 27 markers 25 biological 26 surrogate 26 surrogate 27 markers 27 markers 28 of 28 of 32 damage 29 the 30 degree 30 degree 31 of 30 degree 32 damage 31 of 32 damage 33 and 34 prognosis in doing so , effective therapeutic strategies can be applied . 0 ###LEFT-WALL### 7 strategies 0 ###LEFT-WALL### 10 applied 0 ###LEFT-WALL### 11 . 1 in 2 doing 1 in 4 , 1 in 7 strategies 2 doing 3 so 5 effective 7 strategies 6 therapeutic 7 strategies 7 strategies 8 can 8 can 9 be 9 be 10 applied current in vivo experimental models yield important information , but they [too] have a significant amount of variation . 0 ###LEFT-WALL### 5 models 0 ###LEFT-WALL### 6 yield 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 19 . 1 current 5 models 2 in 3 vivo 3 vivo 4 experimental 4 experimental 5 models 5 models 6 yield 6 yield 8 information 7 important 8 information 9 , 10 but 10 but 11 they 10 but 13 have 11 they 13 have 13 have 16 amount 14 a 15 significant 14 a 16 amount 15 significant 16 amount 16 amount 17 of 17 of 18 variation the goal of this review is to [re] [-] evaluate the use of these in [vivo] models of tbi and assess whether they correlate with the consequence of tbi in humans from the perspective of tau , an axonal microtubule - stabilizing protein . 0 ###LEFT-WALL### 2 goal 0 ###LEFT-WALL### 44 . 1 the 2 goal 2 goal 3 of 2 goal 6 is 3 of 5 review 4 this 5 review 6 is 7 to 6 is 20 and 7 to 20 and 10 evaluate 12 use 10 evaluate 20 and 11 the 12 use 12 use 13 of 12 use 15 in 12 use 18 of 13 of 14 these 15 in 17 models 18 of 19 tbi 20 and 21 assess 21 assess 22 whether 21 assess 30 in 22 whether 23 they 22 whether 24 correlate 23 they 24 correlate 24 correlate 25 with 25 with 27 consequence 26 the 27 consequence 27 consequence 28 of 28 of 29 tbi 30 in 31 humans 31 humans 32 from 32 from 34 perspective 33 the 34 perspective 34 perspective 35 of 34 perspective 42 stabilizing 35 of 36 tau 36 tau 40 microtubule 37 , 40 microtubule 38 an 40 microtubule 39 axonal 40 microtubule 40 microtubule 41 - 42 stabilizing 43 protein we present and [discuss] the current models of traumatic head injury , and we focus on those that assess changes in tau . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 15 focus 0 ###LEFT-WALL### 23 . 1 we 2 present 2 present 3 and 3 and 7 models 3 and 8 of 3 and 15 focus 5 the 7 models 6 current 7 models 8 of 13 and 9 traumatic 10 head 10 head 11 injury 11 injury 13 and 12 , 13 and 13 and 14 we 15 focus 16 on 15 focus 21 in 16 on 17 those 17 those 18 that 17 those 19 assess 18 that 19 assess 19 assess 20 changes 21 in 22 tau we evaluate reports of tbi in humans that measured changes in tau and that were detectable in serum and cerebrospinal fluid , and as [a] pathological consequence in brain tissue . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 evaluate 0 ###LEFT-WALL### 31 . 1 we 2 evaluate 2 evaluate 3 reports 3 reports 4 of 3 reports 8 that 3 reports 17 in 4 of 5 tbi 5 tbi 6 in 6 in 7 humans 8 that 13 and 8 that 15 were 9 measured 10 changes 10 changes 11 in 10 changes 13 and 11 in 12 tau 13 and 14 that 13 and 15 were 15 were 16 detectable 17 in 19 and 18 serum 19 and 19 and 27 consequence 19 and 28 in 20 cerebrospinal 27 consequence 21 fluid 23 and 22 , 23 and 23 and 26 pathological 23 and 27 consequence 24 as 26 pathological 28 in 30 tissue 29 brain 30 tissue background : autobiographical memory ( abm ) refers to the recollection of individual experiences , while personal semantic memory ( psm ) refers [to] personally [relevant] , but shared , facts . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 memory 2 : 8 refers 2 : 32 . 3 autobiographical 4 memory 4 memory 6 abm 4 memory 8 refers 5 ( 6 abm 6 abm 7 ) 8 refers 9 to 8 refers 16 while 8 refers 31 facts 9 to 11 recollection 10 the 11 recollection 11 recollection 12 of 12 of 14 experiences 13 individual 14 experiences 15 , 16 while 16 while 19 memory 16 while 28 but 16 while 30 , 17 personal 19 memory 18 semantic 19 memory 19 memory 21 psm 19 memory 28 but 20 ( 21 psm 21 psm 22 ) 23 refers 25 personally 23 refers 28 but 27 , 28 but 28 but 29 shared mild cognitive impairment ( mci ) is routinely diagnosed with the aid of neuropsychological tests , which do not tap the abm and psm domains . 0 ###LEFT-WALL### 3 impairment 0 ###LEFT-WALL### 9 diagnosed 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 26 . 1 mild 3 impairment 2 cognitive 3 impairment 3 impairment 5 mci 3 impairment 7 is 4 ( 5 mci 5 mci 6 ) 7 is 8 routinely 7 is 9 diagnosed 9 diagnosed 10 with 10 with 12 aid 11 the 12 aid 12 aid 13 of 13 of 15 tests 14 neuropsychological 15 tests 16 , 17 which 16 , 20 tap 17 which 18 do 18 do 19 not 18 do 20 tap 20 tap 25 domains 21 the 25 domains 22 abm 23 and 23 and 24 psm 24 psm 25 domains objective : we aimed to characterize the nature of abm and psm retrieval in cognitively healthy ( hc ) memory complainers [,] [non] - memory complainers , and [mci] participants , [and] to investigate the relationship between neuropsychological tests and personal memory . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 6 characterize 3 we 4 aimed 4 aimed 5 to 5 to 6 characterize 6 characterize 11 and 6 characterize 14 in 7 the 11 and 8 nature 9 of 8 nature 11 and 9 of 10 abm 11 and 13 retrieval 12 psm 13 retrieval 14 in 21 complainers 15 cognitively 16 healthy 16 healthy 18 hc 16 healthy 21 complainers 17 ( 18 hc 18 hc 19 ) 20 memory 21 complainers 21 complainers 28 and 21 complainers 33 to 24 - 28 and 25 memory 26 complainers 26 complainers 28 and 27 , 28 and 28 and 30 participants 28 and 31 , 31 , 33 to 33 to 34 investigate 33 to 43 . 34 investigate 36 relationship 34 investigate 37 between 35 the 36 relationship 37 between 40 and 38 neuropsychological 39 tests 39 tests 40 and 40 and 42 memory 40 and 43 . 41 personal 42 memory methods : gender - and education - matched participants ( hc = 80 and [mci] = 43 ) completed the episodic abm interview ( eami ) and a battery of neuropsychological tests . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 5 and 2 : 19 completed 3 gender 5 and 4 - 5 and 5 and 6 education 5 and 9 participants 5 and 19 completed 7 - 9 participants 8 matched 9 participants 9 participants 11 hc 9 participants 18 ) 10 ( 11 hc 11 hc 14 and 11 hc 18 ) 12 = 13 80 13 80 14 and 14 and 17 43 16 = 17 43 19 completed 27 and 20 the 25 eami 21 episodic 22 abm 22 abm 23 interview 23 interview 25 eami 24 ( 25 eami 25 eami 26 ) 25 eami 27 and 27 and 29 battery 27 and 30 of 28 a 29 battery 30 of 32 tests 31 neuropsychological 32 tests results : abm and psm did not differ between complainers and [non] - complainers , but were poorer in mci participants , after accounting for age and depressive symptomatology . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 and 2 : 11 and 3 abm 4 and 4 and 5 psm 4 and 6 did 6 did 7 not 6 did 11 and 8 differ 9 between 8 differ 11 and 9 between 10 complainers 11 and 16 but 11 and 19 in 11 and 21 participants 13 - 16 but 14 complainers 16 but 15 , 16 but 16 but 17 were 17 were 18 poorer 19 in 20 mci 21 participants 23 after 22 , 23 after 23 after 24 accounting 23 after 30 . 24 accounting 25 for 25 for 27 and 26 age 27 and 27 and 29 symptomatology 28 depressive 29 symptomatology there were significant associations between personal memory and objective memory measures were found in mci participants , but standard cognitive measures were more sensitive to mci . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 18 but 0 ###LEFT-WALL### 27 . 1 there 8 and 2 were 4 associations 2 were 8 and 3 significant 4 associations 4 associations 5 between 5 between 7 memory 6 personal 7 memory 8 and 13 found 9 objective 10 memory 10 memory 11 measures 11 measures 12 were 12 were 13 found 13 found 14 in 13 found 16 participants 14 in 15 mci 17 , 18 but 18 but 21 measures 18 but 22 were 19 standard 21 measures 20 cognitive 21 measures 21 measures 22 were 22 were 24 sensitive 23 more 24 sensitive 24 sensitive 25 to 25 to 26 mci conclusion : personal memory was compromised in mci , reflected by lower scores on the eami . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 4 memory 2 : 9 , 3 personal 4 memory 4 memory 5 was 5 was 9 , 6 compromised 7 in 6 compromised 9 , 7 in 8 mci 9 , 10 reflected 9 , 14 on 10 reflected 11 by 11 by 13 scores 12 lower 13 scores 14 on 16 eami 15 the 16 eami memory complaining , assessed by current approaches , did not have an impact on personal memory . 0 ###LEFT-WALL### 1 memory 0 ###LEFT-WALL### 11 have 0 ###LEFT-WALL### 17 . 1 memory 2 complaining 1 memory 9 did 2 complaining 4 assessed 3 , 4 assessed 4 assessed 5 by 4 assessed 8 , 5 by 7 approaches 6 current 7 approaches 9 did 10 not 9 did 11 have 11 have 13 impact 11 have 14 on 12 an 13 impact 14 on 16 memory 15 personal 16 memory standard subjective questionnaires might not reflect the sorts of concerns that bring individuals to clinical attention . 0 ###LEFT-WALL### 3 questionnaires 0 ###LEFT-WALL### 6 reflect 0 ###LEFT-WALL### 17 . 1 standard 3 questionnaires 2 subjective 3 questionnaires 3 questionnaires 4 might 4 might 5 not 4 might 6 reflect 6 reflect 10 concerns 7 the 8 sorts 8 sorts 9 of 8 sorts 10 concerns 9 of 10 concerns 10 concerns 11 that 10 concerns 12 bring 11 that 12 bring 12 bring 13 individuals 12 bring 14 to 14 to 16 attention 15 clinical 16 attention understanding personal memory [function] in the elderly may aid in the development of a more sensitive measure of subjective memory concerns . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 9 aid 0 ###LEFT-WALL### 22 . 1 understanding 3 memory 1 understanding 5 in 1 understanding 8 may 2 personal 3 memory 5 in 7 elderly 6 the 7 elderly 8 may 9 aid 9 aid 10 in 9 aid 21 concerns 10 in 12 development 11 the 12 development 12 development 13 of 13 of 20 memory 14 a 17 measure 15 more 16 sensitive 16 sensitive 17 measure 17 measure 18 of 17 measure 20 memory 18 of 20 memory 19 subjective 20 memory background : the use of testosterone among aging men has been increasing , but results from studies addressing the effectiveness of testosterone replacement therapy have been equivocal . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 use 2 : 11 been 2 : 14 but 2 : 28 . 3 the 4 use 4 use 5 of 4 use 10 has 5 of 6 testosterone 6 testosterone 7 among 7 among 8 aging 8 aging 9 men 10 has 11 been 11 been 12 increasing 13 , 14 but 14 but 15 results 14 but 26 been 15 results 16 from 15 results 25 have 16 from 17 studies 17 studies 18 addressing 17 studies 21 of 18 addressing 20 effectiveness 19 the 20 effectiveness 21 of 24 therapy 22 testosterone 23 replacement 23 replacement 24 therapy 25 have 26 been 26 been 27 equivocal objective : given our prior pre - clinical studies that reported a major influence of oxidative stress on testosterone's neuroprotective effects [,] we investigated whether the negative effects of testosterone on brain function were predicted [by] [oxidative] [load] . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 11 reported 0 ###LEFT-WALL### 35 predicted 1 objective 2 : 2 : 3 given 3 given 9 studies 4 our 9 studies 5 prior 9 studies 6 pre 7 - 6 pre 9 studies 8 clinical 9 studies 10 that 11 reported 11 reported 14 influence 11 reported 35 predicted 12 a 13 major 12 a 14 influence 13 major 14 influence 14 influence 15 of 14 influence 35 predicted 15 of 17 stress 16 oxidative 17 stress 17 stress 18 on 18 on 19 testosterone's 19 testosterone's 21 effects 19 testosterone's 34 were 20 neuroprotective 21 effects 21 effects 23 we 21 effects 24 investigated 21 effects 34 were 23 we 24 investigated 24 investigated 25 whether 25 whether 28 effects 25 whether 33 function 26 the 28 effects 27 negative 28 effects 28 effects 29 of 28 effects 31 on 28 effects 33 function 29 of 30 testosterone 31 on 32 brain 35 predicted 39 . methods : in order to test our hypothesis , we determined whether circulating total testosterone and luteinizing hormone correlated with cognition in a subset of the texas alzheimer 's research & care consortium ( tarcc ) cohort , consisting of caucasian ( n = 116 ) and mexican - american ( n = 117 ) men . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 57 . 1 methods 2 : 2 : 3 in 3 in 4 order 4 order 5 to 4 order 6 test 5 to 6 test 6 test 8 hypothesis 7 our 8 hypothesis 9 , 10 we 9 , 11 determined 9 , 49 - 10 we 11 determined 11 determined 12 whether 11 determined 20 with 12 whether 13 circulating 12 whether 19 correlated 13 circulating 16 and 13 circulating 19 correlated 14 total 15 testosterone 15 testosterone 16 and 16 and 18 hormone 17 luteinizing 18 hormone 20 with 21 cognition 20 with 22 in 22 in 24 subset 23 a 24 subset 24 subset 25 of 25 of 37 cohort 26 the 27 texas 27 texas 28 alzheimer 28 alzheimer 29 's 29 's 37 cohort 30 research 31 & 31 & 32 care 32 care 33 consortium 33 consortium 35 tarcc 34 ( 35 tarcc 35 tarcc 36 ) 35 tarcc 37 cohort 37 cohort 47 and 38 , 47 and 39 consisting 40 of 39 consisting 47 and 40 of 41 caucasian 41 caucasian 44 = 42 ( 44 = 43 n 44 = 44 = 45 116 44 = 46 ) 47 and 48 mexican 47 and 49 - 49 - 56 men 50 american 53 = 50 american 56 men 51 ( 53 = 52 n 53 = 53 = 54 117 53 = 55 ) we also assessed whether oxidative stress ( as indexed [by] homocysteine levels ) modified this relationship between sex hormones and cognition , and [whether] the levels of two antioxidants , superoxide dismutase - [1] and glutathione s - transferase ( gst ) , varied as a function of circulating testosterone . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 assessed 1 we 3 assessed 2 also 3 assessed 3 assessed 4 whether 4 whether 6 stress 4 whether 14 modified 5 oxidative 6 stress 6 stress 12 levels 6 stress 14 modified 7 ( 12 levels 8 as 9 indexed 9 indexed 11 homocysteine 11 homocysteine 12 levels 12 levels 13 ) 14 modified 23 and 15 this 16 relationship 16 relationship 17 between 16 relationship 20 and 17 between 19 hormones 18 sex 19 hormones 20 and 21 cognition 20 and 23 and 22 , 23 and 23 and 26 levels 23 and 27 of 25 the 26 levels 27 of 29 antioxidants 28 two 29 antioxidants 29 antioxidants 38 - 30 , 38 - 31 superoxide 32 dismutase 32 dismutase 35 and 33 - 35 and 35 and 36 glutathione 35 and 38 - 36 glutathione 37 s 38 - 39 transferase 39 transferase 41 gst 39 transferase 44 varied 40 ( 41 gst 41 gst 42 ) 43 , 44 varied 44 varied 45 as 44 varied 51 . 45 as 47 function 46 a 47 function 47 function 48 of 48 of 49 circulating 49 circulating 50 testosterone results : in a low oxidative stress environment , testosterone was positively associated with the level of the antioxidant , gst , while no deleterious effects [on] cognitive function were noted . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 32 . 1 results 2 : 2 : 3 in 3 in 8 environment 4 a 5 low 4 a 8 environment 5 low 7 stress 6 oxidative 7 stress 7 stress 8 environment 9 , 10 testosterone 9 , 13 associated 10 testosterone 11 was 11 was 13 associated 12 positively 13 associated 13 associated 14 with 13 associated 23 while 14 with 16 level 15 the 16 level 16 level 17 of 17 of 19 antioxidant 18 the 19 antioxidant 19 antioxidant 21 gst 20 , 21 gst 21 gst 22 , 23 while 29 function 23 while 31 noted 24 no 29 function 25 deleterious 26 effects 26 effects 29 function 28 cognitive 29 function 29 function 30 were 30 were 31 noted in contrast , under conditions of high oxidative stress ( homocysteine levels >12 μmol/l ) , testosterone and luteinizing hormone were associated with cognitive impairment , but only among caucasians . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 22 associated 0 ###LEFT-WALL### 31 . 1 in 2 contrast 1 in 3 , 1 in 18 and 3 , 4 under 4 under 5 conditions 4 under 16 , 4 under 18 and 5 conditions 6 of 6 of 9 stress 7 high 9 stress 8 oxidative 9 stress 9 stress 14 μmol/l 10 ( 14 μmol/l 11 homocysteine 14 μmol/l 12 levels 14 μmol/l 13 >12 14 μmol/l 14 μmol/l 15 ) 17 testosterone 18 and 18 and 20 hormone 18 and 21 were 19 luteinizing 20 hormone 21 were 22 associated 22 associated 27 but 23 with 25 impairment 23 with 27 but 24 cognitive 25 impairment 26 , 27 but 27 but 28 only 27 but 29 among 29 among 30 caucasians the ethnic difference was attributed to significantly higher gst levels among mexican [-] americans . 0 ###LEFT-WALL### 3 difference 0 ###LEFT-WALL### 5 attributed 0 ###LEFT-WALL### 15 . 1 the 3 difference 2 ethnic 3 difference 3 difference 4 was 4 was 5 attributed 5 attributed 6 to 5 attributed 11 among 6 to 10 levels 7 significantly 8 higher 8 higher 10 levels 9 gst 10 levels 11 among 14 americans 12 mexican 14 americans conclusion : while testosterone may be beneficial under conditions of low oxidative stress , testosterone appears to have negative consequences under conditions of elevated oxidative stress , but only in caucasians . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 32 . 1 conclusion 2 : 2 : 3 while 2 : 7 beneficial 3 while 4 testosterone 3 while 6 be 4 testosterone 5 may 5 may 6 be 7 beneficial 8 under 8 under 9 conditions 9 conditions 10 of 10 of 13 stress 11 low 13 stress 12 oxidative 13 stress 14 , 15 testosterone 14 , 16 appears 15 testosterone 16 appears 16 appears 17 to 16 appears 18 have 17 to 18 have 18 have 20 consequences 19 negative 20 consequences 20 consequences 28 but 21 under 22 conditions 21 under 28 but 22 conditions 23 of 23 of 26 stress 24 elevated 26 stress 25 oxidative 26 stress 27 , 28 but 28 but 29 only 28 but 30 in 30 in 31 caucasians mexican - americans , however , were protected from any deleterious effects of testosterone , potentially due to higher levels of endogenous antioxidant defenses such as gst . 0 ###LEFT-WALL### 1 mexican 0 ###LEFT-WALL### 2 - 2 - 3 americans 2 - 8 protected 3 americans 7 were 4 , 5 however 5 however 6 , 5 however 7 were 7 were 8 protected 8 protected 9 from 9 from 12 effects 10 any 12 effects 11 deleterious 12 effects 12 effects 13 of 13 of 14 testosterone 14 testosterone 17 due 15 , 17 due 16 potentially 17 due 17 due 18 to 17 due 28 . 18 to 20 levels 19 higher 20 levels 20 levels 21 of 21 of 24 defenses 22 endogenous 24 defenses 23 antioxidant 24 defenses 24 defenses 26 as 25 such 26 as 26 as 27 gst puerto rican adults in the united states mainland live with socioeconomic and health disparities . 0 ###LEFT-WALL### 3 adults 0 ###LEFT-WALL### 9 live 0 ###LEFT-WALL### 15 . 1 puerto 2 rican 2 rican 3 adults 3 adults 4 in 3 adults 9 live 4 in 8 mainland 5 the 8 mainland 6 united 7 states 7 states 8 mainland 9 live 10 with 10 with 12 and 11 socioeconomic 12 and 12 and 14 disparities 13 health 14 disparities to understand their contextual experience of aging , we interviewed participants in the boston puerto rican health study . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 understand 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 19 . 1 to 2 understand 2 understand 5 experience 3 their 5 experience 4 contextual 5 experience 5 experience 6 of 6 of 7 aging 8 , 9 we 8 , 10 interviewed 9 we 10 interviewed 10 interviewed 11 participants 10 interviewed 12 in 12 in 18 study 13 the 18 study 14 boston 15 puerto 15 puerto 16 rican 16 rican 17 health 17 health 18 study we address the tensions between ['] acceptance ['] and fatalismo as a cultural belief , and a function of structural barriers . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 address 0 ###LEFT-WALL### 22 . 1 we 2 address 2 address 4 tensions 2 address 5 between 2 address 11 as 3 the 4 tensions 5 between 9 and 7 acceptance 9 and 9 and 10 fatalismo 11 as 16 and 12 a 13 cultural 12 a 14 belief 13 cultural 14 belief 14 belief 16 and 15 , 16 and 16 and 18 function 16 and 19 of 17 a 18 function 19 of 21 barriers 20 structural 21 barriers the experience of aging is discussed in the context of puerto rico 's history and continued dependence on the united states . 0 ###LEFT-WALL### 2 experience 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 22 . 1 the 2 experience 2 experience 3 of 2 experience 15 and 3 of 4 aging 5 is 6 discussed 5 is 15 and 6 discussed 7 in 7 in 9 context 8 the 9 context 9 context 10 of 10 of 14 history 11 puerto 12 rico 12 rico 13 's 13 's 14 history 15 and 16 continued 16 continued 17 dependence 16 continued 18 on 18 on 21 states 19 the 21 states 20 united 21 states increasing health care costs in the us are due in a large part to the increasing prevalence of chronic diseases in an aging population . 0 ###LEFT-WALL### 4 costs 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 25 . 1 increasing 2 health 2 health 3 care 3 care 4 costs 4 costs 5 in 4 costs 8 are 5 in 7 us 6 the 7 us 8 are 9 due 9 due 10 in 9 due 14 to 9 due 21 in 10 in 13 part 11 a 13 part 12 large 13 part 14 to 17 prevalence 15 the 17 prevalence 16 increasing 17 prevalence 17 prevalence 18 of 18 of 20 diseases 19 chronic 20 diseases 21 in 24 population 22 an 24 population 23 aging 24 population current therapeutic strategies for treating chronic diseases alleviate symptoms allowing patients to live longer with these diseases , but they do little , however , to alter the underlying disease course . 0 ###LEFT-WALL### 3 strategies 0 ###LEFT-WALL### 19 but 0 ###LEFT-WALL### 32 . 1 current 3 strategies 2 therapeutic 3 strategies 3 strategies 4 for 3 strategies 19 but 4 for 5 treating 5 treating 7 diseases 6 chronic 7 diseases 8 alleviate 9 symptoms 8 alleviate 15 with 8 alleviate 19 but 9 symptoms 10 allowing 10 allowing 11 patients 10 allowing 12 to 10 allowing 13 live 12 to 13 live 13 live 14 longer 15 with 17 diseases 16 these 17 diseases 18 , 19 but 19 but 27 alter 20 they 21 do 21 do 22 little 21 do 26 to 23 , 24 however 24 however 25 , 24 however 26 to 26 to 27 alter 27 alter 31 course 28 the 31 course 29 underlying 31 course 30 disease 31 course recent advances in molecular biology are revealing new drug targets that may significantly alter the course of these diseases [and] , as a result , offer economic relief from burgeoning health care costs . 0 ###LEFT-WALL### 2 advances 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 34 . 1 recent 2 advances 2 advances 3 in 2 advances 6 are 3 in 5 biology 4 molecular 5 biology 6 are 7 revealing 7 revealing 10 targets 7 revealing 14 alter 8 new 10 targets 9 drug 10 targets 10 targets 11 that 10 targets 12 may 10 targets 14 alter 11 that 12 may 13 significantly 14 alter 14 alter 16 course 15 the 16 course 16 course 17 of 17 of 19 diseases 18 these 19 diseases 21 , 26 offer 22 as 24 result 22 as 25 , 22 as 26 offer 23 a 24 result 26 offer 28 relief 26 offer 33 costs 27 economic 28 relief 28 relief 29 from 29 from 30 burgeoning 30 burgeoning 31 health 32 care 33 costs endoplasmic reticulum ( er ) stress has been implicated as [an] underlying pathology in many chronic diseases , and , therefore , the development of therapies designed to ameliorate er stress may yield novel , effective treatment strategies . 0 ###LEFT-WALL### 6 stress 0 ###LEFT-WALL### 9 implicated 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 39 . 1 endoplasmic 6 stress 2 reticulum 4 er 2 reticulum 6 stress 3 ( 4 er 4 er 5 ) 6 stress 7 has 7 has 8 been 8 been 9 implicated 9 implicated 10 as 10 as 13 pathology 12 underlying 13 pathology 13 pathology 14 in 14 in 17 diseases 15 many 17 diseases 16 chronic 17 diseases 18 , 19 and 19 and 24 development 19 and 27 designed 20 , 21 therefore 21 therefore 22 , 21 therefore 24 development 23 the 24 development 24 development 25 of 24 development 27 designed 25 of 26 therapies 27 designed 28 to 27 designed 38 strategies 28 to 29 ameliorate 29 ameliorate 30 er 30 er 31 stress 30 er 33 yield 31 stress 32 may 32 may 33 yield 34 novel 35 , 34 novel 37 treatment 36 effective 37 treatment 37 treatment 38 strategies herein , we report that x - box binding protein 1 ( xbp1 ) may be one of the earliest proteins engaged in response to er stress . 0 ###LEFT-WALL### 1 herein 0 ###LEFT-WALL### 16 be 0 ###LEFT-WALL### 28 . 1 herein 7 - 1 herein 15 may 2 , 7 - 3 we 4 report 4 report 5 that 5 that 6 x 5 that 7 - 6 x 7 - 7 - 10 protein 7 - 14 ) 8 box 9 binding 9 binding 10 protein 10 protein 11 1 10 protein 13 xbp1 12 ( 13 xbp1 13 xbp1 14 ) 15 may 16 be 16 be 17 one 17 one 18 of 18 of 21 proteins 19 the 20 earliest 19 the 21 proteins 21 proteins 22 engaged 22 engaged 25 to 23 in 24 response 24 response 25 to 25 to 27 stress 26 er 27 stress we show that a new signaling peptide derived from the er - embedded transient receptor potential calcium channel protein 1 ( trpc1 ) engages xbp1 upstream of nlrp3 inflammasome - mediated maturation and secretion of il - 1β/il - 18 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 41 . 1 we 2 show 2 show 3 that 2 show 7 peptide 2 show 9 from 4 a 5 new 4 a 7 peptide 5 new 7 peptide 6 signaling 7 peptide 7 peptide 8 derived 9 from 11 er 10 the 11 er 12 - 19 protein 12 - 24 engages 12 - 39 - 13 embedded 14 transient 14 transient 19 protein 15 receptor 17 calcium 16 potential 17 calcium 17 calcium 19 protein 18 channel 19 protein 19 protein 20 1 19 protein 22 trpc1 19 protein 24 engages 21 ( 22 trpc1 22 trpc1 23 ) 24 engages 25 xbp1 24 engages 26 upstream 26 upstream 27 of 27 of 28 nlrp3 28 nlrp3 33 and 28 nlrp3 38 1β/il 29 inflammasome 30 - 29 inflammasome 32 maturation 31 mediated 32 maturation 32 maturation 33 and 33 and 34 secretion 33 and 37 - 33 and 38 1β/il 34 secretion 35 of 35 of 36 il 39 - 40 18 moreover , we show that a synthetic homolog of this signaling peptide ( naclynamide ™ ) administered intravenously twice weekly over a 4 [-] week treatment course induced suppuration and evoked partial or complete resolution of lesions associated with a fibrotic granuloma , a lymphosarcoma , and a colo - rectal carcinoma in canine patients . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 56 . 1 moreover 2 , 1 moreover 3 we 3 we 4 show 4 show 5 that 4 show 30 and 4 show 47 and 6 a 7 synthetic 6 a 8 homolog 7 synthetic 8 homolog 8 homolog 9 of 8 homolog 17 administered 8 homolog 30 and 9 of 12 peptide 10 this 12 peptide 11 signaling 12 peptide 12 peptide 15 ™ 13 ( 15 ™ 14 naclynamide 15 ™ 15 ™ 16 ) 17 administered 18 intravenously 17 administered 19 twice 17 administered 20 weekly 17 administered 21 over 21 over 29 suppuration 22 a 29 suppuration 23 4 25 week 25 week 26 treatment 26 treatment 28 induced 27 course 28 induced 28 induced 29 suppuration 30 and 35 resolution 30 and 36 of 30 and 45 lymphosarcoma 31 evoked 35 resolution 32 partial 33 or 33 or 34 complete 33 or 35 resolution 36 of 37 lesions 37 lesions 38 associated 38 associated 39 with 39 with 42 granuloma 40 a 41 fibrotic 40 a 42 granuloma 41 fibrotic 42 granuloma 43 , 45 lymphosarcoma 44 a 45 lymphosarcoma 45 lymphosarcoma 46 , 47 and 52 carcinoma 48 a 49 colo 48 a 52 carcinoma 49 colo 50 - 49 colo 52 carcinoma 51 rectal 52 carcinoma 52 carcinoma 53 in 53 in 55 patients 54 canine 55 patients the mode of action for naclynamide ™ as a first [-] in [-] class anti - cancer drug candidate is discussed . 0 ###LEFT-WALL### 2 mode 0 ###LEFT-WALL### 21 discussed 0 ###LEFT-WALL### 22 . 1 the 2 mode 2 mode 3 of 2 mode 5 for 2 mode 20 is 3 of 4 action 5 for 6 naclynamide 6 naclynamide 7 ™ 7 ™ 8 as 8 as 19 candidate 9 a 12 in 10 first 12 in 12 in 19 candidate 14 class 19 candidate 15 anti 16 - 15 anti 17 cancer 17 cancer 19 candidate 18 drug 19 candidate 20 is 21 discussed objective : to estimate the overall and by age - group characteristics at admission and discharge from rehabilitation between 2001 and 2010 of all late - teens and adults undergoing inpatient rehabilitation for a primary diagnosis of traumatic brain injury ( tbi ) in the united states . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 48 . 2 : 3 to 2 : 4 estimate 2 : 7 and 3 to 4 estimate 4 estimate 6 overall 5 the 6 overall 7 and 12 characteristics 7 and 31 inpatient 8 by 9 age 8 by 10 - 8 by 12 characteristics 11 group 12 characteristics 12 characteristics 13 at 12 characteristics 23 of 12 characteristics 31 inpatient 13 at 15 and 14 admission 15 and 15 and 16 discharge 15 and 17 from 17 from 18 rehabilitation 18 rehabilitation 21 and 19 between 21 and 20 2001 21 and 21 and 22 2010 23 of 30 undergoing 24 all 30 undergoing 25 late 26 - 25 late 27 teens 27 teens 28 and 28 and 29 adults 28 and 30 undergoing 31 inpatient 32 rehabilitation 31 inpatient 33 for 31 inpatient 44 in 33 for 36 diagnosis 34 a 36 diagnosis 35 primary 36 diagnosis 36 diagnosis 37 of 37 of 40 injury 38 traumatic 39 brain 39 brain 40 injury 40 injury 42 tbi 41 ( 42 tbi 42 tbi 43 ) 44 in 47 states 45 the 47 states 46 united 47 states design : secondary data analysis . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 . 1 design 2 : 2 : 5 analysis 3 secondary 4 data 4 data 5 analysis setting : acute inpatient rehabilitation facilities . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 . 1 setting 2 : 2 : 6 facilities 3 acute 4 inpatient 4 inpatient 6 facilities 5 rehabilitation 6 facilities participants : patients aged 16 years and older receiving inpatient rehabilitation for a primary diagnosis of tbi between 2001 and 2010 . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 participants 2 : 2 : 3 patients 3 patients 4 aged 3 patients 9 receiving 3 patients 16 of 4 aged 7 and 5 16 6 years 6 years 7 and 7 and 8 older 9 receiving 11 rehabilitation 9 receiving 12 for 10 inpatient 11 rehabilitation 12 for 15 diagnosis 13 a 15 diagnosis 14 primary 15 diagnosis 16 of 17 tbi 17 tbi 20 and 18 between 20 and 19 2001 20 and 20 and 21 2010 main outcome measures : functional independence , level of disability , and living situation . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 15 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 6 independence 5 functional 6 independence 7 , 12 and 8 level 9 of 8 level 12 and 9 of 10 disability 11 , 12 and 12 and 14 situation 13 living 14 situation results : the incidence of tbi by age [group] found the largest proportion of cases to be aged 80 years and older [,] with a gradual decline in incidence in the age group of 30 years , at which point there was a slight increase . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 4 incidence 2 : 7 by 3 the 4 incidence 4 incidence 5 of 5 of 6 tbi 7 by 8 age 8 age 10 found 8 age 13 proportion 8 age 18 aged 11 the 12 largest 11 the 13 proportion 13 proportion 14 of 13 proportion 18 aged 14 of 15 cases 15 cases 16 to 15 cases 17 be 16 to 17 be 18 aged 21 and 18 aged 24 with 18 aged 30 in 19 80 20 years 20 years 21 and 21 and 22 older 24 with 27 decline 25 a 26 gradual 25 a 27 decline 26 gradual 27 decline 27 decline 28 in 28 in 29 incidence 30 in 33 group 31 the 33 group 32 age 33 group 33 group 34 of 34 of 36 years 35 30 36 years 36 years 38 at 37 , 38 at 38 at 39 which 38 at 40 point 38 at 41 there 38 at 42 was 38 at 46 . 39 which 40 point 41 there 42 was 42 was 45 increase 43 a 44 slight 43 a 45 increase 44 slight 45 increase preinjury alcohol misuse and substance use were found to occur in 22.9 % and 12.2 % of the total population , respectively [;] however , age distributions demonstrated high preinjury use among individuals younger than 50 years ( eg , 46.4 % and 30.6 % for those aged 20 and 29 years , respectively ) [with] decreasing misuse as age increased . 0 ###LEFT-WALL### 3 misuse 0 ###LEFT-WALL### 4 and 1 preinjury 3 misuse 2 alcohol 3 misuse 4 and 16 % 5 substance 6 use 5 substance 7 were 5 substance 8 found 6 use 7 were 8 found 9 to 8 found 11 in 9 to 10 occur 11 in 14 and 12 22.9 13 % 12 22.9 14 and 14 and 15 12.2 15 12.2 16 % 16 % 17 of 16 % 26 age 17 of 20 population 18 the 20 population 19 total 20 population 21 , 22 respectively 21 , 24 however 24 however 25 , 24 however 26 age 26 age 31 use 27 distributions 31 use 28 demonstrated 31 use 29 high 31 use 30 preinjury 31 use 31 use 32 among 31 use 34 younger 31 use 39 eg 32 among 33 individuals 34 younger 35 than 35 than 37 years 36 50 37 years 38 ( 39 eg 39 eg 40 , 40 , 48 aged 41 46.4 42 % 41 46.4 43 and 43 and 44 30.6 43 and 45 % 45 % 46 for 45 % 48 aged 46 for 47 those 48 aged 52 years 48 aged 53 , 49 20 50 and 50 and 51 29 50 and 52 years 53 , 54 respectively 54 respectively 55 ) 54 respectively 57 decreasing 57 decreasing 58 misuse 58 misuse 61 increased 59 as 60 age 59 as 61 increased 60 age 61 increased 61 increased 62 . of the total population , 49.2 % were retired , 31.1 % employed , 14.1 % not working , and 5.6 % students . 0 ###LEFT-WALL### 7 % 0 ###LEFT-WALL### 9 retired 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 24 . 1 of 4 population 1 of 5 , 1 of 7 % 2 the 4 population 3 total 4 population 6 49.2 7 % 7 % 8 were 8 were 9 retired 10 , 23 students 11 31.1 12 % 11 31.1 20 and 12 % 13 employed 13 employed 14 , 13 employed 16 % 13 employed 19 , 15 14.1 16 % 16 % 17 not 17 not 18 working 20 and 21 5.6 20 and 23 students 22 % 23 students the trend of person [(] [s] [ )(living alone between pre - and postrehabilitation showed the least amount [of] change for those aged 16 to 19 years with steadily increasing changes as age increased . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 15 showed 0 ###LEFT-WALL### 35 . 1 the 2 trend 2 trend 3 of 2 trend 13 and 3 of 8 )(living 4 person 8 )(living 8 )(living 9 alone 9 alone 10 between 10 between 11 pre 12 - 13 and 13 and 14 postrehabilitation 13 and 15 showed 15 showed 17 least 15 showed 20 change 16 the 17 least 18 amount 20 change 20 change 21 for 20 change 28 with 20 change 34 increased 21 for 27 years 22 those 27 years 23 aged 27 years 24 16 25 to 25 to 26 19 25 to 27 years 28 with 30 increasing 29 steadily 30 increasing 30 increasing 31 changes 30 increasing 32 as 32 as 33 age 32 as 34 increased 33 age 34 increased similar trends were seen for residence changes pre - and postrehabilitation , with the youngest most likely to return to living at a private residence , and a gradual decrease in return to living at a private residence as age increased . 1 similar 2 trends 2 trends 3 were 3 were 4 seen 4 seen 5 for 5 for 10 and 6 residence 7 changes 7 changes 8 pre 8 pre 10 and 9 - 10 and 10 and 11 postrehabilitation 10 and 12 , 10 and 13 with 10 and 20 to 13 with 15 youngest 14 the 15 youngest 15 youngest 17 likely 16 most 17 likely 17 likely 18 to 17 likely 19 return 18 to 19 return 20 to 21 living 21 living 22 at 21 living 31 in 21 living 35 at 22 at 27 and 23 a 25 residence 24 private 25 residence 25 residence 27 and 26 , 27 and 27 and 30 decrease 28 a 30 decrease 29 gradual 30 decrease 31 in 32 return 32 return 33 to 33 to 34 living 35 at 38 residence 36 a 38 residence 37 private 38 residence 38 residence 41 increased 39 as 40 age 39 as 41 increased 40 age 41 increased 41 increased 42 . fim [instrument] ( " fim " ) motor and cognitive subscale scores demonstrated that younger individuals had lower scores at admission to rehabilitation and higher scores at rehabilitation discharge . 0 ###LEFT-WALL### 8 motor 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 29 discharge 0 ###LEFT-WALL### 30 . 1 fim 5 fim 3 ( 4 " 3 ( 5 fim 5 fim 6 " 5 fim 7 ) 5 fim 8 motor 9 and 10 cognitive 9 and 13 demonstrated 10 cognitive 11 subscale 10 cognitive 12 scores 10 cognitive 13 demonstrated 11 subscale 12 scores 13 demonstrated 14 that 14 that 16 individuals 14 that 17 had 15 younger 16 individuals 16 individuals 17 had 17 had 19 scores 17 had 22 to 17 had 27 at 17 had 29 discharge 18 lower 19 scores 19 scores 20 at 20 at 21 admission 22 to 24 and 23 rehabilitation 24 and 24 and 26 scores 25 higher 26 scores 27 at 28 rehabilitation conclusion : this study provides population estimates for all patients 16 years of age and older receiving inpatient rehabilitation for a primary diagnosis of tbi in the united states between 2001 and 2010 . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 provides 2 : 34 . 3 this 4 study 4 study 5 provides 5 provides 19 rehabilitation 5 provides 20 for 6 population 7 estimates 7 estimates 8 for 7 estimates 13 of 7 estimates 15 and 8 for 12 years 9 all 12 years 10 patients 12 years 11 16 12 years 13 of 14 age 15 and 16 older 15 and 19 rehabilitation 17 receiving 19 rehabilitation 18 inpatient 19 rehabilitation 20 for 23 diagnosis 21 a 23 diagnosis 22 primary 23 diagnosis 23 diagnosis 24 of 24 of 25 tbi 25 tbi 26 in 25 tbi 30 between 26 in 29 states 27 the 29 states 28 united 29 states 30 between 32 and 31 2001 32 and 32 and 33 2010 a recent trend shows the aging of the inpatient tbi rehabilitation population . 0 ###LEFT-WALL### 3 trend 0 ###LEFT-WALL### 4 shows 0 ###LEFT-WALL### 13 . 1 a 2 recent 1 a 3 trend 2 recent 3 trend 3 trend 4 shows 4 shows 6 aging 5 the 6 aging 6 aging 7 of 7 of 12 population 8 the 12 population 9 inpatient 12 population 10 tbi 12 population 11 rehabilitation 12 population many characteristics important to rehabilitation outcomes are influenced by age , with older individuals trending toward being female , having less severe tbis , incurring tbis as a result [of] falls , but showing less improvement during rehabilitation , greater resulting disability , and more changes in their living situation postrehabilitation . 0 ###LEFT-WALL### 2 characteristics 0 ###LEFT-WALL### 8 influenced 0 ###LEFT-WALL### 11 , 1 many 2 characteristics 2 characteristics 3 important 2 characteristics 7 are 3 important 4 to 4 to 6 outcomes 5 rehabilitation 6 outcomes 7 are 8 influenced 8 influenced 9 by 9 by 10 age 11 , 25 incurring 11 , 31 falls 12 with 14 individuals 12 with 15 trending 12 with 25 incurring 13 older 14 individuals 15 trending 16 toward 15 trending 20 having 16 toward 17 being 17 being 18 female 19 , 20 having 20 having 23 tbis 20 having 24 , 21 less 22 severe 22 severe 23 tbis 25 incurring 26 tbis 25 incurring 31 falls 26 tbis 27 as 27 as 29 result 28 a 29 result 31 falls 33 but 32 , 33 but 33 but 46 changes 33 but 52 . 34 showing 46 changes 35 less 36 improvement 36 improvement 37 during 36 improvement 44 and 37 during 38 rehabilitation 38 rehabilitation 42 disability 39 , 42 disability 40 greater 42 disability 41 resulting 42 disability 42 disability 43 , 44 and 45 more 44 and 46 changes 46 changes 47 in 47 in 51 postrehabilitation 48 their 51 postrehabilitation 49 living 50 situation 50 situation 51 postrehabilitation these findings are of particular interest , as the oldest age groups considered in these analyses did not include the baby boom population . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 24 . 1 these 2 findings 2 findings 3 are 3 are 4 of 4 of 6 interest 5 particular 6 interest 7 , 12 groups 7 , 19 include 8 as 11 age 8 as 12 groups 9 the 10 oldest 9 the 11 age 12 groups 13 considered 12 groups 17 did 13 considered 14 in 14 in 16 analyses 15 these 16 analyses 17 did 18 not 17 did 19 include 19 include 23 population 20 the 23 population 21 baby 22 boom 22 boom 23 population background : to facilitate a systematic , comprehensive description of functioning and to enable the use of the international classification of functioning , disability and health ( icf ) in clinical practice and research , core sets have been developed . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 3 to 2 : 12 and 2 : 23 , 2 : 25 and 3 to 12 and 4 facilitate 9 description 4 facilitate 12 and 5 a 6 systematic 5 a 9 description 6 systematic 7 , 6 systematic 9 description 8 comprehensive 9 description 9 description 10 of 10 of 11 functioning 12 and 13 to 12 and 14 enable 13 to 14 enable 14 enable 16 use 15 the 16 use 16 use 17 of 16 use 21 of 17 of 20 classification 18 the 20 classification 19 international 20 classification 21 of 22 functioning 23 , 24 disability 25 and 37 sets 25 and 40 developed 26 health 28 icf 27 ( 28 icf 28 icf 29 ) 28 icf 30 in 28 icf 33 and 30 in 32 practice 31 clinical 32 practice 33 and 34 research 33 and 35 , 33 and 37 sets 36 core 37 sets 37 sets 38 have 38 have 39 been 39 been 40 developed purpose : the aim of this study was to propose a version of the icf core set to classify the physical health of older adults . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 aim 2 : 17 set 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 propose 9 to 10 propose 10 propose 12 version 10 propose 17 set 11 a 12 version 12 version 13 of 13 of 16 core 14 the 16 core 15 icf 16 core 17 set 18 to 18 to 19 classify 19 classify 22 health 20 the 22 health 21 physical 22 health 22 health 23 of 23 of 25 adults 24 older 25 adults methods : the proposition of the icf core set was based on the delphi technique . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 proposition 2 : 11 based 2 : 16 . 3 the 4 proposition 4 proposition 5 of 4 proposition 10 was 5 of 8 core 6 the 8 core 7 icf 8 core 8 core 9 set 10 was 11 based 11 based 12 on 12 on 15 technique 13 the 15 technique 14 delphi 15 technique the panel of experts included 8 brazilian researchers ( physical therapists , medical doctors , nurses , and physical educators ) . 0 ###LEFT-WALL### 2 panel 0 ###LEFT-WALL### 5 included 0 ###LEFT-WALL### 22 . 1 the 2 panel 2 panel 3 of 2 panel 5 included 3 of 4 experts 5 included 8 researchers 6 8 8 researchers 7 brazilian 8 researchers 8 researchers 18 and 9 ( 18 and 10 physical 11 therapists 11 therapists 12 , 12 , 14 doctors 12 , 15 , 13 medical 14 doctors 15 , 16 nurses 15 , 18 and 17 , 18 and 18 and 20 educators 18 and 21 ) 19 physical 20 educators the communication was wholly electronic . 0 ###LEFT-WALL### 2 communication 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 6 . 1 the 2 communication 2 communication 3 was 3 was 5 electronic 4 wholly 5 electronic in total , there were 5 rounds of interactivity between the participants to arrive at the final version of the construct . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 22 . 1 in 2 total 2 total 3 , 2 total 4 there 4 there 5 were 5 were 7 rounds 5 were 10 between 5 were 13 to 6 5 7 rounds 7 rounds 8 of 8 of 9 interactivity 10 between 12 participants 11 the 12 participants 13 to 14 arrive 14 arrive 15 at 15 at 18 version 16 the 18 version 17 final 18 version 18 version 19 of 19 of 21 construct 20 the 21 construct results : the icf core set presented 30 categories ( 14 on body functions , 4 on body structures , 9 on activities or participation , and [3] on environmental factors ) and had a cronbach α of 0.964 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 core 2 : 34 had 2 : 40 . 3 the 5 core 4 icf 5 core 5 core 6 set 5 core 33 and 7 presented 9 categories 7 presented 33 and 8 30 9 categories 9 categories 11 14 9 categories 16 4 10 ( 11 14 11 14 12 on 11 14 15 , 12 on 14 functions 13 body 14 functions 15 , 16 4 16 4 27 and 16 4 32 ) 17 on 19 structures 17 on 27 and 18 body 19 structures 19 structures 21 9 20 , 21 9 21 9 22 on 21 9 26 , 22 on 24 or 23 activities 24 or 24 or 25 participation 26 , 27 and 27 and 29 on 29 on 31 factors 30 environmental 31 factors 33 and 34 had 34 had 37 α 35 a 37 α 36 cronbach 37 α 37 α 38 of 38 of 39 0.964 conclusions : the presented core set is a secure , fast , and accurate instrument for assessing the physical health and engagement of older adults . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 set 2 : 7 is 2 : 26 . 3 the 6 set 4 presented 5 core 5 core 6 set 6 set 7 is 7 is 21 and 8 a 11 fast 9 secure 10 , 9 secure 11 fast 11 fast 13 and 12 , 13 and 13 and 15 instrument 13 and 16 for 13 and 21 and 14 accurate 15 instrument 16 for 17 assessing 17 assessing 20 health 18 the 20 health 19 physical 20 health 21 and 22 engagement 21 and 23 of 23 of 25 adults 24 older 25 adults it defines points related to functioning and health that are relevant when evaluating this population , as well as [when] reevaluating it and monitoring changes . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 defines 1 it 2 defines 2 defines 7 and 3 points 4 related 3 points 5 to 3 points 7 and 5 to 6 functioning 7 and 8 health 7 and 9 that 7 and 10 are 9 that 10 are 10 are 11 relevant 11 relevant 12 when 11 relevant 19 as 12 when 13 evaluating 13 evaluating 15 population 14 this 15 population 16 , 19 as 17 as 18 well 18 well 19 as 19 as 21 reevaluating 19 as 26 . 21 reevaluating 23 and 22 it 23 and 23 and 25 changes 24 monitoring 25 changes background : transforming growth factor beta ( tgf - β1 ) is a pleiotropic cytokine , which is deregulated in atherosclerosis ; however the role of age in this process is unknown . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 transforming 2 : 12 is 2 : 22 ; 2 : 33 . 3 transforming 6 beta 3 transforming 12 is 4 growth 6 beta 5 factor 6 beta 6 beta 8 tgf 6 beta 10 β1 7 ( 8 tgf 8 tgf 9 - 9 - 10 β1 10 β1 11 ) 12 is 15 cytokine 13 a 14 pleiotropic 13 a 15 cytokine 14 pleiotropic 15 cytokine 15 cytokine 17 which 16 , 17 which 17 which 18 is 17 which 22 ; 18 is 19 deregulated 19 deregulated 20 in 20 in 21 atherosclerosis 22 ; 25 role 23 however 25 role 24 the 25 role 25 role 26 of 25 role 28 in 25 role 31 is 26 of 27 age 28 in 30 process 29 this 30 process 31 is 32 unknown we aimed to assess whether tgf [-] β1 signaling is affected by age . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 14 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 assess 3 to 4 assess 4 assess 5 whether 5 whether 8 β1 5 whether 11 affected 6 tgf 8 β1 8 β1 9 signaling 8 β1 10 is 10 is 11 affected 11 affected 12 by 12 by 13 age methods : vascular smooth muscle cells ( vsmc ) were obtained from patients undergoing abdominal surgery . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 1 methods 2 : 2 : 3 vascular 3 vascular 6 cells 3 vascular 14 undergoing 4 smooth 5 muscle 5 muscle 6 cells 6 cells 8 vsmc 6 cells 10 were 7 ( 8 vsmc 8 vsmc 9 ) 10 were 11 obtained 11 obtained 12 from 12 from 13 patients 13 patients 14 undergoing 14 undergoing 16 surgery 15 abdominal 16 surgery levels of tgf - β1 were measured by elisa in sera from 169 patients undergoing coronary artery bypass grafting ( cabg ) . 0 ###LEFT-WALL### 5 β1 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 23 . 1 levels 5 β1 2 of 3 tgf 2 of 4 - 2 of 5 β1 5 β1 6 were 6 were 7 measured 7 measured 8 by 8 by 9 elisa 9 elisa 10 in 9 elisa 12 from 9 elisa 15 undergoing 10 in 11 sera 12 from 14 patients 13 169 14 patients 15 undergoing 19 grafting 16 coronary 19 grafting 17 artery 19 grafting 18 bypass 19 grafting 19 grafting 21 cabg 20 ( 21 cabg 21 cabg 22 ) the p27 expression was determined by western [blot] from internal mammary arteries ( ima ) obtained from cabg patients ( n=13 ) . 0 ###LEFT-WALL### 3 expression 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 23 . 1 the 3 expression 2 p27 3 expression 3 expression 4 was 4 was 5 determined 5 determined 6 by 6 by 7 western 7 western 9 from 7 western 16 obtained 7 western 17 from 7 western 21 n=13 9 from 12 arteries 10 internal 12 arteries 11 mammary 12 arteries 12 arteries 14 ima 13 ( 14 ima 14 ima 15 ) 17 from 19 patients 18 cabg 19 patients 20 ( 21 n=13 21 n=13 22 ) in vsmc from these patients undergoing abdominal surgery , secretion of tgf - β1 was determined by elisa of cell [-] conditioned media . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 15 was 0 ###LEFT-WALL### 24 . 1 in 2 vsmc 1 in 15 was 2 vsmc 3 from 3 from 5 patients 4 these 5 patients 5 patients 6 undergoing 6 undergoing 8 surgery 7 abdominal 8 surgery 8 surgery 10 secretion 9 , 10 secretion 10 secretion 11 of 10 secretion 13 - 11 of 12 tgf 14 β1 15 was 15 was 16 determined 16 determined 17 by 17 by 18 elisa 18 elisa 19 of 19 of 23 media 20 cell 22 conditioned 22 conditioned 23 media results : in vsmc from aged patients we observed a lower tgf - β1 secretion , measured as tgf - β1 concentration in cell conditioned medium [(] p<0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 1 results 2 : 2 : 3 in 2 : 17 measured 3 in 4 vsmc 4 vsmc 5 from 4 vsmc 8 we 4 vsmc 9 observed 5 from 7 patients 6 aged 7 patients 8 we 9 observed 9 observed 12 tgf 10 a 12 tgf 11 lower 12 tgf 12 tgf 15 secretion 13 - 15 secretion 14 β1 15 secretion 15 secretion 16 , 17 measured 18 as 18 as 19 tgf 19 tgf 22 concentration 20 - 22 concentration 21 β1 22 concentration 22 concentration 23 in 22 concentration 29 ) 23 in 28 p<0.001 24 cell 28 p<0.001 25 conditioned 26 medium 26 medium 28 p<0.001 this effect was correlated to an age - dependent decrease of p27 expression in ima from aged cabg patients . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 4 correlated 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 20 . 1 this 2 effect 2 effect 3 was 3 was 4 correlated 4 correlated 5 to 5 to 7 age 6 an 7 age 8 - 10 decrease 9 dependent 10 decrease 10 decrease 11 of 11 of 13 expression 12 p27 13 expression 13 expression 14 in 14 in 15 ima 15 ima 16 from 16 from 19 patients 17 aged 19 patients 18 cabg 19 patients in a similar manner , there was an age - dependent decrease of serum tgf - β1 levels in cabg patients ( p=0.0195 ) . 0 ###LEFT-WALL### 6 there 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 25 . 1 in 4 manner 1 in 5 , 1 in 6 there 2 a 3 similar 2 a 4 manner 3 similar 4 manner 6 there 7 was 7 was 9 age 8 an 9 age 9 age 12 decrease 9 age 18 levels 10 - 12 decrease 11 dependent 12 decrease 12 decrease 13 of 12 decrease 16 - 13 of 15 tgf 14 serum 15 tgf 16 - 18 levels 17 β1 18 levels 18 levels 19 in 18 levels 24 ) 19 in 21 patients 20 cabg 21 patients 21 patients 23 p=0.0195 22 ( 23 p=0.0195 23 p=0.0195 24 ) conclusions : vsmc from aged patients showed a higher degree of cellular senescence and it was associated to a lower tgf - β1 secretion and signaling . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 vsmc 2 : 7 showed 2 : 14 and 2 : 22 - 3 vsmc 4 from 3 vsmc 7 showed 4 from 6 patients 5 aged 6 patients 7 showed 13 senescence 8 a 10 degree 9 higher 10 degree 10 degree 11 of 10 degree 13 senescence 11 of 13 senescence 12 cellular 13 senescence 14 and 15 it 14 and 17 associated 15 it 16 was 16 was 17 associated 17 associated 18 to 18 to 21 tgf 19 a 21 tgf 20 lower 21 tgf 22 - 25 and 23 β1 24 secretion 24 secretion 25 and 25 and 26 signaling background : prospective memory , or remembering to do things in the future , is crucial for independent living in old age . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 1 background 2 : 2 : 6 or 2 : 8 to 3 prospective 4 memory 4 memory 6 or 5 , 6 or 6 or 7 remembering 8 to 14 , 9 do 10 things 9 do 14 , 10 things 11 in 11 in 13 future 12 the 13 future 14 , 15 is 15 is 16 crucial 16 crucial 17 for 16 crucial 20 in 17 for 19 living 18 independent 19 living 20 in 22 age 21 old 22 age although there is evidence of substantial age - related deficits in memory for intentions , older adults have demonstrated the ability to compensate for their deficits in everyday life . 0 ###LEFT-WALL### 17 adults 0 ###LEFT-WALL### 19 demonstrated 0 ###LEFT-WALL### 30 . 1 although 2 there 1 although 3 is 1 although 17 adults 2 there 3 is 3 is 4 evidence 4 evidence 5 of 5 of 7 age 6 substantial 7 age 8 - 9 related 9 related 10 deficits 9 related 11 in 9 related 15 , 9 related 17 adults 11 in 12 memory 12 memory 13 for 13 for 14 intentions 16 older 17 adults 17 adults 18 have 18 have 19 demonstrated 19 demonstrated 21 ability 20 the 21 ability 21 ability 22 to 21 ability 23 compensate 22 to 23 compensate 23 compensate 24 for 24 for 26 deficits 25 their 26 deficits 26 deficits 27 in 27 in 29 life 28 everyday 29 life the present study investigated feedback as a strategy for facilitating prospective memory in the elderly . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 16 . 1 the 3 study 2 present 3 study 3 study 4 investigated 4 investigated 5 feedback 4 investigated 6 as 6 as 8 strategy 7 a 8 strategy 8 strategy 9 for 9 for 10 facilitating 10 facilitating 12 memory 10 facilitating 13 in 11 prospective 12 memory 13 in 15 elderly 14 the 15 elderly method : young and older adults played a computer - based task , virtual week , [in] which they had to remember to carry out life - like intentions . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 played 1 method 2 : 2 : 3 young 4 and 6 adults 5 older 6 adults 6 adults 7 played 7 played 9 computer 8 a 9 computer 9 computer 11 based 9 computer 18 which 10 - 11 based 12 task 15 week 13 , 15 week 14 virtual 15 week 15 week 16 , 16 , 18 which 18 which 24 carry 18 which 30 . 19 they 20 had 20 had 21 to 21 to 22 remember 22 remember 23 to 22 remember 24 carry 23 to 24 carry 24 carry 26 life 24 carry 28 like 25 out 26 life 27 - 28 like 28 like 29 intentions 28 like 30 . after each virtual day , specific feedback on prospective memory performance was automatically provided on the computer screen that participants either proceeded through by themselves ( [non] [-] social feedback ) or were [taken] through by an experimenter ( social feedback ) . 0 ###LEFT-WALL### 7 feedback 0 ###LEFT-WALL### 32 or 0 ###LEFT-WALL### 43 . 1 after 4 day 1 after 5 , 1 after 7 feedback 2 each 4 day 3 virtual 4 day 6 specific 7 feedback 7 feedback 8 on 7 feedback 32 or 8 on 11 performance 9 prospective 10 memory 10 memory 11 performance 12 was 14 provided 12 was 32 or 13 automatically 14 provided 14 provided 15 on 15 on 18 screen 16 the 18 screen 17 computer 18 screen 18 screen 19 that 18 screen 23 through 18 screen 24 by 18 screen 30 feedback 19 that 20 participants 19 that 22 proceeded 20 participants 22 proceeded 21 either 22 proceeded 22 proceeded 23 through 24 by 25 themselves 26 ( 30 feedback 29 social 30 feedback 30 feedback 31 ) 32 or 33 were 33 were 35 through 35 through 36 by 36 by 38 experimenter 37 an 38 experimenter 38 experimenter 41 feedback 39 ( 41 feedback 40 social 41 feedback 41 feedback 42 ) the control group received no feedback . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 received 0 ###LEFT-WALL### 7 . 1 the 3 group 2 control 3 group 3 group 4 received 4 received 6 feedback 5 no 6 feedback results : we found that , compared with no [-] feedback group , only social feedback substantially reduced the age [-] related deficit in prospective memory . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 6 , 2 : 13 , 2 : 27 . 3 we 6 , 4 found 5 that 4 found 6 , 6 , 7 compared 6 , 8 with 8 with 12 group 9 no 12 group 11 feedback 12 group 13 , 14 only 13 , 18 reduced 14 only 16 feedback 15 social 16 feedback 16 feedback 18 reduced 17 substantially 18 reduced 18 reduced 23 deficit 18 reduced 24 in 19 the 23 deficit 20 age 22 related 22 related 23 deficit 24 in 26 memory 25 prospective 26 memory older adults significantly benefited from feedback provided by the experimenter on the tasks of intermediate difficulty . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 4 benefited 0 ###LEFT-WALL### 17 . 1 older 2 adults 2 adults 4 benefited 3 significantly 4 benefited 4 benefited 5 from 5 from 6 feedback 6 feedback 7 provided 7 provided 8 by 7 provided 11 on 8 by 10 experimenter 9 the 10 experimenter 11 on 13 tasks 12 the 13 tasks 13 tasks 14 of 14 of 16 difficulty 15 intermediate 16 difficulty unexpectedly , prospective memory with [non] [-] social feedback was not only worse than with social feedback , but it was not any better than without any feedback at all . 0 ###LEFT-WALL### 4 memory 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 19 but 0 ###LEFT-WALL### 31 . 1 unexpectedly 2 , 1 unexpectedly 4 memory 3 prospective 4 memory 4 memory 5 with 4 memory 10 was 5 with 9 feedback 8 social 9 feedback 10 was 11 not 10 was 12 only 10 was 13 worse 13 worse 14 than 14 than 15 with 15 with 17 feedback 16 social 17 feedback 18 , 19 but 19 but 20 it 19 but 21 was 20 it 21 was 21 was 22 not 21 was 23 any 23 any 24 better 24 better 25 than 24 better 29 at 25 than 26 without 26 without 28 feedback 27 any 28 feedback 29 at 30 all conclusions : the results extended previous findings on the effectiveness of feedback in improving the memory performance of older adults to include memory for intentions . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 results 2 : 5 extended 3 the 4 results 4 results 5 extended 5 extended 7 findings 5 extended 8 on 5 extended 13 in 6 previous 7 findings 8 on 10 effectiveness 9 the 10 effectiveness 10 effectiveness 11 of 11 of 12 feedback 13 in 14 improving 14 improving 17 performance 15 the 17 performance 16 memory 17 performance 17 performance 18 of 17 performance 21 to 17 performance 22 include 18 of 20 adults 19 older 20 adults 21 to 22 include 22 include 23 memory 23 memory 24 for 24 for 25 intentions despite the feedback meeting the critical recommendations of being specific , objective , and well - targeted , it was ineffective when the feedback displayed on the computer was not introduced by the experimenter . 0 ###LEFT-WALL### 19 it 0 ###LEFT-WALL### 20 was 0 ###LEFT-WALL### 35 . 1 despite 14 and 1 despite 18 , 1 despite 19 it 2 the 3 feedback 3 feedback 4 meeting 3 feedback 8 of 3 feedback 11 , 4 meeting 7 recommendations 5 the 7 recommendations 6 critical 7 recommendations 8 of 9 being 9 being 10 specific 11 , 12 objective 11 , 14 and 13 , 14 and 14 and 15 well 14 and 17 targeted 16 - 17 targeted 17 targeted 18 , 19 it 20 was 20 was 21 ineffective 21 ineffective 22 when 21 ineffective 32 by 22 when 24 feedback 22 when 31 introduced 23 the 24 feedback 24 feedback 25 displayed 24 feedback 29 was 25 displayed 26 on 26 on 28 computer 27 the 28 computer 29 was 30 not 29 was 31 introduced 32 by 34 experimenter 33 the 34 experimenter this has implications for computerized training tasks where automated feedback is considered crucial . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 has 0 ###LEFT-WALL### 14 . 1 this 2 has 2 has 3 implications 2 has 8 where 3 implications 4 for 4 for 7 tasks 5 computerized 6 training 6 training 7 tasks 8 where 10 feedback 8 where 12 considered 9 automated 10 feedback 10 feedback 11 is 11 is 12 considered 12 considered 13 crucial the β - amyloid precursor protein undergoes cleavages by β - and [γ] [-] secretasses yielding amyloid - β peptides ( aβ ) that accumulate in alzheimer 's disease . 0 ###LEFT-WALL### 6 protein 0 ###LEFT-WALL### 7 undergoes 0 ###LEFT-WALL### 30 . 1 the 6 protein 2 β 3 - 2 β 4 amyloid 4 amyloid 6 protein 5 precursor 6 protein 6 protein 7 undergoes 7 undergoes 8 cleavages 7 undergoes 9 by 7 undergoes 26 in 9 by 12 and 10 β 12 and 11 - 12 and 12 and 15 secretasses 12 and 16 yielding 12 and 24 that 12 and 25 accumulate 16 yielding 20 peptides 17 amyloid 18 - 17 amyloid 19 β 19 β 20 peptides 20 peptides 22 aβ 21 ( 22 aβ 22 aβ 23 ) 24 that 25 accumulate 26 in 29 disease 27 alzheimer 28 's 28 's 29 disease subsequently , aβ peptides are targets of additional truncations or endoproteolytic cleavages explaining the diversity of aβ - related fragments recovered in cell media or pathologic human fluids . 0 ###LEFT-WALL### 4 peptides 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 19 related 0 ###LEFT-WALL### 29 . 1 subsequently 2 , 1 subsequently 4 peptides 3 aβ 4 peptides 4 peptides 5 are 5 are 6 targets 6 targets 7 of 6 targets 16 of 7 of 10 or 8 additional 9 truncations 9 truncations 10 or 10 or 12 cleavages 10 or 13 explaining 11 endoproteolytic 12 cleavages 13 explaining 15 diversity 14 the 15 diversity 16 of 17 aβ 18 - 19 related 19 related 20 fragments 19 related 22 in 20 fragments 21 recovered 22 in 25 or 23 cell 24 media 24 media 25 or 25 or 28 fluids 26 pathologic 28 fluids 27 human 28 fluids here , [we] focused on aβ1 - 34 ( aβ34 ) that has been detected both in vitro and in vivo and [that] derives from the hydrolysis of aβ by β - secretase . 0 ###LEFT-WALL### 12 that 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 34 . 1 here 2 , 1 here 12 that 2 , 4 focused 4 focused 5 on 4 focused 11 ) 4 focused 12 that 5 on 6 aβ1 6 aβ1 8 34 7 - 8 34 8 34 10 aβ34 8 34 11 ) 9 ( 10 aβ34 10 aβ34 11 ) 12 that 13 has 13 has 14 been 14 been 22 and 15 detected 16 both 15 detected 19 and 15 detected 22 and 17 in 18 vitro 18 vitro 19 and 19 and 21 vivo 20 in 21 vivo 22 and 24 derives 24 derives 25 from 24 derives 30 by 25 from 27 hydrolysis 26 the 27 hydrolysis 27 hydrolysis 28 of 28 of 29 aβ 30 by 33 secretase 31 β 32 - 31 β 33 secretase we have obtained and fully characterized by immunologic and biochemical approaches , a polyclonal antibody that specifically recognizes the [c] [-] terminus of aβx - 34 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 12 , 1 we 2 have 2 have 4 and 3 obtained 4 and 4 and 6 characterized 4 and 7 by 5 fully 6 characterized 7 by 11 approaches 8 immunologic 9 and 9 and 10 biochemical 9 and 11 approaches 12 , 15 antibody 12 , 18 recognizes 12 , 25 - 13 a 15 antibody 14 polyclonal 15 antibody 15 antibody 18 recognizes 16 that 17 specifically 17 specifically 18 recognizes 18 recognizes 22 terminus 19 the 22 terminus 22 terminus 23 of 23 of 24 aβx 25 - 26 34 25 - 27 . we present immunohistochemical evidence for the presence of aβx - 34 in the brain of 3xtg mice and alzheimer 's disease - affected human brains . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 present 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 26 . 1 we 2 present 2 present 4 evidence 3 immunohistochemical 4 evidence 4 evidence 5 for 4 evidence 8 of 5 for 7 presence 6 the 7 presence 8 of 9 aβx 9 aβx 11 34 10 - 11 34 11 34 12 in 11 34 15 of 11 34 22 - 12 in 14 brain 13 the 14 brain 15 of 18 and 16 3xtg 17 mice 17 mice 18 and 18 and 21 disease 19 alzheimer 20 's 20 's 21 disease 22 - 25 brains 23 affected 25 brains 24 human 25 brains finally , we demonstrate a neprilysin - mediated degradation process of aβ34 and the ability of synthetic aβ34 to protect hek cells overexpressing either wild type or swedish - mutated β - amyloid precursor protein from apoptosis . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 demonstrate 0 ###LEFT-WALL### 38 . 1 finally 2 , 1 finally 3 we 3 we 4 demonstrate 4 demonstrate 6 neprilysin 4 demonstrate 30 mutated 5 a 6 neprilysin 6 neprilysin 13 and 6 neprilysin 30 mutated 7 - 13 and 8 mediated 9 degradation 9 degradation 10 process 10 process 11 of 10 process 13 and 11 of 12 aβ34 13 and 15 ability 13 and 16 of 13 and 19 to 13 and 23 overexpressing 13 and 29 - 14 the 15 ability 16 of 18 aβ34 17 synthetic 18 aβ34 19 to 20 protect 20 protect 22 cells 21 hek 22 cells 22 cells 23 overexpressing 23 overexpressing 27 or 24 either 26 type 25 wild 26 type 26 type 27 or 27 or 28 swedish 30 mutated 35 protein 31 β 32 - 31 β 33 amyloid 33 amyloid 35 protein 34 precursor 35 protein 35 protein 36 from 36 from 37 apoptosis objectives : our study aimed at determining the interaction between the prognostic value of diastolic blood pressure ( dbp ) and aortic atherosclerosis ( ats ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 1 objectives 2 : 2 : 4 study 2 : 6 at 3 our 4 study 4 study 5 aimed 6 at 7 determining 7 determining 9 interaction 7 determining 10 between 8 the 9 interaction 10 between 21 and 11 the 13 value 12 prognostic 13 value 13 value 14 of 13 value 21 and 14 of 17 pressure 15 diastolic 16 blood 16 blood 17 pressure 17 pressure 19 dbp 18 ( 19 dbp 19 dbp 20 ) 21 and 23 atherosclerosis 21 and 25 ats 22 aortic 23 atherosclerosis 24 ( 25 ats 25 ats 26 ) background : with aging , equal systolic blood pressures ( sbps ) become associated with low dbps ; i.e . [,] high pulse pressures ( pps ) become associated with a high risk of cardiovascular death . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 9 pressures 2 : 13 become 2 : 18 ; 2 : 19 i.e 2 : 20 . 3 with 4 aging 3 with 5 , 3 with 9 pressures 6 equal 9 pressures 7 systolic 8 blood 8 blood 9 pressures 9 pressures 11 sbps 9 pressures 13 become 10 ( 11 sbps 11 sbps 12 ) 13 become 14 associated 14 associated 15 with 15 with 17 dbps 16 low 17 dbps 18 ; 19 i.e 20 . 24 pressures 20 . 28 become 20 . 37 . 22 high 23 pulse 23 pulse 24 pressures 24 pressures 26 pps 24 pressures 28 become 25 ( 26 pps 26 pps 27 ) 28 become 29 associated 29 associated 30 with 30 with 33 risk 31 a 33 risk 32 high 33 risk 33 risk 34 of 34 of 36 death 35 cardiovascular 36 death this association is usually ascribed to aortic stiffening with age but the precise impact of low dbp per se is yet uncertain . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 23 . 1 this 2 association 2 association 3 is 3 is 4 usually 3 is 6 to 3 is 9 with 4 usually 5 ascribed 6 to 8 stiffening 7 aortic 8 stiffening 9 with 10 age 11 but 14 impact 11 but 20 is 12 the 14 impact 13 precise 14 impact 14 impact 15 of 14 impact 20 is 15 of 17 dbp 16 low 17 dbp 18 per 19 se 19 se 20 is 20 is 21 yet 20 is 22 uncertain methods : 938 hypertensive patients recruited in the seventies had an aortic ats score at pretreatment aortography . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 patients 2 : 14 score 2 : 18 . 3 938 5 patients 4 hypertensive 5 patients 5 patients 6 recruited 5 patients 7 in 5 patients 10 had 7 in 9 seventies 8 the 9 seventies 10 had 13 ats 10 had 14 score 11 an 12 aortic 11 an 13 ats 12 aortic 13 ats 14 score 15 at 15 at 17 aortography 16 pretreatment 17 aortography all - [cause] and cardiovascular deaths were assessed 20 years later . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 8 assessed 0 ###LEFT-WALL### 12 . 1 all 4 and 2 - 4 and 4 and 6 deaths 4 and 7 were 5 cardiovascular 6 deaths 7 were 8 assessed 8 assessed 11 later 9 20 10 years 10 years 11 later the prognostic values of dbp and sbp were assessed by a multivariate cox regression model and their interactions with ats examined . 0 ###LEFT-WALL### 3 values 0 ###LEFT-WALL### 9 assessed 0 ###LEFT-WALL### 22 . 1 the 3 values 2 prognostic 3 values 3 values 4 of 3 values 8 were 4 of 7 sbp 5 dbp 6 and 6 and 7 sbp 8 were 9 assessed 9 assessed 10 by 9 assessed 19 with 10 by 16 and 11 a 15 model 12 multivariate 14 regression 13 cox 14 regression 14 regression 15 model 15 model 16 and 16 and 18 interactions 17 their 18 interactions 19 with 20 ats 20 ats 21 examined results : in the presence of ats , an increase of 10 mmhg in dbp was associated with a protective effect : hazard ratios 0.84 [ 0.72 - 0.99 ] for cardiovascular death [and] 0.88 [ 0.78 - 1.00 ] for all - cause death . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 1 results 2 : 2 : 3 in 3 in 5 presence 4 the 5 presence 5 presence 6 of 6 of 7 ats 8 , 10 increase 8 , 17 associated 8 , 22 : 9 an 10 increase 10 increase 11 of 10 increase 16 was 11 of 13 mmhg 12 10 13 mmhg 13 mmhg 14 in 14 in 15 dbp 16 was 17 associated 17 associated 18 with 18 with 21 effect 19 a 20 protective 19 a 21 effect 20 protective 21 effect 22 : 23 hazard 22 : 43 - 23 hazard 24 ratios 23 hazard 28 - 23 hazard 31 for 23 hazard 41 for 24 ratios 25 0.84 26 [ 28 - 27 0.72 28 - 28 - 29 0.99 28 - 30 ] 31 for 33 death 32 cardiovascular 33 death 33 death 35 0.88 33 death 38 - 36 [ 38 - 37 0.78 38 - 38 - 39 1.00 38 - 40 ] 41 for 42 all 43 - 44 cause 43 - 46 . 44 cause 45 death however , in the absence of ats , dbp had no prognostic value : hazard ratios 1.05 [ 0.89 - 1.23 ] for cardiovascular death and 0.99 [ 0.88 - 1.11 ] [for] all - cause death ( [p] for interaction : 0.061 and 0.087 , respectively ) . 0 ###LEFT-WALL### 9 dbp 0 ###LEFT-WALL### 10 had 0 ###LEFT-WALL### 14 : 0 ###LEFT-WALL### 42 : 0 ###LEFT-WALL### 49 . 1 however 9 dbp 2 , 3 in 3 in 5 absence 3 in 8 , 3 in 9 dbp 4 the 5 absence 5 absence 6 of 6 of 7 ats 9 dbp 10 had 10 had 13 value 11 no 13 value 12 prognostic 13 value 14 : 15 hazard 14 : 26 and 15 hazard 16 ratios 15 hazard 20 - 15 hazard 23 for 16 ratios 17 1.05 18 [ 20 - 19 0.89 20 - 20 - 21 1.23 20 - 22 ] 23 for 25 death 24 cardiovascular 25 death 26 and 27 0.99 26 and 35 - 27 0.99 30 - 28 [ 30 - 29 0.88 30 - 30 - 31 1.11 30 - 32 ] 34 all 35 - 35 - 36 cause 36 cause 37 death 36 cause 40 for 38 ( 40 for 40 for 41 interaction 41 interaction 42 : 42 : 44 and 42 : 47 respectively 43 0.061 44 and 44 and 45 0.087 46 , 47 respectively 47 respectively 48 ) no interaction was found between sbp and ats ( [p] for interaction [>] 0.40 ) . 0 ###LEFT-WALL### 2 interaction 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 16 . 1 no 2 interaction 2 interaction 3 was 3 was 4 found 4 found 5 between 4 found 11 for 5 between 7 and 6 sbp 7 and 7 and 8 ats 9 ( 11 for 11 for 12 interaction 11 for 15 ) 12 interaction 14 0.40 conclusions : the prognostic values of dbp and aortic atheroma are not superimposable ; yet , they are tightly connected : a low dbp is disadvantageous only in the presence of a pathologic aorta . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 8 and 2 : 11 are 2 : 14 ; 2 : 21 : 3 the 5 values 4 prognostic 5 values 5 values 6 of 5 values 8 and 6 of 7 dbp 8 and 10 atheroma 8 and 11 are 9 aortic 10 atheroma 11 are 12 not 11 are 13 superimposable 12 not 13 superimposable 14 ; 17 they 14 ; 20 connected 15 yet 16 , 15 yet 17 they 17 they 18 are 18 are 19 tightly 18 are 20 connected 21 : 24 dbp 21 : 25 is 21 : 35 . 22 a 24 dbp 23 low 24 dbp 24 dbp 25 is 25 is 26 disadvantageous 26 disadvantageous 27 only 27 only 28 in 28 in 30 presence 29 the 30 presence 30 presence 31 of 31 of 34 aorta 32 a 34 aorta 33 pathologic 34 aorta aortic atherosclerosis may explain , at least [partly] , in some high risk populations , [the] j - shape of the already reported dbp - outcome relationship . 0 ###LEFT-WALL### 2 atherosclerosis 0 ###LEFT-WALL### 4 explain 0 ###LEFT-WALL### 25 - 1 aortic 2 atherosclerosis 2 atherosclerosis 3 may 3 may 4 explain 4 explain 7 least 4 explain 10 in 4 explain 19 shape 5 , 7 least 6 at 7 least 7 least 9 , 9 , 10 in 10 in 14 populations 10 in 18 - 11 some 14 populations 12 high 14 populations 13 risk 14 populations 14 populations 17 j 15 , 17 j 17 j 18 - 19 shape 20 of 20 of 24 dbp 21 the 24 dbp 22 already 23 reported 23 reported 24 dbp 25 - 27 relationship 25 - 28 . 26 outcome 27 relationship this article describes and introduces a new innovative tool for bioethics education : a rock opera on the ethics of genetics written by two academics and a drummer legend . 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 30 . 1 this 2 article 2 article 4 and 2 article 10 for 2 article 26 and 3 describes 4 and 4 and 5 introduces 5 introduces 9 tool 6 a 7 new 6 a 9 tool 7 new 9 tool 8 innovative 9 tool 10 for 11 bioethics 11 bioethics 12 education 11 bioethics 22 written 12 education 13 : 13 : 16 opera 14 a 15 rock 14 a 16 opera 15 rock 16 opera 16 opera 17 on 16 opera 20 of 16 opera 22 written 17 on 19 ethics 18 the 19 ethics 20 of 21 genetics 22 written 23 by 23 by 25 academics 24 two 25 academics 26 and 29 legend 27 a 29 legend 28 drummer 29 legend the origin of the idea , the characters and their development , and the themes and approaches as well as initial responses to the music and the show are described , and the various educational usages are explored . 0 ###LEFT-WALL### 32 and 0 ###LEFT-WALL### 38 explored 0 ###LEFT-WALL### 39 . 1 the 2 origin 2 origin 3 of 2 origin 6 , 3 of 5 idea 4 the 5 idea 6 , 8 characters 6 , 9 and 7 the 8 characters 9 and 11 development 9 and 13 and 10 their 11 development 12 , 13 and 13 and 15 themes 13 and 16 and 14 the 15 themes 16 and 17 approaches 16 and 18 as 16 and 30 described 16 and 32 and 18 as 19 well 20 as 26 and 20 as 30 described 21 initial 22 responses 22 responses 23 to 22 responses 26 and 23 to 25 music 24 the 25 music 26 and 28 show 26 and 29 are 27 the 28 show 29 are 30 described 30 described 31 , 31 , 32 and 32 and 36 usages 32 and 37 are 33 the 36 usages 34 various 36 usages 35 educational 36 usages 37 are 38 explored background : as the population ages , the burden on the healthcare system might increase and require changed public health priorities . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 9 burden 2 : 16 and 2 : 22 . 3 as 5 population 3 as 6 ages 3 as 7 , 3 as 9 burden 4 the 5 population 5 population 6 ages 8 the 9 burden 9 burden 10 on 9 burden 14 might 10 on 13 system 11 the 13 system 12 healthcare 13 system 14 might 16 and 15 increase 16 and 16 and 17 require 16 and 21 priorities 17 require 20 health 18 changed 20 health 19 public 20 health as infections are often more severe at older age , we rank notifiable infectious diseases ( id ) and describe trends of id among the general population aged ≥65 years in norway in order to inform public health priorities for the aging population . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 44 . 1 as 2 infections 1 as 3 are 1 as 10 , 1 as 11 we 2 infections 3 are 3 are 4 often 3 are 6 severe 5 more 6 severe 6 severe 7 at 7 at 9 age 8 older 9 age 11 we 19 and 12 rank 15 diseases 12 rank 19 and 13 notifiable 15 diseases 14 infectious 15 diseases 15 diseases 17 id 16 ( 17 id 17 id 18 ) 19 and 20 describe 19 and 24 among 19 and 30 years 20 describe 21 trends 21 trends 22 of 22 of 23 id 24 among 27 population 25 the 27 population 26 general 27 population 27 population 28 aged 28 aged 29 ≥65 30 years 31 in 31 in 32 norway 32 norway 33 in 33 in 34 order 34 order 35 to 34 order 36 inform 35 to 36 inform 36 inform 39 priorities 37 public 39 priorities 38 health 39 priorities 39 priorities 40 for 40 for 43 population 41 the 43 population 42 aging 43 population methods : we included all eligible cases of the 58 ids notified between 1993 and 2011 ( n = 223,758 ; 12 % ≥65 years [ )(and determined annual notification rates as the number of notified cases divided by the number of inhabitants of the corresponding year . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 included 2 : 21 ; 2 : 48 . 3 we 4 included 4 included 7 cases 4 included 19 = 5 all 7 cases 6 eligible 7 cases 7 cases 8 of 8 of 11 ids 9 the 10 58 10 58 11 ids 11 ids 12 notified 12 notified 13 between 13 between 15 and 14 1993 15 and 15 and 16 2011 17 ( 19 = 18 n 19 = 19 = 20 223,758 21 ; 23 % 21 ; 24 ≥65 22 12 23 % 23 % 24 ≥65 24 ≥65 27 )(and 24 ≥65 32 as 25 years 27 )(and 27 )(and 31 rates 28 determined 29 annual 29 annual 31 rates 30 notification 31 rates 32 as 37 cases 33 the 34 number 34 number 35 of 34 number 37 cases 35 of 37 cases 36 notified 37 cases 37 cases 38 divided 37 cases 39 by 37 cases 42 of 39 by 41 number 40 the 41 number 42 of 43 inhabitants 43 inhabitants 44 of 44 of 47 year 45 the 47 year 46 corresponding 47 year we ranked diseases using their average annual notification rate for 2007 - 2011 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 ranked 0 ###LEFT-WALL### 14 . 1 we 2 ranked 2 ranked 3 diseases 3 diseases 4 using 4 using 9 rate 5 their 9 rate 6 average 7 annual 7 annual 9 rate 8 notification 9 rate 9 rate 10 for 10 for 12 - 11 2007 12 - 12 - 13 2011 trends in notification rates from 1993 onwards were determined with a [non] [-] parametric test [for] trend . 0 ###LEFT-WALL### 1 trends 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 18 . 1 trends 2 in 1 trends 8 were 2 in 4 rates 3 notification 4 rates 4 rates 5 from 5 from 6 1993 7 onwards 8 were 8 were 9 determined 9 determined 10 with 10 with 17 trend 11 a 17 trend 14 parametric 15 test 15 test 17 trend using notification rate ratios ( nrr ) , we compared results in those aged ≥65 years to those aged 20 - 64 years . 0 ###LEFT-WALL### 9 we 0 ###LEFT-WALL### 10 compared 0 ###LEFT-WALL### 24 . 1 using 4 ratios 1 using 8 , 1 using 9 we 2 notification 4 ratios 3 rate 4 ratios 4 ratios 6 nrr 5 ( 6 nrr 6 nrr 7 ) 9 we 10 compared 10 compared 11 results 11 results 12 in 11 results 17 to 12 in 16 years 13 those 16 years 14 aged 15 ≥65 15 ≥65 16 years 17 to 23 years 18 those 23 years 19 aged 23 years 20 20 21 - 21 - 22 64 21 - 23 years results : invasive pneumococcal disease was the most common id among the population ≥65 years ( notification rate 58/100,000 ) , followed by pertussis ( 54/100,000 ) and campylobacteriosis ( 30/100,000 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 disease 2 : 6 was 2 : 33 . 3 invasive 5 disease 4 pneumococcal 5 disease 5 disease 6 was 6 was 28 and 7 the 8 most 8 most 10 id 9 common 10 id 10 id 11 among 10 id 28 and 11 among 15 years 12 the 15 years 13 population 15 years 14 ≥65 15 years 15 years 19 58/100,000 15 years 22 followed 16 ( 19 58/100,000 17 notification 19 58/100,000 18 rate 19 58/100,000 19 58/100,000 20 ) 21 , 22 followed 22 followed 23 by 22 followed 27 ) 23 by 24 pertussis 24 pertussis 26 54/100,000 25 ( 26 54/100,000 26 54/100,000 27 ) 28 and 29 campylobacteriosis 28 and 31 30/100,000 30 ( 31 30/100,000 31 30/100,000 32 ) most id notification rates did not change over time , though the notification rate of symptomatic mrsa infections increased from 1/100,000 in 1995 ( first year [of] notification ) to 14/100,000 in 2011.overall , fewer cases were notified among the population ≥65 years compared to 20 - 64 year olds ( nrr [=] 0.73 ) . 0 ###LEFT-WALL### 1 most 0 ###LEFT-WALL### 38 notified 1 most 2 id 1 most 7 change 1 most 38 notified 2 id 3 notification 2 id 4 rates 2 id 5 did 3 notification 4 rates 5 did 6 not 5 did 7 change 7 change 8 over 8 over 9 time 9 time 36 cases 9 time 37 were 10 , 11 though 11 though 14 rate 11 though 19 increased 11 though 34 , 11 though 36 cases 12 the 14 rate 13 notification 14 rate 14 rate 15 of 14 rate 19 increased 15 of 18 infections 16 symptomatic 18 infections 17 mrsa 18 infections 19 increased 20 from 19 increased 22 in 19 increased 30 to 19 increased 32 in 20 from 21 1/100,000 22 in 23 1995 23 1995 28 notification 24 ( 28 notification 25 first 28 notification 26 year 28 notification 28 notification 29 ) 30 to 31 14/100,000 32 in 33 2011.overall 35 fewer 36 cases 36 cases 37 were 38 notified 39 among 38 notified 43 years 38 notified 45 to 39 among 41 population 40 the 41 population 42 ≥65 43 years 43 years 44 compared 45 to 46 20 46 20 50 olds 47 - 50 olds 48 64 50 olds 49 year 50 olds 50 olds 52 nrr 50 olds 56 . 51 ( 52 nrr 52 nrr 54 0.73 52 nrr 55 ) the nrr of each of the invasive bacterial diseases and antibiotic - resistant infections were above 1.5 ( i.e [.] more common in ≥65 ) [,] while the nrr of each food - and waterborne disease , blood - borne disease/sti [and] [(] [non] - invasive ) vaccine preventable disease was below 1 . 1 the 2 nrr 2 nrr 3 of 2 nrr 10 and 3 of 4 each 4 each 5 of 5 of 9 diseases 6 the 9 diseases 7 invasive 9 diseases 8 bacterial 9 diseases 10 and 14 infections 10 and 15 were 11 antibiotic 12 - 11 antibiotic 14 infections 13 resistant 14 infections 15 were 16 above 15 were 27 while 16 above 17 1.5 17 1.5 19 i.e 18 ( 19 i.e 19 i.e 22 common 19 i.e 25 ) 21 more 22 common 22 common 23 in 23 in 24 ≥65 27 while 34 and 27 while 38 blood 28 the 29 nrr 29 nrr 30 of 29 nrr 34 and 30 of 32 food 31 each 32 food 33 - 34 and 34 and 36 disease 34 and 37 , 34 and 38 blood 35 waterborne 36 disease 38 blood 40 borne 38 blood 41 disease/sti 39 - 40 borne 41 disease/sti 48 vaccine 45 - 48 vaccine 46 invasive 47 ) 46 invasive 48 vaccine 48 vaccine 50 disease 48 vaccine 51 was 48 vaccine 54 . 49 preventable 50 disease 50 disease 51 was 51 was 52 below 52 below 53 1 conclusions : based on our results , we emphasise the importance of focusing public health efforts for those ≥65 years on preventing invasive bacterial infections . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 3 based 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 26 . 1 conclusions 2 : 2 : 3 based 3 based 4 on 4 on 6 results 5 our 6 results 7 , 8 we 7 , 9 emphasise 8 we 9 emphasise 9 emphasise 11 importance 9 emphasise 21 on 10 the 11 importance 11 importance 12 of 11 importance 17 for 12 of 13 focusing 13 focusing 16 efforts 14 public 16 efforts 15 health 16 efforts 17 for 20 years 18 those 20 years 19 ≥65 20 years 21 on 22 preventing 22 preventing 25 infections 23 invasive 25 infections 24 bacterial 25 infections this can be achieved by increasing pneumococcal and influenza vaccine uptake , and risk communication including encouraging those aged ≥65 years and their caretakers to seek healthcare at signs of systemic infection . 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 33 . 1 this 2 can 2 can 3 be 3 be 4 achieved 4 achieved 5 by 4 achieved 7 pneumococcal 5 by 6 increasing 8 and 13 and 8 and 19 aged 9 influenza 10 vaccine 10 vaccine 11 uptake 11 uptake 13 and 12 , 13 and 13 and 16 including 13 and 17 encouraging 13 and 19 aged 14 risk 15 communication 15 communication 16 including 17 encouraging 18 those 19 aged 22 and 20 ≥65 21 years 21 years 22 and 22 and 24 caretakers 22 and 25 to 22 and 26 seek 22 and 27 healthcare 23 their 24 caretakers 25 to 26 seek 27 healthcare 28 at 28 at 29 signs 29 signs 30 of 30 of 32 infection 31 systemic 32 infection furthermore , good compliance to infection control measures , screening of the [at] [-] risk population , and careful use of antibiotics may prevent further increase in antibiotic - resistant infections . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 26 increase 0 ###LEFT-WALL### 32 . 1 furthermore 2 , 1 furthermore 18 and 3 good 4 compliance 4 compliance 5 to 4 compliance 9 , 5 to 8 measures 6 infection 8 measures 7 control 8 measures 9 , 10 screening 9 , 18 and 10 screening 11 of 11 of 16 population 12 the 16 population 15 risk 16 population 17 , 18 and 18 and 19 careful 18 and 20 use 18 and 24 prevent 18 and 26 increase 20 use 21 of 20 use 23 may 21 of 22 antibiotics 23 may 24 prevent 25 further 26 increase 26 increase 27 in 27 in 31 infections 28 antibiotic 29 - 28 antibiotic 31 infections 30 resistant 31 infections objectives : in this rapidly changing electronic era , we implemented a study to define age dependent variations in access and use of internet and electronic devices in the exchange of healthcare related information ( hri ) and coordination of clinical care ( ccc ) among elderly patients with cancer . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 15 define 0 ###LEFT-WALL### 51 . 1 objectives 2 : 2 : 3 in 3 in 8 era 4 this 8 era 5 rapidly 6 changing 6 changing 8 era 7 electronic 8 era 9 , 10 we 9 , 11 implemented 10 we 11 implemented 11 implemented 13 study 11 implemented 14 to 12 a 13 study 14 to 15 define 15 define 18 variations 15 define 19 in 15 define 28 in 16 age 18 variations 17 dependent 18 variations 19 in 21 and 20 access 21 and 21 and 22 use 21 and 23 of 23 of 25 and 24 internet 25 and 25 and 27 devices 26 electronic 27 devices 28 in 38 and 29 the 30 exchange 30 exchange 31 of 30 exchange 38 and 31 of 34 information 32 healthcare 34 information 33 related 34 information 34 information 36 hri 35 ( 36 hri 36 hri 37 ) 38 and 39 coordination 39 coordination 40 of 39 coordination 46 among 40 of 42 care 41 clinical 42 care 42 care 44 ccc 43 ( 44 ccc 44 ccc 45 ) 46 among 48 patients 47 elderly 48 patients 48 patients 49 with 49 with 50 cancer materials and methods : data was collected through independently completed surveys after obtaining irb approval in a single institution cancer center over a 4 [-] month period . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 28 . 1 materials 2 and 2 and 3 methods 4 : 5 data 4 : 6 was 5 data 6 was 6 was 11 surveys 6 was 22 over 7 collected 11 surveys 8 through 11 surveys 9 independently 10 completed 10 completed 11 surveys 11 surveys 12 after 12 after 13 obtaining 13 obtaining 15 approval 13 obtaining 16 in 14 irb 15 approval 16 in 21 center 17 a 18 single 17 a 21 center 18 single 19 institution 19 institution 21 center 20 cancer 21 center 22 over 27 period 23 a 27 period 24 4 26 month 26 month 27 period questions regarding internet access and use of electronic media to obtain health information and coordinate care were distributed . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 18 distributed 0 ###LEFT-WALL### 19 . 1 questions 2 regarding 1 questions 5 and 2 regarding 4 access 3 internet 4 access 5 and 6 use 5 and 7 of 5 and 14 and 7 of 9 media 8 electronic 9 media 9 media 10 to 9 media 11 obtain 10 to 11 obtain 11 obtain 13 information 12 health 13 information 14 and 16 care 14 and 17 were 15 coordinate 16 care 17 were 18 distributed the sample was divided in two groups based upon the world health organization ( who ) definition of geriatric patients : < 65 y/o [(] group a [ )(and ≥65 y/o ( group b ) . 0 ###LEFT-WALL### 2 sample 0 ###LEFT-WALL### 4 divided 0 ###LEFT-WALL### 21 : 0 ###LEFT-WALL### 36 . 1 the 2 sample 2 sample 3 was 3 was 4 divided 4 divided 5 in 4 divided 9 upon 5 in 7 groups 6 two 7 groups 7 groups 8 based 9 upon 17 definition 10 the 17 definition 11 world 12 health 12 health 13 organization 13 organization 15 who 14 ( 15 who 15 who 16 ) 15 who 17 definition 17 definition 18 of 18 of 20 patients 19 geriatric 20 patients 21 : 23 65 22 < 23 65 23 65 29 )(and 23 65 31 y/o 23 65 33 group 24 y/o 26 group 26 group 27 a 26 group 29 )(and 29 )(and 30 ≥65 29 )(and 31 y/o 32 ( 33 group 33 group 34 b 33 group 35 ) results : one hundred and twenty - six surveys were analyzed with 70 patients in group a and 56 patients in group b [.] access to the internet and use of email was higher in the group [a] [(] 77 % and 71 % [ )(vs [.] group b ( 36 % and 33 % , p < 0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 and 1 results 2 : 2 : 4 hundred 3 one 4 hundred 5 and 9 surveys 5 and 11 analyzed 6 twenty 7 - 7 - 8 six 7 - 9 surveys 9 surveys 10 were 10 were 11 analyzed 11 analyzed 12 with 12 with 14 patients 13 70 14 patients 14 patients 15 in 15 in 18 and 16 group 17 a 16 group 18 and 18 and 20 patients 18 and 21 in 19 56 20 patients 21 in 22 group 22 group 23 b 22 group 25 access 22 group 33 was 25 access 26 to 25 access 31 of 25 access 33 was 26 to 29 and 27 the 28 internet 28 internet 29 and 29 and 30 use 31 of 32 email 33 was 34 higher 33 was 35 in 35 in 37 group 36 the 37 group 37 group 42 and 37 group 46 )(vs 40 77 41 % 40 77 42 and 42 and 43 71 43 71 44 % 46 )(vs 48 group 48 group 49 b 48 group 55 % 50 ( 55 % 51 36 52 % 51 36 53 and 53 and 54 33 53 and 55 % 55 % 58 < 55 % 61 . 56 , 58 < 57 p 58 < 58 < 59 0.001 58 < 60 ) the younger group felt more comfortable using the internet when compared to the older group ( 70 % vs [.] 40 % , p = 0.01 ) . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 4 felt 0 ###LEFT-WALL### 28 . 1 the 3 group 2 younger 3 group 3 group 4 felt 4 felt 6 comfortable 5 more 6 comfortable 6 comfortable 7 using 6 comfortable 10 when 7 using 9 internet 8 the 9 internet 10 when 11 compared 11 compared 12 to 12 to 15 group 13 the 15 group 14 older 15 group 15 group 18 % 15 group 25 = 16 ( 18 % 17 70 18 % 18 % 19 vs 18 % 23 , 19 vs 22 % 21 40 22 % 23 , 25 = 24 p 25 = 25 = 26 0.01 25 = 27 ) patients in group b demonstrated a strong preference for paper copy based hri and phone calls to ccc than text messages or emails [(] 73 [%] and 95 % , p < 0.001 ) . