indeed , age is an independent risk factor for cardiovascular diseases and is in part an important factor in the increased exponential mortality rates from vascular disease such as myocardial infarction and stroke that occurs in the ageing population . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 40 . 1 indeed 2 , 1 indeed 3 age 3 age 12 and 4 is 8 factor 4 is 12 and 5 an 8 factor 6 independent 8 factor 7 risk 8 factor 8 factor 9 for 9 for 11 diseases 10 cardiovascular 11 diseases 12 and 13 is 12 and 19 in 12 and 36 in 13 is 15 part 13 is 18 factor 14 in 15 part 16 an 17 important 16 an 18 factor 17 important 18 factor 19 in 24 rates 20 the 24 rates 21 increased 23 mortality 22 exponential 23 mortality 23 mortality 24 rates 24 rates 25 from 25 from 27 disease 26 vascular 27 disease 27 disease 29 as 28 such 29 as 29 as 32 and 30 myocardial 31 infarction 31 infarction 32 and 32 and 33 stroke 32 and 34 that 32 and 35 occurs 34 that 35 occurs 36 in 39 population 37 the 39 population 38 ageing 39 population there are a number of mechanisms suggested to explain age - related endothelial dysfunction . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 12 related 0 ###LEFT-WALL### 15 . 1 there 2 are 2 are 6 mechanisms 3 a 4 number 4 number 5 of 4 number 6 mechanisms 5 of 6 mechanisms 6 mechanisms 7 suggested 7 suggested 8 to 8 to 9 explain 9 explain 10 age 11 - 12 related 12 related 14 dysfunction 13 endothelial 14 dysfunction however , recent scientific studies have advanced the notion of oxidative stress and inflammation as the two major risk factors underlying aging and age - related diseases . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 26 related 1 however 2 , 1 however 13 and 2 , 7 advanced 3 recent 5 studies 4 scientific 5 studies 5 studies 6 have 6 have 7 advanced 7 advanced 13 and 8 the 9 notion 9 notion 10 of 9 notion 13 and 10 of 12 stress 11 oxidative 12 stress 13 and 14 inflammation 13 and 23 and 14 inflammation 15 as 15 as 19 risk 16 the 19 risk 17 two 19 risk 18 major 19 risk 20 factors 22 aging 20 factors 23 and 21 underlying 22 aging 23 and 24 age 25 - 26 related 26 related 27 diseases 26 related 28 . regular physical activity , known to have a favorable effect on cardiovascular health , can also improve the function of the ageing endothelium by modulating oxidative stress and inflammatory processes , [as] we discuss in this paper . 0 ###LEFT-WALL### 3 activity 0 ###LEFT-WALL### 17 improve 0 ###LEFT-WALL### 38 . 1 regular 3 activity 2 physical 3 activity 3 activity 5 known 3 activity 15 can 4 , 5 known 5 known 6 to 5 known 11 on 5 known 14 , 6 to 7 have 7 have 10 effect 8 a 10 effect 9 favorable 10 effect 11 on 13 health 12 cardiovascular 13 health 15 can 17 improve 16 also 17 improve 17 improve 19 function 17 improve 24 by 17 improve 35 in 18 the 19 function 19 function 20 of 20 of 23 endothelium 21 the 23 endothelium 22 ageing 23 endothelium 24 by 28 and 25 modulating 27 stress 26 oxidative 27 stress 27 stress 28 and 28 and 30 processes 28 and 31 , 28 and 33 we 28 and 34 discuss 29 inflammatory 30 processes 33 we 34 discuss 35 in 37 paper 36 this 37 paper background : there is a paucity of research on alaska natives and their views on whether or not they believe they will age successfully in their home and community . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 age 0 ###LEFT-WALL### 30 . 2 : 3 there 2 : 4 is 3 there 4 is 4 is 6 paucity 5 a 6 paucity 6 paucity 7 of 7 of 8 research 8 research 9 on 8 research 12 and 8 research 23 age 9 on 10 alaska 11 natives 12 and 12 and 14 views 12 and 15 on 12 and 23 age 13 their 14 views 15 on 18 not 16 whether 17 or 17 or 18 not 18 not 19 they 18 not 20 believe 19 they 20 believe 20 believe 21 they 20 believe 22 will 21 they 22 will 23 age 24 successfully 23 age 25 in 25 in 28 and 26 their 27 home 27 home 28 and 28 and 29 community there is limited understanding of aging experiences across generations . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 10 . 1 there 2 is 2 is 4 understanding 2 is 8 across 3 limited 4 understanding 4 understanding 5 of 5 of 6 aging 6 aging 7 experiences 8 across 9 generations objective : this research explores the concept of successful aging from an urban alaska native perspective and explores whether or not they believe they will achieve a healthy older age . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 1 objective 2 : 2 : 4 research 3 this 4 research 4 research 17 and 5 explores 7 concept 5 explores 17 and 6 the 7 concept 7 concept 8 of 8 of 10 aging 9 successful 10 aging 10 aging 11 from 11 from 16 perspective 12 an 13 urban 12 an 16 perspective 13 urban 16 perspective 14 alaska 16 perspective 15 native 16 perspective 17 and 18 explores 17 and 21 not 19 whether 20 or 20 or 21 not 21 not 22 they 21 not 23 believe 22 they 23 believe 23 believe 24 they 23 believe 26 achieve 24 they 25 will 25 will 26 achieve 26 achieve 30 age 27 a 28 healthy 27 a 30 age 28 healthy 30 age 29 older 30 age design : a cultural consensus model ( ccm ) [approach] was used to gain a sense of the cultural understandings of aging among young alaska natives aged 50 years and younger . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 6 model 2 : 12 used 3 a 4 cultural 3 a 6 model 4 cultural 6 model 5 consensus 6 model 6 model 8 ccm 6 model 11 was 7 ( 8 ccm 8 ccm 9 ) 11 was 12 used 12 used 13 to 12 used 14 gain 13 to 14 gain 14 gain 30 and 15 a 16 sense 16 sense 17 of 16 sense 21 of 16 sense 30 and 17 of 20 understandings 18 the 20 understandings 19 cultural 20 understandings 21 of 22 aging 22 aging 23 among 22 aging 29 years 23 among 25 alaska 24 young 25 alaska 25 alaska 27 aged 26 natives 27 aged 28 50 29 years 30 and 31 younger results : research findings indicate that aging successfully is making the conscious decision to live a clean and healthy life , abstaining from drugs and alcohol , but some of alaska natives do not feel they will age well due to lifestyle factors . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 10 making 1 results 2 : 2 : 3 research 3 research 4 findings 3 research 10 making 4 findings 5 indicate 5 indicate 6 that 6 that 7 aging 6 that 9 is 7 aging 9 is 8 successfully 9 is 9 is 10 making 10 making 13 decision 10 making 25 and 11 the 13 decision 12 conscious 13 decision 13 decision 14 to 13 decision 15 live 14 to 15 live 16 a 20 life 17 clean 18 and 18 and 19 healthy 18 and 20 life 20 life 21 , 21 , 22 abstaining 21 , 25 and 22 abstaining 23 from 23 from 24 drugs 25 and 26 alcohol 25 and 28 but 27 , 28 but 28 but 29 some 28 but 44 . 29 some 30 of 29 some 32 natives 29 some 38 age 30 of 31 alaska 32 natives 33 do 33 do 34 not 33 do 35 feel 35 feel 36 they 35 feel 38 age 36 they 37 will 37 will 38 age 38 age 39 well 38 age 41 to 40 due 41 to 41 to 43 factors 42 lifestyle 43 factors alaska natives see the inability to age well [as] primarily due to the decrease in physical activity , lack of availability of subsistence foods and activities , and the difficulty of living a balanced life in urban settings . 0 ###LEFT-WALL### 2 natives 0 ###LEFT-WALL### 3 see 0 ###LEFT-WALL### 39 . 1 alaska 2 natives 2 natives 3 see 3 see 5 inability 3 see 8 well 4 the 5 inability 5 inability 6 to 5 inability 7 age 6 to 7 age 8 well 10 primarily 8 well 35 life 8 well 36 in 10 primarily 12 to 11 due 12 to 12 to 28 and 13 the 14 decrease 14 decrease 15 in 14 decrease 18 , 15 in 17 activity 16 physical 17 activity 18 , 19 lack 18 , 25 and 19 lack 20 of 19 lack 22 of 20 of 21 availability 22 of 24 foods 23 subsistence 24 foods 25 and 26 activities 25 and 28 and 27 , 28 and 28 and 30 difficulty 28 and 31 of 29 the 30 difficulty 31 of 32 living 33 a 35 life 34 balanced 35 life 36 in 38 settings 37 urban 38 settings conclusions : this research seeks to inform future studies on successful aging that incorporates the experiences and wisdom of alaska natives in hopes of developing an awareness of the importance of practicing a healthy lifestyle and developing guidelines to assist others to age well . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 45 . 2 : 4 research 2 : 5 seeks 2 : 17 and 3 this 4 research 4 research 5 seeks 5 seeks 6 to 5 seeks 7 inform 6 to 7 inform 7 inform 9 studies 7 inform 10 on 7 inform 13 that 7 inform 14 incorporates 8 future 9 studies 10 on 12 aging 11 successful 12 aging 13 that 14 incorporates 14 incorporates 16 experiences 15 the 16 experiences 17 and 36 and 17 and 43 age 18 wisdom 19 of 18 wisdom 31 of 18 wisdom 36 and 19 of 21 natives 20 alaska 21 natives 21 natives 22 in 22 in 23 hopes 23 hopes 24 of 24 of 25 developing 25 developing 27 awareness 26 an 27 awareness 27 awareness 28 of 28 of 30 importance 29 the 30 importance 31 of 32 practicing 32 practicing 35 lifestyle 33 a 34 healthy 33 a 35 lifestyle 34 healthy 35 lifestyle 36 and 38 guidelines 36 and 39 to 36 and 42 to 36 and 43 age 37 developing 38 guidelines 39 to 40 assist 40 assist 41 others 40 assist 42 to 43 age 44 well neurodegenerative diseases share diverse pathological features and among these oxidative stress ( os ) plays a leading role . 0 ###LEFT-WALL### 2 diseases 0 ###LEFT-WALL### 3 share 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 19 . 1 neurodegenerative 2 diseases 2 diseases 3 share 3 share 6 features 4 diverse 6 features 5 pathological 6 features 7 and 11 stress 7 and 15 plays 8 among 9 these 8 among 11 stress 10 oxidative 11 stress 11 stress 13 os 11 stress 15 plays 12 ( 13 os 13 os 14 ) 15 plays 18 role 16 a 18 role 17 leading 18 role impaired activity and reduced expression of antioxidant proteins have been reported as common events in several aging - associated disorders . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 19 associated 0 ###LEFT-WALL### 21 . 1 impaired 2 activity 2 activity 3 and 3 and 5 expression 3 and 6 of 3 and 11 reported 3 and 17 aging 3 and 19 associated 4 reduced 5 expression 6 of 7 antioxidant 7 antioxidant 8 proteins 7 antioxidant 10 been 8 proteins 9 have 9 have 10 been 11 reported 12 as 12 as 14 events 12 as 17 aging 13 common 14 events 14 events 15 in 14 events 17 aging 15 in 16 several 17 aging 18 - 19 associated 20 disorders in this review paper , we first provide an overview of the involvement of reactive oxygen species [-] ( ros - [ )(induced oxidative damage in parkinson 's disease ( pd ) and amyotrophic lateral sclerosis ( als ) . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 8 provide 0 ###LEFT-WALL### 40 . 1 in 4 paper 1 in 5 , 1 in 6 we 2 this 4 paper 3 review 4 paper 6 we 8 provide 7 first 8 provide 8 provide 10 overview 9 an 10 overview 10 overview 11 of 10 overview 14 of 11 of 13 involvement 12 the 13 involvement 14 of 17 species 15 reactive 17 species 16 oxygen 17 species 17 species 20 ros 19 ( 20 ros 20 ros 33 and 20 ros 39 ) 21 - 33 and 23 )(induced 25 damage 24 oxidative 25 damage 25 damage 26 in 25 damage 33 and 26 in 29 disease 27 parkinson 28 's 28 's 29 disease 29 disease 31 pd 30 ( 31 pd 31 pd 32 ) 33 and 36 sclerosis 33 and 38 als 33 and 39 ) 34 amyotrophic 36 sclerosis 35 lateral 36 sclerosis 37 ( 38 als 38 als 39 ) subsequently , we focus on dj - [1] and sod1 proteins , which are involved in pd and als and also exert a prominent role in the interaction between redox homeostasis and neurodegeneration . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 34 . 1 subsequently 2 , 1 subsequently 3 we 3 we 20 and 4 focus 5 on 4 focus 16 in 4 focus 20 and 5 on 9 and 6 dj 9 and 7 - 9 and 9 and 11 proteins 9 and 12 , 9 and 13 which 9 and 14 are 10 sod1 11 proteins 13 which 14 are 14 are 15 involved 16 in 18 and 17 pd 18 and 18 and 19 als 20 and 22 exert 20 and 29 between 21 also 22 exert 22 exert 25 role 22 exert 26 in 23 a 25 role 24 prominent 25 role 26 in 28 interaction 27 the 28 interaction 29 between 32 and 30 redox 31 homeostasis 31 homeostasis 32 and 32 and 33 neurodegeneration interestingly , recent studies demonstrated that dj - [1] and sod1 are both tightly connected with nrf2 protein , a transcriptional factor and master regulator of the expression of many antioxidant/detoxification genes . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 demonstrated 0 ###LEFT-WALL### 33 . 1 interestingly 2 , 1 interestingly 4 studies 3 recent 4 studies 4 studies 5 demonstrated 5 demonstrated 6 that 6 that 10 and 6 that 12 are 7 dj 10 and 8 - 10 and 10 and 11 sod1 10 and 12 are 12 are 13 both 13 both 15 connected 14 tightly 15 connected 15 connected 16 with 16 with 23 and 17 nrf2 18 protein 18 protein 19 , 19 , 22 factor 19 , 23 and 20 a 21 transcriptional 20 a 22 factor 21 transcriptional 22 factor 23 and 25 regulator 23 and 26 of 24 master 25 regulator 26 of 28 expression 27 the 28 expression 28 expression 29 of 29 of 32 genes 30 many 32 genes 31 antioxidant/detoxification 32 genes nrf2 is emerging as a key neuroprotective protein in neurodegenerative diseases , since it helps neuronal cells to cope with toxic insults and os . 0 ###LEFT-WALL### 1 nrf2 0 ###LEFT-WALL### 2 is 1 nrf2 2 is 2 is 3 emerging 3 emerging 4 as 3 emerging 9 in 3 emerging 13 since 4 as 8 protein 5 a 8 protein 6 key 8 protein 7 neuroprotective 8 protein 9 in 11 diseases 10 neurodegenerative 11 diseases 12 , 13 since 13 since 14 it 13 since 15 helps 13 since 25 . 14 it 15 helps 15 helps 17 cells 15 helps 18 to 15 helps 19 cope 16 neuronal 17 cells 18 to 19 cope 19 cope 20 with 20 with 23 and 21 toxic 22 insults 22 insults 23 and 23 and 24 os we [herein] summarize the recent literature providing a detailed picture of the promising therapeutic efficacy of nrf2 natural and synthetic inducers as disease - modifying molecules for the treatment of neurodegenerative diseases . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 summarize 1 we 3 summarize 3 summarize 6 literature 3 summarize 22 as 4 the 6 literature 5 recent 6 literature 6 literature 7 providing 6 literature 11 of 6 literature 16 of 7 providing 10 picture 8 a 10 picture 9 detailed 10 picture 11 of 15 efficacy 12 the 15 efficacy 13 promising 15 efficacy 14 therapeutic 15 efficacy 16 of 21 inducers 17 nrf2 21 inducers 18 natural 19 and 19 and 20 synthetic 19 and 21 inducers 22 as 23 disease 23 disease 25 modifying 24 - 25 modifying 25 modifying 26 molecules 25 modifying 27 for 25 modifying 33 . 27 for 29 treatment 28 the 29 treatment 29 treatment 30 of 30 of 32 diseases 31 neurodegenerative 32 diseases purpose : to study the feasibility of first , reaching functionally declined , but still independent older persons at risk of [falls] through their general practitioner ( gp ) and second , to [reduce] their physiological and psychological fall risk factors with a complex exercise intervention . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 47 . 2 : 3 to 2 : 4 study 2 : 30 and 3 to 4 study 4 study 14 but 4 study 18 persons 4 study 19 at 5 the 6 feasibility 6 feasibility 7 of 6 feasibility 9 , 7 of 8 first 9 , 10 reaching 9 , 14 but 10 reaching 12 declined 11 functionally 12 declined 13 , 14 but 14 but 15 still 14 but 17 older 15 still 16 independent 19 at 20 risk 20 risk 21 of 20 risk 28 gp 21 of 23 through 23 through 26 practitioner 24 their 26 practitioner 25 general 26 practitioner 27 ( 28 gp 28 gp 29 ) 30 and 41 factors 30 and 45 exercise 31 second 32 , 31 second 41 factors 33 to 39 fall 33 to 41 factors 35 their 39 fall 36 physiological 37 and 37 and 38 psychological 37 and 39 fall 40 risk 41 factors 41 factors 42 with 41 factors 45 exercise 42 with 44 complex 43 a 44 complex 45 exercise 46 intervention we investigated the effects of a 16 [-] week exercise intervention on physiological [(] [function] , strength , and balance ) and psychological ( fear of falling ) outcomes in community [-] dwelling older persons in comparison with usual care . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 41 . 1 we 2 investigated 2 investigated 4 effects 2 investigated 12 on 2 investigated 30 in 2 investigated 38 with 3 the 4 effects 4 effects 5 of 5 of 11 intervention 6 a 11 intervention 7 16 9 week 9 week 11 intervention 10 exercise 11 intervention 12 on 22 and 13 physiological 16 , 16 , 17 strength 16 , 19 and 18 , 19 and 19 and 20 balance 19 and 21 ) 19 and 22 and 22 and 29 outcomes 23 psychological 25 fear 23 psychological 29 outcomes 24 ( 25 fear 25 fear 26 of 25 fear 28 ) 26 of 27 falling 30 in 35 persons 31 community 33 dwelling 33 dwelling 35 persons 34 older 35 persons 35 persons 36 in 36 in 37 comparison 38 with 40 care 39 usual 40 care in addition , we obtained data [on] [adherence] of the participants to the exercise program . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 obtained 0 ###LEFT-WALL### 16 . 1 in 2 addition 1 in 3 , 1 in 4 we 4 we 5 obtained 5 obtained 6 data 5 obtained 12 to 6 data 9 of 9 of 11 participants 10 the 11 participants 12 to 15 program 13 the 15 program 14 exercise 15 program methods : tests on physical and psychological fall risk were conducted at study inclusion , and after the 16 - week intervention period in the gp office setting . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 3 tests 2 : 11 conducted 2 : 20 - 3 tests 4 on 3 tests 10 were 4 on 9 risk 5 physical 6 and 6 and 7 psychological 6 and 8 fall 8 fall 9 risk 10 were 11 conducted 11 conducted 16 and 12 at 14 inclusion 12 at 16 and 13 study 14 inclusion 15 , 16 and 16 and 17 after 17 after 19 16 18 the 19 16 20 - 23 period 21 week 22 intervention 22 intervention 23 period 23 period 24 in 23 period 28 setting 24 in 27 office 25 the 27 office 26 gp 27 office [the] 16 - week intervention included progressive and challenging balance , gait , and strength exercise as well as changes to behavioral aspects . 0 ###LEFT-WALL### 2 16 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 24 . 2 16 3 - 3 - 7 progressive 4 week 6 included 5 intervention 6 included 6 included 7 progressive 8 and 14 and 8 and 16 exercise 9 challenging 10 balance 10 balance 11 , 11 , 12 gait 11 , 14 and 13 , 14 and 14 and 15 strength 14 and 16 exercise 16 exercise 17 as 16 exercise 19 as 17 as 18 well 19 as 20 changes 20 changes 21 to 21 to 23 aspects 22 behavioral 23 aspects to account for the hierarchical structure in the chosen study design , [with] patients nested in gps and measurements nested in patients , a [three] - level linear mixed effects model was determined for analysis . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 account 0 ###LEFT-WALL### 12 , 1 to 2 account 2 account 3 for 3 for 6 structure 4 the 6 structure 5 hierarchical 6 structure 6 structure 7 in 7 in 11 design 8 the 11 design 9 chosen 10 study 10 study 11 design 12 , 14 patients 12 , 15 nested 12 , 18 and 14 patients 15 nested 15 nested 16 in 16 in 17 gps 18 and 19 measurements 18 and 20 nested 19 measurements 20 nested 20 nested 21 in 20 nested 26 - 21 in 22 patients 23 , 26 - 24 a 26 - 26 - 30 effects 26 - 36 . 27 level 30 effects 28 linear 30 effects 29 mixed 30 effects 30 effects 31 model 30 effects 32 was 30 effects 33 determined 31 model 32 was 33 determined 34 for 34 for 35 analysis results : in total , 33 gps recruited 378 participants ( 75.4 % females ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 1 results 2 : 2 : 3 in 3 in 10 participants 4 total 5 , 4 total 10 participants 6 33 8 recruited 7 gps 8 recruited 8 recruited 10 participants 9 378 10 participants 10 participants 14 females 11 ( 14 females 12 75.4 14 females 13 % 14 females 14 females 15 ) the mean age of the participants was 78.1 years ( standard deviation 5.9 years ) . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 16 . 1 the 3 age 2 mean 3 age 3 age 4 of 3 age 7 was 4 of 6 participants 5 the 6 participants 7 was 9 years 8 78.1 9 years 9 years 14 years 10 ( 14 years 11 standard 12 deviation 12 deviation 14 years 13 5.9 14 years 14 years 15 ) for balance , a relative improvement of 0.8 seconds was accomplished , and [anxiety] [about] falls was reduced by 3.7 points in the falls efficacy scale - international ( fes - i ) , in the intervention group relative to control group . 0 ###LEFT-WALL### 5 relative 0 ###LEFT-WALL### 18 reduced 0 ###LEFT-WALL### 34 , 0 ###LEFT-WALL### 43 . 1 for 2 balance 1 for 3 , 1 for 5 relative 4 a 5 relative 5 relative 6 improvement 5 relative 13 and 5 relative 17 was 6 improvement 7 of 6 improvement 13 and 7 of 9 seconds 8 0.8 9 seconds 10 was 11 accomplished 10 was 13 and 12 , 13 and 13 and 16 falls 17 was 18 reduced 18 reduced 19 by 18 reduced 22 in 18 reduced 31 - 19 by 21 points 20 3.7 21 points 22 in 26 scale 23 the 26 scale 24 falls 25 efficacy 25 efficacy 26 scale 27 - 31 - 28 international 30 fes 29 ( 30 fes 30 fes 31 - 31 - 32 i 31 - 33 ) 34 , 42 group 35 in 39 relative 35 in 42 group 36 the 39 relative 37 intervention 39 relative 38 group 39 relative 39 relative 40 to 40 to 41 control in total , 76.6 % ( n = 170 [ )(of the intervention group participated in more than 75 % [the] supervised group sessions . 0 ###LEFT-WALL### 5 % 0 ###LEFT-WALL### 15 participated 0 ###LEFT-WALL### 25 . 1 in 2 total 2 total 3 , 2 total 5 % 4 76.6 5 % 5 % 8 = 5 % 15 participated 6 ( 8 = 7 n 8 = 8 = 9 170 9 170 11 )(of 11 )(of 14 group 12 the 14 group 13 intervention 14 group 15 participated 16 in 15 participated 18 than 16 in 17 more 18 than 24 sessions 19 75 20 % 20 % 24 sessions 22 supervised 23 group 23 group 24 sessions conclusion : the strategy to address older persons at high risk of falling in the gp setting with a complex exercise intervention was successful . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 strategy 2 : 23 was 2 : 25 . 3 the 4 strategy 4 strategy 5 to 4 strategy 6 address 4 strategy 23 was 5 to 6 address 6 address 8 persons 7 older 8 persons 8 persons 9 at 8 persons 12 of 8 persons 17 setting 9 at 11 risk 10 high 11 risk 12 of 13 falling 13 falling 14 in 14 in 16 gp 15 the 16 gp 17 setting 18 with 18 with 22 intervention 19 a 22 intervention 20 complex 21 exercise 21 exercise 22 intervention 23 was 24 successful in functionally declined , community - dwelling , older persons a complex intervention for reducing fall risks was [effective] compared with usual care . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 3 declined 0 ###LEFT-WALL### 4 , 1 in 3 declined 2 functionally 3 declined 4 , 5 community 4 , 6 - 6 - 7 dwelling 6 - 8 , 6 - 24 . 8 , 10 persons 8 , 20 compared 9 older 10 persons 10 persons 13 intervention 10 persons 18 was 10 persons 20 compared 11 a 13 intervention 12 complex 13 intervention 13 intervention 14 for 13 intervention 16 fall 13 intervention 17 risks 13 intervention 18 was 14 for 15 reducing 16 fall 17 risks 20 compared 21 with 21 with 23 care 22 usual 23 care background : aging causes physiological and functional changes that [impair] pulmonary function . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 aging 2 : 8 changes 2 : 13 . 3 aging 4 causes 3 aging 6 and 3 aging 8 changes 5 physiological 6 and 6 and 7 functional 8 changes 12 function 9 that 12 function 11 pulmonary 12 function incentive spirometry is widely used for lung expansion , but the effects of volume - oriented incentive spirometry ( vis ) versus flow - oriented incentive spirometry ( fis ) on chest wall volumes , inspiratory muscle activity , and thoracoabdominal synchrony in the elderly are poorly understood . 0 ###LEFT-WALL### 2 spirometry 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 49 . 1 incentive 2 spirometry 2 spirometry 3 is 3 is 5 used 4 widely 5 used 5 used 6 for 6 for 8 expansion 7 lung 8 expansion 9 , 37 muscle 9 , 48 understood 10 but 12 effects 10 but 30 ) 10 but 37 muscle 11 the 12 effects 12 effects 13 of 12 effects 22 versus 13 of 14 volume 14 volume 18 spirometry 15 - 18 spirometry 16 oriented 18 spirometry 17 incentive 18 spirometry 18 spirometry 20 vis 18 spirometry 21 ) 19 ( 20 vis 20 vis 21 ) 22 versus 23 flow 23 flow 27 spirometry 24 - 27 spirometry 25 oriented 27 spirometry 26 incentive 27 spirometry 27 spirometry 29 fis 27 spirometry 30 ) 28 ( 29 fis 29 fis 30 ) 31 on 34 volumes 31 on 35 , 31 on 37 muscle 32 chest 33 wall 33 wall 34 volumes 36 inspiratory 37 muscle 37 muscle 40 and 37 muscle 46 are 37 muscle 48 understood 38 activity 40 and 39 , 40 and 40 and 42 synchrony 40 and 43 in 40 and 46 are 41 thoracoabdominal 42 synchrony 43 in 45 elderly 44 the 45 elderly 47 poorly 48 understood we compared vis and fis in elderly subjects and healthy adult subjects . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 0 ###LEFT-WALL### 13 . 1 we 2 compared 2 compared 5 fis 2 compared 6 in 3 vis 4 and 4 and 5 fis 6 in 9 and 7 elderly 8 subjects 8 subjects 9 and 9 and 12 subjects 10 healthy 11 adult 11 adult 12 subjects chest wall kinematics ( via optoelectronic plethysmography ) and inspiratory muscle activity ( via surface electromyography ) were assessed simultaneously . 0 ###LEFT-WALL### 2 wall 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 21 . 1 chest 2 wall 2 wall 3 kinematics 3 kinematics 5 via 4 ( 5 via 5 via 7 plethysmography 5 via 8 ) 6 optoelectronic 7 plethysmography 9 and 12 activity 9 and 19 assessed 10 inspiratory 11 muscle 11 muscle 12 activity 12 activity 14 via 12 activity 18 were 13 ( 14 via 14 via 16 electromyography 14 via 17 ) 15 surface 16 electromyography 18 were 19 assessed 19 assessed 20 simultaneously synchrony between the superior thorax and abdominal motion [was] calculated [(] phase angle ) . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 15 . 1 synchrony 2 between 1 synchrony 6 and 2 between 5 thorax 3 the 5 thorax 4 superior 5 thorax 6 and 13 angle 6 and 14 ) 7 abdominal 8 motion 8 motion 10 calculated 10 calculated 12 phase 12 phase 13 angle results : in the elderly subjects both types of incentive spirometry increased chest wall volumes similarly , whereas in the healthy adult subjects vis increased the chest wall volume more than did fis . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 11 spirometry 2 : 12 increased 2 : 17 , 3 in 6 subjects 3 in 11 spirometry 4 the 6 subjects 5 elderly 6 subjects 7 both 8 types 8 types 9 of 8 types 11 spirometry 9 of 11 spirometry 10 incentive 11 spirometry 11 spirometry 12 increased 12 increased 15 volumes 12 increased 16 similarly 13 chest 14 wall 14 wall 15 volumes 17 , 30 more 17 , 32 did 18 whereas 24 vis 18 whereas 25 increased 18 whereas 30 more 19 in 23 subjects 19 in 24 vis 20 the 23 subjects 21 healthy 23 subjects 22 adult 23 subjects 24 vis 25 increased 25 increased 29 volume 26 the 29 volume 27 chest 28 wall 28 wall 29 volume 30 more 32 did 31 than 32 did 32 did 33 fis fis and vis triggered similar lower thoracoabdominal synchrony in the elderly subjects , whereas in the healthy adults fis induced lower synchrony than did vis . 0 ###LEFT-WALL### 3 vis 0 ###LEFT-WALL### 20 induced 0 ###LEFT-WALL### 26 . 1 fis 2 and 2 and 3 vis 3 vis 4 triggered 4 triggered 8 synchrony 4 triggered 9 in 4 triggered 14 whereas 5 similar 8 synchrony 6 lower 8 synchrony 7 thoracoabdominal 8 synchrony 9 in 12 subjects 10 the 12 subjects 11 elderly 12 subjects 13 , 14 whereas 14 whereas 19 fis 15 in 18 adults 15 in 19 fis 16 the 18 adults 17 healthy 18 adults 19 fis 20 induced 20 induced 22 synchrony 20 induced 23 than 21 lower 22 synchrony 23 than 24 did 24 did 25 vis fis required more muscle activity in the elderly subjects to create an increase in chest wall volume . 0 ###LEFT-WALL### 1 fis 0 ###LEFT-WALL### 2 required 0 ###LEFT-WALL### 18 . 1 fis 2 required 2 required 5 activity 2 required 6 in 2 required 10 to 2 required 11 create 3 more 5 activity 4 muscle 5 activity 6 in 9 subjects 7 the 9 subjects 8 elderly 9 subjects 10 to 11 create 11 create 13 increase 11 create 14 in 12 an 13 increase 14 in 17 volume 15 chest 17 volume 16 wall 17 volume conclusions : incentive spirometry performance is influenced by age , and the differences between elderly and healthy adults response should be considered in clinical practice . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 performance 2 : 7 influenced 2 : 11 and 2 : 26 . 3 incentive 5 performance 4 spirometry 5 performance 5 performance 6 is 6 is 7 influenced 7 influenced 8 by 8 by 9 age 10 , 11 and 11 and 13 differences 11 and 22 considered 12 the 13 differences 13 differences 14 between 13 differences 20 should 14 between 16 and 15 elderly 16 and 16 and 19 response 17 healthy 18 adults 18 adults 19 response 20 should 21 be 21 be 22 considered 22 considered 23 in 23 in 25 practice 24 clinical 25 practice impaired learning and memory performance is often found in aging as an early sign of dementia . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 17 . 1 impaired 2 learning 2 learning 3 and 3 and 4 memory 3 and 5 performance 3 and 10 aging 5 performance 6 is 6 is 8 found 7 often 8 found 8 found 9 in 9 in 10 aging 10 aging 11 as 11 as 14 sign 12 an 13 early 12 an 14 sign 13 early 14 sign 14 sign 15 of 15 of 16 dementia it is associated with neuronal loss and reduced functioning of cholinergic networks . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 13 . 1 it 2 is 2 is 7 and 3 associated 4 with 3 associated 7 and 4 with 6 loss 5 neuronal 6 loss 7 and 8 reduced 7 and 9 functioning 9 functioning 10 of 10 of 12 networks 11 cholinergic 12 networks here we present evidence that the neurokinin3 receptors ( nk3 - r ) and their influence [on] acetylcholine ( ach ) release may represent a crucial mechanism that underlies age - related deficits in learning and memory . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 32 related 1 here 2 we 2 we 3 present 3 present 4 evidence 4 evidence 5 that 5 that 7 neurokinin3 5 that 24 represent 6 the 7 neurokinin3 7 neurokinin3 8 receptors 7 neurokinin3 22 release 7 neurokinin3 23 may 8 receptors 14 and 8 receptors 22 release 9 ( 14 and 10 nk3 12 r 10 nk3 14 and 11 - 12 r 12 r 13 ) 14 and 18 acetylcholine 14 and 20 ach 14 and 21 ) 15 their 18 acetylcholine 16 influence 18 acetylcholine 19 ( 20 ach 20 ach 21 ) 23 may 24 represent 24 represent 27 mechanism 25 a 27 mechanism 26 crucial 27 mechanism 27 mechanism 28 that 27 mechanism 29 underlies 28 that 29 underlies 29 underlies 30 age 31 - 32 related 32 related 36 and 32 related 38 . 33 deficits 34 in 33 deficits 36 and 34 in 35 learning 36 and 37 memory repeated pharmacological stimulation of nk3 - r in aged rats [was] found to improve learning in the water maze and [in] object - place recognition . 0 ###LEFT-WALL### 1 repeated 1 repeated 3 stimulation 1 repeated 26 . 2 pharmacological 3 stimulation 3 stimulation 4 of 4 of 5 nk3 5 nk3 20 and 6 - 20 and 7 r 8 in 7 r 16 in 7 r 20 and 8 in 10 rats 9 aged 10 rats 10 rats 12 found 10 rats 15 learning 12 found 13 to 13 to 14 improve 16 in 19 maze 17 the 19 maze 18 water 19 maze 20 and 22 object 20 and 25 recognition 20 and 26 . 23 - 25 recognition 24 place 25 recognition 25 recognition 26 . this treatment also enhanced in vivo acetylcholinergic activity in the frontal cortex , hippocampus , and amygdala but reduced nk3 - [r] mrna expression in the hippocampus . 0 ###LEFT-WALL### 2 treatment 0 ###LEFT-WALL### 18 but 0 ###LEFT-WALL### 21 - 0 ###LEFT-WALL### 23 mrna 0 ###LEFT-WALL### 28 . 1 this 2 treatment 2 treatment 18 but 3 also 4 enhanced 4 enhanced 8 activity 4 enhanced 9 in 4 enhanced 18 but 5 in 6 vivo 6 vivo 7 acetylcholinergic 7 acetylcholinergic 8 activity 9 in 16 and 10 the 12 cortex 11 frontal 12 cortex 12 cortex 13 , 13 , 14 hippocampus 13 , 16 and 15 , 16 and 16 and 17 amygdala 18 but 19 reduced 19 reduced 20 nk3 21 - 23 mrna 23 mrna 24 expression 24 expression 25 in 25 in 27 hippocampus 26 the 27 hippocampus furthermore , nk3 - r [agonism] incurred a significantly higher increase in ach levels in aged animals that showed superior learning than in those that were most deficient in learning . 0 ###LEFT-WALL### 5 r 0 ###LEFT-WALL### 7 incurred 0 ###LEFT-WALL### 31 . 1 furthermore 2 , 1 furthermore 5 r 2 , 3 nk3 3 nk3 4 - 3 nk3 5 r 5 r 7 incurred 7 incurred 11 increase 7 incurred 12 in 7 incurred 22 than 8 a 11 increase 9 significantly 10 higher 10 higher 11 increase 12 in 14 levels 13 ach 14 levels 14 levels 15 in 14 levels 18 that 14 levels 19 showed 15 in 17 animals 16 aged 17 animals 18 that 19 showed 19 showed 21 learning 20 superior 21 learning 22 than 25 that 22 than 26 were 22 than 28 deficient 23 in 24 those 23 in 25 that 25 that 26 were 27 most 28 deficient 28 deficient 29 in 29 in 30 learning our findings suggest that the induced activation of ach , rather than basal ach activity , is associated with superior learning in the aged . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 25 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 7 activation 4 that 18 associated 5 the 7 activation 6 induced 7 activation 7 activation 8 of 7 activation 17 is 8 of 9 ach 10 , 12 than 11 rather 12 than 12 than 15 activity 12 than 16 , 12 than 17 is 13 basal 15 activity 14 ach 15 activity 17 is 18 associated 18 associated 19 with 18 associated 22 in 19 with 21 learning 20 superior 21 learning 22 in 24 aged 23 the 24 aged to test whether natural variation in nk3 [-] r [function] also determines learning and memory performance in aged humans , we investigated 209 elderly patients with cognitive impairments . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 29 . 1 to 2 test 2 test 3 whether 2 test 17 in 3 whether 5 variation 3 whether 12 determines 4 natural 5 variation 5 variation 6 in 5 variation 12 determines 6 in 7 nk3 7 nk3 9 r 11 also 12 determines 12 determines 14 and 13 learning 14 and 14 and 16 performance 15 memory 16 performance 17 in 19 humans 18 aged 19 humans 20 , 21 we 20 , 22 investigated 21 we 22 investigated 22 investigated 25 patients 22 investigated 26 with 23 209 25 patients 24 elderly 25 patients 26 with 28 impairments 27 cognitive 28 impairments we found that of the 15 analyzed single single - nucleotide ploymorphism ( snps ) of the nk3 - r - coding gene , tacr3 , the rs2765 snp predicted the degree of impairment of learning and memory in these patients . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 1 we 2 found 2 found 3 that 3 that 4 of 4 of 9 single 5 the 9 single 6 15 7 analyzed 7 analyzed 9 single 8 single 9 single 9 single 12 ploymorphism 9 single 16 of 10 - 12 ploymorphism 11 nucleotide 12 ploymorphism 12 ploymorphism 14 snps 12 ploymorphism 15 ) 13 ( 14 snps 14 snps 15 ) 16 of 23 gene 17 the 23 gene 18 nk3 20 r 18 nk3 22 coding 19 - 20 r 20 r 21 - 22 coding 23 gene 23 gene 25 tacr3 23 gene 28 rs2765 24 , 25 tacr3 25 tacr3 26 , 26 , 28 rs2765 27 the 28 rs2765 28 rs2765 29 snp 28 rs2765 30 predicted 28 rs2765 42 . 29 snp 30 predicted 30 predicted 37 and 30 predicted 39 in 31 the 32 degree 32 degree 33 of 32 degree 37 and 33 of 37 and 34 impairment 35 of 34 impairment 37 and 35 of 36 learning 37 and 38 memory 39 in 41 patients 40 these 41 patients this relationship could be partially explained by a reduced right hippocampus volume in a subsample of 111 tested dementia patients . 0 ###LEFT-WALL### 2 relationship 0 ###LEFT-WALL### 6 explained 0 ###LEFT-WALL### 21 . 1 this 2 relationship 2 relationship 3 could 3 could 4 be 4 be 6 explained 5 partially 6 explained 6 explained 7 by 6 explained 13 in 7 by 12 volume 8 a 12 volume 9 reduced 10 right 10 right 11 hippocampus 11 hippocampus 12 volume 13 in 15 subsample 14 a 15 subsample 15 subsample 16 of 16 of 20 patients 17 111 20 patients 18 tested 20 patients 19 dementia 20 patients these data indicate the nk3 [-] r as an important target to predict and improve learning and memory performance in the aged organism . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 24 . 1 these 2 data 2 data 14 and 3 indicate 5 nk3 3 indicate 8 as 3 indicate 14 and 4 the 5 nk3 5 nk3 7 r 8 as 11 target 9 an 10 important 9 an 11 target 10 important 11 target 11 target 12 to 11 target 13 predict 12 to 13 predict 14 and 15 improve 14 and 20 in 15 improve 17 and 16 learning 17 and 17 and 19 performance 18 memory 19 performance 20 in 23 organism 21 the 23 organism 22 aged 23 organism background : experimental evidence has demonstrated an antineoplastic role for vitamin d in the colon , and [higher] circulating 25 - hydroxyvitamin d [ 25 ( oh )d ] levels are consistently associated with a lower risk of colorectal cancer . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 3 experimental 2 : 6 demonstrated 2 : 17 and 3 experimental 4 evidence 3 experimental 5 has 3 experimental 6 demonstrated 4 evidence 5 has 6 demonstrated 9 role 6 demonstrated 10 for 6 demonstrated 13 in 7 an 8 antineoplastic 7 an 9 role 8 antineoplastic 9 role 10 for 11 vitamin 11 vitamin 12 d 13 in 15 colon 14 the 15 colon 16 , 17 and 17 and 30 levels 17 and 33 associated 19 circulating 20 25 19 circulating 29 ] 19 circulating 30 levels 20 25 22 hydroxyvitamin 21 - 22 hydroxyvitamin 22 hydroxyvitamin 23 d 22 hydroxyvitamin 27 oh 22 hydroxyvitamin 29 ] 24 [ 27 oh 25 25 27 oh 26 ( 27 oh 27 oh 28 )d 27 oh 29 ] 30 levels 31 are 31 are 33 associated 32 consistently 33 associated 33 associated 34 with 34 with 37 risk 35 a 37 risk 36 lower 37 risk 37 risk 38 of 38 of 40 cancer 39 colorectal 40 cancer genome - wide association studies have identified loci associated with levels of circulating 25 ( oh [ ] . [the] identified single - nucleotide polymorphisms ( snps ) from four gene regions collectively explain approximately 5 % of the variance in circulating 25 ( oh )d [.] methods : we investigated whether [five] [polymorphisms] in gc , cyp2r1 , cyp24a1 , and dhcr7/nadsyn1 , genes previously shown to be associated with circulating 25 ( oh )d levels , were associated with colorectal cancer risk in 10,061 cases and 12,768 controls drawn from 13 studies included in the genetics and epidemiology of colorectal cancer consortium ( gecco ) and colon cancer family registry ( ccfr ) . 0 ###LEFT-WALL### 1 genome 0 ###LEFT-WALL### 2 - 2 - 5 studies 2 - 6 have 3 wide 4 association 4 association 5 studies 5 studies 6 have 6 have 8 loci 6 have 10 with 7 identified 8 loci 8 loci 9 associated 10 with 11 levels 11 levels 12 of 11 levels 16 oh 11 levels 20 [the] 12 of 13 circulating 14 25 16 oh 15 ( 16 oh 16 oh 18 ] 16 oh 20 [the] 20 [the] 24 nucleotide 20 [the] 28 ) 21 identified 22 single 21 identified 23 - 23 - 24 nucleotide 24 nucleotide 26 ( 25 polymorphisms 26 ( 26 ( 27 snps 28 ) 29 from 29 from 31 gene 29 from 33 collectively 29 from 37 % 30 four 31 gene 31 gene 33 collectively 32 regions 33 collectively 33 collectively 36 5 34 explain 35 approximately 35 approximately 36 5 37 % 39 the 38 of 39 the 39 the 40 variance 39 the 49 : 39 the 50 we 40 variance 41 in 41 in 47 [.] 41 in 48 methods 42 circulating 44 ( 43 25 44 ( 44 ( 45 oh 44 ( 47 [.] 47 [.] 48 methods 49 : 50 we 50 we 51 investigated 51 investigated 54 [polymorphisms] 54 [polymorphisms] 61 , 55 in 56 gc 56 gc 57 , 56 gc 61 , 57 , 59 , 58 cyp2r1 59 , 59 , 60 cyp24a1 61 , 62 and 61 , 63 dhcr7/nadsyn1 61 , 64 , 61 , 69 be 61 , 70 associated 64 , 66 previously 64 , 69 be 65 genes 66 previously 66 previously 67 shown 67 shown 68 to 70 associated 71 with 71 with 74 ( 71 with 78 , 71 with 79 were 72 circulating 74 ( 73 25 74 ( 74 ( 75 oh 74 ( 77 levels 76 )d 77 levels 77 levels 78 , 79 were 80 associated 80 associated 83 cancer 80 associated 84 risk 81 with 83 cancer 82 colorectal 83 cancer 84 risk 93 13 85 in 93 13 86 10,061 87 cases 87 cases 89 12,768 87 cases 90 controls 87 cases 93 13 88 and 89 12,768 90 controls 91 drawn 91 drawn 92 from 93 13 94 studies 93 13 100 epidemiology 94 studies 95 included 95 included 99 and 96 in 99 and 97 the 98 genetics 98 genetics 99 and 100 epidemiology 107 ) 101 of 102 colorectal 102 colorectal 103 cancer 103 cancer 105 ( 104 consortium 105 ( 105 ( 106 gecco 105 ( 107 ) 107 ) 113 ( 107 ) 115 ) 108 and 109 colon 109 colon 110 cancer 110 cancer 111 family 111 family 113 ( 112 registry 113 ( 113 ( 114 ccfr we conducted a meta - analysis of crude and multivariate - adjusted logistic regression models to calculate odds ratios and associated confidence intervals for snps [individually] , snps [simultaneously] , and for a vitamin d additive genetic risk score ( grs ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conducted 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 43 . 1 we 2 conducted 2 conducted 6 analysis 3 a 4 meta 3 a 6 analysis 4 meta 5 - 4 meta 6 analysis 6 analysis 7 of 7 of 8 crude 9 and 14 regression 9 and 20 and 10 multivariate 11 - 10 multivariate 14 regression 12 adjusted 14 regression 13 logistic 14 regression 14 regression 20 and 15 models 16 to 15 models 19 ratios 15 models 20 and 16 to 17 calculate 17 calculate 18 odds 20 and 21 associated 21 associated 23 intervals 22 confidence 23 intervals 23 intervals 31 and 24 for 25 snps 24 for 31 and 25 snps 28 snps 27 , 28 snps 28 snps 30 , 31 and 32 for 32 for 39 score 33 a 39 score 34 vitamin 35 d 34 vitamin 39 score 36 additive 39 score 37 genetic 39 score 38 risk 39 score 39 score 41 grs 40 ( 41 grs 41 grs 42 ) results : we did not observe a statistically significant association between the 25 ( oh )d - associated snps and colorectal cancer [marginally] , conditionally , [or] as a grs , or [for] colon or rectal cancer separately . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 6 observe 2 : 39 . 3 we 4 did 4 did 5 not 4 did 6 observe 6 observe 10 association 6 observe 18 associated 7 a 8 statistically 7 a 10 association 8 statistically 9 significant 9 significant 10 association 10 association 11 between 10 association 18 associated 11 between 15 oh 12 the 15 oh 13 25 15 oh 14 ( 15 oh 15 oh 16 )d 15 oh 17 - 18 associated 20 and 18 associated 25 conditionally 18 associated 28 as 18 associated 38 separately 19 snps 20 and 20 and 22 cancer 21 colorectal 22 cancer 24 , 25 conditionally 25 conditionally 26 , 28 as 35 or 29 a 30 grs 30 grs 32 or 31 , 32 or 32 or 34 colon 32 or 35 or 35 or 37 cancer 36 rectal 37 cancer conclusions : our findings do not support an association between snps associated with circulating 25 ( oh )d and risk of colorectal cancer . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 7 support 2 : 24 . 3 our 4 findings 4 findings 5 do 5 do 6 not 5 do 7 support 7 support 9 association 7 support 10 between 8 an 9 association 10 between 19 and 11 snps 12 associated 11 snps 13 with 11 snps 19 and 13 with 14 circulating 14 circulating 17 oh 15 25 17 oh 16 ( 17 oh 17 oh 18 )d 19 and 20 risk 19 and 21 of 21 of 23 cancer 22 colorectal 23 cancer additional work is warranted to investigate the complex relationship between 25 ( oh )d and colorectal cancer risk . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 6 investigate 0 ###LEFT-WALL### 19 . 1 additional 2 work 2 work 3 is 3 is 4 warranted 4 warranted 5 to 5 to 6 investigate 6 investigate 9 relationship 6 investigate 10 between 7 the 9 relationship 8 complex 9 relationship 10 between 15 and 11 25 13 oh 12 ( 13 oh 13 oh 14 )d 13 oh 15 and 15 and 18 risk 16 colorectal 17 cancer 17 cancer 18 risk impact : there was no association observed between genetic markers of circulating 25 ( oh )d and colorectal cancer . 0 ###LEFT-WALL### 1 impact 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 was 2 : 20 . 3 there 4 was 4 was 6 association 5 no 6 association 6 association 7 observed 7 observed 8 between 8 between 17 and 9 genetic 10 markers 10 markers 11 of 10 markers 17 and 11 of 12 circulating 12 circulating 15 oh 13 25 15 oh 14 ( 15 oh 15 oh 16 )d 17 and 19 cancer 18 colorectal 19 cancer these genetic markers account for a small proportion of the variance in 25 ( oh )d . objective : people with type 2 diabetes have reduced cardiorespiratory fitness and metabolic impairments that are linked to obesity and often occur prior to the development of type 2 diabetes . 0 ###LEFT-WALL### 3 markers 0 ###LEFT-WALL### 4 account 0 ###LEFT-WALL### 17 . 0 ###LEFT-WALL### 48 . 1 these 3 markers 2 genetic 3 markers 3 markers 4 account 4 account 5 for 4 account 12 in 5 for 8 proportion 6 a 7 small 6 a 8 proportion 7 small 8 proportion 8 proportion 9 of 9 of 11 variance 10 the 11 variance 12 in 15 oh 13 25 15 oh 14 ( 15 oh 15 oh 16 )d 17 . 18 objective 17 . 19 : 19 : 20 people 19 : 37 and 20 people 21 with 20 people 37 and 21 with 24 diabetes 22 type 24 diabetes 23 2 24 diabetes 25 have 26 reduced 25 have 37 and 26 reduced 29 and 26 reduced 35 to 27 cardiorespiratory 28 fitness 28 fitness 29 and 29 and 31 impairments 29 and 32 that 29 and 33 are 30 metabolic 31 impairments 32 that 33 are 33 are 34 linked 35 to 36 obesity 37 and 39 occur 37 and 41 to 38 often 39 occur 40 prior 41 to 41 to 43 development 42 the 43 development 43 development 44 of 44 of 47 diabetes 45 type 47 diabetes 46 2 47 diabetes we hypothesized that obese , older adults with impaired glucose tolerance ( igt ) have lower ability to shift from fat to carbohydrate oxidation when transitioning from rest to submaximal exercise than normal glucose tolerant ( ngt ) controls . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesized 0 ###LEFT-WALL### 40 . 1 we 2 hypothesized 2 hypothesized 7 adults 2 hypothesized 15 have 3 that 4 obese 4 obese 5 , 4 obese 7 adults 6 older 7 adults 7 adults 8 with 7 adults 15 have 8 with 11 tolerance 9 impaired 11 tolerance 10 glucose 11 tolerance 11 tolerance 13 igt 12 ( 13 igt 13 igt 14 ) 15 have 17 ability 15 have 29 to 15 have 32 than 16 lower 17 ability 17 ability 18 to 17 ability 26 transitioning 18 to 19 shift 19 shift 20 from 19 shift 24 oxidation 19 shift 25 when 20 from 21 fat 21 fat 22 to 22 to 23 carbohydrate 25 when 26 transitioning 26 transitioning 27 from 27 from 28 rest 29 to 31 exercise 30 submaximal 31 exercise 32 than 39 controls 33 normal 34 glucose 34 glucose 39 controls 35 tolerant 37 ngt 35 tolerant 39 controls 36 ( 37 ngt 37 ngt 38 ) results : obese subjects with ngt ( n = 13 ) and igt ( n = 10 ) had similar resting rer , but during submaximal exercise those with igt had a lower rer and less transition to carbohydrate oxidation than the ngt group ( p < 0.05 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 44 group 0 ###LEFT-WALL### 50 . 2 : 12 and 2 : 19 had 2 : 24 but 3 obese 4 subjects 4 subjects 5 with 4 subjects 12 and 5 with 6 ngt 6 ngt 9 = 7 ( 9 = 8 n 9 = 9 = 10 13 9 = 11 ) 12 and 13 igt 12 and 18 ) 12 and 19 had 13 igt 16 = 14 ( 16 = 15 n 16 = 16 = 17 10 19 had 22 rer 20 similar 22 rer 21 resting 22 rer 23 , 24 but 24 but 28 those 24 but 31 had 25 during 27 exercise 25 during 28 those 26 submaximal 27 exercise 28 those 29 with 28 those 31 had 29 with 30 igt 31 had 37 transition 31 had 38 to 31 had 41 than 31 had 44 group 32 a 37 transition 33 lower 37 transition 34 rer 35 and 35 and 36 less 35 and 37 transition 38 to 40 oxidation 39 carbohydrate 40 oxidation 41 than 43 ngt 42 the 43 ngt 44 group 47 < 45 ( 47 < 46 p 47 < 47 < 48 0.05 47 < 49 ) the igt group also oxidized less carbohydrate during insulin infusion than ngt ( p < 0.05 ) . 0 ###LEFT-WALL### 3 group 0 ###LEFT-WALL### 5 oxidized 0 ###LEFT-WALL### 18 . 1 the 3 group 2 igt 3 group 3 group 5 oxidized 4 also 5 oxidized 5 oxidized 7 carbohydrate 5 oxidized 8 during 5 oxidized 11 than 6 less 7 carbohydrate 8 during 10 infusion 9 insulin 10 infusion 11 than 12 ngt 12 ngt 15 < 13 ( 15 < 14 p 15 < 15 < 16 0.05 15 < 17 ) rer at each exercise intensity independently correlated with 120 - minute postprandial glucose ( r = - 0.54 to - 0.58 , p < 0.05 ) , but not with body composition , vo₂max , or rer during insulin infusion . 0 ###LEFT-WALL### 36 or 0 ###LEFT-WALL### 41 . 1 rer 2 at 1 rer 8 with 1 rer 36 or 2 at 5 intensity 3 each 5 intensity 4 exercise 5 intensity 5 intensity 7 correlated 6 independently 7 correlated 8 with 9 120 9 120 13 glucose 10 - 13 glucose 11 minute 13 glucose 12 postprandial 13 glucose 13 glucose 16 = 13 glucose 35 , 14 ( 16 = 15 r 16 = 16 = 18 0.54 17 - 18 0.54 18 0.54 28 but 18 0.54 34 vo₂max 19 to 21 0.58 19 to 28 but 20 - 21 0.58 21 0.58 24 < 22 , 24 < 23 p 24 < 24 < 25 0.05 24 < 26 ) 27 , 28 but 28 but 29 not 28 but 30 with 30 with 32 composition 31 body 32 composition 33 , 34 vo₂max 34 vo₂max 35 , 36 or 37 rer 36 or 38 during 38 during 40 infusion 39 insulin 40 infusion conclusions : obese , older adults have metabolic inflexibility during exercise that is associated with the degree of glucose intolerance independent of age and body composition . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 associated 0 ###LEFT-WALL### 27 . 2 : 6 adults 2 : 7 have 3 obese 4 , 3 obese 6 adults 5 older 6 adults 6 adults 7 have 7 have 9 inflexibility 7 have 10 during 7 have 14 associated 8 metabolic 9 inflexibility 10 during 11 exercise 12 that 13 is 13 is 14 associated 14 associated 15 with 15 with 20 intolerance 15 with 24 and 16 the 17 degree 17 degree 18 of 17 degree 20 intolerance 18 of 20 intolerance 19 glucose 20 intolerance 21 independent 22 of 21 independent 24 and 22 of 23 age 24 and 26 composition 25 body 26 composition cerebral dysfunction after cardiac surgery remains a devastating complication and is growing in importance with our aging populations . 0 ###LEFT-WALL### 2 dysfunction 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 19 . 1 cerebral 2 dysfunction 2 dysfunction 3 after 2 dysfunction 10 and 3 after 5 surgery 4 cardiac 5 surgery 6 remains 9 complication 6 remains 10 and 7 a 8 devastating 7 a 9 complication 8 devastating 9 complication 10 and 11 is 10 and 13 in 10 and 15 with 11 is 12 growing 13 in 14 importance 15 with 18 populations 16 our 18 populations 17 aging 18 populations neurological complications following cardiac surgery can be classified broadly as stroke [,] encephalopathy ( including delirium ) , or postoperative cognitive dysfunction ( pocd ) . 0 ###LEFT-WALL### 2 complications 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 26 . 1 neurological 2 complications 2 complications 3 following 2 complications 6 can 3 following 5 surgery 4 cardiac 5 surgery 6 can 7 be 7 be 22 dysfunction 8 classified 9 broadly 8 classified 10 as 8 classified 15 including 8 classified 19 or 10 as 13 encephalopathy 11 stroke 13 encephalopathy 14 ( 15 including 15 including 16 delirium 15 including 17 ) 18 , 19 or 19 or 20 postoperative 19 or 22 dysfunction 21 cognitive 22 dysfunction 22 dysfunction 24 pocd 23 ( 24 pocd 24 pocd 25 ) these etiologies [are] caused primary by cerebral emboli , hypoperfusion , or inflammation that has largely been attributed to the use of cardiopulmonary bypass . 0 ###LEFT-WALL### 24 bypass 0 ###LEFT-WALL### 25 . 1 these 2 etiologies 2 etiologies 4 caused 2 etiologies 5 primary 2 etiologies 9 , 5 primary 6 by 6 by 8 emboli 7 cerebral 8 emboli 9 , 10 hypoperfusion 9 , 12 or 11 , 12 or 12 or 13 inflammation 12 or 14 that 12 or 15 has 12 or 24 bypass 14 that 15 has 15 has 17 been 16 largely 17 been 17 been 18 attributed 18 attributed 19 to 19 to 21 use 20 the 21 use 21 use 22 of 22 of 23 cardiopulmonary preventative operative strategies , such as [off] [-] pump coronary artery bypass grafting ( cabg ) , can potentially reduce the incidence of postoperative neurological complications by avoiding manipulation of the ascending aorta . 0 ###LEFT-WALL### 3 strategies 0 ###LEFT-WALL### 20 reduce 0 ###LEFT-WALL### 34 . 1 preventative 3 strategies 2 operative 3 strategies 3 strategies 6 as 3 strategies 18 can 4 , 6 as 5 such 6 as 6 as 13 grafting 6 as 17 , 9 pump 12 bypass 10 coronary 11 artery 11 artery 12 bypass 12 bypass 13 grafting 13 grafting 15 cabg 14 ( 15 cabg 15 cabg 16 ) 18 can 20 reduce 19 potentially 20 reduce 20 reduce 22 incidence 21 the 22 incidence 22 incidence 23 of 22 incidence 27 by 23 of 26 complications 24 postoperative 26 complications 25 neurological 26 complications 27 by 28 avoiding 28 avoiding 29 manipulation 29 manipulation 30 of 30 of 33 aorta 31 the 33 aorta 32 ascending 33 aorta although [off] [-] pump cabg is associated with reduced risk [of] [stroke] , there are no convincing differences in pocd [between] [off] - pump [and] on - pump cabg . 0 ###LEFT-WALL### 14 there 0 ###LEFT-WALL### 15 are 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 30 . 1 although 5 cabg 1 although 7 associated 1 although 13 , 1 although 14 there 4 pump 5 cabg 5 cabg 6 is 6 is 7 associated 7 associated 8 with 8 with 10 risk 9 reduced 10 risk 14 there 15 are 15 are 18 differences 15 are 19 in 16 no 18 differences 17 convincing 18 differences 19 in 20 pocd 23 - 24 pump 23 - 27 - 24 pump 26 on 27 - 29 cabg 28 pump 29 cabg recently , the focus of postoperative neurological research has shifted from managing cardiopulmonary [bypass] to patient - related factors . 0 ###LEFT-WALL### 4 focus 0 ###LEFT-WALL### 10 shifted 0 ###LEFT-WALL### 20 . 1 recently 2 , 1 recently 4 focus 3 the 4 focus 4 focus 5 of 4 focus 9 has 5 of 8 research 6 postoperative 8 research 7 neurological 8 research 9 has 10 shifted 10 shifted 11 from 11 from 12 managing 12 managing 13 cardiopulmonary 12 managing 15 to 15 to 19 factors 16 patient 17 - 16 patient 19 factors 18 related 19 factors identifying changes in brains of aged individuals undergoing cardiac surgery may improve strategies for preventing cerebral dysfunction . 0 ###LEFT-WALL### 1 identifying 0 ###LEFT-WALL### 12 improve 0 ###LEFT-WALL### 18 . 1 identifying 2 changes 1 identifying 3 in 1 identifying 11 may 3 in 4 brains 4 brains 5 of 5 of 7 individuals 6 aged 7 individuals 7 individuals 8 undergoing 8 undergoing 10 surgery 9 cardiac 10 surgery 11 may 12 improve 12 improve 13 strategies 12 improve 14 for 14 for 15 preventing 15 preventing 17 dysfunction 16 cerebral 17 dysfunction advanced age is associated with more undiagnosed cerebrovascular disease and is a major risk factor for stroke [and] pocd following cardiac surgery . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 23 . 1 advanced 2 age 2 age 10 and 3 is 4 associated 3 is 10 and 4 associated 5 with 5 with 9 disease 6 more 7 undiagnosed 7 undiagnosed 9 disease 8 cerebrovascular 9 disease 10 and 11 is 10 and 16 for 11 is 15 factor 12 a 15 factor 13 major 15 factor 14 risk 15 factor 16 for 22 surgery 17 stroke 20 following 19 pocd 20 following 20 following 22 surgery 21 cardiac 22 surgery preoperative cerebrovascular evaluation and adaptation of surgical strategies will provide preventative approaches for cerebral dysfunction after cabg . 0 ###LEFT-WALL### 3 evaluation 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 18 . 1 preoperative 3 evaluation 2 cerebrovascular 3 evaluation 4 and 5 adaptation 4 and 10 provide 5 adaptation 6 of 5 adaptation 9 will 6 of 8 strategies 7 surgical 8 strategies 9 will 10 provide 10 provide 12 approaches 10 provide 16 after 11 preventative 12 approaches 12 approaches 13 for 13 for 15 dysfunction 14 cerebral 15 dysfunction 16 after 17 cabg this review focuses on recent findings of the relationship between perioperative stress and underlying fragility of the brain in cardiac surgical patients . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 focuses 0 ###LEFT-WALL### 23 . 1 this 2 review 2 review 3 focuses 3 focuses 4 on 3 focuses 10 between 3 focuses 19 in 4 on 6 findings 5 recent 6 findings 6 findings 7 of 7 of 9 relationship 8 the 9 relationship 10 between 13 and 11 perioperative 12 stress 12 stress 13 and 13 and 15 fragility 13 and 16 of 14 underlying 15 fragility 16 of 18 brain 17 the 18 brain 19 in 22 patients 20 cardiac 22 patients 21 surgical 22 patients purpose : we investigated the effects of monocularity on oculomotor control by examining the characteristics of the horizontal saccades of people with one eye , and comparing them to those of a group of age [-] matched controls who viewed the stimuli monocularly and binocularly . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 46 . 2 : 3 we 2 : 4 investigated 2 : 26 and 3 we 4 investigated 4 investigated 6 effects 5 the 6 effects 6 effects 7 of 6 effects 12 by 7 of 8 monocularity 8 monocularity 9 on 9 on 11 control 10 oculomotor 11 control 12 by 13 examining 13 examining 15 characteristics 13 examining 22 with 14 the 15 characteristics 15 characteristics 16 of 16 of 19 saccades 17 the 19 saccades 18 horizontal 19 saccades 19 saccades 20 of 20 of 21 people 22 with 24 eye 23 one 24 eye 25 , 26 and 26 and 27 comparing 26 and 37 matched 27 comparing 28 them 27 comparing 29 to 27 comparing 37 matched 29 to 30 those 30 those 31 of 30 those 34 of 31 of 33 group 32 a 33 group 34 of 35 age 37 matched 38 controls 38 controls 39 who 38 controls 40 viewed 39 who 40 viewed 40 viewed 42 stimuli 40 viewed 44 and 41 the 42 stimuli 43 monocularly 44 and 44 and 45 binocularly methods : participants were tested in a no - gap , no - overlap saccadic task using [a] video - based remote eye tracker . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 3 participants 2 : 5 tested 2 : 9 - 3 participants 4 were 4 were 5 tested 5 tested 6 in 6 in 8 no 7 a 8 no 9 - 10 gap 9 - 11 , 11 , 14 overlap 11 , 20 - 12 no 13 - 12 no 14 overlap 14 overlap 19 video 15 saccadic 16 task 16 task 19 video 17 using 19 video 20 - 24 tracker 21 based 23 eye 22 remote 23 eye 23 eye 24 tracker one group consisted of unilaterally [eye] enucleated participants ( n = 15 ; mean age , 31.27 years ) , the other [of] age - matched people with normal binocular vision ( n = 18 ; mean age , 30.17 years ) . 0 ###LEFT-WALL### 2 group 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 43 . 1 one 2 group 2 group 3 consisted 3 consisted 4 of 4 of 8 participants 5 unilaterally 7 enucleated 7 enucleated 8 participants 8 participants 11 = 9 ( 11 = 10 n 11 = 11 = 12 15 11 = 13 ; 13 ; 15 age 13 ; 26 matched 13 ; 36 ; 14 mean 15 age 15 age 18 years 15 age 24 age 15 age 26 matched 16 , 18 years 17 31.27 18 years 18 years 19 ) 20 , 24 age 21 the 22 other 22 other 24 age 24 age 25 - 26 matched 27 people 26 matched 28 with 26 matched 34 = 28 with 31 vision 29 normal 31 vision 30 binocular 31 vision 32 ( 34 = 33 n 34 = 34 = 35 18 36 ; 37 mean 37 mean 38 age 38 age 41 years 39 , 41 years 40 30.17 41 years 41 years 42 ) results : the horizontal saccade dynamics of enucleated people are similar to those of people with normal binocularity when they view monocularly [and] , with the exception of latency , [when] [they] view binocularly . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 6 dynamics 2 : 10 are 3 the 6 dynamics 4 horizontal 6 dynamics 5 saccade 6 dynamics 6 dynamics 7 of 6 dynamics 10 are 7 of 9 people 8 enucleated 9 people 10 are 11 similar 11 similar 12 to 11 similar 34 binocularly 12 to 13 those 13 those 14 of 13 those 16 with 14 of 15 people 16 with 18 binocularity 17 normal 18 binocularity 18 binocularity 19 when 19 when 20 they 19 when 21 view 20 they 21 view 21 view 22 monocularly 21 view 25 with 21 view 33 view 24 , 25 with 25 with 27 exception 25 with 30 , 26 the 27 exception 27 exception 28 of 28 of 29 latency the data show that the monocular saccades of control and enucleated observers have longer latencies than the binocular saccades of the control group , the saccades of the enucleated observers are as accurate as those of the controls viewing monocularly or binocularly , smaller saccades are more accurate than the larger ones , and abducting saccades are faster than adducting saccades . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 62 . 1 the 2 data 2 data 10 and 3 show 4 that 3 show 7 saccades 3 show 10 and 5 the 7 saccades 6 monocular 7 saccades 7 saccades 8 of 8 of 9 control 10 and 23 group 11 enucleated 12 observers 12 observers 13 have 13 have 15 latencies 13 have 16 than 13 have 23 group 14 longer 15 latencies 16 than 19 saccades 16 than 20 of 17 the 19 saccades 18 binocular 19 saccades 20 of 22 control 21 the 22 control 24 , 26 saccades 24 , 31 are 24 , 43 , 25 the 26 saccades 26 saccades 27 of 26 saccades 31 are 27 of 30 observers 28 the 30 observers 29 enucleated 30 observers 31 are 33 accurate 32 as 33 accurate 33 accurate 34 as 33 accurate 41 or 34 as 35 those 34 as 36 of 36 of 39 viewing 37 the 39 viewing 38 controls 39 viewing 40 monocularly 41 or 41 or 42 binocularly 43 , 45 saccades 43 , 46 are 43 , 54 and 44 smaller 45 saccades 45 saccades 46 are 46 are 47 more 46 are 48 accurate 48 accurate 49 than 49 than 52 ones 50 the 52 ones 51 larger 52 ones 53 , 54 and 54 and 56 saccades 54 and 57 are 55 abducting 56 saccades 56 saccades 57 are 57 are 58 faster 58 faster 59 than 59 than 61 saccades 60 adducting 61 saccades conclusions : our data suggest that the true monocularity produced by early enucleation does not result in slower visual processing in the afferent [(] sensory ) pathway , or in deficits in the efferent ( motor [ )(pathways of the saccadic system . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 data 2 : 5 suggest 3 our 4 data 4 data 5 suggest 5 suggest 6 that 6 that 9 monocularity 6 that 16 result 7 the 9 monocularity 8 true 9 monocularity 9 monocularity 10 produced 9 monocularity 14 does 10 produced 11 by 11 by 13 enucleation 12 early 13 enucleation 14 does 15 not 14 does 16 result 16 result 17 in 16 result 29 or 16 result 32 in 17 in 20 processing 18 slower 20 processing 19 visual 20 processing 21 in 27 pathway 21 in 29 or 22 the 27 pathway 23 afferent 27 pathway 25 sensory 26 ) 25 sensory 27 pathway 28 , 29 or 29 or 30 in 30 in 31 deficits 32 in 34 efferent 33 the 34 efferent 34 efferent 38 )(pathways 35 ( 38 )(pathways 36 motor 38 )(pathways 38 )(pathways 39 of 38 )(pathways 43 . 39 of 42 system 40 the 42 system 41 saccadic 42 system possible [mechanisms] to account for the effects of monocular vision on saccades are discussed . 0 ###LEFT-WALL### 1 possible 0 ###LEFT-WALL### 13 are 0 ###LEFT-WALL### 15 . 1 possible 3 to 1 possible 11 on 1 possible 13 are 3 to 4 account 4 account 5 for 4 account 11 on 5 for 7 effects 6 the 7 effects 7 effects 8 of 8 of 10 vision 9 monocular 10 vision 12 saccades 13 are 13 are 14 discussed purpose : to report the 7 [-] year incidence of age - related cataracts in a metropolitan chinese elderly population . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 report 2 : 13 related 2 : 21 . 3 to 4 report 4 report 9 incidence 5 the 9 incidence 6 7 8 year 8 year 9 incidence 9 incidence 10 of 10 of 11 age 12 - 13 related 13 related 14 cataracts 14 cataracts 15 in 15 in 20 population 16 a 17 metropolitan 16 a 20 population 17 metropolitan 20 population 18 chinese 20 population 19 elderly 20 population methods : the shihpai eye study 2006 included 460 ( 55.8 % ) of 1361 participants in the 1999 baseline survey for a [follow] [-] up eye examination . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 5 eye 3 the 5 eye 4 shihpai 5 eye 5 eye 6 study 5 eye 8 included 5 eye 12 % 5 eye 14 of 6 study 7 2006 6 study 8 included 8 included 9 460 10 ( 12 % 11 55.8 12 % 12 % 13 ) 14 of 16 participants 15 1361 16 participants 16 participants 17 in 17 in 21 survey 18 the 21 survey 19 1999 20 baseline 20 baseline 21 survey 21 survey 22 for 22 for 28 examination 23 a 28 examination 26 up 28 examination 27 eye 28 examination cataract was graded by one ophthalmologist using the lens opacities classification system iii . 0 ###LEFT-WALL### 1 cataract 0 ###LEFT-WALL### 3 graded 0 ###LEFT-WALL### 14 . 1 cataract 2 was 2 was 3 graded 3 graded 4 by 4 by 6 ophthalmologist 5 one 6 ophthalmologist 6 ophthalmologist 7 using 7 using 12 system 8 the 12 system 9 lens 10 opacities 10 opacities 11 classification 11 classification 12 system 12 system 13 iii results : the 7 [-] year incidence of pure nuclear opacity was 18.5 % ( 95 % confidence [interval] [ ci ] : 12.7 % - 24.3 % ) []] ; 34.7 % [(] 95 % ci : 27.6 % - 41.8 % ) for cortical opacity ; and 0.6 % [(] 95 % ci : 0 % - 1.8 % ) for posterior subcapsular opacity . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 7 incidence 2 : 12 was 2 : 23 : 2 : 67 . 3 the 7 incidence 4 7 6 year 6 year 7 incidence 7 incidence 8 of 7 incidence 12 was 8 of 11 opacity 9 pure 11 opacity 10 nuclear 11 opacity 12 was 14 % 13 18.5 14 % 14 % 18 confidence 15 ( 18 confidence 16 95 17 % 17 % 18 confidence 18 confidence 21 ci 18 confidence 22 ] 20 [ 21 ci 21 ci 22 ] 23 : 25 % 23 : 31 ; 24 12.7 25 % 25 % 28 % 26 - 28 % 27 24.3 28 % 28 % 29 ) 31 ; 37 ci 31 ; 38 : 31 ; 48 ; 32 34.7 33 % 33 % 37 ci 35 95 37 ci 36 % 37 ci 37 ci 38 : 38 : 40 % 38 : 45 for 39 27.6 40 % 40 % 43 % 41 - 43 % 42 41.8 43 % 43 % 44 ) 45 for 47 opacity 46 cortical 47 opacity 48 ; 49 and 49 and 55 ci 49 and 56 : 50 0.6 51 % 51 % 55 ci 53 95 55 ci 54 % 55 ci 55 ci 56 : 56 : 58 % 56 : 63 for 57 0 58 % 58 % 61 % 59 - 61 % 60 1.8 61 % 61 % 62 ) 63 for 66 opacity 64 posterior 66 opacity 65 subcapsular 66 opacity a total of 3.5 % ( 95 % [ci] : 0.8 % - 6.2 % ) of participants developed all three types of cataract . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 19 developed 0 ###LEFT-WALL### 25 . 1 a 2 total 2 total 3 of 2 total 17 of 2 total 19 developed 3 of 5 % 4 3.5 5 % 5 % 15 % 6 ( 15 % 7 95 8 % 7 95 13 - 8 % 10 : 10 : 12 % 11 0.8 12 % 13 - 14 6.2 13 - 15 % 15 % 16 ) 17 of 18 participants 19 developed 23 of 20 all 21 three 21 three 23 of 22 types 23 of 23 of 24 cataract nuclear [cataract] was significantly associated with current smoking ( p = 0.04 ; relative risk [[] [rr] []] : 2.05 ; 95 % ci : 1.05 - 3.99 ) . 0 ###LEFT-WALL### 1 nuclear 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 30 . 1 nuclear 3 was 3 was 5 associated 4 significantly 5 associated 5 associated 6 with 6 with 8 smoking 7 current 8 smoking 8 smoking 11 = 9 ( 11 = 10 p 11 = 11 = 12 0.04 11 = 13 ; 13 ; 15 risk 13 ; 19 : 13 ; 21 ; 14 relative 15 risk 15 risk 19 : 19 : 20 2.05 21 ; 24 ci 21 ; 25 : 22 95 24 ci 23 % 24 ci 25 : 26 1.05 26 1.05 28 3.99 27 - 28 3.99 28 3.99 29 ) males were almost half as likely ( p = 0.04 ; [rr] : 0.57 ; 95 % ci : 0.34 - 0.97 ) to develop cortical opacity , whereas participants with a history of diabetes were approximately twice as likely to develop cortical opacity ( p = 0.05 ; [rr] 2.43 ; 95 % ci : 1.02 - 5.81 ) . 0 ###LEFT-WALL### 1 males 0 ###LEFT-WALL### 11 ; 0 ###LEFT-WALL### 61 . 1 males 2 were 2 were 4 half 2 were 6 likely 3 almost 4 half 5 as 6 likely 6 likely 9 = 7 ( 9 = 8 p 9 = 9 = 10 0.04 9 = 11 ; 11 ; 13 : 11 ; 15 ; 13 : 14 0.57 15 ; 17 % 15 ; 36 were 15 ; 49 ; 16 95 17 % 17 % 18 ci 17 % 24 to 17 % 25 develop 18 ci 19 : 19 : 20 0.34 19 : 24 to 20 0.34 22 0.97 21 - 22 0.97 22 0.97 23 ) 25 develop 27 opacity 25 develop 29 whereas 26 cortical 27 opacity 28 , 29 whereas 29 whereas 30 participants 30 participants 31 with 30 participants 34 of 30 participants 36 were 31 with 33 history 32 a 33 history 34 of 35 diabetes 36 were 40 likely 37 approximately 38 twice 38 twice 39 as 39 as 40 likely 40 likely 41 to 40 likely 42 develop 41 to 42 develop 42 develop 44 opacity 43 cortical 44 opacity 44 opacity 47 = 45 ( 47 = 46 p 47 = 47 = 48 0.05 49 ; 51 2.43 49 ; 52 ; 52 ; 55 ci 52 ; 56 : 53 95 55 ci 54 % 55 ci 56 : 57 1.02 57 1.02 59 5.81 58 - 59 5.81 59 5.81 60 ) a higher level of education ( p = 0.03 [;] [rr] : 0.40 ; 95 % ci : 0.18 - 0.91 [ )(and a higher body mass index ( p = 0.02 [;] [rr] : 0.28 ; 95 % ci [:] 0.10 - 0.79 ) [was] protective [of] posterior subcapsular cataract . 0 ###LEFT-WALL### 3 level 0 ###LEFT-WALL### 12 : 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 52 . 1 a 3 level 2 higher 3 level 3 level 4 of 3 level 8 = 3 level 12 : 4 of 5 education 6 ( 8 = 7 p 8 = 8 = 9 0.03 12 : 13 0.40 14 ; 17 ci 14 ; 18 : 15 95 17 ci 16 % 17 ci 18 : 19 0.18 18 : 20 - 18 : 23 )(and 18 : 37 ; 19 0.18 20 - 20 - 21 0.91 23 )(and 28 index 23 )(and 35 : 24 a 28 index 25 higher 26 body 26 body 28 index 27 mass 28 index 28 index 31 = 28 index 35 : 29 ( 31 = 30 p 31 = 31 = 32 0.02 35 : 36 0.28 37 ; 51 cataract 38 95 39 % 39 % 49 posterior 40 ci 42 0.10 40 ci 44 0.79 40 ci 49 posterior 43 - 44 0.79 44 0.79 45 ) 47 protective 49 posterior 49 posterior 51 cataract 50 subcapsular 51 cataract conclusions : this study indicated a high incidence of cortical opacities and lower incidence of nuclear opacities compared with caucasians . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 indicated 2 : 21 . 3 this 4 study 4 study 5 indicated 5 indicated 8 incidence 6 a 7 high 6 a 8 incidence 7 high 8 incidence 8 incidence 9 of 8 incidence 15 of 9 of 12 and 10 cortical 11 opacities 11 opacities 12 and 12 and 14 incidence 13 lower 14 incidence 15 of 17 opacities 16 nuclear 17 opacities 17 opacities 18 compared 18 compared 19 with 19 with 20 caucasians posterior subcapsular opacity [incidence] and cataract surgery rate were comparable . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 were 0 ###LEFT-WALL### 11 . 1 posterior 3 opacity 2 subcapsular 3 opacity 3 opacity 5 and 5 and 8 rate 5 and 9 were 6 cataract 8 rate 7 surgery 8 rate 9 were 10 comparable age - related changes have been documented in anatomical studies on peripheral as well as central vestibular systems . 0 ###LEFT-WALL### 4 changes 0 ###LEFT-WALL### 7 documented 0 ###LEFT-WALL### 19 . 1 age 2 - 1 age 4 changes 3 related 4 changes 4 changes 5 have 5 have 6 been 6 been 7 documented 7 documented 8 in 7 documented 11 on 8 in 10 studies 9 anatomical 10 studies 11 on 18 systems 12 peripheral 18 systems 13 as 14 well 14 well 16 central 15 as 16 central 16 central 18 systems 17 vestibular 18 systems similar changes have also been observed for saccular responses evaluated through cervical vestibular evoked myogenic potential ( cvemp ) after the age of 60 years . 0 ###LEFT-WALL### 1 similar 0 ###LEFT-WALL### 6 observed 0 ###LEFT-WALL### 26 . 1 similar 2 changes 1 similar 5 been 1 similar 6 observed 2 changes 3 have 3 have 5 been 4 also 5 been 6 observed 7 for 6 observed 16 potential 6 observed 20 after 7 for 9 responses 8 saccular 9 responses 9 responses 10 evaluated 10 evaluated 11 through 11 through 12 cervical 13 vestibular 16 potential 14 evoked 16 potential 15 myogenic 16 potential 16 potential 18 cvemp 17 ( 18 cvemp 18 cvemp 19 ) 20 after 22 age 21 the 22 age 22 age 23 of 23 of 25 years 24 60 25 years nevertheless , most of these studies have either made use of small sample sizes , considered inappropriate for normative studies of such kind , or incorporated wider age groups which might have confounded the conclusions . 0 ###LEFT-WALL### 6 studies 0 ###LEFT-WALL### 9 made 1 nevertheless 2 , 1 nevertheless 6 studies 3 most 4 of 3 most 6 studies 4 of 6 studies 5 these 6 studies 6 studies 7 have 7 have 9 made 8 either 9 made 9 made 10 use 10 use 11 of 10 use 16 considered 11 of 14 sizes 12 small 13 sample 13 sample 14 sizes 15 , 16 considered 16 considered 17 inappropriate 16 considered 36 . 17 inappropriate 18 for 18 for 20 studies 19 normative 20 studies 20 studies 21 of 21 of 29 groups 22 such 29 groups 23 kind 25 or 24 , 25 or 25 or 28 age 25 or 29 groups 26 incorporated 28 age 27 wider 28 age 29 groups 30 which 29 groups 31 might 30 which 31 might 31 might 32 have 32 have 33 confounded 33 confounded 35 conclusions 34 the 35 conclusions in order to overcome the [above] shortcomings , the present study aimed at evaluating the effect of age on cvemp using larger sample size and distributing the participants to smaller age group divisions . 0 ###LEFT-WALL### 11 study 0 ###LEFT-WALL### 12 aimed 0 ###LEFT-WALL### 34 . 1 in 2 order 1 in 8 , 1 in 11 study 2 order 3 to 2 order 4 overcome 3 to 4 overcome 4 overcome 7 shortcomings 5 the 7 shortcomings 9 the 11 study 10 present 11 study 11 study 12 aimed 12 aimed 13 at 12 aimed 19 on 12 aimed 21 using 12 aimed 28 participants 12 aimed 29 to 13 at 14 evaluating 14 evaluating 16 effect 15 the 16 effect 16 effect 17 of 17 of 18 age 19 on 20 cvemp 21 using 25 and 22 larger 23 sample 23 sample 24 size 24 size 25 and 25 and 26 distributing 27 the 28 participants 29 to 33 divisions 30 smaller 31 age 31 age 32 group 32 group 33 divisions a cross - sectional design was employed to record cvemps from 280 healthy volunteers in the age range of 10 - 85 years who were distributed to seven age groups ( 10 - 20 , 20 - 30 , 30 - 40 , 40 - 50 , 50 - 60 , 60 - 70 and [above] 70 years ) . 0 ###LEFT-WALL### 2 cross 0 ###LEFT-WALL### 3 - 1 a 2 cross 3 - 5 design 3 - 7 employed 3 - 60 . 4 sectional 5 design 5 design 6 was 6 was 7 employed 7 employed 8 to 7 employed 11 from 7 employed 15 in 8 to 10 cvemps 9 record 10 cvemps 11 from 14 volunteers 12 280 14 volunteers 13 healthy 14 volunteers 15 in 17 age 16 the 17 age 17 age 18 range 17 age 26 distributed 17 age 27 to 17 age 33 - 18 range 19 of 18 range 26 distributed 19 of 23 years 20 10 21 - 21 - 22 85 21 - 23 years 23 years 24 who 23 years 25 were 24 who 25 were 27 to 30 groups 28 seven 29 age 29 age 30 groups 31 ( 33 - 32 10 33 - 33 - 34 20 33 - 59 ) 34 20 36 20 34 20 41 - 34 20 49 - 35 , 36 20 36 20 38 30 36 20 39 , 37 - 38 30 38 30 39 , 39 , 41 - 40 30 41 - 41 - 42 40 41 - 44 40 41 - 46 50 41 - 47 , 43 , 44 40 44 40 45 - 45 - 46 50 46 50 47 , 47 , 49 - 48 50 49 - 49 - 50 60 49 - 52 60 49 - 58 years 49 - 59 ) 51 , 52 60 52 60 53 - 53 - 58 years 54 70 55 and 55 and 57 70 55 and 58 years 58 years 59 ) the latency , amplitude , [inter] [-] aural asymmetry ratio , and threshold were compared using one - way analysis of variance , whereas the response rate was calculated in terms of percentage [of] ears in which the responses were identifiable . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 15 compared 0 ###LEFT-WALL### 42 . 1 the 2 latency 2 latency 3 , 3 , 4 amplitude 3 , 5 , 5 , 10 ratio 5 , 12 and 8 aural 9 asymmetry 9 asymmetry 10 ratio 11 , 12 and 12 and 13 threshold 12 and 14 were 14 were 15 compared 15 compared 16 using 15 compared 24 whereas 15 compared 30 in 16 using 17 one 17 one 20 analysis 18 - 20 analysis 19 way 20 analysis 20 analysis 21 of 20 analysis 23 , 21 of 22 variance 24 whereas 27 rate 24 whereas 29 calculated 25 the 27 rate 26 response 27 rate 27 rate 28 was 28 was 29 calculated 30 in 31 terms 31 terms 32 of 31 terms 36 in 32 of 35 ears 33 percentage 35 ears 36 in 37 which 36 in 39 responses 36 in 40 were 38 the 39 responses 39 responses 40 were 40 were 41 identifiable the results revealed a steady decline [in] response rate and amplitude with advancing age beyond 5th decade [(] 50 - 60 years ) . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 24 . 1 the 2 results 2 results 3 revealed 3 revealed 10 and 4 a 5 steady 4 a 9 rate 5 steady 6 decline 6 decline 9 rate 8 response 9 rate 9 rate 10 and 10 and 11 amplitude 10 and 23 ) 11 amplitude 12 with 12 with 13 advancing 13 advancing 14 age 13 advancing 15 beyond 15 beyond 22 years 16 5th 22 years 17 decade 22 years 19 50 20 - 20 - 21 60 20 - 22 years in addition , the latency of p13 and n23 was prolonged , while the thresholds worsened with increasing age also after 50 years . 0 ###LEFT-WALL### 5 latency 0 ###LEFT-WALL### 11 prolonged 1 in 2 addition 1 in 3 , 1 in 5 latency 4 the 5 latency 5 latency 6 of 5 latency 10 was 6 of 8 and 7 p13 8 and 8 and 9 n23 10 was 11 prolonged 11 prolonged 13 while 12 , 13 while 13 while 15 thresholds 13 while 16 worsened 13 while 24 . 14 the 15 thresholds 15 thresholds 16 worsened 16 worsened 17 with 17 with 18 increasing 18 increasing 19 age 18 increasing 20 also 18 increasing 21 after 21 after 23 years 22 50 23 years hence , age - matched norms have to be considered while interpreting the results of cvemp , especially in individuals above 50 years of age . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 4 - 1 hence 2 , 1 hence 3 age 4 - 6 norms 4 - 7 have 5 matched 6 norms 6 norms 7 have 7 have 8 to 7 have 10 considered 8 to 9 be 9 be 10 considered 10 considered 11 while 11 while 12 interpreting 12 interpreting 14 results 12 interpreting 19 in 13 the 14 results 14 results 15 of 15 of 16 cvemp 17 , 18 especially 17 , 19 in 19 in 20 individuals 19 in 26 . 20 individuals 21 above 20 individuals 24 of 21 above 23 years 22 50 23 years 24 of 25 age mitochondrial topoisomerase i is a genetically distinct mitochondria - dedicated enzyme with a crucial but so far unknown role in the homeostasis of mitochondrial dna metabolism . 0 ###LEFT-WALL### 2 topoisomerase 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 27 . 