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 5 demonstrated 0 ###LEFT-WALL### 35 . 1 patients 2 in 1 patients 5 demonstrated 2 in 3 group 3 group 4 b 5 demonstrated 8 preference 5 demonstrated 22 or 6 a 7 strong 6 a 8 preference 7 strong 8 preference 8 preference 9 for 8 preference 22 or 9 for 14 and 10 paper 12 based 11 copy 12 based 12 based 13 hri 13 hri 14 and 14 and 15 phone 16 calls 17 to 16 calls 19 than 16 calls 21 messages 16 calls 22 or 17 to 18 ccc 20 text 21 messages 22 or 23 emails 22 or 32 < 23 emails 29 % 25 73 27 and 27 and 28 95 27 and 29 % 30 , 32 < 31 p 32 < 32 < 33 0.001 32 < 34 ) a transition zone between the ages of 65 and 70 years was defined to identify patients with increased reluctance to use internet and electronic devices to exchange hri [and] ccc . 0 ###LEFT-WALL### 3 zone 0 ###LEFT-WALL### 27 exchange 0 ###LEFT-WALL### 31 . 1 a 2 transition 1 a 3 zone 2 transition 3 zone 3 zone 4 between 3 zone 7 of 3 zone 12 was 4 between 6 ages 5 the 6 ages 7 of 11 years 8 65 9 and 9 and 10 70 9 and 11 years 12 was 13 defined 13 defined 14 to 13 defined 17 with 13 defined 20 to 13 defined 26 to 14 to 15 identify 15 identify 16 patients 17 with 19 reluctance 18 increased 19 reluctance 20 to 23 and 21 use 22 internet 22 internet 23 and 23 and 25 devices 24 electronic 25 devices 26 to 27 exchange 27 exchange 28 hri 28 hri 30 ccc conclusion [:] the data supports that there is an age - defined underutilization of internet and electronic devices to exchange hri [and] ccc . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 8 is 1 conclusion 4 data 1 conclusion 5 supports 1 conclusion 8 is 3 the 4 data 4 data 5 supports 5 supports 6 that 5 supports 7 there 8 is 10 age 9 an 10 age 10 age 16 and 11 - 16 and 12 defined 13 underutilization 13 underutilization 14 of 13 underutilization 16 and 14 of 15 internet 16 and 18 devices 16 and 19 to 16 and 20 exchange 16 and 24 . 17 electronic 18 devices 19 to 20 exchange 20 exchange 21 hri 21 hri 23 ccc characterization of this age [-] dependent transition zone will enable clinicians to identify patients who may not interface well with electronic communication strategies , and to improve delivery of hri [and] ccc for the elderly . 0 ###LEFT-WALL### 1 characterization 0 ###LEFT-WALL### 10 enable 0 ###LEFT-WALL### 36 . 1 characterization 2 of 1 characterization 9 will 2 of 8 zone 3 this 8 zone 4 age 6 dependent 6 dependent 8 zone 7 transition 8 zone 9 will 10 enable 10 enable 11 clinicians 10 enable 12 to 10 enable 13 identify 12 to 13 identify 13 identify 14 patients 14 patients 15 who 14 patients 25 and 15 who 25 and 16 may 17 not 16 may 18 interface 16 may 25 and 18 interface 19 well 18 interface 20 with 18 interface 23 strategies 20 with 22 communication 21 electronic 22 communication 24 , 25 and 25 and 26 to 25 and 27 improve 26 to 27 improve 27 improve 28 delivery 28 delivery 29 of 29 of 30 hri 30 hri 32 ccc 30 hri 33 for 33 for 35 elderly 34 the 35 elderly aging of an individual entails a progressive decline of functional reserves and loss of homeostasis that eventually lead to mortality . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 5 entails 0 ###LEFT-WALL### 21 . 1 aging 2 of 1 aging 5 entails 2 of 4 individual 3 an 4 individual 5 entails 8 decline 5 entails 19 to 6 a 7 progressive 6 a 8 decline 7 progressive 8 decline 8 decline 9 of 9 of 12 and 10 functional 11 reserves 11 reserves 12 and 12 and 13 loss 12 and 14 of 14 of 15 homeostasis 15 homeostasis 16 that 15 homeostasis 18 lead 16 that 18 lead 17 eventually 18 lead 19 to 20 mortality this process is highly individualized and is influenced by multiple genetic , epigenetic and environmental factors . 0 ###LEFT-WALL### 2 process 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 17 . 1 this 2 process 2 process 6 and 3 is 5 individualized 3 is 6 and 4 highly 5 individualized 6 and 7 is 7 is 8 influenced 8 influenced 9 by 9 by 16 factors 10 multiple 16 factors 11 genetic 12 , 11 genetic 16 factors 13 epigenetic 14 and 14 and 15 environmental 14 and 16 factors this individualization and the diversity of factors influencing aging result in a significant heterogeneity among people with the same chronological age , representing a major challenge in daily oncology practice . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 10 result 1 this 2 individualization 2 individualization 3 and 3 and 5 diversity 3 and 6 of 3 and 10 result 4 the 5 diversity 6 of 7 factors 7 factors 8 influencing 8 influencing 9 aging 10 result 11 in 10 result 15 among 10 result 17 with 11 in 14 heterogeneity 12 a 13 significant 12 a 14 heterogeneity 13 significant 14 heterogeneity 15 among 16 people 17 with 21 age 18 the 19 same 19 same 21 age 20 chronological 21 age 21 age 23 representing 22 , 23 representing 23 representing 26 challenge 23 representing 31 . 24 a 26 challenge 25 major 26 challenge 26 challenge 27 in 27 in 30 practice 28 daily 30 practice 29 oncology 30 practice thus , [many] [factors] other than mere chronological age will contribute to treatment tolerance and outcome in the older patients with cancer . 0 ###LEFT-WALL### 9 age 0 ###LEFT-WALL### 11 contribute 0 ###LEFT-WALL### 23 . 1 thus 2 , 1 thus 9 age 5 other 9 age 6 than 7 mere 7 mere 9 age 8 chronological 9 age 9 age 10 will 10 will 11 contribute 11 contribute 12 to 11 contribute 17 in 11 contribute 21 with 12 to 15 and 13 treatment 14 tolerance 14 tolerance 15 and 15 and 16 outcome 17 in 20 patients 18 the 20 patients 19 older 20 patients 21 with 22 cancer clinical/comprehensive geriatric assessment can provide information on the general health status of individuals , but is far from perfect as a prognostic/predictive tool for individual patients . 0 ###LEFT-WALL### 3 assessment 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 27 . 1 clinical/comprehensive 3 assessment 2 geriatric 3 assessment 3 assessment 15 but 4 can 5 provide 4 can 15 but 5 provide 6 information 5 provide 7 on 7 on 11 status 8 the 11 status 9 general 10 health 10 health 11 status 11 status 12 of 12 of 13 individuals 14 , 15 but 15 but 16 is 16 is 19 perfect 17 far 18 from 18 from 19 perfect 19 perfect 20 as 20 as 23 tool 21 a 22 prognostic/predictive 21 a 23 tool 22 prognostic/predictive 23 tool 23 tool 24 for 24 for 26 patients 25 individual 26 patients on the other hand , aging can also be assessed in terms of biological changes in certain tissues like the blood compartment which result from adaptive alterations due to past history of exposures , as well as intrinsic aging processes . 0 ###LEFT-WALL### 6 aging 0 ###LEFT-WALL### 10 assessed 1 on 4 hand 1 on 5 , 1 on 6 aging 2 the 3 other 3 other 4 hand 6 aging 7 can 7 can 9 be 8 also 9 be 9 be 10 assessed 10 assessed 11 in 10 assessed 16 in 10 assessed 25 from 10 assessed 29 to 11 in 12 terms 12 terms 13 of 13 of 15 changes 14 biological 15 changes 16 in 18 tissues 17 certain 18 tissues 18 tissues 19 like 18 tissues 23 which 18 tissues 24 result 19 like 22 compartment 20 the 22 compartment 21 blood 22 compartment 23 which 24 result 25 from 27 alterations 26 adaptive 27 alterations 28 due 29 to 29 to 31 history 30 past 31 history 31 history 32 of 31 history 37 as 32 of 33 exposures 34 , 37 as 35 as 36 well 36 well 37 as 37 as 40 processes 37 as 41 . 38 intrinsic 40 processes 39 aging 40 processes there are major signs of ['] aging ['] in lymphocytes ( e.g [.] lymphocyte subset distribution , telomere length , p16ink4 [a] expression ) , [and] also in [(] inflammatory ) cytokine expression and gene expression patterns . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 38 . 1 there 2 are 2 are 4 signs 3 major 4 signs 4 signs 5 of 5 of 7 aging 7 aging 9 in 7 aging 27 also 7 aging 28 in 9 in 10 lymphocytes 10 lymphocytes 16 distribution 10 lymphocytes 19 length 11 ( 16 distribution 12 e.g 16 distribution 14 lymphocyte 16 distribution 15 subset 16 distribution 16 distribution 17 , 17 , 19 length 18 telomere 19 length 19 length 23 expression 19 length 25 , 20 , 23 expression 21 p16ink4 23 expression 23 expression 24 ) 28 in 34 and 30 inflammatory 31 ) 30 inflammatory 32 cytokine 32 cytokine 33 expression 33 expression 34 and 34 and 37 patterns 35 gene 37 patterns 36 expression 37 patterns these result from a combination of [the] above two processes , overlaying genetic predispositions which contribute significantly to the aging phenotype . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 result 1 these 2 result 2 result 3 from 3 from 5 combination 4 a 5 combination 5 combination 6 of 6 of 8 above 8 above 10 processes 9 two 10 processes 10 processes 12 overlaying 11 , 12 overlaying 12 overlaying 14 predispositions 12 overlaying 22 . 13 genetic 14 predispositions 14 predispositions 15 which 14 predispositions 16 contribute 15 which 16 contribute 16 contribute 17 significantly 16 contribute 18 to 18 to 21 phenotype 19 the 21 phenotype 20 aging 21 phenotype these potential " aging biomarkers " might provide additional prognostic/predictive information supplementing [clinical] [evaluation] . 0 ###LEFT-WALL### 5 biomarkers 0 ###LEFT-WALL### 8 provide 0 ###LEFT-WALL### 15 . 1 these 5 biomarkers 2 potential 3 " 2 potential 4 aging 4 aging 5 biomarkers 5 biomarkers 6 " 5 biomarkers 7 might 7 might 8 provide 8 provide 12 supplementing 9 additional 11 information 10 prognostic/predictive 11 information 11 information 12 supplementing the purpose of the current paper is to describe the most relevant potential " aging biomarkers " ( markers that indicate the biological functional age of patients [ )(which focus on the biological background , the [(] limited ) available clinical data , and technical challenges . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 35 , 0 ###LEFT-WALL### 47 . 1 the 2 purpose 2 purpose 3 of 2 purpose 7 is 3 of 6 paper 4 the 6 paper 5 current 6 paper 7 is 8 to 7 is 9 describe 8 to 9 describe 9 describe 13 potential 10 the 13 potential 11 most 12 relevant 12 relevant 13 potential 13 potential 14 " 13 potential 15 aging 13 potential 19 markers 15 aging 16 biomarkers 16 biomarkers 17 " 18 ( 19 markers 19 markers 20 that 19 markers 21 indicate 19 markers 35 , 20 that 21 indicate 21 indicate 25 age 21 indicate 31 on 22 the 25 age 23 biological 25 age 24 functional 25 age 25 age 26 of 26 of 27 patients 27 patients 29 )(which 27 patients 30 focus 29 )(which 30 focus 31 on 34 background 32 the 34 background 33 biological 34 background 35 , 44 and 36 the 42 data 38 limited 39 ) 38 limited 42 data 40 available 42 data 41 clinical 42 data 42 data 44 and 43 , 44 and 44 and 46 challenges 45 technical 46 challenges despite their great potential interest , there is a need for much more [(] validated ) clinical data before these biomarkers could be used in a routine clinical setting . 0 ###LEFT-WALL### 7 there 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 30 . 1 despite 5 interest 1 despite 6 , 1 despite 7 there 2 their 5 interest 3 great 4 potential 4 potential 5 interest 7 there 8 is 8 is 10 need 9 a 10 need 10 need 11 for 10 need 15 validated 10 need 18 data 10 need 23 be 10 need 24 used 10 need 25 in 11 for 13 more 12 much 13 more 15 validated 16 ) 15 validated 17 clinical 18 data 19 before 18 data 22 could 19 before 21 biomarkers 20 these 21 biomarkers 22 could 23 be 25 in 29 setting 26 a 29 setting 27 routine 29 setting 28 clinical 29 setting this manuscript tries to provide a guideline on how these markers can be integrated in future research aimed at providing such data . 0 ###LEFT-WALL### 2 manuscript 0 ###LEFT-WALL### 3 tries 0 ###LEFT-WALL### 23 . 1 this 2 manuscript 2 manuscript 3 tries 3 tries 4 to 3 tries 5 provide 4 to 5 provide 5 provide 7 guideline 5 provide 8 on 5 provide 19 at 6 a 7 guideline 8 on 9 how 9 how 11 markers 9 how 14 integrated 10 these 11 markers 11 markers 12 can 12 can 13 be 13 be 14 integrated 14 integrated 15 in 15 in 17 research 16 future 17 research 17 research 18 aimed 19 at 20 providing 20 providing 22 data 21 such 22 data background : old age and hypertension are consistently reported to be the main risk factors of leukoaraiosis . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 and 2 : 9 reported 2 : 18 . 3 old 4 age 4 age 5 and 5 and 6 hypertension 5 and 7 are 7 are 9 reported 8 consistently 9 reported 9 reported 10 to 9 reported 11 be 10 to 11 be 11 be 15 factors 12 the 13 main 12 the 15 factors 14 risk 15 factors 15 factors 16 of 16 of 17 leukoaraiosis the association between white matter lesions ( wmls [ )(and other cardiovascular risk factors ( cvrf ) remains controversial . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 18 remains 0 ###LEFT-WALL### 20 . 1 the 2 association 2 association 3 between 2 association 10 )(and 2 association 18 remains 3 between 6 lesions 4 white 5 matter 5 matter 6 lesions 7 ( 10 )(and 8 wmls 10 )(and 10 )(and 14 factors 10 )(and 16 cvrf 10 )(and 17 ) 11 other 14 factors 12 cardiovascular 14 factors 13 risk 14 factors 15 ( 16 cvrf 16 cvrf 17 ) 18 remains 19 controversial we evaluated the association between cvrf and wmls in a cohort study and determined the blood pressure variables that could predict wml severity . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 . 1 we 13 and 2 evaluated 4 association 2 evaluated 5 between 2 evaluated 9 in 2 evaluated 13 and 3 the 4 association 5 between 7 and 6 cvrf 7 and 7 and 8 wmls 9 in 12 study 10 a 12 study 11 cohort 12 study 13 and 14 determined 14 determined 18 variables 14 determined 21 predict 15 the 18 variables 16 blood 17 pressure 17 pressure 18 variables 18 variables 19 that 18 variables 20 could 18 variables 21 predict 19 that 20 could 21 predict 23 severity 22 wml 23 severity methods : 830 subjects ( 65+/ - 1 years of age , 60 % women ) from the proof study , with a reliable abpm and brain mri , were included . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 - 1 methods 2 : 2 : 4 subjects 3 830 4 subjects 4 subjects 6 65+/ 5 ( 6 65+/ 6 65+/ 7 - 7 - 8 1 7 - 30 were 7 - 32 . 8 1 9 years 8 1 20 study 8 1 22 with 8 1 30 were 9 years 10 of 9 years 17 from 9 years 20 study 10 of 11 age 11 age 15 women 12 , 15 women 13 60 14 % 14 % 15 women 15 women 16 ) 17 from 19 proof 18 the 19 proof 21 , 22 with 22 with 26 and 22 with 29 , 23 a 25 abpm 24 reliable 25 abpm 25 abpm 26 and 26 and 28 mri 27 brain 28 mri 30 were 31 included the exclusion criteria included prior myocardial infarction , stroke , heart failure , atrial fibrillation , type 1 diabetes mellitus , and pacing . 0 ###LEFT-WALL### 3 criteria 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 24 . 1 the 3 criteria 2 exclusion 3 criteria 3 criteria 8 , 4 included 7 infarction 4 included 8 , 5 prior 7 infarction 6 myocardial 7 infarction 8 , 9 stroke 10 , 11 heart 10 , 16 , 11 heart 12 failure 12 failure 15 fibrillation 13 , 15 fibrillation 14 atrial 15 fibrillation 15 fibrillation 16 , 16 , 17 type 17 type 18 1 17 type 22 and 19 diabetes 20 mellitus 20 mellitus 22 and 21 , 22 and 22 and 23 pacing white matter changes on mri were defined as hyperintensities >5 [mm] on flair images . 0 ###LEFT-WALL### 1 white 0 ###LEFT-WALL### 15 . 1 white 2 matter 2 matter 3 changes 2 matter 10 >5 3 changes 4 on 3 changes 6 were 4 on 5 mri 6 were 7 defined 7 defined 8 as 8 as 9 hyperintensities 8 as 10 >5 9 hyperintensities 10 >5 10 >5 12 on 12 on 14 images 13 flair 14 images we used the total degree of wml ( range : 0 - 30 ) by adding the region - specific scores of both hemispheres . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 1 we 2 used 2 used 7 wml 3 the 5 degree 4 total 5 degree 5 degree 6 of 5 degree 7 wml 6 of 7 wml 7 wml 19 - 8 ( 19 - 9 range 10 : 10 : 11 0 10 : 15 by 11 0 13 30 12 - 13 30 13 30 14 ) 15 by 16 adding 16 adding 18 region 16 adding 19 - 17 the 18 region 18 region 19 - 19 - 24 hemispheres 19 - 25 . 20 specific 21 scores 21 scores 22 of 21 scores 24 hemispheres 22 of 24 hemispheres 23 both 24 hemispheres results : linear regression analyses demonstrated a significant relationship between total leukoaraiosis [score] and 24 h systolic blood pressure ( sbp ) , 24 h diastolic bp , daytime sbp and dbp and nighttime sbp . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 6 demonstrated 1 results 2 : 2 : 3 linear 3 linear 5 analyses 3 linear 6 demonstrated 4 regression 5 analyses 5 analyses 6 demonstrated 6 demonstrated 9 relationship 6 demonstrated 10 between 7 a 8 significant 7 a 9 relationship 8 significant 9 relationship 10 between 14 and 11 total 12 leukoaraiosis 12 leukoaraiosis 14 and 14 and 19 pressure 14 and 21 sbp 14 and 27 bp 15 24 16 h 16 h 19 pressure 17 systolic 18 blood 18 blood 19 pressure 20 ( 21 sbp 21 sbp 22 ) 23 , 27 bp 24 24 25 h 25 h 27 bp 26 diastolic 27 bp 27 bp 33 and 27 bp 36 . 28 , 33 and 29 daytime 30 sbp 30 sbp 31 and 31 and 32 dbp 31 and 33 and 33 and 35 sbp 33 and 36 . 34 nighttime 35 sbp no significant relationship was found between leukoaraiosis [score] and clinical sbp , clinical dbp , or nocturnal dip . 0 ###LEFT-WALL### 3 relationship 0 ###LEFT-WALL### 5 found 0 ###LEFT-WALL### 19 . 1 no 3 relationship 2 significant 3 relationship 3 relationship 4 was 4 was 5 found 5 found 6 between 6 between 16 or 7 leukoaraiosis 9 and 9 and 11 sbp 9 and 12 , 10 clinical 11 sbp 12 , 14 dbp 12 , 16 or 13 clinical 14 dbp 15 , 16 or 16 or 18 dip 17 nocturnal 18 dip there was also no significant relationship between leukoaraiosis and other recognized cardiovascular risk factors . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 15 . 1 there 2 was 2 was 3 also 2 was 6 relationship 4 no 6 relationship 5 significant 6 relationship 6 relationship 7 between 6 relationship 11 recognized 6 relationship 13 risk 6 relationship 14 factors 7 between 9 and 8 leukoaraiosis 9 and 9 and 10 other 12 cardiovascular 13 risk 13 risk 14 factors based on a roc curve analysis , we identified the optimal threshold separating high - risk wml patients for a mean 24 h sbp above 123 mmhg ( p<0.05 ) . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 9 identified 0 ###LEFT-WALL### 31 . 1 based 2 on 1 based 7 , 1 based 8 we 2 on 6 analysis 3 a 6 analysis 4 roc 5 curve 5 curve 6 analysis 8 we 9 identified 9 identified 14 high 10 the 14 high 11 optimal 12 threshold 12 threshold 13 separating 13 separating 14 high 14 high 18 patients 15 - 18 patients 16 risk 18 patients 17 wml 18 patients 18 patients 19 for 18 patients 25 above 18 patients 29 p<0.05 18 patients 30 ) 19 for 24 sbp 20 a 21 mean 20 a 24 sbp 21 mean 24 sbp 22 24 23 h 23 h 24 sbp 25 above 27 mmhg 26 123 27 mmhg 28 ( 29 p<0.05 29 p<0.05 30 ) conclusions : even moderate increases in 24 h sbp promote arteriolar fragility of the cerebral white matter in a population aged 65 . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 increases 2 : 10 promote 2 : 23 . 3 even 5 increases 4 moderate 5 increases 5 increases 6 in 5 increases 10 promote 6 in 9 sbp 7 24 8 h 8 h 9 sbp 10 promote 12 fragility 10 promote 18 in 11 arteriolar 12 fragility 12 fragility 13 of 13 of 17 matter 14 the 17 matter 15 cerebral 16 white 16 white 17 matter 18 in 20 population 19 a 20 population 20 population 21 aged 21 aged 22 65 the prognostic implications of such abnormalities in asymptomatic and moderate cardiovascular risk populations remain to be evaluated . 0 ###LEFT-WALL### 3 implications 0 ###LEFT-WALL### 14 remain 0 ###LEFT-WALL### 18 . 1 the 3 implications 2 prognostic 3 implications 3 implications 4 of 3 implications 14 remain 4 of 6 abnormalities 5 such 6 abnormalities 6 abnormalities 7 in 7 in 13 populations 8 asymptomatic 9 and 9 and 10 moderate 9 and 13 populations 11 cardiovascular 13 populations 12 risk 13 populations 14 remain 15 to 15 to 16 be 16 be 17 evaluated objective : research suggests that self - esteem can decline in older adulthood . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 research 2 : 4 suggests 2 : 7 - 3 research 4 suggests 4 suggests 6 self 5 that 6 self 7 - 8 esteem 7 - 10 decline 7 - 14 . 8 esteem 9 can 9 can 10 decline 10 decline 11 in 11 in 13 adulthood 12 older 13 adulthood this process could remove a buffer that normally protects individuals against distress - related changes in cortisol secretion . 0 ###LEFT-WALL### 2 process 0 ###LEFT-WALL### 4 remove 0 ###LEFT-WALL### 14 related 1 this 2 process 2 process 3 could 3 could 4 remove 4 remove 6 buffer 5 a 6 buffer 6 buffer 7 that 6 buffer 9 protects 7 that 9 protects 8 normally 9 protects 9 protects 10 individuals 9 protects 11 against 11 against 12 distress 13 - 14 related 14 related 15 changes 14 related 16 in 14 related 19 . 16 in 18 secretion 17 cortisol 18 secretion we examined this possibility by testing whether change in self [-] esteem would predict alterations in cortisol secretion , particularly among older adults who reported high levels of depressive symptoms or perceived stress . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 1 we 2 examined 2 examined 4 possibility 2 examined 5 by 2 examined 21 among 3 this 4 possibility 5 by 6 testing 6 testing 7 whether 6 testing 16 in 7 whether 8 change 7 whether 14 predict 8 change 9 in 8 change 13 would 9 in 12 esteem 10 self 12 esteem 13 would 14 predict 14 predict 15 alterations 16 in 18 secretion 17 cortisol 18 secretion 19 , 20 particularly 19 , 21 among 21 among 23 adults 21 among 34 . 22 older 23 adults 23 adults 24 who 23 adults 31 or 24 who 31 or 25 reported 27 levels 25 reported 31 or 26 high 27 levels 27 levels 28 of 28 of 30 symptoms 29 depressive 30 symptoms 31 or 32 perceived 32 perceived 33 stress methods : 147 older adults ( aged 60+ ) completed three days of diurnal cortisol measurements at three different time points , namely every two years over a total period of four years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 adults 2 : 21 points 3 147 5 adults 4 older 5 adults 5 adults 8 60+ 5 adults 10 completed 6 ( 8 60+ 7 aged 8 60+ 8 60+ 9 ) 10 completed 12 days 10 completed 17 at 11 three 12 days 12 days 13 of 13 of 16 measurements 14 diurnal 15 cortisol 15 cortisol 16 measurements 17 at 18 three 18 three 20 time 18 three 21 points 19 different 20 time 20 time 21 points 21 points 23 namely 22 , 23 namely 23 namely 27 over 23 namely 34 . 24 every 25 two 25 two 26 years 26 years 27 over 27 over 30 period 28 a 30 period 29 total 30 period 30 period 31 of 31 of 33 years 32 four 33 years measures of self [-] esteem , depressive symptoms , and perceived stress were assessed at t1 and t2 . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 14 assessed 0 ###LEFT-WALL### 19 . 1 measures 2 of 1 measures 6 , 2 of 5 esteem 3 self 5 esteem 6 , 8 symptoms 6 , 10 and 7 depressive 8 symptoms 9 , 10 and 10 and 12 stress 10 and 13 were 11 perceived 12 stress 13 were 14 assessed 14 assessed 15 at 15 at 17 and 16 t1 17 and 17 and 18 t2 potential demographic and health - related [confounds] were measured at baseline ( partnership status , ses , mortality risk index , and medication ) . 0 ###LEFT-WALL### 1 potential 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 25 . 1 potential 8 were 2 demographic 3 and 3 and 4 health 3 and 5 - 3 and 6 related 3 and 8 were 8 were 9 measured 9 measured 10 at 10 at 11 baseline 11 baseline 22 and 12 ( 22 and 13 partnership 14 status 14 status 15 , 15 , 16 ses 15 , 17 , 17 , 20 index 17 , 22 and 18 mortality 20 index 19 risk 20 index 21 , 22 and 22 and 23 medication 22 and 24 ) results : linear regression models indicated that a [decline] in self - esteem from t1 to t2 predicted elevated cortisol output ( aucg ) from t2 to t3 [,] f ( 1 , 137 )=8.09 , β= - . 25 [,] [r] ( 2 )=.05 , p=.005 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 4 regression 3 linear 4 regression 4 regression 5 models 4 regression 6 indicated 4 regression 13 esteem 5 models 6 indicated 6 indicated 11 self 7 that 11 self 8 a 10 in 10 in 11 self 12 - 13 esteem 13 esteem 14 from 13 esteem 27 to 13 esteem 38 - 14 from 15 t1 15 t1 16 to 15 t1 25 from 16 to 21 output 17 t2 21 output 18 predicted 21 output 19 elevated 20 cortisol 20 cortisol 21 output 21 output 23 aucg 22 ( 23 aucg 23 aucg 24 ) 25 from 26 t2 27 to 35 )=8.09 28 t3 30 f 28 t3 32 1 28 t3 35 )=8.09 31 ( 32 1 32 1 33 , 34 137 35 )=8.09 35 )=8.09 37 β= 36 , 37 β= 37 β= 38 - 39 . 40 25 39 . 47 p=.005 39 . 48 . 40 25 45 )=.05 40 25 47 p=.005 43 ( 45 )=.05 44 2 45 )=.05 45 )=.05 46 , interaction analyses revealed that this association was particularly strong among participants who experienced higher t1 or t2 levels of depressive symptoms or perceived stress , +1 [+1sd] : βs= - [.] 34 to - [.] 51 , ps<.001 , but not significant among their counterparts who reported relatively lower levels of depressive symptoms or perceived stress , - 1 s [d] [:] βs=.03 to 11 , ps>.43 . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 revealed 1 interaction 2 analyses 2 analyses 3 revealed 3 revealed 4 that 4 that 6 association 4 that 7 was 5 this 6 association 6 association 7 was 7 was 8 particularly 7 was 9 strong 9 strong 10 among 10 among 11 participants 11 participants 12 who 11 participants 13 experienced 11 participants 19 of 12 who 13 experienced 13 experienced 14 higher 13 experienced 18 levels 15 t1 16 or 16 or 17 t2 16 or 18 levels 19 of 22 or 20 depressive 21 symptoms 21 symptoms 22 or 22 or 24 stress 22 or 25 , 22 or 26 +1 22 or 28 : 23 perceived 24 stress 26 +1 28 : 28 : 40 but 29 βs= 33 to 29 βs= 37 , 30 - 32 34 32 34 33 to 33 to 36 51 34 - 36 51 37 , 38 ps<.001 37 , 40 but 39 , 40 but 40 but 41 not 40 but 42 significant 42 significant 43 among 43 among 45 counterparts 44 their 45 counterparts 45 counterparts 46 who 45 counterparts 54 or 46 who 54 or 47 reported 50 levels 47 reported 54 or 48 relatively 49 lower 49 lower 50 levels 50 levels 51 of 51 of 53 symptoms 52 depressive 53 symptoms 54 or 55 perceived 55 perceived 56 stress 56 stress 63 βs=.03 57 , 63 βs=.03 58 - 59 1 59 1 60 s 60 s 63 βs=.03 63 βs=.03 64 to 63 βs=.03 67 ps>.43 63 βs=.03 68 . 64 to 65 11 66 , 67 ps>.43 67 ps>.43 68 . conclusions : declines in self [-] esteem represent a mechanism that contributes to higher levels of diurnal cortisol secretion if older adults experience psychological distress . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 declines 2 : 8 represent 2 : 26 . 3 declines 4 in 3 declines 8 represent 4 in 7 esteem 5 self 7 esteem 8 represent 10 mechanism 9 a 10 mechanism 10 mechanism 11 that 10 mechanism 12 contributes 11 that 12 contributes 12 contributes 13 to 12 contributes 20 if 13 to 15 levels 14 higher 15 levels 15 levels 16 of 16 of 19 secretion 17 diurnal 18 cortisol 18 cortisol 19 secretion 20 if 22 adults 20 if 23 experience 21 older 22 adults 22 adults 23 experience 23 experience 25 distress 24 psychological 25 distress increases in self [-] esteem , by contrast , can ameliorate older adults ' cortisol regulation in stressful circumstances . 0 ###LEFT-WALL### 1 increases 0 ###LEFT-WALL### 11 ameliorate 0 ###LEFT-WALL### 20 . 1 increases 2 in 1 increases 10 can 2 in 5 esteem 3 self 5 esteem 5 esteem 7 by 6 , 7 by 7 by 8 contrast 7 by 9 , 10 can 11 ameliorate 11 ameliorate 16 regulation 11 ameliorate 17 in 12 older 13 adults 13 adults 14 ' 14 ' 16 regulation 15 cortisol 16 regulation 17 in 19 circumstances 18 stressful 19 circumstances one of the most consistent findings in the biology of depression is an altered activity of the hypothalamic - pituitary - adrenal ( hpa ) axis . 0 ###LEFT-WALL### 1 one 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 27 . 1 one 2 of 1 one 12 is 2 of 6 findings 3 the 4 most 4 most 6 findings 5 consistent 6 findings 6 findings 7 in 7 in 9 biology 8 the 9 biology 9 biology 10 of 10 of 11 depression 12 is 15 activity 13 an 15 activity 14 altered 15 activity 15 activity 16 of 16 of 26 axis 17 the 26 axis 18 hypothalamic 19 - 18 hypothalamic 26 axis 20 pituitary 21 - 20 pituitary 26 axis 22 adrenal 24 hpa 22 adrenal 26 axis 23 ( 24 hpa 24 hpa 25 ) however , data concerning this issue have never been examined with a focus on the older population . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 10 examined 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 3 data 3 data 4 concerning 3 data 7 have 4 concerning 6 issue 5 this 6 issue 7 have 9 been 8 never 9 been 9 been 10 examined 10 examined 11 with 10 examined 14 on 11 with 13 focus 12 a 13 focus 14 on 17 population 15 the 17 population 16 older 17 population here we present a systematic review and meta - analysis , based on studies investigating levels of cortisol , adrenocorticotropic hormone [(] acth ) and corticotropin - releasing hormone [(] crh ) in depressed participants older than 60 and compared with healthy controls . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 44 . 1 here 2 we 2 we 11 , 3 present 10 analysis 3 present 11 , 4 a 5 systematic 4 a 6 review 5 systematic 6 review 6 review 7 and 7 and 8 meta 7 and 9 - 7 and 10 analysis 11 , 12 based 11 , 41 with 12 based 13 on 12 based 25 and 12 based 28 releasing 12 based 33 in 13 on 14 studies 14 studies 15 investigating 16 levels 17 of 16 levels 25 and 17 of 18 cortisol 18 cortisol 23 acth 19 , 23 acth 20 adrenocorticotropic 23 acth 21 hormone 23 acth 23 acth 24 ) 25 and 26 corticotropin 27 - 28 releasing 28 releasing 31 crh 28 releasing 32 ) 29 hormone 31 crh 33 in 39 and 34 depressed 35 participants 34 depressed 39 and 35 participants 36 older 36 older 37 than 37 than 38 60 39 and 40 compared 41 with 43 controls 42 healthy 43 controls we found 20 studies , for a total of 43 comparisons on different indices of hpa axis functioning . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 1 we 2 found 2 found 4 studies 3 20 4 studies 4 studies 6 for 5 , 6 for 6 for 8 total 6 for 19 . 7 a 8 total 8 total 9 of 9 of 11 comparisons 10 43 11 comparisons 11 comparisons 12 on 12 on 14 indices 13 different 14 indices 14 indices 15 of 15 of 17 axis 16 hpa 17 axis 17 axis 18 functioning depression had a significant effect ( hedges ' [g] ) on basal cortisol levels measured in the morning ( 0.89 ) , afternoon ( 0.83 ) and night ( 1.39 ) , but a smaller effect on cortisol measured continuously ( 0.51 ) . 0 ###LEFT-WALL### 1 depression 0 ###LEFT-WALL### 2 had 0 ###LEFT-WALL### 44 . 1 depression 2 had 2 had 5 effect 2 had 11 on 3 a 4 significant 3 a 5 effect 4 significant 5 effect 5 effect 8 ' 6 ( 8 ' 7 hedges 8 ' 8 ' 10 ) 11 on 27 and 12 basal 13 cortisol 13 cortisol 14 levels 14 levels 15 measured 14 levels 27 and 15 measured 16 in 16 in 18 morning 17 the 18 morning 18 morning 20 0.89 18 morning 23 afternoon 19 ( 20 0.89 20 0.89 21 ) 22 , 23 afternoon 23 afternoon 25 0.83 23 afternoon 26 ) 24 ( 25 0.83 25 0.83 26 ) 27 and 28 night 28 night 30 1.39 28 night 33 but 29 ( 30 1.39 30 1.39 31 ) 32 , 33 but 33 but 36 effect 33 but 43 ) 34 a 36 effect 35 smaller 36 effect 36 effect 37 on 37 on 38 cortisol 38 cortisol 39 measured 38 cortisol 42 0.51 39 measured 40 continuously 41 ( 42 0.51 42 0.51 43 ) the effect of depression was even higher on post - dexamethasone cortisol levels ( 3.22 ) , whereas it was [non] - significant on morning acth and crh levels . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 30 . 1 the 2 effect 2 effect 3 of 2 effect 5 was 3 of 4 depression 5 was 6 even 5 was 7 higher 7 higher 8 on 7 higher 18 whereas 8 on 9 post 9 post 13 levels 10 - 13 levels 11 dexamethasone 12 cortisol 12 cortisol 13 levels 13 levels 15 3.22 13 levels 16 ) 14 ( 15 3.22 15 3.22 16 ) 17 , 18 whereas 18 whereas 19 it 18 whereas 20 was 18 whereas 22 - 19 it 20 was 22 - 27 and 23 significant 24 on 23 significant 27 and 24 on 26 acth 25 morning 26 acth 27 and 29 levels 28 crh 29 levels subgroup analyses indicated that various methodological and clinical factors can influence the study results . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 indicated 0 ###LEFT-WALL### 15 . 1 subgroup 2 analyses 2 analyses 3 indicated 3 indicated 4 that 4 that 9 factors 4 that 11 influence 5 various 9 factors 6 methodological 7 and 7 and 8 clinical 7 and 9 factors 9 factors 10 can 10 can 11 influence 11 influence 14 results 12 the 14 results 13 study 14 results overall , older participants suffering from depression show a high degree of dysregulation of hpa axis activity , with differences compared with younger adults . 0 ###LEFT-WALL### 4 participants 0 ###LEFT-WALL### 8 show 1 overall 2 , 1 overall 4 participants 3 older 4 participants 4 participants 5 suffering 4 participants 8 show 5 suffering 6 from 6 from 7 depression 8 show 13 dysregulation 8 show 17 activity 9 a 10 high 9 a 11 degree 10 high 11 degree 11 degree 12 of 11 degree 13 dysregulation 12 of 13 dysregulation 13 dysregulation 14 of 14 of 16 axis 15 hpa 16 axis 17 activity 19 with 18 , 19 with 19 with 20 differences 19 with 25 . 20 differences 21 compared 21 compared 22 with 22 with 24 adults 23 younger 24 adults this might depend on several mechanisms , including physical illnesses , alterations in the cns and immune - endocrinological alterations . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 depend 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 21 . 1 this 2 might 2 might 3 depend 3 depend 4 on 4 on 6 mechanisms 5 several 6 mechanisms 6 mechanisms 8 including 7 , 8 including 8 including 10 illnesses 8 including 11 , 9 physical 10 illnesses 11 , 16 and 12 alterations 13 in 12 alterations 16 and 13 in 15 cns 14 the 15 cns 16 and 20 alterations 17 immune 18 - 17 immune 20 alterations 19 endocrinological 20 alterations further studies are needed to clarify the implications of altered hpa axis activity in older patients suffering from depression . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 needed 0 ###LEFT-WALL### 20 . 1 further 2 studies 2 studies 3 are 3 are 4 needed 4 needed 5 to 4 needed 14 in 5 to 6 clarify 6 clarify 8 implications 7 the 8 implications 8 implications 9 of 9 of 13 activity 10 altered 13 activity 11 hpa 13 activity 12 axis 13 activity 14 in 16 patients 15 older 16 patients 16 patients 17 suffering 16 patients 18 from 18 from 19 depression novel pharmacological approaches might be effective in targeting this pathophysiological feature , thus improving the clinical outcomes . 0 ###LEFT-WALL### 3 approaches 0 ###LEFT-WALL### 5 be 1 novel 3 approaches 2 pharmacological 3 approaches 3 approaches 4 might 4 might 5 be 5 be 6 effective 6 effective 7 in 7 in 8 targeting 8 targeting 11 feature 9 this 11 feature 10 pathophysiological 11 feature 11 feature 14 improving 12 , 14 improving 13 thus 14 improving 14 improving 17 outcomes 14 improving 18 . 15 the 17 outcomes 16 clinical 17 outcomes background : epigenome - wide association studies of human disease and other quantitative traits are [becoming] increasingly common . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 background 2 : 2 : 3 epigenome 4 - 7 studies 4 - 15 are 4 - 19 . 5 wide 6 association 6 association 7 studies 7 studies 8 of 7 studies 15 are 8 of 11 and 9 human 10 disease 10 disease 11 and 11 and 14 traits 12 other 14 traits 13 quantitative 14 traits 15 are 17 increasingly 15 are 18 common [a] series of papers reporting age - related changes in dna methylation profiles in peripheral blood have already been published . 0 ###LEFT-WALL### 2 series 0 ###LEFT-WALL### 6 age 0 ###LEFT-WALL### 8 related 0 ###LEFT-WALL### 21 . 2 series 3 of 2 series 6 age 3 of 4 papers 4 papers 5 reporting 7 - 8 related 8 related 9 changes 9 changes 10 in 9 changes 20 published 10 in 11 dna 11 dna 13 profiles 11 dna 19 been 12 methylation 13 profiles 13 profiles 14 in 13 profiles 17 have 14 in 16 blood 15 peripheral 16 blood 17 have 19 been 18 already 19 been however , blood is a heterogeneous collection of different cell types , each with a very different dna methylation profile . 0 ###LEFT-WALL### 3 blood 0 ###LEFT-WALL### 4 is 1 however 2 , 1 however 3 blood 3 blood 4 is 4 is 11 types 5 a 6 heterogeneous 5 a 7 collection 6 heterogeneous 7 collection 7 collection 8 of 7 collection 11 types 8 of 11 types 9 different 10 cell 10 cell 11 types 11 types 13 each 12 , 13 each 13 each 14 with 13 each 21 . 14 with 20 profile 15 a 16 very 15 a 20 profile 16 very 17 different 17 different 20 profile 18 dna 20 profile 19 methylation 20 profile results : using a statistical method that permits estimating the relative proportion of cell types from dna methylation profiles , we examine data from five previously published studies , and find strong evidence of cell composition change across age in blood . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 42 . 2 : 21 we 2 : 30 and 3 using 6 method 3 using 16 from 3 using 20 , 3 using 21 we 4 a 5 statistical 4 a 6 method 5 statistical 6 method 6 method 7 that 6 method 12 proportion 6 method 13 of 7 that 8 permits 7 that 12 proportion 8 permits 9 estimating 8 permits 12 proportion 9 estimating 11 relative 10 the 11 relative 13 of 15 types 14 cell 15 types 16 from 19 profiles 17 dna 18 methylation 18 methylation 19 profiles 21 we 30 and 22 examine 23 data 22 examine 27 published 22 examine 30 and 23 data 24 from 23 data 27 published 24 from 25 five 26 previously 27 published 27 published 28 studies 29 , 30 and 30 and 31 find 30 and 32 strong 30 and 33 evidence 33 evidence 34 of 34 of 37 change 35 cell 36 composition 36 composition 37 change 37 change 38 across 37 change 40 in 38 across 39 age 40 in 41 blood we also demonstrate that , in these studies , cellular composition explains much of the observed variability in dna methylation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 21 . 1 we 3 demonstrate 2 also 3 demonstrate 3 demonstrate 4 that 4 that 11 composition 4 that 12 explains 5 , 6 in 6 in 8 studies 6 in 9 , 6 in 11 composition 7 these 8 studies 10 cellular 11 composition 11 composition 12 explains 12 explains 13 much 12 explains 18 in 13 much 14 of 14 of 17 variability 15 the 17 variability 16 observed 17 variability 18 in 20 methylation 19 dna 20 methylation furthermore , we find high levels of confounding between age - related variability and cellular composition at the cpg level . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 find 0 ###LEFT-WALL### 21 . 1 furthermore 2 , 1 furthermore 3 we 3 we 4 find 4 find 6 levels 4 find 20 level 5 high 6 levels 6 levels 7 of 6 levels 20 level 7 of 8 confounding 8 confounding 9 between 9 between 10 age 11 - 12 related 12 related 14 and 12 related 17 at 12 related 20 level 13 variability 14 and 14 and 16 composition 15 cellular 16 composition 17 at 19 cpg 18 the 19 cpg conclusions : our findings underscore the importance of considering cell composition variability in epigenetic studies based on whole blood and other heterogeneous tissue sources . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 based 0 ###LEFT-WALL### 25 . 2 : 4 findings 2 : 5 underscore 3 our 4 findings 4 findings 5 underscore 5 underscore 7 importance 6 the 7 importance 7 importance 8 of 7 importance 12 variability 7 importance 16 based 8 of 9 considering 9 considering 11 composition 10 cell 11 composition 12 variability 13 in 12 variability 16 based 13 in 15 studies 14 epigenetic 15 studies 16 based 17 on 17 on 20 and 18 whole 19 blood 19 blood 20 and 20 and 24 sources 21 other 24 sources 22 heterogeneous 24 sources 23 tissue 24 sources we also provide software for estimating [and] exploring this composition confounding for the illumina 450k microarray . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 17 . 1 we 3 provide 2 also 3 provide 3 provide 4 software 4 software 5 for 4 software 8 exploring 5 for 6 estimating 8 exploring 11 confounding 9 this 11 confounding 10 composition 11 confounding 11 confounding 12 for 12 for 16 microarray 13 the 16 microarray 14 illumina 15 450k 15 450k 16 microarray this study examines electroglottographic ( egg ) recordings for 15 young and 14 old male speakers of new zealand english . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examines 0 ###LEFT-WALL### 21 . 1 this 2 study 2 study 3 examines 3 examines 8 recordings 3 examines 9 for 4 electroglottographic 6 egg 4 electroglottographic 8 recordings 5 ( 6 egg 6 egg 7 ) 9 for 20 english 10 15 20 english 11 young 12 and 12 and 16 speakers 12 and 17 of 12 and 20 english 13 14 16 speakers 14 old 16 speakers 15 male 16 speakers 17 of 19 zealand 18 new 19 zealand analysis was performed on the sustained vowels /i:/ and /a:/ at three target levels for both pitch and loudness . 0 ###LEFT-WALL### 1 analysis 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 20 . 1 analysis 2 was 2 was 3 performed 3 performed 4 on 3 performed 9 and 4 on 7 vowels 5 the 7 vowels 6 sustained 7 vowels 8 /i:/ 9 and 9 and 10 /a:/ 10 /a:/ 11 at 11 at 14 levels 12 three 14 levels 13 target 14 levels 14 levels 15 for 15 for 18 and 16 both 18 and 17 pitch 18 and 18 and 19 loudness jitter [was] [greater] for older speakers , and the contact quotient ( qx ) was significantly lower for older speakers . 0 ###LEFT-WALL### 1 jitter 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 21 . 1 jitter 4 for 4 for 6 speakers 5 older 6 speakers 7 , 8 and 8 and 11 quotient 8 and 15 was 9 the 11 quotient 10 contact 11 quotient 11 quotient 13 qx 11 quotient 15 was 12 ( 13 qx 13 qx 14 ) 15 was 16 significantly 15 was 17 lower 17 lower 18 for 18 for 20 speakers 19 older 20 speakers the greater [jitter] [for] older speakers [indicates] [a] decrease in the stability of the vocal production mechanism of the older speakers . 0 ###LEFT-WALL### 6 speakers 0 ###LEFT-WALL### 9 decrease 0 ###LEFT-WALL### 22 . 1 the 6 speakers 2 greater 6 speakers 5 older 6 speakers 6 speakers 9 decrease 9 decrease 10 in 10 in 12 stability 11 the 12 stability 12 stability 13 of 13 of 17 mechanism 14 the 17 mechanism 15 vocal 16 production 16 production 17 mechanism 17 mechanism 18 of 18 of 21 speakers 19 the 21 speakers 20 older 21 speakers [the] [jitter] is an acoustic measure , so to examine the stability at a physiological level , a perturbation measure of the qx is developed and applied to the egg recordings . 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 32 . 3 is 6 measure 4 an 6 measure 5 acoustic 6 measure 6 measure 9 to 7 , 9 to 8 so 9 to 9 to 10 examine 9 to 17 , 10 examine 12 stability 11 the 12 stability 12 stability 13 at 13 at 16 level 14 a 15 physiological 14 a 16 level 15 physiological 16 level 17 , 20 measure 17 , 26 and 18 a 20 measure 19 perturbation 20 measure 20 measure 21 of 20 measure 24 is 21 of 23 qx 22 the 23 qx 24 is 26 and 25 developed 26 and 26 and 27 applied 26 and 28 to 28 to 31 recordings 29 the 31 recordings 30 egg 31 recordings the contact quotient perturbation ( cqp ) showed a significant increase for older speakers ( 1.55 [%] and 3.54 % for young and old , respectively ) , and this demonstrated more about the variability than the [jitter] data alone . 0 ###LEFT-WALL### 4 perturbation 0 ###LEFT-WALL### 8 showed 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 41 . 1 the 4 perturbation 2 contact 4 perturbation 3 quotient 4 perturbation 4 perturbation 6 cqp 4 perturbation 8 showed 5 ( 6 cqp 6 cqp 7 ) 8 showed 11 increase 8 showed 26 respectively 9 a 10 significant 9 a 11 increase 10 significant 11 increase 11 increase 12 for 12 for 14 speakers 13 older 14 speakers 14 speakers 20 % 15 ( 20 % 16 1.55 18 and 18 and 19 3.54 18 and 20 % 20 % 21 for 20 % 25 , 21 for 23 and 22 young 23 and 23 and 24 old 25 , 26 respectively 26 respectively 27 ) 28 , 29 and 29 and 30 this 29 and 31 demonstrated 30 this 31 demonstrated 31 demonstrated 32 more 31 demonstrated 33 about 31 demonstrated 36 than 31 demonstrated 40 alone 33 about 35 variability 34 the 35 variability 36 than 39 data 37 the 39 data when loudness is also considered , the qx was significantly greater for louder vowels , whereas its perturbation was significantly lower for louder vowels . 0 ###LEFT-WALL### 8 qx 0 ###LEFT-WALL### 9 was 1 when 2 loudness 1 when 5 considered 1 when 6 , 1 when 8 qx 2 loudness 3 is 3 is 4 also 3 is 5 considered 7 the 8 qx 8 qx 9 was 9 was 10 significantly 9 was 11 greater 11 greater 12 for 11 greater 16 whereas 12 for 14 vowels 13 louder 14 vowels 15 , 16 whereas 16 whereas 18 perturbation 16 whereas 19 was 16 whereas 25 . 17 its 18 perturbation 18 perturbation 19 was 19 was 20 significantly 19 was 21 lower 21 lower 22 for 22 for 24 vowels 23 louder 24 vowels this relationship combined with the age effect , with the cqp for all three loudness levels being greater for the older speakers . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 3 combined 1 this 2 relationship 2 relationship 3 combined 3 combined 4 with 3 combined 9 with 4 with 7 effect 5 the 7 effect 6 age 7 effect 8 , 9 with 9 with 11 cqp 9 with 12 for 9 with 23 . 10 the 11 cqp 12 for 16 levels 13 all 16 levels 14 three 15 loudness 15 loudness 16 levels 16 levels 17 being 16 levels 19 for 17 being 18 greater 19 for 22 speakers 20 the 22 speakers 21 older 22 speakers the findings of this study will contribute to the development of vocal fold models that account for aging . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 7 contribute 0 ###LEFT-WALL### 19 . 1 the 2 findings 2 findings 3 of 2 findings 6 will 3 of 5 study 4 this 5 study 6 will 7 contribute 7 contribute 8 to 8 to 10 development 9 the 10 development 10 development 11 of 11 of 14 models 12 vocal 14 models 13 fold 14 models 14 models 15 that 14 models 16 account 15 that 16 account 16 account 17 for 17 for 18 aging objective : although apolipoprotein ( apoe ) ε4 allele is a well - established risk [factor] for late - onset alzheimer disease ( ad ) , the mechanism of its effects on ad pathogenesis is not fully understood . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 39 . 2 : 9 allele 2 : 10 is 2 : 26 , 3 although 4 apolipoprotein 3 although 7 ) 3 although 9 allele 4 apolipoprotein 6 apoe 5 ( 6 apoe 6 apoe 7 ) 8 ε4 9 allele 9 allele 10 is 10 is 12 well 11 a 12 well 12 well 15 risk 13 - 15 risk 14 established 15 risk 15 risk 17 for 15 risk 26 , 17 for 22 disease 18 late 19 - 18 late 22 disease 20 onset 22 disease 21 alzheimer 22 disease 22 disease 24 ad 23 ( 24 ad 24 ad 25 ) 26 , 28 mechanism 26 , 38 understood 27 the 28 mechanism 28 mechanism 29 of 28 mechanism 35 is 29 of 31 effects 30 its 31 effects 31 effects 32 on 32 on 34 pathogenesis 33 ad 34 pathogenesis 35 is 36 not 35 is 38 understood 37 fully 38 understood we aimed to investigate the effects of apoe [genotype] on regional cerebral glucose metabolism in cognitively normal [(] cn [ )( . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 22 . 1 we 2 aimed 2 aimed 3 to 2 aimed 10 on 2 aimed 15 in 3 to 4 investigate 4 investigate 6 effects 5 the 6 effects 6 effects 7 of 7 of 8 apoe 10 on 14 metabolism 11 regional 13 glucose 12 cerebral 13 glucose 13 glucose 14 metabolism 15 in 19 cn 16 cognitively 17 normal 17 normal 19 cn we further tried to elucidate whether or not such effects are associated with beta - amyloid protein ( aβ ) deposition . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 tried 0 ###LEFT-WALL### 22 . 1 we 3 tried 2 further 3 tried 3 tried 4 to 3 tried 5 elucidate 4 to 5 elucidate 5 elucidate 8 not 5 elucidate 21 deposition 6 whether 7 or 7 or 8 not 8 not 10 effects 8 not 12 associated 9 such 10 effects 10 effects 11 are 11 are 12 associated 12 associated 13 with 13 with 14 beta 14 beta 17 protein 15 - 17 protein 16 amyloid 17 protein 17 protein 19 aβ 17 protein 20 ) 18 ( 19 aβ 19 aβ 20 ) methods : 31 cn elderly participants underwent clinical examination , a range of neuropsychological tests , apoe genotyping , and pittsburgh compound - b - and fluorodeoxyglucose - pet scans . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 participants 2 : 7 underwent 2 : 10 , 2 : 28 - 3 31 6 participants 4 cn 6 participants 5 elderly 6 participants 6 participants 7 underwent 7 underwent 9 examination 8 clinical 9 examination 10 , 26 and 11 a 12 range 12 range 13 of 12 range 26 and 13 of 15 tests 14 neuropsychological 15 tests 15 tests 23 - 16 , 23 - 17 apoe 18 genotyping 18 genotyping 20 and 19 , 20 and 20 and 22 compound 20 and 23 - 21 pittsburgh 22 compound 23 - 24 b 23 - 25 - 25 - 26 and 26 and 27 fluorodeoxyglucose 28 - 29 pet 28 - 30 scans 28 - 31 . 29 pet 30 scans results : 17 apoe ε4 carriers and 15 [non] - carriers were included . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 14 . 1 results 2 : 2 : 6 carriers 3 17 6 carriers 4 apoe 6 carriers 5 ε4 6 carriers 7 and 8 15 7 and 10 - 8 15 10 - 10 - 11 carriers 11 carriers 12 were 12 were 13 included both hypometabolic and hypermetabolic regions were observed in ε4 carriers compared with noncarriers when age , education , and sex were controlled . 0 ###LEFT-WALL### 5 regions 0 ###LEFT-WALL### 7 observed 1 both 5 regions 2 hypometabolic 3 and 3 and 4 hypermetabolic 3 and 5 regions 5 regions 6 were 6 were 7 observed 7 observed 8 in 7 observed 14 when 8 in 10 carriers 9 ε4 10 carriers 10 carriers 11 compared 11 compared 12 with 12 with 13 noncarriers 14 when 19 and 14 when 22 controlled 15 age 16 , 16 , 17 education 16 , 19 and 18 , 19 and 19 and 20 sex 19 and 21 were 21 were 22 controlled 22 controlled 23 . when the degree of global cerebral aβ deposition was adjusted , the hypometabolic regions in the temporo - parietal area ( i.e [.] , ba 22 and 39 ) largely disappeared , whereas the hypermetabolic regions persisted in medial frontal and anterior temporal areas ( i.e [.] , ba 38 , 11 [,] and 39 ) . 0 ###LEFT-WALL### 14 regions 0 ###LEFT-WALL### 37 persisted 0 ###LEFT-WALL### 57 . 1 when 3 degree 1 when 10 adjusted 1 when 14 regions 2 the 3 degree 3 degree 4 of 3 degree 9 was 4 of 8 deposition 5 global 8 deposition 6 cerebral 8 deposition 7 aβ 8 deposition 9 was 10 adjusted 10 adjusted 11 , 12 the 14 regions 13 hypometabolic 14 regions 14 regions 15 in 14 regions 22 i.e 14 regions 25 ba 14 regions 31 disappeared 15 in 20 area 16 the 20 area 17 temporo 18 - 17 temporo 20 area 19 parietal 20 area 21 ( 22 i.e 22 i.e 24 , 24 , 25 ba 25 ba 27 and 25 ba 29 ) 26 22 27 and 27 and 28 39 30 largely 31 disappeared 31 disappeared 33 whereas 32 , 33 whereas 33 whereas 36 regions 34 the 36 regions 35 hypermetabolic 36 regions 36 regions 37 persisted 37 persisted 38 in 38 in 44 areas 39 medial 44 areas 40 frontal 41 and 41 and 42 anterior 41 and 44 areas 43 temporal 44 areas 44 areas 46 i.e 44 areas 49 ba 44 areas 54 and 45 ( 46 i.e 46 i.e 48 , 48 , 49 ba 49 ba 50 38 49 ba 51 , 51 , 54 and 52 11 54 and 54 and 55 39 54 and 56 ) behaviorally , verbal episodic memory scores of apoe ε4 carriers were slightly lower than those of noncarriers , [though] still within normal range . 0 ###LEFT-WALL### 6 scores 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 24 . 1 behaviorally 2 , 1 behaviorally 6 scores 3 verbal 5 memory 4 episodic 5 memory 5 memory 6 scores 6 scores 7 of 6 scores 10 carriers 6 scores 16 of 6 scores 18 , 7 of 8 apoe 9 ε4 10 carriers 10 carriers 11 were 11 were 13 lower 12 slightly 13 lower 13 lower 14 than 14 than 15 those 15 those 16 of 17 noncarriers 18 , 18 , 20 still 18 , 21 within 21 within 23 range 22 normal 23 range human aging is associated with a progressive decline in skeletal muscle [mass] and force generating capacity , however the exact mechanisms underlying these changes are not fully understood . 0 ###LEFT-WALL### 1 human 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 29 . 1 human 2 aging 1 human 3 is 1 human 4 associated 2 aging 3 is 4 associated 5 with 5 with 8 decline 6 a 8 decline 7 progressive 8 decline 8 decline 9 in 9 in 13 and 10 skeletal 11 muscle 11 muscle 13 and 13 and 14 force 13 and 15 generating 15 generating 16 capacity 17 , 21 mechanisms 17 , 28 understood 18 however 21 mechanisms 19 the 21 mechanisms 20 exact 21 mechanisms 21 mechanisms 22 underlying 21 mechanisms 25 are 22 underlying 24 changes 23 these 24 changes 25 are 26 not 25 are 27 fully 25 are 28 understood rodents models have often been used to enhance our understanding of mechanisms of age - related changes in human skeletal muscle . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 16 related 0 ###LEFT-WALL### 22 . 1 rodents 2 models 2 models 3 have 3 have 5 been 4 often 5 been 5 been 6 used 6 used 7 to 6 used 8 enhance 7 to 8 enhance 8 enhance 10 understanding 9 our 10 understanding 10 understanding 11 of 10 understanding 13 of 11 of 12 mechanisms 13 of 14 age 15 - 16 related 16 related 17 changes 16 related 18 in 18 in 21 muscle 19 human 21 muscle 20 skeletal 21 muscle however , to [what] extent age - related alterations in determinants of muscle force generating capacity observed in rodents resemble those in humans has not been considered thoroughly . 0 ###LEFT-WALL### 6 age 0 ###LEFT-WALL### 29 . 1 however 2 , 1 however 6 age 3 to 5 extent 3 to 6 age 6 age 24 has 7 - 8 related 8 related 9 alterations 8 related 10 in 8 related 22 in 8 related 24 has 10 in 11 determinants 11 determinants 12 of 11 determinants 16 capacity 11 determinants 20 resemble 12 of 15 generating 13 muscle 15 generating 14 force 15 generating 16 capacity 17 observed 17 observed 18 in 17 observed 20 resemble 18 in 19 rodents 20 resemble 21 those 22 in 23 humans 24 has 25 not 24 has 26 been 26 been 27 considered 27 considered 28 thoroughly this review compares the effect of aging on muscle force generating determinants ( muscle [mass] , fiber size , fiber number , fiber type distribution and muscle specific tension ) , in men and male rodents at similar relative age . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 compares 1 this 2 review 2 review 3 compares 3 compares 5 effect 4 the 5 effect 5 effect 6 of 5 effect 18 size 6 of 7 aging 7 aging 8 on 8 on 10 force 9 muscle 10 force 10 force 11 generating 10 force 14 muscle 11 generating 12 determinants 13 ( 14 muscle 14 muscle 16 , 16 , 18 size 17 fiber 18 size 18 size 26 and 18 size 32 in 18 size 41 . 19 , 26 and 20 fiber 21 number 21 number 22 , 22 , 25 distribution 22 , 26 and 23 fiber 25 distribution 24 type 25 distribution 26 and 29 tension 26 and 30 ) 27 muscle 29 tension 28 specific 29 tension 31 , 32 in 32 in 34 and 32 in 41 . 33 men 34 and 34 and 36 rodents 34 and 37 at 35 male 36 rodents 37 at 40 age 38 similar 40 age 39 relative 40 age it appears that muscle aging in male f344*bn rat resembles that in men [most] [;] 32 - 35 - month [-] old rats exhibit similar signs of muscle weakness to those of 70 - 80 [-] yr - old men , and the decline in 36 - 38 [-] month - old rats [is] similar to that in men aged over 80 yrs . 1 it 2 appears 2 appears 3 that 3 that 4 muscle 3 that 10 resembles 4 muscle 5 aging 4 muscle 10 resembles 5 aging 6 in 6 in 9 rat 7 male 9 rat 8 f344*bn 9 rat 10 resembles 11 that 11 that 12 in 12 in 13 men 13 men 16 32 13 men 24 exhibit 16 32 19 - 16 32 24 exhibit 17 - 19 - 18 35 19 - 19 - 23 rats 20 month 23 rats 22 old 23 rats 24 exhibit 26 signs 25 similar 26 signs 26 signs 27 of 26 signs 30 to 27 of 29 weakness 28 muscle 29 weakness 30 to 42 and 31 those 32 of 31 those 42 and 32 of 33 70 33 70 38 - 34 - 38 - 35 80 37 yr 37 yr 38 - 38 - 40 men 38 - 41 , 39 old 40 men 42 and 44 decline 42 and 47 - 42 and 50 month 42 and 53 rats 43 the 44 decline 44 decline 45 in 45 in 46 36 47 - 50 month 48 38 50 month 50 month 51 - 51 - 53 rats 52 old 53 rats 53 rats 55 similar 53 rats 58 in 55 similar 56 to 56 to 57 that 58 in 59 men 59 men 60 aged 60 aged 61 over 61 over 63 yrs 62 80 63 yrs 63 yrs 64 . for male c57bl/6 mice , age - related decline in muscle force generating capacity seems to occur only at higher relative age than in men . 0 ###LEFT-WALL### 9 decline 0 ###LEFT-WALL### 26 . 1 for 3 c57bl/6 1 for 9 decline 2 male 3 c57bl/6 3 c57bl/6 4 mice 3 c57bl/6 8 related 4 mice 6 age 4 mice 8 related 5 , 6 age 6 age 7 - 9 decline 10 in 9 decline 20 higher 9 decline 22 age 9 decline 23 than 10 in 11 muscle 11 muscle 12 force 11 muscle 19 at 12 force 13 generating 12 force 15 seems 13 generating 14 capacity 15 seems 16 to 15 seems 17 occur 16 to 17 occur 17 occur 18 only 17 occur 19 at 21 relative 22 age 23 than 24 in 24 in 25 men we conclude that the effects on determinants of muscle force differ between species as well as within species , but qualitatively show the same pattern as that observed in men . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 28 observed 0 ###LEFT-WALL### 31 . 1 we 2 conclude 2 conclude 3 that 3 that 5 effects 3 that 20 but 4 the 5 effects 5 effects 6 on 5 effects 20 but 6 on 7 determinants 7 determinants 8 of 8 of 10 force 9 muscle 10 force 11 differ 12 between 11 differ 15 well 11 differ 16 as 11 differ 20 but 12 between 13 species 14 as 15 well 16 as 17 within 17 within 18 species 19 , 20 but 20 but 22 show 21 qualitatively 22 show 22 show 25 pattern 22 show 26 as 23 the 24 same 24 same 25 pattern 26 as 27 that 26 as 28 observed 27 that 28 observed 28 observed 29 in 29 in 30 men impaired synaptic plasticity is implicated in the functional decline of the nervous system associated with ageing . 0 ###LEFT-WALL### 3 plasticity 0 ###LEFT-WALL### 5 implicated 0 ###LEFT-WALL### 17 . 1 impaired 3 plasticity 2 synaptic 3 plasticity 3 plasticity 4 is 4 is 5 implicated 5 implicated 6 in 6 in 9 decline 7 the 9 decline 8 functional 9 decline 9 decline 10 of 10 of 13 system 11 the 13 system 12 nervous 13 system 13 system 14 associated 14 associated 15 with 15 with 16 ageing understanding the structure of ageing synapses is essential to understanding the functions of these [synapses] and their role in the ageing nervous system . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 24 . 1 understanding 3 structure 1 understanding 6 synapses 1 understanding 7 is 2 the 3 structure 3 structure 4 of 3 structure 6 synapses 4 of 5 ageing 7 is 8 essential 8 essential 9 to 9 to 10 understanding 10 understanding 12 functions 10 understanding 19 in 11 the 12 functions 12 functions 13 of 13 of 16 and 14 these 16 and 16 and 18 role 17 their 18 role 19 in 23 system 20 the 23 system 21 ageing 23 system 22 nervous 23 system in this review , we summarize studies on ageing [synapses] in vertebrates and invertebrates , focusing on changes in morphology and ultrastructure . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 summarize 0 ###LEFT-WALL### 23 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 summarize 6 summarize 7 studies 6 summarize 8 on 6 summarize 11 in 6 summarize 17 on 6 summarize 19 in 8 on 9 ageing 11 in 13 and 12 vertebrates 13 and 13 and 14 invertebrates 13 and 15 , 13 and 16 focusing 17 on 18 changes 19 in 21 and 20 morphology 21 and 21 and 22 ultrastructure we cover different parts of the nervous system , including the brain , the retina , the cochlea , and the neuromuscular junction . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 cover 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 24 . 1 we 2 cover 2 cover 4 parts 3 different 4 parts 4 parts 5 of 5 of 8 system 6 the 8 system 7 nervous 8 system 8 system 10 including 9 , 10 including 10 including 12 brain 10 including 13 , 11 the 12 brain 13 , 20 and 14 the 15 retina 15 retina 16 , 16 , 18 cochlea 16 , 20 and 17 the 18 cochlea 19 , 20 and 20 and 23 junction 21 the 23 junction 22 neuromuscular 23 junction the morphological characteristics [of] aged [synapses] could shed light on the underlying molecular changes and their functional consequences . 0 ###LEFT-WALL### 3 characteristics 0 ###LEFT-WALL### 8 shed 0 ###LEFT-WALL### 19 . 1 the 3 characteristics 2 morphological 3 characteristics 3 characteristics 5 aged 3 characteristics 7 could 7 could 8 shed 8 shed 9 light 8 shed 10 on 10 on 15 and 11 the 14 changes 12 underlying 14 changes 13 molecular 14 changes 14 changes 15 and 15 and 18 consequences 16 their 18 consequences 17 functional 18 consequences processes that regulate quiescence , self [-] renewal , and differentiation of hematopoietic stem cells ( hscs ) are not well understood . 0 ###LEFT-WALL### 1 processes 0 ###LEFT-WALL### 22 understood 0 ###LEFT-WALL### 23 . 1 processes 2 that 1 processes 3 regulate 1 processes 10 and 1 processes 19 are 2 that 3 regulate 3 regulate 4 quiescence 5 , 10 and 6 self 8 renewal 8 renewal 10 and 9 , 10 and 10 and 11 differentiation 10 and 12 of 10 and 18 ) 12 of 15 cells 13 hematopoietic 14 stem 14 stem 15 cells 15 cells 17 hscs 16 ( 17 hscs 17 hscs 18 ) 19 are 20 not 19 are 21 well 19 are 22 understood owing [,] in part [,] to the ability [of] xenobiotic [ligands] to have persistent effects on the immune system in experimental animals [,] there has been much work to define a physiological role of the aryl hydrocarbon receptor ( ahr ) and its relationship to human disease . 1 owing 4 part 1 owing 19 system 1 owing 25 has 3 in 4 part 4 part 6 to 6 to 8 ability 7 the 8 ability 8 ability 10 xenobiotic 10 xenobiotic 12 to 10 xenobiotic 16 on 12 to 13 have 13 have 15 effects 13 have 16 on 14 persistent 15 effects 17 the 19 system 18 immune 19 system 19 system 20 in 19 system 24 there 20 in 22 animals 21 experimental 22 animals 25 has 26 been 26 been 28 work 26 been 29 to 27 much 28 work 29 to 30 define 30 define 42 and 31 a 33 role 32 physiological 33 role 33 role 34 of 33 role 42 and 34 of 38 receptor 35 the 38 receptor 36 aryl 37 hydrocarbon 37 hydrocarbon 38 receptor 38 receptor 40 ahr 39 ( 40 ahr 40 ahr 41 ) 42 and 44 relationship 42 and 48 . 43 its 44 relationship 44 relationship 45 to 45 to 47 disease 46 human 47 disease persistent ahr activation by dioxin , a potent agonist , results in altered numbers and function of hscs in mice . 0 ###LEFT-WALL### 3 activation 0 ###LEFT-WALL### 11 results 0 ###LEFT-WALL### 21 . 1 persistent 2 ahr 2 ahr 3 activation 3 activation 4 by 3 activation 11 results 4 by 5 dioxin 5 dioxin 9 agonist 6 , 9 agonist 7 a 8 potent 7 a 9 agonist 8 potent 9 agonist 9 agonist 10 , 11 results 12 in 11 results 19 in 12 in 15 and 13 altered 14 numbers 14 numbers 15 and 15 and 16 function 15 and 17 of 17 of 18 hscs 19 in 20 mice hscs from ahr [(] [-] / [-] [ )(knockout [(] [ko] ) mice are hyperproliferative and [have] an altered cell cycle . 0 ###LEFT-WALL### 13 mice 0 ###LEFT-WALL### 14 are 0 ###LEFT-WALL### 22 . 1 hscs 13 mice 2 from 3 ahr 2 from 12 ) 2 from 13 mice 3 ahr 6 / 6 / 9 )(knockout 13 mice 14 are 14 are 16 and 15 hyperproliferative 16 and 16 and 21 cycle 18 an 21 cycle 19 altered 20 cell 20 cell 21 cycle aging [ko] mice show characteristics consistent with premature bone marrow exhaustion . 0 ###LEFT-WALL### 3 mice 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 12 . 1 aging 3 mice 3 mice 4 show 4 show 5 characteristics 5 characteristics 6 consistent 6 consistent 7 with 7 with 11 exhaustion 8 premature 9 bone 9 bone 11 exhaustion 10 marrow 11 exhaustion we propose that the increased proliferation of hscs lacking ahr expression or activity is a result of loss of quiescence , and as such [,] ahr normally acts as a negative regulator to curb excessive or unnecessary proliferation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 39 . 1 we 22 and 2 propose 3 that 2 propose 22 and 3 that 6 proliferation 3 that 14 is 4 the 6 proliferation 5 increased 6 proliferation 6 proliferation 7 of 6 proliferation 14 is 7 of 12 or 8 hscs 9 lacking 8 hscs 12 or 9 lacking 11 expression 10 ahr 11 expression 12 or 13 activity 14 is 16 result 15 a 16 result 16 result 17 of 17 of 18 loss 18 loss 19 of 19 of 20 quiescence 21 , 22 and 22 and 34 curb 23 as 26 ahr 23 as 28 acts 24 such 26 ahr 26 ahr 28 acts 27 normally 28 acts 28 acts 29 as 28 acts 33 to 29 as 32 regulator 30 a 31 negative 30 a 32 regulator 31 negative 32 regulator 33 to 34 curb 34 curb 36 or 35 excessive 36 or 36 or 38 proliferation 37 unnecessary 38 proliferation similarly , prolonged [and/or] inappropriate stimulation of ahr activity may compromise the ability of hscs to sense environmental signals that allow these cells to balance quiescence , proliferation , migration , and differentiation . 0 ###LEFT-WALL### 6 stimulation 0 ###LEFT-WALL### 11 compromise 0 ###LEFT-WALL### 34 . 1 similarly 2 , 1 similarly 6 stimulation 3 prolonged 6 stimulation 5 inappropriate 6 stimulation 6 stimulation 7 of 6 stimulation 10 may 7 of 9 activity 8 ahr 9 activity 10 may 11 compromise 11 compromise 13 ability 11 compromise 24 to 12 the 13 ability 13 ability 14 of 13 ability 16 to 13 ability 17 sense 14 of 15 hscs 16 to 17 sense 17 sense 19 signals 18 environmental 19 signals 19 signals 20 that 19 signals 21 allow 20 that 21 allow 21 allow 23 cells 22 these 23 cells 24 to 32 and 25 balance 26 quiescence 26 quiescence 27 , 27 , 28 proliferation 27 , 29 , 29 , 30 migration 29 , 32 and 31 , 32 and 32 and 33 differentiation these data and others support a hypothesis that deregulation of ahr [function] has an important role in hsc regulation and in the etiology [and/or] progression of certain hematopoietic diseases , many of which are associated with aging . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 5 support 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 38 . 1 these 2 data 2 data 3 and 3 and 4 others 3 and 5 support 5 support 7 hypothesis 6 a 7 hypothesis 7 hypothesis 8 that 8 that 9 deregulation 8 that 13 has 9 deregulation 10 of 9 deregulation 13 has 10 of 11 ahr 13 has 16 role 14 an 15 important 14 an 16 role 15 important 16 role 16 role 20 and 16 role 26 of 17 in 19 regulation 17 in 20 and 18 hsc 19 regulation 20 and 21 in 21 in 25 progression 22 the 25 progression 23 etiology 25 progression 26 of 29 diseases 27 certain 29 diseases 28 hematopoietic 29 diseases 30 , 31 many 30 , 35 associated 31 many 32 of 31 many 34 are 32 of 33 which 34 are 35 associated 35 associated 36 with 36 with 37 aging background : the prevalence of extended [-] spectrum β - lactamase producing enterobacteriaceae ( esbl - e ) is increasing worldwide . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 prevalence 2 : 19 is 3 the 4 prevalence 4 prevalence 5 of 4 prevalence 19 is 5 of 9 β 6 extended 8 spectrum 8 spectrum 9 β 9 β 16 - 10 - 16 - 11 lactamase 12 producing 11 lactamase 16 - 12 producing 15 esbl 13 enterobacteriaceae 15 esbl 14 ( 15 esbl 16 - 17 e 16 - 18 ) 19 is 20 increasing 20 increasing 21 worldwide esbl [-] e are known to colonize different body sites and cause bloodstream infections ( bsi ) , pneumonia , [intra] - abdominal infections and urinary tract infections . 0 ###LEFT-WALL### 1 esbl 0 ###LEFT-WALL### 5 known 1 esbl 3 e 1 esbl 4 are 4 are 5 known 5 known 6 to 5 known 11 and 6 to 11 and 7 colonize 10 sites 7 colonize 11 and 8 different 9 body 9 body 10 sites 11 and 12 cause 12 cause 14 infections 13 bloodstream 14 infections 14 infections 16 bsi 14 infections 19 pneumonia 14 infections 25 and 15 ( 16 bsi 16 bsi 17 ) 18 , 19 pneumonia 19 pneumonia 20 , 22 - 25 and 23 abdominal 24 infections 24 infections 25 and 25 and 28 infections 25 and 29 . 26 urinary 27 tract 27 tract 28 infections even though esbl - e - related morbidity and mortality in high - risk patients - patients receiving immunosuppressants or chemotherapy , as well as those treated in an icu - is considerable , the management of esbl [-] e in these populations has not been systematically reviewed . 0 ###LEFT-WALL### 1 even 0 ###LEFT-WALL### 34 , 0 ###LEFT-WALL### 49 . 1 even 2 though 2 though 3 esbl 2 though 32 is 3 esbl 6 - 3 esbl 32 is 4 - 6 - 5 e 6 - 6 - 9 and 6 - 31 - 7 related 8 morbidity 8 morbidity 9 and 9 and 10 mortality 9 and 11 in 9 and 18 receiving 11 in 17 patients 12 high 15 patients 12 high 17 patients 13 - 15 patients 14 risk 15 patients 15 patients 16 - 18 receiving 20 or 18 receiving 23 as 19 immunosuppressants 20 or 20 or 21 chemotherapy 22 , 23 as 23 as 24 well 23 as 31 - 24 well 25 as 24 well 28 in 25 as 26 those 26 those 27 treated 28 in 30 icu 29 an 30 icu 32 is 33 considerable 34 , 36 management 34 , 48 reviewed 35 the 36 management 36 management 37 of 36 management 44 has 37 of 38 esbl 38 esbl 40 e 38 esbl 41 in 41 in 43 populations 42 these 43 populations 44 has 45 not 44 has 46 been 46 been 48 reviewed 47 systematically 48 reviewed methods : for the purpose of this review , icu patients , patients in hematology and oncology wards and transplant recipients were considered high - risk . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 27 . 1 methods 2 : 2 : 3 for 3 for 5 purpose 4 the 5 purpose 5 purpose 6 of 5 purpose 11 patients 6 of 8 review 7 this 8 review 9 , 11 patients 10 icu 11 patients 11 patients 12 , 12 , 19 and 12 , 23 considered 13 patients 14 in 13 patients 16 and 14 in 15 hematology 16 and 18 wards 16 and 19 and 17 oncology 18 wards 19 and 21 recipients 19 and 22 were 20 transplant 21 recipients 22 were 23 considered 23 considered 26 risk 24 high 25 - 24 high 26 risk an english - language medline search was conducted to identify literature on epidemiology , risk factors , clinical impact and measures of infection control regarding esbl [-] e in high - risk patients published between june 2002 and may 2013 . 0 ###LEFT-WALL### 6 search 0 ###LEFT-WALL### 41 . 1 an 6 search 2 english 3 - 2 english 4 language 4 language 6 search 5 medline 6 search 6 search 7 was 7 was 8 conducted 8 conducted 9 to 8 conducted 12 on 8 conducted 29 in 8 conducted 35 between 9 to 10 identify 10 identify 11 literature 12 on 20 and 13 epidemiology 14 , 14 , 16 factors 14 , 17 , 15 risk 16 factors 17 , 19 impact 17 , 20 and 18 clinical 19 impact 20 and 21 measures 21 measures 22 of 21 measures 25 regarding 22 of 24 control 23 infection 24 control 25 regarding 26 esbl 26 esbl 28 e 29 in 33 patients 30 high 31 - 30 high 33 patients 32 risk 33 patients 33 patients 34 published 35 between 38 and 36 june 37 2002 36 june 38 and 38 and 39 may 39 may 40 2013 results : using the [above] described methodology , 43 [relevant] articles regarding high - risk patients [and] - for areas where literature on exclusively high - risk patients is scarce - 17 articles in standard risk settings were identified . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 1 results 2 : 2 : 3 using 3 using 7 methodology 4 the 7 methodology 6 described 7 methodology 8 , 9 43 9 43 11 articles 11 articles 13 high 11 articles 19 for 12 regarding 13 high 13 high 16 patients 14 - 16 patients 15 risk 16 patients 16 patients 18 - 19 for 20 areas 20 areas 21 where 20 areas 32 17 21 where 22 literature 21 where 29 is 22 literature 23 on 22 literature 29 is 23 on 28 patients 24 exclusively 25 high 25 high 26 - 25 high 28 patients 27 risk 28 patients 29 is 30 scarce 31 - 32 17 32 17 33 articles 32 17 38 were 32 17 39 identified 32 17 40 . 33 articles 34 in 33 articles 38 were 34 in 37 settings 35 standard 37 settings 36 risk 37 settings the evidence on epidemiology , associated risk factors , treatment and hygiene measures were summarized . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 15 summarized 0 ###LEFT-WALL### 16 . 1 the 2 evidence 2 evidence 3 on 2 evidence 5 , 3 on 4 epidemiology 5 , 8 factors 5 , 9 , 6 associated 8 factors 7 risk 8 factors 9 , 10 treatment 9 , 11 and 11 and 13 measures 11 and 14 were 12 hygiene 13 measures 14 were 15 summarized discussion : this review gives a complete overview on the management of esbl [-] e in the high - risk setting . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 4 review 2 : 5 gives 3 this 4 review 4 review 5 gives 5 gives 8 overview 6 a 8 overview 7 complete 8 overview 8 overview 9 on 8 overview 12 of 9 on 11 management 10 the 11 management 12 of 13 esbl 13 esbl 15 e 13 esbl 16 in 13 esbl 21 setting 16 in 20 risk 17 the 20 risk 18 high 19 - 18 high 20 risk tinea pedis , which is a dermatophytic infection of the feet , can involve the interdigital web spaces or the sides of the feet and may be a chronic or recurring condition . 0 ###LEFT-WALL### 2 pedis 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 27 be 0 ###LEFT-WALL### 33 . 1 tinea 2 pedis 3 , 4 which 3 , 5 is 3 , 12 , 4 which 5 is 5 is 8 infection 6 a 7 dermatophytic 6 a 8 infection 7 dermatophytic 8 infection 8 infection 9 of 9 of 11 feet 10 the 11 feet 12 , 25 and 13 can 14 involve 13 can 25 and 14 involve 19 or 15 the 18 spaces 16 interdigital 17 web 17 web 18 spaces 18 spaces 19 or 19 or 21 sides 19 or 22 of 20 the 21 sides 22 of 24 feet 23 the 24 feet 25 and 26 may 26 may 27 be 27 be 32 condition 28 a 32 condition 29 chronic 30 or 30 or 31 recurring 30 or 32 condition the most common etiological agents are anthropophiles , including trichophyton rubrum sensu stricto , which is the most common , followed by trichophyton interdigitale and epidermophyton floccosum . 0 ###LEFT-WALL### 5 agents 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 28 . 1 the 5 agents 2 most 3 common 3 common 5 agents 4 etiological 5 agents 5 agents 6 are 6 are 7 anthropophiles 7 anthropophiles 9 including 8 , 9 including 9 including 11 rubrum 9 including 12 sensu 9 including 14 , 10 trichophyton 11 rubrum 12 sensu 13 stricto 14 , 15 which 14 , 20 , 15 which 20 , 16 is 19 common 16 is 20 , 17 the 19 common 18 most 19 common 20 , 21 followed 20 , 22 by 20 , 27 floccosum 22 by 23 trichophyton 24 interdigitale 25 and 25 and 26 epidermophyton 25 and 27 floccosum there has been a change in this research arena , necessitating [a] re - [evaluation] [of] our knowledge on the topic from a multidisciplinary perspective . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 3 been 1 there 2 has 2 has 3 been 3 been 5 change 4 a 5 change 5 change 6 in 6 in 9 arena 7 this 9 arena 8 research 9 arena 9 arena 11 necessitating 10 , 11 necessitating 11 necessitating 13 re 11 necessitating 19 on 11 necessitating 25 perspective 11 necessitating 26 . 13 re 14 - 13 re 18 knowledge 17 our 18 knowledge 19 on 21 topic 20 the 21 topic 21 topic 22 from 22 from 24 multidisciplinary 23 a 24 multidisciplinary thus , this review aimed to provide a solid overview of the current status and changing patterns of tinea pedis . 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 5 aimed 0 ###LEFT-WALL### 21 . 1 thus 2 , 1 thus 4 review 3 this 4 review 4 review 5 aimed 5 aimed 6 to 5 aimed 7 provide 6 to 7 provide 7 provide 10 overview 8 a 10 overview 9 solid 10 overview 10 overview 11 of 10 overview 18 of 11 of 15 and 12 the 14 status 13 current 14 status 14 status 15 and 15 and 17 patterns 16 changing 17 patterns 18 of 20 pedis 19 tinea 20 pedis the second half of the twentieth century witnessed a global increase in tinea pedis and a clonal spread of one major etiologic agent [,] t [.] rubrum . 0 ###LEFT-WALL### 3 half 0 ###LEFT-WALL### 8 witnessed 0 ###LEFT-WALL### 28 . 1 the 2 second 1 the 3 half 3 half 4 of 3 half 8 witnessed 4 of 7 century 5 the 7 century 6 twentieth 7 century 8 witnessed 11 increase 8 witnessed 12 in 9 a 11 increase 10 global 11 increase 12 in 15 and 13 tinea 14 pedis 14 pedis 15 and 15 and 18 spread 15 and 19 of 16 a 17 clonal 16 a 18 spread 17 clonal 18 spread 19 of 27 rubrum 20 one 27 rubrum 21 major 23 agent 22 etiologic 23 agent 23 agent 25 t 23 agent 27 rubrum this phenomenon is likely due to increases in urbanization and the use of sports and fitness facilities , the growing prevalence of obesity and the aging population . 0 ###LEFT-WALL### 2 phenomenon 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 28 . 1 this 2 phenomenon 2 phenomenon 3 is 3 is 4 likely 4 likely 6 to 5 due 6 to 6 to 7 increases 7 increases 8 in 7 increases 13 of 8 in 10 and 9 urbanization 10 and 10 and 12 use 11 the 12 use 13 of 24 and 14 sports 15 and 15 and 17 facilities 15 and 18 , 16 fitness 17 facilities 18 , 21 prevalence 18 , 24 and 19 the 21 prevalence 20 growing 21 prevalence 21 prevalence 22 of 22 of 23 obesity 24 and 27 population 25 the 27 population 26 aging 27 population for optimal patient care and management , the diagnosis of tinea pedis should be verified by microbiological analysis . 0 ###LEFT-WALL### 9 diagnosis 0 ###LEFT-WALL### 15 verified 0 ###LEFT-WALL### 19 . 1 for 5 and 1 for 7 , 1 for 9 diagnosis 2 optimal 4 care 3 patient 4 care 4 care 5 and 5 and 6 management 8 the 9 diagnosis 9 diagnosis 10 of 9 diagnosis 13 should 10 of 12 pedis 11 tinea 12 pedis 13 should 14 be 14 be 15 verified 15 verified 16 by 16 by 18 analysis 17 microbiological 18 analysis in this review , we discuss the epidemiology , clinical forms , complications and mycological characteristics of tinea pedis and we highlight the pathogenesis , prevention and control parameters of this infection . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 discuss 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 33 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 discuss 6 discuss 8 epidemiology 7 the 8 epidemiology 9 , 20 and 9 , 22 highlight 10 clinical 11 forms 11 forms 12 , 12 , 13 complications 12 , 14 and 14 and 16 characteristics 14 and 17 of 14 and 20 and 15 mycological 16 characteristics 17 of 19 pedis 18 tinea 19 pedis 20 and 21 we 20 and 22 highlight 22 highlight 27 and 23 the 27 and 24 pathogenesis 25 , 25 , 26 prevention 25 , 27 and 27 and 29 parameters 27 and 30 of 28 control 29 parameters 30 of 32 infection 31 this 32 infection phenotypic traits are often influenced by dynamic resource allocation trade - offs which , when occurring over the course of individual lifespan , may manifest as trait aging . 0 ###LEFT-WALL### 2 traits 0 ###LEFT-WALL### 5 influenced 1 phenotypic 2 traits 2 traits 3 are 3 are 4 often 3 are 5 influenced 5 influenced 6 by 6 by 10 trade 7 dynamic 8 resource 8 resource 10 trade 9 allocation 10 trade 10 trade 12 offs 11 - 12 offs 12 offs 13 which 12 offs 24 may 12 offs 25 manifest 12 offs 29 . 13 which 24 may 14 , 15 when 15 when 16 occurring 15 when 23 , 15 when 24 may 16 occurring 17 over 17 over 19 course 18 the 19 course 19 course 20 of 20 of 22 lifespan 21 individual 22 lifespan 25 manifest 26 as 26 as 28 aging 27 trait 28 aging although aging is studied for a variety of traits that are closely tied to reproduction or reproductive effort , the aging of multiple traits related to fitness in other ways are less well understood . 0 ###LEFT-WALL### 30 ways 0 ###LEFT-WALL### 31 are 0 ###LEFT-WALL### 35 . 1 although 2 aging 1 although 4 studied 1 although 30 ways 2 aging 3 is 3 is 4 studied 4 studied 5 for 5 for 7 variety 6 a 7 variety 7 variety 8 of 8 of 9 traits 9 traits 10 that 9 traits 11 are 10 that 11 are 11 are 12 closely 11 are 13 tied 13 tied 14 to 14 to 16 or 15 reproduction 16 or 16 or 18 effort 16 or 19 , 16 or 21 aging 16 or 28 in 17 reproductive 18 effort 20 the 21 aging 21 aging 22 of 21 aging 25 related 22 of 24 traits 23 multiple 24 traits 25 related 26 to 25 related 28 in 26 to 27 fitness 29 other 30 ways 30 ways 31 are 31 are 32 less 31 are 34 understood 33 well 34 understood we took advantage of almost 30 years of data on human whole - organism performance in the national basketball association ( usa ) to examine trends of aging in performance traits associated with scoring . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 25 examine 0 ###LEFT-WALL### 35 . 1 we 2 took 2 took 3 advantage 2 took 16 in 2 took 24 to 3 advantage 4 of 3 advantage 8 of 4 of 7 years 5 almost 6 30 6 30 7 years 8 of 9 data 9 data 10 on 10 on 15 performance 11 human 15 performance 12 whole 13 - 12 whole 15 performance 14 organism 15 performance 16 in 20 association 17 the 20 association 18 national 19 basketball 19 basketball 20 association 20 association 22 usa 21 ( 22 usa 22 usa 23 ) 24 to 25 examine 25 examine 26 trends 26 trends 27 of 26 trends 31 traits 26 trends 34 scoring 27 of 28 aging 28 aging 29 in 29 in 30 performance 31 traits 32 associated 32 associated 33 with 33 with 34 scoring given [that] patterns of aging differ between sexes in other animal species , we also analyzed a smaller dataset on players in the women 's national basketball association to test for potential sex differences in the aging of comparable traits . 0 ###LEFT-WALL### 3 patterns 0 ###LEFT-WALL### 6 differ 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 25 's 0 ###LEFT-WALL### 41 . 1 given 3 patterns 3 patterns 4 of 3 patterns 6 differ 4 of 5 aging 6 differ 7 between 6 differ 9 in 7 between 8 sexes 9 in 12 species 10 other 12 species 11 animal 12 species 13 , 14 we 13 , 16 analyzed 14 we 16 analyzed 15 also 16 analyzed 16 analyzed 19 dataset 16 analyzed 25 's 17 a 19 dataset 18 smaller 19 dataset 19 dataset 20 on 19 dataset 25 's 20 on 21 players 21 players 22 in 22 in 24 women 23 the 24 women 25 's 28 association 25 's 31 for 25 's 35 in 26 national 27 basketball 27 basketball 28 association 28 association 29 to 28 association 30 test 29 to 30 test 31 for 34 differences 32 potential 33 sex 33 sex 34 differences 35 in 37 aging 36 the 37 aging 37 aging 38 of 38 of 40 traits 39 comparable 40 traits we tested the hypothesis that age - related changes in a specific aspect of overall performance can be compensated for by elevated expression of another , related aspect . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 tested 0 ###LEFT-WALL### 26 , 0 ###LEFT-WALL### 29 . 1 we 2 tested 2 tested 4 hypothesis 2 tested 21 by 3 the 4 hypothesis 4 hypothesis 5 that 4 hypothesis 20 for 5 that 6 age 5 that 19 compensated 6 age 17 can 7 - 8 related 8 related 9 changes 8 related 10 in 8 related 17 can 10 in 13 aspect 11 a 12 specific 11 a 13 aspect 12 specific 13 aspect 13 aspect 14 of 14 of 16 performance 15 overall 16 performance 17 can 18 be 18 be 19 compensated 19 compensated 20 for 21 by 23 expression 22 elevated 23 expression 23 expression 24 of 24 of 25 another 26 , 28 aspect 27 related 28 aspect our analyses suggest that the aging of performance traits used in basketball is generally characterized by senescence in males , whereas age - related changes in basketball performance are less evident in females . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 34 . 1 our 2 analyses 2 analyses 3 suggest 3 suggest 4 that 4 that 6 aging 4 that 15 characterized 5 the 6 aging 6 aging 7 of 6 aging 13 is 7 of 9 traits 8 performance 9 traits 9 traits 10 used 10 used 11 in 11 in 12 basketball 13 is 15 characterized 14 generally 15 characterized 15 characterized 16 by 15 characterized 18 in 16 by 17 senescence 18 in 19 males 20 , 25 changes 20 , 29 are 21 whereas 22 age 21 whereas 23 - 21 whereas 25 changes 24 related 25 changes 25 changes 26 in 25 changes 29 are 26 in 28 performance 27 basketball 28 performance 29 are 31 evident 30 less 31 evident 31 evident 32 in 32 in 33 females our data also indicate a different rate of senescence of different performance traits associated with scoring over a male 's lifetime . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 indicate 0 ###LEFT-WALL### 22 . 1 our 2 data 2 data 4 indicate 3 also 4 indicate 4 indicate 7 rate 5 a 7 rate 6 different 7 rate 7 rate 8 of 7 rate 14 associated 8 of 9 senescence 9 senescence 10 of 10 of 13 traits 11 different 12 performance 12 performance 13 traits 14 associated 15 with 14 associated 17 over 15 with 16 scoring 17 over 21 lifetime 18 a 19 male 19 male 20 's 20 's 21 lifetime [none] disorders of the skeleton are one of the most common causes of chronic pain and long - term physical disability in the world . 0 ###LEFT-WALL### 2 disorders 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 25 . 2 disorders 3 of 2 disorders 6 are 3 of 5 skeleton 4 the 5 skeleton 6 are 7 one 6 are 22 in 7 one 8 of 8 of 16 and 9 the 10 most 10 most 12 causes 11 common 12 causes 12 causes 13 of 12 causes 16 and 13 of 15 pain 14 chronic 15 pain 16 and 21 disability 17 long 18 - 17 long 19 term 19 term 21 disability 20 physical 21 disability 22 in 24 world 23 the 24 world chronic skeletal pain is caused by a remarkably diverse group of conditions including trauma - induced fracture , osteoarthritis , osteoporosis , low back pain , orthopedic procedures , celiac disease , sickle cell disease and bone cancer . 0 ###LEFT-WALL### 3 pain 0 ###LEFT-WALL### 5 caused 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 39 . 1 chronic 3 pain 2 skeletal 3 pain 3 pain 4 is 4 is 5 caused 5 caused 6 by 6 by 12 conditions 7 a 10 group 8 remarkably 9 diverse 9 diverse 10 group 10 group 11 of 10 group 12 conditions 11 of 12 conditions 12 conditions 13 including 13 including 14 trauma 15 - 17 fracture 15 - 18 , 15 - 32 , 16 induced 17 fracture 18 , 19 osteoarthritis 18 , 23 low 19 osteoarthritis 21 osteoporosis 19 osteoarthritis 23 low 20 , 21 osteoporosis 21 osteoporosis 22 , 23 low 25 pain 24 back 25 pain 25 pain 28 procedures 25 pain 31 disease 26 , 28 procedures 27 orthopedic 28 procedures 28 procedures 29 , 29 , 31 disease 30 celiac 31 disease 31 disease 32 , 32 , 36 and 33 sickle 35 disease 34 cell 35 disease 35 disease 36 and 36 and 38 cancer 37 bone 38 cancer while these disorders are diverse , what they share [in] [common] is that when chronic skeletal pain occurs in these disorders , there are currently few therapies that can fully control the pain without significant unwanted side effects . 0 ###LEFT-WALL### 7 what 0 ###LEFT-WALL### 31 control 0 ###LEFT-WALL### 39 . 1 while 3 disorders 1 while 4 are 1 while 6 , 1 while 7 what 2 these 3 disorders 3 disorders 4 are 4 are 5 diverse 7 what 8 they 7 what 9 share 7 what 12 is 8 they 9 share 12 is 13 that 13 that 23 there 13 that 24 are 14 when 17 pain 14 when 18 occurs 14 when 22 , 14 when 23 there 15 chronic 17 pain 16 skeletal 17 pain 17 pain 18 occurs 18 occurs 19 in 19 in 21 disorders 20 these 21 disorders 23 there 24 are 24 are 25 currently 24 are 26 few 26 few 27 therapies 26 few 31 control 27 therapies 28 that 27 therapies 29 can 27 therapies 31 control 28 that 29 can 30 fully 31 control 31 control 33 pain 32 the 33 pain 33 pain 34 without 34 without 38 effects 35 significant 37 side 36 unwanted 37 side 37 side 38 effects in this review we focus on recent advances in our knowledge concerning the unique population of primary afferent sensory nerve fibers that innervate the skeleton , the nociceptive and neuropathic mechanisms that are involved in driving skeletal pain , and the neurochemical and structural changes that can occur in sensory and sympathetic nerve fibers and the cns in chronic skeletal pain . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 focus 0 ###LEFT-WALL### 62 . 1 in 3 review 1 in 4 we 2 this 3 review 4 we 5 focus 5 focus 6 on 6 on 8 advances 7 recent 8 advances 8 advances 9 in 8 advances 12 concerning 8 advances 16 of 9 in 11 knowledge 10 our 11 knowledge 12 concerning 15 population 13 the 15 population 14 unique 15 population 16 of 21 fibers 17 primary 18 afferent 18 afferent 21 fibers 19 sensory 20 nerve 20 nerve 21 fibers 21 fibers 22 that 21 fibers 23 innervate 22 that 23 innervate 23 innervate 29 and 23 innervate 58 in 24 the 25 skeleton 25 skeleton 26 , 26 , 28 nociceptive 26 , 29 and 27 the 28 nociceptive 29 and 31 mechanisms 29 and 32 that 29 and 33 are 30 neuropathic 31 mechanisms 32 that 33 are 33 are 34 involved 34 involved 35 in 35 in 36 driving 36 driving 43 and 36 driving 49 in 37 skeletal 38 pain 38 pain 40 and 39 , 40 and 40 and 42 neurochemical 40 and 43 and 41 the 42 neurochemical 43 and 45 changes 43 and 46 that 43 and 47 can 44 structural 45 changes 46 that 47 can 47 can 48 occur 49 in 55 and 50 sensory 51 and 51 and 54 fibers 51 and 55 and 52 sympathetic 53 nerve 53 nerve 54 fibers 55 and 57 cns 56 the 57 cns 58 in 61 pain 59 chronic 61 pain 60 skeletal 61 pain we also discuss therapies targeting nerve growth factor [or] sclerostin for treating skeletal pain . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 15 . 1 we 3 discuss 2 also 3 discuss 3 discuss 4 therapies 3 discuss 11 for 4 therapies 5 targeting 5 targeting 10 sclerostin 6 nerve 7 growth 7 growth 10 sclerostin 8 factor 10 sclerostin 11 for 12 treating 12 treating 14 pain 13 skeletal 14 pain these therapies have provided unique insight into the factors that drive skeletal pain and the structural decline that occurs in the aging skeleton . 0 ###LEFT-WALL### 2 therapies 0 ###LEFT-WALL### 4 provided 0 ###LEFT-WALL### 24 . 1 these 2 therapies 2 therapies 3 have 3 have 4 provided 4 provided 6 insight 4 provided 7 into 5 unique 6 insight 7 into 9 factors 8 the 9 factors 9 factors 10 that 9 factors 11 drive 10 that 11 drive 11 drive 14 and 11 drive 20 in 12 skeletal 13 pain 13 pain 14 and 14 and 17 decline 14 and 18 that 14 and 19 occurs 15 the 17 decline 16 structural 17 decline 18 that 19 occurs 20 in 23 skeleton 21 the 23 skeleton 22 aging 23 skeleton we conclude by discussing how these advances have changed our understanding and potentially the therapeutic options for treating [and/or] preventing chronic pain in the injured , diseased and aged skeleton . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 31 . 1 we 2 conclude 2 conclude 3 by 2 conclude 7 advances 2 conclude 9 changed 3 by 4 discussing 4 discussing 5 how 6 these 7 advances 7 advances 8 have 8 have 9 changed 9 changed 12 and 9 changed 23 in 10 our 11 understanding 11 understanding 12 and 12 and 13 potentially 12 and 16 options 14 the 16 options 15 therapeutic 16 options 16 options 17 for 16 options 20 preventing 17 for 18 treating 20 preventing 22 pain 21 chronic 22 pain 23 in 28 and 24 the 25 injured 25 injured 26 , 26 , 27 diseased 26 , 28 and 28 and 30 skeleton 29 aged 30 skeleton introduction : aging is considered to be one of the most complicated and heterogeneous phenomena and is the main risk factor for most chronic diseases , disabilities and declining health . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 3 aging 2 : 5 considered 3 aging 4 is 4 is 5 considered 5 considered 6 to 5 considered 16 and 6 to 16 and 7 be 8 one 7 be 16 and 8 one 9 of 9 of 15 phenomena 10 the 11 most 11 most 15 phenomena 12 complicated 13 and 13 and 14 heterogeneous 13 and 15 phenomena 16 and 17 is 17 is 28 and 18 the 19 main 18 the 21 factor 20 risk 21 factor 21 factor 22 for 21 factor 26 , 22 for 25 diseases 23 most 25 diseases 24 chronic 25 diseases 26 , 27 disabilities 26 , 28 and 28 and 30 health 29 declining 30 health aging cells cease to divide [and] [drive] the progression of illness through various pathways . 0 ###LEFT-WALL### 2 cells 0 ###LEFT-WALL### 3 cease 0 ###LEFT-WALL### 15 . 1 aging 2 cells 2 cells 3 cease 3 cease 4 to 3 cease 5 divide 4 to 5 divide 5 divide 9 progression 5 divide 12 through 8 the 9 progression 9 progression 10 of 10 of 11 illness 12 through 14 pathways 13 various 14 pathways over the years , a number of anti - aging medicines of natural and synthetic origin have been introduced . 0 ###LEFT-WALL### 11 medicines 0 ###LEFT-WALL### 19 introduced 0 ###LEFT-WALL### 20 . 1 over 3 years 1 over 4 , 1 over 11 medicines 2 the 3 years 5 a 6 number 6 number 7 of 6 number 11 medicines 7 of 11 medicines 8 anti 9 - 8 anti 11 medicines 10 aging 11 medicines 11 medicines 12 of 11 medicines 17 have 12 of 16 origin 13 natural 14 and 14 and 15 synthetic 14 and 16 origin 17 have 18 been 18 been 19 introduced indeed , some studies have identified senescent cells as potential therapeutic targets in the treatment of aging and age - related diseases . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 have 0 ###LEFT-WALL### 21 related 0 ###LEFT-WALL### 23 . 1 indeed 2 , 1 indeed 4 studies 3 some 4 studies 4 studies 5 have 5 have 18 and 6 identified 8 cells 7 senescent 8 cells 8 cells 9 as 8 cells 16 of 8 cells 18 and 9 as 12 targets 10 potential 12 targets 11 therapeutic 12 targets 12 targets 13 in 13 in 15 treatment 14 the 15 treatment 16 of 17 aging 18 and 19 age 20 - 21 related 21 related 22 diseases areas covered : in this review , the authors highlight [and] critically review the possible mechanisms of the aging process and related illnesses . 0 ###LEFT-WALL### 2 covered 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 24 . 1 areas 2 covered 2 covered 3 : 3 : 4 in 4 in 6 review 5 this 6 review 7 , 9 authors 7 , 21 and 8 the 9 authors 9 authors 21 and 10 highlight 12 critically 10 highlight 13 review 10 highlight 21 and 13 review 16 mechanisms 13 review 20 process 14 the 16 mechanisms 15 possible 16 mechanisms 16 mechanisms 17 of 16 mechanisms 20 process 17 of 19 aging 18 the 19 aging 21 and 22 related 21 and 23 illnesses the authors give particular attention to illnesses , including alzheimer 's disease , parkinson 's disease , skin aging and cardiovascular diseases . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 give 0 ###LEFT-WALL### 23 . 1 the 2 authors 2 authors 3 give 3 give 5 attention 3 give 18 skin 3 give 20 and 4 particular 5 attention 5 attention 6 to 5 attention 9 including 6 to 7 illnesses 8 , 9 including 9 including 12 disease 9 including 17 , 10 alzheimer 11 's 11 's 12 disease 12 disease 16 disease 13 , 16 disease 14 parkinson 15 's 15 's 16 disease 16 disease 17 , 18 skin 19 aging 20 and 22 diseases 21 cardiovascular 22 diseases expert opinion : several reports have highlighted that mitochondria are a key factor in the progression of aging and neurodegenerative illnesses . 0 ###LEFT-WALL### 2 opinion 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 22 . 1 expert 2 opinion 3 : 4 several 3 : 10 are 4 several 5 reports 4 several 7 highlighted 4 several 10 are 5 reports 6 have 6 have 7 highlighted 7 highlighted 9 mitochondria 8 that 9 mitochondria 10 are 13 factor 10 are 14 in 11 a 13 factor 12 key 13 factor 14 in 19 and 15 the 16 progression 16 progression 17 of 16 progression 19 and 17 of 18 aging 19 and 21 illnesses 20 neurodegenerative 21 illnesses this is due to their production of extra amounts of reactive oxygen species , which leads into progressive caspase - dependent apoptosis and cell death . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 26 . 1 this 2 is 2 is 4 to 3 due 4 to 4 to 6 production 5 their 6 production 6 production 7 of 6 production 15 which 7 of 13 species 8 extra 9 amounts 9 amounts 10 of 9 amounts 13 species 10 of 13 species 11 reactive 12 oxygen 12 oxygen 13 species 14 , 15 which 15 which 16 leads 15 which 20 - 16 leads 17 into 17 into 19 caspase 18 progressive 19 caspase 20 - 23 and 21 dependent 22 apoptosis 22 apoptosis 23 and 23 and 25 death 24 cell 25 death therefore , strategies to prevent/reduce oxidative stress - [mediated] aging , whether environmental , nutritional and pharmacological , need to be taken into account . 0 ###LEFT-WALL### 3 strategies 0 ###LEFT-WALL### 19 need 0 ###LEFT-WALL### 25 . 1 therefore 2 , 1 therefore 3 strategies 3 strategies 4 to 3 strategies 10 aging 3 strategies 19 need 4 to 7 stress 5 prevent/reduce 7 stress 6 oxidative 7 stress 8 - 10 aging 10 aging 12 whether 10 aging 18 , 11 , 12 whether 12 whether 16 and 12 whether 18 , 13 environmental 14 , 14 , 15 nutritional 14 , 16 and 16 and 17 pharmacological 19 need 20 to 19 need 24 account 20 to 21 be 21 be 22 taken 23 into 24 account presently , drosophila [melanogaster] and caenorhabditis elegans , which focus on the evolutionary and genetic foundations of aging , have helped to establish the screening of several synthetic and natural compounds with large cohorts in a quick manner . 0 ###LEFT-WALL### 6 caenorhabditis 0 ###LEFT-WALL### 7 elegans 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 39 . 1 presently 2 , 1 presently 6 caenorhabditis 3 drosophila 5 and 5 and 6 caenorhabditis 6 caenorhabditis 7 elegans 8 , 9 which 8 , 19 , 9 which 19 , 10 focus 11 on 10 focus 19 , 11 on 14 and 12 the 13 evolutionary 13 evolutionary 14 and 14 and 16 foundations 14 and 17 of 15 genetic 16 foundations 17 of 18 aging 19 , 20 have 20 have 21 helped 21 helped 22 to 21 helped 23 establish 22 to 23 establish 23 establish 25 screening 23 establish 32 with 24 the 25 screening 25 screening 26 of 26 of 31 compounds 27 several 31 compounds 28 synthetic 29 and 29 and 30 natural 29 and 31 compounds 32 with 34 cohorts 32 with 35 in 33 large 34 cohorts 35 in 38 manner 36 a 37 quick 36 a 38 manner 37 quick 38 manner however , there is yet to be any efficient experimental evidence to prove the exact role of senescent cells in age - related dysfunction and further studies are required to better understand these processes . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 13 prove 0 ###LEFT-WALL### 23 related 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 35 . 1 however 2 , 1 however 3 there 3 there 4 is 4 is 5 yet 4 is 6 to 6 to 7 be 7 be 11 evidence 7 be 12 to 8 any 11 evidence 9 efficient 11 evidence 10 experimental 11 evidence 12 to 13 prove 13 prove 16 role 13 prove 20 in 14 the 16 role 15 exact 16 role 16 role 17 of 17 of 19 cells 18 senescent 19 cells 20 in 21 age 22 - 23 related 23 related 24 dysfunction 25 and 27 studies 25 and 29 required 26 further 27 studies 27 studies 28 are 28 are 29 required 29 required 30 to 30 to 32 understand 31 better 32 understand 32 understand 34 processes 33 these 34 processes red blood cells ( rbc ) have been considered almost exclusively as a transporter of metabolic gases and nutrients for the tissues . 0 ###LEFT-WALL### 3 cells 0 ###LEFT-WALL### 9 considered 0 ###LEFT-WALL### 23 . 1 red 2 blood 2 blood 3 cells 3 cells 5 rbc 3 cells 7 have 4 ( 5 rbc 5 rbc 6 ) 7 have 8 been 8 been 9 considered 9 considered 11 exclusively 9 considered 12 as 10 almost 11 exclusively 12 as 14 transporter 13 a 14 transporter 14 transporter 15 of 15 of 18 and 16 metabolic 17 gases 17 gases 18 and 18 and 19 nutrients 18 and 20 for 20 for 22 tissues 21 the 22 tissues it is an accepted dogma that rbcs take up and inactivate endothelium - derived no via rapid reaction with oxyhemoglobin to form methemoglobin and nitrate , thereby limiting no available for vasodilatation . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 1 it 2 is 2 is 5 dogma 2 is 6 that 3 an 5 dogma 4 accepted 5 dogma 6 that 7 rbcs 6 that 10 and 7 rbcs 10 and 8 take 9 up 8 take 10 and 10 and 11 inactivate 10 and 28 limiting 11 inactivate 12 endothelium 12 endothelium 24 and 13 - 24 and 14 derived 15 no 15 no 16 via 15 no 19 with 15 no 24 and 16 via 18 reaction 17 rapid 18 reaction 19 with 20 oxyhemoglobin 20 oxyhemoglobin 21 to 21 to 23 methemoglobin 22 form 23 methemoglobin 24 and 25 nitrate 24 and 26 , 26 , 28 limiting 27 thereby 28 limiting 28 limiting 29 no 28 limiting 31 for 28 limiting 33 . 29 no 30 available 31 for 32 vasodilatation yet it has also been shown that rbcs [not] only act as " no sinks " , but exert an erythrocrine function - i.e an endocrine function of rbc - by synthesizing , transporting and releasing no metabolic products and atp , thereby potentially controlling systemic no bioavailability and vascular tone . 0 ###LEFT-WALL### 1 yet 0 ###LEFT-WALL### 6 shown 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 24 i.e 1 yet 2 it 2 it 3 has 3 has 5 been 4 also 5 been 5 been 6 shown 6 shown 7 that 7 that 8 rbcs 7 that 18 but 8 rbcs 18 but 10 only 11 act 11 act 12 as 11 act 18 but 12 as 13 " 12 as 15 sinks 14 no 15 sinks 15 sinks 16 " 17 , 18 but 18 but 19 exert 19 exert 22 function 20 an 22 function 21 erythrocrine 22 function 23 - 24 i.e 24 i.e 40 and 25 an 27 function 26 endocrine 27 function 27 function 28 of 27 function 35 and 28 of 34 transporting 29 rbc 31 by 29 rbc 34 transporting 30 - 31 by 31 by 32 synthesizing 31 by 33 , 35 and 39 products 35 and 40 and 36 releasing 39 products 37 no 39 products 38 metabolic 39 products 40 and 41 atp 40 and 52 . 41 atp 45 controlling 42 , 45 controlling 43 thereby 45 controlling 44 potentially 45 controlling 45 controlling 49 and 45 controlling 52 . 46 systemic 48 bioavailability 47 no 48 bioavailability 48 bioavailability 49 and 49 and 51 tone 50 vascular 51 tone recent work from our [and] others laboratory demonstrated that human rbcs carry an active type 3 , endothelial no synthase ( enos ) , constitutively producing no under normoxic conditions , the activity of which is compromised in patients with coronary artery disease . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 44 . 1 recent 2 work 2 work 3 from 2 work 16 3 2 work 26 producing 3 from 6 others 4 our 6 others 6 others 11 rbcs 6 others 12 carry 7 laboratory 8 demonstrated 8 demonstrated 11 rbcs 9 that 10 human 10 human 11 rbcs 11 rbcs 12 carry 12 carry 15 type 13 an 14 active 13 an 15 type 14 active 15 type 16 3 20 synthase 17 , 20 synthase 18 endothelial 20 synthase 19 no 20 synthase 20 synthase 22 enos 20 synthase 24 , 21 ( 22 enos 22 enos 23 ) 24 , 26 producing 25 constitutively 26 producing 26 producing 27 no 26 producing 28 under 26 producing 31 , 28 under 30 conditions 29 normoxic 30 conditions 31 , 33 activity 31 , 37 compromised 32 the 33 activity 33 activity 34 of 33 activity 37 compromised 34 of 35 which 34 of 36 is 35 which 36 is 37 compromised 38 in 37 compromised 40 with 38 in 39 patients 40 with 43 disease 41 coronary 42 artery 42 artery 43 disease in this review we aim to discuss the potential role of red cell enos in rbc signaling and function , and to critically revise evidence to this date showing a role of [non] [-] endothelial circulating enos in cardiovascular pathophysiology . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 41 . 1 in 3 review 1 in 4 we 2 this 3 review 4 we 21 and 5 aim 6 to 5 aim 18 and 5 aim 21 and 6 to 18 and 7 discuss 10 role 7 discuss 18 and 8 the 10 role 9 potential 10 role 10 role 11 of 10 role 17 signaling 11 of 14 enos 12 red 13 cell 13 cell 14 enos 14 enos 15 in 15 in 16 rbc 18 and 19 function 20 , 21 and 21 and 22 to 21 and 24 revise 22 to 24 revise 23 critically 24 revise 24 revise 25 evidence 25 evidence 26 to 25 evidence 32 of 26 to 28 date 27 this 28 date 28 date 29 showing 29 showing 31 role 30 a 31 role 32 of 37 enos 35 endothelial 37 enos 36 circulating 37 enos 37 enos 38 in 38 in 40 pathophysiology 39 cardiovascular 40 pathophysiology oxidative stress including dna damage , increased lipid and protein oxidation , are important features of aging and neurodegeneration suggesting that endogenous antioxidant protective pathways are inadequate or overwhelmed . 0 ###LEFT-WALL### 28 or 0 ###LEFT-WALL### 30 . 1 oxidative 28 or 2 stress 9 and 2 stress 13 are 2 stress 28 or 3 including 5 damage 4 dna 5 damage 5 damage 6 , 6 , 8 lipid 6 , 9 and 7 increased 8 lipid 9 and 11 oxidation 9 and 12 , 9 and 13 are 10 protein 11 oxidation 13 are 18 and 14 important 15 features 15 features 16 of 15 features 18 and 16 of 17 aging 18 and 19 neurodegeneration 19 neurodegeneration 20 suggesting 20 suggesting 21 that 21 that 25 pathways 21 that 26 are 22 endogenous 25 pathways 23 antioxidant 25 pathways 24 protective 25 pathways 25 pathways 26 are 26 are 27 inadequate 28 or 29 overwhelmed importantly , oxidative protein damage contributes to age - dependent accumulation of dysfunctional mitochondria or protein aggregates . 0 ###LEFT-WALL### 5 damage 0 ###LEFT-WALL### 6 contributes 0 ###LEFT-WALL### 9 - 1 importantly 2 , 1 importantly 5 damage 3 oxidative 4 protein 4 protein 5 damage 5 damage 6 contributes 6 contributes 7 to 7 to 8 age 9 - 11 accumulation 9 - 17 aggregates 9 - 18 . 10 dependent 11 accumulation 11 accumulation 12 of 11 accumulation 17 aggregates 12 of 15 or 13 dysfunctional 14 mitochondria 14 mitochondria 15 or 15 or 16 protein in addition , environmental toxins such as rotenone and paraquat , which are risk factors for the pathogenesis of neurodegenerative diseases , also promote protein oxidation . 0 ###LEFT-WALL### 24 promote 0 ###LEFT-WALL### 27 . 1 in 9 and 1 in 24 promote 2 addition 3 , 3 , 5 toxins 3 , 9 and 4 environmental 5 toxins 5 toxins 7 as 6 such 7 as 7 as 8 rotenone 9 and 10 paraquat 9 and 12 which 11 , 12 which 12 which 13 are 12 which 22 , 13 are 14 risk 14 risk 15 factors 15 factors 16 for 16 for 18 pathogenesis 17 the 18 pathogenesis 18 pathogenesis 19 of 19 of 21 diseases 20 neurodegenerative 21 diseases 23 also 24 promote 24 promote 26 oxidation 25 protein 26 oxidation the obvious approach of supplementing the primary antioxidant systems designed to suppress the initiation of oxidative stress has been tested in animal models and positive results were obtained . 0 ###LEFT-WALL### 3 approach 0 ###LEFT-WALL### 20 tested 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 29 . 1 the 3 approach 2 obvious 3 approach 3 approach 4 of 3 approach 10 designed 3 approach 18 has 4 of 5 supplementing 5 supplementing 9 systems 6 the 9 systems 7 primary 9 systems 8 antioxidant 9 systems 10 designed 11 to 10 designed 12 suppress 11 to 12 suppress 12 suppress 14 initiation 13 the 14 initiation 14 initiation 15 of 15 of 17 stress 16 oxidative 17 stress 18 has 19 been 19 been 20 tested 20 tested 21 in 21 in 23 models 22 animal 23 models 24 and 26 results 24 and 27 were 25 positive 26 results 26 results 27 were 27 were 28 obtained however , these findings have not been effectively translated to treating human patients , and clinical trials for antioxidant therapies using radical scavenging molecules such as α - tocopherol , ascorbate and coenzyme q have met with limited success , highlighting several limitations to this approach . 0 ###LEFT-WALL### 4 findings 0 ###LEFT-WALL### 9 translated 0 ###LEFT-WALL### 15 and 1 however 2 , 1 however 4 findings 3 these 4 findings 4 findings 5 have 5 have 6 not 5 have 7 been 7 been 8 effectively 7 been 9 translated 9 translated 10 to 10 to 11 treating 11 treating 13 patients 12 human 13 patients 14 , 15 and 15 and 17 trials 15 and 36 met 16 clinical 17 trials 17 trials 18 for 17 trials 21 using 17 trials 35 have 18 for 20 therapies 19 antioxidant 20 therapies 21 using 24 molecules 21 using 26 as 22 radical 24 molecules 23 scavenging 24 molecules 25 such 26 as 26 as 32 and 27 α 29 tocopherol 27 α 30 , 27 α 31 ascorbate 28 - 29 tocopherol 29 tocopherol 30 , 31 ascorbate 32 and 32 and 33 coenzyme 33 coenzyme 34 q 35 have 36 met 36 met 37 with 36 met 41 highlighting 37 with 39 success 38 limited 39 success 40 , 41 highlighting 41 highlighting 43 limitations 41 highlighting 47 . 42 several 43 limitations 43 limitations 44 to 44 to 46 approach 45 this 46 approach therefore , alternative approaches that can circumvent these limitations are needed . 0 ###LEFT-WALL### 4 approaches 0 ###LEFT-WALL### 11 needed 0 ###LEFT-WALL### 12 . 1 therefore 2 , 1 therefore 4 approaches 3 alternative 4 approaches 4 approaches 5 that 4 approaches 6 can 4 approaches 10 are 5 that 6 can 6 can 7 circumvent 7 circumvent 9 limitations 8 these 9 limitations 10 are 11 needed while not previously considered an antioxidant system we propose that the autophagy - lysosomal activities , may serve this essential function in neurodegenerative diseases by removing damaged or dysfunctional proteins and organelles . 0 ###LEFT-WALL### 18 serve 0 ###LEFT-WALL### 33 . 1 while 8 we 1 while 9 propose 1 while 18 serve 2 not 4 considered 2 not 8 we 3 previously 4 considered 4 considered 7 system 5 an 6 antioxidant 5 an 7 system 6 antioxidant 7 system 8 we 9 propose 9 propose 10 that 10 that 12 autophagy 10 that 17 may 11 the 12 autophagy 12 autophagy 15 activities 12 autophagy 17 may 13 - 15 activities 14 lysosomal 15 activities 15 activities 16 , 18 serve 21 function 18 serve 22 in 19 this 21 function 20 essential 21 function 22 in 31 and 23 neurodegenerative 24 diseases 24 diseases 25 by 24 diseases 28 or 25 by 26 removing 26 removing 27 damaged 28 or 30 proteins 28 or 31 and 29 dysfunctional 30 proteins 31 and 32 organelles purpose/introduction : the canadian hypertension education program ( chep ) has identified blood pressure ( bp ) control as a key target for an overall reduction in cardiovascular disease risk . 0 ###LEFT-WALL### 1 purpose/introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 1 purpose/introduction 2 : 2 : 4 canadian 3 the 4 canadian 4 canadian 9 chep 4 canadian 18 control 5 hypertension 6 education 6 education 7 program 7 program 9 chep 8 ( 9 chep 9 chep 10 ) 9 chep 11 has 11 has 14 pressure 11 has 18 control 12 identified 13 blood 13 blood 14 pressure 14 pressure 16 bp 15 ( 16 bp 16 bp 17 ) 18 control 19 as 18 control 23 for 19 as 22 target 20 a 22 target 21 key 22 target 23 for 26 reduction 24 an 26 reduction 25 overall 26 reduction 26 reduction 27 in 27 in 30 risk 28 cardiovascular 29 disease 29 disease 30 risk the power survey ( physicians ' observational work on patient education according to their vascular risk ) used framingham methodology to investigate the impact of an angiotensin - receptor - blocker - based [regimen] on arterial bp and total coronary heart disease ( chd ) risk in a subset of patients recruited in canada . 0 ###LEFT-WALL### 3 survey 0 ###LEFT-WALL### 18 used 0 ###LEFT-WALL### 28 - 0 ###LEFT-WALL### 31 blocker 1 the 3 survey 2 power 3 survey 3 survey 8 work 3 survey 18 used 4 ( 8 work 5 physicians 6 ' 6 ' 8 work 7 observational 8 work 8 work 9 on 8 work 17 ) 9 on 12 according 10 patient 11 education 11 education 12 according 12 according 13 to 13 to 16 risk 14 their 16 risk 15 vascular 16 risk 18 used 20 methodology 18 used 21 to 18 used 22 investigate 19 framingham 20 methodology 21 to 22 investigate 22 investigate 24 impact 23 the 24 impact 24 impact 25 of 25 of 27 angiotensin 26 an 27 angiotensin 28 - 29 receptor 28 - 30 - 30 - 31 blocker 31 blocker 33 based 32 - 33 based 33 based 35 on 33 based 47 in 33 based 53 in 33 based 55 . 35 on 46 risk 36 arterial 46 risk 37 bp 38 and 38 and 42 disease 38 and 44 chd 38 and 46 risk 39 total 41 heart 40 coronary 41 heart 41 heart 42 disease 43 ( 44 chd 44 chd 45 ) 47 in 49 subset 48 a 49 subset 49 subset 50 of 49 subset 52 recruited 50 of 51 patients 53 in 54 canada methods : 309 canadian practices screened for patients with either newly diagnosed or uncontrolled mild/moderate hypertension ( sitting systolic blood pressure [ sbp []] >140 [mmhg] with diastolic blood pressure [ dbp ] < 110 mmhg ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 13 or 3 309 4 canadian 4 canadian 5 practices 5 practices 6 screened 5 practices 12 diagnosed 5 practices 13 or 6 screened 7 for 6 screened 9 with 7 for 8 patients 9 with 10 either 11 newly 12 diagnosed 13 or 16 hypertension 13 or 18 sitting 14 uncontrolled 15 mild/moderate 15 mild/moderate 16 hypertension 17 ( 18 sitting 18 sitting 21 pressure 18 sitting 37 ) 19 systolic 20 blood 20 blood 21 pressure 21 pressure 23 sbp 22 [ 23 sbp 23 sbp 25 >140 23 sbp 37 ) 25 >140 27 with 27 with 30 pressure 27 with 36 mmhg 28 diastolic 30 pressure 29 blood 30 pressure 30 pressure 32 dbp 31 [ 32 dbp 32 dbp 33 ] 34 < 35 110 35 110 36 mmhg treatment comprised eprosartan 600 [mg/day] [with] add [-] on antihypertensive therapy after 1 month if required . 0 ###LEFT-WALL### 1 treatment 0 ###LEFT-WALL### 2 comprised 0 ###LEFT-WALL### 17 . 1 treatment 2 comprised 2 comprised 3 eprosartan 3 eprosartan 4 600 3 eprosartan 7 add 4 600 7 add 7 add 9 on 7 add 12 after 7 add 15 if 9 on 11 therapy 10 antihypertensive 11 therapy 12 after 14 month 13 1 14 month 15 if 16 required the primary efficacy variable was change in sbp at 6 months ; the secondary variable was the absolute change in the framingham 10 - year chd risk score . 0 ###LEFT-WALL### 4 variable 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 24 - 0 ###LEFT-WALL### 29 . 1 the 4 variable 2 primary 4 variable 3 efficacy 4 variable 4 variable 5 was 5 was 6 change 5 was 7 in 5 was 9 at 7 in 8 sbp 9 at 11 months 10 6 11 months 12 ; 15 variable 12 ; 16 was 13 the 15 variable 14 secondary 15 variable 15 variable 16 was 16 was 19 change 17 the 19 change 18 absolute 19 change 19 change 20 in 20 in 22 framingham 21 the 22 framingham 22 framingham 23 10 23 10 24 - 24 - 28 score 25 year 28 score 26 chd 28 score 27 risk 28 score results : 1,385 patients were identified , of whom 1,114 were included in the intention [-] to - treat [(] itt [ )(cohort . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 - 1 results 2 : 2 : 3 1,385 3 1,385 4 patients 3 1,385 5 were 3 1,385 6 identified 3 1,385 8 of 4 patients 5 were 7 , 8 of 8 of 9 whom 8 of 18 - 9 whom 10 1,114 9 whom 17 to 10 1,114 11 were 11 were 12 included 12 included 13 in 12 included 17 to 13 in 15 intention 14 the 15 intention 18 - 23 )(cohort 18 - 24 . 19 treat 23 )(cohort 21 itt 23 )(cohort thirty - eight point four percent of itt patients were managed with monotherapy at 6 months , [versus] 35.2 [%] and 13.7 % with two - drug or multiple - drug therapy , respectively . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 4 point 0 ###LEFT-WALL### 35 . 1 thirty 2 - 2 - 3 eight 2 - 4 point 4 point 6 percent 4 point 12 with 4 point 34 respectively 5 four 6 percent 6 percent 7 of 6 percent 11 managed 7 of 8 itt 8 itt 9 patients 8 itt 10 were 9 patients 10 were 12 with 28 or 13 monotherapy 14 at 13 monotherapy 28 or 14 at 15 6 15 6 16 months 15 6 27 drug 16 months 23 % 16 months 27 drug 17 , 23 % 19 35.2 21 and 21 and 22 13.7 21 and 23 % 23 % 24 with 23 % 26 - 24 with 25 two 28 or 32 therapy 28 or 33 , 29 multiple 30 - 29 multiple 31 drug 31 drug 32 therapy sbp in the itt cohort declined 22.4 ( standard deviation [ sd ] [14.8] ) [mmhg] and dbp declined 10.5 ( sd [10.3] ) [mmhg] during that time . 0 ###LEFT-WALL### 1 sbp 0 ###LEFT-WALL### 6 declined 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 29 . 1 sbp 2 in 1 sbp 6 declined 2 in 5 cohort 3 the 5 cohort 4 itt 5 cohort 6 declined 7 22.4 7 22.4 10 deviation 8 ( 10 deviation 9 standard 10 deviation 10 deviation 12 sd 10 deviation 15 ) 11 [ 12 sd 12 sd 13 ] 17 and 18 dbp 17 and 19 declined 18 dbp 19 declined 19 declined 20 10.5 19 declined 26 during 20 10.5 22 sd 21 ( 22 sd 22 sd 24 ) 26 during 28 time 27 that 28 time the absolute mean framingham score declined 2.1 ( sd 3.1 [ )(points with significant age and sex variation ( p<0.001 ) and differences between the various framingham methods used . 0 ###LEFT-WALL### 5 score 0 ###LEFT-WALL### 6 declined 1 the 5 score 2 absolute 3 mean 3 mean 5 score 4 framingham 5 score 5 score 6 declined 6 declined 7 2.1 7 2.1 12 )(points 8 ( 12 )(points 9 sd 12 )(points 10 3.1 12 )(points 12 )(points 13 with 12 )(points 30 . 13 with 22 and 14 significant 15 age 15 age 16 and 16 and 18 variation 16 and 20 p<0.001 16 and 22 and 17 sex 18 variation 19 ( 20 p<0.001 20 p<0.001 21 ) 22 and 23 differences 22 and 24 between 24 between 28 methods 25 the 28 methods 26 various 28 methods 27 framingham 28 methods 28 methods 29 used discussion/conclusion : primary care physicians were able to use a strategy of bp lowering and chd risk assessment to achieve significant reductions in bp and framingham - assessed chd risk . 0 ###LEFT-WALL### 1 discussion/conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 20 achieve 0 ###LEFT-WALL### 31 . 1 discussion/conclusion 2 : 2 : 4 care 3 primary 4 care 4 care 5 physicians 4 care 14 lowering 5 physicians 6 were 6 were 7 able 7 able 8 to 7 able 9 use 8 to 9 use 9 use 11 strategy 10 a 11 strategy 11 strategy 12 of 11 strategy 14 lowering 12 of 13 bp 15 and 16 chd 15 and 17 risk 16 chd 17 risk 17 risk 18 assessment 17 risk 19 to 19 to 20 achieve 20 achieve 22 reductions 20 achieve 23 in 21 significant 22 reductions 23 in 30 risk 24 bp 25 and 25 and 26 framingham 25 and 27 - 25 and 28 assessed 25 and 30 risk 29 chd 30 risk the effect size estimate of the different framingham methods varied noticeably ; reasons for those differences warrant further investigation . 0 ###LEFT-WALL### 4 estimate 0 ###LEFT-WALL### 10 varied 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 20 . 1 the 4 estimate 2 effect 4 estimate 3 size 4 estimate 4 estimate 5 of 4 estimate 10 varied 5 of 9 methods 6 the 9 methods 7 different 9 methods 8 framingham 9 methods 10 varied 11 noticeably 12 ; 13 reasons 12 ; 17 warrant 13 reasons 14 for 13 reasons 17 warrant 14 for 16 differences 15 those 16 differences 17 warrant 19 investigation 18 further 19 investigation none [age] at menopause marks the end of a woman 's reproductive life and its timing associates with risks for cancer , cardiovascular and bone disorders . 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 27 . 1 none 3 at 1 none 22 , 3 at 5 marks 4 menopause 5 marks 5 marks 7 end 5 marks 17 associates 6 the 7 end 7 end 8 of 7 end 17 associates 8 of 14 and 9 a 10 woman 10 woman 11 's 11 's 13 life 12 reproductive 13 life 13 life 14 and 14 and 16 timing 15 its 16 timing 17 associates 18 with 18 with 19 risks 19 risks 20 for 20 for 21 cancer 22 , 23 cardiovascular 22 , 24 and 24 and 26 disorders 25 bone 26 disorders gwas and candidate gene studies conducted in women of european ancestry [have] identified 27 loci associated with age [at] menopause . 0 ###LEFT-WALL### 20 menopause 0 ###LEFT-WALL### 21 . 1 gwas 2 and 2 and 3 candidate 2 and 5 studies 2 and 17 with 2 and 18 age 4 gene 5 studies 5 studies 6 conducted 6 conducted 7 in 7 in 8 women 8 women 9 of 9 of 15 loci 10 european 13 identified 11 ancestry 13 identified 13 identified 15 loci 14 27 15 loci 15 loci 16 associated 16 associated 17 with 18 age 20 menopause the relevance of these loci to women [of] [african] [ancestry] has not been previously studied . 0 ###LEFT-WALL### 2 relevance 0 ###LEFT-WALL### 15 studied 0 ###LEFT-WALL### 16 . 1 the 2 relevance 2 relevance 3 of 2 relevance 11 has 3 of 5 loci 4 these 5 loci 5 loci 6 to 6 to 7 women 11 has 12 not 11 has 13 been 13 been 14 previously 13 been 15 studied we therefore sought to uncover additional menopause loci and investigate the relevance of european menopause loci by performing a gwas meta - analysis in 6510 women with african ancestry derived [from] 11 studies across the usa . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 37 . 1 we 9 and 2 therefore 3 sought 3 sought 4 to 3 sought 5 uncover 3 sought 9 and 4 to 5 uncover 5 uncover 8 loci 6 additional 7 menopause 7 menopause 8 loci 9 and 10 investigate 9 and 34 across 10 investigate 12 relevance 10 investigate 27 with 11 the 12 relevance 12 relevance 13 of 13 of 16 loci 14 european 15 menopause 15 menopause 16 loci 16 loci 17 by 17 by 18 performing 18 performing 23 analysis 18 performing 24 in 19 a 23 analysis 20 gwas 23 analysis 21 meta 22 - 21 meta 23 analysis 24 in 26 women 25 6510 26 women 27 with 33 studies 28 african 29 ancestry 29 ancestry 30 derived 30 derived 33 studies 32 11 33 studies 34 across 36 usa 35 the 36 usa we did not identify any additional loci significantly associated with age at menopause [in] african americans . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 identify 0 ###LEFT-WALL### 17 . 1 we 2 did 2 did 3 not 2 did 4 identify 4 identify 7 loci 5 any 7 loci 6 additional 7 loci 7 loci 9 associated 8 significantly 9 associated 9 associated 10 with 9 associated 12 at 10 with 11 age 12 at 16 americans 13 menopause 16 americans 15 african 16 americans we replicated the associations between six loci and age [at] menopause ( p - [value] < 0.05 ) : amhr2 , rhbld2 , prim1 , hk3/umc1 , brsk1/tmem150b and mcm8 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 replicated 0 ###LEFT-WALL### 19 : 0 ###LEFT-WALL### 31 . 1 we 2 replicated 2 replicated 4 associations 2 replicated 5 between 2 replicated 14 - 3 the 4 associations 5 between 8 and 6 six 7 loci 7 loci 8 and 8 and 11 menopause 9 age 11 menopause 12 ( 14 - 13 p 14 - 14 - 16 < 14 - 18 ) 16 < 17 0.05 19 : 20 amhr2 19 : 27 , 20 amhr2 22 rhbld2 21 , 22 rhbld2 22 rhbld2 24 prim1 22 rhbld2 27 , 23 , 24 prim1 24 prim1 26 hk3/umc1 24 prim1 27 , 25 , 26 hk3/umc1 26 hk3/umc1 27 , 27 , 29 and 28 brsk1/tmem150b 29 and 29 and 30 mcm8 in addition , associations of 14 loci are directionally consistent with previous reports . 0 ###LEFT-WALL### 4 associations 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 14 . 1 in 2 addition 1 in 3 , 1 in 4 associations 4 associations 5 of 4 associations 8 are 5 of 7 loci 6 14 7 loci 8 are 9 directionally 8 are 10 consistent 10 consistent 11 with 11 with 13 reports 12 previous 13 reports we provide evidence that genetic variants influencing reproductive traits identified in european populations are also important in women of african ancestry residing in usa . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 provide 0 ###LEFT-WALL### 25 . 1 we 2 provide 2 provide 3 evidence 2 provide 17 in 3 evidence 4 that 4 that 6 variants 4 that 14 are 5 genetic 6 variants 6 variants 7 influencing 6 variants 10 identified 6 variants 14 are 7 influencing 9 traits 8 reproductive 9 traits 10 identified 11 in 11 in 13 populations 12 european 13 populations 14 are 15 also 14 are 16 important 17 in 18 women 18 women 19 of 19 of 22 residing 20 african 21 ancestry 21 ancestry 22 residing 22 residing 23 in 23 in 24 usa the spt - ada - gcn5 - acetyltransferase ( saga ) chromatin - modifying complex possesses acetyltransferase and deubiquitinase activities . 0 ###LEFT-WALL### 15 complex 0 ###LEFT-WALL### 16 possesses 0 ###LEFT-WALL### 21 . 1 the 15 complex 2 spt 4 ada 2 spt 12 chromatin 2 spt 15 complex 3 - 4 ada 4 ada 5 - 5 - 12 chromatin 6 gcn5 8 acetyltransferase 6 gcn5 12 chromatin 7 - 8 acetyltransferase 8 acetyltransferase 10 saga 8 acetyltransferase 11 ) 9 ( 10 saga 10 saga 11 ) 12 chromatin 13 - 14 modifying 15 complex 15 complex 16 possesses 16 possesses 18 and 17 acetyltransferase 18 and 18 and 20 activities 19 deubiquitinase 20 activities within this modular complex , ataxin [-] 7 anchors the deubiquitinase activity to the larger complex . 0 ###LEFT-WALL### 6 ataxin 0 ###LEFT-WALL### 9 anchors 0 ###LEFT-WALL### 17 . 1 within 4 complex 1 within 5 , 1 within 6 ataxin 2 this 4 complex 3 modular 4 complex 6 ataxin 8 7 6 ataxin 9 anchors 9 anchors 12 activity 9 anchors 13 to 10 the 12 activity 11 deubiquitinase 12 activity 13 to 16 complex 14 the 16 complex 15 larger 16 complex here we identified and characterized drosophila ataxin - 7 [and] found that reduction of ataxin - 7 protein results in loss of components from the saga complex . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 28 . 1 here 2 we 2 we 4 and 3 identified 4 and 4 and 5 characterized 4 and 7 ataxin 6 drosophila 7 ataxin 7 ataxin 9 7 7 ataxin 11 found 8 - 9 7 9 7 11 found 11 found 13 reduction 11 found 19 results 11 found 20 in 12 that 13 reduction 13 reduction 14 of 14 of 15 ataxin 16 - 17 7 17 7 19 results 18 protein 19 results 20 in 21 loss 21 loss 22 of 21 loss 24 from 22 of 23 components 24 from 27 complex 25 the 27 complex 26 saga 27 complex in contrast to yeast , [where] loss of ataxin - 7 inactivates the deubiquitinase and results in increased h2b ubiquitination , loss of ataxin - 7 results in decreased h2b ubiquitination and h3k9 acetylation without affecting other histone marks . 0 ###LEFT-WALL### 2 contrast 0 ###LEFT-WALL### 12 inactivates 1 in 2 contrast 2 contrast 3 to 2 contrast 12 inactivates 3 to 4 yeast 4 yeast 10 - 5 , 10 - 7 loss 8 of 7 loss 10 - 8 of 9 ataxin 10 - 11 7 12 inactivates 15 and 12 inactivates 17 in 13 the 15 and 14 deubiquitinase 15 and 15 and 16 results 17 in 20 ubiquitination 18 increased 20 ubiquitination 19 h2b 20 ubiquitination 20 ubiquitination 22 loss 20 ubiquitination 32 and 21 , 22 loss 22 loss 23 of 22 loss 25 - 23 of 24 ataxin 25 - 32 and 26 7 27 results 27 results 28 in 27 results 32 and 28 in 31 ubiquitination 29 decreased 31 ubiquitination 30 h2b 31 ubiquitination 32 and 34 acetylation 32 and 35 without 32 and 40 . 33 h3k9 34 acetylation 35 without 36 affecting 36 affecting 39 marks 37 other 39 marks 38 histone 39 marks interestingly , the effect on ubiquitination was conserved in human cells , suggesting a novel mechanism regulating histone deubiquitination in higher organisms . 0 ###LEFT-WALL### 4 effect 0 ###LEFT-WALL### 8 conserved 1 interestingly 2 , 1 interestingly 4 effect 3 the 4 effect 4 effect 5 on 4 effect 7 was 5 on 6 ubiquitination 7 was 8 conserved 8 conserved 9 in 8 conserved 13 suggesting 9 in 11 cells 10 human 11 cells 12 , 13 suggesting 13 suggesting 16 mechanism 13 suggesting 23 . 14 a 15 novel 14 a 16 mechanism 15 novel 16 mechanism 16 mechanism 17 regulating 17 regulating 19 deubiquitination 17 regulating 20 in 18 histone 19 deubiquitination 20 in 22 organisms 21 higher 22 organisms consistent with this mechanism in vivo , we found that a recombinant deubiquitinase module is active in the absence of ataxin [-] 7 in vitro . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 9 found 0 ###LEFT-WALL### 26 . 1 consistent 2 with 1 consistent 6 vivo 1 consistent 7 , 1 consistent 8 we 2 with 4 mechanism 3 this 4 mechanism 5 in 6 vivo 8 we 9 found 9 found 10 that 10 that 14 module 10 that 15 is 11 a 12 recombinant 11 a 14 module 12 recombinant 13 deubiquitinase 13 deubiquitinase 14 module 14 module 15 is 15 is 16 active 16 active 17 in 16 active 25 vitro 17 in 19 absence 18 the 19 absence 19 absence 20 of 20 of 21 ataxin 21 ataxin 23 7 24 in 25 vitro when we examined the consequences of reduced ataxin - 7 in [vivo] , we found that flies exhibited pronounced neural and retinal degeneration , impaired movement , and early lethality . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 15 found 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 31 . 1 when 2 we 1 when 3 examined 1 when 14 we 2 we 3 examined 3 examined 5 consequences 4 the 5 consequences 5 consequences 6 of 6 of 8 ataxin 7 reduced 8 ataxin 8 ataxin 11 in 9 - 11 in 10 7 11 in 11 in 13 , 14 we 15 found 15 found 16 that 15 found 17 flies 15 found 21 and 17 flies 18 exhibited 17 flies 19 pronounced 19 pronounced 20 neural 21 and 23 degeneration 22 retinal 23 degeneration 24 , 28 and 25 impaired 26 movement 26 movement 28 and 27 , 28 and 28 and 30 lethality 29 early 30 lethality objective : phonemic verbal fluency ( pvf ) is a cognitive function that involves serial processes termed clustering and switching and which is impacted in both normal aging and dementia . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 5 fluency 2 : 19 and 2 : 21 and 3 phonemic 5 fluency 4 verbal 5 fluency 5 fluency 7 pvf 5 fluency 9 is 6 ( 7 pvf 7 pvf 8 ) 9 is 12 function 10 a 12 function 11 cognitive 12 function 12 function 13 that 12 function 19 and 13 that 14 involves 14 involves 16 processes 15 serial 16 processes 16 processes 19 and 17 termed 18 clustering 17 termed 19 and 19 and 20 switching 21 and 22 which 21 and 24 impacted 22 which 23 is 23 is 24 impacted 24 impacted 25 in 25 in 29 and 26 both 29 and 27 normal 28 aging 27 normal 29 and 29 and 30 dementia 29 and 31 . the cognitive reserve hypothesis suggests that appropriate cognitive stimulation could maintain [or] [improve] cognitive performance . 0 ###LEFT-WALL### 4 hypothesis 0 ###LEFT-WALL### 5 suggests 0 ###LEFT-WALL### 16 . 1 the 4 hypothesis 2 cognitive 3 reserve 3 reserve 4 hypothesis 4 hypothesis 5 suggests 5 suggests 6 that 6 that 9 stimulation 6 that 11 maintain 7 appropriate 9 stimulation 8 cognitive 9 stimulation 9 stimulation 10 could 10 could 11 maintain 11 maintain 15 performance 14 cognitive 15 performance this study examines the effect on pvf performance of a brief crossword - based intervention in a cognitively normal , community - based sample . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examines 0 ###LEFT-WALL### 22 - 1 this 2 study 2 study 3 examines 3 examines 5 effect 3 examines 6 on 4 the 5 effect 6 on 8 performance 7 pvf 8 performance 8 performance 9 of 9 of 12 crossword 10 a 11 brief 10 a 12 crossword 11 brief 12 crossword 12 crossword 15 intervention 13 - 15 intervention 14 based 15 intervention 15 intervention 16 in 15 intervention 22 - 16 in 21 community 17 a 18 cognitively 17 a 21 community 18 cognitively 19 normal 19 normal 20 , 19 normal 21 community 22 - 24 sample 22 - 25 . 23 based 24 sample methods : thirty - seven members of active retirement groups volunteered to participate and were randomly assigned to a crossword group and a control group . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 17 assigned 0 ###LEFT-WALL### 26 . 1 methods 2 : 2 : 4 - 3 thirty 4 - 4 - 5 seven 4 - 6 members 4 - 17 assigned 6 members 7 of 6 members 11 volunteered 7 of 10 groups 8 active 9 retirement 9 retirement 10 groups 11 volunteered 12 to 11 volunteered 17 assigned 12 to 14 and 13 participate 14 and 14 and 15 were 15 were 17 assigned 16 randomly 17 assigned 17 assigned 18 to 18 to 22 and 19 a 21 group 20 crossword 21 group 21 group 22 and 22 and 25 group 23 a 25 group 24 control 25 group the former attempted a crossword daily for 4 weeks while the latter kept a daily gratitude diary for the same period . 0 ###LEFT-WALL### 2 former 0 ###LEFT-WALL### 3 attempted 0 ###LEFT-WALL### 22 . 1 the 2 former 2 former 3 attempted 3 attempted 5 crossword 4 a 5 crossword 5 crossword 6 daily 6 daily 7 for 6 daily 10 while 7 for 9 weeks 8 4 9 weeks 10 while 12 latter 10 while 13 kept 11 the 12 latter 12 latter 13 kept 13 kept 17 diary 14 a 15 daily 14 a 17 diary 15 daily 16 gratitude 16 gratitude 17 diary 17 diary 18 for 18 for 21 period 19 the 20 same 20 same 21 period results : 2 × 2 mixed analyses of variance revealed that the crossword group performed significantly better over time than the control group in both total pvf score and in the cluster size component . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 7 analyses 3 2 7 analyses 4 × 6 mixed 5 2 6 mixed 6 mixed 7 analyses 7 analyses 8 of 7 analyses 11 that 7 analyses 17 better 8 of 9 variance 9 variance 10 revealed 11 that 14 group 11 that 17 better 12 the 14 group 13 crossword 14 group 14 group 15 performed 14 group 17 better 15 performed 16 significantly 17 better 29 and 18 over 19 time 18 over 29 and 19 time 23 group 19 time 28 score 20 than 23 group 21 the 23 group 22 control 23 group 23 group 24 in 23 group 28 score 24 in 27 pvf 25 both 27 pvf 26 total 27 pvf 29 and 30 in 30 in 34 component 31 the 34 component 32 cluster 34 component 33 size 34 component conclusion : daily crosswords may be a simple and effective means of bolstering pvf performance in older people . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 4 crosswords 2 : 6 be 3 daily 4 crosswords 4 crosswords 5 may 5 may 6 be 6 be 11 means 7 a 11 means 8 simple 9 and 9 and 10 effective 9 and 11 means 11 means 12 of 12 of 13 bolstering 13 bolstering 15 performance 13 bolstering 16 in 14 pvf 15 performance 16 in 18 people 17 older 18 people none none importance : to describe the first case of preimplantation genetic diagnosis ( pgd ) and in vitro fertilization ( ivf ) performed for the prevention of genetic prion disease in the children of a 27 [-] year [-] old asymptomatic woman with a family history of gerstmann - sträussler - sheinker [syndrome] ( gss ) . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 6 describe 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 58 . 1 none 3 importance 1 none 5 to 1 none 6 describe 2 none 3 importance 3 importance 4 : 4 : 5 to 6 describe 9 case 7 the 9 case 8 first 9 case 9 case 10 of 10 of 13 diagnosis 11 preimplantation 13 diagnosis 12 genetic 13 diagnosis 13 diagnosis 15 pgd 14 ( 15 pgd 15 pgd 16 ) 17 and 20 fertilization 17 and 24 performed 18 in 19 vitro 19 vitro 20 fertilization 20 fertilization 22 ivf 20 fertilization 24 performed 21 ( 22 ivf 22 ivf 23 ) 24 performed 25 for 24 performed 44 with 25 for 27 prevention 26 the 27 prevention 27 prevention 28 of 27 prevention 35 of 28 of 31 disease 29 genetic 30 prion 30 prion 31 disease 31 disease 32 in 32 in 34 children 33 the 34 children 35 of 43 woman 36 a 43 woman 37 27 39 year 39 year 43 woman 41 old 43 woman 42 asymptomatic 43 woman 44 with 47 history 45 a 47 history 46 family 47 history 47 history 48 of 47 history 51 sträussler 48 of 49 gerstmann 50 - 51 sträussler 51 sträussler 56 gss 51 sträussler 57 ) 52 - 56 gss 53 sheinker 56 gss 55 ( 56 gss 56 gss 57 ) observations : pgd and fertilization cycles resulted in detection of 6 f198s mutation - free embryos . 0 ###LEFT-WALL### 1 observations 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 4 and 2 : 7 resulted 2 : 14 - 3 pgd 4 and 4 and 6 cycles 4 and 7 resulted 5 fertilization 6 cycles 7 resulted 8 in 8 in 9 detection 9 detection 10 of 10 of 13 mutation 11 6 12 f198s 12 f198s 13 mutation 14 - 16 embryos 15 free 16 embryos of these , 2 were selected for embryo transfer to the patient 's uterus , yielding a clinical twin pregnancy and birth of healthy but slightly premature offspring with normal development at age 27 months . 0 ###LEFT-WALL### 4 2 0 ###LEFT-WALL### 6 selected 1 of 2 these 1 of 3 , 1 of 4 2 4 2 5 were 5 were 6 selected 6 selected 7 for 6 selected 10 to 6 selected 16 yielding 7 for 9 transfer 8 embryo 9 transfer 10 to 14 uterus 11 the 12 patient 12 patient 13 's 13 's 14 uterus 15 , 16 yielding 16 yielding 35 months 16 yielding 36 . 17 a 20 pregnancy 18 clinical 19 twin 19 twin 20 pregnancy 20 pregnancy 21 and 21 and 22 birth 21 and 23 of 21 and 29 with 21 and 35 months 23 of 28 offspring 24 healthy 25 but 25 but 27 premature 25 but 28 offspring 26 slightly 27 premature 29 with 31 development 30 normal 31 development 31 development 32 at 32 at 33 age 33 age 34 27 conclusion and relevance : ivf with pgd is a viable option for couples who wish to avoid passing the disease to their offspring . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 4 : 1 conclusion 2 and 2 and 3 relevance 4 : 5 ivf 4 : 8 is 4 : 24 . 5 ivf 6 with 5 ivf 8 is 6 with 7 pgd 8 is 11 option 9 a 10 viable 9 a 11 option 10 viable 11 option 11 option 12 for 11 option 16 to 11 option 17 avoid 12 for 13 couples 13 couples 14 who 13 couples 15 wish 14 who 15 wish 16 to 17 avoid 17 avoid 18 passing 18 passing 20 disease 18 passing 21 to 19 the 20 disease 21 to 23 offspring 22 their 23 offspring neurologists should be aware of pgd to be able to better consult at - risk families on their reproductive choices . 0 ###LEFT-WALL### 1 neurologists 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 14 - 1 neurologists 2 should 2 should 3 be 3 be 4 aware 4 aware 5 of 5 of 6 pgd 6 pgd 7 to 6 pgd 13 at 7 to 8 be 8 be 9 able 9 able 10 to 9 able 12 consult 10 to 12 consult 11 better 12 consult 12 consult 13 at 14 - 15 risk 14 - 21 . 15 risk 16 families 16 families 17 on 17 on 20 choices 18 their 20 choices 19 reproductive 20 choices introduction : while there is consensus on how to treat acute appendicitis , the most suitable treatment for an appendiceal inflammatory mass is still debated . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 17 treatment 2 : 23 is 3 while 4 there 3 while 5 is 3 while 13 , 3 while 17 treatment 4 there 5 is 5 is 6 consensus 5 is 7 on 7 on 8 how 8 how 9 to 8 how 10 treat 9 to 10 treat 10 treat 12 appendicitis 11 acute 12 appendicitis 14 the 15 most 15 most 17 treatment 16 suitable 17 treatment 17 treatment 18 for 17 treatment 23 is 18 for 22 mass 19 an 22 mass 20 appendiceal 22 mass 21 inflammatory 22 mass 23 is 24 still 23 is 25 debated 24 still 25 debated this study compares the outcomes of operative and nonoperative management . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 compares 0 ###LEFT-WALL### 11 . 1 this 2 study 2 study 3 compares 3 compares 5 outcomes 4 the 5 outcomes 5 outcomes 6 of 6 of 10 management 7 operative 8 and 8 and 9 nonoperative 8 and 10 management material and methods : we retrospectively evaluated 119 patients ( 2007 - 2011 ) with an appendiceal inflammatory mass , 85 [of] [whom] were treated nonoperatively and [34] operatively . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 material 2 and 2 and 3 methods 4 : 5 we 4 : 7 evaluated 4 : 20 , 4 : 30 . 5 we 7 evaluated 6 retrospectively 7 evaluated 7 evaluated 9 patients 7 evaluated 15 with 8 119 9 patients 9 patients 12 - 10 ( 12 - 11 2007 12 - 12 - 13 2011 12 - 14 ) 15 with 19 mass 16 an 17 appendiceal 16 an 19 mass 17 appendiceal 19 mass 18 inflammatory 19 mass 20 , 21 85 20 , 25 treated 21 85 24 were 24 were 25 treated 25 treated 27 and 26 nonoperatively 27 and 27 and 29 operatively of the nonoperative patients , 69 did not receive interventional treatment and [16] underwent percutaneous drainage of an accompanying abscess ; the data for these patients were analyzed separately . 0 ###LEFT-WALL### 6 69 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 21 ; 0 ###LEFT-WALL### 30 . 1 of 4 patients 1 of 5 , 1 of 6 69 2 the 4 patients 3 nonoperative 4 patients 6 69 7 did 7 did 8 not 7 did 12 and 9 receive 11 treatment 9 receive 12 and 10 interventional 11 treatment 12 and 14 underwent 12 and 16 drainage 15 percutaneous 16 drainage 16 drainage 17 of 17 of 20 abscess 18 an 20 abscess 19 accompanying 20 abscess 21 ; 23 data 21 ; 28 analyzed 22 the 23 data 23 data 24 for 23 data 27 were 24 for 26 patients 25 these 26 patients 27 were 28 analyzed 28 analyzed 29 separately results : of the noninterventional managed patients , 49 ( 71.0 % ) experienced at least one recurrence and 37 ( 53.6 % ) ultimately needed an acute surgical or radiological intervention . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 33 . 1 results 2 : 2 : 3 of 3 of 7 patients 4 the 7 patients 5 noninterventional 7 patients 6 managed 7 patients 8 , 9 49 8 , 14 experienced 8 , 19 and 9 49 12 % 9 49 14 experienced 10 ( 12 % 11 71.0 12 % 12 % 13 ) 14 experienced 18 recurrence 15 at 16 least 16 least 17 one 17 one 18 recurrence 19 and 20 37 19 and 26 needed 20 37 23 % 20 37 26 needed 21 ( 23 % 22 53.6 23 % 23 % 24 ) 25 ultimately 26 needed 26 needed 32 intervention 27 an 28 acute 27 an 32 intervention 28 acute 32 intervention 29 surgical 30 or 30 or 31 radiological 30 or 32 intervention of the 16 patients who underwent percutaneous drainage , 7 ( 43.8 % ) experienced at least one recurrence and 6 ( 37.5 % ) underwent an acute surgical [or] [(] [second] ) percutaneous intervention . 0 ###LEFT-WALL### 10 7 0 ###LEFT-WALL### 15 experienced 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 36 . 1 of 4 patients 1 of 9 , 1 of 10 7 2 the 3 16 3 16 4 patients 4 patients 5 who 4 patients 6 underwent 5 who 6 underwent 6 underwent 8 drainage 7 percutaneous 8 drainage 10 7 13 % 10 7 15 experienced 11 ( 13 % 12 43.8 13 % 13 % 14 ) 15 experienced 19 recurrence 16 at 17 least 17 least 18 one 18 one 19 recurrence 20 and 21 6 20 and 26 underwent 21 6 24 % 21 6 26 underwent 22 ( 24 % 23 37.5 24 % 24 % 25 ) 26 underwent 35 intervention 27 an 28 acute 27 an 35 intervention 28 acute 35 intervention 29 surgical 33 ) 29 surgical 35 intervention 34 percutaneous 35 intervention none of the operated patients had a recurrence and the incidence of complications was 17.6 % . 0 ###LEFT-WALL### 5 patients 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 17 . 1 none 2 of 1 none 5 patients 2 of 5 patients 3 the 5 patients 4 operated 5 patients 5 patients 6 had 6 had 8 recurrence 7 a 8 recurrence 9 and 11 incidence 9 and 14 was 10 the 11 incidence 11 incidence 12 of 11 incidence 14 was 12 of 13 complications 14 was 16 % 15 17.6 16 % the incidence of underlying malignant [tumor] in our study population was 5.9 % . 0 ###LEFT-WALL### 2 incidence 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 14 . 1 the 2 incidence 2 incidence 3 of 2 incidence 11 was 3 of 4 underlying 4 underlying 5 malignant 5 malignant 7 in 7 in 10 population 8 our 10 population 9 study 10 population 11 was 13 % 12 5.9 13 % in 35 patients , the definitive diagnosis remained unclear because the patients did not undergo surgery or follow - up colonoscopy after nonoperative treatment . 0 ###LEFT-WALL### 7 diagnosis 0 ###LEFT-WALL### 8 remained 0 ###LEFT-WALL### 19 - 1 in 3 patients 1 in 4 , 1 in 7 diagnosis 2 35 3 patients 5 the 7 diagnosis 6 definitive 7 diagnosis 7 diagnosis 8 remained 8 remained 9 unclear 9 unclear 10 because 10 because 12 patients 10 because 17 or 11 the 12 patients 12 patients 17 or 13 did 14 not 13 did 15 undergo 13 did 17 or 15 undergo 16 surgery 17 or 18 follow 19 - 20 up 19 - 25 . 20 up 21 colonoscopy 20 up 22 after 22 after 24 treatment 23 nonoperative 24 treatment the rate of extensive [(] ileocecal [+] hemicolonic ) resection in all operated patients was 30.8 % . 0 ###LEFT-WALL### 2 rate 0 ###LEFT-WALL### 15 was 0 ###LEFT-WALL### 18 . 1 the 2 rate 2 rate 3 of 2 rate 15 was 3 of 10 resection 4 extensive 10 resection 6 ileocecal 10 resection 8 hemicolonic 9 ) 8 hemicolonic 10 resection 10 resection 11 in 11 in 14 patients 12 all 14 patients 13 operated 14 patients 15 was 17 % 16 30.8 17 % noninterventional management or a percutaneous intervention should be reserved as a bridge to surgery for patients with a large accompanying abscess or [as] treatment for patients with significant comorbidity . 0 ###LEFT-WALL### 8 be 0 ###LEFT-WALL### 30 . 1 noninterventional 2 management 2 management 3 or 3 or 6 intervention 3 or 7 should 4 a 5 percutaneous 4 a 6 intervention 5 percutaneous 6 intervention 7 should 8 be 8 be 9 reserved 9 reserved 10 as 9 reserved 13 to 10 as 12 bridge 11 a 12 bridge 13 to 14 surgery 14 surgery 15 for 14 surgery 17 with 14 surgery 25 for 15 for 16 patients 17 with 22 or 18 a 19 large 18 a 21 abscess 19 large 21 abscess 20 accompanying 21 abscess 21 abscess 22 or 22 or 24 treatment 25 for 26 patients 26 patients 27 with 27 with 29 comorbidity 28 significant 29 comorbidity if nonoperative treatment is chosen , follow - up colonoscopy is mandatory to exclude malignancy . 0 ###LEFT-WALL### 7 follow 0 ###LEFT-WALL### 8 - 1 if 3 treatment 1 if 5 chosen 1 if 6 , 1 if 7 follow 2 nonoperative 3 treatment 3 treatment 4 is 4 is 5 chosen 5 chosen 6 , 8 - 10 colonoscopy 8 - 11 is 8 - 16 . 9 up 10 colonoscopy 10 colonoscopy 11 is 11 is 12 mandatory 12 mandatory 13 to 12 mandatory 14 exclude 13 to 14 exclude 14 exclude 15 malignancy [strategically] selecting patients for discussions and documentation about limiting life - sustaining treatments - choosing the right time along the end - [of] - life trajectory for such an intervention and identifying patients at high risk of facing end - of [-] life decisions - can have a profound impact on the value of advance care planning ( acp [ )(efforts . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 - 2 selecting 3 patients 3 patients 4 for 3 patients 6 and 4 for 5 discussions 6 and 7 documentation 7 documentation 8 about 8 about 9 limiting 9 limiting 10 life 11 - 13 treatments 11 - 22 - 12 sustaining 13 treatments 13 treatments 15 choosing 14 - 15 choosing 15 choosing 18 time 15 choosing 19 along 15 choosing 22 - 16 the 18 time 17 right 18 time 19 along 21 end 20 the 21 end 22 - 24 - 24 - 36 risk 25 life 26 trajectory 26 trajectory 27 for 26 trajectory 31 and 27 for 30 intervention 28 such 29 an 29 an 30 intervention 31 and 33 patients 31 and 34 at 31 and 36 risk 32 identifying 33 patients 34 at 35 high 36 risk 37 of 36 risk 46 can 37 of 39 end 38 facing 39 end 39 end 41 of 40 - 41 of 41 of 44 decisions 41 of 45 - 43 life 44 decisions 46 can 47 have 47 have 50 impact 47 have 51 on 48 a 49 profound 48 a 50 impact 49 profound 50 impact 51 on 53 value 52 the 53 value 53 value 54 of 54 of 57 planning 55 advance 57 planning 56 care 57 planning 57 planning 61 )(efforts 58 ( 61 )(efforts 59 acp 61 )(efforts 61 )(efforts 62 . because much of the currently studied acp efforts have led to a disappointingly small proportion of patients eventually benefitting from an ad , careful targeting of the intervention should also improve the efficacy of such projects . 0 ###LEFT-WALL### 25 targeting 0 ###LEFT-WALL### 31 improve 0 ###LEFT-WALL### 37 . 1 because 2 much 1 because 10 led 1 because 23 , 1 because 25 targeting 2 much 3 of 2 much 10 led 3 of 7 acp 4 the 7 acp 5 currently 6 studied 6 studied 7 acp 7 acp 8 efforts 7 acp 9 have 8 efforts 9 have 10 led 11 to 10 led 20 from 11 to 15 proportion 12 a 15 proportion 13 disappointingly 14 small 14 small 15 proportion 15 proportion 16 of 16 of 17 patients 17 patients 19 benefitting 18 eventually 19 benefitting 20 from 22 ad 21 an 22 ad 24 careful 25 targeting 25 targeting 26 of 25 targeting 29 should 26 of 28 intervention 27 the 28 intervention 29 should 31 improve 30 also 31 improve 31 improve 33 efficacy 32 the 33 efficacy 33 efficacy 34 of 34 of 36 projects 35 such 36 projects a key to optimal timing and strategic selection of target patients for an acp program is prognostication , and we briefly highlight prognostication tools and studies that may point us toward high - value ad interventions . 0 ###LEFT-WALL### 2 key 0 ###LEFT-WALL### 16 is 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 37 . 1 a 2 key 2 key 3 to 2 key 9 of 2 key 16 is 3 to 6 and 4 optimal 5 timing 5 timing 6 and 6 and 8 selection 7 strategic 8 selection 9 of 11 patients 10 target 11 patients 11 patients 12 for 12 for 15 program 13 an 15 program 14 acp 15 program 16 is 17 prognostication 18 , 19 and 19 and 20 we 19 and 22 highlight 20 we 22 highlight 21 briefly 22 highlight 22 highlight 23 prognostication 22 highlight 31 toward 23 prognostication 25 and 23 prognostication 27 that 23 prognostication 28 may 24 tools 25 and 25 and 26 studies 27 that 28 may 28 may 29 point 29 point 30 us 31 toward 36 interventions 32 high 33 - 32 high 36 interventions 34 value 36 interventions 35 ad 36 interventions it is well established that [insulin] - like growth factor 1 ( igf - 1 ) circulating levels correlate with age and that heritability and influence of igf - 1 gene variation on igf - 1 levels also well - known . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 1 it 2 is 2 is 3 well 2 is 5 that 3 well 4 established 5 that 18 levels 5 that 19 correlate 7 - 8 like 8 like 10 factor 8 like 16 ) 8 like 18 levels 9 growth 10 factor 10 factor 11 1 10 factor 13 igf 12 ( 13 igf 13 igf 15 1 13 igf 16 ) 14 - 15 1 15 1 16 ) 17 circulating 18 levels 18 levels 19 correlate 19 correlate 20 with 20 with 25 and 21 age 22 and 22 and 23 that 22 and 24 heritability 24 heritability 25 and 25 and 26 influence 25 and 27 of 25 and 36 1 25 and 37 levels 25 and 41 known 27 of 28 igf 28 igf 32 variation 29 - 32 variation 30 1 32 variation 31 gene 32 variation 32 variation 33 on 32 variation 35 - 33 on 34 igf 36 1 37 levels 37 levels 38 also 37 levels 39 well 40 - 41 known 41 known 42 . however , the influence of age on the genetic factors determining igf - 1 levels is not clear . 0 ###LEFT-WALL### 4 influence 0 ###LEFT-WALL### 16 is 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 4 influence 3 the 4 influence 4 influence 5 of 4 influence 16 is 5 of 6 age 6 age 7 on 6 age 11 determining 7 on 10 factors 8 the 10 factors 9 genetic 10 factors 11 determining 12 igf 12 igf 14 1 12 igf 15 levels 13 - 14 1 14 1 15 levels 16 is 17 not 16 is 18 clear 17 not 18 clear to achieve these aims , we measured plasma levels of igf - 1 and genotyped 18 snps with minor allele frequency >0.1 in a large sample , 4,471 uk female twins . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 achieve 0 ###LEFT-WALL### 5 , 1 to 2 achieve 2 achieve 4 aims 3 these 4 aims 5 , 6 we 5 , 7 measured 5 , 12 - 6 we 7 measured 7 measured 9 levels 8 plasma 9 levels 9 levels 10 of 10 of 11 igf 12 - 13 1 12 - 14 and 14 and 17 snps 14 and 22 >0.1 15 genotyped 17 snps 16 18 17 snps 17 snps 18 with 17 snps 22 >0.1 18 with 21 frequency 19 minor 20 allele 20 allele 21 frequency 22 >0.1 23 in 23 in 26 sample 24 a 25 large 24 a 26 sample 25 large 26 sample 26 sample 31 twins 27 , 31 twins 28 4,471 31 twins 29 uk 31 twins 30 female 31 twins 31 twins 32 . heritability explained 42 % of igf - 1 variation adjusted for age and [in] unadjusted sample [was] independent of age . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 21 . 1 heritability 10 adjusted 1 heritability 11 for 1 heritability 13 and 2 explained 4 % 2 explained 7 - 2 explained 9 variation 2 explained 10 adjusted 3 42 4 % 4 % 5 of 5 of 6 igf 8 1 9 variation 9 variation 10 adjusted 11 for 12 age 13 and 18 independent 13 and 19 of 15 unadjusted 16 sample 16 sample 18 independent 19 of 20 age ten snps in four haploblocks showed significant association [with] igf - 1 levels , with p = 0.01 - 0.0005 . 0 ###LEFT-WALL### 1 ten 0 ###LEFT-WALL### 17 = 0 ###LEFT-WALL### 21 . 1 ten 2 snps 1 ten 15 with 1 ten 17 = 2 snps 3 in 2 snps 6 showed 3 in 5 haploblocks 4 four 5 haploblocks 6 showed 10 igf 6 showed 15 with 7 significant 8 association 8 association 10 igf 10 igf 13 levels 11 - 13 levels 12 1 13 levels 13 levels 14 , 16 p 17 = 17 = 19 - 18 0.01 19 - 19 - 20 0.0005 the most distal snp was located up to 90 kbp from the igf - 1 gene . 0 ###LEFT-WALL### 4 snp 0 ###LEFT-WALL### 6 located 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 17 . 1 the 2 most 2 most 4 snp 3 distal 4 snp 4 snp 5 was 5 was 6 located 6 located 11 from 7 up 8 to 8 to 9 90 9 90 10 kbp 10 kbp 11 from 11 from 13 igf 12 the 13 igf 14 - 16 gene 15 1 16 gene when their age [-] dependent effects were examined , one snp , rs855203 , showed significant ( p = 0.0009 ) age - dependent interaction effect on igf - 1 levels variation . 0 ###LEFT-WALL### 11 snp 0 ###LEFT-WALL### 15 showed 0 ###LEFT-WALL### 33 . 1 when 6 effects 1 when 8 examined 1 when 11 snp 2 their 6 effects 3 age 6 effects 5 dependent 6 effects 6 effects 7 were 7 were 8 examined 8 examined 9 , 10 one 11 snp 11 snp 13 rs855203 11 snp 15 showed 12 , 13 rs855203 13 rs855203 14 , 15 showed 22 age 15 showed 30 1 15 showed 31 levels 16 significant 19 = 16 significant 22 age 17 ( 19 = 18 p 19 = 19 = 20 0.0009 19 = 21 ) 22 age 26 effect 23 - 26 effect 24 dependent 25 interaction 25 interaction 26 effect 26 effect 27 on 26 effect 29 - 27 on 28 igf 30 1 31 levels 31 levels 32 variation [this] is the first study to test the age × genotype interaction in igf - 1 levels . 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 18 . 2 is 5 study 2 is 11 genotype 3 the 5 study 4 first 5 study 5 study 6 to 5 study 7 test 6 to 7 test 7 test 10 × 8 the 10 × 9 age 10 × 11 genotype 12 interaction 11 genotype 13 in 13 in 14 igf 15 - 17 levels 16 1 17 levels the genomic region marked by rs855203 may consequently be of significance for further molecular and pharmacogenetic research [,] in particular in advanced age . 0 ###LEFT-WALL### 3 region 0 ###LEFT-WALL### 9 be 0 ###LEFT-WALL### 24 . 1 the 3 region 2 genomic 3 region 3 region 4 marked 3 region 7 may 4 marked 5 by 5 by 6 rs855203 7 may 9 be 8 consequently 9 be 9 be 10 of 9 be 12 for 9 be 20 particular 9 be 21 in 10 of 11 significance 12 for 17 research 13 further 17 research 14 molecular 15 and 15 and 16 pharmacogenetic 15 and 17 research 19 in 20 particular 21 in 23 age 22 advanced 23 age importance : persons with type 2 diabetes mellitus ( t2dm ) are at increased risk for decline [in] cognitive function [,] reduced brain volume , and increased white matter lesions in the brain . 0 ###LEFT-WALL### 1 importance 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 3 persons 2 : 12 are 3 persons 4 with 3 persons 12 are 4 with 8 mellitus 5 type 7 diabetes 6 2 7 diabetes 7 diabetes 8 mellitus 8 mellitus 10 t2dm 9 ( 10 t2dm 10 t2dm 11 ) 12 are 13 at 13 at 26 and 14 increased 15 risk 15 risk 16 for 15 risk 26 and 16 for 24 volume 17 decline 24 volume 19 cognitive 23 brain 20 function 22 reduced 22 reduced 23 brain 23 brain 24 volume 25 , 26 and 26 and 30 lesions 26 and 31 in 27 increased 30 lesions 28 white 30 lesions 29 matter 30 lesions 31 in 33 brain 32 the 33 brain poor control of blood pressure ( bp ) and lipid levels are risk factors for t2dm - related cognitive decline , but the effect of intensive treatment on brain function and structure is unknown . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 12 are 0 ###LEFT-WALL### 17 - 0 ###LEFT-WALL### 35 . 1 poor 2 control 2 control 3 of 2 control 9 and 3 of 5 pressure 4 blood 5 pressure 5 pressure 7 bp 6 ( 7 bp 7 bp 8 ) 9 and 11 levels 9 and 12 are 10 lipid 11 levels 12 are 14 factors 13 risk 14 factors 14 factors 15 for 15 for 16 t2dm 17 - 20 decline 17 - 21 , 18 related 20 decline 19 cognitive 20 decline 21 , 30 function 21 , 31 and 22 but 24 effect 22 but 30 function 23 the 24 effect 24 effect 25 of 25 of 27 treatment 26 intensive 27 treatment 27 treatment 28 on 28 on 29 brain 31 and 32 structure 31 and 33 is 32 structure 33 is 33 is 34 unknown objective : to examine whether intensive therapy for hypertension [and] combination therapy with a statin plus a fibrate reduces the risk [of] decline in cognitive [function] and total brain volume ( tbv ) in patients with t2dm . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 examine 2 : 38 . 3 to 4 examine 4 examine 5 whether 4 examine 34 in 5 whether 7 therapy 5 whether 19 reduces 6 intensive 7 therapy 7 therapy 8 for 7 therapy 13 with 7 therapy 19 reduces 8 for 12 therapy 9 hypertension 11 combination 11 combination 12 therapy 13 with 15 statin 14 a 15 statin 15 statin 16 plus 16 plus 18 fibrate 17 a 18 fibrate 19 reduces 23 decline 19 reduces 24 in 20 the 23 decline 21 risk 23 decline 24 in 30 volume 25 cognitive 27 and 27 and 28 total 27 and 29 brain 29 brain 30 volume 30 volume 32 tbv 31 ( 32 tbv 32 tbv 33 ) 34 in 35 patients 35 patients 36 with 36 with 37 t2dm design , setting , and participants : a north american multicenter clinical trial including 2977 participants without baseline clinical evidence of cognitive impairment or dementia and with hemoglobin a1c ( hba1c ) levels less than 7.5 % randomized to a systolic bp goal of less than 120 vs less than 140 [mm] hg ( n = 1439 [ )( to a fibrate vs placebo in patients with low - density lipoprotein cholesterol levels less than 100 mg/dl ( n = 1538 ) . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 7 : 2 , 6 participants 3 setting 4 , 3 setting 6 participants 5 and 6 participants 6 participants 7 : 7 : 13 trial 8 a 13 trial 9 north 11 multicenter 10 american 11 multicenter 11 multicenter 13 trial 12 clinical 13 trial 13 trial 14 including 14 including 16 participants 15 2977 16 participants 16 participants 26 and 17 without 20 evidence 17 without 26 and 18 baseline 20 evidence 19 clinical 20 evidence 20 evidence 21 of 21 of 24 or 22 cognitive 23 impairment 23 impairment 24 or 24 or 25 dementia 26 and 27 with 27 with 28 hemoglobin 28 hemoglobin 29 a1c 28 hemoglobin 33 levels 29 a1c 31 hba1c 29 a1c 33 levels 30 ( 31 hba1c 31 hba1c 32 ) 33 levels 34 less 33 levels 35 than 35 than 37 % 35 than 44 of 36 7.5 37 % 37 % 38 randomized 38 randomized 39 to 39 to 43 goal 40 a 43 goal 41 systolic 43 goal 42 bp 43 goal 44 of 47 120 45 less 46 than 46 than 47 120 47 120 48 vs 47 120 56 = 48 vs 53 hg 49 less 50 than 50 than 51 140 51 140 53 hg 54 ( 56 = 55 n 56 = 56 = 57 1439 57 1439 60 to 57 1439 65 in 57 1439 67 with 60 to 62 fibrate 61 a 62 fibrate 62 fibrate 63 vs 63 vs 64 placebo 65 in 66 patients 67 with 68 low 68 low 73 levels 69 - 73 levels 70 density 73 levels 71 lipoprotein 72 cholesterol 72 cholesterol 73 levels 73 levels 80 = 73 levels 83 . 74 less 75 than 75 than 76 100 76 100 77 mg/dl 77 mg/dl 80 = 78 ( 80 = 79 n 80 = 80 = 81 1538 80 = 82 ) participants were recruited from august 1 , 2003 , through october 31 , 2005 , with the final follow - up visit by june 30 , 2009 . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 recruited 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 28 . 1 participants 2 were 2 were 3 recruited 3 recruited 4 from 3 recruited 9 , 3 recruited 10 through 4 from 5 august 5 august 6 1 5 august 8 2003 7 , 8 2003 8 2003 9 , 10 through 11 october 11 october 12 31 11 october 14 2005 13 , 14 2005 14 2005 15 , 15 , 19 follow 15 , 20 - 16 with 18 final 16 with 19 follow 17 the 18 final 20 - 22 visit 20 - 26 , 21 up 22 visit 22 visit 23 by 23 by 24 june 24 june 25 30 26 , 27 2009 main outcome measures : cognition was assessed at baseline and 20 and 40 months . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 1 main 2 outcome 2 outcome 3 measures 4 : 5 cognition 4 : 7 assessed 4 : 15 . 5 cognition 6 was 6 was 7 assessed 7 assessed 8 at 8 at 10 and 9 baseline 10 and 10 and 14 months 11 20 12 and 12 and 13 40 12 and 14 months a subset of 503 participants underwent baseline and 40 [-] month brain magnetic resonance imaging to assess for change in tbv and other structural measures of brain health . 0 ###LEFT-WALL### 2 subset 0 ###LEFT-WALL### 6 underwent 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 29 . 1 a 2 subset 2 subset 3 of 2 subset 6 underwent 3 of 5 participants 4 503 5 participants 6 underwent 7 baseline 8 and 11 month 8 and 12 brain 9 40 11 month 11 month 12 brain 12 brain 15 imaging 12 brain 18 for 13 magnetic 14 resonance 14 resonance 15 imaging 15 imaging 16 to 15 imaging 17 assess 16 to 17 assess 18 for 22 and 19 change 20 in 19 change 22 and 20 in 21 tbv 22 and 25 measures 22 and 26 of 23 other 25 measures 24 structural 25 measures 26 of 28 health 27 brain 28 health results : baseline mean hba1c level was 8.3 % ; mean age , 62 years ; [and] mean duration of t2dm , 10 years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 level 2 : 7 was 2 : 10 ; 2 : 16 ; 3 baseline 4 mean 4 mean 6 level 5 hba1c 6 level 6 level 7 was 7 was 9 % 8 8.3 9 % 10 ; 11 mean 11 mean 12 age 12 age 15 years 13 , 15 years 14 62 15 years 15 years 16 ; 16 ; 18 mean 18 mean 19 duration 19 duration 20 of 19 duration 24 years 20 of 21 t2dm 22 , 24 years 23 10 24 years 24 years 25 . at 40 months , no differences [in] cognitive function were found in the intensive [bp] - lowering trial or in the fibrate trial . 0 ###LEFT-WALL### 9 function 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 24 . 1 at 3 months 1 at 4 , 1 at 9 function 2 40 3 months 5 no 9 function 6 differences 9 function 8 cognitive 9 function 9 function 10 were 10 were 11 found 11 found 19 or 12 in 18 trial 12 in 19 or 13 the 18 trial 14 intensive 16 - 14 intensive 18 trial 17 lowering 18 trial 19 or 20 in 20 in 23 trial 21 the 23 trial 22 fibrate 23 trial at 40 months , tbv had declined more in the intensive [vs] standard [bp] - lowering group [(] difference , - 4.4 [ 95 % ci , - 7.8 to - 1.1 []] cm ( 3 ) [;] p = .01[!] ) . 0 ###LEFT-WALL### 5 tbv 0 ###LEFT-WALL### 7 declined 0 ###LEFT-WALL### 43 . 1 at 3 months 1 at 4 , 1 at 5 tbv 2 40 3 months 5 tbv 6 had 6 had 7 declined 7 declined 8 more 7 declined 9 in 9 in 19 difference 10 the 19 difference 11 intensive 19 difference 13 standard 15 - 13 standard 19 difference 16 lowering 17 group 17 group 19 difference 19 difference 22 4.4 19 difference 29 7.8 20 , 22 4.4 21 - 22 4.4 22 4.4 26 ci 22 4.4 27 , 23 [ 26 ci 24 95 26 ci 25 % 26 ci 26 ci 27 , 28 - 29 7.8 29 7.8 30 to 29 7.8 36 3 29 7.8 40 = 29 7.8 42 ) 30 to 34 cm 31 - 32 1.1 32 1.1 34 cm 35 ( 36 3 36 3 37 ) 39 p 40 = 40 = 41 .01[!] 40 = 42 ) fibrate therapy had no effect on tbv compared [with] [placebo] . 0 ###LEFT-WALL### 2 therapy 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 11 . 1 fibrate 2 therapy 2 therapy 3 had 3 had 5 effect 3 had 6 on 4 no 5 effect 6 on 7 tbv 7 tbv 8 compared conclusions and relevance : in participants with long - standing t2dm and at high risk for cardiovascular events , intensive bp control and fibrate therapy in the presence of controlled low - density lipoprotein cholesterol levels did not produce a measurable effect on cognitive decline [at] 40 months of follow - up . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 4 : 1 conclusions 2 and 2 and 3 relevance 4 : 50 follow 4 : 51 - 5 in 6 participants 5 in 50 follow 6 participants 12 and 7 with 11 t2dm 7 with 12 and 8 long 9 - 8 long 10 standing 10 standing 11 t2dm 12 and 13 at 13 at 23 and 14 high 15 risk 15 risk 16 for 15 risk 19 , 16 for 18 events 17 cardiovascular 18 events 19 , 22 control 19 , 23 and 20 intensive 22 control 21 bp 22 control 23 and 25 therapy 23 and 26 in 23 and 29 of 24 fibrate 25 therapy 26 in 28 presence 27 the 28 presence 29 of 35 cholesterol 30 controlled 33 density 31 low 32 - 31 low 33 density 33 density 34 lipoprotein 34 lipoprotein 35 cholesterol 35 cholesterol 36 levels 35 cholesterol 49 of 36 levels 37 did 37 did 38 not 37 did 39 produce 39 produce 42 effect 40 a 42 effect 41 measurable 42 effect 42 effect 43 on 43 on 48 months 44 cognitive 45 decline 45 decline 48 months 47 40 48 months 48 months 49 of 51 - 52 up 51 - 53 . intensive bp control was associated with greater decline [in] tbv at 40 months relative to standard therapy . 0 ###LEFT-WALL### 3 control 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 18 . 1 intensive 2 bp 2 bp 3 control 3 control 4 was 4 was 5 associated 5 associated 6 with 6 with 10 tbv 7 greater 10 tbv 8 decline 10 tbv 10 tbv 11 at 10 tbv 14 relative 11 at 13 months 12 40 13 months 14 relative 15 to 15 to 17 therapy 16 standard 17 therapy trial registration clinicaltrials.gov identifier : nct00000620 . 0 ###LEFT-WALL### 4 identifier 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 7 . 1 trial 2 registration 2 registration 4 identifier 3 clinicaltrials.gov 4 identifier 4 identifier 5 : 5 : 6 nct00000620 charles darwin knew that the fossil record is not overwhelmingly supportive of genetic and phenotypic gradualism ; therefore , he developed the core of his theory on the basis of breeding experiments . 0 ###LEFT-WALL### 2 darwin 0 ###LEFT-WALL### 3 knew 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 33 . 1 charles 2 darwin 2 darwin 3 knew 3 knew 4 that 4 that 7 record 4 that 8 is 5 the 7 record 6 fossil 7 record 7 record 8 is 8 is 9 not 8 is 12 of 9 not 10 overwhelmingly 10 overwhelmingly 11 supportive 12 of 14 and 13 genetic 14 and 14 and 16 gradualism 15 phenotypic 16 gradualism 17 ; 20 he 17 ; 21 developed 18 therefore 19 , 18 therefore 20 he 20 he 21 developed 21 developed 23 core 22 the 23 core 23 core 24 of 23 core 30 of 24 of 26 theory 25 his 26 theory 26 theory 27 on 27 on 29 basis 28 the 29 basis 30 of 31 breeding 31 breeding 32 experiments here , i present evidence for the existence of a cell biological mechanism that strongly points to the almost forgotten european concept of saltatory evolution of nonadaptive characters , which is in perfect agreement with the gaps in the fossil record . 0 ###LEFT-WALL### 3 i 0 ###LEFT-WALL### 4 present 0 ###LEFT-WALL### 29 , 0 ###LEFT-WALL### 42 . 1 here 2 , 1 here 3 i 3 i 4 present 4 present 5 evidence 5 evidence 6 for 5 evidence 9 of 5 evidence 14 that 5 evidence 16 points 6 for 8 existence 7 the 8 existence 9 of 13 mechanism 10 a 13 mechanism 11 cell 13 mechanism 12 biological 13 mechanism 14 that 16 points 15 strongly 16 points 16 points 17 to 16 points 25 evolution 17 to 22 concept 18 the 22 concept 19 almost 20 forgotten 20 forgotten 21 european 21 european 22 concept 22 concept 23 of 23 of 24 saltatory 25 evolution 26 of 26 of 28 characters 27 nonadaptive 28 characters 29 , 30 which 29 , 31 is 30 which 31 is 31 is 32 in 31 is 38 in 32 in 34 agreement 33 perfect 34 agreement 34 agreement 35 with 35 with 37 gaps 36 the 37 gaps 38 in 41 record 39 the 41 record 40 fossil 41 record the standard model of chromosomal evolution has always been handicapped by a paradox , namely , [how] [speciation] can occur by spontaneous chromosomal rearrangements that are known to decrease the fertility of heterozygotes in a population . 0 ###LEFT-WALL### 3 model 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 37 . 1 the 3 model 2 standard 3 model 3 model 4 of 3 model 16 , 4 of 6 evolution 5 chromosomal 6 evolution 7 has 9 been 7 has 16 , 8 always 9 been 9 been 10 handicapped 10 handicapped 11 by 11 by 13 paradox 12 a 13 paradox 14 , 15 namely 14 , 16 , 16 , 19 can 19 can 20 occur 20 occur 21 by 20 occur 28 to 20 occur 29 decrease 21 by 24 rearrangements 22 spontaneous 24 rearrangements 23 chromosomal 24 rearrangements 24 rearrangements 25 that 24 rearrangements 26 are 25 that 26 are 26 are 27 known 28 to 29 decrease 29 decrease 31 fertility 29 decrease 34 in 30 the 31 fertility 31 fertility 32 of 32 of 33 heterozygotes 34 in 36 population 35 a 36 population however , the hallmark of almost all closely related species is a differing chromosome complement and therefore chromosomal rearrangements seem to be crucial [for] [speciation] . 0 ###LEFT-WALL### 4 hallmark 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 26 . 1 however 2 , 1 however 4 hallmark 3 the 4 hallmark 4 hallmark 5 of 4 hallmark 11 is 5 of 10 species 6 almost 9 related 7 all 9 related 8 closely 9 related 9 related 10 species 11 is 15 complement 12 a 15 complement 13 differing 14 chromosome 14 chromosome 15 complement 16 and 17 therefore 16 and 19 rearrangements 16 and 20 seem 18 chromosomal 19 rearrangements 19 rearrangements 20 seem 20 seem 21 to 20 seem 22 be 21 to 22 be 22 be 23 crucial telomeres , the caps of eukaryotic chromosomes , erode in somatic tissues during life , but have been thought to remain stable in the germline of a species . 0 ###LEFT-WALL### 1 telomeres 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 29 . 1 telomeres 4 caps 1 telomeres 16 but 2 , 4 caps 3 the 4 caps 4 caps 5 of 4 caps 8 , 5 of 7 chromosomes 6 eukaryotic 7 chromosomes 9 erode 10 in 9 erode 13 during 9 erode 16 but 10 in 12 tissues 11 somatic 12 tissues 13 during 14 life 15 , 16 but 16 but 17 have 17 have 18 been 18 been 19 thought 19 thought 20 to 20 to 21 remain 21 remain 22 stable 22 stable 23 in 23 in 25 germline 24 the 25 germline 25 germline 26 of 26 of 28 species 27 a 28 species recently , a large human study spanning three healthy generations clearly found a cumulative telomere effect , which is [indicative] of transgenerational telomere erosion in the human species . 0 ###LEFT-WALL### 6 study 0 ###LEFT-WALL### 12 found 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 29 . 1 recently 2 , 1 recently 6 study 3 a 4 large 3 a 6 study 4 large 5 human 5 human 6 study 6 study 7 spanning 6 study 12 found 7 spanning 10 generations 8 three 10 generations 9 healthy 10 generations 11 clearly 12 found 12 found 16 effect 13 a 14 cumulative 13 a 16 effect 14 cumulative 15 telomere 15 telomere 16 effect 17 , 18 which 17 , 19 is 18 which 19 is 19 is 21 of 19 is 25 in 21 of 24 erosion 22 transgenerational 24 erosion 23 telomere 24 erosion 25 in 28 species 26 the 28 species 27 human 28 species the telomeric sync model [of] speciation presented here is based on telomere erosion between generations , which leads to identical fusions of chromosomes and triggers a transposon - mediated genomic repatterning in the germline of many individuals of a species . 0 ###LEFT-WALL### 6 speciation 0 ###LEFT-WALL### 10 based 0 ###LEFT-WALL### 28 - 0 ###LEFT-WALL### 41 . 1 the 6 speciation 2 telomeric 3 sync 3 sync 6 speciation 4 model 6 speciation 6 speciation 7 presented 6 speciation 9 is 7 presented 8 here 9 is 10 based 10 based 11 on 10 based 14 between 11 on 13 erosion 12 telomere 13 erosion 14 between 15 generations 15 generations 17 which 16 , 17 which 17 which 24 and 17 which 28 - 18 leads 19 to 18 leads 24 and 19 to 21 fusions 20 identical 21 fusions 21 fusions 22 of 22 of 23 chromosomes 24 and 25 triggers 25 triggers 27 transposon 26 a 27 transposon 28 - 31 repatterning 29 mediated 31 repatterning 30 genomic 31 repatterning 31 repatterning 32 in 31 repatterning 35 of 32 in 34 germline 33 the 34 germline 35 of 37 individuals 36 many 37 individuals 37 individuals 38 of 38 of 40 species 39 a 40 species the phenotypic outcome of the telomere - triggered transposon activity is the saltatory appearance of nonadaptive characters simultaneously in many individuals . 0 ###LEFT-WALL### 3 outcome 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 22 . 1 the 3 outcome 2 phenotypic 3 outcome 3 outcome 4 of 3 outcome 11 is 4 of 10 activity 5 the 10 activity 6 telomere 7 - 6 telomere 9 transposon 8 triggered 9 transposon 9 transposon 10 activity 11 is 14 appearance 11 is 18 simultaneously 11 is 19 in 12 the 14 appearance 13 saltatory 14 appearance 14 appearance 15 of 15 of 17 characters 16 nonadaptive 17 characters 19 in 21 individuals 20 many 21 individuals transgenerational telomere erosion is therefore the material basis of aging at the species level . 0 ###LEFT-WALL### 3 erosion 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 15 . 1 transgenerational 3 erosion 2 telomere 3 erosion 3 erosion 4 is 4 is 5 therefore 4 is 8 basis 4 is 11 at 6 the 8 basis 7 material 8 basis 8 basis 9 of 9 of 10 aging 11 at 14 level 12 the 14 level 13 species 14 level human tdp - 43 represents the main component of neuronal inclusions found in patients with neurodegenerative diseases , especially frontotemporal lobar degeneration and amyotrophic lateral sclerosis . 0 ###LEFT-WALL### 2 tdp 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 27 . 1 human 2 tdp 3 - 4 43 3 - 5 represents 4 43 5 represents 5 represents 8 component 5 represents 13 in 5 represents 15 with 6 the 8 component 7 main 8 component 8 component 9 of 8 component 12 found 9 of 11 inclusions 10 neuronal 11 inclusions 13 in 14 patients 15 with 23 and 16 neurodegenerative 17 diseases 17 diseases 18 , 18 , 22 degeneration 18 , 23 and 19 especially 20 frontotemporal 20 frontotemporal 22 degeneration 21 lobar 22 degeneration 23 and 26 sclerosis 24 amyotrophic 26 sclerosis 25 lateral 26 sclerosis in vitro [and] in vivo studies have shown that the tar dna - binding protein 43 ( tdp - 43 ) drosophila ortholog ( tbph ) can biochemically [and] functionally overlap the properties of the human factor . 0 ###LEFT-WALL### 6 studies 0 ###LEFT-WALL### 8 shown 0 ###LEFT-WALL### 38 . 1 in 2 vitro 2 vitro 6 studies 4 in 5 vivo 5 vivo 6 studies 6 studies 7 have 7 have 8 shown 8 shown 9 that 9 that 12 dna 9 that 31 overlap 10 the 12 dna 11 tar 12 dna 12 dna 14 binding 12 dna 27 can 13 - 14 binding 14 binding 15 protein 14 binding 26 ) 15 protein 16 43 15 protein 23 ortholog 17 ( 23 ortholog 18 tdp 20 43 18 tdp 23 ortholog 19 - 20 43 20 43 21 ) 22 drosophila 23 ortholog 23 ortholog 25 tbph 23 ortholog 26 ) 24 ( 25 tbph 25 tbph 26 ) 27 can 31 overlap 28 biochemically 31 overlap 30 functionally 31 overlap 31 overlap 33 properties 32 the 33 properties 33 properties 34 of 34 of 37 factor 35 the 37 factor 36 human 37 factor to test this hypothesis and further validate the fly system as a useful model to study this type of diseases , we have now characterized human tdp - 43 and drosophila tbph similarity in terms of protein - protein interaction pathways . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 21 , 1 to 5 and 2 test 4 hypothesis 2 test 5 and 3 this 4 hypothesis 5 and 7 validate 6 further 7 validate 7 validate 10 system 7 validate 15 to 8 the 10 system 9 fly 10 system 10 system 11 as 11 as 14 model 12 a 14 model 13 useful 14 model 15 to 16 study 16 study 20 diseases 17 this 18 type 18 type 19 of 18 type 20 diseases 19 of 20 diseases 21 , 22 we 21 , 25 characterized 21 , 38 - 22 we 23 have 23 have 25 characterized 24 now 25 characterized 25 characterized 27 tdp 26 human 27 tdp 27 tdp 33 similarity 28 - 33 similarity 29 43 30 and 30 and 31 drosophila 31 drosophila 32 tbph 32 tbph 33 similarity 33 similarity 34 in 33 similarity 36 of 33 similarity 38 - 34 in 35 terms 36 of 37 protein 38 - 41 pathways 38 - 42 . 39 protein 41 pathways 40 interaction 41 pathways in this work we show that tdp - 43 and tbph share the ability to associate in vitro with hrp38/hrb98de/cg9983 , the fruit fly ortholog of the human hnrnp a1/a2 factors . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 show 1 in 3 work 1 in 4 we 2 this 3 work 4 we 5 show 5 show 7 tdp 5 show 9 43 5 show 10 and 6 that 7 tdp 8 - 9 43 10 and 12 share 10 and 14 ability 11 tbph 12 share 13 the 14 ability 14 ability 15 to 14 ability 16 associate 15 to 16 associate 16 associate 18 vitro 16 associate 19 with 17 in 18 vitro 19 with 20 hrp38/hrb98de/cg9983 20 hrp38/hrb98de/cg9983 25 ortholog 21 , 25 ortholog 22 the 25 ortholog 23 fruit 25 ortholog 24 fly 25 ortholog 25 ortholog 26 of 25 ortholog 32 . 26 of 31 factors 27 the 31 factors 28 human 31 factors 29 hnrnp 31 factors 30 a1/a2 31 factors interestingly , the protein regions of tdp [-] 43 and hrp38 responsible for reciprocal interactions are conserved through evolution . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 17 conserved 0 ###LEFT-WALL### 20 . 1 interestingly 2 , 1 interestingly 10 and 3 the 5 regions 4 protein 5 regions 5 regions 6 of 5 regions 10 and 6 of 7 tdp 7 tdp 9 43 10 and 11 hrp38 10 and 12 responsible 10 and 16 are 12 responsible 13 for 13 for 15 interactions 14 reciprocal 15 interactions 16 are 17 conserved 17 conserved 18 through 18 through 19 evolution functionally , experiments in hela cells demonstrate that tdp - 43 is necessary for the inhibitory activity of hrp38 on splicing . 