1 mitochondrial 2 topoisomerase 2 topoisomerase 3 i 2 topoisomerase 4 is 4 is 11 enzyme 5 a 6 genetically 5 a 11 enzyme 6 genetically 7 distinct 7 distinct 11 enzyme 8 mitochondria 9 - 8 mitochondria 11 enzyme 10 dedicated 11 enzyme 11 enzyme 12 with 12 with 19 role 13 a 19 role 14 crucial 15 but 15 but 17 far 15 but 19 role 16 so 17 far 18 unknown 19 role 19 role 20 in 19 role 23 of 20 in 22 homeostasis 21 the 22 homeostasis 23 of 26 metabolism 24 mitochondrial 26 metabolism 25 dna 26 metabolism here , we present data suggesting a negative regulatory function in mitochondrial transcription or transcript stability . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 present 0 ###LEFT-WALL### 17 . 1 here 2 , 1 here 3 we 3 we 4 present 4 present 5 data 5 data 6 suggesting 6 suggesting 10 function 6 suggesting 11 in 7 a 8 negative 7 a 10 function 8 negative 10 function 9 regulatory 10 function 11 in 14 or 12 mitochondrial 13 transcription 13 transcription 14 or 14 or 16 stability 15 transcript 16 stability deficiency or depletion of mitochondrial topoisomerase i increased mitochondrial transcripts , whereas overexpression lowered mitochondrial transcripts , depleted respiratory complexes i , [iii] and iv , decreased cell respiration and raised superoxide levels . 0 ###LEFT-WALL### 2 or 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 34 . 1 deficiency 2 or 2 or 3 depletion 2 or 4 of 2 or 24 and 4 of 6 topoisomerase 5 mitochondrial 6 topoisomerase 6 topoisomerase 7 i 8 increased 10 transcripts 8 increased 12 whereas 8 increased 24 and 9 mitochondrial 10 transcripts 11 , 12 whereas 12 whereas 13 overexpression 12 whereas 14 lowered 12 whereas 22 , 13 overexpression 14 lowered 14 lowered 16 transcripts 15 mitochondrial 16 transcripts 16 transcripts 20 complexes 17 , 20 complexes 18 depleted 20 complexes 19 respiratory 20 complexes 20 complexes 21 i 20 complexes 22 , 22 , 24 and 24 and 30 and 25 iv 26 , 25 iv 30 and 27 decreased 29 respiration 27 decreased 30 and 28 cell 29 respiration 30 and 31 raised 31 raised 33 levels 32 superoxide 33 levels acute depletion of mitochondrial topoisomerase i triggered neither a nuclear mito - biogenic stress response nor compensatory topoisomerase iiβ upregulation , suggesting the concomitant increase in mitochondrial transcripts was due to release [of] a local inhibitory effect . 0 ###LEFT-WALL### 2 depletion 0 ###LEFT-WALL### 7 triggered 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 32 release 0 ###LEFT-WALL### 38 . 1 acute 2 depletion 2 depletion 3 of 2 depletion 7 triggered 3 of 5 topoisomerase 4 mitochondrial 5 topoisomerase 5 topoisomerase 6 i 7 triggered 16 nor 8 neither 16 nor 9 a 10 nuclear 9 a 15 response 10 nuclear 14 stress 11 mito 12 - 11 mito 14 stress 13 biogenic 14 stress 14 stress 15 response 15 response 16 nor 16 nor 20 upregulation 17 compensatory 18 topoisomerase 18 topoisomerase 20 upregulation 19 iiβ 20 upregulation 21 , 22 suggesting 21 , 29 was 22 suggesting 25 increase 22 suggesting 26 in 22 suggesting 29 was 23 the 25 increase 24 concomitant 25 increase 26 in 28 transcripts 27 mitochondrial 28 transcripts 29 was 30 due 30 due 31 to 30 due 32 release 31 to 32 release 32 release 37 effect 34 a 35 local 34 a 37 effect 35 local 37 effect 36 inhibitory 37 effect mitochondrial topoisomerase i was co - immunoprecipitated with mitochondrial rna [polymerase] . 0 ###LEFT-WALL### 2 topoisomerase 0 ###LEFT-WALL### 4 was 1 mitochondrial 2 topoisomerase 2 topoisomerase 3 i 2 topoisomerase 4 was 4 was 5 co 5 co 7 immunoprecipitated 6 - 7 immunoprecipitated 7 immunoprecipitated 8 with 7 immunoprecipitated 12 . 8 with 10 rna 9 mitochondrial 10 rna it selectively accumulated and rapidly exchanged at a subset of nucleoids distinguished by the presence of newly synthesized rna [and/or] mitochondrial rna [polymerase] . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 24 . 1 it 4 and 2 selectively 3 accumulated 3 accumulated 4 and 4 and 6 exchanged 4 and 7 at 4 and 22 rna 5 rapidly 6 exchanged 7 at 9 subset 8 a 9 subset 9 subset 10 of 10 of 11 nucleoids 11 nucleoids 12 distinguished 12 distinguished 13 by 13 by 15 presence 14 the 15 presence 15 presence 16 of 16 of 19 rna 17 newly 18 synthesized 18 synthesized 19 rna 21 mitochondrial 22 rna the inactive y559f - mutant behaved similarly without affecting mitochondrial transcripts . 0 ###LEFT-WALL### 3 y559f 0 ###LEFT-WALL### 4 - 1 the 3 y559f 2 inactive 3 y559f 4 - 5 mutant 4 - 6 behaved 4 - 12 . 5 mutant 6 behaved 6 behaved 11 transcripts 7 similarly 8 without 7 similarly 10 mitochondrial 8 without 9 affecting 10 mitochondrial 11 transcripts in conclusion , mitochondrial topoisomerase i dampens mitochondrial transcription and thereby alters respiratory capacity . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 15 . 1 in 2 conclusion 3 , 5 topoisomerase 3 , 10 and 4 mitochondrial 5 topoisomerase 5 topoisomerase 6 i 5 topoisomerase 10 and 7 dampens 9 transcription 7 dampens 10 and 8 mitochondrial 9 transcription 10 and 12 alters 11 thereby 12 alters 12 alters 14 capacity 13 respiratory 14 capacity the mechanism [involves] selective association of the active enzyme with transcriptionally active nucleoids and a direct interaction with mitochondrial rna polymerase . 0 ###LEFT-WALL### 21 polymerase 0 ###LEFT-WALL### 22 . 1 the 5 association 2 mechanism 5 association 4 selective 5 association 5 association 6 of 5 association 14 and 6 of 9 enzyme 7 the 9 enzyme 8 active 9 enzyme 9 enzyme 10 with 10 with 13 nucleoids 11 transcriptionally 12 active 12 active 13 nucleoids 14 and 17 interaction 14 and 18 with 14 and 21 polymerase 15 a 16 direct 15 a 17 interaction 16 direct 17 interaction 18 with 20 rna 19 mitochondrial 20 rna the inhibitory role of topoisomerase i in mitochondrial transcription is strikingly different from the stimulatory role of topoisomerase i in nuclear transcription . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 23 . 1 the 3 role 2 inhibitory 3 role 3 role 4 of 3 role 10 is 4 of 5 topoisomerase 5 topoisomerase 6 i 5 topoisomerase 7 in 7 in 9 transcription 8 mitochondrial 9 transcription 10 is 12 different 11 strikingly 12 different 12 different 13 from 12 different 20 in 13 from 16 role 14 the 16 role 15 stimulatory 16 role 16 role 17 of 17 of 18 topoisomerase 18 topoisomerase 19 i 20 in 22 transcription 21 nuclear 22 transcription mutations of the von hippel - lindau ( vhl ) tumor suppressor gene cause hereditary and sporadic renal cell carcinomas ( rccs ) . 0 ###LEFT-WALL### 1 mutations 0 ###LEFT-WALL### 14 cause 0 ###LEFT-WALL### 24 . 1 mutations 2 of 1 mutations 14 cause 2 of 13 gene 3 the 13 gene 4 von 5 hippel 5 hippel 7 lindau 5 hippel 13 gene 6 - 7 lindau 7 lindau 9 vhl 7 lindau 10 ) 8 ( 9 vhl 9 vhl 10 ) 11 tumor 12 suppressor 12 suppressor 13 gene 14 cause 20 carcinomas 15 hereditary 16 and 16 and 17 sporadic 16 and 19 cell 18 renal 19 cell 19 cell 20 carcinomas 20 carcinomas 22 rccs 21 ( 22 rccs 22 rccs 23 ) the best characterized function of vhl protein is suppression of the α subunit [of] hypoxia inducible factor ( hif ) . 0 ###LEFT-WALL### 4 function 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 21 . 1 the 2 best 1 the 4 function 3 characterized 4 function 4 function 5 of 4 function 8 is 5 of 7 protein 6 vhl 7 protein 8 is 9 suppression 9 suppression 10 of 10 of 17 factor 11 the 17 factor 12 α 17 factor 13 subunit 17 factor 15 hypoxia 17 factor 16 inducible 17 factor 17 factor 19 hif 18 ( 19 hif 19 hif 20 ) additional vhl functions have been reported , including induction of senescence upon loss of vhl mediated by downregulation of the chromatin remodeling factor p400 . 0 ###LEFT-WALL### 3 functions 0 ###LEFT-WALL### 6 reported 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 25 . 1 additional 3 functions 2 vhl 3 functions 3 functions 4 have 4 have 5 been 5 been 6 reported 7 , 8 including 7 , 16 mediated 8 including 9 induction 8 including 12 upon 8 including 16 mediated 9 induction 10 of 10 of 11 senescence 12 upon 13 loss 13 loss 14 of 14 of 15 vhl 16 mediated 17 by 17 by 18 downregulation 18 downregulation 19 of 18 downregulation 22 remodeling 19 of 21 chromatin 20 the 21 chromatin 22 remodeling 24 p400 23 factor 24 p400 in the present study , we investigated the relationship between the expression of p400 and patient survival following rcc diagnosis taking advantage of [a] large and well - documented series of rcc patients with long - term follow - up information . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 investigated 1 in 4 study 1 in 5 , 1 in 6 we 2 the 4 study 3 present 4 study 6 we 7 investigated 7 investigated 9 relationship 8 the 9 relationship 9 relationship 10 between 9 relationship 13 of 10 between 12 expression 11 the 12 expression 13 of 20 diagnosis 14 p400 15 and 15 and 16 patient 15 and 17 survival 17 survival 20 diagnosis 18 following 20 diagnosis 19 rcc 20 diagnosis 20 diagnosis 21 taking 20 diagnosis 23 of 20 diagnosis 30 series 21 taking 22 advantage 23 of 26 and 25 large 26 and 26 and 27 well 28 - 30 series 29 documented 30 series 30 series 31 of 30 series 33 patients 30 series 38 follow 30 series 42 . 31 of 32 rcc 33 patients 34 with 33 patients 38 follow 34 with 37 term 35 long 36 - 35 long 37 term 38 follow 40 up 39 - 40 up 40 up 41 information 40 up 42 . the expression of p400 was measured by immunohistochemistry using a tissue microarray containing tumor tissue samples from 868 rcc patients . 0 ###LEFT-WALL### 2 expression 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 21 . 1 the 2 expression 2 expression 3 of 2 expression 5 was 3 of 4 p400 5 was 6 measured 6 measured 7 by 6 measured 9 using 7 by 8 immunohistochemistry 9 using 12 microarray 10 a 11 tissue 10 a 12 microarray 11 tissue 12 microarray 12 microarray 13 containing 13 containing 16 samples 14 tumor 16 samples 15 tissue 16 samples 16 samples 17 from 17 from 20 patients 18 868 20 patients 19 rcc 20 patients chi - squared tests , kaplan - meier curves , cox regression models and spearman 's rank correlation estimates were used to investigate the possible relationship between p400 expression and ki - 67 proliferative index , clinical and pathological characteristics and patient survival . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 21 used 0 ###LEFT-WALL### 32 - 1 chi 2 - 1 chi 14 and 3 squared 4 tests 4 tests 5 , 5 , 13 models 5 , 14 and 6 kaplan 9 curves 6 kaplan 12 regression 7 - 9 curves 8 meier 9 curves 9 curves 10 , 11 cox 12 regression 12 regression 13 models 14 and 19 estimates 14 and 20 were 15 spearman 16 's 16 's 19 estimates 17 rank 18 correlation 18 correlation 19 estimates 20 were 21 used 21 used 22 to 21 used 23 investigate 22 to 23 investigate 23 investigate 26 relationship 24 the 26 relationship 25 possible 26 relationship 26 relationship 27 between 27 between 30 and 28 p400 29 expression 29 expression 30 and 30 and 31 ki 32 - 35 index 32 - 36 , 32 - 44 . 33 67 35 index 34 proliferative 35 index 36 , 41 and 37 clinical 38 and 38 and 39 pathological 38 and 40 characteristics 40 characteristics 41 and 41 and 43 survival 42 patient 43 survival complete loss of p400 expression was detected in 64 % of all tumor specimens , and decreased p400 expression was associated with advanced tumor stage , higher grade of malignancy and regional lymph node metastasis . 0 ###LEFT-WALL### 25 stage 0 ###LEFT-WALL### 26 , 0 ###LEFT-WALL### 36 . 1 complete 2 loss 2 loss 3 of 2 loss 16 and 3 of 4 p400 4 p400 5 expression 4 p400 6 was 4 p400 7 detected 5 expression 6 was 7 detected 8 in 8 in 10 % 9 64 10 % 10 % 11 of 11 of 14 specimens 12 all 14 specimens 13 tumor 14 specimens 15 , 16 and 16 and 18 p400 16 and 19 expression 16 and 22 with 16 and 25 stage 17 decreased 18 p400 19 expression 20 was 20 was 21 associated 21 associated 22 with 23 advanced 24 tumor 24 tumor 25 stage 26 , 31 and 27 higher 28 grade 28 grade 29 of 28 grade 31 and 29 of 30 malignancy 31 and 35 metastasis 32 regional 33 lymph 33 lymph 34 node 34 node 35 metastasis among well - differentiated rccs , high [proliferation] ( ki - 67 index>10 ) was found in 12 % of carcinomas with an increased p400 expression , compared to 5 % of rccs with decreased p400 expression . 0 ###LEFT-WALL### 5 rccs 0 ###LEFT-WALL### 27 , 0 ###LEFT-WALL### 38 . 1 among 2 well 1 among 3 - 1 among 5 rccs 4 differentiated 5 rccs 5 rccs 13 index>10 5 rccs 27 , 6 , 13 index>10 7 high 10 ki 7 high 13 index>10 9 ( 10 ki 10 ki 11 - 12 67 13 index>10 13 index>10 14 ) 15 was 16 found 15 was 27 , 16 found 17 in 17 in 19 % 18 12 19 % 19 % 20 of 20 of 21 carcinomas 21 carcinomas 22 with 22 with 26 expression 23 an 26 expression 24 increased 26 expression 25 p400 26 expression 27 , 28 compared 27 , 34 with 28 compared 29 to 29 to 31 % 30 5 31 % 31 % 32 of 32 of 33 rccs 34 with 37 expression 35 decreased 37 expression 36 p400 37 expression multiple cox regression indicated that patients with low proliferative tumors and increased p400 expression had a 60 % lower cancer - specific mortality risk compared to those affected by low proliferative rccs with decreased p400 expression . 0 ###LEFT-WALL### 3 regression 0 ###LEFT-WALL### 4 indicated 0 ###LEFT-WALL### 21 - 1 multiple 3 regression 2 cox 3 regression 3 regression 4 indicated 4 indicated 5 that 5 that 6 patients 5 that 15 had 6 patients 7 with 6 patients 15 had 7 with 11 and 8 low 10 tumors 9 proliferative 10 tumors 10 tumors 11 and 11 and 14 expression 12 increased 13 p400 13 p400 14 expression 15 had 20 cancer 16 a 20 cancer 17 60 18 % 18 % 20 cancer 19 lower 20 cancer 21 - 24 risk 21 - 25 compared 21 - 37 . 22 specific 23 mortality 23 mortality 24 risk 24 risk 25 compared 25 compared 26 to 25 compared 33 with 25 compared 36 expression 26 to 27 those 27 those 28 affected 28 affected 29 by 29 by 32 rccs 30 low 32 rccs 31 proliferative 32 rccs 33 with 35 p400 34 decreased 35 p400 in summary , patients affected by highly proliferative tumors with decreased p400 expression exhibit a poor prognosis by multiple cox regression . 0 ###LEFT-WALL### 14 exhibit 0 ###LEFT-WALL### 22 . 1 in 4 patients 1 in 14 exhibit 2 summary 3 , 2 summary 4 patients 4 patients 5 affected 5 affected 6 by 5 affected 10 with 6 by 9 tumors 7 highly 8 proliferative 8 proliferative 9 tumors 10 with 13 expression 11 decreased 13 expression 12 p400 13 expression 14 exhibit 17 prognosis 14 exhibit 18 by 15 a 16 poor 15 a 17 prognosis 16 poor 17 prognosis 18 by 21 regression 19 multiple 21 regression 20 cox 21 regression our data suggest that the highly proliferative , decreased [-] p400 subgroup of rccs represents tumors that are characterized by a loss of the tumor [-] suppressive mechanism of senescence . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 31 . 1 our 2 data 2 data 3 suggest 3 suggest 4 that 4 that 12 subgroup 4 that 15 represents 5 the 12 subgroup 6 highly 7 proliferative 7 proliferative 8 , 7 proliferative 12 subgroup 9 decreased 12 subgroup 11 p400 12 subgroup 12 subgroup 13 of 12 subgroup 15 represents 13 of 14 rccs 15 represents 16 tumors 16 tumors 17 that 16 tumors 18 are 17 that 18 are 18 are 19 characterized 19 characterized 20 by 20 by 22 loss 21 a 22 loss 22 loss 23 of 23 of 28 mechanism 24 the 28 mechanism 25 tumor 28 mechanism 27 suppressive 28 mechanism 28 mechanism 29 of 29 of 30 senescence the incidence of chronic respiratory diseases ( e.g [.] , chronic obstructive pulmonary disease , copd ) and interstitial lung diseases ( e.g [.] , pneumonia and lung fibrosis ) increases with age . 0 ###LEFT-WALL### 18 and 1 the 2 incidence 2 incidence 3 of 2 incidence 18 and 3 of 6 diseases 4 chronic 6 diseases 5 respiratory 6 diseases 6 diseases 14 disease 6 diseases 16 copd 7 ( 14 disease 8 e.g 10 , 8 e.g 14 disease 11 chronic 14 disease 12 obstructive 14 disease 13 pulmonary 14 disease 14 disease 15 , 15 , 16 copd 16 copd 17 ) 18 and 21 diseases 18 and 31 increases 19 interstitial 20 lung 20 lung 21 diseases 22 ( 31 increases 23 e.g 27 and 23 e.g 31 increases 25 , 27 and 26 pneumonia 27 and 27 and 29 fibrosis 27 and 30 ) 28 lung 29 fibrosis 31 increases 32 with 31 increases 34 . 32 with 33 age in addition to immune senescence , the accumulation of senescent cells [directly] in lung tissue might play a critical role in the increased prevalence of these pulmonary diseases . 0 ###LEFT-WALL### 8 accumulation 0 ###LEFT-WALL### 17 play 0 ###LEFT-WALL### 29 . 1 in 2 addition 1 in 6 , 1 in 8 accumulation 2 addition 3 to 3 to 5 senescence 4 immune 5 senescence 7 the 8 accumulation 8 accumulation 9 of 8 accumulation 16 might 9 of 11 cells 10 senescent 11 cells 11 cells 13 in 13 in 15 tissue 14 lung 15 tissue 16 might 17 play 17 play 20 role 17 play 21 in 18 a 19 critical 18 a 20 role 19 critical 20 role 21 in 24 prevalence 22 the 24 prevalence 23 increased 24 prevalence 24 prevalence 25 of 25 of 28 diseases 26 these 28 diseases 27 pulmonary 28 diseases in the last couple of years , detailed studies have identified the presence of senescent cells in the aging lung and in diseased lungs of patients with copd and lung fibrosis . 0 ###LEFT-WALL### 9 studies 0 ###LEFT-WALL### 11 identified 0 ###LEFT-WALL### 32 . 1 in 4 couple 1 in 7 , 1 in 9 studies 2 the 4 couple 3 last 4 couple 4 couple 5 of 5 of 6 years 8 detailed 9 studies 9 studies 10 have 10 have 11 identified 11 identified 13 presence 11 identified 27 with 12 the 13 presence 13 presence 14 of 14 of 16 cells 15 senescent 16 cells 16 cells 21 and 17 in 20 lung 17 in 21 and 18 the 20 lung 19 aging 20 lung 21 and 22 in 22 in 24 lungs 23 diseased 24 lungs 24 lungs 25 of 25 of 26 patients 27 with 29 and 28 copd 29 and 29 and 31 fibrosis 30 lung 31 fibrosis cellular senescence has been shown for epithelial cells of bronchi and alveoli as well as mesenchymal and vascular cells . 0 ###LEFT-WALL### 2 senescence 0 ###LEFT-WALL### 5 shown 0 ###LEFT-WALL### 20 . 1 cellular 2 senescence 2 senescence 3 has 3 has 4 been 4 been 5 shown 5 shown 6 for 5 shown 15 as 6 for 8 cells 7 epithelial 8 cells 8 cells 9 of 9 of 11 and 10 bronchi 11 and 11 and 12 alveoli 13 as 14 well 14 well 15 as 15 as 19 cells 16 mesenchymal 17 and 17 and 18 vascular 17 and 19 cells known risk factors for pulmonary diseases ( cigarette smoke , air pollutions , bacterial infections , etc [.] ) were identified in experimental studies as being possible mediators in the development of cellular senescence . 0 ###LEFT-WALL### 3 factors 0 ###LEFT-WALL### 11 air 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 35 . 1 known 3 factors 2 risk 3 factors 3 factors 4 for 3 factors 11 air 4 for 6 diseases 5 pulmonary 6 diseases 6 diseases 9 smoke 7 ( 9 smoke 8 cigarette 9 smoke 9 smoke 10 , 11 air 12 pollutions 13 , 15 infections 13 , 21 identified 14 bacterial 15 infections 15 infections 17 etc 15 infections 20 were 16 , 17 etc 17 etc 19 ) 20 were 21 identified 21 identified 22 in 21 identified 25 as 21 identified 29 in 22 in 24 studies 23 experimental 24 studies 25 as 28 mediators 26 being 28 mediators 27 possible 28 mediators 29 in 31 development 30 the 31 development 31 development 32 of 32 of 34 senescence 33 cellular 34 senescence the present findings indicate the importance of cellular senescence in normal lung aging and in premature aging of the lung in patients with copd , lung fibrosis , and probably other respiratory diseases . 0 ###LEFT-WALL### 3 findings 0 ###LEFT-WALL### 4 indicate 0 ###LEFT-WALL### 34 . 1 the 3 findings 2 present 3 findings 3 findings 4 indicate 4 indicate 29 and 5 the 6 importance 6 importance 7 of 6 importance 25 , 7 of 9 senescence 8 cellular 9 senescence 9 senescence 14 and 10 in 13 aging 10 in 14 and 11 normal 12 lung 12 lung 13 aging 14 and 15 in 15 in 17 aging 16 premature 17 aging 17 aging 18 of 18 of 20 lung 19 the 20 lung 20 lung 21 in 21 in 22 patients 22 patients 23 with 23 with 24 copd 25 , 27 fibrosis 25 , 29 and 26 lung 27 fibrosis 28 , 29 and 29 and 30 probably 29 and 33 diseases 31 other 33 diseases 32 respiratory 33 diseases importance : diabetes is associated with an elevated risk of coronary heart disease ( chd ) . 0 ###LEFT-WALL### 1 importance 0 ###LEFT-WALL### 2 : 2 : 3 diabetes 2 : 5 associated 2 : 17 . 3 diabetes 4 is 4 is 5 associated 5 associated 6 with 6 with 9 risk 7 an 9 risk 8 elevated 9 risk 9 risk 10 of 10 of 13 disease 11 coronary 12 heart 12 heart 13 disease 13 disease 15 chd 14 ( 15 chd 15 chd 16 ) previous studies have suggested that the genetic factors predisposing to excess cardiovascular risk may be different in diabetic and nondiabetic individuals . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 suggested 0 ###LEFT-WALL### 22 . 1 previous 2 studies 2 studies 3 have 3 have 4 suggested 4 suggested 5 that 5 that 8 factors 5 that 15 be 6 the 8 factors 7 genetic 8 factors 8 factors 9 predisposing 8 factors 14 may 9 predisposing 10 to 9 predisposing 13 risk 10 to 11 excess 12 cardiovascular 13 risk 14 may 15 be 15 be 16 different 16 different 17 in 17 in 21 individuals 18 diabetic 19 and 19 and 20 nondiabetic 19 and 21 individuals objective : to identify genetic determinants of chd that are specific to patients with diabetes . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 identify 2 : 16 . 3 to 4 identify 4 identify 6 determinants 5 genetic 6 determinants 6 determinants 7 of 6 determinants 9 that 6 determinants 10 are 7 of 8 chd 9 that 10 are 10 are 11 specific 11 specific 12 to 11 specific 14 with 12 to 13 patients 14 with 15 diabetes design , setting , and participants : we studied 5 independent sets of chd cases and chd - negative controls from the nurses ' health study ( enrolled in 1976 and followed up through 2008 [ )(, health professionals follow - up study ( enrolled in 1986 and followed up through [2008] [ )(, joslin heart study ( enrolled in 2001 - 2008 ) , gargano heart study ( enrolled in 2001 - 2008 [ )( and catanzaro study ( enrolled in 2004 - 2010 ) . 0 ###LEFT-WALL### 6 participants 0 ###LEFT-WALL### 7 : 0 ###LEFT-WALL### 9 studied 1 design 3 setting 2 , 3 setting 3 setting 4 , 3 setting 5 and 5 and 6 participants 7 : 8 we 8 we 9 studied 9 studied 12 sets 10 5 12 sets 11 independent 12 sets 12 sets 13 of 13 of 19 negative 14 chd 15 cases 15 cases 16 and 16 and 17 chd 16 and 18 - 16 and 19 negative 19 negative 31 and 20 controls 21 from 20 controls 26 study 20 controls 29 in 20 controls 31 and 21 from 25 health 22 the 23 nurses 23 nurses 24 ' 24 ' 25 health 26 study 28 enrolled 27 ( 28 enrolled 29 in 30 1976 31 and 32 followed 31 and 33 up 31 and 42 up 33 up 34 through 34 through 35 2008 35 2008 40 follow 37 )(, 40 follow 38 health 39 professionals 39 professionals 40 follow 40 follow 41 - 42 up 48 and 43 study 45 enrolled 43 study 46 in 43 study 48 and 44 ( 45 enrolled 46 in 47 1986 48 and 57 study 48 and 59 enrolled 49 followed 57 study 50 up 57 study 51 through 54 )(, 51 through 57 study 55 joslin 56 heart 56 heart 57 study 58 ( 59 enrolled 59 enrolled 60 in 60 in 61 2001 61 2001 63 2008 61 2001 73 - 62 - 63 2008 63 2008 64 ) 65 , 73 - 66 gargano 67 heart 67 heart 68 study 68 study 70 enrolled 68 study 73 - 69 ( 70 enrolled 70 enrolled 71 in 71 in 72 2001 73 - 79 study 74 2008 77 and 77 and 78 catanzaro 78 catanzaro 79 study 79 study 81 enrolled 80 ( 81 enrolled 81 enrolled 82 in 81 enrolled 87 . 82 in 83 2004 83 2004 85 2010 84 - 85 2010 85 2010 86 ) included were a total of 1517 chd cases and 2671 chd - negative controls , all with type 2 diabetes . 0 ###LEFT-WALL### 1 included 0 ###LEFT-WALL### 2 were 1 included 2 were 2 were 9 and 3 a 4 total 4 total 5 of 4 total 9 and 5 of 8 cases 6 1517 8 cases 7 chd 8 cases 9 and 11 chd 9 and 14 controls 9 and 16 all 10 2671 11 chd 12 - 14 controls 13 negative 14 controls 14 controls 15 , 15 , 16 all 16 all 17 with 16 all 21 . 17 with 20 diabetes 18 type 20 diabetes 19 2 20 diabetes results in diabetic patients were compared with those in 737 nondiabetic chd cases and 1637 nondiabetic chd - negative controls from the nurses ' health study and health professionals follow - up study cohorts . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 6 compared 0 ###LEFT-WALL### 18 - 1 results 2 in 1 results 5 were 2 in 4 patients 3 diabetic 4 patients 5 were 6 compared 6 compared 7 with 6 compared 9 in 7 with 8 those 9 in 14 and 10 737 13 cases 11 nondiabetic 13 cases 12 chd 13 cases 13 cases 14 and 14 and 17 chd 15 1637 17 chd 16 nondiabetic 17 chd 18 - 20 controls 18 - 32 up 18 - 35 . 19 negative 20 controls 20 controls 21 from 20 controls 32 up 21 from 27 and 22 the 23 nurses 23 nurses 24 ' 24 ' 26 study 25 health 26 study 26 study 27 and 27 and 30 follow 27 and 31 - 28 health 29 professionals 29 professionals 30 follow 32 up 34 cohorts 33 study 34 cohorts exposures included 2,543,016 common genetic variants occurring throughout the genome . 0 ###LEFT-WALL### 1 exposures 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 11 . 1 exposures 2 included 2 included 6 variants 3 2,543,016 6 variants 4 common 6 variants 5 genetic 6 variants 6 variants 7 occurring 7 occurring 8 throughout 8 throughout 10 genome 9 the 10 genome main outcomes and measures : coronary heart disease -- defined as fatal or nonfatal myocardial infarction , coronary artery bypass grafting , percutaneous transluminal coronary angioplasty , or angiographic evidence of significant stenosis of the coronary arteries . 0 ###LEFT-WALL### 4 measures 0 ###LEFT-WALL### 5 : 1 main 2 outcomes 2 outcomes 3 and 3 and 4 measures 4 measures 5 : 5 : 8 disease 6 coronary 7 heart 7 heart 8 disease 8 disease 10 defined 9 -- 10 defined 10 defined 11 as 10 defined 38 . 11 as 16 infarction 12 fatal 13 or 13 or 14 nonfatal 13 or 16 infarction 15 myocardial 16 infarction 16 infarction 28 or 17 , 28 or 18 coronary 19 artery 19 artery 20 bypass 20 bypass 21 grafting 21 grafting 22 , 22 , 26 angioplasty 22 , 28 or 23 percutaneous 25 coronary 24 transluminal 25 coronary 25 coronary 26 angioplasty 27 , 28 or 28 or 30 evidence 28 or 31 of 28 or 34 of 28 or 38 . 29 angiographic 30 evidence 31 of 33 stenosis 32 significant 33 stenosis 34 of 37 arteries 35 the 37 arteries 36 coronary 37 arteries results : a variant on chromosome 1q25 ( rs10911021 ) was consistently associated with chd risk among diabetic participants , with risk allele frequencies of 0.733 in cases vs 0.679 in controls ( odds [ratio] , 1.36 [ 95 % ci , 1.22 - 1.51 ] ; p = 2 × 10 ( - 8 ) [ )( 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 58 )( 2 : 4 variant 2 : 13 associated 2 : 47 ; 3 a 4 variant 4 variant 5 on 4 variant 9 rs10911021 4 variant 11 was 5 on 7 1q25 6 chromosome 7 1q25 8 ( 9 rs10911021 9 rs10911021 10 ) 11 was 13 associated 12 consistently 13 associated 13 associated 14 with 13 associated 44 - 14 with 16 risk 15 chd 16 risk 16 risk 17 among 16 risk 21 with 17 among 19 participants 18 diabetic 19 participants 20 , 21 with 21 with 24 frequencies 21 with 28 cases 21 with 42 , 22 risk 24 frequencies 23 allele 24 frequencies 24 frequencies 25 of 25 of 27 in 26 0.733 27 in 28 cases 29 vs 28 cases 31 in 29 vs 30 0.679 31 in 32 controls 32 controls 34 odds 33 ( 34 odds 34 odds 37 1.36 34 odds 42 , 36 , 37 1.36 37 1.36 41 ci 37 1.36 42 , 38 [ 41 ci 39 95 41 ci 40 % 41 ci 41 ci 42 , 42 , 44 - 43 1.22 44 - 44 - 45 1.51 44 - 46 ] 47 ; 48 p 47 ; 49 = 48 p 49 = 49 = 51 × 50 2 51 × 51 × 52 10 51 × 55 8 53 ( 55 8 54 - 55 8 55 8 56 ) no association between this variant and chd was detected among nondiabetic participants , with risk allele frequencies of 0.697 in cases vs 0.696 in controls ( odds [ratio] , 0.99 [ 95 % ci , 0.87 - 1.13 ] [;] p = .89[!] ) , consistent with a significant gene × diabetes interaction on chd risk ( p = 2 × 10 ( - 4 ) ) . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 9 detected 0 ###LEFT-WALL### 68 . 1 no 2 association 2 association 3 between 2 association 8 was 3 between 6 and 4 this 5 variant 5 variant 6 and 6 and 7 chd 8 was 9 detected 9 detected 10 among 9 detected 14 with 10 among 12 participants 11 nondiabetic 12 participants 13 , 14 with 14 with 17 frequencies 14 with 67 ) 15 risk 17 frequencies 16 allele 17 frequencies 17 frequencies 18 of 17 frequencies 22 vs 18 of 21 cases 19 0.697 20 in 20 in 21 cases 22 vs 25 controls 23 0.696 24 in 24 in 25 controls 25 controls 27 odds 25 controls 36 0.87 26 ( 27 odds 27 odds 30 0.99 27 odds 35 , 29 , 30 0.99 30 0.99 34 ci 30 0.99 35 , 31 [ 34 ci 32 95 34 ci 33 % 34 ci 34 ci 35 , 35 , 36 0.87 36 0.87 38 1.13 36 0.87 42 = 36 0.87 46 consistent 36 0.87 67 ) 37 - 38 1.13 38 1.13 39 ] 41 p 42 = 42 = 43 .89[!] 42 = 44 ) 45 , 46 consistent 46 consistent 47 with 46 consistent 66 ) 47 with 53 interaction 48 a 49 significant 48 a 53 interaction 49 significant 51 × 50 gene 51 × 51 × 52 diabetes 52 diabetes 53 interaction 53 interaction 54 on 54 on 56 risk 55 chd 56 risk 56 risk 59 = 56 risk 65 4 57 ( 59 = 58 p 59 = 59 = 61 × 60 2 61 × 61 × 62 10 63 ( 65 4 64 - 65 4 65 4 66 ) compared with protective allele homozygotes , rs10911021 risk allele homozygotes were characterized by a 32 % decrease in the expression of the neighboring glutamate - ammonia ligase ( glul ) gene in human endothelial cells ( p = .0048[!] ) . 0 ###LEFT-WALL### 10 homozygotes 0 ###LEFT-WALL### 12 characterized 0 ###LEFT-WALL### 41 . 1 compared 2 with 1 compared 6 , 1 compared 10 homozygotes 2 with 5 homozygotes 3 protective 5 homozygotes 4 allele 5 homozygotes 7 rs10911021 9 allele 8 risk 9 allele 9 allele 10 homozygotes 10 homozygotes 11 were 11 were 12 characterized 12 characterized 13 by 12 characterized 18 in 12 characterized 32 in 13 by 17 decrease 14 a 17 decrease 15 32 16 % 16 % 17 decrease 18 in 20 expression 19 the 20 expression 20 expression 21 of 21 of 31 gene 22 the 31 gene 23 neighboring 31 gene 24 glutamate 27 ligase 24 glutamate 31 gene 25 - 27 ligase 26 ammonia 27 ligase 27 ligase 29 glul 27 ligase 30 ) 28 ( 29 glul 29 glul 30 ) 32 in 35 cells 33 human 35 cells 34 endothelial 35 cells 35 cells 38 = 36 ( 38 = 37 p 38 = 38 = 39 .0048[!] 38 = 40 ) a decreased ratio between plasma levels [of] [γ] - glutamyl cycle intermediates pyroglutamic and glutamic acid was also shown in risk allele homozygotes ( p = .029[!] ) . 0 ###LEFT-WALL### 3 ratio 0 ###LEFT-WALL### 6 levels 0 ###LEFT-WALL### 9 - 1 a 3 ratio 2 decreased 3 ratio 3 ratio 4 between 3 ratio 6 levels 4 between 5 plasma 9 - 12 intermediates 9 - 22 allele 9 - 29 . 10 glutamyl 12 intermediates 11 cycle 12 intermediates 12 intermediates 16 acid 12 intermediates 19 shown 12 intermediates 22 allele 13 pyroglutamic 14 and 14 and 15 glutamic 14 and 16 acid 16 acid 17 was 17 was 18 also 17 was 19 shown 19 shown 20 in 20 in 21 risk 22 allele 23 homozygotes 22 allele 26 = 24 ( 26 = 25 p 26 = 26 = 27 .029[!] 26 = 28 ) conclusion and relevance : a single - nucleotide polymorphism ( rs10911021 ) was identified that was significantly associated with chd among persons with diabetes but not in those without diabetes and was functionally related to glutamic acid metabolism , suggesting a mechanistic link . 0 ###LEFT-WALL### 3 relevance 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 34 related 1 conclusion 2 and 2 and 3 relevance 4 : 9 polymorphism 4 : 31 and 5 a 6 single 5 a 9 polymorphism 6 single 7 - 6 single 8 nucleotide 8 nucleotide 9 polymorphism 9 polymorphism 11 rs10911021 9 polymorphism 13 was 10 ( 11 rs10911021 11 rs10911021 12 ) 13 was 14 identified 15 that 16 was 16 was 31 and 17 significantly 18 associated 18 associated 19 with 18 associated 25 but 18 associated 31 and 19 with 20 chd 21 among 22 persons 21 among 25 but 22 persons 23 with 23 with 24 diabetes 25 but 26 not 25 but 27 in 27 in 28 those 28 those 29 without 29 without 30 diabetes 31 and 32 was 32 was 34 related 33 functionally 34 related 34 related 35 to 34 related 40 suggesting 35 to 38 metabolism 36 glutamic 37 acid 37 acid 38 metabolism 39 , 40 suggesting 40 suggesting 43 link 40 suggesting 44 . 41 a 43 link 42 mechanistic 43 link background : the soluble form of the receptor for advanced glycation [end] - products ( srage ) has been studied in various diseases . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 5 form 2 : 20 studied 3 the 5 form 4 soluble 5 form 5 form 6 of 5 form 18 has 6 of 8 receptor 7 the 8 receptor 8 receptor 9 for 9 for 11 glycation 10 advanced 11 glycation 11 glycation 14 products 13 - 14 products 14 products 16 srage 14 products 17 ) 15 ( 16 srage 16 srage 17 ) 18 has 19 been 19 been 20 studied 20 studied 21 in 21 in 23 diseases 22 various 23 diseases it is not clear why srage levels vary between studies , with controversial results . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 1 it 2 is 2 is 3 not 2 is 4 clear 4 clear 5 why 5 why 7 levels 5 why 8 vary 6 srage 7 levels 7 levels 8 vary 8 vary 9 between 9 between 10 studies 10 studies 12 with 11 , 12 with 12 with 14 results 12 with 15 . 13 controversial 14 results what also remains to be determined is whether [receptor] for advanced glycation end [-] products ( rage ) [ligands] could affect srage assessment by epitope masking . 0 ###LEFT-WALL### 1 what 0 ###LEFT-WALL### 26 masking 0 ###LEFT-WALL### 27 . 1 what 3 remains 1 what 7 is 2 also 3 remains 3 remains 4 to 3 remains 6 determined 4 to 5 be 7 is 8 whether 8 whether 10 for 10 for 12 glycation 11 advanced 12 glycation 12 glycation 15 products 12 glycation 26 masking 13 end 15 products 15 products 17 rage 15 products 20 could 16 ( 17 rage 17 rage 18 ) 20 could 21 affect 21 affect 23 assessment 22 srage 23 assessment 23 assessment 24 by 24 by 25 epitope 25 epitope 26 masking recently described anti - srage autoantibodies may play an interfering role . 0 ###LEFT-WALL### 6 autoantibodies 0 ###LEFT-WALL### 8 play 0 ###LEFT-WALL### 12 . 1 recently 2 described 2 described 6 autoantibodies 3 anti 4 - 3 anti 6 autoantibodies 5 srage 6 autoantibodies 6 autoantibodies 7 may 7 may 8 play 8 play 11 role 9 an 11 role 10 interfering 11 role the aim of this study was therefore to investigate the influence of rage ligands and anti - srage autoantibodies on srage quantification . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 14 ligands 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 23 . 1 the 2 aim 2 aim 3 of 2 aim 5 study 2 aim 6 was 2 aim 14 ligands 3 of 4 this 5 study 6 was 6 was 7 therefore 6 was 8 to 8 to 9 investigate 9 investigate 11 influence 10 the 11 influence 11 influence 12 of 12 of 13 rage 15 and 18 srage 15 and 19 autoantibodies 16 anti 17 - 16 anti 18 srage 18 srage 19 autoantibodies 19 autoantibodies 20 on 20 on 22 quantification 21 srage 22 quantification using elisa , anti - srage autoantibodies ( iggs ) were identified in haemodialysis ( hd ) patients , then purified and incubated with rhu - srage or serum to investigate their effects on srage levels . 0 ###LEFT-WALL### 1 using 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 37 . 1 using 2 elisa 1 using 22 and 2 elisa 7 autoantibodies 3 , 7 autoantibodies 4 anti 5 - 4 anti 7 autoantibodies 6 srage 7 autoantibodies 7 autoantibodies 9 iggs 7 autoantibodies 10 ) 8 ( 9 iggs 9 iggs 10 ) 11 were 20 then 11 were 22 and 12 identified 13 in 12 identified 18 patients 12 identified 20 then 13 in 14 haemodialysis 14 haemodialysis 16 hd 15 ( 16 hd 16 hd 17 ) 19 , 20 then 20 then 21 purified 22 and 23 incubated 22 and 24 with 22 and 30 to 24 with 28 or 25 rhu 26 - 25 rhu 27 srage 27 srage 28 or 28 or 29 serum 30 to 31 investigate 31 investigate 33 effects 31 investigate 34 on 32 their 33 effects 34 on 36 levels 35 srage 36 levels results : rage ligands , either alone at three different concentrations [(] cml was also tested at different glycation levels ) [or] a mixture of all these ligands , did not affect srage levels when incubated with rhu - srage or control serum . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 rage 2 : 4 ligands 2 : 5 , 2 : 41 or 2 : 44 . 3 rage 4 ligands 5 , 7 alone 5 , 14 was 5 , 15 also 6 either 7 alone 7 alone 8 at 7 alone 14 was 8 at 11 concentrations 9 three 11 concentrations 10 different 11 concentrations 13 cml 14 was 15 also 24 mixture 15 also 29 , 16 tested 17 at 16 tested 21 ) 16 tested 24 mixture 17 at 20 levels 18 different 20 levels 19 glycation 20 levels 23 a 24 mixture 24 mixture 25 of 24 mixture 29 , 25 of 27 these 26 all 27 these 28 ligands 29 , 29 , 30 did 30 did 31 not 30 did 41 or 32 affect 34 levels 32 affect 35 when 32 affect 37 with 32 affect 41 or 33 srage 34 levels 35 when 36 incubated 37 with 40 srage 38 rhu 39 - 38 rhu 40 srage 41 or 42 control 42 control 43 serum compared with healthy controls , hd patients had higher levels of srage ( p < 0.001 ) and anti - srage iggs ( p < 0.05 ) . 0 ###LEFT-WALL### 7 patients 0 ###LEFT-WALL### 8 had 0 ###LEFT-WALL### 28 . 1 compared 2 with 1 compared 5 , 1 compared 7 patients 2 with 4 controls 3 healthy 4 controls 6 hd 7 patients 7 patients 8 had 8 had 18 and 8 had 25 < 9 higher 10 levels 10 levels 11 of 10 levels 18 and 11 of 12 srage 12 srage 15 < 13 ( 15 < 14 p 15 < 15 < 16 0.001 15 < 17 ) 18 and 22 iggs 19 anti 20 - 19 anti 21 srage 21 srage 22 iggs 23 ( 25 < 24 p 25 < 25 < 26 0.05 25 < 27 ) however , [incubation] of rhu - srage with purified iggs from hd patients had no effect on srage quantification . 0 ###LEFT-WALL### 13 patients 0 ###LEFT-WALL### 14 had 0 ###LEFT-WALL### 20 . 1 however 2 , 1 however 13 patients 4 of 7 srage 4 of 13 patients 5 rhu 6 - 5 rhu 7 srage 7 srage 8 with 8 with 10 iggs 9 purified 10 iggs 10 iggs 11 from 11 from 12 hd 13 patients 14 had 14 had 16 effect 14 had 17 on 15 no 16 effect 17 on 19 quantification 18 srage 19 quantification conclusions : rage ligands or anti - srage autoantibodies did not interfere with srage quantification . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 rage 2 : 4 ligands 2 : 5 or 2 : 16 . 3 rage 4 ligands 5 or 9 autoantibodies 5 or 12 interfere 6 anti 7 - 6 anti 9 autoantibodies 8 srage 9 autoantibodies 9 autoantibodies 10 did 10 did 11 not 10 did 12 interfere 12 interfere 13 with 13 with 15 quantification 14 srage 15 quantification further studies are required to elucidate the variability in srage levels reported in the literature and to define the potential of srage for use as a reliable biomarker . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 29 . 1 further 2 studies 2 studies 3 are 3 are 16 and 4 required 5 to 4 required 9 in 4 required 11 levels 4 required 12 reported 4 required 16 and 5 to 6 elucidate 6 elucidate 8 variability 7 the 8 variability 9 in 10 srage 11 levels 12 reported 12 reported 13 in 13 in 15 literature 14 the 15 literature 16 and 17 to 16 and 18 define 16 and 25 as 17 to 18 define 18 define 20 potential 19 the 20 potential 20 potential 21 of 21 of 22 srage 22 srage 23 for 23 for 24 use 25 as 28 biomarker 26 a 28 biomarker 27 reliable 28 biomarker objective [:] to assess effect of age on the characteristic of left [ventricular] ( lv ) twist [-] displacement loop in health volunteers by velocity vector imaging ( vvi ) and to provide a new method for lv function [evaluation] [in] [clinic] . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 31 and 0 ###LEFT-WALL### 43 . 1 objective 3 to 1 objective 4 assess 1 objective 31 and 3 to 4 assess 4 assess 5 effect 4 assess 8 on 5 effect 6 of 6 of 7 age 8 on 10 characteristic 9 the 10 characteristic 10 characteristic 11 of 11 of 19 displacement 12 left 15 lv 12 left 16 ) 12 left 17 twist 14 ( 15 lv 15 lv 16 ) 17 twist 19 displacement 20 loop 21 in 20 loop 31 and 21 in 23 volunteers 22 health 23 volunteers 23 volunteers 24 by 24 by 27 imaging 25 velocity 27 imaging 26 vector 27 imaging 27 imaging 29 vvi 28 ( 29 vvi 29 vvi 30 ) 31 and 32 to 31 and 39 function 32 to 33 provide 33 provide 36 method 33 provide 37 for 34 a 35 new 34 a 36 method 35 new 36 method 37 for 38 lv methods : after obtaining basal and apical lv short - axis images in 98 healthy volunteers ( 18 - 75 years old ) by 2 - dimensional echocardiography , we use vvi software to analysis lv twist motion and radial displacement at each plane off - line . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 48 . 1 methods 2 : 2 : 3 after 3 after 4 obtaining 4 obtaining 6 and 4 obtaining 8 lv 4 obtaining 9 short 5 basal 6 and 6 and 7 apical 10 - 12 images 10 - 29 , 11 axis 12 images 12 images 13 in 12 images 24 by 13 in 16 volunteers 14 98 16 volunteers 15 healthy 16 volunteers 16 volunteers 19 - 17 ( 19 - 18 18 19 - 19 - 20 75 19 - 22 old 19 - 23 ) 20 75 21 years 21 years 22 old 24 by 25 2 25 2 28 echocardiography 26 - 28 echocardiography 27 dimensional 28 echocardiography 28 echocardiography 29 , 29 , 30 we 29 , 31 use 29 , 46 - 30 we 31 use 31 use 33 software 31 use 34 to 32 vvi 33 software 34 to 35 analysis 35 analysis 36 lv 35 analysis 39 and 35 analysis 45 off 37 twist 38 motion 38 motion 39 and 39 and 41 displacement 39 and 42 at 39 and 44 plane 40 radial 41 displacement 42 at 43 each 44 plane 45 off 46 - 47 line [the] peak lv [twist] ( ptw ) , the peak [untwist] velocity ( putwv ) , the proportion of [untwist] in isovolumetric relaxation period ( iutw [%] ) and [lv] radial displacement [(] [dis] ) were measured and calculated . 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 40 . 2 peak 3 lv 2 peak 16 , 3 lv 6 ptw 3 lv 12 velocity 5 ( 6 ptw 6 ptw 7 ) 8 , 12 velocity 9 the 12 velocity 10 peak 12 velocity 12 velocity 14 putwv 12 velocity 15 ) 13 ( 14 putwv 14 putwv 15 ) 16 , 38 and 17 the 18 proportion 18 proportion 19 of 18 proportion 29 and 19 of 21 in 21 in 24 period 22 isovolumetric 23 relaxation 23 relaxation 24 period 24 period 26 iutw 25 ( 26 iutw 26 iutw 28 ) 29 and 32 displacement 29 and 35 ) 29 and 36 were 31 radial 32 displacement 36 were 38 and 37 measured 38 and 38 and 39 calculated then we constructed lv [twist] - [displacement] loop and compared the characteristic of them among different groups . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 constructed 0 ###LEFT-WALL### 6 - 1 then 2 we 2 we 3 constructed 3 constructed 4 lv 6 - 9 and 6 - 18 . 8 loop 9 and 9 and 10 compared 10 compared 12 characteristic 10 compared 15 among 11 the 12 characteristic 12 characteristic 13 of 13 of 14 them 15 among 17 groups 16 different 17 groups results : ptw increased gradually with the increase in age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 . 1 results 2 : 2 : 3 ptw 3 ptw 4 increased 4 increased 5 gradually 4 increased 6 with 4 increased 9 in 6 with 8 increase 7 the 8 increase 9 in 10 age the biggest putwv was in the group of 30 - 60 years old . 0 ###LEFT-WALL### 13 old 0 ###LEFT-WALL### 14 . 1 the 2 biggest 1 the 13 old 3 putwv 4 was 4 was 5 in 5 in 7 group 6 the 7 group 7 group 8 of 8 of 10 - 9 30 10 - 10 - 11 60 11 60 12 years 12 years 13 old iutw [%] increased gradually before 60 years old , then decreased after that . 0 ###LEFT-WALL### 1 iutw 0 ###LEFT-WALL### 10 then 0 ###LEFT-WALL### 14 . 1 iutw 10 then 3 increased 4 gradually 3 increased 5 before 3 increased 10 then 5 before 6 60 6 60 8 old 7 years 8 old 9 , 10 then 10 then 11 decreased 10 then 12 after 12 after 13 that [dis] [was] [not] obviously different [among] [the] three groups . 0 ###LEFT-WALL### 9 groups 0 ###LEFT-WALL### 10 . 4 obviously 5 different 5 different 9 groups 8 three 9 groups the characteristic of [lv] twist [-] displacement [loop] was like the configuration of 8 . 0 ###LEFT-WALL### 2 characteristic 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 15 . 1 the 2 characteristic 2 characteristic 3 of 2 characteristic 9 was 3 of 7 displacement 5 twist 7 displacement 9 was 10 like 10 like 12 configuration 11 the 12 configuration 12 configuration 13 of 13 of 14 8 there was a linear relation between twist [and] displacement during systole , and the slope increased gradually with the increase in age . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 23 . 1 there 2 was 2 was 5 relation 2 was 6 between 2 was 10 during 2 was 18 with 3 a 5 relation 4 linear 5 relation 6 between 9 displacement 7 twist 9 displacement 10 during 13 and 11 systole 13 and 12 , 13 and 13 and 15 slope 13 and 16 increased 14 the 15 slope 16 increased 17 gradually 18 with 20 increase 19 the 20 increase 20 increase 21 in 21 in 22 age during early diastole , the relatively small radial expanding displacement displayed with untwisting , resulting in a much steeper twist [-] displacement relationship curve occurred in each group , which was getting smooth gradually when the radial expanding displacement increased during mid [to] late diastole . 0 ###LEFT-WALL### 8 radial 0 ###LEFT-WALL### 25 occurred 0 ###LEFT-WALL### 29 , 0 ###LEFT-WALL### 46 . 1 during 3 diastole 1 during 4 , 1 during 8 radial 2 early 3 diastole 5 the 8 radial 6 relatively 7 small 7 small 8 radial 8 radial 9 expanding 8 radial 25 occurred 9 expanding 10 displacement 10 displacement 11 displayed 10 displacement 16 in 11 displayed 12 with 11 displayed 14 , 11 displayed 15 resulting 12 with 13 untwisting 16 in 24 curve 17 a 18 much 17 a 24 curve 18 much 19 steeper 19 steeper 24 curve 20 twist 24 curve 22 displacement 24 curve 23 relationship 24 curve 25 occurred 26 in 26 in 28 group 27 each 28 group 29 , 30 which 29 , 31 was 30 which 31 was 31 was 32 getting 32 getting 33 smooth 33 smooth 34 gradually 33 smooth 35 when 33 smooth 41 during 35 when 37 radial 35 when 40 increased 36 the 37 radial 37 radial 38 expanding 37 radial 40 increased 38 expanding 39 displacement 41 during 45 diastole 42 mid 45 diastole 44 late 45 diastole conclusions : vvi can be used [to] effectively and noninvasively assess lv [twist] - [displacement] loop with change in age and provide important information for lv [function] . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 3 vvi 2 : 9 and 2 : 14 - 3 vvi 4 can 4 can 9 and 5 be 6 used 5 be 9 and 6 used 8 effectively 9 and 11 assess 10 noninvasively 11 assess 11 assess 12 lv 14 - 21 and 16 loop 17 with 16 loop 19 in 16 loop 21 and 17 with 18 change 19 in 20 age 21 and 22 provide 22 provide 24 information 23 important 24 information 24 information 25 for 25 for 26 lv the effect of age must take into account [when] [evaluate] the [lv] function by the twist - [displacement] loop . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 6 take 0 ###LEFT-WALL### 17 - 1 the 2 effect 2 effect 3 of 2 effect 5 must 3 of 4 age 5 must 6 take 6 take 8 account 6 take 13 function 6 take 14 by 7 into 8 account 11 the 13 function 14 by 16 twist 15 the 16 twist 17 - 19 loop 17 - 20 . introduction : observational studies do not always find positive associations between physical activity and muscle strength despite intervention studies consistently showing that exercise improves strength in older adults . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 4 studies 2 : 14 and 3 observational 4 studies 4 studies 14 and 5 do 6 not 5 do 8 find 5 do 14 and 7 always 8 find 8 find 10 associations 8 find 11 between 9 positive 10 associations 11 between 13 activity 12 physical 13 activity 14 and 15 muscle 14 and 26 in 15 muscle 16 strength 15 muscle 17 despite 17 despite 19 studies 18 intervention 19 studies 19 studies 21 showing 20 consistently 21 showing 21 showing 22 that 22 that 23 exercise 22 that 24 improves 23 exercise 24 improves 24 improves 25 strength 26 in 28 adults 27 older 28 adults in previous analyses of the mrc national survey of health and development ( nshd ) , the 1946 british birth cohort , there was no evidence of an association between leisure time physical activity ( ltpa ) across adulthood and grip strength at age 53 . 0 ###LEFT-WALL### 23 there 0 ###LEFT-WALL### 24 was 0 ###LEFT-WALL### 46 . 1 in 11 and 1 in 22 , 1 in 23 there 2 previous 3 analyses 3 analyses 4 of 3 analyses 9 of 3 analyses 11 and 4 of 8 survey 5 the 8 survey 6 mrc 7 national 7 national 8 survey 9 of 10 health 11 and 12 development 11 and 14 nshd 11 and 21 cohort 13 ( 14 nshd 14 nshd 15 ) 16 , 21 cohort 17 the 21 cohort 18 1946 21 cohort 19 british 20 birth 20 birth 21 cohort 21 cohort 22 , 23 there 24 was 24 was 26 evidence 24 was 43 at 25 no 26 evidence 26 evidence 27 of 26 evidence 30 between 26 evidence 38 across 27 of 29 association 28 an 29 association 30 between 34 activity 31 leisure 34 activity 32 time 34 activity 33 physical 34 activity 34 activity 36 ltpa 35 ( 36 ltpa 36 ltpa 37 ) 38 across 40 and 39 adulthood 40 and 40 and 42 strength 41 grip 42 strength 43 at 44 age 44 age 45 53 this study tested the hypothesis that cumulative benefits of ltpa across mid - life on grip strength will have emerged by age 60 - 64 . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 tested 0 ###LEFT-WALL### 26 . 1 this 2 study 2 study 3 tested 3 tested 5 hypothesis 3 tested 24 - 4 the 5 hypothesis 5 hypothesis 6 that 6 that 8 benefits 6 that 20 emerged 7 cumulative 8 benefits 8 benefits 9 of 8 benefits 18 will 9 of 10 ltpa 10 ltpa 11 across 11 across 14 life 12 mid 13 - 12 mid 14 life 14 life 15 on 15 on 17 strength 16 grip 17 strength 18 will 19 have 19 have 20 emerged 20 emerged 21 by 21 by 22 age 23 60 24 - 24 - 25 64 methods : data from the mrc nshd were used to investigate the associations between ltpa at ages 36 , 43 , 53 and 60 - 64 and grip strength at 60 - 64 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 27 and 2 : 34 . 3 data 4 from 3 data 27 and 4 from 6 mrc 5 the 6 mrc 6 mrc 7 nshd 6 mrc 8 were 7 nshd 8 were 9 used 10 to 9 used 14 between 9 used 26 64 9 used 27 and 10 to 11 investigate 11 investigate 13 associations 12 the 13 associations 14 between 15 ltpa 15 ltpa 16 at 15 ltpa 20 43 15 ltpa 23 and 16 at 17 ages 17 ages 18 36 19 , 20 43 20 43 21 , 21 , 23 and 22 53 23 and 23 and 24 60 23 and 25 - 27 and 28 grip 27 and 30 at 28 grip 29 strength 30 at 32 - 31 60 32 - 32 - 33 64 linear regression models were constructed to examine the effect of activity at each age separately and as a cumulative score , including adjustment for potential confounders and testing of life course hypotheses . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 5 constructed 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 33 . 1 linear 2 regression 2 regression 3 models 3 models 4 were 4 were 5 constructed 5 constructed 6 to 6 to 7 examine 7 examine 9 effect 7 examine 12 at 7 examine 15 separately 8 the 9 effect 9 effect 10 of 10 of 11 activity 12 at 14 age 13 each 14 age 16 and 27 and 16 and 31 course 17 as 20 score 17 as 21 , 17 as 27 and 18 a 20 score 19 cumulative 20 score 22 including 23 adjustment 23 adjustment 24 for 23 adjustment 27 and 24 for 26 confounders 25 potential 26 confounders 27 and 28 testing 27 and 29 of 27 and 31 course 29 of 30 life 31 course 32 hypotheses results : there were complete longitudinal data available for 1,645 participants . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 were 2 : 12 . 3 there 4 were 4 were 7 data 5 complete 7 data 6 longitudinal 7 data 7 data 8 available 8 available 9 for 9 for 11 participants 10 1,645 11 participants there was evidence of a cumulative effect of ltpa across mid - life on grip strength at 60 - 64 . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 21 . 1 there 2 was 2 was 3 evidence 3 evidence 4 of 4 of 7 effect 5 a 6 cumulative 5 a 7 effect 6 cumulative 7 effect 7 effect 8 of 8 of 9 ltpa 9 ltpa 10 across 9 ltpa 14 on 10 across 13 life 11 mid 12 - 11 mid 13 life 14 on 16 strength 15 grip 16 strength 16 strength 17 at 17 at 19 - 18 60 19 - 19 - 20 64 compared with the third of participants who reported the least ltpa participation across the four time points , those in the top third had on average 2.11 kg [(] 95 % ci : 0.88 , 3.35 [ )(stronger grip [after] adjustments . 0 ###LEFT-WALL### 19 those 0 ###LEFT-WALL### 33 : 0 ###LEFT-WALL### 42 . 1 compared 2 with 1 compared 18 , 1 compared 19 those 2 with 4 third 3 the 4 third 4 third 5 of 4 third 13 across 5 of 6 participants 6 participants 7 who 6 participants 8 reported 7 who 8 reported 8 reported 10 least 8 reported 12 participation 9 the 10 least 11 ltpa 12 participation 13 across 17 points 14 the 15 four 15 four 17 points 16 time 17 points 19 those 20 in 19 those 24 had 20 in 23 third 21 the 22 top 21 the 23 third 24 had 26 average 24 had 32 ci 25 on 26 average 27 2.11 28 kg 28 kg 32 ci 30 95 32 ci 31 % 32 ci 33 : 34 0.88 33 : 35 , 35 , 41 adjustments 36 3.35 41 adjustments 38 )(stronger 39 grip 39 grip 41 adjustments conclusions : increased levels of ltpa across mid - life were associated with stronger grip [at] age 60 - 64 , in both men and women . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 levels 2 : 12 associated 2 : 27 . 3 increased 4 levels 4 levels 5 of 4 levels 11 were 5 of 6 ltpa 6 ltpa 7 across 7 across 10 life 8 mid 9 - 8 mid 10 life 11 were 12 associated 12 associated 13 with 13 with 17 age 13 with 22 in 14 stronger 15 grip 15 grip 17 age 17 age 18 60 17 age 20 64 19 - 20 64 20 64 21 , 22 in 25 and 23 both 24 men 24 men 25 and 25 and 26 women as these associations have emerged since age 53 , it suggests that ltpa [across] adulthood may prevent decline in grip strength in early old age . 0 ###LEFT-WALL### 10 it 0 ###LEFT-WALL### 11 suggests 0 ###LEFT-WALL### 26 . 1 as 3 associations 1 as 5 emerged 1 as 9 , 1 as 10 it 2 these 3 associations 3 associations 4 have 4 have 5 emerged 5 emerged 6 since 6 since 7 age 7 age 8 53 10 it 11 suggests 11 suggests 12 that 12 that 13 ltpa 12 that 18 decline 13 ltpa 15 adulthood 13 ltpa 17 prevent 15 adulthood 16 may 16 may 17 prevent 18 decline 19 in 18 decline 22 in 19 in 21 strength 20 grip 21 strength 22 in 25 age 23 early 25 age 24 old 25 age background : evidence suggests cahmb may impact muscle mass [and/or] strength in older adults , yet no long - term studies have compared its effectiveness in sedentary and resistance training conditions . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 3 evidence 2 : 4 suggests 3 evidence 4 suggests 4 suggests 5 cahmb 4 suggests 23 compared 5 cahmb 6 may 6 may 7 impact 7 impact 11 strength 7 impact 12 in 7 impact 16 yet 8 muscle 9 mass 9 mass 11 strength 12 in 14 adults 13 older 14 adults 15 , 16 yet 16 yet 21 studies 17 no 21 studies 18 long 19 - 18 long 21 studies 20 term 21 studies 21 studies 22 have 22 have 23 compared 23 compared 25 effectiveness 23 compared 26 in 24 its 25 effectiveness 26 in 28 and 27 sedentary 28 and 28 and 29 resistance 28 and 30 training 30 training 31 conditions the purpose of this study was to evaluate the effects of 24 weeks of cahmb supplementation and resistance training ( 3 [d] [wk] ( - 1 ) ) or cahmb supplementation only in ≥65 [yr] old adults . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 38 . 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 evaluate 7 to 8 evaluate 8 evaluate 10 effects 8 evaluate 32 only 9 the 10 effects 10 effects 11 of 11 of 13 weeks 12 24 13 weeks 13 weeks 14 of 14 of 29 or 15 cahmb 16 supplementation 16 supplementation 17 and 17 and 19 training 17 and 21 3 17 and 29 or 18 resistance 19 training 20 ( 21 3 21 3 26 1 21 3 28 ) 24 ( 26 1 25 - 26 1 26 1 27 ) 29 or 31 supplementation 30 cahmb 31 supplementation 32 only 33 in 33 in 37 adults 34 ≥65 37 adults 36 old 37 adults methods : this double - blinded , placebo - controlled , [trial] occurred in two phases under ad [libitum] conditions . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 21 . 1 methods 2 : 2 : 4 double 3 this 4 double 4 double 6 blinded 5 - 6 blinded 6 blinded 7 , 7 , 8 placebo 7 , 9 - 9 - 11 , 10 controlled 11 , 11 , 13 occurred 13 occurred 14 in 13 occurred 17 under 14 in 16 phases 15 two 16 phases 17 under 20 conditions 18 ad 20 conditions phase i consisted of two [non] - exercise groups : [(] a [ )(placebo and [(] [b] [ )(3 g cahmb consumed [twice] daily . 0 ###LEFT-WALL### 1 phase 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 10 : 0 ###LEFT-WALL### 25 . 1 phase 2 i 1 phase 3 consisted 3 consisted 4 of 4 of 5 two 5 two 9 groups 7 - 9 groups 8 exercise 9 groups 9 groups 10 : 10 : 15 and 12 a 14 )(placebo 14 )(placebo 15 and 15 and 24 daily 19 )(3 20 g 20 g 22 consumed 21 cahmb 22 consumed 22 consumed 24 daily phase ii consisted of two resistance exercise groups : ( a [ )(placebo and resistance exercise and [(] [b] [ )(3 g cahmb consumed twice daily and resistance exercise ( re ) . 0 ###LEFT-WALL### 1 phase 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 33 . 1 phase 2 ii 1 phase 3 consisted 3 consisted 4 of 4 of 5 two 5 two 6 resistance 5 two 9 : 5 two 17 and 6 resistance 7 exercise 6 resistance 8 groups 6 resistance 9 : 7 exercise 8 groups 10 ( 17 and 11 a 13 )(placebo 13 )(placebo 14 and 14 and 16 exercise 14 and 17 and 15 resistance 16 exercise 17 and 29 exercise 17 and 31 re 17 and 32 ) 21 )(3 22 g 22 g 29 exercise 23 cahmb 24 consumed 23 cahmb 27 and 24 consumed 25 twice 24 consumed 26 daily 27 and 28 resistance 27 and 29 exercise 30 ( 31 re 31 re 32 ) strength and functionality were assessed in both phases with isokinetic leg extension and flexion at 60°·s ( - 1 ) and 180°·s ( - 1 ) ( le60 , lf60 , le180 , lf180 ) , hand grip strength ( hg ) and get - up - and [-] [go] [(] gug ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 assessed 0 ###LEFT-WALL### 36 , 1 strength 2 and 2 and 3 functionality 2 and 4 were 4 were 5 assessed 5 assessed 6 in 5 assessed 9 with 6 in 8 phases 7 both 8 phases 9 with 21 and 10 isokinetic 11 leg 11 leg 12 extension 12 extension 13 and 13 and 14 flexion 13 and 15 at 13 and 19 1 13 and 21 and 15 at 16 60°·s 17 ( 19 1 18 - 19 1 19 1 20 ) 21 and 22 180°·s 21 and 25 1 21 and 28 le60 21 and 30 lf60 23 ( 25 1 24 - 25 1 25 1 26 ) 27 ( 28 le60 28 le60 29 , 29 , 30 lf60 30 lf60 32 le180 30 lf60 35 ) 31 , 32 le180 32 le180 34 lf180 32 le180 35 ) 33 , 34 lf180 34 lf180 35 ) 36 , 43 and 36 , 45 - 37 hand 39 strength 37 hand 43 and 38 grip 39 strength 39 strength 41 hg 40 ( 41 hg 41 hg 42 ) 43 and 44 get 45 - 48 and 45 - 54 . 46 up 48 and 47 - 48 and 48 and 52 gug 48 and 53 ) dual x - ray absorptiometry ( dxa ) was used to measure arm [,] leg [,] [and] total body lean [mass] ( lm ) as well as total fat [mass] ( fm ) . 0 ###LEFT-WALL### 1 dual 0 ###LEFT-WALL### 10 used 0 ###LEFT-WALL### 34 . 1 dual 2 x 1 dual 7 dxa 1 dual 9 was 3 - 7 dxa 4 ray 5 absorptiometry 5 absorptiometry 7 dxa 6 ( 7 dxa 7 dxa 8 ) 9 was 10 used 10 used 11 to 10 used 12 measure 11 to 12 measure 12 measure 20 lean 12 measure 27 as 13 arm 15 leg 15 leg 20 lean 18 total 19 body 19 body 20 lean 20 lean 23 lm 22 ( 23 lm 23 lm 24 ) 25 as 26 well 26 well 27 as 27 as 29 fat 28 total 29 fat 29 fat 32 fm 31 ( 32 fm 32 fm 33 ) muscle quality was measured for arm [(] mq ( hg )=hg/arm lm ) and leg ( mq60=le60/leg lm ) ( mq180=le180/leg lm ) . 0 ###LEFT-WALL### 2 quality 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 24 . 1 muscle 2 quality 2 quality 3 was 3 was 14 and 4 measured 5 for 4 measured 14 and 5 for 8 mq 6 arm 8 mq 8 mq 12 lm 9 ( 12 lm 10 hg 12 lm 11 )=hg/arm 12 lm 12 lm 13 ) 14 and 15 leg 14 and 22 lm 15 leg 18 lm 16 ( 18 lm 17 mq60=le60/leg 18 lm 18 lm 19 ) 20 ( 22 lm 21 mq180=le180/leg 22 lm 22 lm 23 ) results : at 24 weeks of phase i , change in le60 ( +8.8 [%] ) and mq180 ( +20.8 % [ )( cahmb was significantly ( p<0.05 ) greater than that [for] placebo group . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 17 and 2 : 35 group 3 at 5 weeks 3 at 9 , 3 at 17 and 4 24 5 weeks 5 weeks 6 of 6 of 7 phase 7 phase 8 i 10 change 11 in 10 change 17 and 11 in 12 le60 12 le60 14 +8.8 13 ( 14 +8.8 14 +8.8 16 ) 17 and 18 mq180 17 and 30 greater 17 and 35 group 18 mq180 20 +20.8 19 ( 20 +20.8 20 +20.8 24 cahmb 20 +20.8 25 was 20 +20.8 28 p<0.05 20 +20.8 29 ) 21 % 24 cahmb 24 cahmb 25 was 25 was 26 significantly 27 ( 28 p<0.05 28 p<0.05 29 ) 30 greater 31 than 31 than 34 placebo 32 that 34 placebo additionally , only cahmb showed significant ( p<0.05 ) improvements in total lm ( 2.2 % ) , leg lm ( 2.1 % ) , and le180 ( +17.3 [%] ) , though no treatment effect was observed . 0 ###LEFT-WALL### 3 only 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 32 , 0 ###LEFT-WALL### 39 . 1 additionally 2 , 1 additionally 3 only 3 only 4 cahmb 4 cahmb 5 showed 5 showed 10 improvements 5 showed 12 total 5 showed 13 lm 5 showed 26 and 6 significant 8 p<0.05 6 significant 9 ) 6 significant 10 improvements 7 ( 8 p<0.05 8 p<0.05 9 ) 11 in 12 total 13 lm 16 % 13 lm 20 lm 14 ( 16 % 15 2.2 16 % 16 % 17 ) 18 , 20 lm 19 leg 20 lm 20 lm 23 % 20 lm 25 , 21 ( 23 % 22 2.1 23 % 23 % 24 ) 26 and 27 le180 27 le180 29 +17.3 28 ( 29 +17.3 29 +17.3 31 ) 32 , 36 effect 32 , 38 observed 33 though 35 treatment 33 though 36 effect 34 no 35 treatment 36 effect 37 was 37 was 38 observed phase ii demonstrated that re significantly improved total lm ( 4.3 % ) , le60 ( 22.8 % ) , le180 ( 21.4 % ) , hg ( 9.8 % ) , and gug ( 10.2 % ) with no difference between treatment groups . 0 ###LEFT-WALL### 1 phase 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 45 . 1 phase 2 ii 1 phase 3 demonstrated 3 demonstrated 4 that 4 that 5 re 4 that 7 improved 5 re 7 improved 6 significantly 7 improved 7 improved 9 lm 7 improved 39 with 7 improved 42 between 8 total 9 lm 9 lm 12 % 9 lm 15 le60 10 ( 12 % 11 4.3 12 % 12 % 13 ) 14 , 15 le60 15 le60 18 % 15 le60 21 le180 15 le60 38 ) 16 ( 18 % 17 22.8 18 % 18 % 19 ) 20 , 21 le180 21 le180 24 % 21 le180 33 and 21 le180 38 ) 22 ( 24 % 23 21.4 24 % 24 % 25 ) 26 , 33 and 27 hg 30 % 27 hg 33 and 28 ( 30 % 29 9.8 30 % 30 % 31 ) 32 , 33 and 33 and 34 gug 33 and 37 % 33 and 38 ) 35 ( 37 % 36 10.2 37 % 37 % 38 ) 39 with 41 difference 40 no 41 difference 42 between 44 groups 43 treatment 44 groups at [week] 24 , only cahmb [group] significantly improved fm ( - 3.8 % ) and mqhg ( 7.3 % ) ; however there was no treatment main effect for these variables . 0 ###LEFT-WALL### 5 only 0 ###LEFT-WALL### 9 improved 0 ###LEFT-WALL### 22 ; 0 ###LEFT-WALL### 33 . 1 at 3 24 1 at 4 , 1 at 5 only 5 only 6 cahmb 6 cahmb 9 improved 8 significantly 9 improved 9 improved 16 and 10 fm 14 % 10 fm 16 and 11 ( 14 % 12 - 13 3.8 13 3.8 14 % 14 % 15 ) 16 and 17 mqhg 17 mqhg 20 % 18 ( 20 % 19 7.3 20 % 20 % 21 ) 22 ; 24 there 22 ; 25 was 23 however 24 there 24 there 25 was 25 was 29 effect 26 no 29 effect 27 treatment 29 effect 28 main 29 effect 29 effect 30 for 30 for 32 variables 31 these 32 variables conclusion : cahmb improved strength and mq without re . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 cahmb 2 : 4 improved 2 : 10 . 3 cahmb 4 improved 4 improved 6 and 4 improved 8 without 5 strength 6 and 6 and 7 mq 8 without 9 re further , re is an effective intervention for improving all measures of body composition and functionality . 0 ###LEFT-WALL### 3 re 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 17 . 1 further 2 , 1 further 3 re 3 re 4 is 4 is 7 intervention 5 an 6 effective 5 an 7 intervention 6 effective 7 intervention 7 intervention 8 for 8 for 9 improving 9 improving 11 measures 10 all 11 measures 11 measures 12 of 12 of 15 and 13 body 14 composition 14 composition 15 and 15 and 16 functionality the il [-] 6 gene polymorphism has been associated with disease prevalence and different physiological responses to exercise . 0 ###LEFT-WALL### 6 polymorphism 0 ###LEFT-WALL### 9 associated 0 ###LEFT-WALL### 19 . 1 the 6 polymorphism 2 il 4 6 2 il 6 polymorphism 5 gene 6 polymorphism 6 polymorphism 7 has 7 has 8 been 8 been 9 associated 9 associated 10 with 9 associated 17 to 10 with 13 and 11 disease 12 prevalence 12 prevalence 13 and 13 and 16 responses 14 different 16 responses 15 physiological 16 responses 17 to 18 exercise eccentric resistance exercise ( ere ) is considered a nonpharmacological tool to prevent the chronic degenerative profile associated with aging and obesity . 0 ###LEFT-WALL### 3 exercise 0 ###LEFT-WALL### 13 prevent 0 ###LEFT-WALL### 23 . 1 eccentric 2 resistance 2 resistance 3 exercise 3 exercise 5 ere 3 exercise 7 is 4 ( 5 ere 5 ere 6 ) 7 is 8 considered 8 considered 11 tool 8 considered 12 to 9 a 10 nonpharmacological 9 a 11 tool 10 nonpharmacological 11 tool 12 to 13 prevent 13 prevent 21 and 14 the 17 profile 15 chronic 17 profile 16 degenerative 17 profile 17 profile 18 associated 17 profile 19 with 17 profile 21 and 19 with 20 aging 21 and 22 obesity consequently , the aim of the present study was to investigate the influence of il - 6 - 174g/c [polymorphism] on acute interleukin - 6 ( il - 6 ) and creatine kinase ( ck ) temporal response [to] ere in elderly obese women . 0 ###LEFT-WALL### 4 aim 0 ###LEFT-WALL### 45 . 1 consequently 2 , 1 consequently 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 investigate 10 to 11 investigate 11 investigate 40 ere 11 investigate 41 in 12 the 13 influence 13 influence 14 of 13 influence 31 and 14 of 15 il 15 il 17 6 15 il 27 il 16 - 17 6 17 6 19 174g/c 17 6 24 - 18 - 19 174g/c 19 174g/c 21 on 19 174g/c 24 - 21 on 23 interleukin 22 acute 23 interleukin 24 - 27 il 25 6 27 il 26 ( 27 il 27 il 28 - 27 il 29 6 27 il 30 ) 28 - 29 6 29 6 30 ) 31 and 33 kinase 31 and 35 ck 31 and 40 ere 32 creatine 33 kinase 34 ( 35 ck 35 ck 36 ) 37 temporal 38 response 38 response 40 ere 41 in 44 women 42 elderly 44 women 43 obese 44 women ninety women completed seven sets of ten repetitions ( [eccentric] only [ )(of an acute ere session at 110 % of the ten repetitions maximum ( 10rm ) . 0 ###LEFT-WALL### 2 women 0 ###LEFT-WALL### 3 completed 0 ###LEFT-WALL### 29 . 1 ninety 2 women 2 women 3 completed 3 completed 5 sets 4 seven 5 sets 5 sets 6 of 5 sets 13 )(of 6 of 8 repetitions 7 ten 8 repetitions 9 ( 11 only 9 ( 13 )(of 13 )(of 17 session 13 )(of 28 ) 14 an 15 acute 14 an 17 session 15 acute 17 session 16 ere 17 session 17 session 18 at 17 session 21 of 17 session 27 10rm 18 at 20 % 19 110 20 % 21 of 25 maximum 22 the 25 maximum 23 ten 24 repetitions 24 repetitions 25 maximum 26 ( 27 10rm 27 10rm 28 ) il - 6 [genotypes] displayed no difference at baseline . 0 ###LEFT-WALL### 3 6 0 ###LEFT-WALL### 5 displayed 0 ###LEFT-WALL### 10 . 1 il 2 - 1 il 3 6 3 6 5 displayed 5 displayed 7 difference 5 displayed 8 at 6 no 7 difference 8 at 9 baseline ere induced changes in ck concentration over time occurred only in the gg group [,] f ( 2.619 , 136.173 )=5.199 , p=0.003 [,] with ck activity increased from 106.8±6.9 [u/l] pre - intervention to 122.7±11.2 [u/l] at 24 h and 131.9±14.4 [u/l] at 48 h post - exercise . 1 ere 2 induced 2 induced 3 changes 3 changes 4 in 3 changes 7 over 3 changes 9 occurred 4 in 6 concentration 5 ck 6 concentration 7 over 8 time 9 occurred 10 only 9 occurred 11 in 11 in 23 p=0.003 12 the 23 p=0.003 13 gg 21 )=5.199 13 gg 23 p=0.003 14 group 16 f 14 group 18 2.619 17 ( 18 2.619 18 2.619 19 , 19 , 21 )=5.199 20 136.173 21 )=5.199 21 )=5.199 22 , 23 p=0.003 25 with 23 p=0.003 28 increased 23 p=0.003 35 to 25 with 27 activity 26 ck 27 activity 28 increased 29 from 29 from 34 intervention 30 106.8±6.9 34 intervention 32 pre 33 - 32 pre 34 intervention 35 to 41 and 36 122.7±11.2 38 at 36 122.7±11.2 41 and 38 at 40 h 39 24 40 h 41 and 42 131.9±14.4 41 and 44 at 44 at 47 post 45 48 46 h 46 h 47 post 47 post 49 exercise 48 - 49 exercise 49 exercise 50 . il - 6 concentration in the gg group was lower than the cc/cg group only at 0 h post - exercise ( 3.78±0.58 [pg/ml] versus 6.51±1.91 [pg/ml] , p=0.030 ) . 0 ###LEFT-WALL### 4 concentration 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 31 . 1 il 2 - 1 il 4 concentration 3 6 4 concentration 4 concentration 5 in 4 concentration 9 was 5 in 8 group 6 the 8 group 7 gg 8 group 9 was 10 lower 10 lower 11 than 10 lower 15 only 11 than 14 group 12 the 14 group 13 cc/cg 14 group 15 only 16 at 16 at 19 post 17 0 18 h 18 h 19 post 19 post 21 exercise 19 post 29 p=0.030 20 - 21 exercise 21 exercise 23 3.78±0.58 21 exercise 28 , 22 ( 23 3.78±0.58 23 3.78±0.58 25 versus 23 3.78±0.58 28 , 25 versus 26 6.51±1.91 28 , 29 p=0.030 29 p=0.030 30 ) only the gg [genotype] group had higher ck activity 24 - 48 h following ere and greater ck integral values , while il - 6 activity over 48 h was higher in the cc/cg genotype group . 0 ###LEFT-WALL### 1 only 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 37 . 1 only 5 group 2 the 5 group 3 gg 5 group 5 group 6 had 6 had 9 activity 6 had 22 while 7 higher 9 activity 8 ck 9 activity 9 activity 10 24 9 activity 20 values 11 - 20 values 12 48 13 h 13 h 14 following 14 following 15 ere 15 ere 16 and 16 and 18 ck 16 and 20 values 17 greater 18 ck 19 integral 20 values 20 values 21 , 22 while 23 il 22 while 36 group 23 il 25 6 23 il 35 genotype 23 il 36 group 24 - 25 6 25 6 26 activity 25 6 30 was 25 6 35 genotype 26 activity 27 over 26 activity 30 was 27 over 29 h 28 48 29 h 30 was 31 higher 30 was 32 in 32 in 34 cc/cg 33 the 34 cc/cg in conclusion , il - 6 genotype affects ck and il - 6 in response to ere . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 18 . 1 in 2 conclusion 3 , 4 il 3 , 8 affects 4 il 6 6 4 il 7 genotype 4 il 8 affects 5 - 6 6 6 6 7 genotype 8 affects 10 and 8 affects 16 to 9 ck 10 and 10 and 15 response 11 il 15 response 12 - 13 6 13 6 14 in 14 in 15 response 16 to 17 ere it is [of] interest that the ere protocol induced an elevation in ck , indicating possible muscle damage without exacerbating il - 6 and ck for the gg [genotype] . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 30 . 1 it 2 is 2 is 4 interest 2 is 5 that 5 that 8 protocol 5 that 9 induced 6 the 8 protocol 7 ere 8 protocol 8 protocol 9 induced 9 induced 11 elevation 9 induced 12 in 10 an 11 elevation 12 in 13 ck 13 ck 15 indicating 14 , 15 indicating 15 indicating 18 damage 15 indicating 19 without 15 indicating 22 - 16 possible 17 muscle 17 muscle 18 damage 19 without 20 exacerbating 20 exacerbating 21 il 22 - 25 ck 23 6 24 and 24 and 25 ck 25 ck 26 for 26 for 28 gg 27 the 28 gg fractures of the proximal femur are the most devastating outcome of osteoporosis . 0 ###LEFT-WALL### 1 fractures 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 13 . 1 fractures 2 of 1 fractures 6 are 2 of 5 femur 3 the 5 femur 4 proximal 5 femur 6 are 10 outcome 7 the 10 outcome 8 most 9 devastating 9 devastating 10 outcome 10 outcome 11 of 11 of 12 osteoporosis it is generally understood [that] age - related changes in hip structure confer increased risk , but there have been few explicit comparisons of such changes in healthy subjects to those [with] hip fracture . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 35 . 1 it 2 is 2 is 3 generally 2 is 6 age 4 understood 6 age 7 - 9 changes 7 - 13 confer 7 - 16 , 8 related 9 changes 9 changes 10 in 9 changes 13 confer 10 in 12 structure 11 hip 12 structure 13 confer 15 risk 14 increased 15 risk 16 , 17 but 16 , 34 fracture 17 but 18 there 17 but 20 been 18 there 19 have 19 have 20 been 20 been 21 few 21 few 23 comparisons 21 few 34 fracture 22 explicit 23 comparisons 23 comparisons 24 of 23 comparisons 30 to 23 comparisons 34 fracture 24 of 26 changes 25 such 26 changes 26 changes 27 in 27 in 29 subjects 28 healthy 29 subjects 30 to 33 hip 31 those 33 hip in this study , we used quantitative computed tomography and tensor - based morphometry ( tbm ) to identify three - dimensional internal structural patterns of the proximal femur associated with age and [with] incident hip fracture . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 21 - 0 ###LEFT-WALL### 38 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 used 6 used 10 and 6 used 18 to 6 used 19 identify 7 quantitative 9 tomography 8 computed 9 tomography 9 tomography 10 and 10 and 14 morphometry 10 and 16 tbm 11 tensor 12 - 11 tensor 14 morphometry 13 based 14 morphometry 15 ( 16 tbm 16 tbm 17 ) 18 to 19 identify 19 identify 20 three 21 - 25 patterns 22 dimensional 25 patterns 23 internal 25 patterns 24 structural 25 patterns 25 patterns 26 of 26 of 29 femur 27 the 29 femur 28 proximal 29 femur 29 femur 30 associated 30 associated 31 with 31 with 33 and 32 age 33 and 33 and 37 fracture 35 incident 37 fracture 36 hip 37 fracture a population [-] based cohort of 349 women representing a broad age range ( 21 - 97 years ) was included in this study , along with a cohort of 222 older women ( mean age 79±7years ) with [(] n=74 ) and [without] [(] n=148 ) incident hip fracture . 0 ###LEFT-WALL### 43 and 0 ###LEFT-WALL### 51 . 1 a 2 population 1 a 5 cohort 2 population 4 based 4 based 5 cohort 5 cohort 6 of 5 cohort 43 and 6 of 8 women 7 349 8 women 8 women 9 representing 8 women 21 included 9 representing 11 broad 10 a 11 broad 11 broad 13 range 11 broad 20 was 12 age 13 range 13 range 18 years 13 range 20 was 14 ( 18 years 15 21 16 - 16 - 17 97 16 - 18 years 18 years 19 ) 21 included 22 in 21 included 27 with 22 in 24 study 23 this 24 study 25 , 27 with 26 along 27 with 27 with 29 cohort 27 with 42 ) 28 a 29 cohort 29 cohort 30 of 29 cohort 39 with 30 of 33 women 31 222 33 women 32 older 33 women 33 women 37 79±7years 34 ( 37 79±7years 35 mean 36 age 36 age 37 79±7years 37 79±7years 38 ) 39 with 41 n=74 43 and 50 fracture 46 n=148 47 ) 46 n=148 49 hip 48 incident 49 hip 49 hip 50 fracture images were spatially normalized to a standardized space , and age - and fracture - specific morphometric features were identified based on statistical maps of shape features described as local changes of bone volume . 0 ###LEFT-WALL### 1 images 0 ###LEFT-WALL### 4 normalized 0 ###LEFT-WALL### 35 . 1 images 2 were 2 were 4 normalized 3 spatially 4 normalized 4 normalized 5 to 4 normalized 22 on 4 normalized 29 as 5 to 13 and 6 a 8 space 7 standardized 8 space 8 space 10 and 9 , 10 and 10 and 11 age 10 and 13 and 12 - 13 and 13 and 14 fracture 13 and 15 - 13 and 18 features 13 and 19 were 13 and 20 identified 16 specific 18 features 17 morphometric 18 features 18 features 19 were 20 identified 21 based 22 on 24 maps 23 statistical 24 maps 24 maps 25 of 25 of 27 features 26 shape 27 features 27 features 28 described 29 as 31 changes 30 local 31 changes 31 changes 32 of 32 of 34 volume 33 bone 34 volume morphometric features were visualized as maps of local contractions and expansions , and significance was displayed as student 's [t] - test statistical maps . 0 ###LEFT-WALL### 1 morphometric 0 ###LEFT-WALL### 16 displayed 0 ###LEFT-WALL### 21 - 1 morphometric 2 features 1 morphometric 3 were 1 morphometric 4 visualized 1 morphometric 5 as 1 morphometric 15 was 2 features 3 were 5 as 13 and 6 maps 7 of 6 maps 10 and 7 of 9 contractions 8 local 9 contractions 10 and 11 expansions 10 and 13 and 12 , 13 and 13 and 14 significance 15 was 16 displayed 16 displayed 17 as 17 as 19 's 18 student 19 's 21 - 22 test 21 - 25 . 22 test 24 maps 23 statistical 24 maps significant age - related changes included local expansions of regions low in volumetric bone mineral density ( vbmd ) and local contractions of regions high in vbmd . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 28 . 1 significant 2 age 2 age 8 expansions 3 - 4 related 4 related 5 changes 4 related 6 included 6 included 7 local 7 local 8 expansions 8 expansions 9 of 8 expansions 11 low 8 expansions 20 and 9 of 10 regions 11 low 12 in 12 in 16 density 13 volumetric 14 bone 14 bone 15 mineral 15 mineral 16 density 16 density 18 vbmd 17 ( 18 vbmd 18 vbmd 19 ) 20 and 22 contractions 20 and 23 of 21 local 22 contractions 23 of 24 regions 24 regions 25 high 25 high 26 in 26 in 27 vbmd some significant fracture - related features resembled an accentuated aging process , including local expansion of the superior aspect of the trabecular bone compartment in the femoral neck , with contraction of the adjoining cortical bone . 0 ###LEFT-WALL### 3 fracture 0 ###LEFT-WALL### 7 resembled 0 ###LEFT-WALL### 37 . 1 some 3 fracture 2 significant 3 fracture 3 fracture 7 resembled 4 - 5 related 5 related 6 features 5 related 7 resembled 7 resembled 11 process 7 resembled 13 including 7 resembled 30 with 8 an 11 process 9 accentuated 11 process 10 aging 11 process 12 , 13 including 13 including 15 expansion 13 including 25 in 13 including 29 , 14 local 15 expansion 15 expansion 16 of 15 expansion 20 of 16 of 19 aspect 17 the 19 aspect 18 superior 19 aspect 20 of 24 compartment 21 the 24 compartment 22 trabecular 23 bone 23 bone 24 compartment 25 in 28 neck 26 the 28 neck 27 femoral 28 neck 30 with 31 contraction 31 contraction 32 of 32 of 36 bone 33 the 36 bone 34 adjoining 36 bone 35 cortical 36 bone however , other features were observed only in the comparison of hip fracture subjects with age - matched controls including focal contractions of the cortical bone at the superior aspect of the femoral neck , the lateral cortical bone just inferior to the greater trochanter , and the anterior intertrochanteric region . 