0 ###LEFT-WALL### 3 experiments 0 ###LEFT-WALL### 7 demonstrate 0 ###LEFT-WALL### 10 - 1 functionally 2 , 1 functionally 3 experiments 3 experiments 4 in 3 experiments 7 demonstrate 4 in 6 cells 5 hela 6 cells 7 demonstrate 9 tdp 8 that 9 tdp 10 - 11 43 10 - 12 is 10 - 22 . 11 43 12 is 12 is 13 necessary 13 necessary 14 for 13 necessary 20 on 14 for 17 activity 15 the 17 activity 16 inhibitory 17 activity 17 activity 18 of 18 of 19 hrp38 20 on 21 splicing finally , drosophila in vivo studies show that hrp38 deficiency produces locomotive defects and life span shortening in tdp - 43 with and [without] animals . 0 ###LEFT-WALL### 6 studies 0 ###LEFT-WALL### 7 show 0 ###LEFT-WALL### 26 . 1 finally 2 , 1 finally 6 studies 2 , 3 drosophila 3 drosophila 6 studies 4 in 5 vivo 5 vivo 6 studies 6 studies 7 show 7 show 8 that 7 show 9 hrp38 7 show 23 and 9 hrp38 10 deficiency 9 hrp38 22 with 10 deficiency 11 produces 11 produces 14 and 12 locomotive 13 defects 13 defects 14 and 14 and 16 span 14 and 17 shortening 15 life 16 span 17 shortening 18 in 17 shortening 21 43 17 shortening 22 with 18 in 19 tdp 20 - 21 43 23 and 25 animals these results suggest that hnrnp protein levels can play a modulatory role on tdp - 43 functions . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 18 . 1 these 2 results 2 results 3 suggest 3 suggest 4 that 4 that 7 levels 4 that 9 play 5 hnrnp 6 protein 6 protein 7 levels 7 levels 8 can 8 can 9 play 9 play 12 role 9 play 13 on 10 a 11 modulatory 10 a 12 role 11 modulatory 12 role 13 on 14 tdp 15 - 17 functions 16 43 17 functions reproductive surgeries leave women more susceptible to postoperative hypervolemic hyponatremia because during this period women can retain water at an accelerated pace and much faster than they do sodium . 0 ###LEFT-WALL### 2 surgeries 0 ###LEFT-WALL### 3 leave 0 ###LEFT-WALL### 30 . 1 reproductive 2 surgeries 2 surgeries 3 leave 3 leave 4 women 3 leave 6 susceptible 5 more 6 susceptible 6 susceptible 7 to 6 susceptible 11 because 7 to 10 hyponatremia 8 postoperative 10 hyponatremia 9 hypervolemic 10 hyponatremia 11 because 15 women 11 because 17 retain 12 during 14 period 12 during 15 women 13 this 14 period 15 women 16 can 16 can 17 retain 17 retain 18 water 17 retain 19 at 19 at 29 sodium 20 an 22 pace 21 accelerated 22 pace 22 pace 23 and 23 and 25 faster 23 and 29 sodium 24 much 25 faster 25 faster 26 than 26 than 28 do 27 they 28 do this review proposes that estrogen and progestogen exposure play an important role in the increased risk of hyponatremia in menopausal women . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 proposes 0 ###LEFT-WALL### 22 . 1 this 2 review 2 review 3 proposes 3 proposes 4 that 4 that 6 and 4 that 9 play 5 estrogen 6 and 6 and 8 exposure 7 progestogen 8 exposure 9 play 12 role 9 play 13 in 9 play 19 in 10 an 11 important 10 an 12 role 11 important 12 role 13 in 16 risk 14 the 16 risk 15 increased 16 risk 16 risk 17 of 17 of 18 hyponatremia 19 in 21 women 20 menopausal 21 women estrogen and progesterone exposure have important effects on both body fluid regulation and cardiovascular function and both of these reproductive hormones impact blood pressure responses to sodium loads . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 have 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 29 . 1 estrogen 2 and 2 and 4 exposure 2 and 5 have 3 progesterone 4 exposure 5 have 7 effects 5 have 8 on 6 important 7 effects 8 on 13 and 9 both 13 and 10 body 12 regulation 11 fluid 12 regulation 12 regulation 13 and 13 and 15 function 14 cardiovascular 15 function 16 and 17 both 16 and 22 impact 17 both 18 of 17 both 22 impact 18 of 21 hormones 19 these 21 hormones 20 reproductive 21 hormones 22 impact 25 responses 22 impact 26 to 23 blood 25 responses 24 pressure 25 responses 26 to 28 loads 27 sodium 28 loads this article provides information on the effects of female reproductive hormones and hormone therapy ( ht ) on fluid regulation and cardiovascular function [during] menopause . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 26 . 1 this 2 article 2 article 3 provides 3 provides 4 information 4 information 5 on 5 on 7 effects 6 the 7 effects 7 effects 8 of 7 effects 18 on 8 of 12 and 9 female 11 hormones 10 reproductive 11 hormones 11 hormones 12 and 12 and 14 therapy 12 and 16 ht 13 hormone 14 therapy 15 ( 16 ht 16 ht 17 ) 18 on 21 and 19 fluid 20 regulation 20 regulation 21 and 21 and 25 menopause 22 cardiovascular 23 function 23 function 25 menopause thirst - and fluid - regulating hormones respond to both osmotic and volume stimuli . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 8 respond 0 ###LEFT-WALL### 15 . 1 thirst 3 and 2 - 3 and 3 and 4 fluid 3 and 5 - 3 and 6 regulating 3 and 8 respond 6 regulating 7 hormones 8 respond 9 to 9 to 12 and 10 both 12 and 11 osmotic 12 and 12 and 14 stimuli 13 volume 14 stimuli aging women maintain thirst sensitivity to osmotic stimuli but lose some thirst sensitivity to changes in central body fluid volume . 0 ###LEFT-WALL### 2 women 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 21 . 1 aging 2 women 2 women 9 but 3 maintain 5 sensitivity 3 maintain 9 but 4 thirst 5 sensitivity 5 sensitivity 6 to 6 to 8 stimuli 7 osmotic 8 stimuli 9 but 10 lose 10 lose 13 sensitivity 10 lose 14 to 10 lose 16 in 11 some 13 sensitivity 12 thirst 13 sensitivity 14 to 15 changes 16 in 20 volume 17 central 18 body 18 body 20 volume 19 fluid 20 volume thus , older adults are more at risk of dehydration because they may replenish fluids at a slower rate . 0 ###LEFT-WALL### 4 adults 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 20 . 1 thus 2 , 1 thus 4 adults 3 older 4 adults 4 adults 5 are 5 are 6 more 5 are 7 at 5 are 11 because 7 at 8 risk 8 risk 9 of 9 of 10 dehydration 11 because 12 they 11 because 14 replenish 12 they 13 may 13 may 14 replenish 14 replenish 15 fluids 14 replenish 16 at 16 at 19 rate 17 a 19 rate 18 slower 19 rate estrogen therapy increases osmotic sensitivity for mechanisms to retain body water so may help menopausal women control body fluids and avoid dehydration . 0 ###LEFT-WALL### 1 estrogen 0 ###LEFT-WALL### 12 so 2 therapy 3 increases 3 increases 5 sensitivity 4 osmotic 5 sensitivity 5 sensitivity 6 for 5 sensitivity 8 to 5 sensitivity 9 retain 6 for 7 mechanisms 8 to 9 retain 9 retain 11 water 9 retain 12 so 10 body 11 water 12 so 20 and 12 so 23 . 13 may 14 help 13 may 20 and 14 help 16 women 14 help 17 control 15 menopausal 16 women 17 control 19 fluids 18 body 19 fluids 20 and 21 avoid 21 avoid 22 dehydration some progestogens can mitigate estradiol effects on water and sodium retention through competition with aldosterone for the mineralocorticoid receptor and attenuating aldosterone - mediated sodium retention in the distal tubule . 0 ###LEFT-WALL### 2 progestogens 0 ###LEFT-WALL### 4 mitigate 0 ###LEFT-WALL### 31 . 1 some 2 progestogens 2 progestogens 3 can 3 can 4 mitigate 4 mitigate 9 and 4 mitigate 12 through 4 mitigate 14 with 4 mitigate 27 in 5 estradiol 6 effects 6 effects 7 on 6 effects 9 and 7 on 8 water 9 and 11 retention 10 sodium 11 retention 12 through 13 competition 14 with 20 and 15 aldosterone 16 for 15 aldosterone 20 and 16 for 19 receptor 17 the 19 receptor 18 mineralocorticoid 19 receptor 20 and 26 retention 21 attenuating 25 sodium 22 aldosterone 23 - 22 aldosterone 25 sodium 24 mediated 25 sodium 25 sodium 26 retention 27 in 30 tubule 28 the 30 tubule 29 distal 30 tubule however , some progestogens can increase cardiovascular risks . 0 ###LEFT-WALL### 4 progestogens 0 ###LEFT-WALL### 6 increase 0 ###LEFT-WALL### 9 . 1 however 2 , 1 however 4 progestogens 3 some 4 progestogens 4 progestogens 5 can 5 can 6 increase 6 increase 8 risks 7 cardiovascular 8 risks appropriate balance of these hormones within ht is important to avoid the negative consequences of body fluid and sodium retention , including edema and hypertension . 0 ###LEFT-WALL### 2 balance 0 ###LEFT-WALL### 22 including 0 ###LEFT-WALL### 26 . 1 appropriate 2 balance 2 balance 3 of 2 balance 8 is 3 of 5 hormones 4 these 5 hormones 5 hormones 6 within 6 within 7 ht 8 is 9 important 9 important 10 to 9 important 22 including 10 to 11 avoid 11 avoid 14 consequences 12 the 14 consequences 13 negative 14 consequences 14 consequences 15 of 15 of 18 and 16 body 17 fluid 17 fluid 18 and 18 and 20 retention 18 and 21 , 18 and 22 including 19 sodium 20 retention 22 including 24 and 23 edema 24 and 24 and 25 hypertension beyond their own family caregivers , home healthcare nurses play a pivotal role in caring for those dying at home . 0 ###LEFT-WALL### 9 nurses 0 ###LEFT-WALL### 10 play 0 ###LEFT-WALL### 21 . 1 beyond 5 caregivers 1 beyond 6 , 1 beyond 9 nurses 2 their 3 own 2 their 5 caregivers 4 family 5 caregivers 7 home 9 nurses 8 healthcare 9 nurses 9 nurses 10 play 10 play 13 role 10 play 14 in 11 a 12 pivotal 11 a 13 role 12 pivotal 13 role 14 in 15 caring 15 caring 16 for 15 caring 19 at 16 for 17 those 17 those 18 dying 19 at 20 home however , deciding the timing of the next visit for these patients and their families is not straightforward . 0 ###LEFT-WALL### 3 deciding 0 ###LEFT-WALL### 16 is 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 3 deciding 3 deciding 5 timing 3 deciding 16 is 4 the 5 timing 5 timing 6 of 6 of 9 visit 7 the 8 next 7 the 9 visit 9 visit 10 for 10 for 13 and 11 these 12 patients 12 patients 13 and 13 and 15 families 14 their 15 families 16 is 17 not 16 is 18 straightforward the palliative care : determining next home care nurse visit decision guide supports clinicians in their decision - making process of planning visits to most effectively meet the needs and goals of patients and families during the final months of life . 0 ###LEFT-WALL### 3 care 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 42 . 1 the 3 care 2 palliative 3 care 4 : 5 determining 4 : 14 clinicians 4 : 18 - 5 determining 13 supports 5 determining 14 clinicians 6 next 13 supports 7 home 8 care 8 care 9 nurse 9 nurse 10 visit 10 visit 13 supports 11 decision 13 supports 12 guide 13 supports 14 clinicians 15 in 15 in 17 decision 16 their 17 decision 18 - 19 making 18 - 23 visits 19 making 20 process 19 making 23 visits 20 process 21 of 21 of 22 planning 23 visits 24 to 24 to 27 meet 25 most 26 effectively 26 effectively 27 meet 27 meet 34 and 28 the 29 needs 29 needs 30 and 30 and 31 goals 30 and 32 of 30 and 34 and 32 of 33 patients 34 and 35 families 34 and 36 during 34 and 40 of 36 during 39 months 37 the 39 months 38 final 39 months 40 of 41 life this article describes how a provincial health authority in canada improved patient care and staff satisfaction by transforming the role of home care ( hc ) liaison . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 describes 0 ###LEFT-WALL### 28 . 1 this 2 article 2 article 3 describes 3 describes 4 how 4 how 8 authority 4 how 11 improved 5 a 6 provincial 5 a 8 authority 6 provincial 7 health 7 health 8 authority 8 authority 9 in 8 authority 11 improved 9 in 10 canada 11 improved 27 liaison 12 patient 13 care 13 care 14 and 14 and 16 satisfaction 14 and 17 by 14 and 27 liaison 15 staff 16 satisfaction 17 by 18 transforming 18 transforming 20 role 19 the 20 role 20 role 21 of 20 role 25 hc 21 of 23 care 22 home 23 care 24 ( 25 hc 25 hc 26 ) the transformation focused on clearly defining the role , function and reporting structure , and identifying which healthcare providers could fill the liaison role . 0 ###LEFT-WALL### 2 transformation 0 ###LEFT-WALL### 3 focused 0 ###LEFT-WALL### 25 . 1 the 2 transformation 2 transformation 3 focused 3 focused 4 on 3 focused 24 role 4 on 6 defining 5 clearly 6 defining 6 defining 15 and 7 the 8 role 8 role 9 , 9 , 10 function 9 , 11 and 11 and 13 structure 11 and 15 and 12 reporting 13 structure 14 , 15 and 15 and 16 identifying 15 and 17 which 15 and 21 fill 17 which 19 providers 17 which 21 fill 18 healthcare 19 providers 19 providers 20 could 20 could 21 fill 22 the 24 role 23 liaison 24 role the transformation included adoption of transition best practices , leveraging an electronic referral system , creation of an interprofessional team , standardization of tools/orientation , and strong evaluation metrics , centralizing decision making , and developing a process for streaming referrals . 0 ###LEFT-WALL### 4 adoption 0 ###LEFT-WALL### 8 practices 0 ###LEFT-WALL### 9 , 1 the 4 adoption 2 transformation 3 included 3 included 4 adoption 4 adoption 5 of 4 adoption 8 practices 5 of 6 transition 7 best 8 practices 9 , 22 standardization 9 , 29 metrics 10 leveraging 14 system 10 leveraging 21 , 10 leveraging 22 standardization 11 an 14 system 12 electronic 13 referral 13 referral 14 system 14 system 16 creation 15 , 16 creation 16 creation 17 of 16 creation 21 , 17 of 20 team 18 an 19 interprofessional 18 an 20 team 19 interprofessional 20 team 22 standardization 23 of 22 standardization 29 metrics 23 of 26 and 24 tools/orientation 26 and 25 , 26 and 26 and 28 evaluation 27 strong 28 evaluation 29 metrics 31 centralizing 30 , 31 centralizing 31 centralizing 35 and 31 centralizing 38 process 31 centralizing 42 . 32 decision 33 making 33 making 35 and 34 , 35 and 35 and 36 developing 37 a 38 process 38 process 39 for 39 for 41 referrals 40 streaming 41 referrals the authors identify key success factors that made the transformation possible , as well as challenges and work that remains to sustain the change . 1 the 2 authors 2 authors 3 identify 3 identify 6 factors 4 key 6 factors 5 success 6 factors 6 factors 7 that 6 factors 8 made 7 that 8 made 8 made 10 transformation 9 the 10 transformation 10 transformation 11 possible 11 possible 13 as 12 , 13 as 13 as 17 and 13 as 25 . 14 well 15 as 14 well 17 and 15 as 16 challenges 17 and 18 work 17 and 19 that 17 and 20 remains 19 that 20 remains 20 remains 21 to 21 to 22 sustain 22 sustain 24 change 23 the 24 change none background : blood transfusion is frequently required in children undergoing cardiac surgery and is associated with altered postoperative [outcome] . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 18 altered 0 ###LEFT-WALL### 21 . 1 none 2 background 1 none 17 with 1 none 18 altered 2 background 3 : 3 : 4 blood 4 blood 5 transfusion 4 blood 14 and 5 transfusion 14 and 6 is 8 required 6 is 14 and 7 frequently 8 required 8 required 9 in 9 in 10 children 10 children 11 undergoing 11 undergoing 13 surgery 12 cardiac 13 surgery 14 and 15 is 15 is 16 associated 16 associated 17 with 18 altered 19 postoperative this may be due to alterations in red blood cell properties related to the storage process . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 17 . 1 this 2 may 2 may 3 be 3 be 5 to 3 be 7 in 3 be 13 to 4 due 5 to 5 to 6 alterations 7 in 11 properties 8 red 9 blood 9 blood 11 properties 10 cell 11 properties 11 properties 12 related 13 to 16 process 14 the 16 process 15 storage 16 process objective : to evaluate the effect of blood storage duration on postoperative morbidity and mortality in children undergoing cardiac surgery . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 6 effect 4 evaluate 11 on 4 evaluate 16 in 5 the 6 effect 6 effect 7 of 7 of 10 duration 8 blood 10 duration 9 storage 10 duration 11 on 14 and 12 postoperative 13 morbidity 13 morbidity 14 and 14 and 15 mortality 16 in 17 children 17 children 18 undergoing 18 undergoing 20 surgery 19 cardiac 20 surgery design : a retrospective review of a paediatric cardiac surgery database . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 . 1 design 2 : 2 : 5 review 3 a 4 retrospective 3 a 5 review 4 retrospective 5 review 5 review 6 of 6 of 11 database 7 a 8 paediatric 7 a 11 database 8 paediatric 10 surgery 9 cardiac 10 surgery 10 surgery 11 database setting : department of anaesthesiology , queen fabiola children 's university hospital , brussels , belgium . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 17 . 1 setting 2 : 2 : 3 department 3 department 4 of 4 of 5 anaesthesiology 6 , 12 hospital 6 , 13 , 7 queen 8 fabiola 8 fabiola 9 children 9 children 10 's 10 's 12 hospital 11 university 12 hospital 13 , 14 brussels 13 , 15 , 15 , 16 belgium participants : children transfused with one or two units of blood in the perioperative period . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 1 participants 2 : 2 : 3 children 3 children 4 transfused 4 transfused 5 with 5 with 9 units 6 one 7 or 7 or 8 two 7 or 9 units 9 units 10 of 10 of 11 blood 11 blood 12 in 12 in 15 period 13 the 15 period 14 perioperative 15 period interventions : none . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 2 : 2 : 3 none 2 : 4 . main outcome measures : storage duration was used to allocate children to the group ['] young ' or the group ['] [old] ['] ( cut - off = 7 days ) . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 32 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 5 storage 5 storage 6 duration 5 storage 10 allocate 6 duration 7 was 7 was 8 used 8 used 9 to 8 used 10 allocate 9 to 10 allocate 10 allocate 18 or 10 allocate 25 cut 11 children 12 to 11 children 18 or 12 to 17 ' 13 the 16 young 14 group 16 young 16 young 17 ' 18 or 20 group 19 the 20 group 24 ( 25 cut 25 cut 27 off 25 cut 31 ) 26 - 27 off 27 off 30 days 27 off 31 ) 28 = 29 7 29 7 30 days the primary endpoint was a composite based on the incidence of [hospital] [mortality] [and/or] the incidence of at least one organ failure . 0 ###LEFT-WALL### 3 endpoint 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 23 . 1 the 3 endpoint 2 primary 3 endpoint 3 endpoint 4 was 4 was 6 composite 5 a 6 composite 6 composite 7 based 6 composite 11 of 6 composite 17 of 7 based 8 on 8 on 10 incidence 9 the 10 incidence 11 of 16 incidence 15 the 16 incidence 17 of 22 failure 18 at 19 least 19 least 20 one 20 one 22 failure 21 organ 22 failure results : from 1014 children in the database , 570 were included in the final analysis . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 17 . 1 results 2 : 2 : 3 from 2 : 6 in 3 from 5 children 4 1014 5 children 6 in 8 database 7 the 8 database 9 , 10 570 9 , 12 included 10 570 11 were 11 were 12 included 12 included 13 in 13 in 16 analysis 14 the 16 analysis 15 final 16 analysis one hundred and eighteen patients were included in the group ['] young ['] [ median ( interquartile range , iqr ) storage duration 6 ( 5 to 7 [ )(days ] and 452 in [the] group ['] [old] ['] [ storage duration 14 ( 11 to 19 ) days ] . 0 ###LEFT-WALL### 4 eighteen 0 ###LEFT-WALL### 7 included 0 ###LEFT-WALL### 51 . 1 one 2 hundred 2 hundred 3 and 3 and 4 eighteen 4 eighteen 5 patients 4 eighteen 6 were 4 eighteen 7 included 5 patients 6 were 7 included 8 in 7 included 32 and 8 in 10 group 9 the 10 group 12 young 23 duration 12 young 32 and 14 [ 23 duration 15 median 18 range 15 median 22 storage 16 ( 18 range 17 interquartile 18 range 18 range 20 iqr 18 range 21 ) 19 , 20 iqr 20 iqr 21 ) 22 storage 23 duration 23 duration 24 6 23 duration 30 )(days 23 duration 31 ] 25 ( 30 )(days 26 5 27 to 27 to 28 7 27 to 30 )(days 30 )(days 31 ] 32 and 49 days 32 and 50 ] 33 452 34 in 34 in 49 days 36 group 42 duration 36 group 49 days 40 [ 42 duration 41 storage 42 duration 42 duration 43 14 42 duration 46 to 42 duration 48 ) 44 ( 46 to 45 11 46 to 46 to 47 19 46 to 48 ) no difference was found in mortality , length of icu [stay] , mechanical ventilation duration , postoperative infection and major organ dysfunction . 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 23 . 1 no 2 difference 2 difference 3 was 3 was 4 found 4 found 5 in 5 in 6 mortality 6 mortality 8 length 6 mortality 15 duration 7 , 8 length 8 length 9 of 8 length 12 , 9 of 10 icu 12 , 15 duration 13 mechanical 14 ventilation 14 ventilation 15 duration 15 duration 16 , 16 , 19 and 17 postoperative 18 infection 18 infection 19 and 19 and 22 dysfunction 20 major 21 organ 21 organ 22 dysfunction duration of storage used as a continuous variable did not influence the incidence of the composite endpoint when evaluated by univariate or multivariate logistic regression analyses . 0 ###LEFT-WALL### 1 duration 0 ###LEFT-WALL### 11 influence 0 ###LEFT-WALL### 27 . 1 duration 2 of 1 duration 4 used 1 duration 9 did 2 of 3 storage 4 used 5 as 5 as 8 variable 6 a 7 continuous 6 a 8 variable 7 continuous 8 variable 9 did 10 not 9 did 11 influence 11 influence 22 or 12 the 13 incidence 13 incidence 14 of 13 incidence 22 or 14 of 16 composite 15 the 16 composite 16 composite 17 endpoint 17 endpoint 18 when 17 endpoint 20 by 18 when 19 evaluated 20 by 21 univariate 22 or 26 analyses 23 multivariate 25 regression 24 logistic 25 regression 25 regression 26 analyses conclusion : red blood cell storage duration did not influence postoperative morbidity and mortality in paediatric cardiac surgery patients transfused with one or two units of blood . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 3 red 0 ###LEFT-WALL### 28 . 1 conclusion 2 : 2 : 3 red 3 red 6 storage 3 red 15 in 3 red 21 with 4 blood 6 storage 5 cell 6 storage 6 storage 7 duration 6 storage 10 influence 7 duration 8 did 8 did 9 not 8 did 10 influence 10 influence 13 and 11 postoperative 12 morbidity 12 morbidity 13 and 13 and 14 mortality 15 in 19 patients 16 paediatric 19 patients 17 cardiac 19 patients 18 surgery 19 patients 19 patients 20 transfused 21 with 25 units 22 one 23 or 23 or 24 two 23 or 25 units 25 units 26 of 26 of 27 blood purpose : with the aging of society in developed countries and advances in surgical technology in recent years , surgery is increasing in elderly patients . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 26 . 1 purpose 2 : 2 : 3 with 2 : 8 in 2 : 13 in 3 with 5 aging 4 the 5 aging 5 aging 6 of 6 of 7 society 8 in 11 and 9 developed 10 countries 9 developed 11 and 11 and 12 advances 13 in 15 technology 14 surgical 15 technology 15 technology 16 in 16 in 18 years 17 recent 18 years 19 , 20 surgery 19 , 21 is 20 surgery 21 is 21 is 22 increasing 22 increasing 23 in 23 in 25 patients 24 elderly 25 patients when performing surgery in older patients , both surgical outcomes and the maintenance of postoperative quality of life ( qol ) are important issues . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 22 are 0 ###LEFT-WALL### 25 . 1 when 2 performing 1 when 7 , 1 when 11 and 2 performing 3 surgery 2 performing 4 in 4 in 6 patients 5 older 6 patients 8 both 10 outcomes 9 surgical 10 outcomes 10 outcomes 11 and 11 and 13 maintenance 11 and 14 of 11 and 17 of 11 and 22 are 12 the 13 maintenance 14 of 16 quality 15 postoperative 16 quality 17 of 18 life 18 life 20 qol 19 ( 20 qol 20 qol 21 ) 22 are 24 issues 23 important 24 issues this study investigated surgical outcomes and postoperative qol in octogenarians who underwent cardiac valvular surgery . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 16 . 1 this 2 study 2 study 3 investigated 3 investigated 6 and 3 investigated 9 in 4 surgical 5 outcomes 5 outcomes 6 and 6 and 8 qol 7 postoperative 8 qol 9 in 10 octogenarians 10 octogenarians 11 who 10 octogenarians 12 underwent 11 who 12 underwent 12 underwent 15 surgery 13 cardiac 15 surgery 14 valvular 15 surgery methods and results : fifty - nine ( 16 males ) [octogenarians] ( 80 - 89 years old , mean age , 82.4 ± 2.4 years ) underwent cardiac valvular surgery between august 1999 and june 2011 . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 38 . 1 methods 2 and 2 and 3 results 4 : 6 - 4 : 20 mean 5 fifty 6 - 6 - 7 nine 6 - 10 males 6 - 15 - 6 - 20 mean 8 ( 10 males 9 16 10 males 10 males 11 ) 13 ( 15 - 14 80 15 - 15 - 16 89 15 - 18 old 15 - 19 , 16 89 17 years 17 years 18 old 20 mean 21 age 20 mean 28 underwent 21 age 26 years 21 age 28 underwent 22 , 26 years 23 82.4 26 years 24 ± 26 years 25 2.4 26 years 26 years 27 ) 28 underwent 35 and 29 cardiac 31 surgery 30 valvular 31 surgery 31 surgery 32 between 31 surgery 35 and 32 between 33 august 33 august 34 1999 35 and 36 june 36 june 37 2011 a qol questionnaire , which included the barthel index ( bi ) , fillenbaum instrumental activities of daily living ( fiadl ) , and the vitality index ( vi ) , was sent to all survivors . 0 ###LEFT-WALL### 3 questionnaire 0 ###LEFT-WALL### 33 sent 0 ###LEFT-WALL### 37 . 1 a 3 questionnaire 2 qol 3 questionnaire 3 questionnaire 5 which 3 questionnaire 32 was 4 , 5 which 5 which 6 included 5 which 31 , 6 included 11 bi 7 the 11 bi 8 barthel 9 index 9 index 11 bi 10 ( 11 bi 11 bi 12 ) 11 bi 24 and 13 , 24 and 14 fillenbaum 15 instrumental 15 instrumental 16 activities 16 activities 17 of 16 activities 24 and 17 of 21 fiadl 18 daily 19 living 19 living 21 fiadl 20 ( 21 fiadl 21 fiadl 22 ) 23 , 24 and 24 and 27 index 24 and 29 vi 24 and 31 , 25 the 27 index 26 vitality 27 index 28 ( 29 vi 29 vi 30 ) 32 was 33 sent 33 sent 34 to 34 to 36 survivors 35 all 36 survivors kaplan - meier analysis was used to assess survival . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 10 . 1 kaplan 2 - 1 kaplan 4 analysis 3 meier 4 analysis 4 analysis 5 was 5 was 6 used 6 used 7 to 6 used 8 assess 7 to 8 assess 8 assess 9 survival hospital mortality was 1.6 % ( 1 patient ) . 0 ###LEFT-WALL### 2 mortality 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 10 . 1 hospital 2 mortality 2 mortality 3 was 3 was 5 % 4 1.6 5 % 5 % 8 patient 6 ( 8 patient 7 1 8 patient 8 patient 9 ) the 3 - , 5 - [,] [and] 7 - year survival rates were 81.2 % , 75.4 % , [and] 67.8 % , respectively . 0 ###LEFT-WALL### 13 rates 0 ###LEFT-WALL### 14 were 0 ###LEFT-WALL### 26 . 1 the 13 rates 2 3 3 - 3 - 6 - 3 - 13 rates 4 , 6 - 5 5 6 - 6 - 9 7 6 - 10 - 11 year 13 rates 12 survival 13 rates 13 rates 14 were 14 were 16 % 14 were 25 respectively 15 81.2 16 % 16 % 19 % 17 , 19 % 18 75.4 19 % 19 % 23 % 19 % 24 , 20 , 23 % 22 67.8 23 % 23 % 24 , the bi showed that 87.5 % of patients did not require caregiving , the fiadl showed that 32.5 % were highly independent , and [the] vi showed that 87.5 % were motivated to live . 0 ###LEFT-WALL### 2 bi 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 35 . 1 the 2 bi 2 bi 3 showed 3 showed 4 that 4 that 6 % 4 that 11 require 5 87.5 6 % 6 % 7 of 6 % 9 did 7 of 8 patients 9 did 10 not 9 did 11 require 11 require 12 caregiving 13 , 15 fiadl 13 , 16 showed 14 the 15 fiadl 15 fiadl 16 showed 16 showed 17 that 17 that 19 % 17 that 24 and 18 32.5 19 % 19 % 24 and 20 were 22 independent 20 were 24 and 21 highly 22 independent 23 , 24 and 24 and 34 live 26 vi 27 showed 27 showed 28 that 27 showed 30 % 27 showed 32 motivated 29 87.5 30 % 30 % 31 were 31 were 32 motivated 32 motivated 33 to 33 to 34 live conclusions : short - term outcomes were satisfactory , [with] low complication and mortality rates . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 outcomes 2 : 7 were 2 : 9 , 2 : 16 . 3 short 4 - 3 short 5 term 5 term 6 outcomes 6 outcomes 7 were 7 were 8 satisfactory 9 , 12 complication 9 , 13 and 11 low 12 complication 13 and 14 mortality 13 and 15 rates 14 mortality 15 rates mid - term outcomes showed maintenance of the minimal required adl and good motivation for living . 0 ###LEFT-WALL### 4 outcomes 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 17 . 1 mid 2 - 1 mid 3 term 3 term 4 outcomes 4 outcomes 5 showed 5 showed 6 maintenance 5 showed 11 adl 5 showed 12 and 5 showed 15 for 6 maintenance 7 of 6 maintenance 10 required 7 of 9 minimal 8 the 9 minimal 12 and 14 motivation 13 good 14 motivation 15 for 16 living however , independence in social activities was decreased , suggesting the need for comprehensive social support . 0 ###LEFT-WALL### 3 independence 0 ###LEFT-WALL### 8 decreased 1 however 2 , 1 however 3 independence 3 independence 4 in 3 independence 7 was 4 in 6 activities 5 social 6 activities 7 was 8 decreased 8 decreased 10 suggesting 9 , 10 suggesting 10 suggesting 12 need 10 suggesting 17 . 11 the 12 need 12 need 13 for 13 for 16 support 14 comprehensive 16 support 15 social 16 support the purpose of this study was to investigate the dentin bond durability of a one - step , fluoride - containing , glass ionomer - based adhesive system , reactmer bond ( rb ) , and that of a two [-] step , fluoride - containing , self - etch adhesive [system] , clearfil protect bond ( cpb ) . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 16 - 0 ###LEFT-WALL### 60 . 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 investigate 7 to 8 investigate 8 investigate 12 durability 9 the 12 durability 10 dentin 11 bond 11 bond 12 durability 12 durability 13 of 13 of 15 one 14 a 15 one 16 - 17 step 16 - 18 , 16 - 20 - 18 , 19 fluoride 20 - 36 and 20 - 45 - 21 containing 22 , 22 , 28 system 22 , 29 , 23 glass 28 system 24 ionomer 25 - 24 ionomer 28 system 26 based 28 system 27 adhesive 28 system 29 , 33 rb 29 , 36 and 30 reactmer 31 bond 31 bond 33 rb 32 ( 33 rb 33 rb 34 ) 35 , 36 and 36 and 37 that 36 and 38 of 36 and 44 fluoride 38 of 42 step 39 a 42 step 40 two 42 step 43 , 44 fluoride 44 fluoride 45 - 45 - 46 containing 45 - 47 , 47 , 48 self 47 , 49 - 49 - 50 etch 50 etch 51 adhesive 51 adhesive 58 cpb 53 , 58 cpb 54 clearfil 55 protect 55 protect 56 bond 56 bond 58 cpb 57 ( 58 cpb 58 cpb 59 ) enamel was removed from the occlusal surfaces of teeth , and flat dentin surfaces were entirely covered with a composite resin following the application of an adhesive material ( n=10 ) . 0 ###LEFT-WALL### 1 enamel 0 ###LEFT-WALL### 3 removed 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 32 . 1 enamel 2 was 2 was 3 removed 3 removed 4 from 4 from 7 surfaces 5 the 7 surfaces 6 occlusal 7 surfaces 7 surfaces 8 of 8 of 9 teeth 10 , 11 and 11 and 14 surfaces 11 and 17 covered 12 flat 13 dentin 13 dentin 14 surfaces 14 surfaces 15 were 15 were 16 entirely 15 were 17 covered 17 covered 18 with 18 with 21 resin 19 a 20 composite 19 a 21 resin 20 composite 21 resin 21 resin 22 following 21 resin 25 of 21 resin 30 n=10 22 following 24 application 23 the 24 application 25 of 28 material 26 an 28 material 27 adhesive 28 material 29 ( 30 n=10 30 n=10 31 ) after specimens were sectioned into rectangular sticks of 0.87 ± 0.03 [mm] ( 2 ) , the sticks were randomly assigned into two accelerated aging time period groups : 1 week or 1 year . 0 ###LEFT-WALL### 18 sticks 0 ###LEFT-WALL### 21 assigned 0 ###LEFT-WALL### 29 : 0 ###LEFT-WALL### 35 . 1 after 2 specimens 1 after 4 sectioned 1 after 16 , 1 after 18 sticks 2 specimens 3 were 3 were 4 sectioned 4 sectioned 5 into 5 into 7 sticks 6 rectangular 7 sticks 7 sticks 8 of 8 of 10 ± 9 0.87 10 ± 10 ± 11 0.03 10 ± 14 2 13 ( 14 2 14 2 15 ) 17 the 18 sticks 18 sticks 19 were 19 were 21 assigned 20 randomly 21 assigned 21 assigned 22 into 21 assigned 26 time 22 into 23 two 23 two 24 accelerated 23 two 25 aging 26 time 27 period 26 time 28 groups 27 period 28 groups 29 : 32 or 30 1 31 week 31 week 32 or 32 or 34 year 33 1 34 year microtensile bond strengths were determined . 0 ###LEFT-WALL### 3 strengths 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 6 . 1 microtensile 3 strengths 2 bond 3 strengths 3 strengths 4 were 4 were 5 determined bond strength of rb increased significantly after 1 year ( 1 week=27.80 ± [10.57] mpa versus 1 year=36.93 ± [14.38] mpa [ )(( p<0.05 ) . 0 ###LEFT-WALL### 1 bond 1 bond 2 strength 1 bond 6 significantly 1 bond 7 after 2 strength 3 of 2 strength 5 increased 3 of 4 rb 7 after 9 year 8 1 9 year 9 year 15 mpa 10 ( 15 mpa 11 1 15 mpa 12 week=27.80 15 mpa 13 ± 15 mpa 15 mpa 16 versus 15 mpa 26 . 16 versus 21 mpa 17 1 21 mpa 18 year=36.93 21 mpa 19 ± 21 mpa 21 mpa 24 p<0.05 23 )(( 24 p<0.05 24 p<0.05 25 ) in contrast , there was no significant difference in bond strength between the two time periods for cpb [(] 1 week=51.74 ± 17.8 mpa versus 1 year=56.03 ± [18.85] mpa [ )(( p>0.05 [ )( 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 1 in 2 contrast 1 in 3 , 1 in 4 there 4 there 5 was 5 was 8 difference 5 was 9 in 5 was 12 between 5 was 15 time 6 no 8 difference 7 significant 8 difference 9 in 11 strength 10 bond 11 strength 12 between 14 two 13 the 14 two 15 time 16 periods 15 time 22 ± 16 periods 17 for 16 periods 22 ± 17 for 21 week=51.74 18 cpb 20 1 18 cpb 21 week=51.74 22 ± 24 mpa 23 17.8 24 mpa 24 mpa 25 versus 24 mpa 33 p>0.05 25 versus 30 mpa 26 1 30 mpa 27 year=56.03 30 mpa 28 ± 30 mpa 32 )(( 33 p>0.05 33 p>0.05 35 )( both fluoride - containing adhesives seemed to demonstrate reliable bonding performance after 1 year of accelerated aging in water . 0 ###LEFT-WALL### 2 fluoride 0 ###LEFT-WALL### 3 - 1 both 2 fluoride 3 - 4 containing 3 - 6 seemed 3 - 20 . 4 containing 5 adhesives 4 containing 6 seemed 6 seemed 7 to 6 seemed 8 demonstrate 7 to 8 demonstrate 8 demonstrate 11 performance 8 demonstrate 12 after 8 demonstrate 18 in 9 reliable 11 performance 10 bonding 11 performance 12 after 14 year 13 1 14 year 14 year 15 of 15 of 17 aging 16 accelerated 17 aging 18 in 19 water the present study aimed to compare post - aging microtensile values of fissure sealant ( fs ) containing amorphous calcium phosphate ( acp ) [with] [or] without bonding after various enamel - etching methods . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 aimed 1 the 3 study 2 present 3 study 3 study 4 aimed 4 aimed 5 to 4 aimed 9 aging 4 aimed 27 without 5 to 6 compare 6 compare 7 post 8 - 9 aging 9 aging 11 values 9 aging 24 ) 10 microtensile 11 values 11 values 12 of 11 values 18 containing 11 values 23 acp 12 of 14 sealant 13 fissure 14 sealant 14 sealant 16 fs 15 ( 16 fs 16 fs 17 ) 18 containing 21 phosphate 19 amorphous 20 calcium 20 calcium 21 phosphate 22 ( 23 acp 23 acp 24 ) 27 without 28 bonding 28 bonding 29 after 29 after 31 enamel 30 various 31 enamel 31 enamel 33 etching 32 - 33 etching 33 etching 34 methods 33 etching 35 . the buccal enamel surfaces of teeth were prepared and divided into five main groups according to enamel etching ( group 1 [;] acid - etching , group 2 [;] air - abrasion , group 3 [;] 2w , group 4 [;] 3w , and group 5 [;] 4w of er:yag laser ) . 0 ###LEFT-WALL### 2 buccal 0 ###LEFT-WALL### 3 enamel 1 the 2 buccal 2 buccal 3 enamel 3 enamel 4 surfaces 3 enamel 11 into 4 surfaces 5 of 4 surfaces 9 and 5 of 6 teeth 7 were 8 prepared 7 were 9 and 9 and 10 divided 11 into 15 according 12 five 14 groups 13 main 14 groups 14 groups 15 according 15 according 16 to 15 according 17 enamel 15 according 18 etching 15 according 23 acid 15 according 25 etching 16 to 17 enamel 19 ( 23 acid 20 group 21 1 20 group 23 acid 23 acid 24 - 24 - 25 etching 25 etching 31 - 26 , 31 - 27 group 28 2 27 group 30 air 30 air 31 - 31 - 32 abrasion 32 abrasion 34 group 32 abrasion 44 and 33 , 34 group 34 group 35 3 34 group 37 2w 34 group 38 , 35 3 37 2w 38 , 44 and 39 group 40 4 39 group 42 3w 42 3w 44 and 43 , 44 and 44 and 48 4w 44 and 52 ) 44 and 53 . 45 group 48 4w 46 5 48 4w 48 4w 49 of 49 of 51 laser 50 er:yag 51 laser each main group was subdivided as with [(] subgroup b [ )(or without [(] subgroup a ) [a] bonding [system] . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 5 subdivided 0 ###LEFT-WALL### 21 . 1 each 3 group 2 main 3 group 3 group 4 was 4 was 5 subdivided 5 subdivided 6 as 5 subdivided 17 ) 5 subdivided 19 bonding 6 as 12 )(or 7 with 9 subgroup 7 with 12 )(or 9 subgroup 10 b 12 )(or 13 without 13 without 15 subgroup 15 subgroup 16 a we applied fs - containing acp to etched enamel surfaces . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 applied 0 ###LEFT-WALL### 4 - 1 we 2 applied 2 applied 3 fs 4 - 5 containing 4 - 10 surfaces 4 - 11 . 5 containing 6 acp 5 containing 7 to 5 containing 10 surfaces 7 to 9 enamel 8 etched 9 enamel all specimens were aged by thermocycling and water bath . 0 ###LEFT-WALL### 2 specimens 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 10 . 1 all 2 specimens 2 specimens 3 were 3 were 4 aged 4 aged 5 by 5 by 7 and 6 thermocycling 7 and 7 and 9 bath 8 water 9 bath we then measured microtensile bond strengths and analyzed data with two - way anova and tukey 's tests . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 19 . 1 we 7 and 2 then 3 measured 3 measured 6 strengths 3 measured 7 and 4 microtensile 5 bond 5 bond 6 strengths 7 and 8 analyzed 8 analyzed 9 data 8 analyzed 10 with 10 with 11 two 12 - 15 and 13 way 14 anova 14 anova 15 and 15 and 18 tests 16 tukey 17 's 17 's 18 tests we found a statistically significant difference between group 1 and group 2 , between subgroup b of group 5 and subgroups b of all other groups , and between subgroups a and subgroups b of all main groups ( p<0.01 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 42 . 1 we 2 found 2 found 6 difference 2 found 28 and 3 a 6 difference 4 statistically 5 significant 5 significant 6 difference 6 difference 7 between 7 between 10 and 8 group 9 1 8 group 10 and 10 and 11 group 10 and 13 , 11 group 12 2 14 between 20 and 14 between 28 and 15 subgroup 16 b 15 subgroup 17 of 15 subgroup 20 and 17 of 18 group 18 group 19 5 20 and 21 subgroups 20 and 23 of 21 subgroups 22 b 23 of 26 groups 24 all 25 other 25 other 26 groups 27 , 28 and 28 and 29 between 29 between 32 and 30 subgroups 31 a 30 subgroups 32 and 32 and 33 subgroups 32 and 35 of 33 subgroups 34 b 35 of 38 groups 36 all 38 groups 37 main 38 groups 38 groups 40 p<0.01 39 ( 40 p<0.01 40 p<0.01 41 ) er:yag laser - etching may be an alternative enamel etching method to acid - etching for acp - containing fs . 0 ###LEFT-WALL### 2 laser 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 21 . 1 er:yag 2 laser 3 - 4 etching 3 - 6 be 4 etching 5 may 5 may 6 be 6 be 11 method 7 an 8 alternative 7 an 11 method 8 alternative 9 enamel 9 enamel 10 etching 10 etching 11 method 11 method 12 to 11 method 19 containing 12 to 13 acid 13 acid 15 etching 14 - 15 etching 15 etching 16 for 15 etching 18 - 16 for 17 acp 19 containing 20 fs all routinely utilized sedatives and anesthetics have been found neurotoxic in a wide variety of animal species , including [non] - human primates . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 found 1 all 4 sedatives 2 routinely 3 utilized 3 utilized 4 sedatives 4 sedatives 5 and 5 and 6 anesthetics 5 and 7 have 7 have 8 been 8 been 9 found 9 found 10 neurotoxic 10 neurotoxic 11 in 11 in 14 variety 12 a 13 wide 12 a 14 variety 13 wide 14 variety 14 variety 15 of 15 of 17 species 16 animal 17 species 17 species 21 - 18 , 21 - 19 including 21 - 21 - 23 primates 21 - 24 . 22 human 23 primates neurotoxic effects observed in animals include histologic evidence for apoptotic neuronal cell death and subsequent learning and memory impairment . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 6 include 0 ###LEFT-WALL### 20 . 1 neurotoxic 2 effects 2 effects 3 observed 2 effects 6 include 3 observed 4 in 4 in 5 animals 6 include 8 evidence 6 include 9 for 7 histologic 8 evidence 9 for 17 and 10 apoptotic 12 cell 11 neuronal 12 cell 12 cell 13 death 13 death 14 and 14 and 16 learning 14 and 17 and 15 subsequent 16 learning 17 and 19 impairment 18 memory 19 impairment several cohort studies in neonates with significant comorbidities requiring surgical procedures early in life have also demonstrated abnormal neurodevelopmental outcomes . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 17 demonstrated 0 ###LEFT-WALL### 21 . 1 several 3 studies 2 cohort 3 studies 3 studies 4 in 3 studies 15 have 4 in 5 neonates 5 neonates 6 with 6 with 8 comorbidities 7 significant 8 comorbidities 8 comorbidities 9 requiring 8 comorbidities 12 early 9 requiring 11 procedures 10 surgical 11 procedures 12 early 13 in 13 in 14 life 15 have 17 demonstrated 16 also 17 demonstrated 17 demonstrated 20 outcomes 18 abnormal 20 outcomes 19 neurodevelopmental 20 outcomes this article provides an overview of the currently available data from both animal experiments and human clinical studies regarding the effects of sedatives and anesthetics on the developing brain . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 30 . 1 this 2 article 2 article 3 provides 3 provides 5 overview 3 provides 11 from 3 provides 26 on 4 an 5 overview 5 overview 6 of 6 of 10 data 7 the 10 data 8 currently 9 available 9 available 10 data 11 from 15 and 12 both 15 and 13 animal 14 experiments 14 experiments 15 and 15 and 18 studies 16 human 18 studies 17 clinical 18 studies 18 studies 19 regarding 19 regarding 21 effects 20 the 21 effects 21 effects 22 of 22 of 24 and 23 sedatives 24 and 24 and 25 anesthetics 26 on 29 brain 27 the 29 brain 28 developing 29 brain objective : this study aimed at defining the incidence and demographics of clinically diagnosed retinal vein occlusion ( rvo ) in korea . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 4 study 3 this 4 study 4 study 5 aimed 5 aimed 6 at 6 at 7 defining 7 defining 10 and 7 defining 21 in 8 the 9 incidence 9 incidence 10 and 10 and 11 demographics 10 and 12 of 10 and 19 rvo 12 of 17 occlusion 13 clinically 14 diagnosed 14 diagnosed 16 vein 15 retinal 16 vein 16 vein 17 occlusion 18 ( 19 rvo 19 rvo 20 ) 21 in 22 korea design : nationwide population - based retrospective study using data entered into the korean national health claims database from 2007 through 2011 . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 23 . 1 design 2 : 2 : 4 population 3 nationwide 4 population 5 - 8 study 5 - 17 claims 6 based 8 study 7 retrospective 8 study 8 study 9 using 8 study 17 claims 9 using 10 data 9 using 12 into 10 data 11 entered 12 into 16 health 13 the 16 health 14 korean 15 national 15 national 16 health 17 claims 18 database 17 claims 19 from 19 from 20 2007 20 2007 21 through 21 through 22 2011 participants : data of the entire population of korea ( n = 47,990,761 , based on the 2010 census ) were analyzed . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 22 analyzed 2 : 23 . 3 data 4 of 3 data 8 of 3 data 21 were 4 of 7 population 5 the 7 population 6 entire 7 population 8 of 9 korea 9 korea 12 = 9 korea 15 based 10 ( 12 = 11 n 12 = 12 = 13 47,990,761 12 = 14 , 14 , 15 based 15 based 16 on 15 based 20 ) 16 on 19 census 17 the 19 census 18 2010 19 census 21 were 22 analyzed methods : the korean national health claims database was analyzed to identify patients with rvo . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 6 health 2 : 7 claims 3 the 6 health 4 korean 6 health 5 national 6 health 6 health 7 claims 7 claims 8 database 7 claims 10 analyzed 8 database 9 was 9 was 10 analyzed 10 analyzed 11 to 10 analyzed 14 with 11 to 12 identify 12 identify 13 patients 14 with 15 rvo incident cases included individuals with no rvo claims in 2007 , but with rvo claims in the years 2008 through 2011 . 0 ###LEFT-WALL### 1 incident 0 ###LEFT-WALL### 2 cases 0 ###LEFT-WALL### 22 . 1 incident 2 cases 2 cases 4 individuals 2 cases 5 with 3 included 4 individuals 5 with 8 claims 6 no 8 claims 7 rvo 8 claims 8 claims 12 but 9 in 10 2007 9 in 12 but 11 , 12 but 12 but 13 with 13 with 15 claims 14 rvo 15 claims 15 claims 16 in 15 claims 20 through 16 in 18 years 17 the 18 years 18 years 19 2008 20 through 21 2011 the incidence rate of rvo was estimated for the entire korean population . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 7 estimated 0 ###LEFT-WALL### 13 . 1 the 3 rate 2 incidence 3 rate 3 rate 4 of 3 rate 6 was 4 of 5 rvo 6 was 7 estimated 7 estimated 8 for 8 for 12 population 9 the 12 population 10 entire 11 korean 11 korean 12 population main outcome measures : the person - time incidence rates of clinically diagnosed rvo in korea , including the age - and gender - specific incidence rates , were estimated . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 7 - 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 6 person 5 the 6 person 7 - 22 and 7 - 30 estimated 7 - 31 . 8 time 9 incidence 9 incidence 10 rates 10 rates 11 of 10 rates 22 and 11 of 14 rvo 12 clinically 13 diagnosed 13 diagnosed 14 rvo 14 rvo 15 in 15 in 16 korea 16 korea 18 including 17 , 18 including 18 including 20 age 18 including 21 - 19 the 20 age 22 and 23 gender 22 and 27 rates 22 and 29 were 24 - 27 rates 25 specific 26 incidence 26 incidence 27 rates 27 rates 28 , 29 were 30 estimated results : a total of 92 730 rvo cases ( 56.4 % in women ) were identified . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 results 2 : 2 : 4 total 3 a 4 total 4 total 5 of 4 total 17 identified 5 of 6 92 7 730 8 rvo 8 rvo 9 cases 8 rvo 16 were 8 rvo 17 identified 9 cases 12 % 9 cases 16 were 10 ( 12 % 11 56.4 12 % 12 % 13 in 12 % 15 ) 13 in 14 women the incidence rate of clinically diagnosed rvo during the study period was 48.31 per 100,000 person - years ( 95 % confidence [interval] [ ci ] , 48.00 - 48.62 ) . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 32 . 1 the 3 rate 2 incidence 3 rate 3 rate 4 of 3 rate 12 was 4 of 7 rvo 5 clinically 6 diagnosed 6 diagnosed 7 rvo 7 rvo 8 during 8 during 11 period 9 the 11 period 10 study 11 period 12 was 13 48.31 13 48.31 14 per 13 48.31 18 years 13 48.31 29 - 14 per 16 person 15 100,000 16 person 17 - 18 years 18 years 22 confidence 18 years 27 , 19 ( 22 confidence 20 95 21 % 21 % 22 confidence 22 confidence 25 ci 22 confidence 26 ] 24 [ 25 ci 25 ci 26 ] 27 , 29 - 28 48.00 29 - 29 - 30 48.62 29 - 31 ) the incidence rate among men and women was 42.40 ( 95 % ci , 41.99 - 42.81 [ )(and 54.14 ( 95 % ci , 53.67 - 54.60 [ )(per 100,000 person - years , respectively ( p < 0.001 ) . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 42 . 1 the 3 rate 2 incidence 3 rate 3 rate 4 among 3 rate 8 was 4 among 6 and 5 men 6 and 6 and 7 women 8 was 9 42.40 8 was 36 respectively 8 was 39 < 9 42.40 13 ci 9 42.40 16 - 10 ( 13 ci 11 95 13 ci 12 % 13 ci 13 ci 14 , 14 , 16 - 15 41.99 16 - 16 - 19 )(and 16 - 35 , 17 42.81 19 )(and 19 )(and 20 54.14 19 )(and 24 ci 19 )(and 27 - 21 ( 24 ci 22 95 24 ci 23 % 24 ci 24 ci 25 , 25 , 27 - 26 53.67 27 - 27 - 28 54.60 27 - 30 )(per 27 - 34 years 27 - 35 , 30 )(per 32 person 31 100,000 32 person 33 - 34 years 34 years 35 , 37 ( 39 < 38 p 39 < 39 < 40 0.001 39 < 41 ) the highest incidence of 214.92 per 100,000 person - years ( 95 % ci , 211.29 - 218.56 ) was observed in the age group of 70 to 74 years ( 186.62 [ 95 % ci , 181.46 - 191.78 []] and 236.25 [ 95 % ci , 231.21 - 241.29 []] per 100,000 person - years for men and women aged 70 to 74 years , respectively ) . 0 ###LEFT-WALL### 3 incidence 0 ###LEFT-WALL### 21 observed 0 ###LEFT-WALL### 39 - 0 ###LEFT-WALL### 70 . 1 the 2 highest 1 the 3 incidence 3 incidence 4 of 3 incidence 20 was 4 of 5 214.92 5 214.92 6 per 5 214.92 10 years 5 214.92 17 - 6 per 8 person 7 100,000 8 person 9 - 10 years 10 years 14 ci 10 years 15 , 11 ( 14 ci 12 95 14 ci 13 % 14 ci 14 ci 15 , 15 , 17 - 16 211.29 17 - 17 - 18 218.56 17 - 19 ) 20 was 21 observed 21 observed 22 in 22 in 25 group 23 the 25 group 24 age 25 group 25 group 26 of 25 group 32 186.62 25 group 38 181.46 26 of 30 years 27 70 28 to 28 to 29 74 28 to 30 years 31 ( 32 186.62 32 186.62 36 ci 32 186.62 37 , 33 [ 36 ci 34 95 36 ci 35 % 36 ci 36 ci 37 , 37 , 38 181.46 38 181.46 39 - 39 - 42 and 39 - 56 - 40 191.78 42 and 42 and 43 236.25 42 and 47 ci 44 [ 47 ci 45 95 47 ci 46 % 47 ci 47 ci 50 - 47 ci 56 - 48 , 50 - 49 231.21 50 - 50 - 51 241.29 50 - 53 per 50 - 56 - 53 per 55 person 54 100,000 55 person 56 - 57 years 56 - 62 aged 57 years 58 for 57 years 62 aged 58 for 60 and 59 men 60 and 60 and 61 women 62 aged 63 70 62 aged 68 respectively 63 70 64 to 64 to 66 years 65 74 66 years 67 , 68 respectively 68 respectively 69 ) the incidence rate of rvo increased as the age of the population increased - more than doubling approximately every 10 years from the second to the seventh decade of life . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 6 increased 0 ###LEFT-WALL### 31 . 1 the 3 rate 2 incidence 3 rate 3 rate 4 of 3 rate 6 increased 4 of 5 rvo 6 increased 7 as 6 increased 25 to 7 as 9 age 8 the 9 age 9 age 10 of 10 of 12 population 11 the 12 population 12 population 13 increased 12 population 19 every 12 population 22 from 13 increased 14 - 13 increased 17 doubling 15 more 16 than 16 than 17 doubling 18 approximately 19 every 19 every 21 years 20 10 21 years 22 from 24 second 23 the 24 second 25 to 28 decade 26 the 27 seventh 26 the 28 decade 28 decade 29 of 29 of 30 life retinal vein occlusion occurred more often in men 30 to 54 years of age and in men older than 85 years , but was more common in women 55 to 84 years of age . 0 ###LEFT-WALL### 3 occlusion 0 ###LEFT-WALL### 23 but 0 ###LEFT-WALL### 35 . 1 retinal 2 vein 2 vein 3 occlusion 3 occlusion 23 but 4 occurred 6 often 4 occurred 7 in 4 occurred 23 but 5 more 6 often 7 in 8 men 8 men 9 30 8 men 15 and 8 men 18 older 10 to 12 years 10 to 15 and 11 54 12 years 12 years 13 of 13 of 14 age 15 and 16 in 16 in 17 men 18 older 19 than 19 than 21 years 20 85 21 years 22 , 23 but 23 but 24 was 24 was 26 common 25 more 26 common 26 common 27 in 27 in 28 women 28 women 29 55 28 women 30 to 28 women 33 of 30 to 32 years 31 84 32 years 33 of 34 age conclusions : this study reports the population [-] based rvo incidence in korea . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 reports 2 : 14 . 3 this 4 study 4 study 5 reports 5 reports 11 incidence 5 reports 12 in 6 the 11 incidence 7 population 9 based 9 based 11 incidence 10 rvo 11 incidence 12 in 13 korea the rvo incidence increased exponentially as the age of the population increased , and the rvo incidence in women was 1.28 times higher than that in men . 0 ###LEFT-WALL### 3 incidence 0 ###LEFT-WALL### 20 was 0 ###LEFT-WALL### 28 . 1 the 3 incidence 2 rvo 3 incidence 3 incidence 4 increased 3 incidence 9 of 3 incidence 20 was 4 increased 5 exponentially 4 increased 6 as 6 as 8 age 7 the 8 age 9 of 14 and 10 the 11 population 11 population 12 increased 11 population 14 and 13 , 14 and 14 and 17 incidence 14 and 18 in 15 the 17 incidence 16 rvo 17 incidence 18 in 19 women 20 was 22 times 20 was 23 higher 21 1.28 22 times 23 higher 24 than 23 higher 26 in 24 than 25 that 26 in 27 men the increasing burden of ageing populations and their healthcare expenditure is a major challenge worldwide . 0 ###LEFT-WALL### 3 burden 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 16 . 1 the 3 burden 2 increasing 3 burden 3 burden 4 of 3 burden 11 is 4 of 7 and 5 ageing 6 populations 6 populations 7 and 7 and 10 expenditure 8 their 10 expenditure 9 healthcare 10 expenditure 11 is 14 challenge 11 is 15 worldwide 12 a 13 major 12 a 14 challenge 13 major 14 challenge ageing is a complex disorder and can be defined as progressive decline in function [with] time leading to increased incidence [of] various cardiovascular , neurological and immunological diseases . 0 ###LEFT-WALL### 1 ageing 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 29 . 1 ageing 2 is 2 is 12 decline 3 a 4 complex 3 a 12 decline 4 complex 5 disorder 5 disorder 6 and 6 and 7 can 6 and 8 be 8 be 9 defined 10 as 11 progressive 11 progressive 12 decline 12 decline 13 in 12 decline 17 leading 13 in 16 time 14 function 16 time 17 leading 18 to 18 to 28 diseases 19 increased 20 incidence 20 incidence 28 diseases 22 various 28 diseases 23 cardiovascular 24 , 24 , 25 neurological 24 , 26 and 26 and 27 immunological 26 and 28 diseases the human genome comprises [of] many protein coding and even more [non] - coding rna genes . 0 ###LEFT-WALL### 3 genome 0 ###LEFT-WALL### 4 comprises 1 the 3 genome 2 human 3 genome 3 genome 4 comprises 4 comprises 6 many 4 comprises 9 and 4 comprises 14 coding 7 protein 8 coding 7 protein 9 and 9 and 11 more 10 even 11 more 13 - 14 coding 14 coding 16 genes 14 coding 17 . 15 rna 16 genes micrornas , a class [of] [non] - coding rna , regulate the expression of multiple messenger rnas post - transcriptionally [and] [are] reported to be involved in crucial aspects of cell biology encompassing ageing . 0 ###LEFT-WALL### 1 micrornas 0 ###LEFT-WALL### 11 regulate 1 micrornas 4 class 1 micrornas 11 regulate 2 , 4 class 3 a 4 class 4 class 8 coding 4 class 10 , 7 - 8 coding 8 coding 9 rna 8 coding 10 , 11 regulate 13 expression 11 regulate 23 reported 12 the 13 expression 13 expression 14 of 14 of 18 post 15 multiple 16 messenger 16 messenger 18 post 17 rnas 18 post 19 - 23 reported 20 transcriptionally 23 reported 23 reported 24 to 23 reported 26 involved 23 reported 27 in 23 reported 35 . 24 to 25 be 25 be 26 involved 27 in 29 aspects 28 crucial 29 aspects 29 aspects 30 of 29 aspects 33 encompassing 30 of 32 biology 31 cell 32 biology 33 encompassing 34 ageing recently , several studies have reported the regulation of micrornas with ageing and micrornas like mir - 34 have emerged as critical regulator [of] ageing extending from caenorhabditis elegans to mammals . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 32 . 1 recently 2 , 1 recently 4 studies 3 several 4 studies 4 studies 5 have 5 have 13 and 6 reported 8 regulation 6 reported 11 with 6 reported 13 and 7 the 8 regulation 8 regulation 9 of 9 of 10 micrornas 11 with 12 ageing 13 and 14 micrornas 14 micrornas 15 like 15 like 16 mir 16 mir 18 34 16 mir 29 elegans 17 - 18 34 18 34 19 have 19 have 20 emerged 20 emerged 21 as 21 as 25 ageing 21 as 29 elegans 22 critical 23 regulator 23 regulator 25 ageing 25 ageing 26 extending 25 ageing 29 elegans 26 extending 27 from 27 from 28 caenorhabditis 29 elegans 30 to 30 to 31 mammals here , we summarize the reported role of micrornas as well as long noncoding rnas ( lncrnas ) in the process of ageing with a special emphasis on cardiovascular ageing . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 summarize 0 ###LEFT-WALL### 31 . 1 here 2 , 1 here 3 we 3 we 4 summarize 4 summarize 7 role 4 summarize 12 as 5 the 7 role 6 reported 7 role 7 role 8 of 8 of 9 micrornas 10 as 11 well 11 well 12 as 12 as 14 noncoding 13 long 14 noncoding 14 noncoding 15 rnas 14 noncoding 19 in 14 noncoding 24 with 14 noncoding 28 on 15 rnas 17 lncrnas 16 ( 17 lncrnas 17 lncrnas 18 ) 19 in 21 process 20 the 21 process 21 process 22 of 22 of 23 ageing 24 with 27 emphasis 25 a 26 special 25 a 27 emphasis 26 special 27 emphasis 28 on 30 ageing 29 cardiovascular 30 ageing sirt6 is a histone deacetylase that has been proposed as a potential therapeutic target for metabolic disorders and the prevention of age - associated diseases . 0 ###LEFT-WALL### 1 sirt6 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 26 . 1 sirt6 2 is 2 is 4 histone 2 is 5 deacetylase 3 a 4 histone 5 deacetylase 6 that 5 deacetylase 7 has 6 that 7 has 7 has 8 been 8 been 9 proposed 9 proposed 10 as 10 as 14 target 11 a 12 potential 11 a 14 target 12 potential 14 target 13 therapeutic 14 target 14 target 15 for 14 target 21 of 15 for 18 and 16 metabolic 17 disorders 17 disorders 18 and 18 and 20 prevention 19 the 20 prevention 21 of 22 age 23 - 25 diseases 24 associated 25 diseases we have previously reported on the identification of quercetin and vitexin as sirt6 inhibitors , and studied structurally related flavonoids including luteolin , kaempferol , apigenin and naringenin . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 29 . 1 we 2 have 2 have 16 and 3 previously 4 reported 4 reported 5 on 4 reported 12 as 4 reported 16 and 5 on 10 and 6 the 7 identification 7 identification 8 of 7 identification 10 and 8 of 9 quercetin 10 and 11 vitexin 12 as 14 inhibitors 13 sirt6 14 inhibitors 15 , 16 and 16 and 17 studied 17 studied 20 flavonoids 18 structurally 19 related 19 related 20 flavonoids 20 flavonoids 21 including 21 including 27 and 22 luteolin 23 , 23 , 24 kaempferol 23 , 25 , 25 , 26 apigenin 25 , 27 and 27 and 28 naringenin it was determined that the sirt6 protein remained active after immobilization and that a single frontal displacement could correctly predict the functional activity of the immobilized enzyme . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 28 . 1 it 2 was 2 was 3 determined 3 determined 12 and 4 that 7 protein 4 that 8 remained 4 that 12 and 5 the 7 protein 6 sirt6 7 protein 7 protein 8 remained 8 remained 9 active 9 active 10 after 10 after 11 immobilization 12 and 13 that 13 that 17 displacement 13 that 20 predict 14 a 15 single 14 a 17 displacement 15 single 17 displacement 16 frontal 17 displacement 17 displacement 18 could 18 could 20 predict 19 correctly 20 predict 20 predict 23 activity 21 the 23 activity 22 functional 23 activity 23 activity 24 of 24 of 27 enzyme 25 the 27 enzyme 26 immobilized 27 enzyme the previous study generated a preliminary pharmacophore for the quercetin binding site on sirt6 , containing 3 hydrogen bond donors and one hydrogen bond acceptor . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 generated 1 the 3 study 2 previous 3 study 3 study 4 generated 4 generated 7 pharmacophore 4 generated 13 on 4 generated 16 containing 5 a 7 pharmacophore 6 preliminary 7 pharmacophore 7 pharmacophore 8 for 8 for 12 site 9 the 12 site 10 quercetin 11 binding 11 binding 12 site 13 on 14 sirt6 15 , 16 containing 16 containing 21 and 16 containing 26 . 17 3 21 and 18 hydrogen 20 donors 19 bond 20 donors 20 donors 21 and 21 and 25 acceptor 22 one 25 acceptor 23 hydrogen 24 bond 24 bond 25 acceptor in this study , we have generated a refined pharmacophore with an additional twelve quercetin analogs . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 7 generated 0 ###LEFT-WALL### 17 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 have 6 have 7 generated 7 generated 10 pharmacophore 7 generated 11 with 8 a 10 pharmacophore 9 refined 10 pharmacophore 11 with 16 analogs 12 an 13 additional 13 additional 14 twelve 14 twelve 16 analogs 15 quercetin 16 analogs the resulting model had a positive linear behavior between the experimental elution time verses the fit values obtained from the model with a correlation coefficient of 0.8456 . 0 ###LEFT-WALL### 3 model 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 28 . 1 the 3 model 2 resulting 3 model 3 model 4 had 4 had 8 behavior 5 a 6 positive 5 a 8 behavior 6 positive 8 behavior 7 linear 8 behavior 8 behavior 9 between 8 behavior 17 values 8 behavior 18 obtained 9 between 14 verses 10 the 14 verses 11 experimental 12 elution 12 elution 14 verses 13 time 14 verses 15 the 17 values 16 fit 17 values 17 values 18 obtained 18 obtained 19 from 18 obtained 22 with 19 from 21 model 20 the 21 model 22 with 25 coefficient 23 a 25 coefficient 24 correlation 25 coefficient 25 coefficient 26 of 26 of 27 0.8456 numerous clinical and epidemiological reports indicate that patients with history of vascular illness [such] [as] stroke are more likely to develop dementia as the clinical manifestation of alzheimer 's disease . 0 ###LEFT-WALL### 1 numerous 0 ###LEFT-WALL### 17 are 0 ###LEFT-WALL### 31 . 1 numerous 17 are 2 clinical 3 and 3 and 4 epidemiological 3 and 5 reports 3 and 16 stroke 3 and 17 are 5 reports 6 indicate 6 indicate 7 that 7 that 8 patients 7 that 16 stroke 8 patients 9 with 8 patients 11 of 8 patients 16 stroke 9 with 10 history 11 of 13 illness 12 vascular 13 illness 17 are 19 likely 18 more 19 likely 19 likely 20 to 19 likely 21 develop 20 to 21 develop 21 develop 22 dementia 21 develop 23 as 23 as 26 manifestation 24 the 26 manifestation 25 clinical 26 manifestation 26 manifestation 27 of 27 of 30 disease 28 alzheimer 29 's 29 's 30 disease however , there are little data regarding the pathologic mechanisms that link vascular risk factors to the factors associated with dementia [onset] . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 23 . 1 however 2 , 1 however 3 there 3 there 4 are 4 are 6 data 5 little 6 data 6 data 7 regarding 6 data 16 to 7 regarding 10 mechanisms 8 the 10 mechanisms 9 pathologic 10 mechanisms 10 mechanisms 11 that 10 mechanisms 12 link 11 that 12 link 12 link 15 factors 13 vascular 15 factors 14 risk 15 factors 16 to 18 factors 17 the 18 factors 18 factors 19 associated 18 factors 20 with 20 with 21 dementia we provide evidence that suggests intriguing detrimental interactions between stroke [and] β - amyloid ( aβ ) toxicity in the hippocampus . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 provide 0 ###LEFT-WALL### 22 . 1 we 2 provide 2 provide 3 evidence 3 evidence 4 that 3 evidence 5 suggests 4 that 5 suggests 5 suggests 6 intriguing 6 intriguing 8 interactions 6 intriguing 9 between 6 intriguing 19 in 7 detrimental 8 interactions 9 between 18 toxicity 10 stroke 18 toxicity 12 β 13 - 12 β 18 toxicity 14 amyloid 16 aβ 14 amyloid 18 toxicity 15 ( 16 aβ 16 aβ 17 ) 19 in 21 hippocampus 20 the 21 hippocampus stroke was induced by unilateral striatal injection of endothelin - 1 , the potent vasoconstrictor . 0 ###LEFT-WALL### 1 stroke 0 ###LEFT-WALL### 3 induced 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 16 . 1 stroke 2 was 2 was 3 induced 3 induced 4 by 4 by 7 injection 5 unilateral 7 injection 6 striatal 7 injection 7 injection 8 of 8 of 9 endothelin 9 endothelin 11 1 10 - 11 1 11 1 12 , 12 , 15 vasoconstrictor 13 the 15 vasoconstrictor 14 potent 15 vasoconstrictor aβ toxicity was modeled by bilateral intracerebroventricular injections of the toxic fragment aβ . 0 ###LEFT-WALL### 2 toxicity 0 ###LEFT-WALL### 4 modeled 0 ###LEFT-WALL### 14 . 1 aβ 2 toxicity 2 toxicity 3 was 3 was 4 modeled 4 modeled 5 by 5 by 8 injections 6 bilateral 8 injections 7 intracerebroventricular 8 injections 8 injections 9 of 9 of 13 aβ 10 the 12 fragment 11 toxic 12 fragment 12 fragment 13 aβ gross morphologic changes in comorbid aβ and stroke rats were enlargement of the lateral ventricles with concomitant shrinkage of the hippocampus . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 22 . 1 gross 3 changes 2 morphologic 3 changes 3 changes 4 in 3 changes 7 and 4 in 6 aβ 5 comorbid 6 aβ 7 and 9 rats 7 and 10 were 8 stroke 9 rats 10 were 11 enlargement 11 enlargement 12 of 12 of 15 ventricles 13 the 15 ventricles 14 lateral 15 ventricles 15 ventricles 16 with 15 ventricles 19 of 16 with 18 shrinkage 17 concomitant 18 shrinkage 19 of 21 hippocampus 20 the 21 hippocampus the hippocampus displayed a series of synergistic biochemical alterations , including microgliosis , deposition of aβ precursor protein fragments , and cellular degeneration . 0 ###LEFT-WALL### 2 hippocampus 0 ###LEFT-WALL### 3 displayed 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 24 . 1 the 2 hippocampus 2 hippocampus 3 displayed 3 displayed 5 series 3 displayed 11 including 4 a 5 series 5 series 6 of 6 of 9 alterations 7 synergistic 9 alterations 8 biochemical 9 alterations 10 , 11 including 11 including 12 microgliosis 11 including 13 , 13 , 21 and 14 deposition 15 of 14 deposition 21 and 15 of 19 fragments 16 aβ 17 precursor 17 precursor 19 fragments 18 protein 19 fragments 20 , 21 and 21 and 23 degeneration 22 cellular 23 degeneration in addition , there was bilateral induction of connexin43 , reduced neuronal survival , and impaired dendritic development [of] adult - born immature neurons in the dentate gyrus of these rats compared with either rats alone . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 10 , 1 in 2 addition 1 in 3 , 1 in 4 there 4 there 5 was 5 was 7 induction 6 bilateral 7 induction 7 induction 8 of 8 of 9 connexin43 10 , 15 and 10 , 21 - 11 reduced 13 survival 12 neuronal 13 survival 13 survival 15 and 14 , 15 and 15 and 20 adult 16 impaired 18 development 17 dendritic 18 development 18 development 20 adult 21 - 24 neurons 21 - 32 compared 21 - 37 . 22 born 24 neurons 23 immature 24 neurons 24 neurons 25 in 24 neurons 32 compared 25 in 28 gyrus 26 the 28 gyrus 27 dentate 28 gyrus 28 gyrus 29 of 29 of 31 rats 30 these 31 rats 32 compared 33 with 33 with 34 either 33 with 35 rats 35 rats 36 alone behaviorally , there was impairment in the hippocampal - based discriminative fear - conditioning to context task indicating learning and memory deficit . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 23 . 1 behaviorally 2 , 1 behaviorally 3 there 3 there 4 was 4 was 5 impairment 5 impairment 6 in 6 in 20 and 7 the 14 conditioning 8 hippocampal 12 fear 8 hippocampal 13 - 8 hippocampal 14 conditioning 9 - 12 fear 10 based 12 fear 11 discriminative 12 fear 12 fear 13 - 14 conditioning 15 to 14 conditioning 20 and 15 to 18 indicating 16 context 17 task 17 task 18 indicating 18 indicating 19 learning 20 and 22 deficit 21 memory 22 deficit these results suggest an insight into the relationship between hippocampal atrophy , pathology , and functional impairment . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 18 . 1 these 2 results 2 results 3 suggest 3 suggest 5 insight 3 suggest 6 into 3 suggest 9 between 4 an 5 insight 6 into 8 relationship 7 the 8 relationship 9 between 15 and 10 hippocampal 11 atrophy 11 atrophy 12 , 12 , 13 pathology 12 , 15 and 14 , 15 and 15 and 17 impairment 16 functional 17 impairment our work not only highlights the exacerbated pathology that emerges when aβ toxicity and stroke occur comorbidly but also demonstrates that this comorbid rat model exhibits physiopathology that is highly characteristic of the human condition . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 19 also 0 ###LEFT-WALL### 36 . 1 our 2 work 2 work 19 also 3 not 4 only 4 only 19 also 5 highlights 8 pathology 5 highlights 11 when 5 highlights 19 also 6 the 8 pathology 7 exacerbated 8 pathology 8 pathology 9 that 8 pathology 10 emerges 9 that 10 emerges 11 when 14 and 11 when 16 occur 12 aβ 13 toxicity 13 toxicity 14 and 14 and 15 stroke 14 and 16 occur 16 occur 17 comorbidly 18 but 19 also 19 also 20 demonstrates 20 demonstrates 21 that 21 that 25 model 21 that 26 exhibits 22 this 25 model 23 comorbid 25 model 24 rat 25 model 25 model 26 exhibits 26 exhibits 27 physiopathology 27 physiopathology 28 that 27 physiopathology 29 is 27 physiopathology 32 of 28 that 29 is 29 is 31 characteristic 30 highly 31 characteristic 32 of 35 condition 33 the 35 condition 34 human 35 condition background : detection of " any cognitive impairment " is mandated as part of the medicare annual wellness visit , but screening all patients may result in excessive false positives . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 detection 2 : 11 mandated 2 : 20 , 2 : 31 . 3 detection 4 of 3 detection 10 is 4 of 5 " 4 of 8 impairment 6 any 8 impairment 7 cognitive 8 impairment 8 impairment 9 " 10 is 11 mandated 11 mandated 12 as 12 as 13 part 13 part 14 of 14 of 19 visit 15 the 19 visit 16 medicare 19 visit 17 annual 18 wellness 18 wellness 19 visit 20 , 24 patients 20 , 26 result 21 but 22 screening 21 but 24 patients 22 screening 23 all 24 patients 25 may 25 may 26 result 26 result 27 in 27 in 30 positives 28 excessive 30 positives 29 false 30 positives accuracy was good across the cohorts ( harrell 's [c] statistic : chs , 0.68 ; fhs , 0.77 ; hrs , 0.76 ; salsa , 0.78 [ )( 0 ###LEFT-WALL### 1 accuracy 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 12 : 1 accuracy 2 was 2 was 3 good 3 good 4 across 4 across 6 cohorts 5 the 6 cohorts 6 cohorts 11 statistic 7 ( 11 statistic 8 harrell 9 's 9 's 11 statistic 11 statistic 12 : 12 : 13 chs 12 : 14 , 12 : 29 )( 14 , 15 0.68 14 , 16 ; 16 ; 17 fhs 16 ; 18 , 18 , 19 0.77 18 , 20 ; 20 ; 21 hrs 20 ; 22 , 22 , 23 0.76 22 , 24 ; 24 ; 25 salsa 24 ; 26 , 26 , 27 0.78 conclusions : the dementia screening indicator is a simple tool that may be useful in primary care settings to identify high - risk patients to target for cognitive screening . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 6 indicator 2 : 7 is 3 the 6 indicator 4 dementia 5 screening 5 screening 6 indicator 6 indicator 7 is 7 is 10 tool 8 a 10 tool 9 simple 10 tool 10 tool 11 that 10 tool 20 identify 11 that 12 may 12 may 13 be 13 be 14 useful 14 useful 15 in 14 useful 19 to 15 in 18 settings 16 primary 18 settings 17 care 18 settings 19 to 20 identify 20 identify 24 patients 20 identify 27 for 21 high 22 - 21 high 24 patients 23 risk 24 patients 24 patients 25 to 24 patients 26 target 25 to 26 target 27 for 29 screening 28 cognitive 29 screening developmental processes are inherently time - related , with various time metrics and transition points being used to proxy [how] change is organized with respect to [the] theoretically underlying mechanisms . 0 ###LEFT-WALL### 2 processes 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 31 . 1 developmental 2 processes 2 processes 3 are 3 are 4 inherently 3 are 5 time 3 are 7 related 6 - 7 related 7 related 8 , 8 , 9 with 8 , 22 is 9 with 13 and 9 with 22 is 10 various 12 metrics 11 time 12 metrics 12 metrics 13 and 13 and 15 points 13 and 16 being 14 transition 15 points 16 being 17 used 17 used 18 to 18 to 19 proxy 21 change 22 is 22 is 23 organized 23 organized 24 with 23 organized 26 to 24 with 25 respect 26 to 29 underlying 28 theoretically 29 underlying 29 underlying 30 mechanisms using an approach based on akaike weights , we tested whether developmental trajectories ( for each time metric ) [of] depressive symptoms in late life are more efficiently described as a single continuous process [or] as [a] 2 - phase process . 0 ###LEFT-WALL### 1 using 0 ###LEFT-WALL### 4 based 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 42 . 1 using 3 approach 1 using 4 based 2 an 3 approach 4 based 5 on 4 based 7 weights 5 on 6 akaike 8 , 9 we 8 , 10 tested 9 we 10 tested 10 tested 11 whether 11 whether 13 trajectories 11 whether 40 phase 12 developmental 13 trajectories 13 trajectories 15 for 13 trajectories 40 phase 14 ( 15 for 15 for 17 time 15 for 39 - 16 each 17 time 17 time 22 symptoms 17 time 29 described 18 metric 19 ) 18 metric 22 symptoms 21 depressive 22 symptoms 22 symptoms 23 in 22 symptoms 26 are 23 in 25 life 24 late 25 life 26 are 28 efficiently 26 are 29 described 27 more 28 efficiently 29 described 30 as 30 as 34 process 31 a 32 single 31 a 34 process 32 single 34 process 33 continuous 34 process 34 process 36 as 36 as 38 2 40 phase 41 process comparing fits of linear and multiphase growth models , we found that 2 - phase models demonstrated better fit than did single - phase models across all time metrics . 0 ###LEFT-WALL### 10 we 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 30 . 1 comparing 2 fits 1 comparing 9 , 1 comparing 10 we 2 fits 3 of 3 of 8 models 4 linear 5 and 5 and 6 multiphase 5 and 8 models 7 growth 8 models 10 we 11 found 11 found 12 that 11 found 13 2 14 - 16 models 14 - 21 did 15 phase 16 models 16 models 17 demonstrated 16 models 19 fit 16 models 21 did 18 better 19 fit 20 than 21 did 21 did 25 models 21 did 26 across 22 single 23 - 22 single 24 phase 24 phase 25 models 26 across 29 metrics 27 all 29 metrics 28 time 29 metrics time - to [-] death and time - to/from - disability - onset models provided more efficient descriptions of changes in depressive symptoms than did time - from [-] birth models , with time - to [-] death models representing the best overall fit . 0 ###LEFT-WALL### 1 time 0 ###LEFT-WALL### 12 - 1 time 3 to 1 time 9 to/from 2 - 3 to 3 to 6 and 3 to 8 - 5 death 6 and 6 and 7 time 6 and 8 - 9 to/from 11 disability 10 - 11 disability 11 disability 12 - 12 - 13 onset 12 - 20 changes 13 onset 14 models 13 onset 19 of 13 onset 20 changes 14 models 15 provided 15 provided 18 descriptions 16 more 17 efficient 17 efficient 18 descriptions 18 descriptions 19 of 20 changes 21 in 20 changes 24 than 21 in 23 symptoms 22 depressive 23 symptoms 24 than 25 did 24 than 33 with 25 did 26 time 26 time 28 from 27 - 28 from 28 from 31 models 28 from 32 , 30 birth 31 models 33 with 34 time 34 time 36 to 35 - 36 to 36 to 38 death 36 to 45 . 38 death 39 models 38 death 44 fit 39 models 40 representing 39 models 44 fit 40 representing 42 best 41 the 42 best 43 overall 44 fit our findings support prior research that late - life changes in depressive symptoms are driven by disablement and , particularly , mortality processes [,] rather than advancing chronological age . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 8 - 1 our 2 findings 2 findings 3 support 3 support 5 research 3 support 7 late 4 prior 5 research 6 that 7 late 8 - 10 changes 8 - 15 driven 8 - 18 and 8 - 30 . 9 life 10 changes 10 changes 11 in 10 changes 14 are 11 in 13 symptoms 12 depressive 13 symptoms 14 are 15 driven 15 driven 16 by 16 by 17 disablement 18 and 19 , 18 and 22 mortality 18 and 23 processes 19 , 20 particularly 20 particularly 21 , 20 particularly 22 mortality 22 mortality 23 processes 23 processes 26 than 23 processes 29 age 25 rather 26 than 26 than 27 advancing 28 chronological 29 age developmental researchers across content areas can compare age with other relevant time metrics to determine if chronological age or other processes drive the underlying developmental change in their construct of interest . 0 ###LEFT-WALL### 2 researchers 0 ###LEFT-WALL### 7 compare 0 ###LEFT-WALL### 32 . 1 developmental 2 researchers 2 researchers 3 across 2 researchers 6 can 3 across 5 areas 4 content 5 areas 6 can 7 compare 7 compare 8 age 8 age 9 with 8 age 14 to 8 age 15 determine 9 with 13 metrics 10 other 13 metrics 11 relevant 13 metrics 12 time 13 metrics 14 to 15 determine 15 determine 16 if 16 if 19 or 16 if 22 drive 17 chronological 18 age 18 age 19 or 19 or 21 processes 19 or 22 drive 20 other 21 processes 22 drive 26 change 22 drive 27 in 23 the 26 change 24 underlying 26 change 25 developmental 26 change 27 in 29 construct 28 their 29 construct 29 construct 30 of 30 of 31 interest how does cognitive control change with age , and what are the processes underlying these changes ? 0 ###LEFT-WALL### 1 how 0 ###LEFT-WALL### 5 change 0 ###LEFT-WALL### 17 ? 1 how 2 does 2 does 4 control 2 does 5 change 3 cognitive 4 control 5 change 6 with 6 with 9 and 7 age 9 and 8 , 9 and 9 and 10 what 9 and 11 are 9 and 14 underlying 11 are 13 processes 12 the 13 processes 13 processes 14 underlying 14 underlying 16 changes 15 these 16 changes this question has been extensively studied using versions of the task - switching paradigm , which allow participants to actively prepare for the upcoming task ( kray , eber , [&] karbach , 2008 ) . 0 ###LEFT-WALL### 2 question 0 ###LEFT-WALL### 6 studied 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 36 . 1 this 2 question 2 question 3 has 3 has 4 been 4 been 6 studied 5 extensively 6 studied 6 studied 7 using 7 using 8 versions 8 versions 9 of 9 of 11 task 10 the 11 task 12 - 14 paradigm 12 - 15 , 13 switching 14 paradigm 15 , 16 which 15 , 17 allow 16 which 17 allow 17 allow 18 participants 17 allow 19 to 17 allow 22 for 19 to 21 prepare 20 actively 21 prepare 22 for 25 task 23 the 25 task 24 upcoming 25 task 25 task 27 kray 25 task 32 karbach 26 ( 27 kray 27 kray 29 eber 27 kray 30 , 28 , 29 eber 29 eber 30 , 30 , 32 karbach 32 karbach 34 2008 32 karbach 35 ) 33 , 34 2008 34 2008 35 ) little is known , however , about age - related changes in this ability across the life span when there is no opportunity to anticipate task goals . 0 ###LEFT-WALL### 1 little 0 ###LEFT-WALL### 3 known 0 ###LEFT-WALL### 10 related 1 little 2 is 2 is 3 known 3 known 5 however 3 known 7 about 4 , 5 however 5 however 6 , 7 about 8 age 9 - 10 related 10 related 11 changes 10 related 12 in 10 related 15 across 10 related 28 . 12 in 14 ability 13 this 14 ability 15 across 18 span 16 the 18 span 17 life 18 span 18 span 19 when 19 when 20 there 19 when 21 is 20 there 21 is 21 is 23 opportunity 22 no 23 opportunity 23 opportunity 24 to 23 opportunity 25 anticipate 24 to 25 anticipate 25 anticipate 27 goals 26 task 27 goals we examined the effect of 2 kinds of verbal self - instruction - labeling either the task goal or the relevant feature of the stimulus - on 2 components of cognitive control , goal setting and switching , in children , young adults , and older adults . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 48 . 1 we 2 examined 2 examined 4 effect 3 the 4 effect 4 effect 5 of 4 effect 14 labeling 5 of 8 of 6 2 8 of 7 kinds 8 of 8 of 10 self 8 of 12 instruction 9 verbal 10 self 11 - 12 instruction 12 instruction 13 - 14 labeling 19 or 14 labeling 27 on 14 labeling 39 in 15 either 19 or 16 the 18 goal 17 task 18 goal 18 goal 19 or 19 or 22 feature 19 or 23 of 20 the 22 feature 21 relevant 22 feature 23 of 25 stimulus 24 the 25 stimulus 26 - 27 on 27 on 36 and 27 on 38 , 28 2 29 components 29 components 30 of 29 components 33 , 30 of 32 control 31 cognitive 32 control 33 , 35 setting 33 , 36 and 34 goal 35 setting 36 and 37 switching 36 and 38 , 39 in 45 and 40 children 41 , 41 , 43 adults 41 , 45 and 42 young 43 adults 44 , 45 and 45 and 47 adults 46 older 47 adults all participants performed single - task blocks and mixed - task blocks ( involving unpredictable switching between 2 tasks ) in silent and labeling conditions . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 10 - 1 all 2 participants 2 participants 8 and 3 performed 7 blocks 3 performed 8 and 4 single 5 - 4 single 6 task 6 task 7 blocks 8 and 9 mixed 10 - 11 task 10 - 26 . 11 task 12 blocks 11 task 14 involving 11 task 21 in 13 ( 14 involving 14 involving 16 switching 14 involving 17 between 14 involving 20 ) 15 unpredictable 16 switching 17 between 19 tasks 18 2 19 tasks 21 in 25 conditions 22 silent 23 and 23 and 24 labeling 23 and 25 conditions participants categorized bidimensional stimuli either by [picture] or by color , depending on their spatial position in [a] 2 - cell vertical grid . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 categorized 0 ###LEFT-WALL### 20 - 1 participants 2 categorized 2 categorized 4 stimuli 2 categorized 8 or 3 bidimensional 4 stimuli 5 either 8 or 6 by 8 or 8 or 9 by 8 or 10 color 10 color 12 depending 11 , 12 depending 12 depending 13 on 12 depending 17 in 12 depending 20 - 13 on 16 position 14 their 16 position 15 spatial 16 position 17 in 19 2 20 - 23 grid 20 - 24 . 21 cell 23 grid 22 vertical 23 grid response times revealed an inverted [u] shape in performance with age . 0 ###LEFT-WALL### 2 times 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 12 . 1 response 2 times 2 times 3 revealed 3 revealed 7 shape 3 revealed 8 in 3 revealed 10 with 4 an 7 shape 5 inverted 7 shape 8 in 9 performance 10 with 11 age these age differences were more pronounced for goal setting than for switching , thus generalizing results obtained in situations taping proactive control to this new context forcing reactive control . 0 ###LEFT-WALL### 3 differences 0 ###LEFT-WALL### 6 pronounced 1 these 3 differences 2 age 3 differences 3 differences 4 were 4 were 5 more 4 were 6 pronounced 6 pronounced 7 for 6 pronounced 10 than 6 pronounced 11 for 7 for 9 setting 8 goal 9 setting 11 for 12 switching 12 switching 15 generalizing 13 , 15 generalizing 14 thus 15 generalizing 15 generalizing 16 results 15 generalizing 23 to 15 generalizing 30 . 16 results 17 obtained 16 results 20 taping 17 obtained 18 in 18 in 19 situations 20 taping 22 control 21 proactive 22 control 23 to 26 context 24 this 25 new 25 new 26 context 26 context 27 forcing 27 forcing 29 control 28 reactive 29 control further , differential age - related effects of verbalization were also obtained . 0 ###LEFT-WALL### 4 age 0 ###LEFT-WALL### 12 obtained 0 ###LEFT-WALL### 13 . 1 further 2 , 1 further 4 age 3 differential 4 age 4 age 10 were 5 - 6 related 6 related 7 effects 6 related 10 were 7 effects 8 of 8 of 9 verbalization 10 were 12 obtained 11 also 12 obtained verbalizations were detrimental for young adults , beneficial for older adults , and had mixed effects in children . 0 ###LEFT-WALL### 1 verbalizations 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 19 . 1 verbalizations 13 and 2 were 3 detrimental 2 were 13 and 3 detrimental 4 for 4 for 6 adults 5 young 6 adults 6 adults 8 beneficial 7 , 8 beneficial 8 beneficial 9 for 8 beneficial 12 , 9 for 11 adults 10 older 11 adults 12 , 13 and 13 and 14 had 14 had 15 mixed 15 mixed 16 effects 15 mixed 17 in 17 in 18 children these differences are interpreted in terms of qualitative developmental changes in reactive goal [-] setting strategies . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 4 interpreted 0 ###LEFT-WALL### 17 . 1 these 2 differences 2 differences 3 are 3 are 4 interpreted 4 interpreted 5 in 4 interpreted 11 in 5 in 6 terms 6 terms 7 of 7 of 10 changes 8 qualitative 10 changes 9 developmental 10 changes 11 in 16 strategies 12 reactive 13 goal 13 goal 16 strategies 15 setting 16 strategies aim : to identify lifestyle factors associated with healthy aging in middle [-] aged and older australian men . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 19 . 1 aim 2 : 2 : 3 to 2 : 4 identify 3 to 4 identify 4 identify 5 lifestyle 5 lifestyle 6 factors 5 lifestyle 7 associated 6 factors 7 associated 7 associated 8 with 8 with 10 aging 8 with 11 in 9 healthy 10 aging 11 in 18 men 12 middle 18 men 14 aged 15 and 15 and 16 older 15 and 17 australian 17 australian 18 men methods : a cross - sectional , population - based , computer - assisted telephone interview study explored self - reported health outcomes , and associated determinants for general and reproductive health ( the men in australia telephone survey ) in men aged 40 years and older ( n = 5990 ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 53 . 2 : 4 cross 2 : 11 , 3 a 4 cross 4 cross 8 population 4 cross 10 based 5 - 8 population 6 sectional 7 , 6 sectional 8 population 8 population 9 - 9 - 10 based 10 based 11 , 11 , 12 computer 11 , 13 - 13 - 19 self 13 - 21 reported 13 - 25 and 14 assisted 19 self 15 telephone 16 interview 16 interview 18 explored 17 study 18 explored 18 explored 19 self 20 - 21 reported 21 reported 23 outcomes 22 health 23 outcomes 24 , 25 and 25 and 27 determinants 25 and 43 aged 26 associated 27 determinants 27 determinants 28 for 27 determinants 41 in 27 determinants 43 aged 28 for 32 health 29 general 30 and 30 and 31 reproductive 30 and 32 health 32 health 39 survey 33 ( 39 survey 34 the 39 survey 35 men 36 in 35 men 38 telephone 36 in 37 australia 38 telephone 39 survey 39 survey 40 ) 41 in 42 men 43 aged 46 and 44 40 45 years 45 years 46 and 46 and 47 older 47 older 50 = 48 ( 50 = 49 n 50 = 50 = 51 5990 50 = 52 ) " good health " was defined by [self] - reported health ( excellent/very [good] ) combined with absence [of] self [-] reported high blood pressure , heart disease , stroke , diabetes and depression symptoms . 0 ###LEFT-WALL### 1 " 0 ###LEFT-WALL### 2 good 0 ###LEFT-WALL### 16 combined 0 ###LEFT-WALL### 36 . 2 good 3 health 2 good 7 by 2 good 16 combined 3 health 4 " 3 health 5 was 5 was 6 defined 6 defined 7 by 9 - 10 reported 10 reported 11 health 10 reported 16 combined 11 health 13 excellent/very 12 ( 13 excellent/very 13 excellent/very 15 ) 16 combined 17 with 16 combined 35 symptoms 17 with 33 and 18 absence 20 self 20 self 25 pressure 22 reported 25 pressure 23 high 25 pressure 24 blood 25 pressure 25 pressure 26 , 26 , 28 disease 26 , 29 , 27 heart 28 disease 29 , 30 stroke 29 , 31 , 31 , 32 diabetes 31 , 33 and 33 and 34 depression categories of sexual activity frequency in the previous four weeks ranged from zero to 12+ times . 0 ###LEFT-WALL### 1 categories 0 ###LEFT-WALL### 11 ranged 0 ###LEFT-WALL### 17 . 1 categories 2 of 1 categories 11 ranged 2 of 5 frequency 3 sexual 4 activity 4 activity 5 frequency 5 frequency 6 in 6 in 10 weeks 7 the 10 weeks 8 previous 10 weeks 9 four 10 weeks 11 ranged 12 from 11 ranged 14 to 12 from 13 zero 14 to 16 times 15 12+ 16 times results : " good health " declined with increasing age with 17 % of men over 70 years reporting " good health " . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 1 results 2 : 2 : 3 " 2 : 5 health 4 good 5 health 5 health 6 " 5 health 7 declined 5 health 8 with 5 health 14 of 8 with 9 increasing 9 increasing 10 age 9 increasing 11 with 11 with 13 % 12 17 13 % 14 of 15 men 15 men 16 over 15 men 19 reporting 16 over 18 years 17 70 18 years 19 reporting 20 " 19 reporting 22 health 21 good 22 health 22 health 23 " in multivariable logistic regression models , significant inverse associations were found between modifiable lifestyle factors - both underweight and overweight/obesity , physical inactivity , smoking and high alcohol consumption - and " good health " . 0 ###LEFT-WALL### 9 associations 0 ###LEFT-WALL### 11 found 1 in 5 models 1 in 6 , 1 in 9 associations 2 multivariable 5 models 3 logistic 5 models 4 regression 5 models 7 significant 8 inverse 8 inverse 9 associations 9 associations 10 were 10 were 11 found 11 found 12 between 12 between 15 factors 13 modifiable 14 lifestyle 14 lifestyle 15 factors 15 factors 19 and 15 factors 26 and 16 - 19 and 17 both 19 and 18 underweight 19 and 19 and 20 overweight/obesity 19 and 21 , 21 , 26 and 22 physical 23 inactivity 23 inactivity 24 , 24 , 25 smoking 24 , 26 and 26 and 34 health 26 and 36 . 27 high 29 consumption 28 alcohol 29 consumption 29 consumption 31 and 30 - 31 and 31 and 32 " 31 and 33 good 31 and 34 health 34 health 35 " low - risk alcohol intake and living with a partner were positively associated with " good health " . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 19 . 1 low 2 - 1 low 6 and 3 risk 5 intake 4 alcohol 5 intake 5 intake 6 and 6 and 7 living 6 and 8 with 6 and 11 were 8 with 10 partner 9 a 10 partner 11 were 13 associated 12 positively 13 associated 13 associated 14 with 14 with 15 " 14 with 17 health 16 good 17 health 17 health 18 " sexual activity [was] also positively associated with " good health " ( p < 0.001 ) with elevated odds ratios ( ors ) for each category of frequency of sexual activity ( 1 - 4 , 5 - 8 , 9 - 12 or 12+ times in the past 4 weeks ) relative to zero frequency ( ors 1.68 to 2.16 ) . 0 ###LEFT-WALL### 44 or 0 ###LEFT-WALL### 63 . 