0 ###LEFT-WALL### 4 features 0 ###LEFT-WALL### 6 observed 0 ###LEFT-WALL### 52 . 1 however 2 , 1 however 4 features 3 other 4 features 4 features 5 were 5 were 6 observed 6 observed 7 only 6 observed 15 with 6 observed 42 to 7 only 8 in 8 in 10 comparison 9 the 10 comparison 10 comparison 11 of 11 of 14 subjects 12 hip 14 subjects 13 fracture 14 subjects 15 with 16 age 15 with 41 inferior 16 age 19 controls 17 - 19 controls 18 matched 19 controls 19 controls 20 including 19 controls 23 of 19 controls 27 at 19 controls 35 , 20 including 22 contractions 21 focal 22 contractions 23 of 26 bone 24 the 26 bone 25 cortical 26 bone 27 at 30 aspect 28 the 30 aspect 29 superior 30 aspect 30 aspect 31 of 31 of 34 neck 32 the 34 neck 33 femoral 34 neck 36 the 41 inferior 37 lateral 39 bone 38 cortical 39 bone 39 bone 41 inferior 40 just 41 inferior 42 to 47 and 43 the 45 trochanter 44 greater 45 trochanter 45 trochanter 47 and 46 , 47 and 47 and 51 region 48 the 51 region 49 anterior 51 region 50 intertrochanteric 51 region results of this study support the idea that the spatial distribution of morphometric features is relevant to age - related changes [in] [bone] and independent to fracture risk . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 5 support 0 ###LEFT-WALL### 20 related 0 ###LEFT-WALL### 29 . 1 results 2 of 1 results 5 support 2 of 4 study 3 this 4 study 5 support 7 idea 6 the 7 idea 7 idea 8 that 8 that 11 distribution 8 that 18 age 9 the 11 distribution 10 spatial 11 distribution 11 distribution 12 of 11 distribution 15 is 12 of 14 features 13 morphometric 14 features 15 is 16 relevant 16 relevant 17 to 16 relevant 18 age 17 to 18 age 19 - 20 related 20 related 24 and 21 changes 24 and 24 and 25 independent 24 and 26 to 26 to 28 risk 27 fracture 28 risk in women , the identification by tbm of fracture [-] specific morphometric alterations of the proximal femur , in conjunction with vbmd and clinical risk factors , may improve hip fracture prediction . 0 ###LEFT-WALL### 5 identification 0 ###LEFT-WALL### 29 improve 0 ###LEFT-WALL### 33 . 1 in 2 women 1 in 3 , 1 in 5 identification 4 the 5 identification 5 identification 6 by 5 identification 28 may 6 by 7 tbm 7 tbm 8 of 8 of 13 alterations 9 fracture 13 alterations 11 specific 13 alterations 12 morphometric 13 alterations 13 alterations 14 of 13 alterations 21 with 14 of 17 femur 15 the 17 femur 16 proximal 17 femur 18 , 21 with 19 in 20 conjunction 20 conjunction 21 with 21 with 23 and 21 with 27 , 22 vbmd 23 and 23 and 26 factors 24 clinical 26 factors 25 risk 26 factors 28 may 29 improve 29 improve 32 prediction 30 hip 31 fracture 31 fracture 32 prediction the prevalence of hiv [-] associated neurocognitive disorder has not changed from the pre - to the potent antiretroviral therapy era , remaining at approximately 50 % . 0 ###LEFT-WALL### 2 prevalence 0 ###LEFT-WALL### 11 changed 1 the 2 prevalence 2 prevalence 3 of 2 prevalence 9 has 3 of 8 disorder 4 hiv 6 associated 6 associated 8 disorder 7 neurocognitive 8 disorder 9 has 10 not 9 has 11 changed 11 changed 12 from 12 from 14 pre 13 the 14 pre 14 pre 16 to 14 pre 23 remaining 15 - 16 to 16 to 21 era 16 to 22 , 17 the 21 era 18 potent 20 therapy 19 antiretroviral 20 therapy 20 therapy 21 era 22 , 23 remaining 23 remaining 24 at 23 remaining 28 . 24 at 27 % 25 approximately 26 50 26 50 27 % in research settings , mild neurocognitive disorder ( mnd ) [and] [so] - called asymptomatic neurocognitive impairment ( ani ) are now more common than hiv - associated dementia . 0 ###LEFT-WALL### 3 settings 0 ###LEFT-WALL### 21 are 0 ###LEFT-WALL### 27 - 0 ###LEFT-WALL### 30 . 1 in 2 research 1 in 3 settings 3 settings 7 disorder 3 settings 21 are 4 , 7 disorder 5 mild 7 disorder 6 neurocognitive 7 disorder 7 disorder 9 mnd 7 disorder 14 called 7 disorder 20 ) 8 ( 9 mnd 9 mnd 10 ) 13 - 14 called 14 called 17 impairment 14 called 20 ) 15 asymptomatic 17 impairment 16 neurocognitive 17 impairment 17 impairment 19 ani 18 ( 19 ani 19 ani 20 ) 21 are 22 now 21 are 24 common 23 more 24 common 24 common 25 than 25 than 26 hiv 27 - 29 dementia 28 associated 29 dementia the diagnosis of ani is misleading [because] functional deficits , when tested in a laboratory , and degree of neuropsychologic testing abnormalities are often comparable in patients with ani and those with symptomatic mnd . 0 ###LEFT-WALL### 2 diagnosis 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 35 . 1 the 2 diagnosis 2 diagnosis 3 of 2 diagnosis 5 is 3 of 4 ani 5 is 9 deficits 6 misleading 9 deficits 8 functional 9 deficits 10 , 22 abnormalities 10 , 23 are 11 when 12 tested 11 when 22 abnormalities 12 tested 13 in 13 in 17 and 14 a 15 laboratory 15 laboratory 17 and 16 , 17 and 17 and 18 degree 17 and 19 of 19 of 21 testing 20 neuropsychologic 21 testing 22 abnormalities 23 are 23 are 24 often 23 are 25 comparable 25 comparable 26 in 25 comparable 32 with 26 in 30 and 27 patients 28 with 27 patients 30 and 28 with 29 ani 30 and 31 those 32 with 34 mnd 33 symptomatic 34 mnd age - related comorbidities increase the risk of cognitive impairment in hiv infection . 0 ###LEFT-WALL### 4 comorbidities 0 ###LEFT-WALL### 5 increase 0 ###LEFT-WALL### 14 . 1 age 2 - 1 age 4 comorbidities 3 related 4 comorbidities 4 comorbidities 5 increase 5 increase 7 risk 5 increase 11 in 6 the 7 risk 7 risk 8 of 8 of 10 impairment 9 cognitive 10 impairment 11 in 13 infection 12 hiv 13 infection [management] of impairment includes ensuring that patients are on and adhere to antiretroviral therapy and addressing comorbidities . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 18 . 2 of 3 impairment 2 of 10 and 4 includes 5 ensuring 4 includes 10 and 5 ensuring 6 that 5 ensuring 9 on 6 that 7 patients 6 that 8 are 7 patients 8 are 8 are 9 on 10 and 11 adhere 11 adhere 12 to 12 to 15 and 13 antiretroviral 14 therapy 14 therapy 15 and 15 and 17 comorbidities 16 addressing 17 comorbidities switching from effective and well - tolerated antiretroviral therapy for patients with mild cognitive impairment is not routinely recommended , but this must still be addressed on a case [-] [by] - case basis . 0 ###LEFT-WALL### 1 switching 0 ###LEFT-WALL### 26 addressed 0 ###LEFT-WALL### 32 - 1 switching 2 from 1 switching 19 recommended 1 switching 21 but 1 switching 23 must 2 from 4 and 3 effective 4 and 4 and 5 well 6 - 19 recommended 7 tolerated 9 therapy 8 antiretroviral 9 therapy 9 therapy 10 for 9 therapy 12 with 9 therapy 16 is 10 for 11 patients 12 with 15 impairment 13 mild 15 impairment 14 cognitive 15 impairment 16 is 17 not 17 not 18 routinely 18 routinely 19 recommended 19 recommended 20 , 21 but 22 this 23 must 25 be 24 still 25 be 25 be 26 addressed 26 addressed 27 on 27 on 29 case 28 a 29 case 32 - 34 basis 32 - 35 . 33 case 34 basis this article summarizes a presentation by victor [g] [.] valcour , md , at the ias - usa continuing education program held in atlanta , georgia , in april 2013 . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 summarizes 0 ###LEFT-WALL### 31 . 1 this 2 article 2 article 3 summarizes 3 summarizes 5 presentation 3 summarizes 28 in 4 a 5 presentation 5 presentation 6 by 5 presentation 12 md 6 by 10 valcour 7 victor 10 valcour 11 , 12 md 12 md 14 at 12 md 18 usa 12 md 27 , 13 , 14 at 14 at 16 ias 14 at 17 - 15 the 16 ias 17 - 18 usa 18 usa 19 continuing 18 usa 23 in 18 usa 26 georgia 18 usa 27 , 19 continuing 22 held 20 education 22 held 21 program 22 held 23 in 24 atlanta 25 , 26 georgia 26 georgia 27 , 28 in 29 april 29 april 30 2013 thirty years into the hiv epidemic , the management and investigation of neurologic complications of hiv disease have evolved from a struggle to understand and treat inexorable disorders to an optimistic effort to address more subtle but often complex conditions in patients surviving long - term with a chronic disease . 0 ###LEFT-WALL### 2 years 0 ###LEFT-WALL### 19 evolved 0 ###LEFT-WALL### 51 . 1 thirty 2 years 2 years 3 into 2 years 19 evolved 3 into 5 hiv 4 the 5 hiv 5 hiv 10 and 5 hiv 18 have 6 epidemic 7 , 7 , 9 management 7 , 10 and 8 the 9 management 10 and 11 investigation 10 and 12 of 10 and 15 of 10 and 18 have 12 of 14 complications 13 neurologic 14 complications 15 of 17 disease 16 hiv 17 disease 19 evolved 20 from 19 evolved 46 term 20 from 22 struggle 21 a 22 struggle 22 struggle 23 to 22 struggle 25 and 23 to 25 and 24 understand 25 and 25 and 26 treat 25 and 29 to 26 treat 28 disorders 26 treat 29 to 27 inexorable 28 disorders 30 an 31 optimistic 30 an 46 term 31 optimistic 32 effort 32 effort 33 to 32 effort 34 address 32 effort 40 conditions 33 to 34 address 34 address 35 more 34 address 37 but 36 subtle 37 but 37 but 38 often 37 but 39 complex 40 conditions 41 in 40 conditions 43 surviving 41 in 42 patients 44 long 45 - 44 long 46 term 46 term 47 with 47 with 50 disease 48 a 50 disease 49 chronic 50 disease in 2013 , practitioners , patients , and investigators can realistically aim for an outstanding quality of life for those living with hiv infection and seek to reduce morbidity associated with milder forms of hiv - associated neurocognitive disorder ( hand ) . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 43 . 1 in 2 2013 1 in 3 , 1 in 8 and 4 practitioners 5 , 5 , 6 patients 5 , 8 and 7 , 8 and 8 and 9 investigators 8 and 25 and 10 can 12 aim 10 can 25 and 11 realistically 12 aim 12 aim 13 for 12 aim 19 for 12 aim 24 infection 13 for 16 quality 14 an 15 outstanding 14 an 16 quality 15 outstanding 16 quality 16 quality 17 of 17 of 18 life 19 for 20 those 20 those 21 living 20 those 22 with 22 with 23 hiv 25 and 26 seek 25 and 39 disorder 26 seek 27 to 26 seek 28 reduce 27 to 28 reduce 28 reduce 29 morbidity 29 morbidity 30 associated 30 associated 31 with 30 associated 36 - 30 associated 37 associated 31 with 33 forms 32 milder 33 forms 33 forms 34 of 34 of 35 hiv 38 neurocognitive 39 disorder 39 disorder 41 hand 40 ( 41 hand 41 hand 42 ) neurologic presentations at the 20th conference on retroviruses and opportunistic infections ( croi ) reflected [this] now well - established paradigm shift , focusing on treatment strategies to optimize neurologic and cognitive function , the pathogenesis of hand in the current era , imaging biomarkers of hand , the confluence of hiv infection and aging , and characterization of central nervous system hiv reservoirs of infection . 0 ###LEFT-WALL### 1 neurologic 0 ###LEFT-WALL### 15 reflected 0 ###LEFT-WALL### 19 - 2 presentations 3 at 2 presentations 9 and 3 at 6 conference 4 the 6 conference 5 20th 6 conference 6 conference 7 on 7 on 8 retroviruses 9 and 11 infections 9 and 13 croi 9 and 15 reflected 10 opportunistic 11 infections 12 ( 13 croi 13 croi 14 ) 15 reflected 17 now 15 reflected 18 well 15 reflected 19 - 19 - 22 shift 19 - 23 , 19 - 67 . 20 established 22 shift 21 paradigm 22 shift 23 , 57 and 24 focusing 25 on 24 focusing 48 , 25 on 27 strategies 26 treatment 27 strategies 27 strategies 28 to 27 strategies 29 optimize 28 to 29 optimize 29 optimize 45 biomarkers 30 neurologic 31 and 31 and 33 function 31 and 36 pathogenesis 31 and 45 biomarkers 32 cognitive 33 function 34 , 36 pathogenesis 35 the 36 pathogenesis 36 pathogenesis 37 of 36 pathogenesis 39 in 36 pathogenesis 43 , 37 of 38 hand 39 in 42 era 40 the 42 era 41 current 42 era 44 imaging 45 biomarkers 45 biomarkers 46 of 46 of 47 hand 48 , 50 confluence 48 , 54 and 49 the 50 confluence 50 confluence 51 of 51 of 53 infection 52 hiv 53 infection 54 and 55 aging 54 and 57 and 56 , 57 and 57 and 58 characterization 57 and 59 of 59 of 64 reservoirs 60 central 62 system 61 nervous 62 system 62 system 64 reservoirs 63 hiv 64 reservoirs 64 reservoirs 65 of 65 of 66 infection in this article , the authors construct a story of one woman 's ( justine 's [ )(experience of learning to run within the context of a beginners group . 0 ###LEFT-WALL### 6 authors 0 ###LEFT-WALL### 7 construct 1 in 3 article 1 in 4 , 1 in 6 authors 2 this 3 article 5 the 6 authors 6 authors 7 construct 7 construct 9 story 8 a 9 story 9 story 10 of 9 story 18 )(experience 10 of 13 's 11 one 12 woman 12 woman 13 's 14 ( 18 )(experience 15 justine 16 's 16 's 18 )(experience 18 )(experience 19 of 18 )(experience 30 . 19 of 20 learning 20 learning 21 to 20 learning 22 run 21 to 22 run 22 run 23 within 23 within 25 context 24 the 25 context 25 context 26 of 26 of 29 group 27 a 29 group 28 beginners 29 group building on existing scholarship on narrative , aging , and physical activity , this work is part of a larger ethnographic project examining subjective accounts of the physically active aging body across the life course . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 36 . 1 building 2 on 1 building 10 and 2 on 4 scholarship 3 existing 4 scholarship 4 scholarship 5 on 5 on 6 narrative 6 narrative 8 aging 7 , 8 aging 8 aging 9 , 10 and 12 activity 11 physical 12 activity 13 , 15 work 13 , 16 is 14 this 15 work 15 work 16 is 16 is 17 part 17 part 18 of 18 of 22 project 19 a 22 project 20 larger 22 project 21 ethnographic 22 project 22 project 23 examining 22 project 26 of 23 examining 25 accounts 24 subjective 25 accounts 26 of 31 body 27 the 31 body 28 physically 29 active 29 active 31 body 30 aging 31 body 31 body 32 across 32 across 35 course 33 the 35 course 34 life 35 course concerned with often simplistically linear problems of representation , the authors present a messy text that represents the complex and fluid nature of justine 's embodied tale . 0 ###LEFT-WALL### 11 authors 0 ###LEFT-WALL### 12 present 0 ###LEFT-WALL### 28 . 1 concerned 2 with 1 concerned 9 , 1 concerned 11 authors 2 with 6 problems 3 often 5 linear 4 simplistically 5 linear 5 linear 6 problems 6 problems 7 of 7 of 8 representation 10 the 11 authors 11 authors 12 present 12 present 15 text 13 a 15 text 14 messy 15 text 15 text 16 that 15 text 17 represents 16 that 17 represents 17 represents 22 nature 18 the 22 nature 19 complex 20 and 20 and 21 fluid 20 and 22 nature 22 nature 23 of 23 of 27 tale 24 justine 25 's 25 's 27 tale 26 embodied 27 tale the aim is to show the intersection of biographical [(] storied ) identity with health behavior choices and to interrogate the process of challenging narrative foreclosure . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 27 . 1 the 2 aim 2 aim 3 is 3 is 4 to 3 is 18 and 4 to 18 and 5 show 7 intersection 5 show 14 with 5 show 18 and 6 the 7 intersection 7 intersection 8 of 8 of 13 identity 9 biographical 13 identity 11 storied 12 ) 11 storied 13 identity 14 with 17 choices 15 health 17 choices 16 behavior 17 choices 18 and 19 to 18 and 20 interrogate 19 to 20 interrogate 20 interrogate 22 process 21 the 22 process 22 process 23 of 23 of 24 challenging 24 challenging 26 foreclosure 25 narrative 26 foreclosure by using the emerging genre of messy text as a creative analytic practice , the authors avoid prompting a single , closed , convergent reading of justine 's story . 0 ###LEFT-WALL### 16 authors 0 ###LEFT-WALL### 17 avoid 1 by 2 using 1 by 16 authors 2 using 5 genre 3 the 5 genre 4 emerging 5 genre 5 genre 6 of 6 of 8 text 7 messy 8 text 9 as 13 practice 9 as 14 , 9 as 16 authors 10 a 11 creative 10 a 13 practice 11 creative 13 practice 12 analytic 13 practice 15 the 16 authors 16 authors 17 avoid 17 avoid 18 prompting 18 prompting 20 single 19 a 20 single 20 single 22 closed 20 single 25 reading 21 , 22 closed 22 closed 23 , 23 , 25 reading 24 convergent 25 reading 25 reading 26 of 25 reading 30 . 26 of 29 story 27 justine 28 's 28 's 29 story instead , they provoke interpretation within the reader [as] witness and expand the ways in which research on aging and physical activity has been represented . 0 ###LEFT-WALL### 3 they 0 ###LEFT-WALL### 11 and 1 instead 2 , 1 instead 3 they 3 they 11 and 4 provoke 5 interpretation 4 provoke 11 and 5 interpretation 6 within 6 within 10 witness 7 the 10 witness 8 reader 10 witness 11 and 12 expand 11 and 14 ways 13 the 14 ways 14 ways 15 in 15 in 16 which 15 in 22 activity 15 in 25 represented 17 research 18 on 17 research 20 and 18 on 19 aging 20 and 21 physical 20 and 22 activity 22 activity 23 has 23 has 24 been 24 been 25 represented 25 represented 26 . background : little is known about the safety and efficacy of endovascular therapy for acute ischemic stroke [in] octogenarians . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 little 2 : 5 known 2 : 20 . 3 little 4 is 4 is 5 known 5 known 6 about 5 known 14 for 6 about 9 and 7 the 8 safety 8 safety 9 and 9 and 10 efficacy 9 and 11 of 11 of 13 therapy 12 endovascular 13 therapy 14 for 19 octogenarians 15 acute 17 stroke 16 ischemic 17 stroke 17 stroke 19 octogenarians aim : we performed a systematic review and meta - analysis of published studies comparing outcomes of octogenarians and younger patients after endovascular treatment [for] acute ischemic stroke . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 performed 2 : 10 - 3 we 4 performed 4 performed 8 and 5 a 7 review 6 systematic 7 review 7 review 8 and 8 and 9 meta 8 and 10 - 10 - 28 stroke 10 - 29 . 11 analysis 12 of 11 analysis 19 and 12 of 14 studies 13 published 14 studies 14 studies 15 comparing 14 studies 17 of 15 comparing 16 outcomes 17 of 18 octogenarians 19 and 21 patients 19 and 28 stroke 20 younger 21 patients 21 patients 22 after 22 after 24 treatment 23 endovascular 24 treatment 26 acute 28 stroke 27 ischemic 28 stroke methods : a computerized search of the medical literature from 1990 to 2012 was performed to identify comparative studies of endovascular treatment of ischemic stroke patients 80 years or older and younger patients . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 search 2 : 15 performed 2 : 34 . 3 a 4 computerized 3 a 5 search 4 computerized 5 search 5 search 6 of 5 search 9 literature 5 search 14 was 5 search 15 performed 6 of 8 medical 7 the 8 medical 9 literature 12 to 9 literature 14 was 10 from 12 to 11 1990 12 to 12 to 13 2012 15 performed 16 to 15 performed 29 or 16 to 17 identify 17 identify 19 studies 18 comparative 19 studies 19 studies 20 of 20 of 22 treatment 21 endovascular 22 treatment 22 treatment 23 of 23 of 26 patients 24 ischemic 25 stroke 25 stroke 26 patients 26 patients 27 80 28 years 29 or 29 or 33 patients 30 older 31 and 31 and 32 younger 31 and 33 patients data on clinical outcomes , mortality , symptomatic intracerebral hemorrhage , and recanalization were abstracted . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 14 were 0 ###LEFT-WALL### 16 . 1 data 2 on 1 data 5 , 2 on 4 outcomes 3 clinical 4 outcomes 5 , 6 mortality 5 , 7 , 7 , 10 hemorrhage 7 , 12 and 8 symptomatic 10 hemorrhage 9 intracerebral 10 hemorrhage 11 , 12 and 12 and 13 recanalization 12 and 14 were 14 were 15 abstracted results : data from eight studies with 2729 patients were included in the final analysis . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 3 data 2 : 11 included 3 data 4 from 3 data 10 were 4 from 6 studies 5 eight 6 studies 6 studies 7 with 7 with 9 patients 8 2729 9 patients 10 were 11 included 11 included 12 in 12 in 15 analysis 13 the 15 analysis 14 final 15 analysis good functional outcome defined as modified rankin score 2 or less within 90 days was more common in younger patients compared with octogenarians [ odds ratio 2.694 ; 95 % confidence interval 1.941 - 3.740 , p < 0.001 [ )( 0 ###LEFT-WALL### 7 rankin 0 ###LEFT-WALL### 15 was 0 ###LEFT-WALL### 28 ; 0 ###LEFT-WALL### 41 )( 1 good 7 rankin 2 functional 3 outcome 3 outcome 7 rankin 4 defined 7 rankin 5 as 6 modified 6 modified 7 rankin 7 rankin 10 or 7 rankin 15 was 8 score 9 2 8 score 10 or 10 or 11 less 10 or 12 within 12 within 14 days 13 90 14 days 15 was 17 common 16 more 17 common 17 common 18 in 18 in 20 patients 19 younger 20 patients 20 patients 21 compared 20 patients 22 with 20 patients 26 ratio 22 with 23 octogenarians 24 [ 26 ratio 25 odds 26 ratio 26 ratio 27 2.694 26 ratio 28 ; 28 ; 32 interval 28 ; 38 < 29 95 30 % 30 % 32 interval 31 confidence 32 interval 32 interval 33 1.941 32 interval 35 3.740 32 interval 38 < 34 - 35 3.740 35 3.740 36 , 37 p 38 < 38 < 39 0.001 symptomatic hemorrhage and death [were] significantly more come in patients 80 years or older ( odds ratio 1.604 ; 95 % confidence interval 1.013 - 2.540 , p = 0.04 and odds ratio 3.695 [;] 95 % confidence interval 2.517 - 5.424 , [p] < 0.001 , respectively ) . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 19 ; 0 ###LEFT-WALL### 50 . 1 symptomatic 2 hemorrhage 2 hemorrhage 3 and 3 and 4 death 3 and 7 more 3 and 8 come 3 and 17 ratio 6 significantly 7 more 7 more 8 come 8 come 9 in 8 come 13 or 9 in 10 patients 11 80 12 years 12 years 13 or 13 or 14 older 15 ( 17 ratio 16 odds 17 ratio 17 ratio 18 1.604 17 ratio 19 ; 19 ; 23 interval 19 ; 29 = 19 ; 31 and 20 95 23 interval 21 % 23 interval 22 confidence 23 interval 23 interval 24 1.013 23 interval 26 2.540 23 interval 29 = 25 - 26 2.540 26 2.540 27 , 28 p 29 = 29 = 30 0.04 31 and 39 interval 31 and 45 < 32 odds 33 ratio 33 ratio 39 interval 34 3.695 39 interval 36 95 39 interval 37 % 39 interval 38 confidence 39 interval 39 interval 40 2.517 39 interval 42 5.424 39 interval 45 < 41 - 42 5.424 42 5.424 43 , 45 < 46 0.001 45 < 48 respectively 47 , 48 respectively 48 respectively 49 ) successful recanalization defined as thrombolysis in myocardial infarction ( timi ) 2 - 3 was seen less frequently in older patients ; however , this did not reach statistical significance ( odds ratio 0.814 ; 95 % confidence interval 0.522 - 1.269 , p = 0.364 [ )( 0 ###LEFT-WALL### 2 recanalization 0 ###LEFT-WALL### 16 seen 0 ###LEFT-WALL### 22 ; 0 ###LEFT-WALL### 48 )( 1 successful 2 recanalization 2 recanalization 3 defined 2 recanalization 15 was 3 defined 4 as 3 defined 6 in 3 defined 13 - 4 as 5 thrombolysis 6 in 10 timi 7 myocardial 8 infarction 8 infarction 10 timi 9 ( 10 timi 10 timi 11 ) 12 2 13 - 13 - 14 3 15 was 16 seen 16 seen 18 frequently 16 seen 19 in 17 less 18 frequently 19 in 21 patients 20 older 21 patients 22 ; 25 this 22 ; 28 reach 22 ; 35 ; 23 however 24 , 23 however 25 this 25 this 26 did 26 did 27 not 26 did 28 reach 28 reach 30 significance 29 statistical 30 significance 30 significance 33 ratio 31 ( 33 ratio 32 odds 33 ratio 33 ratio 34 0.814 33 ratio 35 ; 35 ; 39 interval 35 ; 45 = 36 95 37 % 37 % 38 confidence 38 confidence 39 interval 39 interval 40 0.522 39 interval 42 1.269 39 interval 45 = 41 - 42 1.269 42 1.269 43 , 44 p 45 = 45 = 46 0.364 conclusion : formal meta - analysis showed that octogenarians are less likely to achieve functional independence and have higher rates of mortality and intracerebral hemorrhage following endovascular treatment for ischemic stroke compared [with] younger patients . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 23 and 3 formal 6 analysis 4 meta 5 - 4 meta 6 analysis 6 analysis 17 and 6 analysis 23 and 7 showed 8 that 7 showed 17 and 8 that 9 octogenarians 8 that 10 are 9 octogenarians 10 are 10 are 12 likely 11 less 12 likely 12 likely 13 to 12 likely 14 achieve 13 to 14 achieve 14 achieve 16 independence 15 functional 16 independence 17 and 18 have 18 have 20 rates 19 higher 20 rates 20 rates 21 of 21 of 22 mortality 23 and 25 hemorrhage 23 and 26 following 24 intracerebral 25 hemorrhage 26 following 28 treatment 26 following 29 for 27 endovascular 28 treatment 29 for 35 patients 30 ischemic 31 stroke 31 stroke 32 compared 32 compared 35 patients 34 younger 35 patients decisions regarding endovascular treatment of elderly patients should be individualized until randomized controlled trials are available . 0 ###LEFT-WALL### 1 decisions 0 ###LEFT-WALL### 10 individualized 0 ###LEFT-WALL### 17 . 1 decisions 2 regarding 1 decisions 8 should 2 regarding 4 treatment 3 endovascular 4 treatment 4 treatment 5 of 5 of 7 patients 6 elderly 7 patients 8 should 9 be 9 be 10 individualized 10 individualized 11 until 11 until 14 trials 11 until 15 are 12 randomized 14 trials 13 controlled 14 trials 14 trials 15 are 15 are 16 available the purpose of this study was to determine the relationship among health - related quality of life ( hrqol ) , physical fitness , and physical activity in older patients after recent discharge [from] hospital . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 14 related 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 36 . 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 determine 7 to 8 determine 8 determine 10 relationship 8 determine 11 among 9 the 10 relationship 11 among 12 health 13 - 14 related 14 related 15 quality 14 related 21 , 15 quality 16 of 15 quality 19 hrqol 16 of 17 life 18 ( 19 hrqol 19 hrqol 20 ) 21 , 35 hospital 22 physical 23 fitness 23 fitness 25 and 24 , 25 and 25 and 27 activity 25 and 28 in 25 and 35 hospital 26 physical 27 activity 28 in 30 patients 29 older 30 patients 30 patients 31 after 31 after 33 discharge 32 recent 33 discharge one hundred fifteen independent - living older adults ( ages 70 - 92 years ) were included . 0 ###LEFT-WALL### 8 adults 0 ###LEFT-WALL### 17 included 0 ###LEFT-WALL### 18 . 1 one 2 hundred 2 hundred 3 fifteen 3 fifteen 8 adults 4 independent 5 - 4 independent 8 adults 6 living 8 adults 7 older 8 adults 8 adults 10 ages 8 adults 14 years 8 adults 16 were 9 ( 10 ages 10 ages 11 70 10 ages 12 - 12 - 14 years 13 92 14 years 14 years 15 ) 16 were 17 included hrqol ( medical outcomes study 36 - item short form health survey ) , physical activity ( physical activity scale for the elderly ) , and physical fitness ( senior fitness test ) were measured 2 - 4 weeks after discharge . 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 34 were 0 ###LEFT-WALL### 42 . 1 hrqol 5 study 1 hrqol 26 and 2 ( 5 study 3 medical 5 study 4 outcomes 5 study 5 study 6 36 5 study 12 survey 5 study 16 activity 5 study 25 , 7 - 12 survey 8 item 12 survey 9 short 10 form 10 form 11 health 11 health 12 survey 12 survey 13 ) 14 , 16 activity 15 physical 16 activity 16 activity 20 scale 16 activity 24 ) 17 ( 20 scale 18 physical 19 activity 19 activity 20 scale 20 scale 21 for 20 scale 24 ) 21 for 23 elderly 22 the 23 elderly 25 , 26 and 26 and 28 fitness 26 and 32 test 26 and 34 were 27 physical 28 fitness 29 ( 32 test 30 senior 31 fitness 31 fitness 32 test 32 test 33 ) 34 were 35 measured 35 measured 37 - 35 measured 40 after 36 2 37 - 37 - 38 4 39 weeks 40 after 40 after 41 discharge higher levels of physical activity and physical fitness were correlated with higher self - reported hrqol . 0 ###LEFT-WALL### 13 self 0 ###LEFT-WALL### 15 reported 1 higher 2 levels 2 levels 3 of 2 levels 6 and 3 of 5 activity 4 physical 5 activity 6 and 7 physical 6 and 8 fitness 6 and 11 with 6 and 13 self 8 fitness 9 were 9 were 10 correlated 10 correlated 11 with 12 higher 13 self 14 - 15 reported 15 reported 16 hrqol 15 reported 17 . although cause and effect cannot be determined from this study , the results suggest that a particular focus on the value of physical activity and physical fitness while [in] hospital and when discharged from hospital may be important to encourage patients to actively preserve independence and hrqol . 0 ###LEFT-WALL### 10 study 0 ###LEFT-WALL### 11 , 1 although 3 and 1 although 7 determined 1 although 10 study 2 cause 3 and 3 and 4 effect 3 and 5 cannot 5 cannot 6 be 6 be 7 determined 7 determined 8 from 8 from 9 this 11 , 13 results 11 , 18 focus 12 the 13 results 13 results 14 suggest 14 suggest 15 that 15 that 17 particular 15 that 18 focus 16 a 17 particular 18 focus 19 on 18 focus 28 while 19 on 25 and 20 the 21 value 21 value 22 of 21 value 25 and 22 of 24 activity 23 physical 24 activity 25 and 27 fitness 26 physical 27 fitness 28 while 31 and 28 while 40 encourage 30 hospital 31 and 31 and 32 when 31 and 33 discharged 31 and 34 from 31 and 36 may 34 from 35 hospital 36 may 37 be 37 be 38 important 38 important 39 to 39 to 40 encourage 40 encourage 41 patients 40 encourage 42 to 40 encourage 44 preserve 42 to 44 preserve 43 actively 44 preserve 44 preserve 46 and 45 independence 46 and 46 and 47 hrqol 46 and 48 . it may be especially important to target those with lower levels of physical activity , poorer physical fitness , and multiple comorbidities . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 23 . 1 it 2 may 2 may 3 be 3 be 4 especially 3 be 5 important 5 important 6 to 5 important 7 target 6 to 7 target 7 target 20 and 8 those 9 with 8 those 15 , 9 with 11 levels 10 lower 11 levels 11 levels 12 of 12 of 14 activity 13 physical 14 activity 15 , 18 fitness 15 , 20 and 16 poorer 18 fitness 17 physical 18 fitness 19 , 20 and 20 and 22 comorbidities 21 multiple 22 comorbidities none introduction : understanding sexual behavior is important when evaluating the health needs of older adults . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 17 . 1 none 2 introduction 1 none 4 understanding 1 none 7 is 2 introduction 3 : 3 : 4 understanding 4 understanding 6 behavior 5 sexual 6 behavior 7 is 8 important 8 important 9 when 9 when 10 evaluating 10 evaluating 13 needs 11 the 13 needs 12 health 13 needs 13 needs 14 of 14 of 16 adults 15 older 16 adults little research has addressed the effect of specific health conditions on sexual inactivity in this growing population . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 addressed 0 ###LEFT-WALL### 18 . 1 little 2 research 2 research 3 has 3 has 4 addressed 4 addressed 6 effect 4 addressed 11 on 4 addressed 14 in 5 the 6 effect 6 effect 7 of 7 of 10 conditions 8 specific 9 health 9 health 10 conditions 11 on 13 inactivity 12 sexual 13 inactivity 14 in 17 population 15 this 16 growing 16 growing 17 population aim : the study aims to assess the association of mental and physical health conditions with sexual inactivity among adults 55 and older living in the villages , florida . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 7 assess 1 aim 2 : 2 : 5 aims 2 : 6 to 3 the 5 aims 4 study 5 aims 6 to 7 assess 7 assess 22 and 7 assess 25 in 8 the 9 association 9 association 10 of 9 association 22 and 10 of 15 conditions 11 mental 12 and 12 and 13 physical 12 and 15 conditions 14 health 15 conditions 15 conditions 16 with 15 conditions 19 among 16 with 18 inactivity 17 sexual 18 inactivity 19 among 20 adults 20 adults 21 55 22 and 24 living 23 older 24 living 25 in 27 villages 26 the 27 villages 27 villages 29 florida 28 , 29 florida 29 florida 30 . methods : exposure data for 22 [self] - reported health conditions were assessed in relation to sexual inactivity in 22,654 participants ages 55 and older , including 1,879 participants over age 80 in a community - based cross - sectional study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 reported 0 ###LEFT-WALL### 36 - 1 methods 2 : 2 : 4 data 3 exposure 4 data 4 data 5 for 5 for 6 22 8 - 9 reported 9 reported 10 health 9 reported 16 to 9 reported 36 - 10 health 11 conditions 10 health 12 were 10 health 13 assessed 11 conditions 12 were 14 in 15 relation 15 relation 16 to 16 to 18 inactivity 17 sexual 18 inactivity 18 inactivity 19 in 18 inactivity 24 and 19 in 21 participants 20 22,654 21 participants 22 ages 23 55 22 ages 24 and 24 and 25 older 25 older 27 including 26 , 27 including 27 including 29 participants 27 including 33 in 27 including 36 - 28 1,879 29 participants 29 participants 30 over 30 over 31 age 31 age 32 80 33 in 35 community 34 a 35 community 36 - 38 cross 36 - 39 - 37 based 38 cross 39 - 41 study 39 - 42 . 40 sectional 41 study logistic regression analyses were conducted separately for men and women to evaluate the likelihood of being sexually active for each health condition . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 5 conducted 0 ###LEFT-WALL### 23 . 1 logistic 2 regression 2 regression 3 analyses 2 regression 4 were 2 regression 5 conducted 3 analyses 4 were 5 conducted 6 separately 5 conducted 7 for 5 conducted 11 to 7 for 9 and 8 men 9 and 9 and 10 women 11 to 12 evaluate 12 evaluate 14 likelihood 13 the 14 likelihood 14 likelihood 15 of 15 of 16 being 16 being 17 sexually 16 being 18 active 18 active 19 for 19 for 22 condition 20 each 22 condition 21 health 22 condition covariates included age , race , education , income , self - reported overall health , and marital status . 0 ###LEFT-WALL### 1 covariates 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 20 . 1 covariates 2 included 2 included 3 age 3 age 5 race 4 , 5 race 5 race 7 education 5 race 9 income 5 race 10 , 6 , 7 education 7 education 8 , 8 , 9 income 9 income 10 , 10 , 11 self 10 , 12 - 12 - 17 and 13 reported 15 health 14 overall 15 health 15 health 17 and 16 , 17 and 17 and 19 status 18 marital 19 status main outcome measures : the odds ratio and 95 % confidence intervals for sexual activity status were calculated separately for men and women . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 24 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 7 ratio 5 the 7 ratio 6 odds 7 ratio 8 and 12 intervals 8 and 18 calculated 9 95 12 intervals 10 % 11 confidence 11 confidence 12 intervals 12 intervals 13 for 12 intervals 17 were 13 for 16 status 14 sexual 15 activity 15 activity 16 status 17 were 18 calculated 18 calculated 19 separately 18 calculated 20 for 20 for 22 and 21 men 22 and 22 and 23 women results : fifty - five percent of men and 45 % [of] women reported being sexually active . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 2 : 9 and 3 fifty 4 - 4 - 5 five 4 - 6 percent 6 percent 7 of 6 percent 9 and 7 of 8 men 9 and 13 women 9 and 14 reported 9 and 15 being 10 45 11 % 11 % 13 women 15 being 17 active 16 sexually 17 active sexual inactivity was significantly related to cancer , bladder/bowl problems , major surgery , poor vision , mental health conditions , and cardiovascular disease and its risk factors including diabetes , hypertension , and high cholesterol . 0 ###LEFT-WALL### 2 inactivity 0 ###LEFT-WALL### 5 related 0 ###LEFT-WALL### 37 . 1 sexual 2 inactivity 2 inactivity 3 was 3 was 4 significantly 3 was 5 related 5 related 6 to 6 to 22 and 7 cancer 8 , 8 , 10 problems 8 , 11 , 9 bladder/bowl 10 problems 11 , 13 surgery 11 , 14 , 12 major 13 surgery 14 , 16 vision 14 , 17 , 15 poor 16 vision 17 , 20 conditions 17 , 22 and 18 mental 19 health 19 health 20 conditions 21 , 22 and 22 and 28 factors 22 and 29 including 23 cardiovascular 24 disease 24 disease 25 and 25 and 27 risk 25 and 28 factors 26 its 27 risk 29 including 34 and 30 diabetes 31 , 31 , 32 hypertension 31 , 34 and 33 , 34 and 34 and 36 cholesterol 35 high 36 cholesterol additional associations with sexual inactivity included hearing loss and dementia for men , and dermatologic conditions , problems with the joints , bone or back , gastrointestinal problems , alcohol misuse , chronic wound care , and gum disease in women . 0 ###LEFT-WALL### 9 and 1 additional 2 associations 2 associations 3 with 2 associations 6 included 2 associations 7 hearing 2 associations 9 and 3 with 5 inactivity 4 sexual 5 inactivity 7 hearing 8 loss 9 and 10 dementia 9 and 11 for 9 and 24 or 11 for 14 and 12 men 14 and 13 , 14 and 14 and 16 conditions 14 and 17 , 15 dermatologic 16 conditions 17 , 24 or 18 problems 19 with 18 problems 22 , 19 with 21 joints 20 the 21 joints 22 , 23 bone 22 , 24 or 24 or 25 back 24 or 28 problems 24 or 37 and 24 or 42 . 26 , 28 problems 27 gastrointestinal 28 problems 28 problems 29 , 29 , 37 and 30 alcohol 31 misuse 31 misuse 32 , 32 , 35 care 32 , 37 and 33 chronic 35 care 34 wound 35 care 36 , 37 and 37 and 39 disease 37 and 40 in 37 and 42 . 38 gum 39 disease 40 in 41 women conclusions : mental and physical health conditions have very similar associations with sexual inactivity in men and women . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 and 2 : 8 have 2 : 19 . 3 mental 4 and 4 and 7 conditions 4 and 8 have 5 physical 6 health 6 health 7 conditions 8 have 11 associations 8 have 12 with 8 have 15 in 9 very 10 similar 10 similar 11 associations 12 with 14 inactivity 13 sexual 14 inactivity 15 in 17 and 16 men 17 and 17 and 18 women increased sexual activity was associated with positive physical , social , and emotional health indicators . 0 ###LEFT-WALL### 3 activity 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 16 . 1 increased 3 activity 2 sexual 3 activity 3 activity 4 was 4 was 5 associated 5 associated 6 with 6 with 15 indicators 7 positive 14 health 8 physical 9 , 9 , 10 social 9 , 12 and 11 , 12 and 12 and 13 emotional 12 and 14 health 14 health 15 indicators aim : most studies about the structures of the human skin have been on the general histologic features of the skin . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 2 : 4 studies 2 : 13 been 2 : 22 . 3 most 4 studies 4 studies 5 about 4 studies 12 have 5 about 7 structures 6 the 7 structures 7 structures 8 of 8 of 11 skin 9 the 11 skin 10 human 11 skin 12 have 13 been 13 been 14 on 14 on 18 features 15 the 18 features 16 general 18 features 17 histologic 18 features 18 features 19 of 19 of 21 skin 20 the 21 skin the purpose of this study was to understand the relationship between the microrelief ( mr ) pattern and histologic structure of the human skin , [and] to find the usefulness of the three - dimensional reconstruction ( 3dr ) technique of pathological skin tissue . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 45 . 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 understand 7 to 8 understand 8 understand 10 relationship 8 understand 11 between 9 the 10 relationship 11 between 18 and 12 the 17 pattern 13 microrelief 15 mr 13 microrelief 16 ) 13 microrelief 17 pattern 14 ( 15 mr 15 mr 16 ) 17 pattern 18 and 18 and 20 structure 18 and 21 of 19 histologic 20 structure 21 of 24 skin 22 the 24 skin 23 human 24 skin 25 , 27 to 25 , 28 find 27 to 28 find 28 find 30 usefulness 28 find 40 technique 29 the 30 usefulness 30 usefulness 31 of 31 of 33 three 32 the 33 three 33 three 36 reconstruction 34 - 36 reconstruction 35 dimensional 36 reconstruction 36 reconstruction 38 3dr 36 reconstruction 39 ) 37 ( 38 3dr 38 3dr 39 ) 40 technique 41 of 41 of 44 tissue 42 pathological 43 skin 43 skin 44 tissue materials , subjects , and methods : human skin specimens were obtained from the medial forearm , abdomen , and volar aspects of the finger tips of cadavers . 0 ###LEFT-WALL### 6 methods 0 ###LEFT-WALL### 7 : 0 ###LEFT-WALL### 29 . 1 materials 3 subjects 2 , 3 subjects 3 subjects 4 , 3 subjects 5 and 4 , 5 and 5 and 6 methods 7 : 10 specimens 7 : 12 obtained 8 human 9 skin 9 skin 10 specimens 10 specimens 11 were 11 were 12 obtained 12 obtained 13 from 13 from 20 and 14 the 16 forearm 15 medial 16 forearm 16 forearm 17 , 17 , 18 abdomen 17 , 20 and 19 , 20 and 20 and 22 aspects 21 volar 22 aspects 22 aspects 23 of 23 of 26 tips 24 the 26 tips 25 finger 26 tips 26 tips 27 of 27 of 28 cadavers two - dimensional surface - viewed images of the skin showing mr patterns were obtained using dry dermoscopy . 0 ###LEFT-WALL### 1 two 0 ###LEFT-WALL### 2 - 2 - 4 surface 2 - 5 - 2 - 19 . 3 dimensional 4 surface 5 - 7 images 6 viewed 7 images 7 images 8 of 7 images 11 showing 8 of 10 skin 9 the 10 skin 11 showing 12 mr 11 showing 13 patterns 11 showing 15 obtained 13 patterns 14 were 14 were 15 obtained 15 obtained 16 using 16 using 18 dermoscopy 17 dry 18 dermoscopy histologic structures of the skin were evaluated by 3 d images obtained using the 3dr technique . 0 ###LEFT-WALL### 2 structures 0 ###LEFT-WALL### 7 evaluated 0 ###LEFT-WALL### 17 . 1 histologic 2 structures 2 structures 3 of 2 structures 6 were 3 of 5 skin 4 the 5 skin 6 were 7 evaluated 7 evaluated 8 by 8 by 11 images 9 3 10 d 10 d 11 images 11 images 12 obtained 12 obtained 13 using 13 using 16 technique 14 the 16 technique 15 3dr 16 technique results : mr was deeper and wider in the abdomen than in the medial side of the forearm . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 mr 2 : 4 was 2 : 19 . 3 mr 4 was 4 was 6 and 5 deeper 6 and 6 and 7 wider 7 wider 8 in 7 wider 11 than 8 in 10 abdomen 9 the 10 abdomen 11 than 12 in 12 in 15 side 13 the 15 side 14 medial 15 side 15 side 16 of 16 of 18 forearm 17 the 18 forearm in the medial side of the forearm , 10.27 rete ridges were distributed in a plateau , on average . 0 ###LEFT-WALL### 11 ridges 0 ###LEFT-WALL### 13 distributed 1 in 4 side 1 in 8 , 1 in 11 ridges 2 the 4 side 3 medial 4 side 4 side 5 of 5 of 7 forearm 6 the 7 forearm 9 10.27 11 ridges 10 rete 11 ridges 11 ridges 12 were 12 were 13 distributed 13 distributed 14 in 14 in 16 plateau 15 a 16 plateau 16 plateau 19 average 17 , 19 average 18 on 19 average 19 average 20 . in the abdomen , about 14.37 rete ridges were distributed in a plateau . 0 ###LEFT-WALL### 8 ridges 0 ###LEFT-WALL### 10 distributed 0 ###LEFT-WALL### 14 . 1 in 3 abdomen 1 in 4 , 1 in 8 ridges 2 the 3 abdomen 5 about 6 14.37 6 14.37 8 ridges 7 rete 8 ridges 8 ridges 9 were 9 were 10 distributed 10 distributed 11 in 11 in 13 plateau 12 a 13 plateau from 3dr technique , mr [pattern] thought to be a superordinate concept to rete ridges . 0 ###LEFT-WALL### 5 mr 0 ###LEFT-WALL### 7 thought 0 ###LEFT-WALL### 16 . 1 from 3 technique 1 from 4 , 1 from 5 mr 2 3dr 3 technique 5 mr 7 thought 7 thought 8 to 7 thought 13 to 8 to 9 be 9 be 12 concept 10 a 11 superordinate 10 a 12 concept 11 superordinate 12 concept 13 to 15 ridges 14 rete 15 ridges conclusion : the 3dr technique was useful and may allow a better understanding of the pathogenetic changes in the skin surface in aging skin . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 technique 2 : 8 and 2 : 25 . 3 the 5 technique 4 3dr 5 technique 5 technique 8 and 6 was 7 useful 6 was 8 and 8 and 9 may 8 and 18 in 8 and 22 in 9 may 10 allow 10 allow 13 understanding 11 a 13 understanding 12 better 13 understanding 13 understanding 14 of 14 of 17 changes 15 the 17 changes 16 pathogenetic 17 changes 18 in 21 surface 19 the 21 surface 20 skin 21 surface 22 in 23 aging 23 aging 24 skin a brief valsalva manoeuvre , lasting 2 - 3 s , performed by young healthy men during strength exercise reduces transmural pressure acting on intrathoracic arteries . 0 ###LEFT-WALL### 4 manoeuvre 0 ###LEFT-WALL### 12 performed 0 ###LEFT-WALL### 27 . 1 a 4 manoeuvre 2 brief 4 manoeuvre 3 valsalva 4 manoeuvre 4 manoeuvre 6 lasting 4 manoeuvre 12 performed 5 , 6 lasting 6 lasting 10 s 6 lasting 11 , 7 2 8 - 8 - 9 3 8 - 10 s 12 performed 13 by 13 by 16 men 14 young 16 men 15 healthy 16 men 16 men 17 during 16 men 23 acting 16 men 24 on 17 during 18 strength 18 strength 19 exercise 18 strength 20 reduces 19 exercise 20 reduces 20 reduces 22 pressure 21 transmural 22 pressure 24 on 26 arteries 25 intrathoracic 26 arteries in this study , we sought to verify this finding in older men . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 sought 0 ###LEFT-WALL### 14 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 sought 6 sought 7 to 6 sought 8 verify 7 to 8 verify 8 verify 10 finding 8 verify 11 in 9 this 10 finding 11 in 13 men 12 older 13 men twenty normotensive , prehypertensive and moderately hypertensive otherwise healthy men 46 - 69 years old performed knee extensions combined with inspiration or with brief valsalva manoeuvre performed at 10 , 20 and 40 mmhg mouth pressure . 0 ###LEFT-WALL### 10 men 0 ###LEFT-WALL### 17 knee 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 37 . 1 twenty 10 men 2 normotensive 3 , 3 , 4 prehypertensive 3 , 5 and 5 and 7 hypertensive 5 and 10 men 6 moderately 7 hypertensive 7 hypertensive 8 otherwise 9 healthy 10 men 10 men 15 old 10 men 16 performed 10 men 17 knee 11 46 12 - 12 - 13 69 12 - 14 years 14 years 15 old 17 knee 18 extensions 17 knee 28 at 18 extensions 19 combined 19 combined 22 or 19 combined 27 performed 20 with 21 inspiration 20 with 22 or 22 or 23 with 23 with 25 valsalva 24 brief 25 valsalva 26 manoeuvre 27 performed 28 at 29 10 30 , 34 mmhg 30 , 35 mouth 31 20 32 and 32 and 33 40 32 and 34 mmhg 34 mmhg 35 mouth 35 mouth 36 pressure same respiratory manoeuvres were also performed at rest . 0 ###LEFT-WALL### 1 same 0 ###LEFT-WALL### 6 performed 0 ###LEFT-WALL### 9 . 1 same 3 manoeuvres 1 same 4 were 1 same 6 performed 2 respiratory 3 manoeuvres 3 manoeuvres 4 were 5 also 6 performed 6 performed 7 at 7 at 8 rest [non] - invasively measured blood pressure , knee angle , respiratory airflow and mouth pressure were continuously registered . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 18 registered 0 ###LEFT-WALL### 19 . 2 - 13 and 3 invasively 13 and 4 measured 5 blood 5 blood 6 pressure 6 pressure 7 , 7 , 9 angle 7 , 10 , 8 knee 9 angle 10 , 12 airflow 10 , 13 and 11 respiratory 12 airflow 13 and 15 pressure 13 and 16 were 14 mouth 15 pressure 16 were 18 registered 17 continuously 18 registered in comparison to inspiration , estimated transmural pressure acting on thoracic arteries changed slightly and insignificantly [during] brief valsalva manoeuvre at 10 and 20 mmhg mouth pressure . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 20 manoeuvre 0 ###LEFT-WALL### 28 . 1 in 2 comparison 1 in 5 , 1 in 15 and 2 comparison 3 to 3 to 4 inspiration 6 estimated 8 pressure 7 transmural 8 pressure 8 pressure 9 acting 8 pressure 15 and 9 acting 10 on 10 on 12 arteries 11 thoracic 12 arteries 12 arteries 13 changed 13 changed 14 slightly 15 and 19 valsalva 15 and 20 manoeuvre 16 insignificantly 18 brief 18 brief 19 valsalva 20 manoeuvre 21 at 21 at 27 pressure 22 10 23 and 23 and 24 20 23 and 25 mmhg 25 mmhg 26 mouth 26 mouth 27 pressure at 40 mmhg mouth pressure , transmural pressure declined at rest [(] - 8·8 ± 11·4 [mmhg] ) and during knee extension [(] - 12·1 ± 11·9 [mmhg] ) . 0 ###LEFT-WALL### 8 pressure 0 ###LEFT-WALL### 9 declined 0 ###LEFT-WALL### 30 . 1 at 5 pressure 1 at 6 , 1 at 8 pressure 2 40 3 mmhg 3 mmhg 5 pressure 4 mouth 5 pressure 7 transmural 8 pressure 8 pressure 9 declined 9 declined 19 and 10 at 11 rest 10 at 19 and 11 rest 16 11·4 13 - 16 11·4 14 8·8 16 11·4 15 ± 16 11·4 16 11·4 18 ) 19 and 20 during 20 during 22 extension 21 knee 22 extension 22 extension 27 11·9 24 - 27 11·9 25 12·1 27 11·9 26 ± 27 11·9 27 11·9 29 ) this decline [ensued] , as peak systolic pressure [increase] caused by this manoeuvre , was [distinctly] < 40 mmhg . 0 ###LEFT-WALL### 2 decline 0 ###LEFT-WALL### 15 was 0 ###LEFT-WALL### 20 . 1 this 2 decline 2 decline 5 as 2 decline 15 was 4 , 5 as 5 as 8 pressure 5 as 14 , 6 peak 8 pressure 7 systolic 8 pressure 8 pressure 10 caused 10 caused 11 by 11 by 13 manoeuvre 12 this 13 manoeuvre 15 was 19 mmhg 17 < 18 40 18 40 19 mmhg [only] a main effect of mouth pressure [was] revealed ( p<0·001 ) and neither exercise nor interaction between these factors , what suggests that transmural pressure decline , depended mainly on intrathoracic pressure developed during brief valsalva [manoeuvre] . 0 ###LEFT-WALL### 16 nor 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 39 . 2 a 4 effect 3 main 4 effect 4 effect 5 of 4 effect 13 and 5 of 7 pressure 6 mouth 7 pressure 7 pressure 9 revealed 7 pressure 11 p<0·001 10 ( 11 p<0·001 11 p<0·001 12 ) 13 and 15 exercise 13 and 16 nor 14 neither 15 exercise 16 nor 17 interaction 17 interaction 18 between 18 between 20 factors 19 these 20 factors 21 , 22 what 21 , 28 , 22 what 28 , 23 suggests 24 that 23 suggests 28 , 24 that 26 pressure 24 that 27 decline 25 transmural 26 pressure 28 , 29 depended 28 , 30 mainly 28 , 35 during 30 mainly 31 on 31 on 33 pressure 32 intrathoracic 33 pressure 33 pressure 34 developed 35 during 37 valsalva 36 brief 37 valsalva resting blood pressure did not influence the effect [of] brief valsalva manoeuvre on transmural pressure . 0 ###LEFT-WALL### 3 pressure 0 ###LEFT-WALL### 6 influence 0 ###LEFT-WALL### 16 . 1 resting 2 blood 2 blood 3 pressure 3 pressure 4 did 4 did 5 not 4 did 6 influence 6 influence 12 manoeuvre 6 influence 13 on 7 the 12 manoeuvre 8 effect 12 manoeuvre 10 brief 12 manoeuvre 11 valsalva 12 manoeuvre 13 on 15 pressure 14 transmural 15 pressure objectives : in japan , the prevalence of depression has been reported to occur among 1 in 4 family caregivers . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 21 . 1 objectives 2 : 2 : 3 in 3 in 4 japan 5 , 7 prevalence 5 , 12 reported 6 the 7 prevalence 7 prevalence 8 of 7 prevalence 10 has 8 of 9 depression 10 has 11 been 11 been 12 reported 12 reported 13 to 12 reported 14 occur 13 to 14 occur 14 occur 15 among 14 occur 17 in 15 among 16 1 17 in 20 caregivers 18 4 20 caregivers 19 family 20 caregivers the purpose of this study was to investigate the self - rated burden associated with mental health conditions among caregivers . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 11 - 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 10 self 9 the 10 self 11 - 13 burden 12 rated 13 burden 13 burden 14 associated 14 associated 15 with 14 associated 19 among 15 with 18 conditions 16 mental 17 health 17 health 18 conditions 19 among 20 caregivers methods : we studied 95 caregivers aged 38 - 87 years in a cross - sectional study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 2 : 11 years 2 : 15 - 3 we 4 studied 4 studied 6 caregivers 5 95 6 caregivers 6 caregivers 7 aged 7 aged 9 - 8 38 9 - 9 - 10 87 10 87 11 years 11 years 12 in 12 in 14 cross 13 a 14 cross 15 - 17 study 16 sectional 17 study the general health questionnaire ( ghq - 12 ) score of 4 or more [was] defined as poor mental health . 0 ###LEFT-WALL### 13 or 0 ###LEFT-WALL### 21 . 1 the 10 score 2 general 10 score 3 health 4 questionnaire 4 questionnaire 6 ghq 4 questionnaire 10 score 5 ( 6 ghq 6 ghq 8 12 6 ghq 9 ) 7 - 8 12 8 12 9 ) 10 score 11 of 10 score 13 or 11 of 12 4 13 or 20 health 14 more 16 defined 16 defined 20 health 17 as 18 poor 18 poor 20 health 19 mental 20 health results : the proportion of caregivers with poor mental health was 24 % . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 proportion 2 : 11 was 2 : 14 . 3 the 4 proportion 4 proportion 5 of 4 proportion 11 was 5 of 6 caregivers 6 caregivers 7 with 7 with 10 health 8 poor 10 health 9 mental 10 health 11 was 13 % 12 24 13 % caregivers with a high ghq - 12 score had the number of caregiver burdens increased by 2.5 - fold compared to those with a low ghq - 12 score ( p = 0.001 ) . 0 ###LEFT-WALL### 1 caregivers 0 ###LEFT-WALL### 9 had 0 ###LEFT-WALL### 27 - 0 ###LEFT-WALL### 35 . 1 caregivers 2 with 1 caregivers 7 12 1 caregivers 8 score 1 caregivers 9 had 2 with 5 ghq 3 a 5 ghq 4 high 5 ghq 6 - 7 12 7 12 8 score 9 had 14 burdens 9 had 21 to 9 had 23 with 10 the 11 number 11 number 12 of 11 number 14 burdens 12 of 14 burdens 13 caregiver 14 burdens 14 burdens 15 increased 15 increased 16 by 15 increased 18 - 15 increased 20 compared 16 by 17 2.5 19 fold 20 compared 21 to 22 those 23 with 26 ghq 24 a 25 low 24 a 26 ghq 25 low 26 ghq 27 - 28 12 27 - 29 score 28 12 29 score 29 score 32 = 30 ( 32 = 31 p 32 = 32 = 33 0.001 32 = 34 ) the proportion of caregivers with a high ghq - 12 score was significantly higher with an increasing number of behavioral problems among care recipients ( p = 0.003 ) . 0 ###LEFT-WALL### 2 proportion 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 30 . 1 the 2 proportion 2 proportion 3 of 2 proportion 10 12 2 proportion 11 score 2 proportion 12 was 3 of 4 caregivers 4 caregivers 5 with 5 with 8 ghq 6 a 7 high 6 a 8 ghq 7 high 8 ghq 9 - 10 12 10 12 11 score 12 was 13 significantly 12 was 14 higher 14 higher 15 with 14 higher 22 among 15 with 21 problems 16 an 18 number 17 increasing 18 number 18 number 19 of 18 number 21 problems 19 of 21 problems 20 behavioral 21 problems 22 among 24 recipients 23 care 24 recipients 24 recipients 27 = 25 ( 27 = 26 p 27 = 27 = 28 0.003 27 = 29 ) a mediational model was used to identify the underlying mechanism of the relationship between the number of behavioral problems and poor mental health in caregivers . 0 ###LEFT-WALL### 3 model 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 26 . 1 a 2 mediational 1 a 3 model 2 mediational 3 model 3 model 4 was 4 was 5 used 5 used 6 to 5 used 7 identify 6 to 7 identify 7 identify 10 mechanism 7 identify 14 between 7 identify 24 in 8 the 10 mechanism 9 underlying 10 mechanism 10 mechanism 11 of 11 of 13 relationship 12 the 13 relationship 14 between 20 and 15 the 16 number 16 number 17 of 16 number 20 and 17 of 19 problems 18 behavioral 19 problems 20 and 23 health 21 poor 23 health 22 mental 23 health 24 in 25 caregivers consequently , we found that mental health conditions in caregivers were associated with both the number of caregiver burdens and behavioral problems among care recipients . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 26 . 1 consequently 2 , 1 consequently 3 we 3 we 4 found 4 found 8 conditions 4 found 12 associated 5 that 6 mental 6 mental 8 conditions 7 health 8 conditions 8 conditions 9 in 8 conditions 11 were 9 in 10 caregivers 11 were 12 associated 12 associated 13 with 13 with 20 and 14 both 20 and 15 the 16 number 16 number 17 of 16 number 20 and 17 of 19 burdens 18 caregiver 19 burdens 20 and 22 problems 20 and 23 among 21 behavioral 22 problems 23 among 25 recipients 24 care 25 recipients conclusions : it is vital to provide support not only to the caregivers but also to their elderly relatives , paying particular attention to early identification of poor mental health in caregivers so as to administer effective interventions , and to offer useful advice concerning [how] to deal with behavioral problems . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 and 0 ###LEFT-WALL### 52 . 2 : 3 it 2 : 4 is 2 : 9 not 3 it 4 is 4 is 5 vital 5 vital 6 to 5 vital 7 provide 6 to 7 provide 7 provide 8 support 9 not 10 only 9 not 21 paying 9 not 32 caregivers 11 to 13 caregivers 11 to 14 but 12 the 13 caregivers 14 but 15 also 14 but 16 to 14 but 20 , 14 but 21 paying 16 to 19 relatives 17 their 19 relatives 18 elderly 19 relatives 21 paying 23 attention 21 paying 31 in 21 paying 32 caregivers 22 particular 23 attention 23 attention 24 to 24 to 26 identification 25 early 26 identification 26 identification 27 of 27 of 30 health 28 poor 30 health 29 mental 30 health 32 caregivers 33 so 32 caregivers 34 as 34 as 35 to 35 to 40 and 36 administer 38 interventions 36 administer 40 and 37 effective 38 interventions 39 , 40 and 40 and 41 to 40 and 42 offer 41 to 42 offer 42 offer 44 advice 42 offer 45 concerning 42 offer 47 to 42 offer 49 with 43 useful 44 advice 47 to 48 deal 49 with 51 problems 50 behavioral 51 problems the number of cancer survivors has been steadily increasing due in part to the aging population and advancements in cancer care and treatment . 0 ###LEFT-WALL### 2 number 0 ###LEFT-WALL### 7 been 0 ###LEFT-WALL### 24 . 1 the 2 number 2 number 3 of 2 number 6 has 3 of 5 survivors 4 cancer 5 survivors 6 has 7 been 7 been 9 increasing 8 steadily 9 increasing 9 increasing 22 and 10 due 11 in 10 due 22 and 11 in 17 and 12 part 13 to 12 part 17 and 13 to 16 population 14 the 16 population 15 aging 16 population 17 and 18 advancements 17 and 19 in 19 in 21 care 20 cancer 21 care 22 and 23 treatment of the [current] 13.7 million cancer survivors in the united states , most are [65] [or] older . 0 ###LEFT-WALL### 13 most 0 ###LEFT-WALL### 14 are 0 ###LEFT-WALL### 18 . 1 of 7 survivors 1 of 12 , 1 of 13 most 2 the 5 million 4 13.7 5 million 5 million 7 survivors 6 cancer 7 survivors 7 survivors 8 in 8 in 11 states 9 the 11 states 10 united 11 states 13 most 14 are 14 are 17 older aging changes and the presence of comorbidities add complexity to the care of cancer survivors . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 8 add 0 ###LEFT-WALL### 16 . 1 aging 2 changes 2 changes 3 and 3 and 5 presence 3 and 6 of 3 and 8 add 4 the 5 presence 6 of 7 comorbidities 8 add 9 complexity 8 add 10 to 10 to 12 care 11 the 12 care 12 care 13 of 13 of 15 survivors 14 cancer 15 survivors in addition . common long - term cancer - related symptoms and late effects of cancer treatments provide challenges to nurses and other health professionals caring for older cancer survivors . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 3 . 0 ###LEFT-WALL### 31 . 1 in 2 addition 3 . 8 cancer 3 . 10 related 3 . 12 and 4 common 7 term 5 long 6 - 5 long 7 term 7 term 8 cancer 9 - 10 related 10 related 11 symptoms 12 and 14 effects 12 and 18 provide 13 late 14 effects 14 effects 15 of 14 effects 18 provide 15 of 17 treatments 16 cancer 17 treatments 18 provide 19 challenges 18 provide 20 to 18 provide 27 for 20 to 22 and 21 nurses 22 and 22 and 25 professionals 22 and 26 caring 23 other 25 professionals 24 health 25 professionals 27 for 30 survivors 28 older 29 cancer 29 cancer 30 survivors transition from oncology care to primary or shared care requires understanding of detailed information about the specific cancer diagnosis , treatments received , and recommendations for [follow] - up care to prevent recurrence , recognize treatment - associated health effects , and understand strategies for health [promotion] . 0 ###LEFT-WALL### 1 transition 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 34 , 0 ###LEFT-WALL### 48 . 1 transition 2 from 1 transition 4 care 1 transition 12 of 1 transition 13 detailed 2 from 3 oncology 4 care 5 to 4 care 10 requires 5 to 7 or 6 primary 7 or 7 or 9 care 8 shared 9 care 10 requires 11 understanding 11 understanding 12 of 13 detailed 14 information 13 detailed 15 about 15 about 19 diagnosis 16 the 19 diagnosis 17 specific 18 cancer 18 cancer 19 diagnosis 19 diagnosis 21 treatments 20 , 21 treatments 21 treatments 22 received 21 treatments 23 , 24 and 25 recommendations 24 and 30 care 25 recommendations 26 for 25 recommendations 30 care 26 for 29 up 28 - 29 up 30 care 31 to 31 to 34 , 32 prevent 33 recurrence 32 prevent 34 , 34 , 42 and 34 , 45 for 35 recognize 36 treatment 35 recognize 42 and 36 treatment 40 effects 37 - 40 effects 38 associated 40 effects 39 health 40 effects 40 effects 41 , 41 , 42 and 42 and 43 understand 43 understand 44 strategies 45 for 46 health nurses in all practice areas will care for cancer survivors and must be prepared to deliver safe and effective care . 0 ###LEFT-WALL### 1 nurses 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 21 . 1 nurses 2 in 1 nurses 11 and 2 in 5 areas 3 all 5 areas 4 practice 5 areas 6 will 7 care 6 will 11 and 7 care 8 for 8 for 10 survivors 9 cancer 10 survivors 11 and 12 must 12 must 13 be 13 be 14 prepared 14 prepared 15 to 15 to 16 deliver 16 deliver 20 care 17 safe 18 and 18 and 19 effective 18 and 20 care in this brief response to migo and westerberg we explain why we think that their criticism of our previous research showing familiarity deficits in mild cognitive impairment patients ( mci ) is not sound . 0 ###LEFT-WALL### 9 we 0 ###LEFT-WALL### 10 explain 0 ###LEFT-WALL### 35 . 1 in 4 response 1 in 9 we 2 this 4 response 3 brief 4 response 4 response 5 to 5 to 8 westerberg 6 migo 7 and 7 and 8 westerberg 9 we 10 explain 10 explain 11 why 11 why 12 we 11 why 13 think 12 we 13 think 13 think 14 that 14 that 16 criticism 14 that 34 sound 15 their 16 criticism 16 criticism 17 of 16 criticism 21 showing 16 criticism 32 is 17 of 20 research 18 our 20 research 19 previous 20 research 21 showing 22 familiarity 21 showing 23 deficits 23 deficits 24 in 24 in 28 patients 25 mild 27 impairment 26 cognitive 27 impairment 27 impairment 28 patients 28 patients 30 mci 29 ( 30 mci 30 mci 31 ) 32 is 33 not 32 is 34 sound more concretely , we have replicated the effect several times previously , and we justify statistically the fact that in the previous paper we had to combine two mci samples to demonstrate a reliable familiarity deficit . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 37 . 1 more 2 concretely 2 concretely 3 , 2 concretely 4 we 4 we 13 and 5 have 6 replicated 5 have 13 and 6 replicated 8 effect 6 replicated 10 times 6 replicated 11 previously 7 the 8 effect 9 several 10 times 12 , 13 and 13 and 32 demonstrate 14 we 15 justify 15 justify 16 statistically 15 justify 18 fact 17 the 18 fact 18 fact 19 that 19 that 24 we 19 that 25 had 20 in 23 paper 20 in 24 we 21 the 23 paper 22 previous 23 paper 24 we 25 had 25 had 26 to 25 had 31 to 26 to 27 combine 27 combine 28 two 27 combine 29 mci 27 combine 30 samples 29 mci 30 samples 31 to 32 demonstrate 32 demonstrate 36 deficit 33 a 36 deficit 34 reliable 35 familiarity 35 familiarity 36 deficit we note that there are several studies showing conflicting results . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 note 0 ###LEFT-WALL### 11 . 1 we 2 note 2 note 3 that 3 that 4 there 3 that 5 are 4 there 5 are 5 are 7 studies 6 several 7 studies 7 studies 8 showing 8 showing 9 conflicting 8 showing 10 results 9 conflicting 10 results however , although the basis for these discrepancies remains uncertain , a new report has replicated the presence of deficits in familiarity , and more importantly [,] demonstrated its correlation with structural imaging biomarkers of alzheimer 's disease . 0 ###LEFT-WALL### 14 report 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 39 . 1 however 2 , 1 however 14 report 2 , 3 although 3 although 5 basis 3 although 9 remains 3 although 11 , 3 although 14 report 4 the 5 basis 5 basis 6 for 5 basis 9 remains 6 for 8 discrepancies 7 these 8 discrepancies 9 remains 10 uncertain 12 a 13 new 12 a 14 report 13 new 14 report 14 report 15 has 15 has 24 and 16 replicated 18 presence 16 replicated 21 in 16 replicated 24 and 17 the 18 presence 18 presence 19 of 19 of 20 deficits 21 in 22 familiarity 23 , 24 and 24 and 28 demonstrated 24 and 31 with 25 more 26 importantly 26 importantly 28 demonstrated 28 demonstrated 30 correlation 29 its 30 correlation 31 with 34 biomarkers 32 structural 34 biomarkers 33 imaging 34 biomarkers 34 biomarkers 35 of 35 of 38 disease 36 alzheimer 37 's 37 's 38 disease root transparency has proven to be related to age and has been considered by different odontological methods for age estimation . 0 ###LEFT-WALL### 2 transparency 0 ###LEFT-WALL### 4 proven 0 ###LEFT-WALL### 21 . 1 root 2 transparency 2 transparency 3 has 3 has 4 proven 4 proven 5 to 4 proven 13 considered 5 to 10 and 6 be 7 related 6 be 10 and 7 related 8 to 8 to 9 age 10 and 11 has 11 has 12 been 12 been 13 considered 13 considered 14 by 14 by 17 methods 15 different 17 methods 16 odontological 17 methods 17 methods 18 for 18 for 20 estimation 19 age 20 estimation very little is [known] concerning possible variations of root transparency with heat , although the applicability of the method to burnt remains depends on the possible modifications of this specific variable . 0 ###LEFT-WALL### 2 little 0 ###LEFT-WALL### 3 is 1 very 2 little 2 little 3 is 3 is 5 concerning 5 concerning 7 variations 5 concerning 11 with 5 concerning 14 although 6 possible 7 variations 7 variations 8 of 8 of 10 transparency 9 root 10 transparency 11 with 12 heat 13 , 14 although 14 although 16 applicability 14 although 23 depends 14 although 32 . 15 the 16 applicability 16 applicability 17 of 16 applicability 23 depends 17 of 19 method 18 the 19 method 19 method 20 to 20 to 22 remains 21 burnt 22 remains 23 depends 24 on 24 on 27 modifications 25 the 27 modifications 26 possible 27 modifications 27 modifications 28 of 28 of 31 variable 29 this 31 variable 30 specific 31 variable this pilot study presents the results of an experiment performed on 105 teeth obtained from dental patients and autopsy material , heated in an industrial oven at 50 °c , 100 °c , 150 °c and 200 °c . root transparency was measured before and after the charring experiment . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 39 . 1 this 3 study 2 pilot 3 study 3 study 21 , 4 presents 6 results 4 presents 21 , 5 the 6 results 6 results 7 of 7 of 18 and 8 an 9 experiment 9 experiment 10 performed 9 experiment 14 obtained 9 experiment 18 and 10 performed 11 on 11 on 13 teeth 12 105 13 teeth 14 obtained 15 from 15 from 17 patients 16 dental 17 patients 18 and 20 material 19 autopsy 20 material 21 , 22 heated 22 heated 23 in 22 heated 36 and 23 in 26 oven 24 an 26 oven 25 industrial 26 oven 26 oven 27 at 26 oven 32 °c 27 at 29 °c 28 50 29 °c 30 , 32 °c 31 100 32 °c 32 °c 33 , 34 150 35 °c 35 °c 36 and 36 and 38 °c 37 200 38 °c 39 . 41 transparency 39 . 50 . 40 root 41 transparency 41 transparency 42 was 42 was 43 measured 43 measured 45 and 44 before 45 and 45 and 46 after 46 after 49 experiment 47 the 49 experiment 48 charring 49 experiment the heating process proved to radically modify root transparency , which decreased in 20 % of samples at 50 °c , in 34.6 % at 100 °c , in 50 % at 150 °c , in 77 % at 200 °c [.] the overall correlation index ( ci ) between decrease in root transparency and increase in temperature amounted to 0.96 . 0 ###LEFT-WALL### 3 process 0 ###LEFT-WALL### 59 amounted 0 ###LEFT-WALL### 62 . 1 the 3 process 2 heating 3 process 3 process 4 proved 3 process 59 amounted 4 proved 5 to 4 proved 7 modify 5 to 7 modify 6 radically 7 modify 7 modify 9 transparency 7 modify 50 between 7 modify 52 in 7 modify 57 in 8 root 9 transparency 9 transparency 11 which 10 , 11 which 11 which 12 decreased 11 which 49 ) 12 decreased 13 in 12 decreased 18 at 12 decreased 22 in 12 decreased 29 in 12 decreased 36 in 12 decreased 46 index 13 in 15 % 14 20 15 % 15 % 16 of 16 of 17 samples 18 at 20 °c 19 50 20 °c 21 , 22 in 22 in 24 % 22 in 28 , 23 34.6 24 % 24 % 25 at 25 at 27 °c 26 100 27 °c 28 , 29 in 29 in 31 % 29 in 35 , 30 50 31 % 31 % 32 at 32 at 34 °c 33 150 34 °c 36 in 38 % 37 77 38 % 38 % 39 at 39 at 41 °c 40 200 41 °c 43 the 46 index 44 overall 45 correlation 45 correlation 46 index 46 index 48 ci 47 ( 48 ci 48 ci 49 ) 50 between 51 decrease 52 in 55 and 53 root 54 transparency 54 transparency 55 and 55 and 56 increase 57 in 58 temperature 59 amounted 60 to 60 to 61 0.96 these results show that heat may modify root transparency and suggest caution in using methods based on root transparency for age estimation . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 23 . 1 these 2 results 2 results 10 and 3 show 4 that 3 show 10 and 4 that 5 heat 4 that 7 modify 5 heat 6 may 6 may 7 modify 7 modify 9 transparency 8 root 9 transparency 10 and 11 suggest 10 and 13 in 10 and 17 on 11 suggest 12 caution 13 in 14 using 14 using 15 methods 15 methods 16 based 17 on 19 transparency 18 root 19 transparency 19 transparency 20 for 20 for 22 estimation 21 age 22 estimation none none none calcium sparks in cardiac myocytes are brief , localized calcium releases from the [sarcoplasmic] reticulum ( sr ) believed to be caused by locally regenerative calcium - induced calcium release [(] cicr ) via couplons , clusters of ryanodine receptors ( ryrs ) . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 47 . 1 none 4 calcium 1 none 5 sparks 1 none 9 are 2 none 3 none 3 none 4 calcium 4 calcium 5 sparks 5 sparks 6 in 6 in 8 myocytes 7 cardiac 8 myocytes 9 are 10 brief 10 brief 23 to 11 , 22 believed 12 localized 14 releases 13 calcium 14 releases 14 releases 15 from 14 releases 20 sr 14 releases 22 believed 15 from 18 reticulum 16 the 18 reticulum 19 ( 20 sr 20 sr 21 ) 22 believed 23 to 23 to 24 be 24 be 25 caused 25 caused 26 by 25 caused 37 via 26 by 29 calcium 27 locally 28 regenerative 28 regenerative 29 calcium 29 calcium 35 cicr 30 - 35 cicr 31 induced 35 cicr 32 calcium 33 release 33 release 35 cicr 35 cicr 36 ) 37 via 38 couplons 38 couplons 40 clusters 39 , 40 clusters 40 clusters 41 of 40 clusters 46 ) 41 of 43 receptors 42 ryanodine 43 receptors 43 receptors 45 ryrs 44 ( 45 ryrs 45 ryrs 46 ) how such regeneration is terminated is [uncertain] . 0 ###LEFT-WALL### 1 how 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 8 . 1 how 3 regeneration 1 how 5 terminated 1 how 6 is 2 such 3 regeneration 3 regeneration 4 is 4 is 5 terminated we performed numerical simulations of an idealized stochastic model of spark production , assuming a ryr gating scheme with only two states [(] open and closed ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 performed 0 ###LEFT-WALL### 28 . 1 we 2 performed 2 performed 4 simulations 3 numerical 4 simulations 4 simulations 5 of 5 of 9 model 6 an 9 model 7 idealized 9 model 8 stochastic 9 model 9 model 10 of 10 of 12 production 11 spark 12 production 12 production 14 assuming 13 , 14 assuming 14 assuming 18 scheme 14 assuming 19 with 14 assuming 27 ) 15 a 18 scheme 16 ryr 18 scheme 17 gating 18 scheme 19 with 21 two 20 only 21 two 21 two 22 states 21 two 25 and 22 states 25 and 24 open 25 and 25 and 26 closed local depletion of calcium in the sr was inevitable during a spark , and this could terminate sparks by interrupting cicr , [with] or without assumed modulation of ryr gating by sr lumenal calcium . 0 ###LEFT-WALL### 2 depletion 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 35 . 1 local 2 depletion 2 depletion 3 of 2 depletion 8 was 3 of 4 calcium 4 calcium 5 in 5 in 7 sr 6 the 7 sr 8 was 9 inevitable 9 inevitable 10 during 10 during 12 spark 11 a 12 spark 13 , 14 and 14 and 15 this 14 and 17 terminate 15 this 16 could 16 could 17 terminate 17 terminate 18 sparks 18 sparks 24 or 18 sparks 28 of 18 sparks 30 gating 19 by 20 interrupting 19 by 24 or 20 interrupting 21 cicr 22 , 24 or 24 or 25 without 25 without 27 modulation 26 assumed 27 modulation 28 of 29 ryr 30 gating 31 by 30 gating 34 calcium 31 by 32 sr 33 lumenal 34 calcium spark termination by local sr depletion was not robust : under some conditions , sparks could be greatly and variably prolonged , terminating by stochastic attrition - a phenomenon we dub " spark metastability . " 0 ###LEFT-WALL### 1 spark 0 ###LEFT-WALL### 10 : 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 35 . 1 spark 2 termination 1 spark 7 was 1 spark 10 : 2 termination 3 by 2 termination 7 was 3 by 6 depletion 4 local 6 depletion 5 sr 6 depletion 7 was 8 not 8 not 9 robust 10 : 11 under 11 under 13 conditions 12 some 13 conditions 14 , 15 sparks 14 , 19 and 15 sparks 19 and 16 could 17 be 16 could 19 and 17 be 18 greatly 19 and 21 prolonged 19 and 23 terminating 19 and 29 phenomenon 20 variably 21 prolonged 22 , 23 terminating 23 terminating 24 by 23 terminating 27 - 24 by 26 attrition 25 stochastic 26 attrition 28 a 29 phenomenon 29 phenomenon 30 we 29 phenomenon 31 dub 30 we 31 dub 31 dub 32 " 31 dub 34 metastability 33 spark 34 metastability 35 . 36 " spark fluorescence rise time was not a good surrogate for the duration of calcium [release] . 0 ###LEFT-WALL### 4 time 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 16 . 1 spark 4 time 2 fluorescence 4 time 3 rise 4 time 4 time 5 was 5 was 6 not 5 was 9 surrogate 7 a 8 good 7 a 9 surrogate 8 good 9 surrogate 9 surrogate 10 for 9 surrogate 13 of 10 for 12 duration 11 the 12 duration 13 of 14 calcium using a highly simplified , deterministic model of the dynamics of a couplon , we show that spark metastability depends on the kinetic relationship of ryr gating and junctional sr refilling rates . 0 ###LEFT-WALL### 15 we 0 ###LEFT-WALL### 16 show 0 ###LEFT-WALL### 33 . 1 using 7 model 1 using 14 , 1 using 15 we 2 a 3 highly 2 a 7 model 3 highly 4 simplified 4 simplified 5 , 6 deterministic 7 model 7 model 8 of 7 model 11 of 8 of 10 dynamics 9 the 10 dynamics 11 of 13 couplon 12 a 13 couplon 15 we 16 show 16 show 18 spark 16 show 28 and 17 that 18 spark 18 spark 19 metastability 18 spark 27 gating 19 metastability 20 depends 20 depends 21 on 21 on 24 relationship 22 the 24 relationship 23 kinetic 24 relationship 24 relationship 25 of 25 of 26 ryr 26 ryr 27 gating 28 and 30 sr 29 junctional 30 sr 30 sr 31 refilling 31 refilling 32 rates the conditions for spark metastability resemble those produced by known mutations of ryr2 and casq2 that cause life - threatening triggered arrhythmias , and spark metastability may be mitigated by altering the kinetics of the ryr in a manner similar to the effects of drugs known to prevent those arrhythmias . 0 ###LEFT-WALL### 2 conditions 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 51 . 1 the 2 conditions 2 conditions 3 for 2 conditions 24 and 3 for 5 metastability 4 spark 5 metastability 6 resemble 7 those 6 resemble 20 threatening 6 resemble 24 and 7 those 8 produced 8 produced 9 by 9 by 14 and 10 known 11 mutations 11 mutations 12 of 11 mutations 14 and 12 of 13 ryr2 14 and 15 casq2 14 and 16 that 14 and 17 cause 16 that 17 cause 17 cause 18 life 19 - 20 threatening 20 threatening 22 arrhythmias 20 threatening 23 , 21 triggered 22 arrhythmias 24 and 48 prevent 25 spark 26 metastability 26 metastability 27 may 27 may 28 be 28 be 29 mitigated 29 mitigated 30 by 29 mitigated 37 in 29 mitigated 40 similar 30 by 31 altering 31 altering 33 kinetics 32 the 33 kinetics 33 kinetics 34 of 34 of 36 ryr 35 the 36 ryr 37 in 39 manner 38 a 39 manner 40 similar 41 to 40 similar 47 to 41 to 43 effects 42 the 43 effects 43 effects 44 of 44 of 45 drugs 45 drugs 46 known 47 to 48 prevent 48 prevent 50 arrhythmias 49 those 50 arrhythmias the model was unable to explain the distributions of spark amplitudes and rise times seen in chemically skinned cat atrial myocytes , suggesting that such sparks may be more complex events involving heterogeneity of couplons or local propagation among sub - clusters of ryrs . 0 ###LEFT-WALL### 2 model 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 41 - 0 ###LEFT-WALL### 45 . 1 the 2 model 2 model 3 was 3 was 4 unable 4 unable 5 to 4 unable 6 explain 5 to 6 explain 6 explain 8 distributions 6 explain 40 sub 7 the 8 distributions 8 distributions 9 of 8 distributions 40 sub 9 of 23 suggesting 10 spark 11 amplitudes 11 amplitudes 12 and 12 and 14 times 12 and 22 , 12 and 23 suggesting 13 rise 14 times 14 times 15 seen 15 seen 16 in 16 in 21 myocytes 17 chemically 18 skinned 18 skinned 19 cat 19 cat 21 myocytes 20 atrial 21 myocytes 23 suggesting 24 that 23 suggesting 39 among 24 that 26 sparks 24 that 28 be 25 such 26 sparks 26 sparks 27 may 27 may 28 be 28 be 31 events 29 more 30 complex 30 complex 31 events 31 events 32 involving 32 involving 33 heterogeneity 32 involving 39 among 33 heterogeneity 34 of 34 of 36 or 35 couplons 36 or 36 or 38 propagation 37 local 38 propagation 41 - 42 clusters 42 clusters 43 of 43 of 44 ryrs alzheimer 's disease ( ad ) is a neurodegenerative disorder characterized [by] progressive cognitive decline and is the most common cause of dementia in the elderly . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 27 . 1 alzheimer 2 's 2 's 3 disease 3 disease 5 ad 3 disease 16 and 4 ( 5 ad 5 ad 6 ) 7 is 15 decline 7 is 16 and 8 a 9 neurodegenerative 8 a 15 decline 9 neurodegenerative 15 decline 10 disorder 11 characterized 11 characterized 15 decline 13 progressive 15 decline 14 cognitive 15 decline 16 and 17 is 16 and 24 in 17 is 21 cause 18 the 21 cause 19 most 20 common 20 common 21 cause 21 cause 22 of 22 of 23 dementia 24 in 26 elderly 25 the 26 elderly histopathologically , ad features insoluble aggregates of two proteins in the brain , amyloid - β ( aβ ) and the microtubule - associated protein tau , both of which have been linked to the small ubiquitin - like modifier [(] sumo ) . 0 ###LEFT-WALL### 3 ad 0 ###LEFT-WALL### 4 features 1 histopathologically 2 , 1 histopathologically 3 ad 3 ad 4 features 4 features 20 and 5 insoluble 6 aggregates 6 aggregates 7 of 6 aggregates 20 and 7 of 9 proteins 8 two 9 proteins 9 proteins 10 in 9 proteins 16 β 10 in 12 brain 11 the 12 brain 12 brain 14 amyloid 13 , 14 amyloid 14 amyloid 15 - 15 - 16 β 16 β 18 aβ 16 β 19 ) 17 ( 18 aβ 18 aβ 19 ) 20 and 22 microtubule 20 and 26 tau 21 the 22 microtubule 23 - 26 tau 24 associated 25 protein 25 protein 26 tau 26 tau 28 both 26 tau 39 like 26 tau 44 . 27 , 28 both 28 both 29 of 28 both 38 - 29 of 30 which 30 which 31 have 31 have 32 been 32 been 33 linked 33 linked 34 to 34 to 37 ubiquitin 35 the 37 ubiquitin 36 small 37 ubiquitin 38 - 39 like 39 like 42 sumo 39 like 43 ) 40 modifier 42 sumo a large body of research has elucidated many of the molecular and cellular pathways that underlie ad , including those involving the abnormal aβ and tau aggregates . 0 ###LEFT-WALL### 3 body 0 ###LEFT-WALL### 7 elucidated 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 28 . 1 a 2 large 1 a 3 body 2 large 3 body 3 body 4 of 3 body 6 has 4 of 5 research 6 has 7 elucidated 7 elucidated 14 pathways 8 many 9 of 8 many 14 pathways 9 of 14 pathways 10 the 14 pathways 11 molecular 12 and 12 and 13 cellular 12 and 14 pathways 14 pathways 15 that 14 pathways 16 underlie 15 that 16 underlie 16 underlie 17 ad 18 , 19 including 18 , 27 aggregates 19 including 25 and 19 including 27 aggregates 20 those 21 involving 20 those 25 and 21 involving 24 aβ 22 the 24 aβ 23 abnormal 24 aβ 25 and 26 tau however , a full understanding of the etiology and pathogenesis of the disease has remained elusive . 0 ###LEFT-WALL### 5 understanding 0 ###LEFT-WALL### 15 remained 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 5 understanding 3 a 4 full 3 a 5 understanding 4 full 5 understanding 5 understanding 6 of 5 understanding 14 has 6 of 9 and 7 the 8 etiology 8 etiology 9 and 9 and 10 pathogenesis 9 and 11 of 11 of 13 disease 12 the 13 disease 14 has 15 remained 15 remained 16 elusive consequently , there are currently no effective therapeutic options that can modify the disease progression and slow or stop the decline of cognitive functioning . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 25 . 1 consequently 2 , 1 consequently 3 there 3 there 4 are 4 are 5 currently 4 are 9 options 6 no 9 options 7 effective 9 options 8 therapeutic 9 options 9 options 10 that 9 options 16 and 10 that 16 and 11 can 12 modify 11 can 16 and 12 modify 15 progression 13 the 15 progression 14 disease 15 progression 16 and 18 or 17 slow 18 or 18 or 19 stop 19 stop 21 decline 20 the 21 decline 21 decline 22 of 22 of 24 functioning 23 cognitive 24 functioning as part of the effort to address this lacking [,] there needs a better understanding of the signaling pathways that become impaired under ad pathology , including the regulatory mechanisms that normally control those networks . 0 ###LEFT-WALL### 27 including 0 ###LEFT-WALL### 35 networks 0 ###LEFT-WALL### 36 . 1 as 2 part 1 as 12 needs 1 as 26 , 1 as 27 including 2 part 3 of 2 part 12 needs 3 of 5 effort 4 the 5 effort 5 effort 6 to 5 effort 7 address 6 to 7 address 7 address 9 lacking 7 address 11 there 8 this 9 lacking 12 needs 15 understanding 13 a 15 understanding 14 better 15 understanding 15 understanding 16 of 16 of 19 pathways 17 the 19 pathways 18 signaling 19 pathways 19 pathways 20 that 19 pathways 21 become 19 pathways 23 under 20 that 21 become 21 become 22 impaired 23 under 25 pathology 24 ad 25 pathology 27 including 30 mechanisms 27 including 35 networks 28 the 30 mechanisms 29 regulatory 30 mechanisms 30 mechanisms 31 that 30 mechanisms 33 control 31 that 33 control 32 normally 33 control 33 control 34 those one such mechanism involves sumoylation , which is a post - translational modification ( ptm ) that is involved in regulating many aspects of cell biology and has also been found to have several critical [neuron] - specific roles . 0 ###LEFT-WALL### 3 mechanism 0 ###LEFT-WALL### 4 involves 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 31 found 0 ###LEFT-WALL### 40 . 1 one 2 such 2 such 3 mechanism 3 mechanism 4 involves 4 involves 5 sumoylation 6 , 7 which 6 , 27 and 7 which 8 is 8 is 10 post 9 a 10 post 10 post 13 modification 11 - 13 modification 12 translational 13 modification 13 modification 15 ptm 13 modification 16 ) 14 ( 15 ptm 15 ptm 16 ) 17 that 27 and 18 is 19 involved 18 is 27 and 19 involved 20 in 20 in 21 regulating 21 regulating 23 aspects 22 many 23 aspects 23 aspects 24 of 24 of 26 biology 25 cell 26 biology 27 and 28 has 28 has 30 been 29 also 30 been 30 been 31 found 31 found 32 to 32 to 33 have 33 have 39 roles 34 several 39 roles 35 critical 37 - 35 critical 39 roles 38 specific 39 roles early studies have indicated that the sumo system is likely altered with ad - type pathology , which may impact aβ levels and tau aggregation . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 indicated 1 early 2 studies 2 studies 3 have 3 have 4 indicated 4 indicated 5 that 5 that 8 system 5 that 11 altered 6 the 8 system 7 sumo 8 system 8 system 9 is 9 is 11 altered 10 likely 11 altered 11 altered 12 with 12 with 13 ad 13 ad 16 pathology 14 - 16 pathology 15 type 16 pathology 16 pathology 18 which 16 pathology 26 . 17 , 18 which 18 which 19 may 18 which 26 . 19 may 20 impact 20 impact 23 and 21 aβ 22 levels 22 levels 23 and 23 and 25 aggregation 24 tau 25 aggregation although [still] a relatively unexplored topic , sumoylation will likely emerge as a significant factor in ad pathogenesis in ways which may be somewhat analogous to other regulatory ptms such as phosphorylation . 0 ###LEFT-WALL### 8 sumoylation 0 ###LEFT-WALL### 11 emerge 0 ###LEFT-WALL### 33 . 1 although 6 topic 1 although 7 , 1 although 8 sumoylation 3 a 4 relatively 3 a 6 topic 4 relatively 5 unexplored 5 unexplored 6 topic 8 sumoylation 9 will 9 will 11 emerge 10 likely 11 emerge 11 emerge 12 as 11 emerge 19 in 12 as 15 factor 13 a 14 significant 13 a 15 factor 14 significant 15 factor 15 factor 16 in 16 in 18 pathogenesis 17 ad 18 pathogenesis 19 in 20 ways 20 ways 21 which 20 ways 22 may 21 which 22 may 22 may 23 be 23 be 25 analogous 24 somewhat 25 analogous 25 analogous 26 to 25 analogous 31 as 26 to 29 ptms 27 other 29 ptms 28 regulatory 29 ptms 30 such 31 as 31 as 32 phosphorylation thus , in addition to the upstream effects on tau and aβ processing , there may also be downstream effects mediated by aβ aggregates or other ad - related factors on sumo - regulated signaling pathways . 0 ###LEFT-WALL### 15 there 0 ###LEFT-WALL### 18 be 0 ###LEFT-WALL### 37 . 1 thus 15 there 2 , 3 in 3 in 11 and 3 in 14 , 3 in 15 there 4 addition 5 to 4 addition 11 and 5 to 8 effects 6 the 8 effects 7 upstream 8 effects 8 effects 9 on 9 on 10 tau 11 and 13 processing 11 and 14 , 12 aβ 13 processing 15 there 16 may 16 may 18 be 17 also 18 be 18 be 20 effects 18 be 22 by 19 downstream 20 effects 20 effects 21 mediated 22 by 25 or 23 aβ 24 aggregates 24 aggregates 25 or 25 or 27 ad 25 or 28 - 25 or 34 regulated 25 or 35 signaling 26 other 27 ad 28 - 29 related 29 related 30 factors 29 related 31 on 29 related 33 - 29 related 34 regulated 31 on 32 sumo 35 signaling 36 pathways multiple proteins that have functions relevant to ad pathology have been identified as sumo substrates , including those involved in synaptic physiology , mitochondrial dynamics , and inflammatory signaling . 0 ###LEFT-WALL### 2 proteins 0 ###LEFT-WALL### 12 identified 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 30 . 1 multiple 2 proteins 2 proteins 3 that 2 proteins 4 have 2 proteins 10 have 3 that 4 have 4 have 5 functions 5 functions 6 relevant 6 relevant 7 to 7 to 9 pathology 8 ad 9 pathology 10 have 11 been 11 been 12 identified 12 identified 13 as 13 as 15 substrates 14 sumo 15 substrates 15 substrates 17 including 16 , 17 including 17 including 18 those 17 including 23 , 18 those 19 involved 19 involved 20 in 20 in 22 physiology 21 synaptic 22 physiology 23 , 27 and 24 mitochondrial 25 dynamics 25 dynamics 27 and 26 , 27 and 27 and 29 signaling 28 inflammatory 29 signaling ongoing studies will determine [how] these sumo - regulated functions in neurons and glial cells may be impacted by aβ and ad pathology . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 determine 0 ###LEFT-WALL### 8 - 1 ongoing 2 studies 2 studies 3 will 3 will 4 determine 4 determine 7 sumo 6 these 7 sumo 8 - 13 and 8 - 18 impacted 8 - 24 . 9 regulated 10 functions 10 functions 11 in 10 functions 13 and 11 in 12 neurons 13 and 15 cells 13 and 16 may 14 glial 15 cells 16 may 17 be 17 be 18 impacted 18 impacted 19 by 19 by 23 pathology 20 aβ 21 and 21 and 22 ad 22 ad 23 pathology here , we present a review of the current literature on the involvement of sumo in ad , as well as an overview of the sumoylated proteins and pathways that are potentially dysregulated with ad pathogenesis . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 present 1 here 2 , 1 here 3 we 3 we 4 present 4 present 6 review 5 a 6 review 6 review 7 of 6 review 14 of 6 review 21 as 7 of 10 literature 8 the 10 literature 9 current 10 literature 10 literature 11 on 11 on 13 involvement 12 the 13 involvement 14 of 15 sumo 15 sumo 16 in 16 in 17 ad 18 , 21 as 19 as 20 well 20 well 21 as 21 as 28 and 21 as 37 . 22 an 23 overview 23 overview 24 of 23 overview 28 and 24 of 27 proteins 25 the 27 proteins 26 sumoylated 27 proteins 28 and 29 pathways 28 and 30 that 28 and 31 are 30 that 31 are 31 are 33 dysregulated 32 potentially 33 dysregulated 33 dysregulated 34 with 34 with 36 pathogenesis 35 ad 36 pathogenesis down 's syndrome ( ds ) is the most frequent genetic cause of intellectual disability and is a chromosomal abnormality of chromosome 21 trisomy . 0 ###LEFT-WALL### 3 syndrome 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 . 1 down 2 's 2 's 3 syndrome 3 syndrome 5 ds 3 syndrome 16 and 4 ( 5 ds 5 ds 6 ) 7 is 12 cause 7 is 16 and 8 the 12 cause 9 most 10 frequent 10 frequent 12 cause 11 genetic 12 cause 12 cause 13 of 13 of 15 disability 14 intellectual 15 disability 16 and 17 is 16 and 24 trisomy 17 is 20 abnormality 18 a 19 chromosomal 18 a 20 abnormality 19 chromosomal 20 abnormality 20 abnormality 21 of 21 of 22 chromosome 22 chromosome 23 21 the pericentrin gene ( pcnt ) has sequenced [in] 21q22.3 inside of the minimal critical region for down 's syndrome . 0 ###LEFT-WALL### 3 gene 0 ###LEFT-WALL### 8 sequenced 0 ###LEFT-WALL### 21 . 1 the 3 gene 2 pericentrin 3 gene 3 gene 5 pcnt 3 gene 7 has 4 ( 5 pcnt 5 pcnt 6 ) 7 has 8 sequenced 8 sequenced 10 21q22.3 8 sequenced 12 of 11 inside 12 of 12 of 16 region 13 the 16 region 14 minimal 16 region 15 critical 16 region 16 region 17 for 17 for 20 syndrome 18 down 19 's 19 's 20 syndrome alterations of pcnt [gene] are associated with dwarfism , cardiomyopathy and other pathologies . 0 ###LEFT-WALL### 1 alterations 0 ###LEFT-WALL### 6 associated 0 ###LEFT-WALL### 14 . 1 alterations 2 of 1 alterations 5 are 2 of 3 pcnt 5 are 6 associated 6 associated 7 with 7 with 11 and 8 dwarfism 9 , 9 , 10 cardiomyopathy 9 , 11 and 11 and 13 pathologies 12 other 13 pathologies in this study , we have evaluated the possible differential expression of pcnt mrna , by qrt - pcr , in peripheral blood leukocytes of ds subjects compared with the normal population . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 7 evaluated 0 ###LEFT-WALL### 33 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 have 6 have 7 evaluated 7 evaluated 11 expression 7 evaluated 28 compared 8 the 11 expression 9 possible 10 differential 10 differential 11 expression 11 expression 12 of 11 expression 28 compared 12 of 13 pcnt 13 pcnt 14 mrna 14 mrna 16 by 14 mrna 21 in 15 , 16 by 16 by 17 qrt 16 by 20 , 17 qrt 19 pcr 18 - 19 pcr 19 pcr 20 , 21 in 24 leukocytes 22 peripheral 23 blood 23 blood 24 leukocytes 24 leukocytes 25 of 25 of 27 subjects 26 ds 27 subjects 28 compared 29 with 29 with 32 population 30 the 32 population 31 normal 32 population in the present case - control study , pcnt gene expression was increased by 72.72 % in 16 out 22 ds samples compared with normal subjects . 0 ###LEFT-WALL### 6 control 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 27 . 1 in 4 case 1 in 5 - 1 in 6 control 2 the 4 case 3 present 4 case 6 control 7 study 8 , 11 expression 8 , 13 increased 9 pcnt 11 expression 10 gene 11 expression 11 expression 12 was 12 was 13 increased 13 increased 14 by 13 increased 17 in 13 increased 19 out 13 increased 24 with 14 by 16 % 15 72.72 16 % 17 in 18 16 19 out 22 samples 20 22 22 samples 21 ds 22 samples 22 samples 23 compared 24 with 26 subjects 25 normal 26 subjects our data suggest that changes in the expression levels of pcnt in ds subjects may be involved into the molecular mechanism of down 's syndrome . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 26 . 1 our 2 data 2 data 3 suggest 3 suggest 4 that 4 that 5 changes 4 that 17 involved 5 changes 6 in 5 changes 15 may 6 in 9 levels 7 the 9 levels 8 expression 9 levels 9 levels 10 of 10 of 11 pcnt 11 pcnt 12 in 12 in 14 subjects 13 ds 14 subjects 15 may 16 be 16 be 17 involved 17 involved 18 into 18 into 21 mechanism 19 the 21 mechanism 20 molecular 21 mechanism 21 mechanism 22 of 22 of 25 syndrome 23 down 24 's 24 's 25 syndrome the heritability of borderline personality ( bp ) [features] has been established in multiple twin [and] family studies . 0 ###LEFT-WALL### 2 heritability 0 ###LEFT-WALL### 12 established 0 ###LEFT-WALL### 19 . 1 the 2 heritability 2 heritability 3 of 2 heritability 10 has 3 of 5 personality 4 borderline 5 personality 5 personality 7 bp 6 ( 7 bp 7 bp 8 ) 10 has 11 been 11 been 12 established 12 established 13 in 13 in 18 studies 14 multiple 15 twin 15 twin 18 studies 17 family 18 studies using data from the borderline subscale [of] the personality assessment inventory borderline features scale ( pai - bor ) collected in two dutch cohorts [(] n=7125 [ )(, the netherlands twin register and the netherlands study of depression and anxiety , we show that heritability of the pai - bor total score using genome - wide single - nucleotide polymorphism ( snps ) is estimated at 23 % , [and] that the genetic variance is substantially higher in [affect] instability items compared with the other three subscales of the pai - bor ( 42.7 % [vs] [non] - significant estimates for self - harm , negative relations and identity problems ) . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 6 subscale 1 using 2 data 2 data 3 from 2 data 6 subscale 3 from 5 borderline 4 the 5 borderline 6 subscale 9 personality 8 the 9 personality 9 personality 16 pai 9 personality 20 collected 9 personality 21 in 10 assessment 11 inventory 11 inventory 12 borderline 12 borderline 13 features 13 features 14 scale 14 scale 16 pai 15 ( 16 pai 16 pai 17 - 16 pai 18 bor 16 pai 20 collected 17 - 18 bor 18 bor 19 ) 21 in 33 and 22 two 23 dutch 23 dutch 24 cohorts 24 cohorts 26 n=7125 26 n=7125 28 )(, 28 )(, 32 register 28 )(, 33 and 29 the 32 register 30 netherlands 31 twin 31 twin 32 register 33 and 36 study 33 and 42 we 33 and 43 show 34 the 35 netherlands 35 netherlands 36 study 36 study 37 of 37 of 39 and 38 depression 39 and 39 and 40 anxiety 39 and 41 , 42 we 43 show 43 show 44 that 43 show 45 heritability 43 show 55 - 45 heritability 46 of 46 of 48 pai 47 the 48 pai 49 - 55 - 50 bor 54 genome 51 total 52 score 52 score 54 genome 53 using 54 genome 54 genome 55 - 55 - 59 nucleotide 56 wide 59 nucleotide 57 single 58 - 57 single 59 nucleotide 59 nucleotide 60 polymorphism 59 nucleotide 64 is 59 nucleotide 65 estimated 59 nucleotide 66 at 60 polymorphism 62 snps 60 polymorphism 64 is 61 ( 62 snps 62 snps 63 ) 66 at 68 % 67 23 68 % 68 % 71 that 68 % 75 is 68 % 77 higher 69 , 71 that 71 that 74 variance 71 that 75 is 72 the 74 variance 73 genetic 74 variance 74 variance 75 is 76 substantially 77 higher 77 higher 78 in 77 higher 83 with 78 in 81 items 80 instability 81 items 81 items 82 compared 83 with 86 three 83 with 87 subscales 84 the 85 other 85 other 86 three 87 subscales 88 of 88 of 100 estimates 89 the 100 estimates 90 pai 92 bor 90 pai 100 estimates 91 - 92 bor 92 bor 95 % 92 bor 98 - 93 ( 95 % 94 42.7 95 % 95 % 98 - 99 significant 100 estimates 100 estimates 101 for 100 estimates 108 and 101 for 102 self 103 - 108 and 104 harm 105 , 105 , 107 relations 105 , 108 and 106 negative 107 relations 108 and 110 problems 108 and 111 ) 108 and 112 . 109 identity 110 problems we present results from a first genome - wide association study of bp features , which shows a promising signal on chromosome 5 corresponding to serinc5 , a protein involved in myelination . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 present 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 33 . 1 we 2 present 2 present 3 results 3 results 4 from 4 from 7 genome 5 a 7 genome 6 first 7 genome 7 genome 11 study 8 - 11 study 9 wide 10 association 10 association 11 study 11 study 12 of 11 study 15 , 12 of 14 features 13 bp 14 features 15 , 16 which 15 , 17 shows 15 , 27 , 16 which 17 shows 17 shows 20 signal 17 shows 21 on 18 a 19 promising 18 a 20 signal 19 promising 20 signal 21 on 22 chromosome 22 chromosome 23 5 22 chromosome 24 corresponding 24 corresponding 25 to 25 to 26 serinc5 27 , 32 myelination 28 a 31 in 29 protein 30 involved 30 involved 31 in 31 in 32 myelination reduced myelination has [been] suggested as possibly having a role in the development of psychiatric disorders characterized by lack of social interaction . 0 ###LEFT-WALL### 2 myelination 0 ###LEFT-WALL### 8 having 0 ###LEFT-WALL### 23 . 1 reduced 2 myelination 2 myelination 3 has 3 has 5 suggested 5 suggested 8 having 6 as 7 possibly 7 possibly 8 having 8 having 10 role 8 having 11 in 9 a 10 role 11 in 13 development 12 the 13 development 13 development 14 of 13 development 17 characterized 14 of 16 disorders 15 psychiatric 16 disorders 17 characterized 18 by 18 by 19 lack 19 lack 20 of 20 of 22 interaction 21 social 22 interaction the signal was confirmed in a third independent dutch cohort drawn from the erasmus rucphen family study ( n=1301 ) . 0 ###LEFT-WALL### 2 signal 0 ###LEFT-WALL### 4 confirmed 0 ###LEFT-WALL### 21 . 1 the 2 signal 2 signal 3 was 3 was 4 confirmed 4 confirmed 5 in 5 in 10 cohort 6 a 10 cohort 7 third 9 dutch 8 independent 9 dutch 9 dutch 10 cohort 10 cohort 11 drawn 11 drawn 12 from 12 from 17 study 13 the 17 study 14 erasmus 15 rucphen 15 rucphen 16 family 16 family 17 study 17 study 19 n=1301 18 ( 19 n=1301 19 n=1301 20 ) our analyses were complemented by investigating the heterogeneity that was implied by the differences in genetic variance components in the four subscales of the pai - bor . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 4 complemented 0 ###LEFT-WALL### 28 . 1 our 2 analyses 2 analyses 3 were 3 were 4 complemented 4 complemented 5 by 4 complemented 15 in 5 by 6 investigating 6 investigating 8 heterogeneity 6 investigating 12 by 7 the 8 heterogeneity 8 heterogeneity 9 that 8 heterogeneity 10 was 9 that 10 was 10 was 11 implied 12 by 14 differences 13 the 14 differences 15 in 18 components 16 genetic 17 variance 17 variance 18 components 18 components 19 in 18 components 23 of 19 in 22 subscales 20 the 21 four 21 four 22 subscales 23 of 27 bor 24 the 27 bor 25 pai 27 bor 26 - 27 bor these analyses show that the association of snps tagging serinc5 differs substantially across the 24 items of the pai - bor . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 22 . 1 these 2 analyses 2 analyses 3 show 3 show 4 that 4 that 6 association 4 that 11 differs 5 the 6 association 6 association 7 of 6 association 11 differs 7 of 8 snps 8 snps 9 tagging 9 tagging 10 serinc5 11 differs 12 substantially 11 differs 13 across 13 across 16 items 14 the 15 24 15 24 16 items 16 items 17 of 17 of 21 bor 18 the 21 bor 19 pai 21 bor 20 - 21 bor further , using reverse regression we showed that the effects were present only in subjects with higher scores on the pai - bor . 0 ###LEFT-WALL### 3 using 0 ###LEFT-WALL### 18 scores 0 ###LEFT-WALL### 24 . 1 further 2 , 1 further 3 using 3 using 5 regression 3 using 17 higher 3 using 18 scores 4 reverse 5 regression 5 regression 6 we 5 regression 16 with 6 we 7 showed 7 showed 8 that 8 that 10 effects 8 that 11 were 9 the 10 effects 10 effects 11 were 11 were 12 present 12 present 13 only 12 present 14 in 12 present 16 with 14 in 15 subjects 18 scores 19 on 19 on 23 bor 20 the 23 bor 21 pai 23 bor 22 - 23 bor taken together , these results suggest that future genome - wide analyses can benefit substantially by taking into account the phenotypic and genetic heterogeneity of bp features . 0 ###LEFT-WALL### 5 results 0 ###LEFT-WALL### 6 suggest 0 ###LEFT-WALL### 10 - 1 taken 2 together 1 taken 3 , 1 taken 5 results 4 these 5 results 5 results 6 suggest 6 suggest 9 genome 7 that 9 genome 8 future 9 genome 10 - 12 analyses 10 - 14 benefit 10 - 28 . 11 wide 12 analyses 12 analyses 13 can 13 can 14 benefit 14 benefit 15 substantially 14 benefit 16 by 14 benefit 24 heterogeneity 16 by 17 taking 17 taking 19 account 18 into 19 account 20 the 24 heterogeneity 21 phenotypic 22 and 22 and 23 genetic 22 and 24 heterogeneity 24 heterogeneity 25 of 25 of 27 features 26 bp 27 features we tested the null hypotheses that neither age , gender nor muscle pre - cocontraction state affect the latencies of changes in upper extremity kinematics or elbow muscle activity following an impulsive force to the hand . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 tested 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 37 . 1 we 2 tested 2 tested 5 hypotheses 3 the 5 hypotheses 4 null 5 hypotheses 5 hypotheses 6 that 5 hypotheses 8 age 6 that 8 age 7 neither 8 age 9 , 11 nor 9 , 26 or 10 gender 11 nor 11 nor 16 state 11 nor 26 or 12 muscle 16 state 13 pre 14 - 13 pre 15 cocontraction 15 cocontraction 16 state 17 affect 19 latencies 17 affect 22 in 17 affect 26 or 18 the 19 latencies 19 latencies 20 of 20 of 21 changes 22 in 25 kinematics 23 upper 24 extremity 24 extremity 25 kinematics 26 or 27 elbow 26 or 34 to 27 elbow 29 activity 28 muscle 29 activity 29 activity 30 following 30 following 33 force 31 an 32 impulsive 31 an 33 force 32 impulsive 33 force 34 to 36 hand 35 the 36 hand thirty - eight healthy young and older adult volunteers lay prone on an apparatus with shoulders flexed 75 ° and arms slightly flexed . 0 ###LEFT-WALL### 9 volunteers 0 ###LEFT-WALL### 10 lay 0 ###LEFT-WALL### 24 . 1 thirty 2 - 2 - 3 eight 2 - 9 volunteers 4 healthy 8 adult 5 young 6 and 6 and 7 older 6 and 8 adult 8 adult 9 volunteers 9 volunteers 10 lay 10 lay 11 prone 11 prone 12 on 12 on 14 apparatus 13 an 14 apparatus 14 apparatus 15 with 14 apparatus 23 flexed 15 with 16 shoulders 16 shoulders 20 and 17 flexed 19 ° 17 flexed 20 and 18 75 19 ° 20 and 21 arms 22 slightly 23 flexed the [non] [-] dominant hand was subjected to three trials of impulsive loading with arm muscles precontracted to 25 , 50 , or 75 % of maximum pre - cocontraction levels . 0 ###LEFT-WALL### 5 hand 0 ###LEFT-WALL### 7 subjected 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 32 . 1 the 5 hand 4 dominant 5 hand 5 hand 6 was 6 was 7 subjected 7 subjected 8 to 7 subjected 14 with 7 subjected 18 to 8 to 10 trials 9 three 10 trials 10 trials 11 of 11 of 13 loading 12 impulsive 13 loading 14 with 16 muscles 15 arm 16 muscles 16 muscles 17 precontracted 18 to 19 25 20 , 21 50 20 , 23 or 22 , 23 or 23 or 25 % 23 or 31 levels 24 75 25 % 25 % 26 of 25 % 31 levels 26 of 30 cocontraction 27 maximum 30 cocontraction 28 pre 29 - 28 pre 30 cocontraction limb kinematic data and upper extremity electromyographic ( emg ) activity were acquired . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 13 acquired 0 ###LEFT-WALL### 14 . 1 limb 3 data 2 kinematic 3 data 3 data 4 and 4 and 11 activity 4 and 12 were 5 upper 6 extremity 6 extremity 11 activity 7 electromyographic 9 emg 7 electromyographic 11 activity 8 ( 9 emg 9 emg 10 ) 12 were 13 acquired the results showed that pre [-] cocontraction muscle level ( p < 0.001 ) and gender ( p < 0.05 for wrist and shoulder ) affected joint displacement onset times and age affected emg onset times ( p < 0.05 ) . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 showed 1 the 2 results 2 results 3 showed 3 showed 9 level 3 showed 15 and 4 that 5 pre 5 pre 9 level 7 cocontraction 8 muscle 8 muscle 9 level 9 level 12 < 10 ( 12 < 11 p 12 < 12 < 13 0.001 12 < 14 ) 15 and 16 gender 16 gender 19 < 17 ( 19 < 18 p 19 < 19 < 20 0.05 20 0.05 21 for 21 for 31 and 22 wrist 23 and 23 and 24 shoulder 23 and 25 ) 23 and 26 affected 23 and 31 and 26 affected 27 joint 27 joint 30 times 28 displacement 30 times 29 onset 30 times 31 and 32 age 31 and 42 . 32 age 33 affected 33 affected 36 times 34 emg 35 onset 35 onset 36 times 36 times 39 < 37 ( 39 < 38 p 39 < 39 < 40 0.05 39 < 41 ) the peak applied force ( [f1] [ )( a mean ( ± sd ) [27] ( ± 2 ) [ms] after impact . 0 ###LEFT-WALL### 2 peak 0 ###LEFT-WALL### 3 applied 0 ###LEFT-WALL### 23 . 1 the 2 peak 2 peak 3 applied 3 applied 4 force 3 applied 21 after 4 force 10 mean 5 ( 10 mean 9 a 10 mean 10 mean 13 sd 10 mean 17 ± 10 mean 19 ) 11 ( 13 sd 12 ± 13 sd 13 sd 14 ) 16 ( 17 ± 17 ± 18 2 17 ± 19 ) 21 after 22 impact the latencies for the wrist , elbow , and shoulder displacements were 21 ± 3 , 29 ± 5 , and 34 ± 7 [m] s , respectively . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 21 and 1 the 2 latencies 2 latencies 3 for 2 latencies 6 , 3 for 5 wrist 4 the 5 wrist 6 , 7 elbow 6 , 9 and 8 , 9 and 9 and 11 displacements 9 and 12 were 10 shoulder 11 displacements 12 were 14 ± 13 21 14 ± 14 ± 15 3 14 ± 18 ± 16 , 18 ± 17 29 18 ± 18 ± 19 5 18 ± 20 , 20 , 21 and 21 and 22 34 21 and 23 ± 22 34 23 ± 23 ± 26 s 23 ± 28 respectively 24 7 26 s 27 , 28 respectively 28 respectively 29 . because the latencies for elbow flexion and lateral triceps emg were 23 ± 5 and 84 ± 8 m [s] , respectively , muscle pre - activation rather than stretch reflexes prevent arm buckling under impulsive end loads . 0 ###LEFT-WALL### 24 muscle 0 ###LEFT-WALL### 39 . 1 because 3 latencies 1 because 17 ± 1 because 24 muscle 2 the 3 latencies 3 latencies 4 for 3 latencies 17 ± 4 for 13 ± 5 elbow 6 flexion 6 flexion 7 and 7 and 9 triceps 7 and 10 emg 7 and 11 were 7 and 13 ± 8 lateral 9 triceps 10 emg 11 were 12 23 13 ± 13 ± 15 and 14 5 15 and 15 and 16 84 17 ± 19 m 18 8 19 m 21 , 22 respectively 22 respectively 23 , 22 respectively 24 muscle 24 muscle 27 activation 24 muscle 29 than 24 muscle 35 under 25 pre 26 - 25 pre 27 activation 28 rather 29 than 29 than 30 stretch 30 stretch 31 reflexes 30 stretch 32 prevent 31 reflexes 32 prevent 32 prevent 34 buckling 33 arm 34 buckling 35 under 38 loads 36 impulsive 37 end 37 end 38 loads aim : " saving appearances behavior " , pretending to know the correct answer , or a reply of deceptive replies , are often found in the reply of patients with dementia . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 1 aim 2 : 2 : 3 " 2 : 4 saving 4 saving 6 behavior 4 saving 9 pretending 5 appearances 6 behavior 6 behavior 7 " 8 , 9 pretending 9 pretending 10 to 9 pretending 11 know 9 pretending 33 . 10 to 11 know 11 know 16 or 11 know 25 found 12 the 14 answer 13 correct 14 answer 14 answer 16 or 15 , 16 or 16 or 18 reply 16 or 22 , 16 or 23 are 17 a 18 reply 18 reply 19 of 19 of 21 replies 20 deceptive 21 replies 23 are 24 often 23 are 25 found 25 found 26 in 26 in 28 reply 27 the 28 reply 28 reply 29 of 29 of 30 patients 30 patients 31 with 31 with 32 dementia we have already found that we can classify the answers to " what is the latest news on tv or newspapers ? " into 4 types , including saving appearances answer . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 22 ? 0 ###LEFT-WALL### 31 answer 0 ###LEFT-WALL### 32 . 1 we 2 have 2 have 4 found 3 already 4 found 4 found 5 that 5 that 6 we 5 that 8 classify 6 we 7 can 7 can 8 classify 8 classify 10 answers 8 classify 11 to 9 the 10 answers 11 to 12 " 11 to 13 what 13 what 14 is 14 is 17 news 14 is 18 on 15 the 16 latest 15 the 17 news 18 on 20 or 19 tv 20 or 20 or 21 newspapers 22 ? 23 " 22 ? 30 appearances 24 into 26 types 24 into 27 , 24 into 30 appearances 25 4 26 types 28 including 30 appearances 29 saving 30 appearances 30 appearances 31 answer the purpose of the present study is to develop a simple clinical diagnostic method based on the answers to " what is the latest news on tv or newspapers ? " for differentiating patients with alzheimer 's disease ( ad ) from those with mild cognitive impairment ( mci ) , [and] to test the validity , sensitivity and specificity of the method . 0 ###LEFT-WALL### 28 or 0 ###LEFT-WALL### 51 , 0 ###LEFT-WALL### 64 . 1 the 2 purpose 2 purpose 3 of 2 purpose 15 based 2 purpose 28 or 3 of 5 present 4 the 5 present 5 present 6 study 5 present 7 is 6 study 7 is 7 is 8 to 8 to 9 develop 9 develop 14 method 10 a 11 simple 10 a 14 method 11 simple 14 method 12 clinical 14 method 13 diagnostic 14 method 15 based 16 on 15 based 19 to 16 on 18 answers 17 the 18 answers 19 to 20 " 19 to 21 what 21 what 22 is 22 is 25 news 23 the 24 latest 23 the 25 news 25 news 26 on 26 on 27 tv 28 or 29 newspapers 28 or 30 ? 28 or 32 for 30 ? 31 " 32 for 33 differentiating 33 differentiating 34 patients 33 differentiating 35 with 33 differentiating 42 from 33 differentiating 44 with 35 with 38 disease 36 alzheimer 37 's 37 's 38 disease 38 disease 40 ad 39 ( 40 ad 40 ad 41 ) 42 from 43 those 44 with 47 impairment 45 mild 47 impairment 46 cognitive 47 impairment 47 impairment 49 mci 48 ( 49 mci 49 mci 50 ) 51 , 53 to 51 , 54 test 53 to 54 test 54 test 59 and 55 the 56 validity 56 validity 57 , 57 , 58 sensitivity 57 , 59 and 59 and 60 specificity 59 and 61 of 61 of 63 method 62 the 63 method methods : we recruited 133 consecutive outpatients with ad , 116 with mci , and 54 normal cognitive aging controls ( nc ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 recruited 2 : 24 . 3 we 4 recruited 4 recruited 7 outpatients 4 recruited 8 with 5 133 7 outpatients 6 consecutive 7 outpatients 8 with 15 and 9 ad 11 116 9 ad 15 and 10 , 11 116 11 116 12 with 11 116 14 , 12 with 13 mci 14 , 15 and 15 and 20 controls 15 and 22 nc 16 54 20 controls 17 normal 20 controls 18 cognitive 20 controls 19 aging 20 controls 21 ( 22 nc 22 nc 23 ) mini - mental state examination ( mmse ) was performed for all of the subjects . 0 ###LEFT-WALL### 1 mini 0 ###LEFT-WALL### 10 performed 0 ###LEFT-WALL### 16 . 1 mini 7 mmse 1 mini 9 was 2 - 7 mmse 3 mental 4 state 4 state 5 examination 5 examination 7 mmse 6 ( 7 mmse 7 mmse 8 ) 9 was 10 performed 10 performed 11 for 11 for 15 subjects 12 all 13 of 12 all 15 subjects 13 of 15 subjects 14 the 15 subjects severity of memory disturbance was rated 0 ( none ) to 3 ( severe ) according to the results of the 3 - object recall [portion] of the mmse questionnaire . 0 ###LEFT-WALL### 1 severity 0 ###LEFT-WALL### 6 rated 1 severity 2 of 1 severity 6 rated 2 of 3 memory 3 memory 4 disturbance 3 memory 5 was 4 disturbance 5 was 6 rated 7 0 6 rated 11 to 7 0 9 none 8 ( 9 none 9 none 10 ) 11 to 12 3 12 3 23 - 13 ( 23 - 14 severe 15 ) 14 severe 16 according 16 according 17 to 16 according 23 - 17 to 19 results 18 the 19 results 19 results 20 of 20 of 22 3 21 the 22 3 23 - 25 recall 23 - 31 . 24 object 25 recall 25 recall 27 of 27 of 30 questionnaire 28 the 30 questionnaire 29 mmse 30 questionnaire results : only 20 % of ad and 32 % of mci responded correctly about the recent news while 96 % of nc responded correctly . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 26 . 1 results 2 : 2 : 5 % 3 only 4 20 4 20 5 % 5 % 6 of 6 of 7 ad 8 and 10 % 8 and 13 responded 9 32 10 % 10 % 11 of 10 % 13 responded 11 of 12 mci 13 responded 14 correctly 13 responded 15 about 13 responded 19 while 15 about 18 news 16 the 18 news 17 recent 18 news 19 while 21 % 19 while 24 responded 20 96 21 % 21 % 22 of 21 % 24 responded 22 of 23 nc 24 responded 25 correctly among patients with ad [and] mci , one third of them showed " saving appearance behavior " . 0 ###LEFT-WALL### 9 third 0 ###LEFT-WALL### 12 showed 0 ###LEFT-WALL### 18 . 1 among 2 patients 1 among 7 , 1 among 9 third 2 patients 3 with 3 with 4 ad 4 ad 6 mci 8 one 9 third 9 third 10 of 9 third 12 showed 10 of 11 them 12 showed 13 " 12 showed 16 behavior 14 saving 16 behavior 15 appearance 16 behavior 16 behavior 17 " taking the result of the memory disturbance according to the mmse in consideration , the present study indicates that the ad patients can be distinguished from mci and nc with high sensitivity ( 98 % ) and high specificity ( 94 % ) using this simple , one - phrase question . 0 ###LEFT-WALL### 17 study 0 ###LEFT-WALL### 18 indicates 0 ###LEFT-WALL### 52 . 1 taking 3 result 1 taking 9 to 1 taking 12 in 1 taking 14 , 1 taking 17 study 2 the 3 result 3 result 4 of 4 of 7 disturbance 5 the 7 disturbance 6 memory 7 disturbance 8 according 9 to 9 to 11 mmse 10 the 11 mmse 12 in 13 consideration 15 the 17 study 16 present 17 study 17 study 18 indicates 18 indicates 19 that 19 that 22 patients 19 that 24 be 20 the 22 patients 21 ad 22 patients 22 patients 23 can 23 can 24 be 24 be 37 and 24 be 44 using 25 distinguished 26 from 25 distinguished 28 and 26 from 27 mci 28 and 29 nc 28 and 37 and 29 nc 30 with 30 with 32 sensitivity 31 high 32 sensitivity 32 sensitivity 35 % 33 ( 35 % 34 98 35 % 35 % 36 ) 37 and 39 specificity 37 and 42 % 38 high 39 specificity 40 ( 42 % 41 94 42 % 42 % 43 ) 44 using 51 question 45 this 51 question 46 simple 48 one 46 simple 49 - 46 simple 50 phrase 47 , 48 one 48 one 49 - 50 phrase 51 question conclusions : " what is the latest news on tv or papers ? " was highly effective in identifying ad [and] mci . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 " 2 : 4 what 2 : 5 is 2 : 23 . 4 what 5 is 5 is 7 latest 6 the 7 latest 7 latest 8 news 7 latest 19 identifying 8 news 9 on 8 news 15 was 9 on 11 or 10 tv 11 or 11 or 12 papers 11 or 13 ? 13 ? 14 " 15 was 16 highly 15 was 17 effective 17 effective 18 in 18 in 19 identifying 19 identifying 20 ad 20 ad 22 mci the present study suggests that the " saving appearances answer " is associated with the onset or awareness of memory impairment , the maintenance of the frontal lobe function and other characteristics of the patient . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 suggests 0 ###LEFT-WALL### 36 . 1 the 3 study 2 present 3 study 3 study 4 suggests 4 suggests 5 that 5 that 10 answer 5 that 13 associated 6 the 7 " 6 the 10 answer 8 saving 10 answer 9 appearances 10 answer 10 answer 11 " 10 answer 12 is 12 is 13 associated 13 associated 14 with 14 with 30 and 15 the 16 onset 16 onset 17 or 17 or 18 awareness 17 or 22 , 18 awareness 19 of 19 of 21 impairment 20 memory 21 impairment 22 , 24 maintenance 22 , 30 and 23 the 24 maintenance 24 maintenance 25 of 25 of 29 function 26 the 29 function 27 frontal 28 lobe 28 lobe 29 function 30 and 32 characteristics 30 and 33 of 31 other 32 characteristics 33 of 35 patient 34 the 35 patient [none] none none none none objective : the purpose of this study was to determine the relationship between the timed up and go test and postoperative morbidity and 1 [-] year mortality , [and] to compare the timed up and go to the standard - of [-] care surgical risk calculators for prediction of postoperative complications . 0 ###LEFT-WALL### 6 objective 0 ###LEFT-WALL### 7 : 2 none 3 none 3 none 4 none 4 none 5 none 5 none 6 objective 7 : 9 purpose 7 : 13 was 8 the 9 purpose 9 purpose 10 of 9 purpose 13 was 10 of 12 study 11 this 12 study 13 was 14 to 14 to 15 determine 15 determine 17 relationship 15 determine 18 between 16 the 17 relationship 18 between 25 and 19 the 21 up 20 timed 21 up 21 up 22 and 22 and 24 test 22 and 25 and 23 go 24 test 25 and 32 mortality 25 and 33 , 25 and 35 to 26 postoperative 32 mortality 27 morbidity 28 and 28 and 31 year 28 and 32 mortality 29 1 31 year 33 , 35 to 35 to 36 compare 36 compare 41 go 37 the 41 go 38 timed 39 up 39 up 40 and 40 and 41 go 41 go 42 to 41 go 46 of 42 to 44 standard 43 the 44 standard 45 - 46 of 46 of 51 calculators 46 of 57 . 48 care 51 calculators 49 surgical 51 calculators 50 risk 51 calculators 51 calculators 52 for 51 calculators 54 of 52 for 53 prediction 54 of 56 complications 55 postoperative 56 complications methods : in this prospective cohort study , patients 65 years and older undergoing elective colorectal and cardiac operations with a minimum of 1 [-] year follow [-] up were included . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 7 study 2 : 8 , 3 in 6 cohort 3 in 7 study 4 this 6 cohort 5 prospective 6 cohort 8 , 12 and 8 , 31 included 9 patients 11 years 10 65 11 years 11 years 12 and 12 and 14 undergoing 12 and 19 operations 12 and 27 follow 12 and 30 were 13 older 14 undergoing 15 elective 19 operations 16 colorectal 17 and 17 and 18 cardiac 17 and 19 operations 19 operations 20 with 19 operations 23 of 19 operations 27 follow 20 with 22 minimum 21 a 22 minimum 23 of 26 year 24 1 26 year 27 follow 29 up 30 were 31 included the timed up and go test was performed preoperatively . 0 ###LEFT-WALL### 6 test 0 ###LEFT-WALL### 8 performed 0 ###LEFT-WALL### 10 . 1 the 6 test 2 timed 3 up 3 up 4 and 4 and 5 go 5 go 6 test 6 test 7 was 7 was 8 performed 8 performed 9 preoperatively this timed test starts with the subject standing from a chair , [walking] 10 feet , returning to the chair , and ends after the subject sits . 0 ###LEFT-WALL### 3 test 0 ###LEFT-WALL### 4 starts 0 ###LEFT-WALL### 28 . 1 this 3 test 2 timed 3 test 3 test 4 starts 4 starts 5 with 4 starts 9 from 4 starts 17 returning 5 with 7 subject 6 the 7 subject 7 subject 8 standing 9 from 11 chair 10 a 11 chair 11 chair 15 feet 12 , 15 feet 14 10 15 feet 15 feet 16 , 17 returning 18 to 17 returning 24 after 18 to 22 and 19 the 20 chair 20 chair 22 and 21 , 22 and 22 and 23 ends 24 after 26 subject 24 after 27 sits 25 the 26 subject 26 subject 27 sits timed up and go results were grouped as fast ≤ 10 seconds , intermediate = 11 - 14 seconds , and slow ≥ 15 seconds . 0 ###LEFT-WALL### 5 results 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 26 . 1 timed 5 results 2 up 3 and 3 and 4 go 4 go 5 results 5 results 21 and 6 were 7 grouped 6 were 21 and 7 grouped 8 as 8 as 12 seconds 9 fast 12 seconds 10 ≤ 12 seconds 11 10 12 seconds 12 seconds 19 seconds 13 , 19 seconds 14 intermediate 17 - 14 intermediate 19 seconds 15 = 16 11 16 11 17 - 17 - 18 14 19 seconds 20 , 21 and 22 slow 21 and 25 seconds 22 slow 23 ≥ 23 ≥ 24 15 receiver operating characteristic curves were used to compare the 3 timed up and go groups to current standard - [of] [-] care surgical risk calculators at forecasting postoperative complications . 0 ###LEFT-WALL### 4 curves 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 30 . 1 receiver 2 operating 2 operating 4 curves 3 characteristic 4 curves 4 curves 5 were 5 were 6 used 6 used 7 to 6 used 15 groups 7 to 8 compare 8 compare 11 timed 9 the 11 timed 10 3 11 timed 11 timed 14 go 11 timed 15 groups 12 up 13 and 13 and 14 go 14 go 15 groups 15 groups 16 to 15 groups 26 at 16 to 25 calculators 17 current 22 care 18 standard 19 - 18 standard 22 care 22 care 25 calculators 23 surgical 25 calculators 24 risk 25 calculators 26 at 27 forecasting 27 forecasting 29 complications 28 postoperative 29 complications results : this study included 272 subjects ( mean age of 74 ± 6 years ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 included 2 : 17 . 3 this 4 study 4 study 5 included 5 included 7 subjects 6 272 7 subjects 7 subjects 10 age 8 ( 10 age 9 mean 10 age 10 age 11 of 10 age 16 ) 11 of 15 years 12 74 15 years 13 ± 15 years 14 6 15 years slower timed up and go was associated with increased postoperative complications [after] colorectal [(] fast 13 % , intermediate 29 [%] , and slow 77 [%] [;] p < 0.001 ) and cardiac ( fast 11 % , [intermediate] 26 % , and slow 52 [%] [;] p < 0.001 [ )( . 0 ###LEFT-WALL### 5 go 0 ###LEFT-WALL### 7 associated 1 slower 5 go 2 timed 3 up 3 up 4 and 4 and 5 go 5 go 6 was 6 was 7 associated 7 associated 8 with 7 associated 13 colorectal 8 with 11 complications 9 increased 11 complications 10 postoperative 11 complications 13 colorectal 23 and 15 fast 23 and 16 13 17 % 17 % 19 intermediate 18 , 19 intermediate 19 intermediate 20 29 19 intermediate 22 , 22 , 23 and 23 and 32 and 24 slow 29 < 24 slow 32 and 25 77 29 < 28 p 29 < 29 < 30 0.001 29 < 31 ) 32 and 43 and 33 cardiac 35 fast 33 cardiac 43 and 34 ( 35 fast 35 fast 42 , 36 11 37 % 37 % 41 % 38 , 41 % 40 26 41 % 41 % 42 , 42 , 43 and 43 and 44 slow 44 slow 49 < 45 52 49 < 48 p 49 < 49 < 50 0.001 49 < 53 . slower timed up and go was associated with increased 1 - year mortality following both colorectal ( fast 3 % , intermediate 10 [%] , and slow 31 [%] [;] p = 0.006 ) and cardiac ( fast 2 % , [intermediate] 3 % , and slow 12 [%] [;] p = 0.039 [ )( . 0 ###LEFT-WALL### 2 timed 0 ###LEFT-WALL### 9 increased 0 ###LEFT-WALL### 11 - 1 slower 2 timed 2 timed 5 go 2 timed 8 with 2 timed 9 increased 3 up 4 and 4 and 5 go 5 go 6 was 6 was 7 associated 7 associated 8 with 9 increased 10 1 11 - 13 mortality 12 year 13 mortality 13 mortality 14 following 14 following 15 both 14 following 26 and 16 colorectal 18 fast 16 colorectal 26 and 17 ( 18 fast 18 fast 25 , 19 3 20 % 20 % 22 intermediate 21 , 22 intermediate 22 intermediate 23 10 22 intermediate 25 , 25 , 26 and 26 and 35 and 27 slow 32 = 27 slow 35 and 28 31 32 = 31 p 32 = 32 = 33 0.006 32 = 34 ) 35 and 46 and 36 cardiac 38 fast 36 cardiac 46 and 37 ( 38 fast 38 fast 45 , 39 2 40 % 40 % 44 % 41 , 44 % 43 3 44 % 44 % 45 , 45 , 46 and 46 and 47 slow 47 slow 52 = 48 12 52 = 51 p 52 = 52 = 53 0.039 52 = 56 . conclusions : slower timed up and go forecasted increased postoperative complications and 1 [-] year mortality across surgical specialties . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 7 go 2 : 9 increased 2 : 20 . 3 slower 7 go 4 timed 5 up 5 up 6 and 6 and 7 go 7 go 8 forecasted 7 go 9 increased 9 increased 12 and 9 increased 17 across 10 postoperative 11 complications 11 complications 12 and 12 and 16 mortality 13 1 15 year 15 year 16 mortality 17 across 19 specialties 18 surgical 19 specialties regardless of operation performed , the timed up and go compared favorably to the more complex risk calculators at forecasting postoperative complications . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 11 compared 0 ###LEFT-WALL### 23 . 1 regardless 2 of 2 of 3 operation 2 of 5 , 2 of 9 and 3 operation 4 performed 6 the 8 up 7 timed 8 up 8 up 9 and 9 and 10 go 9 and 11 compared 11 compared 12 favorably 11 compared 13 to 11 compared 19 at 13 to 18 calculators 14 the 18 calculators 15 more 16 complex 16 complex 18 calculators 17 risk 18 calculators 19 at 20 forecasting 20 forecasting 22 complications 21 postoperative 22 complications background : aging is an established risk factor for contrast - induced nephropathy ( cin ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 aging 2 : 4 is 2 : 17 . 3 aging 4 is 4 is 8 factor 5 an 8 factor 6 established 8 factor 7 risk 8 factor 8 factor 9 for 9 for 10 contrast 10 contrast 13 nephropathy 11 - 13 nephropathy 12 induced 13 nephropathy 13 nephropathy 15 cin 13 nephropathy 16 ) 14 ( 15 cin 15 cin 16 ) however , little information is available on the incidence and clinical outcome of cin for the elderly patients in japan . 0 ###LEFT-WALL### 4 information 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 4 information 3 little 4 information 4 information 5 is 5 is 6 available 6 available 7 on 6 available 15 for 6 available 19 in 7 on 10 and 8 the 9 incidence 9 incidence 10 and 10 and 12 outcome 10 and 13 of 11 clinical 12 outcome 13 of 14 cin 15 for 18 patients 16 the 18 patients 17 elderly 18 patients 19 in 20 japan objectives : we determined the incidence and clinical outcome of cin in the japanese elderly patient . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 determined 2 : 17 . 3 we 4 determined 4 determined 7 and 4 determined 12 in 5 the 6 incidence 6 incidence 7 and 7 and 9 outcome 7 and 10 of 8 clinical 9 outcome 10 of 11 cin 12 in 16 patient 13 the 16 patient 14 japanese 16 patient 15 elderly 16 patient methods : we studied 292 patients who had mild renal dysfunction ( estimated glomerular filtration [rate] ( egfr ) [<] 60 ml/min/1.73 [m] ( 2 ) ) at baseline and underwent coronary angiography . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 30 and 2 : 34 . 3 we 30 and 4 studied 6 patients 4 studied 30 and 5 292 6 patients 6 patients 7 who 6 patients 8 had 7 who 8 had 8 had 11 dysfunction 8 had 28 at 9 mild 11 dysfunction 10 renal 11 dysfunction 11 dysfunction 15 filtration 12 ( 15 filtration 13 estimated 15 filtration 14 glomerular 15 filtration 15 filtration 22 ml/min/1.73 15 filtration 27 ) 17 ( 22 ml/min/1.73 18 egfr 19 ) 18 egfr 22 ml/min/1.73 21 60 22 ml/min/1.73 22 ml/min/1.73 25 2 22 ml/min/1.73 26 ) 24 ( 25 2 25 2 26 ) 28 at 29 baseline 30 and 31 underwent 31 underwent 33 angiography 32 coronary 33 angiography patients were divided into two groups base on their age : the elderly group ( age ≥ 75 , n=108 [ )(and the control group ( age<75 , n=184 ) . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 7 base 0 ###LEFT-WALL### 11 : 0 ###LEFT-WALL### 31 . 1 patients 2 were 2 were 3 divided 3 divided 4 into 4 into 5 two 5 two 6 groups 5 two 7 base 6 groups 7 base 7 base 8 on 8 on 10 age 9 their 10 age 11 : 14 group 12 the 14 group 13 elderly 14 group 14 group 22 )(and 15 ( 22 )(and 16 age 17 ≥ 17 ≥ 18 75 17 ≥ 19 , 19 , 20 n=108 19 , 22 )(and 22 )(and 25 group 22 )(and 27 age<75 22 )(and 29 n=184 22 )(and 30 ) 23 the 25 group 24 control 25 group 26 ( 27 age<75 27 age<75 28 , 28 , 29 n=184 29 n=184 30 ) cin was defined as a 25 % increase in serum creatinine or an increase in serum creatinine by>0.5 [mg/dl] above the baseline value [at] or within 2 days post procedure . 0 ###LEFT-WALL### 1 cin 0 ###LEFT-WALL### 3 defined 0 ###LEFT-WALL### 31 . 1 cin 2 was 2 was 3 defined 3 defined 4 as 3 defined 9 in 3 defined 18 by>0.5 4 as 8 increase 5 a 8 increase 6 25 7 % 7 % 8 increase 9 in 12 or 10 serum 11 creatinine 11 creatinine 12 or 12 or 14 increase 12 or 15 in 13 an 14 increase 15 in 17 creatinine 16 serum 17 creatinine 18 by>0.5 25 or 20 above 23 value 20 above 25 or 21 the 23 value 22 baseline 23 value 25 or 26 within 26 within 30 procedure 27 2 28 days 28 days 29 post 29 post 30 procedure results : patients in the elderly group had a higher incidence of cin ( 14 % ) than those in the control group ( 9 % ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 8 had 2 : 28 . 3 patients 4 in 3 patients 8 had 4 in 7 group 5 the 7 group 6 elderly 7 group 8 had 11 incidence 8 had 18 than 8 had 20 in 9 a 11 incidence 10 higher 11 incidence 11 incidence 12 of 12 of 13 cin 13 cin 16 % 14 ( 16 % 15 14 16 % 16 % 17 ) 18 than 19 those 20 in 23 group 21 the 23 group 22 control 23 group 23 group 26 % 24 ( 26 % 25 9 26 % 26 % 27 ) in patients who developed cin , there was no significant difference between the two groups in baseline gfr and gfr on days 1 , 2 , 7 and 30 after the procedure . 0 ###LEFT-WALL### 7 there 0 ###LEFT-WALL### 8 was 1 in 2 patients 1 in 6 , 1 in 7 there 2 patients 3 who 2 patients 4 developed 3 who 4 developed 4 developed 5 cin 7 there 8 was 8 was 11 difference 8 was 12 between 8 was 16 in 8 was 21 on 9 no 11 difference 10 significant 11 difference 12 between 15 groups 13 the 14 two 14 two 15 groups 16 in 20 gfr 17 baseline 20 gfr 18 gfr 19 and 19 and 20 gfr 21 on 22 days 22 days 23 1 22 days 25 2 24 , 25 2 25 2 28 and 25 2 33 . 26 , 28 and 27 7 28 and 28 and 29 30 28 and 30 after 28 and 33 . 30 after 32 procedure 31 the 32 procedure furthermore , death occurred in 3 patients in the elderly group ( 20 % ) whereas no patient died in the control group ( p=0.092 ) . 0 ###LEFT-WALL### 3 death 0 ###LEFT-WALL### 4 occurred 0 ###LEFT-WALL### 27 . 1 furthermore 2 , 1 furthermore 3 death 3 death 4 occurred 4 occurred 5 in 4 occurred 8 in 4 occurred 16 whereas 5 in 7 patients 6 3 7 patients 8 in 11 group 9 the 11 group 10 elderly 11 group 11 group 14 % 12 ( 14 % 13 20 14 % 14 % 15 ) 16 whereas 18 patient 16 whereas 19 died 17 no 18 patient 18 patient 19 died 19 died 20 in 20 in 23 group 21 the 23 group 22 control 23 group 23 group 25 p=0.092 24 ( 25 p=0.092 25 p=0.092 26 ) conclusion : aging ( age ≥ 75 ) is a risk factor for cin in japanese . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 aging 2 : 9 is 2 : 17 . 3 aging 6 ≥ 3 aging 9 is 4 ( 6 ≥ 5 age 6 ≥ 6 ≥ 7 75 6 ≥ 8 ) 9 is 12 factor 10 a 12 factor 11 risk 12 factor 12 factor 13 for 13 for 14 cin 14 cin 15 in 15 in 16 japanese cin in the elderly patients may be associated with prolonged renal dysfunction and poor prognosis . 0 ###LEFT-WALL### 1 cin 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 16 . 1 cin 2 in 1 cin 6 may 2 in 5 patients 3 the 5 patients 4 elderly 5 patients 6 may 7 be 7 be 8 associated 8 associated 9 with 9 with 13 and 10 prolonged 12 dysfunction 11 renal 12 dysfunction 12 dysfunction 13 and 13 and 15 prognosis 14 poor 15 prognosis none none postprandial insulin [release] is lower in [healthy] aerobically trained ( t ) compared to untrained ( ut ) individuals . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 15 compared 0 ###LEFT-WALL### 22 . 1 none 3 postprandial 1 none 11 trained 1 none 13 t 1 none 15 compared 2 none 3 postprandial 3 postprandial 4 insulin 3 postprandial 8 in 3 postprandial 11 trained 4 insulin 6 is 6 is 7 lower 7 lower 8 in 10 aerobically 11 trained 12 ( 13 t 13 t 14 ) 15 compared 16 to 16 to 21 individuals 17 untrained 19 ut 17 untrained 21 individuals 18 ( 19 ut 19 ut 20 ) this may be mediated by a lower release of the two incretin hormones [ glucagon [like] peptide - 1 ( glp - 1 ) and glucose - dependent insulinotropic polypeptide [(] gip [ )( in t [.] the aim of this study was to assess [and] [compare] gut hormone response and satiety changes after a liquid meal intake in young , [healthy] t and ut males . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 4 mediated 1 this 2 may 2 may 3 be 3 be 4 mediated 4 mediated 5 by 5 by 8 release 6 a 8 release 7 lower 8 release 8 release 9 of 9 of 13 hormones 10 the 11 two 11 two 13 hormones 12 incretin 13 hormones 13 hormones 18 - 14 [ 18 - 15 glucagon 17 peptide 17 peptide 18 - 18 - 19 1 19 1 27 - 20 ( 27 - 21 glp 23 1 21 glp 25 and 22 - 23 1 23 1 24 ) 25 and 26 glucose 25 and 27 - 27 - 32 gip 28 dependent 32 gip 29 insulinotropic 32 gip 30 polypeptide 32 gip 32 gip 35 in 32 gip 39 aim 32 gip 43 was 35 in 36 t 38 the 39 aim 39 aim 40 of 39 aim 43 was 40 of 42 study 41 this 42 study 43 was 44 to 44 to 45 assess 45 assess 51 and 48 gut 49 hormone 49 hormone 50 response 50 response 51 and 51 and 53 changes 52 satiety 53 changes 53 changes 54 after 54 after 58 intake 55 a 58 intake 56 liquid 58 intake 57 meal 58 intake 58 intake 59 in 59 in 64 and 60 young 61 , 61 , 63 t 61 , 64 and 64 and 66 males 64 and 67 . 65 ut 66 males postprandial gut hormone release and subjective feelings of hunger , satiety , fullness and prospective food consumption were assessed before [and] frequently for the following 3 h after a 200 ml liquid meal [(] 1,260 kj and 27 [,] 41 [and] 32 energy [%] as protein , carbohydrates and fat , respectively [ )(in ten t and ten ut young , healthy male subjects . 0 ###LEFT-WALL### 4 release 0 ###LEFT-WALL### 5 and 1 postprandial 2 gut 2 gut 3 hormone 3 hormone 4 release 5 and 7 feelings 6 subjective 7 feelings 7 feelings 8 of 7 feelings 18 were 8 of 14 and 9 hunger 10 , 10 , 11 satiety 10 , 12 , 12 , 13 fullness 12 , 14 and 14 and 17 consumption 15 prospective 16 food 16 food 17 consumption 18 were 19 assessed 19 assessed 20 before 19 assessed 22 frequently 19 assessed 23 for 23 for 25 following 24 the 25 following 25 following 28 after 26 3 27 h 27 h 28 after 28 after 37 and 29 a 36 kj 30 200 31 ml 31 ml 36 kj 32 liquid 36 kj 33 meal 36 kj 35 1,260 36 kj 36 kj 37 and 37 and 43 energy 37 and 45 as 38 27 43 energy 40 41 43 energy 42 32 43 energy 45 as 49 and 46 protein 47 , 47 , 48 carbohydrates 47 , 49 and 49 and 50 fat 49 and 51 , 49 and 54 )(in 51 , 52 respectively 51 , 54 )(in 54 )(in 64 subjects 54 )(in 65 . 55 ten 64 subjects 56 t 57 and 57 and 59 ut 57 and 63 male 58 ten 59 ut 60 young 61 , 60 young 63 male 62 healthy 63 male 63 male 64 subjects the insulin and gip responses were markedly lower in t than ut and correlated during the first 30 min after the liquid meal . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 . 1 the 2 insulin 2 insulin 3 and 3 and 5 responses 3 and 13 and 4 gip 5 responses 6 were 8 lower 6 were 13 and 7 markedly 8 lower 8 lower 9 in 8 lower 11 than 9 in 10 t 11 than 12 ut 13 and 14 correlated 13 and 20 after 14 correlated 15 during 15 during 17 first 16 the 17 first 18 30 19 min 19 min 20 after 20 after 23 meal 21 the 23 meal 22 liquid 23 meal baseline glp - 1 concentration was higher in t versus ut , but the response in the following 3 h after a liquid meal was similar in t and ut . 0 ###LEFT-WALL### 2 glp 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 31 . 1 baseline 2 glp 3 - 4 1 3 - 13 but 4 1 5 concentration 4 1 6 was 4 1 10 versus 5 concentration 6 was 6 was 7 higher 6 was 8 in 8 in 9 t 10 versus 11 ut 12 , 13 but 13 but 15 response 13 but 25 was 14 the 15 response 15 response 16 in 15 response 25 was 16 in 18 following 17 the 18 following 18 following 21 after 19 3 20 h 20 h 21 after 21 after 24 meal 22 a 24 meal 23 liquid 24 meal 25 was 26 similar 26 similar 27 in 27 in 29 and 28 t 29 and 29 and 30 ut satiety measures did not differ between groups throughout the test . 0 ###LEFT-WALL### 2 measures 0 ###LEFT-WALL### 5 differ 0 ###LEFT-WALL### 11 . 1 satiety 2 measures 2 measures 3 did 3 did 4 not 3 did 5 differ 5 differ 6 between 5 differ 8 throughout 6 between 7 groups 8 throughout 10 test 9 the 10 test it is possible that in [aerobically] t [subjects] , a lower gip release is partly responsible for a lower postprandial incretin stimulated insulin secretion . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 25 . 1 it 2 is 2 is 3 possible 3 possible 4 that 4 that 13 release 4 that 14 is 5 in 7 t 5 in 9 , 5 in 13 release 10 a 13 release 11 lower 13 release 12 gip 13 release 13 release 14 is 14 is 16 responsible 15 partly 16 responsible 16 responsible 17 for 17 for 24 secretion 18 a 24 secretion 19 lower 21 incretin 20 postprandial 21 incretin 21 incretin 22 stimulated 22 stimulated 23 insulin 23 insulin 24 secretion the performance of many everyday activities requires the coordination of the two upper limbs to achieve the goal of the task . 0 ###LEFT-WALL### 2 performance 0 ###LEFT-WALL### 7 requires 0 ###LEFT-WALL### 22 . 1 the 2 performance 2 performance 3 of 2 performance 7 requires 3 of 6 activities 4 many 6 activities 5 everyday 6 activities 7 requires 9 coordination 7 requires 15 to 7 requires 16 achieve 8 the 9 coordination 9 coordination 10 of 10 of 14 limbs 11 the 12 two 12 two 14 limbs 13 upper 14 limbs 15 to 16 achieve 16 achieve 18 goal 17 the 18 goal 18 goal 19 of 19 of 21 task 20 the 21 task although bimanual performance has been studied in detail in adults , few studies have examined how children coordinate the movements of the two hands during symmetric and asymmetric bimanual prehension . 0 ###LEFT-WALL### 13 studies 0 ###LEFT-WALL### 15 examined 0 ###LEFT-WALL### 31 . 1 although 3 performance 1 although 6 studied 1 although 11 , 1 although 13 studies 2 bimanual 3 performance 3 performance 4 has 4 has 5 been 5 been 6 studied 6 studied 7 in 6 studied 9 in 7 in 8 detail 9 in 10 adults 12 few 13 studies 13 studies 14 have 14 have 15 examined 15 examined 16 how 16 how 17 children 16 how 18 coordinate 17 children 18 coordinate 18 coordinate 20 movements 18 coordinate 25 during 19 the 20 movements 20 movements 21 of 21 of 24 hands 22 the 23 two 23 two 24 hands 25 during 30 prehension 26 symmetric 27 and 27 and 28 asymmetric 27 and 30 prehension 29 bimanual 30 prehension with the current study , we asked younger [(] 4 - 6 years , n = 14 ) and older ( 7 - 10 years , n = 16 ) children to complete a discrete bimanual task . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 asked 0 ###LEFT-WALL### 38 . 1 with 4 study 1 with 5 , 1 with 6 we 2 the 4 study 3 current 4 study 6 we 7 asked 7 asked 31 children 7 asked 32 to 8 younger 13 years 10 4 11 - 11 - 12 6 11 - 13 years 13 years 16 = 13 years 19 and 14 , 16 = 15 n 16 = 16 = 17 14 16 = 18 ) 19 and 20 older 19 and 31 children 20 older 28 = 21 ( 23 - 22 7 23 - 23 - 25 years 23 - 26 , 23 - 28 = 24 10 25 years 26 , 28 = 27 n 28 = 28 = 29 16 28 = 30 ) 32 to 33 complete 33 complete 37 task 34 a 35 discrete 34 a 37 task 35 discrete 37 task 36 bimanual 37 task specifically , they reached to grasp cylinders located at near and far positions in either unimanual or bimanual condition . 0 ###LEFT-WALL### 3 they 0 ###LEFT-WALL### 4 reached 0 ###LEFT-WALL### 20 . 1 specifically 2 , 1 specifically 3 they 3 they 4 reached 4 reached 5 to 4 reached 14 in 5 to 6 grasp 6 grasp 7 cylinders 6 grasp 9 at 7 cylinders 8 located 9 at 13 positions 10 near 11 and 11 and 12 far 11 and 13 positions 14 in 19 condition 15 either 17 or 16 unimanual 17 or 17 or 18 bimanual 17 or 19 condition during bimanual symmetric conditions , participants performed movements with both hands toward two objects located at the same distance [(] both near or both far ) , while in the bimanual asymmetric conditions , they reached for objects at different distances . 0 ###LEFT-WALL### 6 participants 0 ###LEFT-WALL### 15 located 0 ###LEFT-WALL### 23 or 0 ###LEFT-WALL### 42 . 1 during 4 conditions 1 during 5 , 1 during 6 participants 2 bimanual 4 conditions 3 symmetric 4 conditions 6 participants 7 performed 7 performed 8 movements 7 performed 9 with 9 with 11 hands 9 with 15 located 10 both 11 hands 11 hands 12 toward 12 toward 14 objects 13 two 14 objects 15 located 16 at 16 at 19 distance 17 the 18 same 18 same 19 distance 19 distance 21 both 19 distance 22 near 21 both 22 near 23 or 35 they 23 or 36 reached 24 both 25 far 25 far 26 ) 25 far 35 they 27 , 28 while 28 while 29 in 28 while 34 , 28 while 35 they 29 in 33 conditions 30 the 33 conditions 31 bimanual 33 conditions 32 asymmetric 33 conditions 35 they 36 reached 36 reached 37 for 37 for 38 objects 38 objects 39 at 39 at 41 distances 40 different 41 distances results of the kinematic analyses indicated that the young children consistently experienced the " two target " effect , whereby bimanual movements were executed more slowly than unimanual movements to the same distance . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 16 target 1 results 2 of 1 results 16 target 2 of 5 analyses 3 the 5 analyses 4 kinematic 5 analyses 5 analyses 6 indicated 5 analyses 7 that 5 analyses 12 experienced 7 that 10 children 7 that 12 experienced 8 the 10 children 9 young 10 children 10 children 12 experienced 11 consistently 12 experienced 12 experienced 15 two 13 the 14 " 13 the 15 two 16 target 17 " 16 target 18 effect 16 target 20 whereby 19 , 20 whereby 20 whereby 22 movements 20 whereby 24 executed 20 whereby 34 . 21 bimanual 22 movements 22 movements 23 were 23 were 24 executed 24 executed 26 slowly 24 executed 27 than 24 executed 30 to 25 more 26 slowly 27 than 29 movements 28 unimanual 29 movements 30 to 33 distance 31 the 32 same 32 same 33 distance older children employed a hybrid strategy , exhibiting slower movements in bimanual congruent conditions , but larger [non] - dominant apertures in bimanual incongruent conditions . 0 ###LEFT-WALL### 2 children 0 ###LEFT-WALL### 3 employed 0 ###LEFT-WALL### 26 . 1 older 2 children 2 children 3 employed 3 employed 6 strategy 3 employed 16 but 3 employed 22 in 4 a 5 hybrid 4 a 6 strategy 5 hybrid 6 strategy 6 strategy 8 exhibiting 7 , 8 exhibiting 8 exhibiting 10 movements 8 exhibiting 11 in 8 exhibiting 15 , 9 slower 10 movements 11 in 14 conditions 12 bimanual 14 conditions 13 congruent 14 conditions 16 but 21 apertures 17 larger 19 - 17 larger 21 apertures 20 dominant 21 apertures 22 in 25 conditions 23 bimanual 25 conditions 24 incongruent 25 conditions this hybrid strategy was hypothesized to stem from developmental changes occurring in the integration of sensory information around 8 years of age . 0 ###LEFT-WALL### 3 strategy 0 ###LEFT-WALL### 5 hypothesized 0 ###LEFT-WALL### 23 . 1 this 2 hybrid 2 hybrid 3 strategy 3 strategy 4 was 4 was 5 hypothesized 5 hypothesized 6 to 5 hypothesized 8 from 5 hypothesized 18 around 6 to 7 stem 8 from 10 changes 9 developmental 10 changes 10 changes 11 occurring 11 occurring 12 in 12 in 14 integration 13 the 14 integration 14 integration 15 of 15 of 17 information 16 sensory 17 information 18 around 20 years 19 8 20 years 20 years 21 of 21 of 22 age while older children exhibited temporal and spatial coordination patterns that were similar to patterns reported in adults , large relative timing differences at the start and end of bimanual movements and considerably weaker spatial coupling were seen in the younger children . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 15 reported 0 ###LEFT-WALL### 42 . 1 while 3 children 1 while 6 and 2 older 3 children 3 children 4 exhibited 5 temporal 6 and 6 and 9 patterns 6 and 10 that 6 and 11 were 6 and 15 reported 7 spatial 8 coordination 8 coordination 9 patterns 10 that 11 were 11 were 12 similar 12 similar 13 to 13 to 14 patterns 15 reported 16 in 15 reported 18 , 15 reported 31 and 15 reported 37 seen 16 in 17 adults 19 large 20 relative 20 relative 21 timing 21 timing 22 differences 22 differences 23 at 22 differences 26 and 23 at 25 start 24 the 25 start 26 and 27 end 26 and 28 of 26 and 31 and 28 of 30 movements 29 bimanual 30 movements 31 and 35 coupling 31 and 36 were 32 considerably 33 weaker 33 weaker 35 coupling 34 spatial 35 coupling 36 were 37 seen 37 seen 38 in 38 in 41 children 39 the 41 children 40 younger 41 children background : hiv and hepatitis c virus ( hcv ) [infections] may increase interleukin - 6 ( il - 6 ) [and] [c] - reactive protein ( crp ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 7 virus 2 : 13 increase 2 : 24 - 2 : 30 . 3 hiv 4 and 4 and 5 hepatitis 4 and 7 virus 5 hepatitis 6 c 7 virus 9 hcv 7 virus 12 may 8 ( 9 hcv 9 hcv 10 ) 12 may 13 increase 13 increase 14 interleukin 14 interleukin 18 il 15 - 18 il 16 6 18 il 17 ( 18 il 18 il 19 - 18 il 20 6 18 il 24 - 19 - 20 6 20 6 21 ) 24 - 26 protein 25 reactive 26 protein 26 protein 28 crp 27 ( 28 crp 28 crp 29 ) however , relationships between inflammatory biomarkers , chronic viral infections , clinical factors , and behavioral factors remain poorly understood . 0 ###LEFT-WALL### 3 relationships 0 ###LEFT-WALL### 18 remain 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 3 relationships 3 relationships 4 between 3 relationships 18 remain 4 between 15 and 5 inflammatory 6 biomarkers 6 biomarkers 7 , 7 , 10 infections 7 , 11 , 8 chronic 10 infections 9 viral 10 infections 11 , 13 factors 11 , 15 and 12 clinical 13 factors 14 , 15 and 15 and 17 factors 16 behavioral 17 factors 18 remain 19 poorly 18 remain 20 understood methods : using linear regression , [we] modeled cross - sectional associations between loge il - 6 or loge crp levels and hcv , hiv , injection drug use , and comorbidity among 1191 injection drug users . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 38 . 1 methods 2 : 2 : 3 using 3 using 5 regression 4 linear 5 regression 6 , 9 cross 6 , 10 - 8 modeled 9 cross 10 - 12 associations 10 - 16 - 11 sectional 12 associations 12 associations 13 between 13 between 15 il 14 loge 15 il 16 - 17 6 16 - 18 or 18 or 22 and 18 or 28 drug 19 loge 21 levels 20 crp 21 levels 21 levels 22 and 22 and 27 injection 22 and 28 drug 23 hcv 25 hiv 24 , 25 hiv 25 hiv 26 , 25 hiv 27 injection 28 drug 31 and 28 drug 33 among 29 use 31 and 30 , 31 and 31 and 32 comorbidity 33 among 37 users 34 1191 37 users 35 injection 37 users 36 drug 37 users results : mean age was 47 years , 46.0 % reported currently injecting drugs , 59.0 % were hcv monoinfected , and 27 % were hcv/hiv coinfected . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 4 age 2 : 5 was 2 : 15 , 3 mean 4 age 4 age 5 was 5 was 7 years 6 47 7 years 7 years 10 % 8 , 10 % 9 46.0 10 % 10 % 11 reported 10 % 13 injecting 10 % 15 , 12 currently 13 injecting 13 injecting 14 drugs 15 , 17 % 15 , 18 were 15 , 22 and 16 59.0 17 % 17 % 18 were 18 were 19 hcv 19 hcv 20 monoinfected 21 , 22 and 22 and 24 % 22 and 25 were 23 27 24 % 24 % 25 were 25 were 26 hcv/hiv 26 hcv/hiv 27 coinfected in multivariable models , higher loge il - 6 [was] associated with hcv monoinfection [ [β] = 0.191 , 95 % confidence interval ( ci ) : 0.043 to 0.339 []] [and] hcv/hiv coinfection ( [β] = 0.394 , 95 % ci : 0.214 to 0.574 ) . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 4 , 1 in 3 models 2 multivariable 3 models 4 , 7 il 4 , 8 - 5 higher 7 il 6 loge 7 il 8 - 9 6 8 - 19 , 9 6 11 associated 11 associated 12 with 11 associated 14 monoinfection 12 with 13 hcv 14 monoinfection 18 0.191 15 [ 18 0.191 17 = 18 0.191 18 0.191 19 , 19 , 23 interval 19 , 27 : 20 95 23 interval 21 % 22 confidence 22 confidence 23 interval 23 interval 25 ci 23 interval 27 : 24 ( 25 ci 25 ci 26 ) 27 : 28 0.043 28 0.043 29 to 28 0.043 38 0.394 29 to 34 coinfection 30 0.339 34 coinfection 33 hcv/hiv 34 coinfection 35 ( 38 0.394 37 = 38 0.394 38 0.394 41 % 38 0.394 48 . 39 , 41 % 40 95 41 % 41 % 42 ci 41 % 43 : 41 % 47 ) 42 ci 43 : 43 : 45 to 44 0.214 45 to 45 to 46 0.574 in contrast , hcv monoinfection [(] β = - 0.523 , 95 % ci : - 0.275 to - 0.789 [ )(and hcv/hiv coinfection [(] β = - 0.554 95 % ci : - 0.260 to - 0.847 [ )(were associated with lower crp . 0 ###LEFT-WALL### 7 β 0 ###LEFT-WALL### 9 - 1 in 2 contrast 1 in 3 , 1 in 7 β 4 hcv 5 monoinfection 5 monoinfection 7 β 7 β 8 = 9 - 10 0.523 9 - 19 - 10 0.523 13 % 11 , 13 % 12 95 13 % 13 % 14 ci 13 % 18 to 13 % 19 - 14 ci 15 : 15 : 17 0.275 15 : 18 to 16 - 17 0.275 19 - 20 0.789 19 - 22 )(and 19 - 28 - 22 )(and 26 β 23 hcv/hiv 26 β 24 coinfection 26 β 26 β 27 = 28 - 32 ci 28 - 33 : 29 0.554 32 ci 30 95 32 ci 31 % 32 ci 33 : 35 0.260 33 : 45 . 34 - 35 0.260 35 0.260 36 to 35 0.260 40 )(were 36 to 38 0.847 37 - 38 0.847 40 )(were 41 associated 41 associated 42 with 42 with 44 crp 43 lower 44 crp lower crp with hcv infection was independent of liver fibrosis severity , synthetic function , or liver injury markers ; crp decreased with higher hcv rna . 0 ###LEFT-WALL### 2 crp 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 20 ; 1 lower 2 crp 2 crp 3 with 2 crp 6 was 3 with 5 infection 4 hcv 5 infection 6 was 16 or 7 independent 8 of 7 independent 12 , 8 of 11 severity 9 liver 11 severity 10 fibrosis 11 severity 12 , 14 function 12 , 16 or 13 synthetic 14 function 15 , 16 or 16 or 19 markers 17 liver 19 markers 18 injury 19 markers 20 ; 21 crp 20 ; 22 decreased 21 crp 22 decreased 22 decreased 23 with 23 with 26 rna 24 higher 26 rna 25 hcv 26 rna 26 rna 27 . increased injection intensity was associated [with] higher il - 6 ( p = 0.003 ) and crp ( p < 0.001 ) [;] increasing comorbidity ( p < 0.001 [ )( older age ( p = 0.028 ) were associated with higher il - 6 [;] older age was associated with higher crp among hcv - uninfected participants ( p = 0.021 ) . 0 ###LEFT-WALL### 2 injection 0 ###LEFT-WALL### 5 associated 1 increased 2 injection 2 injection 3 intensity 2 injection 4 was 2 injection 5 associated 3 intensity 4 was 5 associated 7 higher 5 associated 16 and 8 il 10 6 8 il 16 and 9 - 10 6 10 6 13 = 10 6 15 ) 11 ( 13 = 12 p 13 = 13 = 14 0.003 13 = 15 ) 16 and 17 crp 16 and 24 increasing 16 and 28 < 17 crp 20 < 18 ( 20 < 19 p 20 < 20 < 21 0.001 20 < 22 ) 24 increasing 25 comorbidity 26 ( 28 < 27 p 28 < 28 < 29 0.001 29 0.001 33 age 29 0.001 39 were 29 0.001 40 associated 29 0.001 41 with 32 older 33 age 33 age 36 = 33 age 39 were 34 ( 36 = 35 p 36 = 36 = 37 0.028 36 = 38 ) 41 with 43 il 42 higher 43 il 43 il 45 6 43 il 50 associated 44 - 45 6 45 6 48 age 45 6 49 was 45 6 50 associated 47 older 48 age 48 age 49 was 50 associated 51 with 50 associated 54 among 51 with 53 crp 52 higher 53 crp 54 among 55 hcv 55 hcv 58 participants 56 - 58 participants 57 uninfected 58 participants 58 participants 61 = 58 participants 64 . 59 ( 61 = 60 p 61 = 61 = 62 0.021 61 = 63 ) conclusion : hiv and hcv infections contribute to chronic inflammation ; however , reduced crp possibly occurs through hcv - mediated mechanisms . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 4 and 2 : 7 contribute 2 : 11 ; 3 hiv 4 and 4 and 6 infections 4 and 7 contribute 5 hcv 6 infections 7 contribute 8 to 8 to 10 inflammation 9 chronic 10 inflammation 11 ; 15 crp 11 ; 17 occurs 11 ; 20 - 12 however 13 , 12 however 15 crp 14 reduced 15 crp 15 crp 17 occurs 16 possibly 17 occurs 17 occurs 18 through 18 through 19 hcv 20 - 22 mechanisms 21 mediated 22 mechanisms findings highlight potentially modifiable contributors to inflammation . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 highlight 0 ###LEFT-WALL### 8 . 1 findings 2 highlight 2 highlight 5 contributors 2 highlight 6 to 3 potentially 4 modifiable 4 modifiable 5 contributors 6 to 7 inflammation importance the [search] for novel alzheimer [disease] ( ad ) genes or pathologic mutations within known ad loci is ongoing . 0 ###LEFT-WALL### 2 the 0 ###LEFT-WALL### 19 is 0 ###LEFT-WALL### 21 . 1 importance 2 the 2 the 4 for 2 the 15 within 2 the 19 is 4 for 12 or 5 novel 11 genes 6 alzheimer 9 ad 8 ( 9 ad 9 ad 10 ) 9 ad 11 genes 11 genes 12 or 12 or 14 mutations 13 pathologic 14 mutations 15 within 18 loci 16 known 18 loci 17 ad 18 loci 19 is 20 ongoing the development of array technologies has helped to identify rare recessive mutations among long runs of homozygosity ( rohs ) , in which both parental alleles are identical . 0 ###LEFT-WALL### 2 development 0 ###LEFT-WALL### 7 helped 1 the 2 development 2 development 3 of 2 development 6 has 3 of 5 technologies 4 array 5 technologies 6 has 7 helped 7 helped 8 to 7 helped 9 identify 8 to 9 identify 9 identify 12 mutations 9 identify 13 among 10 rare 12 mutations 11 recessive 12 mutations 13 among 15 runs 14 long 15 runs 15 runs 16 of 15 runs 19 rohs 15 runs 22 in 16 of 17 homozygosity 18 ( 19 rohs 19 rohs 20 ) 21 , 22 in 22 in 23 which 22 in 26 alleles 22 in 27 are 22 in 29 . 24 both 26 alleles 25 parental 26 alleles 26 alleles 27 are 27 are 28 identical caribbean hispanics are known to have an elevated risk for ad and tend to have large families with evidence of inbreeding . 0 ###LEFT-WALL### 2 hispanics 0 ###LEFT-WALL### 4 known 0 ###LEFT-WALL### 22 . 1 caribbean 2 hispanics 2 hispanics 3 are 3 are 4 known 4 known 5 to 4 known 14 to 4 known 15 have 5 to 12 and 6 have 9 risk 6 have 10 for 6 have 12 and 7 an 9 risk 8 elevated 9 risk 10 for 11 ad 12 and 13 tend 14 to 15 have 15 have 17 families 15 have 18 with 16 large 17 families 18 with 19 evidence 19 evidence 20 of 20 of 21 inbreeding objective to test the hypothesis that the late - onset ad in a caribbean hispanic population might be explained in part by the homozygosity of unknown loci that could harbor recessive ad risk haplotypes or pathologic mutations . 0 ###LEFT-WALL### 3 test 0 ###LEFT-WALL### 19 explained 0 ###LEFT-WALL### 38 . 1 objective 2 to 2 to 3 test 4 the 5 hypothesis 5 hypothesis 6 that 5 hypothesis 19 explained 6 that 11 ad 6 that 18 be 7 the 11 ad 8 late 9 - 8 late 11 ad 10 onset 11 ad 11 ad 12 in 11 ad 17 might 12 in 16 population 13 a 16 population 14 caribbean 15 hispanic 15 hispanic 16 population 17 might 18 be 19 explained 20 in 20 in 35 or 21 part 22 by 21 part 25 of 21 part 35 or 22 by 24 homozygosity 23 the 24 homozygosity 25 of 27 loci 26 unknown 27 loci 27 loci 28 that 27 loci 29 could 28 that 29 could 29 could 30 harbor 30 harbor 34 haplotypes 31 recessive 34 haplotypes 32 ad 34 haplotypes 33 risk 34 haplotypes 35 or 37 mutations 36 pathologic 37 mutations design we used genome - wide array data to identify rohs ( >1 megabase ) and conducted global burden and locus - specific roh analyses . 0 ###LEFT-WALL### 4 genome 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 26 . 1 design 2 we 2 we 3 used 3 used 4 genome 5 - 8 data 6 wide 7 array 7 array 8 data 8 data 9 to 8 data 16 and 9 to 16 and 10 identify 11 rohs 10 identify 16 and 11 rohs 14 megabase 12 ( 14 megabase 13 >1 14 megabase 14 megabase 15 ) 16 and 17 conducted 16 and 25 analyses 18 global 19 burden 19 burden 20 and 20 and 21 locus 20 and 22 - 20 and 24 roh 23 specific 24 roh 24 roh 25 analyses setting a whole - genome case - control roh study . 0 ###LEFT-WALL### 6 case 0 ###LEFT-WALL### 7 - 1 setting 2 a 1 setting 6 case 3 whole 4 - 3 whole 5 genome 5 genome 6 case 7 - 8 control 7 - 11 . 8 control 10 study 9 roh 10 study participants a caribbean hispanic data set of 547 unrelated cases ( 48.8 % with familial ad ) and 542 controls collected from a population known to have [a] 3 - fold higher risk of ad vs [non] [-] hispanics in the same community . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 25 known 0 ###LEFT-WALL### 30 - 1 participants 2 a 1 participants 3 caribbean 3 caribbean 5 data 4 hispanic 5 data 5 data 6 set 5 data 7 of 5 data 18 and 7 of 10 cases 8 547 10 cases 9 unrelated 10 cases 10 cases 13 % 11 ( 13 % 12 48.8 13 % 13 % 14 with 13 % 17 ) 14 with 16 ad 15 familial 16 ad 18 and 20 controls 18 and 21 collected 19 542 20 controls 21 collected 22 from 22 from 24 population 23 a 24 population 24 population 25 known 25 known 26 to 25 known 27 have 26 to 27 have 27 have 29 3 30 - 31 fold 30 - 44 . 31 fold 33 risk 31 fold 40 in 32 higher 33 risk 33 risk 34 of 34 of 39 hispanics 35 ad 36 vs 36 vs 39 hispanics 40 in 43 community 41 the 42 same 41 the 43 community based on a structure program analysis , our data set consisted of african hispanic ( 207 cases and 192 controls ) and european hispanic ( 329 cases and 326 controls ) participants . 0 ###LEFT-WALL### 9 data 0 ###LEFT-WALL### 11 consisted 1 based 2 on 1 based 7 , 1 based 9 data 2 on 6 analysis 3 a 6 analysis 4 structure 6 analysis 5 program 6 analysis 8 our 9 data 9 data 10 set 9 data 11 consisted 11 consisted 12 of 12 of 14 hispanic 13 african 14 hispanic 14 hispanic 22 and 15 ( 22 and 16 207 17 cases 17 cases 18 and 18 and 20 controls 18 and 21 ) 18 and 22 and 19 192 20 controls 22 and 32 participants 22 and 33 . 23 european 32 participants 24 hispanic 28 and 24 hispanic 32 participants 25 ( 28 and 26 329 27 cases 27 cases 28 and 28 and 30 controls 28 and 31 ) 29 326 30 controls exposure alzheimer disease risk genes . 0 ###LEFT-WALL### 5 genes 0 ###LEFT-WALL### 6 . 1 exposure 2 alzheimer 2 alzheimer 5 genes 3 disease 5 genes 4 risk 5 genes main outcomes and measures we calculated the total and mean lengths of the rohs per sample . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 calculated 0 ###LEFT-WALL### 17 . 1 main 2 outcomes 2 outcomes 3 and 3 and 4 measures 4 measures 5 we 5 we 6 calculated 6 calculated 11 lengths 7 the 11 lengths 8 total 9 and 9 and 10 mean 9 and 11 lengths 11 lengths 12 of 12 of 14 rohs 13 the 14 rohs 14 rohs 15 per 15 per 16 sample global burden measurements among autosomal chromosomes were investigated in cases vs controls . 0 ###LEFT-WALL### 3 measurements 0 ###LEFT-WALL### 8 investigated 0 ###LEFT-WALL### 13 . 1 global 2 burden 2 burden 3 measurements 3 measurements 4 among 3 measurements 7 were 4 among 6 chromosomes 5 autosomal 6 chromosomes 7 were 8 investigated 8 investigated 9 in 9 in 10 cases 10 cases 11 vs 11 vs 12 controls pools of overlapping roh segments ( consensus regions ) were identified , and the case [to] control ratio was calculated for each consensus region . 0 ###LEFT-WALL### 1 pools 0 ###LEFT-WALL### 11 identified 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 25 . 1 pools 2 of 1 pools 8 regions 1 pools 10 were 2 of 3 overlapping 3 overlapping 5 segments 4 roh 5 segments 6 ( 8 regions 7 consensus 8 regions 8 regions 9 ) 10 were 11 identified 12 , 13 and 13 and 18 ratio 13 and 20 calculated 14 the 18 ratio 15 case 18 ratio 17 control 18 ratio 18 ratio 19 was 19 was 20 calculated 20 calculated 21 for 21 for 24 region 22 each 24 region 23 consensus 24 region we formulated the tested hypothesis before data [collection] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 formulated 0 ###LEFT-WALL### 9 . 