1 sexual 2 activity 2 activity 6 associated 2 activity 44 or 4 also 6 associated 5 positively 6 associated 6 associated 7 with 6 associated 14 < 6 associated 17 with 6 associated 34 - 6 associated 38 - 6 associated 42 - 7 with 8 " 7 with 10 health 9 good 10 health 10 health 11 " 12 ( 14 < 13 p 14 < 14 < 15 0.001 14 < 16 ) 17 with 20 ratios 17 with 24 for 18 elevated 19 odds 19 odds 20 ratios 20 ratios 22 ors 21 ( 22 ors 22 ors 23 ) 24 for 26 category 25 each 26 category 26 category 27 of 26 category 29 of 27 of 28 frequency 29 of 31 activity 30 sexual 31 activity 32 ( 34 - 33 1 34 - 34 - 35 4 34 - 36 , 36 , 38 - 37 5 38 - 38 - 39 8 38 - 40 , 41 9 42 - 42 - 43 12 44 or 46 times 44 or 52 ) 44 or 53 relative 44 or 58 ors 45 12+ 46 times 46 times 47 in 47 in 51 weeks 48 the 49 past 48 the 50 4 50 4 51 weeks 53 relative 54 to 54 to 56 frequency 55 zero 56 frequency 57 ( 58 ors 58 ors 59 1.68 58 ors 60 to 58 ors 62 ) 60 to 61 2.16 conclusion : this study suggests that sexual activity is an important [correlate] of retaining good health [in] [middle] - and older - aged men , independent of other behavioral determinants . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 suggests 2 : 31 . 3 this 4 study 4 study 5 suggests 5 suggests 6 that 6 that 8 activity 6 that 9 is 7 sexual 8 activity 8 activity 9 is 9 is 26 independent 10 an 26 independent 11 important 13 of 11 important 20 and 13 of 14 retaining 14 retaining 16 health 15 good 16 health 19 - 20 and 20 and 24 men 20 and 25 , 20 and 26 independent 21 older 22 - 21 older 24 men 23 aged 24 men 26 independent 27 of 27 of 30 determinants 28 other 30 determinants 29 behavioral 30 determinants methods : we enrolled 50 cases of npc and 20 cases of nasopharyngitis ( npi ) specimens to test the expressions of [γ] - h2ax and ebv latent membrane protein 1 ( lmp1 ) by immunohistochemical method ( ihc ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 3 we 2 : 4 enrolled 3 we 4 enrolled 4 enrolled 17 specimens 4 enrolled 35 by 5 50 17 specimens 6 cases 7 of 6 cases 9 and 7 of 8 npc 9 and 11 cases 9 and 12 of 9 and 15 npi 9 and 17 specimens 10 20 11 cases 12 of 13 nasopharyngitis 14 ( 15 npi 15 npi 16 ) 17 specimens 18 to 17 specimens 22 of 17 specimens 26 and 18 to 19 test 19 test 21 expressions 20 the 21 expressions 21 expressions 22 of 24 - 26 and 25 h2ax 26 and 26 and 30 protein 26 and 33 lmp1 26 and 34 ) 27 ebv 30 protein 28 latent 30 protein 29 membrane 30 protein 30 protein 31 1 32 ( 33 lmp1 33 lmp1 34 ) 35 by 37 method 36 immunohistochemical 37 method 37 method 39 ihc 38 ( 39 ihc 39 ihc 40 ) and then in lmp1 - negative samples , we detected the ebv - encoded rna ( eber ) using in situ hybridization . 0 ###LEFT-WALL### 1 and 0 ###LEFT-WALL### 23 . 1 and 2 then 1 and 9 we 1 and 10 detected 3 in 4 lmp1 3 in 8 , 3 in 9 we 4 lmp1 7 samples 5 - 7 samples 6 negative 7 samples 7 samples 8 , 9 we 10 detected 10 detected 12 ebv 10 detected 19 using 11 the 12 ebv 12 ebv 17 eber 13 - 17 eber 14 encoded 17 eber 15 rna 17 eber 16 ( 17 eber 17 eber 18 ) 19 using 21 situ 19 using 22 hybridization 20 in 21 situ [the] [γ] - h2ax level was detected in npc cells cne1 before and after ebv infection using western blotting . 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 7 detected 0 ###LEFT-WALL### 20 . 3 - 4 h2ax 4 h2ax 5 level 4 h2ax 6 was 4 h2ax 7 detected 5 level 6 was 7 detected 8 in 7 detected 11 cne1 8 in 10 cells 9 npc 10 cells 11 cne1 13 and 12 before 13 and 13 and 14 after 14 after 16 infection 15 ebv 16 infection 16 infection 17 using 17 using 19 blotting 18 western 19 blotting results : [γ] - h2ax was expressed in most npc specimens ( 94 % ) , which was much higher than that in npi ( 40 % ) , and ebv was presented in 94 % of npc but only 30 % in npi . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 45 . 2 : 4 - 2 : 7 expressed 2 : 16 , 4 - 5 h2ax 5 h2ax 6 was 6 was 7 expressed 7 expressed 8 in 8 in 11 specimens 9 most 11 specimens 10 npc 11 specimens 11 specimens 14 % 12 ( 14 % 13 94 14 % 14 % 15 ) 16 , 17 which 16 , 18 was 16 , 30 and 17 which 18 was 18 was 19 much 19 much 20 higher 19 much 23 in 19 much 27 % 20 higher 21 than 21 than 22 that 23 in 24 npi 25 ( 27 % 26 40 27 % 27 % 28 ) 29 , 30 and 30 and 31 ebv 30 and 33 presented 31 ebv 32 was 32 was 33 presented 33 presented 34 in 33 presented 39 but 33 presented 43 in 34 in 36 % 35 94 36 % 36 % 37 of 37 of 38 npc 39 but 42 % 40 only 41 30 41 30 42 % 43 in 44 npi moreover , [γ] [-] h2ax was positive in 97.9 % of the ebv - positive specimens , which indicated the close correlation between [γ] [-] h2ax expression and ebv infection ( p<0.05 ) . 0 ###LEFT-WALL### 5 h2ax 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 34 . 1 moreover 2 , 1 moreover 5 h2ax 5 h2ax 6 was 6 was 7 positive 7 positive 8 in 8 in 10 % 9 97.9 10 % 10 % 11 of 10 % 16 specimens 11 of 13 ebv 12 the 13 ebv 14 - 16 specimens 15 positive 16 specimens 16 specimens 17 , 17 , 18 which 17 , 19 indicated 18 which 19 indicated 19 indicated 22 correlation 19 indicated 23 between 20 the 22 correlation 21 close 22 correlation 23 between 28 and 26 h2ax 27 expression 27 expression 28 and 28 and 30 infection 28 and 32 p<0.05 29 ebv 30 infection 31 ( 32 p<0.05 32 p<0.05 33 ) finally , western blotting showed that [γ] - h2ax level significantly increased in cne1 cells after ebv infection . 0 ###LEFT-WALL### 4 blotting 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 8 - 1 finally 2 , 1 finally 4 blotting 3 western 4 blotting 4 blotting 5 showed 5 showed 6 that 8 - 10 level 8 - 12 increased 8 - 19 . 9 h2ax 10 level 10 level 12 increased 11 significantly 12 increased 12 increased 13 in 12 increased 16 after 13 in 15 cells 14 cne1 15 cells 16 after 18 infection 17 ebv 18 infection conclusion : this study demonstrated that an intimate connection existed between [γ] [-] h2ax expression and ebv infection in [npc] both in vivo and in vitro . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 demonstrated 2 : 27 . 3 this 4 study 4 study 5 demonstrated 5 demonstrated 6 that 6 that 9 connection 6 that 10 existed 7 an 8 intimate 7 an 9 connection 8 intimate 9 connection 9 connection 10 existed 10 existed 11 between 10 existed 19 in 10 existed 24 and 11 between 16 and 14 h2ax 15 expression 15 expression 16 and 16 and 18 infection 17 ebv 18 infection 19 in 21 both 22 in 23 vivo 23 vivo 24 and 24 and 26 vitro 25 in 26 vitro ebv infection might induce dna damage in cne1 cells , which causes genome instability and initiates or promotes the tumorigenesis and development of npc . 0 ###LEFT-WALL### 2 infection 0 ###LEFT-WALL### 4 induce 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 25 . 1 ebv 2 infection 2 infection 3 might 3 might 4 induce 4 induce 6 damage 5 dna 6 damage 6 damage 7 in 7 in 9 cells 8 cne1 9 cells 10 , 11 which 10 , 15 and 11 which 15 and 12 causes 14 instability 12 causes 15 and 13 genome 14 instability 15 and 17 or 16 initiates 17 or 17 or 18 promotes 18 promotes 21 and 19 the 21 and 20 tumorigenesis 21 and 21 and 22 development 21 and 23 of 23 of 24 npc studies [of] face recognition in older adults ( 60 years of age and older ) report increases in false alarms over younger adults ( usually 18 - 30 years of age ) , but no age differences in hits . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 3 face 0 ###LEFT-WALL### 40 . 1 studies 3 face 3 face 4 recognition 3 face 5 in 3 face 34 but 5 in 7 adults 6 older 7 adults 7 adults 13 and 8 ( 13 and 9 60 10 years 10 years 11 of 10 years 13 and 11 of 12 age 13 and 17 increases 13 and 18 in 13 and 21 over 13 and 26 18 13 and 33 , 14 older 15 ) 14 older 16 report 16 report 17 increases 18 in 20 alarms 19 false 20 alarms 21 over 23 adults 22 younger 23 adults 24 ( 25 usually 24 ( 26 18 26 18 29 years 26 18 33 , 27 - 29 years 28 30 29 years 29 years 30 of 29 years 32 ) 30 of 31 age 34 but 37 differences 35 no 37 differences 36 age 37 differences 37 differences 38 in 38 in 39 hits to examine this phenomenon , we compared older and younger adults in categorical perception of faces . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 examine 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 17 . 1 to 2 examine 2 examine 4 phenomenon 3 this 4 phenomenon 5 , 6 we 5 , 7 compared 6 we 7 compared 7 compared 11 adults 7 compared 12 in 8 older 9 and 9 and 10 younger 9 and 11 adults 12 in 14 perception 13 categorical 14 perception 14 perception 15 of 15 of 16 faces we hypothesized that face representations in older adults would be broadly tuned , resulting in overlapping representations , manifested by a shallower slope in identity categorization than in younger adults , and age - related reductions in the advantage [for] [between] - categories , as compared [with] [within] - category , face discrimination . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesized 1 we 2 hypothesized 2 hypothesized 4 face 2 hypothesized 14 resulting 3 that 4 face 4 face 5 representations 4 face 10 be 4 face 12 tuned 5 representations 6 in 5 representations 9 would 6 in 8 adults 7 older 8 adults 9 would 10 be 11 broadly 12 tuned 13 , 14 resulting 14 resulting 15 in 14 resulting 19 manifested 15 in 17 representations 16 overlapping 17 representations 18 , 19 manifested 19 manifested 20 by 19 manifested 24 in 19 manifested 27 than 20 by 23 slope 21 a 23 slope 22 shallower 23 slope 24 in 26 categorization 25 identity 26 categorization 27 than 28 in 28 in 36 reductions 29 younger 30 adults 30 adults 32 and 31 , 32 and 32 and 33 age 32 and 34 - 32 and 35 related 32 and 36 reductions 36 reductions 37 in 36 reductions 43 categories 37 in 39 advantage 38 the 39 advantage 42 - 43 categories 43 categories 44 , 44 , 46 compared 45 as 46 compared 46 compared 49 - 46 compared 50 category 46 compared 54 . 50 category 53 discrimination 51 , 53 discrimination 52 face 53 discrimination 53 discrimination 54 . we morphed faces to change linearly from one identity to another . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 morphed 0 ###LEFT-WALL### 12 . 1 we 2 morphed 2 morphed 3 faces 2 morphed 4 to 4 to 5 change 5 change 6 linearly 5 change 7 from 5 change 10 to 7 from 9 identity 8 one 9 identity 10 to 11 another we used familiar or unfamiliar faces in separate conditions to examine the role of familiarity . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 0 ###LEFT-WALL### 16 . 1 we 2 used 2 used 6 faces 2 used 7 in 2 used 10 to 2 used 11 examine 3 familiar 4 or 4 or 5 unfamiliar 4 or 6 faces 7 in 9 conditions 8 separate 9 conditions 10 to 11 examine 11 examine 13 role 12 the 13 role 13 role 14 of 14 of 15 familiarity categorical perception was assessed in an identity [-] classification task and a discrimination task . 0 ###LEFT-WALL### 2 perception 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 15 . 1 categorical 2 perception 2 perception 3 was 3 was 4 assessed 4 assessed 5 in 5 in 11 and 6 an 10 task 7 identity 10 task 9 classification 10 task 10 task 11 and 11 and 14 task 12 a 13 discrimination 12 a 14 task 13 discrimination 14 task older adults showed a shallower slope and poorer discrimination compared with younger adults , and both groups exhibited better performance with familiar than unfamiliar faces . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 26 . 1 older 2 adults 2 adults 15 and 3 showed 7 and 3 showed 10 compared 3 showed 15 and 4 a 6 slope 5 shallower 6 slope 6 slope 7 and 7 and 9 discrimination 7 and 10 compared 8 poorer 9 discrimination 10 compared 11 with 11 with 13 adults 12 younger 13 adults 14 , 15 and 15 and 17 groups 15 and 21 with 16 both 17 groups 17 groups 20 performance 18 exhibited 20 performance 19 better 20 performance 21 with 25 faces 22 familiar 25 faces 23 than 24 unfamiliar 24 unfamiliar 25 faces enhanced discriminability for [between] [-] categories [as] compared [with] within [-] category faces was seen for both familiar and unfamiliar faces in younger adults , but only for familiar faces in older adults . 0 ###LEFT-WALL### 2 discriminability 0 ###LEFT-WALL### 15 seen 0 ###LEFT-WALL### 34 . 1 enhanced 2 discriminability 2 discriminability 3 for 2 discriminability 8 compared 2 discriminability 14 was 3 for 6 categories 8 compared 10 within 10 within 13 faces 12 category 13 faces 14 was 15 seen 15 seen 16 for 16 for 21 faces 17 both 21 faces 18 familiar 19 and 19 and 20 unfamiliar 19 and 21 faces 21 faces 26 but 21 faces 31 in 22 in 24 adults 22 in 26 but 23 younger 24 adults 25 , 26 but 26 but 27 only 26 but 28 for 28 for 30 faces 29 familiar 30 faces 31 in 33 adults 32 older 33 adults the more broadly tuned representations of unfamiliar faces in older adults may lead to misidentification and greater false alarms for unfamiliar faces , but not for familiar faces . 0 ###LEFT-WALL### 5 representations 0 ###LEFT-WALL### 13 lead 0 ###LEFT-WALL### 29 . 1 the 5 representations 2 more 3 broadly 3 broadly 4 tuned 4 tuned 5 representations 5 representations 6 of 5 representations 12 may 6 of 8 faces 7 unfamiliar 8 faces 8 faces 9 in 9 in 11 adults 10 older 11 adults 12 may 13 lead 13 lead 14 to 14 to 16 and 15 misidentification 16 and 16 and 19 alarms 16 and 24 but 17 greater 19 alarms 18 false 19 alarms 20 for 22 faces 20 for 24 but 21 unfamiliar 22 faces 23 , 24 but 24 but 25 not 24 but 26 for 26 for 28 faces 27 familiar 28 faces background : human aging is associated with dna methylation changes at specific sites in the genome . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 3 human 2 : 10 changes 3 human 4 aging 3 human 5 is 5 is 6 associated 6 associated 7 with 7 with 8 dna 8 dna 9 methylation 8 dna 10 changes 9 methylation 10 changes 10 changes 11 at 11 at 13 sites 12 specific 13 sites 13 sites 14 in 14 in 16 genome 15 the 16 genome these epigenetic modifications may be used to track donor age for forensic analysis or to estimate biological age . 0 ###LEFT-WALL### 3 modifications 0 ###LEFT-WALL### 14 or 0 ###LEFT-WALL### 19 . 1 these 3 modifications 2 epigenetic 3 modifications 3 modifications 14 or 4 may 5 be 4 may 14 or 5 be 6 used 6 used 7 to 6 used 8 track 7 to 8 track 8 track 10 age 9 donor 10 age 10 age 11 for 11 for 13 analysis 12 forensic 13 analysis 14 or 15 to 14 or 16 estimate 15 to 16 estimate 16 estimate 18 age 17 biological 18 age results : we perform a comprehensive analysis of methylation profiles to narrow down 102 age - related cpg sites in blood . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 perform 2 : 17 related 2 : 22 . 3 we 4 perform 4 perform 7 analysis 4 perform 11 to 5 a 7 analysis 6 comprehensive 7 analysis 7 analysis 8 of 8 of 10 profiles 9 methylation 10 profiles 11 to 12 narrow 12 narrow 13 down 13 down 15 age 14 102 15 age 16 - 17 related 17 related 19 sites 17 related 20 in 18 cpg 19 sites 20 in 21 blood we demonstrate that most of these age - associated methylation changes are reversed in induced pluripotent stem cells ( ipscs ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 demonstrate 0 ###LEFT-WALL### 8 - 1 we 2 demonstrate 2 demonstrate 3 that 3 that 4 most 3 that 7 age 4 most 5 of 4 most 7 age 5 of 6 these 8 - 11 changes 8 - 13 reversed 8 - 22 . 9 associated 10 methylation 10 methylation 11 changes 11 changes 12 are 12 are 13 reversed 13 reversed 14 in 14 in 18 cells 15 induced 16 pluripotent 16 pluripotent 18 cells 17 stem 18 cells 18 cells 20 ipscs 19 ( 20 ipscs 20 ipscs 21 ) methylation levels at three age - related cpgs -- located in the genes itga2b , aspa and pde4c -- were subsequently analyzed by bisulfite pyrosequencing of 151 blood samples . 0 ###LEFT-WALL### 1 methylation 0 ###LEFT-WALL### 2 levels 0 ###LEFT-WALL### 7 related 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 29 samples 0 ###LEFT-WALL### 30 . 1 methylation 2 levels 2 levels 3 at 3 at 5 age 4 three 5 age 6 - 7 related 7 related 8 cpgs 7 related 10 located 7 related 15 , 9 -- 10 located 10 located 11 in 10 located 15 , 11 in 14 itga2b 12 the 13 genes 13 genes 14 itga2b 15 , 17 and 15 , 22 analyzed 16 aspa 17 and 17 and 18 pde4c 17 and 19 -- 17 and 20 were 20 were 21 subsequently 20 were 22 analyzed 22 analyzed 23 by 23 by 24 bisulfite 24 bisulfite 25 pyrosequencing 24 bisulfite 29 samples 25 pyrosequencing 26 of 25 pyrosequencing 29 samples 26 of 28 blood 27 151 28 blood this epigenetic aging signature facilitates age predictions with a mean absolute deviation from chronological age of less than 5 years . 0 ###LEFT-WALL### 4 signature 0 ###LEFT-WALL### 5 facilitates 0 ###LEFT-WALL### 21 . 1 this 4 signature 2 epigenetic 4 signature 3 aging 4 signature 4 signature 5 facilitates 5 facilitates 7 predictions 5 facilitates 8 with 6 age 7 predictions 8 with 12 deviation 9 a 10 mean 9 a 12 deviation 10 mean 12 deviation 11 absolute 12 deviation 12 deviation 13 from 12 deviation 16 of 13 from 15 age 14 chronological 15 age 16 of 20 years 17 less 18 than 18 than 19 5 19 5 20 years this precision is higher than age predictions based on telomere length . 0 ###LEFT-WALL### 2 precision 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 12 . 1 this 2 precision 2 precision 3 is 3 is 4 higher 4 higher 5 than 5 than 7 predictions 6 age 7 predictions 7 predictions 8 based 8 based 9 on 9 on 11 length 10 telomere 11 length variation of age predictions correlates [moderately] with clinical and lifestyle parameters supporting the notion that age - associated methylation changes are associated more with biological age than with chronological age . 0 ###LEFT-WALL### 1 variation 0 ###LEFT-WALL### 5 correlates 0 ###LEFT-WALL### 17 - 1 variation 2 of 1 variation 5 correlates 2 of 4 predictions 3 age 4 predictions 5 correlates 7 with 7 with 9 and 8 clinical 9 and 9 and 11 parameters 9 and 12 supporting 9 and 15 that 9 and 16 age 10 lifestyle 11 parameters 12 supporting 14 notion 13 the 14 notion 15 that 16 age 17 - 20 changes 17 - 22 associated 17 - 31 . 18 associated 19 methylation 19 methylation 20 changes 20 changes 21 are 21 are 22 associated 22 associated 23 more 22 associated 24 with 22 associated 27 than 24 with 26 age 25 biological 26 age 27 than 28 with 28 with 30 age 29 chronological 30 age furthermore , patients with acquired aplastic anemia or dyskeratosis congenita -- two diseases associated with progressive bone marrow failure and severe telomere attrition -- are predicted to be prematurely aged . 0 ###LEFT-WALL### 8 or 0 ###LEFT-WALL### 10 congenita 0 ###LEFT-WALL### 26 predicted 0 ###LEFT-WALL### 31 . 1 furthermore 2 , 1 furthermore 8 or 3 patients 4 with 3 patients 8 or 4 with 7 anemia 5 acquired 7 anemia 6 aplastic 7 anemia 8 or 9 dyskeratosis 8 or 10 congenita 11 -- 26 predicted 12 two 13 diseases 13 diseases 14 associated 13 diseases 26 predicted 14 associated 15 with 15 with 18 marrow 16 progressive 17 bone 17 bone 18 marrow 18 marrow 20 and 18 marrow 25 are 19 failure 20 and 20 and 23 attrition 20 and 24 -- 20 and 25 are 21 severe 22 telomere 22 telomere 23 attrition 26 predicted 27 to 27 to 28 be 28 be 30 aged 29 prematurely 30 aged conclusions : our epigenetic aging signature provides a simple biomarker to estimate the state of aging in blood . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 6 signature 2 : 7 provides 3 our 6 signature 4 epigenetic 6 signature 5 aging 6 signature 6 signature 7 provides 7 provides 10 biomarker 7 provides 11 to 8 a 9 simple 8 a 10 biomarker 9 simple 10 biomarker 11 to 12 estimate 12 estimate 14 state 13 the 14 state 14 state 15 of 15 of 16 aging 16 aging 17 in 17 in 18 blood age - associated dna methylation changes are counteracted in ipscs . 0 ###LEFT-WALL### 6 changes 0 ###LEFT-WALL### 8 counteracted 0 ###LEFT-WALL### 11 . 1 age 2 - 1 age 6 changes 3 associated 6 changes 4 dna 6 changes 5 methylation 6 changes 6 changes 7 are 7 are 8 counteracted 8 counteracted 9 in 9 in 10 ipscs on the other hand , [over] - estimation of chronological age in bone marrow failure syndromes is indicative for exhaustion of the hematopoietic cell pool . 0 ###LEFT-WALL### 4 hand 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 26 . 1 on 3 other 1 on 4 hand 2 the 3 other 5 , 7 - 5 , 17 is 7 - 8 estimation 8 estimation 9 of 8 estimation 17 is 9 of 11 age 10 chronological 11 age 11 age 12 in 12 in 16 syndromes 13 bone 16 syndromes 14 marrow 16 syndromes 15 failure 16 syndromes 17 is 18 indicative 18 indicative 19 for 19 for 20 exhaustion 20 exhaustion 21 of 21 of 25 pool 22 the 25 pool 23 hematopoietic 24 cell 24 cell 25 pool thus , epigenetic changes upon aging seem to reflect biological aging of blood . 0 ###LEFT-WALL### 4 changes 0 ###LEFT-WALL### 7 seem 0 ###LEFT-WALL### 14 . 1 thus 2 , 1 thus 4 changes 3 epigenetic 4 changes 4 changes 5 upon 4 changes 7 seem 5 upon 6 aging 7 seem 8 to 7 seem 9 reflect 8 to 9 reflect 9 reflect 11 aging 10 biological 11 aging 11 aging 12 of 12 of 13 blood muscle loss and wasting [occurs] with aging and in multiple disease states including cancer , heart failure , chronic obstructive pulmonary disease , end - stage liver disease , end - stage renal disease and hiv . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 24 end 0 ###LEFT-WALL### 25 - 0 ###LEFT-WALL### 37 . 1 muscle 2 loss 2 loss 3 and 3 and 4 wasting 3 and 8 and 3 and 24 end 6 with 7 aging 6 with 8 and 8 and 9 in 9 in 12 states 10 multiple 11 disease 11 disease 12 states 12 states 13 including 12 states 17 failure 12 states 22 disease 13 including 14 cancer 15 , 17 failure 16 heart 17 failure 17 failure 18 , 18 , 22 disease 19 chronic 22 disease 20 obstructive 22 disease 21 pulmonary 22 disease 22 disease 23 , 25 - 28 disease 25 - 29 , 26 stage 27 liver 27 liver 28 disease 29 , 30 end 29 , 31 - 31 - 35 and 32 stage 34 disease 33 renal 34 disease 34 disease 35 and 35 and 36 hiv cachexia is defined as a multifactorial syndrome that is associated with anorexia , weight loss and increased catabolism , with increased morbidity and mortality . 0 ###LEFT-WALL### 1 cachexia 0 ###LEFT-WALL### 3 defined 0 ###LEFT-WALL### 25 . 1 cachexia 2 is 2 is 3 defined 3 defined 4 as 3 defined 20 with 4 as 7 syndrome 5 a 6 multifactorial 5 a 7 syndrome 6 multifactorial 7 syndrome 7 syndrome 10 associated 7 syndrome 16 and 8 that 9 is 9 is 10 associated 10 associated 11 with 11 with 12 anorexia 13 , 16 and 14 weight 15 loss 15 loss 16 and 16 and 18 catabolism 16 and 19 , 17 increased 18 catabolism 20 with 23 and 21 increased 22 morbidity 22 morbidity 23 and 23 and 24 mortality currently no therapy is approved for the treatment or prevention of cachexia . 0 ###LEFT-WALL### 3 therapy 0 ###LEFT-WALL### 5 approved 0 ###LEFT-WALL### 13 . 1 currently 3 therapy 2 no 3 therapy 3 therapy 4 is 4 is 5 approved 5 approved 6 for 6 for 9 or 7 the 8 treatment 8 treatment 9 or 9 or 10 prevention 9 or 11 of 11 of 12 cachexia different treatment options have been suggested but many have proven to be ineffective or associated with adverse events . 0 ###LEFT-WALL### 3 options 0 ###LEFT-WALL### 6 suggested 0 ###LEFT-WALL### 7 but 0 ###LEFT-WALL### 19 . 1 different 2 treatment 2 treatment 3 options 3 options 4 have 4 have 5 been 5 been 6 suggested 7 but 8 many 7 but 10 proven 8 many 9 have 9 have 10 proven 10 proven 11 to 10 proven 14 or 11 to 14 or 12 be 13 ineffective 12 be 14 or 14 or 15 associated 14 or 16 with 16 with 18 events 17 adverse 18 events nonsteroidal selective androgen receptor modulators ( sarms ) are a new class of anabolic agents that bind the androgen receptor and exhibit tissue selectivity . 0 ###LEFT-WALL### 5 modulators 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 25 . 1 nonsteroidal 5 modulators 2 selective 3 androgen 3 androgen 5 modulators 4 receptor 5 modulators 5 modulators 7 sarms 5 modulators 9 are 6 ( 7 sarms 7 sarms 8 ) 9 are 21 and 10 a 11 new 10 a 12 class 11 new 12 class 12 class 13 of 12 class 21 and 13 of 15 agents 14 anabolic 15 agents 15 agents 16 that 15 agents 17 bind 16 that 17 bind 17 bind 20 receptor 18 the 20 receptor 19 androgen 20 receptor 21 and 24 selectivity 22 exhibit 24 selectivity 23 tissue 24 selectivity enobosarm ( gtx - 024 , s - 22 ) is a recently developed sarm , developed by gtx , inc . 0 ###LEFT-WALL### 1 enobosarm 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 22 . 1 enobosarm 3 gtx 1 enobosarm 5 024 1 enobosarm 8 - 1 enobosarm 16 , 2 ( 3 gtx 3 gtx 4 - 4 - 5 024 5 024 6 , 6 , 8 - 7 s 8 - 8 - 9 22 8 - 10 ) 11 is 15 sarm 11 is 16 , 12 a 15 sarm 13 recently 14 developed 14 developed 15 sarm 16 , 17 developed 16 , 18 by 18 by 21 inc 19 gtx 21 inc 20 , 21 inc ( tn , usa [ )(, which has been tested in phase i , [ii] and [iii] trials with promising results in terms of improving lean body mass [and] measurements of physical function [and] power . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 26 lean 0 ###LEFT-WALL### 36 . 1 ( 2 tn 2 tn 3 , 2 tn 16 and 4 usa 7 which 4 usa 16 and 6 )(, 7 which 7 which 8 has 7 which 14 , 8 has 9 been 9 been 10 tested 10 tested 11 in 11 in 12 phase 12 phase 13 i 14 , 16 and 16 and 18 trials 16 and 19 with 16 and 22 in 16 and 24 of 16 and 26 lean 19 with 20 promising 20 promising 21 results 22 in 23 terms 24 of 25 improving 26 lean 30 measurements 27 body 28 mass 28 mass 30 measurements 30 measurements 31 of 31 of 35 power 32 physical 35 power 33 function 35 power enobosarm has received fast track designation by the us fda and results from the phase iii trials power1 and power2 will help determine approval for use in the prevention and treatment of muscle wasting in patients with [non] [-] small - cell lung cancer . 0 ###LEFT-WALL### 1 enobosarm 0 ###LEFT-WALL### 2 has 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 23 determine 0 ###LEFT-WALL### 45 . 1 enobosarm 2 has 2 has 6 designation 3 received 6 designation 4 fast 5 track 5 track 6 designation 6 designation 7 by 7 by 10 fda 8 the 10 fda 9 us 10 fda 11 and 19 and 11 and 22 help 12 results 13 from 12 results 19 and 13 from 18 power1 14 the 17 trials 15 phase 16 iii 15 phase 17 trials 17 trials 18 power1 19 and 20 power2 19 and 21 will 21 will 22 help 22 help 23 determine 23 determine 24 approval 23 determine 25 for 23 determine 27 in 23 determine 37 with 25 for 26 use 27 in 30 and 28 the 29 prevention 29 prevention 30 and 30 and 31 treatment 30 and 32 of 32 of 34 wasting 33 muscle 34 wasting 34 wasting 35 in 35 in 36 patients 37 with 44 cancer 40 small 41 - 40 small 44 cancer 42 cell 43 lung 43 lung 44 cancer this article provides an introduction to enobosarm as a new therapeutic strategy for the prevention and treatment of cachexia . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 20 . 1 this 2 article 2 article 3 provides 3 provides 5 introduction 3 provides 6 to 3 provides 8 as 4 an 5 introduction 6 to 7 enobosarm 8 as 12 strategy 9 a 10 new 9 a 12 strategy 10 new 12 strategy 11 therapeutic 12 strategy 12 strategy 13 for 12 strategy 18 of 13 for 16 and 14 the 15 prevention 15 prevention 16 and 16 and 17 treatment 18 of 19 cachexia a review of the literature was performed using search terms ' cachexia ['] , ['] sarcopenia ['] , ['] sarm ['] , ['] enobosarm ['] and ['] gtx - [024] ['] in september 2013 using multiple databases as well as online resources . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 7 performed 1 a 2 review 2 review 3 of 2 review 6 was 3 of 5 literature 4 the 5 literature 6 was 7 performed 7 performed 8 using 8 using 20 sarm 9 search 10 terms 10 terms 11 ' 11 ' 20 sarm 12 cachexia 14 , 12 cachexia 20 sarm 16 sarcopenia 18 , 16 sarcopenia 20 sarm 20 sarm 26 and 20 sarm 32 in 22 , 26 and 24 enobosarm 26 and 26 and 28 gtx 26 and 29 - 29 - 32 in 32 in 37 databases 32 in 43 . 33 september 36 multiple 34 2013 36 multiple 35 using 36 multiple 36 multiple 37 databases 37 databases 40 as 38 as 39 well 39 well 40 as 40 as 42 resources 41 online 42 resources none none none background : despite widespread use of multivitamin supplements , their effect on cognitive health - a critical issue with aging - remains inconclusive . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 25 remains 0 ###LEFT-WALL### 27 . 1 none 4 background 1 none 5 : 1 none 25 remains 2 none 3 none 3 none 4 background 4 background 5 : 5 : 6 despite 6 despite 8 use 7 widespread 8 use 8 use 9 of 9 of 11 supplements 10 multivitamin 11 supplements 11 supplements 14 effect 11 supplements 21 issue 12 , 14 effect 13 their 14 effect 14 effect 15 on 14 effect 18 - 15 on 17 health 16 cognitive 17 health 18 - 21 issue 19 a 21 issue 20 critical 21 issue 21 issue 22 with 21 issue 24 - 22 with 23 aging 25 remains 26 inconclusive to date , no long - term clinical trials have studied multivitamin use and cognitive decline in older persons . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 date 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 20 . 1 to 2 date 3 , 7 term 3 , 11 studied 4 no 7 term 5 long 6 - 5 long 7 term 7 term 9 trials 7 term 10 have 7 term 11 studied 8 clinical 9 trials 9 trials 10 have 11 studied 14 and 11 studied 17 in 12 multivitamin 13 use 13 use 14 and 14 and 16 decline 15 cognitive 16 decline 17 in 19 persons 18 older 19 persons objective : to evaluate whether long - term multivitamin supplementation affects cognitive health in later life . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 2 : 17 . 3 to 4 evaluate 4 evaluate 5 whether 5 whether 10 supplementation 5 whether 11 affects 6 long 7 - 6 long 8 term 8 term 10 supplementation 9 multivitamin 10 supplementation 10 supplementation 11 affects 11 affects 13 health 11 affects 14 in 12 cognitive 13 health 14 in 16 life 15 later 16 life design : randomized , double - blind , placebo - controlled trial [of] [a] multivitamin from 1997 to 1 june 2011 . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 3 randomized 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 22 . 1 design 2 : 2 : 3 randomized 4 , 9 placebo 4 , 10 - 5 double 6 - 5 double 9 placebo 7 blind 8 , 7 blind 9 placebo 10 - 15 multivitamin 11 controlled 15 multivitamin 12 trial 15 multivitamin 15 multivitamin 16 from 16 from 20 june 17 1997 18 to 18 to 19 1 18 to 20 june 20 june 21 2011 the cognitive function substudy began in 1998 . 0 ###LEFT-WALL### 4 substudy 0 ###LEFT-WALL### 5 began 0 ###LEFT-WALL### 8 . 1 the 4 substudy 2 cognitive 3 function 3 function 4 substudy 4 substudy 5 began 5 began 6 in 6 in 7 1998 up to 4 repeated cognitive assessments by telephone interview were completed over 12 years . 0 ###LEFT-WALL### 3 4 0 ###LEFT-WALL### 11 completed 0 ###LEFT-WALL### 15 . 1 up 2 to 2 to 3 4 3 4 4 repeated 3 4 6 assessments 3 4 9 interview 3 4 10 were 5 cognitive 6 assessments 6 assessments 9 interview 7 by 8 telephone 8 telephone 9 interview 10 were 11 completed 11 completed 12 over 12 over 14 years 13 12 14 years [(] clinicaltrials.gov : nct00270647 ) setting : the physicians ' health study ii . 0 ###LEFT-WALL### 2 clinicaltrials.gov 0 ###LEFT-WALL### 3 : 3 : 6 setting 3 : 7 : 3 : 14 . 4 nct00270647 5 ) 4 nct00270647 6 setting 6 setting 7 : 7 : 12 study 8 the 9 physicians 9 physicians 10 ' 10 ' 12 study 11 health 12 study 12 study 13 ii patients : 5947 male physicians aged 65 years or older . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 . 1 patients 2 : 2 : 5 physicians 3 5947 5 physicians 4 male 5 physicians 5 physicians 6 aged 6 aged 9 or 7 65 8 years 8 years 9 or 9 or 10 older intervention : daily multivitamin or placebo . 0 ###LEFT-WALL### 1 intervention 0 ###LEFT-WALL### 2 : 2 : 5 or 2 : 7 . 3 daily 4 multivitamin 4 multivitamin 5 or 5 or 6 placebo measurements : a global composite score averaging 5 tests of global cognition , verbal memory , and category fluency . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 measurements 2 : 2 : 17 and 3 a 4 global 3 a 6 score 4 global 6 score 5 composite 6 score 6 score 7 averaging 6 score 10 of 6 score 13 , 7 averaging 9 tests 8 5 9 tests 10 of 12 cognition 11 global 12 cognition 13 , 15 memory 13 , 17 and 14 verbal 15 memory 16 , 17 and 17 and 19 fluency 18 category 19 fluency the secondary end point was a verbal memory score combining 4 tests of verbal memory , which is a strong predictor of alzheimer disease . 0 ###LEFT-WALL### 4 point 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 the 4 point 2 secondary 3 end 3 end 4 point 4 point 5 was 5 was 9 score 6 a 7 verbal 6 a 9 score 7 verbal 8 memory 8 memory 9 score 9 score 10 combining 9 score 13 of 10 combining 12 tests 11 4 12 tests 13 of 15 memory 14 verbal 15 memory 16 , 17 which 16 , 18 is 17 which 18 is 18 is 21 predictor 19 a 20 strong 19 a 21 predictor 20 strong 21 predictor 21 predictor 22 of 22 of 24 disease 23 alzheimer 24 disease results : no difference was found in mean cognitive change over time between the multivitamin and placebo groups or in the mean level of cognition at any of the 4 assessments . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 difference 2 : 6 found 2 : 32 . 3 no 4 difference 4 difference 5 was 5 was 6 found 6 found 7 in 6 found 11 over 6 found 26 at 7 in 10 change 8 mean 10 change 9 cognitive 10 change 11 over 12 time 12 time 19 or 13 between 16 and 13 between 19 or 14 the 15 multivitamin 15 multivitamin 16 and 16 and 18 groups 17 placebo 18 groups 19 or 20 in 20 in 23 level 21 the 23 level 22 mean 23 level 23 level 24 of 24 of 25 cognition 26 at 27 any 27 any 28 of 28 of 31 assessments 29 the 30 4 30 4 31 assessments specifically , for the global composite score , the mean difference in cognitive change over [follow] - up was - 0.01 su ( 95 % ci , - 0.04 to 0.02 su ) when treatment was compared [with] [placebo] . 0 ###LEFT-WALL### 11 difference 0 ###LEFT-WALL### 19 was 0 ###LEFT-WALL### 40 . 1 specifically 11 difference 2 , 3 for 3 for 7 score 3 for 8 , 3 for 11 difference 4 the 7 score 5 global 7 score 6 composite 7 score 9 the 11 difference 10 mean 11 difference 11 difference 12 in 11 difference 15 over 11 difference 19 was 12 in 14 change 13 cognitive 14 change 15 over 18 up 17 - 18 up 19 was 22 su 19 was 34 when 20 - 21 0.01 21 0.01 22 su 22 su 26 ci 22 su 32 su 23 ( 26 ci 24 95 26 ci 25 % 26 ci 26 ci 27 , 28 - 32 su 29 0.04 30 to 30 to 31 0.02 30 to 32 su 32 su 33 ) 34 when 35 treatment 34 when 37 compared 35 treatment 36 was 36 was 37 compared similarly , cognitive performance did not differ between the multivitamin and placebo groups on the secondary outcome , verbal memory ( mean [difference] in cognitive change over [follow] - up , - 0.005 su [ ci , - 0.04 to 0.03 su ] ) . 0 ###LEFT-WALL### 4 performance 0 ###LEFT-WALL### 7 differ 0 ###LEFT-WALL### 45 . 1 similarly 2 , 1 similarly 4 performance 3 cognitive 4 performance 4 performance 5 did 5 did 6 not 5 did 7 differ 7 differ 8 between 7 differ 14 on 8 between 11 and 9 the 10 multivitamin 10 multivitamin 11 and 11 and 13 groups 12 placebo 13 groups 14 on 17 outcome 15 the 17 outcome 16 secondary 17 outcome 17 outcome 20 memory 18 , 20 memory 19 verbal 20 memory 20 memory 22 mean 20 memory 34 su 20 memory 44 ) 21 ( 22 mean 22 mean 24 in 22 mean 27 over 22 mean 31 , 24 in 26 change 25 cognitive 26 change 27 over 30 up 29 - 30 up 32 - 34 su 33 0.005 34 su 34 su 36 ci 34 su 44 ) 35 [ 36 ci 36 ci 42 su 36 ci 44 ) 37 , 42 su 38 - 40 to 39 0.04 40 to 40 to 41 0.03 40 to 42 su 42 su 43 ] limitation : doses of vitamins may be too low or the population may be too well - nourished to benefit from a multivitamin . 0 ###LEFT-WALL### 1 limitation 0 ###LEFT-WALL### 2 : 2 : 3 doses 2 : 7 be 2 : 10 or 3 doses 4 of 3 doses 6 may 4 of 5 vitamins 6 may 7 be 7 be 9 low 8 too 9 low 10 or 12 population 10 or 14 be 11 the 12 population 12 population 13 may 13 may 14 be 14 be 15 too 14 be 16 well 14 be 18 nourished 17 - 18 nourished 18 nourished 19 to 18 nourished 24 . 19 to 20 benefit 20 benefit 21 from 21 from 23 multivitamin 22 a 23 multivitamin conclusion : in male physicians aged 65 years or older , long - term use of a daily multivitamin did not provide cognitive benefits . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 - 1 conclusion 2 : 2 : 3 in 3 in 5 physicians 4 male 5 physicians 5 physicians 6 aged 6 aged 9 or 6 aged 11 , 6 aged 12 long 7 65 8 years 8 years 9 or 9 or 10 older 13 - 15 use 13 - 22 provide 13 - 25 . 14 term 15 use 15 use 16 of 15 use 20 did 16 of 19 multivitamin 17 a 19 multivitamin 18 daily 19 multivitamin 20 did 21 not 20 did 22 provide 22 provide 24 benefits 23 cognitive 24 benefits primary funding source : national institutes of health , basf , pfizer , and dsm nutritional products . 0 ###LEFT-WALL### 3 source 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 18 . 1 primary 2 funding 2 funding 3 source 3 source 4 : 4 : 6 institutes 5 national 6 institutes 6 institutes 7 of 7 of 14 and 8 health 9 , 9 , 10 basf 9 , 14 and 10 basf 12 pfizer 11 , 12 pfizer 12 pfizer 13 , 13 , 14 and 14 and 17 products 15 dsm 16 nutritional 16 nutritional 17 products resveratrol , a phenolic compound found in various plants , including grapes , berries , and peanuts , shows promise for the treatment of cancer , aging , type 2 diabetes , and cardiovascular diseases . 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 36 . 1 resveratrol 5 compound 1 resveratrol 11 including 1 resveratrol 13 , 2 , 5 compound 3 a 4 phenolic 3 a 5 compound 4 phenolic 5 compound 5 compound 6 found 5 compound 10 , 6 found 7 in 7 in 9 plants 8 various 9 plants 11 including 12 grapes 13 , 14 berries 13 , 16 and 15 , 16 and 16 and 17 peanuts 16 and 18 , 16 and 19 shows 16 and 20 promise 16 and 33 and 19 shows 20 promise 20 promise 21 for 21 for 23 treatment 22 the 23 treatment 23 treatment 24 of 23 treatment 31 diabetes 24 of 25 cancer 25 cancer 27 aging 26 , 27 aging 27 aging 28 , 28 , 31 diabetes 29 type 31 diabetes 30 2 31 diabetes 31 diabetes 32 , 33 and 35 diseases 34 cardiovascular 35 diseases resveratrol can promote transcription factor nuclear factor [-] erythroid [2] - related factor 2 ( nrf2 ) activation , increase the expression level of sirt - 1 , which is a sirtuin family protein , and reduce mtor pathway signaling . 0 ###LEFT-WALL### 1 resveratrol 0 ###LEFT-WALL### 3 promote 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 41 . 1 resveratrol 2 can 2 can 3 promote 3 promote 18 activation 4 transcription 18 activation 5 factor 18 activation 6 nuclear 7 factor 7 factor 18 activation 9 erythroid 13 factor 9 erythroid 18 activation 11 - 13 factor 12 related 13 factor 13 factor 14 2 13 factor 16 nrf2 13 factor 17 ) 15 ( 16 nrf2 16 nrf2 17 ) 19 , 36 and 20 increase 23 level 20 increase 36 and 21 the 23 level 22 expression 23 level 23 level 24 of 24 of 25 sirt 25 sirt 27 1 26 - 27 1 27 1 29 which 27 1 35 , 28 , 29 which 29 which 30 is 29 which 35 , 30 is 34 protein 31 a 34 protein 32 sirtuin 34 protein 33 family 34 protein 36 and 37 reduce 37 reduce 40 signaling 38 mtor 40 signaling 39 pathway 40 signaling this compound has anti - inflammatory properties in that it inhibits or antagonizes the nuclear factor - κb ( nf - κb ) activity , which is a redox - sensitive transcription factor that coordinates the inflammatory response . 0 ###LEFT-WALL### 2 compound 0 ###LEFT-WALL### 3 has 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 35 coordinates 0 ###LEFT-WALL### 39 . 1 this 2 compound 2 compound 3 has 3 has 7 properties 3 has 9 that 4 anti 5 - 4 anti 7 properties 6 inflammatory 7 properties 8 in 9 that 9 that 10 it 9 that 12 or 10 it 12 or 11 inhibits 12 or 12 or 13 antagonizes 12 or 16 factor 14 the 16 factor 15 nuclear 16 factor 16 factor 24 activity 17 - 24 activity 18 κb 20 nf 18 κb 24 activity 19 ( 20 nf 20 nf 21 - 22 κb 23 ) 22 κb 24 activity 24 activity 25 , 25 , 26 which 25 , 27 is 26 which 27 is 27 is 33 factor 28 a 29 redox 28 a 33 factor 29 redox 30 - 29 redox 33 factor 31 sensitive 32 transcription 32 transcription 33 factor 33 factor 34 that 33 factor 35 coordinates 34 that 35 coordinates 35 coordinates 38 response 36 the 38 response 37 inflammatory 38 response inflammation and oxidative stress , which are common features in patients with chronic kidney disease ( ckd ) , are interrelated and associated with cardiovascular disease and the progression of ckd itself . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 33 . 1 inflammation 2 and 2 and 4 stress 2 and 6 which 2 and 20 are 3 oxidative 4 stress 5 , 6 which 6 which 7 are 6 which 19 , 7 are 9 features 8 common 9 features 9 features 10 in 10 in 11 patients 11 patients 12 with 11 patients 17 ckd 12 with 15 disease 13 chronic 14 kidney 14 kidney 15 disease 16 ( 17 ckd 17 ckd 18 ) 20 are 22 and 21 interrelated 22 and 22 and 23 associated 22 and 32 itself 23 associated 24 with 24 with 27 and 25 cardiovascular 26 disease 26 disease 27 and 27 and 29 progression 27 and 30 of 28 the 29 progression 30 of 31 ckd because of the modulation of the mechanisms involved in the inflammatory - oxidative stress cycle , resveratrol could play an important role in controlling ckd - related metabolic derangements . 0 ###LEFT-WALL### 17 resveratrol 0 ###LEFT-WALL### 19 play 0 ###LEFT-WALL### 27 related 1 because 2 of 1 because 16 , 1 because 17 resveratrol 2 of 4 modulation 3 the 4 modulation 4 modulation 5 of 5 of 7 mechanisms 6 the 7 mechanisms 7 mechanisms 8 involved 8 involved 9 in 9 in 15 cycle 10 the 15 cycle 11 inflammatory 12 - 11 inflammatory 14 stress 13 oxidative 14 stress 14 stress 15 cycle 17 resveratrol 18 could 18 could 19 play 19 play 22 role 19 play 23 in 20 an 21 important 20 an 22 role 21 important 22 role 23 in 24 controlling 24 controlling 25 ckd 26 - 27 related 27 related 29 derangements 27 related 30 . 28 metabolic 29 derangements although resveratrol supplementation in theory is [a] promising therapy in this patient group , there are no studies evaluating its effects . 0 ###LEFT-WALL### 15 there 0 ###LEFT-WALL### 16 are 0 ###LEFT-WALL### 22 . 1 although 3 supplementation 1 although 6 is 1 although 14 , 1 although 15 there 2 resveratrol 3 supplementation 3 supplementation 4 in 3 supplementation 6 is 4 in 5 theory 6 is 8 promising 8 promising 9 therapy 8 promising 10 in 10 in 13 group 11 this 13 group 12 patient 13 group 15 there 16 are 16 are 18 studies 17 no 18 studies 18 studies 19 evaluating 19 evaluating 21 effects 20 its 21 effects thus , the present review aims to describe the role of resveratrol in inflammation and oxidative stress modulation and its possible benefits to patients with ckd . 0 ###LEFT-WALL### 5 review 0 ###LEFT-WALL### 6 aims 0 ###LEFT-WALL### 27 . 1 thus 2 , 1 thus 5 review 3 the 5 review 4 present 5 review 5 review 6 aims 6 aims 7 to 6 aims 8 describe 7 to 8 describe 8 describe 10 role 8 describe 13 in 8 describe 23 to 8 describe 25 with 9 the 10 role 10 role 11 of 11 of 12 resveratrol 13 in 19 and 14 inflammation 15 and 15 and 18 modulation 15 and 19 and 16 oxidative 17 stress 17 stress 18 modulation 19 and 22 benefits 20 its 22 benefits 21 possible 22 benefits 23 to 24 patients 25 with 26 ckd background : among senior drivers , benzodiazepines ( bzds ) have a documented effect on the risk of road traffic crashes ( rtcs ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 25 . 1 background 2 : 2 : 3 among 3 among 5 drivers 4 senior 5 drivers 6 , 7 benzodiazepines 6 , 11 have 7 benzodiazepines 9 bzds 7 benzodiazepines 11 have 8 ( 9 bzds 9 bzds 10 ) 11 have 14 effect 11 have 15 on 12 a 14 effect 13 documented 14 effect 15 on 17 risk 16 the 17 risk 17 risk 18 of 18 of 21 crashes 19 road 21 crashes 20 traffic 21 crashes 21 crashes 23 rtcs 22 ( 23 rtcs 23 rtcs 24 ) it remains unclear [however] if bzds play the same role when considering marital status . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 remains 0 ###LEFT-WALL### 15 . 1 it 2 remains 2 remains 3 unclear 3 unclear 5 if 5 if 6 bzds 5 if 7 play 6 bzds 7 play 7 play 10 role 7 play 11 when 8 the 9 same 9 same 10 role 11 when 12 considering 12 considering 14 status 13 marital 14 status therefore , we aimed to investigate the role of marital status in the association between bzd use and injurious rtcs among senior drivers . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 aimed 0 ###LEFT-WALL### 24 . 1 therefore 2 , 1 therefore 3 we 3 we 4 aimed 4 aimed 5 to 4 aimed 6 investigate 5 to 6 investigate 6 investigate 8 role 6 investigate 12 in 6 investigate 15 between 6 investigate 21 among 7 the 8 role 8 role 9 of 9 of 11 status 10 marital 11 status 12 in 14 association 13 the 14 association 15 between 18 and 16 bzd 17 use 17 use 18 and 18 and 20 rtcs 19 injurious 20 rtcs 21 among 23 drivers 22 senior 23 drivers methods : matched case - control study based on five national swedish registers ( n = [154] 225 ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 case 2 : 5 - 3 matched 4 case 5 - 6 control 5 - 20 . 6 control 7 study 6 control 16 = 7 study 8 based 8 based 9 on 9 on 13 registers 10 five 13 registers 11 national 13 registers 12 swedish 13 registers 14 ( 16 = 15 n 16 = 16 = 18 225 16 = 19 ) cases comprised the first [non] - alcohol - related injurious rtc sustained by drivers aged 50 - 80 years from july 2005 to december 2009 and controls included registered residents with a valid license who did not crash during that period . 0 ###LEFT-WALL### 1 cases 0 ###LEFT-WALL### 2 comprised 0 ###LEFT-WALL### 9 related 0 ###LEFT-WALL### 42 . 1 cases 2 comprised 2 comprised 4 first 3 the 4 first 4 first 7 alcohol 6 - 7 alcohol 7 alcohol 8 - 8 - 9 related 9 related 11 rtc 10 injurious 11 rtc 11 rtc 12 sustained 11 rtc 26 and 12 sustained 13 by 13 by 14 drivers 15 aged 17 - 15 aged 20 from 15 aged 23 to 15 aged 26 and 16 50 17 - 17 - 18 80 18 80 19 years 19 years 20 from 20 from 21 july 21 july 22 2005 23 to 24 december 24 december 25 2009 26 and 27 controls 27 controls 30 residents 27 controls 31 with 28 included 30 residents 29 registered 30 residents 31 with 34 license 31 with 39 during 32 a 34 license 33 valid 34 license 34 license 35 who 34 license 36 did 35 who 36 did 36 did 37 not 36 did 38 crash 39 during 41 period 40 that 41 period four controls were matched to each case by sex , age and place of residence . 0 ###LEFT-WALL### 2 controls 0 ###LEFT-WALL### 4 matched 0 ###LEFT-WALL### 16 . 1 four 2 controls 2 controls 3 were 3 were 4 matched 4 matched 5 to 4 matched 8 by 5 to 7 case 6 each 7 case 8 by 12 and 9 sex 10 , 10 , 11 age 10 , 12 and 12 and 13 place 12 and 14 of 14 of 15 residence conditional logistic regression analysis for injurious rtc was performed with adjustment for occupation [and] number [of] medications . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 9 performed 0 ###LEFT-WALL### 18 . 1 conditional 2 logistic 2 logistic 4 analysis 3 regression 4 analysis 4 analysis 5 for 4 analysis 8 was 5 for 7 rtc 6 injurious 7 rtc 8 was 9 performed 9 performed 10 with 9 performed 12 for 10 with 11 adjustment 12 for 17 medications 13 occupation 17 medications 15 number 17 medications the main exposure was dispensation of bzds , [alone] or [in] combination with other psychotropic medications , 1 - 30 days prior to the crash date stratified by marital status . 0 ###LEFT-WALL### 3 exposure 0 ###LEFT-WALL### 4 was 1 the 2 main 1 the 3 exposure 3 exposure 4 was 4 was 5 dispensation 5 dispensation 6 of 5 dispensation 13 with 6 of 10 or 7 bzds 10 or 8 , 10 or 10 or 12 combination 13 with 16 medications 14 other 16 medications 15 psychotropic 16 medications 16 medications 22 prior 17 , 22 prior 18 1 22 prior 19 - 20 30 20 30 21 days 21 days 22 prior 22 prior 23 to 22 prior 27 stratified 22 prior 28 by 22 prior 31 . 23 to 26 date 24 the 26 date 25 crash 26 date 28 by 30 status 29 marital 30 status compared to married drivers , those divorced ( 1.48 , 1.43 - 1.53 ) and widowed [(] 1.54 ; 1.45 - 1.63 ) had higher adjusted ors . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 19 ; 0 ###LEFT-WALL### 28 . 1 compared 2 to 1 compared 15 and 2 to 4 drivers 3 married 4 drivers 4 drivers 6 those 4 drivers 12 - 5 , 6 those 6 those 7 divorced 6 those 9 1.48 6 those 10 , 8 ( 9 1.48 9 1.48 10 , 10 , 12 - 11 1.43 12 - 12 - 13 1.53 12 - 14 ) 15 and 16 widowed 15 and 18 1.54 19 ; 20 1.45 19 ; 24 had 20 1.45 22 1.63 20 1.45 24 had 21 - 22 1.63 22 1.63 23 ) 24 had 27 ors 25 higher 27 ors 26 adjusted 27 ors marital status modified the association between bzds and rtcs , particularly among younger male drivers . 0 ###LEFT-WALL### 2 status 0 ###LEFT-WALL### 3 modified 0 ###LEFT-WALL### 16 . 1 marital 2 status 2 status 3 modified 3 modified 5 association 3 modified 6 between 3 modified 11 particularly 4 the 5 association 6 between 8 and 7 bzds 8 and 8 and 9 rtcs 8 and 10 , 11 particularly 12 among 12 among 15 drivers 13 younger 15 drivers 14 male 15 drivers conclusions : both bzds and marital status independently affect the risk for senior drivers to be involved in an rtc . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 and 2 : 9 affect 2 : 21 . 3 both 5 and 4 bzds 5 and 5 and 7 status 5 and 9 affect 6 marital 7 status 8 independently 9 affect 9 affect 11 risk 9 affect 12 for 9 affect 15 to 10 the 11 risk 12 for 14 drivers 13 senior 14 drivers 15 to 16 be 16 be 17 involved 17 involved 18 in 18 in 20 rtc 19 an 20 rtc however , marital status plays a role in the association between bzd use and rtcs and this may have implications for targeting risk populations for rtcs among senior drivers . 0 ###LEFT-WALL### 4 status 0 ###LEFT-WALL### 5 plays 0 ###LEFT-WALL### 30 . 1 however 2 , 1 however 4 status 3 marital 4 status 4 status 5 plays 5 plays 7 role 5 plays 8 in 5 plays 11 between 5 plays 27 among 6 a 7 role 8 in 10 association 9 the 10 association 11 between 12 bzd 12 bzd 16 and 12 bzd 22 targeting 13 use 14 and 14 and 15 rtcs 14 and 16 and 16 and 17 this 16 and 18 may 18 may 19 have 19 have 20 implications 19 have 21 for 21 for 22 targeting 22 targeting 24 populations 22 targeting 25 for 23 risk 24 populations 25 for 26 rtcs 27 among 29 drivers 28 senior 29 drivers background : increasing age is associated with a decline in cognition and motor skills , while at the same time exacerbating one's risk of developing obstructive sleep apnea ( osa ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 4 age 2 : 12 and 3 increasing 4 age 4 age 5 is 5 is 12 and 6 associated 7 with 6 associated 12 and 7 with 9 decline 8 a 9 decline 9 decline 10 in 10 in 11 cognition 12 and 13 motor 12 and 16 while 13 motor 14 skills 15 , 16 while 16 while 17 at 16 while 31 ) 17 at 20 time 18 the 19 same 19 same 20 time 20 time 21 exacerbating 20 time 24 of 21 exacerbating 22 one's 21 exacerbating 23 risk 24 of 25 developing 25 developing 28 apnea 26 obstructive 27 sleep 27 sleep 28 apnea 28 apnea 30 osa 29 ( 30 osa 30 osa 31 ) osa - related cognitive deficits are highly prevalent and can affect various memory systems including overnight memory consolidation on a motor sequence task . 0 ###LEFT-WALL### 1 osa 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 23 task 0 ###LEFT-WALL### 24 . 2 - 3 related 2 - 11 affect 3 related 6 are 3 related 7 highly 4 cognitive 5 deficits 5 deficits 6 are 8 prevalent 9 and 9 and 10 can 9 and 11 affect 11 affect 13 memory 12 various 13 memory 13 memory 14 systems 13 memory 23 task 14 systems 15 including 14 systems 23 task 15 including 18 consolidation 15 including 19 on 16 overnight 17 memory 17 memory 18 consolidation 19 on 22 sequence 20 a 22 sequence 21 motor 22 sequence thus , the aim of our study was to examine the effect of aging on sleep - dependent motor memory consolidation in patients [with] and without osa . 0 ###LEFT-WALL### 4 aim 0 ###LEFT-WALL### 17 - 0 ###LEFT-WALL### 28 . 1 thus 2 , 1 thus 4 aim 3 the 4 aim 4 aim 5 of 4 aim 8 was 5 of 7 study 6 our 7 study 8 was 9 to 8 was 10 examine 9 to 10 examine 10 examine 12 effect 10 examine 15 on 11 the 12 effect 12 effect 13 of 13 of 14 aging 15 on 16 sleep 17 - 21 consolidation 18 dependent 19 motor 19 motor 20 memory 20 memory 21 consolidation 21 consolidation 25 and 22 in 23 patients 22 in 25 and 25 and 26 without 26 without 27 osa methods : we studied 44 patients ( 19 - 68 years [ )(who had been referred by a physician for a baseline polysomnography ( psg ) evaluation . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 studied 3 we 4 studied 4 studied 6 patients 5 44 6 patients 6 patients 11 years 7 ( 11 years 8 19 9 - 9 - 10 68 9 - 11 years 11 years 13 )(who 11 years 14 had 11 years 28 . 13 )(who 14 had 14 had 15 been 15 been 16 referred 16 referred 17 by 17 by 19 physician 18 a 19 physician 19 physician 20 for 20 for 27 evaluation 21 a 27 evaluation 22 baseline 27 evaluation 23 polysomnography 25 psg 23 polysomnography 26 ) 23 polysomnography 27 evaluation 24 ( 25 psg 25 psg 26 ) based on their psg , patients were assigned either to the osa group ( ahi>5/h ) , or control [(] [non] - osa [ )( ( ahi<5/h ) . 0 ###LEFT-WALL### 6 patients 0 ###LEFT-WALL### 18 or 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 29 . 1 based 2 on 1 based 5 , 1 based 6 patients 2 on 4 psg 3 their 4 psg 6 patients 18 or 7 were 8 assigned 7 were 18 or 8 assigned 9 either 8 assigned 10 to 10 to 13 group 11 the 13 group 12 osa 13 group 13 group 15 ahi>5/h 14 ( 15 ahi>5/h 15 ahi>5/h 16 ) 17 , 18 or 18 or 19 control 22 - 23 osa 23 osa 27 ahi<5/h 26 ( 27 ahi<5/h 27 ahi<5/h 28 ) all subjects performed the psychomotor vigilance task ( pvt ) and the motor sequence learning task [(] [mst] ) in the evening and again [in] the morning after their psg . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 31 . 1 all 2 subjects 2 subjects 3 performed 3 performed 23 and 3 performed 28 after 4 the 9 pvt 5 psychomotor 6 vigilance 6 vigilance 7 task 7 task 9 pvt 8 ( 9 pvt 9 pvt 10 ) 9 pvt 11 and 11 and 16 task 11 and 19 ) 11 and 20 in 11 and 23 and 12 the 16 task 13 motor 14 sequence 14 sequence 15 learning 15 learning 16 task 20 in 22 evening 21 the 22 evening 23 and 24 again 23 and 27 morning 26 the 27 morning 28 after 30 psg 29 their 30 psg results : despite similar learning in the evening , osa subjects showed significantly less overnight improvement on [the] [mst] [,] both for immediate ( osa - 2.7 % ± 2.8 % [vs] [.] controls 12.2 % ± 3.5 % [;] p = 0.002 ) [and] plateau improvement ( osa 4.9 % ± 2.3 % [vs] [.] controls 21.1%± 4.0 [%] [;] p = 0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 12 showed 1 results 2 : 2 : 3 despite 3 despite 5 learning 4 similar 5 learning 5 learning 6 in 6 in 8 evening 7 the 8 evening 9 , 11 subjects 10 osa 11 subjects 11 subjects 12 showed 12 showed 14 less 12 showed 15 overnight 12 showed 16 improvement 12 showed 17 on 13 significantly 14 less 17 on 21 both 21 both 22 for 22 for 29 ± 23 immediate 25 osa 23 immediate 29 ± 24 ( 25 osa 25 osa 26 - 27 2.7 28 % 28 % 29 ± 29 ± 31 % 29 ± 34 controls 30 2.8 31 % 31 % 34 controls 34 controls 37 ± 35 12.2 37 ± 36 % 37 ± 37 ± 39 % 37 ± 46 plateau 38 3.5 39 % 39 % 42 = 39 % 46 plateau 41 p 42 = 42 = 43 0.002 42 = 44 ) 46 plateau 47 improvement 47 improvement 58 21.1%± 48 ( 58 21.1%± 49 osa 50 4.9 49 osa 58 21.1%± 51 % 58 21.1%± 52 ± 58 21.1%± 53 2.3 54 % 54 % 58 21.1%± 57 controls 58 21.1%± 58 21.1%± 59 4.0 58 21.1%± 63 = 58 21.1%± 66 . 62 p 63 = 63 = 64 0.001 63 = 65 ) within the osa group , there was a significant negative correlation between overnight [mst] improvement and age [(] r ( 2 [ )(= 0.3 [;] p = 0.01 [ )(, an effect that was not observed in the non - osa group [(] r ( 2 [ )(= 0.08 [;] p = 0.23 [ )( 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 5 , 1 within 3 osa 1 within 4 group 2 the 3 osa 5 , 6 there 5 , 7 was 6 there 7 was 7 was 11 correlation 8 a 11 correlation 9 significant 11 correlation 10 negative 11 correlation 11 correlation 12 between 12 between 16 and 13 overnight 15 improvement 15 improvement 16 and 16 and 17 age 16 and 23 )(= 16 and 27 = 19 r 23 )(= 20 ( 23 )(= 21 2 23 )(= 23 )(= 24 0.3 26 p 27 = 27 = 28 0.01 27 = 30 )(, 30 )(, 36 observed 31 an 32 effect 32 effect 33 that 32 effect 34 was 32 effect 36 observed 33 that 34 was 34 was 35 not 36 observed 37 in 37 in 42 group 38 the 42 group 39 non 41 osa 40 - 41 osa 41 osa 42 group 42 group 48 )(= 42 group 52 = 44 r 48 )(= 45 ( 48 )(= 46 2 48 )(= 48 )(= 49 0.08 51 p 52 = 52 = 53 0.23 52 = 55 )( conclusions : consistent with previous research , healthy sleepers demonstrated a higher degree of sleep - dependent overnight improvement on the [mst] [,] [an] effect not mitigated by increasing age . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 31 . 1 conclusions 2 : 2 : 3 consistent 3 consistent 4 with 4 with 6 research 5 previous 6 research 7 , 9 sleepers 7 , 10 demonstrated 7 , 16 - 8 healthy 9 sleepers 9 sleepers 10 demonstrated 10 demonstrated 15 sleep 11 a 13 degree 12 higher 13 degree 13 degree 14 of 13 degree 15 sleep 14 of 15 sleep 16 - 19 improvement 17 dependent 19 improvement 18 overnight 19 improvement 19 improvement 20 on 19 improvement 28 by 20 on 25 effect 21 the 25 effect 25 effect 26 not 26 not 27 mitigated 28 by 29 increasing 29 increasing 30 age however , the presence of untreated obstructive sleep apnea is associated with an aging [-] related cognitive deficit , otherwise [not] present in individuals without osa . 0 ###LEFT-WALL### 4 presence 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 27 . 1 however 2 , 1 however 4 presence 3 the 4 presence 4 presence 5 of 4 presence 10 is 5 of 9 apnea 6 untreated 8 sleep 7 obstructive 8 sleep 8 sleep 9 apnea 10 is 19 , 11 associated 12 with 11 associated 19 , 12 with 18 deficit 13 an 18 deficit 14 aging 18 deficit 16 related 18 deficit 17 cognitive 18 deficit 19 , 22 present 19 , 23 in 19 , 25 without 20 otherwise 22 present 23 in 24 individuals 25 without 26 osa as other research has linked the presence of osa to [a] higher likelihood of developing dementia , future studies are necessary to examine if the inhibition of memory consolidation is tied to the onset of neurodegenerative disease . 0 ###LEFT-WALL### 19 studies 0 ###LEFT-WALL### 23 examine 0 ###LEFT-WALL### 38 . 1 as 3 research 1 as 5 linked 1 as 19 studies 2 other 3 research 3 research 4 has 4 has 5 linked 5 linked 7 presence 5 linked 10 to 6 the 7 presence 7 presence 8 of 8 of 9 osa 10 to 13 likelihood 12 higher 13 likelihood 13 likelihood 14 of 14 of 15 developing 16 dementia 17 , 16 dementia 19 studies 18 future 19 studies 19 studies 20 are 20 are 21 necessary 21 necessary 22 to 21 necessary 23 examine 22 to 23 examine 23 examine 24 if 24 if 26 inhibition 24 if 31 tied 25 the 26 inhibition 26 inhibition 27 of 26 inhibition 30 is 27 of 29 consolidation 28 memory 29 consolidation 30 is 31 tied 31 tied 32 to 32 to 34 onset 33 the 34 onset 34 onset 35 of 35 of 37 disease 36 neurodegenerative 37 disease accurate and robust brain extraction is a critical step in most neuroimaging analysis pipelines . 0 ###LEFT-WALL### 5 extraction 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 15 . 1 accurate 2 and 2 and 3 robust 2 and 4 brain 4 brain 5 extraction 5 extraction 6 is 6 is 9 step 7 a 8 critical 7 a 9 step 8 critical 9 step 9 step 10 in 10 in 14 pipelines 11 most 14 pipelines 12 neuroimaging 13 analysis 13 analysis 14 pipelines in particular , for the large - scale multi - site neuroimaging studies involving a significant number of subjects with diverse age and diagnostic groups , accurate and robust extraction of the brain automatically and consistently is highly desirable . 0 ###LEFT-WALL### 12 neuroimaging 0 ###LEFT-WALL### 37 is 0 ###LEFT-WALL### 40 . 1 in 2 particular 2 particular 3 , 2 particular 12 neuroimaging 4 for 11 site 4 for 12 neuroimaging 5 the 11 site 6 large 7 - 6 large 8 scale 8 scale 11 site 9 multi 10 - 9 multi 11 site 12 neuroimaging 13 studies 12 neuroimaging 20 with 12 neuroimaging 35 and 12 neuroimaging 37 is 13 studies 14 involving 14 involving 19 subjects 15 a 16 significant 15 a 17 number 16 significant 17 number 17 number 18 of 17 number 19 subjects 18 of 19 subjects 20 with 23 and 20 with 30 extraction 21 diverse 22 age 22 age 23 and 23 and 25 groups 23 and 26 , 24 diagnostic 25 groups 27 accurate 28 and 28 and 29 robust 28 and 30 extraction 30 extraction 31 of 31 of 33 brain 32 the 33 brain 34 automatically 35 and 35 and 36 consistently 37 is 38 highly 37 is 39 desirable in this paper , we introduce population - specific probability maps to guide the brain extraction of diverse subject groups , including both healthy and diseased adult human populations , both developing and aging human populations , as well as [non] [-] human primates . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 introduce 0 ###LEFT-WALL### 45 . 1 in 3 paper 1 in 4 , 1 in 5 we 2 this 3 paper 5 we 6 introduce 6 introduce 7 population 6 introduce 22 including 6 introduce 40 as 7 population 11 maps 8 - 11 maps 9 specific 11 maps 10 probability 11 maps 11 maps 12 to 11 maps 13 guide 11 maps 17 of 11 maps 21 , 12 to 13 guide 13 guide 16 extraction 14 the 16 extraction 15 brain 16 extraction 17 of 20 groups 18 diverse 19 subject 19 subject 20 groups 21 , 22 including 22 including 33 and 22 including 37 , 23 both 33 and 24 healthy 25 and 25 and 29 populations 25 and 30 , 25 and 32 developing 25 and 33 and 26 diseased 27 adult 27 adult 29 populations 28 human 29 populations 31 both 32 developing 33 and 36 populations 34 aging 35 human 35 human 36 populations 38 as 39 well 39 well 40 as 40 as 44 primates 43 human 44 primates specifically , the proposed method combines an atlas - base [d] approach , for coarse skull - stripping , with a deformable - surface - based approach that is guided by local intensity information and population - specific prior information learned from a set of real brain images for more localized refinement . 0 ###LEFT-WALL### 5 method 0 ###LEFT-WALL### 6 combines 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 10 base 1 specifically 2 , 1 specifically 5 method 3 the 5 method 4 proposed 5 method 5 method 6 combines 6 combines 8 atlas 7 an 8 atlas 9 - 10 base 10 base 12 approach 10 base 14 for 10 base 18 stripping 10 base 20 with 13 , 14 for 14 for 16 skull 14 for 17 - 15 coarse 16 skull 17 - 18 stripping 18 stripping 19 , 20 with 27 approach 21 a 27 approach 22 deformable 24 surface 22 deformable 27 approach 23 - 24 surface 24 surface 25 - 26 based 27 approach 27 approach 30 guided 27 approach 31 by 28 that 29 is 29 is 30 guided 31 by 39 prior 32 local 33 intensity 33 intensity 34 information 34 information 35 and 35 and 36 population 35 and 37 - 35 and 39 prior 38 specific 39 prior 39 prior 51 localized 40 information 41 learned 41 learned 42 from 41 learned 48 images 41 learned 51 localized 42 from 44 set 43 a 44 set 45 of 47 brain 45 of 48 images 46 real 47 brain 48 images 49 for 48 images 51 localized 49 for 50 more 51 localized 52 refinement 51 localized 53 . comprehensive quantitative evaluations were performed on the diverse large - scale populations of adni dataset with over 800 subjects [(] 55 ∼ 90 years of age [,] multi - site , various diagnosis groups ) , oasis dataset with over 400 subjects [(] 18 ∼ 96 years of age , wide age range , various diagnosis groups [ )(, and nih pediatrics dataset with 150 subjects [(] 5 ∼ 18 years of age , multi - site , wide age range as a complementary age group to the adult dataset [ )( 0 ###LEFT-WALL### 1 comprehensive 0 ###LEFT-WALL### 5 performed 1 comprehensive 3 evaluations 1 comprehensive 4 were 1 comprehensive 5 performed 2 quantitative 3 evaluations 3 evaluations 4 were 5 performed 6 on 5 performed 16 with 6 on 12 populations 7 the 12 populations 8 diverse 11 scale 9 large 10 - 9 large 11 scale 11 scale 12 populations 12 populations 13 of 13 of 15 dataset 14 adni 15 dataset 16 with 18 800 16 with 24 years 17 over 18 800 18 800 19 subjects 18 800 22 ∼ 19 subjects 21 55 19 subjects 22 ∼ 23 90 24 years 24 years 25 of 25 of 37 oasis 26 age 37 oasis 28 multi 30 site 28 multi 36 , 28 multi 37 oasis 29 - 30 site 30 site 34 groups 30 site 35 ) 31 , 34 groups 32 various 33 diagnosis 33 diagnosis 34 groups 34 groups 35 ) 37 oasis 38 dataset 37 oasis 42 subjects 38 dataset 39 with 38 dataset 42 subjects 39 with 41 400 40 over 41 400 42 subjects 47 years 44 18 47 years 45 ∼ 47 years 46 96 47 years 47 years 48 of 48 of 60 and 49 age 50 , 50 , 53 range 50 , 54 , 51 wide 53 range 52 age 53 range 54 , 57 groups 54 , 60 and 55 various 56 diagnosis 56 diagnosis 57 groups 59 )(, 60 and 60 and 63 dataset 60 and 72 of 61 nih 63 dataset 62 pediatrics 63 dataset 63 dataset 64 with 64 with 71 years 65 150 71 years 66 subjects 71 years 68 5 71 years 69 ∼ 71 years 70 18 71 years 72 of 73 age 73 age 77 site 73 age 81 range 74 , 77 site 75 multi 76 - 75 multi 77 site 77 site 78 , 78 , 81 range 79 wide 81 range 80 age 81 range 81 range 82 as 81 range 87 to 81 range 92 )( 82 as 86 group 83 a 84 complementary 83 a 86 group 84 complementary 85 age 85 age 86 group 87 to 90 dataset 88 the 90 dataset 89 adult 90 dataset the results demonstrate that our method consistently yields the best overall results across [almost] the entire human life span , with [only] a single set of parameters . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 1 the 2 results 2 results 3 demonstrate 3 demonstrate 4 that 4 that 6 method 4 that 8 yields 5 our 6 method 6 method 8 yields 7 consistently 8 yields 8 yields 12 results 9 the 10 best 9 the 12 results 11 overall 12 results 12 results 13 across 12 results 21 with 13 across 19 span 15 the 19 span 16 entire 17 human 17 human 18 life 18 life 19 span 20 , 21 with 21 with 24 single 21 with 25 set 21 with 28 . 23 a 24 single 25 set 26 of 26 of 27 parameters to demonstrate its capability to work on [non] - human primates , the proposed method is further evaluated using a rhesus macaque dataset with 20 subjects . 0 ###LEFT-WALL### 15 method 0 ###LEFT-WALL### 18 evaluated 0 ###LEFT-WALL### 27 . 1 to 2 demonstrate 1 to 12 , 1 to 15 method 2 demonstrate 4 capability 3 its 4 capability 4 capability 5 to 4 capability 6 work 4 capability 11 primates 5 to 6 work 6 work 7 on 9 - 11 primates 10 human 11 primates 11 primates 12 , 13 the 15 method 14 proposed 15 method 15 method 16 is 16 is 17 further 16 is 18 evaluated 18 evaluated 19 using 19 using 23 dataset 19 using 24 with 20 a 23 dataset 21 rhesus 23 dataset 22 macaque 23 dataset 24 with 26 subjects 25 20 26 subjects quantitative comparisons [with] popularly used state - [of] - the [-] art methods , including bet , two - pass bet , bet - b , bse , hwa , robex and afni , demonstrate that the proposed method performs favorably with superior performance on all testing datasets , indicating its robustness and effectiveness . 0 ###LEFT-WALL### 1 quantitative 0 ###LEFT-WALL### 6 state 0 ###LEFT-WALL### 7 - 2 comparisons 5 used 2 comparisons 6 state 4 popularly 5 used 6 state 7 - 7 - 9 - 7 - 14 , 7 - 17 , 9 - 13 methods 10 the 13 methods 12 art 13 methods 14 , 16 bet 15 including 16 bet 17 , 18 two 17 , 19 - 19 - 27 bse 20 pass 27 bse 21 bet 24 - 21 bet 27 bse 22 , 24 - 23 bet 24 - 24 - 25 b 24 - 26 , 27 bse 33 afni 27 bse 35 demonstrate 28 , 33 afni 29 hwa 31 robex 30 , 31 robex 31 robex 32 and 32 and 33 afni 33 afni 34 , 35 demonstrate 36 that 36 that 39 method 36 that 40 performs 37 the 39 method 38 proposed 39 method 39 method 40 performs 40 performs 41 favorably 40 performs 42 with 42 with 44 performance 42 with 45 on 43 superior 44 performance 45 on 47 testing 46 all 47 testing 47 testing 48 datasets 47 testing 50 indicating 49 , 50 indicating 50 indicating 53 and 50 indicating 55 . 51 its 52 robustness 52 robustness 53 and 53 and 54 effectiveness introduction : the hospital admission risk profile ( harp ) instrument is commonly used to assess risk of [functional] [decline] when older people are admitted to [hospital] . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 11 instrument 2 : 14 used 2 : 28 . 3 the 11 instrument 4 hospital 5 admission 5 admission 6 risk 6 risk 7 profile 7 profile 9 harp 8 ( 9 harp 9 harp 10 ) 9 harp 11 instrument 11 instrument 12 is 12 is 14 used 13 commonly 14 used 14 used 15 to 14 used 16 assess 15 to 16 assess 16 assess 17 risk 17 risk 18 of 17 risk 23 people 17 risk 26 to 18 of 21 when 22 older 23 people 23 people 24 are 24 are 25 admitted 25 admitted 26 to harp has moderate diagnostic accuracy ( 65 % ) for downstream decreased scores in activities of daily living . 0 ###LEFT-WALL### 1 harp 0 ###LEFT-WALL### 2 has 0 ###LEFT-WALL### 19 . 1 harp 2 has 2 has 5 accuracy 2 has 10 for 2 has 14 in 3 moderate 5 accuracy 4 diagnostic 5 accuracy 5 accuracy 8 % 6 ( 8 % 7 65 8 % 8 % 9 ) 10 for 13 scores 11 downstream 13 scores 12 decreased 13 scores 14 in 15 activities 15 activities 16 of 16 of 18 living 17 daily 18 living this paper reports the diagnostic accuracy of harp for downstream quality of life . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 3 reports 0 ###LEFT-WALL### 14 . 1 this 2 paper 2 paper 3 reports 3 reports 6 accuracy 4 the 6 accuracy 5 diagnostic 6 accuracy 6 accuracy 7 of 7 of 8 harp 8 harp 9 for 9 for 11 quality 10 downstream 11 quality 11 quality 12 of 12 of 13 life it also tests whether adding other measures to harp improves its diagnostic accuracy . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 tests 0 ###LEFT-WALL### 14 . 1 it 3 tests 2 also 3 tests 3 tests 4 whether 4 whether 5 adding 4 whether 10 improves 5 adding 7 measures 5 adding 8 to 5 adding 10 improves 6 other 7 measures 8 to 9 harp 10 improves 13 accuracy 11 its 13 accuracy 12 diagnostic 13 accuracy methods : one hundred and forty - eight independent community dwelling individuals aged 65 years or older were recruited in the emergency department of one large australian hospital with a medical problem for which they were discharged without a hospital ward admission . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 43 . 1 methods 2 : 2 : 6 forty 3 one 4 hundred 4 hundred 5 and 5 and 6 forty 6 forty 12 individuals 6 forty 18 were 6 forty 19 recruited 6 forty 20 in 7 - 8 eight 8 eight 12 individuals 9 independent 12 individuals 10 community 12 individuals 11 dwelling 12 individuals 12 individuals 13 aged 12 individuals 18 were 13 aged 16 or 14 65 15 years 15 years 16 or 16 or 17 older 20 in 23 department 21 the 23 department 22 emergency 23 department 23 department 24 of 23 department 29 with 23 department 33 for 24 of 28 hospital 25 one 28 hospital 26 large 28 hospital 27 australian 28 hospital 29 with 32 problem 30 a 32 problem 31 medical 32 problem 33 for 34 which 33 for 35 they 33 for 37 discharged 35 they 36 were 36 were 37 discharged 37 discharged 38 without 38 without 42 admission 39 a 42 admission 40 hospital 41 ward 41 ward 42 admission data , including age , sex [,] primary language , [highest] level of education , postcode , living status , requiring care for daily activities , using a gait aid , receiving formal community supports , instrumental activities of daily living in the last week , hospitalization and [falls] [in] the last 12 months , and mental state were collected at recruitment . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 6 sex 1 data 3 including 1 data 6 sex 2 , 3 including 3 including 4 age 3 including 5 , 6 sex 9 language 6 sex 18 living 8 primary 9 language 9 language 12 level 10 , 12 level 12 level 13 of 12 level 16 postcode 12 level 17 , 13 of 14 education 15 , 16 postcode 16 postcode 17 , 17 , 18 living 18 living 19 status 18 living 21 requiring 20 , 21 requiring 21 requiring 22 care 21 requiring 30 aid 22 care 23 for 23 for 25 activities 24 daily 25 activities 25 activities 27 using 26 , 27 using 27 using 29 gait 28 a 29 gait 30 aid 32 receiving 30 aid 38 activities 30 aid 42 in 31 , 32 receiving 32 receiving 35 supports 32 receiving 36 , 33 formal 35 supports 34 community 35 supports 37 instrumental 38 activities 38 activities 39 of 39 of 41 living 40 daily 41 living 42 in 45 week 43 the 45 week 44 last 45 week 45 week 56 and 46 , 56 and 47 hospitalization 48 and 48 and 54 months 48 and 55 , 48 and 56 and 51 the 52 last 51 the 53 12 53 12 54 months 55 , 56 and 56 and 57 mental 56 and 58 state 56 and 59 were 56 and 60 collected 56 and 63 . 58 state 59 were 60 collected 61 at 61 at 62 recruitment harp scores were derived from a formula that summed scores assigned to age , activities of daily living , and mental state categories . 0 ###LEFT-WALL### 2 scores 0 ###LEFT-WALL### 4 derived 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 24 . 1 harp 2 scores 2 scores 3 were 3 were 4 derived 4 derived 5 from 4 derived 11 assigned 5 from 7 formula 6 a 7 formula 7 formula 8 that 7 formula 9 summed 8 that 9 summed 9 summed 10 scores 11 assigned 12 to 11 assigned 13 age 12 to 13 age 14 , 15 activities 14 , 22 state 15 activities 16 of 15 activities 22 state 16 of 20 and 17 daily 18 living 17 daily 20 and 19 , 20 and 20 and 21 mental 22 state 23 categories physical and mental component scores of a quality of life measure were captured by telephone [interview] at 1 and 3 months [after] recruitment . 0 ###LEFT-WALL### 23 recruitment 0 ###LEFT-WALL### 24 . 1 physical 2 and 2 and 4 component 2 and 5 scores 2 and 11 measure 2 and 12 were 3 mental 4 component 5 scores 6 of 5 scores 11 measure 6 of 8 quality 7 a 8 quality 8 quality 9 of 9 of 10 life 12 were 13 captured 13 captured 15 telephone 13 captured 17 at 14 by 15 telephone 17 at 19 and 18 1 19 and 19 and 20 3 20 3 21 months 21 months 23 recruitment results : harp scores are moderately accurate at predicting downstream decline in physical quality of life , but did not predict downstream decline [in] mental quality of life . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 harp 2 : 18 but 2 : 29 . 3 harp 4 scores 3 harp 9 predicting 3 harp 18 but 4 scores 5 are 5 are 6 moderately 5 are 7 accurate 7 accurate 8 at 8 at 9 predicting 9 predicting 10 downstream 11 decline 12 in 11 decline 18 but 12 in 14 quality 13 physical 14 quality 14 quality 15 of 15 of 16 life 17 , 18 but 18 but 19 did 19 did 20 not 19 did 21 predict 21 predict 26 quality 22 downstream 23 decline 23 decline 26 quality 25 mental 26 quality 26 quality 27 of 27 of 28 life the addition of other variables to harp did not improve its diagnostic accuracy for either measure of quality of life . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 10 improve 0 ###LEFT-WALL### 21 . 1 the 2 addition 2 addition 3 of 2 addition 8 did 3 of 5 variables 4 other 5 variables 5 variables 6 to 6 to 7 harp 8 did 9 not 8 did 10 improve 10 improve 13 accuracy 11 its 13 accuracy 12 diagnostic 13 accuracy 13 accuracy 14 for 14 for 18 quality 15 either 16 measure 16 measure 17 of 16 measure 18 quality 17 of 18 quality 18 quality 19 of 19 of 20 life conclusion : harp is a poor predictor of quality of life . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 harp 2 : 4 is 2 : 12 . 3 harp 4 is 4 is 7 predictor 5 a 6 poor 5 a 7 predictor 6 poor 7 predictor 7 predictor 8 of 8 of 9 quality 9 quality 10 of 10 of 11 life background : to compare intraocular pressure ( iop ) readings using the icare rebound tonometer [(] rbt [ )(versus the goldmann applanation tonometer ( gat ) in late elderly [(] aged 75 years or older ) subjects [with] or [without] glaucoma , [and] to evaluate the influence of central corneal thickness ( cct [ )(on iop readings . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 10 readings 2 : 14 rebound 3 to 4 compare 3 to 9 ) 3 to 10 readings 4 compare 6 pressure 5 intraocular 6 pressure 6 pressure 8 iop 7 ( 8 iop 8 iop 9 ) 10 readings 11 using 10 readings 14 rebound 11 using 13 icare 12 the 13 icare 14 rebound 17 rbt 15 tonometer 17 rbt 17 rbt 19 )(versus 17 rbt 27 in 19 )(versus 23 tonometer 20 the 23 tonometer 21 goldmann 22 applanation 22 applanation 23 tonometer 23 tonometer 25 gat 24 ( 25 gat 25 gat 26 ) 27 in 39 or 28 late 33 years 29 elderly 33 years 31 aged 33 years 32 75 33 years 33 years 34 or 34 or 37 subjects 34 or 39 or 35 older 36 ) 35 older 37 subjects 39 or 41 glaucoma 39 or 42 , 39 or 44 to 39 or 45 evaluate 44 to 45 evaluate 45 evaluate 47 influence 46 the 47 influence 47 influence 48 of 47 influence 53 cct 48 of 51 thickness 49 central 51 thickness 50 corneal 51 thickness 52 ( 53 cct 53 cct 55 )(on 53 cct 58 . 55 )(on 57 readings 56 iop 57 readings methods : the iop measurements were obtained using the rbt and gat , and cct was measured using a specular - type microscope . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 measurements 2 : 7 obtained 2 : 14 and 2 : 24 . 3 the 5 measurements 4 iop 5 measurements 5 measurements 6 were 6 were 7 obtained 7 obtained 8 using 8 using 12 gat 9 the 12 gat 10 rbt 11 and 11 and 12 gat 13 , 14 and 14 and 15 cct 14 and 17 measured 15 cct 16 was 16 was 17 measured 17 measured 18 using 18 using 23 microscope 19 a 23 microscope 20 specular 21 - 20 specular 23 microscope 22 type 23 microscope bland - altman analysis was used to assess the clinical agreement between the two instruments . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 16 . 1 bland 2 - 1 bland 4 analysis 3 altman 4 analysis 4 analysis 5 was 5 was 6 used 6 used 7 to 6 used 8 assess 7 to 8 assess 8 assess 11 agreement 8 assess 12 between 9 the 11 agreement 10 clinical 11 agreement 12 between 15 instruments 13 the 14 two 14 two 15 instruments the influence of cct adjusted for age on iop readings was analyzed by multiple linear regression analysis . 0 ###LEFT-WALL### 2 influence 0 ###LEFT-WALL### 12 analyzed 0 ###LEFT-WALL### 18 . 1 the 2 influence 2 influence 3 of 2 influence 5 adjusted 2 influence 11 was 3 of 4 cct 5 adjusted 6 for 5 adjusted 8 on 6 for 7 age 8 on 10 readings 9 iop 10 readings 11 was 12 analyzed 12 analyzed 13 by 13 by 17 analysis 14 multiple 17 analysis 15 linear 17 analysis 16 regression 17 analysis results : this study included 58 eyes of 29 normal subjects and 54 eyes of 28 glaucoma patients . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 4 study 2 : 5 included 3 this 4 study 4 study 5 included 5 included 7 eyes 6 58 7 eyes 7 eyes 8 of 8 of 12 and 9 29 11 subjects 10 normal 11 subjects 11 subjects 12 and 12 and 14 eyes 12 and 15 of 13 54 14 eyes 15 of 18 patients 16 28 18 patients 17 glaucoma 18 patients the mean age was 80.7±4.3 years ( normal subjects ) and 83.1±5.1 years ( glaucoma patients ) . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 18 . 1 the 3 age 2 mean 3 age 3 age 4 was 4 was 11 and 5 80.7±4.3 6 years 6 years 9 subjects 6 years 11 and 7 ( 9 subjects 8 normal 9 subjects 9 subjects 10 ) 11 and 13 years 12 83.1±5.1 13 years 13 years 16 patients 14 ( 16 patients 15 glaucoma 16 patients 16 patients 17 ) the mean iop readings were 13.6±3.5 [mmhg] and 13.2±2.8 [mmhg] ( using the rbt and gat , respectively ) for normal subjects , and 13.6±3.3 [mmhg] and 13.5±2.9 [mmhg] for glaucoma patients . 0 ###LEFT-WALL### 4 readings 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 33 . 1 the 4 readings 2 mean 4 readings 3 iop 4 readings 4 readings 5 were 5 were 8 and 6 13.6±3.5 8 and 8 and 32 patients 9 13.2±2.8 12 using 9 13.2±2.8 18 respectively 9 13.2±2.8 20 for 9 13.2±2.8 24 and 11 ( 12 using 12 using 16 gat 12 using 17 , 13 the 16 gat 14 rbt 15 and 15 and 16 gat 17 , 18 respectively 18 respectively 19 ) 20 for 22 subjects 21 normal 22 subjects 23 , 24 and 24 and 27 and 24 and 32 patients 25 13.6±3.3 27 and 27 and 28 13.5±2.9 28 13.5±2.9 30 for 30 for 31 glaucoma the 95 % confidence interval of the differences between the two instruments was - 3.3 to 4.0 mmhg for normal subjects and - 2.9 to 1.6 mmhg [for] glaucoma patients . 0 ###LEFT-WALL### 5 interval 0 ###LEFT-WALL### 13 was 0 ###LEFT-WALL### 31 . 1 the 5 interval 2 95 3 % 3 % 4 confidence 4 confidence 5 interval 5 interval 6 of 5 interval 9 between 5 interval 13 was 6 of 8 differences 7 the 8 differences 9 between 12 instruments 10 the 11 two 11 two 12 instruments 13 was 18 mmhg 14 - 16 to 15 3.3 16 to 16 to 17 4.0 16 to 18 mmhg 18 mmhg 19 for 19 for 22 and 20 normal 21 subjects 21 subjects 22 and 22 and 30 patients 23 - 24 2.9 24 2.9 25 to 25 to 26 1.6 25 to 27 mmhg 27 mmhg 30 patients 29 glaucoma 30 patients the iop readings by two instruments were significantly correlated with cct in eyes with glaucoma ( for the rbt , β=0.036 and p=0.002 , and for the gat , β=0.021 and p=0.033 ) but not in normal eyes . 0 ###LEFT-WALL### 3 readings 0 ###LEFT-WALL### 9 correlated 0 ###LEFT-WALL### 39 . 1 the 3 readings 2 iop 3 readings 3 readings 4 by 3 readings 7 were 4 by 6 instruments 5 two 6 instruments 7 were 8 significantly 7 were 9 correlated 9 correlated 10 with 9 correlated 25 and 9 correlated 34 but 9 correlated 36 in 10 with 11 cct 11 cct 12 in 12 in 13 eyes 14 with 15 glaucoma 14 with 25 and 15 glaucoma 17 for 15 glaucoma 22 and 16 ( 17 for 17 for 19 rbt 17 for 20 , 18 the 19 rbt 20 , 22 and 21 β=0.036 22 and 22 and 23 p=0.002 22 and 24 , 25 and 26 for 26 for 31 and 27 the 28 gat 28 gat 29 , 29 , 30 β=0.021 29 , 31 and 31 and 32 p=0.033 31 and 33 ) 34 but 35 not 36 in 38 eyes 37 normal 38 eyes conclusion : iop readings measured using the rbt and gat showed within the allowable range in the late elderly subjects [with] or without glaucoma . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 25 . 1 conclusion 2 : 2 : 3 iop 3 iop 4 readings 3 iop 5 measured 4 readings 5 measured 5 measured 6 using 6 using 8 rbt 7 the 8 rbt 9 and 10 gat 9 and 11 showed 10 gat 11 showed 11 showed 12 within 11 showed 22 or 12 within 15 range 13 the 15 range 14 allowable 15 range 16 in 20 subjects 16 in 22 or 17 the 20 subjects 18 late 20 subjects 19 elderly 20 subjects 22 or 23 without 23 without 24 glaucoma eyes with glaucoma were correlated closely with cct using each instrument . 0 ###LEFT-WALL### 1 eyes 0 ###LEFT-WALL### 5 correlated 0 ###LEFT-WALL### 12 . 1 eyes 2 with 1 eyes 4 were 2 with 3 glaucoma 4 were 5 correlated 5 correlated 6 closely 5 correlated 7 with 7 with 8 cct 8 cct 9 using 9 using 11 instrument 10 each 11 instrument background : nursing home residents are mainly older people with multiple diseases and taking multiple medications . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 5 residents 2 : 6 are 3 nursing 4 home 4 home 5 residents 5 residents 6 are 6 are 7 mainly 6 are 13 and 8 older 9 people 9 people 10 with 9 people 13 and 10 with 12 diseases 11 multiple 12 diseases 13 and 16 medications 14 taking 15 multiple 15 multiple 16 medications the quality use of medication and its association with health related quality of life ( hrqol ) have not been reported in malaysia . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 21 reported 0 ###LEFT-WALL### 24 . 1 the 3 use 2 quality 3 use 3 use 4 of 3 use 6 and 4 of 5 medication 6 and 8 association 6 and 9 with 6 and 18 have 7 its 8 association 9 with 12 quality 10 health 11 related 11 related 12 quality 12 quality 13 of 13 of 14 life 14 life 16 hrqol 15 ( 16 hrqol 16 hrqol 17 ) 18 have 19 not 18 have 20 been 20 been 21 reported 21 reported 22 in 22 in 23 malaysia this study aims to investigate the association between the use of potentially inappropriate medications ( pims ) and the changes observed in the hrqol among older nursing home residents . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 30 . 1 this 2 study 2 study 3 aims 3 aims 4 to 3 aims 5 investigate 4 to 5 investigate 5 investigate 7 association 5 investigate 8 between 6 the 7 association 8 between 10 use 9 the 10 use 10 use 11 of 11 of 14 medications 12 potentially 13 inappropriate 13 inappropriate 14 medications 14 medications 16 pims 15 ( 16 pims 16 pims 17 ) 18 and 20 changes 18 and 28 home 19 the 20 changes 20 changes 21 observed 20 changes 28 home 21 observed 22 in 22 in 24 hrqol 23 the 24 hrqol 24 hrqol 25 among 25 among 27 nursing 26 older 27 nursing 28 home 29 residents methods : a prospective [follow] up study was conducted at four nongovernmental organization nursing homes in penang , malaysia . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 20 . 1 methods 2 : 2 : 13 organization 3 a 4 prospective 3 a 13 organization 4 prospective 7 study 6 up 7 study 7 study 8 was 8 was 9 conducted 9 conducted 10 at 10 at 11 four 12 nongovernmental 13 organization 13 organization 14 nursing 14 nursing 15 homes 14 nursing 16 in 16 in 17 penang 18 , 19 malaysia older residents [(] ≥65 years old ) taking at least one prescribed medication were included . 0 ###LEFT-WALL### 2 residents 0 ###LEFT-WALL### 4 ≥65 0 ###LEFT-WALL### 16 . 1 older 2 residents 2 residents 4 ≥65 4 ≥65 5 years 5 years 8 taking 5 years 15 included 6 old 7 ) 6 old 8 taking 8 taking 11 one 8 taking 12 prescribed 8 taking 14 were 9 at 10 least 10 least 11 one 11 one 12 prescribed 12 prescribed 13 medication 14 were 15 included residents with pims were identified by using screening tool of older person 's potentially inappropriate prescriptions ( stopp ) criteria . 0 ###LEFT-WALL### 1 residents 0 ###LEFT-WALL### 5 identified 0 ###LEFT-WALL### 21 . 1 residents 2 with 1 residents 4 were 2 with 3 pims 4 were 5 identified 5 identified 6 by 6 by 7 using 7 using 9 tool 8 screening 9 tool 9 tool 10 of 10 of 20 criteria 11 older 12 person 12 person 13 's 13 's 20 criteria 14 potentially 15 inappropriate 15 inappropriate 20 criteria 16 prescriptions 18 stopp 17 ( 18 stopp 18 stopp 19 ) 18 stopp 20 criteria hrqol was assessed using euroqol - 5 [dimension] ( eq - 5 d ) and euroqol - visual analog scale [(] eq - vas ) at baseline and after a 3 [-] month [follow] up . 0 ###LEFT-WALL### 1 hrqol 0 ###LEFT-WALL### 3 assessed 1 hrqol 2 was 2 was 3 assessed 3 assessed 4 using 4 using 5 euroqol 5 euroqol 7 5 6 - 7 5 7 5 15 and 7 5 36 . 9 ( 15 and 10 eq 13 d 10 eq 15 and 11 - 13 d 12 5 13 d 13 d 14 ) 15 and 16 euroqol 15 and 28 and 15 and 36 . 16 euroqol 22 eq 17 - 22 eq 18 visual 19 analog 19 analog 22 eq 20 scale 22 eq 22 eq 24 vas 22 eq 25 ) 23 - 24 vas 24 vas 25 ) 26 at 27 baseline 26 at 28 and 28 and 29 after 29 after 33 month 30 a 33 month 31 3 33 month 33 month 35 up the association of pims with hrqol was analyzed using mann - whitney [u] test . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 8 analyzed 0 ###LEFT-WALL### 11 - 1 the 2 association 2 association 3 of 2 association 7 was 3 of 4 pims 4 pims 5 with 5 with 6 hrqol 7 was 8 analyzed 8 analyzed 9 using 9 using 10 mann 11 - 14 test 11 - 15 . 12 whitney 14 test results : the median age of the 211 participants was 77 years ( interquartile range 72 - 82 years ) and the median number of prescription medicines was four ( interquartile range three to six ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 5 age 2 : 10 was 2 : 21 and 3 the 5 age 4 median 5 age 5 age 6 of 5 age 10 was 6 of 9 participants 7 the 8 211 8 211 9 participants 10 was 12 years 11 77 12 years 12 years 15 range 12 years 19 years 13 ( 15 range 14 interquartile 15 range 15 range 16 72 15 range 17 - 17 - 19 years 18 82 19 years 19 years 20 ) 21 and 24 number 21 and 28 was 22 the 24 number 23 median 24 number 24 number 25 of 24 number 28 was 25 of 27 medicines 26 prescription 27 medicines 28 was 29 four 29 four 32 range 30 ( 32 range 31 interquartile 32 range 32 range 34 to 32 range 36 ) 33 three 34 to 34 to 35 six the prevalence of pims was 23.7 [%] and 18.6 % at baseline and 3 months later , respectively . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 5 was 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 5 was 3 of 4 pims 5 was 10 % 5 was 11 at 5 was 18 respectively 6 23.7 8 and 8 and 9 18.6 8 and 10 % 11 at 13 and 12 baseline 13 and 13 and 15 months 13 and 16 later 14 3 15 months 17 , 18 respectively 18 respectively 19 . the most commonly prescribed pims in decreasing order were first generation antihistamine , prescriptions of duplicate drug class , glibenclamide with type 2 diabetes mellitus , and anticholinergic to treat extrapyramidal side effects of neuroleptic medications . 0 ###LEFT-WALL### 5 pims 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 37 . 1 the 2 most 2 most 5 pims 3 commonly 4 prescribed 4 prescribed 5 pims 5 pims 6 in 5 pims 9 were 6 in 7 decreasing 7 decreasing 8 order 9 were 12 antihistamine 10 first 12 antihistamine 11 generation 12 antihistamine 13 , 27 and 14 prescriptions 15 of 14 prescriptions 27 and 15 of 18 class 16 duplicate 18 class 17 drug 18 class 18 class 20 glibenclamide 19 , 20 glibenclamide 20 glibenclamide 21 with 20 glibenclamide 26 , 21 with 25 mellitus 22 type 25 mellitus 23 2 24 diabetes 24 diabetes 25 mellitus 26 , 27 and 27 and 28 anticholinergic 27 and 29 to 27 and 34 of 29 to 33 effects 30 treat 33 effects 31 extrapyramidal 32 side 32 side 33 effects 34 of 36 medications 35 neuroleptic 36 medications at baseline , there was no significant difference among residents [with] or without pims in each bracket of eq - 5 d , eq - 5 d index , or eq - vas scores . 0 ###LEFT-WALL### 4 there 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 25 - 1 at 2 baseline 1 at 3 , 1 at 4 there 4 there 5 was 5 was 8 difference 5 was 12 or 5 was 15 in 6 no 8 difference 7 significant 8 difference 9 among 10 residents 9 among 12 or 12 or 13 without 13 without 14 pims 15 in 17 bracket 16 each 17 bracket 17 bracket 18 of 18 of 19 eq 19 eq 22 d 19 eq 24 eq 20 - 22 d 21 5 22 d 22 d 23 , 23 , 24 eq 24 eq 25 - 25 - 28 index 25 - 30 or 25 - 35 . 26 5 27 d 27 d 28 index 29 , 30 or 30 or 33 vas 30 or 34 scores 31 eq 33 vas 32 - 33 vas 33 vas 34 scores comparison of the differences in the mean score index of [eq] - 5 d between baseline and after 3 months also showed no statistically significant differences . 0 ###LEFT-WALL### 1 comparison 0 ###LEFT-WALL### 22 showed 0 ###LEFT-WALL### 27 . 1 comparison 2 of 1 comparison 5 in 1 comparison 22 showed 2 of 4 differences 3 the 4 differences 5 in 9 index 6 the 9 index 7 mean 8 score 8 score 9 index 9 index 10 of 10 of 14 d 12 - 13 5 13 5 14 d 14 d 17 and 15 between 16 baseline 15 between 17 and 17 and 18 after 18 after 20 months 19 3 20 months 21 also 22 showed 22 showed 26 differences 23 no 26 differences 24 statistically 25 significant 25 significant 26 differences conclusion : pims were found to be relatively common among older nursing home residents . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 pims 2 : 7 be 2 : 15 . 3 pims 4 were 4 were 5 found 5 found 6 to 6 to 7 be 7 be 9 common 8 relatively 9 common 9 common 10 among 10 among 14 residents 11 older 12 nursing 12 nursing 14 residents 13 home 14 residents however , no significant changes were observed in hrqol among these residents . 0 ###LEFT-WALL### 5 changes 0 ###LEFT-WALL### 7 observed 0 ###LEFT-WALL### 13 . 1 however 2 , 1 however 5 changes 3 no 5 changes 4 significant 5 changes 5 changes 6 were 6 were 7 observed 7 observed 8 in 7 observed 10 among 8 in 9 hrqol 10 among 12 residents 11 these 12 residents further studies with a bigger sample size and longer [follow] up period are required to establish this association . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 14 required 0 ###LEFT-WALL### 19 . 1 further 2 studies 2 studies 3 with 2 studies 13 are 3 with 12 period 4 a 12 period 5 bigger 6 sample 6 sample 7 size 7 size 8 and 8 and 9 longer 8 and 12 period 11 up 12 period 13 are 14 required 14 required 15 to 14 required 16 establish 15 to 16 establish 16 establish 18 association 17 this 18 association objective : brain damage within the right middle cerebral artery ( mca ) territory is particularly disruptive to mediolateral postural stabilization . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 objective 2 : 2 : 4 damage 3 brain 4 damage 4 damage 5 within 4 damage 14 territory 4 damage 15 is 4 damage 17 disruptive 5 within 10 artery 6 the 10 artery 7 right 8 middle 8 middle 10 artery 9 cerebral 10 artery 10 artery 12 mca 11 ( 12 mca 12 mca 13 ) 14 territory 15 is 16 particularly 17 disruptive 17 disruptive 18 to 18 to 21 stabilization 19 mediolateral 21 stabilization 20 postural 21 stabilization the objective of this cross [-] sectional study was to test the hypothesis that chronic right mca infarcts ( as compared to left ) [are] associated with slower and more bilaterally asymmetrical gait . 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 34 . 1 the 2 objective 2 objective 3 of 2 objective 29 and 3 of 5 cross 4 this 5 cross 5 cross 8 study 5 cross 11 test 7 sectional 8 study 8 study 9 was 9 was 10 to 9 was 11 test 10 to 11 test 11 test 13 hypothesis 11 test 28 slower 12 the 13 hypothesis 13 hypothesis 14 that 13 hypothesis 27 with 14 that 16 right 14 that 23 left 15 chronic 16 right 16 right 17 mca 16 right 22 to 16 right 23 left 17 mca 18 infarcts 18 infarcts 20 as 19 ( 20 as 20 as 21 compared 21 compared 22 to 23 left 24 ) 23 left 26 associated 26 associated 27 with 29 and 33 gait 30 more 31 bilaterally 31 bilaterally 32 asymmetrical 32 asymmetrical 33 gait we further hypothesized that in those with chronic right mca [infarct] , locomotor performance is more dependent on gray matter ( gm ) volumes within noninfarcted regions of the brain that are involved in motor control yet lie outside of the mca territory . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 hypothesized 0 ###LEFT-WALL### 38 lie 1 we 3 hypothesized 2 further 3 hypothesized 3 hypothesized 4 that 4 that 14 performance 4 that 38 lie 5 in 6 those 5 in 12 , 5 in 14 performance 6 those 7 with 7 with 10 mca 8 chronic 10 mca 9 right 10 mca 13 locomotor 14 performance 14 performance 15 is 15 is 17 dependent 16 more 17 dependent 17 dependent 18 on 18 on 20 matter 19 gray 20 matter 20 matter 22 gm 21 ( 22 gm 22 gm 23 ) 24 volumes 25 within 24 volumes 28 of 24 volumes 31 that 24 volumes 32 are 24 volumes 38 lie 25 within 27 regions 26 noninfarcted 27 regions 28 of 30 brain 29 the 30 brain 31 that 32 are 32 are 33 involved 33 involved 34 in 34 in 36 control 35 motor 36 control 37 yet 38 lie 38 lie 40 of 38 lie 44 . 39 outside 40 of 40 of 43 territory 41 the 43 territory 42 mca 43 territory methods : gait speed was assessed in 19 subjects with right mca infarct , 20 with left mca infarct , and [108] controls . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 gait 2 : 6 assessed 2 : 14 , 2 : 24 . 3 gait 4 speed 3 gait 5 was 3 gait 6 assessed 4 speed 5 was 6 assessed 7 in 6 assessed 10 with 6 assessed 12 mca 6 assessed 13 infarct 7 in 9 subjects 8 19 9 subjects 10 with 11 right 12 mca 13 infarct 14 , 15 20 14 , 21 and 15 20 16 with 15 20 21 and 16 with 18 mca 17 left 18 mca 19 infarct 21 and 20 , 21 and 21 and 23 controls bilateral plantar pressure and temporal symmetry ratios were calculated in a subset of the cohort . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 9 calculated 0 ###LEFT-WALL### 16 . 1 bilateral 3 pressure 2 plantar 3 pressure 3 pressure 4 and 4 and 7 ratios 4 and 8 were 5 temporal 6 symmetry 6 symmetry 7 ratios 8 were 9 calculated 9 calculated 10 in 10 in 12 subset 11 a 12 subset 12 subset 13 of 13 of 15 cohort 14 the 15 cohort gm volumes within 5 regions outside of the mca territory ( superior parietal [lobe] , precuneus , caudate , putamen , and cerebellum ) were quantified from anatomic mris . 0 ###LEFT-WALL### 2 volumes 0 ###LEFT-WALL### 26 quantified 0 ###LEFT-WALL### 30 . 1 gm 2 volumes 2 volumes 3 within 2 volumes 16 precuneus 2 volumes 18 caudate 2 volumes 25 were 3 within 5 regions 4 5 5 regions 5 regions 6 outside 5 regions 7 of 7 of 10 territory 8 the 10 territory 9 mca 10 territory 11 ( 16 precuneus 12 superior 16 precuneus 13 parietal 15 , 13 parietal 16 precuneus 16 precuneus 17 , 17 , 18 caudate 18 caudate 22 and 18 caudate 24 ) 19 , 22 and 20 putamen 22 and 21 , 22 and 22 and 23 cerebellum 22 and 24 ) 25 were 26 quantified 26 quantified 27 from 27 from 29 mris 28 anatomic 29 mris results : right and left [infarct] groups had similar poststroke duration ( 7.6 ± 6.0 years ) , infarct size , and functional independence . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 25 . 1 results 2 : 2 : 3 right 4 and 7 groups 4 and 18 , 5 left 7 groups 7 groups 18 , 8 had 11 duration 8 had 18 , 9 similar 11 duration 10 poststroke 11 duration 11 duration 16 years 12 ( 16 years 13 7.6 16 years 14 ± 16 years 15 6.0 16 years 16 years 17 ) 18 , 19 infarct 19 infarct 22 and 20 size 22 and 21 , 22 and 22 and 24 independence 23 functional 24 independence the right [infarct] group demonstrated slower gait speed and greater asymmetry compared to the left infarct group and controls ( p < 0.05 ) . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 5 demonstrated 0 ###LEFT-WALL### 25 . 1 the 4 group 2 right 4 group 4 group 5 demonstrated 5 demonstrated 6 slower 5 demonstrated 9 and 5 demonstrated 16 infarct 7 gait 8 speed 8 speed 9 and 9 and 11 asymmetry 9 and 12 compared 9 and 16 infarct 10 greater 11 asymmetry 12 compared 13 to 13 to 15 left 14 the 15 left 16 infarct 18 and 16 infarct 22 < 17 group 18 and 18 and 19 controls 20 ( 22 < 21 p 22 < 22 < 23 0.05 22 < 24 ) in the right infarct [group] only , those with larger gm volumes within the cerebellum [(] r ( 2 [ )(= 0.32 , p = 0.02 ) and caudate [(] r ( 2 [ )(= 0.56 , p < 0.001 ) exhibited faster gait speed . 0 ###LEFT-WALL### 4 infarct 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 46 . 1 in 3 right 1 in 4 infarct 2 the 3 right 4 infarct 6 only 7 , 28 and 7 , 42 exhibited 8 those 9 with 8 those 28 and 9 with 12 volumes 10 larger 12 volumes 11 gm 12 volumes 12 volumes 13 within 13 within 15 cerebellum 14 the 15 cerebellum 15 cerebellum 21 )(= 15 cerebellum 25 = 17 r 21 )(= 18 ( 21 )(= 19 2 21 )(= 21 )(= 22 0.32 21 )(= 23 , 23 , 25 = 24 p 25 = 25 = 26 0.02 25 = 27 ) 28 and 29 caudate 28 and 35 )(= 28 and 39 < 28 and 42 exhibited 31 r 35 )(= 32 ( 35 )(= 33 2 35 )(= 35 )(= 36 0.56 35 )(= 37 , 37 , 39 < 38 p 39 < 39 < 40 0.001 39 < 41 ) 42 exhibited 45 speed 43 faster 44 gait 44 gait 45 speed conclusion : individuals with chronic lesions within the right mca territory , as compared to the left mca territory , exhibit slower , more asymmetrical gait . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 individuals 2 : 20 , 3 individuals 4 with 4 with 6 lesions 5 chronic 6 lesions 6 lesions 7 within 6 lesions 15 to 7 within 11 territory 8 the 11 territory 9 right 11 territory 10 mca 11 territory 11 territory 14 compared 12 , 14 compared 13 as 14 compared 15 to 19 territory 16 the 19 territory 17 left 19 territory 18 mca 19 territory 20 , 26 gait 21 exhibit 26 gait 22 slower 23 , 22 slower 26 gait 24 more 25 asymmetrical 25 asymmetrical 26 gait for these individuals , larger gm volumes within regions outside of the [infarcted] vascular territory may help preserve locomotor control . 0 ###LEFT-WALL### 7 volumes 0 ###LEFT-WALL### 17 help 0 ###LEFT-WALL### 21 . 1 for 3 individuals 1 for 4 , 1 for 7 volumes 2 these 3 individuals 5 larger 7 volumes 6 gm 7 volumes 7 volumes 8 within 7 volumes 16 may 8 within 9 regions 9 regions 10 outside 9 regions 11 of 11 of 15 territory 12 the 15 territory 14 vascular 15 territory 16 may 17 help 17 help 18 preserve 18 preserve 20 control 19 locomotor 20 control introduction : [non] - alcoholic fatty liver disease ( nafld ) is related to unhealthy habits , mainly to unfavorable dietary profiles . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 4 - 2 : 13 related 4 - 8 disease 5 alcoholic 6 fatty 6 fatty 7 liver 7 liver 8 disease 8 disease 10 nafld 8 disease 12 is 9 ( 10 nafld 10 nafld 11 ) 12 is 13 related 13 related 14 to 14 to 16 habits 15 unhealthy 16 habits 16 habits 19 to 17 , 18 mainly 17 , 19 to 19 to 22 profiles 19 to 23 . 20 unfavorable 22 profiles 21 dietary 22 profiles mthfr [gene] encodes methylenetetrahydrofolate reductase , a regulatory enzyme whose polymorphisms are associated with hyperhomocysteinemia . 0 ###LEFT-WALL### 1 mthfr 0 ###LEFT-WALL### 3 encodes 1 mthfr 3 encodes 3 encodes 5 reductase 4 methylenetetrahydrofolate 5 reductase 5 reductase 9 enzyme 6 , 9 enzyme 7 a 8 regulatory 7 a 9 enzyme 8 regulatory 9 enzyme 9 enzyme 10 whose 9 enzyme 16 . 10 whose 11 polymorphisms 11 polymorphisms 12 are 12 are 13 associated 13 associated 14 with 14 with 15 hyperhomocysteinemia among polymorphisms , c677t , a thermolabile form , but not a1298c , [thermostable] , was associated with fatty liver and insulin resistance . 1 among 2 polymorphisms 1 among 3 , 1 among 4 c677t 4 c677t 8 form 4 c677t 16 was 5 , 8 form 6 a 8 form 7 thermolabile 8 form 8 form 10 but 8 form 15 , 9 , 10 but 10 but 11 not 10 but 12 a1298c 10 but 13 , 16 was 17 associated 17 associated 18 with 18 with 21 and 19 fatty 20 liver 20 liver 21 and 21 and 23 resistance 21 and 24 . 22 insulin 23 resistance aim : to investigate if nafld , in subjects referred for nutritional assessment and counselling , has any difference of prevalence and severity when associated with isolated mthfr a1298c polymorphism [and] hyperhomocysteinemia . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 3 to 2 : 4 investigate 3 to 4 investigate 4 investigate 5 if 4 investigate 24 when 5 if 6 nafld 5 if 17 has 6 nafld 8 in 6 nafld 17 has 7 , 8 in 8 in 14 and 8 in 16 , 9 subjects 10 referred 9 subjects 11 for 9 subjects 14 and 11 for 13 assessment 12 nutritional 13 assessment 14 and 15 counselling 17 has 19 difference 18 any 19 difference 19 difference 20 of 20 of 22 and 21 prevalence 22 and 22 and 23 severity 24 when 25 associated 25 associated 26 with 26 with 32 hyperhomocysteinemia 27 isolated 30 polymorphism 28 mthfr 29 a1298c 29 a1298c 30 polymorphism 30 polymorphism 32 hyperhomocysteinemia insulin resistance was assessed by homa - ir , nafld by ultrasound brigh - liver - score ( bls ) . 0 ###LEFT-WALL### 2 resistance 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 21 . 1 insulin 2 resistance 2 resistance 3 was 3 was 4 assessed 4 assessed 5 by 5 by 6 homa 7 - 8 ir 8 ir 10 nafld 9 , 10 nafld 10 nafld 11 by 10 nafld 20 ) 11 by 13 brigh 12 ultrasound 13 brigh 13 brigh 15 liver 13 brigh 19 bls 14 - 15 liver 15 liver 16 - 16 - 19 bls 17 score 19 bls 18 ( 19 bls 19 bls 20 ) results : mthfr subgroups ( wild and a1298c single polymorphism ) were not different for age , gender , dietary profile and bmi . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 4 subgroups 2 : 12 were 3 mthfr 4 subgroups 4 subgroups 7 and 4 subgroups 12 were 5 ( 7 and 6 wild 7 and 7 and 10 polymorphism 7 and 11 ) 8 a1298c 10 polymorphism 9 single 10 polymorphism 12 were 13 not 12 were 14 different 13 not 14 different 14 different 15 for 15 for 22 and 16 age 17 , 17 , 18 gender 17 , 19 , 19 , 21 profile 19 , 22 and 20 dietary 21 profile 22 and 23 bmi in nafld , mthfr 1298ac [(] [heterozygous] [ )( . homozygous wild [genotype] ( mthfr 1298aa ) patients had more severe nafld ( bls [:] 1.12 ± 1.14 vs [.] 0.54 ± 0.76 , p < 0.029 ) , greater insulin resistance [(] homa 3.20±2.35 vs [.] 2.12 ± 1.12 [;] p < 0.036 [ )(, higher [ast] [and] gammagt . 0 ###LEFT-WALL### 5 1298ac 0 ###LEFT-WALL### 10 . 1 in 2 nafld 2 nafld 4 mthfr 3 , 4 mthfr 4 mthfr 5 1298ac 10 . 18 patients 10 . 19 had 11 homozygous 18 patients 12 wild 16 1298aa 12 wild 18 patients 14 ( 16 1298aa 15 mthfr 16 1298aa 16 1298aa 17 ) 18 patients 19 had 19 had 27 ± 20 more 21 severe 21 severe 27 ± 22 nafld 24 bls 23 ( 24 bls 24 bls 27 ± 26 1.12 27 ± 27 ± 28 1.14 27 ± 29 vs 29 vs 41 insulin 31 0.54 41 insulin 32 ± 36 < 32 ± 39 , 32 ± 41 insulin 33 0.76 36 < 34 , 36 < 35 p 36 < 36 < 37 0.029 36 < 38 ) 40 greater 41 insulin 41 insulin 44 homa 41 insulin 45 3.20±2.35 41 insulin 46 vs 42 resistance 44 homa 44 homa 45 3.20±2.35 46 vs 49 ± 48 2.12 49 ± 49 ± 50 1.12 49 ± 53 < 52 p 53 < 53 < 54 0.036 54 0.036 60 gammagt 56 )(, 60 gammagt 57 higher 60 gammagt 60 gammagt 61 . conclusions : mthfr1298ac gene heterozygous polymorphisms can be weakly predictive for nafld severity . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 polymorphisms 2 : 8 be 2 : 14 . 3 mthfr1298ac 6 polymorphisms 4 gene 6 polymorphisms 5 heterozygous 6 polymorphisms 6 polymorphisms 7 can 7 can 8 be 8 be 9 weakly 8 be 10 predictive 10 predictive 11 for 11 for 13 severity 12 nafld 13 severity this mutation occurs frequently in populations with low prevalence of overall mortality and [of] atherosclerosis - associated disease : it could have maintained and maintain its persistence by an heterozygosis advantage mechanism , within significant adherence [to] healthy nutritional profiles . 0 ###LEFT-WALL### 2 mutation 0 ###LEFT-WALL### 24 and 1 this 2 mutation 2 mutation 3 occurs 3 occurs 4 frequently 3 occurs 5 in 3 occurs 7 with 5 in 6 populations 7 with 9 prevalence 8 low 9 prevalence 9 prevalence 10 of 9 prevalence 20 it 9 prevalence 22 have 10 of 13 and 11 overall 12 mortality 12 mortality 13 and 13 and 15 atherosclerosis 13 and 16 - 13 and 17 associated 13 and 18 disease 13 and 19 : 18 disease 19 : 20 it 21 could 21 could 22 have 22 have 24 and 23 maintained 24 and 24 and 25 maintain 24 and 27 persistence 26 its 27 persistence 27 persistence 28 by 27 persistence 34 within 28 by 32 mechanism 29 an 32 mechanism 30 heterozygosis 32 mechanism 31 advantage 32 mechanism 33 , 34 within 34 within 40 profiles 34 within 41 . 35 significant 36 adherence 36 adherence 40 profiles 38 healthy 40 profiles 39 nutritional 40 profiles interactions of nutrition , genetics and health are a part of the aging process throughout the life span and a greater consideration to the genetic characteristics of populations and individuals is warranted . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 33 . 1 interactions 2 of 1 interactions 4 , 2 of 3 nutrition 4 , 5 genetics 4 , 6 and 6 and 7 health 6 and 8 are 8 are 10 part 8 are 15 throughout 9 a 10 part 10 part 11 of 11 of 14 process 12 the 14 process 13 aging 14 process 15 throughout 18 span 16 the 18 span 17 life 18 span 19 and 22 consideration 19 and 32 warranted 20 a 22 consideration 21 greater 22 consideration 22 consideration 23 to 22 consideration 31 is 23 to 26 characteristics 24 the 26 characteristics 25 genetic 26 characteristics 26 characteristics 27 of 27 of 29 and 28 populations 29 and 29 and 30 individuals 31 is 32 warranted purpose : survivors of childhood cancer are at an increased risk of developing subsequent neoplasms . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 3 survivors 2 : 7 are 2 : 16 . 3 survivors 4 of 3 survivors 7 are 4 of 6 cancer 5 childhood 6 cancer 7 are 8 at 8 at 11 risk 9 an 11 risk 10 increased 11 risk 11 risk 12 of 12 of 13 developing 13 developing 15 neoplasms 14 subsequent 15 neoplasms in long - term survivors of childhood malignancies treated with and without cranial radiation therapy ( crt ) , undergoing unenhanced magnetic resonance imaging ( mri ) of the brain , we estimated detection of intracranial neoplasms . 0 ###LEFT-WALL### 32 we 0 ###LEFT-WALL### 33 estimated 0 ###LEFT-WALL### 38 . 1 in 5 survivors 1 in 11 and 2 long 3 - 2 long 4 term 4 term 5 survivors 5 survivors 6 of 6 of 7 childhood 7 childhood 8 malignancies 7 childhood 10 with 8 malignancies 9 treated 9 treated 10 with 11 and 12 without 11 and 27 ) 11 and 32 we 12 without 15 therapy 13 cranial 14 radiation 14 radiation 15 therapy 15 therapy 17 crt 15 therapy 20 undergoing 16 ( 17 crt 17 crt 18 ) 19 , 20 undergoing 20 undergoing 24 imaging 20 undergoing 27 ) 21 unenhanced 23 resonance 22 magnetic 23 resonance 23 resonance 24 imaging 24 imaging 26 mri 25 ( 26 mri 26 mri 27 ) 28 of 30 brain 28 of 31 , 28 of 32 we 29 the 30 brain 32 we 33 estimated 33 estimated 34 detection 34 detection 35 of 35 of 37 neoplasms 36 intracranial 37 neoplasms methods : to investigate neurocognitive outcomes , 219 survivors of childhood cancer underwent unenhanced screening mri of the brain . 1 methods 2 : 2 : 3 to 2 : 4 investigate 3 to 4 investigate 4 investigate 6 outcomes 5 neurocognitive 6 outcomes 6 outcomes 9 survivors 7 , 9 survivors 8 219 9 survivors 9 survivors 10 of 9 survivors 14 unenhanced 9 survivors 15 screening 9 survivors 20 . 10 of 11 childhood 11 childhood 12 cancer 11 childhood 13 underwent 12 cancer 13 underwent 15 screening 16 mri 16 mri 17 of 17 of 19 brain 18 the 19 brain of the survivors , 164 had been treated for acute lymphoblastic leukemia ( all ) ( 125 received crt ) and [55] for hodgkin lymphoma ( hl ) ( none received crt ) . 0 ###LEFT-WALL### 5 164 0 ###LEFT-WALL### 8 treated 0 ###LEFT-WALL### 34 . 1 of 3 survivors 1 of 4 , 1 of 5 164 2 the 3 survivors 5 164 6 had 6 had 7 been 7 been 8 treated 8 treated 21 and 9 for 12 leukemia 9 for 21 and 10 acute 12 leukemia 11 lymphoblastic 12 leukemia 12 leukemia 14 all 12 leukemia 18 received 13 ( 14 all 14 all 15 ) 16 ( 18 received 17 125 18 received 18 received 19 crt 18 received 20 ) 21 and 23 for 23 for 25 lymphoma 24 hodgkin 25 lymphoma 25 lymphoma 27 hl 25 lymphoma 31 received 26 ( 27 hl 27 hl 28 ) 29 ( 31 received 30 none 31 received 31 received 32 crt 31 received 33 ) mri examinations were reviewed and systematically coded by a single neuroradiologist . 0 ###LEFT-WALL### 2 examinations 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 12 . 1 mri 2 examinations 2 examinations 3 were 3 were 5 and 4 reviewed 5 and 5 and 7 coded 5 and 8 by 6 systematically 7 coded 8 by 11 neuroradiologist 9 a 10 single 9 a 11 neuroradiologist 10 single 11 neuroradiologist demographic and treatment characteristics were compared for survivors [with] and without subsequent neoplasms . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 6 compared 0 ###LEFT-WALL### 14 . 1 demographic 2 and 2 and 4 characteristics 2 and 5 were 3 treatment 4 characteristics 5 were 6 compared 6 compared 10 and 7 for 8 survivors 7 for 10 and 10 and 11 without 11 without 13 neoplasms 12 subsequent 13 neoplasms results : nineteen of the 219 survivors ( 8.7 % ) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years ( range 12 - 46 years ) from diagnosis . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 nineteen 2 : 12 had 2 : 39 . 3 nineteen 4 of 3 nineteen 10 % 3 nineteen 12 had 4 of 7 survivors 5 the 6 219 6 219 7 survivors 8 ( 10 % 9 8.7 10 % 10 % 11 ) 12 had 14 total 12 had 21 by 13 a 14 total 14 total 15 of 14 total 20 identified 15 of 19 neoplasms 16 31 19 neoplasms 17 subsequent 19 neoplasms 18 intracranial 19 neoplasms 21 by 22 neuroimaging 22 neuroimaging 23 at 23 at 26 time 24 a 26 time 25 median 26 time 26 time 27 of 26 time 37 from 27 of 29 years 28 25 29 years 29 years 31 range 30 ( 31 range 31 range 32 12 31 range 35 years 31 range 36 ) 33 - 35 years 34 46 35 years 35 years 36 ) 37 from 38 diagnosis all neoplasms occurred after crt , except for a single vestibular schwannoma within the cervical radiation field in a hl survivor . 0 ###LEFT-WALL### 2 neoplasms 0 ###LEFT-WALL### 3 occurred 1 all 2 neoplasms 2 neoplasms 3 occurred 3 occurred 4 after 4 after 5 crt 5 crt 7 except 6 , 7 except 7 except 8 for 7 except 22 . 8 for 12 schwannoma 9 a 10 single 9 a 12 schwannoma 10 single 12 schwannoma 11 vestibular 12 schwannoma 12 schwannoma 13 within 13 within 17 field 14 the 17 field 15 cervical 16 radiation 16 radiation 17 field 17 field 18 in 18 in 21 survivor 19 a 21 survivor 20 hl 21 survivor the prevalence of subsequent neoplasms after crt exposure was 14.4 % ( 18 of 125 ) . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 17 . 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 9 was 3 of 5 neoplasms 4 subsequent 5 neoplasms 5 neoplasms 6 after 6 after 8 exposure 7 crt 8 exposure 9 was 11 % 10 14.4 11 % 11 % 13 18 12 ( 13 18 13 18 14 of 13 18 16 ) 14 of 15 125 by noncontrast mri , intracranial neoplasms were most suggestive [of] meningiomas . 0 ###LEFT-WALL### 6 neoplasms 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 12 . 1 by 2 noncontrast 1 by 6 neoplasms 3 mri 4 , 3 mri 6 neoplasms 5 intracranial 6 neoplasms 6 neoplasms 7 were 7 were 11 meningiomas 8 most 9 suggestive 9 suggestive 11 meningiomas most patients presented with no specific , localizing neurological complaints . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 presented 0 ###LEFT-WALL### 11 . 1 most 2 patients 2 patients 3 presented 3 presented 4 with 3 presented 10 complaints 4 with 8 localizing 5 no 8 localizing 6 specific 7 , 6 specific 8 localizing 9 neurological 10 complaints in addition to the schwannoma , six tumors were resected based on results of mri screening , all of which were meningiomas on histologic review . 0 ###LEFT-WALL### 18 all 0 ###LEFT-WALL### 21 were 0 ###LEFT-WALL### 26 . 1 in 2 addition 1 in 17 , 1 in 18 all 2 addition 3 to 2 addition 7 six 3 to 5 schwannoma 4 the 5 schwannoma 6 , 7 six 7 six 8 tumors 7 six 9 were 7 six 10 resected 7 six 11 based 7 six 17 , 8 tumors 9 were 11 based 12 on 12 on 13 results 13 results 14 of 14 of 16 screening 15 mri 16 screening 18 all 19 of 18 all 21 were 19 of 20 which 21 were 22 meningiomas 22 meningiomas 23 on 23 on 25 review 24 histologic 25 review conclusion : unenhanced brain mri of long - term survivors of childhood cancer detected a substantial number of intracranial neoplasms . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 mri 2 : 14 detected 2 : 21 . 3 unenhanced 5 mri 4 brain 5 mri 5 mri 6 of 5 mri 14 detected 6 of 10 survivors 7 long 8 - 7 long 9 term 9 term 10 survivors 10 survivors 11 of 11 of 13 cancer 12 childhood 13 cancer 14 detected 17 number 15 a 16 substantial 15 a 17 number 16 substantial 17 number 17 number 18 of 18 of 20 neoplasms 19 intracranial 20 neoplasms screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received crt should be evaluated . 0 ###LEFT-WALL### 1 screening 0 ###LEFT-WALL### 19 evaluated 0 ###LEFT-WALL### 20 . 1 screening 2 for 1 screening 5 of 1 screening 17 should 2 for 4 detection 3 early 4 detection 5 of 7 neoplasms 6 intracranial 7 neoplasms 7 neoplasms 8 among 7 neoplasms 11 of 8 among 9 aging 9 aging 10 survivors 11 of 13 cancer 12 childhood 13 cancer 13 cancer 14 who 13 cancer 15 received 14 who 15 received 15 received 16 crt 17 should 18 be 18 be 19 evaluated implications for cancer survivors : the high prevalence of incidentally detected subsequent intracranial neoplasms after crt in long - term survivors of childhood cancer and the minimal symptoms reported by those with intracranial tumors in our study indicate that brain mri screening of long - term survivors who received crt may be warranted . 0 ###LEFT-WALL### 4 survivors 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 54 . 1 implications 2 for 2 for 3 cancer 3 cancer 4 survivors 5 : 8 prevalence 5 : 25 and 6 the 8 prevalence 7 high 8 prevalence 8 prevalence 9 of 8 prevalence 22 of 9 of 14 neoplasms 10 incidentally 11 detected 11 detected 14 neoplasms 12 subsequent 14 neoplasms 13 intracranial 14 neoplasms 14 neoplasms 15 after 15 after 16 crt 16 crt 17 in 17 in 21 survivors 18 long 19 - 18 long 20 term 20 term 21 survivors 22 of 24 cancer 23 childhood 24 cancer 25 and 28 symptoms 25 and 38 indicate 26 the 28 symptoms 27 minimal 28 symptoms 28 symptoms 29 reported 28 symptoms 38 indicate 29 reported 30 by 29 reported 32 with 30 by 31 those 32 with 34 tumors 33 intracranial 34 tumors 34 tumors 35 in 35 in 37 study 36 our 37 study 38 indicate 39 that 39 that 42 screening 39 that 53 warranted 40 brain 42 screening 41 mri 42 screening 42 screening 43 of 42 screening 51 may 43 of 47 survivors 44 long 45 - 44 long 46 term 46 term 47 survivors 47 survivors 48 who 47 survivors 49 received 48 who 49 received 49 received 50 crt 51 may 52 be 52 be 53 warranted prospective studies of such screening are needed . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 7 needed 0 ###LEFT-WALL### 8 . 1 prospective 2 studies 2 studies 3 of 2 studies 6 are 3 of 5 screening 4 such 5 screening 6 are 7 needed as society ages , aging medical problems such as organ damage or failure among senior citizens increases , raising the demand for organ repair technologies . 0 ###LEFT-WALL### 5 aging 0 ###LEFT-WALL### 17 increases 1 as 2 society 1 as 3 ages 1 as 4 , 1 as 5 aging 2 society 3 ages 5 aging 7 problems 5 aging 14 among 5 aging 17 increases 6 medical 7 problems 7 problems 9 as 8 such 9 as 9 as 12 or 10 organ 11 damage 11 damage 12 or 12 or 13 failure 14 among 16 citizens 15 senior 16 citizens 17 increases 19 raising 18 , 19 raising 19 raising 21 demand 19 raising 26 . 20 the 21 demand 21 demand 22 for 22 for 25 technologies 23 organ 25 technologies 24 repair 25 technologies synthetic materials have been developed and applied in various parts [of] human [body] to meet the biomedical needs . 0 ###LEFT-WALL### 2 materials 0 ###LEFT-WALL### 15 meet 0 ###LEFT-WALL### 19 . 1 synthetic 2 materials 2 materials 3 have 3 have 4 been 4 been 6 and 5 developed 6 and 6 and 7 applied 7 applied 8 in 8 in 10 parts 9 various 10 parts 10 parts 12 human 12 human 14 to 14 to 15 meet 15 meet 18 needs 16 the 18 needs 17 biomedical 18 needs hydrogels , in particular , have found extensive applications as wound healing , drug delivery and controlled release , and scaffold materials in the human body . 0 ###LEFT-WALL### 1 hydrogels 0 ###LEFT-WALL### 7 found 0 ###LEFT-WALL### 27 . 1 hydrogels 4 particular 1 hydrogels 6 have 2 , 4 particular 3 in 4 particular 4 particular 5 , 6 have 7 found 7 found 9 applications 7 found 10 as 8 extensive 9 applications 10 as 20 and 11 wound 12 healing 12 healing 13 , 13 , 15 delivery 13 , 16 and 14 drug 15 delivery 16 and 18 release 16 and 20 and 17 controlled 18 release 19 , 20 and 20 and 22 materials 20 and 23 in 21 scaffold 22 materials 23 in 26 body 24 the 26 body 25 human 26 body the development of the next generation of soft hydrogel biomaterials focuses on facile synthetic methods , efficacy of treatment , and tunable multi - functionalities for applications . 0 ###LEFT-WALL### 2 development 0 ###LEFT-WALL### 10 biomaterials 0 ###LEFT-WALL### 28 . 1 the 2 development 2 development 3 of 2 development 10 biomaterials 3 of 6 generation 4 the 5 next 4 the 6 generation 6 generation 7 of 7 of 9 hydrogel 8 soft 9 hydrogel 10 biomaterials 11 focuses 10 biomaterials 12 on 10 biomaterials 26 for 12 on 21 and 13 facile 15 methods 14 synthetic 15 methods 15 methods 16 , 16 , 17 efficacy 16 , 21 and 17 efficacy 18 of 18 of 19 treatment 20 , 21 and 21 and 25 functionalities 22 tunable 25 functionalities 23 multi 24 - 23 multi 25 functionalities 26 for 27 applications supramolecular 3 d entities are highly attractive materials for biomedical application . 0 ###LEFT-WALL### 4 entities 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 12 . 1 supramolecular 4 entities 2 3 3 d 3 d 4 entities 4 entities 5 are 5 are 8 materials 6 highly 7 attractive 7 attractive 8 materials 8 materials 9 for 9 for 11 application 10 biomedical 11 application they are assembled by modules via various [non] - covalent bonds ( hydrogen bonds , p - p stacking [and/or] van der waals interactions ) . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 3 assembled 0 ###LEFT-WALL### 26 . 1 they 2 are 2 are 3 assembled 3 assembled 4 by 3 assembled 6 via 4 by 5 modules 6 via 11 bonds 7 various 9 - 7 various 11 bonds 10 covalent 11 bonds 11 bonds 14 bonds 11 bonds 24 interactions 12 ( 14 bonds 13 hydrogen 14 bonds 14 bonds 15 , 15 , 24 interactions 16 p 17 - 17 - 18 p 17 - 24 interactions 19 stacking 24 interactions 21 van 24 interactions 22 der 23 waals 23 waals 24 interactions 24 interactions 25 ) biodegradable thermogels are a class of such supramolecular assembled materials . 0 ###LEFT-WALL### 2 thermogels 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 11 . 1 biodegradable 2 thermogels 2 thermogels 3 are 3 are 5 class 4 a 5 class 5 class 6 of 6 of 10 materials 7 such 10 materials 8 supramolecular 10 materials 9 assembled 10 materials their use as soft biomaterials and their related applications are described in this review . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 described 0 ###LEFT-WALL### 15 . 1 their 2 use 2 use 3 as 2 use 6 and 3 as 5 biomaterials 4 soft 5 biomaterials 6 and 9 applications 6 and 10 are 7 their 9 applications 8 related 9 applications 10 are 11 described 11 described 12 in 12 in 14 review 13 this 14 review future directions in the advancement and refinement of facial rejuvenation techniques represent a response to patient demand for higher aesthetic impact with less procedural downtime and with minimal scarring as evidence of previous surgery . 0 ###LEFT-WALL### 2 directions 0 ###LEFT-WALL### 12 represent 0 ###LEFT-WALL### 35 . 1 future 2 directions 2 directions 3 in 2 directions 8 of 2 directions 12 represent 3 in 6 and 4 the 5 advancement 5 advancement 6 and 6 and 7 refinement 8 of 11 techniques 9 facial 10 rejuvenation 10 rejuvenation 11 techniques 12 represent 14 response 12 represent 30 as 13 a 14 response 14 response 15 to 15 to 17 demand 16 patient 17 demand 17 demand 26 and 18 for 21 impact 18 for 26 and 19 higher 21 impact 20 aesthetic 21 impact 21 impact 22 with 22 with 25 downtime 23 less 25 downtime 24 procedural 25 downtime 26 and 27 with 27 with 29 scarring 28 minimal 29 scarring 30 as 31 evidence 31 evidence 32 of 32 of 34 surgery 33 previous 34 surgery with surgical procedures , the trend of innovation in response to demand has been toward more minimally invasive approaches that have the predictability and durability of results of more traditional approaches . 0 ###LEFT-WALL### 6 trend 0 ###LEFT-WALL### 14 been 0 ###LEFT-WALL### 32 . 1 with 3 procedures 1 with 4 , 1 with 6 trend 2 surgical 3 procedures 5 the 6 trend 6 trend 7 of 6 trend 11 to 6 trend 13 has 7 of 8 innovation 8 innovation 10 response 9 in 10 response 11 to 12 demand 13 has 14 been 14 been 15 toward 15 toward 19 approaches 16 more 19 approaches 17 minimally 18 invasive 18 invasive 19 approaches 19 approaches 20 that 19 approaches 21 have 20 that 21 have 21 have 24 and 22 the 24 and 23 predictability 24 and 24 and 25 durability 24 and 26 of 26 of 27 results 27 results 28 of 28 of 31 approaches 29 more 30 traditional 30 traditional 31 approaches with nonsurgical procedures , there have been new developments in achieving more significant aesthetic improvements with less downtime and less invasively . 0 ###LEFT-WALL### 5 there 0 ###LEFT-WALL### 7 been 0 ###LEFT-WALL### 22 . 1 with 3 procedures 1 with 4 , 1 with 5 there 2 nonsurgical 3 procedures 5 there 6 have 6 have 7 been 7 been 9 developments 7 been 21 invasively 8 new 9 developments 9 developments 10 in 10 in 11 achieving 11 achieving 15 improvements 11 achieving 19 and 12 more 15 improvements 13 significant 15 improvements 14 aesthetic 15 improvements 15 improvements 16 with 16 with 17 less 18 downtime 19 and 19 and 20 less the ephemeral effects of neurotoxins and fillers are well described for facial remodeling and rejuvenation . 0 ###LEFT-WALL### 3 effects 0 ###LEFT-WALL### 10 described 0 ###LEFT-WALL### 16 . 1 the 3 effects 2 ephemeral 3 effects 3 effects 4 of 3 effects 8 are 4 of 6 and 5 neurotoxins 6 and 6 and 7 fillers 8 are 9 well 8 are 10 described 10 described 11 for 11 for 14 and 12 facial 13 remodeling 13 remodeling 14 and 14 and 15 rejuvenation less is known about their long - term effects on skin rejuvenation and neocollagenesis . 0 ###LEFT-WALL### 1 less 0 ###LEFT-WALL### 3 known 0 ###LEFT-WALL### 15 . 1 less 2 is 2 is 3 known 3 known 4 about 3 known 10 on 4 about 9 effects 5 their 9 effects 6 long 7 - 6 long 8 term 8 term 9 effects 10 on 13 and 11 skin 12 rejuvenation 12 rejuvenation 13 and 13 and 14 neocollagenesis this article aims to review current available science and literature to support the use of these cosmetic procedures as lasting antiaging treatments . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 23 . 1 this 2 article 2 article 3 aims 3 aims 4 to 3 aims 11 to 3 aims 12 support 4 to 5 review 5 review 9 and 6 current 8 science 7 available 8 science 8 science 9 and 9 and 10 literature 11 to 12 support 12 support 14 use 12 support 19 as 13 the 14 use 14 use 15 of 15 of 18 procedures 16 these 18 procedures 17 cosmetic 18 procedures 19 as 22 treatments 20 lasting 22 treatments 21 antiaging 22 treatments radiofrequency ( rf ) and intense focused ultrasound ( ifus ) are increasingly used to address skin laxity of the face and neck . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 14 used 0 ###LEFT-WALL### 24 . 1 radiofrequency 3 rf 2 ( 3 rf 3 rf 4 ) 3 rf 5 and 5 and 8 ultrasound 5 and 10 ifus 5 and 12 are 6 intense 8 ultrasound 7 focused 8 ultrasound 9 ( 10 ifus 10 ifus 11 ) 12 are 14 used 13 increasingly 14 used 14 used 15 to 14 used 22 and 15 to 22 and 16 address 18 laxity 16 address 22 and 17 skin 18 laxity 18 laxity 19 of 19 of 21 face 20 the 21 face 22 and 23 neck both nonablative rf and ultrasound create a heat [-] induced tissue response that leads to collagen remodeling and other ultrastructural changes . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 create 0 ###LEFT-WALL### 22 . 1 both 3 rf 2 nonablative 3 rf 3 rf 4 and 4 and 5 ultrasound 4 and 6 create 6 create 12 response 6 create 15 to 7 a 8 heat 7 a 12 response 8 heat 12 response 10 induced 11 tissue 11 tissue 12 response 12 response 13 that 12 response 14 leads 13 that 14 leads 15 to 18 and 16 collagen 17 remodeling 17 remodeling 18 and 18 and 21 changes 19 other 21 changes 20 ultrastructural 21 changes although these treatments are not meant to replace surgical procedures , patient satisfaction in the majority of studies has been consistently high . 0 ###LEFT-WALL### 13 satisfaction 0 ###LEFT-WALL### 20 been 0 ###LEFT-WALL### 23 . 1 although 3 treatments 1 although 6 meant 1 although 11 , 1 although 13 satisfaction 2 these 3 treatments 3 treatments 4 are 4 are 5 not 4 are 6 meant 6 meant 7 to 7 to 8 replace 8 replace 10 procedures 9 surgical 10 procedures 12 patient 13 satisfaction 13 satisfaction 14 in 13 satisfaction 19 has 14 in 18 studies 15 the 16 majority 16 majority 17 of 16 majority 18 studies 17 of 18 studies 19 has 20 been 20 been 21 consistently 20 been 22 high this article discusses the various rf and ifus technologies currently in use and reviews pertinent clinical studies evaluating their efficacy and safety . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 23 . 1 this 2 article 2 article 13 and 2 article 18 evaluating 2 article 21 and 3 discusses 9 technologies 3 discusses 10 currently 3 discusses 11 in 3 discusses 13 and 4 the 9 technologies 5 various 9 technologies 6 rf 7 and 7 and 8 ifus 8 ifus 9 technologies 11 in 12 use 13 and 14 reviews 14 reviews 17 studies 15 pertinent 17 studies 16 clinical 17 studies 18 evaluating 20 efficacy 19 their 20 efficacy 21 and 22 safety for many patients , sun damage , trauma , prior cutaneous carcinomas , and aging have created a less [than] optimal skin appearance . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 17 created 0 ###LEFT-WALL### 24 . 1 for 3 patients 1 for 14 and 2 many 3 patients 3 patients 6 damage 4 , 6 damage 5 sun 6 damage 6 damage 7 , 8 trauma 9 , 9 , 12 carcinomas 9 , 14 and 10 prior 12 carcinomas 11 cutaneous 12 carcinomas 13 , 14 and 14 and 15 aging 14 and 16 have 16 have 17 created 17 created 23 appearance 18 a 23 appearance 19 less 21 optimal 21 optimal 22 skin 22 skin 23 appearance there are currently multiple forms of ablative therapy to correct such concerns . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 13 . 1 there 2 are 2 are 3 currently 2 are 5 forms 2 are 9 to 4 multiple 5 forms 5 forms 6 of 6 of 8 therapy 7 ablative 8 therapy 9 to 10 correct 10 correct 12 concerns 11 such 12 concerns dermabrasion is a form of resurfacing that mechanically alters the skin at the level of the dermis [,] to promote collagen remodeling and re - epithelialization . 0 ###LEFT-WALL### 1 dermabrasion 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 27 . 1 dermabrasion 2 is 2 is 4 form 3 a 4 form 4 form 5 of 4 form 7 that 4 form 9 alters 5 of 6 resurfacing 7 that 9 alters 8 mechanically 9 alters 9 alters 11 skin 9 alters 23 and 10 the 11 skin 12 at 14 level 12 at 23 and 13 the 14 level 14 level 15 of 15 of 17 dermis 16 the 17 dermis 17 dermis 19 to 17 dermis 22 remodeling 19 to 20 promote 20 promote 21 collagen 21 collagen 22 remodeling 23 and 24 re 24 re 25 - 24 re 26 epithelialization facial skin has a rich vascular and adnexal network , allowing the rapid healing of controlled damage because blood , macronutrients , and oxygen are readily available . 0 ###LEFT-WALL### 2 skin 0 ###LEFT-WALL### 3 has 1 facial 2 skin 2 skin 3 has 3 has 9 network 4 a 5 rich 4 a 9 network 5 rich 9 network 6 vascular 7 and 7 and 8 adnexal 7 and 9 network 9 network 11 allowing 10 , 11 allowing 11 allowing 14 healing 11 allowing 18 because 11 allowing 28 . 12 the 14 healing 13 rapid 14 healing 14 healing 15 of 15 of 17 damage 16 controlled 17 damage 18 because 23 and 18 because 25 are 19 blood 20 , 20 , 21 macronutrients 20 , 23 and 22 , 23 and 23 and 24 oxygen 23 and 25 are 25 are 26 readily 25 are 27 available sebaceous glands and hair follicles are important in the regeneration process of the dermis . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 15 . 1 sebaceous 2 glands 2 glands 3 and 3 and 5 follicles 3 and 6 are 4 hair 5 follicles 6 are 7 important 7 important 8 in 8 in 11 process 9 the 11 process 10 regeneration 11 process 11 process 12 of 12 of 14 dermis 13 the 14 dermis dermabrasion can be taken down [layer] by [layer] to remove the proper level of skin , so that the desired effect is obtained . 0 ###LEFT-WALL### 1 dermabrasion 0 ###LEFT-WALL### 4 taken 1 dermabrasion 2 can 2 can 3 be 3 be 4 taken 4 taken 5 down 4 taken 9 to 5 down 7 by 9 to 10 remove 10 remove 13 level 10 remove 18 that 11 the 13 level 12 proper 13 level 13 level 14 of 14 of 15 skin 16 , 18 that 17 so 18 that 18 that 21 effect 18 that 23 obtained 18 that 24 . 19 the 21 effect 20 desired 21 effect 21 effect 22 is 22 is 23 obtained by completely removing the epidermis and penetrating into the reticular and papillary dermis , controlled damage is obtained and remodeling of the skin 's structural proteins , into a more organized manner , occurs during the healing process . 0 ###LEFT-WALL### 16 damage 0 ###LEFT-WALL### 17 is 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 39 . 1 by 3 removing 1 by 14 , 1 by 16 damage 2 completely 3 removing 3 removing 6 and 3 removing 8 into 4 the 5 epidermis 5 epidermis 6 and 6 and 7 penetrating 8 into 13 dermis 9 the 13 dermis 10 reticular 11 and 11 and 12 papillary 11 and 13 dermis 15 controlled 16 damage 16 damage 17 is 17 is 18 obtained 19 and 20 remodeling 19 and 34 occurs 20 remodeling 21 of 20 remodeling 34 occurs 21 of 26 proteins 22 the 23 skin 23 skin 24 's 24 's 26 proteins 25 structural 26 proteins 26 proteins 28 into 27 , 28 into 28 into 32 manner 28 into 33 , 29 a 32 manner 30 more 31 organized 31 organized 32 manner 34 occurs 35 during 35 during 38 process 36 the 38 process 37 healing 38 process this abrasion technique leads to clinically significant improvements in skin structure , quality , and appearance . 0 ###LEFT-WALL### 3 technique 0 ###LEFT-WALL### 4 leads 0 ###LEFT-WALL### 17 . 1 this 3 technique 2 abrasion 3 technique 3 technique 4 leads 4 leads 5 to 4 leads 9 in 5 to 8 improvements 6 clinically 7 significant 7 significant 8 improvements 9 in 15 and 10 skin 11 structure 11 structure 12 , 12 , 13 quality 12 , 15 and 14 , 15 and 15 and 16 appearance with the recent proliferation of over the counter cosmeceuticals , prescription topical skin treatments have the cache of being evidence - [based] and not being available outside the setting of a patient - physician interaction . 0 ###LEFT-WALL### 14 treatments 0 ###LEFT-WALL### 15 have 0 ###LEFT-WALL### 36 . 1 with 4 proliferation 1 with 10 , 1 with 14 treatments 2 the 4 proliferation 3 recent 4 proliferation 4 proliferation 5 of 5 of 6 over 6 over 9 cosmeceuticals 7 the 9 cosmeceuticals 8 counter 9 cosmeceuticals 11 prescription 14 treatments 12 topical 13 skin 13 skin 14 treatments 14 treatments 15 have 15 have 17 cache 16 the 17 cache 17 cache 18 of 17 cache 26 available 18 of 19 being 19 being 23 and 20 evidence 23 and 21 - 23 and 23 and 24 not 23 and 25 being 26 available 27 outside 27 outside 29 setting 28 the 29 setting 29 setting 30 of 30 of 35 interaction 31 a 35 interaction 32 patient 33 - 32 patient 34 physician 34 physician 35 interaction in the setting of facial rejuvenation , patient demand for prescription topical skin treatments falls into three main roles : [(] 1 [ )(stimulation of collagen [production] [;] ( 2 ) improvement of dyspigmentation [;] and [(] 3 [ )(amelioration of adult acne . 0 ###LEFT-WALL### 9 demand 0 ###LEFT-WALL### 15 falls 0 ###LEFT-WALL### 20 : 0 ###LEFT-WALL### 44 . 1 in 3 setting 1 in 7 , 1 in 9 demand 2 the 3 setting 3 setting 4 of 4 of 6 rejuvenation 5 facial 6 rejuvenation 8 patient 9 demand 9 demand 10 for 9 demand 15 falls 10 for 14 treatments 11 prescription 14 treatments 12 topical 13 skin 13 skin 14 treatments 15 falls 16 into 16 into 19 roles 17 three 19 roles 18 main 19 roles 20 : 36 and 22 1 24 )(stimulation 24 )(stimulation 25 of 24 )(stimulation 36 and 25 of 32 improvement 26 collagen 30 2 26 collagen 32 improvement 29 ( 30 2 30 2 31 ) 32 improvement 33 of 33 of 34 dyspigmentation 36 and 40 )(amelioration 36 and 41 of 38 3 40 )(amelioration 41 of 43 acne 42 adult 43 acne topical skin care regimens are a mainstay treatment for aging skin . 0 ###LEFT-WALL### 4 regimens 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 12 . 1 topical 2 skin 2 skin 4 regimens 3 care 4 regimens 4 regimens 5 are 5 are 8 treatment 6 a 8 treatment 7 mainstay 8 treatment 8 treatment 9 for 9 for 10 aging 10 aging 11 skin all patients seeking skin rejuvenation can benefit from this low - risk intervention . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 7 benefit 0 ###LEFT-WALL### 14 . 1 all 2 patients 2 patients 3 seeking 2 patients 6 can 3 seeking 5 rejuvenation 4 skin 5 rejuvenation 6 can 7 benefit 7 benefit 8 from 8 from 13 intervention 9 this 10 low 10 low 11 - 10 low 13 intervention 12 risk 13 intervention this article reviews available nonprescription topical treatments for rejuvenation including moisturizers , antioxidants , retinols , and sunscreen . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 reviews 0 ###LEFT-WALL### 19 . 1 this 2 article 2 article 3 reviews 3 reviews 7 treatments 4 available 5 nonprescription 5 nonprescription 7 treatments 6 topical 7 treatments 7 treatments 8 for 8 for 17 and 9 rejuvenation 10 including 9 rejuvenation 12 , 10 including 11 moisturizers 12 , 13 antioxidants 12 , 14 , 14 , 15 retinols 14 , 17 and 16 , 17 and 17 and 18 sunscreen none current approaches to [falls] prevention mostly rely on secondary and tertiary prevention and target individuals at high risk of falls . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 21 falls 0 ###LEFT-WALL### 22 . 1 none 3 approaches 1 none 14 and 1 none 21 falls 2 current 3 approaches 3 approaches 4 to 3 approaches 14 and 4 to 6 prevention 7 mostly 8 rely 8 rely 9 on 8 rely 14 and 9 on 13 prevention 10 secondary 11 and 11 and 12 tertiary 11 and 13 prevention 14 and 15 target 14 and 20 of 15 target 16 individuals 15 target 17 at 17 at 19 risk 18 high 19 risk 19 risk 20 of an alternative is primary prevention , in which all seniors are screened , referred as appropriate , and educated regarding falls risk . 0 ###LEFT-WALL### 2 alternative 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 23 . 1 an 2 alternative 2 alternative 3 is 3 is 5 prevention 4 primary 5 prevention 5 prevention 7 in 6 , 7 in 7 in 8 which 7 in 10 seniors 7 in 11 are 7 in 13 , 9 all 10 seniors 10 seniors 11 are 11 are 12 screened 13 , 14 referred 13 , 21 falls 14 referred 15 as 14 referred 21 falls 15 as 20 regarding 16 appropriate 18 and 17 , 18 and 18 and 19 educated 18 and 20 regarding 21 falls 22 risk little information is available on research designs that allow investigation of this approach in the setting of aging services delivery , where randomization may not be possible . 0 ###LEFT-WALL### 2 information 0 ###LEFT-WALL### 3 is 1 little 2 information 2 information 3 is 3 is 4 available 4 available 5 on 4 available 14 in 5 on 7 designs 6 research 7 designs 7 designs 8 that 7 designs 9 allow 8 that 9 allow 9 allow 10 investigation 10 investigation 11 of 11 of 13 approach 12 this 13 approach 14 in 16 setting 15 the 16 setting 16 setting 17 of 17 of 18 aging 18 aging 20 delivery 18 aging 22 where 19 services 20 delivery 21 , 22 where 22 where 23 randomization 22 where 26 be 22 where 28 . 23 randomization 24 may 24 may 25 not 24 may 26 be 26 be 27 possible healthy steps for older adults , a statewide program of the pennsylvania ( pa ) department of aging , involves a combination of education about [falls] and screening for balance problems , with referral to personal physicians and home safety assessments . 0 ###LEFT-WALL### 27 and 1 healthy 2 steps 2 steps 3 for 2 steps 27 and 3 for 4 older 4 older 5 adults 4 older 20 involves 5 adults 9 program 5 adults 20 involves 6 , 9 program 7 a 8 statewide 7 a 9 program 8 statewide 9 program 9 program 10 of 9 program 17 of 9 program 19 , 10 of 16 department 11 the 16 department 12 pennsylvania 14 pa 12 pennsylvania 16 department 13 ( 14 pa 14 pa 15 ) 17 of 18 aging 20 involves 22 combination 20 involves 25 about 21 a 22 combination 22 combination 23 of 23 of 24 education 27 and 28 screening 27 and 29 for 29 for 31 problems 30 balance 31 problems 31 problems 33 with 32 , 33 with 33 with 38 and 33 with 42 . 34 referral 35 to 34 referral 38 and 35 to 37 physicians 36 personal 37 physicians 38 and 41 assessments 39 home 40 safety 40 safety 41 assessments we developed a [non] [-] randomized statewide trial , falls free pa , to assess its effectiveness in reducing falls [incidence] over 12 months . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 developed 0 ###LEFT-WALL### 25 . 1 we 2 developed 2 developed 8 trial 2 developed 14 to 3 a 8 trial 6 randomized 8 trial 7 statewide 8 trial 8 trial 12 pa 9 , 12 pa 10 falls 11 free 11 free 12 pa 12 pa 13 , 14 to 15 assess 15 assess 17 effectiveness 15 assess 20 falls 16 its 17 effectiveness 17 effectiveness 18 in 17 effectiveness 20 falls 18 in 19 reducing 20 falls 22 over 22 over 24 months 23 12 24 months we recruited 814 seniors who completed the program ( 503 [first] - time participants , 311 people repeating the program ) and 1,020 who did not participate in the program , from the same sites . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 recruited 0 ###LEFT-WALL### 22 and 1 we 2 recruited 2 recruited 4 seniors 2 recruited 12 - 3 814 4 seniors 4 seniors 5 who 4 seniors 6 completed 5 who 6 completed 6 completed 8 program 7 the 8 program 9 ( 12 - 10 503 12 - 12 - 14 participants 12 - 21 ) 13 time 14 participants 14 participants 17 people 15 , 17 people 16 311 17 people 17 people 18 repeating 17 people 21 ) 18 repeating 20 program 19 the 20 program 22 and 23 1,020 22 and 27 participate 23 1,020 24 who 23 1,020 25 did 23 1,020 27 participate 24 who 25 did 25 did 26 not 27 participate 28 in 28 in 30 program 29 the 30 program 30 program 32 from 31 , 32 from 32 from 35 sites 32 from 36 . 33 the 34 same 34 same 35 sites we assessed the quality of this [non] - randomized design by examining [recruitment] , follow - up across study groups , and comparability at baseline . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 assessed 0 ###LEFT-WALL### 14 , 1 we 2 assessed 2 assessed 4 quality 3 the 4 quality 4 quality 5 of 4 quality 10 design 5 of 6 this 8 - 10 design 9 randomized 10 design 10 design 11 by 10 design 14 , 11 by 12 examining 14 , 15 follow 15 follow 17 up 16 - 17 up 17 up 18 across 17 up 26 . 18 across 22 and 19 study 20 groups 20 groups 22 and 21 , 22 and 22 and 23 comparability 22 and 24 at 24 at 25 baseline of older adults approached in senior centers , 90.5 % ( n = 2,219 ) signed informed consent , and 1,834 ( 82.4 % ) completed baseline assessments and were eligible for [follow] - up . 0 ###LEFT-WALL### 10 % 0 ###LEFT-WALL### 16 signed 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 36 . 1 of 3 adults 1 of 8 , 1 of 10 % 2 older 3 adults 3 adults 4 approached 4 approached 5 in 5 in 7 centers 6 senior 7 centers 9 90.5 10 % 10 % 13 = 10 % 16 signed 11 ( 13 = 12 n 13 = 13 = 14 2,219 13 = 15 ) 16 signed 18 consent 17 informed 18 consent 19 , 20 and 20 and 21 1,834 20 and 29 and 21 1,834 24 % 21 1,834 29 and 22 ( 24 % 23 82.4 24 % 24 % 25 ) 26 completed 28 assessments 26 completed 29 and 27 baseline 28 assessments 29 and 30 were 30 were 31 eligible 31 eligible 32 for 32 for 35 up 34 - 35 up attrition in the three groups over 12 months was low and [non] - differential [(] < 10 % for withdrawal [and] < 2 % for other loss to follow - up ) . 0 ###LEFT-WALL### 1 attrition 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 29 follow 0 ###LEFT-WALL### 33 . 1 attrition 2 in 1 attrition 9 was 2 in 5 groups 3 the 4 three 4 three 5 groups 5 groups 6 over 6 over 8 months 7 12 8 months 9 was 10 low 11 and 13 - 11 and 22 < 13 - 14 differential 16 < 17 10 17 10 18 % 18 % 19 for 18 % 22 < 19 for 20 withdrawal 22 < 24 % 22 < 25 for 22 < 28 to 23 2 24 % 25 for 27 loss 26 other 27 loss 28 to 29 follow 29 follow 31 up 30 - 31 up 31 up 32 ) median follow - up , which involved standardized monthly assessment [of] falls , was 10 months in all study groups . 0 ###LEFT-WALL### 2 follow 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 21 . 1 median 2 follow 2 follow 4 up 3 - 4 up 4 up 5 , 5 , 6 which 5 , 13 , 6 which 10 assessment 7 involved 10 assessment 8 standardized 10 assessment 9 monthly 10 assessment 10 assessment 13 , 12 falls 13 , 13 , 14 was 13 , 17 in 13 , 20 groups 14 was 16 months 15 10 16 months 17 in 19 study 18 all 19 study at baseline , the groups did not differ in measures of health or [falls] risk factors . 0 ###LEFT-WALL### 5 groups 0 ###LEFT-WALL### 13 or 0 ###LEFT-WALL### 17 . 1 at 2 baseline 1 at 3 , 1 at 5 groups 4 the 5 groups 5 groups 13 or 6 did 7 not 6 did 8 differ 6 did 13 or 8 differ 9 in 9 in 10 measures 10 measures 11 of 11 of 12 health 13 or 15 risk 15 risk 16 factors comparable status at baseline , [recruitment] from common sites , and similar experience with retention suggest that the [non] [-] randomized design will be effective for assessment of this approach to primary prevention of falls . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 16 suggest 0 ###LEFT-WALL### 36 . 1 comparable 2 status 2 status 3 at 2 status 11 and 3 at 4 baseline 4 baseline 7 from 5 , 7 from 7 from 9 sites 7 from 10 , 8 common 9 sites 10 , 11 and 11 and 13 experience 11 and 14 with 11 and 16 suggest 12 similar 13 experience 14 with 15 retention 16 suggest 17 that 17 that 22 design 17 that 35 falls 18 the 22 design 21 randomized 22 design 22 design 23 will 22 design 34 of 22 design 35 falls 23 will 24 be 24 be 25 effective 25 effective 26 for 25 effective 31 to 26 for 27 assessment 27 assessment 28 of 28 of 30 approach 29 this 30 approach 31 to 33 prevention 32 primary 33 prevention 33 prevention 34 of exposure to 2 [-] mhz transcranial diagnostic ultrasound enhances the thrombolytic activity of intravenously administered tissue plasminogen [activator] ( iv - tpa [ )(in acute ischemic stroke [(] sonothrombolysis ) . 0 ###LEFT-WALL### 1 exposure 0 ###LEFT-WALL### 9 enhances 0 ###LEFT-WALL### 31 . 1 exposure 2 to 1 exposure 9 enhances 2 to 8 ultrasound 3 2 5 mhz 5 mhz 8 ultrasound 6 transcranial 7 diagnostic 7 diagnostic 8 ultrasound 9 enhances 12 activity 10 the 12 activity 11 thrombolytic 12 activity 12 activity 13 of 13 of 17 plasminogen 14 intravenously 15 administered 15 administered 17 plasminogen 16 tissue 17 plasminogen 17 plasminogen 20 iv 17 plasminogen 22 tpa 19 ( 20 iv 20 iv 21 - 21 - 22 tpa 22 tpa 24 )(in 22 tpa 30 ) 24 )(in 29 sonothrombolysis 25 acute 27 stroke 26 ischemic 27 stroke 27 stroke 29 sonothrombolysis however , rates of arterial recanalization vary widely , depending upon the clot burden , its location , and stroke subtype . 0 ###LEFT-WALL### 3 rates 0 ###LEFT-WALL### 7 vary 1 however 2 , 1 however 3 rates 3 rates 4 of 3 rates 7 vary 4 of 6 recanalization 5 arterial 6 recanalization 7 vary 8 widely 7 vary 10 depending 9 , 10 depending 10 depending 11 upon 10 depending 22 . 11 upon 13 clot 12 the 13 clot 13 clot 19 and 13 clot 21 subtype 14 burden 15 , 15 , 17 location 15 , 19 and 16 its 17 location 18 , 19 and 19 and 20 stroke 19 and 21 subtype we evaluated the influence of age and cholesterol level of the blood clots on sonothrombolysis in an in [vitro] model . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 evaluated 0 ###LEFT-WALL### 21 . 1 we 2 evaluated 2 evaluated 4 influence 3 the 4 influence 4 influence 5 of 4 influence 13 clots 4 influence 20 model 5 of 7 and 6 age 7 and 7 and 9 level 7 and 10 of 8 cholesterol 9 level 10 of 12 blood 11 the 12 blood 13 clots 14 on 13 clots 16 in 13 clots 20 model 14 on 15 sonothrombolysis 16 in 18 in 17 an 18 in to " age " the clots , serum was replaced by fresh blood periodically . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 15 . 1 to 2 " 1 to 3 age 3 age 4 " 3 age 6 clots 5 the 6 clots 7 , 8 serum 7 , 10 replaced 8 serum 9 was 9 was 10 replaced 10 replaced 11 by 10 replaced 14 periodically 11 by 13 blood 12 fresh 13 blood we increased the cholesterol content of the clots by adding cholesterin to the blood . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 increased 0 ###LEFT-WALL### 15 . 1 we 2 increased 2 increased 5 content 2 increased 9 by 3 the 5 content 4 cholesterol 5 content 5 content 6 of 6 of 8 clots 7 the 8 clots 9 by 10 adding 10 adding 11 cholesterin 10 adding 12 to 12 to 14 blood 13 the 14 blood the clots were lysed by tpa [and/or] transcranial doppler ultrasound sonication for 1 h . 0 ###LEFT-WALL### 2 clots 0 ###LEFT-WALL### 4 lysed 0 ###LEFT-WALL### 15 . 1 the 2 clots 2 clots 3 were 3 were 4 lysed 4 lysed 5 by 5 by 11 sonication 6 tpa 11 sonication 8 transcranial 11 sonication 9 doppler 11 sonication 10 ultrasound 11 sonication 11 sonication 12 for 12 for 14 h 13 1 14 h the extent of thrombolysis induced by various treatment protocols ( controls , sonication , tpa , and sonothrombolysis ) was evaluated with relative changes in the clot weights and in the clot structure by scanning electron microscopy ( sem ) at end of the experiment . 0 ###LEFT-WALL### 2 extent 0 ###LEFT-WALL### 21 evaluated 0 ###LEFT-WALL### 46 . 1 the 2 extent 2 extent 3 of 2 extent 17 and 2 extent 20 was 3 of 4 thrombolysis 4 thrombolysis 5 induced 4 thrombolysis 6 by 6 by 9 protocols 7 various 8 treatment 8 treatment 9 protocols 9 protocols 11 controls 10 ( 11 controls 11 controls 12 , 12 , 17 and 13 sonication 14 , 14 , 15 tpa 14 , 17 and 16 , 17 and 17 and 18 sonothrombolysis 17 and 19 ) 20 was 21 evaluated 21 evaluated 22 with 21 evaluated 29 and 22 with 24 changes 23 relative 24 changes 25 in 28 weights 25 in 29 and 26 the 28 weights 27 clot 28 weights 29 and 30 in 30 in 33 structure 31 the 33 structure 32 clot 33 structure 33 structure 34 by 33 structure 43 of 34 by 35 scanning 35 scanning 37 microscopy 35 scanning 42 end 36 electron 37 microscopy 37 microscopy 39 sem 38 ( 39 sem 39 sem 40 ) 41 at 42 end 43 of 45 experiment 44 the 45 experiment sonothrombolysis induced significantly higher weight reduction in fresh clots ( 37.3 % in 2 - h old clots versus 24.8 % in 10 - h [ones] , p < 0.005 ) as well as the clots with higher cholesterol levels ( 41.7 versus 30.6 % in normal cholesterol clots , p < 0.005 ) . 0 ###LEFT-WALL### 1 sonothrombolysis 0 ###LEFT-WALL### 2 induced 0 ###LEFT-WALL### 55 . 1 sonothrombolysis 2 induced 2 induced 3 significantly 2 induced 6 reduction 2 induced 34 as 4 higher 6 reduction 5 weight 6 reduction 6 reduction 7 in 6 reduction 18 clots 7 in 9 clots 8 fresh 9 clots 10 ( 18 clots 11 37.3 13 in 12 % 13 in 13 in 18 clots 14 2 15 - 15 - 16 h 15 - 18 clots 17 old 18 clots 18 clots 19 versus 18 clots 29 < 18 clots 31 ) 19 versus 22 in 20 24.8 22 in 21 % 22 in 23 10 24 - 24 - 25 h 24 - 29 < 27 , 29 < 28 p 29 < 29 < 30 0.005 29 < 31 ) 32 as 33 well 33 well 34 as 34 as 36 clots 35 the 36 clots 36 clots 37 with 37 with 40 levels 38 higher 40 levels 39 cholesterol 40 levels 40 levels 42 41.7 41 ( 42 41.7 42 41.7 43 versus 42 41.7 46 in 42 41.7 54 ) 43 versus 45 % 44 30.6 45 % 46 in 49 clots 47 normal 48 cholesterol 48 cholesterol 49 clots 49 clots 52 < 50 , 52 < 51 p 52 < 52 < 53 0.005 52 < 54 ) sem demonstrated patterns of clot dissolution among various treatment modalities . 0 ###LEFT-WALL### 1 sem 0 ###LEFT-WALL### 2 demonstrated 0 ###LEFT-WALL### 11 . 1 sem 2 demonstrated 2 demonstrated 3 patterns 2 demonstrated 7 among 3 patterns 4 of 4 of 6 dissolution 5 clot 6 dissolution 7 among 10 modalities 8 various 9 treatment 9 treatment 10 modalities sonothrombolysis induced better clot lysis in fresh thrombi with high cholesterol levels . 0 ###LEFT-WALL### 1 sonothrombolysis 0 ###LEFT-WALL### 2 induced 0 ###LEFT-WALL### 13 . 1 sonothrombolysis 2 induced 2 induced 5 lysis 2 induced 6 in 2 induced 9 with 3 better 4 clot 4 clot 5 lysis 6 in 8 thrombi 7 fresh 8 thrombi 9 with 12 levels 10 high 11 cholesterol 11 cholesterol 12 levels background : micronutrients are associated with dementia and cognitive decline among older adults . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 micronutrients 2 : 5 associated 2 : 14 . 3 micronutrients 4 are 4 are 5 associated 5 associated 6 with 5 associated 11 among 6 with 8 and 7 dementia 8 and 8 and 10 decline 9 cognitive 10 decline 11 among 13 adults 12 older 13 adults however , nutritional biomarkers [of] [such] [decline] have not been identified . 0 ###LEFT-WALL### 4 biomarkers 0 ###LEFT-WALL### 11 identified 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 4 biomarkers 3 nutritional 4 biomarkers 4 biomarkers 8 have 8 have 9 not 8 have 10 been 10 been 11 identified we attempted to identify nutritional biomarkers that were independent risk markers of cognitive [decline] in a population of older japanese . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 21 . 1 we 2 attempted 2 attempted 3 to 2 attempted 4 identify 3 to 4 identify 4 identify 6 biomarkers 5 nutritional 6 biomarkers 6 biomarkers 7 that 6 biomarkers 12 of 6 biomarkers 13 cognitive 7 that 8 were 8 were 11 markers 9 independent 11 markers 10 risk 11 markers 11 markers 12 of 13 cognitive 15 in 15 in 17 population 16 a 17 population 17 population 18 of 18 of 20 japanese 19 older 20 japanese cognition was assessed by the mini - mental state examination , and cognitive decline was defined as a decrease of at least three points on the mini - mental state examination . 0 ###LEFT-WALL### 1 cognition 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 28 - 0 ###LEFT-WALL### 32 . 1 cognition 2 was 2 was 3 assessed 3 assessed 4 by 4 by 6 mini 5 the 6 mini 6 mini 8 mental 7 - 8 mental 8 mental 9 state 8 mental 24 points 8 mental 28 - 9 state 12 and 9 state 14 decline 9 state 15 was 10 examination 12 and 11 , 12 and 12 and 13 cognitive 12 and 14 decline 15 was 16 defined 16 defined 17 as 17 as 19 decrease 17 as 24 points 18 a 19 decrease 19 decrease 20 of 19 decrease 24 points 20 of 23 three 21 at 22 least 22 least 23 three 24 points 25 on 25 on 27 mini 26 the 27 mini 28 - 31 examination 29 mental 30 state 30 state 31 examination results : during an average follow - up of 2.7 years [,] 115 adults ( 16.9 % ) developed cognitive decline . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 6 follow 2 : 7 - 3 during 5 average 3 during 6 follow 4 an 5 average 7 - 11 years 7 - 21 decline 8 up 11 years 9 of 10 2.7 9 of 11 years 11 years 14 adults 11 years 19 developed 11 years 21 decline 13 115 14 adults 14 adults 17 % 14 adults 19 developed 15 ( 17 % 16 16.9 17 % 17 % 18 ) 19 developed 20 cognitive the corresponding odds ratios were 1.81 ( 1.05 - 3.22 [ )(and 1.03 ( 0.58 - 1.83 ) , respectively , for high - density lipoprotein cholesterol and 2.06 ( 1.14 - 3.77 ) [and] 1.02 ( 0.54 - 1.94 ) [for] albumin . 0 ###LEFT-WALL### 4 ratios 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 44 . 1 the 4 ratios 2 corresponding 3 odds 3 odds 4 ratios 4 ratios 5 were 5 were 6 1.81 5 were 9 - 5 were 20 respectively 5 were 22 for 7 ( 9 - 8 1.05 9 - 9 - 12 )(and 9 - 19 , 10 3.22 12 )(and 12 )(and 13 1.03 12 )(and 16 - 14 ( 16 - 15 0.58 16 - 16 - 17 1.83 16 - 18 ) 19 , 20 respectively 20 respectively 21 , 22 for 28 and 23 high 24 - 23 high 25 density 25 density 27 cholesterol 26 lipoprotein 27 cholesterol 27 cholesterol 28 and 28 and 43 albumin 29 2.06 43 albumin 30 ( 32 - 31 1.14 32 - 32 - 33 3.77 32 - 34 ) 32 - 43 albumin 36 1.02 43 albumin 37 ( 39 - 38 0.54 39 - 39 - 40 1.94 39 - 41 ) 39 - 43 albumin background : neonatal asphyxia is one of the leading causes of death in newborn [and] permanent neurological disabilities in surviving children . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 asphyxia 2 : 5 is 2 : 22 . 3 neonatal 4 asphyxia 4 asphyxia 5 is 5 is 6 one 6 one 7 of 7 of 10 causes 8 the 10 causes 9 leading 10 causes 10 causes 11 of 10 causes 13 in 11 of 12 death 13 in 18 disabilities 14 newborn 18 disabilities 16 permanent 18 disabilities 17 neurological 18 disabilities 18 disabilities 19 in 19 in 20 surviving 20 surviving 21 children the underlying hypoxic - ischemic ( hi ) injury triggers an inflammatory response leading to neuronal damage . 0 ###LEFT-WALL### 9 injury 0 ###LEFT-WALL### 10 triggers 0 ###LEFT-WALL### 18 . 1 the 9 injury 2 underlying 9 injury 3 hypoxic 4 - 3 hypoxic 9 injury 5 ischemic 7 hi 5 ischemic 9 injury 6 ( 7 hi 7 hi 8 ) 9 injury 10 triggers 10 triggers 13 response 11 an 12 inflammatory 11 an 13 response 12 inflammatory 13 response 13 response 14 leading 14 leading 15 to 15 to 17 damage 16 neuronal 17 damage here , we tested the hypothesis that high - dose intravenous immunoglobulin ( ivig ) could exert immunomodulatory effect in rat pups subjected to hi injury . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 tested 0 ###LEFT-WALL### 27 . 1 here 2 , 1 here 3 we 3 we 4 tested 4 tested 6 hypothesis 4 tested 20 in 5 the 6 hypothesis 6 hypothesis 7 that 7 that 12 immunoglobulin 7 that 17 exert 8 high 9 - 8 high 12 immunoglobulin 10 dose 12 immunoglobulin 11 intravenous 12 immunoglobulin 12 immunoglobulin 14 ivig 12 immunoglobulin 16 could 13 ( 14 ivig 14 ivig 15 ) 16 could 17 exert 17 exert 19 effect 18 immunomodulatory 19 effect 20 in 22 pups 21 rat 22 pups 22 pups 23 subjected 23 subjected 24 to 24 to 26 injury 25 hi 26 injury methods : hi injury was induced in 7 - d - old pups by ligating the common carotid artery followed by exposure to 8 % oxygen for 2 h . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 injury 2 : 6 induced 3 hi 4 injury 4 injury 5 was 5 was 6 induced 6 induced 7 in 6 induced 11 - 7 in 8 7 9 - 11 - 10 d 11 - 11 - 13 pups 12 old 13 pups 13 pups 14 by 13 pups 21 by 13 pups 23 to 14 by 15 ligating 15 ligating 19 artery 16 the 19 artery 17 common 18 carotid 18 carotid 19 artery 19 artery 20 followed 21 by 22 exposure 23 to 26 oxygen 24 8 25 % 25 % 26 oxygen 26 oxygen 27 for 27 for 29 h 28 2 29 h 29 h 30 . brain infarction was evaluated by imaging stained coronal brain sections . 0 ###LEFT-WALL### 2 infarction 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 11 . 1 brain 2 infarction 2 infarction 3 was 3 was 4 evaluated 4 evaluated 5 by 5 by 6 imaging 6 imaging 10 sections 7 stained 9 brain 8 coronal 9 brain 9 brain 10 sections neurological deficits were assessed in weeks 1 through 4 after hi . 0 ###LEFT-WALL### 2 deficits 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 12 . 1 neurological 2 deficits 2 deficits 3 were 3 were 4 assessed 4 assessed 5 in 4 assessed 8 through 4 assessed 10 after 5 in 6 weeks 6 weeks 7 1 8 through 9 4 10 after 11 hi western [blotting] and immunohistochemistry were used to assess complement fragment deposition in the brain tissue . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 16 . 1 western 3 and 3 and 4 immunohistochemistry 3 and 5 were 5 were 6 used 6 used 7 to 7 to 8 assess 8 assess 11 deposition 9 complement 11 deposition 10 fragment 11 deposition 11 deposition 12 in 12 in 15 tissue 13 the 15 tissue 14 brain 15 tissue results : treatment with ivig at 2 g/kg significantly and in a dose - responsive manner reduced brain infarction size as well as mortality and neurological deficits caused by hi . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 31 . 1 results 2 : 2 : 3 treatment 2 : 4 with 2 : 6 at 2 : 9 significantly 4 with 5 ivig 6 at 8 g/kg 7 2 8 g/kg 10 and 16 manner 10 and 17 reduced 11 in 13 dose 11 in 14 - 11 in 16 manner 12 a 13 dose 15 responsive 16 manner 16 manner 17 reduced 17 reduced 20 size 17 reduced 29 by 18 brain 20 size 19 infarction 20 size 20 size 21 as 20 size 28 caused 21 as 22 well 23 as 25 and 23 as 28 caused 24 mortality 25 and 25 and 27 deficits 25 and 28 caused 26 neurological 27 deficits 29 by 30 hi anatomical and functional improvements in ivig - treated pups correlated with decreased deposition of c3b complement fragments in the injured brain hemisphere . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 7 - 1 anatomical 2 and 2 and 4 improvements 2 and 5 in 3 functional 4 improvements 5 in 6 ivig 7 - 9 pups 7 - 16 complement 7 - 23 . 8 treated 9 pups 9 pups 10 correlated 9 pups 11 with 9 pups 14 of 9 pups 16 complement 11 with 13 deposition 12 decreased 13 deposition 14 of 15 c3b 16 complement 17 fragments 16 complement 18 in 18 in 22 hemisphere 19 the 22 hemisphere 20 injured 21 brain 21 brain 22 hemisphere conclusion : ivig significantly improved the outcome of hi injury in rat pups and could potentially be used for the treatment of human neonatal asphyxia to target proinflammatory complement fragments . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 1 conclusion 2 : 2 : 3 ivig 3 ivig 14 and 4 significantly 5 improved 5 improved 7 outcome 5 improved 14 and 6 the 7 outcome 7 outcome 8 of 7 outcome 11 in 8 of 10 injury 9 hi 10 injury 11 in 13 pups 12 rat 13 pups 14 and 15 could 15 could 17 be 16 potentially 17 be 17 be 18 used 18 used 19 for 18 used 26 to 18 used 27 target 19 for 21 treatment 20 the 21 treatment 21 treatment 22 of 22 of 25 asphyxia 23 human 25 asphyxia 24 neonatal 25 asphyxia 26 to 27 target 27 target 30 fragments 28 proinflammatory 29 complement 29 complement 30 fragments objective : serum sclerostin levels have been reported to be inversely associated with serum 25ohd levels , but the effect of vitamin d and calcium supplementation on serum sclerostin levels is unknown . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 16 levels 0 ###LEFT-WALL### 18 but 0 ###LEFT-WALL### 33 . 1 objective 2 : 2 : 3 serum 3 serum 5 levels 3 serum 16 levels 4 sclerostin 5 levels 5 levels 6 have 6 have 7 been 7 been 8 reported 8 reported 9 to 8 reported 16 levels 9 to 10 be 10 be 12 associated 11 inversely 12 associated 12 associated 13 with 13 with 14 serum 15 25ohd 16 levels 17 , 18 but 18 but 20 effect 18 but 31 is 19 the 20 effect 20 effect 21 of 20 effect 26 supplementation 20 effect 30 levels 20 effect 31 is 21 of 24 and 22 vitamin 23 d 22 vitamin 24 and 24 and 25 calcium 26 supplementation 27 on 26 supplementation 30 levels 27 on 29 sclerostin 28 serum 29 sclerostin 31 is 32 unknown this study was carried out to determine whether vitamin d and calcium supplementation altered serum sclerostin levels in healthy older adults . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 7 determine 0 ###LEFT-WALL### 22 . 1 this 2 study 2 study 3 was 3 was 4 carried 4 carried 5 out 4 carried 6 to 6 to 7 determine 7 determine 8 whether 7 determine 18 in 8 whether 11 and 8 whether 14 altered 9 vitamin 10 d 9 vitamin 11 and 11 and 13 supplementation 11 and 14 altered 12 calcium 13 supplementation 14 altered 17 levels 15 serum 17 levels 16 sclerostin 17 levels 18 in 21 adults 19 healthy 21 adults 20 older 21 adults design : we measured serum sclerostin levels at baseline and after 2 years in 279 men and women who participated in a placebo - controlled vitamin d ( 700 iu/day ) and calcium ( 500 mg/day ) intervention trial carried out in men and women aged ≥65 years . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 measured 2 : 49 . 3 we 4 measured 4 measured 48 years 5 serum 6 sclerostin 6 sclerostin 7 levels 7 levels 10 and 7 levels 32 and 8 at 9 baseline 8 at 10 and 10 and 11 after 11 after 17 and 12 2 13 years 13 years 14 in 13 years 17 and 14 in 16 men 15 279 16 men 17 and 18 women 17 and 19 who 17 and 20 participated 19 who 20 participated 20 participated 21 in 21 in 23 placebo 22 a 23 placebo 23 placebo 26 vitamin 24 - 26 vitamin 25 controlled 26 vitamin 26 vitamin 27 d 26 vitamin 30 iu/day 26 vitamin 31 ) 28 ( 30 iu/day 29 700 30 iu/day 30 iu/day 31 ) 32 and 33 calcium 32 and 36 mg/day 32 and 40 carried 34 ( 36 mg/day 35 500 36 mg/day 36 mg/day 37 ) 38 intervention 40 carried 39 trial 40 carried 40 carried 48 years 41 out 42 in 41 out 44 and 42 in 43 men 44 and 45 women 44 and 46 aged 46 aged 48 years 47 ≥65 48 years method : serum sclerostin levels were measured using the mesoscale discovery chemiluminescence assay . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 5 levels 2 : 6 were 2 : 14 . 3 serum 4 sclerostin 4 sclerostin 5 levels 5 levels 6 were 6 were 7 measured 7 measured 8 using 8 using 13 assay 9 the 13 assay 10 mesoscale 11 discovery 11 discovery 13 assay 12 chemiluminescence 13 assay results : in the men , sclerostin levels increased over 2 years by 4.11±1.81 [ng/l] ( 13.1 % ) in the vitamin d plus calcium - supplemented group and decreased [by] 3.16±1.78 [ng/l] ( 10.9 % ) in the placebo group ( p=0.005 for difference [in] change ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 3 in 3 in 5 men 4 the 5 men 5 men 8 levels 6 , 8 levels 7 sclerostin 8 levels 8 levels 9 increased 8 levels 49 . 9 increased 10 over 9 increased 38 in 10 over 12 years 11 2 12 years 12 years 13 by 12 years 20 in 13 by 14 4.11±1.81 14 4.11±1.81 18 % 16 ( 18 % 17 13.1 18 % 18 % 19 ) 20 in 22 vitamin 21 the 22 vitamin 22 vitamin 23 d 22 vitamin 24 plus 22 vitamin 29 and 24 plus 25 calcium 26 - 29 and 27 supplemented 28 group 28 group 29 and 29 and 32 3.16±1.78 29 and 36 % 29 and 37 ) 30 decreased 32 3.16±1.78 34 ( 36 % 35 10.9 36 % 36 % 37 ) 38 in 41 group 39 the 41 group 40 placebo 41 group 41 group 43 p=0.005 42 ( 43 p=0.005 43 p=0.005 44 for 43 p=0.005 48 ) 44 for 47 change 45 difference 47 change adjustments for the season of measurement , baseline physical activity levels , baseline serum sclerostin levels , and total body bone mineral content did not substantially alter the changes . 0 ###LEFT-WALL### 1 adjustments 0 ###LEFT-WALL### 27 alter 0 ###LEFT-WALL### 30 . 1 adjustments 2 for 1 adjustments 5 of 1 adjustments 24 did 2 for 4 season 3 the 4 season 5 of 18 and 6 measurement 7 , 7 , 11 levels 7 , 12 , 8 baseline 11 levels 9 physical 10 activity 10 activity 11 levels 12 , 16 levels 12 , 18 and 13 baseline 14 serum 14 serum 16 levels 15 sclerostin 16 levels 17 , 18 and 18 and 23 content 19 total 23 content 20 body 22 mineral 21 bone 22 mineral 22 mineral 23 content 24 did 25 not 24 did 27 alter 26 substantially 27 alter 27 alter 29 changes 28 the 29 changes in the women , there was no significant group difference in change in serum sclerostin levels either before or after the [above] [-] mentioned adjustments . 0 ###LEFT-WALL### 5 there 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 26 . 1 in 3 women 1 in 4 , 1 in 5 there 2 the 3 women 5 there 6 was 6 was 10 difference 6 was 11 in 6 was 13 in 6 was 19 or 7 no 10 difference 8 significant 9 group 9 group 10 difference 11 in 12 change 13 in 16 levels 14 serum 15 sclerostin 15 sclerostin 16 levels 17 either 19 or 18 before 19 or 19 or 20 after 20 after 25 adjustments 21 the 25 adjustments 24 mentioned 25 adjustments in both the sexes , vitamin d and calcium supplementation significantly increased serum ionized calcium levels and decreased parathyroid hormone levels . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 12 increased 0 ###LEFT-WALL### 22 . 1 in 2 both 1 in 8 and 3 the 4 sexes 4 sexes 5 , 5 , 6 vitamin 5 , 8 and 6 vitamin 7 d 8 and 10 supplementation 8 and 12 increased 9 calcium 10 supplementation 11 significantly 12 increased 12 increased 13 serum 13 serum 17 and 14 ionized 16 levels 14 ionized 17 and 15 calcium 16 levels 17 and 18 decreased 17 and 21 levels 18 decreased 19 parathyroid 20 hormone 21 levels conclusion : men and women appear to have different serum sclerostin responses to vitamin d and calcium supplementation . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 19 . 1 conclusion 2 : 2 : 3 men 4 and 5 women 4 and 6 appear 5 women 6 appear 6 appear 7 to 6 appear 8 have 7 to 8 have 8 have 12 responses 8 have 13 to 9 different 10 serum 10 serum 12 responses 11 sclerostin 12 responses 13 to 16 and 14 vitamin 15 d 14 vitamin 16 and 16 and 18 supplementation 17 calcium 18 supplementation the reason for this difference remains to be determined . 0 ###LEFT-WALL### 2 reason 0 ###LEFT-WALL### 6 remains 0 ###LEFT-WALL### 10 . 1 the 2 reason 2 reason 3 for 2 reason 6 remains 3 for 5 difference 4 this 5 difference 6 remains 7 to 7 to 8 be 8 be 9 determined to define the retinal phenotype of subjects with familial dysautonomia ( fd ) . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 define 0 ###LEFT-WALL### 14 . 1 to 2 define 2 define 5 phenotype 2 define 8 with 3 the 5 phenotype 4 retinal 5 phenotype 5 phenotype 6 of 6 of 7 subjects 8 with 10 dysautonomia 9 familial 10 dysautonomia 10 dysautonomia 12 fd 11 ( 12 fd 12 fd 13 ) a cross - sectional study was carried out in 90 subjects divided in three groups of 30 each ( fd subjects , asymptomatic carriers and controls ) . 0 ###LEFT-WALL### 2 cross 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 28 . 1 a 2 cross 3 - 5 study 3 - 7 carried 4 sectional 5 study 5 study 6 was 6 was 7 carried 7 carried 8 out 7 carried 9 in 9 in 11 subjects 10 90 11 subjects 11 subjects 12 divided 11 subjects 25 and 12 divided 13 in 12 divided 18 each 13 in 15 groups 14 three 15 groups 15 groups 16 of 16 of 17 30 19 ( 25 and 20 fd 21 subjects 21 subjects 22 , 22 , 24 carriers 22 , 25 and 23 asymptomatic 24 carriers 25 and 26 controls 25 and 27 ) the study was developed at the dysautonomia center , new york university medical center . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 developed 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 15 . 1 the 2 study 2 study 3 was 3 was 4 developed 4 developed 5 at 5 at 8 center 6 the 8 center 7 dysautonomia 8 center 9 , 14 center 10 new 11 york 11 york 12 university 12 university 13 medical 13 medical 14 center all subjects underwent spectral domain optical coherence tomography ( oct [ )(and full neuro - ophthalmic examinations . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 18 . 1 all 2 subjects 2 subjects 3 underwent 3 underwent 17 examinations 4 spectral 5 domain 5 domain 17 examinations 6 optical 7 coherence 7 coherence 17 examinations 8 tomography 12 )(and 8 tomography 17 examinations 9 ( 12 )(and 10 oct 12 )(and 12 )(and 14 neuro 12 )(and 15 - 13 full 14 neuro 16 ophthalmic 17 examinations in a subset of affected subjects , visual evoked potentials and microperimetry were also obtained . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 15 obtained 0 ###LEFT-WALL### 16 . 1 in 3 subset 1 in 7 , 1 in 11 and 2 a 3 subset 3 subset 4 of 4 of 6 subjects 5 affected 6 subjects 8 visual 10 potentials 9 evoked 10 potentials 10 potentials 11 and 11 and 12 microperimetry 11 and 13 were 13 were 15 obtained 14 also 15 obtained we compared the retinal nerve fiber layer ( rnfl ) [thickness] from oct between the three groups . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 0 ###LEFT-WALL### 18 . 1 we 2 compared 2 compared 7 layer 2 compared 12 from 2 compared 14 between 3 the 7 layer 4 retinal 5 nerve 5 nerve 7 layer 6 fiber 7 layer 7 layer 9 rnfl 8 ( 9 rnfl 9 rnfl 10 ) 12 from 13 oct 14 between 17 groups 15 the 16 three 16 three 17 groups oct showed loss of the rnfl in all fd subjects [predominantly] in the maculopapillary region ( 63 % [temporally] , p < 0.0001 [;] and 21 % nasally , p < 0.005 ) . 0 ###LEFT-WALL### 1 oct 0 ###LEFT-WALL### 2 showed 0 ###LEFT-WALL### 34 . 1 oct 2 showed 2 showed 3 loss 2 showed 10 subjects 2 showed 25 and 2 showed 28 nasally 2 showed 31 < 3 loss 4 of 4 of 6 rnfl 5 the 6 rnfl 6 rnfl 7 in 7 in 9 fd 8 all 9 fd 10 subjects 12 in 10 subjects 22 < 12 in 15 region 13 the 15 region 14 maculopapillary 15 region 15 region 18 % 16 ( 18 % 17 63 18 % 18 % 20 , 20 , 22 < 21 p 22 < 22 < 23 0.0001 25 and 27 % 26 21 27 % 29 , 31 < 30 p 31 < 31 < 32 0.005 31 < 33 ) rnfl loss was [greatest] in older fd subjects and was associated with decreased visual acuity and color vision , central visual field defects , temporal optic nerve pallor , and delayed visual evoked potentials . 0 ###LEFT-WALL### 2 loss 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 35 . 1 rnfl 2 loss 2 loss 9 and 3 was 5 in 3 was 9 and 5 in 8 subjects 6 older 8 subjects 7 fd 8 subjects 9 and 10 was 10 was 16 and 11 associated 12 with 11 associated 16 and 12 with 15 acuity 13 decreased 15 acuity 14 visual 15 acuity 16 and 17 color 17 color 18 vision 18 vision 23 defects 19 , 23 defects 20 central 22 field 21 visual 22 field 22 field 23 defects 23 defects 24 , 24 , 30 and 25 temporal 28 pallor 26 optic 28 pallor 27 nerve 28 pallor 28 pallor 30 and 29 , 30 and 30 and 34 potentials 31 delayed 34 potentials 32 visual 34 potentials 33 evoked 34 potentials asymptomatic carriers of the fd gene mutation all had thinner rnfl ( 12 % [globally] , p < 0.005 ) . 0 ###LEFT-WALL### 2 carriers 0 ###LEFT-WALL### 9 had 0 ###LEFT-WALL### 21 . 1 asymptomatic 2 carriers 2 carriers 3 of 2 carriers 9 had 3 of 7 mutation 4 the 7 mutation 5 fd 7 mutation 6 gene 7 mutation 8 all 9 had 9 had 11 rnfl 10 thinner 11 rnfl 11 rnfl 14 % 11 rnfl 18 < 12 ( 14 % 13 12 14 % 14 % 16 , 16 , 18 < 17 p 18 < 18 < 19 0.005 18 < 20 ) oct and clinical neuro - ophthalmological findings suggest that maculopapillary ganglion cells are primarily affected in fd subjects , leading to a specific optic nerve damage that closely resembles mitochondrial optic neuropathies . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 8 suggest 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 33 . 1 oct 2 and 2 and 7 findings 2 and 8 suggest 3 clinical 7 findings 4 neuro 5 - 4 neuro 7 findings 6 ophthalmological 7 findings 8 suggest 12 cells 8 suggest 15 affected 9 that 10 maculopapillary 10 maculopapillary 12 cells 11 ganglion 12 cells 12 cells 13 are 13 are 15 affected 14 primarily 15 affected 15 affected 16 in 16 in 18 subjects 17 fd 18 subjects 19 , 20 leading 19 , 29 resembles 20 leading 21 to 20 leading 26 damage 20 leading 29 resembles 21 to 25 nerve 22 a 23 specific 22 a 25 nerve 23 specific 25 nerve 24 optic 25 nerve 27 that 28 closely 28 closely 29 resembles 29 resembles 32 neuropathies 30 mitochondrial 32 neuropathies 31 optic 32 neuropathies this raises the possibility that reduced ikap levels may affect mitochondrial proteins and their function in the nervous system , particularly in the retina . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 raises 1 this 2 raises 2 raises 4 possibility 3 the 4 possibility 4 possibility 5 that 5 that 8 levels 5 that 10 affect 6 reduced 8 levels 7 ikap 8 levels 8 levels 9 may 9 may 10 affect 10 affect 13 and 10 affect 16 in 11 mitochondrial 12 proteins 12 proteins 13 and 13 and 15 function 14 their 15 function 16 in 19 system 17 the 19 system 18 nervous 19 system 19 system 22 in 20 , 21 particularly 20 , 22 in 22 in 24 retina 22 in 25 . 23 the 24 retina existing reports on the frequencies of neurodegenerative diseases are typically based on clinical diagnoses . 0 ###LEFT-WALL### 2 reports 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 15 . 1 existing 2 reports 2 reports 3 on 2 reports 9 are 3 on 5 frequencies 4 the 5 frequencies 5 frequencies 6 of 6 of 8 diseases 7 neurodegenerative 8 diseases 9 are 10 typically 9 are 12 on 10 typically 11 based 12 on 14 diagnoses 13 clinical 14 diagnoses we sought to determine these frequencies in a prospectively assessed , community [-] based autopsy series . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 sought 0 ###LEFT-WALL### 17 . 1 we 2 sought 2 sought 3 to 2 sought 4 determine 3 to 4 determine 4 determine 6 frequencies 4 determine 7 in 5 these 6 frequencies 7 in 16 series 8 a 9 prospectively 8 a 16 series 9 prospectively 10 assessed 10 assessed 11 , 12 community 14 based 14 based 15 autopsy 15 autopsy 16 series included subjects had normal cognitive and movement disorder assessments at study entry . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 13 . 