1 we 2 formulated 2 formulated 5 hypothesis 2 formulated 6 before 3 the 5 hypothesis 4 tested 5 hypothesis 6 before 7 data results in total , we identified 17 137 autosomal regions with rohs . 0 ###LEFT-WALL### 3 total 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 13 . 1 results 2 in 2 in 3 total 4 , 5 we 4 , 6 identified 5 we 6 identified 6 identified 10 regions 6 identified 11 with 7 17 10 regions 8 137 10 regions 9 autosomal 10 regions 11 with 12 rohs the mean length of the roh per person was significantly greater in cases vs controls ( p = .0039[!] ) , and this association was stronger with familial ad ( p = .0005[!] ) . 0 ###LEFT-WALL### 3 length 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 35 . 1 the 3 length 2 mean 3 length 3 length 4 of 3 length 9 was 4 of 6 roh 5 the 6 roh 6 roh 7 per 7 per 8 person 9 was 10 significantly 9 was 11 greater 11 greater 12 in 12 in 13 cases 13 cases 14 vs 14 vs 15 controls 15 controls 18 = 16 ( 18 = 17 p 18 = 18 = 19 .0039[!] 18 = 20 ) 21 , 22 and 22 and 24 association 22 and 25 was 23 this 24 association 24 association 25 was 25 was 26 stronger 26 stronger 27 with 27 with 29 ad 28 familial 29 ad 29 ad 32 = 30 ( 32 = 31 p 32 = 32 = 33 .0005[!] 32 = 34 ) among the european hispanics , a consensus region at the exoc4 locus was significantly associated with ad even after correction for multiple testing ( empirical [p] value 1 [ emp1 ] , . 0001 ; emp2 [,] . 002 ; 21 ad cases [vs] 2 controls [ )( 0 ###LEFT-WALL### 8 region 0 ###LEFT-WALL### 15 associated 0 ###LEFT-WALL### 33 . 1 among 3 european 1 among 8 region 2 the 3 european 4 hispanics 5 , 4 hispanics 8 region 6 a 8 region 7 consensus 8 region 8 region 9 at 8 region 13 was 9 at 12 locus 10 the 12 locus 11 exoc4 12 locus 13 was 15 associated 14 significantly 15 associated 15 associated 16 with 16 with 17 ad 16 with 18 even 16 with 19 after 19 after 20 correction 20 correction 21 for 20 correction 27 value 21 for 23 testing 22 multiple 23 testing 24 ( 27 value 25 empirical 27 value 27 value 28 1 27 value 30 emp1 27 value 32 , 29 [ 30 emp1 30 emp1 31 ] 33 . 34 0001 33 . 35 ; 33 . 38 . 35 ; 36 emp2 38 . 39 002 38 . 40 ; 38 . 48 )( 40 ; 42 ad 40 ; 43 cases 41 21 42 ad 42 ad 43 cases 43 cases 46 controls 45 2 46 controls among the african hispanic subset , the most significant [but] nominal association was observed for ctnna3 , a well [-] known ad gene candidate ( emp1 , . 002 ; 10 ad cases [vs] 0 controls [ )( 0 ###LEFT-WALL### 12 association 0 ###LEFT-WALL### 14 observed 0 ###LEFT-WALL### 28 . 0 ###LEFT-WALL### 38 )( 1 among 5 subset 1 among 6 , 1 among 12 association 2 the 5 subset 3 african 5 subset 4 hispanic 5 subset 7 the 12 association 8 most 9 significant 9 significant 11 nominal 11 nominal 12 association 12 association 13 was 13 was 14 observed 14 observed 15 for 15 for 16 ctnna3 16 ctnna3 24 candidate 17 , 24 candidate 18 a 24 candidate 19 well 21 known 21 known 24 candidate 22 ad 24 candidate 23 gene 24 candidate 24 candidate 26 emp1 24 candidate 27 , 25 ( 26 emp1 26 emp1 27 , 28 . 29 002 28 . 30 ; 30 ; 32 ad 30 ; 33 cases 31 10 32 ad 32 ad 33 cases 33 cases 36 controls 35 0 36 controls conclusions and relevance our results show that rohs could significantly contribute to the etiology of ad . 0 ###LEFT-WALL### 5 results 0 ###LEFT-WALL### 6 show 0 ###LEFT-WALL### 17 . 1 conclusions 2 and 2 and 3 relevance 3 relevance 5 results 4 our 5 results 5 results 6 show 6 show 7 that 7 that 8 rohs 7 that 11 contribute 8 rohs 9 could 9 could 11 contribute 10 significantly 11 contribute 11 contribute 12 to 12 to 14 etiology 13 the 14 etiology 14 etiology 15 of 15 of 16 ad future studies would require the analysis of larger , relatively inbred data sets that might reveal novel recessive ad genes . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 require 0 ###LEFT-WALL### 21 . 1 future 2 studies 2 studies 3 would 3 would 4 require 4 require 6 analysis 4 require 16 reveal 5 the 6 analysis 6 analysis 7 of 6 analysis 14 that 6 analysis 15 might 7 of 13 sets 8 larger 9 , 8 larger 12 data 10 relatively 11 inbred 11 inbred 12 data 12 data 13 sets 14 that 15 might 16 reveal 20 genes 17 novel 20 genes 18 recessive 20 genes 19 ad 20 genes the next step is to conduct sequencing of top significant loci in a subset of samples with overlapping rohs . 0 ###LEFT-WALL### 3 step 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 20 . 1 the 2 next 1 the 3 step 3 step 4 is 4 is 5 to 4 is 12 in 4 is 17 with 5 to 7 sequencing 6 conduct 7 sequencing 7 sequencing 8 of 8 of 11 loci 9 top 11 loci 10 significant 11 loci 12 in 14 subset 13 a 14 subset 14 subset 15 of 15 of 16 samples 17 with 18 overlapping 18 overlapping 19 rohs models of duration bisection have focused on the effects of stimulus spacing and stimulus modality . 0 ###LEFT-WALL### 1 models 0 ###LEFT-WALL### 6 focused 0 ###LEFT-WALL### 16 . 1 models 2 of 1 models 5 have 2 of 4 bisection 3 duration 4 bisection 5 have 6 focused 6 focused 7 on 7 on 13 and 8 the 9 effects 9 effects 10 of 9 effects 13 and 10 of 11 stimulus 11 stimulus 12 spacing 13 and 15 modality 14 stimulus 15 modality however , interactions between stimulus spacing and stimulus modality have not been examined systematically . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 13 examined 0 ###LEFT-WALL### 15 . 1 however 2 , 1 however 7 and 3 interactions 4 between 3 interactions 7 and 4 between 5 stimulus 5 stimulus 6 spacing 7 and 9 modality 7 and 10 have 8 stimulus 9 modality 10 have 11 not 10 have 12 been 12 been 13 examined 13 examined 14 systematically two duration bisection experiments that address this issue are reported . 0 ###LEFT-WALL### 4 experiments 0 ###LEFT-WALL### 10 reported 0 ###LEFT-WALL### 11 . 1 two 4 experiments 2 duration 4 experiments 3 bisection 4 experiments 4 experiments 5 that 4 experiments 6 address 4 experiments 9 are 5 that 6 address 6 address 8 issue 7 this 8 issue 9 are 10 reported experiment 1 showed that stimulus spacing influenced the classification of auditory , but not visual , stimuli . 0 ###LEFT-WALL### 1 experiment 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 18 . 1 experiment 2 1 1 experiment 3 showed 3 showed 5 stimulus 3 showed 13 but 4 that 5 stimulus 5 stimulus 6 spacing 5 stimulus 10 of 6 spacing 7 influenced 7 influenced 9 classification 8 the 9 classification 9 classification 10 of 11 auditory 13 but 12 , 13 but 13 but 14 not 13 but 15 visual 14 not 15 visual 16 , 17 stimuli experiment 2 used a wider stimulus range , and showed stimulus spacing effects for both visual and auditory stimuli , although the effects were larger for auditory stimuli . 0 ###LEFT-WALL### 1 experiment 0 ###LEFT-WALL### 9 and 1 experiment 2 2 1 experiment 9 and 3 used 7 range 3 used 9 and 4 a 7 range 5 wider 7 range 6 stimulus 7 range 8 , 9 and 9 and 10 showed 9 and 14 for 9 and 21 although 10 showed 11 stimulus 11 stimulus 12 spacing 12 spacing 13 effects 14 for 19 stimuli 15 both 19 stimuli 16 visual 17 and 17 and 18 auditory 17 and 19 stimuli 20 , 21 although 21 although 23 effects 21 although 24 were 21 although 29 . 22 the 23 effects 23 effects 24 were 24 were 25 larger 25 larger 26 for 26 for 28 stimuli 27 auditory 28 stimuli a version of temporal range frequency theory was applied to the data , and was used to demonstrate that the qualitative pattern of results can be captured with the single assumption that the durations of visual stimuli are less discriminable from one another than are the durations of auditory stimuli . 0 ###LEFT-WALL### 2 version 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 51 . 1 a 2 version 2 version 3 of 2 version 8 was 3 of 7 theory 4 temporal 5 range 5 range 6 frequency 6 frequency 7 theory 8 was 14 and 9 applied 10 to 9 applied 14 and 10 to 12 data 11 the 12 data 13 , 14 and 14 and 15 was 15 was 16 used 16 used 17 to 16 used 18 demonstrate 17 to 18 demonstrate 18 demonstrate 19 that 19 that 22 pattern 19 that 27 captured 20 the 22 pattern 21 qualitative 22 pattern 22 pattern 23 of 22 pattern 25 can 23 of 24 results 25 can 26 be 26 be 27 captured 27 captured 28 with 27 captured 40 discriminable 28 with 31 assumption 28 with 39 less 29 the 31 assumption 30 single 31 assumption 31 assumption 32 that 32 that 34 durations 32 that 38 are 33 the 34 durations 34 durations 35 of 34 durations 38 are 35 of 37 stimuli 36 visual 37 stimuli 40 discriminable 41 from 40 discriminable 44 than 41 from 43 another 42 one 43 another 44 than 45 are 45 are 47 durations 46 the 47 durations 47 durations 48 of 48 of 50 stimuli 49 auditory 50 stimuli background : mixed dementia ( md ) , i.e . [,] the coexistence of alzheimer 's disease ( ad ) and cerebrovascular disease ( cvd ) , is a common dementia [subtype] . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 . 1 background 2 : 2 : 9 i.e 3 mixed 9 i.e 4 dementia 6 md 4 dementia 8 , 4 dementia 9 i.e 5 ( 6 md 6 md 7 ) 10 . 21 and 10 . 27 , 10 . 33 . 12 the 13 coexistence 13 coexistence 14 of 13 coexistence 21 and 14 of 17 disease 15 alzheimer 16 's 16 's 17 disease 17 disease 19 ad 18 ( 19 ad 19 ad 20 ) 21 and 23 disease 21 and 25 cvd 22 cerebrovascular 23 disease 24 ( 25 cvd 25 cvd 26 ) 27 , 28 is 28 is 31 dementia 29 a 30 common 29 a 31 dementia 30 common 31 dementia few studies have attempted to establish the cognitive profiles of mild - moderate md and compare it to the profiles of ad using a comprehensive neuropsychological test battery . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 29 . 1 few 2 studies 2 studies 15 and 3 have 4 attempted 3 have 15 and 4 attempted 5 to 4 attempted 6 establish 5 to 6 establish 6 establish 9 profiles 7 the 9 profiles 8 cognitive 9 profiles 9 profiles 10 of 10 of 14 md 11 mild 12 - 11 mild 14 md 13 moderate 14 md 15 and 16 compare 16 compare 17 it 16 compare 18 to 16 compare 23 using 18 to 20 profiles 19 the 20 profiles 20 profiles 21 of 21 of 22 ad 23 using 28 battery 24 a 28 battery 25 comprehensive 27 test 26 neuropsychological 27 test 27 test 28 battery we aimed to establish the neuropsychological profile of mild - moderate md in relation to mild - moderate ad . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 20 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 establish 3 to 4 establish 4 establish 7 profile 4 establish 15 to 5 the 7 profile 6 neuropsychological 7 profile 7 profile 8 of 8 of 12 md 9 mild 10 - 9 mild 12 md 11 moderate 12 md 13 in 14 relation 14 relation 15 to 15 to 19 ad 16 mild 17 - 16 mild 18 moderate 18 moderate 19 ad methods : patients with consensus diagnoses of md and ad of mild - moderate severity ( clinical dementia rating [score] of 1 - 2 ) were recruited from a memory clinic . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 27 recruited 2 : 32 . 3 patients 4 with 3 patients 7 of 3 patients 26 were 4 with 6 diagnoses 5 consensus 6 diagnoses 7 of 10 ad 8 md 9 and 9 and 10 ad 10 ad 11 of 11 of 15 severity 12 mild 13 - 12 mild 15 severity 14 moderate 15 severity 15 severity 19 rating 16 ( 19 rating 17 clinical 19 rating 18 dementia 19 rating 19 rating 21 of 19 rating 25 ) 21 of 23 - 22 1 23 - 23 - 24 2 26 were 27 recruited 27 recruited 28 from 28 from 31 clinic 29 a 31 clinic 30 memory 31 clinic cognitive performance was measured by a formal neuropsychological battery covering domains of attention , language , verbal and visual memory , visuoconstruction , visuomotor speed and executive function . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 29 . 1 cognitive 3 was 2 performance 3 was 3 was 4 measured 4 measured 5 by 5 by 9 battery 6 a 9 battery 7 formal 9 battery 8 neuropsychological 9 battery 9 battery 10 covering 9 battery 12 of 10 covering 11 domains 12 of 13 attention 13 attention 15 language 14 , 15 language 15 language 16 , 16 , 26 and 16 , 28 function 17 verbal 18 and 18 and 19 visual 18 and 20 memory 20 memory 21 , 21 , 22 visuoconstruction 21 , 23 , 23 , 25 speed 23 , 26 and 24 visuomotor 25 speed 26 and 27 executive 26 and 28 function cognitive domain scores are [z] - scores calculated using the mean and sds of the ad group . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 8 calculated 1 cognitive 4 are 2 domain 3 scores 3 scores 4 are 6 - 8 calculated 7 scores 8 calculated 8 calculated 9 using 8 calculated 18 . 9 using 12 and 10 the 11 mean 11 mean 12 and 12 and 17 group 13 sds 14 of 13 sds 17 group 14 of 16 ad 15 the 16 ad ancovas with age and education as covariates were employed to examine differences in mean score difference [of] cognitive domains and subtests between patients with md and ad . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 20 and 1 ancovas 2 with 1 ancovas 4 and 2 with 3 age 4 and 5 education 4 and 6 as 4 and 20 and 6 as 7 covariates 8 were 9 employed 8 were 20 and 9 employed 10 to 9 employed 11 examine 10 to 11 examine 11 examine 12 differences 11 examine 13 in 13 in 19 domains 14 mean 15 score 15 score 16 difference 16 difference 19 domains 18 cognitive 19 domains 20 and 21 subtests 20 and 22 between 20 and 24 with 22 between 23 patients 24 with 27 ad 25 md 26 and 26 and 27 ad 27 ad 28 . results : 151 patients were recruited with the majority of ad ( n=96 , 63.6 % ) and a minority of md ( n=55 , 36.4 % ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 4 patients 2 : 6 recruited 3 151 4 patients 4 patients 5 were 5 were 6 recruited 6 recruited 7 with 7 with 18 and 8 the 9 majority 9 majority 10 of 9 majority 18 and 10 of 11 ad 11 ad 13 n=96 12 ( 13 n=96 13 n=96 16 % 13 n=96 17 ) 14 , 16 % 15 63.6 16 % 16 % 17 ) 18 and 20 minority 18 and 21 of 18 and 24 n=55 19 a 20 minority 21 of 22 md 23 ( 24 n=55 24 n=55 27 % 24 n=55 28 ) 25 , 27 % 26 36.4 27 % 27 % 28 ) there were no significant differences in the demographic characteristics of patients with md and ad . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 16 . 1 there 2 were 2 were 5 differences 3 no 5 differences 4 significant 5 differences 5 differences 6 in 5 differences 10 of 6 in 9 characteristics 7 the 9 characteristics 8 demographic 9 characteristics 10 of 11 patients 11 patients 12 with 12 with 14 and 13 md 14 and 14 and 15 ad however , patients with md were significantly more impaired than ad patients in global cognitive composite , attention and visuoconstruction ( global cognitive composite [:] - 0.32±0.98 vs 0±1 , p=0.011 ; attention : - 0.32±0.90 vs 0±1 , p=0.013 ; visuoconstruction : - 0.27±0.99 vs 0±1 , p=0.024 , respectively ) . 0 ###LEFT-WALL### 3 patients 0 ###LEFT-WALL### 9 impaired 0 ###LEFT-WALL### 32 ; 0 ###LEFT-WALL### 49 p=0.024 0 ###LEFT-WALL### 53 . 1 however 2 , 1 however 3 patients 3 patients 4 with 3 patients 6 were 4 with 5 md 6 were 8 more 6 were 9 impaired 7 significantly 8 more 9 impaired 10 than 9 impaired 13 in 10 than 12 patients 11 ad 12 patients 13 in 19 and 14 global 18 attention 15 cognitive 18 attention 16 composite 17 , 16 composite 18 attention 18 attention 19 and 19 and 20 visuoconstruction 19 and 27 0.32±0.98 19 and 31 p=0.011 21 ( 27 0.32±0.98 22 global 27 0.32±0.98 23 cognitive 27 0.32±0.98 24 composite 26 - 24 composite 27 0.32±0.98 27 0.32±0.98 28 vs 27 0.32±0.98 30 , 28 vs 29 0±1 30 , 31 p=0.011 31 p=0.011 32 ; 32 ; 33 attention 32 ; 34 : 32 ; 35 - 33 attention 34 : 35 - 36 0.32±0.90 35 - 41 ; 36 0.32±0.90 37 vs 37 vs 40 p=0.013 38 0±1 39 , 38 0±1 40 p=0.013 41 ; 42 visuoconstruction 41 ; 43 : 41 ; 44 - 42 visuoconstruction 43 : 44 - 45 0.27±0.99 44 - 48 , 45 0.27±0.99 46 vs 46 vs 47 0±1 48 , 49 p=0.024 49 p=0.024 51 respectively 50 , 51 respectively 51 respectively 52 ) conclusion : the neuropsychological profile of patients with md of mild - moderate severity is characterized by a poorer global performance [,] as well as attention and visuoconstruction than those with ad of mild - moderate severity . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 profile 2 : 16 characterized 2 : 38 . 3 the 5 profile 4 neuropsychological 5 profile 5 profile 6 of 5 profile 15 is 6 of 7 patients 7 patients 8 with 8 with 9 md 9 md 10 of 10 of 14 severity 11 mild 12 - 11 mild 13 moderate 13 moderate 14 severity 15 is 16 characterized 16 characterized 17 by 16 characterized 23 as 16 characterized 29 than 17 by 21 performance 18 a 21 performance 19 poorer 21 performance 20 global 21 performance 23 as 27 and 24 well 25 as 24 well 27 and 25 as 26 attention 27 and 28 visuoconstruction 29 than 30 those 29 than 31 with 31 with 32 ad 32 ad 33 of 33 of 37 severity 34 mild 35 - 34 mild 37 severity 36 moderate 37 severity c - reactive protein ( crp ) participates in the systemic response to inflammation . 0 ###LEFT-WALL### 1 c 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 15 . 1 c 2 - 2 - 4 protein 3 reactive 4 protein 4 protein 6 crp 4 protein 8 participates 5 ( 6 crp 6 crp 7 ) 8 participates 9 in 8 participates 13 to 9 in 12 response 10 the 12 response 11 systemic 12 response 13 to 14 inflammation previous studies report inconsistent findings regarding the relationship between plasma crp and alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 report 0 ###LEFT-WALL### 19 . 1 previous 2 studies 2 studies 3 report 3 report 5 findings 4 inconsistent 5 findings 5 findings 6 regarding 6 regarding 8 relationship 6 regarding 9 between 7 the 8 relationship 9 between 12 and 10 plasma 11 crp 11 crp 12 and 12 and 15 disease 12 and 17 ad 13 alzheimer 14 's 14 's 15 disease 16 ( 17 ad 17 ad 18 ) we measured plasma crp in 203 subjects with ad , 58 subjects with mild cognitive impairment ( mci ) and 117 normal aging subjects and administered annual mini - mental state examinations ( mmse ) during a 3 [-] year [follow] - up period to [investigate] crp 's relationship with diagnosis and progression of cognitive decline . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 10 , 1 we 2 measured 2 measured 4 crp 2 measured 5 in 2 measured 8 with 3 plasma 4 crp 5 in 7 subjects 6 203 7 subjects 8 with 9 ad 10 , 20 and 11 58 12 subjects 12 subjects 13 with 12 subjects 20 and 13 with 16 impairment 14 mild 16 impairment 15 cognitive 16 impairment 16 impairment 18 mci 17 ( 18 mci 18 mci 19 ) 20 and 23 aging 20 and 25 and 21 117 23 aging 22 normal 23 aging 24 subjects 25 and 25 and 26 administered 25 and 36 during 26 administered 28 mini 27 annual 28 mini 28 mini 34 mmse 29 - 34 mmse 30 mental 31 state 31 state 32 examinations 32 examinations 34 mmse 33 ( 34 mmse 34 mmse 35 ) 36 during 40 year 37 a 40 year 38 3 40 year 40 year 52 and 42 - 52 and 43 up 44 period 44 period 45 to 44 period 50 with 44 period 52 and 45 to 49 relationship 47 crp 48 's 48 's 49 relationship 50 with 51 diagnosis 52 and 53 progression 52 and 57 . 53 progression 54 of 54 of 56 decline 55 cognitive 56 decline adjusted for age , sex , and education , subjects with ad had significantly lower levels of plasma crp than subjects with mci and normal aging . 0 ###LEFT-WALL### 10 subjects 0 ###LEFT-WALL### 13 had 0 ###LEFT-WALL### 27 . 1 adjusted 2 for 1 adjusted 9 , 1 adjusted 10 subjects 2 for 7 and 3 age 4 , 4 , 5 sex 4 , 7 and 6 , 7 and 7 and 8 education 10 subjects 11 with 10 subjects 13 had 11 with 12 ad 13 had 16 levels 13 had 20 than 14 significantly 15 lower 15 lower 16 levels 16 levels 17 of 17 of 19 crp 18 plasma 19 crp 20 than 24 and 21 subjects 22 with 21 subjects 24 and 22 with 23 mci 24 and 25 normal 24 and 26 aging however [,] there was no significant association between plasma crp at baseline and subsequent cognitive decline as assessed by longitudinal changes in mmse score . 0 ###LEFT-WALL### 24 score 0 ###LEFT-WALL### 25 . 1 however 3 there 1 however 4 was 1 however 24 score 3 there 4 was 4 was 7 association 5 no 7 association 6 significant 7 association 7 association 8 between 8 between 10 crp 9 plasma 10 crp 10 crp 11 at 10 crp 19 by 10 crp 22 in 11 at 13 and 12 baseline 13 and 13 and 16 decline 13 and 18 assessed 14 subsequent 16 decline 15 cognitive 16 decline 17 as 18 assessed 19 by 21 changes 20 longitudinal 21 changes 22 in 23 mmse our results support previous reports of reduced levels of plasma crp in ad and indicate its potential utility as a biomarker for the diagnosis of ad . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 27 . 1 our 2 results 2 results 14 and 3 support 5 reports 3 support 12 in 3 support 14 and 4 previous 5 reports 5 reports 6 of 5 reports 9 of 6 of 8 levels 7 reduced 8 levels 9 of 11 crp 10 plasma 11 crp 12 in 13 ad 14 and 15 indicate 15 indicate 18 utility 15 indicate 19 as 16 its 18 utility 17 potential 18 utility 19 as 21 biomarker 20 a 21 biomarker 21 biomarker 22 for 21 biomarker 25 of 22 for 24 diagnosis 23 the 24 diagnosis 25 of 26 ad objective : to examine the effect of a multi - component , delirium prevention intervention on rates of incident delirium for patients admitted to specialist elderly care wards . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 23 admitted 1 objective 2 : 2 : 3 to 2 : 4 examine 3 to 4 examine 4 examine 6 effect 4 examine 23 admitted 5 the 6 effect 6 effect 7 of 6 effect 18 of 6 effect 23 admitted 7 of 15 intervention 8 a 9 multi 8 a 15 intervention 9 multi 10 - 9 multi 13 delirium 11 component 12 , 11 component 13 delirium 13 delirium 15 intervention 14 prevention 15 intervention 15 intervention 16 on 16 on 17 rates 18 of 20 delirium 19 incident 20 delirium 20 delirium 21 for 21 for 22 patients 23 admitted 24 to 23 admitted 29 . 24 to 28 wards 25 specialist 28 wards 26 elderly 27 care 27 care 28 wards design : ['] before ['] and ['] after ['] study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 . 1 design 2 : 2 : 6 and 4 before 6 and 6 and 8 after 8 after 10 study setting : three specialist elderly care wards in a general hospital . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 . 1 setting 2 : 2 : 7 wards 3 three 7 wards 4 specialist 7 wards 5 elderly 6 care 6 care 7 wards 7 wards 8 in 8 in 11 hospital 9 a 11 hospital 10 general 11 hospital subjects : older people admitted as emergencies . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 . 1 subjects 2 : 2 : 4 people 3 older 4 people 4 people 5 admitted 5 admitted 6 as 6 as 7 emergencies methods : a multi - component delirium prevention intervention that targeted delirium risk factors was implemented by clinical staff . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 9 intervention 2 : 16 implemented 2 : 20 . 3 a 4 multi 3 a 9 intervention 4 multi 5 - 4 multi 6 component 6 component 8 prevention 7 delirium 8 prevention 8 prevention 9 intervention 9 intervention 10 that 9 intervention 14 factors 9 intervention 15 was 10 that 13 risk 10 that 14 factors 11 targeted 12 delirium 12 delirium 13 risk 13 risk 14 factors 15 was 16 implemented 16 implemented 17 by 17 by 19 staff 18 clinical 19 staff demographic information and assessments for delirium risk factors were recorded by research staff within 24 h of admission to the ward . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 10 recorded 0 ###LEFT-WALL### 22 . 1 demographic 2 information 2 information 3 and 3 and 4 assessments 3 and 5 for 3 and 9 were 5 for 8 factors 6 delirium 8 factors 7 risk 8 factors 9 were 10 recorded 10 recorded 11 by 10 recorded 19 to 11 by 13 staff 12 research 13 staff 13 staff 14 within 14 within 16 h 15 24 16 h 16 h 17 of 17 of 18 admission 19 to 21 ward 20 the 21 ward new onset [(] incident [ )(delirium was diagnosed by daily research staff assessments using the confusion assessment method and delirium rating scale - revised - 98 . 0 ###LEFT-WALL### 6 )(delirium 0 ###LEFT-WALL### 8 diagnosed 0 ###LEFT-WALL### 25 - 0 ###LEFT-WALL### 27 . 1 new 6 )(delirium 2 onset 4 incident 4 incident 6 )(delirium 6 )(delirium 7 was 7 was 8 diagnosed 8 diagnosed 9 by 9 by 19 and 10 daily 11 research 11 research 13 assessments 12 staff 13 assessments 13 assessments 14 using 13 assessments 19 and 14 using 18 method 15 the 18 method 16 confusion 17 assessment 17 assessment 18 method 19 and 22 scale 19 and 24 revised 20 delirium 21 rating 21 rating 22 scale 23 - 24 revised 24 revised 25 - 25 - 26 98 results : a total of 436 patients were recruited ( 249 in [the] ['] before ['] [and] 187 in the ['] [after] ['] group ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 total 2 : 9 recruited 2 : 26 . 3 a 4 total 4 total 5 of 4 total 8 were 5 of 7 patients 6 436 7 patients 8 were 9 recruited 9 recruited 15 before 10 ( 15 before 11 249 12 in 12 in 15 before 15 before 18 187 15 before 25 ) 18 187 19 in 19 in 24 group 20 the 24 group incident delirium was significantly reduced ( ['] before ['] = 13.3 % [;] ['] after ['] = 4.6 % [;] p = 0.006 ) . 0 ###LEFT-WALL### 2 delirium 0 ###LEFT-WALL### 5 reduced 0 ###LEFT-WALL### 25 . 1 incident 2 delirium 2 delirium 3 was 3 was 4 significantly 3 was 5 reduced 5 reduced 8 before 6 ( 8 before 8 before 12 % 8 before 24 ) 10 = 11 13.3 11 13.3 12 % 12 % 15 after 15 after 19 % 17 = 18 4.6 18 4.6 19 % 19 % 22 = 21 p 22 = 22 = 23 0.006 delirium severity and duration were significantly reduced in the ['] [after] ['] group . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 reduced 0 ###LEFT-WALL### 14 . 1 delirium 2 severity 2 severity 3 and 3 and 4 duration 3 and 5 were 5 were 6 significantly 5 were 7 reduced 7 reduced 8 in 8 in 13 group 9 the 13 group mortality , length of stay [,] activities of daily living [score] at discharge and new discharge to residential or nursing home rates were similar for both groups . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 28 . 1 mortality 2 , 2 , 3 length 2 , 14 and 3 length 4 of 4 of 7 activities 5 stay 7 activities 7 activities 8 of 8 of 10 living 9 daily 10 living 10 living 12 at 12 at 13 discharge 14 and 16 discharge 14 and 17 to 14 and 23 were 15 new 16 discharge 17 to 19 or 18 residential 19 or 19 or 22 rates 20 nursing 21 home 21 home 22 rates 23 were 24 similar 24 similar 25 for 25 for 27 groups 26 both 27 groups conclusions : a multi - component , delirium prevention intervention directed at delirium risk factors and implemented by local clinical staff can reduce incident delirium on specialist elderly care wards . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 31 . 1 conclusions 2 : 2 : 6 component 3 a 4 multi 3 a 6 component 4 multi 5 - 4 multi 6 component 7 , 10 intervention 7 , 23 reduce 8 delirium 10 intervention 9 prevention 10 intervention 10 intervention 11 directed 10 intervention 12 at 10 intervention 16 and 10 intervention 22 can 12 at 14 risk 13 delirium 14 risk 15 factors 16 and 16 and 17 implemented 16 and 18 by 18 by 21 staff 19 local 21 staff 20 clinical 21 staff 22 can 23 reduce 23 reduce 25 delirium 23 reduce 26 on 24 incident 25 delirium 26 on 30 wards 27 specialist 29 care 28 elderly 29 care 29 care 30 wards background : multi - compartment medication devices ( mmds ) are widely used , primarily by older people , to aid correct - medication taking . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 background 2 : 2 : 3 multi 4 - 7 devices 4 - 13 used 4 - 26 . 5 compartment 6 medication 6 medication 7 devices 7 devices 9 mmds 7 devices 11 are 8 ( 9 mmds 9 mmds 10 ) 11 are 12 widely 11 are 13 used 13 used 16 by 13 used 20 to 13 used 21 aid 14 , 15 primarily 14 , 16 by 16 by 18 people 16 by 19 , 17 older 18 people 20 to 21 aid 21 aid 25 taking 22 correct 23 - 22 correct 24 medication 24 medication 25 taking several mmd types are available yet little is known about the ease with which patients with varying functional ability use these devices and whether some types are easier than others . 0 ###LEFT-WALL### 1 several 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 9 known 0 ###LEFT-WALL### 31 . 1 several 2 mmd 1 several 3 types 1 several 4 are 2 mmd 3 types 4 are 5 available 4 are 6 yet 6 yet 7 little 7 little 8 is 8 is 9 known 9 known 10 about 10 about 23 and 11 the 12 ease 12 ease 13 with 12 ease 23 and 13 with 14 which 13 with 15 patients 13 with 20 use 15 patients 16 with 15 patients 20 use 16 with 17 varying 17 varying 19 ability 18 functional 19 ability 20 use 22 devices 21 these 22 devices 23 and 24 whether 23 and 26 types 23 and 27 are 23 and 28 easier 25 some 26 types 26 types 27 are 28 easier 29 than 29 than 30 others such knowledge would assist healthcare practitioners in advising patients on a suitable choice [of] device . 0 ###LEFT-WALL### 2 knowledge 0 ###LEFT-WALL### 4 assist 0 ###LEFT-WALL### 16 . 1 such 2 knowledge 2 knowledge 3 would 3 would 4 assist 4 assist 6 practitioners 4 assist 7 in 5 healthcare 6 practitioners 7 in 8 advising 8 advising 9 patients 8 advising 10 on 10 on 15 device 11 a 12 suitable 11 a 15 device 12 suitable 15 device 13 choice 15 device objective : this study investigates the ease with which patients with differing functional ability use three types of mmd . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 4 study 2 : 5 investigates 3 this 4 study 4 study 5 investigates 5 investigates 7 ease 6 the 7 ease 7 ease 8 with 8 with 9 which 8 with 10 patients 8 with 15 use 10 patients 11 with 10 patients 15 use 11 with 14 ability 12 differing 14 ability 13 functional 14 ability 15 use 17 types 16 three 17 types 17 types 18 of 18 of 19 mmd method : participants were recruited from an older person 's medical ward . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 3 participants 2 : 5 recruited 2 : 13 . 3 participants 4 were 4 were 5 recruited 5 recruited 6 from 6 from 12 ward 7 an 9 person 8 older 9 person 9 person 10 's 10 's 12 ward 11 medical 12 ward demographic and medication information , cognitive function , visual acuity and manual dexterity were recorded . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 15 recorded 0 ###LEFT-WALL### 16 . 1 demographic 2 and 2 and 4 information 2 and 5 , 3 medication 4 information 5 , 7 function 5 , 8 , 6 cognitive 7 function 8 , 10 acuity 8 , 11 and 9 visual 10 acuity 11 and 13 dexterity 11 and 14 were 12 manual 13 dexterity 14 were 15 recorded the venalink® , nomad clear® and dosett® mmds were tested . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 tested 0 ###LEFT-WALL### 11 . 1 the 2 venalink® 2 venalink® 3 , 3 , 5 clear® 3 , 6 and 4 nomad 5 clear® 6 and 8 mmds 6 and 9 were 7 dosett® 8 mmds 9 were 10 tested participants rated each mmd according to text readability , ease of opening , ease of medication removal , transportability and overall rating . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 rated 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 23 . 1 participants 2 rated 2 rated 3 each 2 rated 4 mmd 2 rated 6 to 5 according 6 to 6 to 8 readability 7 text 8 readability 8 readability 10 ease 9 , 10 ease 10 ease 11 of 10 ease 13 , 11 of 12 opening 13 , 20 and 14 ease 15 of 14 ease 18 , 15 of 17 removal 16 medication 17 removal 18 , 19 transportability 18 , 20 and 20 and 21 overall 20 and 22 rating these ratings were compared between mmds for all patients and for subgroups with differing functional abilities . 0 ###LEFT-WALL### 2 ratings 0 ###LEFT-WALL### 4 compared 0 ###LEFT-WALL### 17 . 1 these 2 ratings 2 ratings 3 were 3 were 4 compared 4 compared 5 between 4 compared 13 with 5 between 6 mmds 6 mmds 10 and 7 for 9 patients 7 for 10 and 8 all 9 patients 10 and 11 for 11 for 12 subgroups 13 with 16 abilities 14 differing 16 abilities 15 functional 16 abilities results : the mmds were trialled by 50 patients ; the majority rated text readability well but rated mmds poorly according to the other criteria . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 mmds 2 : 6 trialled 2 : 10 ; 3 the 4 mmds 4 mmds 5 were 5 were 6 trialled 6 trialled 7 by 7 by 9 patients 8 50 9 patients 10 ; 12 majority 10 ; 17 but 11 the 12 majority 12 majority 17 but 13 rated 16 well 13 rated 17 but 14 text 16 well 15 readability 16 well 17 but 18 rated 18 rated 19 mmds 18 rated 20 poorly 18 rated 22 to 21 according 22 to 22 to 25 criteria 23 the 24 other 24 other 25 criteria cognitively impaired participants may encounter difficulties in opening and removing medication from venalink® and nomad® . 0 ###LEFT-WALL### 3 participants 0 ###LEFT-WALL### 5 encounter 0 ###LEFT-WALL### 16 . 1 cognitively 2 impaired 2 impaired 3 participants 3 participants 4 may 4 may 5 encounter 5 encounter 9 and 6 difficulties 7 in 6 difficulties 9 and 7 in 8 opening 9 and 11 medication 9 and 12 from 10 removing 11 medication 12 from 14 and 13 venalink® 14 and 14 and 15 nomad® the dosett® consistently rated better across all criteria . 0 ###LEFT-WALL### 2 dosett® 0 ###LEFT-WALL### 4 rated 0 ###LEFT-WALL### 9 . 1 the 2 dosett® 2 dosett® 4 rated 3 consistently 4 rated 4 rated 5 better 5 better 6 across 6 across 8 criteria 7 all 8 criteria transportability was the most influential criterion for overall mmd usability . 0 ###LEFT-WALL### 1 transportability 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 11 . 1 transportability 2 was 2 was 6 criterion 2 was 10 usability 3 the 6 criterion 4 most 5 influential 5 influential 6 criterion 6 criterion 7 for 7 for 8 overall 8 overall 9 mmd conclusion : the poor patient rating of mmds which are widely used in practice is of concern . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 patient 2 : 15 is 2 : 18 . 3 the 5 patient 4 poor 5 patient 5 patient 6 rating 5 patient 7 of 5 patient 15 is 7 of 8 mmds 8 mmds 9 which 8 mmds 10 are 9 which 10 are 10 are 12 used 11 widely 12 used 12 used 13 in 13 in 14 practice 15 is 16 of 16 of 17 concern some mmds may be difficult to open and access , especially for patients with cognitive impairment . 0 ###LEFT-WALL### 2 mmds 0 ###LEFT-WALL### 8 and 1 some 2 mmds 2 mmds 8 and 3 may 4 be 3 may 8 and 4 be 5 difficult 5 difficult 6 to 5 difficult 7 open 6 to 7 open 8 and 9 access 8 and 12 for 10 , 11 especially 10 , 12 for 12 for 13 patients 12 for 17 . 13 patients 14 with 14 with 16 impairment 15 cognitive 16 impairment this offers some guidance to health professionals in advising patients on [mmd] choice however , overall mmd rating appears dominated by transportability . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 offers 0 ###LEFT-WALL### 23 . 1 this 2 offers 2 offers 3 some 2 offers 4 guidance 2 offers 5 to 2 offers 8 in 5 to 7 professionals 6 health 7 professionals 8 in 9 advising 9 advising 10 patients 9 advising 11 on 9 advising 16 overall 9 advising 19 appears 11 on 13 choice 14 however 15 , 14 however 16 overall 16 overall 17 mmd 16 overall 18 rating 16 overall 19 appears 19 appears 20 dominated 20 dominated 21 by 21 by 22 transportability background : although maintaining activity is key to successful pain management , and important to health and wellbeing , it is known that older people in pain frequently alter or reduce activity levels . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 known 0 ###LEFT-WALL### 34 . 1 background 2 : 2 : 3 although 3 although 20 it 4 maintaining 5 activity 4 maintaining 7 key 4 maintaining 19 , 4 maintaining 20 it 5 activity 6 is 6 is 7 key 7 key 8 to 7 key 17 and 8 to 10 pain 9 successful 10 pain 11 management 13 and 12 , 13 and 13 and 14 important 13 and 15 to 13 and 17 and 15 to 16 health 17 and 18 wellbeing 20 it 21 is 21 is 22 known 22 known 23 that 23 that 25 people 23 that 30 or 24 older 25 people 25 people 26 in 25 people 30 or 26 in 27 pain 28 frequently 29 alter 29 alter 30 or 30 or 31 reduce 31 reduce 33 levels 32 activity 33 levels a ['] fear [-] avoidance ['] model is often used to explain avoidance of activity in the face of pain . 0 ###LEFT-WALL### 7 model 0 ###LEFT-WALL### 10 used 0 ###LEFT-WALL### 21 . 1 a 7 model 3 fear 7 model 5 avoidance 7 model 7 model 8 is 8 is 10 used 9 often 10 used 10 used 11 to 10 used 12 explain 11 to 12 explain 12 explain 13 avoidance 12 explain 16 in 13 avoidance 14 of 14 of 15 activity 16 in 18 face 17 the 18 face 18 face 19 of 19 of 20 pain however , this model is not intended to take [account] [of] the wider context in which activity changes take place [,] nor older people 's own explanations for their behaviour . 0 ###LEFT-WALL### 4 model 0 ###LEFT-WALL### 7 intended 0 ###LEFT-WALL### 31 . 1 however 2 , 1 however 4 model 3 this 4 model 4 model 5 is 5 is 6 not 5 is 7 intended 7 intended 8 to 7 intended 9 take 8 to 9 take 9 take 22 nor 12 the 14 context 13 wider 14 context 14 context 15 in 14 context 22 nor 15 in 16 which 15 in 17 activity 15 in 18 changes 15 in 20 place 16 which 17 activity 18 changes 20 place 19 take 20 place 22 nor 27 explanations 22 nor 28 for 23 older 24 people 24 people 25 's 25 's 26 own 25 's 27 explanations 28 for 30 behaviour 29 their 30 behaviour objective : to investigate the reasons why older people in the community adjust their activity levels when living with chronic pain . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 investigate 2 : 22 . 3 to 4 investigate 4 investigate 6 reasons 5 the 6 reasons 6 reasons 7 why 7 why 9 people 7 why 13 adjust 8 older 9 people 9 people 10 in 9 people 13 adjust 10 in 12 community 11 the 12 community 13 adjust 16 levels 13 adjust 17 when 14 their 16 levels 15 activity 16 levels 17 when 18 living 18 living 19 with 19 with 21 pain 20 chronic 21 pain methods : thirty - one people aged between 67 and 92 were purposively sampled from respondents to a community - based cross - sectional survey . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 thirty 2 : 14 sampled 2 : 20 - 3 thirty 6 people 3 thirty 7 aged 3 thirty 12 were 4 - 5 one 5 one 6 people 6 people 7 aged 7 aged 8 between 8 between 10 and 9 67 10 and 10 and 11 92 12 were 13 purposively 12 were 14 sampled 14 sampled 15 from 14 sampled 17 to 15 from 16 respondents 17 to 19 community 18 a 19 community 20 - 22 cross 20 - 23 - 21 based 22 cross 23 - 25 survey 23 - 26 . 24 sectional 25 survey all participants had reported long - term pain and were interviewed about this . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 14 . 1 all 2 participants 2 participants 3 had 3 had 9 and 4 reported 8 pain 4 reported 9 and 5 long 6 - 5 long 7 term 7 term 8 pain 9 and 10 were 10 were 11 interviewed 11 interviewed 12 about 12 about 13 this data were collected and analysed using a qualitative constructivist grounded theory approach . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 12 approach 0 ###LEFT-WALL### 13 . 1 data 4 and 1 data 12 approach 2 were 3 collected 2 were 4 and 4 and 5 analysed 5 analysed 6 using 5 analysed 10 grounded 6 using 9 constructivist 6 using 10 grounded 7 a 8 qualitative 7 a 9 constructivist 8 qualitative 9 constructivist 10 grounded 11 theory findings : explanations for deliberative reduction or ceasing of activities reflected a desire to prevent pain exacerbation , thereby avoiding medical intervention . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 or 1 findings 2 : 2 : 3 explanations 3 explanations 4 for 4 for 6 reduction 5 deliberative 6 reduction 7 or 8 ceasing 7 or 11 reflected 8 ceasing 9 of 8 ceasing 11 reflected 9 of 10 activities 11 reflected 13 desire 11 reflected 20 avoiding 12 a 13 desire 13 desire 14 to 13 desire 15 prevent 14 to 15 prevent 15 prevent 17 exacerbation 16 pain 17 exacerbation 18 , 20 avoiding 19 thereby 20 avoiding 20 avoiding 22 intervention 20 avoiding 23 . 21 medical 22 intervention it also reflected a desire to safeguard autonomy in the face of pain in older age . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 reflected 0 ###LEFT-WALL### 17 . 1 it 3 reflected 2 also 3 reflected 3 reflected 5 desire 4 a 5 desire 5 desire 6 to 5 desire 7 safeguard 6 to 7 safeguard 7 safeguard 8 autonomy 7 safeguard 9 in 7 safeguard 14 in 9 in 11 face 10 the 11 face 11 face 12 of 12 of 13 pain 14 in 16 age 15 older 16 age restrictions were often rationalised as normal in older age , although co - existing accounts of perseverance and frustration with limitation were also evident . 0 ###LEFT-WALL### 1 restrictions 0 ###LEFT-WALL### 4 rationalised 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 25 . 1 restrictions 2 were 2 were 3 often 2 were 4 rationalised 4 rationalised 6 normal 5 as 6 normal 6 normal 7 in 7 in 9 age 8 older 9 age 10 , 15 accounts 10 , 22 were 11 although 12 co 11 although 13 - 11 although 15 accounts 14 existing 15 accounts 15 accounts 16 of 15 accounts 22 were 16 of 18 and 17 perseverance 18 and 18 and 19 frustration 18 and 20 with 20 with 21 limitation 22 were 23 also 22 were 24 evident conclusions : a rational desire to avoid pain exacerbation and medical intervention motivated restrictions to activity . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 17 . 1 conclusions 2 : 2 : 5 desire 3 a 5 desire 4 rational 5 desire 5 desire 6 to 5 desire 7 avoid 6 to 7 avoid 7 avoid 9 exacerbation 8 pain 9 exacerbation 10 and 12 intervention 10 and 13 motivated 11 medical 12 intervention 12 intervention 13 motivated 13 motivated 14 restrictions 13 motivated 15 to 15 to 16 activity however , deliberative limitation of activity has the potential to compromise autonomy by increasing social isolation and [de] [-] conditioning . 0 ###LEFT-WALL### 4 limitation 0 ###LEFT-WALL### 7 has 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 4 limitation 3 deliberative 4 limitation 4 limitation 5 of 4 limitation 7 has 5 of 6 activity 7 has 9 potential 8 the 9 potential 9 potential 10 to 10 to 17 and 11 compromise 12 autonomy 12 autonomy 13 by 12 autonomy 17 and 13 by 14 increasing 14 increasing 16 isolation 15 social 16 isolation 17 and 20 conditioning supporting older people with pain to be active requires sensitivity to the function of activity [restriction] , especially as a means of preventing deterioration . 0 ###LEFT-WALL### 1 supporting 0 ###LEFT-WALL### 9 requires 1 supporting 3 people 1 supporting 4 with 1 supporting 6 to 1 supporting 9 requires 2 older 3 people 4 with 5 pain 6 to 7 be 7 be 8 active 9 requires 10 sensitivity 9 requires 11 to 11 to 13 function 12 the 13 function 13 function 14 of 14 of 15 activity 15 activity 19 as 17 , 18 especially 17 , 19 as 19 as 21 means 19 as 25 . 20 a 21 means 21 means 22 of 22 of 23 preventing 23 preventing 24 deterioration background : the aim of this study was to examine morphometric features of the cerebral surface in adolescent and adult female subjects with bulimia nervosa ( bn ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 examine 0 ###LEFT-WALL### 29 . 2 : 4 aim 3 the 4 aim 4 aim 5 of 4 aim 7 study 4 aim 10 examine 5 of 6 this 7 study 8 was 8 was 9 to 8 was 10 examine 9 to 10 examine 10 examine 12 features 11 morphometric 12 features 12 features 13 of 12 features 23 with 12 features 27 bn 13 of 16 surface 14 the 16 surface 15 cerebral 16 surface 16 surface 17 in 17 in 19 and 18 adolescent 19 and 19 and 22 subjects 20 adult 21 female 21 female 22 subjects 23 with 25 nervosa 24 bulimia 25 nervosa 26 ( 27 bn 27 bn 28 ) methods : anatomical magnetic resonance images were acquired from 34 adolescent and adult female subjects with bn and 34 healthy age - matched control subjects . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 images 2 : 8 acquired 2 : 12 and 2 : 26 . 3 anatomical 6 images 4 magnetic 5 resonance 5 resonance 6 images 6 images 7 were 7 were 8 acquired 8 acquired 9 from 8 acquired 11 adolescent 9 from 10 34 12 and 15 subjects 12 and 24 control 13 adult 15 subjects 14 female 15 subjects 15 subjects 16 with 15 subjects 23 matched 15 subjects 24 control 16 with 18 and 17 bn 18 and 18 and 21 age 18 and 22 - 19 34 21 age 20 healthy 21 age 24 control 25 subjects we compared the groups in the morphological characteristics of their cerebral surfaces while controlling for age and illness duration . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 0 ###LEFT-WALL### 20 . 1 we 2 compared 2 compared 4 groups 2 compared 5 in 2 compared 13 while 3 the 4 groups 5 in 8 characteristics 6 the 8 characteristics 7 morphological 8 characteristics 8 characteristics 9 of 9 of 12 surfaces 10 their 12 surfaces 11 cerebral 12 surfaces 13 while 14 controlling 14 controlling 15 for 14 controlling 19 duration 15 for 17 and 16 age 17 and 17 and 18 illness results : significant reductions of local volumes on the brain surface were detected in frontal and temporoparietal areas in the bn compared with control participants . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 reductions 2 : 13 detected 3 significant 4 reductions 4 reductions 5 of 4 reductions 12 were 5 of 7 volumes 6 local 7 volumes 7 volumes 8 on 8 on 11 surface 9 the 11 surface 10 brain 11 surface 12 were 13 detected 13 detected 14 in 13 detected 19 in 14 in 16 and 15 frontal 16 and 16 and 18 areas 17 temporoparietal 18 areas 19 in 21 bn 20 the 21 bn 21 bn 22 compared 22 compared 23 with 23 with 25 participants 24 control 25 participants reductions in inferior frontal regions correlated inversely with symptom severity , age , and stroop interference scores in the bn group . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 21 group 0 ###LEFT-WALL### 22 . 1 reductions 2 in 1 reductions 14 and 2 in 5 regions 3 inferior 5 regions 4 frontal 5 regions 5 regions 6 correlated 6 correlated 7 inversely 6 correlated 8 with 8 with 10 severity 9 symptom 10 severity 10 severity 12 age 11 , 12 age 12 age 13 , 13 , 14 and 14 and 15 stroop 14 and 16 interference 14 and 17 scores 14 and 21 group 16 interference 17 scores 17 scores 18 in 18 in 20 bn 19 the 20 bn conclusions : these findings suggest that local volumes of inferior frontal regions are smaller in individuals with bn compared with healthy individuals . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 4 findings 2 : 5 suggest 3 these 4 findings 4 findings 5 suggest 5 suggest 12 regions 5 suggest 13 are 6 that 7 local 7 local 8 volumes 8 volumes 9 of 8 volumes 12 regions 9 of 12 regions 10 inferior 12 regions 11 frontal 12 regions 12 regions 13 are 13 are 14 smaller 14 smaller 15 in 14 smaller 17 with 15 in 16 individuals 17 with 18 bn 18 bn 19 compared 19 compared 20 with 20 with 22 individuals 21 healthy 22 individuals these reductions along the cerebral surface might contribute to functional deficits in self [-] regulation and to the persistence of these deficits over development in bn . 0 ###LEFT-WALL### 2 reductions 0 ###LEFT-WALL### 8 contribute 0 ###LEFT-WALL### 27 . 1 these 2 reductions 2 reductions 3 along 2 reductions 7 might 3 along 6 surface 4 the 6 surface 5 cerebral 6 surface 7 might 8 contribute 8 contribute 9 to 8 contribute 23 over 8 contribute 25 in 9 to 11 deficits 10 functional 11 deficits 11 deficits 16 and 12 in 15 regulation 12 in 16 and 13 self 15 regulation 16 and 17 to 17 to 19 persistence 18 the 19 persistence 19 persistence 20 of 20 of 22 deficits 21 these 22 deficits 23 over 24 development 25 in 26 bn background : even with healthy and active aging , many older adults will experience a decrease in physical capacities . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 20 . 1 background 2 : 2 : 9 , 3 even 4 with 3 even 9 , 4 with 6 and 5 healthy 6 and 6 and 7 active 6 and 8 aging 9 , 14 experience 10 many 12 adults 11 older 12 adults 12 adults 13 will 13 will 14 experience 14 experience 16 decrease 14 experience 17 in 15 a 16 decrease 17 in 19 capacities 18 physical 19 capacities this decrease might be associated with diminished functional autonomy . 0 ###LEFT-WALL### 2 decrease 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 10 . 1 this 2 decrease 2 decrease 3 might 3 might 4 be 4 be 5 associated 5 associated 6 with 6 with 9 autonomy 7 diminished 9 autonomy 8 functional 9 autonomy however , little is known about the physical capacities associated with functional autonomy in older women and men . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 3 little 3 little 4 is 4 is 5 known 5 known 6 about 6 about 9 capacities 7 the 9 capacities 8 physical 9 capacities 9 capacities 10 associated 10 associated 11 with 10 associated 14 in 11 with 13 autonomy 12 functional 13 autonomy 14 in 17 and 15 older 16 women 16 women 17 and 17 and 18 men objective : this study aimed to examine gender - specific associations between functional autonomy and physical capacities in independent older women and men . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 24 . 1 objective 2 : 2 : 4 study 3 this 4 study 4 study 5 aimed 5 aimed 6 to 6 to 7 examine 7 examine 8 gender 9 - 15 and 10 specific 11 associations 11 associations 12 between 11 associations 15 and 12 between 14 autonomy 13 functional 14 autonomy 15 and 17 capacities 15 and 18 in 16 physical 17 capacities 18 in 22 and 19 independent 21 women 20 older 21 women 21 women 22 and 22 and 23 men methods : secondary analyses were carried out using cross [-] sectional data from 652 women and 613 men who participated in the nuage longitudinal study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 3 secondary 2 : 6 carried 3 secondary 4 analyses 3 secondary 5 were 3 secondary 6 carried 4 analyses 5 were 6 carried 7 out 7 out 8 using 7 out 21 in 8 using 12 data 8 using 13 from 9 cross 12 data 11 sectional 12 data 13 from 16 and 14 652 15 women 15 women 16 and 16 and 18 men 16 and 19 who 16 and 20 participated 17 613 18 men 19 who 20 participated 21 in 25 study 22 the 25 study 23 nuage 25 study 24 longitudinal 25 study the " functional autonomy measurement system " ( smaf ) was used to evaluate functional autonomy . 0 ###LEFT-WALL### 6 system 0 ###LEFT-WALL### 12 used 0 ###LEFT-WALL### 17 . 1 the 2 " 1 the 6 system 3 functional 4 autonomy 4 autonomy 6 system 5 measurement 6 system 6 system 7 " 6 system 9 smaf 6 system 11 was 8 ( 9 smaf 9 smaf 10 ) 11 was 12 used 12 used 13 to 12 used 14 evaluate 13 to 14 evaluate 14 evaluate 16 autonomy 15 functional 16 autonomy the physical capacities measured ( tests used ) were : biceps and quadriceps strength ( microfet dynamometer ) , grip strength ( martin vigorimeter ) , unipodal balance , changing position [&] walking ( timed up and [go] [ )( normal [&] fast walking ( four - meter walking speed [ )(and changing position ( chair stand ) . 0 ###LEFT-WALL### 3 capacities 0 ###LEFT-WALL### 10 : 1 the 3 capacities 2 physical 3 capacities 3 capacities 4 measured 3 capacities 6 tests 3 capacities 9 were 5 ( 6 tests 6 tests 7 used 6 tests 8 ) 10 : 12 and 10 : 19 , 11 biceps 12 and 12 and 14 strength 12 and 17 dynamometer 13 quadriceps 14 strength 15 ( 17 dynamometer 16 microfet 17 dynamometer 17 dynamometer 18 ) 19 , 20 grip 19 , 26 , 20 grip 21 strength 21 strength 24 vigorimeter 22 ( 24 vigorimeter 23 martin 24 vigorimeter 24 vigorimeter 25 ) 26 , 37 and 27 unipodal 28 balance 28 balance 29 , 29 , 31 position 29 , 37 and 30 changing 31 position 31 position 33 walking 33 walking 35 timed 33 walking 36 up 34 ( 35 timed 37 and 41 normal 37 and 44 walking 43 fast 44 walking 44 walking 47 - 45 ( 47 - 46 four 47 - 47 - 48 meter 47 - 59 . 48 meter 49 walking 49 walking 52 )(and 50 speed 52 )(and 52 )(and 54 position 52 )(and 57 stand 53 changing 54 position 55 ( 57 stand 56 chair 57 stand 57 stand 58 ) correlation and multiple linear regression analyses adjusted for age , depressive symptoms and body composition were performed . 0 ###LEFT-WALL### 1 correlation 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 18 . 2 and 13 and 2 and 16 were 3 multiple 6 analyses 4 linear 5 regression 5 regression 6 analyses 6 analyses 7 adjusted 6 analyses 10 , 7 adjusted 8 for 8 for 9 age 10 , 12 symptoms 10 , 13 and 11 depressive 12 symptoms 13 and 15 composition 13 and 16 were 14 body 15 composition 16 were 17 performed results : on average , participants were aged 73 years and had mild to moderate functional autonomy loss . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 1 results 2 : 2 : 3 on 3 on 6 participants 4 average 5 , 4 average 6 participants 6 participants 11 and 6 participants 13 mild 7 were 10 years 7 were 11 and 8 aged 10 years 9 73 10 years 11 and 12 had 13 mild 14 to 14 to 18 loss 15 moderate 17 autonomy 16 functional 17 autonomy 17 autonomy 18 loss in women , after controlling for age , depressive symptoms and body composition , greater functional autonomy was best explained by faster changing position [&] walking skills and superior biceps strength [(] r ( 2 )=0.46 [;] p<0.001 ) . 0 ###LEFT-WALL### 17 autonomy 0 ###LEFT-WALL### 20 explained 0 ###LEFT-WALL### 40 . 1 in 2 women 1 in 3 , 1 in 17 autonomy 3 , 4 after 4 after 5 controlling 4 after 14 , 4 after 17 autonomy 5 controlling 6 for 5 controlling 13 composition 6 for 11 and 7 age 8 , 8 , 10 symptoms 8 , 11 and 9 depressive 10 symptoms 11 and 12 body 15 greater 17 autonomy 16 functional 17 autonomy 17 autonomy 18 was 18 was 19 best 18 was 20 explained 20 explained 21 by 21 by 28 and 22 faster 24 position 23 changing 24 position 24 position 26 walking 24 position 28 and 26 walking 27 skills 28 and 31 strength 28 and 38 p<0.001 29 superior 31 strength 30 biceps 31 strength 31 strength 33 r 34 ( 38 p<0.001 35 2 36 )=0.46 36 )=0.46 38 p<0.001 38 p<0.001 39 ) after controlling for depressive symptoms , faster changing position [&] walking skills and better unipodal balance best explained greater functional autonomy in men [(] r ( 2 )=0.21 ; p<0.001 [ )( 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 17 best 0 ###LEFT-WALL### 29 ; 0 ###LEFT-WALL### 30 p<0.001 0 ###LEFT-WALL### 32 )( 1 after 2 controlling 1 after 6 , 1 after 13 and 2 controlling 3 for 3 for 5 symptoms 4 depressive 5 symptoms 7 faster 9 position 8 changing 9 position 9 position 11 walking 9 position 13 and 11 walking 12 skills 13 and 16 balance 13 and 17 best 14 better 16 balance 15 unipodal 16 balance 17 best 21 autonomy 18 explained 21 autonomy 19 greater 21 autonomy 20 functional 21 autonomy 21 autonomy 22 in 22 in 23 men 23 men 25 r 23 men 28 )=0.21 26 ( 28 )=0.21 27 2 28 )=0.21 28 )=0.21 29 ; 29 ; 30 p<0.001 conclusion : according to these results , physical capacities are moderately [associated] with functional autonomy among independent older adults , especially women . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 1 conclusion 2 : 2 : 4 to 3 according 4 to 4 to 6 results 5 these 6 results 7 , 9 capacities 7 , 10 are 8 physical 9 capacities 9 capacities 10 are 10 are 11 moderately 10 are 13 with 10 are 16 among 13 with 15 autonomy 14 functional 15 autonomy 16 among 19 adults 17 independent 19 adults 18 older 19 adults 19 adults 22 women 20 , 21 especially 20 , 22 women 22 women 23 . the objective of this study is to examine the prevalence and factors associated with frailty in peruvian navy veteran 's older adults and family members . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 26 . 1 the 2 objective 2 objective 3 of 2 objective 11 and 3 of 5 study 4 this 5 study 6 is 7 to 6 is 8 examine 6 is 11 and 7 to 8 examine 8 examine 10 prevalence 9 the 10 prevalence 11 and 12 factors 12 factors 13 associated 12 factors 14 with 12 factors 16 in 14 with 15 frailty 16 in 25 members 17 peruvian 25 members 18 navy 19 veteran 19 veteran 20 's 20 's 22 adults 21 older 22 adults 22 adults 23 and 23 and 24 family 23 and 25 members a total of 311 [non] - institutionalized men and women aged 60 years and older , from the geriatrics service of the peruvian navy medical center ( centro médico naval " cirujano mayor santiago távara " ) were assessed between may and october 2010 . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 39 assessed 0 ###LEFT-WALL### 45 . 1 a 2 total 2 total 3 of 2 total 9 and 2 total 38 were 3 of 4 311 6 - 9 and 7 institutionalized 8 men 8 men 9 and 9 and 10 women 9 and 17 from 9 and 37 ) 10 women 11 aged 11 aged 14 and 12 60 13 years 13 years 14 and 14 and 15 older 16 , 17 from 17 from 20 service 17 from 37 ) 18 the 20 service 19 geriatrics 20 service 20 service 21 of 20 service 35 távara 21 of 26 center 22 the 23 peruvian 23 peruvian 26 center 24 navy 25 medical 25 medical 26 center 27 ( 35 távara 28 centro 29 médico 29 médico 30 naval 30 naval 31 " 30 naval 32 cirujano 32 cirujano 33 mayor 33 mayor 35 távara 34 santiago 35 távara 35 távara 36 " 35 távara 37 ) 38 were 39 assessed 39 assessed 40 between 40 between 42 and 41 may 42 and 42 and 43 october 43 october 44 2010 additionally , information on socio - demographic factors , medical conditions , depressive symptoms , disability , and cognitive function were obtained . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 22 obtained 0 ###LEFT-WALL### 23 . 1 additionally 2 , 1 additionally 18 and 3 information 4 on 3 information 12 , 4 on 11 conditions 5 socio 8 factors 5 socio 9 , 5 socio 11 conditions 6 - 8 factors 7 demographic 8 factors 8 factors 9 , 10 medical 11 conditions 12 , 14 symptoms 12 , 15 , 13 depressive 14 symptoms 15 , 16 disability 15 , 18 and 17 , 18 and 18 and 20 function 18 and 21 were 19 cognitive 20 function 21 were 22 obtained of the 311 participants , 78 ( 25.1 % ) were not frail , 147 ( 47.3 % ) were pre - frail , [and] 86 ( 27.8 % ) were frail . 0 ###LEFT-WALL### 15 147 0 ###LEFT-WALL### 20 were 0 ###LEFT-WALL### 22 - 1 of 4 participants 1 of 14 , 1 of 15 147 2 the 3 311 3 311 4 participants 4 participants 13 frail 5 , 13 frail 6 78 9 % 6 78 11 were 7 ( 9 % 8 25.1 9 % 9 % 10 ) 11 were 12 not 12 not 13 frail 13 frail 14 , 15 147 18 % 15 147 20 were 16 ( 18 % 17 47.3 18 % 18 % 19 ) 20 were 21 pre 22 - 26 86 22 - 31 were 22 - 33 . 23 frail 24 , 23 frail 26 86 26 86 29 % 26 86 31 were 27 ( 29 % 28 27.8 29 % 29 % 30 ) 31 were 32 frail using logistic regression analysis , we found that older age , being married , falls in the last year and disability were factors significantly associated with being frail . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 found 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 29 . 1 using 4 analysis 1 using 5 , 1 using 6 we 2 logistic 3 regression 3 regression 4 analysis 6 we 7 found 7 found 8 that 8 that 10 age 8 that 15 falls 9 older 10 age 10 age 12 being 10 age 15 falls 11 , 12 being 12 being 13 married 12 being 14 , 15 falls 16 in 16 in 19 year 17 the 19 year 18 last 19 year 20 and 21 disability 20 and 22 were 21 disability 22 were 22 were 23 factors 22 were 26 with 23 factors 25 associated 24 significantly 25 associated 26 with 27 being 27 being 28 frail we conclude that prevalence of pre - frail and frail status in peruvian navy veterans and family members is high . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 21 . 1 we 2 conclude 2 conclude 3 that 3 that 4 prevalence 3 that 19 is 4 prevalence 5 of 4 prevalence 19 is 5 of 11 status 6 pre 7 - 6 pre 11 status 8 frail 9 and 9 and 10 frail 9 and 11 status 11 status 12 in 12 in 16 and 13 peruvian 15 veterans 14 navy 15 veterans 15 veterans 16 and 16 and 18 members 17 family 18 members 19 is 20 high our data reports risk factors for frailty that have been reported in the past in other population groups . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 reports 0 ###LEFT-WALL### 19 . 1 our 2 data 2 data 3 reports 3 reports 5 factors 3 reports 12 in 3 reports 15 in 4 risk 5 factors 5 factors 6 for 5 factors 8 that 5 factors 9 have 6 for 7 frailty 8 that 9 have 9 have 10 been 10 been 11 reported 12 in 14 past 13 the 14 past 15 in 18 groups 16 other 18 groups 17 population 18 groups a larger sample and longitudinal follow - up [are] needed to design and implement comprehensive geriatric interventions that can benefit peruvian navy veteran 's older adults at risk of becoming frail . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 follow 0 ###LEFT-WALL### 7 - 1 a 3 sample 2 larger 3 sample 3 sample 4 and 4 and 5 longitudinal 4 and 6 follow 7 - 13 and 7 - 32 . 8 up 13 and 10 needed 11 to 10 needed 13 and 11 to 12 design 13 and 14 implement 14 implement 17 interventions 15 comprehensive 17 interventions 16 geriatric 17 interventions 17 interventions 18 that 17 interventions 19 can 18 that 19 can 19 can 20 benefit 20 benefit 26 adults 20 benefit 27 at 21 peruvian 23 veteran 22 navy 23 veteran 23 veteran 24 's 24 's 26 adults 25 older 26 adults 27 at 28 risk 28 risk 29 of 29 of 30 becoming 30 becoming 31 frail neurodegenerative diseases ( nds ) are defined by the accumulation of abnormal protein deposits in the central nervous system ( cns ) , and only neuropathological examination enables a definitive diagnosis . 0 ###LEFT-WALL### 2 diseases 0 ###LEFT-WALL### 7 defined 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 32 . 1 neurodegenerative 2 diseases 2 diseases 4 nds 2 diseases 6 are 3 ( 4 nds 4 nds 5 ) 6 are 7 defined 7 defined 8 by 7 defined 15 in 8 by 10 accumulation 9 the 10 accumulation 10 accumulation 11 of 11 of 14 deposits 12 abnormal 13 protein 13 protein 14 deposits 15 in 19 system 16 the 19 system 17 central 19 system 18 nervous 19 system 19 system 21 cns 20 ( 21 cns 21 cns 22 ) 23 , 24 and 24 and 25 only 24 and 27 examination 24 and 28 enables 26 neuropathological 27 examination 27 examination 28 enables 28 enables 31 diagnosis 29 a 30 definitive 29 a 31 diagnosis 30 definitive 31 diagnosis brain banks and their associated scientific programs have shaped the actual knowledge of nds , identifying [and] characterizing the cns deposits that define new diseases , formulating staging schemes , and establishing correlations between neuropathological changes and clinical features . 0 ###LEFT-WALL### 1 brain 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 40 . 1 brain 2 banks 3 and 7 programs 3 and 9 shaped 4 their 7 programs 5 associated 7 programs 6 scientific 7 programs 7 programs 8 have 8 have 9 shaped 9 shaped 31 and 10 the 12 knowledge 11 actual 12 knowledge 12 knowledge 13 of 12 knowledge 15 , 13 of 14 nds 15 , 16 identifying 15 , 31 and 16 identifying 18 characterizing 18 characterizing 21 deposits 18 characterizing 27 formulating 19 the 21 deposits 20 cns 21 deposits 21 deposits 22 that 21 deposits 23 define 22 that 23 define 23 define 25 diseases 24 new 25 diseases 26 , 27 formulating 27 formulating 29 schemes 27 formulating 30 , 28 staging 29 schemes 31 and 33 correlations 31 and 34 between 32 establishing 33 correlations 34 between 37 and 35 neuropathological 36 changes 36 changes 37 and 37 and 39 features 38 clinical 39 features however , brain banks have evolved to accommodate the banking of biofluids as well as dna and rna samples . 0 ###LEFT-WALL### 3 brain 0 ###LEFT-WALL### 6 evolved 0 ###LEFT-WALL### 20 . 1 however 2 , 1 however 3 brain 3 brain 4 banks 3 brain 5 have 3 brain 6 evolved 4 banks 5 have 6 evolved 7 to 6 evolved 13 as 6 evolved 15 as 7 to 8 accommodate 8 accommodate 10 banking 9 the 10 banking 10 banking 11 of 11 of 12 biofluids 13 as 14 well 15 as 17 and 16 dna 17 and 17 and 19 samples 18 rna 19 samples moreover , the value of biobanks is greatly enhanced if they link all the multidimensional clinical and laboratory information of each case , which is accomplished , optimally , using systematic and standardized operating procedures , and in the framework of multidisciplinary teams with the support of a flexible and user - friendly database system that facilitates the sharing of information of all the teams in the network . 0 ###LEFT-WALL### 4 value 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 69 . 1 moreover 2 , 1 moreover 4 value 3 the 4 value 4 value 5 of 4 value 7 is 5 of 6 biobanks 7 is 9 enhanced 8 greatly 9 enhanced 9 enhanced 10 if 10 if 11 they 10 if 12 link 11 they 12 link 12 link 13 all 13 all 14 the 13 all 19 information 14 the 19 information 15 multidimensional 19 information 16 clinical 17 and 17 and 18 laboratory 17 and 19 information 19 information 20 of 20 of 22 case 21 each 22 case 23 , 24 which 23 , 26 accomplished 23 , 29 , 24 which 25 is 25 is 26 accomplished 26 accomplished 28 optimally 27 , 28 optimally 28 optimally 29 , 29 , 35 procedures 29 , 37 and 30 using 35 procedures 31 systematic 32 and 32 and 34 operating 32 and 35 procedures 33 standardized 34 operating 36 , 37 and 37 and 56 that 37 and 57 facilitates 38 in 40 framework 38 in 56 that 39 the 40 framework 40 framework 41 of 41 of 43 teams 42 multidisciplinary 43 teams 43 teams 44 with 43 teams 47 of 44 with 46 support 45 the 46 support 47 of 55 system 48 a 55 system 49 flexible 50 and 50 and 51 user 50 and 52 - 50 and 55 system 53 friendly 54 database 54 database 55 system 56 that 57 facilitates 57 facilitates 59 sharing 57 facilitates 66 in 58 the 59 sharing 59 sharing 60 of 59 sharing 62 of 60 of 61 information 62 of 63 all 63 all 64 the 63 all 65 teams 64 the 65 teams 66 in 68 network 67 the 68 network we describe a biobanking system that is a platform for discovery research at the center for neurodegenerative disease research at the university of pennsylvania . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 describe 0 ###LEFT-WALL### 25 . 1 we 2 describe 2 describe 5 system 2 describe 10 for 3 a 5 system 4 biobanking 5 system 5 system 6 that 5 system 7 is 6 that 7 is 7 is 9 platform 8 a 9 platform 10 for 12 research 11 discovery 12 research 12 research 13 at 12 research 16 for 13 at 15 center 14 the 15 center 16 for 19 research 17 neurodegenerative 18 disease 18 disease 19 research 19 research 20 at 19 research 23 of 20 at 22 university 21 the 22 university 23 of 24 pennsylvania background : maximum step length is a brief clinical test involving stepping out and back as far as possible with the arms folded across the chest . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 length 2 : 6 is 2 : 27 . 3 maximum 5 length 4 step 5 length 5 length 6 is 6 is 14 and 6 is 17 far 6 is 18 as 7 a 10 test 8 brief 10 test 9 clinical 10 test 10 test 11 involving 10 test 14 and 11 involving 12 stepping 12 stepping 13 out 14 and 15 back 16 as 17 far 18 as 19 possible 19 possible 20 with 20 with 22 arms 21 the 22 arms 22 arms 23 folded 22 arms 24 across 24 across 26 chest 25 the 26 chest this test has been shown to predict fall risk , but the biomechanics of this test are not fully understood . 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 5 shown 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 21 . 1 this 2 test 2 test 3 has 3 has 4 been 4 been 5 shown 5 shown 6 to 6 to 7 predict 7 predict 9 risk 8 fall 9 risk 10 , 11 but 11 but 13 biomechanics 11 but 20 understood 12 the 13 biomechanics 13 biomechanics 14 of 13 biomechanics 17 are 14 of 16 test 15 this 16 test 17 are 18 not 17 are 20 understood 19 fully 20 understood knee and hip kinetics ( moments and powers ) are greater for longer steps and for younger subjects , but younger subjects also step farther . 0 ###LEFT-WALL### 4 kinetics 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 26 . 1 knee 2 and 2 and 3 hip 2 and 4 kinetics 4 kinetics 7 and 4 kinetics 10 are 5 ( 7 and 6 moments 7 and 7 and 8 powers 7 and 9 ) 10 are 11 greater 11 greater 15 and 12 for 14 steps 12 for 15 and 13 longer 14 steps 15 and 16 for 16 for 18 subjects 17 younger 18 subjects 19 , 20 but 20 but 22 subjects 20 but 24 step 21 younger 22 subjects 22 subjects 24 step 23 also 24 step 24 step 25 farther methods : to separate the effects of step length , age , and fall history on joint kinetics ; healthy younger [(] age=27 ( 5 ) , n=14 [ )(, [older] [non] - fallers [(] age=72 ( 5 ) , n=14 [ )(, and older fallers ( age=75 ( 6 ) , n=11 ) all stepped to the same relative target distances of 20 - 80 % of their height . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 10 , 2 : 12 , 3 to 4 separate 4 separate 6 effects 5 the 6 effects 6 effects 7 of 7 of 9 length 8 step 9 length 10 , 11 age 12 , 13 and 12 , 18 kinetics 12 , 19 ; 13 and 15 history 14 fall 15 history 15 history 16 on 15 history 18 kinetics 16 on 17 joint 19 ; 28 n=14 19 ; 30 )(, 20 healthy 28 n=14 21 younger 28 n=14 23 age=27 25 5 23 age=27 27 , 23 age=27 28 n=14 24 ( 25 5 25 5 26 ) 30 )(, 33 - 33 - 44 and 34 fallers 41 n=14 36 age=72 38 5 36 age=72 40 , 36 age=72 41 n=14 37 ( 38 5 38 5 39 ) 41 n=14 44 and 43 )(, 44 and 44 and 46 fallers 44 and 48 age=75 44 and 53 n=11 44 and 56 stepped 45 older 46 fallers 47 ( 48 age=75 48 age=75 50 6 48 age=75 51 ) 49 ( 50 6 50 6 51 ) 52 , 53 n=11 53 n=11 54 ) 55 all 56 stepped 56 stepped 57 to 57 to 62 distances 58 the 59 same 58 the 62 distances 60 relative 62 distances 61 target 62 distances 62 distances 63 of 63 of 64 20 64 20 67 % 65 - 67 % 66 80 67 % 67 % 68 of 67 % 71 . 68 of 70 height 69 their 70 height knee and hip kinetics and knee co - contraction were calculated . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 11 calculated 0 ###LEFT-WALL### 12 . 1 knee 2 and 2 and 3 hip 2 and 4 kinetics 4 kinetics 5 and 5 and 9 contraction 5 and 10 were 6 knee 9 contraction 7 co 8 - 7 co 9 contraction 10 were 11 calculated findings : hip and knee kinetics and knee co - contraction all increased with step length , but older [non] - fallers and fallers utilized greater stepping hip and less stepping knee extensor kinetics . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 but 0 ###LEFT-WALL### 32 knee 0 ###LEFT-WALL### 35 . 1 findings 2 : 2 : 7 and 3 hip 4 and 4 and 6 kinetics 4 and 7 and 5 knee 6 kinetics 7 and 9 co 7 and 11 contraction 8 knee 9 co 10 - 11 contraction 11 contraction 13 increased 11 contraction 14 with 11 contraction 17 , 12 all 13 increased 14 with 16 length 15 step 16 length 18 but 23 and 18 but 25 utilized 19 older 21 - 19 older 22 fallers 22 fallers 23 and 23 and 24 fallers 23 and 25 utilized 25 utilized 27 stepping 26 greater 27 stepping 27 stepping 29 and 27 stepping 32 knee 28 hip 29 and 29 and 31 stepping 29 and 32 knee 30 less 31 stepping 32 knee 34 kinetics 33 extensor 34 kinetics fallers had greater stepping knee co - contraction than [non] - fallers . 0 ###LEFT-WALL### 1 fallers 0 ###LEFT-WALL### 2 had 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 13 . 1 fallers 2 had 2 had 8 contraction 2 had 9 than 3 greater 5 knee 4 stepping 5 knee 5 knee 8 contraction 6 co 7 - 6 co 8 contraction 11 - 12 fallers stance knee co - contraction of [non] [-] fallers was similar to young for shorter steps and similar to fallers for longer steps . 0 ###LEFT-WALL### 5 contraction 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 24 . 1 stance 5 contraction 2 knee 5 contraction 3 co 4 - 3 co 5 contraction 5 contraction 6 of 5 contraction 10 was 6 of 9 fallers 10 was 11 similar 11 similar 12 to 12 to 23 steps 13 young 14 for 13 young 17 and 14 for 16 steps 15 shorter 16 steps 17 and 18 similar 17 and 23 steps 18 similar 19 to 18 similar 21 for 19 to 20 fallers 21 for 22 longer interpretation : age had minimal effects and fall history had no effects on joint kinetics of steps to similar distances . 0 ###LEFT-WALL### 1 interpretation 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 3 age 2 : 4 had 2 : 7 and 3 age 4 had 4 had 6 effects 5 minimal 6 effects 7 and 9 history 7 and 10 had 8 fall 9 history 9 history 10 had 10 had 12 effects 10 had 13 on 10 had 18 to 11 no 12 effects 13 on 15 kinetics 14 joint 15 kinetics 15 kinetics 16 of 16 of 17 steps 18 to 20 distances 19 similar 20 distances effects of age and fall history on knee co - contraction may contribute to age - related kinetic differences and shorter maximal step lengths of older [non] - fallers and fallers , but step length correlated with every variable tested . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 17 related 0 ###LEFT-WALL### 33 but 0 ###LEFT-WALL### 41 . 1 effects 2 of 1 effects 4 and 2 of 3 age 4 and 5 fall 4 and 6 history 4 and 13 contribute 6 history 7 on 6 history 12 may 7 on 11 contraction 8 knee 11 contraction 9 co 10 - 9 co 11 contraction 12 may 13 contribute 13 contribute 14 to 14 to 15 age 16 - 17 related 17 related 30 and 17 related 32 , 18 kinetic 19 differences 19 differences 20 and 20 and 24 lengths 20 and 25 of 20 and 30 and 21 shorter 24 lengths 22 maximal 23 step 23 step 24 lengths 25 of 29 fallers 26 older 28 - 26 older 29 fallers 30 and 31 fallers 32 , 33 but 33 but 35 length 33 but 36 correlated 34 step 35 length 35 length 36 correlated 36 correlated 37 with 37 with 39 variable 38 every 39 variable 39 variable 40 tested thus , declines in maximum step length could indicate declines in hip and knee extensor kinetics and impaired performance on similar tasks like recovering from a trip . 0 ###LEFT-WALL### 3 declines 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 28 . 1 thus 2 , 1 thus 3 declines 3 declines 4 in 3 declines 17 and 4 in 7 length 5 maximum 7 length 6 step 7 length 8 could 9 indicate 8 could 17 and 9 indicate 10 declines 9 indicate 11 in 11 in 13 and 12 hip 13 and 13 and 16 kinetics 14 knee 15 extensor 15 extensor 16 kinetics 17 and 18 impaired 18 impaired 19 performance 18 impaired 20 on 18 impaired 23 like 20 on 22 tasks 21 similar 22 tasks 23 like 24 recovering 24 recovering 25 from 25 from 27 trip 26 a 27 trip we describe 2 frameworks in which personality dimensions relevant to health , such as conscientiousness , can be used to inform interventions designed to promote health aging . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 28 . 1 we 2 describe 2 describe 4 frameworks 2 describe 24 to 3 2 4 frameworks 4 frameworks 5 in 4 frameworks 19 used 5 in 6 which 5 in 7 personality 5 in 8 dimensions 5 in 18 be 6 which 7 personality 8 dimensions 9 relevant 8 dimensions 17 can 9 relevant 10 to 9 relevant 14 as 10 to 11 health 12 , 14 as 13 such 14 as 14 as 15 conscientiousness 14 as 16 , 17 can 18 be 19 used 20 to 20 to 21 inform 21 inform 22 interventions 22 interventions 23 designed 24 to 25 promote 25 promote 26 health 26 health 27 aging first , contemporary data and theory do not suggest that personality is " immutable , " but instead focus on questions of who changes , [in] what way , why , when , and how . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 9 suggest 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 36 . 1 first 2 , 1 first 5 and 3 contemporary 4 data 4 data 5 and 5 and 6 theory 5 and 7 do 7 do 8 not 7 do 9 suggest 9 suggest 10 that 10 that 11 personality 10 that 12 is 11 personality 12 is 12 is 13 " 12 is 14 immutable 14 immutable 17 but 15 , 16 " 15 , 17 but 17 but 18 instead 17 but 19 focus 17 but 25 , 19 focus 20 on 19 focus 22 of 20 on 21 questions 22 of 23 who 22 of 24 changes 23 who 24 changes 25 , 27 what 27 what 34 and 28 way 29 , 29 , 30 why 29 , 31 , 31 , 32 when 31 , 34 and 33 , 34 and 34 and 35 how in fact , the notion that personality could be changed was part and parcel of many schools of psychotherapy , which suggested that long - term and meaningful change in symptoms could not be achieved without change in relevant aspects of personality . 0 ###LEFT-WALL### 5 notion 0 ###LEFT-WALL### 11 was 1 in 2 fact 2 fact 3 , 2 fact 5 notion 4 the 5 notion 5 notion 6 that 5 notion 10 changed 5 notion 11 was 6 that 7 personality 6 that 10 changed 7 personality 8 could 8 could 9 be 9 be 10 changed 11 was 13 and 12 part 13 and 13 and 14 parcel 13 and 15 of 13 and 21 which 15 of 17 schools 16 many 17 schools 17 schools 18 of 18 of 19 psychotherapy 20 , 21 which 21 which 22 suggested 21 which 43 . 22 suggested 27 and 22 suggested 35 achieved 23 that 26 term 24 long 25 - 24 long 26 term 26 term 27 and 27 and 29 change 27 and 30 in 27 and 32 could 28 meaningful 29 change 30 in 31 symptoms 32 could 33 not 32 could 34 be 34 be 35 achieved 35 achieved 36 without 35 achieved 38 in 36 without 37 change 38 in 40 aspects 39 relevant 40 aspects 40 aspects 41 of 41 of 42 personality we review intervention research documenting change in personality . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 9 . 1 we 2 review 2 review 4 research 3 intervention 4 research 4 research 5 documenting 5 documenting 6 change 5 documenting 7 in 7 in 8 personality on the basis of an integrative view of personality as a complex system , we describe a bottom - up model [of] change in which interventions to change basic personality processes eventuate in changes at the trait level . 0 ###LEFT-WALL### 15 we 0 ###LEFT-WALL### 16 describe 1 on 3 basis 1 on 15 we 2 the 3 basis 3 basis 4 of 3 basis 8 of 4 of 7 view 5 an 7 view 6 integrative 7 view 8 of 9 personality 10 as 13 system 10 as 14 , 10 as 15 we 11 a 13 system 12 complex 13 system 15 we 16 describe 16 describe 18 bottom 16 describe 20 up 17 a 18 bottom 19 - 20 up 20 up 23 change 20 up 39 . 