1 included 2 subjects 2 subjects 3 had 3 had 9 assessments 3 had 10 at 4 normal 9 assessments 5 cognitive 6 and 6 and 7 movement 6 and 9 assessments 8 disorder 9 assessments 10 at 12 entry 11 study 12 entry of the 119 cases meeting these criteria , 52 % were women ; the median age of study entry was 83.5 years ( range , 67 - 99 years ) , and the median duration from the first visit until death was 4.3 years ( range , 0 - 10 years ) . 0 ###LEFT-WALL### 10 % 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 13 ; 1 of 4 cases 1 of 8 , 1 of 10 % 2 the 3 119 3 119 4 cases 4 cases 5 meeting 5 meeting 7 criteria 6 these 7 criteria 9 52 10 % 10 % 11 were 11 were 12 women 13 ; 16 age 13 ; 20 was 13 ; 32 and 14 the 16 age 15 median 16 age 16 age 17 of 16 age 20 was 17 of 19 entry 18 study 19 entry 20 was 22 years 21 83.5 22 years 22 years 24 range 22 years 26 67 23 ( 24 range 24 range 25 , 25 , 26 67 26 67 29 years 26 67 31 , 27 - 29 years 28 99 29 years 29 years 30 ) 32 and 35 duration 32 and 42 was 33 the 35 duration 34 median 35 duration 35 duration 36 from 35 duration 42 was 36 from 39 visit 37 the 39 visit 38 first 39 visit 39 visit 40 until 40 until 41 death 42 was 44 years 43 4.3 44 years 44 years 46 range 45 ( 46 range 46 range 48 0 46 range 53 . 47 , 48 0 48 0 51 years 48 0 53 . 49 - 51 years 50 10 51 years 51 years 52 ) [at] autopsy , clinicopathological diagnoses were made in 30 cases ( 25 % ) . 0 ###LEFT-WALL### 2 autopsy 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 15 . 3 , 5 diagnoses 3 , 7 made 4 clinicopathological 5 diagnoses 5 diagnoses 6 were 6 were 7 made 7 made 8 in 8 in 10 cases 9 30 10 cases 10 cases 13 % 11 ( 13 % 12 25 13 % 13 % 14 ) these diagnoses included 20 with alzheimer disease ( ad ) ( 17 % ) , 7 with vascular dementia ( 6 % ) , 4 with progressive supranuclear palsy ( 3 % ) , 3 with parkinson disease and 1 each with dementia with lewy bodies , corticobasal degeneration , or multiple system atrophy ( 0.8 % [each] ) . 0 ###LEFT-WALL### 2 diagnoses 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 60 . 1 these 2 diagnoses 2 diagnoses 3 included 3 included 4 20 3 included 5 with 3 included 36 with 5 with 7 disease 5 with 35 3 6 alzheimer 7 disease 7 disease 9 ad 7 disease 13 % 7 disease 16 7 8 ( 9 ad 9 ad 10 ) 11 ( 13 % 12 17 13 % 13 % 14 ) 15 , 16 7 16 7 17 with 16 7 22 % 16 7 25 4 16 7 34 , 17 with 19 dementia 18 vascular 19 dementia 20 ( 22 % 21 6 22 % 22 % 23 ) 24 , 25 4 25 4 26 with 25 4 33 ) 26 with 29 palsy 27 progressive 29 palsy 28 supranuclear 29 palsy 29 palsy 32 % 30 ( 32 % 31 3 32 % 32 % 33 ) 36 with 39 and 36 with 54 atrophy 37 parkinson 38 disease 38 disease 39 and 39 and 53 system 40 1 53 system 41 each 42 with 41 each 47 , 42 with 43 dementia 43 dementia 44 with 44 with 46 bodies 45 lewy 46 bodies 47 , 49 degeneration 47 , 51 or 48 corticobasal 49 degeneration 50 , 51 or 51 or 52 multiple 51 or 53 system 54 atrophy 57 % 55 ( 57 % 56 0.8 57 % 57 % 59 ) of the 87 subjects still clinically normal at death ( 73 % ) , 33 had extensive ad pathology ( preclinical ad ) ( 38 % ) , 17 had incidental lewy bodies ( 20 % ) , and 4 had incidental pathology consistent with progressive supranuclear palsy ( 5 % ) . 0 ###LEFT-WALL### 15 33 0 ###LEFT-WALL### 28 , 0 ###LEFT-WALL### 53 . 1 of 4 subjects 1 of 15 33 2 the 3 87 3 87 4 subjects 5 still 15 33 6 clinically 7 normal 7 normal 8 at 7 normal 14 , 7 normal 15 33 8 at 9 death 9 death 12 % 10 ( 12 % 11 73 12 % 12 % 13 ) 15 33 16 had 16 had 19 pathology 17 extensive 19 pathology 18 ad 19 pathology 19 pathology 22 ad 19 pathology 26 % 20 ( 22 ad 21 preclinical 22 ad 22 ad 23 ) 24 ( 26 % 25 38 26 % 26 % 27 ) 28 , 29 17 28 , 30 had 28 , 39 and 29 17 30 had 30 had 33 bodies 31 incidental 33 bodies 32 lewy 33 bodies 33 bodies 36 % 34 ( 36 % 35 20 36 % 36 % 37 ) 38 , 39 and 39 and 40 4 39 and 41 had 40 4 41 had 41 had 43 pathology 42 incidental 43 pathology 43 pathology 44 consistent 43 pathology 51 % 44 consistent 45 with 45 with 48 palsy 46 progressive 48 palsy 47 supranuclear 48 palsy 49 ( 51 % 50 5 51 % 51 % 52 ) the diagnoses were not mutually exclusive . 0 ###LEFT-WALL### 2 diagnoses 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 7 . 1 the 2 diagnoses 2 diagnoses 3 were 3 were 4 not 3 were 6 exclusive 4 not 5 mutually [although] limited by a relatively small sample size , the neuropathological outcome of these initially normal elderly subjects represents a rough estimate of the incidence of these neurodegenerative conditions over a defined time period . 0 ###LEFT-WALL### 12 outcome 0 ###LEFT-WALL### 19 represents 0 ###LEFT-WALL### 35 . 2 limited 3 by 2 limited 9 , 2 limited 12 outcome 3 by 8 size 4 a 5 relatively 4 a 8 size 5 relatively 6 small 6 small 7 sample 7 sample 8 size 10 the 12 outcome 11 neuropathological 12 outcome 12 outcome 13 of 12 outcome 19 represents 13 of 18 subjects 14 these 18 subjects 15 initially 16 normal 16 normal 18 subjects 17 elderly 18 subjects 19 represents 22 estimate 19 represents 30 over 20 a 21 rough 20 a 22 estimate 21 rough 22 estimate 22 estimate 23 of 23 of 25 incidence 24 the 25 incidence 25 incidence 26 of 26 of 29 conditions 27 these 29 conditions 28 neurodegenerative 29 conditions 30 over 34 period 31 a 34 period 32 defined 34 period 33 time 34 period in 2010 , a new recessive cohesinopathy disorder , designated warsaw [breakage] [syndrome] ( wabs ) , was described . 0 ###LEFT-WALL### 8 disorder 0 ###LEFT-WALL### 18 was 0 ###LEFT-WALL### 20 . 1 in 2 2010 1 in 3 , 1 in 8 disorder 4 a 8 disorder 5 new 7 cohesinopathy 6 recessive 7 cohesinopathy 7 cohesinopathy 8 disorder 8 disorder 10 designated 8 disorder 18 was 9 , 10 designated 10 designated 15 wabs 10 designated 17 , 11 warsaw 15 wabs 14 ( 15 wabs 15 wabs 16 ) 18 was 19 described the individual with wabs displayed microcephaly , pre - and postnatal growth retardation , and abnormal skin pigmentation . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 19 . 1 the 2 individual 2 individual 3 with 2 individual 10 and 3 with 4 wabs 4 wabs 5 displayed 4 wabs 8 pre 5 displayed 6 microcephaly 7 , 8 pre 8 pre 9 - 10 and 13 retardation 10 and 15 and 11 postnatal 12 growth 12 growth 13 retardation 14 , 15 and 15 and 18 pigmentation 16 abnormal 17 skin 17 skin 18 pigmentation cytogenetic analysis revealed mitomycin c ( mmc ) - induced chromosomal breakage ; however , an additional sister chromatid cohesion defect was also observed . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 9 - 1 cytogenetic 2 analysis 2 analysis 3 revealed 3 revealed 4 mitomycin 4 mitomycin 5 c 4 mitomycin 7 mmc 6 ( 7 mmc 7 mmc 8 ) 9 - 12 breakage 9 - 13 ; 9 - 25 . 10 induced 12 breakage 11 chromosomal 12 breakage 13 ; 21 defect 13 ; 24 observed 14 however 15 , 14 however 21 defect 16 an 21 defect 17 additional 18 sister 18 sister 21 defect 19 chromatid 21 defect 20 cohesion 21 defect 21 defect 22 was 22 was 23 also 22 was 24 observed wabs is genetically linked to bi - allelic mutations in the chlr1/ddx11 gene which encodes a protein of the conserved family of iron - sulfur ( fe - s ) cluster dna helicases . 0 ###LEFT-WALL### 1 wabs 0 ###LEFT-WALL### 4 linked 0 ###LEFT-WALL### 34 . 1 wabs 2 is 2 is 4 linked 3 genetically 4 linked 4 linked 5 to 4 linked 10 in 5 to 9 mutations 6 bi 7 - 6 bi 9 mutations 8 allelic 9 mutations 10 in 13 gene 11 the 13 gene 12 chlr1/ddx11 13 gene 13 gene 14 which 13 gene 15 encodes 14 which 15 encodes 15 encodes 17 protein 16 a 17 protein 17 protein 18 of 17 protein 22 of 18 of 21 family 19 the 21 family 20 conserved 21 family 22 of 33 helicases 23 iron 25 sulfur 23 iron 33 helicases 24 - 25 sulfur 25 sulfur 27 fe 25 sulfur 30 ) 26 ( 27 fe 27 fe 29 s 27 fe 30 ) 28 - 29 s 29 s 30 ) 31 cluster 33 helicases 32 dna 33 helicases mutations in the budding yeast ortholog of chlr1 , known as chl1 , were known to cause sister chromatid cohesion defects , indicating a conserved function of the gene . 0 ###LEFT-WALL### 1 mutations 0 ###LEFT-WALL### 15 known 1 mutations 2 in 1 mutations 14 were 2 in 6 ortholog 3 the 6 ortholog 4 budding 5 yeast 5 yeast 6 ortholog 6 ortholog 7 of 7 of 8 chlr1 8 chlr1 10 known 9 , 10 known 10 known 11 as 10 known 13 , 11 as 12 chl1 14 were 15 known 15 known 16 to 15 known 17 cause 16 to 17 cause 17 cause 21 defects 17 cause 23 indicating 18 sister 20 cohesion 19 chromatid 20 cohesion 20 cohesion 21 defects 22 , 23 indicating 23 indicating 26 function 23 indicating 30 . 24 a 26 function 25 conserved 26 function 26 function 27 of 27 of 29 gene 28 the 29 gene in 2012 , three affected siblings were identified with similar symptoms to the original wabs case , and found to have a homozygous mutation in the conserved fe - s [domain] of chlr1 , confirming the genetic linkage . 0 ###LEFT-WALL### 6 siblings 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 29 - 1 in 2 2012 1 in 3 , 1 in 6 siblings 4 three 6 siblings 5 affected 6 siblings 6 siblings 18 and 7 were 8 identified 7 were 18 and 8 identified 9 with 9 with 11 symptoms 10 similar 11 symptoms 11 symptoms 12 to 12 to 16 case 13 the 16 case 14 original 16 case 15 wabs 16 case 17 , 18 and 18 and 19 found 18 and 20 to 20 to 21 have 21 have 24 mutation 21 have 25 in 22 a 24 mutation 23 homozygous 24 mutation 25 in 28 fe 26 the 28 fe 27 conserved 28 fe 29 - 30 s 30 s 32 of 32 of 33 chlr1 33 chlr1 35 confirming 34 , 35 confirming 35 confirming 38 linkage 35 confirming 39 . 36 the 38 linkage 37 genetic 38 linkage significantly , the clinically relevant mutations perturbed chlr1 dna unwinding activity . 0 ###LEFT-WALL### 6 mutations 0 ###LEFT-WALL### 7 perturbed 0 ###LEFT-WALL### 12 . 1 significantly 2 , 1 significantly 6 mutations 3 the 6 mutations 4 clinically 5 relevant 5 relevant 6 mutations 6 mutations 7 perturbed 7 perturbed 9 dna 8 chlr1 9 dna 9 dna 10 unwinding 10 unwinding 11 activity in addition to its genetic importance in human disease , chlr1 is implicated in papillomavirus genome maintenance and cancer . 0 ###LEFT-WALL### 11 chlr1 0 ###LEFT-WALL### 13 implicated 0 ###LEFT-WALL### 20 . 1 in 2 addition 1 in 10 , 1 in 11 chlr1 2 addition 3 to 3 to 6 importance 4 its 6 importance 5 genetic 6 importance 6 importance 7 in 7 in 9 disease 8 human 9 disease 11 chlr1 12 is 12 is 13 implicated 13 implicated 14 in 14 in 18 and 15 papillomavirus 17 maintenance 16 genome 17 maintenance 17 maintenance 18 and 18 and 19 cancer although its precise functions in genome homeostasis are still not well understood , ongoing molecular studies of chlr1 suggest the helicase plays a critically important role in cellular replication [and/or] dna repair . 0 ###LEFT-WALL### 16 studies 0 ###LEFT-WALL### 19 suggest 0 ###LEFT-WALL### 33 . 1 although 4 functions 1 although 12 understood 1 although 13 , 1 although 16 studies 2 its 4 functions 3 precise 4 functions 4 functions 5 in 4 functions 8 are 5 in 7 homeostasis 6 genome 7 homeostasis 8 are 10 not 8 are 11 well 8 are 12 understood 9 still 10 not 14 ongoing 16 studies 15 molecular 16 studies 16 studies 17 of 16 studies 19 suggest 17 of 18 chlr1 19 suggest 21 helicase 19 suggest 22 plays 20 the 21 helicase 21 helicase 22 plays 22 plays 26 role 22 plays 27 in 23 a 24 critically 23 a 26 role 24 critically 25 important 25 important 26 role 27 in 32 repair 28 cellular 29 replication 29 replication 32 repair 31 dna 32 repair introduction : population aging translates into more people with chronic [non] - communicable diseases , disability , frailty and dependency . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 3 population 2 : 5 translates 2 : 21 . 3 population 4 aging 3 population 5 translates 5 translates 6 into 5 translates 9 with 6 into 8 people 7 more 8 people 9 with 19 and 10 chronic 14 diseases 10 chronic 18 frailty 12 - 14 diseases 13 communicable 14 diseases 14 diseases 16 disability 14 diseases 17 , 15 , 16 disability 16 disability 17 , 18 frailty 19 and 19 and 20 dependency the study of frailty [--] a clinical syndrome associated with an increased risk of falls , disability , hospitalization , institutionalization and death -- is important to improve clinical practice and population health indicators . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 15 falls 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 35 . 1 the 2 study 2 study 3 of 2 study 15 falls 3 of 4 frailty 4 frailty 8 syndrome 4 frailty 14 of 6 a 7 clinical 6 a 8 syndrome 7 clinical 8 syndrome 8 syndrome 9 associated 9 associated 10 with 10 with 13 risk 11 an 13 risk 12 increased 13 risk 13 risk 14 of 16 , 17 disability 16 , 25 is 17 disability 22 and 17 disability 25 is 18 , 22 and 19 hospitalization 20 , 20 , 21 institutionalization 20 , 22 and 22 and 23 death 22 and 24 -- 25 is 26 important 26 important 27 to 27 to 28 improve 28 improve 31 and 29 clinical 30 practice 30 practice 31 and 31 and 34 indicators 32 population 34 indicators 33 health 34 indicators objectives : in a cohort of older adults in havana and matanzas provinces , cuba , estimate prevalence of frailty and its risk factors ; determine incidence [of] dependency ; estimate mortality risk and identify mortality predictors . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 38 . 1 objectives 2 : 2 : 3 in 2 : 9 in 3 in 5 cohort 4 a 5 cohort 5 cohort 6 of 6 of 8 adults 7 older 8 adults 9 in 13 provinces 10 havana 11 and 11 and 12 matanzas 12 matanzas 13 provinces 13 provinces 15 cuba 14 , 15 cuba 15 cuba 16 , 16 , 17 estimate 16 , 25 ; 17 estimate 18 prevalence 18 prevalence 19 of 19 of 21 and 20 frailty 21 and 21 and 24 factors 22 its 24 factors 23 risk 24 factors 25 ; 26 determine 25 ; 30 ; 26 determine 29 dependency 27 incidence 29 dependency 30 ; 34 and 31 estimate 33 risk 31 estimate 34 and 32 mortality 33 risk 34 and 35 identify 35 identify 37 predictors 36 mortality 37 predictors methods : a prospective longitudinal study was conducted door [to] door , from june 2003 through july 2011 , in a cohort of 2813 adults aged ≥65 years living in selected municipalities of havana and matanzas provinces ; mean followup time was 4.1 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 11 door 2 : 12 , 2 : 45 . 3 a 4 prospective 3 a 11 door 4 prospective 6 study 5 longitudinal 6 study 6 study 7 was 7 was 8 conducted 9 door 11 door 12 , 25 adults 12 , 26 aged 12 , 38 ; 13 from 14 june 13 from 25 adults 14 june 15 2003 16 through 17 july 16 through 19 , 16 through 25 adults 17 july 18 2011 20 in 22 cohort 20 in 25 adults 21 a 22 cohort 22 cohort 23 of 23 of 24 2813 25 adults 26 aged 26 aged 28 years 27 ≥65 28 years 28 years 29 living 28 years 33 of 29 living 30 in 30 in 32 municipalities 31 selected 32 municipalities 33 of 35 and 34 havana 35 and 35 and 37 provinces 36 matanzas 37 provinces 38 ; 41 time 38 ; 42 was 39 mean 41 time 40 followup 41 time 41 time 42 was 42 was 44 years 43 4.1 44 years independent variables included demographics , behavioral risk factors and socioeconomic indicators , chronic [non] - communicable diseases [(] hypertension , stroke , dementia , depression , diabetes , anemia ) , number of comorbidities , and apoe ε4 [genotype] . 0 ###LEFT-WALL### 2 variables 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 40 . 1 independent 2 variables 2 variables 3 included 3 included 36 and 4 demographics 5 , 5 , 8 factors 5 , 9 and 6 behavioral 8 factors 7 risk 8 factors 9 and 11 indicators 9 and 12 , 10 socioeconomic 11 indicators 12 , 19 hypertension 12 , 20 , 13 chronic 15 - 13 chronic 17 diseases 16 communicable 17 diseases 17 diseases 19 hypertension 20 , 21 stroke 20 , 22 , 22 , 32 number 22 , 36 and 23 dementia 25 depression 23 dementia 32 number 24 , 25 depression 25 depression 27 diabetes 25 depression 29 anemia 25 depression 31 , 26 , 27 diabetes 27 diabetes 28 , 28 , 29 anemia 29 anemia 30 ) 32 number 33 of 33 of 34 comorbidities 35 , 36 and 36 and 38 ε4 37 apoe 38 ε4 dependent variables were frailty , dependency and mortality . 0 ###LEFT-WALL### 2 variables 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 9 . 1 dependent 2 variables 2 variables 3 were 3 were 7 and 4 frailty 5 , 5 , 6 dependency 5 , 7 and 7 and 8 mortality criteria for frailty were slow walking speed , exhaustion , weight loss , low physical activity and cognitive decline . 0 ###LEFT-WALL### 1 criteria 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 20 . 1 criteria 2 for 1 criteria 4 were 2 for 3 frailty 4 were 17 and 5 slow 6 walking 5 slow 8 , 6 walking 7 speed 8 , 9 exhaustion 8 , 10 , 10 , 12 loss 10 , 13 , 11 weight 12 loss 13 , 16 activity 13 , 17 and 14 low 16 activity 15 physical 16 activity 17 and 19 decline 18 cognitive 19 decline prevalence and frailty risk were estimated by poisson regression , while dependency and mortality risks and their predictors were determined using cox regression . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 6 estimated 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 24 . 1 prevalence 2 and 2 and 4 risk 2 and 5 were 3 frailty 4 risk 5 were 6 estimated 6 estimated 7 by 7 by 9 regression 8 poisson 9 regression 10 , 16 and 10 , 19 were 11 while 13 and 11 while 16 and 12 dependency 13 and 13 and 14 mortality 15 risks 16 and 16 and 18 predictors 16 and 19 were 17 their 18 predictors 19 were 20 determined 20 determined 21 using 21 using 23 regression 22 cox 23 regression results : frailty syndrome prevalence was 21.6 % ( ci 17.9 [%] - 23.8 % ) at baseline ; it was positively associated with advanced age , anemia and presence of comorbidities ( stroke [,] dementia , depression , three [or] more physically debilitating diseases ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 associated 0 ###LEFT-WALL### 47 . 2 : 5 prevalence 2 : 6 was 2 : 19 ; 3 frailty 4 syndrome 4 syndrome 5 prevalence 5 prevalence 6 was 6 was 8 % 6 was 17 at 7 21.6 8 % 8 % 10 ci 9 ( 10 ci 10 ci 11 17.9 10 ci 15 % 10 ci 16 ) 13 - 15 % 14 23.8 15 % 15 % 16 ) 17 at 18 baseline 19 ; 20 it 20 it 21 was 21 was 22 positively 21 was 23 associated 23 associated 24 with 24 with 29 and 25 advanced 26 age 26 age 27 , 27 , 28 anemia 27 , 29 and 29 and 30 presence 29 and 31 of 31 of 32 comorbidities 32 comorbidities 36 dementia 32 comorbidities 38 depression 33 ( 36 dementia 34 stroke 36 dementia 36 dementia 37 , 37 , 38 depression 38 depression 40 three 38 depression 46 ) 39 , 40 three 40 three 44 debilitating 40 three 46 ) 42 more 43 physically 43 physically 44 debilitating 44 debilitating 45 diseases male sex , higher educational level , married or partnered status , and more household amenities were inversely associated with frailty prevalence . 0 ###LEFT-WALL### 2 sex 0 ###LEFT-WALL### 9 or 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 . 1 male 2 sex 2 sex 6 level 2 sex 9 or 3 , 6 level 4 higher 6 level 5 educational 6 level 6 level 7 , 8 married 9 or 9 or 10 partnered 9 or 11 status 12 , 13 and 13 and 16 amenities 13 and 19 associated 14 more 16 amenities 15 household 16 amenities 16 amenities 17 were 17 were 18 inversely 17 were 19 associated 19 associated 20 with 20 with 22 prevalence 21 frailty 22 prevalence in followup , dependency [incidence] was 33.1 per 1000 person - years ( ci 29.1 - 37.6 ) and mortality was 55.1 per 1000 person - years . 0 ###LEFT-WALL### 4 dependency 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 19 and 1 in 2 followup 1 in 3 , 1 in 4 dependency 4 dependency 6 was 6 was 7 33.1 7 33.1 8 per 7 33.1 12 years 8 per 10 person 9 1000 10 person 11 - 12 years 12 years 14 ci 12 years 18 ) 13 ( 14 ci 14 ci 16 - 14 ci 18 ) 15 29.1 16 - 16 - 17 37.6 19 and 20 mortality 19 and 21 was 20 mortality 21 was 21 was 22 55.1 22 55.1 23 per 22 55.1 27 years 23 per 25 person 24 1000 25 person 26 - 27 years 27 years 28 . advanced age , male sex , lower occupational status during productive years , dependency , frailty , dementia , depression , cerebrovascular disease and diabetes were all associated with higher risk of death . 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 28 associated 0 ###LEFT-WALL### 34 . 1 advanced 2 age 2 age 3 , 3 , 5 sex 3 , 6 , 4 male 5 sex 6 , 9 status 6 , 13 , 7 lower 9 status 8 occupational 9 status 9 status 10 during 10 during 12 years 11 productive 12 years 13 , 14 dependency 13 , 15 , 15 , 16 frailty 15 , 17 , 17 , 23 disease 17 , 24 and 18 dementia 20 depression 18 dementia 23 disease 19 , 20 depression 20 depression 21 , 22 cerebrovascular 23 disease 24 and 25 diabetes 24 and 26 were 26 were 28 associated 27 all 28 associated 28 associated 29 with 29 with 31 risk 30 higher 31 risk 31 risk 32 of 32 of 33 death conclusions : given the challenge for developing countries presented by demographic and epidemiologic transition [;] the high prevalence in older adults of frailty syndrome , dependency and chronic [non] - communicable diseases [;] and the association of all these with higher mortality , attention [should] [be] targeted to older adults as a risk group . 1 conclusions 2 : 2 : 3 given 3 given 5 challenge 3 given 6 for 4 the 5 challenge 6 for 7 developing 7 developing 8 countries 7 developing 14 transition 8 countries 9 presented 8 countries 14 transition 9 presented 10 by 10 by 12 and 11 demographic 12 and 12 and 13 epidemiologic 14 transition 18 prevalence 16 the 18 prevalence 17 high 18 prevalence 18 prevalence 19 in 18 prevalence 22 of 19 in 21 adults 20 older 21 adults 22 of 34 and 23 frailty 24 syndrome 24 syndrome 25 , 25 , 26 dependency 25 , 27 and 27 and 32 diseases 27 and 34 and 28 chronic 30 - 28 chronic 32 diseases 31 communicable 32 diseases 34 and 36 association 34 and 37 of 35 the 36 association 37 of 39 these 38 all 39 these 39 these 40 with 39 these 44 attention 40 with 42 mortality 41 higher 42 mortality 43 , 44 attention 44 attention 47 targeted 44 attention 55 . 47 targeted 48 to 47 targeted 51 as 48 to 50 adults 49 older 50 adults 51 as 54 group 52 a 54 group 53 risk 54 group this should include greater social protection , age - appropriate health services , and modification and control of cardiovascular risk factors . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 3 include 0 ###LEFT-WALL### 9 - 1 this 2 should 2 should 3 include 3 include 6 protection 4 greater 6 protection 5 social 6 protection 6 protection 8 age 7 , 8 age 8 age 9 - 9 - 16 and 9 - 22 . 10 appropriate 11 health 11 health 12 services 12 services 14 and 13 , 14 and 14 and 15 modification 14 and 16 and 16 and 17 control 16 and 18 of 18 of 21 factors 19 cardiovascular 21 factors 20 risk 21 factors none background : communication between dentists and patients 65 years or older is a critical aspect of providing optimum care , particularly given the increasing number of older adults and the communication barriers they often encounter . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 13 is 1 none 2 background 1 none 3 : 1 none 13 is 2 background 3 : 3 : 11 or 4 communication 5 between 4 communication 11 or 5 between 10 years 6 dentists 7 and 7 and 8 patients 7 and 10 years 8 patients 9 65 11 or 12 older 13 is 16 aspect 14 a 15 critical 14 a 16 aspect 15 critical 16 aspect 16 aspect 17 of 16 aspect 23 given 17 of 18 providing 18 providing 20 care 19 optimum 20 care 21 , 23 given 22 particularly 23 given 23 given 26 number 23 given 37 . 24 the 26 number 25 increasing 26 number 26 number 27 of 26 number 34 they 26 number 36 encounter 27 of 30 and 28 older 29 adults 29 adults 30 and 30 and 33 barriers 31 the 33 barriers 32 communication 33 barriers 34 they 36 encounter 35 often 36 encounter methods : the authors conducted a targeted literature review of the broad health communication literature and published health literacy guidelines to examine the barriers to effective communication that are specific to the older adult population , as well as strategies for overcoming these barriers . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 authors 3 the 4 authors 4 authors 16 and 5 conducted 9 review 5 conducted 16 and 6 a 9 review 7 targeted 8 literature 8 literature 9 review 9 review 10 of 10 of 15 literature 11 the 15 literature 12 broad 13 health 13 health 15 literature 14 communication 15 literature 16 and 17 published 16 and 21 to 17 published 20 guidelines 18 health 19 literacy 19 literacy 20 guidelines 21 to 22 examine 22 examine 24 barriers 22 examine 31 to 22 examine 39 as 23 the 24 barriers 24 barriers 25 to 24 barriers 28 that 24 barriers 29 are 25 to 27 communication 26 effective 27 communication 28 that 29 are 29 are 30 specific 31 to 35 population 32 the 35 population 33 older 34 adult 34 adult 35 population 36 , 39 as 37 as 38 well 38 well 39 as 39 as 40 strategies 39 as 45 . 40 strategies 41 for 41 for 42 overcoming 42 overcoming 44 barriers 43 these 44 barriers results : findings from health communication and health literacy research provide insight into techniques to improve communication with older patients , such as [preparing] an agenda for the appointment , exhibiting warm nonverbal behavior , listening attentively , asking open - ended questions , using simple language , presenting key points one at a time and providing patients with written instructions . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 3 findings 2 : 31 exhibiting 3 findings 4 from 3 findings 7 and 3 findings 11 provide 3 findings 18 with 4 from 5 health 6 communication 7 and 7 and 10 research 7 and 11 provide 8 health 10 research 9 literacy 10 research 11 provide 12 insight 11 provide 13 into 11 provide 15 to 13 into 14 techniques 15 to 16 improve 16 improve 17 communication 18 with 20 patients 19 older 20 patients 20 patients 23 as 21 , 23 as 22 such 23 as 23 as 26 agenda 23 as 30 , 25 an 26 agenda 26 agenda 27 for 27 for 29 appointment 28 the 29 appointment 30 , 31 exhibiting 31 exhibiting 34 behavior 31 exhibiting 45 using 31 exhibiting 62 . 32 warm 34 behavior 33 nonverbal 34 behavior 34 behavior 36 listening 34 behavior 41 - 35 , 36 listening 36 listening 37 attentively 36 listening 38 , 38 , 41 - 39 asking 40 open 39 asking 41 - 41 - 43 questions 41 - 44 , 42 ended 43 questions 45 using 56 and 46 simple 47 language 47 language 48 , 48 , 51 points 48 , 56 and 49 presenting 51 points 50 key 51 points 51 points 52 one 51 points 53 at 53 at 55 time 54 a 55 time 56 and 58 patients 57 providing 58 patients 58 patients 59 with 59 with 61 instructions 60 written 61 instructions conclusions : physical , psychological and literacy issues pertaining to both patients and providers present barriers to effective communication . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 13 and 2 : 15 present 2 : 20 . 3 physical 4 , 4 , 5 psychological 4 , 6 and 6 and 8 issues 6 and 9 pertaining 6 and 13 and 7 literacy 8 issues 9 pertaining 10 to 10 to 12 patients 11 both 12 patients 13 and 14 providers 13 and 15 present 15 present 16 barriers 16 barriers 17 to 17 to 19 communication 18 effective 19 communication practitioners can surmount these barriers by enacting communication strategies tailored to older adults . 0 ###LEFT-WALL### 1 practitioners 0 ###LEFT-WALL### 3 surmount 0 ###LEFT-WALL### 14 . 1 practitioners 2 can 2 can 3 surmount 3 surmount 5 barriers 3 surmount 6 by 4 these 5 barriers 6 by 7 enacting 7 enacting 9 strategies 8 communication 9 strategies 9 strategies 10 tailored 10 tailored 11 to 11 to 13 adults 12 older 13 adults practical implications . 0 ###LEFT-WALL### 2 implications 0 ###LEFT-WALL### 3 . 1 practical 2 implications dentists can overcome barriers to communication and improve the quality of patient care by considering the communication barriers specific to older adults and enacting strategies to overcome these barriers . 0 ###LEFT-WALL### 1 dentists 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 30 . 1 dentists 7 and 2 can 3 overcome 2 can 7 and 3 overcome 4 barriers 3 overcome 5 to 5 to 6 communication 7 and 8 improve 7 and 26 to 8 improve 10 quality 8 improve 14 by 8 improve 20 to 9 the 10 quality 10 quality 11 of 11 of 13 care 12 patient 13 care 14 by 15 considering 15 considering 18 barriers 15 considering 19 specific 16 the 18 barriers 17 communication 18 barriers 20 to 23 and 21 older 22 adults 22 adults 23 and 23 and 25 strategies 24 enacting 25 strategies 26 to 27 overcome 27 overcome 29 barriers 28 these 29 barriers knee pain is commonly seen in orthopedic and rehabilitation outpatient clinical settings , and in the aging population . 0 ###LEFT-WALL### 2 pain 0 ###LEFT-WALL### 5 seen 0 ###LEFT-WALL### 19 . 1 knee 2 pain 2 pain 3 is 3 is 5 seen 4 commonly 5 seen 5 seen 14 and 6 in 8 and 6 in 14 and 7 orthopedic 8 and 8 and 12 settings 9 rehabilitation 12 settings 10 outpatient 12 settings 11 clinical 12 settings 13 , 14 and 14 and 15 in 15 in 18 population 16 the 18 population 17 aging 18 population bursitis of the knee joint , especially when the volume of the synovial fluid is large enough , can compress [and] [distend] the nearby soft tissues , causing pain in the knee joint . 0 ###LEFT-WALL### 1 bursitis 0 ###LEFT-WALL### 20 compress 1 bursitis 2 of 1 bursitis 19 can 2 of 5 joint 3 the 5 joint 4 knee 5 joint 6 , 7 especially 6 , 8 when 8 when 10 volume 8 when 15 is 8 when 18 , 8 when 19 can 9 the 10 volume 10 volume 11 of 10 volume 15 is 11 of 14 fluid 12 the 14 fluid 13 synovial 14 fluid 15 is 16 large 16 large 17 enough 19 can 20 compress 20 compress 26 tissues 23 the 26 tissues 24 nearby 26 tissues 25 soft 26 tissues 26 tissues 28 causing 27 , 28 causing 28 causing 29 pain 28 causing 30 in 28 causing 34 . 30 in 33 joint 31 the 33 joint 32 knee 33 joint out of all the bursae surrounding the knee joint , supra - patellar bursitis is most often associated with knee pain . 0 ###LEFT-WALL### 1 out 0 ###LEFT-WALL### 15 is 0 ###LEFT-WALL### 22 . 1 out 2 of 1 out 6 surrounding 1 out 15 is 2 of 3 all 3 all 4 the 3 all 5 bursae 4 the 5 bursae 6 surrounding 14 bursitis 7 the 14 bursitis 8 knee 14 bursitis 9 joint 10 , 9 joint 14 bursitis 11 supra 12 - 11 supra 14 bursitis 13 patellar 14 bursitis 15 is 16 most 16 most 18 associated 17 often 18 associated 18 associated 19 with 19 with 21 pain 20 knee 21 pain treatment strategies in managing supra - patellar bursitis include the aspiration of joint synovial fluid and then followed by steroid injection into the bursa . 0 ###LEFT-WALL### 2 strategies 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 . 1 treatment 2 strategies 2 strategies 3 in 2 strategies 16 and 3 in 4 managing 4 managing 8 bursitis 5 supra 6 - 5 supra 8 bursitis 7 patellar 8 bursitis 9 include 11 aspiration 9 include 16 and 10 the 11 aspiration 11 aspiration 12 of 12 of 15 fluid 13 joint 15 fluid 14 synovial 15 fluid 16 and 18 followed 17 then 18 followed 18 followed 19 by 18 followed 21 injection 18 followed 22 into 20 steroid 21 injection 22 into 24 bursa 23 the 24 bursa when supra - patellar bursitis [is] caused [by] degenerative disorders , the concept of viscosupplementation treatment may be effective by injecting hyaluronic acid into the bursa . 0 ###LEFT-WALL### 13 concept 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 27 . 1 when 5 bursitis 1 when 7 caused 1 when 11 , 1 when 13 concept 2 supra 3 - 2 supra 5 bursitis 4 patellar 5 bursitis 5 bursitis 7 caused 7 caused 10 disorders 9 degenerative 10 disorders 12 the 13 concept 13 concept 14 of 13 concept 17 may 14 of 16 treatment 15 viscosupplementation 16 treatment 17 may 18 be 18 be 19 effective 19 effective 20 by 19 effective 24 into 20 by 21 injecting 21 injecting 23 acid 22 hyaluronic 23 acid 24 into 26 bursa 25 the 26 bursa however , the rheology or the changes in the concentrations of proteins ( biomarkers ) that are related to the development of bursitis in the synovial fluid is virtually unexplored . 0 ###LEFT-WALL### 27 fluid 0 ###LEFT-WALL### 28 is 0 ###LEFT-WALL### 31 . 1 however 27 fluid 2 , 18 related 3 the 4 rheology 4 rheology 5 or 5 or 7 changes 5 or 8 in 5 or 18 related 6 the 7 changes 8 in 10 concentrations 9 the 10 concentrations 10 concentrations 11 of 10 concentrations 16 that 10 concentrations 17 are 11 of 12 proteins 12 proteins 14 biomarkers 13 ( 14 biomarkers 14 biomarkers 15 ) 16 that 17 are 18 related 19 to 18 related 27 fluid 19 to 21 development 20 the 21 development 21 development 22 of 22 of 23 bursitis 23 bursitis 24 in 24 in 26 synovial 25 the 26 synovial 27 fluid 28 is 28 is 30 unexplored 29 virtually 30 unexplored therefore , this study aimed to identify the concentration changes in the synovial fluid total protein amount and individual proteins associated with supra - patellar bursitis using the bradford protein assay and western immunoglobulin methods . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 aimed 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 36 . 1 therefore 2 , 1 therefore 4 study 3 this 4 study 4 study 5 aimed 5 aimed 6 to 5 aimed 10 changes 5 aimed 11 in 6 to 7 identify 7 identify 9 concentration 8 the 9 concentration 11 in 17 amount 12 the 17 amount 13 synovial 16 protein 14 fluid 16 protein 15 total 16 protein 16 protein 17 amount 18 and 20 proteins 18 and 21 associated 19 individual 20 proteins 20 proteins 21 associated 21 associated 22 with 21 associated 27 using 22 with 26 bursitis 23 supra 24 - 23 supra 26 bursitis 25 patellar 26 bursitis 27 using 32 and 28 the 31 assay 29 bradford 30 protein 30 protein 31 assay 31 assay 32 and 32 and 35 methods 33 western 34 immunoglobulin 34 immunoglobulin 35 methods a total of 20 patients were divided into two groups with 10 patients in each group . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 7 divided 0 ###LEFT-WALL### 17 . 1 a 2 total 2 total 3 of 2 total 6 were 3 of 5 patients 4 20 5 patients 6 were 7 divided 7 divided 8 into 7 divided 14 in 8 into 10 groups 9 two 10 groups 10 groups 11 with 11 with 13 patients 12 10 13 patients 14 in 16 group 15 each 16 group one group received the high molecular weight hyaluronic acid product of synvisc hylan g - [f] 20 and the other group received the low molecular weight hyaluronic acid product of hya - joint synovial fluid supplement once per week injection into the bursa for a total of 3 weeks . 0 ###LEFT-WALL### 2 group 0 ###LEFT-WALL### 3 received 0 ###LEFT-WALL### 15 - 1 one 2 group 2 group 3 received 3 received 10 product 4 the 10 product 5 high 7 weight 6 molecular 7 weight 7 weight 10 product 8 hyaluronic 9 acid 9 acid 10 product 10 product 11 of 11 of 13 hylan 12 synvisc 13 hylan 13 hylan 14 g 15 - 17 20 15 - 18 and 15 - 32 - 18 and 21 group 18 and 22 received 19 the 20 other 20 other 21 group 21 group 22 received 22 received 29 product 23 the 29 product 24 low 26 weight 25 molecular 26 weight 26 weight 29 product 27 hyaluronic 28 acid 28 acid 29 product 29 product 30 of 30 of 31 hya 32 - 33 joint 32 - 50 . 33 joint 36 supplement 33 joint 37 once 33 joint 41 into 34 synovial 35 fluid 35 fluid 36 supplement 37 once 38 per 38 per 40 injection 39 week 40 injection 41 into 43 bursa 42 the 43 bursa 43 bursa 44 for 43 bursa 47 of 44 for 46 total 45 a 46 total 47 of 49 weeks 48 3 49 weeks significant decreases in the synovial fluid total protein concentrations were observed after the second dosage of high molecular weight hyaluronic acid injections . 0 ###LEFT-WALL### 1 significant 0 ###LEFT-WALL### 2 decreases 0 ###LEFT-WALL### 11 observed 1 significant 2 decreases 2 decreases 3 in 3 in 6 fluid 4 the 6 fluid 5 synovial 6 fluid 7 total 8 protein 8 protein 9 concentrations 8 protein 10 were 8 protein 11 observed 9 concentrations 10 were 11 observed 12 after 11 observed 23 . 12 after 15 dosage 13 the 14 second 13 the 15 dosage 15 dosage 16 of 16 of 22 injections 17 high 19 weight 18 molecular 19 weight 19 weight 22 injections 20 hyaluronic 21 acid 21 acid 22 injections apolipoprotein a - i [,] interleukin 1 beta , alpha 1 antitrypsin , and matrix metalloproteinase 1 proteins revealed a trend of decreasing western immunoblotting band densities after hyaluronic acid injections . 0 ###LEFT-WALL### 8 beta 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 32 . 1 apolipoprotein 8 beta 2 a 3 - 3 - 4 i 3 - 8 beta 6 interleukin 7 1 6 interleukin 8 beta 9 , 18 proteins 9 , 19 revealed 10 alpha 18 proteins 11 1 12 antitrypsin 12 antitrypsin 14 and 13 , 14 and 14 and 15 matrix 14 and 18 proteins 16 metalloproteinase 17 1 16 metalloproteinase 18 proteins 18 proteins 19 revealed 19 revealed 21 trend 20 a 21 trend 21 trend 22 of 22 of 23 decreasing 23 decreasing 27 densities 23 decreasing 28 after 24 western 27 densities 25 immunoblotting 27 densities 26 band 27 densities 28 after 31 injections 29 hyaluronic 30 acid 30 acid 31 injections the decreases in apolipoprotein a - i [and] interleukin 1 beta protein band densities were significant in the high molecular weight hyaluronic acid injection group . 0 ###LEFT-WALL### 2 decreases 0 ###LEFT-WALL### 15 were 0 ###LEFT-WALL### 26 . 1 the 2 decreases 2 decreases 3 in 2 decreases 15 were 3 in 14 densities 4 apolipoprotein 14 densities 5 a 6 - 6 - 7 i 6 - 9 interleukin 9 interleukin 10 1 9 interleukin 14 densities 11 beta 12 protein 12 protein 13 band 13 band 14 densities 15 were 16 significant 16 significant 17 in 17 in 25 group 18 the 25 group 19 high 21 weight 20 molecular 21 weight 21 weight 25 group 22 hyaluronic 24 injection 23 acid 24 injection 24 injection 25 group transthyretin , complement 5 , and matrilin 3 proteins revealed a trend of increasing western immunoblotting band densities after hyaluronic acid injections . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 revealed 0 ###LEFT-WALL### 23 . 1 transthyretin 2 , 2 , 3 complement 2 , 6 and 3 complement 4 5 5 , 6 and 6 and 9 proteins 6 and 10 revealed 7 matrilin 8 3 7 matrilin 9 proteins 10 revealed 12 trend 11 a 12 trend 12 trend 13 of 12 trend 19 after 13 of 18 densities 14 increasing 15 western 15 western 18 densities 16 immunoblotting 18 densities 17 band 18 densities 19 after 22 injections 20 hyaluronic 22 injections 21 acid 22 injections transthyretin revealed significant increases in protein band densities in both the high and low molecular weight hyaluronic acid injection groups . 0 ###LEFT-WALL### 1 transthyretin 0 ###LEFT-WALL### 2 revealed 0 ###LEFT-WALL### 21 . 1 transthyretin 2 revealed 2 revealed 4 increases 2 revealed 9 in 3 significant 4 increases 4 increases 5 in 5 in 8 densities 6 protein 8 densities 7 band 8 densities 9 in 13 and 10 both 13 and 11 the 12 high 12 high 13 and 13 and 20 groups 14 low 20 groups 15 molecular 16 weight 16 weight 19 injection 17 hyaluronic 18 acid 18 acid 19 injection 19 injection 20 groups this study may provide the rationale for targeting several biomarkers associated with lipid transport , inflammation , and anti - aging as possible disease modifying therapies for the treatment of supra - patellar bursitis and even degenerative joint disorders . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 40 . 1 this 2 study 2 study 3 may 3 may 4 provide 4 provide 6 rationale 4 provide 12 with 5 the 6 rationale 6 rationale 7 for 7 for 10 biomarkers 8 targeting 10 biomarkers 9 several 10 biomarkers 10 biomarkers 11 associated 12 with 18 and 13 lipid 14 transport 14 transport 15 , 15 , 16 inflammation 15 , 18 and 17 , 18 and 18 and 24 disease 18 and 25 modifying 19 anti 20 - 19 anti 24 disease 21 aging 24 disease 22 as 23 possible 23 possible 24 disease 25 modifying 26 therapies 25 modifying 27 for 27 for 35 and 28 the 29 treatment 29 treatment 30 of 29 treatment 35 and 30 of 34 bursitis 31 supra 32 - 31 supra 34 bursitis 33 patellar 34 bursitis 35 and 39 disorders 36 even 37 degenerative 37 degenerative 38 joint 38 joint 39 disorders centenarians are rare and exceptional individuals characterized by a peculiar phenotype . 0 ###LEFT-WALL### 1 centenarians 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 12 . 1 centenarians 2 are 2 are 6 individuals 3 rare 4 and 4 and 5 exceptional 4 and 6 individuals 6 individuals 7 characterized 7 characterized 8 by 8 by 11 phenotype 9 a 10 peculiar 9 a 11 phenotype 10 peculiar 11 phenotype they are the best example of healthy aging in humans as most of [them] have escaped or substantially delayed the onset of major age - related diseases . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 26 related 0 ###LEFT-WALL### 28 . 1 they 2 are 2 are 5 example 3 the 4 best 3 the 5 example 5 example 6 of 5 example 13 of 6 of 8 aging 7 healthy 8 aging 8 aging 9 in 9 in 10 humans 10 humans 11 as 11 as 12 most 13 of 17 or 15 have 16 escaped 15 have 17 or 17 or 19 delayed 18 substantially 19 delayed 19 delayed 21 onset 20 the 21 onset 21 onset 22 of 22 of 24 age 23 major 24 age 25 - 26 related 26 related 27 diseases within this scenario , the purpose of the present work was to understand if immune status is associated with survival and health status in centenarians . 0 ###LEFT-WALL### 6 purpose 0 ###LEFT-WALL### 26 . 1 within 3 scenario 1 within 4 , 1 within 6 purpose 2 this 3 scenario 5 the 6 purpose 6 purpose 7 of 6 purpose 11 was 7 of 10 work 8 the 10 work 9 present 10 work 11 was 12 to 11 was 13 understand 12 to 13 understand 13 understand 14 if 14 if 16 status 14 if 18 associated 15 immune 16 status 16 status 17 is 17 is 18 associated 18 associated 19 with 19 with 21 and 20 survival 21 and 21 and 23 status 21 and 24 in 22 health 23 status 24 in 25 centenarians to this aim , 116 centenarians were concomitantly characterized for their immunological , health and functional status , and followed - up for five - year survival . 0 ###LEFT-WALL### 6 centenarians 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 28 . 1 to 3 aim 1 to 4 , 1 to 6 centenarians 2 this 3 aim 5 116 6 centenarians 6 centenarians 19 and 7 were 9 characterized 7 were 19 and 8 concomitantly 9 characterized 9 characterized 10 for 10 for 15 and 11 their 14 health 12 immunological 13 , 12 immunological 14 health 14 health 15 and 15 and 17 status 16 functional 17 status 18 , 19 and 19 and 20 followed 19 and 22 up 19 and 27 survival 21 - 22 up 22 up 23 for 22 up 25 - 23 for 24 five 26 year 27 survival ated [to] frailty , as well as functional and cognitive status , did not show any significant correlation with the immune clustering , despite being capable per se of predicting survival . 0 ###LEFT-WALL### 3 frailty 0 ###LEFT-WALL### 15 show 1 ated 3 frailty 3 frailty 7 as 3 frailty 13 did 4 , 7 as 5 as 6 well 6 well 7 as 7 as 11 status 7 as 12 , 8 functional 9 and 9 and 10 cognitive 9 and 11 status 13 did 14 not 13 did 15 show 15 show 18 correlation 16 any 18 correlation 17 significant 18 correlation 18 correlation 19 with 18 correlation 22 clustering 19 with 21 immune 20 the 21 immune 22 clustering 24 despite 23 , 24 despite 24 despite 25 being 24 despite 32 . 25 being 26 capable 26 capable 28 se 26 capable 29 of 27 per 28 se 29 of 30 predicting 30 predicting 31 survival in conclusion , high values of basic immunological parameters and important [t] cell subsets correlate with five - year survival in centenarians , independent of other phenotypic characteristics . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 29 . 1 in 2 conclusion 2 conclusion 3 , 3 , 5 values 3 , 10 and 4 high 5 values 5 values 6 of 6 of 9 parameters 7 basic 9 parameters 8 immunological 9 parameters 10 and 13 cell 10 and 14 subsets 10 and 15 correlate 10 and 25 of 11 important 13 cell 14 subsets 15 correlate 15 correlate 16 with 16 with 17 five 16 with 24 independent 17 five 20 survival 18 - 20 survival 19 year 20 survival 20 survival 21 in 20 survival 23 , 21 in 22 centenarians 25 of 28 characteristics 26 other 28 characteristics 27 phenotypic 28 characteristics this unexpected biological scenario is compatible with the general hypothesis that in centenarians a progressive disconnection and loss of biological coherence among the different functions of the body occur , [where] [survival/mortality] result from the failure of any of these domains which apparently follow an independent age - related trajectory . 0 ###LEFT-WALL### 4 scenario 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 51 . 1 this 4 scenario 2 unexpected 4 scenario 3 biological 4 scenario 4 scenario 5 is 5 is 6 compatible 6 compatible 7 with 7 with 10 hypothesis 8 the 10 hypothesis 9 general 10 hypothesis 10 hypothesis 11 that 11 that 17 and 11 that 29 occur 12 in 13 centenarians 12 in 17 and 14 a 16 disconnection 15 progressive 16 disconnection 16 disconnection 17 and 17 and 18 loss 17 and 19 of 17 and 29 occur 19 of 21 coherence 20 biological 21 coherence 21 coherence 22 among 21 coherence 26 of 22 among 25 functions 23 the 25 functions 24 different 25 functions 26 of 28 body 27 the 28 body 30 , 33 result 30 , 48 - 33 result 34 from 34 from 36 failure 35 the 36 failure 36 failure 37 of 37 of 38 any 38 any 39 of 39 of 41 domains 40 these 41 domains 41 domains 42 which 41 domains 44 follow 42 which 44 follow 43 apparently 44 follow 44 follow 47 age 45 an 46 independent 45 an 47 age 46 independent 47 age 48 - 50 trajectory 49 related 50 trajectory hyperglycemia in diabetes results in the glycation of long - [lived] proteins . 0 ###LEFT-WALL### 1 hyperglycemia 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 13 . 1 hyperglycemia 2 in 1 hyperglycemia 4 results 2 in 3 diabetes 4 results 5 in 5 in 7 glycation 6 the 7 glycation 7 glycation 8 of 8 of 12 proteins 9 long 10 - 9 long 12 proteins protein glycation leads to the formation of advanced glycation end products ( ages ) , which are implicated in delayed wound healing and other diabetes - associated pathologies , one of which is periodontal disease . 0 ###LEFT-WALL### 3 leads 0 ###LEFT-WALL### 27 associated 1 protein 3 leads 2 glycation 3 leads 3 leads 4 to 3 leads 7 of 3 leads 13 ages 3 leads 16 which 3 leads 27 associated 4 to 6 formation 5 the 6 formation 7 of 11 products 8 advanced 11 products 9 glycation 11 products 10 end 11 products 12 ( 13 ages 13 ages 14 ) 15 , 16 which 16 which 17 are 16 which 26 - 17 are 18 implicated 18 implicated 19 in 19 in 23 and 20 delayed 21 wound 21 wound 22 healing 22 healing 23 and 23 and 25 diabetes 24 other 25 diabetes 27 associated 28 pathologies 28 pathologies 30 one 29 , 30 one 30 one 31 of 30 one 36 . 31 of 32 which 32 which 33 is 33 is 35 disease 34 periodontal 35 disease research into the mechanisms by which glycated long - [lived] proteins such as collagen exert their effects can allow for the understanding of diabetic pathologies and the development of appropriate treatments . 0 ###LEFT-WALL### 1 research 0 ###LEFT-WALL### 20 for 0 ###LEFT-WALL### 32 . 1 research 2 into 1 research 5 by 1 research 18 can 2 into 4 mechanisms 3 the 4 mechanisms 5 by 6 which 5 by 11 proteins 5 by 15 exert 7 glycated 11 proteins 8 long 9 - 8 long 11 proteins 11 proteins 13 as 11 proteins 15 exert 12 such 13 as 13 as 14 collagen 15 exert 17 effects 16 their 17 effects 18 can 20 for 19 allow 20 for 20 for 22 understanding 21 the 22 understanding 22 understanding 23 of 23 of 26 and 24 diabetic 25 pathologies 25 pathologies 26 and 26 and 28 development 26 and 29 of 27 the 28 development 29 of 31 treatments 30 appropriate 31 treatments however , the high cost of purified protein can be a limitation for many laboratories around the world . 0 ###LEFT-WALL### 5 cost 0 ###LEFT-WALL### 10 be 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 5 cost 3 the 5 cost 4 high 5 cost 5 cost 6 of 5 cost 9 can 6 of 8 protein 7 purified 8 protein 9 can 10 be 10 be 12 limitation 11 a 12 limitation 12 limitation 13 for 13 for 15 laboratories 14 many 15 laboratories 15 laboratories 16 around 16 around 18 world 17 the 18 world the objective of this study was to develop a low - cost in vitro model [of] glycated gelatine as an alternative to the glycated collagen model . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 11 - 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 develop 7 to 8 develop 8 develop 10 low 9 a 10 low 11 - 12 cost 11 - 27 . 12 cost 14 vitro 12 cost 18 gelatine 13 in 14 vitro 15 model 17 glycated 17 glycated 18 gelatine 18 gelatine 19 as 19 as 21 alternative 20 an 21 alternative 21 alternative 22 to 22 to 26 model 23 the 26 model 24 glycated 26 model 25 collagen 26 model we investigated the glycation of gelatine type a , a denatured form of collagen , which is low - cost and abundantly available . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 24 . 1 we 2 investigated 2 investigated 4 glycation 3 the 4 glycation 4 glycation 5 of 5 of 7 type 6 gelatine 7 type 7 type 8 a 7 type 12 form 7 type 16 which 9 , 12 form 10 a 11 denatured 10 a 12 form 11 denatured 12 form 12 form 13 of 12 form 15 , 13 of 14 collagen 15 , 16 which 16 which 17 is 16 which 19 - 17 is 18 low 19 - 21 and 20 cost 21 and 21 and 23 available 22 abundantly 23 available in this study , gelatine was incubated for 7 days with ribose or methylglyoxal ( mg ) . 0 ###LEFT-WALL### 5 gelatine 0 ###LEFT-WALL### 7 incubated 0 ###LEFT-WALL### 18 . 1 in 3 study 1 in 4 , 1 in 5 gelatine 2 this 3 study 5 gelatine 6 was 6 was 7 incubated 7 incubated 8 for 7 incubated 11 with 8 for 10 days 9 7 10 days 11 with 13 or 12 ribose 13 or 13 or 14 methylglyoxal 13 or 16 mg 15 ( 16 mg 16 mg 17 ) cross - linking , autofluorescence and uv - vis spectrophotometry assays were performed and indicated a dose [-] dependent linear increase in cross - linking and autofluorescence of gelatine by ribose and mg . 0 ###LEFT-WALL### 1 cross 1 cross 3 linking 2 - 3 linking 3 linking 8 - 3 linking 26 and 3 linking 30 by 3 linking 34 . 4 , 8 - 5 autofluorescence 6 and 6 and 7 uv 6 and 8 - 8 - 9 vis 8 - 24 - 9 vis 11 assays 9 vis 23 cross 10 spectrophotometry 11 assays 11 assays 14 and 11 assays 23 cross 12 were 13 performed 12 were 14 and 14 and 15 indicated 14 and 22 in 15 indicated 21 increase 16 a 21 increase 17 dose 21 increase 19 dependent 21 increase 20 linear 21 increase 25 linking 26 and 26 and 27 autofluorescence 26 and 28 of 28 of 29 gelatine 30 by 32 and 31 ribose 32 and 32 and 33 mg mg produced more cross [-] linking compared to ribose at the same concentrations . 0 ###LEFT-WALL### 1 mg 0 ###LEFT-WALL### 2 produced 0 ###LEFT-WALL### 14 . 1 mg 2 produced 2 produced 6 linking 3 more 6 linking 4 cross 6 linking 6 linking 7 compared 7 compared 8 to 7 compared 10 at 8 to 9 ribose 10 at 13 concentrations 11 the 12 same 12 same 13 concentrations the uv - vis spectra of the glycated gelatines confirmed the presence of age fluorophores . 0 ###LEFT-WALL### 2 uv 0 ###LEFT-WALL### 3 - 1 the 2 uv 3 - 5 spectra 3 - 10 confirmed 3 - 16 . 4 vis 5 spectra 5 spectra 6 of 5 spectra 10 confirmed 6 of 9 gelatines 7 the 9 gelatines 8 glycated 9 gelatines 10 confirmed 12 presence 10 confirmed 15 fluorophores 11 the 12 presence 12 presence 13 of 12 presence 15 fluorophores 13 of 14 age because diabetes is a risk factor for periodontal disease , the effect of the glycated substrates on the basic behaviour of human periodontal [ligament] ( hpdl ) cells was evaluated . 0 ###LEFT-WALL### 12 effect 0 ###LEFT-WALL### 30 evaluated 0 ###LEFT-WALL### 31 . 1 because 2 diabetes 1 because 3 is 1 because 10 , 1 because 12 effect 2 diabetes 3 is 3 is 6 factor 4 a 6 factor 5 risk 6 factor 6 factor 7 for 7 for 9 disease 8 periodontal 9 disease 11 the 12 effect 12 effect 13 of 12 effect 17 on 12 effect 29 was 13 of 16 substrates 14 the 16 substrates 15 glycated 16 substrates 17 on 20 behaviour 18 the 20 behaviour 19 basic 20 behaviour 20 behaviour 21 of 21 of 28 cells 22 human 28 cells 23 periodontal 26 hpdl 23 periodontal 28 cells 25 ( 26 hpdl 26 hpdl 27 ) 29 was 30 evaluated glycation dose dependently reduced hpdl attachment and cell spreading , indicating that the novel glycated gelatine substrate affects cell behaviour . 0 ###LEFT-WALL### 7 and 1 glycation 6 attachment 2 dose 6 attachment 3 dependently 4 reduced 4 reduced 6 attachment 5 hpdl 6 attachment 6 attachment 7 and 7 and 8 cell 7 and 9 spreading 9 spreading 11 indicating 10 , 11 indicating 11 indicating 12 that 11 indicating 21 . 12 that 17 substrate 12 that 18 affects 13 the 17 substrate 14 novel 15 glycated 15 glycated 16 gelatine 16 gelatine 17 substrate 17 substrate 18 affects 18 affects 20 behaviour 19 cell 20 behaviour these results show that gelatine glycated with ribose or mg can be used as low - cost in vitro models to study the effects of protein glycation on cell behaviour in diabetes and ageing . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 16 - 1 these 2 results 2 results 3 show 3 show 4 that 4 that 9 or 4 that 13 used 5 gelatine 6 glycated 5 gelatine 7 with 5 gelatine 9 or 7 with 8 ribose 9 or 10 mg 9 or 11 can 11 can 12 be 12 be 13 used 13 used 15 low 14 as 15 low 16 - 17 cost 16 - 20 models 16 - 35 . 17 cost 20 models 18 in 19 vitro 19 vitro 20 models 20 models 21 to 20 models 27 glycation 20 models 28 on 20 models 31 in 21 to 22 study 22 study 24 effects 23 the 24 effects 24 effects 25 of 25 of 26 protein 28 on 30 behaviour 29 cell 30 behaviour 31 in 33 and 32 diabetes 33 and 33 and 34 ageing [none] none mindfulness - based stress reduction ( mbsr ) reduces symptoms of depression , anxiety , and fear of recurrence among breast cancer ( bc ) survivors . 0 ###LEFT-WALL### 3 mindfulness 0 ###LEFT-WALL### 11 reduces 0 ###LEFT-WALL### 29 . 2 none 3 mindfulness 3 mindfulness 7 reduction 3 mindfulness 11 reduces 4 - 7 reduction 5 based 7 reduction 6 stress 7 reduction 7 reduction 9 mbsr 7 reduction 10 ) 8 ( 9 mbsr 9 mbsr 10 ) 11 reduces 28 survivors 12 symptoms 13 of 12 symptoms 15 , 13 of 14 depression 15 , 16 anxiety 15 , 18 and 17 , 18 and 18 and 19 fear 18 and 20 of 18 and 22 among 18 and 28 survivors 20 of 21 recurrence 22 among 24 cancer 23 breast 24 cancer 24 cancer 26 bc 25 ( 26 bc 26 bc 27 ) however , the effects of mbsr ( bc ) on telomere length ( tl ) and telomerase activity ( ta ) , known markers of cellular aging , psychological stress , and disease risk , are not known . 0 ###LEFT-WALL### 4 effects 0 ###LEFT-WALL### 38 known 0 ###LEFT-WALL### 39 . 1 however 2 , 1 however 4 effects 3 the 4 effects 4 effects 5 of 4 effects 36 are 5 of 16 and 6 mbsr 8 bc 6 mbsr 10 on 6 mbsr 16 and 7 ( 8 bc 8 bc 9 ) 10 on 12 length 11 telomere 12 length 12 length 14 tl 13 ( 14 tl 14 tl 15 ) 16 and 18 activity 16 and 20 ta 16 and 24 markers 17 telomerase 18 activity 19 ( 20 ta 20 ta 21 ) 22 , 24 markers 23 known 24 markers 24 markers 25 of 24 markers 35 , 25 of 32 and 26 cellular 27 aging 26 cellular 28 , 28 , 30 stress 28 , 32 and 29 psychological 30 stress 31 , 32 and 32 and 34 risk 33 disease 34 risk 36 are 37 not 36 are 38 known this randomized [,] wait - listed , controlled study , nested within a larger trial , investigated the effects of mbsr ( bc ) on tl and ta . 0 ###LEFT-WALL### 4 wait 0 ###LEFT-WALL### 10 , 1 this 4 wait 2 randomized 4 wait 4 wait 6 listed 4 wait 10 , 5 - 6 listed 6 listed 7 , 8 controlled 9 study 8 controlled 10 , 10 , 16 , 11 nested 12 within 11 nested 16 , 12 within 15 trial 13 a 15 trial 14 larger 15 trial 16 , 17 investigated 17 investigated 19 effects 17 investigated 25 on 18 the 19 effects 19 effects 20 of 19 effects 23 bc 20 of 21 mbsr 22 ( 23 bc 23 bc 24 ) 25 on 28 ta 26 tl 27 and 27 and 28 ta 28 ta 29 . assessments of ta and tl were obtained along with psychological measurements at baseline , 6 weeks , and 12 weeks after completing the mbsr ( bc ) program . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 obtained 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 29 . 1 assessments 2 of 1 assessments 4 and 2 of 3 ta 4 and 5 tl 4 and 6 were 6 were 7 obtained 7 obtained 9 with 7 obtained 12 at 8 along 9 with 9 with 11 measurements 10 psychological 11 measurements 12 at 13 baseline 13 baseline 16 weeks 14 , 16 weeks 15 6 16 weeks 16 weeks 17 , 18 and 20 weeks 18 and 28 program 19 12 20 weeks 20 weeks 21 after 20 weeks 28 program 21 after 22 completing 22 completing 24 mbsr 23 the 24 mbsr 24 mbsr 26 bc 25 ( 26 bc 26 bc 27 ) the mean age of 142 participants was 55.3 years ; 72 % were [non] - hispanic white ; 78 % had stage i or [ii] cancer ; and 36 % received both chemotherapy and radiation . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 36 . 1 the 3 age 2 mean 3 age 3 age 4 of 3 age 7 was 4 of 6 participants 5 142 6 participants 7 was 9 years 8 55.3 9 years 10 ; 12 % 10 ; 13 were 10 ; 15 - 11 72 12 % 12 % 13 were 15 - 17 white 15 - 18 ; 16 hispanic 17 white 18 ; 20 % 18 ; 21 had 18 ; 27 ; 19 78 20 % 20 % 21 had 21 had 24 or 22 stage 23 i 22 stage 24 or 24 or 26 cancer 27 ; 28 and 28 and 30 % 28 and 31 received 29 36 30 % 30 % 31 received 31 received 34 and 32 both 34 and 33 chemotherapy 34 and 34 and 35 radiation in analyses adjusted for baseline ta and psychological status , ta increased steadily over 12 weeks in the mbsr ( bc ) group ( approximately 17 % ) compared to essentially [no] increase in the control group ( approximately 3 % , p < [.] 01 ) . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 33 increase 0 ###LEFT-WALL### 48 . 1 in 2 analyses 1 in 7 and 2 analyses 3 adjusted 4 for 5 baseline 4 for 7 and 6 ta 7 and 7 and 9 status 7 and 10 , 7 and 11 ta 7 and 29 compared 8 psychological 9 status 10 , 11 ta 11 ta 12 increased 11 ta 28 ) 12 increased 13 steadily 12 increased 14 over 12 increased 17 in 14 over 16 weeks 15 12 16 weeks 17 in 23 group 18 the 23 group 19 mbsr 21 bc 19 mbsr 23 group 20 ( 21 bc 21 bc 22 ) 23 group 27 % 24 ( 27 % 25 approximately 26 17 26 17 27 % 27 % 28 ) 29 compared 30 to 30 to 33 increase 31 essentially 33 increase 33 increase 34 in 34 in 37 group 35 the 37 group 36 control 37 group 37 group 41 % 38 ( 41 % 39 approximately 40 3 40 3 41 % 41 % 44 < 41 % 47 ) 42 , 44 < 43 p 44 < 44 < 46 01 in contrast , no [between] [-] group difference was observed for tl ( p = [.] 92 ) . 0 ###LEFT-WALL### 8 difference 0 ###LEFT-WALL### 10 observed 0 ###LEFT-WALL### 19 . 1 in 2 contrast 1 in 3 , 1 in 8 difference 4 no 8 difference 7 group 8 difference 8 difference 9 was 9 was 10 observed 10 observed 11 for 11 for 12 tl 12 tl 15 = 13 ( 15 = 14 p 15 = 15 = 17 92 15 = 18 ) these results provide preliminary evidence that mbsr ( bc ) increases ta in peripheral blood mononuclear cells from bc patients and have implications for understanding how mbsr ( bc ) may extend cell longevity at the cellular level . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 39 . 1 these 2 results 2 results 3 provide 3 provide 5 evidence 4 preliminary 5 evidence 5 evidence 6 that 6 that 7 mbsr 6 that 22 have 7 mbsr 9 bc 7 mbsr 21 and 8 ( 9 bc 9 bc 10 ) 11 increases 12 ta 11 increases 13 in 11 increases 21 and 13 in 17 cells 14 peripheral 15 blood 15 blood 17 cells 16 mononuclear 17 cells 17 cells 18 from 18 from 20 patients 19 bc 20 patients 21 and 22 have 22 have 23 implications 22 have 35 at 23 implications 24 for 24 for 25 understanding 25 understanding 26 how 26 how 27 mbsr 26 how 32 extend 27 mbsr 29 bc 27 mbsr 31 may 28 ( 29 bc 29 bc 30 ) 31 may 32 extend 32 extend 34 longevity 33 cell 34 longevity 35 at 38 level 36 the 38 level 37 cellular 38 level protein - energy [homeostasis] is a major determinant of healthy aging . 0 ###LEFT-WALL### 3 energy 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 12 . 1 protein 2 - 1 protein 3 energy 3 energy 5 is 5 is 8 determinant 6 a 7 major 6 a 8 determinant 7 major 8 determinant 8 determinant 9 of 9 of 11 aging 10 healthy 11 aging inadequate nutritional intakes and physical activity , together with endocrine disturbances are associated with [of] sarcopenia and frailty . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 19 . 1 inadequate 3 intakes 2 nutritional 3 intakes 3 intakes 4 and 4 and 6 activity 4 and 7 , 4 and 9 with 4 and 12 are 5 physical 6 activity 8 together 9 with 9 with 11 disturbances 10 endocrine 11 disturbances 12 are 13 associated 13 associated 14 with 14 with 17 and 16 sarcopenia 17 and 17 and 18 frailty guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition [in] [elderly] . 0 ###LEFT-WALL### 1 guidelines 0 ###LEFT-WALL### 6 address 0 ###LEFT-WALL### 17 . 1 guidelines 2 from 1 guidelines 6 address 2 from 4 societies 3 scientific 4 societies 5 mainly 6 address 6 address 12 and 7 the 12 and 8 quantitative 9 aspects 9 aspects 10 of 9 aspects 12 and 10 of 11 protein 12 and 14 nutrition 13 energy 14 nutrition besides these quantitative aspects of protein load [,] perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding , the use of fast proteins and the addition of leucine or citrulline to dietary protein . 0 ###LEFT-WALL### 4 aspects 0 ###LEFT-WALL### 7 load 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 38 . 1 besides 4 aspects 2 these 4 aspects 3 quantitative 4 aspects 4 aspects 5 of 4 aspects 7 load 5 of 6 protein 7 load 10 strategies 7 load 11 to 9 perspective 10 strategies 11 to 16 and 12 promote 15 synthesis 12 promote 16 and 13 muscle 15 synthesis 14 protein 15 synthesis 16 and 17 prevent 17 prevent 21 feeding 18 sarcopenia 21 feeding 19 include 20 pulse 20 pulse 21 feeding 22 , 28 and 23 the 24 use 24 use 25 of 24 use 28 and 25 of 27 proteins 26 fast 27 proteins 28 and 30 addition 28 and 31 of 28 and 35 to 29 the 30 addition 31 of 33 or 32 leucine 33 or 33 or 34 citrulline 35 to 37 protein 36 dietary 37 protein an integrated management of sarcopenia , taking into account the determinants of muscle wasting , i.e . nutrition , physical activity , anabolic factors such as androgens , vitamin d and n - 3 polyunsaturated fatty acids status , needs to be tested in the prevention and treatment of sarcopenia . 0 ###LEFT-WALL### 1 an 0 ###LEFT-WALL### 2 integrated 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 16 i.e 0 ###LEFT-WALL### 17 . 1 an 2 integrated 2 integrated 3 management 3 management 4 of 4 of 5 sarcopenia 5 sarcopenia 7 taking 6 , 7 taking 7 taking 9 account 7 taking 11 determinants 7 taking 15 , 8 into 9 account 10 the 11 determinants 11 determinants 12 of 12 of 14 wasting 13 muscle 14 wasting 15 , 16 i.e 17 . 18 nutrition 17 . 40 needs 17 . 51 . 18 nutrition 21 activity 18 nutrition 24 factors 18 nutrition 31 and 18 nutrition 40 needs 19 , 21 activity 20 physical 21 activity 21 activity 22 , 22 , 24 factors 23 anabolic 24 factors 24 factors 26 as 24 factors 28 , 25 such 26 as 26 as 27 androgens 28 , 31 and 29 vitamin 30 d 29 vitamin 31 and 31 and 38 status 31 and 39 , 32 n 33 - 33 - 34 3 33 - 38 status 35 polyunsaturated 37 acids 36 fatty 37 acids 37 acids 38 status 40 needs 41 to 40 needs 43 tested 41 to 42 be 42 be 43 tested 43 tested 44 in 44 in 47 and 45 the 46 prevention 46 prevention 47 and 47 and 48 treatment 47 and 49 of 49 of 50 sarcopenia the importance of physical activity , specifically resistance training , is emphasized , [not] only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition . 0 ###LEFT-WALL### 2 importance 0 ###LEFT-WALL### 12 emphasized 1 the 2 importance 2 importance 3 of 2 importance 11 is 3 of 5 activity 4 physical 5 activity 5 activity 9 training 6 , 7 specifically 6 , 9 training 8 resistance 9 training 9 training 10 , 11 is 12 emphasized 12 emphasized 16 in 13 , 15 only 13 , 16 in 16 in 17 order 16 in 38 . 17 order 18 to 17 order 19 facilitate 18 to 19 facilitate 19 facilitate 28 and 20 muscle 22 anabolism 21 protein 22 anabolism 22 anabolism 23 but 22 anabolism 28 and 23 but 25 to 23 but 26 increase 24 also 25 to 25 to 26 increase 26 increase 27 appetite 28 and 30 intake 28 and 34 at 28 and 36 of 29 food 30 intake 30 intake 31 in 31 in 33 people 32 elderly 33 people 34 at 35 risk 36 of 37 malnutrition according to present data , healthy nutrition in elderly [should] respect the guidelines for protein and energy requirement , privilege a mediterranean way of alimentation , [and] be associated with a regular physical activity . 0 ###LEFT-WALL### 20 privilege 0 ###LEFT-WALL### 26 , 0 ###LEFT-WALL### 28 be 0 ###LEFT-WALL### 35 . 1 according 2 to 2 to 4 data 2 to 19 , 2 to 20 privilege 3 present 4 data 4 data 7 nutrition 5 , 7 nutrition 6 healthy 7 nutrition 7 nutrition 8 in 7 nutrition 19 , 8 in 18 requirement 9 elderly 11 respect 11 respect 18 requirement 12 the 13 guidelines 13 guidelines 14 for 13 guidelines 16 and 14 for 15 protein 16 and 17 energy 16 and 18 requirement 20 privilege 23 way 21 a 23 way 22 mediterranean 23 way 23 way 24 of 24 of 25 alimentation 26 , 28 be 28 be 29 associated 29 associated 30 with 30 with 34 activity 31 a 32 regular 31 a 34 activity 32 regular 34 activity 33 physical 34 activity further issues relate to the identification of the genetics determinants of protein energy wasting [in] [elderly] . 0 ###LEFT-WALL### 2 issues 0 ###LEFT-WALL### 3 relate 0 ###LEFT-WALL### 17 . 1 further 2 issues 2 issues 3 relate 3 relate 4 to 3 relate 10 determinants 4 to 6 identification 5 the 6 identification 6 identification 7 of 7 of 9 genetics 8 the 9 genetics 10 determinants 11 of 11 of 14 wasting 12 protein 14 wasting 13 energy 14 wasting diminished skeletal muscle performance with aging , disuse , and disease may be partially attributed to the loss of myofilament proteins . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 15 attributed 0 ###LEFT-WALL### 22 . 1 diminished 3 muscle 2 skeletal 3 muscle 3 muscle 4 performance 4 performance 5 with 4 performance 7 , 5 with 6 aging 7 , 8 disuse 7 , 10 and 9 , 10 and 10 and 11 disease 10 and 12 may 12 may 13 be 13 be 15 attributed 14 partially 15 attributed 15 attributed 16 to 16 to 18 loss 17 the 18 loss 18 loss 19 of 19 of 21 proteins 20 myofilament 21 proteins several laboratories have found a disproportionate loss of myosin protein content relative to other myofilament proteins , but due to methodological limitations , the structural manifestation of this protein loss is unknown . 0 ###LEFT-WALL### 2 laboratories 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 33 . 1 several 2 laboratories 2 laboratories 3 have 3 have 4 found 4 found 7 loss 4 found 11 content 5 a 6 disproportionate 5 a 7 loss 6 disproportionate 7 loss 7 loss 8 of 8 of 10 protein 9 myosin 10 protein 11 content 12 relative 12 relative 18 but 13 to 16 proteins 13 to 18 but 14 other 16 proteins 15 myofilament 16 proteins 17 , 18 but 18 but 20 to 19 due 20 to 20 to 22 limitations 21 methodological 22 limitations 23 , 26 manifestation 23 , 31 is 24 the 26 manifestation 25 structural 26 manifestation 26 manifestation 27 of 26 manifestation 31 is 27 of 30 loss 28 this 30 loss 29 protein 30 loss 31 is 32 unknown to [investigate] [how] variations in myosin content affect ensemble cross - bridge behavior and force production we simulated muscle contraction in the half [-] sarcomere as myosin was removed either ( [i] [ )(uniformly , from [the] z - line end of thick - filaments , or [(] ii ) [randomly] , along the length of thick - filaments . 0 ###LEFT-WALL### 8 affect 0 ###LEFT-WALL### 11 - 1 to 4 variations 1 to 8 affect 4 variations 5 in 5 in 7 content 6 myosin 7 content 8 affect 10 cross 9 ensemble 10 cross 11 - 20 contraction 12 bridge 13 behavior 13 behavior 14 and 14 and 16 production 14 and 17 we 14 and 18 simulated 14 and 20 contraction 15 force 16 production 17 we 18 simulated 19 muscle 20 contraction 20 contraction 21 in 20 contraction 29 removed 21 in 23 half 22 the 23 half 23 half 25 sarcomere 23 half 28 was 25 sarcomere 26 as 25 sarcomere 28 was 26 as 27 myosin 29 removed 30 either 29 removed 34 )(uniformly 29 removed 36 from 29 removed 41 end 31 ( 34 )(uniformly 34 )(uniformly 35 , 35 , 36 from 36 from 38 z 36 from 39 - 40 line 41 end 41 end 42 of 41 end 53 along 42 of 47 or 43 thick 44 - 43 thick 45 filaments 45 filaments 47 or 46 , 47 or 47 or 49 ii 47 or 50 ) 52 , 53 along 53 along 55 length 53 along 60 . 54 the 55 length 55 length 56 of 56 of 59 filaments 57 thick 58 - 57 thick 59 filaments uniform myosin removal decreased force production , showing a slightly steeper force - to - myosin content relationship than the 1:1 relationship that would be expected from the loss of cross [-] bridges . 0 ###LEFT-WALL### 1 uniform 0 ###LEFT-WALL### 15 - 1 uniform 2 myosin 2 myosin 3 removal 2 myosin 14 to 3 removal 4 decreased 4 decreased 6 production 4 decreased 14 to 5 force 6 production 6 production 8 showing 7 , 8 showing 8 showing 12 force 8 showing 13 - 9 a 12 force 10 slightly 11 steeper 11 steeper 12 force 15 - 18 relationship 15 - 19 than 15 - 34 . 16 myosin 18 relationship 17 content 18 relationship 19 than 22 relationship 19 than 26 expected 20 the 22 relationship 21 1:1 22 relationship 22 relationship 23 that 22 relationship 24 would 22 relationship 25 be 23 that 24 would 25 be 26 expected 26 expected 27 from 27 from 29 loss 28 the 29 loss 29 loss 30 of 30 of 33 bridges 31 cross 33 bridges random myosin removal also decreased force production , but this decrease was less than observed with uniform myosin loss , largely due to increased myosin attachment time ( [ton] [ )(and fractional cross - bridge binding with random myosin loss . 0 ###LEFT-WALL### 3 removal 0 ###LEFT-WALL### 5 decreased 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 15 observed 0 ###LEFT-WALL### 41 . 1 random 2 myosin 2 myosin 3 removal 3 removal 5 decreased 4 also 5 decreased 5 decreased 7 production 6 force 7 production 8 , 9 but 9 but 11 decrease 9 but 12 was 10 this 11 decrease 11 decrease 12 was 12 was 13 less 12 was 14 than 14 than 15 observed 15 observed 16 with 15 observed 36 binding 15 observed 37 with 16 with 18 myosin 16 with 19 loss 17 uniform 18 myosin 19 loss 23 to 20 , 21 largely 20 , 23 to 22 due 23 to 23 to 31 )(and 23 to 34 - 24 increased 25 myosin 25 myosin 26 attachment 26 attachment 27 time 27 time 31 )(and 28 ( 31 )(and 31 )(and 33 cross 32 fractional 33 cross 35 bridge 36 binding 37 with 39 myosin 37 with 40 loss 38 random 39 myosin these findings support our prior observations that prolonged ton may augment force production in single fibers with randomly reduced myosin content from chronic heart failure patients . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 27 . 1 these 2 findings 2 findings 3 support 3 support 6 observations 3 support 14 in 3 support 17 with 4 our 6 observations 5 prior 6 observations 6 observations 9 ton 6 observations 11 augment 7 that 9 ton 8 prolonged 9 ton 9 ton 10 may 10 may 11 augment 11 augment 13 production 12 force 13 production 14 in 16 fibers 15 single 16 fibers 17 with 20 myosin 18 randomly 19 reduced 19 reduced 20 myosin 20 myosin 21 content 21 content 22 from 22 from 26 patients 23 chronic 26 patients 24 heart 26 patients 25 failure 26 patients these simulations also illustrate that the pattern of myosin loss along thick - filaments influences ensemble cross [-] bridge behavior and maintenance of force throughout the sarcomere . 0 ###LEFT-WALL### 2 simulations 0 ###LEFT-WALL### 4 illustrate 0 ###LEFT-WALL### 28 . 1 these 2 simulations 2 simulations 4 illustrate 3 also 4 illustrate 4 illustrate 21 and 4 illustrate 25 throughout 5 that 21 and 6 the 7 pattern 7 pattern 8 of 7 pattern 21 and 8 of 9 myosin 9 myosin 10 loss 9 myosin 15 influences 10 loss 11 along 10 loss 15 influences 11 along 14 filaments 12 thick 13 - 12 thick 14 filaments 15 influences 20 behavior 16 ensemble 20 behavior 17 cross 20 behavior 19 bridge 20 behavior 21 and 22 maintenance 21 and 23 of 23 of 24 force 25 throughout 27 sarcomere 26 the 27 sarcomere alanine expansion mutations in [poly] [(] a [ )(- binding protein [nuclear] 1 ( pabpn1 ) cause muscle weakness in the late - onset disorder oculopharyngeal muscular dystrophy . 0 ###LEFT-WALL### 3 mutations 0 ###LEFT-WALL### 17 cause 0 ###LEFT-WALL### 29 . 1 alanine 2 expansion 2 expansion 3 mutations 3 mutations 4 in 3 mutations 11 protein 3 mutations 17 cause 4 in 7 a 9 )(- 11 protein 10 binding 11 protein 11 protein 13 1 11 protein 15 pabpn1 11 protein 16 ) 14 ( 15 pabpn1 15 pabpn1 16 ) 17 cause 19 weakness 17 cause 20 in 18 muscle 19 weakness 20 in 28 dystrophy 21 the 28 dystrophy 22 late 23 - 22 late 24 onset 24 onset 25 disorder 25 disorder 28 dystrophy 26 oculopharyngeal 28 dystrophy 27 muscular 28 dystrophy in affected muscles , expanded pabpn1 forms nuclear aggregates , depleting levels of soluble pabpn1 [and] inducing a genome - [wide] shift from distal [to] proximal polyadenylation site usage . 0 ###LEFT-WALL### 6 pabpn1 0 ###LEFT-WALL### 7 forms 0 ###LEFT-WALL### 20 - 1 in 4 , 1 in 6 pabpn1 2 affected 3 muscles 2 affected 4 , 4 , 5 expanded 6 pabpn1 7 forms 7 forms 9 aggregates 7 forms 11 depleting 8 nuclear 9 aggregates 10 , 11 depleting 11 depleting 12 levels 11 depleting 20 - 12 levels 13 of 13 of 15 pabpn1 14 soluble 15 pabpn1 15 pabpn1 17 inducing 17 inducing 19 genome 18 a 19 genome 20 - 22 shift 20 - 30 . 22 shift 23 from 22 shift 29 usage 23 from 27 polyadenylation 24 distal 27 polyadenylation 26 proximal 27 polyadenylation 28 site 29 usage pabpn1 protein accumulation is regulated by the ubiquitin proteasome system , which is highly dysregulated in oculopharyngeal muscular dystrophy . 0 ###LEFT-WALL### 3 accumulation 0 ###LEFT-WALL### 5 regulated 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 20 . 1 pabpn1 3 accumulation 2 protein 3 accumulation 3 accumulation 4 is 4 is 5 regulated 5 regulated 6 by 6 by 10 system 7 the 10 system 8 ubiquitin 10 system 9 proteasome 10 system 11 , 12 which 11 , 15 dysregulated 12 which 13 is 13 is 14 highly 13 is 15 dysregulated 15 dysregulated 16 in 16 in 19 dystrophy 17 oculopharyngeal 19 dystrophy 18 muscular 19 dystrophy we show that arih2 e3 - ligase regulates pabpn1 protein accumulation and aggregation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 6 - 1 we 2 show 2 show 3 that 2 show 5 e3 4 arih2 5 e3 6 - 7 ligase 6 - 8 regulates 6 - 14 . 7 ligase 8 regulates 8 regulates 12 and 9 pabpn1 11 accumulation 10 protein 11 accumulation 11 accumulation 12 and 12 and 13 aggregation levels of arih2 mrna are regulated by pabpn1 via proximal polyadenylation site usage . 0 ###LEFT-WALL### 1 levels 0 ###LEFT-WALL### 6 regulated 0 ###LEFT-WALL### 14 . 1 levels 2 of 1 levels 5 are 2 of 4 mrna 3 arih2 4 mrna 5 are 6 regulated 6 regulated 7 by 6 regulated 9 via 7 by 8 pabpn1 9 via 13 usage 10 proximal 11 polyadenylation 11 polyadenylation 13 usage 12 site 13 usage we demonstrate that masking the proximal polyadenylation site in arih2 3 ['] untranslated [region] by antisense oligonucleotides elevates the expression of arih2 and pabpn1 and restores myogenic defects that are induced by arih2 or pabpn1 down - regulation in cell culture . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 demonstrate 0 ###LEFT-WALL### 37 - 0 ###LEFT-WALL### 42 . 1 we 2 demonstrate 2 demonstrate 3 that 2 demonstrate 25 and 3 that 4 masking 3 that 25 and 4 masking 8 site 4 masking 9 in 5 the 8 site 6 proximal 7 polyadenylation 7 polyadenylation 8 site 9 in 10 arih2 10 arih2 11 3 10 arih2 13 untranslated 13 untranslated 15 by 15 by 17 oligonucleotides 16 antisense 17 oligonucleotides 18 elevates 20 expression 18 elevates 25 and 19 the 20 expression 20 expression 21 of 21 of 23 and 22 arih2 23 and 23 and 24 pabpn1 25 and 26 restores 26 restores 28 defects 26 restores 32 by 26 restores 36 down 27 myogenic 28 defects 28 defects 29 that 28 defects 30 are 29 that 30 are 30 are 31 induced 32 by 34 or 33 arih2 34 or 34 or 35 pabpn1 37 - 38 regulation 38 regulation 39 in 39 in 41 culture 40 cell 41 culture in vivo arih2 mrna levels significantly decrease from midlife in vastus lateralis muscles and highly correlate with muscle degeneration . 0 ###LEFT-WALL### 5 levels 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 20 . 1 in 2 vivo 2 vivo 5 levels 3 arih2 5 levels 4 mrna 5 levels 5 levels 14 and 6 significantly 7 decrease 7 decrease 8 from 7 decrease 10 in 7 decrease 13 muscles 7 decrease 14 and 8 from 9 midlife 10 in 12 lateralis 11 vastus 12 lateralis 14 and 16 correlate 14 and 17 with 14 and 19 degeneration 15 highly 16 correlate 17 with 18 muscle we suggest that the expression of both genes is maintained by a feed - [forward] loop between mrna stability regulated by pabpn1 and protein turnover regulated by arih2 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 suggest 0 ###LEFT-WALL### 14 - 1 we 2 suggest 2 suggest 3 that 3 that 5 expression 3 that 10 maintained 4 the 5 expression 5 expression 6 of 5 expression 9 is 6 of 8 genes 7 both 8 genes 9 is 10 maintained 10 maintained 11 by 11 by 13 feed 12 a 13 feed 14 - 16 loop 14 - 29 . 16 loop 17 between 16 loop 21 by 17 between 19 stability 18 mrna 19 stability 19 stability 20 regulated 21 by 23 and 22 pabpn1 23 and 23 and 25 turnover 23 and 26 regulated 24 protein 25 turnover 26 regulated 27 by 27 by 28 arih2 objectives : this study sought to identify nonredundant atrial [fibrillation] ( af ) genetic susceptibility signals and examine their cumulative relations with af risk . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 4 study 3 this 4 study 4 study 5 sought 5 sought 6 to 5 sought 22 with 6 to 17 and 7 identify 16 signals 7 identify 17 and 8 nonredundant 15 susceptibility 9 atrial 12 af 9 atrial 13 ) 9 atrial 15 susceptibility 11 ( 12 af 12 af 13 ) 14 genetic 15 susceptibility 15 susceptibility 16 signals 17 and 18 examine 18 examine 21 relations 19 their 21 relations 20 cumulative 21 relations 22 with 24 risk 23 af 24 risk background : af - associated loci span broad genomic regions that may contain multiple susceptibility signals . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 background 2 : 2 : 3 af 4 - 6 loci 4 - 7 span 4 - 17 . 5 associated 6 loci 6 loci 7 span 7 span 10 regions 8 broad 10 regions 9 genomic 10 regions 10 regions 11 that 10 regions 12 may 11 that 12 may 12 may 13 contain 13 contain 16 signals 14 multiple 15 susceptibility 15 susceptibility 16 signals whether multiple signals exist at af loci has not been systematically [explored] . 0 ###LEFT-WALL### 1 whether 0 ###LEFT-WALL### 10 been 0 ###LEFT-WALL### 13 . 1 whether 3 signals 1 whether 4 exist 1 whether 8 has 2 multiple 3 signals 3 signals 4 exist 4 exist 5 at 5 at 7 loci 6 af 7 loci 8 has 9 not 8 has 10 been 10 been 11 systematically methods : we performed association testing conditioned on the most significant , independently associated genetic markers at 9 established af loci using 2 complementary techniques in 64,683 individuals of european ancestry [(] 3,869 [incident] and 3,302 prevalent af cases ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 3 we 2 : 4 performed 2 : 12 , 3 we 4 performed 4 performed 6 testing 5 association 6 testing 6 testing 7 conditioned 7 conditioned 8 on 7 conditioned 11 significant 8 on 10 most 9 the 10 most 12 , 16 markers 12 , 19 established 13 independently 16 markers 14 associated 16 markers 15 genetic 16 markers 16 markers 17 at 16 markers 19 established 17 at 18 9 19 established 21 loci 19 established 26 in 20 af 21 loci 21 loci 22 using 22 using 25 techniques 23 2 25 techniques 24 complementary 25 techniques 26 in 35 and 27 64,683 28 individuals 28 individuals 29 of 28 individuals 35 and 29 of 31 ancestry 30 european 31 ancestry 31 ancestry 33 3,869 35 and 39 cases 35 and 40 ) 36 3,302 39 cases 37 prevalent 39 cases 38 af 39 cases genetic risk scores were created and tested for association [with] af in europeans and an independent sample of 11,309 individuals of japanese [ancestry] ( 7,916 prevalent af cases ) . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 30 . 1 genetic 3 scores 2 risk 3 scores 3 scores 6 and 3 scores 14 and 4 were 5 created 4 were 6 and 6 and 7 tested 6 and 8 for 6 and 12 in 8 for 11 af 9 association 11 af 12 in 13 europeans 14 and 17 sample 14 and 18 of 14 and 21 of 14 and 28 cases 15 an 16 independent 15 an 17 sample 16 independent 17 sample 18 of 20 individuals 19 11,309 20 individuals 21 of 22 japanese 24 ( 28 cases 25 7,916 28 cases 26 prevalent 28 cases 27 af 28 cases 28 cases 29 ) results : we observed at least 4 distinct af susceptibility signals on chromosome 4q25 upstream of pitx2 , but not at the remaining 8 af loci . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 we 2 : 4 observed 3 we 4 observed 4 observed 11 signals 5 at 6 least 6 least 7 4 7 4 11 signals 8 distinct 10 susceptibility 9 af 10 susceptibility 10 susceptibility 11 signals 11 signals 19 but 12 on 14 4q25 12 on 19 but 13 chromosome 14 4q25 14 4q25 15 upstream 15 upstream 16 of 16 of 17 pitx2 18 , 19 but 19 but 20 not 19 but 21 at 21 at 26 loci 22 the 23 remaining 22 the 24 8 24 8 26 loci 25 af 26 loci a multilocus score comprised 12 genetic markers demonstrated an estimated 5 - fold [gradient] in af risk . 0 ###LEFT-WALL### 3 score 0 ###LEFT-WALL### 4 comprised 0 ###LEFT-WALL### 12 - 1 a 3 score 2 multilocus 3 score 3 score 4 comprised 4 comprised 5 12 5 12 7 markers 5 12 8 demonstrated 6 genetic 7 markers 7 markers 8 demonstrated 8 demonstrated 11 5 9 an 10 estimated 10 estimated 11 5 12 - 13 fold 12 - 18 . 13 fold 15 in 15 in 17 risk 16 af 17 risk we observed a similar spectrum of risk associated with these markers in japanese . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 observed 0 ###LEFT-WALL### 14 . 1 we 2 observed 2 observed 5 spectrum 3 a 4 similar 3 a 5 spectrum 4 similar 5 spectrum 5 spectrum 6 of 6 of 7 risk 7 risk 8 associated 8 associated 9 with 8 associated 12 in 9 with 11 markers 10 these 11 markers 12 in 13 japanese regions containing af signals on chromosome 4q25 displayed a greater degree of evolutionary conservation than the remainder of the locus , suggesting that they may tag regulatory elements . 0 ###LEFT-WALL### 1 regions 0 ###LEFT-WALL### 8 displayed 1 regions 2 containing 1 regions 8 displayed 2 containing 4 signals 2 containing 5 on 3 af 4 signals 5 on 7 4q25 6 chromosome 7 4q25 8 displayed 14 conservation 8 displayed 15 than 8 displayed 22 suggesting 9 a 11 degree 10 greater 11 degree 11 degree 12 of 11 degree 14 conservation 12 of 14 conservation 13 evolutionary 14 conservation 15 than 17 remainder 16 the 17 remainder 17 remainder 18 of 18 of 20 locus 19 the 20 locus 21 , 22 suggesting 22 suggesting 23 that 22 suggesting 29 . 23 that 24 they 23 that 26 tag 24 they 25 may 25 may 26 tag 26 tag 28 elements 27 regulatory 28 elements conclusions : the chromosome 4q25 af locus is architecturally complex and harbors at least 4 af susceptibility signals in individuals of [european] [ancestry] . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 1 conclusions 2 : 2 : 5 4q25 3 the 5 4q25 4 chromosome 5 4q25 5 4q25 7 locus 5 4q25 21 of 6 af 7 locus 7 locus 11 and 8 is 10 complex 8 is 11 and 9 architecturally 10 complex 11 and 12 harbors 11 and 18 signals 13 at 14 least 14 least 15 4 15 4 18 signals 16 af 18 signals 17 susceptibility 18 signals 18 signals 19 in 19 in 20 individuals 20 individuals 21 of similar polygenic af susceptibility exists between europeans and japanese . 0 ###LEFT-WALL### 4 susceptibility 0 ###LEFT-WALL### 5 exists 0 ###LEFT-WALL### 10 . 1 similar 4 susceptibility 2 polygenic 4 susceptibility 3 af 4 susceptibility 4 susceptibility 5 exists 5 exists 6 between 6 between 8 and 7 europeans 8 and 8 and 9 japanese future work is necessary to identify causal variants , determine mechanisms by which associated loci predispose [to] af , and explore whether af susceptibility signals classify individuals at risk for af and related morbidity . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 6 identify 0 ###LEFT-WALL### 10 determine 0 ###LEFT-WALL### 35 . 1 future 2 work 2 work 3 is 3 is 4 necessary 4 necessary 5 to 4 necessary 6 identify 5 to 6 identify 6 identify 8 variants 7 causal 8 variants 9 , 10 determine 10 determine 11 mechanisms 10 determine 22 whether 10 determine 28 at 11 mechanisms 12 by 12 by 13 which 12 by 15 loci 12 by 20 and 14 associated 15 loci 15 loci 20 and 16 predispose 18 af 16 predispose 20 and 19 , 20 and 20 and 21 explore 22 whether 25 signals 22 whether 26 classify 23 af 24 susceptibility 24 susceptibility 25 signals 25 signals 26 classify 26 classify 27 individuals 28 at 29 risk 29 risk 30 for 30 for 32 and 31 af 32 and 32 and 34 morbidity 33 related 34 morbidity consumer behavior differs among individuals ; one such common individual difference is financial extravagance . 0 ###LEFT-WALL### 2 behavior 0 ###LEFT-WALL### 3 differs 0 ###LEFT-WALL### 6 ; 0 ###LEFT-WALL### 15 . 1 consumer 2 behavior 2 behavior 3 differs 3 differs 4 among 4 among 5 individuals 6 ; 11 difference 6 ; 12 is 7 one 8 such 8 such 11 difference 9 common 11 difference 10 individual 11 difference 11 difference 12 is 12 is 14 extravagance 13 financial 14 extravagance recent research suggests that the activation of the caudate nucleus plays an important role in consumer behavior . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 18 . 1 recent 2 research 2 research 3 suggests 3 suggests 4 that 4 that 6 activation 4 that 11 plays 5 the 6 activation 6 activation 7 of 6 activation 11 plays 7 of 10 nucleus 8 the 10 nucleus 9 caudate 10 nucleus 11 plays 14 role 11 plays 15 in 12 an 13 important 12 an 14 role 13 important 14 role 15 in 17 behavior 16 consumer 17 behavior however , to the best of our knowledge , no study has investigated the specific relationship between the caudate nucleus and consumer financial extravagance . 0 ###LEFT-WALL### 11 study 0 ###LEFT-WALL### 13 investigated 0 ###LEFT-WALL### 25 . 1 however 2 , 1 however 11 study 3 to 5 best 3 to 9 , 3 to 11 study 4 the 5 best 5 best 6 of 6 of 8 knowledge 7 our 8 knowledge 10 no 11 study 11 study 12 has 12 has 13 investigated 13 investigated 16 relationship 13 investigated 17 between 14 the 16 relationship 15 specific 16 relationship 17 between 21 and 18 the 20 nucleus 19 caudate 20 nucleus 20 nucleus 21 and 21 and 24 extravagance 22 consumer 24 extravagance 23 financial 24 extravagance therefore , in this study , we investigated the association between individual differences in financial extravagance and regional gray matter volume in the caudate nucleus by using voxel - based morphometry ( vbm ) . 0 ###LEFT-WALL### 7 we 0 ###LEFT-WALL### 8 investigated 0 ###LEFT-WALL### 35 . 