21 model 23 change 23 change 24 in 24 in 25 which 24 in 26 interventions 24 in 31 processes 24 in 32 eventuate 25 which 26 interventions 26 interventions 27 to 27 to 28 change 29 basic 31 processes 30 personality 31 processes 31 processes 32 eventuate 32 eventuate 33 in 33 in 34 changes 34 changes 35 at 35 at 38 level 36 the 38 level 37 trait 38 level a 2nd framework leverages the descriptive and predictive power of personality to tailor individual risk prediction and treatment , as well as [refine] public health programs , to the relevant dispositional characteristics of the target population . 0 ###LEFT-WALL### 3 framework 0 ###LEFT-WALL### 4 leverages 0 ###LEFT-WALL### 37 . 1 a 3 framework 2 2nd 3 framework 3 framework 4 leverages 4 leverages 9 power 5 the 9 power 6 descriptive 7 and 7 and 8 predictive 7 and 9 power 9 power 10 of 9 power 12 to 9 power 13 tailor 10 of 11 personality 12 to 13 tailor 13 tailor 17 and 13 tailor 22 as 13 tailor 28 to 14 individual 16 prediction 15 risk 16 prediction 16 prediction 17 and 17 and 18 treatment 19 , 22 as 20 as 21 well 21 well 22 as 22 as 26 programs 22 as 27 , 24 public 25 health 25 health 26 programs 28 to 32 characteristics 29 the 32 characteristics 30 relevant 32 characteristics 31 dispositional 32 characteristics 32 characteristics 33 of 33 of 36 population 34 the 36 population 35 target 36 population these methods dovetail [with] , and add a systematic and rigorous psychosocial dimension to [,] the personalized medicine and patient - centeredness movements in medicine . 0 ###LEFT-WALL### 2 methods 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 26 . 1 these 2 methods 2 methods 6 and 3 dovetail 6 and 5 , 6 and 6 and 7 add 6 and 14 to 6 and 23 movements 7 add 13 dimension 8 a 13 dimension 9 systematic 10 and 10 and 11 rigorous 10 and 13 dimension 12 psychosocial 13 dimension 14 to 19 and 16 the 18 medicine 17 personalized 18 medicine 18 medicine 19 and 19 and 22 centeredness 20 patient 21 - 20 patient 22 centeredness 23 movements 24 in 24 in 25 medicine in addition to improving health through earlier intervention and increased fit between treatments and persons , cost - effectiveness improvements can be realized by more accurate resource allocation . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 23 realized 1 in 2 addition 2 addition 3 to 2 addition 9 and 3 to 4 improving 4 improving 5 health 4 improving 6 through 6 through 8 intervention 7 earlier 8 intervention 9 and 11 fit 9 and 12 between 9 and 17 cost 10 increased 11 fit 12 between 14 and 13 treatments 14 and 14 and 15 persons 16 , 17 cost 17 cost 18 - 19 effectiveness 20 improvements 19 effectiveness 22 be 19 effectiveness 23 realized 20 improvements 21 can 21 can 22 be 23 realized 24 by 23 realized 29 . 24 by 28 allocation 25 more 28 allocation 26 accurate 27 resource 27 resource 28 allocation numerous examples from the personality , health , and aging literature on conscientiousness and other traits are provided throughout , and we conclude with a series of recommendations for research in these emerging areas . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 18 provided 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 35 . 1 numerous 2 examples 2 examples 3 from 2 examples 9 and 3 from 5 personality 4 the 5 personality 5 personality 7 health 6 , 7 health 7 health 8 , 9 and 11 literature 9 and 17 are 10 aging 11 literature 11 literature 12 on 12 on 14 and 13 conscientiousness 14 and 14 and 16 traits 15 other 16 traits 17 are 18 provided 18 provided 19 throughout 20 , 21 and 21 and 22 we 21 and 23 conclude 22 we 23 conclude 23 conclude 24 with 23 conclude 31 in 23 conclude 33 emerging 24 with 26 series 25 a 26 series 26 series 27 of 27 of 28 recommendations 28 recommendations 29 for 29 for 30 research 31 in 32 these 33 emerging 34 areas in this study , we used a life span model to study the subjective perception of creative personality ( cp ) in emerging , young , middle - aged , and older hong kong chinese adults . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 24 , 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 used 6 used 10 model 6 used 11 to 6 used 12 study 7 a 10 model 8 life 9 span 9 span 10 model 11 to 12 study 12 study 15 perception 12 study 22 in 13 the 15 perception 14 subjective 15 perception 15 perception 16 of 15 perception 20 cp 16 of 18 personality 17 creative 18 personality 19 ( 20 cp 20 cp 21 ) 22 in 23 emerging 24 , 27 middle 24 , 28 - 25 young 26 , 25 young 27 middle 28 - 36 adults 28 - 37 . 29 aged 31 and 30 , 31 and 31 and 32 older 31 and 36 adults 33 hong 36 adults 34 kong 36 adults 35 chinese 36 adults we also asked participants to estimate the approximate age by which people develop and lose cp across adulthood . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 19 . 1 we 3 asked 2 also 3 asked 3 asked 4 participants 3 asked 5 to 5 to 14 and 6 estimate 9 age 6 estimate 14 and 7 the 9 age 8 approximate 9 age 9 age 10 by 10 by 11 which 10 by 12 people 10 by 13 develop 12 people 13 develop 14 and 15 lose 14 and 18 adulthood 15 lose 16 cp 15 lose 17 across we expected an interesting interplay between internalized age stereotypes and age - related differentiation in beliefs about personality development . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 expected 0 ###LEFT-WALL### 20 . 1 we 2 expected 2 expected 14 differentiation 2 expected 15 in 2 expected 17 about 3 an 4 interesting 3 an 14 differentiation 4 interesting 5 interplay 5 interplay 6 between 5 interplay 10 and 6 between 9 stereotypes 7 internalized 8 age 8 age 9 stereotypes 10 and 11 age 10 and 12 - 10 and 13 related 10 and 14 differentiation 15 in 16 beliefs 17 about 19 development 18 personality 19 development older adults perceived increases in both gains and losses in cp in old age . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 3 perceived 0 ###LEFT-WALL### 15 . 1 older 2 adults 2 adults 3 perceived 3 perceived 4 increases 3 perceived 5 in 3 perceived 10 in 3 perceived 12 in 5 in 8 and 6 both 7 gains 7 gains 8 and 8 and 9 losses 10 in 11 cp 12 in 14 age 13 old 14 age but they still maintained a similar level of self [-] perceived cp traits when compared with young participants . 0 ###LEFT-WALL### 1 but 0 ###LEFT-WALL### 19 . 1 but 2 they 1 but 4 maintained 2 they 4 maintained 3 still 4 maintained 4 maintained 7 level 4 maintained 14 when 5 a 6 similar 5 a 7 level 6 similar 7 level 7 level 8 of 8 of 13 traits 9 self 11 perceived 11 perceived 13 traits 12 cp 13 traits 14 when 15 compared 15 compared 16 with 16 with 18 participants 17 young 18 participants emerging , young , and middle - aged adults were less optimistic about their creativity development into old age . 0 ###LEFT-WALL### 9 adults 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 20 . 1 emerging 2 , 1 emerging 9 adults 3 young 5 and 4 , 5 and 5 and 6 middle 5 and 7 - 5 and 8 aged 5 and 9 adults 9 adults 10 were 10 were 12 optimistic 11 less 12 optimistic 12 optimistic 13 about 13 about 16 development 14 their 16 development 15 creativity 16 development 16 development 17 into 17 into 19 age 18 old 19 age young adults , in contrast to older adults , believed that gains in cp began and ceased at an earlier age . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 10 believed 0 ###LEFT-WALL### 22 . 1 young 2 adults 2 adults 4 in 2 adults 10 believed 3 , 4 in 4 in 5 contrast 4 in 9 , 5 contrast 6 to 6 to 8 adults 7 older 8 adults 10 believed 11 that 10 believed 12 gains 11 that 12 gains 12 gains 13 in 13 in 14 cp 14 cp 16 and 15 began 16 and 16 and 17 ceased 16 and 18 at 18 at 21 age 19 an 21 age 20 earlier 21 age positive perceptions of cp in one's aging process may have implications for aging successfully . 0 ###LEFT-WALL### 2 perceptions 0 ###LEFT-WALL### 10 have 0 ###LEFT-WALL### 15 . 1 positive 2 perceptions 2 perceptions 3 of 2 perceptions 9 may 3 of 4 cp 4 cp 5 in 5 in 7 aging 6 one's 7 aging 7 aging 8 process 9 may 10 have 10 have 11 implications 11 implications 12 for 12 for 13 aging 13 aging 14 successfully although it is generally agreed that recall performance declines more than recognition memory performance in the course of normal aging , there are some dissenting voices . 0 ###LEFT-WALL### 8 performance 0 ###LEFT-WALL### 9 declines 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 27 . 1 although 2 it 1 although 5 agreed 1 although 8 performance 2 it 3 is 3 is 5 agreed 4 generally 5 agreed 6 that 8 performance 7 recall 8 performance 8 performance 9 declines 9 declines 10 more 9 declines 11 than 9 declines 15 in 11 than 14 performance 12 recognition 13 memory 13 memory 14 performance 15 in 17 course 16 the 17 course 17 course 18 of 18 of 20 aging 19 normal 20 aging 21 , 22 there 21 , 23 are 22 there 23 are 23 are 26 voices 24 some 26 voices 25 dissenting 26 voices there are also a few empirical findings that cast doubt on that conclusion . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 14 . 1 there 2 are 2 are 3 also 2 are 7 findings 4 a 5 few 5 few 7 findings 6 empirical 7 findings 7 findings 8 that 7 findings 9 cast 8 that 9 cast 9 cast 10 doubt 9 cast 11 on 11 on 13 conclusion 12 that 13 conclusion in light of these ambiguities the present experiments were designed to answer the question in a more definitive fashion . 0 ###LEFT-WALL### 8 experiments 0 ###LEFT-WALL### 10 designed 0 ###LEFT-WALL### 20 . 1 in 2 light 1 in 8 experiments 2 light 3 of 3 of 5 ambiguities 4 these 5 ambiguities 6 the 8 experiments 7 present 8 experiments 8 experiments 9 were 9 were 10 designed 10 designed 11 to 10 designed 12 answer 11 to 12 answer 12 answer 14 question 12 answer 15 in 13 the 14 question 15 in 19 fashion 16 a 19 fashion 17 more 18 definitive 18 definitive 19 fashion over a series of 3 experiments , groups of younger and older adults performed recall and recognition tests successively on the same lists of words . 0 ###LEFT-WALL### 8 groups 0 ###LEFT-WALL### 14 performed 0 ###LEFT-WALL### 26 . 1 over 3 series 1 over 7 , 1 over 8 groups 2 a 3 series 3 series 4 of 4 of 6 experiments 5 3 6 experiments 8 groups 9 of 8 groups 14 performed 9 of 13 adults 10 younger 11 and 11 and 12 older 11 and 13 adults 14 performed 16 and 14 performed 19 successively 14 performed 20 on 15 recall 16 and 16 and 18 tests 17 recognition 18 tests 20 on 23 lists 21 the 22 same 22 same 23 lists 23 lists 24 of 24 of 25 words several analyses of the resulting data converge on the conclusion that there is a consistent age - related [decrement] in recall that is disproportionately greater than the age - related [decrement] in recognition . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 7 converge 1 several 2 analyses 2 analyses 3 of 2 analyses 7 converge 3 of 6 data 4 the 6 data 5 resulting 6 data 7 converge 8 on 7 converge 30 related 8 on 10 conclusion 9 the 10 conclusion 10 conclusion 11 that 10 conclusion 18 related 11 that 12 there 11 that 13 is 12 there 13 is 13 is 16 age 14 a 15 consistent 14 a 16 age 15 consistent 16 age 17 - 18 related 18 related 20 in 18 related 29 - 20 in 21 recall 21 recall 22 that 21 recall 23 is 22 that 23 is 23 is 25 greater 24 disproportionately 25 greater 25 greater 26 than 26 than 28 age 27 the 28 age 29 - 30 related 30 related 32 in 30 related 34 . 32 in 33 recognition this conclusion is in line with several theoretical accounts of age - related differences in cognitive processing and also with emerging evidence from cognitive neuroscience . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 13 related 1 this 2 conclusion 2 conclusion 3 is 3 is 5 line 3 is 6 with 4 in 5 line 6 with 9 accounts 7 several 9 accounts 8 theoretical 9 accounts 9 accounts 10 of 10 of 11 age 12 - 13 related 13 related 14 differences 13 related 26 . 14 differences 18 and 15 in 17 processing 15 in 18 and 16 cognitive 17 processing 18 and 19 also 18 and 20 with 20 with 22 evidence 21 emerging 22 evidence 22 evidence 23 from 23 from 25 neuroscience 24 cognitive 25 neuroscience we use the image - mediation [model] ( klatzky & lederman , 1987 ) as a framework to investigate potential sources of adult age differences in the haptic recognition of two - dimensional ( 2 d ) shapes . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 32 - 0 ###LEFT-WALL### 39 . 1 we 2 use 2 use 4 image 2 use 15 as 2 use 18 to 3 the 4 image 4 image 6 mediation 5 - 6 mediation 6 mediation 11 lederman 6 mediation 13 1987 6 mediation 14 ) 8 ( 11 lederman 9 klatzky 10 & 10 & 11 lederman 11 lederman 12 , 12 , 13 1987 13 1987 14 ) 15 as 17 framework 16 a 17 framework 18 to 19 investigate 19 investigate 21 sources 19 investigate 26 in 20 potential 21 sources 21 sources 22 of 22 of 25 differences 23 adult 25 differences 24 age 25 differences 26 in 29 recognition 27 the 29 recognition 28 haptic 29 recognition 29 recognition 30 of 30 of 31 two 32 - 38 shapes 33 dimensional 36 d 33 dimensional 38 shapes 34 ( 36 d 35 2 36 d 36 d 37 ) this model states that the low - resolution [,] temporally sequential , haptic input is translated into a visual image , which is then reperceived through the visual processors , before it is matched against a long - term memory representation and named . 0 ###LEFT-WALL### 2 model 0 ###LEFT-WALL### 3 states 0 ###LEFT-WALL### 44 . 1 this 2 model 2 model 3 states 3 states 4 that 4 that 8 resolution 4 that 16 translated 5 the 8 resolution 6 low 7 - 6 low 8 resolution 8 resolution 14 input 8 resolution 15 is 8 resolution 16 translated 10 temporally 11 sequential 11 sequential 12 , 11 sequential 14 input 13 haptic 14 input 14 input 15 is 16 translated 17 into 16 translated 31 before 17 into 20 image 18 a 19 visual 18 a 20 image 19 visual 20 image 20 image 22 which 21 , 22 which 22 which 23 is 22 which 30 , 23 is 24 then 23 is 25 reperceived 25 reperceived 26 through 26 through 29 processors 27 the 29 processors 28 visual 29 processors 31 before 32 it 31 before 42 and 32 it 42 and 33 is 34 matched 33 is 42 and 34 matched 35 against 35 against 41 representation 36 a 37 long 36 a 41 representation 37 long 38 - 37 long 39 term 39 term 41 representation 40 memory 41 representation 42 and 43 named in three experiments we tested groups of 12 [older] ( mean age 73.11 ) and three groups of 12 young adults ( mean age 22.80 ) each . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 tested 0 ###LEFT-WALL### 28 . 1 in 3 experiments 1 in 4 we 2 three 3 experiments 4 we 5 tested 5 tested 15 and 5 tested 27 each 6 groups 7 of 6 groups 15 and 7 of 8 12 8 12 12 age 10 ( 12 age 11 mean 12 age 12 age 13 73.11 12 age 14 ) 15 and 17 groups 15 and 18 of 16 three 17 groups 18 of 21 adults 19 12 21 adults 20 young 21 adults 21 adults 24 age 22 ( 24 age 23 mean 24 age 24 age 25 22.80 24 age 26 ) in experiment 1 we confirm age - related differences in haptic 2 d shape recognition , and we show the typical age × complexity interaction . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 confirm 0 ###LEFT-WALL### 8 related 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 26 . 1 in 2 experiment 1 in 4 we 2 experiment 3 1 4 we 5 confirm 5 confirm 6 age 7 - 8 related 8 related 9 differences 8 related 16 , 9 differences 10 in 10 in 15 recognition 11 haptic 14 shape 12 2 13 d 13 d 14 shape 14 shape 15 recognition 16 , 17 and 17 and 18 we 17 and 19 show 18 we 19 show 19 show 24 complexity 19 show 25 interaction 20 the 24 complexity 21 typical 22 age 22 age 24 complexity 23 × 24 complexity in experiment 2 we show that if we facilitate the visual translation process , age differences become smaller , but [only] with simple shapes and not with the more complex everyday objects . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 show 1 in 2 experiment 1 in 4 we 2 experiment 3 2 4 we 5 show 5 show 6 that 6 that 16 differences 6 that 17 become 7 if 8 we 7 if 9 facilitate 7 if 14 , 7 if 16 differences 8 we 9 facilitate 9 facilitate 13 process 10 the 13 process 11 visual 12 translation 12 translation 13 process 15 age 16 differences 16 differences 17 become 17 become 18 smaller 18 smaller 20 but 19 , 20 but 20 but 25 and 20 but 33 . 22 with 24 shapes 22 with 25 and 23 simple 24 shapes 25 and 26 not 25 and 27 with 27 with 32 objects 28 the 32 objects 29 more 30 complex 30 complex 32 objects 31 everyday 32 objects in experiment 3 we target the last step in the model ( matching and naming ) for complex stimuli . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 target 0 ###LEFT-WALL### 20 . 1 in 2 experiment 1 in 4 we 2 experiment 3 3 4 we 5 target 5 target 8 step 5 target 9 in 5 target 17 for 6 the 7 last 6 the 8 step 9 in 11 model 10 the 11 model 11 model 14 and 12 ( 14 and 13 matching 14 and 14 and 15 naming 14 and 16 ) 17 for 19 stimuli 18 complex 19 stimuli we found that age differences in exploration time were considerably reduced when this component process was facilitated by providing a category name . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 23 . 1 we 2 found 2 found 3 that 3 that 5 differences 3 that 11 reduced 4 age 5 differences 5 differences 6 in 5 differences 9 were 6 in 8 time 7 exploration 8 time 9 were 11 reduced 10 considerably 11 reduced 11 reduced 12 when 12 when 15 process 12 when 17 facilitated 13 this 14 component 14 component 15 process 15 process 16 was 16 was 17 facilitated 17 facilitated 18 by 18 by 19 providing 19 providing 22 name 20 a 22 name 21 category 22 name we conclude that the image [-] mediation model can explain adult [-] age differences in haptic recognition , particularly if the role of working memory in forming the transient visual image is considered . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 1 we 2 conclude 2 conclude 3 that 3 that 8 model 3 that 10 explain 4 the 8 model 5 image 8 model 7 mediation 8 model 8 model 9 can 9 can 10 explain 10 explain 14 differences 10 explain 15 in 10 explain 20 if 11 adult 13 age 13 age 14 differences 15 in 17 recognition 16 haptic 17 recognition 18 , 19 particularly 18 , 20 if 20 if 22 role 20 if 33 considered 20 if 34 . 21 the 22 role 22 role 23 of 22 role 32 is 23 of 24 working 24 working 25 memory 24 working 26 in 26 in 27 forming 27 forming 31 image 28 the 31 image 29 transient 31 image 30 visual 31 image 32 is 33 considered our findings suggest that sensorimotor skills thought to rely on peripheral processes for the most part are critically constrained by age - related changes in central processing capacity in later adulthood . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 23 related 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 6 skills 4 that 17 are 5 sensorimotor 6 skills 6 skills 7 thought 6 skills 8 to 6 skills 16 part 6 skills 17 are 8 to 9 rely 9 rely 10 on 9 rely 13 for 10 on 12 processes 11 peripheral 12 processes 13 for 15 most 14 the 15 most 15 most 16 part 17 are 19 constrained 18 critically 19 constrained 19 constrained 20 by 20 by 21 age 22 - 23 related 23 related 24 changes 23 related 25 in 23 related 32 . 25 in 28 capacity 26 central 28 capacity 27 processing 28 capacity 28 capacity 29 in 29 in 31 adulthood 30 later 31 adulthood the present study examined age - related differences in multisensory integration and the role of attention in age - related differences in multisensory integration . 0 ###LEFT-WALL### 5 age 0 ###LEFT-WALL### 20 related 0 ###LEFT-WALL### 25 . 1 the 5 age 2 present 3 study 3 study 4 examined 4 examined 5 age 5 age 20 related 6 - 7 related 7 related 8 differences 7 related 9 in 7 related 17 in 7 related 19 - 7 related 20 related 9 in 12 and 10 multisensory 11 integration 11 integration 12 and 12 and 14 role 12 and 15 of 13 the 14 role 15 of 16 attention 17 in 18 age 20 related 21 differences 21 differences 22 in 22 in 24 integration 23 multisensory 24 integration the sound - induced flash illusion -- the misperception of the number of visual flashes due to the simultaneous presentation of a different number of auditory beeps -- was used to examine the strength of multisensory integration in older and younger observers . 0 ###LEFT-WALL### 2 sound 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 43 . 1 the 2 sound 3 - 6 illusion 3 - 30 used 4 induced 5 flash 5 flash 6 illusion 6 illusion 9 misperception 6 illusion 29 was 7 -- 9 misperception 8 the 9 misperception 9 misperception 10 of 9 misperception 21 of 9 misperception 28 -- 10 of 15 flashes 11 the 12 number 12 number 13 of 12 number 15 flashes 13 of 15 flashes 14 visual 15 flashes 15 flashes 17 to 16 due 17 to 17 to 20 presentation 18 the 20 presentation 19 simultaneous 20 presentation 21 of 27 beeps 22 a 24 number 23 different 24 number 24 number 25 of 24 number 27 beeps 25 of 27 beeps 26 auditory 27 beeps 29 was 30 used 30 used 31 to 30 used 32 examine 31 to 32 examine 32 examine 34 strength 32 examine 38 in 33 the 34 strength 34 strength 35 of 35 of 37 integration 36 multisensory 37 integration 38 in 42 observers 39 older 40 and 40 and 41 younger 40 and 42 observers the effects of integration were examined when discriminating 1 - 3 flashes , 1 - 3 beeps , or 1 - 3 flashes presented with 1 - 3 beeps . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 6 examined 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 30 . 1 the 2 effects 2 effects 3 of 2 effects 5 were 3 of 4 integration 5 were 6 examined 6 examined 7 when 7 when 8 discriminating 7 when 12 flashes 8 discriminating 10 - 8 discriminating 12 flashes 9 1 10 - 10 - 11 3 13 , 14 1 13 , 15 - 14 1 15 - 15 - 19 or 16 3 17 beeps 17 beeps 19 or 18 , 19 or 19 or 23 flashes 19 or 24 presented 19 or 25 with 20 1 21 - 21 - 22 3 21 - 23 flashes 25 with 29 beeps 26 1 27 - 27 - 28 3 27 - 29 beeps stimulus conditions were blocked according to these conditions with baseline ( unisensory ) performance assessed during the multisensory block . 0 ###LEFT-WALL### 2 conditions 0 ###LEFT-WALL### 4 blocked 0 ###LEFT-WALL### 20 . 1 stimulus 2 conditions 2 conditions 3 were 3 were 4 blocked 4 blocked 6 to 4 blocked 9 with 4 blocked 16 during 5 according 6 to 6 to 8 conditions 7 these 8 conditions 9 with 10 baseline 9 with 15 assessed 10 baseline 12 unisensory 11 ( 12 unisensory 12 unisensory 13 ) 14 performance 15 assessed 16 during 19 block 17 the 19 block 18 multisensory 19 block older participants demonstrated greater multisensory integration -- a greater influence of the beeps [when] judging the number of visual flashes -- than younger observers . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 25 . 1 older 2 participants 2 participants 3 demonstrated 3 demonstrated 6 integration 3 demonstrated 22 than 4 greater 5 multisensory 5 multisensory 6 integration 6 integration 10 influence 7 -- 10 influence 8 a 10 influence 9 greater 10 influence 10 influence 11 of 10 influence 15 judging 10 influence 21 -- 11 of 13 beeps 12 the 13 beeps 15 judging 20 flashes 16 the 17 number 17 number 18 of 17 number 20 flashes 18 of 20 flashes 19 visual 20 flashes 22 than 24 observers 23 younger 24 observers in a second experiment , the role of attention was assessed using a go/no - [go] paradigm . 0 ###LEFT-WALL### 7 role 0 ###LEFT-WALL### 11 assessed 0 ###LEFT-WALL### 18 . 1 in 4 experiment 1 in 5 , 1 in 7 role 2 a 4 experiment 3 second 4 experiment 6 the 7 role 7 role 8 of 7 role 10 was 8 of 9 attention 10 was 11 assessed 11 assessed 12 using 12 using 17 paradigm 13 a 14 go/no 13 a 17 paradigm 14 go/no 15 - 14 go/no 17 paradigm the results of experiment 2 replicated those of experiment 1 . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 6 replicated 0 ###LEFT-WALL### 11 . 1 the 2 results 2 results 3 of 2 results 6 replicated 3 of 4 experiment 4 experiment 5 2 6 replicated 7 those 7 those 8 of 8 of 9 experiment 9 experiment 10 1 in addition , the strength of the illusion was modulated by the sensory domain of the go/no - go task , though this did not differ by age group . 0 ###LEFT-WALL### 5 strength 0 ###LEFT-WALL### 10 modulated 0 ###LEFT-WALL### 18 - 1 in 2 addition 1 in 3 , 1 in 5 strength 4 the 5 strength 5 strength 6 of 5 strength 9 was 6 of 8 illusion 7 the 8 illusion 9 was 10 modulated 10 modulated 11 by 11 by 14 domain 12 the 14 domain 13 sensory 14 domain 14 domain 15 of 15 of 17 go/no 16 the 17 go/no 18 - 19 go 18 - 21 , 18 - 30 . 19 go 20 task 21 , 29 group 22 though 23 this 22 though 26 differ 22 though 29 group 23 this 24 did 24 did 25 not 24 did 26 differ 26 differ 27 by 27 by 28 age in the visual go/no - [go] task we found a decrease in the illusion , yet in the auditory go/no - [go] task we found an increase in the illusion . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 25 found 0 ###LEFT-WALL### 31 . 1 in 7 task 1 in 8 we 2 the 7 task 3 visual 7 task 4 go/no 5 - 4 go/no 7 task 8 we 9 found 9 found 11 decrease 9 found 12 in 9 found 16 yet 10 a 11 decrease 12 in 14 illusion 13 the 14 illusion 15 , 16 yet 16 yet 24 we 17 in 23 task 17 in 24 we 18 the 23 task 19 auditory 23 task 20 go/no 21 - 20 go/no 23 task 24 we 25 found 25 found 27 increase 25 found 28 in 26 an 27 increase 28 in 30 illusion 29 the 30 illusion these results demonstrate that older individuals exhibit increased multisensory integration compared with younger individuals . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 15 . 1 these 2 results 2 results 3 demonstrate 3 demonstrate 4 that 4 that 6 individuals 4 that 7 exhibit 5 older 6 individuals 6 individuals 7 exhibit 7 exhibit 10 integration 8 increased 10 integration 9 multisensory 10 integration 10 integration 11 compared 11 compared 12 with 12 with 14 individuals 13 younger 14 individuals attention was also found to modulate the strength of the sound - induced flash illusion . 0 ###LEFT-WALL### 1 attention 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 16 . 1 attention 2 was 2 was 3 also 2 was 4 found 4 found 5 to 5 to 6 modulate 6 modulate 8 strength 7 the 8 strength 8 strength 9 of 9 of 15 illusion 10 the 15 illusion 11 sound 12 - 11 sound 14 flash 13 induced 14 flash 14 flash 15 illusion however , the results also suggest that attention was not likely to be a factor in the age - related differences in multisensory integration . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 6 suggest 0 ###LEFT-WALL### 20 related 1 however 2 , 1 however 4 results 3 the 4 results 4 results 6 suggest 5 also 6 suggest 6 suggest 8 attention 6 suggest 9 was 7 that 8 attention 8 attention 9 was 9 was 10 not 9 was 11 likely 10 not 11 likely 11 likely 12 to 11 likely 13 be 12 to 13 be 13 be 15 factor 14 a 15 factor 15 factor 16 in 16 in 18 age 17 the 18 age 19 - 20 related 20 related 21 differences 20 related 25 . 21 differences 22 in 22 in 24 integration 23 multisensory 24 integration working memory declines with normal aging , but the nature of this impairment is debated . 0 ###LEFT-WALL### 1 working 0 ###LEFT-WALL### 3 declines 0 ###LEFT-WALL### 8 but 0 ###LEFT-WALL### 16 . 1 working 2 memory 1 working 3 declines 3 declines 4 with 4 with 6 aging 5 normal 6 aging 7 , 8 but 8 but 10 nature 8 but 15 debated 9 the 10 nature 10 nature 11 of 10 nature 14 is 11 of 13 impairment 12 this 13 impairment 14 is 15 debated studies based on detecting changes to arrays of visual objects have identified two possible components to age - related decline : a reduction in the number of items that can be stored , or a deficit in maintaining the associations ( bindings ) between individual object features . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 12 identified 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 48 . 1 studies 2 based 1 studies 3 on 1 studies 11 have 3 on 4 detecting 4 detecting 5 changes 4 detecting 6 to 6 to 7 arrays 7 arrays 8 of 8 of 10 objects 9 visual 10 objects 11 have 12 identified 12 identified 15 components 13 two 15 components 14 possible 15 components 15 components 16 to 16 to 17 age 18 - 20 decline 18 - 21 : 19 related 20 decline 21 : 34 or 22 a 23 reduction 23 reduction 24 in 23 reduction 34 or 24 in 28 items 25 the 26 number 26 number 27 of 26 number 28 items 27 of 28 items 28 items 29 that 28 items 30 can 29 that 30 can 30 can 31 be 31 be 32 stored 33 , 34 or 34 or 36 deficit 34 or 44 between 35 a 36 deficit 36 deficit 37 in 37 in 38 maintaining 38 maintaining 40 associations 39 the 40 associations 40 associations 42 bindings 41 ( 42 bindings 42 bindings 43 ) 44 between 47 features 45 individual 47 features 46 object 47 features however , some investigations have reported intact binding with aging , and specific deficits arising only in alzheimer 's disease . 0 ###LEFT-WALL### 4 investigations 0 ###LEFT-WALL### 6 reported 0 ###LEFT-WALL### 21 . 1 however 2 , 1 however 4 investigations 3 some 4 investigations 4 investigations 5 have 5 have 6 reported 6 reported 12 and 6 reported 17 in 7 intact 8 binding 7 intact 12 and 8 binding 9 with 9 with 10 aging 11 , 12 and 12 and 14 deficits 12 and 15 arising 13 specific 14 deficits 15 arising 16 only 17 in 20 disease 18 alzheimer 19 's 19 's 20 disease here , using a recently developed continuous measure of recall fidelity , we tested the precision with which adults of different ages could reproduce from memory the orientation and color of a probed array item . 0 ###LEFT-WALL### 13 we 0 ###LEFT-WALL### 14 tested 0 ###LEFT-WALL### 36 . 1 here 2 , 1 here 13 we 3 using 8 measure 3 using 12 , 3 using 13 we 4 a 8 measure 5 recently 6 developed 6 developed 8 measure 7 continuous 8 measure 8 measure 9 of 9 of 11 fidelity 10 recall 11 fidelity 13 we 14 tested 14 tested 16 precision 15 the 16 precision 16 precision 17 with 16 precision 31 of 17 with 18 which 17 with 19 adults 17 with 29 and 19 adults 20 of 19 adults 29 and 20 of 22 ages 21 different 22 ages 23 could 24 reproduce 23 could 29 and 24 reproduce 25 from 24 reproduce 28 orientation 25 from 26 memory 27 the 28 orientation 29 and 30 color 31 of 35 item 32 a 35 item 33 probed 34 array 34 array 35 item the results reveal a further component [of] cognitive decline : an age - related decrease in the resolution with which visual information can be maintained in working memory . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 reveal 0 ###LEFT-WALL### 25 maintained 0 ###LEFT-WALL### 29 . 1 the 2 results 2 results 3 reveal 3 reveal 9 decline 3 reveal 10 : 4 a 9 decline 5 further 9 decline 6 component 9 decline 8 cognitive 9 decline 9 decline 10 : 11 an 12 age 12 age 25 maintained 13 - 14 related 14 related 15 decrease 14 related 25 maintained 15 decrease 16 in 15 decrease 19 with 16 in 18 resolution 17 the 18 resolution 19 with 20 which 19 with 22 information 19 with 24 be 21 visual 22 information 22 information 23 can 23 can 24 be 25 maintained 26 in 26 in 27 working 27 working 28 memory this increase in recall variability with age was [strongest] under conditions of greater memory [load] . 0 ###LEFT-WALL### 2 increase 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 16 . 1 this 2 increase 2 increase 3 in 2 increase 8 was 3 in 5 variability 4 recall 5 variability 5 variability 6 with 6 with 7 age 8 was 10 under 10 under 11 conditions 11 conditions 12 of 12 of 14 memory 13 greater 14 memory moreover , analysis of the distribution of errors revealed that older participants were more likely to incorrectly report one of the unprobed items in memory , consistent with an age - related [increase] in misbinding . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 9 revealed 0 ###LEFT-WALL### 32 related 1 moreover 2 , 1 moreover 3 analysis 3 analysis 4 of 3 analysis 9 revealed 4 of 6 distribution 5 the 6 distribution 6 distribution 7 of 7 of 8 errors 9 revealed 10 that 11 older 12 participants 12 participants 13 were 13 were 15 likely 14 more 15 likely 15 likely 16 to 15 likely 18 report 16 to 18 report 17 incorrectly 18 report 18 report 19 one 18 report 32 related 19 one 20 of 19 one 32 related 20 of 23 items 21 the 23 items 22 unprobed 23 items 23 items 24 in 23 items 27 consistent 24 in 25 memory 26 , 27 consistent 27 consistent 28 with 27 consistent 31 - 28 with 30 age 29 an 30 age 32 related 34 in 32 related 36 . 34 in 35 misbinding these results indicate a systematic decline with age in working memory resources that can be recruited to store visual information . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 21 . 1 these 2 results 2 results 3 indicate 3 indicate 6 decline 4 a 6 decline 5 systematic 6 decline 6 decline 7 with 6 decline 13 that 6 decline 14 can 7 with 8 age 8 age 9 in 9 in 10 working 10 working 12 resources 11 memory 12 resources 13 that 14 can 14 can 15 be 15 be 16 recruited 16 recruited 17 to 17 to 18 store 18 store 20 information 19 visual 20 information the paradigm presented here provides a sensitive index of both memory [resolution] and feature binding , with the potential for assessing their modulation by interventions . 0 ###LEFT-WALL### 2 paradigm 0 ###LEFT-WALL### 5 provides 1 the 2 paradigm 2 paradigm 3 presented 2 paradigm 5 provides 3 presented 4 here 5 provides 8 index 6 a 7 sensitive 6 a 8 index 7 sensitive 8 index 8 index 9 of 9 of 13 and 10 both 13 and 11 memory 13 and 13 and 14 feature 13 and 15 binding 13 and 17 with 16 , 17 with 17 with 19 potential 17 with 26 . 18 the 19 potential 19 potential 20 for 20 for 21 assessing 21 assessing 23 modulation 21 assessing 24 by 22 their 23 modulation 24 by 25 interventions the findings have implications for understanding the mechanisms underpinning working memory deficits in both health and disease . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 18 . 1 the 2 findings 2 findings 3 have 3 have 4 implications 4 implications 5 for 5 for 6 understanding 6 understanding 8 mechanisms 7 the 8 mechanisms 8 mechanisms 9 underpinning 9 underpinning 12 deficits 9 underpinning 13 in 10 working 11 memory 11 memory 12 deficits 13 in 16 and 14 both 16 and 15 health 16 and 16 and 17 disease older adults ( 65 + years ) often have greater difficulty in reading than young adults ( 18 - 30 years ) . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 9 have 0 ###LEFT-WALL### 23 . 1 older 2 adults 2 adults 5 + 2 adults 9 have 3 ( 5 + 4 65 5 + 5 + 6 years 5 + 7 ) 8 often 9 have 9 have 11 difficulty 9 have 12 in 9 have 14 than 10 greater 11 difficulty 12 in 13 reading 14 than 16 adults 15 young 16 adults 16 adults 21 years 17 ( 21 years 18 18 19 - 19 - 20 30 19 - 21 years 21 years 22 ) however , the extent to which this difficulty is attributable to impaired eye [-] movement control is uncertain . 0 ###LEFT-WALL### 4 extent 0 ###LEFT-WALL### 17 is 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 4 extent 3 the 4 extent 4 extent 5 to 4 extent 17 is 5 to 6 which 5 to 8 difficulty 5 to 9 is 7 this 8 difficulty 8 difficulty 9 is 9 is 10 attributable 10 attributable 11 to 11 to 16 control 12 impaired 13 eye 13 eye 16 control 15 movement 16 control 17 is 18 uncertain to address this issue , the alignment and location of the two eyes ' fixations during reading were monitored for young and older adults . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 address 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 25 . 1 to 2 address 2 address 4 issue 3 this 4 issue 5 , 8 and 5 , 19 monitored 6 the 7 alignment 7 alignment 8 and 8 and 9 location 8 and 10 of 8 and 18 were 10 of 15 fixations 11 the 12 two 12 two 13 eyes 13 eyes 14 ' 14 ' 15 fixations 15 fixations 16 during 16 during 17 reading 18 were 19 monitored 19 monitored 20 for 20 for 24 adults 21 young 22 and 22 and 23 older 22 and 24 adults older adults showed typical patterns of reading difficulty but the results revealed no age differences in the alignment or location of the two eyes ' fixations . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 27 . 1 older 2 adults 2 adults 3 showed 3 showed 5 patterns 4 typical 5 patterns 5 patterns 6 of 6 of 7 reading 7 reading 8 difficulty 9 but 11 results 9 but 12 revealed 10 the 11 results 11 results 12 revealed 12 revealed 15 differences 12 revealed 16 in 13 no 15 differences 14 age 15 differences 16 in 19 or 17 the 18 alignment 18 alignment 19 or 19 or 20 location 19 or 21 of 21 of 26 fixations 22 the 23 two 23 two 24 eyes 24 eyes 25 ' 25 ' 26 fixations thus , the difficulty older adults experience in reading is not related to oculomotor control , which appears to be preserved into older age . 0 ###LEFT-WALL### 7 experience 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 thus 2 , 1 thus 7 experience 3 the 7 experience 4 difficulty 7 experience 5 older 6 adults 6 adults 7 experience 7 experience 8 in 7 experience 10 is 8 in 9 reading 10 is 11 not 10 is 13 to 11 not 12 related 13 to 15 control 14 oculomotor 15 control 16 , 17 which 16 , 18 appears 17 which 18 appears 18 appears 19 to 18 appears 21 preserved 19 to 20 be 20 be 21 preserved 21 preserved 22 into 22 into 24 age 23 older 24 age mammalian neural stem cells ( nscs ) are of particular interest because of their role in brain development and function . 0 ###LEFT-WALL### 4 cells 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 21 . 1 mammalian 3 stem 2 neural 3 stem 3 stem 4 cells 4 cells 6 nscs 4 cells 8 are 5 ( 6 nscs 6 nscs 7 ) 8 are 9 of 8 are 12 because 8 are 16 in 9 of 11 interest 10 particular 11 interest 12 because 13 of 13 of 15 role 14 their 15 role 16 in 19 and 17 brain 18 development 18 development 19 and 19 and 20 function recent findings suggest the intimate involvement of programmed cell death ( pcd ) in the turnover of nscs . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 19 . 1 recent 2 findings 2 findings 3 suggest 3 suggest 6 involvement 3 suggest 14 in 4 the 6 involvement 5 intimate 6 involvement 6 involvement 7 of 7 of 10 death 8 programmed 9 cell 9 cell 10 death 10 death 12 pcd 11 ( 12 pcd 12 pcd 13 ) 14 in 16 turnover 15 the 16 turnover 16 turnover 17 of 17 of 18 nscs however , the underlying mechanisms of pcd are largely unknown . 0 ###LEFT-WALL### 5 mechanisms 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 11 . 1 however 2 , 1 however 5 mechanisms 3 the 5 mechanisms 4 underlying 5 mechanisms 5 mechanisms 6 of 5 mechanisms 8 are 6 of 7 pcd 8 are 9 largely 8 are 10 unknown although apoptosis [is] the best [-] defined form of pcd , accumulating evidence has revealed a wide spectrum of pcd encompassing apoptosis , autophagic cell death ( acd ) and necrosis . 0 ###LEFT-WALL### 5 best 0 ###LEFT-WALL### 7 defined 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 32 . 1 although 2 apoptosis 1 although 5 best 4 the 5 best 5 best 7 defined 7 defined 8 form 8 form 9 of 9 of 10 pcd 11 , 13 evidence 11 , 15 revealed 12 accumulating 13 evidence 13 evidence 14 has 14 has 15 revealed 15 revealed 18 spectrum 16 a 17 wide 16 a 18 spectrum 17 wide 18 spectrum 18 spectrum 19 of 19 of 30 and 20 pcd 21 encompassing 20 pcd 30 and 21 encompassing 22 apoptosis 22 apoptosis 26 death 23 , 26 death 24 autophagic 26 death 25 cell 26 death 26 death 28 acd 26 death 29 ) 27 ( 28 acd 28 acd 29 ) 30 and 31 necrosis this mini - review aims to illustrate a unique regulation of pcd in nscs . 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 5 aims 0 ###LEFT-WALL### 15 . 1 this 2 mini 2 mini 3 - 2 mini 4 review 4 review 5 aims 5 aims 6 to 5 aims 7 illustrate 6 to 7 illustrate 7 illustrate 10 regulation 7 illustrate 13 in 8 a 10 regulation 9 unique 10 regulation 10 regulation 11 of 11 of 12 pcd 13 in 14 nscs the results of our recent studies on autophagic death of adult hippocampal neural [stem] ( hcn ) cells are also discussed . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 21 discussed 0 ###LEFT-WALL### 22 . 1 the 2 results 2 results 3 of 2 results 19 are 3 of 6 studies 4 our 6 studies 5 recent 6 studies 6 studies 7 on 7 on 9 death 8 autophagic 9 death 9 death 10 of 10 of 18 cells 11 adult 18 cells 12 hippocampal 18 cells 13 neural 16 hcn 13 neural 18 cells 15 ( 16 hcn 16 hcn 17 ) 19 are 21 discussed 20 also 21 discussed hcn cell death following insulin withdrawal clearly provides a reliable model that can be used to analyze the molecular mechanisms of acd in the larger context of pcd . 0 ###LEFT-WALL### 3 death 0 ###LEFT-WALL### 8 provides 0 ###LEFT-WALL### 29 . 1 hcn 3 death 2 cell 3 death 3 death 4 following 3 death 8 provides 4 following 6 withdrawal 4 following 7 clearly 5 insulin 6 withdrawal 8 provides 11 model 8 provides 16 to 9 a 11 model 10 reliable 11 model 11 model 12 that 11 model 13 can 12 that 13 can 13 can 14 be 14 be 15 used 16 to 17 analyze 17 analyze 20 mechanisms 17 analyze 23 in 18 the 20 mechanisms 19 molecular 20 mechanisms 20 mechanisms 21 of 21 of 22 acd 23 in 26 context 24 the 26 context 25 larger 26 context 26 context 27 of 27 of 28 pcd more research efforts are needed to increase our understanding of the molecular basis of nsc [turnover] under degenerating conditions , such as aging , stress and neurological diseases . 0 ###LEFT-WALL### 3 efforts 0 ###LEFT-WALL### 7 increase 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 29 . 1 more 3 efforts 2 research 3 efforts 3 efforts 4 are 4 are 5 needed 5 needed 6 to 6 to 7 increase 7 increase 9 understanding 7 increase 17 under 8 our 9 understanding 9 understanding 10 of 9 understanding 14 of 10 of 13 basis 11 the 13 basis 12 molecular 13 basis 14 of 15 nsc 17 under 19 conditions 18 degenerating 19 conditions 19 conditions 22 as 20 , 22 as 21 such 22 as 22 as 23 aging 22 as 24 , 24 , 26 and 25 stress 26 and 26 and 28 diseases 27 neurological 28 diseases efforts aimed at protecting and harnessing endogenous nscs will offer novel opportunities for the development of new therapeutic strategies for neuropathologies . 0 ###LEFT-WALL### 1 efforts 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 22 . 1 efforts 5 and 2 aimed 3 at 2 aimed 5 and 3 at 4 protecting 5 and 10 offer 6 harnessing 8 nscs 6 harnessing 9 will 7 endogenous 8 nscs 9 will 10 offer 10 offer 12 opportunities 10 offer 13 for 11 novel 12 opportunities 13 for 15 development 14 the 15 development 15 development 16 of 16 of 19 strategies 17 new 19 strategies 18 therapeutic 19 strategies 19 strategies 20 for 20 for 21 neuropathologies this project examines the effects of spiritual care on [chronically] ill and aging populations and those who care for them by studying the development of a comprehensive pastoral care program at episcopal communities & services ( ecs ) [,] [a] [nonprofit] that owns two continuing care retirement communities ( ccrc ) in southern california ( in 2010 ecs operated three communities ) . 0 ###LEFT-WALL### 2 project 0 ###LEFT-WALL### 3 examines 1 this 2 project 2 project 3 examines 3 examines 5 effects 3 examines 9 on 4 the 5 effects 5 effects 6 of 6 of 8 care 7 spiritual 8 care 9 on 15 and 11 ill 12 and 12 and 14 populations 12 and 15 and 13 aging 14 populations 15 and 16 those 15 and 17 who 15 and 18 care 15 and 21 by 15 and 25 of 17 who 18 care 18 care 19 for 19 for 20 them 21 by 22 studying 22 studying 24 development 23 the 24 development 25 of 30 program 26 a 30 program 27 comprehensive 30 program 28 pastoral 29 care 29 care 30 program 30 program 31 at 31 at 37 ecs 31 at 42 that 31 at 43 owns 32 episcopal 33 communities 33 communities 34 & 34 & 35 services 35 services 37 ecs 36 ( 37 ecs 37 ecs 38 ) 42 that 43 owns 43 owns 50 ccrc 43 owns 52 in 44 two 50 ccrc 45 continuing 46 care 46 care 47 retirement 47 retirement 48 communities 48 communities 50 ccrc 49 ( 50 ccrc 50 ccrc 51 ) 52 in 54 california 53 southern 54 california 54 california 56 in 55 ( 56 in 56 in 57 2010 56 in 63 . 57 2010 59 operated 58 ecs 59 operated 59 operated 61 communities 59 operated 62 ) 60 three 61 communities the study includes the vision , methodology , and specific steps taken to implement this spiritual care program and methods to measure its efficacy . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 includes 0 ###LEFT-WALL### 25 . 1 the 2 study 2 study 3 includes 3 includes 9 and 3 includes 13 to 4 the 5 vision 5 vision 6 , 6 , 7 methodology 6 , 9 and 8 , 9 and 9 and 11 steps 9 and 12 taken 10 specific 11 steps 13 to 14 implement 14 implement 19 and 14 implement 21 to 15 this 18 program 16 spiritual 17 care 17 care 18 program 18 program 19 and 19 and 20 methods 21 to 22 measure 22 measure 24 efficacy 23 its 24 efficacy data is analyzed from satisfaction surveys conducted the year before the program 's introduction and surveys taken 2 and 4 years after the institution of the pastoral care program , along with anecdotal findings . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 analyzed 0 ###LEFT-WALL### 35 . 1 data 2 is 2 is 3 analyzed 3 analyzed 4 from 4 from 6 surveys 5 satisfaction 6 surveys 6 surveys 7 conducted 7 conducted 10 before 7 conducted 32 with 8 the 9 year 9 year 10 before 10 before 15 and 11 the 12 program 12 program 13 's 13 's 14 introduction 14 introduction 15 and 15 and 16 surveys 15 and 30 , 16 surveys 17 taken 16 surveys 25 of 17 taken 22 after 18 2 19 and 19 and 20 4 19 and 21 years 21 years 22 after 22 after 24 institution 23 the 24 institution 25 of 29 program 26 the 29 program 27 pastoral 28 care 28 care 29 program 31 along 32 with 32 with 34 findings 33 anecdotal 34 findings results indicated that spiritual awareness and satisfaction increased throughout the resident population after the pastoral care program 's establishment and that satisfaction levels continued to improve as the program developed over time . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 indicated 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 33 . 1 results 2 indicated 2 indicated 5 awareness 3 that 4 spiritual 4 spiritual 5 awareness 6 and 20 and 6 and 26 improve 7 satisfaction 8 increased 7 satisfaction 13 after 7 satisfaction 20 and 8 increased 9 throughout 9 throughout 12 population 10 the 12 population 11 resident 12 population 13 after 19 establishment 14 the 17 program 15 pastoral 16 care 16 care 17 program 17 program 18 's 18 's 19 establishment 20 and 21 that 20 and 23 levels 20 and 25 to 20 and 26 improve 22 satisfaction 23 levels 23 levels 24 continued 24 continued 25 to 26 improve 27 as 27 as 29 program 28 the 29 program 29 program 30 developed 30 developed 31 over 31 over 32 time this study suggests that spiritual support ( both religious and nonreligious ) is a vital factor in well - being and quality of life at the end of life and that transdisciplinary palliative care is needed in long - term care settings to address spiritual and psychosocial needs . 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 36 needed 0 ###LEFT-WALL### 49 . 1 this 2 study 2 study 3 suggests 3 suggests 4 that 4 that 6 support 4 that 13 is 5 spiritual 6 support 6 support 10 and 7 ( 10 and 8 both 10 and 9 religious 10 and 10 and 11 nonreligious 10 and 12 ) 13 is 16 factor 13 is 17 in 13 is 18 well 14 a 15 vital 14 a 16 factor 15 vital 16 factor 19 - 21 and 20 being 21 and 21 and 22 quality 22 quality 23 of 23 of 30 and 24 life 25 at 24 life 30 and 25 at 27 end 26 the 27 end 27 end 28 of 28 of 29 life 30 and 31 that 30 and 32 transdisciplinary 30 and 36 needed 32 transdisciplinary 34 care 32 transdisciplinary 35 is 32 transdisciplinary 36 needed 33 palliative 34 care 34 care 35 is 36 needed 37 in 36 needed 43 to 36 needed 44 address 37 in 42 settings 38 long 39 - 38 long 42 settings 40 term 41 care 41 care 42 settings 43 to 44 address 44 address 48 needs 45 spiritual 46 and 46 and 47 psychosocial 46 and 48 needs human aging is associated with a progressive loss of muscle mass [and] strength and a concomitant fat accumulation in form [of] inter - muscular adipose tissue , causing skeletal muscle function decline and immobilization . 0 ###LEFT-WALL### 1 human 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 35 . 1 human 2 aging 1 human 3 is 3 is 4 associated 4 associated 5 with 5 with 8 loss 6 a 7 progressive 6 a 8 loss 7 progressive 8 loss 8 loss 9 of 8 loss 14 and 8 loss 22 inter 9 of 10 muscle 11 mass 13 strength 13 strength 14 and 14 and 18 accumulation 14 and 22 inter 15 a 18 accumulation 16 concomitant 17 fat 17 fat 18 accumulation 18 accumulation 19 in 19 in 20 form 23 - 33 and 24 muscular 25 adipose 25 adipose 26 tissue 26 tissue 27 , 27 , 32 decline 27 , 33 and 28 causing 32 decline 29 skeletal 30 muscle 30 muscle 31 function 31 function 32 decline 33 and 34 immobilization fat accumulation can also occur as [intra] [-] muscular [triglycerides] ( imtg ) deposition in lipid droplets , which are associated with perilipin proteins , such as perilipin2 ( plin2 ) . 0 ###LEFT-WALL### 2 accumulation 0 ###LEFT-WALL### 5 occur 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 32 . 1 fat 2 accumulation 2 accumulation 3 can 3 can 5 occur 4 also 5 occur 5 occur 6 as 5 occur 15 in 6 as 14 deposition 9 muscular 12 imtg 9 muscular 14 deposition 11 ( 12 imtg 12 imtg 13 ) 15 in 17 droplets 16 lipid 17 droplets 18 , 19 which 18 , 21 associated 19 which 20 are 20 are 21 associated 21 associated 22 with 22 with 24 proteins 23 perilipin 24 proteins 24 proteins 27 as 25 , 27 as 26 such 27 as 27 as 28 perilipin2 27 as 31 ) 28 perilipin2 30 plin2 29 ( 30 plin2 30 plin2 31 ) it is not known whether plin2 expression changes with age and [if] this has consequences on muscle [mass] and strength . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 known 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 21 . 1 it 2 is 2 is 3 not 2 is 4 known 4 known 5 whether 5 whether 7 expression 5 whether 8 changes 6 plin2 7 expression 7 expression 8 changes 8 changes 9 with 9 with 10 age 11 and 13 this 11 and 14 has 13 this 14 has 14 has 15 consequences 14 has 16 on 16 on 19 and 17 muscle 19 and 19 and 20 strength we studied the expression of plin2 in the vastus lateralis ( vl ) muscle of both healthy subjects and patients affected by lower limb mobility limitation of different age . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 21 affected 0 ###LEFT-WALL### 30 . 1 we 2 studied 2 studied 4 expression 3 the 4 expression 4 expression 5 of 5 of 6 plin2 6 plin2 7 in 6 plin2 14 muscle 6 plin2 21 affected 7 in 10 lateralis 8 the 10 lateralis 9 vastus 10 lateralis 10 lateralis 12 vl 11 ( 12 vl 12 vl 13 ) 14 muscle 15 of 14 muscle 21 affected 15 of 19 and 16 both 19 and 17 healthy 18 subjects 18 subjects 19 and 19 and 20 patients 21 affected 22 by 22 by 26 limitation 23 lower 24 limb 24 limb 26 limitation 25 mobility 26 limitation 26 limitation 27 of 27 of 29 age 28 different 29 age we found that plin2 expression increases with age , this phenomenon being particularly evident in patients . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 17 . 1 we 2 found 2 found 3 that 3 that 5 expression 3 that 6 increases 4 plin2 5 expression 5 expression 6 increases 6 increases 7 with 6 increases 12 being 7 with 8 age 9 , 12 being 10 this 11 phenomenon 11 phenomenon 12 being 12 being 14 evident 13 particularly 14 evident 14 evident 15 in 15 in 16 patients moreover , plin2 expression is inversely correlated with quadriceps strength and vl thickness . 0 ###LEFT-WALL### 3 plin2 0 ###LEFT-WALL### 9 quadriceps 0 ###LEFT-WALL### 14 . 1 moreover 2 , 1 moreover 3 plin2 3 plin2 4 expression 3 plin2 8 with 3 plin2 9 quadriceps 4 expression 5 is 5 is 6 inversely 5 is 7 correlated 7 correlated 8 with 9 quadriceps 11 and 10 strength 11 and 11 and 13 thickness 12 vl 13 thickness to investigate the molecular mechanisms underpinning this phenomenon , we focused on igf - 1/p53 network/signalling [pathway] , involved in muscle physiology . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 investigate 0 ###LEFT-WALL### 9 , 1 to 2 investigate 2 investigate 5 mechanisms 3 the 5 mechanisms 4 molecular 5 mechanisms 5 mechanisms 6 underpinning 6 underpinning 8 phenomenon 7 this 8 phenomenon 9 , 10 we 9 , 11 focused 10 we 11 focused 11 focused 12 on 12 on 13 igf 13 igf 16 network/signalling 13 igf 19 involved 14 - 16 network/signalling 15 1/p53 16 network/signalling 16 network/signalling 18 , 18 , 19 involved 19 involved 20 in 19 involved 23 . 20 in 22 physiology 21 muscle 22 physiology we found that plin2 expression strongly correlates with increased p53 activation and reduced igf - 1 expression . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 18 . 1 we 2 found 2 found 3 that 3 that 5 expression 3 that 7 correlates 4 plin2 5 expression 5 expression 7 correlates 6 strongly 7 correlates 7 correlates 8 with 8 with 12 and 9 increased 11 activation 9 increased 12 and 10 p53 11 activation 12 and 13 reduced 12 and 17 expression 13 reduced 14 igf 15 - 16 1 16 1 17 expression to confirm these observations made on humans , we studied mice overexpressing muscle - specific igf - 1 , which are protected from sarcopenia . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 confirm 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 25 . 1 to 2 confirm 2 confirm 4 observations 2 confirm 5 made 3 these 4 observations 4 observations 5 made 5 made 6 on 5 made 7 humans 8 , 9 we 8 , 10 studied 9 we 10 studied 10 studied 11 mice 11 mice 12 overexpressing 11 mice 20 which 11 mice 21 are 12 overexpressing 13 muscle 13 muscle 16 igf 14 - 16 igf 15 specific 16 igf 16 igf 18 1 16 igf 19 , 17 - 18 1 18 1 19 , 20 which 21 are 21 are 22 protected 22 protected 23 from 23 from 24 sarcopenia these mice resulted almost negative for the expression of plin2 and p53 at two years of age . 0 ###LEFT-WALL### 2 mice 0 ###LEFT-WALL### 3 resulted 0 ###LEFT-WALL### 18 . 1 these 2 mice 2 mice 3 resulted 3 resulted 5 negative 4 almost 5 negative 5 negative 6 for 5 negative 13 at 6 for 8 expression 7 the 8 expression 8 expression 9 of 9 of 11 and 10 plin2 11 and 11 and 12 p53 13 at 15 years 14 two 15 years 15 years 16 of 16 of 17 age we conclude that fat deposition within skeletal muscle in form of plin2 - coated lipid droplets increases with age and is associated with decreased muscle strength and thickness , likely through an igf - 1 - and p53 - dependent mechanism . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 22 associated 0 ###LEFT-WALL### 42 . 1 we 2 conclude 2 conclude 5 deposition 3 that 4 fat 4 fat 5 deposition 5 deposition 6 within 5 deposition 11 of 6 within 8 muscle 7 skeletal 8 muscle 8 muscle 9 in 9 in 10 form 11 of 12 plin2 13 - 20 and 14 coated 17 increases 14 coated 20 and 15 lipid 17 increases 16 droplets 17 increases 17 increases 18 with 18 with 19 age 20 and 21 is 21 is 22 associated 22 associated 23 with 23 with 37 and 24 decreased 25 muscle 25 muscle 26 strength 26 strength 27 and 27 and 28 thickness 27 and 30 likely 27 and 37 and 29 , 30 likely 30 likely 31 through 30 likely 36 - 31 through 33 igf 32 an 33 igf 33 igf 35 1 34 - 35 1 35 1 36 - 37 and 41 mechanism 38 p53 39 - 38 p53 40 dependent 40 dependent 41 mechanism the data also suggest that excessive intramuscular fat accumulation could be the initial trigger for p53 activation and consequent loss of muscle mass and strength . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 suggest 0 ###LEFT-WALL### 26 . 1 the 2 data 2 data 4 suggest 3 also 4 suggest 4 suggest 5 that 5 that 9 accumulation 5 that 11 be 6 excessive 9 accumulation 7 intramuscular 9 accumulation 8 fat 9 accumulation 9 accumulation 10 could 10 could 11 be 11 be 24 and 12 the 14 trigger 13 initial 14 trigger 14 trigger 15 for 14 trigger 24 and 15 for 16 p53 16 p53 18 and 16 p53 23 mass 17 activation 18 and 18 and 20 loss 18 and 21 of 18 and 23 mass 19 consequent 20 loss 21 of 22 muscle 24 and 25 strength background : the i405v polymorphism of the cholesteryl ester transfer protein gene ( cetp ) has been suggested to be a protective factor conferring longevity in ashkenazi jews , although findings in other races are not supportive . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 be 2 : 5 polymorphism 2 : 18 suggested 3 the 5 polymorphism 4 i405v 5 polymorphism 5 polymorphism 6 of 5 polymorphism 16 has 6 of 12 gene 7 the 12 gene 8 cholesteryl 10 transfer 9 ester 10 transfer 10 transfer 11 protein 11 protein 12 gene 12 gene 14 cetp 13 ( 14 cetp 14 cetp 15 ) 16 has 17 been 17 been 18 suggested 18 suggested 19 to 19 to 20 be 20 be 23 factor 21 a 22 protective 21 a 23 factor 22 protective 23 factor 23 factor 24 conferring 24 conferring 25 longevity 24 conferring 30 although 25 longevity 26 in 26 in 28 jews 27 ashkenazi 28 jews 29 , 30 although 30 although 31 findings 30 although 35 are 30 although 38 . 31 findings 32 in 31 findings 35 are 32 in 34 races 33 other 34 races 35 are 36 not 35 are 37 supportive 36 not 37 supportive this paper describes a case - control study and a meta - analysis conducted to derive [a] more precise estimation of the association between cetp 405v and longevity . 0 ###LEFT-WALL### 2 paper 0 ###LEFT-WALL### 3 describes 0 ###LEFT-WALL### 6 - 1 this 2 paper 2 paper 3 describes 3 describes 5 case 4 a 5 case 6 - 9 and 6 - 14 conducted 6 - 29 . 7 control 8 study 8 study 9 and 9 and 13 analysis 9 and 14 conducted 10 a 11 meta 10 a 13 analysis 11 meta 12 - 11 meta 13 analysis 14 conducted 15 to 14 conducted 24 between 15 to 16 derive 16 derive 20 estimation 18 more 20 estimation 19 precise 20 estimation 20 estimation 21 of 21 of 23 association 22 the 23 association 24 between 27 and 25 cetp 26 405v 26 405v 27 and 27 and 28 longevity methods : we enrolled 1,021 ethnic han chinese participants ( 506 in the longevity group and 515 controls ) , then performed a meta - analysis that integrated the current study and previously published ones . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 3 we 2 : 21 then 3 we 21 then 4 enrolled 9 participants 4 enrolled 21 then 5 1,021 9 participants 6 ethnic 8 chinese 7 han 8 chinese 8 chinese 9 participants 9 participants 11 506 10 ( 11 506 11 506 12 in 11 506 19 ) 12 in 16 and 13 the 15 group 14 longevity 15 group 15 group 16 and 16 and 18 controls 16 and 19 ) 17 515 18 controls 20 , 21 then 21 then 32 and 22 performed 26 analysis 22 performed 32 and 23 a 24 meta 23 a 26 analysis 24 meta 25 - 24 meta 26 analysis 26 analysis 27 that 26 analysis 28 integrated 27 that 28 integrated 28 integrated 31 study 29 the 31 study 30 current 31 study 32 and 34 published 33 previously 34 published 34 published 35 ones pooled odds ratios ( or ) were calculated for allele contrasts , dominant and recessive inheritance models to assess the association between cetp 405v and longevity according to the ethnic stratification . 0 ###LEFT-WALL### 2 odds 0 ###LEFT-WALL### 8 calculated 0 ###LEFT-WALL### 32 . 1 pooled 2 odds 2 odds 3 ratios 2 odds 7 were 2 odds 8 calculated 3 ratios 5 or 3 ratios 7 were 4 ( 5 or 5 or 6 ) 8 calculated 9 for 8 calculated 12 , 8 calculated 16 inheritance 8 calculated 17 models 9 for 11 contrasts 10 allele 11 contrasts 13 dominant 14 and 14 and 15 recessive 14 and 16 inheritance 16 inheritance 17 models 17 models 18 to 17 models 22 between 17 models 25 and 17 models 28 to 18 to 19 assess 19 assess 21 association 20 the 21 association 22 between 23 cetp 24 405v 25 and 25 and 26 longevity 27 according 28 to 28 to 31 stratification 29 the 31 stratification 30 ethnic 31 stratification a synergy was detected between 405v and apoe ε4 ( p=0.001 , or=0.530 ) . 0 ###LEFT-WALL### 2 synergy 0 ###LEFT-WALL### 4 detected 0 ###LEFT-WALL### 15 . 1 a 2 synergy 2 synergy 3 was 3 was 4 detected 4 detected 5 between 5 between 7 and 6 405v 7 and 7 and 9 ε4 7 and 11 p=0.001 7 and 13 or=0.530 8 apoe 9 ε4 10 ( 11 p=0.001 11 p=0.001 12 , 12 , 13 or=0.530 13 or=0.530 14 ) after ethnic stratification , 405v remained a risk allele in east asians but no significant association was found in europeans or white americans . 0 ###LEFT-WALL### 5 405v 0 ###LEFT-WALL### 13 but 0 ###LEFT-WALL### 24 . 1 after 3 stratification 1 after 4 , 1 after 5 405v 2 ethnic 3 stratification 5 405v 13 but 6 remained 9 allele 6 remained 10 in 6 remained 13 but 7 a 9 allele 8 risk 9 allele 10 in 12 asians 11 east 12 asians 13 but 21 or 14 no 16 association 15 significant 16 association 16 association 17 was 17 was 21 or 18 found 19 in 18 found 20 europeans 18 found 21 or 21 or 22 white 22 white 23 americans conclusion : our case - control study suggests cetp 405v as a risk allele against longevity in chinese . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 19 . 1 conclusion 2 : 2 : 4 case 3 our 4 case 5 - 7 study 5 - 8 suggests 6 control 7 study 7 study 8 suggests 8 suggests 10 405v 8 suggests 14 allele 9 cetp 10 405v 10 405v 11 as 10 405v 14 allele 11 as 13 risk 12 a 13 risk 14 allele 15 against 14 allele 17 in 15 against 16 longevity 17 in 18 chinese the meta - analysis suggests the involvement of cetp 405v is protective in ashkenazi jews but is a risk allele against longevity in the east asian ( chinese ) population . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 5 suggests 1 the 4 analysis 2 meta 3 - 2 meta 4 analysis 4 analysis 5 suggests 5 suggests 7 involvement 5 suggests 16 but 6 the 7 involvement 7 involvement 8 of 8 of 10 405v 9 cetp 10 405v 11 is 12 protective 11 is 16 but 12 protective 13 in 13 in 15 jews 14 ashkenazi 15 jews 16 but 17 is 17 is 19 risk 18 a 19 risk 19 risk 20 allele 20 allele 21 against 20 allele 23 in 21 against 22 longevity 23 in 26 asian 24 the 26 asian 25 east 26 asian 26 asian 30 population 27 ( 30 population 28 chinese 29 ) 28 chinese 30 population 30 population 31 . the main focus of this study is to illustrate the applicability of latent class analysis in the assessment of cognitive performance profiles during ageing . 0 ###LEFT-WALL### 3 focus 0 ###LEFT-WALL### 25 . 1 the 2 main 1 the 3 focus 3 focus 4 of 3 focus 7 is 4 of 6 study 5 this 6 study 7 is 8 to 7 is 9 illustrate 8 to 9 illustrate 9 illustrate 11 applicability 9 illustrate 16 in 9 illustrate 23 during 10 the 11 applicability 11 applicability 12 of 12 of 15 analysis 13 latent 14 class 14 class 15 analysis 16 in 18 assessment 17 the 18 assessment 18 assessment 19 of 19 of 22 profiles 20 cognitive 21 performance 21 performance 22 profiles 23 during 24 ageing principal component analysis ( pca ) was used to detect main cognitive dimensions ( based on the neurocognitive test variables ) and bayesian latent class analysis ( lca ) models ( without constraints ) were used to explore patterns of cognitive performance among community [-] dwelling older individuals . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 8 used 0 ###LEFT-WALL### 49 . 1 principal 3 analysis 2 component 3 analysis 3 analysis 5 pca 3 analysis 7 was 4 ( 5 pca 5 pca 6 ) 7 was 8 used 8 used 9 to 9 to 22 and 10 detect 13 dimensions 10 detect 15 based 10 detect 22 and 11 main 13 dimensions 12 cognitive 13 dimensions 14 ( 15 based 15 based 16 on 15 based 21 ) 16 on 20 variables 17 the 20 variables 18 neurocognitive 19 test 19 test 20 variables 22 and 38 explore 23 bayesian 26 analysis 23 bayesian 30 models 23 bayesian 35 were 24 latent 25 class 25 class 26 analysis 26 analysis 28 lca 26 analysis 30 models 27 ( 28 lca 28 lca 29 ) 30 models 32 without 31 ( 32 without 32 without 33 constraints 32 without 34 ) 35 were 36 used 36 used 37 to 37 to 38 explore 38 explore 39 patterns 39 patterns 40 of 40 of 42 performance 41 cognitive 42 performance 42 performance 43 among 43 among 48 individuals 44 community 46 dwelling 46 dwelling 48 individuals 47 older 48 individuals gender , age and number of school years were explored as variables . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 10 explored 0 ###LEFT-WALL### 13 . 1 gender 2 , 2 , 3 age 2 , 4 and 4 and 5 number 4 and 6 of 4 and 9 were 6 of 8 years 7 school 8 years 9 were 10 explored 10 explored 11 as 11 as 12 variables three cognitive dimensions were identified : general cognition ( mmse ) , memory ( mem [ )(and executive ( exec ) function . 0 ###LEFT-WALL### 3 dimensions 0 ###LEFT-WALL### 5 identified 0 ###LEFT-WALL### 6 : 1 three 3 dimensions 2 cognitive 3 dimensions 3 dimensions 4 were 4 were 5 identified 6 : 8 cognition 7 general 8 cognition 8 cognition 10 mmse 8 cognition 13 memory 9 ( 10 mmse 10 mmse 11 ) 12 , 13 memory 13 memory 17 )(and 13 memory 23 . 14 ( 17 )(and 15 mem 17 )(and 17 )(and 22 function 17 )(and 23 . 18 executive 20 exec 18 executive 22 function 19 ( 20 exec 20 exec 21 ) based on these , three latent classes of cognitive performance profiles ( lc1 to lc3 ) were identified among the older adults . 0 ###LEFT-WALL### 7 classes 0 ###LEFT-WALL### 18 identified 0 ###LEFT-WALL### 23 . 1 based 2 on 1 based 4 , 1 based 7 classes 2 on 3 these 5 three 7 classes 6 latent 7 classes 7 classes 8 of 7 classes 17 were 8 of 11 profiles 9 cognitive 10 performance 10 performance 11 profiles 11 profiles 13 lc1 12 ( 13 lc1 13 lc1 14 to 13 lc1 16 ) 14 to 15 lc3 17 were 18 identified 18 identified 19 among 19 among 22 adults 20 the 22 adults 21 older 22 adults these classes corresponded [to] stronger to weaker performance patterns ( lc1>lc2>lc3 ) across all dimensions ; each latent class denoted the same hierarchy in the proportion of males , age and number of school years . 0 ###LEFT-WALL### 2 classes 0 ###LEFT-WALL### 3 corresponded 0 ###LEFT-WALL### 16 ; 0 ###LEFT-WALL### 36 . 1 these 2 classes 2 classes 3 corresponded 3 corresponded 5 stronger 5 stronger 6 to 5 stronger 13 across 6 to 9 patterns 7 weaker 8 performance 8 performance 9 patterns 9 patterns 11 lc1>lc2>lc3 10 ( 11 lc1>lc2>lc3 11 lc1>lc2>lc3 12 ) 13 across 15 dimensions 14 all 15 dimensions 16 ; 19 class 16 ; 20 denoted 17 each 19 class 18 latent 19 class 19 class 20 denoted 20 denoted 23 hierarchy 21 the 22 same 22 same 23 hierarchy 23 hierarchy 24 in 23 hierarchy 27 of 23 hierarchy 33 of 24 in 26 proportion 25 the 26 proportion 27 of 31 and 28 males 29 , 29 , 30 age 29 , 31 and 31 and 32 number 33 of 35 years 34 school 35 years bayesian lca provided a powerful tool to explore cognitive typologies among healthy cognitive agers . 0 ###LEFT-WALL### 2 lca 0 ###LEFT-WALL### 3 provided 0 ###LEFT-WALL### 15 . 1 bayesian 2 lca 2 lca 3 provided 3 provided 6 tool 3 provided 7 to 4 a 5 powerful 4 a 6 tool 5 powerful 6 tool 7 to 8 explore 8 explore 10 typologies 8 explore 11 among 9 cognitive 10 typologies 11 among 14 agers 12 healthy 14 agers 13 cognitive 14 agers objectives : to extend existing research on the us health disadvantage relative to europe by studying the relationships of disability with age from midlife to old age in the us and four european regions ( england/northern and western europe/southern europe/eastern europe ) including their wealth - related differences , using a flexible statistical approach to model the age - functions . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 61 . 1 objectives 2 : 2 : 3 to 2 : 12 relative 3 to 4 extend 4 extend 6 research 4 extend 7 on 5 existing 6 research 7 on 11 disadvantage 8 the 11 disadvantage 9 us 10 health 10 health 11 disadvantage 12 relative 13 to 12 relative 15 by 13 to 14 europe 15 by 16 studying 16 studying 18 relationships 16 studying 21 with 17 the 18 relationships 18 relationships 19 of 19 of 20 disability 21 with 31 and 21 with 60 functions 22 age 23 from 22 age 28 in 22 age 31 and 23 from 24 midlife 24 midlife 25 to 25 to 27 age 26 old 27 age 28 in 30 us 29 the 30 us 31 and 34 regions 31 and 37 and 32 four 34 regions 33 european 34 regions 35 ( 37 and 36 england/northern 37 and 37 and 41 europe 37 and 42 ) 37 and 43 including 37 and 48 differences 37 and 50 using 37 and 59 - 38 western 39 europe/southern 39 europe/southern 40 europe/eastern 40 europe/eastern 41 europe 43 including 45 wealth 44 their 45 wealth 46 - 48 differences 47 related 48 differences 48 differences 49 , 49 , 50 using 50 using 54 approach 50 using 55 to 50 using 59 - 51 a 54 approach 52 flexible 54 approach 53 statistical 54 approach 55 to 56 model 56 model 58 age 57 the 58 age methods : we used data from three studies on aging , with nationally representative samples of adults aged 50 to 85 from 15 countries ( n = 48225 ) : the us - american health and retirement study ( hrs ) , the english longitudinal study of ageing ( elsa ) and the survey of health , ageing and retirement in europe ( share ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 66 . 2 : 3 we 2 : 4 used 2 : 30 : 2 : 33 - 3 we 4 used 4 used 5 data 5 data 6 from 5 data 12 with 6 from 8 studies 7 three 8 studies 8 studies 9 on 9 on 10 aging 11 , 12 with 12 with 15 samples 12 with 30 : 13 nationally 14 representative 14 representative 15 samples 15 samples 16 of 15 samples 18 aged 15 samples 27 = 16 of 17 adults 18 aged 20 to 18 aged 22 from 19 50 20 to 20 to 21 85 22 from 24 countries 23 15 24 countries 25 ( 27 = 26 n 27 = 27 = 28 48225 27 = 29 ) 30 : 32 us 31 the 32 us 33 - 36 and 34 american 35 health 35 health 36 and 36 and 40 hrs 36 and 52 and 37 retirement 38 study 38 study 40 hrs 39 ( 40 hrs 40 hrs 41 ) 42 , 52 and 43 the 46 study 44 english 46 study 45 longitudinal 46 study 46 study 47 of 46 study 52 and 47 of 50 elsa 48 ageing 50 elsa 49 ( 50 elsa 50 elsa 51 ) 52 and 54 survey 52 and 55 of 52 and 59 and 52 and 65 ) 53 the 54 survey 55 of 56 health 57 , 59 and 58 ageing 59 and 59 and 60 retirement 59 and 65 ) 60 retirement 61 in 61 in 64 share 62 europe 64 share 63 ( 64 share outcomes were mobility limitations and limitations in instrumental activities of daily living . 0 ###LEFT-WALL### 1 outcomes 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 13 . 1 outcomes 2 were 2 were 5 and 3 mobility 4 limitations 4 limitations 5 and 5 and 6 limitations 5 and 7 in 5 and 10 of 7 in 9 activities 8 instrumental 9 activities 10 of 12 living 11 daily 12 living we applied fractional polynomials of age to determine best fitting functional forms for age on disability in each region , while controlling for socio - demographic characteristics and important risk factors ( hypertension [,] diabetes , obesity , smoking , physical inactivity ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 applied 1 we 2 applied 2 applied 4 polynomials 2 applied 21 while 3 fractional 4 polynomials 4 polynomials 5 of 4 polynomials 10 fitting 4 polynomials 15 on 4 polynomials 17 in 5 of 6 age 6 age 7 to 6 age 8 determine 7 to 8 determine 8 determine 9 best 10 fitting 12 forms 11 functional 12 forms 12 forms 13 for 13 for 14 age 15 on 16 disability 17 in 19 region 18 each 19 region 20 , 21 while 21 while 22 controlling 21 while 44 . 22 controlling 23 for 22 controlling 31 factors 23 for 28 and 24 socio 25 - 24 socio 27 characteristics 26 demographic 27 characteristics 27 characteristics 28 and 28 and 30 risk 29 important 30 risk 31 factors 35 diabetes 31 factors 37 obesity 32 ( 35 diabetes 33 hypertension 35 diabetes 35 diabetes 36 , 36 , 37 obesity 37 obesity 39 smoking 37 obesity 43 ) 38 , 39 smoking 39 smoking 42 inactivity 39 smoking 43 ) 40 , 42 inactivity 41 physical 42 inactivity 42 inactivity 43 ) results : findings showed high levels of disability in the us with small age - related changes between 50 and 85 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 findings 2 : 4 showed 2 : 16 related 3 findings 4 showed 4 showed 6 levels 4 showed 9 in 5 high 6 levels 6 levels 7 of 7 of 8 disability 9 in 11 us 10 the 11 us 11 us 12 with 12 with 14 age 13 small 14 age 15 - 16 related 16 related 17 changes 17 changes 20 and 18 between 20 and 19 50 20 and 20 and 21 85 levels of disability were generally lower in eastern europe , followed by england and southern europe and [lowest] in northern and western europe . 0 ###LEFT-WALL### 1 levels 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 24 . 1 levels 2 of 1 levels 10 , 2 of 3 disability 4 were 5 generally 4 were 6 lower 4 were 10 , 6 lower 7 in 7 in 9 europe 8 eastern 9 europe 10 , 11 followed 10 , 17 and 10 , 23 europe 12 by 14 and 12 by 17 and 13 england 14 and 14 and 16 europe 15 southern 16 europe 17 and 19 in 19 in 21 and 20 northern 21 and 21 and 22 western in these latter countries age - related increases of disability , though , were steeper than in the us , especially in eastern and southern europe . 0 ###LEFT-WALL### 4 countries 0 ###LEFT-WALL### 5 age 0 ###LEFT-WALL### 6 - 1 in 3 latter 1 in 4 countries 2 these 3 latter 4 countries 5 age 6 - 8 increases 6 - 14 were 7 related 8 increases 8 increases 9 of 8 increases 14 were 9 of 10 disability 11 , 12 though 12 though 13 , 12 though 14 were 14 were 15 steeper 15 steeper 16 than 16 than 17 in 17 in 19 us 18 the 19 us 19 us 22 in 20 , 21 especially 20 , 22 in 22 in 24 and 22 in 27 . 23 eastern 24 and 24 and 26 europe 25 southern 26 europe for all countries and at all ages , disability levels were higher among adults with low wealth compared to those with high wealth , with [largest] wealth - related differences among those in early old age in the usa . 0 ###LEFT-WALL### 10 levels 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 29 related 1 for 3 countries 1 for 4 and 2 all 3 countries 4 and 5 at 4 and 8 , 4 and 10 levels 5 at 7 ages 6 all 7 ages 9 disability 10 levels 10 levels 11 were 11 were 12 higher 12 higher 13 among 12 higher 15 with 12 higher 19 to 12 higher 25 with 13 among 14 adults 15 with 17 wealth 16 low 17 wealth 17 wealth 18 compared 19 to 20 those 20 those 21 with 21 with 23 wealth 22 high 23 wealth 24 , 25 with 25 with 27 wealth 25 with 28 - 28 - 29 related 29 related 30 differences 29 related 33 in 29 related 37 in 29 related 40 . 30 differences 31 among 31 among 32 those 33 in 36 age 34 early 36 age 35 old 36 age 37 in 39 usa 38 the 39 usa conclusions : this paper illustrates considerable variations of disability and its relationship with age . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 paper 2 : 5 illustrates 2 : 15 . 3 this 4 paper 4 paper 5 illustrates 5 illustrates 7 variations 5 illustrates 13 with 6 considerable 7 variations 7 variations 8 of 8 of 10 and 9 disability 10 and 10 and 12 relationship 11 its 12 relationship 13 with 14 age it supports the hypothesis that less developed social policies and more pronounced socioeconomic inequalities are related to higher levels of disability and an earlier onset of disability . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 supports 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 28 . 1 it 2 supports 2 supports 4 hypothesis 3 the 4 hypothesis 4 hypothesis 5 that 5 that 6 less 5 that 7 developed 6 less 7 developed 7 developed 9 policies 8 social 9 policies 10 and 14 inequalities 10 and 16 related 11 more 14 inequalities 12 pronounced 14 inequalities 13 socioeconomic 14 inequalities 14 inequalities 15 are 15 are 16 related 16 related 17 to 17 to 19 levels 18 higher 19 levels 19 levels 20 of 20 of 22 and 21 disability 22 and 22 and 25 onset 22 and 26 of 23 an 25 onset 24 earlier 25 onset 26 of 27 disability background : in eukaryotes the genetic material is enclosed by a continuous membrane system , the nuclear envelope ( ne ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 7 material 2 : 9 enclosed 2 : 22 . 3 in 4 eukaryotes 3 in 7 material 5 the 7 material 6 genetic 7 material 7 material 8 is 8 is 9 enclosed 9 enclosed 10 by 10 by 14 system 11 a 12 continuous 11 a 14 system 12 continuous 13 membrane 13 membrane 14 system 14 system 18 envelope 15 , 18 envelope 16 the 18 envelope 17 nuclear 18 envelope 18 envelope 20 ne 18 envelope 21 ) 19 ( 20 ne 20 ne 21 ) along the ne specific proteins assemble to form meshworks and mutations in these proteins have been described in a group of human diseases called laminopathies . 0 ###LEFT-WALL### 5 proteins 0 ###LEFT-WALL### 6 assemble 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 26 . 1 along 3 ne 1 along 5 proteins 2 the 3 ne 4 specific 5 proteins 5 proteins 6 assemble 6 assemble 7 to 7 to 8 form 8 form 9 meshworks 10 and 11 mutations 10 and 17 described 11 mutations 12 in 11 mutations 15 have 12 in 14 proteins 13 these 14 proteins 15 have 16 been 16 been 17 described 17 described 18 in 18 in 20 group 19 a 20 group 20 group 21 of 20 group 24 called 21 of 23 diseases 22 human 23 diseases 24 called 25 laminopathies laminopathies include lipodystrophies , muscle and cardiac diseases as well as metabolic or progeroid syndromes . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 16 . 1 laminopathies 3 lipodystrophies 2 include 3 lipodystrophies 3 lipodystrophies 4 , 4 , 5 muscle 4 , 6 and 6 and 8 diseases 6 and 11 as 7 cardiac 8 diseases 9 as 10 well 10 well 11 as 11 as 15 syndromes 12 metabolic 13 or 13 or 14 progeroid 13 or 15 syndromes most laminopathies are caused by mutations in the lmnagene encoding lamins a/c . together with nesprins ( nuclear envelope spectrin repeat proteins ) they are core components of the linc complex ( linker of nucleoskeleton and cytoskeleton ) . 0 ###LEFT-WALL### 2 laminopathies 0 ###LEFT-WALL### 4 caused 0 ###LEFT-WALL### 13 . 1 most 2 laminopathies 2 laminopathies 3 are 3 are 4 caused 4 caused 5 by 4 caused 7 in 5 by 6 mutations 7 in 12 a/c 8 the 12 a/c 9 lmnagene 12 a/c 10 encoding 12 a/c 11 lamins 12 a/c 13 . 24 they 13 . 26 core 13 . 39 . 14 together 24 they 15 with 16 nesprins 15 with 24 they 16 nesprins 22 proteins 17 ( 22 proteins 18 nuclear 22 proteins 19 envelope 20 spectrin 20 spectrin 21 repeat 21 repeat 22 proteins 22 proteins 23 ) 24 they 25 are 25 are 26 core 26 core 27 components 27 components 28 of 27 components 36 and 28 of 31 complex 29 the 31 complex 30 linc 31 complex 32 ( 36 and 33 linker 34 of 33 linker 36 and 34 of 35 nucleoskeleton 36 and 37 cytoskeleton 36 and 38 ) the linc complex connects the nucleoskeleton and the cytoskeleton and plays a role in the transfer of mechanically induced signals along the ne into the nucleus , and its components have been attributed functions in maintaining nuclear and cellular organization as well as signal transduction . 0 ###LEFT-WALL### 3 complex 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 46 . 1 the 3 complex 2 linc 3 complex 3 complex 10 and 4 connects 7 and 4 connects 10 and 5 the 6 nucleoskeleton 6 nucleoskeleton 7 and 7 and 9 cytoskeleton 8 the 9 cytoskeleton 10 and 11 plays 11 plays 13 role 11 plays 14 in 11 plays 24 into 12 a 13 role 14 in 16 transfer 15 the 16 transfer 16 transfer 17 of 17 of 20 signals 18 mechanically 19 induced 19 induced 20 signals 20 signals 21 along 21 along 23 ne 22 the 23 ne 24 into 26 nucleus 25 the 26 nucleus 27 , 28 and 28 and 30 components 28 and 32 been 29 its 30 components 30 components 31 have 31 have 32 been 32 been 34 functions 33 attributed 34 functions 34 functions 35 in 35 in 40 organization 36 maintaining 40 organization 37 nuclear 38 and 38 and 39 cellular 38 and 40 organization 40 organization 43 as 41 as 42 well 42 well 43 as 43 as 45 transduction 44 signal 45 transduction results : here we narrowed down the interaction sites between lamin a and nesprin - 2 [to] aa 403 - 425 in lamin a and [aa] 6146 - 6347 [in] nesprin - 2 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 we 2 : 5 narrowed 2 : 32 - 2 : 34 . 3 here 4 we 4 we 5 narrowed 5 narrowed 6 down 5 narrowed 10 between 5 narrowed 22 in 6 down 9 sites 7 the 9 sites 8 interaction 9 sites 10 between 13 and 11 lamin 12 a 11 lamin 13 and 13 and 14 nesprin 14 nesprin 20 - 15 - 16 2 16 2 18 aa 16 2 20 - 18 aa 19 403 20 - 21 425 22 in 25 and 23 lamin 24 a 23 lamin 25 and 25 and 31 nesprin 27 6146 28 - 28 - 29 6347 28 - 31 nesprin 32 - 33 2 laminopathic mutations in and around the involved region of lamin a ( r401c , g411d , g413c , v415i , r419c , l421p , r427g , q432x ) modulate the interaction with nesprin - 2 and this may contribute to the disease phenotype . 0 ###LEFT-WALL### 2 mutations 0 ###LEFT-WALL### 36 and 0 ###LEFT-WALL### 44 . 1 laminopathic 2 mutations 2 mutations 4 and 2 mutations 9 of 2 mutations 36 and 3 in 4 and 4 and 5 around 4 and 8 region 6 the 8 region 7 involved 8 region 9 of 10 lamin 10 lamin 11 a 10 lamin 13 r401c 10 lamin 15 g411d 10 lamin 17 g413c 10 lamin 23 l421p 12 ( 13 r401c 13 r401c 14 , 14 , 15 g411d 15 g411d 16 , 16 , 17 g413c 17 g413c 19 v415i 17 g413c 22 , 18 , 19 v415i 19 v415i 21 r419c 19 v415i 22 , 20 , 21 r419c 21 r419c 22 , 22 , 23 l421p 23 l421p 25 r427g 23 l421p 27 q432x 23 l421p 28 ) 24 , 25 r427g 25 r427g 26 , 26 , 27 q432x 27 q432x 28 ) 29 modulate 31 interaction 29 modulate 32 with 29 modulate 36 and 30 the 31 interaction 32 with 33 nesprin 32 with 35 2 34 - 35 2 36 and 39 contribute 37 this 38 may 38 may 39 contribute 39 contribute 40 to 40 to 43 phenotype 41 the 43 phenotype 42 disease 43 phenotype the most notable mutation is the lamin a mutation q432x that alters linc complex protein assemblies and causes chromosomal and transcription factor rearrangements . 0 ###LEFT-WALL### 4 mutation 0 ###LEFT-WALL### 23 rearrangements 0 ###LEFT-WALL### 24 . 1 the 4 mutation 2 most 3 notable 3 notable 4 mutation 4 mutation 5 is 5 is 9 mutation 6 the 9 mutation 7 lamin 8 a 7 lamin 9 mutation 9 mutation 10 q432x 9 mutation 23 rearrangements 10 q432x 11 that 10 q432x 17 and 10 q432x 23 rearrangements 11 that 17 and 12 alters 16 assemblies 12 alters 17 and 13 linc 15 protein 14 complex 15 protein 15 protein 16 assemblies 17 and 18 causes 18 causes 20 and 19 chromosomal 20 and 20 and 22 factor 21 transcription 22 factor conclusion : mutations in nesprin [-] 2 and lamin a are characterised by complex [genotype] phenotype relations . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 8 and 2 : 12 characterised 2 : 18 . 3 mutations 4 in 3 mutations 8 and 4 in 5 nesprin 5 nesprin 7 2 8 and 9 lamin 8 and 11 are 9 lamin 10 a 11 are 12 characterised 12 characterised 13 by 13 by 17 relations 14 complex 16 phenotype 16 phenotype 17 relations our data show that each mutation in lmnaanalysed here has a distinct impact on the interaction among both proteins that substantially explains how distinct mutations in widely expressed genes lead to the formation of phenotypically different diseases . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 38 . 1 our 2 data 2 data 3 show 3 show 4 that 3 show 5 each 3 show 6 mutation 3 show 10 has 6 mutation 7 in 6 mutation 9 here 6 mutation 10 has 7 in 8 lmnaanalysed 10 has 13 impact 11 a 12 distinct 11 a 13 impact 12 distinct 13 impact 13 impact 14 on 13 impact 20 that 13 impact 22 explains 14 on 16 interaction 15 the 16 interaction 16 interaction 17 among 17 among 19 proteins 18 both 19 proteins 20 that 22 explains 21 substantially 22 explains 22 explains 23 how 23 how 25 mutations 23 how 30 lead 24 distinct 25 mutations 25 mutations 26 in 25 mutations 30 lead 26 in 29 genes 27 widely 28 expressed 28 expressed 29 genes 30 lead 31 to 31 to 33 formation 32 the 33 formation 33 formation 34 of 34 of 37 diseases 35 phenotypically 36 different 36 different 37 diseases background : emergency physicians are exposed to greater stress during a 24 [-] hour shift ( 24 h [s] ) than a 14 [-] hour night shift ( 14 h [s] ) , with an impact lasting several days . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 physicians 2 : 6 exposed 3 emergency 4 physicians 4 physicians 5 are 5 are 6 exposed 6 exposed 7 to 6 exposed 10 during 6 exposed 21 than 6 exposed 34 with 7 to 9 stress 8 greater 9 stress 10 during 15 shift 11 a 15 shift 12 24 14 hour 14 hour 15 shift 15 shift 18 h 16 ( 18 h 17 24 18 h 18 h 20 ) 21 than 27 shift 22 a 27 shift 23 14 25 hour 25 hour 27 shift 26 night 27 shift 27 shift 30 h 28 ( 30 h 29 14 30 h 30 h 32 ) 33 , 34 with 34 with 36 impact 34 with 37 lasting 34 with 40 . 35 an 36 impact 37 lasting 39 days 38 several 39 days interleukin - 8 ( il - 8 ) is postulated to be a chronic stress biomarker . 0 ###LEFT-WALL### 1 interleukin 0 ###LEFT-WALL### 10 postulated 0 ###LEFT-WALL### 17 . 1 interleukin 5 il 1 interleukin 9 is 2 - 5 il 3 8 5 il 4 ( 5 il 5 il 7 8 5 il 8 ) 6 - 7 8 7 8 8 ) 9 is 10 postulated 10 postulated 11 to 11 to 12 be 12 be 16 biomarker 13 a 14 chronic 13 a 16 biomarker 14 chronic 15 stress 15 stress 16 biomarker however , no studies have tracked il - 8 over several shifts or used it for monitoring short - term residual stress . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 tracked 0 ###LEFT-WALL### 19 - 1 however 2 , 1 however 4 studies 3 no 4 studies 4 studies 5 have 5 have 6 tracked 6 tracked 7 il 7 il 9 8 8 - 9 8 9 8 11 several 9 8 17 monitoring 9 8 19 - 10 over 11 several 11 several 13 or 12 shifts 13 or 13 or 14 used 13 or 16 for 14 used 15 it 16 for 17 monitoring 17 monitoring 18 short 19 - 20 term 19 - 23 . 20 term 22 stress 21 residual 22 stress the il [-] 8 response to the shifts may also increase with age . 0 ###LEFT-WALL### 5 response 0 ###LEFT-WALL### 11 increase 0 ###LEFT-WALL### 14 . 1 the 5 response 2 il 4 8 2 il 5 response 5 response 6 to 5 response 9 may 6 to 8 shifts 7 the 8 shifts 9 may 11 increase 10 also 11 increase 11 increase 12 with 12 with 13 age conveniently , il - 8 can be measured [non] [-] intrusively from urine . 0 ###LEFT-WALL### 5 8 0 ###LEFT-WALL### 7 be 0 ###LEFT-WALL### 14 . 1 conveniently 2 , 1 conveniently 5 8 2 , 3 il 3 il 4 - 3 il 5 8 5 8 6 can 6 can 7 be 7 be 8 measured 8 measured 11 intrusively 8 measured 12 from 12 from 13 urine methods : we conducted a shifts [-] randomized trial comparing 17 emergency physicians ' urinary il - 8 levels during [a] 24 h [s] , [a] 14 [h] s , and a control day ( clerical work on return [from] [leave] ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 conducted 2 : 43 . 3 we 4 conducted 4 conducted 31 and 5 a 9 trial 6 shifts 8 randomized 8 randomized 9 trial 9 trial 10 comparing 9 trial 31 and 10 comparing 16 il 11 17 13 physicians 12 emergency 13 physicians 13 physicians 14 ' 14 ' 16 il 15 urinary 16 il 16 il 19 levels 16 il 29 s 17 - 19 levels 18 8 19 levels 19 levels 20 during 19 levels 25 , 20 during 23 h 22 24 23 h 25 , 29 s 27 14 29 s 29 s 30 , 30 , 31 and 31 and 34 day 31 and 37 work 32 a 33 control 32 a 34 day 33 control 34 day 35 ( 37 work 36 clerical 37 work 37 work 38 on 37 work 42 ) 38 on 39 return mean levels of il - 8 were compared using a wilcoxon matched - pairs test . 0 ###LEFT-WALL### 1 mean 0 ###LEFT-WALL### 13 - 1 mean 2 levels 1 mean 9 using 2 levels 3 of 2 levels 8 compared 3 of 4 il 4 il 6 8 4 il 7 were 5 - 6 8 6 8 7 were 9 using 11 wilcoxon 10 a 11 wilcoxon 11 wilcoxon 12 matched 13 - 15 test 13 - 16 . 14 pairs 15 test independent associations of key factors including shifts , stress , and age with il - 8 levels were further assessed in a multivariable generalized estimating equations model . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 15 - 1 independent 2 associations 2 associations 3 of 2 associations 11 and 3 of 5 factors 4 key 5 factors 5 factors 6 including 5 factors 9 stress 6 including 7 shifts 8 , 9 stress 9 stress 10 , 10 , 11 and 11 and 12 age 11 and 13 with 13 with 14 il 15 - 17 levels 15 - 20 assessed 15 - 28 . 16 8 17 levels 17 levels 18 were 18 were 19 further 18 were 20 assessed 20 assessed 21 in 21 in 27 model 22 a 23 multivariable 22 a 27 model 23 multivariable 27 model 24 generalized 27 model 25 estimating 26 equations 26 equations 27 model results : mean urinary il - 8 levels almost doubled during [and] [after] a [24] h [s] compared with [a] 14 h [s] or a control day . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 28 . 1 results 2 : 2 : 5 il 3 mean 5 il 4 urinary 5 il 6 - 24 or 7 8 8 levels 8 levels 10 doubled 8 levels 18 compared 8 levels 24 or 9 almost 10 doubled 10 doubled 11 during 11 during 16 h 14 a 16 h 18 compared 19 with 19 with 22 h 21 14 22 h 24 or 27 day 25 a 27 day 26 control 27 day furthermore , il - 8 levels failed to return to control values at the end of the third day after the shift despite a rest day following the 24 h [s] . 0 ###LEFT-WALL### 6 levels 0 ###LEFT-WALL### 7 failed 1 furthermore 2 , 1 furthermore 6 levels 2 , 3 il 3 il 4 - 3 il 6 levels 5 8 6 levels 6 levels 7 failed 7 failed 8 to 7 failed 9 return 8 to 9 return 9 return 10 to 9 return 20 after 9 return 23 despite 9 return 30 h 10 to 11 control 11 control 12 values 12 values 13 at 12 values 16 of 13 at 15 end 14 the 15 end 16 of 19 day 17 the 18 third 17 the 19 day 20 after 22 shift 21 the 22 shift 23 despite 27 following 24 a 25 rest 24 a 27 following 25 rest 27 following 26 day 27 following 28 the 30 h 29 24 30 h 30 h 32 . in the multivariable model , engaging in a 24 [h] s [,] self - reported stress , and age were independently associated with higher il - 8 levels . 0 ###LEFT-WALL### 6 engaging 0 ###LEFT-WALL### 22 associated 0 ###LEFT-WALL### 26 - 1 in 4 model 1 in 5 , 1 in 6 engaging 2 the 4 model 3 multivariable 4 model 6 engaging 7 in 6 engaging 20 were 7 in 13 self 8 a 13 self 9 24 11 s 11 s 13 self 14 - 15 reported 15 reported 18 and 15 reported 20 were 16 stress 18 and 17 , 18 and 18 and 19 age 20 were 21 independently 20 were 22 associated 22 associated 23 with 23 with 25 il 24 higher 25 il 26 - 28 levels 26 - 29 . 27 8 28 levels [a] 24 h [s] significantly increased il - 8 levels by 1.9 ng ( p = .007[!] ) . 0 ###LEFT-WALL### 3 h 0 ###LEFT-WALL### 6 increased 0 ###LEFT-WALL### 19 . 2 24 3 h 3 h 6 increased 5 significantly 6 increased 6 increased 7 il 7 il 10 levels 8 - 10 levels 9 8 10 levels 10 levels 11 by 10 levels 16 = 10 levels 18 ) 11 by 13 ng 12 1.9 13 ng 14 ( 16 = 15 p 16 = 16 = 17 .007[!] similarly , for every unit increase [in] self - reported stress , there was a 0.11 ng increase in il - 8 levels ( p = .003[!] ) ; and for every one year advance in age of physicians , il - 8 levels also increased by 0.11 ng ( p = .018[!] ) . 0 ###LEFT-WALL### 13 there 0 ###LEFT-WALL### 14 was 0 ###LEFT-WALL### 29 ; 0 ###LEFT-WALL### 55 . 1 similarly 2 , 1 similarly 13 there 3 for 8 self 3 for 13 there 4 every 8 self 5 unit 8 self 6 increase 8 self 9 - 10 reported 10 reported 11 stress 10 reported 12 , 10 reported 13 there 13 there 14 was 14 was 18 increase 14 was 19 in 15 a 18 increase 16 0.11 17 ng 17 ng 18 increase 19 in 20 il 20 il 23 levels 21 - 23 levels 22 8 23 levels 23 levels 26 = 23 levels 29 ; 24 ( 26 = 25 p 26 = 26 = 27 .003[!] 26 = 28 ) 29 ; 30 and 30 and 44 levels 30 and 46 increased 31 for 35 advance 31 for 44 levels 32 every 35 advance 33 one 34 year 34 year 35 advance 35 advance 36 in 35 advance 38 of 35 advance 41 il 36 in 37 age 38 of 39 physicians 40 , 41 il 41 il 42 - 43 8 44 levels 44 levels 46 increased 45 also 46 increased 46 increased 47 by 46 increased 52 = 47 by 49 ng 48 0.11 49 ng 50 ( 52 = 51 p 52 = 52 = 53 .018[!] 52 = 54 ) conclusion : the 24 h [s] generated a prolonged response of the immune system . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 h 2 : 7 generated 2 : 15 . 3 the 5 h 4 24 5 h 5 h 7 generated 7 generated 10 response 8 a 10 response 9 prolonged 10 response 10 response 11 of 11 of 14 system 12 the 14 system 13 immune 14 system urinary il - [8] was a strong biomarker of stress under intensive and prolonged demands , both acutely [and] over time . 0 ###LEFT-WALL### 2 il 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 22 . 1 urinary 2 il 3 - 5 was 5 was 8 biomarker 5 was 17 both 5 was 18 acutely 5 was 20 over 6 a 7 strong 6 a 8 biomarker 7 strong 8 biomarker 8 biomarker 9 of 9 of 10 stress 10 stress 11 under 11 under 13 and 12 intensive 13 and 13 and 15 demands 13 and 16 , 14 prolonged 15 demands 20 over 21 time because elevated il - 8 levels are associated with cardiovascular disease and negative psychological consequences , we suggest that emergency physicians limit their exposure to 24 h [s] , especially with advancing age . 0 ###LEFT-WALL### 17 we 0 ###LEFT-WALL### 18 suggest 1 because 3 il 1 because 8 associated 1 because 17 we 2 elevated 3 il 3 il 6 levels 3 il 7 are 3 il 8 associated 4 - 5 8 5 8 6 levels 6 levels 7 are 9 with 12 and 9 with 17 we 10 cardiovascular 11 disease 11 disease 12 and 12 and 15 consequences 12 and 16 , 13 negative 15 consequences 14 psychological 15 consequences 17 we 18 suggest 18 suggest 19 that 19 that 21 physicians 19 that 22 limit 20 emergency 21 physicians 22 limit 24 exposure 23 their 24 exposure 24 exposure 25 to 24 exposure 31 with 25 to 27 h 26 24 27 h 29 , 30 especially 29 , 31 with 31 with 32 advancing 31 with 34 . 32 advancing 33 age background : insulin resistance ( ir ) is believed to be the underlying mechanism of metabolic syndrome [and] type 2 diabetes mellitus ( dm ) . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 be 0 ###LEFT-WALL### 26 . 2 : 3 insulin 3 insulin 4 resistance 3 insulin 11 be 4 resistance 6 ir 4 resistance 8 is 5 ( 6 ir 6 ir 7 ) 8 is 9 believed 9 believed 10 to 10 to 11 be 11 be 14 mechanism 12 the 14 mechanism 13 underlying 14 mechanism 14 mechanism 15 of 15 of 22 mellitus 16 metabolic 22 mellitus 17 syndrome 19 type 19 type 22 mellitus 20 2 21 diabetes 21 diabetes 22 mellitus 22 mellitus 24 dm 23 ( 24 dm 24 dm 25 ) recently , a few studies have demonstrated that phthalates could cause oxidative stress which would contribute to the development of ir . 0 ###LEFT-WALL### 5 studies 0 ###LEFT-WALL### 7 demonstrated 0 ###LEFT-WALL### 22 . 1 recently 2 , 1 recently 5 studies 3 a 4 few 4 few 5 studies 5 studies 6 have 6 have 7 demonstrated 7 demonstrated 8 that 8 that 9 phthalates 8 that 11 cause 9 phthalates 10 could 10 could 11 cause 11 cause 13 stress 12 oxidative 13 stress 13 stress 14 which 13 stress 15 would 14 which 15 would 15 would 16 contribute 16 contribute 17 to 17 to 19 development 18 the 19 development 19 development 20 of 20 of 21 ir therefore , we evaluated whether exposure to phthalates affects ir , and oxidative stress is involved in the phthalates - ir pathway . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 20 - 1 therefore 2 , 1 therefore 3 we 3 we 4 evaluated 4 evaluated 5 whether 4 evaluated 14 stress 4 evaluated 16 involved 5 whether 6 exposure 5 whether 9 affects 6 exposure 7 to 6 exposure 9 affects 7 to 8 phthalates 9 affects 12 and 10 ir 12 and 11 , 12 and 12 and 13 oxidative 14 stress 15 is 15 is 16 involved 16 involved 17 in 17 in 19 phthalates 18 the 19 phthalates 20 - 22 pathway 20 - 23 . 21 ir 22 pathway methods : we recruited 560 elderly participants , and obtained blood and urine samples during repeated medical examinations . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 9 and 2 : 19 . 3 we 9 and 4 recruited 7 participants 4 recruited 9 and 5 560 7 participants 6 elderly 7 participants 8 , 9 and 9 and 10 obtained 10 obtained 12 and 10 obtained 15 during 11 blood 12 and 12 and 14 samples 13 urine 14 samples 15 during 18 examinations 16 repeated 18 examinations 17 medical 18 examinations for the determination of phthalate exposure , we measured urinary levels of mono - [(] 2 - ethyl - 5 - hydroxyhexyl ) phthalate ( mehhp [ )(and mono - ( 2 - ethyl - 5 - oxohexyl ) phthalate [(] [meohp] [ )(as metabolites of diethylhexyl phthalates ( dehp ) , and mono - n - butyl phthalate [(] mnbp ) as a metabolite of di - butyl phthalate ( dbp ) . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 9 measured 1 for 3 determination 1 for 7 , 1 for 8 we 2 the 3 determination 3 determination 4 of 4 of 6 exposure 5 phthalate 6 exposure 8 we 9 measured 9 measured 11 levels 10 urinary 11 levels 11 levels 12 of 12 of 24 phthalate 13 mono 17 - 13 mono 24 phthalate 14 - 17 - 16 2 17 - 17 - 18 ethyl 18 ethyl 20 5 18 ethyl 22 hydroxyhexyl 19 - 20 5 20 5 21 - 21 - 22 hydroxyhexyl 22 hydroxyhexyl 23 ) 24 phthalate 28 )(and 24 phthalate 33 - 25 ( 28 )(and 26 mehhp 28 )(and 28 )(and 29 mono 28 )(and 30 - 31 ( 33 - 32 2 33 - 33 - 34 ethyl 34 ethyl 36 5 34 ethyl 40 phthalate 35 - 36 5 36 5 38 oxohexyl 36 5 40 phthalate 37 - 38 oxohexyl 38 oxohexyl 39 ) 40 phthalate 44 )(as 44 )(as 53 and 45 metabolites 46 of 45 metabolites 53 and 46 of 48 phthalates 47 diethylhexyl 48 phthalates 48 phthalates 50 dehp 49 ( 50 dehp 50 dehp 51 ) 52 , 53 and 53 and 61 mnbp 53 and 62 ) 53 and 63 as 54 mono 57 - 54 mono 59 phthalate 55 - 57 - 56 n 57 - 57 - 58 butyl 59 phthalate 61 mnbp 63 as 65 metabolite 64 a 65 metabolite 65 metabolite 66 of 65 metabolite 70 phthalate 66 of 67 di 68 - 70 phthalate 69 butyl 70 phthalate 70 phthalate 72 dbp 70 phthalate 74 . 71 ( 72 dbp 72 dbp 73 ) malondialdehyde ( mda ) , an oxidative stress biomarker , was also measured in urine samples . 0 ###LEFT-WALL### 3 mda 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 17 . 1 malondialdehyde 3 mda 2 ( 3 mda 3 mda 4 ) 3 mda 9 biomarker 3 mda 11 was 5 , 9 biomarker 6 an 7 oxidative 6 an 9 biomarker 7 oxidative 8 stress 8 stress 9 biomarker 9 biomarker 10 , 11 was 12 also 11 was 13 measured 13 measured 14 in 14 in 16 samples 15 urine 16 samples we measured serum levels of fasting glucose and insulin , and derived the homeostatic model assessment ( homa ) [index] to assess ir . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 24 . 1 we 11 and 2 measured 4 levels 2 measured 11 and 3 serum 4 levels 4 levels 5 of 5 of 8 and 6 fasting 7 glucose 7 glucose 8 and 8 and 9 insulin 10 , 11 and 11 and 12 derived 11 and 21 to 12 derived 16 assessment 13 the 16 assessment 14 homeostatic 16 assessment 15 model 16 assessment 16 assessment 18 homa 17 ( 18 homa 18 homa 19 ) 21 to 22 assess 22 assess 23 ir a mixed [-] effect model and penalized regression spline were used to estimate the associations among phthalate metabolites , mda , and ir . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 used 0 ###LEFT-WALL### 24 . 1 a 5 model 2 mixed 4 effect 4 effect 5 model 5 model 6 and 6 and 9 spline 6 and 10 were 7 penalized 9 spline 8 regression 9 spline 10 were 11 used 11 used 12 to 11 used 13 estimate 12 to 13 estimate 13 estimate 15 associations 14 the 15 associations 15 associations 16 among 16 among 22 and 17 phthalate 18 metabolites 18 metabolites 19 , 19 , 20 mda 19 , 22 and 21 , 22 and 22 and 23 ir results : the molar sum of mehhp and meohp ( ∑dehp ) were significantly associated with homa ( β [=] 0.26 , p = 0.040 ) , and the association [was] apparent among participants with a history of dm ( β [=] 0.88 , p = 0.037 ) and [among] females ( β [=] 0.30 , p = 0.022 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 and 3 the 5 sum 4 molar 5 sum 5 sum 6 of 5 sum 8 and 6 of 7 mehhp 8 and 9 meohp 8 and 11 ∑dehp 8 and 13 were 10 ( 11 ∑dehp 11 ∑dehp 12 ) 13 were 15 associated 14 significantly 15 associated 15 associated 16 with 16 with 28 and 17 homa 19 β 17 homa 28 and 18 ( 19 β 19 β 21 0.26 19 β 24 = 19 β 27 , 22 , 24 = 23 p 24 = 24 = 25 0.040 24 = 26 ) 28 and 30 association 28 and 38 of 29 the 30 association 30 association 32 apparent 32 apparent 33 among 32 apparent 35 with 33 among 34 participants 35 with 37 history 36 a 37 history 38 of 49 and 39 dm 41 β 39 dm 49 and 40 ( 41 β 41 β 46 = 41 β 48 ) 43 0.88 46 = 44 , 46 = 45 p 46 = 46 = 47 0.037 49 and 51 females 49 and 53 β 52 ( 53 β 53 β 55 0.30 53 β 58 = 53 β 61 . 56 , 58 = 57 p 58 = 58 = 59 0.022 58 = 60 ) however , the relation between mnbp and homa was not found . 0 ###LEFT-WALL### 4 relation 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 12 . 1 however 2 , 1 however 4 relation 3 the 4 relation 4 relation 5 between 4 relation 9 was 5 between 7 and 6 mnbp 7 and 7 and 8 homa 9 was 10 not 9 was 11 found when we evaluated whether oxidative stress is involved in increases of homa by ∑dehp , mda levels were significantly associated with increases of ∑dehp [(] β = 0.11 , p<0.001 ) and homa [(] β = 0.49 , p = 0.049 ) . 0 ###LEFT-WALL### 26 β 0 ###LEFT-WALL### 27 = 0 ###LEFT-WALL### 32 and 0 ###LEFT-WALL### 43 . 1 when 2 we 1 when 3 evaluated 1 when 26 β 2 we 3 evaluated 3 evaluated 4 whether 4 whether 6 stress 4 whether 8 involved 5 oxidative 6 stress 6 stress 7 is 7 is 8 involved 8 involved 9 in 8 involved 13 by 9 in 10 increases 10 increases 11 of 11 of 12 homa 13 by 16 mda 14 ∑dehp 15 , 14 ∑dehp 16 mda 16 mda 17 levels 16 mda 23 of 17 levels 18 were 18 were 20 associated 19 significantly 20 associated 20 associated 21 with 21 with 22 increases 22 increases 23 of 24 ∑dehp 26 β 26 β 27 = 27 = 28 0.11 28 0.11 30 p<0.001 29 , 30 p<0.001 30 p<0.001 31 ) 32 and 33 homa 32 and 35 β 33 homa 35 β 35 β 37 0.49 36 = 37 0.49 37 0.49 40 = 38 , 40 = 39 p 40 = 40 = 41 0.049 40 = 42 ) conclusions : our study results suggest that exposure to dehp in the elderly population increases ir , which is related with oxidative stress , and that participants with a history of dm and females are more susceptible to dehp exposure . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 results 2 : 6 suggest 2 : 33 and 2 : 41 . 3 our 5 results 4 study 5 results 5 results 6 suggest 6 suggest 7 that 7 that 8 exposure 7 that 15 increases 8 exposure 9 to 8 exposure 15 increases 9 to 10 dehp 10 dehp 11 in 11 in 14 population 12 the 14 population 13 elderly 14 population 15 increases 27 participants 16 ir 18 which 16 ir 25 and 17 , 18 which 18 which 19 is 18 which 24 , 19 is 20 related 20 related 21 with 21 with 23 stress 22 oxidative 23 stress 25 and 26 that 25 and 27 participants 27 participants 28 with 27 participants 31 of 28 with 30 history 29 a 30 history 31 of 32 dm 33 and 34 females 33 and 35 are 34 females 35 are 35 are 36 more 35 are 37 susceptible 37 susceptible 38 to 38 to 40 exposure 39 dehp 40 exposure the purpose of this study was to characterize quadriceps femoris muscle fatigue of both lower extremities in patients with knee osteoarthritis ( oa ) . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 11 muscle 0 ###LEFT-WALL### 25 . 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 characterize 7 to 8 characterize 8 characterize 9 quadriceps 9 quadriceps 10 femoris 9 quadriceps 11 muscle 10 femoris 11 muscle 11 muscle 12 fatigue 11 muscle 17 in 11 muscle 19 with 12 fatigue 13 of 13 of 16 extremities 14 both 16 extremities 15 lower 16 extremities 17 in 18 patients 19 with 21 osteoarthritis 20 knee 21 osteoarthritis 21 osteoarthritis 23 oa 22 ( 23 oa 23 oa 24 ) sixty - two subjects ( mean age 68.2 years , standard deviation [ sd ] ± 7.9 years [ )( knee oa participated in the study . 0 ###LEFT-WALL### 4 subjects 0 ###LEFT-WALL### 16 ± 0 ###LEFT-WALL### 27 . 1 sixty 2 - 2 - 3 two 2 - 4 subjects 4 subjects 9 years 4 subjects 16 ± 5 ( 9 years 6 mean 7 age 7 age 9 years 8 68.2 9 years 9 years 12 deviation 9 years 15 ] 10 , 12 deviation 11 standard 12 deviation 12 deviation 14 sd 12 deviation 15 ] 13 [ 14 sd 14 sd 15 ] 16 ± 18 years 16 ± 24 in 17 7.9 18 years 18 years 22 oa 18 years 23 participated 21 knee 22 oa 22 oa 23 participated 24 in 26 study 25 the 26 study significantly higher knee pain was reported in the involved knee than in the contralateral knee , as determined by a visual analog scale . 0 ###LEFT-WALL### 4 pain 0 ###LEFT-WALL### 6 reported 0 ###LEFT-WALL### 24 . 1 significantly 2 higher 2 higher 3 knee 3 knee 4 pain 4 pain 5 was 5 was 6 reported 6 reported 7 in 6 reported 11 than 6 reported 19 by 7 in 10 knee 8 the 10 knee 9 involved 10 knee 11 than 12 in 12 in 15 knee 13 the 15 knee 14 contralateral 15 knee 15 knee 18 determined 16 , 18 determined 17 as 18 determined 19 by 23 scale 20 a 21 visual 20 a 23 scale 21 visual 22 analog 22 analog 23 scale significant differences were demonstrated between the lower extremities in terms of maximal voluntary isometric contraction , in favor of the less involved leg ( p = 0.0001 ) . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 4 demonstrated 0 ###LEFT-WALL### 29 . 1 significant 2 differences 2 differences 3 were 3 were 4 demonstrated 4 demonstrated 5 between 4 demonstrated 9 in 5 between 8 extremities 6 the 8 extremities 7 lower 8 extremities 9 in 10 terms 10 terms 11 of 11 of 15 contraction 12 maximal 15 contraction 13 voluntary 15 contraction 14 isometric 15 contraction 15 contraction 17 in 16 , 17 in 17 in 18 favor 17 in 28 ) 18 favor 19 of 19 of 23 leg 20 the 23 leg 21 less 22 involved 22 involved 23 leg 23 leg 26 = 24 ( 26 = 25 p 26 = 26 = 27 0.0001 26 = 28 ) in contrast , the degree of fatigue of the quadriceps femoris muscle , as measured by the [decrement] [in] force production following ten repeated contractions , was significantly higher in the contralateral leg ( p = 0.0002 ) . 0 ###LEFT-WALL### 7 fatigue 0 ###LEFT-WALL### 27 was 0 ###LEFT-WALL### 39 . 1 in 2 contrast 1 in 3 , 1 in 7 fatigue 4 the 5 degree 5 degree 6 of 5 degree 7 fatigue 6 of 7 fatigue 7 fatigue 8 of 7 fatigue 11 femoris 7 fatigue 12 muscle 7 fatigue 15 measured 7 fatigue 27 was 8 of 10 quadriceps 9 the 10 quadriceps 11 femoris 12 muscle 13 , 15 measured 14 as 15 measured 15 measured 16 by 15 measured 26 , 16 by 21 production 17 the 21 production 20 force 21 production 21 production 22 following 22 following 25 contractions 23 ten 25 contractions 24 repeated 25 contractions 27 was 29 higher 28 significantly 29 higher 29 higher 30 in 29 higher 36 = 30 in 33 leg 31 the 33 leg 32 contralateral 33 leg 34 ( 36 = 35 p 36 = 36 = 37 0.0002 36 = 38 ) furthermore , normalization of the fatigue results to the first contraction yielded a similar result ( p < 0.0001 ) . 0 ###LEFT-WALL### 3 normalization 0 ###LEFT-WALL### 12 yielded 0 ###LEFT-WALL### 21 . 1 furthermore 2 , 1 furthermore 3 normalization 3 normalization 4 of 3 normalization 12 yielded 4 of 7 results 5 the 7 results 6 fatigue 7 results 7 results 8 to 8 to 11 contraction 9 the 10 first 9 the 11 contraction 12 yielded 15 result 13 a 14 similar 13 a 15 result 14 similar 15 result 15 result 18 < 16 ( 18 < 17 p 18 < 18 < 19 0.0001 18 < 20 ) similar results were noted when analysis was performed separately for subjects whose involvement was unilateral or bilateral . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 4 noted 0 ###LEFT-WALL### 18 . 1 similar 2 results 2 results 3 were 3 were 4 noted 4 noted 5 when 4 noted 9 separately 4 noted 10 for 4 noted 16 or 5 when 6 analysis 5 when 7 was 6 analysis 7 was 7 was 8 performed 10 for 11 subjects 11 subjects 12 whose 12 whose 13 involvement 13 involvement 14 was 15 unilateral 16 or 16 or 17 bilateral the results indicate that , irrespective of the initial strength of contraction , the rate of muscle fatigue in the contralateral leg is significantly higher than in the involved leg . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 31 . 1 the 2 results 2 results 3 indicate 3 indicate 4 that 4 that 15 rate 4 that 23 is 5 , 7 of 6 irrespective 7 of 7 of 10 strength 7 of 13 , 7 of 15 rate 8 the 10 strength 9 initial 10 strength 10 strength 11 of 11 of 12 contraction 14 the 15 rate 15 rate 16 of 15 rate 23 is 16 of 18 fatigue 17 muscle 18 fatigue 18 fatigue 19 in 19 in 22 leg 20 the 22 leg 21 contralateral 22 leg 23 is 25 higher 24 significantly 25 higher 25 higher 26 than 26 than 27 in 27 in 30 leg 28 the 30 leg 29 involved 30 leg hypotheses for these unexpected results are suggested . 0 ###LEFT-WALL### 1 hypotheses 0 ###LEFT-WALL### 7 suggested 0 ###LEFT-WALL### 8 . 1 hypotheses 2 for 1 hypotheses 6 are 2 for 5 results 3 these 5 results 4 unexpected 5 results 6 are 7 suggested rehabilitation of patients with knee oa should focus on increasing quadriceps muscle strength and endurance for both lower extremities . 0 ###LEFT-WALL### 1 rehabilitation 0 ###LEFT-WALL### 8 focus 0 ###LEFT-WALL### 20 . 1 rehabilitation 2 of 1 rehabilitation 7 should 2 of 3 patients 3 patients 4 with 4 with 6 oa 5 knee 6 oa 7 should 8 focus 8 focus 9 on 8 focus 14 and 8 focus 16 for 9 on 10 increasing 10 increasing 11 quadriceps 12 muscle 13 strength 13 strength 14 and 14 and 15 endurance 16 for 19 extremities 17 both 19 extremities 18 lower 19 extremities introduction : the aim of this study is to report our 6 - year single - center experience with l5 - s1 axial lumbar interbody fusion ( axialif ) . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 report 0 ###LEFT-WALL### 30 . 2 : 4 aim 3 the 4 aim 4 aim 5 of 4 aim 7 study 4 aim 8 is 5 of 6 this 7 study 8 is 8 is 9 to 9 to 10 report 10 report 12 6 11 our 12 6 12 6 18 experience 12 6 26 fusion 13 - 18 experience 14 year 18 experience 15 single 16 - 15 single 17 center 17 center 18 experience 18 experience 19 with 18 experience 21 - 19 with 20 l5 21 - 26 fusion 22 s1 26 fusion 23 axial 25 interbody 24 lumbar 25 interbody 25 interbody 26 fusion 26 fusion 28 axialif 26 fusion 29 ) 27 ( 28 axialif 28 axialif 29 ) methods : a total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with axialif at l5 - s1 , and were followed for a minimum of 1 year ( mean [:] 21 months ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 4 total 3 a 4 total 4 total 5 of 5 of 7 patients 6 131 7 patients 7 patients 8 with 7 patients 13 refractory 8 with 12 disease 9 symptomatic 11 disc 10 degenerative 11 disc 11 disc 12 disease 13 refractory 14 to 14 to 16 treatment 15 nonsurgical 16 treatment 16 treatment 26 and 16 treatment 32 of 17 were 18 treated 17 were 26 and 18 treated 19 with 18 treated 21 at 19 with 20 axialif 21 at 22 l5 22 l5 24 s1 23 - 24 s1 24 s1 25 , 26 and 27 were 27 were 28 followed 28 followed 29 for 29 for 31 minimum 30 a 31 minimum 32 of 34 year 33 1 34 year 34 year 39 months 35 ( 39 months 36 mean 39 months 38 21 39 months 39 months 40 ) main outcomes included back and leg pain severity , oswestry disability index score , working status , analgesic medication use , patient satisfaction , and complications . 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 27 . 1 main 2 outcomes 2 outcomes 3 included 2 outcomes 5 and 3 included 4 back 5 and 8 severity 5 and 9 , 6 leg 7 pain 7 pain 8 severity 9 , 13 score 9 , 14 , 10 oswestry 11 disability 11 disability 12 index 12 index 13 score 14 , 16 status 14 , 17 , 15 working 16 status 17 , 20 use 17 , 21 , 18 analgesic 19 medication 19 medication 20 use 21 , 23 satisfaction 21 , 25 and 22 patient 23 satisfaction 24 , 25 and 25 and 26 complications computed tomography was used to determine postoperative fusion status . 0 ###LEFT-WALL### 2 tomography 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 10 . 1 computed 2 tomography 2 tomography 3 was 3 was 4 used 4 used 5 to 4 used 6 determine 5 to 6 determine 6 determine 9 status 7 postoperative 8 fusion 8 fusion 9 status results : no intraoperative complications , including vascular , neural , urologic , or bowel injuries , were reported . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 5 complications 2 : 19 reported 3 no 5 complications 4 intraoperative 5 complications 5 complications 7 including 5 complications 18 were 6 , 7 including 7 including 14 or 7 including 17 , 8 vascular 9 , 9 , 10 neural 9 , 11 , 11 , 12 urologic 11 , 14 or 13 , 14 or 14 or 16 injuries 14 or 17 , 15 bowel 16 injuries 18 were 19 reported back and leg pain severity decreased by 51 % and 42 % , respectively , [during] [the] follow - up period ( [both] p < 0.001 ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 pain 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 28 . 1 back 2 and 2 and 3 leg 2 and 4 pain 4 pain 5 severity 5 severity 6 decreased 6 decreased 7 by 7 by 9 % 8 51 9 % 10 and 12 % 10 and 18 follow 11 42 12 % 12 % 18 follow 13 , 14 respectively 14 respectively 15 , 14 respectively 18 follow 18 follow 20 up 19 - 20 up 20 up 21 period 20 up 27 ) 21 period 25 < 22 ( 25 < 24 p 25 < 25 < 26 0.001 25 < 27 ) back function scores improved 50 % compared to baseline . 0 ###LEFT-WALL### 3 scores 0 ###LEFT-WALL### 4 improved 0 ###LEFT-WALL### 10 . 1 back 3 scores 2 function 3 scores 3 scores 4 improved 4 improved 6 % 5 50 6 % 6 % 7 compared 7 compared 8 to 8 to 9 baseline clinical success , defined as improvement ≥30 % , was 67 % for back pain severity , 65 % for leg pain severity , and 71 % [for] back function . 0 ###LEFT-WALL### 2 success 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 31 . 1 clinical 2 success 2 success 4 defined 2 success 10 was 3 , 4 defined 4 defined 5 as 4 defined 9 , 5 as 8 % 6 improvement 7 ≥30 7 ≥30 8 % 10 was 12 % 11 67 12 % 12 % 13 for 13 for 16 severity 14 back 16 severity 15 pain 16 severity 17 , 19 % 17 , 30 function 18 65 19 % 19 % 20 for 19 % 30 function 20 for 25 and 21 leg 23 severity 22 pain 23 severity 23 severity 25 and 24 , 25 and 25 and 29 back 26 71 27 % 27 % 29 back the employment rate increased from 47 % before surgery to 64 % at [final] [follow] - up ( p < 0.001 ) . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 4 increased 0 ###LEFT-WALL### 23 . 1 the 3 rate 2 employment 3 rate 3 rate 4 increased 4 increased 5 from 4 increased 8 before 4 increased 10 to 5 from 7 % 6 47 7 % 8 before 9 surgery 10 to 12 % 11 64 12 % 12 % 13 at 12 % 20 < 13 at 17 up 16 - 17 up 18 ( 20 < 19 p 20 < 20 < 21 0.001 20 < 22 ) less than one in four patients regularly used analgesic medications postsurgery . 0 ###LEFT-WALL### 3 one 0 ###LEFT-WALL### 8 used 0 ###LEFT-WALL### 12 . 1 less 2 than 2 than 3 one 3 one 4 in 3 one 8 used 4 in 6 patients 5 four 6 patients 7 regularly 8 used 8 used 11 postsurgery 9 analgesic 11 postsurgery 10 medications 11 postsurgery patient satisfaction with the axialif procedure was 83 % . 0 ###LEFT-WALL### 2 satisfaction 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 10 . 1 patient 2 satisfaction 2 satisfaction 3 with 2 satisfaction 7 was 3 with 6 procedure 4 the 6 procedure 5 axialif 6 procedure 7 was 9 % 8 83 9 % the fusion rate was 87.8 % at [final] [follow] - up . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 12 . 1 the 3 rate 2 fusion 3 rate 3 rate 4 was 4 was 6 % 5 87.8 6 % 6 % 7 at 7 at 11 up 10 - 11 up [during] follow - up , 17 ( 13.0 % ) patients underwent 18 reoperations on the lumbar spine , including pedicle screw fixation ( n = 10 ) , total disc replacement of an uninvolved level ( n = 3 ) , facet screw fixation ( n = 3 ) , facet screw removal ( n = 1 ) , and interbody fusion at l4 - l5 ( n = 1 ) . 0 ###LEFT-WALL### 2 follow 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 73 . 3 - 11 patients 3 - 12 underwent 4 up 6 17 4 up 10 ) 4 up 11 patients 5 , 6 17 6 17 9 % 6 17 10 ) 7 ( 9 % 8 13.0 9 % 9 % 10 ) 11 patients 12 underwent 12 underwent 61 and 12 underwent 64 at 13 18 14 reoperations 14 reoperations 15 on 14 reoperations 61 and 15 on 18 spine 16 the 18 spine 17 lumbar 18 spine 18 spine 20 including 18 spine 32 replacement 19 , 20 including 20 including 23 fixation 20 including 28 ) 21 pedicle 22 screw 22 screw 23 fixation 23 fixation 26 = 24 ( 26 = 25 n 26 = 26 = 27 10 26 = 28 ) 29 , 32 replacement 30 total 32 replacement 31 disc 32 replacement 32 replacement 33 of 32 replacement 60 , 33 of 45 fixation 34 an 45 fixation 35 uninvolved 43 facet 36 level 39 = 36 level 42 , 36 level 43 facet 37 ( 39 = 38 n 39 = 39 = 40 3 39 = 41 ) 43 facet 44 screw 44 screw 45 fixation 45 fixation 48 = 45 fixation 54 removal 46 ( 48 = 47 n 48 = 48 = 49 3 48 = 50 ) 51 , 54 removal 52 facet 54 removal 53 screw 54 removal 54 removal 57 = 54 removal 59 ) 55 ( 57 = 56 n 57 = 57 = 58 1 60 , 61 and 61 and 63 fusion 62 interbody 63 fusion 64 at 65 l4 65 l4 67 l5 66 - 67 l5 67 l5 70 = 67 l5 72 ) 68 ( 70 = 69 n 70 = 70 = 71 1 eight ( 6.1 % ) [reoperations] were at the index level . 0 ###LEFT-WALL### 1 eight 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 12 . 1 eight 4 % 1 eight 7 were 2 ( 4 % 3 6.1 4 % 4 % 5 ) 7 were 8 at 7 were 11 level 8 at 10 index 9 the 10 index conclusion : single - level axialif is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 14 achieve 0 ###LEFT-WALL### 24 . 1 conclusion 2 : 2 : 5 level 3 single 4 - 3 single 5 level 5 level 6 axialif 5 level 14 achieve 6 axialif 7 is 7 is 12 means 7 is 13 to 8 a 12 means 9 safe 10 and 10 and 11 effective 10 and 12 means 13 to 14 achieve 14 achieve 16 fusion 14 achieve 17 in 14 achieve 19 with 15 lumbosacral 16 fusion 17 in 18 patients 19 with 23 disease 20 symptomatic 22 disc 21 degenerative 22 disc 22 disc 23 disease pulmonary o2 uptake ( v ( [o₂p] [ )( )(and leg blood flow ( lbf ) kinetics were examined at the onset of moderate - intensity exercise , [during] hyperventilation [with] and without associated hypocapnic alkalosis . 0 ###LEFT-WALL### 2 o2 0 ###LEFT-WALL### 19 examined 0 ###LEFT-WALL### 37 . 1 pulmonary 2 o2 2 o2 3 uptake 2 o2 17 kinetics 2 o2 18 were 3 uptake 10 )(and 3 uptake 17 kinetics 4 ( 10 )(and 5 v 10 )(and 6 ( 10 )(and 10 )(and 13 flow 10 )(and 15 lbf 10 )(and 16 ) 11 leg 13 flow 12 blood 13 flow 14 ( 15 lbf 15 lbf 16 ) 18 were 19 examined 19 examined 32 and 20 at 22 onset 20 at 32 and 21 the 22 onset 22 onset 23 of 23 of 30 hyperventilation 24 moderate 27 exercise 24 moderate 30 hyperventilation 25 - 27 exercise 26 intensity 27 exercise 27 exercise 28 , 32 and 33 without 33 without 36 alkalosis 34 associated 36 alkalosis 35 hypocapnic 36 alkalosis [the] [v] [(] o₂p ) was measured breath by breath using mass spectrometry and a volume turbine . 0 ###LEFT-WALL### 4 o₂p 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 18 . 4 o₂p 5 ) 4 o₂p 6 was 6 was 8 breath 6 was 9 by 7 measured 8 breath 9 by 14 and 10 breath 11 using 10 breath 14 and 11 using 13 spectrometry 12 mass 13 spectrometry 14 and 17 turbine 15 a 16 volume 15 a 17 turbine 16 volume 17 turbine femoral artery mean blood velocity was measured by doppler ultrasound , and lbf was calculated from femoral artery diameter [and] mean blood velocity . 0 ###LEFT-WALL### 5 velocity 0 ###LEFT-WALL### 7 measured 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 24 . 1 femoral 2 artery 2 artery 5 velocity 3 mean 4 blood 4 blood 5 velocity 5 velocity 6 was 6 was 7 measured 7 measured 8 by 7 measured 10 ultrasound 8 by 9 doppler 11 , 12 and 12 and 13 lbf 12 and 15 calculated 13 lbf 14 was 14 was 15 calculated 15 calculated 16 from 16 from 23 velocity 17 femoral 18 artery 18 artery 19 diameter 19 diameter 23 velocity 21 mean 23 velocity 22 blood 23 velocity phase [2] v ( o₂p ) kinetics [(] τv ( o₂p [ )( (was different ( p < 0.05 ) amongst all three conditions ( con , 19 ± 7 s [;] hypo , 43 ± 17 [s] [;] and normo , 30 ± [8] s [ )(, while lbf kinetics [(] τlbf ) [was] slower [(] [p] < 0.05 [ )(in hypo ( 31 ± [9] s ) compared with both con ( 19 ± [3] s ) and normo ( 20 ± [6] s ) . 1 phase 3 v 1 phase 5 o₂p 1 phase 9 τv 4 ( 5 o₂p 5 o₂p 6 ) 7 kinetics 9 τv 9 τv 11 o₂p 9 τv 14 (was 10 ( 11 o₂p 11 o₂p 13 )( 14 (was 15 different 15 different 18 < 15 different 21 amongst 16 ( 18 < 17 p 18 < 18 < 19 0.05 18 < 20 ) 21 amongst 24 conditions 22 all 23 three 23 three 24 conditions 24 conditions 26 con 24 conditions 33 hypo 24 conditions 36 ± 25 ( 26 con 26 con 27 , 27 , 33 hypo 28 19 33 hypo 29 ± 33 hypo 30 7 31 s 31 s 33 hypo 33 hypo 34 , 34 , 36 ± 35 43 36 ± 36 ± 48 )(, 37 17 40 and 40 and 41 normo 41 normo 46 s 42 , 46 s 43 30 46 s 44 ± 46 s 46 s 48 )(, 48 )(, 49 while 49 while 50 lbf 49 while 51 kinetics 49 while 54 ) 49 while 56 slower 50 lbf 51 kinetics 51 kinetics 53 τlbf 56 slower 63 hypo 59 < 60 0.05 60 0.05 62 )(in 62 )(in 63 hypo 63 hypo 68 s 63 hypo 70 compared 64 ( 68 s 65 31 68 s 66 ± 68 s 68 s 69 ) 70 compared 71 with 71 with 80 and 72 both 80 and 73 con 78 s 73 con 80 and 74 ( 78 s 75 19 78 s 76 ± 78 s 78 s 79 ) 80 and 81 normo 80 and 88 . 81 normo 86 s 82 ( 86 s 83 20 86 s 84 ± 86 s 86 s 87 ) similar to previous findings , hypo [was] associated with [slower] v ( o₂p ) and lbf kinetics compared with con . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 18 compared 0 ###LEFT-WALL### 21 . 1 similar 2 to 1 similar 15 and 2 to 4 findings 3 previous 4 findings 4 findings 6 hypo 5 , 6 hypo 6 hypo 8 associated 6 hypo 9 with 6 hypo 13 o₂p 6 hypo 14 ) 9 with 11 v 12 ( 13 o₂p 13 o₂p 14 ) 15 and 17 kinetics 15 and 18 compared 16 lbf 17 kinetics 18 compared 19 with 19 with 20 con in the present study , preventing [the] fall in end [-] [tidal] p ( co₂ ) ( normo ) restored lbf kinetics [,] but not v ( o₂p ) [kinetics] , which remained ['] slowed ['] relative to con . 1 in 4 study 1 in 5 , 1 in 8 fall 2 the 4 study 3 present 4 study 6 preventing 8 fall 8 fall 9 in 8 fall 15 co₂ 8 fall 18 normo 8 fall 20 restored 9 in 10 end 10 end 13 p 14 ( 15 co₂ 15 co₂ 16 ) 17 ( 18 normo 18 normo 19 ) 20 restored 22 kinetics 21 lbf 22 kinetics 22 kinetics 24 but 22 kinetics 28 o₂p 22 kinetics 32 which 24 but 25 not 24 but 26 v 27 ( 28 o₂p 28 o₂p 29 ) 31 , 32 which 32 which 33 remained 32 which 40 . 33 remained 37 relative 33 remained 38 to 35 slowed 37 relative 38 to 39 con these data suggest that the hyperventilation manoeuvre itself [(] i.e . independent [of] induced hypocapnic alkalosis [ )(may contribute to the slower [v] [(] [o₂p] ) kinetics observed during hypo . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 11 . 0 ###LEFT-WALL### 31 . 1 these 2 data 2 data 3 suggest 3 suggest 4 that 4 that 6 hyperventilation 4 that 7 manoeuvre 5 the 6 hyperventilation 7 manoeuvre 8 itself 7 manoeuvre 10 i.e 11 . 16 alkalosis 11 . 19 contribute 12 independent 16 alkalosis 14 induced 16 alkalosis 15 hypocapnic 16 alkalosis 16 alkalosis 18 )(may 18 )(may 19 contribute 19 contribute 20 to 19 contribute 29 during 20 to 27 kinetics 21 the 27 kinetics 22 slower 26 ) 22 slower 27 kinetics 27 kinetics 28 observed 29 during 30 hypo background : older people are exposed to multiple medicines that possess anticholinergic properties . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 people 2 : 6 exposed 2 : 14 . 3 older 4 people 4 people 5 are 5 are 6 exposed 6 exposed 7 to 7 to 9 medicines 8 multiple 9 medicines 9 medicines 10 that 9 medicines 11 possess 10 that 11 possess 11 possess 13 properties 12 anticholinergic 13 properties the use of anticholinergic medicines is associated with the risk of morbidity , mortality and cognitive decline , particularly in older people . 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 23 . 1 the 2 use 2 use 3 of 2 use 6 is 3 of 5 medicines 4 anticholinergic 5 medicines 6 is 7 associated 7 associated 8 with 7 associated 19 particularly 8 with 10 risk 9 the 10 risk 10 risk 11 of 11 of 12 morbidity 12 morbidity 15 and 13 , 15 and 14 mortality 15 and 15 and 17 decline 15 and 18 , 16 cognitive 17 decline 19 particularly 20 in 20 in 22 people 21 older 22 people anticholinergic exposure can be measured using tools such as the drug burden index - anticholinergic component ( dbi - ach ) and the anticholinergic drug scale ( ads ) . 0 ###LEFT-WALL### 1 anticholinergic 0 ###LEFT-WALL### 4 be 0 ###LEFT-WALL### 30 . 1 anticholinergic 4 be 2 exposure 3 can 3 can 4 be 4 be 5 measured 5 measured 6 using 6 using 22 and 7 tools 9 as 7 tools 22 and 8 such 9 as 9 as 13 index 10 the 13 index 11 drug 12 burden 12 burden 13 index 13 index 20 ach 14 - 20 ach 15 anticholinergic 20 ach 16 component 18 dbi 16 component 19 - 16 component 20 ach 17 ( 18 dbi 18 dbi 19 - 20 ach 21 ) 22 and 26 scale 22 and 28 ads 23 the 26 scale 24 anticholinergic 25 drug 25 drug 26 scale 27 ( 28 ads 28 ads 29 ) objective : the aim of this population - level study was to determine the extent of anticholinergic exposure in older people , particularly among those receiving acetylcholinesterase inhibitors in new zealand . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 1 objective 2 : 2 : 4 aim 2 : 23 particularly 2 : 29 in 3 the 4 aim 4 aim 5 of 5 of 7 population 6 this 7 population 7 population 9 level 8 - 9 level 9 level 10 study 9 level 13 determine 9 level 22 , 10 study 11 was 11 was 12 to 11 was 13 determine 12 to 13 determine 13 determine 15 extent 13 determine 19 in 14 the 15 extent 15 extent 16 of 16 of 18 exposure 17 anticholinergic 18 exposure 19 in 21 people 20 older 21 people 23 particularly 24 among 24 among 28 inhibitors 25 those 28 inhibitors 26 receiving 27 acetylcholinesterase 27 acetylcholinesterase 28 inhibitors 29 in 31 zealand 30 new 31 zealand methods : the study used data extracted from pharmaceutical claims data mart ( pharms ) for the year 2011 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 methods 2 : 2 : 6 data 3 the 6 data 4 study 5 used 5 used 6 data 6 data 7 extracted 7 extracted 8 from 7 extracted 16 for 8 from 12 mart 9 pharmaceutical 10 claims 10 claims 11 data 11 data 12 mart 12 mart 14 pharms 13 ( 14 pharms 14 pharms 15 ) 16 for 18 year 17 the 18 year 18 year 19 2011 a total of 537,387 individuals aged 65 years and older were included in the study [,] of whom 45.10 % were men . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 12 included 0 ###LEFT-WALL### 23 . 1 a 2 total 2 total 3 of 2 total 5 individuals 2 total 11 were 2 total 12 included 3 of 4 537,387 5 individuals 6 aged 5 individuals 11 were 6 aged 9 and 7 65 8 years 8 years 9 and 9 and 10 older 12 included 13 in 12 included 22 men 13 in 15 study 14 the 15 study 15 study 17 of 17 of 18 whom 18 whom 20 % 18 whom 21 were 19 45.10 20 % 20 % 21 were individuals dispensed donepezil at any time during 2011 were selected as the acetylcholinesterase inhibitor ( achei ) [group] ( n = 4,258 [ )( the remainder were included in [the] [non] - acetylcholinesterase inhibitor [(] [non] - achei ) [group] ( n = 533,129 ) . 0 ###LEFT-WALL### 1 individuals 0 ###LEFT-WALL### 2 dispensed 1 individuals 2 dispensed 2 dispensed 3 donepezil 3 donepezil 4 at 3 donepezil 10 selected 3 donepezil 11 as 4 at 5 any 5 any 6 time 5 any 9 were 6 time 7 during 6 time 9 were 7 during 8 2011 11 as 14 inhibitor 12 the 14 inhibitor 13 acetylcholinesterase 14 inhibitor 14 inhibitor 16 achei 14 inhibitor 21 = 15 ( 16 achei 16 achei 17 ) 19 ( 21 = 20 n 21 = 21 = 22 4,258 22 4,258 26 remainder 22 4,258 29 in 22 4,258 34 inhibitor 25 the 26 remainder 26 remainder 27 were 27 were 28 included 28 included 29 in 32 - 34 inhibitor 33 acetylcholinesterase 34 inhibitor 34 inhibitor 38 achei 34 inhibitor 43 = 34 inhibitor 46 . 37 - 38 achei 38 achei 39 ) 41 ( 43 = 42 n 43 = 43 = 44 533,129 43 = 45 ) anticholinergic exposure was measured using the dbi - ach and the ads . 0 ###LEFT-WALL### 2 exposure 0 ###LEFT-WALL### 4 measured 1 anticholinergic 2 exposure 2 exposure 3 was 3 was 4 measured 4 measured 5 using 5 using 7 dbi 6 the 7 dbi 7 dbi 10 and 8 - 10 and 9 ach 10 and 10 and 12 ads 10 and 13 . 11 the 12 ads results : analysis of the pharms dataset revealed that , in 2011 , anticholinergic exposure [as] defined by the dbi - ach and the ads was 31.80 [%] and 52.66 % , respectively . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 analysis 2 : 8 revealed 2 : 21 - 3 analysis 4 of 3 analysis 8 revealed 4 of 7 dataset 5 the 7 dataset 6 pharms 7 dataset 8 revealed 9 that 8 revealed 11 in 10 , 11 in 11 in 12 2011 11 in 21 - 12 2011 15 exposure 13 , 15 exposure 14 anticholinergic 15 exposure 15 exposure 17 defined 15 exposure 18 by 15 exposure 21 - 18 by 20 dbi 19 the 20 dbi 21 - 22 ach 21 - 23 and 23 and 25 ads 23 and 26 was 24 the 25 ads 25 ads 26 was 26 was 31 % 26 was 33 respectively 27 31.80 29 and 29 and 30 52.66 29 and 31 % 32 , 33 respectively 33 respectively 34 . the mean number of medicines dispensed was 5.64 ± 3.91 ( ± sd ) with a 95 % confidence interval of 5.63 - 5.65 . 0 ###LEFT-WALL### 3 number 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 25 . 1 the 3 number 2 mean 3 number 3 number 4 of 3 number 7 was 4 of 5 medicines 5 medicines 6 dispensed 7 was 9 ± 7 was 15 with 8 5.64 9 ± 9 ± 10 3.91 9 ± 13 sd 11 ( 13 sd 12 ± 13 sd 13 sd 14 ) 15 with 20 interval 16 a 20 interval 17 95 18 % 18 % 19 confidence 19 confidence 20 interval 20 interval 21 of 21 of 23 - 22 5.63 23 - 23 - 24 5.65 in the achei group , anticholinergic exposure using the dbi - ach and [the] ads was 42.93 % ( median 0 ; interquartile range ( iqr [ )(1 [ )(and 58.50 % [(] median 0 [;] iqr 0 ) , respectively . 0 ###LEFT-WALL### 15 ads 0 ###LEFT-WALL### 16 was 0 ###LEFT-WALL### 22 ; 0 ###LEFT-WALL### 23 interquartile 1 in 4 group 1 in 11 - 1 in 15 ads 2 the 4 group 3 achei 4 group 4 group 7 exposure 5 , 7 exposure 6 anticholinergic 7 exposure 7 exposure 8 using 7 exposure 11 - 8 using 10 dbi 9 the 10 dbi 12 ach 13 and 13 and 15 ads 15 ads 16 was 16 was 18 % 17 42.93 18 % 18 % 20 median 19 ( 20 median 20 median 21 0 20 median 22 ; 22 ; 23 interquartile 23 interquartile 24 range 23 interquartile 41 respectively 24 range 37 iqr 25 ( 37 iqr 26 iqr 28 )(1 26 iqr 30 )(and 30 )(and 34 median 30 )(and 37 iqr 31 58.50 32 % 32 % 34 median 34 median 35 0 37 iqr 38 0 37 iqr 39 ) 40 , 41 respectively 41 respectively 42 . ads level 3 medicines such as amitriptyline , nortriptyline and oxybutynin were commonly prescribed in both groups . 0 ###LEFT-WALL### 1 ads 0 ###LEFT-WALL### 2 level 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 18 . 1 ads 2 level 2 level 4 medicines 3 3 4 medicines 4 medicines 6 as 5 such 6 as 6 as 7 amitriptyline 8 , 10 and 8 , 14 prescribed 9 nortriptyline 10 and 10 and 11 oxybutynin 10 and 12 were 12 were 14 prescribed 13 commonly 14 prescribed 14 prescribed 15 in 15 in 17 groups 16 both 17 groups amitriptyline , nortriptyline , oxybutynin and paroxetine are medicines considered to have significant anticholinergic potency . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 16 . 1 amitriptyline 2 , 2 , 3 nortriptyline 2 , 4 , 4 , 5 oxybutynin 4 , 6 and 6 and 7 paroxetine 6 and 8 are 8 are 9 medicines 9 medicines 10 considered 10 considered 11 to 10 considered 12 have 11 to 12 have 12 have 15 potency 13 significant 15 potency 14 anticholinergic 15 potency of these medicines , nortriptyline and oxybutynin were more frequently prescribed in individuals taking donepezil . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 prescribed 0 ###LEFT-WALL### 16 . 1 of 3 medicines 1 of 4 , 1 of 6 and 2 these 3 medicines 5 nortriptyline 6 and 6 and 7 oxybutynin 6 and 8 were 8 were 11 prescribed 9 more 10 frequently 10 frequently 11 prescribed 11 prescribed 12 in 12 in 13 individuals 13 individuals 14 taking 14 taking 15 donepezil conclusions : a significant proportion of older people [are] exposed to medicines with anticholinergic properties , including those dispensed acetylcholinesterase inhibitors . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 1 conclusions 2 : 2 : 5 proportion 3 a 4 significant 3 a 5 proportion 4 significant 5 proportion 5 proportion 6 of 5 proportion 10 exposed 5 proportion 17 including 6 of 8 people 7 older 8 people 10 exposed 11 to 11 to 12 medicines 12 medicines 13 with 13 with 15 properties 14 anticholinergic 15 properties 16 , 17 including 17 including 21 inhibitors 17 including 22 . 18 those 21 inhibitors 19 dispensed 20 acetylcholinesterase 20 acetylcholinesterase 21 inhibitors further research is required to explore associations between different measures of anticholinergic exposure and clinically relevant outcomes in older people on a population level . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 required 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 further 2 research 2 research 3 is 3 is 4 required 4 required 5 to 4 required 6 explore 5 to 6 explore 6 explore 7 associations 6 explore 8 between 8 between 10 measures 9 different 10 measures 10 measures 11 of 11 of 13 exposure 12 anticholinergic 13 exposure 14 and 17 outcomes 14 and 24 level 15 clinically 17 outcomes 16 relevant 17 outcomes 17 outcomes 18 in 17 outcomes 24 level 18 in 20 people 19 older 20 people 20 people 21 on 21 on 23 population 22 a 23 population none none background : with the expected rise in newly diagnosed cancer cases among the elderly in singapore , the affordability of cancer treatments , particularly of targeted therapies , will be a growing concern for patients . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 32 be 0 ###LEFT-WALL### 38 . 1 none 2 none 1 none 13 cases 1 none 31 will 2 none 3 background 2 none 4 : 2 none 13 cases 3 background 4 : 4 : 5 with 4 : 9 in 5 with 8 rise 6 the 8 rise 7 expected 8 rise 9 in 12 cancer 10 newly 11 diagnosed 11 diagnosed 12 cancer 13 cases 14 among 13 cases 17 in 14 among 16 elderly 15 the 16 elderly 17 in 18 singapore 18 singapore 21 affordability 19 , 21 affordability 20 the 21 affordability 21 affordability 22 of 21 affordability 27 of 21 affordability 30 , 22 of 24 treatments 23 cancer 24 treatments 25 , 26 particularly 25 , 27 of 27 of 29 therapies 27 of 30 , 28 targeted 29 therapies 31 will 32 be 32 be 35 concern 33 a 35 concern 34 growing 35 concern 35 concern 36 for 36 for 37 patients this study examines the perspectives of aging cancer patients on the financial burden of their cancer treatments . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examines 0 ###LEFT-WALL### 18 . 1 this 2 study 2 study 3 examines 3 examines 5 perspectives 4 the 5 perspectives 5 perspectives 6 of 6 of 7 aging 7 aging 9 patients 7 aging 10 on 8 cancer 9 patients 10 on 13 burden 11 the 13 burden 12 financial 13 burden 13 burden 14 of 14 of 17 treatments 15 their 17 treatments 16 cancer 17 treatments methods : a single - center , prospective study was conducted in the largest ambulatory cancer center in singapore . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 20 . 1 methods 2 : 2 : 6 center 3 a 4 single 3 a 6 center 4 single 5 - 4 single 6 center 7 , 9 study 7 , 11 conducted 8 prospective 9 study 9 study 10 was 10 was 11 conducted 11 conducted 12 in 11 conducted 18 in 12 in 17 center 13 the 14 largest 13 the 17 center 15 ambulatory 16 cancer 16 cancer 17 center 18 in 19 singapore older [(] 50 years old and above ) cancer patients receiving treatment were recruited . 0 ###LEFT-WALL### 5 old 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 15 . 1 older 5 old 3 50 4 years 4 years 5 old 6 and 10 patients 6 and 14 recruited 7 above 8 ) 7 above 10 patients 9 cancer 10 patients 10 patients 11 receiving 10 patients 13 were 11 receiving 12 treatment 13 were 14 recruited patients completed three sets of self [-] reporting tools assessing [their] ( a [ )(demographics and lifestyles , ( [b] [ )(health - related quality of life , and [(] [c] [ )(perceptions of cancer treatment costs . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 2 completed 0 ###LEFT-WALL### 38 . 1 patients 2 completed 2 completed 29 and 3 three 4 sets 4 sets 5 of 4 sets 29 and 5 of 10 assessing 6 self 9 tools 8 reporting 9 tools 9 tools 10 assessing 10 assessing 25 quality 12 ( 25 quality 13 a 25 quality 15 )(demographics 16 and 16 and 17 lifestyles 16 and 18 , 16 and 22 )(health 16 and 24 related 19 ( 22 )(health 22 )(health 23 - 24 related 25 quality 25 quality 26 of 25 quality 28 , 26 of 27 life 29 and 33 )(perceptions 29 and 34 of 34 of 37 costs 35 cancer 37 costs 36 treatment 37 costs the association between targeted therapy utilities and their perceived financial burden was evaluated using a multivariable logistic regression . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 13 evaluated 0 ###LEFT-WALL### 19 . 1 the 2 association 2 association 3 between 2 association 12 was 3 between 7 and 4 targeted 5 therapy 5 therapy 6 utilities 6 utilities 7 and 7 and 11 burden 8 their 11 burden 9 perceived 11 burden 10 financial 11 burden 12 was 13 evaluated 13 evaluated 14 using 14 using 18 regression 15 a 16 multivariable 15 a 18 regression 16 multivariable 18 regression 17 logistic 18 regression results : five hundred and sixteen patients were included in the study . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 7 patients 2 : 9 included 2 : 13 . 3 five 4 hundred 4 hundred 5 and 5 and 6 sixteen 6 sixteen 7 patients 7 patients 8 were 8 were 9 included 9 included 10 in 10 in 12 study 11 the 12 study the majority of the respondents ( 69.6 % ) were between 50 and 64 years old . 0 ###LEFT-WALL### 5 respondents 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 17 . 1 the 2 majority 2 majority 3 of 2 majority 5 respondents 3 of 5 respondents 4 the 5 respondents 5 respondents 8 % 5 respondents 10 were 6 ( 8 % 7 69.6 8 % 8 % 9 ) 10 were 11 between 10 were 16 old 11 between 13 and 12 50 13 and 13 and 14 64 14 64 15 years 15 years 16 old the majority were singaporeans ( 97.7 % ) , belonged to the ethnic chinese group ( 88.4 % ) , and most were female [(] 59.1 [%] [ )( 0 ###LEFT-WALL### 2 majority 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 29 )( 1 the 2 majority 2 majority 9 , 3 were 4 singaporeans 3 were 9 , 4 singaporeans 7 % 5 ( 7 % 6 97.7 7 % 7 % 8 ) 9 , 10 belonged 9 , 11 to 11 to 15 group 12 the 15 group 13 ethnic 15 group 14 chinese 15 group 15 group 18 % 16 ( 18 % 17 88.4 18 % 18 % 19 ) 20 , 21 and 21 and 22 most 21 and 23 were 22 most 23 were 23 were 24 female 24 female 26 59.1 the users of targeted therapies were 2.92 times more likely to perceive that the amount of cash that they spent on cancer treatment was more than expected and 2.52 times more likely to have difficulty paying for cancer treatments . 0 ###LEFT-WALL### 2 users 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 40 . 1 the 2 users 2 users 3 of 2 users 6 were 3 of 5 therapies 4 targeted 5 therapies 6 were 10 likely 7 2.92 8 times 8 times 9 more 9 more 10 likely 10 likely 11 to 11 to 12 perceive 12 perceive 13 that 12 perceive 28 and 12 perceive 33 to 14 the 15 amount 15 amount 16 of 15 amount 27 expected 15 amount 28 and 16 of 17 cash 17 cash 18 that 17 cash 20 spent 18 that 19 they 18 that 20 spent 19 they 20 spent 20 spent 21 on 20 spent 25 more 20 spent 26 than 21 on 22 cancer 22 cancer 23 treatment 22 cancer 24 was 23 treatment 24 was 28 and 31 more 29 2.52 30 times 30 times 31 more 32 likely 33 to 33 to 34 have 34 have 35 difficulty 35 difficulty 36 paying 35 difficulty 37 for 37 for 39 treatments 38 cancer 39 treatments fortunately , the majority of the respondents ( 70.6 % ) found their existing financial schemes helpful in reducing the necessary out [-] [of] - pocket expenses . 0 ###LEFT-WALL### 7 respondents 0 ###LEFT-WALL### 12 found 0 ###LEFT-WALL### 28 . 1 fortunately 2 , 1 fortunately 7 respondents 3 the 4 majority 4 majority 5 of 4 majority 7 respondents 5 of 7 respondents 6 the 7 respondents 7 respondents 10 % 7 respondents 12 found 8 ( 10 % 9 70.6 10 % 10 % 11 ) 12 found 16 schemes 13 their 16 schemes 14 existing 16 schemes 15 financial 16 schemes 16 schemes 17 helpful 17 helpful 18 in 18 in 19 reducing 19 reducing 27 expenses 20 the 27 expenses 21 necessary 26 pocket 22 out 25 - 22 out 26 pocket 26 pocket 27 expenses conclusions : although aging cancer patients feel that the financial schemes in singapore have helped them tremendously , the general perception is that they require further help to offset their out - [of] - pocket expenses . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 6 patients 2 : 7 feel 3 although 5 cancer 3 although 6 patients 4 aging 5 cancer 6 patients 7 feel 7 feel 8 that 8 that 11 schemes 8 that 15 helped 9 the 11 schemes 10 financial 11 schemes 11 schemes 12 in 11 schemes 14 have 12 in 13 singapore 14 have 15 helped 15 helped 16 them 15 helped 17 tremendously 15 helped 34 - 18 , 34 - 19 the 20 general 20 general 29 offset 20 general 34 - 21 perception 22 is 22 is 23 that 23 that 24 they 23 that 29 offset 24 they 25 require 25 require 27 help 25 require 28 to 26 further 27 help 28 to 29 offset 29 offset 31 out 29 offset 32 - 30 their 31 out 34 - 36 expenses 34 - 37 . 35 pocket 36 expenses this is especially true for users of targeted therapies and those who have [a] poorer health status . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 18 . 1 this 2 is 2 is 4 true 3 especially 4 true 4 true 5 for 5 for 6 users 6 users 7 of 7 of 10 and 8 targeted 9 therapies 9 therapies 10 and 10 and 11 those 10 and 12 who 10 and 13 have 12 who 13 have 13 have 17 status 15 poorer 16 health 16 health 17 status hiv - infected individuals suffer from accelerated aging , which manifests as premature cardiovascular and bone disease . 0 ###LEFT-WALL### 4 individuals 0 ###LEFT-WALL### 5 suffer 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 18 . 1 hiv 2 - 1 hiv 4 individuals 3 infected 4 individuals 4 individuals 5 suffer 5 suffer 6 from 6 from 8 aging 7 accelerated 8 aging 9 , 10 which 9 , 11 manifests 10 which 11 manifests 11 manifests 17 disease 12 as 13 premature 13 premature 17 disease 14 cardiovascular 15 and 15 and 16 bone 15 and 17 disease however , little is [known] of the association of these two disorders in the hiv population . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 3 little 3 little 4 is 4 is 6 of 4 is 13 in 6 of 8 association 7 the 8 association 8 association 9 of 9 of 12 disorders 10 these 11 two 11 two 12 disorders 13 in 16 population 14 the 16 population 15 hiv 16 population our objective was to investigate the association between a marker of atherosclerosis ( coronary artery calcium [ cac ] ) and low bone mineral density ( bmd ) in a cross - sectional cohort [of] hiv - infected patients . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 37 - 0 ###LEFT-WALL### 40 . 1 our 2 objective 2 objective 3 was 3 was 4 to 3 was 5 investigate 4 to 5 investigate 5 investigate 7 association 5 investigate 8 between 5 investigate 29 in 6 the 7 association 8 between 21 and 9 a 10 marker 10 marker 11 of 10 marker 21 and 11 of 12 atherosclerosis 12 atherosclerosis 16 calcium 13 ( 16 calcium 14 coronary 16 calcium 15 artery 16 calcium 16 calcium 18 cac 16 calcium 20 ) 17 [ 18 cac 18 cac 19 ] 21 and 25 density 21 and 27 bmd 22 low 25 density 23 bone 25 density 24 mineral 25 density 26 ( 27 bmd 27 bmd 28 ) 29 in 31 cross 30 a 31 cross 31 cross 36 hiv 32 - 36 hiv 33 sectional 36 hiv 34 cohort 36 hiv 36 hiv 37 - 37 - 39 patients 38 infected 39 patients the study was conducted at the university of modena and reggio emilia , italy . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 15 . 1 the 2 study 2 study 3 was 3 was 4 conducted 4 conducted 5 at 5 at 7 university 6 the 7 university 7 university 8 of 8 of 10 and 9 modena 10 and 10 and 12 emilia 11 reggio 12 emilia 13 , 14 italy a total of 636 consecutive [middle] - aged , hiv - infected subjects were recruited between january 2006 and december 2010 . 0 ###LEFT-WALL### 2 total 0 ###LEFT-WALL### 15 recruited 0 ###LEFT-WALL### 22 . 1 a 2 total 2 total 3 of 2 total 14 were 3 of 13 subjects 4 636 13 subjects 5 consecutive 7 - 5 consecutive 13 subjects 8 aged 10 hiv 8 aged 13 subjects 9 , 10 hiv 10 hiv 11 - 12 infected 13 subjects 14 were 15 recruited 15 recruited 16 between 16 between 19 and 17 january 18 2006 17 january 19 and 19 and 20 december 20 december 21 2010 all patients underwent cac and bmd assessment . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 8 . 1 all 2 patients 2 patients 3 underwent 3 underwent 7 assessment 4 cac 5 and 5 and 6 bmd 6 bmd 7 assessment patients were categorized according to a cac score [<] 100 or >100 units based on previous literature that identified this cut - point as a marker of increased risk . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 14 based 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 30 . 1 patients 2 were 2 were 3 categorized 3 categorized 5 to 4 according 5 to 5 to 7 cac 6 a 7 cac 7 cac 11 or 7 cac 14 based 8 score 10 100 8 score 11 or 11 or 13 units 11 or 14 based 12 >100 13 units 14 based 15 on 15 on 17 literature 16 previous 17 literature 17 literature 19 identified 17 literature 21 cut 18 that 19 identified 20 this 21 cut 21 cut 22 - 22 - 23 point 23 point 24 as 24 as 26 marker 25 a 26 marker 26 marker 27 of 27 of 29 risk 28 increased 29 risk low femoral and lumbar spine bmd was defined as [<] 25th percentile value for the study cohort . 0 ###LEFT-WALL### 6 bmd 0 ###LEFT-WALL### 8 defined 0 ###LEFT-WALL### 18 . 1 low 6 bmd 2 femoral 3 and 3 and 4 lumbar 3 and 6 bmd 5 spine 6 bmd 6 bmd 7 was 7 was 8 defined 8 defined 9 as 8 defined 14 for 9 as 13 value 11 25th 13 value 12 percentile 13 value 14 for 17 cohort 15 the 17 cohort 16 study 17 cohort logistic regression and [bootstrap] analysis were used to assess the independent association between cac and bmd . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 used 1 logistic 2 regression 2 regression 3 and 3 and 5 analysis 3 and 6 were 6 were 7 used 7 used 8 to 7 used 9 assess 8 to 9 assess 9 assess 12 association 9 assess 13 between 10 the 12 association 11 independent 12 association 13 between 16 bmd 14 cac 15 and 15 and 16 bmd 16 bmd 17 . the main outcome measure was a cac score >100 . 0 ###LEFT-WALL### 4 measure 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 10 . 1 the 2 main 1 the 4 measure 3 outcome 4 measure 4 measure 5 was 5 was 9 >100 6 a 9 >100 7 cac 9 >100 8 score 9 >100 patients with cac > 100 were older and more likely to be men , diabetic , and overweight . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 19 . 1 patients 2 with 1 patients 14 , 2 with 3 cac 3 cac 5 100 3 cac 6 were 3 cac 10 likely 4 > 5 100 5 100 6 were 6 were 8 and 7 older 8 and 8 and 9 more 10 likely 11 to 10 likely 12 be 11 to 12 be 12 be 13 men 14 , 15 diabetic 14 , 17 and 16 , 17 and 17 and 18 overweight patients with cac < 100 had better [renal] function and a lower cardiovascular risk profile . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 16 . 1 patients 2 with 1 patients 10 and 2 with 3 cac 3 cac 5 100 3 cac 6 had 4 < 5 100 5 100 6 had 6 had 7 better 6 had 9 function 10 and 15 profile 11 a 15 profile 12 lower 15 profile 13 cardiovascular 15 profile 14 risk 15 profile [bootstrap] analyses confirmed these findings . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 confirmed 0 ###LEFT-WALL### 6 . 2 analyses 3 confirmed 3 confirmed 5 findings 4 these 5 findings in summary , cac was independently associated with low femoral bmd in hiv - infected patients . 0 ###LEFT-WALL### 2 summary 0 ###LEFT-WALL### 3 , 1 in 2 summary 3 , 4 cac 3 , 7 associated 3 , 14 - 4 cac 5 was 5 was 6 independently 5 was 7 associated 7 associated 8 with 7 associated 12 in 8 with 11 bmd 9 low 11 bmd 10 femoral 11 bmd 12 in 13 hiv 14 - 16 patients 14 - 17 . 15 infected 16 patients future studies should test whether therapies that attenuate cardiovascular risk in hiv favorably impact bone health . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 test 0 ###LEFT-WALL### 17 . 1 future 2 studies 2 studies 3 should 3 should 4 test 4 test 5 whether 5 whether 6 therapies 5 whether 14 impact 6 therapies 7 that 6 therapies 8 attenuate 6 therapies 14 impact 7 that 8 attenuate 8 attenuate 10 risk 8 attenuate 11 in 9 cardiovascular 10 risk 11 in 12 hiv 13 favorably 14 impact 14 impact 16 health 15 bone 16 health purpose : in this study , the author sought to investigate if [and] when the ability to process temporal - fine - structure ( tfs ) cues deteriorates with age in adults with audiometrically normal hearing sensitivity . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 38 . 1 purpose 2 : 2 : 3 in 3 in 5 study 4 this 5 study 6 , 8 author 6 , 9 sought 7 the 8 author 8 author 9 sought 9 sought 10 to 9 sought 11 investigate 10 to 11 investigate 11 investigate 12 if 11 investigate 29 with 12 if 14 when 14 when 16 ability 14 when 28 deteriorates 15 the 16 ability 16 ability 17 to 16 ability 18 process 16 ability 28 deteriorates 17 to 18 process 18 process 27 cues 19 temporal 23 structure 19 temporal 27 cues 20 - 23 structure 21 fine 22 - 21 fine 23 structure 23 structure 25 tfs 23 structure 26 ) 24 ( 25 tfs 25 tfs 26 ) 29 with 30 age 30 age 31 in 31 in 32 adults 32 adults 33 with 33 with 37 sensitivity 34 audiometrically 35 normal 35 normal 36 hearing 36 hearing 37 sensitivity method : using a cross - sectional design , the author assessed tfs sensitivity in 102 normal - hearing adults sampled from across the entire range of adulthood ( ages 18 - 90 years ) , using 2 psychophysical tests for the assessment [of] [within] - [and] across [-] ear tfs processing . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 11 author 2 : 12 assessed 3 using 5 cross 3 using 9 , 3 using 11 author 4 a 5 cross 5 cross 8 design 6 - 8 design 7 sectional 8 design 8 design 9 , 10 the 11 author 11 author 12 assessed 12 assessed 14 sensitivity 13 tfs 14 sensitivity 14 sensitivity 15 in 14 sensitivity 20 adults 14 sensitivity 21 sampled 15 in 19 hearing 16 102 19 hearing 17 normal 18 - 17 normal 19 hearing 20 adults 21 sampled 21 sampled 22 from 22 from 23 across 23 across 26 range 24 the 26 range 25 entire 26 range 26 range 27 of 27 of 28 adulthood 28 adulthood 32 - 28 adulthood 37 using 29 ( 32 - 30 ages 31 18 30 ages 32 - 32 - 34 years 32 - 35 ) 33 90 34 years 36 , 37 using 37 using 40 tests 37 using 48 across 38 2 40 tests 39 psychophysical 40 tests 40 tests 41 for 41 for 43 assessment 42 the 43 assessment 46 - 48 across 48 across 52 processing 48 across 53 . 50 ear 52 processing 51 tfs 52 processing results : both types of tfs sensitivity ( monaural and binaural ) declined gradually starting in young adulthood , with the earliest significant deficit already apparent in early midlife ( i.e [.] , between ages 40 and 49 years ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 1 results 2 : 2 : 4 types 2 : 20 with 3 both 4 types 4 types 5 of 4 types 15 starting 5 of 6 tfs 6 tfs 7 sensitivity 6 tfs 13 declined 7 sensitivity 10 and 7 sensitivity 13 declined 8 ( 10 and 9 monaural 10 and 10 and 11 binaural 10 and 12 ) 13 declined 14 gradually 15 starting 16 in 15 starting 18 adulthood 17 young 18 adulthood 19 , 20 with 20 with 24 deficit 20 with 25 already 20 with 26 apparent 20 with 40 ) 21 the 22 earliest 21 the 24 deficit 23 significant 24 deficit 26 apparent 27 in 27 in 29 midlife 28 early 29 midlife 29 midlife 31 i.e 30 ( 31 i.e 31 i.e 34 between 31 i.e 40 ) 33 , 34 between 34 between 37 and 34 between 40 ) 35 ages 36 40 35 ages 37 and 37 and 39 years 37 and 40 ) 38 49 39 years tfs sensitivity was not correlated with absolute sensitivity at the test frequency . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 13 . 1 tfs 2 sensitivity 2 sensitivity 3 was 3 was 4 not 3 was 6 with 3 was 9 at 4 not 5 correlated 6 with 8 sensitivity 7 absolute 8 sensitivity 9 at 12 frequency 10 the 12 frequency 11 test 12 frequency conclusions : some suprathreshold auditory processing abilities decline throughout adulthood , even when an individual 's peripheral hearing is clinically normal . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 7 abilities 2 : 11 , 2 : 22 . 3 some 7 abilities 4 suprathreshold 7 abilities 5 auditory 7 abilities 6 processing 7 abilities 7 abilities 11 , 8 decline 9 throughout 8 decline 11 , 9 throughout 10 adulthood 11 , 12 even 11 , 13 when 13 when 18 hearing 13 when 19 is 14 an 15 individual 15 individual 16 's 16 's 18 hearing 17 peripheral 18 hearing 18 hearing 19 is 19 is 20 clinically 19 is 21 normal these deficits are not captured by a conventional , audiometric hearing assessment but may contribute to the increasing difficulties with age to identify speech in noisy environments . 0 ###LEFT-WALL### 2 deficits 0 ###LEFT-WALL### 13 but 0 ###LEFT-WALL### 28 . 1 these 2 deficits 2 deficits 3 are 3 are 4 not 3 are 13 but 5 captured 6 by 5 captured 12 assessment 5 captured 13 but 6 by 11 hearing 7 a 11 hearing 8 conventional 9 , 8 conventional 11 hearing 10 audiometric 11 hearing 13 but 14 may 14 may 15 contribute 15 contribute 16 to 15 contribute 20 with 15 contribute 22 to 16 to 19 difficulties 17 the 19 difficulties 18 increasing 19 difficulties 20 with 21 age 22 to 23 identify 23 identify 24 speech 23 identify 25 in 25 in 27 environments 26 noisy 27 environments from a methodological point of view , the existence of such age effects warrants the use of age [-] matched participant groups when comparing normal and impaired peripheral hearing . 0 ###LEFT-WALL### 9 existence 0 ###LEFT-WALL### 14 warrants 0 ###LEFT-WALL### 30 . 1 from 4 point 1 from 9 existence 2 a 4 point 3 methodological 4 point 5 of 6 view 5 of 7 , 5 of 9 existence 8 the 9 existence 9 existence 10 of 9 existence 14 warrants 10 of 13 effects 11 such 13 effects 12 age 13 effects 14 warrants 16 use 14 warrants 23 when 15 the 16 use 16 use 17 of 17 of 22 groups 18 age 20 matched 20 matched 21 participant 21 participant 22 groups 23 when 24 comparing 24 comparing 26 and 25 normal 26 and 26 and 29 hearing 27 impaired 29 hearing 28 peripheral 29 hearing purpose [to] give an overview of the third in a series of research forums emerged from the second international conference on adult hearing screening ( ahs 2012 ) , which was held in cernobbio ( lake como , italy ) in june 2012 . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 3 give 0 ###LEFT-WALL### 44 . 1 purpose 3 give 3 give 5 overview 3 give 20 conference 3 give 41 in 4 an 5 overview 5 overview 6 of 5 overview 12 of 6 of 8 third 7 the 8 third 8 third 9 in 9 in 11 series 10 a 11 series 12 of 13 research 13 research 14 forums 13 research 16 from 14 forums 15 emerged 15 emerged 16 from 17 the 18 second 17 the 20 conference 19 international 20 conference 20 conference 21 on 20 conference 30 which 21 on 24 screening 22 adult 23 hearing 23 hearing 24 screening 24 screening 26 ahs 25 ( 26 ahs 26 ahs 27 2012 26 ahs 28 ) 29 , 30 which 30 which 31 was 30 which 40 ) 31 was 32 held 32 held 33 in 33 in 34 cernobbio 34 cernobbio 37 como 35 ( 37 como 36 lake 37 como 37 como 39 italy 37 como 40 ) 38 , 39 italy 39 italy 40 ) 41 in 42 june 42 june 43 2012 the first two research forums , published in the previous [and] current issues of this journal , included several key contributions from the ahs meeting in 2 major topic areas , " hearing screening in adults and older adults " [(] vol [.] 