1 therefore 2 , 1 therefore 7 we 2 , 3 in 3 in 5 study 3 in 6 , 3 in 7 we 4 this 5 study 7 we 8 investigated 8 investigated 10 association 8 investigated 11 between 8 investigated 14 in 8 investigated 26 by 9 the 10 association 11 between 13 differences 12 individual 13 differences 14 in 17 and 15 financial 16 extravagance 16 extravagance 17 and 17 and 21 volume 17 and 22 in 18 regional 20 matter 19 gray 20 matter 20 matter 21 volume 22 in 25 nucleus 23 the 25 nucleus 24 caudate 25 nucleus 26 by 27 using 27 using 31 morphometry 28 voxel 29 - 28 voxel 31 morphometry 30 based 31 morphometry 31 morphometry 33 vbm 32 ( 33 vbm 33 vbm 34 ) we recruited 776 healthy , right - handed individuals ( 432 men and 344 women [;] mean age=20.7 ± 1.8 ) and used voxel - based morphometry and a financial extravagance questionnaire to determine the association between financial extravagance and gray matter structure in the caudate nucleus . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 recruited 1 we 2 recruited 2 recruited 6 right 2 recruited 8 handed 3 776 6 right 4 healthy 5 , 4 healthy 6 right 7 - 8 handed 8 handed 9 individuals 8 handed 48 . 9 individuals 11 432 10 ( 11 432 11 432 22 and 11 432 26 based 11 432 48 . 12 men 13 and 13 and 19 ± 13 and 21 ) 13 and 22 and 14 344 19 ± 15 women 17 mean 17 mean 19 ± 18 age=20.7 19 ± 19 ± 20 1.8 22 and 24 voxel 22 and 25 - 22 and 26 based 23 used 24 voxel 26 based 40 and 27 morphometry 28 and 28 and 32 questionnaire 28 and 33 to 28 and 37 between 28 and 39 extravagance 29 a 30 financial 29 a 32 questionnaire 30 financial 32 questionnaire 31 extravagance 32 questionnaire 33 to 34 determine 34 determine 36 association 34 determine 37 between 35 the 36 association 38 financial 39 extravagance 39 extravagance 40 and 40 and 43 structure 40 and 44 in 41 gray 43 structure 42 matter 43 structure 44 in 47 nucleus 45 the 47 nucleus 46 caudate 47 nucleus our measure of financial extravagance was based on the novelty seeking subscales of the japanese version of the temperament and character inventory . 0 ###LEFT-WALL### 5 extravagance 0 ###LEFT-WALL### 7 based 0 ###LEFT-WALL### 23 . 1 our 2 measure 2 measure 3 of 2 measure 5 extravagance 3 of 5 extravagance 4 financial 5 extravagance 5 extravagance 6 was 6 was 7 based 7 based 8 on 8 on 10 novelty 9 the 10 novelty 10 novelty 11 seeking 11 seeking 12 subscales 12 subscales 13 of 13 of 16 version 14 the 16 version 15 japanese 16 version 16 version 17 of 17 of 20 and 18 the 19 temperament 19 temperament 20 and 20 and 22 inventory 21 character 22 inventory a multiple regression analysis including financial extravagance , age , sex , raven 's advanced progressive matrix score , total intracranial volume , and novelty seeking subscales was conducted to examine what variables were related to regional gray matter volume in the region of interest within the caudate nucleus . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 29 conducted 0 ###LEFT-WALL### 35 related 1 a 2 multiple 1 a 4 analysis 2 multiple 3 regression 3 regression 4 analysis 4 analysis 5 including 4 analysis 28 was 5 including 24 and 6 financial 7 extravagance 7 extravagance 8 , 8 , 9 age 8 , 10 , 10 , 11 sex 10 , 12 , 12 , 18 score 12 , 19 , 13 raven 14 's 14 's 18 score 15 advanced 16 progressive 16 progressive 17 matrix 17 matrix 18 score 19 , 22 volume 19 , 24 and 20 total 22 volume 21 intracranial 22 volume 23 , 24 and 24 and 25 novelty 24 and 26 seeking 26 seeking 27 subscales 28 was 29 conducted 29 conducted 30 to 30 to 31 examine 31 examine 32 what 31 examine 35 related 32 what 33 variables 32 what 34 were 32 what 35 related 33 variables 34 were 35 related 36 to 35 related 50 . 36 to 49 nucleus 37 regional 38 gray 38 gray 39 matter 39 matter 40 volume 40 volume 41 in 40 volume 49 nucleus 41 in 43 region 42 the 43 region 43 region 44 of 44 of 45 interest 45 interest 46 within 46 within 48 caudate 47 the 48 caudate a significant positive correlation was found between the obtained financial extravagance score and regional gray matter volume in the caudate nucleus . 0 ###LEFT-WALL### 4 correlation 0 ###LEFT-WALL### 6 found 0 ###LEFT-WALL### 22 . 1 a 2 significant 1 a 4 correlation 2 significant 4 correlation 3 positive 4 correlation 4 correlation 5 was 5 was 6 found 6 found 7 between 6 found 18 in 7 between 13 and 8 the 12 score 9 obtained 11 extravagance 10 financial 11 extravagance 11 extravagance 12 score 12 score 13 and 13 and 17 volume 14 regional 15 gray 15 gray 16 matter 16 matter 17 volume 18 in 21 nucleus 19 the 21 nucleus 20 caudate 21 nucleus we found that structural variations in the caudate nucleus contributed to individual differences in financial extravagance . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 17 . 1 we 2 found 2 found 5 variations 2 found 6 in 2 found 11 to 2 found 14 in 3 that 4 structural 4 structural 5 variations 6 in 9 nucleus 7 the 9 nucleus 8 caudate 9 nucleus 9 nucleus 10 contributed 11 to 13 differences 12 individual 13 differences 14 in 16 extravagance 15 financial 16 extravagance this finding may provide a new neuroscientific approach to understanding individual characteristics of consumers . 0 ###LEFT-WALL### 2 finding 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 15 . 1 this 2 finding 2 finding 3 may 3 may 4 provide 4 provide 8 approach 4 provide 9 to 5 a 6 new 5 a 8 approach 6 new 8 approach 7 neuroscientific 8 approach 9 to 10 understanding 10 understanding 12 characteristics 11 individual 12 characteristics 12 characteristics 13 of 13 of 14 consumers mitochondria are highly dynamic organelles and their proper function is crucial for the maintenance of cellular homeostasis . 0 ###LEFT-WALL### 1 mitochondria 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 18 . 1 mitochondria 2 are 2 are 5 organelles 3 highly 4 dynamic 4 dynamic 5 organelles 6 and 9 function 6 and 10 is 7 their 9 function 8 proper 9 function 9 function 10 is 10 is 11 crucial 11 crucial 12 for 12 for 14 maintenance 13 the 14 maintenance 14 maintenance 15 of 15 of 17 homeostasis 16 cellular 17 homeostasis mitochondrial biogenesis and mitophagy are two pathways that regulate mitochondrial content and metabolism preserving homeostasis . 0 ###LEFT-WALL### 2 biogenesis 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 16 . 1 mitochondrial 2 biogenesis 3 and 4 mitophagy 3 and 5 are 4 mitophagy 5 are 5 are 7 pathways 6 two 7 pathways 7 pathways 8 that 7 pathways 9 regulate 8 that 9 regulate 9 regulate 12 and 10 mitochondrial 11 content 11 content 12 and 12 and 13 metabolism 12 and 14 preserving 14 preserving 15 homeostasis the tight regulation between these opposing processes is essential for cellular adaptation in response to cellular metabolic state [,] stress and other intracellular or environmental signals . 0 ###LEFT-WALL### 3 regulation 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 27 . 1 the 3 regulation 2 tight 3 regulation 3 regulation 4 between 3 regulation 8 is 4 between 7 processes 5 these 7 processes 6 opposing 7 processes 8 is 9 essential 9 essential 10 for 9 essential 15 to 10 for 12 adaptation 11 cellular 12 adaptation 12 adaptation 14 response 13 in 14 response 15 to 21 and 16 cellular 18 state 17 metabolic 18 state 18 state 20 stress 20 stress 21 and 21 and 26 signals 22 other 26 signals 23 intracellular 24 or 24 or 25 environmental 24 or 26 signals interestingly , imbalance between mitochondrial proliferation [and] degradation process results in progressive development of numerous pathologic conditions . 0 ###LEFT-WALL### 3 imbalance 0 ###LEFT-WALL### 10 results 0 ###LEFT-WALL### 18 . 1 interestingly 2 , 1 interestingly 3 imbalance 3 imbalance 4 between 3 imbalance 10 results 4 between 9 process 5 mitochondrial 6 proliferation 6 proliferation 9 process 8 degradation 9 process 10 results 11 in 11 in 13 development 12 progressive 13 development 13 development 14 of 14 of 17 conditions 15 numerous 17 conditions 16 pathologic 17 conditions here we review recent studies that highlight the intricate interplay between mitochondrial biogenesis and mitophagy , mainly focusing on the molecular mechanisms that govern the coordination of these processes and their involvement in age - related pathologies and ageing . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 36 related 0 ###LEFT-WALL### 40 . 1 here 2 we 2 we 3 review 3 review 5 studies 3 review 11 between 3 review 18 focusing 4 recent 5 studies 5 studies 6 that 5 studies 7 highlight 6 that 7 highlight 7 highlight 10 interplay 8 the 10 interplay 9 intricate 10 interplay 11 between 14 and 12 mitochondrial 13 biogenesis 13 biogenesis 14 and 14 and 15 mitophagy 16 , 18 focusing 17 mainly 18 focusing 18 focusing 19 on 18 focusing 35 - 19 on 22 mechanisms 20 the 22 mechanisms 21 molecular 22 mechanisms 22 mechanisms 23 that 22 mechanisms 24 govern 22 mechanisms 27 of 22 mechanisms 33 in 23 that 24 govern 24 govern 26 coordination 25 the 26 coordination 27 of 30 and 28 these 29 processes 29 processes 30 and 30 and 32 involvement 31 their 32 involvement 33 in 34 age 35 - 36 related 36 related 38 and 37 pathologies 38 and 38 and 39 ageing objective : china is experiencing a rapid increase in cancer [incidence] in elderly patients . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 china 2 : 4 is 2 : 15 . 3 china 4 is 4 is 5 experiencing 5 experiencing 8 increase 5 experiencing 9 in 5 experiencing 12 in 6 a 7 rapid 6 a 8 increase 7 rapid 8 increase 9 in 10 cancer 12 in 14 patients 13 elderly 14 patients in order to better understand this group , a large study of patients from multiple tertiary centers in the beijing area was designed . 0 ###LEFT-WALL### 11 study 0 ###LEFT-WALL### 23 designed 0 ###LEFT-WALL### 24 . 1 in 2 order 1 in 8 , 1 in 11 study 2 order 3 to 2 order 5 understand 3 to 5 understand 4 better 5 understand 5 understand 7 group 6 this 7 group 9 a 10 large 9 a 11 study 10 large 11 study 11 study 12 of 11 study 22 was 12 of 13 patients 13 patients 14 from 14 from 17 centers 15 multiple 17 centers 16 tertiary 17 centers 17 centers 18 in 18 in 21 area 19 the 21 area 20 beijing 21 area 22 was 23 designed this study was designed to provide insight into their unique treatment preferences , including the use of traditional chinese medicine ( tcm ) . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 designed 0 ###LEFT-WALL### 24 . 1 this 2 study 2 study 3 was 3 was 4 designed 4 designed 5 to 4 designed 6 provide 5 to 6 provide 6 provide 7 insight 6 provide 8 into 8 into 12 preferences 9 their 12 preferences 10 unique 11 treatment 11 treatment 12 preferences 12 preferences 14 including 13 , 14 including 14 including 16 use 14 including 23 ) 15 the 16 use 16 use 17 of 16 use 22 tcm 17 of 20 medicine 18 traditional 20 medicine 19 chinese 20 medicine 21 ( 22 tcm 22 tcm 23 ) materials and methods : 803 patients from nine hospitals in the beijing area were enrolled into this study . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 materials 2 and 2 and 3 methods 4 : 6 patients 4 : 15 enrolled 4 : 19 . 5 803 6 patients 6 patients 7 from 6 patients 14 were 7 from 9 hospitals 8 nine 9 hospitals 9 hospitals 10 in 10 in 13 area 11 the 13 area 12 beijing 13 area 14 were 15 enrolled 15 enrolled 16 into 16 into 18 study 17 this 18 study the inclusion criteria were patients who were 65 years or older and had a diagnosis of cancer at any stage . 0 ###LEFT-WALL### 3 criteria 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 21 . 1 the 3 criteria 2 inclusion 3 criteria 3 criteria 4 were 4 were 5 patients 5 patients 6 who 5 patients 12 and 6 who 12 and 7 were 10 or 7 were 12 and 8 65 9 years 9 years 10 or 10 or 11 older 12 and 13 had 13 had 15 diagnosis 13 had 18 at 14 a 15 diagnosis 15 diagnosis 16 of 16 of 17 cancer 18 at 20 stage 19 any 20 stage the cga questionnaire used with these patients included the chinese translation of the gero - oncology health and quality of life assessment tool . 0 ###LEFT-WALL### 3 questionnaire 0 ###LEFT-WALL### 8 included 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 24 . 1 the 3 questionnaire 2 cga 3 questionnaire 3 questionnaire 4 used 3 questionnaire 8 included 4 used 5 with 5 with 7 patients 6 these 7 patients 8 included 11 translation 9 the 11 translation 10 chinese 11 translation 11 translation 12 of 12 of 14 gero 13 the 14 gero 15 - 16 oncology 16 oncology 18 and 16 oncology 23 tool 17 health 18 and 18 and 19 quality 18 and 20 of 18 and 23 tool 20 of 22 assessment 21 life 22 assessment the questionnaire was provided to patients by a research nurse and was administered in mandarin . 0 ###LEFT-WALL### 2 questionnaire 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 16 . 1 the 2 questionnaire 2 questionnaire 11 and 3 was 4 provided 3 was 11 and 4 provided 5 to 4 provided 7 by 5 to 6 patients 7 by 10 nurse 8 a 9 research 8 a 10 nurse 9 research 10 nurse 11 and 12 was 12 was 13 administered 13 administered 14 in 14 in 15 mandarin results : the mean age of the patients was 72 years ( range 65 - 94 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 age 2 : 9 was 2 : 18 . 3 the 5 age 4 mean 5 age 5 age 6 of 5 age 9 was 6 of 8 patients 7 the 8 patients 9 was 11 years 10 72 11 years 11 years 13 range 12 ( 13 range 13 range 15 - 13 range 17 ) 14 65 15 - 15 - 16 94 the patients were mainly male ( 59.8 % ) [and] [of] han ethnicity ( 95.4 % ) . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 18 . 1 the 2 patients 2 patients 3 were 3 were 4 mainly 3 were 13 ethnicity 5 male 8 % 5 male 13 ethnicity 6 ( 8 % 7 59.8 8 % 8 % 9 ) 12 han 13 ethnicity 13 ethnicity 16 % 14 ( 16 % 15 95.4 16 % 16 % 17 ) about 45 % of these patients also had concurrent tcm in addition to their other cancer treatments . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 8 had 0 ###LEFT-WALL### 18 . 1 about 2 45 2 45 3 % 3 % 4 of 3 % 8 had 4 of 6 patients 5 these 6 patients 7 also 8 had 8 had 10 tcm 8 had 11 in 8 had 13 to 9 concurrent 10 tcm 11 in 12 addition 13 to 17 treatments 14 their 15 other 15 other 17 treatments 16 cancer 17 treatments about 70 % were able to manage their activities of daily living without assistance . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 15 . 1 about 2 70 2 70 3 % 3 % 4 were 4 were 5 able 5 able 6 to 5 able 7 manage 6 to 7 manage 7 manage 9 activities 8 their 9 activities 9 activities 10 of 10 of 12 living 11 daily 12 living 12 living 13 without 13 without 14 assistance patients on tcm were more likely to have higher number [of] co - morbidities compared to their counterparts . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 13 - 1 patients 2 on 1 patients 4 were 2 on 3 tcm 4 were 6 likely 5 more 6 likely 6 likely 7 to 6 likely 8 have 7 to 8 have 8 have 12 co 9 higher 10 number 10 number 12 co 13 - 14 morbidities 13 - 15 compared 13 - 19 . 14 morbidities 15 compared 15 compared 16 to 16 to 18 counterparts 17 their 18 counterparts conclusion : this is the largest prospective study of cga assessments done on elderly patients with cancer in asia . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 this 2 : 4 is 2 : 20 . 3 this 4 is 4 is 8 study 5 the 6 largest 5 the 8 study 7 prospective 8 study 8 study 9 of 9 of 11 assessments 10 cga 11 assessments 11 assessments 12 done 12 done 13 on 12 done 16 with 12 done 18 in 13 on 15 patients 14 elderly 15 patients 16 with 17 cancer 18 in 19 asia the study demonstrates that cga provides insights into understanding the needs of elderly chinese patients with cancer . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 demonstrates 0 ###LEFT-WALL### 18 . 1 the 2 study 2 study 3 demonstrates 3 demonstrates 4 that 4 that 5 cga 4 that 6 provides 5 cga 6 provides 6 provides 7 insights 6 provides 8 into 8 into 9 understanding 9 understanding 11 needs 9 understanding 16 with 10 the 11 needs 11 needs 12 of 12 of 15 patients 13 elderly 15 patients 14 chinese 15 patients 16 with 17 cancer tcm is used frequently in china , and its impact on quality of life needs further investigation . 0 ###LEFT-WALL### 1 tcm 0 ###LEFT-WALL### 3 used 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 18 . 1 tcm 2 is 2 is 3 used 3 used 4 frequently 3 used 5 in 5 in 6 china 7 , 8 and 8 and 10 impact 8 and 15 needs 9 its 10 impact 10 impact 11 on 10 impact 15 needs 11 on 12 quality 12 quality 13 of 13 of 14 life 15 needs 17 investigation 16 further 17 investigation the human gastrointestinal tract contains distinct microbial communities that differ in composition and function based on their location , as well as age , sex , race/ethnicity , and diet of their host . 0 ###LEFT-WALL### 4 tract 0 ###LEFT-WALL### 5 contains 0 ###LEFT-WALL### 34 . 1 the 4 tract 2 human 4 tract 3 gastrointestinal 4 tract 4 tract 5 contains 5 contains 8 communities 6 distinct 8 communities 7 microbial 8 communities 8 communities 9 that 8 communities 10 differ 9 that 10 differ 10 differ 11 in 10 differ 22 as 11 in 13 and 12 composition 13 and 13 and 14 function 13 and 15 based 15 based 16 on 15 based 19 , 15 based 21 well 16 on 18 location 17 their 18 location 20 as 21 well 22 as 29 and 23 age 24 , 24 , 25 sex 24 , 26 , 26 , 27 race/ethnicity 26 , 29 and 28 , 29 and 29 and 30 diet 29 and 31 of 31 of 33 host 32 their 33 host we describe the bacterial taxa present in different locations of the gi tract , and their specific metabolic features . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 describe 0 ###LEFT-WALL### 20 . 1 we 2 describe 2 describe 5 taxa 3 the 5 taxa 4 bacterial 5 taxa 5 taxa 6 present 6 present 7 in 7 in 9 locations 8 different 9 locations 9 locations 10 of 10 of 15 and 11 the 13 tract 12 gi 13 tract 13 tract 15 and 14 , 15 and 15 and 19 features 16 their 19 features 17 specific 19 features 18 metabolic 19 features the distinct features of these specific microbial communities might affect human health and disease . 0 ###LEFT-WALL### 3 features 0 ###LEFT-WALL### 10 affect 0 ###LEFT-WALL### 15 . 1 the 3 features 2 distinct 3 features 3 features 4 of 3 features 9 might 4 of 8 communities 5 these 8 communities 6 specific 8 communities 7 microbial 8 communities 9 might 10 affect 10 affect 13 and 11 human 12 health 12 health 13 and 13 and 14 disease several bacterial taxa and metabolic modules ( biochemical functions ) have been associated with human health and the absence of disease . 0 ###LEFT-WALL### 6 modules 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 22 . 1 several 6 modules 2 bacterial 6 modules 3 taxa 4 and 4 and 5 metabolic 4 and 6 modules 6 modules 9 functions 6 modules 11 have 7 ( 9 functions 8 biochemical 9 functions 9 functions 10 ) 11 have 12 been 12 been 13 associated 13 associated 14 with 14 with 17 and 15 human 16 health 16 health 17 and 17 and 19 absence 17 and 20 of 18 the 19 absence 20 of 21 disease core features of the healthy microbiome might be defined and targeted to prevent disease and optimize human health . 0 ###LEFT-WALL### 1 core 0 ###LEFT-WALL### 19 . 1 core 2 features 1 core 12 to 2 features 3 of 3 of 6 microbiome 4 the 6 microbiome 5 healthy 6 microbiome 6 microbiome 10 and 7 might 8 be 7 might 10 and 8 be 9 defined 10 and 11 targeted 12 to 15 and 13 prevent 14 disease 13 prevent 15 and 15 and 16 optimize 16 optimize 18 health 17 human 18 health neuroprotective effects of phytoestrogen compounds ( found in soy ) have been demonstrated in animal research and cell culture studies . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 13 demonstrated 0 ###LEFT-WALL### 21 . 1 neuroprotective 2 effects 2 effects 3 of 2 effects 11 have 3 of 5 compounds 4 phytoestrogen 5 compounds 5 compounds 7 found 6 ( 7 found 7 found 8 in 7 found 10 ) 8 in 9 soy 11 have 12 been 12 been 13 demonstrated 13 demonstrated 14 in 14 in 17 and 15 animal 16 research 16 research 17 and 17 and 20 studies 18 cell 19 culture 19 culture 20 studies in particular , phytoestrogens have been shown to reduce alzheimer 's disease ( ad ) related pathology , potentially alleviating risk of ad progression . 0 ###LEFT-WALL### 4 phytoestrogens 0 ###LEFT-WALL### 7 shown 1 in 2 particular 2 particular 3 , 2 particular 4 phytoestrogens 4 phytoestrogens 5 have 5 have 6 been 6 been 7 shown 7 shown 8 to 7 shown 20 alleviating 8 to 9 reduce 9 reduce 17 pathology 10 alzheimer 11 's 11 's 17 pathology 12 disease 14 ad 13 ( 14 ad 14 ad 15 ) 14 ad 16 related 16 related 17 pathology 18 , 20 alleviating 19 potentially 20 alleviating 20 alleviating 21 risk 20 alleviating 25 . 21 risk 22 of 22 of 24 progression 23 ad 24 progression in addition to their antioxidant properties , soy products also have the ability to affect cognition via interaction with estrogen receptors . 0 ###LEFT-WALL### 9 products 0 ###LEFT-WALL### 11 have 0 ###LEFT-WALL### 22 . 1 in 2 addition 1 in 7 , 1 in 9 products 2 addition 3 to 3 to 6 properties 4 their 6 properties 5 antioxidant 6 properties 8 soy 9 products 9 products 11 have 10 also 11 have 11 have 13 ability 11 have 17 via 12 the 13 ability 13 ability 14 to 13 ability 15 affect 14 to 15 affect 15 affect 16 cognition 17 via 18 interaction 18 interaction 19 with 19 with 21 receptors 20 estrogen 21 receptors however , observational studies and randomised controlled trials in humans have resulted in inconclusive findings within this domain . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 12 resulted 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 5 and 3 observational 4 studies 4 studies 5 and 5 and 8 trials 5 and 9 in 5 and 11 have 6 randomised 8 trials 7 controlled 8 trials 9 in 10 humans 11 have 12 resulted 12 resulted 13 in 12 resulted 16 within 13 in 15 findings 14 inconclusive 15 findings 16 within 18 domain 17 this 18 domain there are several possible reasons for these discrepant data . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 10 . 1 there 2 are 2 are 5 reasons 3 several 5 reasons 4 possible 5 reasons 5 reasons 6 for 6 for 9 data 7 these 9 data 8 discrepant 9 data studies which report no effect of phytoestrogens on cognition have mainly been carried out in european cohorts , with an average low dietary consumption . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 13 carried 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 25 . 1 studies 2 which 1 studies 3 report 1 studies 10 have 2 which 3 report 3 report 5 effect 3 report 8 on 4 no 5 effect 5 effect 6 of 6 of 7 phytoestrogens 8 on 9 cognition 10 have 12 been 11 mainly 12 been 12 been 13 carried 13 carried 14 out 13 carried 15 in 15 in 17 cohorts 16 european 17 cohorts 18 , 22 low 19 with 21 average 19 with 22 low 20 an 21 average 22 low 24 consumption 23 dietary 24 consumption in contrast , investigation [of] asian populations , with a higher general intake of tofu ( a [non] - fermented soy [product] ) have shown negative associations [with] cognitive [function] in those over the age of 65 . 0 ###LEFT-WALL### 7 populations 0 ###LEFT-WALL### 25 shown 0 ###LEFT-WALL### 38 . 1 in 2 contrast 1 in 3 , 1 in 7 populations 4 investigation 7 populations 6 asian 7 populations 7 populations 9 with 7 populations 24 have 8 , 9 with 9 with 13 intake 9 with 23 ) 10 a 13 intake 11 higher 13 intake 12 general 13 intake 13 intake 14 of 13 intake 19 - 14 of 15 tofu 16 ( 19 - 17 a 19 - 19 - 21 soy 19 - 23 ) 20 fermented 21 soy 24 have 25 shown 25 shown 27 associations 26 negative 27 associations 27 associations 29 cognitive 27 associations 36 of 29 cognitive 31 in 29 cognitive 33 over 31 in 32 those 33 over 35 age 34 the 35 age 36 of 37 65 consideration of type [of] soy [product] is important , as in the latter sample , protective effects of tempe ( fermented soy ) were also observed . 0 ###LEFT-WALL### 1 consideration 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 26 observed 0 ###LEFT-WALL### 27 . 1 consideration 2 of 1 consideration 7 is 2 of 5 soy 3 type 5 soy 7 is 8 important 7 is 10 as 9 , 10 as 10 as 17 effects 10 as 26 observed 11 in 14 sample 11 in 15 , 11 in 17 effects 12 the 14 sample 13 latter 14 sample 16 protective 17 effects 17 effects 18 of 17 effects 24 were 18 of 19 tempe 19 tempe 22 soy 20 ( 22 soy 21 fermented 22 soy 22 soy 23 ) 24 were 25 also 24 were 26 observed limited data provide evidence that effects of phytoestrogens on cognition may be modified by dosage , duration of consumption and cognitive test used . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 24 . 1 limited 2 data 2 data 3 provide 3 provide 4 evidence 4 evidence 5 that 5 that 6 effects 5 that 13 modified 6 effects 7 of 6 effects 11 may 7 of 8 phytoestrogens 8 phytoestrogens 9 on 9 on 10 cognition 11 may 12 be 12 be 13 modified 13 modified 14 by 14 by 15 dosage 16 , 20 and 17 duration 18 of 17 duration 20 and 18 of 19 consumption 20 and 22 test 20 and 23 used 21 cognitive 22 test additionally , characteristics of the study population including age , gender , ethnicity and menopausal status appear to be mediating variables . 0 ###LEFT-WALL### 3 characteristics 0 ###LEFT-WALL### 17 appear 0 ###LEFT-WALL### 22 . 1 additionally 2 , 1 additionally 3 characteristics 3 characteristics 4 of 3 characteristics 17 appear 4 of 14 and 5 the 7 population 6 study 7 population 7 population 8 including 7 population 10 , 8 including 9 age 10 , 11 gender 10 , 12 , 12 , 13 ethnicity 12 , 14 and 14 and 16 status 15 menopausal 16 status 17 appear 18 to 17 appear 19 be 18 to 19 be 19 be 20 mediating 20 mediating 21 variables phytoestrogen treatment interventions have also shown time - limited positive effects on cognition . 0 ###LEFT-WALL### 3 interventions 0 ###LEFT-WALL### 6 shown 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 14 . 1 phytoestrogen 3 interventions 2 treatment 3 interventions 3 interventions 4 have 4 have 6 shown 5 also 6 shown 6 shown 7 time 8 - 11 effects 9 limited 11 effects 10 positive 11 effects 11 effects 12 on 12 on 13 cognition these findings are consistent with estrogen treatment studies , where initial positive short - term cognitive effects may occur , which reverse with long - term continuous use in elderly women . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 32 . 1 these 2 findings 2 findings 3 are 3 are 4 consistent 4 consistent 5 with 5 with 8 studies 6 estrogen 7 treatment 7 treatment 8 studies 8 studies 10 where 9 , 10 where 10 where 17 effects 10 where 19 occur 10 where 20 , 11 initial 15 term 12 positive 15 term 13 short 14 - 13 short 15 term 15 term 17 effects 16 cognitive 17 effects 17 effects 18 may 18 may 19 occur 20 , 21 which 20 , 22 reverse 21 which 22 reverse 22 reverse 23 with 23 with 28 use 24 long 25 - 24 long 26 term 26 term 28 use 27 continuous 28 use 28 use 29 in 29 in 31 women 30 elderly 31 women well controlled , large scale studies are needed to assess the effects of phytoestrogens on the aging brain and provide further understanding of this association . 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 26 . 1 well 3 , 2 controlled 3 , 3 , 19 and 4 large 5 scale 5 scale 6 studies 6 studies 7 are 7 are 19 and 8 needed 9 to 8 needed 10 assess 8 needed 19 and 9 to 10 assess 10 assess 12 effects 10 assess 15 on 11 the 12 effects 12 effects 13 of 13 of 14 phytoestrogens 15 on 18 brain 16 the 18 brain 17 aging 18 brain 19 and 20 provide 20 provide 22 understanding 21 further 22 understanding 22 understanding 23 of 23 of 25 association 24 this 25 association previous research has found that as a marker of childhood circumstances , height is correlated with cognitive functioning at older ages . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 22 . 1 previous 2 research 2 research 3 has 3 has 4 found 4 found 5 that 5 that 13 height 5 that 15 correlated 6 as 8 marker 6 as 12 , 6 as 13 height 7 a 8 marker 8 marker 9 of 9 of 11 circumstances 10 childhood 11 circumstances 13 height 14 is 14 is 15 correlated 15 correlated 16 with 15 correlated 19 at 16 with 18 functioning 17 cognitive 18 functioning 19 at 21 ages 20 older 21 ages using data from the survey of health , ageing , and retirement in europe ( share ) and about 17,000 respondents from 11 countries , we find that height is positively and significantly associated with cognitive functioning in later life despite controlling for a myriad of possible confounding factors . 0 ###LEFT-WALL### 26 we 0 ###LEFT-WALL### 27 find 0 ###LEFT-WALL### 50 . 1 using 2 data 1 using 3 from 1 using 18 and 1 using 22 from 1 using 25 , 1 using 26 we 3 from 5 survey 4 the 5 survey 5 survey 6 of 6 of 11 and 7 health 8 , 8 , 9 ageing 8 , 11 and 10 , 11 and 11 and 12 retirement 13 in 14 europe 13 in 18 and 14 europe 16 share 15 ( 16 share 16 share 17 ) 18 and 19 about 19 about 21 respondents 20 17,000 21 respondents 22 from 24 countries 23 11 24 countries 26 we 27 find 27 find 29 height 27 find 32 and 28 that 29 height 29 height 32 and 30 is 31 positively 30 is 32 and 32 and 34 associated 33 significantly 34 associated 34 associated 35 with 34 associated 38 in 34 associated 41 despite 35 with 37 functioning 36 cognitive 37 functioning 38 in 40 life 39 later 40 life 41 despite 42 controlling 42 controlling 43 for 42 controlling 49 factors 43 for 45 myriad 44 a 45 myriad 45 myriad 46 of 46 of 48 confounding 47 possible 48 confounding a 10 cm increase in height is associated with a 0.04 standard deviation increase in a summary cognitive score ( mean 0.02 , std . dev . 0 ###LEFT-WALL### 4 increase 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 25 . 0 ###LEFT-WALL### 26 dev 0 ###LEFT-WALL### 27 . 1 a 4 increase 2 10 3 cm 3 cm 4 increase 4 increase 5 in 4 increase 7 is 5 in 6 height 7 is 8 associated 8 associated 9 with 8 associated 15 in 8 associated 24 std 9 with 14 increase 10 a 14 increase 11 0.04 14 increase 12 standard 13 deviation 13 deviation 14 increase 15 in 19 score 16 a 19 score 17 summary 19 score 18 cognitive 19 score 19 score 21 mean 20 ( 21 mean 21 mean 22 0.02 21 mean 23 , 25 . 26 dev we find that being born in a country where the infant mortality rate at the time of birth is high has a negative and significant influence on cognitive functioning in later life . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 find 0 ###LEFT-WALL### 33 . 1 we 2 find 2 find 3 that 3 that 4 being 3 that 21 has 4 being 5 born 4 being 21 has 5 born 6 in 6 in 8 country 7 a 8 country 8 country 9 where 9 where 13 rate 9 where 19 is 10 the 13 rate 11 infant 13 rate 12 mortality 13 rate 13 rate 14 at 13 rate 19 is 14 at 16 time 15 the 16 time 16 time 17 of 17 of 18 birth 19 is 20 high 21 has 26 influence 22 a 26 influence 23 negative 24 and 24 and 25 significant 24 and 26 influence 26 influence 27 on 27 on 29 functioning 28 cognitive 29 functioning 29 functioning 30 in 30 in 32 life 31 later 32 life a 10 % increase in the infant mortality rate is associated with a 0.1 standard deviation decrease in the summary cognitive score . 0 ###LEFT-WALL### 4 increase 0 ###LEFT-WALL### 11 associated 0 ###LEFT-WALL### 23 . 1 a 4 increase 2 10 3 % 3 % 4 increase 4 increase 5 in 4 increase 10 is 5 in 9 rate 6 the 9 rate 7 infant 9 rate 8 mortality 9 rate 10 is 11 associated 11 associated 12 with 11 associated 18 in 12 with 17 decrease 13 a 17 decrease 14 0.1 17 decrease 15 standard 16 deviation 16 deviation 17 decrease 18 in 22 score 19 the 22 score 20 summary 22 score 21 cognitive 22 score we also find some evidence that height serves as a protective factor against age related deterioration in cognitive functioning . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 find 0 ###LEFT-WALL### 20 . 1 we 3 find 2 also 3 find 3 find 5 evidence 4 some 5 evidence 5 evidence 6 that 5 evidence 8 serves 6 that 7 height 6 that 8 serves 7 height 8 serves 8 serves 9 as 8 serves 13 against 9 as 12 factor 10 a 11 protective 10 a 12 factor 11 protective 12 factor 13 against 16 deterioration 14 age 15 related 15 related 16 deterioration 16 deterioration 17 in 17 in 19 functioning 18 cognitive 19 functioning for persons of average stature , age related decreases in cognition scores are 3 - 5 percentage points smaller if they move up a quartile in the height distribution . 0 ###LEFT-WALL### 9 decreases 0 ###LEFT-WALL### 13 are 0 ###LEFT-WALL### 30 . 1 for 2 persons 1 for 6 , 1 for 9 decreases 2 persons 3 of 3 of 5 stature 4 average 5 stature 6 , 8 related 7 age 8 related 8 related 9 decreases 9 decreases 10 in 9 decreases 13 are 10 in 12 scores 11 cognition 12 scores 13 are 18 points 13 are 19 smaller 14 3 15 - 15 - 16 5 15 - 18 points 17 percentage 18 points 19 smaller 20 if 20 if 21 they 20 if 22 move 21 they 22 move 22 move 23 up 22 move 25 quartile 22 move 26 in 24 a 25 quartile 26 in 29 distribution 27 the 29 distribution 28 height 29 distribution our results also suggest that there is a significant positive association between height and cognitive abilities across countries for this pre - 1950 birth cohort of respondents , with correlations ranging from 0.4 to 0.8 . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 suggest 0 ###LEFT-WALL### 36 . 1 our 2 results 2 results 4 suggest 3 also 4 suggest 4 suggest 5 that 4 suggest 7 is 5 that 6 there 5 that 7 is 7 is 11 association 8 a 11 association 9 significant 11 association 10 positive 11 association 11 association 12 between 12 between 14 and 13 height 14 and 14 and 16 abilities 14 and 28 , 14 and 29 with 15 cognitive 16 abilities 16 abilities 17 across 17 across 18 countries 18 countries 19 for 18 countries 26 of 19 for 25 cohort 20 this 25 cohort 21 pre 22 - 21 pre 25 cohort 23 1950 24 birth 24 birth 25 cohort 26 of 27 respondents 29 with 30 correlations 30 correlations 31 ranging 31 ranging 34 to 32 from 34 to 33 0.4 34 to 34 to 35 0.8 background : one of the hallmarks of haptic exploration [is] that it typically involves movement between skin and object . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 18 and 3 one 4 of 3 one 7 of 3 one 18 and 4 of 6 hallmarks 5 the 6 hallmarks 7 of 9 exploration 8 haptic 9 exploration 9 exploration 11 that 9 exploration 14 involves 11 that 12 it 11 that 14 involves 12 it 14 involves 13 typically 14 involves 14 involves 15 movement 14 involves 16 between 16 between 17 skin 18 and 19 object explored objects may contact multiple digits simultaneously so information about motion must be integrated across digits , a process about which little is known . 0 ###LEFT-WALL### 2 objects 0 ###LEFT-WALL### 4 contact 0 ###LEFT-WALL### 8 so 1 explored 2 objects 2 objects 3 may 3 may 4 contact 4 contact 6 digits 4 contact 7 simultaneously 4 contact 8 so 5 multiple 6 digits 8 so 9 information 8 so 14 integrated 9 information 10 about 9 information 12 must 10 about 11 motion 12 must 13 be 13 be 14 integrated 14 integrated 15 across 15 across 16 digits 16 digits 19 process 17 , 19 process 18 a 19 process 19 process 20 about 19 process 25 . 20 about 21 which 20 about 22 little 20 about 24 known 22 little 23 is 23 is 24 known 24 known 25 . new method : to fill this gap , we have developed a stimulator that allows for the simultaneous and independent delivery of motion stimuli to multiple digits . 0 ###LEFT-WALL### 2 method 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 28 . 1 new 2 method 3 : 4 to 3 : 5 fill 3 : 8 , 3 : 16 for 4 to 5 fill 5 fill 7 gap 6 this 7 gap 8 , 9 we 8 , 11 developed 9 we 10 have 10 have 11 developed 11 developed 13 stimulator 12 a 13 stimulator 13 stimulator 14 that 13 stimulator 16 for 14 that 16 for 15 allows 16 for 16 for 21 delivery 16 for 25 to 17 the 21 delivery 18 simultaneous 19 and 19 and 20 independent 19 and 21 delivery 21 delivery 22 of 22 of 24 stimuli 23 motion 24 stimuli 25 to 27 digits 26 multiple 27 digits the stimulator consists of individual units that deliver motion with three degrees of freedom : rotation ( to produce motion ) , vertical [excursion] ( to control depth of [indentation] into the skin ) and arm orientation ( to control the direction of motion ) . 0 ###LEFT-WALL### 2 stimulator 0 ###LEFT-WALL### 3 consists 0 ###LEFT-WALL### 46 . 1 the 2 stimulator 2 stimulator 3 consists 3 consists 4 of 4 of 6 units 5 individual 6 units 6 units 7 that 6 units 8 deliver 7 that 8 deliver 8 deliver 9 motion 8 deliver 16 rotation 8 deliver 35 and 9 motion 10 with 10 with 11 three 11 three 14 freedom 11 three 15 : 12 degrees 13 of 12 degrees 14 freedom 13 of 14 freedom 14 freedom 15 : 16 rotation 18 to 16 rotation 23 vertical 17 ( 18 to 18 to 19 produce 18 to 21 ) 19 produce 20 motion 22 , 23 vertical 23 vertical 26 to 23 vertical 34 ) 25 ( 26 to 26 to 27 control 26 to 34 ) 27 control 28 depth 28 depth 29 of 29 of 31 into 31 into 33 skin 32 the 33 skin 35 and 37 orientation 36 arm 37 orientation 37 orientation 39 to 38 ( 39 to 39 to 40 control 39 to 45 ) 40 control 42 direction 41 the 42 direction 42 direction 43 of 43 of 44 motion each degree of freedom is controlled by a single motor . 0 ###LEFT-WALL### 4 freedom 0 ###LEFT-WALL### 6 controlled 0 ###LEFT-WALL### 11 . 1 each 2 degree 2 degree 3 of 2 degree 4 freedom 3 of 4 freedom 4 freedom 5 is 5 is 6 controlled 6 controlled 7 by 7 by 10 motor 8 a 9 single 8 a 10 motor 9 single 10 motor the compact design of the simulator allows for the side [-] by [-] side arrangement of the stimulator units such that they impinge upon adjacent fingers . 0 ###LEFT-WALL### 3 design 0 ###LEFT-WALL### 8 for 0 ###LEFT-WALL### 27 . 1 the 3 design 2 compact 3 design 3 design 4 of 3 design 8 for 4 of 6 simulator 5 the 6 simulator 7 allows 8 for 8 for 10 side 8 for 12 by 8 for 21 that 9 the 10 side 12 by 15 arrangement 14 side 15 arrangement 15 arrangement 16 of 16 of 19 units 17 the 19 units 18 stimulator 19 units 20 such 21 that 21 that 22 they 21 that 23 impinge 22 they 23 impinge 23 impinge 24 upon 24 upon 26 fingers 25 adjacent 26 fingers results : to demonstrate the functionality of the stimulator , we performed a series of psychophysical experiments that investigate the perception of motion on multiple fingers . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 demonstrate 2 : 10 , 2 : 27 . 3 to 4 demonstrate 4 demonstrate 6 functionality 5 the 6 functionality 6 functionality 7 of 7 of 9 stimulator 8 the 9 stimulator 10 , 11 we 10 , 12 performed 11 we 12 performed 12 performed 14 series 13 a 14 series 14 series 15 of 15 of 17 experiments 16 psychophysical 17 experiments 17 experiments 18 that 17 experiments 19 investigate 18 that 19 investigate 19 investigate 21 perception 19 investigate 24 on 20 the 21 perception 21 perception 22 of 22 of 23 motion 24 on 26 fingers 25 multiple 26 fingers we find that , while the sensitivity to changes in motion direction is equivalent whether stimuli are presented to the same or to different fingers , the perceived direction of motion depends on the relative configuration of the digits . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 find 0 ###LEFT-WALL### 40 . 1 we 2 find 2 find 3 that 3 that 29 direction 3 that 32 depends 4 , 5 while 5 while 7 sensitivity 5 while 13 is 5 while 26 , 5 while 29 direction 6 the 7 sensitivity 7 sensitivity 8 to 7 sensitivity 13 is 8 to 9 changes 9 changes 10 in 10 in 12 direction 11 motion 12 direction 13 is 14 equivalent 14 equivalent 15 whether 15 whether 16 stimuli 15 whether 18 presented 16 stimuli 17 are 17 are 18 presented 18 presented 22 or 19 to 21 same 19 to 22 or 20 the 21 same 22 or 23 to 23 to 25 fingers 24 different 25 fingers 27 the 29 direction 28 perceived 29 direction 29 direction 30 of 29 direction 32 depends 30 of 31 motion 32 depends 33 on 33 on 36 configuration 34 the 36 configuration 35 relative 36 configuration 36 configuration 37 of 37 of 39 digits 38 the 39 digits comparison with existing methods : we replicated the results of previous experiments investigating motion discrimination with a single digit and were able to extend these findings by investigating motion perception across multiple digits . 0 ###LEFT-WALL### 4 methods 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 34 . 1 comparison 2 with 2 with 3 existing 3 existing 4 methods 5 : 6 we 5 : 20 and 6 we 20 and 7 replicated 9 results 7 replicated 16 with 7 replicated 20 and 8 the 9 results 9 results 10 of 10 of 12 experiments 11 previous 12 experiments 12 experiments 13 investigating 13 investigating 15 discrimination 14 motion 15 discrimination 16 with 19 digit 17 a 19 digit 18 single 19 digit 20 and 21 were 20 and 27 by 21 were 22 able 22 able 23 to 22 able 24 extend 23 to 24 extend 24 extend 26 findings 25 these 26 findings 27 by 28 investigating 28 investigating 30 perception 28 investigating 31 across 29 motion 30 perception 31 across 33 digits 32 multiple 33 digits conclusion : the novel motion stimulator will be an invaluable tool to investigate [how] motion information is integrated across multiple digits . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 6 stimulator 2 : 8 be 3 the 6 stimulator 4 novel 5 motion 5 motion 6 stimulator 6 stimulator 7 will 7 will 8 be 8 be 11 tool 8 be 12 to 9 an 10 invaluable 9 an 11 tool 10 invaluable 11 tool 12 to 13 investigate 13 investigate 15 motion 15 motion 16 information 15 motion 17 is 15 motion 18 integrated 16 information 17 is 18 integrated 19 across 19 across 21 digits 20 multiple 21 digits the use of dietary intervention has evolved into a promising approach to prevent the onset and progression of brain diseases . 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 7 evolved 0 ###LEFT-WALL### 21 . 1 the 2 use 2 use 3 of 2 use 6 has 3 of 5 intervention 4 dietary 5 intervention 6 has 7 evolved 7 evolved 8 into 7 evolved 12 to 8 into 11 approach 9 a 10 promising 9 a 11 approach 10 promising 11 approach 12 to 13 prevent 13 prevent 16 and 14 the 15 onset 15 onset 16 and 16 and 17 progression 16 and 18 of 18 of 20 diseases 19 brain 20 diseases the positive relationship between intake of omega - 3 long chain polyunsaturated fatty acids ( ω3 - lcpufas ) and decreased onset of disease - and aging - related deterioration of brain health is increasingly endorsed across epidemiological and diet - interventional studies . 0 ###LEFT-WALL### 3 relationship 0 ###LEFT-WALL### 43 studies 0 ###LEFT-WALL### 44 . 1 the 3 relationship 2 positive 3 relationship 3 relationship 4 between 3 relationship 43 studies 4 between 20 and 5 intake 6 of 5 intake 20 and 6 of 7 omega 7 omega 14 acids 8 - 14 acids 9 3 14 acids 10 long 11 chain 11 chain 14 acids 12 polyunsaturated 14 acids 13 fatty 14 acids 14 acids 16 ω3 14 acids 19 ) 15 ( 16 ω3 16 ω3 18 lcpufas 16 ω3 19 ) 17 - 18 lcpufas 18 lcpufas 19 ) 20 and 22 onset 20 and 23 of 21 decreased 22 onset 23 of 26 and 24 disease 26 and 25 - 26 and 26 and 27 aging 28 - 29 related 29 related 30 deterioration 29 related 43 studies 30 deterioration 31 of 30 deterioration 36 endorsed 31 of 32 brain 32 brain 33 health 32 brain 34 is 33 health 34 is 34 is 35 increasingly 36 endorsed 37 across 36 endorsed 42 interventional 37 across 39 and 38 epidemiological 39 and 39 and 40 diet 39 and 41 - promising results are found regarding to the protection of proper brain circulation , structure and functionality in healthy and diseased humans and animal models . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 25 . 1 promising 2 results 2 results 3 are 3 are 4 found 4 found 5 regarding 5 regarding 6 to 5 regarding 22 and 6 to 8 protection 7 the 8 protection 8 protection 9 of 9 of 11 brain 10 proper 11 brain 12 circulation 13 , 13 , 14 structure 13 , 15 and 15 and 16 functionality 15 and 22 and 16 functionality 17 in 17 in 21 humans 18 healthy 19 and 19 and 20 diseased 19 and 21 humans 22 and 24 models 23 animal 24 models these include enhanced cerebral blood flow ( cbf ) , white and gray matter integrity , and improved cognitive functioning , and [are] possibly mediated through increased neurovascular coupling , neuroprotection and neuronal plasticity , respectively . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 37 . 1 these 17 and 2 include 6 flow 2 include 17 and 3 enhanced 6 flow 4 cerebral 5 blood 5 blood 6 flow 6 flow 8 cbf 6 flow 15 integrity 7 ( 8 cbf 8 cbf 9 ) 10 , 15 integrity 11 white 12 and 12 and 13 gray 12 and 15 integrity 14 matter 15 integrity 15 integrity 16 , 17 and 18 improved 18 improved 22 and 18 improved 36 respectively 19 cognitive 20 functioning 19 cognitive 22 and 21 , 22 and 22 and 29 coupling 22 and 32 and 24 possibly 25 mediated 25 mediated 29 coupling 26 through 29 coupling 27 increased 29 coupling 28 neurovascular 29 coupling 30 , 32 and 31 neuroprotection 32 and 32 and 34 plasticity 32 and 35 , 33 neuronal 34 plasticity contrary , studies investigating diets high in saturated fats provide opposite results , which may eventually lead to irreversible damage . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 10 provide 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 21 . 1 contrary 2 , 1 contrary 3 studies 3 studies 4 investigating 3 studies 10 provide 4 investigating 5 diets 5 diets 6 high 6 high 7 in 7 in 9 fats 8 saturated 9 fats 10 provide 11 opposite 11 opposite 12 results 13 , 14 which 13 , 17 lead 14 which 15 may 15 may 17 lead 16 eventually 17 lead 17 lead 18 to 18 to 20 damage 19 irreversible 20 damage studies like these are of great importance given the high incidence of obesity caused by [the] increased and decreased consumption of respectively saturated fats and ω3 - lcpufas in the western civilization . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 27 - 0 ###LEFT-WALL### 33 . 1 studies 2 like 1 studies 4 are 2 like 3 these 4 are 5 of 4 are 15 by 5 of 7 importance 6 great 7 importance 7 importance 8 given 7 importance 12 of 8 given 11 incidence 9 the 11 incidence 10 high 11 incidence 12 of 13 obesity 13 obesity 14 caused 15 by 18 and 17 increased 18 and 18 and 19 decreased 18 and 20 consumption 20 consumption 21 of 21 of 25 and 22 respectively 23 saturated 23 saturated 24 fats 24 fats 25 and 25 and 26 ω3 27 - 32 civilization 28 lcpufas 29 in 28 lcpufas 32 civilization 29 in 31 western 30 the 31 western this paper will review in vivo research conducted on the effects of ω3 - lcpufas and saturated fatty acids on integrity ( circulation , structure and function ) of the young , aging and diseased brain . 0 ###LEFT-WALL### 34 and 0 ###LEFT-WALL### 37 . 1 this 2 paper 2 paper 16 and 2 paper 34 and 3 will 4 review 3 will 16 and 4 review 6 vivo 4 review 7 research 5 in 6 vivo 7 research 8 conducted 7 research 12 of 8 conducted 9 on 9 on 11 effects 10 the 11 effects 12 of 15 lcpufas 13 ω3 14 - 13 ω3 15 lcpufas 16 and 17 saturated 17 saturated 19 acids 18 fatty 19 acids 19 acids 20 on 19 acids 29 of 20 on 21 integrity 21 integrity 26 and 22 ( 26 and 23 circulation 24 , 24 , 25 structure 24 , 26 and 26 and 27 function 26 and 28 ) 29 of 33 aging 30 the 33 aging 31 young 32 , 31 young 33 aging 34 and 36 brain 35 diseased 36 brain immune responses in the brain are thought to play a role in disorders of the central nervous system , but an understanding of the process underlying [how] immune cells get into the brain and their fate there remains unclear . 0 ###LEFT-WALL### 1 immune 0 ###LEFT-WALL### 7 thought 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 40 . 1 immune 2 responses 1 immune 6 are 1 immune 7 thought 2 responses 3 in 2 responses 6 are 3 in 5 brain 4 the 5 brain 7 thought 8 to 7 thought 12 in 7 thought 14 of 8 to 9 play 9 play 11 role 10 a 11 role 12 in 13 disorders 14 of 18 system 15 the 18 system 16 central 18 system 17 nervous 18 system 19 , 20 but 20 but 22 understanding 20 but 38 remains 21 an 22 understanding 22 understanding 23 of 22 understanding 29 cells 22 understanding 30 get 22 understanding 38 remains 23 of 26 underlying 24 the 26 underlying 25 process 26 underlying 28 immune 29 cells 29 cells 30 get 30 get 31 into 30 get 37 there 31 into 34 and 32 the 33 brain 33 brain 34 and 34 and 36 fate 35 their 36 fate 38 remains 39 unclear in this study , we used [a] 2 - photon microscopy to reveal that neutrophils infiltrate brain and migrate toward amyloid plaques in a mouse model of alzheimer 's disease . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 31 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 used 6 used 8 2 9 - 11 microscopy 10 photon 11 microscopy 11 microscopy 12 to 11 microscopy 18 and 12 to 13 reveal 13 reveal 14 that 14 that 15 neutrophils 14 that 18 and 15 neutrophils 18 and 16 infiltrate 17 brain 16 infiltrate 18 and 18 and 19 migrate 18 and 20 toward 18 and 23 in 20 toward 22 plaques 21 amyloid 22 plaques 23 in 26 model 24 a 26 model 25 mouse 26 model 26 model 27 of 27 of 30 disease 28 alzheimer 29 's 29 's 30 disease these findings suggest a new molecular process underlying the pathophysiology of alzheimer 's disease . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 15 . 1 these 2 findings 2 findings 3 suggest 3 suggest 7 process 4 a 5 new 4 a 7 process 5 new 7 process 6 molecular 7 process 7 process 8 underlying 8 underlying 10 pathophysiology 9 the 10 pathophysiology 10 pathophysiology 11 of 11 of 14 disease 12 alzheimer 13 's 13 's 14 disease alzheimer 's disease ( ad ) is a senile dementia [with] increased incidence in older subjects ( age >65 years ) . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 22 . 1 alzheimer 2 's 2 's 3 disease 3 disease 5 ad 3 disease 7 is 4 ( 5 ad 5 ad 6 ) 7 is 13 incidence 8 a 9 senile 8 a 13 incidence 9 senile 10 dementia 10 dementia 12 increased 12 increased 13 incidence 13 incidence 14 in 14 in 16 subjects 15 older 16 subjects 16 subjects 20 years 17 ( 20 years 18 age 20 years 19 >65 20 years 20 years 21 ) one of the earliest markers of ad is oxidative dna damage . 0 ###LEFT-WALL### 1 one 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 12 . 1 one 2 of 1 one 8 is 2 of 5 markers 3 the 4 earliest 3 the 5 markers 5 markers 6 of 6 of 7 ad 8 is 11 damage 9 oxidative 11 damage 10 dna 11 damage recently , it has been reported that preclinical ad patient brains show elevated levels of oxidative damage in both nuclear and mitochondrial nucleic acids . 0 ###LEFT-WALL### 3 it 0 ###LEFT-WALL### 5 been 0 ###LEFT-WALL### 25 . 1 recently 2 , 1 recently 3 it 3 it 4 has 4 has 5 been 5 been 9 ad 5 been 11 brains 5 been 13 elevated 5 been 18 in 6 reported 9 ad 7 that 8 preclinical 8 preclinical 9 ad 10 patient 11 brains 11 brains 12 show 12 show 13 elevated 13 elevated 14 levels 14 levels 15 of 15 of 17 damage 16 oxidative 17 damage 18 in 24 acids 19 both 24 acids 20 nuclear 21 and 21 and 22 mitochondrial 21 and 24 acids 23 nucleic 24 acids moreover , different oxidative lesions in mitochondrial dna are between 5 - and 10 - fold higher than in nuclear dna in both control and ad postmortem brains . 0 ###LEFT-WALL### 5 lesions 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 29 . 1 moreover 2 , 1 moreover 5 lesions 3 different 5 lesions 4 oxidative 5 lesions 5 lesions 6 in 5 lesions 9 are 6 in 8 dna 7 mitochondrial 8 dna 9 are 10 between 10 between 11 5 12 - 13 and 13 and 14 10 13 and 15 - 14 10 15 - 15 - 16 fold 16 fold 17 higher 16 fold 18 than 16 fold 22 in 18 than 19 in 19 in 21 dna 20 nuclear 21 dna 22 in 25 and 23 both 25 and 24 control 25 and 25 and 26 ad 25 and 27 postmortem 25 and 28 brains 27 postmortem 28 brains we previously showed that there is a significant loss of base excision repair ( ber ) [components] in whole tissue extracts of ad and mild cognitive impairment subjects relative to matched control subjects . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 34 . 1 we 3 showed 2 previously 3 showed 3 showed 4 that 4 that 5 there 4 that 6 is 5 there 6 is 6 is 28 subjects 7 a 9 loss 8 significant 9 loss 9 loss 10 of 9 loss 18 in 9 loss 22 of 9 loss 24 and 10 of 13 repair 11 base 13 repair 12 excision 13 repair 13 repair 15 ber 14 ( 15 ber 15 ber 16 ) 18 in 21 extracts 19 whole 21 extracts 20 tissue 21 extracts 22 of 23 ad 24 and 25 mild 24 and 27 impairment 26 cognitive 27 impairment 27 impairment 28 subjects 28 subjects 29 relative 29 relative 30 to 30 to 33 subjects 31 matched 32 control 32 control 33 subjects however , comprehensive analysis of specific steps in ber levels in mitochondrial extracts of ad patient brains is not available . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 4 analysis 3 comprehensive 4 analysis 4 analysis 5 of 4 analysis 18 is 5 of 7 steps 6 specific 7 steps 7 steps 8 in 8 in 10 levels 9 ber 10 levels 10 levels 11 in 11 in 13 extracts 12 mitochondrial 13 extracts 13 extracts 14 of 14 of 17 brains 15 ad 17 brains 16 patient 17 brains 18 is 19 not 18 is 20 available 19 not 20 available in this study , we mainly investigated various components of ber in mitochondrial extracts of ad and matched control postmortem brain samples . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 23 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 17 and 6 mainly 7 investigated 7 investigated 9 components 7 investigated 12 in 7 investigated 17 and 8 various 9 components 9 components 10 of 10 of 11 ber 12 in 14 extracts 13 mitochondrial 14 extracts 14 extracts 15 of 15 of 16 ad 17 and 18 matched 18 matched 20 postmortem 19 control 20 postmortem 20 postmortem 21 brain 20 postmortem 22 samples 21 brain 22 samples we found that the 5 - hydroxyuracil incision and ligase activities are significantly lower in ad brains , whereas the uracil incision , abasic site cleavage , and deoxyribonucleotide triphosphate incorporation activities are normal in these samples . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 6 - 1 we 2 found 2 found 3 that 2 found 5 5 4 the 5 5 6 - 8 incision 6 - 9 and 6 - 33 are 6 - 38 . 7 hydroxyuracil 8 incision 9 and 11 activities 9 and 12 are 10 ligase 11 activities 11 activities 12 are 12 are 13 significantly 12 are 14 lower 12 are 19 whereas 14 lower 15 in 15 in 17 brains 16 ad 17 brains 18 , 19 whereas 19 whereas 28 and 20 the 22 incision 21 uracil 22 incision 22 incision 23 , 23 , 26 cleavage 23 , 28 and 24 abasic 25 site 25 site 26 cleavage 27 , 28 and 28 and 32 activities 28 and 33 are 29 deoxyribonucleotide 30 triphosphate 30 triphosphate 32 activities 31 incorporation 32 activities 33 are 34 normal 34 normal 35 in 35 in 37 samples 36 these 37 samples low - grade inflammation and endothelial dysfunction are related to cognitive [decline] and dementia , in a complex interplay with vascular factors and aging . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 related 0 ###LEFT-WALL### 25 . 1 low 2 - 1 low 3 grade 3 grade 4 inflammation 4 inflammation 5 and 5 and 7 dysfunction 5 and 8 are 6 endothelial 7 dysfunction 8 are 9 related 9 related 10 to 9 related 20 with 10 to 19 interplay 11 cognitive 13 and 13 and 14 dementia 13 and 15 , 13 and 16 in 13 and 19 interplay 16 in 18 complex 17 a 18 complex 20 with 23 and 21 vascular 22 factors 22 factors 23 and 23 and 24 aging we investigated , in an older population , low - grade inflammation and endothelial dysfunction in relation to detailed assessment of cognitive functioning . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 24 . 1 we 2 investigated 2 investigated 4 in 3 , 4 in 4 in 7 population 4 in 8 , 5 an 7 population 6 older 7 population 8 , 13 and 9 low 10 - 9 low 11 grade 11 grade 12 inflammation 12 inflammation 13 and 13 and 15 dysfunction 13 and 18 to 13 and 21 of 14 endothelial 15 dysfunction 16 in 17 relation 17 relation 18 to 18 to 20 assessment 19 detailed 20 assessment 21 of 23 functioning 22 cognitive 23 functioning furthermore , we explored this association within the context of vascular factors . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 explored 0 ###LEFT-WALL### 13 . 1 furthermore 2 , 1 furthermore 3 we 3 we 4 explored 4 explored 6 association 4 explored 7 within 5 this 6 association 7 within 9 context 8 the 9 context 9 context 10 of 10 of 12 factors 11 vascular 12 factors in 2005 - 2008 , all participants underwent neuropsychological examination . 0 ###LEFT-WALL### 7 participants 0 ###LEFT-WALL### 8 underwent 0 ###LEFT-WALL### 11 . 1 in 3 - 1 in 5 , 1 in 7 participants 2 2005 3 - 3 - 4 2008 6 all 7 participants 7 participants 8 underwent 8 underwent 10 examination 9 neuropsychological 10 examination composite [z] - scores were computed for low - grade inflammation and endothelial dysfunction at both time points , and for six domains of cognitive functioning ( abstract reasoning , memory , information processing speed , attention and executive functioning , visuoconstruction , and language ) . 0 ###LEFT-WALL### 4 scores 0 ###LEFT-WALL### 6 computed 0 ###LEFT-WALL### 47 . 1 composite 3 - 1 composite 4 scores 4 scores 5 were 5 were 6 computed 6 computed 7 for 6 computed 20 and 7 for 12 and 8 low 9 - 8 low 10 grade 10 grade 11 inflammation 11 inflammation 12 and 12 and 14 dysfunction 13 endothelial 14 dysfunction 15 at 18 points 15 at 20 and 16 both 18 points 17 time 18 points 19 , 20 and 20 and 21 for 21 for 23 domains 22 six 23 domains 23 domains 24 of 24 of 26 functioning 25 cognitive 26 functioning 26 functioning 29 reasoning 26 functioning 38 and 27 ( 29 reasoning 28 abstract 29 reasoning 29 reasoning 31 memory 29 reasoning 32 , 30 , 31 memory 31 memory 32 , 32 , 38 and 33 information 34 processing 33 information 36 , 34 processing 35 speed 36 , 37 attention 36 , 38 and 38 and 39 executive 38 and 40 functioning 38 and 44 and 38 and 46 ) 41 , 44 and 42 visuoconstruction 44 and 43 , 44 and 44 and 45 language 44 and 46 ) the association between low - grade inflammation and endothelial dysfunction , and cognitive functioning was evaluated with linear regression analysis . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 16 evaluated 0 ###LEFT-WALL### 21 . 1 the 2 association 2 association 3 between 2 association 14 functioning 2 association 15 was 3 between 12 and 4 low 5 - 4 low 7 inflammation 6 grade 7 inflammation 7 inflammation 8 and 8 and 10 dysfunction 8 and 12 and 9 endothelial 10 dysfunction 11 , 12 and 12 and 13 cognitive 15 was 16 evaluated 16 evaluated 17 with 17 with 20 analysis 18 linear 19 regression 19 regression 20 analysis in secondary analyses , we explored the relation with vascular risk factors and cardiovascular disease . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 explored 0 ###LEFT-WALL### 16 . 1 in 3 analyses 1 in 4 , 1 in 5 we 2 secondary 3 analyses 5 we 6 explored 6 explored 8 relation 6 explored 9 with 7 the 8 relation 9 with 13 and 10 vascular 12 factors 11 risk 12 factors 12 factors 13 and 13 and 15 disease 14 cardiovascular 15 disease low - grade inflammation and endothelial dysfunction were associated with worse performance on information processing speed and attention and executive functioning , in prospective and cross - sectional analyses ( standardized betas ranging from - 0.20 to - 0.10 ) . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 41 . 1 low 2 - 1 low 3 grade 3 grade 4 inflammation 4 inflammation 5 and 5 and 7 dysfunction 5 and 8 were 6 endothelial 7 dysfunction 8 were 9 associated 9 associated 10 with 10 with 19 and 11 worse 12 performance 12 performance 13 on 12 performance 17 and 13 on 14 information 14 information 15 processing 15 processing 16 speed 17 and 18 attention 17 and 19 and 19 and 20 executive 19 and 21 functioning 19 and 29 analyses 21 functioning 23 in 22 , 23 in 23 in 25 and 23 in 27 - 24 prospective 25 and 25 and 26 cross 27 - 29 analyses 28 sectional 29 analyses 29 analyses 32 betas 29 analyses 40 ) 30 ( 32 betas 31 standardized 32 betas 32 betas 33 ranging 32 betas 34 from 32 betas 40 ) 34 from 37 to 35 - 36 0.20 36 0.20 37 to 37 to 39 0.10 38 - 39 0.10 no significant relation with other cognitive domains was observed . 0 ###LEFT-WALL### 3 relation 0 ###LEFT-WALL### 9 observed 0 ###LEFT-WALL### 10 . 1 no 3 relation 2 significant 3 relation 3 relation 4 with 3 relation 8 was 4 with 7 domains 5 other 7 domains 6 cognitive 7 domains 8 was 9 observed adjusting for vascular factors slightly attenuated the associations . 0 ###LEFT-WALL### 1 adjusting 0 ###LEFT-WALL### 6 attenuated 0 ###LEFT-WALL### 9 . 1 adjusting 2 for 1 adjusting 6 attenuated 2 for 4 factors 3 vascular 4 factors 5 slightly 6 attenuated 6 attenuated 8 associations 7 the 8 associations low - grade inflammation and endothelial dysfunction accounted for only 2.6 % explained variance in cognitive functioning , on top of related vascular risk factors and cardiovascular disease . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 8 accounted 1 low 2 - 1 low 3 grade 3 grade 4 inflammation 4 inflammation 5 and 5 and 7 dysfunction 5 and 8 accounted 6 endothelial 7 dysfunction 8 accounted 9 for 8 accounted 15 in 9 for 14 variance 10 only 11 2.6 11 2.6 12 % 12 % 13 explained 13 explained 14 variance 15 in 17 functioning 16 cognitive 17 functioning 17 functioning 21 of 18 , 21 of 19 on 20 top 20 top 21 of 21 of 26 and 21 of 29 . 22 related 25 factors 23 vascular 25 factors 24 risk 25 factors 25 factors 26 and 26 and 28 disease 27 cardiovascular 28 disease bootstrapping analyses show that low - grade inflammation and endothelial dysfunction mediate the relation between vascular risk factors and cognitive functioning . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 22 . 1 bootstrapping 2 analyses 2 analyses 3 show 3 show 4 that 4 that 9 and 4 that 12 mediate 5 low 6 - 5 low 9 and 7 grade 8 inflammation 8 inflammation 9 and 9 and 11 dysfunction 9 and 12 mediate 10 endothelial 11 dysfunction 12 mediate 14 relation 12 mediate 15 between 13 the 14 relation 15 between 19 and 16 vascular 18 factors 17 risk 18 factors 18 factors 19 and 19 and 20 cognitive 19 and 21 functioning this study shows that low - grade inflammation and endothelial dysfunction contribute to reduced information processing speed and executive functioning in an older population . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 shows 0 ###LEFT-WALL### 25 . 1 this 2 study 2 study 3 shows 3 shows 7 grade 3 shows 18 and 3 shows 21 in 4 that 7 grade 5 low 6 - 5 low 7 grade 7 grade 9 and 7 grade 16 processing 8 inflammation 9 and 9 and 11 dysfunction 9 and 12 contribute 10 endothelial 11 dysfunction 12 contribute 13 to 13 to 15 information 14 reduced 15 information 15 information 16 processing 16 processing 17 speed 18 and 19 executive 19 executive 20 functioning 21 in 24 population 22 an 24 population 23 older 24 population background : transcranial magnetic stimulation ( tms ) can affect episodic memory , one of the main cognitive hallmarks of aging , but the mechanisms of action remain unclear . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 but 0 ###LEFT-WALL### 30 . 1 background 2 : 2 : 3 transcranial 3 transcranial 5 stimulation 3 transcranial 10 affect 4 magnetic 5 stimulation 5 stimulation 7 tms 5 stimulation 9 can 6 ( 7 tms 7 tms 8 ) 9 can 10 affect 10 affect 12 memory 11 episodic 12 memory 12 memory 14 one 13 , 14 one 14 one 15 of 14 one 20 of 14 one 22 , 15 of 19 hallmarks 16 the 17 main 16 the 19 hallmarks 18 cognitive 19 hallmarks 20 of 21 aging 23 but 25 mechanisms 23 but 28 remain 24 the 25 mechanisms 25 mechanisms 26 of 25 mechanisms 28 remain 26 of 27 action 28 remain 29 unclear objectives : to evaluate the behavioral and functional impact of excitatory tms in a group of healthy elders . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 9 impact 4 evaluate 13 in 5 the 9 impact 6 behavioral 7 and 7 and 8 functional 7 and 9 impact 9 impact 10 of 10 of 12 tms 11 excitatory 12 tms 13 in 18 elders 14 a 15 group 15 group 16 of 15 group 18 elders 16 of 18 elders 17 healthy 18 elders methods : we applied a paradigm of repetitive tms - intermittent theta - burst stimulation - over left inferior frontal gyrus in healthy elders ( n = 24 ) and evaluated its impact on the performance of an episodic memory task with two levels of processing and the associated brain activity as captured by a pre and post fmri scans . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 60 scans 0 ###LEFT-WALL### 61 . 2 : 3 we 2 : 4 applied 2 : 10 - 2 : 13 - 3 we 4 applied 4 applied 6 paradigm 5 a 6 paradigm 6 paradigm 7 of 7 of 9 tms 8 repetitive 9 tms 10 - 12 theta 11 intermittent 12 theta 13 - 30 and 14 burst 15 stimulation 14 burst 17 over 14 burst 30 and 16 - 17 over 17 over 21 gyrus 17 over 29 ) 18 left 21 gyrus 19 inferior 21 gyrus 20 frontal 21 gyrus 21 gyrus 22 in 22 in 24 elders 23 healthy 24 elders 24 elders 27 = 25 ( 27 = 26 n 27 = 27 = 28 24 27 = 29 ) 30 and 31 evaluated 31 evaluated 47 and 31 evaluated 54 by 32 its 33 impact 33 impact 34 on 33 impact 37 of 33 impact 47 and 34 on 36 performance 35 the 36 performance 37 of 41 task 38 an 41 task 39 episodic 41 task 40 memory 41 task 41 task 42 with 41 task 45 of 42 with 44 levels 43 two 44 levels 45 of 46 processing 47 and 51 activity 47 and 53 captured 48 the 51 activity 49 associated 50 brain 50 brain 51 activity 52 as 53 captured 54 by 57 and 55 a 56 pre 56 pre 57 and 57 and 58 post 57 and 59 fmri 57 and 60 scans 59 fmri 60 scans results : in the post - tms fmri we found tms - related activity increases in left prefrontal and cerebellum - occipital areas specifically during deep encoding but not during shallow encoding or at rest . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 fmri 2 : 17 left 2 : 36 . 3 in 5 post 3 in 6 - 3 in 8 fmri 4 the 5 post 7 tms 8 fmri 8 fmri 9 we 8 fmri 16 in 8 fmri 17 left 9 we 10 found 10 found 11 tms 10 found 15 increases 11 tms 15 increases 12 - 13 related 13 related 14 activity 13 related 15 increases 15 increases 16 in 17 left 23 areas 17 left 24 specifically 17 left 25 during 17 left 28 but 17 left 33 or 18 prefrontal 19 and 19 and 20 cerebellum 19 and 21 - 19 and 23 areas 22 occipital 23 areas 25 during 27 encoding 26 deep 27 encoding 28 but 29 not 30 during 32 encoding 30 during 33 or 31 shallow 32 encoding 33 or 34 at 34 at 35 rest furthermore , we found a task - dependent change in connectivity during the encoding task between cerebellum - occipital areas and the tms - targeted left inferior frontal region . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 24 - 1 furthermore 2 , 1 furthermore 3 we 3 we 4 found 4 found 6 task 4 found 20 areas 4 found 21 and 5 a 6 task 6 task 9 change 7 - 9 change 8 dependent 9 change 9 change 10 in 9 change 12 during 9 change 16 between 9 change 18 - 10 in 11 connectivity 12 during 15 task 13 the 15 task 14 encoding 15 task 16 between 17 cerebellum 19 occipital 20 areas 21 and 23 tms 22 the 23 tms 24 - 29 region 24 - 30 . 25 targeted 29 region 26 left 29 region 27 inferior 29 region 28 frontal 29 region this connectivity change correlated with the tms effects over brain networks . 0 ###LEFT-WALL### 3 change 0 ###LEFT-WALL### 11 networks 0 ###LEFT-WALL### 12 . 1 this 3 change 2 connectivity 3 change 3 change 4 correlated 3 change 11 networks 4 correlated 5 with 4 correlated 9 over 5 with 8 effects 6 the 8 effects 7 tms 8 effects 9 over 10 brain conclusions : the results suggest that the aged brain responds to brain stimulation in a state - dependent manner as engaged by different tasks components and that tms effect is related to inter - individual connectivity changes measures . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 suggest 2 : 39 . 3 the 4 results 4 results 5 suggest 5 suggest 6 that 6 that 9 brain 6 that 10 responds 7 the 9 brain 8 aged 9 brain 9 brain 10 responds 10 responds 36 connectivity 10 responds 37 changes 11 to 13 stimulation 11 to 36 connectivity 12 brain 13 stimulation 14 in 16 state 14 in 34 - 14 in 36 connectivity 15 a 16 state 16 state 26 and 17 - 26 and 18 dependent 19 manner 19 manner 21 engaged 19 manner 26 and 20 as 21 engaged 21 engaged 22 by 22 by 25 components 23 different 24 tasks 24 tasks 25 components 26 and 28 tms 26 and 29 effect 26 and 33 inter 26 and 34 - 27 that 28 tms 29 effect 30 is 30 is 31 related 31 related 32 to 32 to 33 inter 35 individual 36 connectivity 36 connectivity 37 changes 37 changes 38 measures these findings reveal fundamental insights into brain network dynamics in aging and the capacity to probe them with combined behavioral and stimulation approaches . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 reveal 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 24 . 1 these 2 findings 2 findings 3 reveal 3 reveal 5 insights 3 reveal 19 combined 4 fundamental 5 insights 5 insights 6 into 5 insights 15 to 5 insights 18 with 5 insights 19 combined 6 into 12 and 7 brain 9 dynamics 8 network 9 dynamics 9 dynamics 10 in 9 dynamics 12 and 10 in 11 aging 12 and 14 capacity 13 the 14 capacity 15 to 16 probe 16 probe 17 them 16 probe 18 with 19 combined 20 behavioral 21 and 22 stimulation 21 and 23 approaches 22 stimulation 23 approaches the critical impact that microbiota [have] on health and disease makes the interaction between host [and] microbiome [increasingly] important as we evaluate therapeutics . 0 ###LEFT-WALL### 3 impact 0 ###LEFT-WALL### 11 makes 0 ###LEFT-WALL### 24 . 1 the 3 impact 2 critical 3 impact 3 impact 5 microbiota 3 impact 11 makes 4 that 5 microbiota 5 microbiota 7 on 7 on 9 and 8 health 9 and 9 and 10 disease 11 makes 13 interaction 11 makes 14 between 11 makes 23 therapeutics 12 the 13 interaction 14 between 17 microbiome 15 host 17 microbiome 17 microbiome 19 important 19 important 20 as 20 as 22 evaluate 21 we 22 evaluate here , we highlight growing evidence that , beyond disease , microbes also affect the most fundamental [of] host physiological [phenotypes] , [the] rate of aging itself . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 28 . 1 here 2 , 1 here 3 we 3 we 4 highlight 4 highlight 6 evidence 5 growing 6 evidence 6 evidence 7 that 7 that 12 microbes 7 that 14 affect 8 , 9 beyond 9 beyond 10 disease 9 beyond 11 , 9 beyond 12 microbes 12 microbes 14 affect 13 also 14 affect 14 affect 24 rate 15 the 24 rate 16 most 17 fundamental 17 fundamental 19 host 19 host 24 rate 20 physiological 22 , 20 physiological 24 rate 24 rate 25 of 25 of 26 aging 26 aging 27 itself rare diseases are powerful windows into biological processes and can serve as models for the development of therapeutic strategies . 0 ###LEFT-WALL### 2 diseases 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 20 . 1 rare 2 diseases 2 diseases 3 are 3 are 5 windows 3 are 6 into 3 are 12 as 4 powerful 5 windows 6 into 9 and 7 biological 8 processes 8 processes 9 and 9 and 11 serve 10 can 11 serve 12 as 13 models 13 models 14 for 14 for 16 development 15 the 16 development 16 development 17 of 17 of 19 strategies 18 therapeutic 19 strategies the progress made on the premature aging disorder progeria is a shining example of the impact [that] studies of rare diseases can have . 0 ###LEFT-WALL### 2 progress 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 24 . 1 the 2 progress 2 progress 3 made 2 progress 10 is 3 made 4 on 4 on 9 progeria 5 the 8 disorder 6 premature 8 disorder 7 aging 8 disorder 8 disorder 9 progeria 10 is 13 example 11 a 13 example 12 shining 13 example 13 example 14 of 14 of 16 impact 15 the 16 impact 16 impact 18 studies 16 impact 23 have 18 studies 19 of 18 studies 22 can 19 of 21 diseases 20 rare 21 diseases 22 can 23 have two recent studies identify [how] sex - specific pheromonal factors in flies and worms alter lifespan through metabolic pathways that are shared with mammals . 0 ###LEFT-WALL### 3 studies 0 ###LEFT-WALL### 4 identify 0 ###LEFT-WALL### 7 - 1 two 3 studies 2 recent 3 studies 3 studies 4 identify 4 identify 6 sex 7 - 10 factors 7 - 15 alter 7 - 25 . 8 specific 10 factors 9 pheromonal 10 factors 10 factors 11 in 10 factors 15 alter 11 in 13 and 12 flies 13 and 13 and 14 worms 15 alter 16 lifespan 15 alter 17 through 17 through 19 pathways 18 metabolic 19 pathways 19 pathways 20 that 19 pathways 21 are 20 that 21 are 21 are 22 shared 22 shared 23 with 23 with 24 mammals sex differences in human lifespans imply nonautonomous effects modulated by sex - specific gene - environment interactions that could still include pheromonal mechanisms . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 6 imply 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 24 . 1 sex 2 differences 2 differences 3 in 2 differences 6 imply 3 in 5 lifespans 4 human 5 lifespans 6 imply 8 effects 6 imply 10 by 7 nonautonomous 8 effects 8 effects 9 modulated 10 by 11 sex 12 - 14 gene 12 - 15 - 13 specific 14 gene 15 - 17 interactions 16 environment 17 interactions 17 interactions 18 that 17 interactions 19 could 18 that 19 could 19 could 21 include 20 still 21 include 21 include 23 mechanisms 22 pheromonal 23 mechanisms knowledge of deciduous crown formation times is useful in forensic anthropology and when aging juvenile remains from an archaeological context . 0 ###LEFT-WALL### 1 knowledge 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 21 . 1 knowledge 2 of 1 knowledge 7 is 2 of 6 times 3 deciduous 4 crown 4 crown 5 formation 5 formation 6 times 7 is 8 useful 8 useful 9 in 9 in 12 and 10 forensic 11 anthropology 11 anthropology 12 and 12 and 13 when 12 and 14 aging 14 aging 16 remains 15 juvenile 16 remains 16 remains 17 from 17 from 20 context 18 an 19 archaeological 18 an 20 context 19 archaeological 20 context until now , histological techniques for calculating enamel formation times in deciduous teeth have been completely dependent on being able to visualise clear daily incremental markings . 0 ###LEFT-WALL### 5 techniques 0 ###LEFT-WALL### 15 been 0 ###LEFT-WALL### 27 . 1 until 2 now 1 until 3 , 1 until 5 techniques 4 histological 5 techniques 5 techniques 6 for 5 techniques 14 have 6 for 7 calculating 7 calculating 8 enamel 8 enamel 9 formation 8 enamel 10 times 9 formation 10 times 10 times 11 in 11 in 13 teeth 12 deciduous 13 teeth 14 have 15 been 15 been 16 completely 15 been 17 dependent 17 dependent 18 on 17 dependent 21 to 17 dependent 22 visualise 18 on 19 being 19 being 20 able 21 to 22 visualise 22 visualise 26 markings 23 clear 26 markings 24 daily 26 markings 25 incremental 26 markings in the first part of this study we took twenty deciduous teeth where daily incremental markings were easily visible on both aspects of the crown and used these as the basis for generating regression equations to predict enamel formation times . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 9 took 0 ###LEFT-WALL### 41 . 1 in 7 study 1 in 8 we 2 the 4 part 3 first 4 part 4 part 5 of 4 part 7 study 5 of 7 study 6 this 7 study 8 we 9 took 9 took 12 teeth 9 took 13 where 9 took 29 as 9 took 36 to 10 twenty 12 teeth 11 deciduous 12 teeth 13 where 16 markings 13 where 26 and 14 daily 16 markings 15 incremental 16 markings 16 markings 26 and 17 were 19 visible 17 were 26 and 18 easily 19 visible 19 visible 20 on 20 on 22 aspects 21 both 22 aspects 22 aspects 23 of 23 of 25 crown 24 the 25 crown 26 and 27 used 27 used 28 these 29 as 31 basis 30 the 31 basis 31 basis 32 for 32 for 33 generating 33 generating 35 equations 34 regression 35 equations 36 to 37 predict 37 predict 40 times 38 enamel 39 formation 39 formation 40 times we were then able to use these regression equations to calculate deciduous crown formation times in [a] further fifty deciduous teeth where it was not possible to see daily increments . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 11 calculate 1 we 2 were 2 were 3 then 2 were 4 able 4 able 5 to 4 able 6 use 5 to 6 use 6 use 9 equations 6 use 10 to 6 use 11 calculate 7 these 9 equations 8 regression 9 equations 10 to 11 calculate 11 calculate 15 times 11 calculate 16 in 11 calculate 22 where 11 calculate 27 to 11 calculate 31 . 12 deciduous 13 crown 13 crown 14 formation 14 formation 15 times 16 in 21 teeth 18 further 21 teeth 19 fifty 21 teeth 20 deciduous 21 teeth 22 where 23 it 22 where 24 was 23 it 24 was 24 was 25 not 24 was 26 possible 25 not 26 possible 27 to 28 see 28 see 30 increments 29 daily 30 increments we present here new data for deciduous crown formation times based on these regression equations . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 present 0 ###LEFT-WALL### 16 . 1 we 2 present 2 present 3 here 2 present 5 data 2 present 6 for 2 present 12 on 4 new 5 data 6 for 10 times 7 deciduous 8 crown 8 crown 10 times 9 formation 10 times 10 times 11 based 12 on 15 equations 13 these 15 equations 14 regression 15 equations in the second part of this study [these] regression formulae were applied blind to teeth from two individuals with known medical histories . 0 ###LEFT-WALL### 10 formulae 0 ###LEFT-WALL### 12 applied 0 ###LEFT-WALL### 23 . 1 in 7 study 1 in 10 formulae 2 the 3 second 2 the 4 part 4 part 5 of 4 part 7 study 5 of 7 study 6 this 7 study 9 regression 10 formulae 10 formulae 11 were 11 were 12 applied 12 applied 13 blind 13 blind 14 to 13 blind 16 from 13 blind 19 with 14 to 15 teeth 16 from 18 individuals 17 two 18 individuals 19 with 22 histories 20 known 22 histories 21 medical 22 histories the formulae were able to successfully determine the times of prenatal and postnatal enamel formation relative to the neonatal line and also to correctly estimate the ages at which accentuated ['] stress lines ' occurred during the period of deciduous crown formation . 0 ###LEFT-WALL### 2 formulae 0 ###LEFT-WALL### 7 determine 0 ###LEFT-WALL### 43 . 1 the 2 formulae 2 formulae 3 were 3 were 4 able 4 able 5 to 5 to 7 determine 6 successfully 7 determine 7 determine 9 times 7 determine 21 and 8 the 9 times 9 times 10 of 9 times 21 and 10 of 15 formation 11 prenatal 12 and 12 and 13 postnatal 12 and 14 enamel 14 enamel 15 formation 15 formation 16 relative 16 relative 17 to 17 to 19 neonatal 18 the 19 neonatal 20 line 21 and 21 and 23 to 21 and 25 estimate 22 also 23 to 23 to 25 estimate 24 correctly 25 estimate 25 estimate 27 ages 26 the 27 ages 27 ages 28 at 27 ages 39 of 28 at 29 which 28 at 32 stress 28 at 34 ' 28 at 35 occurred 29 which 32 stress 30 accentuated 32 stress 33 lines 34 ' 34 ' 35 occurred 35 occurred 36 during 36 during 38 period 37 the 38 period 39 of 42 formation 40 deciduous 41 crown 41 crown 42 formation data about the possible correlation between reduction of the regeneration capacity in the course of phylogeny and formation of malignant tumours have been summarized from invertebrates to mammals . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 24 summarized 0 ###LEFT-WALL### 29 . 1 data 2 about 1 data 15 of 1 data 22 have 2 about 5 correlation 3 the 5 correlation 4 possible 5 correlation 5 correlation 6 between 5 correlation 8 of 6 between 7 reduction 8 of 11 capacity 9 the 11 capacity 10 regeneration 11 capacity 11 capacity 12 in 12 in 14 course 13 the 14 course 15 of 17 and 16 phylogeny 17 and 17 and 18 formation 17 and 19 of 19 of 21 tumours 20 malignant 21 tumours 22 have 23 been 23 been 24 summarized 24 summarized 25 from 24 summarized 27 to 25 from 26 invertebrates 27 to 28 mammals the evolutionarily increasing complexity of body building plane [and] expectancy of longevity in the course of phylogeny seems to be grossly negatively correlated with diminished regeneration capacity , but [positively] with increased occurrence of malignant tumours . 0 ###LEFT-WALL### 4 complexity 0 ###LEFT-WALL### 18 seems 0 ###LEFT-WALL### 37 . 1 the 4 complexity 2 evolutionarily 3 increasing 3 increasing 4 complexity 4 complexity 5 of 4 complexity 11 of 4 complexity 13 in 4 complexity 16 of 4 complexity 18 seems 5 of 10 expectancy 6 body 10 expectancy 7 building 10 expectancy 8 plane 10 expectancy 11 of 12 longevity 13 in 15 course 14 the 15 course 16 of 17 phylogeny 18 seems 19 to 18 seems 23 correlated 19 to 20 be 20 be 23 correlated 21 grossly 23 correlated 22 negatively 23 correlated 23 correlated 29 but 24 with 27 capacity 24 with 29 but 25 diminished 26 regeneration 26 regeneration 27 capacity 28 , 29 but 29 but 31 with 31 with 33 occurrence 32 increased 33 occurrence 33 occurrence 34 of 34 of 36 tumours 35 malignant 36 tumours a certain evolution - based switch - off mechanism reducing the extent of regeneration [in] developmentally complicated and long - living animals such as mammals and birds can be hypothesized and benefits of loss of this ability are discussed . 0 ###LEFT-WALL### 3 evolution 0 ###LEFT-WALL### 4 - 1 a 3 evolution 2 certain 3 evolution 4 - 6 switch 4 - 7 - 5 based 6 switch 7 - 26 and 7 - 39 discussed 7 - 40 . 8 off 10 reducing 8 off 26 and 9 mechanism 10 reducing 11 the 12 extent 12 extent 13 of 12 extent 14 regeneration 13 of 14 regeneration 14 regeneration 17 complicated 14 regeneration 18 and 16 developmentally 17 complicated 18 and 22 animals 18 and 24 as 18 and 26 and 19 long 20 - 19 long 21 living 21 living 22 animals 23 such 24 as 24 as 25 mammals 26 and 27 birds 26 and 31 and 26 and 33 of 26 and 38 are 28 can 29 be 28 can 31 and 29 be 30 hypothesized 31 and 32 benefits 33 of 34 loss 34 loss 35 of 35 of 37 ability 36 this 37 ability 38 are 39 discussed this high incidence of malignancies seems to be related , in addition to other factors , to prolonged [and] cumulative exposure to cancerogenic stimuli in the course [of] lifetime . 0 ###LEFT-WALL### 3 incidence 0 ###LEFT-WALL### 6 seems 0 ###LEFT-WALL### 30 . 1 this 3 incidence 2 high 3 incidence 3 incidence 4 of 3 incidence 6 seems 4 of 5 malignancies 6 seems 7 to 6 seems 9 related 7 to 8 be 8 be 9 related 9 related 11 in 9 related 17 to 9 related 22 to 9 related 25 in 10 , 11 in 11 in 12 addition 11 in 16 , 12 addition 13 to 13 to 15 factors 14 other 15 factors 17 to 21 exposure 18 prolonged 21 exposure 20 cumulative 21 exposure 22 to 24 stimuli 23 cancerogenic 24 stimuli 25 in 29 lifetime 26 the 29 lifetime 27 course 29 lifetime longevity , supported by the progress and availability of medical care to the population , has been unveiling this phenomenon during recent decades . 0 ###LEFT-WALL### 1 longevity 0 ###LEFT-WALL### 17 been 0 ###LEFT-WALL### 24 . 1 longevity 3 supported 1 longevity 16 has 2 , 3 supported 3 supported 4 by 3 supported 12 to 3 supported 15 , 4 by 7 and 5 the 6 progress 6 progress 7 and 7 and 8 availability 7 and 9 of 9 of 11 care 10 medical 11 care 12 to 14 population 13 the 14 population 16 has 17 been 17 been 18 unveiling 18 unveiling 20 phenomenon 18 unveiling 21 during 19 this 20 phenomenon 21 during 23 decades 22 recent 23 decades from this point of view , ageing represents the main risk for cancer acquisition . 0 ###LEFT-WALL### 7 ageing 0 ###LEFT-WALL### 8 represents 0 ###LEFT-WALL### 15 . 1 from 3 point 1 from 6 , 1 from 7 ageing 2 this 3 point 3 point 4 of 4 of 5 view 7 ageing 8 represents 8 represents 11 risk 9 the 10 main 9 the 11 risk 11 risk 12 for 12 for 14 acquisition 13 cancer 14 acquisition the probable role of microenvironment in all the discussed phenomena such as healing/regeneration , inflammation , and cancer is discussed and targeting of microenvironment is consequently predicted as a possible therapeutic target where controlled manipulation may represent a new approach to the treatment of cancer patients . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 20 discussed 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 47 . 1 the 3 role 2 probable 3 role 3 role 4 of 3 role 6 in 3 role 19 is 4 of 5 microenvironment 6 in 7 all 7 all 8 the 7 all 10 phenomena 8 the 10 phenomena 9 discussed 10 phenomena 10 phenomena 12 as 11 such 12 as 12 as 17 and 13 healing/regeneration 14 , 14 , 15 inflammation 14 , 17 and 16 , 17 and 17 and 18 cancer 19 is 20 discussed 21 and 22 targeting 21 and 27 predicted 22 targeting 23 of 22 targeting 25 is 23 of 24 microenvironment 25 is 27 predicted 26 consequently 27 predicted 27 predicted 28 as 27 predicted 33 where 28 as 32 target 29 a 30 possible 29 a 32 target 30 possible 32 target 31 therapeutic 32 target 33 where 35 manipulation 33 where 37 represent 34 controlled 35 manipulation 35 manipulation 36 may 36 may 37 represent 37 represent 40 approach 37 represent 41 to 38 a 39 new 38 a 40 approach 39 new 40 approach 41 to 43 treatment 42 the 43 treatment 43 treatment 44 of 44 of 46 patients 45 cancer 46 patients cma proteolytic activity has a reciprocal relationship with macroautophagy : cma is most active in cells in which macroautophagy is least active . 0 ###LEFT-WALL### 3 activity 0 ###LEFT-WALL### 4 has 0 ###LEFT-WALL### 10 : 0 ###LEFT-WALL### 23 . 1 cma 3 activity 2 proteolytic 3 activity 3 activity 4 has 4 has 7 relationship 5 a 6 reciprocal 5 a 7 relationship 6 reciprocal 7 relationship 7 relationship 8 with 8 with 9 macroautophagy 10 : 11 cma 10 : 12 is 11 cma 12 is 12 is 14 active 13 most 14 active 14 active 15 in 15 in 16 cells 16 cells 17 in 17 in 18 which 17 in 19 macroautophagy 17 in 20 is 19 macroautophagy 20 is 20 is 21 least 20 is 22 active normal renal proximal tubular cells have low levels of macroautophagy , but high basal levels of cma activity . 0 ###LEFT-WALL### 5 cells 0 ###LEFT-WALL### 6 have 0 ###LEFT-WALL### 19 . 1 normal 5 cells 2 renal 5 cells 3 proximal 5 cells 4 tubular 5 cells 5 cells 6 have 6 have 8 levels 7 low 8 levels 8 levels 9 of 9 of 15 levels 10 macroautophagy 12 but 11 , 12 but 12 but 13 high 12 but 15 levels 14 basal 15 levels 15 levels 16 of 16 of 18 activity 17 cma 18 activity cma activity is regulated by starvation , growth factors , oxidative stress , lipids , aging , and retinoic acid signaling . 0 ###LEFT-WALL### 2 activity 0 ###LEFT-WALL### 4 regulated 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 22 . 1 cma 2 activity 2 activity 3 is 3 is 4 regulated 4 regulated 5 by 5 by 6 starvation 7 , 18 and 8 growth 9 factors 9 factors 10 , 10 , 12 stress 10 , 13 , 11 oxidative 12 stress 13 , 14 lipids 13 , 15 , 15 , 16 aging 15 , 18 and 17 , 18 and 18 and 20 acid 18 and 21 signaling 19 retinoic 20 acid the physiological consequences of changes in cma activity depend on the substrate proteins present in a given cell type . 0 ###LEFT-WALL### 3 consequences 0 ###LEFT-WALL### 9 depend 0 ###LEFT-WALL### 20 . 1 the 3 consequences 2 physiological 3 consequences 3 consequences 4 of 3 consequences 9 depend 4 of 5 changes 5 changes 6 in 6 in 8 activity 7 cma 8 activity 9 depend 10 on 10 on 13 proteins 11 the 13 proteins 12 substrate 13 proteins 13 proteins 14 present 14 present 15 in 15 in 19 type 16 a 19 type 17 given 18 cell 18 cell 19 type in the proximal tubule , increased cma results from protein or calorie starvation and from oxidative stress . 0 ###LEFT-WALL### 7 cma 0 ###LEFT-WALL### 8 results 0 ###LEFT-WALL### 18 . 1 in 4 tubule 1 in 5 , 1 in 7 cma 2 the 4 tubule 3 proximal 4 tubule 6 increased 7 cma 7 cma 8 results 8 results 14 and 9 from 11 or 9 from 14 and 10 protein 11 or 11 or 13 starvation 12 calorie 13 starvation 14 and 15 from 15 from 17 stress 16 oxidative 17 stress