22 , june 2013 [ )(and " aging and hearing [:] mechanisms and effects " ( this issue ) . 0 ###LEFT-WALL### 5 forums 0 ###LEFT-WALL### 6 , 1 the 2 first 1 the 3 two 3 two 5 forums 4 research 5 forums 6 , 17 , 7 published 8 in 7 published 13 issues 7 published 17 , 8 in 12 current 9 the 10 previous 9 the 12 current 13 issues 14 of 14 of 16 journal 15 this 16 journal 17 , 18 included 18 included 21 contributions 18 included 26 in 19 several 21 contributions 20 key 21 contributions 21 contributions 22 from 21 contributions 25 meeting 22 from 24 ahs 23 the 24 ahs 26 in 30 areas 27 2 30 areas 28 major 29 topic 29 topic 30 areas 30 areas 33 hearing 31 , 32 " 31 , 33 hearing 33 hearing 42 vol 34 screening 35 in 34 screening 42 vol 35 in 39 adults 36 adults 37 and 37 and 38 older 38 older 39 adults 39 adults 40 " 42 vol 44 22 42 vol 52 and 45 , 52 and 46 june 47 2013 46 june 49 )(and 49 )(and 50 " 49 )(and 51 aging 49 )(and 52 and 52 and 57 effects 52 and 61 issue 52 and 63 . 53 hearing 55 mechanisms 55 mechanisms 56 and 56 and 57 effects 57 effects 58 " 59 ( 61 issue 60 this 61 issue 61 issue 62 ) in the 7 articles showcased in this research forum on " intervention and rehabilitation strategies for adults and older adults , " the authors provide a multifaceted view on recent advancements in intervention strategies for adults with hearing loss [,] with ample emphasis on auditory training [;] discuss the research challenges that need to be tackled in this field [;] and explore new ways to take into account the individual needs and obtain a deeper understanding of the peculiar attributes of hearing in older adults [.] 0 ###LEFT-WALL### 4 articles 0 ###LEFT-WALL### 5 showcased 1 in 3 7 1 in 4 articles 2 the 3 7 4 articles 5 showcased 5 showcased 6 in 5 showcased 9 forum 5 showcased 10 on 6 in 8 research 7 this 8 research 10 on 11 " 10 on 13 and 12 intervention 13 and 13 and 15 strategies 14 rehabilitation 15 strategies 15 strategies 16 for 16 for 18 and 17 adults 18 and 18 and 20 adults 18 and 21 , 18 and 24 authors 18 and 25 provide 18 and 29 on 19 older 20 adults 21 , 22 " 23 the 24 authors 24 authors 25 provide 25 provide 28 view 26 a 28 view 27 multifaceted 28 view 29 on 31 advancements 30 recent 31 advancements 31 advancements 32 in 32 in 34 strategies 33 intervention 34 strategies 34 strategies 35 for 34 strategies 37 with 35 for 36 adults 37 with 38 hearing 38 hearing 39 loss 38 hearing 48 discuss 39 loss 41 with 39 loss 44 on 41 with 43 emphasis 42 ample 43 emphasis 44 on 46 training 45 auditory 46 training 48 discuss 51 challenges 48 discuss 54 to 49 the 51 challenges 50 research 51 challenges 51 challenges 52 that 51 challenges 53 need 52 that 53 need 54 to 61 and 55 be 56 tackled 55 be 61 and 56 tackled 57 in 57 in 59 field 58 this 59 field 61 and 62 explore 61 and 64 ways 63 new 64 ways 64 ways 65 to 64 ways 73 obtain 65 to 72 and 66 take 68 account 66 take 71 needs 66 take 72 and 67 into 68 account 69 the 71 needs 70 individual 71 needs 72 and 73 obtain 73 obtain 76 understanding 73 obtain 83 in 74 a 76 understanding 75 deeper 76 understanding 76 understanding 77 of 77 of 80 attributes 78 the 80 attributes 79 peculiar 80 attributes 80 attributes 81 of 81 of 82 hearing 83 in 85 adults 84 older 85 adults purpose this research forum , " aging and hearing : mechanisms and effects , " highlights 6 contributions presented at the 2nd international conference on adult hearing screening ( ahs 2012 ) , held in cernobbio ( lake como , italy ) in june 2012 . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 10 : 0 ###LEFT-WALL### 46 . 1 purpose 2 this 2 this 3 research 3 research 4 forum 4 forum 5 , 5 , 6 " 5 , 7 aging 5 , 8 and 8 and 9 hearing 10 : 12 and 10 : 34 held 11 mechanisms 12 and 12 and 13 effects 12 and 16 highlights 12 and 34 held 14 , 15 " 14 , 16 highlights 16 highlights 17 6 16 highlights 18 contributions 16 highlights 19 presented 16 highlights 30 ahs 16 highlights 33 , 18 contributions 19 presented 19 presented 20 at 20 at 24 conference 21 the 24 conference 22 2nd 23 international 23 international 24 conference 24 conference 25 on 25 on 28 screening 26 adult 27 hearing 27 hearing 28 screening 29 ( 30 ahs 30 ahs 31 2012 30 ahs 32 ) 34 held 35 in 34 held 36 cernobbio 34 held 43 in 36 cernobbio 39 como 37 ( 39 como 38 lake 39 como 39 como 41 italy 39 como 42 ) 40 , 41 italy 41 italy 42 ) 43 in 44 june 44 june 45 2012 overall , the articles in this research forum give insight into the causes , mechanisms , and consequences of auditory dysfunctions in adults , with particular focus on their implications for screening , assessment , and intervention . 0 ###LEFT-WALL### 4 articles 0 ###LEFT-WALL### 9 give 0 ###LEFT-WALL### 33 , 0 ###LEFT-WALL### 38 . 1 overall 2 , 1 overall 4 articles 3 the 4 articles 4 articles 5 in 4 articles 9 give 5 in 8 forum 6 this 8 forum 7 research 8 forum 9 give 10 insight 9 give 17 and 9 give 22 in 9 give 25 with 10 insight 11 into 10 insight 15 mechanisms 11 into 13 causes 12 the 13 causes 14 , 15 mechanisms 15 mechanisms 16 , 16 , 17 and 17 and 18 consequences 18 consequences 19 of 19 of 21 dysfunctions 20 auditory 21 dysfunctions 22 in 23 adults 24 , 25 with 25 with 27 focus 25 with 33 , 26 particular 27 focus 27 focus 28 on 28 on 30 implications 29 their 30 implications 30 implications 31 for 31 for 32 screening 33 , 36 and 34 assessment 36 and 35 , 36 and 36 and 37 intervention despite the extensive use of botulinum toxin type a ( bont - a ) in treatments for glabellar frown lines , the dose - response effect in the glabellar muscles remains unknown . 0 ###LEFT-WALL### 26 effect 0 ###LEFT-WALL### 31 remains 0 ###LEFT-WALL### 33 . 1 despite 4 use 1 despite 26 effect 2 the 4 use 3 extensive 4 use 4 use 5 of 4 use 15 in 4 use 17 for 5 of 8 type 6 botulinum 8 type 7 toxin 8 type 8 type 9 a 8 type 12 - 10 ( 12 - 11 bont 12 - 12 - 13 a 12 - 14 ) 15 in 16 treatments 17 for 20 lines 18 glabellar 19 frown 19 frown 20 lines 20 lines 23 dose 21 , 23 dose 22 the 23 dose 23 dose 24 - 25 response 26 effect 26 effect 27 in 26 effect 31 remains 27 in 30 muscles 28 the 30 muscles 29 glabellar 30 muscles 31 remains 32 unknown the aim of this randomized [,] double - blind , placebo [-] controlled prospective study was to characterize the neurophysiological parameters that correlate with the effect of bont - a in the glabellar muscles and its diffusion to surrounding ocular muscles . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 29 - 1 the 2 aim 2 aim 3 of 2 aim 16 was 3 of 15 study 4 this 15 study 5 randomized 11 placebo 7 double 8 - 7 double 11 placebo 9 blind 10 , 9 blind 11 placebo 11 placebo 13 controlled 13 controlled 15 study 14 prospective 15 study 16 was 17 to 16 was 18 characterize 17 to 18 characterize 18 characterize 21 parameters 18 characterize 24 with 19 the 21 parameters 20 neurophysiological 21 parameters 21 parameters 22 that 21 parameters 23 correlate 22 that 23 correlate 24 with 26 effect 25 the 26 effect 26 effect 27 of 27 of 28 bont 29 - 41 muscles 29 - 42 . 30 a 31 in 31 in 41 muscles 32 the 34 muscles 33 glabellar 34 muscles 34 muscles 35 and 35 and 37 diffusion 35 and 38 to 35 and 41 muscles 36 its 37 diffusion 38 to 39 surrounding 40 ocular 41 muscles sixteen healthy women were recruited and randomized to 3 different dose [-] groups of onabotulinumtoxin a ( vistabel® ) or placebo and followed 24 weeks by neuro - physiological examinations . 0 ###LEFT-WALL### 3 women 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 31 . 1 sixteen 3 women 2 healthy 3 women 3 women 22 and 4 were 6 and 4 were 22 and 5 recruited 6 and 6 and 7 randomized 6 and 8 to 6 and 20 or 8 to 9 3 10 different 11 dose 11 dose 13 groups 13 groups 14 of 13 groups 20 or 14 of 15 onabotulinumtoxin 15 onabotulinumtoxin 16 a 15 onabotulinumtoxin 18 vistabel® 17 ( 18 vistabel® 18 vistabel® 19 ) 20 or 21 placebo 22 and 23 followed 23 followed 25 weeks 23 followed 26 by 24 24 25 weeks 26 by 30 examinations 27 neuro 28 - 27 neuro 30 examinations 29 physiological 30 examinations efficacy of treatment on corrugator supercilii muscles was measured by compound motor action potential ( cmap ) and electromyography ( emg ) . 0 ###LEFT-WALL### 1 efficacy 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 23 . 1 efficacy 2 of 1 efficacy 8 was 2 of 3 treatment 3 treatment 4 on 4 on 7 muscles 5 corrugator 7 muscles 6 supercilii 7 muscles 8 was 18 and 9 measured 10 by 9 measured 18 and 10 by 14 potential 11 compound 14 potential 12 motor 14 potential 13 action 14 potential 14 potential 16 cmap 15 ( 16 cmap 16 cmap 17 ) 18 and 19 electromyography 18 and 21 emg 20 ( 21 emg 21 emg 22 ) photographs were used to score glabellar frown lines . 0 ###LEFT-WALL### 1 photographs 0 ###LEFT-WALL### 3 used 0 ###LEFT-WALL### 9 . 1 photographs 2 were 2 were 3 used 3 used 4 to 3 used 5 score 4 to 5 score 5 score 8 lines 6 glabellar 7 frown 7 frown 8 lines diffusion of the drug to surrounding muscles was assessed by cmap of the nasalis muscle , emg and concentric needle electrode [jitter] analysis ( cne ) of the orbicularis oculi muscle . 0 ###LEFT-WALL### 1 diffusion 0 ###LEFT-WALL### 9 assessed 0 ###LEFT-WALL### 32 . 1 diffusion 2 of 1 diffusion 5 to 1 diffusion 8 was 2 of 4 drug 3 the 4 drug 5 to 6 surrounding 6 surrounding 7 muscles 8 was 9 assessed 9 assessed 10 by 10 by 11 cmap 11 cmap 12 of 11 cmap 18 and 11 cmap 20 needle 11 cmap 25 cne 11 cmap 27 of 12 of 14 nasalis 13 the 14 nasalis 15 muscle 16 , 16 , 17 emg 16 , 18 and 18 and 19 concentric 18 and 20 needle 20 needle 23 analysis 21 electrode 23 analysis 24 ( 25 cne 25 cne 26 ) 27 of 29 orbicularis 28 the 29 orbicularis 29 orbicularis 30 oculi 29 orbicularis 31 muscle 30 oculi 31 muscle cmap reduction correlated well with intramuscular bont - a dose . 0 ###LEFT-WALL### 2 reduction 0 ###LEFT-WALL### 3 correlated 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 11 . 1 cmap 2 reduction 2 reduction 3 correlated 3 correlated 4 well 3 correlated 5 with 5 with 7 bont 6 intramuscular 7 bont 8 - 10 dose 9 a 10 dose muscle paralysis , measured by emg , began from 2 weeks and was not entirely reversed at 24 weeks in individuals who received high dose of onabotulinumtoxin . 0 ###LEFT-WALL### 2 paralysis 0 ###LEFT-WALL### 16 reversed 0 ###LEFT-WALL### 28 . 1 muscle 2 paralysis 2 paralysis 4 measured 2 paralysis 12 and 3 , 4 measured 4 measured 5 by 4 measured 7 , 5 by 6 emg 8 began 9 from 8 began 12 and 9 from 11 weeks 10 2 11 weeks 12 and 13 was 13 was 14 not 13 was 16 reversed 15 entirely 16 reversed 16 reversed 17 at 17 at 18 24 18 24 19 weeks 18 24 25 dose 18 24 26 of 19 weeks 20 in 19 weeks 22 who 19 weeks 23 received 19 weeks 25 dose 20 in 21 individuals 22 who 23 received 23 received 24 high 26 of 27 onabotulinumtoxin limited diffusion of orbicularis oculi was detected with cne . 0 ###LEFT-WALL### 2 diffusion 0 ###LEFT-WALL### 7 detected 0 ###LEFT-WALL### 10 . 1 limited 2 diffusion 2 diffusion 3 of 2 diffusion 6 was 3 of 5 oculi 4 orbicularis 5 oculi 6 was 7 detected 7 detected 8 with 8 with 9 cne in conclusion , we developed a novel neurophysiological strategy for effect [evaluation] of bont - a in glabellar muscles . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 1 in 2 conclusion 3 , 4 we 3 , 5 developed 3 , 15 - 4 we 5 developed 5 developed 9 strategy 6 a 7 novel 6 a 9 strategy 7 novel 9 strategy 8 neurophysiological 9 strategy 9 strategy 10 for 9 strategy 13 of 10 for 11 effect 13 of 14 bont 15 - 19 muscles 15 - 20 . 16 a 17 in 17 in 19 muscles 18 glabellar 19 muscles cmap and emg correlated with given bont - a dose and [are] more defined effect measures than clinical glabellar photo scales . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 8 - 1 cmap 2 and 2 and 3 emg 3 emg 4 correlated 3 emg 5 with 5 with 7 bont 6 given 7 bont 8 - 15 effect 8 - 16 measures 8 - 22 . 9 a 10 dose 10 dose 11 and 11 and 13 more 11 and 15 effect 14 defined 15 effect 15 effect 16 measures 16 measures 17 than 16 measures 21 scales 17 than 20 photo 18 clinical 20 photo 19 glabellar 20 photo background : older adults undergo operations as our population ages . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 adults 2 : 5 undergo 2 : 11 . 3 older 4 adults 4 adults 5 undergo 5 undergo 6 operations 5 undergo 7 as 7 as 10 ages 8 our 10 ages 9 population 10 ages increasing life expectancy and disease burden , along with decreased functional status and organ reserve , place the elderly surgical patient at higher general risk in the perioperative state . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 17 place 0 ###LEFT-WALL### 30 . 1 increasing 2 life 2 life 3 expectancy 3 expectancy 4 and 4 and 6 burden 4 and 9 with 4 and 17 place 5 disease 6 burden 7 , 9 with 8 along 9 with 9 with 13 and 9 with 16 , 10 decreased 12 status 11 functional 12 status 12 status 13 and 13 and 15 reserve 14 organ 15 reserve 17 place 21 patient 17 place 26 in 18 the 21 patient 19 elderly 21 patient 20 surgical 21 patient 21 patient 22 at 22 at 25 risk 23 higher 24 general 24 general 25 risk 26 in 29 state 27 the 29 state 28 perioperative 29 state in particular , these patients have more diseases including dementia and medications that put them [specifically] at higher risk of delirium . 0 ###LEFT-WALL### 5 patients 0 ###LEFT-WALL### 6 have 0 ###LEFT-WALL### 22 . 1 in 2 particular 2 particular 3 , 2 particular 5 patients 4 these 5 patients 5 patients 6 have 6 have 8 diseases 7 more 8 diseases 8 diseases 9 including 9 including 11 and 10 dementia 11 and 11 and 12 medications 11 and 13 that 11 and 14 put 13 that 14 put 14 put 15 them 14 put 17 at 17 at 19 risk 18 higher 19 risk 19 risk 20 of 20 of 21 delirium purpose : this overview describes the diagnosis , pathophysiology , and treatment of delirium and its interface with depression and dementia , and explains aging changes based on the picture of perioperative management in surgical interventions . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 4 overview 2 : 23 and 2 : 37 . 3 this 4 overview 4 overview 23 and 5 describes 7 diagnosis 5 describes 23 and 6 the 7 diagnosis 7 diagnosis 20 and 8 , 20 and 9 pathophysiology 11 and 10 , 11 and 11 and 12 treatment 11 and 13 of 11 and 18 with 11 and 20 and 13 of 15 and 14 delirium 15 and 15 and 17 interface 16 its 17 interface 18 with 19 depression 20 and 21 dementia 20 and 22 , 23 and 24 explains 24 explains 26 changes 25 aging 26 changes 26 changes 27 based 26 changes 31 of 26 changes 34 in 27 based 28 on 28 on 30 picture 29 the 30 picture 31 of 33 management 32 perioperative 33 management 34 in 36 interventions 35 surgical 36 interventions conclusions : today , surgeons must be equipped to attend the geriatric patient 's needs . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 16 . 1 conclusions 2 : 2 : 3 today 4 , 5 surgeons 4 , 8 equipped 5 surgeons 6 must 6 must 7 be 7 be 8 equipped 8 equipped 9 to 9 to 10 attend 10 attend 15 needs 11 the 13 patient 12 geriatric 13 patient 13 patient 14 's 14 's 15 needs early recognition of comorbidities such as dementia and delirium as well as speedy and competent therapeutic treatment can limit consequences and impact . 0 ###LEFT-WALL### 2 recognition 0 ###LEFT-WALL### 19 limit 0 ###LEFT-WALL### 23 . 1 early 2 recognition 2 recognition 3 of 2 recognition 18 can 3 of 4 comorbidities 4 comorbidities 6 as 4 comorbidities 12 as 5 such 6 as 6 as 8 and 7 dementia 8 and 8 and 9 delirium 10 as 11 well 11 well 12 as 12 as 17 treatment 13 speedy 14 and 14 and 15 competent 14 and 17 treatment 16 therapeutic 17 treatment 18 can 19 limit 19 limit 21 and 20 consequences 21 and 21 and 22 impact unlabelled : the aim of this study was to assess the relationships between both a marker of bone formation and a marker of bone turnover [and] age , sex , and pubertal stage in a group ( n = 439 ) of healthy children and adolescents . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 , 0 ###LEFT-WALL### 47 . 1 unlabelled 2 : 2 : 4 aim 3 the 4 aim 4 aim 5 of 4 aim 7 study 4 aim 10 assess 5 of 6 this 7 study 8 was 8 was 9 to 8 was 10 assess 9 to 10 assess 10 assess 12 relationships 10 assess 13 between 11 the 12 relationships 13 between 20 and 14 both 20 and 15 a 16 marker 16 marker 17 of 16 marker 20 and 17 of 19 formation 18 bone 19 formation 20 and 22 marker 20 and 23 of 21 a 22 marker 23 of 27 age 24 bone 25 turnover 25 turnover 27 age 28 , 45 and 29 sex 31 and 30 , 31 and 31 and 33 stage 31 and 34 in 31 and 42 of 31 and 45 and 32 pubertal 33 stage 34 in 36 group 35 a 36 group 36 group 39 = 37 ( 39 = 38 n 39 = 39 = 40 439 39 = 41 ) 42 of 44 children 43 healthy 44 children 45 and 46 adolescents these reference data should be instrumental in interpretation of results . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 5 be 0 ###LEFT-WALL### 11 . 1 these 3 data 2 reference 3 data 3 data 4 should 4 should 5 be 5 be 6 instrumental 6 instrumental 7 in 7 in 8 interpretation 8 interpretation 9 of 9 of 10 results introduction : the skeletal system has high metabolic activity . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 5 system 2 : 6 has 2 : 10 . 3 the 5 system 4 skeletal 5 system 5 system 6 has 6 has 9 activity 7 high 9 activity 8 metabolic 9 activity in children , bone markers may be useful in diagnostics and treatment management of skeletal diseases but there could be difficulties with interpretation of results . 0 ###LEFT-WALL### 5 markers 0 ###LEFT-WALL### 20 be 0 ###LEFT-WALL### 26 . 1 in 2 children 1 in 3 , 1 in 5 markers 4 bone 5 markers 5 markers 6 may 6 may 7 be 7 be 8 useful 8 useful 9 in 9 in 11 and 10 diagnostics 11 and 11 and 12 treatment 11 and 13 management 11 and 20 be 13 management 14 of 13 management 19 could 14 of 16 diseases 15 skeletal 16 diseases 16 diseases 17 but 17 but 18 there 19 could 20 be 20 be 21 difficulties 21 difficulties 22 with 22 with 23 interpretation 23 interpretation 24 of 24 of 25 results compared with adults , children have elevated bone marker levels due to high skeletal growth velocity and rapid bone turnover . 0 ###LEFT-WALL### 5 children 0 ###LEFT-WALL### 7 elevated 0 ###LEFT-WALL### 21 . 1 compared 2 with 1 compared 4 , 1 compared 5 children 2 with 3 adults 5 children 6 have 6 have 7 elevated 7 elevated 10 levels 7 elevated 12 to 8 bone 10 levels 9 marker 10 levels 11 due 12 to 12 to 17 and 13 high 15 growth 14 skeletal 15 growth 15 growth 16 velocity 16 velocity 17 and 17 and 20 turnover 18 rapid 19 bone 19 bone 20 turnover thus , valid age - and sex - specific reference data should be obtained for each pediatric population living in a particular climate and with a similar lifestyle . 0 ###LEFT-WALL### 11 data 0 ###LEFT-WALL### 14 obtained 0 ###LEFT-WALL### 29 . 1 thus 2 , 1 thus 11 data 3 valid 4 age 4 age 6 and 5 - 6 and 6 and 7 sex 6 and 8 - 6 and 11 data 9 specific 10 reference 10 reference 11 data 11 data 12 should 12 should 13 be 13 be 14 obtained 14 obtained 15 for 15 for 18 population 16 each 18 population 17 pediatric 18 population 18 population 19 living 18 population 24 and 20 in 23 climate 20 in 24 and 21 a 23 climate 22 particular 23 climate 24 and 25 with 25 with 28 lifestyle 26 a 28 lifestyle 27 similar 28 lifestyle the aim of this study was to assess the relationships between [both] a marker of bone formation ( procollagen type [i] n - terminal propeptide [ [pinp] []] [ )(and a marker of bone turnover ( osteocalcin [ oc ] ) [and] [age] , sex , and pubertal stage in a group of healthy children and adolescents . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 6 was 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 11 between 7 to 8 assess 8 assess 10 relationships 9 the 10 relationships 11 between 14 marker 13 a 14 marker 14 marker 15 of 15 of 17 formation 16 bone 17 formation 17 formation 23 - 18 ( 23 - 19 procollagen 20 type 20 type 22 n 20 type 23 - 23 - 30 )(and 24 terminal 25 propeptide 25 propeptide 30 )(and 26 [ 30 )(and 30 )(and 32 marker 31 a 32 marker 32 marker 33 of 33 of 35 turnover 34 bone 35 turnover 35 turnover 37 osteocalcin 35 turnover 47 and 36 ( 37 osteocalcin 37 osteocalcin 39 oc 37 osteocalcin 41 ) 38 [ 39 oc 39 oc 40 ] 44 , 47 and 45 sex 47 and 46 , 47 and 47 and 49 stage 47 and 50 in 47 and 53 of 47 and 58 . 48 pubertal 49 stage 50 in 52 group 51 a 52 group 53 of 56 and 54 healthy 55 children 55 children 56 and 56 and 57 adolescents methods : four hundred thirty - nine healthy caucasian children participated . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 - 1 methods 2 : 2 : 5 thirty 3 four 4 hundred 4 hundred 5 thirty 6 - 10 children 6 - 11 participated 6 - 12 . 7 nine 10 children 8 healthy 9 caucasian 9 caucasian 10 children 10 children 11 participated their height , weight , and pubertal stage were recorded . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 recorded 0 ###LEFT-WALL### 11 . 1 their 2 height 2 height 3 , 3 , 4 weight 3 , 6 and 5 , 6 and 6 and 8 stage 6 and 9 were 7 pubertal 8 stage 9 were 10 recorded fasting pinp and oc were measured using a morning blood sample . 0 ###LEFT-WALL### 1 fasting 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 12 . 1 fasting 5 were 2 pinp 3 and 3 and 4 oc 3 and 5 were 5 were 6 measured 6 measured 7 using 7 using 11 sample 8 a 9 morning 8 a 11 sample 9 morning 11 sample 10 blood 11 sample results : the highest levels of pinp were observed during the first year of life . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 levels 2 : 9 observed 2 : 16 . 3 the 4 highest 3 the 5 levels 5 levels 6 of 5 levels 8 were 6 of 7 pinp 8 were 9 observed 9 observed 10 during 10 during 13 year 11 the 12 first 11 the 13 year 13 year 14 of 14 of 15 life there is no oc postnatal peak , but levels are higher than the adult reference interval throughout childhood . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 8 but 0 ###LEFT-WALL### 19 . 1 there 2 is 2 is 6 peak 3 no 6 peak 4 oc 6 peak 5 postnatal 6 peak 7 , 8 but 8 but 9 levels 8 but 10 are 9 levels 10 are 10 are 11 higher 11 higher 12 than 11 higher 17 throughout 12 than 16 interval 13 the 16 interval 14 adult 16 interval 15 reference 16 interval 17 throughout 18 childhood oc peaks with the pubertal growth spurt at second [-] third tanner stage [of] breast development in girls and [at] second [-] third tanner stage of genital development in boys . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 31 . 1 oc 2 peaks 2 peaks 3 with 2 peaks 19 and 3 with 7 spurt 4 the 7 spurt 5 pubertal 6 growth 6 growth 7 spurt 7 spurt 8 at 7 spurt 17 in 8 at 16 development 9 second 15 breast 11 third 15 breast 12 tanner 15 breast 13 stage 15 breast 15 breast 16 development 17 in 18 girls 19 and 25 stage 19 and 26 of 21 second 25 stage 23 third 25 stage 24 tanner 25 stage 26 of 28 development 27 genital 28 development 28 development 29 in 29 in 30 boys pinp peaks during second [-] third tanner [stage] of breast development in girls and [at] third tanner stage of genital development in boys . 0 ###LEFT-WALL### 1 pinp 0 ###LEFT-WALL### 2 peaks 0 ###LEFT-WALL### 24 . 1 pinp 2 peaks 2 peaks 3 during 2 peaks 12 in 2 peaks 22 in 3 during 7 tanner 4 second 7 tanner 6 third 7 tanner 7 tanner 9 of 9 of 11 development 10 breast 11 development 12 in 14 and 13 girls 14 and 14 and 18 stage 14 and 19 of 16 third 18 stage 17 tanner 18 stage 19 of 21 development 20 genital 21 development 22 in 23 boys conclusion : this study provides reference data for oc and pinp in healthy caucasian children from a central european population . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 provides 2 : 21 . 3 this 4 study 4 study 5 provides 5 provides 7 data 5 provides 8 for 5 provides 12 in 6 reference 7 data 8 for 11 pinp 9 oc 10 and 10 and 11 pinp 12 in 15 children 13 healthy 14 caucasian 14 caucasian 15 children 15 children 16 from 16 from 20 population 17 a 20 population 18 central 19 european 19 european 20 population berberine ( brb ) , a natural alkaloid , has a long history of medicinal use in both ayurvedic and old chinese medicine . 0 ###LEFT-WALL### 3 brb 0 ###LEFT-WALL### 10 has 0 ###LEFT-WALL### 24 . 1 berberine 3 brb 2 ( 3 brb 3 brb 4 ) 3 brb 8 alkaloid 3 brb 10 has 5 , 8 alkaloid 6 a 7 natural 6 a 8 alkaloid 7 natural 8 alkaloid 8 alkaloid 9 , 10 has 13 history 10 has 17 in 11 a 12 long 11 a 13 history 12 long 13 history 13 history 14 of 14 of 16 use 15 medicinal 16 use 17 in 20 and 18 both 20 and 19 ayurvedic 20 and 20 and 23 medicine 21 old 22 chinese 22 chinese 23 medicine recently , available as a dietary supplement , berberine is reported to have application in treatment of variety diseases . 0 ###LEFT-WALL### 9 berberine 0 ###LEFT-WALL### 11 reported 0 ###LEFT-WALL### 20 . 1 recently 2 , 1 recently 9 berberine 2 , 3 available 3 available 4 as 3 available 8 , 3 available 9 berberine 4 as 7 supplement 5 a 6 dietary 5 a 7 supplement 6 dietary 7 supplement 9 berberine 10 is 10 is 11 reported 11 reported 12 to 11 reported 13 have 12 to 13 have 13 have 14 application 13 have 15 in 15 in 16 treatment 16 treatment 17 of 17 of 19 diseases 18 variety 19 diseases previously we observed that brb inhibited mtor/s6 signaling concurrently with reduction of the level of endogenous oxidants and constitutive dna damage response . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 observed 0 ###LEFT-WALL### 23 . 1 previously 2 we 2 we 3 observed 3 observed 4 that 4 that 5 brb 4 that 6 inhibited 5 brb 6 inhibited 6 inhibited 7 mtor/s6 6 inhibited 9 concurrently 6 inhibited 10 with 7 mtor/s6 8 signaling 10 with 18 and 11 reduction 12 of 11 reduction 18 and 12 of 14 level 13 the 14 level 14 level 15 of 15 of 17 oxidants 16 endogenous 17 oxidants 18 and 22 response 19 constitutive 22 response 20 dna 22 response 21 damage 22 response we currently tested whether berberine can affect premature , stress - induced cellular senescence caused by mitoxantrone . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 tested 0 ###LEFT-WALL### 18 . 1 we 3 tested 2 currently 3 tested 3 tested 4 whether 4 whether 5 berberine 4 whether 7 affect 5 berberine 6 can 6 can 7 affect 7 affect 14 senescence 8 premature 10 stress 8 premature 14 senescence 9 , 10 stress 10 stress 11 - 12 induced 14 senescence 13 cellular 14 senescence 14 senescence 15 caused 15 caused 16 by 16 by 17 mitoxantrone the depth of senescence was quantitatively measured by morphometric parameters , senescence - associated β - galactosidase , induction of p21waf1 , replication stress ( γh2ax expression ) , and mtor signaling ; the latter revealed by ribosomal s6 protein ( rps6 ) phosphorylation . 0 ###LEFT-WALL### 2 depth 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 45 . 1 the 2 depth 2 depth 3 of 2 depth 5 was 3 of 4 senescence 5 was 7 measured 6 quantitatively 7 measured 7 measured 8 by 8 by 10 parameters 9 morphometric 10 parameters 10 parameters 12 senescence 10 parameters 17 galactosidase 11 , 12 senescence 12 senescence 15 β 12 senescence 16 - 13 - 15 β 14 associated 15 β 15 β 16 - 16 - 17 galactosidase 17 galactosidase 18 , 18 , 30 and 18 , 33 ; 19 induction 20 of 19 induction 30 and 20 of 21 p21waf1 21 p21waf1 24 stress 22 , 24 stress 23 replication 24 stress 24 stress 27 expression 24 stress 29 , 25 ( 27 expression 26 γh2ax 27 expression 27 expression 28 ) 30 and 31 mtor 30 and 32 signaling 33 ; 35 latter 33 ; 36 revealed 34 the 35 latter 35 latter 36 revealed 36 revealed 37 by 36 revealed 44 phosphorylation 37 by 40 protein 38 ribosomal 40 protein 39 s6 40 protein 40 protein 42 rps6 41 ( 42 rps6 42 rps6 43 ) all these markers of senescence were distinctly diminished , in a concentration - dependent manner , by berberine . 0 ###LEFT-WALL### 1 all 0 ###LEFT-WALL### 8 diminished 0 ###LEFT-WALL### 19 . 1 all 2 these 1 all 3 markers 1 all 6 were 2 these 3 markers 3 markers 4 of 4 of 5 senescence 6 were 8 diminished 7 distinctly 8 diminished 8 diminished 10 in 8 diminished 17 by 9 , 10 in 10 in 12 concentration 10 in 16 , 11 a 12 concentration 12 concentration 15 manner 13 - 15 manner 14 dependent 15 manner 15 manner 16 , 17 by 18 berberine in view of the evidence that brb localizes in mitochondria , inhibits respiratory electron chain and activates ampk , the observed attenuation of the replication stress - induced cellular senescence most likely is mediated by ampk that leads to inhibition of mtor signaling . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 27 - 1 in 2 view 1 in 11 , 1 in 16 and 2 view 3 of 2 view 6 that 3 of 5 evidence 4 the 5 evidence 6 that 7 brb 6 that 8 localizes 7 brb 8 localizes 8 localizes 9 in 9 in 10 mitochondria 12 inhibits 15 chain 12 inhibits 16 and 13 respiratory 14 electron 14 electron 15 chain 16 and 17 activates 17 activates 18 ampk 18 ampk 22 attenuation 19 , 22 attenuation 20 the 22 attenuation 21 observed 22 attenuation 22 attenuation 23 of 22 attenuation 27 - 23 of 26 stress 24 the 26 stress 25 replication 26 stress 27 - 30 senescence 27 - 34 mediated 27 - 44 . 28 induced 30 senescence 29 cellular 30 senescence 30 senescence 33 is 31 most 32 likely 32 likely 33 is 33 is 34 mediated 34 mediated 35 by 34 mediated 39 to 35 by 36 ampk 36 ampk 37 that 36 ampk 38 leads 37 that 38 leads 39 to 40 inhibition 40 inhibition 41 of 41 of 42 mtor 42 mtor 43 signaling in support of this mechanism is the observation that rhodamine123 , the cationic probe targeting mitochondrial electron chain , also suppressed rps6 phosphorylation . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 24 . 1 in 2 support 1 in 6 is 2 support 3 of 3 of 5 mechanism 4 this 5 mechanism 6 is 8 observation 7 the 8 observation 8 observation 9 that 8 observation 21 suppressed 9 that 10 rhodamine123 9 that 21 suppressed 10 rhodamine123 14 probe 10 rhodamine123 21 suppressed 11 , 14 probe 12 the 14 probe 13 cationic 14 probe 14 probe 15 targeting 14 probe 19 , 15 targeting 18 chain 16 mitochondrial 17 electron 17 electron 18 chain 20 also 21 suppressed 21 suppressed 23 phosphorylation 22 rps6 23 phosphorylation purpose of review : as life expectancy increases and population age advances , diagnosis and treatment of diseases common in the geriatric population assume an increasingly important role in modern medicine . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 4 : 1 purpose 2 of 2 of 3 review 4 : 15 and 4 : 24 assume 4 : 32 . 5 as 9 and 5 as 11 age 5 as 15 and 6 life 7 expectancy 7 expectancy 8 increases 8 increases 9 and 9 and 10 population 9 and 11 age 12 advances 13 , 13 , 14 diagnosis 13 , 15 and 15 and 16 treatment 15 and 17 of 15 and 24 assume 17 of 18 diseases 18 diseases 19 common 19 common 20 in 20 in 23 population 21 the 23 population 22 geriatric 23 population 24 assume 28 role 24 assume 29 in 25 an 28 role 26 increasingly 27 important 27 important 28 role 29 in 31 medicine 30 modern 31 medicine in the last few years , the emergence of age - specific reference ranges for thyroid [-] stimulating hormone [(] tsh ) has added to the complexity of diagnosis of thyroid dysfunction in this age group , especially in the ['] subclinical ['] category . 0 ###LEFT-WALL### 8 emergence 0 ###LEFT-WALL### 24 added 1 in 5 years 1 in 6 , 1 in 8 emergence 2 the 3 last 2 the 4 few 4 few 5 years 7 the 8 emergence 8 emergence 9 of 8 emergence 14 ranges 8 emergence 23 has 9 of 10 age 11 - 14 ranges 12 specific 14 ranges 13 reference 14 ranges 14 ranges 15 for 14 ranges 22 ) 15 for 21 tsh 16 thyroid 19 hormone 18 stimulating 19 hormone 19 hormone 21 tsh 23 has 24 added 24 added 25 to 24 added 33 in 25 to 27 complexity 26 the 27 complexity 27 complexity 28 of 28 of 29 diagnosis 29 diagnosis 30 of 30 of 32 dysfunction 31 thyroid 32 dysfunction 33 in 36 group 34 this 36 group 35 age 36 group 36 group 39 in 37 , 38 especially 37 , 39 in 39 in 44 category 39 in 45 . 40 the 44 category 42 subclinical 44 category recent findings : the recent studies confirm an increase in population tsh distribution with age , both [in] cross - sectional and longitudinal studies . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 recent 2 findings 3 : 6 studies 3 : 16 , 3 : 20 - 4 the 6 studies 5 recent 6 studies 6 studies 16 , 7 confirm 9 increase 7 confirm 14 with 7 confirm 16 , 8 an 9 increase 9 increase 10 in 10 in 13 distribution 11 population 13 distribution 12 tsh 13 distribution 14 with 15 age 16 , 19 cross 17 both 19 cross 20 - 24 studies 20 - 25 . 21 sectional 22 and 22 and 23 longitudinal 22 and 24 studies conclusive evidence about adverse cardiovascular , metabolic , and cognitive consequences of subclinical hypothyroidism in the elderly remains elusive . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 18 remains 0 ###LEFT-WALL### 20 . 1 conclusive 2 evidence 2 evidence 3 about 2 evidence 18 remains 3 about 11 consequences 4 adverse 11 consequences 5 cardiovascular 6 , 6 , 7 metabolic 6 , 9 and 8 , 9 and 9 and 10 cognitive 9 and 11 consequences 11 consequences 12 of 11 consequences 15 in 12 of 14 hypothyroidism 13 subclinical 14 hypothyroidism 15 in 17 elderly 16 the 17 elderly 18 remains 19 elusive the transient nature of subtle degrees of thyroid dysfunction in a significant proportion of elderly patients has also been reproduced in the recent publications . 0 ###LEFT-WALL### 3 nature 0 ###LEFT-WALL### 20 reproduced 0 ###LEFT-WALL### 25 . 1 the 3 nature 2 transient 3 nature 3 nature 4 of 3 nature 17 has 4 of 9 dysfunction 5 subtle 6 degrees 6 degrees 7 of 6 degrees 9 dysfunction 7 of 9 dysfunction 8 thyroid 9 dysfunction 9 dysfunction 10 in 10 in 13 proportion 11 a 12 significant 11 a 13 proportion 12 significant 13 proportion 13 proportion 14 of 14 of 16 patients 15 elderly 16 patients 17 has 19 been 18 also 19 been 19 been 20 reproduced 20 reproduced 21 in 21 in 24 publications 22 the 24 publications 23 recent 24 publications summary : a growing body of literature in the last few years , reviewed here , highlights the importance of employing additional caution before assigning diagnoses of hypothyroidism or hyperthyroidism to elderly patients and initiation of treatment modalities that can have long - lasting effects . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 2 : 5 body 2 : 17 highlights 2 : 29 or 2 : 43 - 3 a 5 body 4 growing 5 body 5 body 6 of 5 body 14 reviewed 5 body 17 highlights 6 of 7 literature 7 literature 8 in 8 in 12 years 9 the 10 last 9 the 11 few 11 few 12 years 13 , 14 reviewed 14 reviewed 15 here 14 reviewed 16 , 17 highlights 19 importance 17 highlights 24 before 18 the 19 importance 19 importance 20 of 20 of 21 employing 21 employing 23 caution 22 additional 23 caution 24 before 25 assigning 25 assigning 26 diagnoses 26 diagnoses 27 of 27 of 28 hypothyroidism 29 or 34 and 29 or 42 long 30 hyperthyroidism 31 to 30 hyperthyroidism 34 and 31 to 33 patients 32 elderly 33 patients 34 and 35 initiation 34 and 36 of 34 and 42 long 36 of 38 modalities 37 treatment 38 modalities 38 modalities 39 that 38 modalities 41 have 39 that 40 can 40 can 41 have 43 - 45 effects 43 - 46 . 44 lasting 45 effects purpose of review : to provide information on the role of the essential trace element selenium , which enables appropriate thyroid hormone synthesis , secretion , and metabolism , and to discuss supplementation with various selenium compounds , which prevent thyroid diseases such as goiter and exert beneficial effects in thyroid autoimmune diseases . 0 ###LEFT-WALL### 3 review 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 54 . 1 purpose 2 of 2 of 3 review 4 : 5 to 4 : 6 provide 4 : 17 , 4 : 38 , 5 to 6 provide 6 provide 7 information 6 provide 8 on 8 on 10 role 9 the 10 role 10 role 11 of 11 of 16 selenium 12 the 16 selenium 13 essential 14 trace 14 trace 16 selenium 15 element 16 selenium 17 , 18 which 17 , 30 and 18 which 30 and 19 enables 27 and 19 enables 30 and 20 appropriate 21 thyroid 21 thyroid 22 hormone 22 hormone 23 synthesis 23 synthesis 24 , 24 , 25 secretion 24 , 27 and 26 , 27 and 27 and 28 metabolism 27 and 29 , 30 and 31 to 30 and 32 discuss 31 to 32 discuss 32 discuss 33 supplementation 32 discuss 34 with 34 with 37 compounds 35 various 36 selenium 36 selenium 37 compounds 38 , 39 which 38 , 46 and 39 which 46 and 40 prevent 42 diseases 40 prevent 44 as 40 prevent 46 and 41 thyroid 42 diseases 43 such 44 as 44 as 45 goiter 46 and 47 exert 47 exert 49 effects 48 beneficial 49 effects 49 effects 50 in 50 in 53 diseases 51 thyroid 52 autoimmune 52 autoimmune 53 diseases recent findings : selenium administration in both autoimmune thyroiditis ( m [.] [hashimoto] ) and mild graves ' disease improves clinical scores and well - being of patients and reduces autoimmune antibody titres in several prospective , placebo - controlled supplementation studies . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 : 1 recent 2 findings 2 findings 3 : 3 : 15 and 4 selenium 5 administration 5 administration 6 in 5 administration 15 and 6 in 9 thyroiditis 7 both 9 thyroiditis 8 autoimmune 9 thyroiditis 9 thyroiditis 11 m 10 ( 11 m 11 m 14 ) 15 and 19 disease 16 mild 17 graves 17 graves 18 ' 18 ' 19 disease 19 disease 29 and 20 improves 23 and 20 improves 26 being 20 improves 29 and 21 clinical 22 scores 22 scores 23 and 23 and 24 well 25 - 26 being 26 being 27 of 27 of 28 patients 29 and 30 reduces 29 and 34 in 29 and 38 placebo 30 reduces 33 titres 31 autoimmune 33 titres 32 antibody 33 titres 34 in 35 several 36 prospective 37 , 36 prospective 38 placebo 38 placebo 42 studies 39 - 42 studies 40 controlled 41 supplementation 41 supplementation 42 studies 42 studies 43 . summary : adequate nutritional supply of selenium , together with the two other essential trace elements iodine and iron , [is] required for a healthy thyroid during development and adolescence , as well as in the adult and aging populations . 0 ###LEFT-WALL### 1 summary 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 1 summary 2 : 2 : 5 supply 2 : 32 as 2 : 34 as 3 adequate 5 supply 4 nutritional 5 supply 5 supply 6 of 6 of 7 selenium 7 selenium 10 with 8 , 10 with 9 together 10 with 10 with 16 elements 10 with 31 , 11 the 13 other 12 two 13 other 13 other 16 elements 14 essential 16 elements 15 trace 16 elements 16 elements 18 and 16 elements 22 required 17 iodine 18 and 18 and 19 iron 18 and 20 , 18 and 22 required 22 required 23 for 23 for 29 and 24 a 26 thyroid 25 healthy 26 thyroid 26 thyroid 27 during 26 thyroid 29 and 27 during 28 development 29 and 30 adolescence 32 as 33 well 34 as 35 in 35 in 38 and 36 the 37 adult 37 adult 38 and 38 and 40 populations 39 aging 40 populations background : cancers are emerging public health problems in developing countries like nigeria . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 cancers 2 : 4 are 2 : 14 . 3 cancers 4 are 4 are 8 problems 4 are 9 in 4 are 12 like 5 emerging 6 public 6 public 8 problems 7 health 8 problems 9 in 10 developing 10 developing 11 countries 12 like 13 nigeria the epidemiological shift and aging population make cancers a challenge . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 7 make 0 ###LEFT-WALL### 11 . 1 the 3 shift 2 epidemiological 3 shift 3 shift 4 and 4 and 6 population 4 and 7 make 5 aging 6 population 7 make 8 cancers 7 make 10 challenge 9 a 10 challenge objective : we set out to describe the pattern of death due to cancer in our medical ward . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 set 2 : 19 . 3 we 4 set 4 set 5 out 4 set 6 to 6 to 7 describe 7 describe 9 pattern 7 describe 13 to 7 describe 15 in 8 the 9 pattern 9 pattern 10 of 10 of 11 death 12 due 13 to 13 to 14 cancer 15 in 18 ward 16 our 18 ward 17 medical 18 ward the hospital is one of the premier hospitals covering the south east zone of nigeria . 0 ###LEFT-WALL### 2 hospital 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 16 . 1 the 2 hospital 2 hospital 3 is 3 is 4 one 4 one 5 of 5 of 8 hospitals 6 the 8 hospitals 7 premier 8 hospitals 8 hospitals 9 covering 9 covering 13 zone 10 the 13 zone 11 south 12 east 12 east 13 zone 13 zone 14 of 14 of 15 nigeria materials and methods : we retrospectively reviewed the case notes and death certificates of all who died of cancer in our adult medical wards for 16 years ( january 1995 to [december] 2010 ) . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 35 . 1 materials 2 and 2 and 3 methods 4 : 5 we 4 : 7 reviewed 5 we 7 reviewed 6 retrospectively 7 reviewed 7 reviewed 11 and 7 reviewed 20 in 7 reviewed 25 for 8 the 10 notes 9 case 10 notes 10 notes 11 and 11 and 13 certificates 11 and 14 of 12 death 13 certificates 14 of 15 all 15 all 16 who 15 all 17 died 16 who 17 died 17 died 18 of 18 of 19 cancer 20 in 24 wards 21 our 24 wards 22 adult 24 wards 23 medical 24 wards 25 for 27 years 26 16 27 years 27 years 29 january 28 ( 29 january 29 january 31 to 29 january 34 ) 30 1995 31 to 31 to 33 2010 statistical analysis used : statistical package for social sciences ( spss inc . 0 ###LEFT-WALL### 3 used 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 13 . 1 statistical 2 analysis 2 analysis 3 used 3 used 4 : 4 : 6 package 5 statistical 6 package 6 package 7 for 7 for 12 inc 8 social 9 sciences 9 sciences 11 spss 10 ( 11 spss 11 spss 12 inc chicago , il ) version 17.0 was used . 0 ###LEFT-WALL### 5 version 0 ###LEFT-WALL### 8 used 0 ###LEFT-WALL### 9 . 1 chicago 3 il 2 , 3 il 3 il 4 ) 3 il 5 version 5 version 6 17.0 5 version 7 was 7 was 8 used results : twenty seven [thousand] , five hundred and fourteen patients were admitted into the medical wards . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 18 . 1 results 2 : 2 : 4 seven 3 twenty 4 seven 6 , 11 patients 6 , 13 admitted 7 five 8 hundred 8 hundred 9 and 9 and 10 fourteen 10 fourteen 11 patients 11 patients 12 were 12 were 13 admitted 13 admitted 14 into 14 into 17 wards 15 the 17 wards 16 medical 17 wards six [thousand] , two hundred and fifty died . 0 ###LEFT-WALL### 1 six 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 9 . 3 , 7 fifty 3 , 8 died 4 two 5 hundred 5 hundred 6 and 6 and 7 fifty 7 fifty 8 died out of the 6250 deaths , cancers accounted for 7.6 % . 0 ###LEFT-WALL### 7 cancers 0 ###LEFT-WALL### 8 accounted 0 ###LEFT-WALL### 12 . 1 out 2 of 2 of 5 deaths 2 of 6 , 2 of 7 cancers 3 the 4 6250 4 6250 5 deaths 7 cancers 8 accounted 8 accounted 9 for 9 for 11 % 10 7.6 11 % male to female [ratio] was 2.4:1 . 0 ###LEFT-WALL### 1 male 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 7 . 1 male 2 to 1 male 5 was 2 to 3 female 5 was 6 2.4:1 the mean age at death was 43.7 ± 17.4 years . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 11 . 1 the 3 age 2 mean 3 age 3 age 4 at 3 age 6 was 4 at 5 death 6 was 10 years 7 43.7 10 years 8 ± 10 years 9 17.4 10 years the mean age at death in both sexes was similar [(] 42.9 ± 17.5 for men and 45.7 ± 17.0 years for women ) , p = 0.109 . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 29 . 1 the 3 age 2 mean 3 age 3 age 4 at 3 age 6 in 3 age 9 was 4 at 5 death 6 in 8 sexes 7 both 8 sexes 9 was 13 ± 10 similar 13 ± 12 42.9 13 ± 13 ± 14 17.5 13 ± 15 for 13 ± 27 = 15 for 17 and 16 men 17 and 17 and 21 years 17 and 24 ) 18 45.7 21 years 19 ± 21 years 20 17.0 21 years 21 years 22 for 22 for 23 women 25 , 27 = 26 p 27 = 27 = 28 0.109 primary liver cell carcinoma was the most common cause of death among men ( 40.8 % ) , while cancer of hematopoietic organ was the most common in women ( 48.7 % ) . 0 ###LEFT-WALL### 4 carcinoma 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 34 . 1 primary 2 liver 2 liver 4 carcinoma 3 cell 4 carcinoma 4 carcinoma 5 was 5 was 7 most 6 the 7 most 7 most 8 common 8 common 9 cause 8 common 12 among 8 common 19 while 9 cause 10 of 10 of 11 death 12 among 13 men 13 men 16 % 14 ( 16 % 15 40.8 16 % 16 % 17 ) 18 , 19 while 19 while 20 cancer 19 while 24 was 19 while 33 ) 20 cancer 21 of 20 cancer 24 was 21 of 23 organ 22 hematopoietic 23 organ 24 was 26 most 24 was 27 common 25 the 26 most 27 common 28 in 28 in 29 women 29 women 32 % 30 ( 32 % 31 48.7 32 % 32 % 33 ) the overall fatality rate was 1.7 % ( 477/27 [514] [ )(of medical admissions . 0 ###LEFT-WALL### 4 rate 0 ###LEFT-WALL### 5 was 1 the 4 rate 2 overall 3 fatality 3 fatality 4 rate 4 rate 5 was 5 was 7 % 6 1.7 7 % 7 % 9 477/27 8 ( 9 477/27 9 477/27 12 )(of 9 477/27 15 . 12 )(of 14 admissions 13 medical 14 admissions younger [and] middle age groups were most commonly affected in both sexes . 0 ###LEFT-WALL### 5 groups 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 13 . 1 younger 3 middle 3 middle 5 groups 4 age 5 groups 5 groups 6 were 6 were 7 most 7 most 9 affected 8 commonly 9 affected 9 affected 10 in 10 in 12 sexes 11 both 12 sexes conclusion : since the most productive age groups were affected , governments in developing countries [should] as a matter of urgency put in place adequate cancer preventive and curative services . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 8 groups 2 : 9 were 2 : 11 , 3 since 5 most 3 since 8 groups 4 the 5 most 6 productive 8 groups 7 age 8 groups 8 groups 9 were 9 were 10 affected 11 , 12 governments 11 , 24 place 12 governments 13 in 12 governments 22 put 12 governments 24 place 13 in 14 developing 14 developing 15 countries 15 countries 17 as 17 as 19 matter 18 a 19 matter 19 matter 20 of 20 of 21 urgency 22 put 23 in 24 place 30 services 25 adequate 30 services 26 cancer 30 services 27 preventive 28 and 28 and 29 curative 28 and 30 services purpose : the purpose of this study was to compare the prognostic validity of alternative measures of health ratings , including those that tap temporal reflections , on adult mortality . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 4 purpose 2 : 8 was 2 : 31 . 3 the 4 purpose 4 purpose 5 of 4 purpose 8 was 5 of 7 study 6 this 7 study 8 was 9 to 9 to 10 compare 10 compare 13 validity 10 compare 21 including 10 compare 28 on 11 the 13 validity 12 prognostic 13 validity 13 validity 14 of 13 validity 17 of 14 of 16 measures 15 alternative 16 measures 17 of 19 ratings 18 health 19 ratings 20 , 21 including 21 including 22 those 21 including 27 , 22 those 23 that 22 those 24 tap 23 that 24 tap 24 tap 26 reflections 25 temporal 26 reflections 28 on 30 mortality 29 adult 30 mortality design and methods : the study uses a national sample of 1,266 americans 50 - 74 years old in 1995 , with vital status tracked through 2005 , to compare the effect of 3 types of health ratings on mortality : conventional indicator [of] self - rated health ( srh ) , age comparison form of srh , and health ratings that incorporate temporal dimensions . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 28 , 1 design 3 methods 2 and 3 methods 3 methods 4 : 4 : 18 old 4 : 19 in 4 : 22 with 5 the 18 old 6 study 7 uses 7 uses 10 sample 8 a 10 sample 9 national 10 sample 10 sample 11 of 11 of 13 americans 12 1,266 13 americans 13 americans 15 - 14 50 15 - 15 - 16 74 16 74 17 years 17 years 18 old 19 in 20 1995 21 , 22 with 22 with 24 status 22 with 25 tracked 22 with 28 , 23 vital 24 status 25 tracked 26 through 26 through 27 2005 28 , 29 to 28 , 30 compare 28 , 41 : 29 to 30 compare 30 compare 32 effect 30 compare 39 on 31 the 32 effect 32 effect 33 of 33 of 36 of 34 3 36 of 35 types 36 of 36 of 38 ratings 37 health 38 ratings 39 on 40 mortality 41 : 45 self 41 : 46 - 41 : 52 , 42 conventional 43 indicator 43 indicator 45 self 46 - 48 health 47 rated 48 health 48 health 50 srh 49 ( 50 srh 50 srh 51 ) 52 , 53 age 53 age 55 form 54 comparison 55 form 55 form 56 of 56 of 59 and 57 srh 59 and 58 , 59 and 59 and 65 dimensions 59 and 66 . 60 health 65 dimensions 61 ratings 65 dimensions 62 that 63 incorporate 63 incorporate 65 dimensions 64 temporal 65 dimensions logistic regression was used to estimate the odds of mortality associated with alternative health ratings while adjusting for health conditions , lifestyle factors , and status characteristics and resources . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 6 estimate 0 ###LEFT-WALL### 30 . 1 logistic 2 regression 2 regression 3 was 3 was 4 used 4 used 5 to 5 to 6 estimate 6 estimate 28 and 7 the 8 odds 8 odds 9 of 8 odds 18 for 8 odds 21 , 9 of 10 mortality 10 mortality 11 associated 11 associated 12 with 11 associated 16 while 12 with 15 ratings 13 alternative 14 health 14 health 15 ratings 16 while 17 adjusting 18 for 20 conditions 19 health 20 conditions 21 , 23 factors 21 , 25 and 22 lifestyle 23 factors 24 , 25 and 25 and 27 characteristics 25 and 28 and 26 status 27 characteristics 28 and 29 resources results : self - rated health was a consistent predictor of mortality , but the respondent 's expected health rating - 10 years in the future - was an independent predictor . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 18 expected 0 ###LEFT-WALL### 32 . 1 results 2 : 2 : 3 self 4 - 6 health 4 - 7 was 4 - 14 but 5 rated 6 health 6 health 7 was 7 was 10 predictor 8 a 9 consistent 8 a 10 predictor 9 consistent 10 predictor 10 predictor 11 of 11 of 12 mortality 13 , 14 but 14 but 16 respondent 14 but 17 's 15 the 16 respondent 16 respondent 17 's 17 's 18 expected 18 expected 19 health 18 expected 28 was 19 health 20 rating 19 health 23 years 19 health 28 was 21 - 23 years 22 10 23 years 23 years 24 in 23 years 27 - 24 in 26 future 25 the 26 future 28 was 31 predictor 29 an 31 predictor 30 independent 31 predictor future health expectations were more important than past ( recalled change [ )(in predicting mortality risk : people with more negative expectations of future health were less likely to survive . 0 ###LEFT-WALL### 3 expectations 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 10 recalled 0 ###LEFT-WALL### 17 : 1 future 3 expectations 2 health 3 expectations 3 expectations 4 were 4 were 5 more 4 were 6 important 6 important 7 than 7 than 8 past 9 ( 10 recalled 10 recalled 11 change 10 recalled 17 : 11 change 13 )(in 13 )(in 14 predicting 14 predicting 16 risk 15 mortality 16 risk 17 : 18 people 17 : 26 were 17 : 31 . 18 people 19 with 18 people 26 were 19 with 22 expectations 20 more 21 negative 21 negative 22 expectations 22 expectations 23 of 23 of 25 health 24 future 25 health 26 were 28 likely 27 less 28 likely 28 likely 29 to 28 likely 30 survive 29 to 30 survive implications : the findings reveal the importance of future time perspective for older people and suggest that it is more useful to query older people about their future health expectations than about how their health has changed . 0 ###LEFT-WALL### 1 implications 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 4 findings 2 : 15 and 3 the 4 findings 4 findings 15 and 5 reveal 7 importance 5 reveal 12 for 5 reveal 15 and 6 the 7 importance 7 importance 8 of 8 of 11 perspective 9 future 11 perspective 10 time 11 perspective 12 for 14 people 13 older 14 people 15 and 16 suggest 15 and 31 than 16 suggest 17 that 17 that 18 it 17 that 23 query 18 it 19 is 19 is 21 useful 20 more 21 useful 21 useful 22 to 21 useful 23 query 22 to 23 query 23 query 25 people 23 query 26 about 24 older 25 people 26 about 30 expectations 27 their 30 expectations 28 future 30 expectations 29 health 30 expectations 31 than 32 about 32 about 33 how 33 how 35 health 33 how 37 changed 34 their 35 health 35 health 36 has 36 has 37 changed premature graying is an important cause of low [self] - esteem , often interfering with socio - cultural adjustment . 0 ###LEFT-WALL### 1 premature 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 20 . 1 premature 2 graying 1 premature 3 is 3 is 6 cause 4 an 5 important 4 an 6 cause 5 important 6 cause 6 cause 7 of 7 of 19 adjustment 8 low 11 esteem 8 low 19 adjustment 10 - 11 esteem 11 esteem 14 interfering 11 esteem 17 - 12 , 14 interfering 13 often 14 interfering 14 interfering 15 with 14 interfering 17 - 15 with 16 socio 18 cultural 19 adjustment the onset and progression of graying or canities correlate very closely with chronological aging , and occur in varying degrees in all individuals eventually , regardless of gender or race . 0 ###LEFT-WALL### 7 or 0 ###LEFT-WALL### 16 and 1 the 2 onset 2 onset 3 and 3 and 4 progression 3 and 5 of 3 and 7 or 5 of 6 graying 7 or 8 canities 7 or 16 and 9 correlate 11 closely 9 correlate 12 with 9 correlate 16 and 10 very 11 closely 12 with 14 aging 13 chronological 14 aging 15 , 16 and 16 and 17 occur 17 occur 18 in 18 in 19 varying 19 varying 20 degrees 19 varying 21 in 19 varying 24 eventually 19 varying 27 of 21 in 23 individuals 22 all 23 individuals 25 , 27 of 26 regardless 27 of 27 of 29 or 27 of 31 . 28 gender 29 or 29 or 30 race premature canities may occur alone as an autosomal dominant condition [or] in association with various autoimmune or premature aging syndromes . 0 ###LEFT-WALL### 2 canities 0 ###LEFT-WALL### 4 occur 0 ###LEFT-WALL### 21 . 1 premature 2 canities 2 canities 3 may 3 may 4 occur 4 occur 5 alone 4 occur 6 as 4 occur 13 association 4 occur 14 with 6 as 10 condition 7 an 10 condition 8 autosomal 10 condition 9 dominant 10 condition 12 in 13 association 14 with 20 syndromes 15 various 20 syndromes 16 autoimmune 17 or 17 or 18 premature 17 or 20 syndromes 19 aging 20 syndromes it needs to be differentiated from various genetic hypomelanotic hair disorders . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 needs 0 ###LEFT-WALL### 12 . 1 it 2 needs 2 needs 3 to 2 needs 5 differentiated 3 to 4 be 4 be 5 differentiated 5 differentiated 6 from 6 from 11 disorders 7 various 10 hair 8 genetic 10 hair 9 hypomelanotic 10 hair 10 hair 11 disorders reduction in melanogenically active melanocytes in the hair bulb of gray anagen hair follicles with resultant pigment loss is central to the pathogenesis of graying . 0 ###LEFT-WALL### 1 reduction 0 ###LEFT-WALL### 19 is 0 ###LEFT-WALL### 26 . 1 reduction 2 in 1 reduction 6 in 1 reduction 19 is 2 in 5 melanocytes 3 melanogenically 4 active 4 active 5 melanocytes 6 in 9 bulb 7 the 9 bulb 8 hair 9 bulb 9 bulb 10 of 10 of 14 follicles 11 gray 14 follicles 12 anagen 13 hair 13 hair 14 follicles 14 follicles 15 with 15 with 18 loss 16 resultant 17 pigment 17 pigment 18 loss 19 is 20 central 20 central 21 to 21 to 23 pathogenesis 22 the 23 pathogenesis 23 pathogenesis 24 of 24 of 25 graying defective melanosomal transfers to cortical keratinocytes and melanin incontinence due to melanocyte degeneration are also believed to contribute to this . 0 ###LEFT-WALL### 3 transfers 0 ###LEFT-WALL### 16 believed 0 ###LEFT-WALL### 21 . 1 defective 3 transfers 2 melanosomal 3 transfers 3 transfers 4 to 3 transfers 11 to 3 transfers 14 are 4 to 7 and 5 cortical 6 keratinocytes 6 keratinocytes 7 and 7 and 9 incontinence 8 melanin 9 incontinence 10 due 11 to 11 to 13 degeneration 12 melanocyte 13 degeneration 14 are 15 also 14 are 16 believed 16 believed 17 to 16 believed 18 contribute 17 to 18 contribute 18 contribute 19 to 19 to 20 this the white color of canities is an optical effect ; the reflection of incident light masks the intrinsic pale yellow color of hair keratin . 0 ###LEFT-WALL### 3 color 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 25 . 1 the 3 color 2 white 3 color 3 color 4 of 3 color 6 is 4 of 5 canities 6 is 9 effect 7 an 8 optical 7 an 9 effect 8 optical 9 effect 10 ; 12 reflection 10 ; 16 masks 11 the 12 reflection 12 reflection 13 of 12 reflection 16 masks 13 of 15 light 14 incident 15 light 16 masks 21 color 17 the 20 yellow 18 intrinsic 19 pale 19 pale 20 yellow 20 yellow 21 color 21 color 22 of 22 of 24 keratin 23 hair 24 keratin full range of color [from] normal to white can be seen both along individual hair and from hair to hair , and admixture of pigmented and white hair is believed to give the appearance of gray . 0 ###LEFT-WALL### 2 range 0 ###LEFT-WALL### 11 seen 0 ###LEFT-WALL### 30 believed 1 full 2 range 2 range 3 of 2 range 6 normal 2 range 9 can 3 of 4 color 6 normal 7 to 6 normal 8 white 7 to 8 white 9 can 10 be 10 be 11 seen 12 both 16 and 12 both 22 and 13 along 15 hair 13 along 16 and 14 individual 15 hair 16 and 17 from 17 from 18 hair 18 hair 19 to 19 to 20 hair 21 , 22 and 22 and 23 admixture 22 and 24 of 22 and 30 believed 24 of 26 and 25 pigmented 26 and 26 and 27 white 26 and 28 hair 26 and 29 is 28 hair 29 is 30 believed 31 to 30 believed 37 . 31 to 32 give 32 give 34 appearance 33 the 34 appearance 34 appearance 35 of 35 of 36 gray graying of hair is usually progressive and permanent , but there are occasional reports of spontaneous repigmentation of gray hair . 0 ###LEFT-WALL### 1 graying 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 21 . 1 graying 2 of 1 graying 4 is 2 of 3 hair 4 is 5 usually 4 is 7 and 6 progressive 7 and 7 and 8 permanent 9 , 10 but 9 , 12 are 10 but 11 there 10 but 12 are 12 are 14 reports 13 occasional 14 reports 14 reports 15 of 14 reports 18 of 15 of 17 repigmentation 16 spontaneous 17 repigmentation 18 of 20 hair 19 gray 20 hair studies evaluating the association of canities with osteopenia and cardiovascular disease have revealed mixed results . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 13 revealed 0 ###LEFT-WALL### 16 . 1 studies 2 evaluating 1 studies 12 have 2 evaluating 4 association 3 the 4 association 4 association 5 of 5 of 6 canities 6 canities 7 with 7 with 9 and 8 osteopenia 9 and 9 and 11 disease 10 cardiovascular 11 disease 12 have 13 revealed 13 revealed 15 results 14 mixed 15 results despite the extensive molecular research being carried out to understand the pathogenesis of canities , there is paucity of effective evidence - based treatment options . 0 ###LEFT-WALL### 16 there 0 ###LEFT-WALL### 17 is 1 despite 5 research 1 despite 16 there 2 the 5 research 3 extensive 5 research 4 molecular 5 research 6 being 7 carried 6 being 15 , 6 being 16 there 7 carried 8 out 7 carried 9 to 9 to 10 understand 10 understand 12 pathogenesis 11 the 12 pathogenesis 12 pathogenesis 13 of 13 of 14 canities 16 there 17 is 17 is 18 paucity 18 paucity 19 of 18 paucity 25 options 19 of 21 evidence 20 effective 21 evidence 22 - 25 options 23 based 24 treatment 24 treatment 25 options 25 options 26 . reports of repigmentation of previously white hair following certain inflammatory processes and use of drugs have suggested the possibility [of] cytokine [-] induced recruitment of outer sheath melanocytes to the hair bulb and rekindled the hope for finding an effective drug for treatment of premature canities . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 47 . 1 reports 2 of 1 reports 8 following 1 reports 12 and 2 of 3 repigmentation 3 repigmentation 4 of 4 of 7 hair 5 previously 6 white 6 white 7 hair 8 following 11 processes 9 certain 11 processes 10 inflammatory 11 processes 12 and 13 use 12 and 14 of 12 and 33 and 14 of 15 drugs 16 have 17 suggested 16 have 33 and 17 suggested 24 recruitment 17 suggested 29 to 18 the 24 recruitment 19 possibility 23 induced 21 cytokine 23 induced 23 induced 24 recruitment 24 recruitment 25 of 25 of 28 melanocytes 26 outer 27 sheath 27 sheath 28 melanocytes 29 to 32 bulb 30 the 32 bulb 31 hair 32 bulb 33 and 34 rekindled 34 rekindled 36 hope 34 rekindled 37 for 34 rekindled 42 for 35 the 36 hope 37 for 38 finding 38 finding 41 drug 39 an 40 effective 39 an 41 drug 40 effective 41 drug 42 for 43 treatment 43 treatment 44 of 44 of 46 canities 45 premature 46 canities in the end , camouflage techniques using hair colorants are outlined . 0 ###LEFT-WALL### 6 techniques 0 ###LEFT-WALL### 11 outlined 0 ###LEFT-WALL### 12 . 1 in 3 end 1 in 4 , 1 in 6 techniques 2 the 3 end 5 camouflage 6 techniques 6 techniques 7 using 6 techniques 10 are 7 using 9 colorants 8 hair 9 colorants 10 are 11 outlined there is a need in our society to raise the national consciousness about aging , health , and the prospects for longevity , so that many more persons take responsibility for their personal health and understand what we will need in an era of health - care reform to promote health across the life course . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 1 there 2 is 2 is 4 need 2 is 25 that 3 a 4 need 4 need 5 in 5 in 7 society 6 our 7 society 7 society 8 to 7 society 13 about 7 society 14 aging 7 society 18 and 8 to 9 raise 9 raise 12 consciousness 9 raise 13 about 10 the 12 consciousness 11 national 12 consciousness 15 , 18 and 16 health 18 and 17 , 18 and 18 and 20 prospects 18 and 23 , 19 the 20 prospects 20 prospects 21 for 21 for 22 longevity 24 so 25 that 25 that 28 persons 25 that 35 and 26 many 27 more 27 more 28 persons 28 persons 35 and 29 take 30 responsibility 29 take 35 and 30 responsibility 31 for 31 for 34 health 32 their 34 health 33 personal 34 health 35 and 36 understand 36 understand 37 what 37 what 38 we 37 what 40 need 38 we 39 will 39 will 40 need 40 need 41 in 41 in 43 era 42 an 43 era 43 era 44 of 43 era 48 reform 44 of 45 health 46 - 48 reform 47 care 48 reform 48 reform 49 to 48 reform 50 promote 48 reform 56 . 49 to 50 promote 50 promote 51 health 51 health 52 across 52 across 55 course 53 the 55 course 54 life 55 course we address this [imperative] by offering a relevant curriculum through a public - health lens , designed especially for university undergraduate students . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 23 . 1 we 16 , 2 address 3 this 2 address 5 by 2 address 16 , 5 by 6 offering 6 offering 9 curriculum 6 offering 10 through 7 a 8 relevant 7 a 9 curriculum 8 relevant 9 curriculum 10 through 15 lens 11 a 12 public 11 a 15 lens 12 public 13 - 12 public 14 health 14 health 15 lens 16 , 17 designed 16 , 18 especially 18 especially 19 for 19 for 22 students 20 university 22 students 21 undergraduate 22 students unlike the traditional educational focus on graduate students who are already committed to a career in the health professions , the students in our sights have little prior exposure to the course content and [are] still largely uncertain of their career plans . 0 ###LEFT-WALL### 22 students 0 ###LEFT-WALL### 26 have 0 ###LEFT-WALL### 43 . 1 unlike 5 focus 1 unlike 20 , 1 unlike 22 students 2 the 5 focus 3 traditional 5 focus 4 educational 5 focus 5 focus 6 on 6 on 8 students 7 graduate 8 students 8 students 9 who 8 students 10 are 9 who 10 are 10 are 12 committed 11 already 12 committed 12 committed 13 to 12 committed 16 in 13 to 15 career 14 a 15 career 16 in 19 professions 17 the 19 professions 18 health 19 professions 21 the 22 students 22 students 23 in 22 students 26 have 23 in 25 sights 24 our 25 sights 26 have 29 exposure 26 have 30 to 26 have 34 and 27 little 29 exposure 28 prior 29 exposure 30 to 32 course 31 the 32 course 33 content 34 and 34 and 36 still 34 and 38 uncertain 37 largely 38 uncertain 38 uncertain 39 of 39 of 42 plans 40 their 42 plans 41 career 42 plans we believe this proposed course will help students understand aging processes as these evolve over time , understand the opportunities that arise from greater life expectancy , encourage them to promote their own health , and make a social contract to do so for society . 0 ###LEFT-WALL### 42 do 0 ###LEFT-WALL### 46 . 1 we 2 believe 2 believe 5 course 2 believe 9 understand 3 this 5 course 4 proposed 5 course 5 course 6 will 6 will 7 help 7 help 8 students 7 help 9 understand 9 understand 11 processes 9 understand 17 , 10 aging 11 processes 11 processes 12 as 11 processes 17 , 12 as 13 these 14 evolve 15 over 14 evolve 17 , 15 over 16 time 17 , 27 , 17 , 30 to 17 , 41 to 18 understand 20 opportunities 18 understand 23 from 18 understand 27 , 19 the 20 opportunities 20 opportunities 21 that 20 opportunities 22 arise 21 that 22 arise 23 from 26 expectancy 24 greater 25 life 25 life 26 expectancy 27 , 28 encourage 28 encourage 29 them 30 to 36 and 31 promote 34 health 31 promote 36 and 32 their 33 own 32 their 34 health 35 , 36 and 36 and 37 make 36 and 40 contract 38 a 40 contract 39 social 40 contract 41 to 42 do 42 do 43 so 42 do 44 for 44 for 45 society the increasing prevalence of co - occurring multiple chronic conditions in an aging population has influenced the debate on complexity in chronic care and nowadays provides an impetus to the reform of numerous health systems . 0 ###LEFT-WALL### 3 prevalence 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 36 . 1 the 3 prevalence 2 increasing 3 prevalence 3 prevalence 4 of 3 prevalence 15 has 4 of 10 conditions 5 co 6 - 5 co 8 multiple 7 occurring 8 multiple 8 multiple 10 conditions 9 chronic 10 conditions 10 conditions 11 in 11 in 14 population 12 an 14 population 13 aging 14 population 15 has 24 and 16 influenced 18 debate 16 influenced 19 on 16 influenced 21 in 16 influenced 24 and 17 the 18 debate 19 on 20 complexity 21 in 23 care 22 chronic 23 care 24 and 26 provides 24 and 29 to 25 nowadays 26 provides 26 provides 28 impetus 27 an 28 impetus 29 to 31 reform 30 the 31 reform 31 reform 32 of 32 of 35 systems 33 numerous 34 health 34 health 35 systems this article presents a theoretical lens for understanding the complexity of chronic care based on research and debate conducted in the context of multiple quality improvement programs over the last five years in belgium and the netherlands . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 presents 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 27 programs 0 ###LEFT-WALL### 38 . 1 this 2 article 2 article 3 presents 3 presents 6 lens 3 presents 7 for 4 a 5 theoretical 4 a 6 lens 5 theoretical 6 lens 7 for 8 understanding 8 understanding 10 complexity 9 the 10 complexity 10 complexity 11 of 11 of 13 care 12 chronic 13 care 13 care 14 based 14 based 15 on 15 on 16 research 17 and 18 debate 17 and 19 conducted 18 debate 19 conducted 19 conducted 20 in 20 in 22 context 21 the 22 context 22 context 23 of 23 of 25 quality 24 multiple 25 quality 25 quality 26 improvement 25 quality 27 programs 26 improvement 27 programs 27 programs 28 over 27 programs 33 in 28 over 32 years 29 the 32 years 30 last 32 years 31 five 32 years 33 in 35 and 34 belgium 35 and 35 and 37 netherlands 36 the 37 netherlands we consider four major components of complexity in chronic care against a background of complex adaptive systems [:] ( 1 [ )(case ( patient ) complexity [;] ( 2 ) care complexity ; [(] 3 [ )(quality assessment complexity [;] and [(] 4 [ )(health systems complexity . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 consider 0 ###LEFT-WALL### 33 ; 0 ###LEFT-WALL### 48 . 1 we 2 consider 2 consider 5 components 2 consider 32 complexity 3 four 5 components 4 major 5 components 5 components 6 of 6 of 7 complexity 7 complexity 8 in 7 complexity 11 against 7 complexity 14 of 7 complexity 22 )(case 8 in 10 care 9 chronic 10 care 11 against 13 background 12 a 13 background 14 of 17 systems 15 complex 17 systems 16 adaptive 17 systems 19 ( 22 )(case 20 1 22 )(case 22 )(case 26 complexity 22 )(case 30 ) 23 ( 26 complexity 24 patient 25 ) 24 patient 26 complexity 26 complexity 29 2 26 complexity 30 ) 28 ( 29 2 29 2 30 ) 31 care 32 complexity 33 ; 41 and 35 3 37 )(quality 37 )(quality 38 assessment 38 assessment 39 complexity 39 complexity 41 and 41 and 47 complexity 43 4 45 )(health 45 )(health 47 complexity 46 systems 47 complexity each of these components represents a range of elements that contribute to the picture of complexity in chronic care . 0 ###LEFT-WALL### 1 each 0 ###LEFT-WALL### 5 represents 0 ###LEFT-WALL### 20 . 1 each 2 of 1 each 5 represents 2 of 4 components 3 these 4 components 5 represents 7 range 6 a 7 range 7 range 8 of 8 of 9 elements 9 elements 10 that 9 elements 11 contribute 10 that 11 contribute 11 contribute 12 to 11 contribute 17 in 12 to 14 picture 13 the 14 picture 14 picture 15 of 15 of 16 complexity 17 in 19 care 18 chronic 19 care we emphasize that planning for chronic care requires equal attention to the complexity of all four components . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 emphasize 0 ###LEFT-WALL### 18 . 1 we 2 emphasize 2 emphasize 3 that 3 that 4 planning 3 that 8 requires 4 planning 5 for 4 planning 8 requires 5 for 7 care 6 chronic 7 care 8 requires 10 attention 8 requires 11 to 9 equal 10 attention 11 to 13 complexity 12 the 13 complexity 13 complexity 14 of 14 of 17 components 15 all 16 four 16 four 17 components it also requires multifaceted interventions and implementation strategies that target improvements in multiple outcomes related to the structural , process , and outcome components of care . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 requires 0 ###LEFT-WALL### 15 related 0 ###LEFT-WALL### 27 . 1 it 3 requires 2 also 3 requires 3 requires 6 and 3 requires 15 related 4 multifaceted 5 interventions 5 interventions 6 and 6 and 8 strategies 6 and 9 that 6 and 10 target 6 and 15 related 7 implementation 8 strategies 9 that 10 target 10 target 11 improvements 11 improvements 12 in 12 in 14 outcomes 13 multiple 14 outcomes 15 related 16 to 16 to 22 and 17 the 20 process 18 structural 19 , 18 structural 20 process 20 process 22 and 21 , 22 and 22 and 24 components 22 and 25 of 23 outcome 24 components 25 of 26 care further empirical research is needed to assess the validity of our complexity framework in the health - care environment . 0 ###LEFT-WALL### 3 research 0 ###LEFT-WALL### 5 needed 0 ###LEFT-WALL### 17 - 1 further 3 research 2 empirical 3 research 3 research 4 is 4 is 5 needed 5 needed 6 to 6 to 7 assess 7 assess 9 validity 7 assess 14 in 8 the 9 validity 9 validity 10 of 10 of 13 framework 11 our 13 framework 12 complexity 13 framework 14 in 16 health 15 the 16 health 17 - 19 environment 17 - 20 . 18 care 19 environment objectives : subtle deficits in visual selective attention have been found in amnestic mild cognitive impairment ( amci ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 deficits 2 : 11 found 2 : 20 . 3 subtle 4 deficits 4 deficits 5 in 4 deficits 9 have 5 in 8 attention 6 visual 8 attention 7 selective 8 attention 9 have 10 been 10 been 11 found 11 found 12 in 12 in 16 impairment 13 amnestic 16 impairment 14 mild 16 impairment 15 cognitive 16 impairment 16 impairment 18 amci 17 ( 18 amci 18 amci 19 ) however , few studies have explored performance on visual search paradigms or the simon task , which are known to be sensitive to disease severity in alzheimer 's patients . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 explored 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 30 . 1 however 2 , 1 however 4 studies 3 few 4 studies 4 studies 5 have 5 have 6 explored 6 explored 7 performance 6 explored 8 on 8 on 12 or 9 visual 11 paradigms 10 search 11 paradigms 11 paradigms 12 or 12 or 15 task 13 the 15 task 14 simon 15 task 16 , 17 which 16 , 19 known 17 which 18 are 18 are 19 known 19 known 20 to 19 known 21 be 20 to 21 be 21 be 22 sensitive 22 sensitive 23 to 22 sensitive 26 in 23 to 25 severity 24 disease 25 severity 26 in 29 patients 27 alzheimer 28 's 28 's 29 patients furthermore , there is limited research investigating [how] deficiencies can be ameliorated with exogenous support ( auditory cues ) . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 20 . 1 furthermore 2 , 1 furthermore 3 there 3 there 4 is 4 is 6 research 5 limited 6 research 6 research 7 investigating 6 research 9 deficiencies 6 research 11 be 6 research 12 ameliorated 9 deficiencies 10 can 10 can 11 be 12 ameliorated 13 with 13 with 15 support 14 exogenous 15 support 15 support 18 cues 16 ( 18 cues 17 auditory 18 cues 18 cues 19 ) method : sixteen individuals with amci and 14 control participants completed 3 experimental tasks that varied in demand and cue availability : visual search - alerting , visual search - orienting , and simon task . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 7 and 2 : 16 varied 2 : 22 : 2 : 36 . 3 sixteen 4 individuals 4 individuals 5 with 4 individuals 7 and 5 with 6 amci 7 and 10 participants 7 and 11 completed 8 14 10 participants 9 control 10 participants 11 completed 14 tasks 12 3 14 tasks 13 experimental 14 tasks 14 tasks 15 that 14 tasks 16 varied 15 that 16 varied 16 varied 17 in 17 in 19 and 18 demand 19 and 19 and 21 availability 20 cue 21 availability 22 : 24 search 22 : 25 - 23 visual 24 search 25 - 26 alerting 25 - 27 , 27 , 29 search 27 , 30 - 28 visual 29 search 30 - 33 and 31 orienting 33 and 32 , 33 and 33 and 35 task 34 simon 35 task results : visual selective attention was influenced by amci , auditory cues , and task characteristics . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 5 attention 2 : 7 influenced 3 visual 5 attention 4 selective 5 attention 5 attention 6 was 6 was 7 influenced 7 influenced 8 by 8 by 14 and 9 amci 10 , 10 , 12 cues 10 , 14 and 11 auditory 12 cues 13 , 14 and 14 and 16 characteristics 15 task 16 characteristics visual search abilities were relatively consistent across groups . 0 ###LEFT-WALL### 3 abilities 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 9 . 1 visual 2 search 2 search 3 abilities 3 abilities 4 were 4 were 6 consistent 5 relatively 6 consistent 6 consistent 7 across 7 across 8 groups the amci participants were impaired on the simon task when working memory was required , but conflict [resolution] was similar to controls . 0 ###LEFT-WALL### 3 participants 0 ###LEFT-WALL### 5 impaired 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 23 . 1 the 3 participants 2 amci 3 participants 3 participants 4 were 4 were 5 impaired 5 impaired 6 on 6 on 9 task 7 the 9 task 8 simon 9 task 9 task 10 when 10 when 11 working 10 when 14 required 11 working 12 memory 11 working 13 was 13 was 14 required 14 required 15 , 15 , 16 but 16 but 17 conflict 16 but 19 was 17 conflict 19 was 19 was 20 similar 20 similar 21 to 21 to 22 controls spatially informative orienting cues improved response times , whereas spatially neutral alerting cues did not influence performance . 0 ###LEFT-WALL### 4 cues 0 ###LEFT-WALL### 16 influence 0 ###LEFT-WALL### 18 . 1 spatially 2 informative 2 informative 4 cues 3 orienting 4 cues 4 cues 5 improved 5 improved 7 times 5 improved 9 whereas 6 response 7 times 8 , 9 whereas 9 whereas 13 cues 10 spatially 11 neutral 11 neutral 13 cues 12 alerting 13 cues 13 cues 14 did 14 did 15 not 14 did 16 influence 16 influence 17 performance finally , spatially informative auditory cues benefited the amci group more than controls in the visual search task , specifically at the largest array size where orienting demands were [greatest] . 0 ###LEFT-WALL### 6 cues 0 ###LEFT-WALL### 7 benefited 1 finally 2 , 1 finally 6 cues 3 spatially 6 cues 4 informative 6 cues 5 auditory 6 cues 6 cues 7 benefited 7 benefited 10 group 7 benefited 11 more 7 benefited 12 than 8 the 10 group 9 amci 10 group 12 than 13 controls 13 controls 14 in 13 controls 21 at 14 in 18 task 15 the 18 task 16 visual 17 search 17 search 18 task 19 , 20 specifically 19 , 21 at 21 at 25 size 21 at 31 . 22 the 23 largest 22 the 25 size 24 array 25 size 25 size 26 where 26 where 27 orienting 26 where 29 were 27 orienting 28 demands 27 orienting 29 were discussion : these findings suggest that individuals with amci have working memory deficits and subtle deficiencies in orienting attention and rely on exogenous information to guide attention . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 20 and 2 : 28 . 3 these 4 findings 4 findings 20 and 5 suggest 6 that 5 suggest 20 and 6 that 7 individuals 6 that 10 have 7 individuals 8 with 7 individuals 10 have 8 with 9 amci 10 have 14 and 10 have 17 in 11 working 13 deficits 12 memory 13 deficits 13 deficits 14 and 14 and 16 deficiencies 15 subtle 16 deficiencies 17 in 18 orienting 18 orienting 19 attention 20 and 21 rely 21 rely 22 on 22 on 24 information 23 exogenous 24 information 24 information 25 to 25 to 27 attention 26 guide 27 attention is the developing bilingual brain fundamentally similar to the monolingual brain ( e.g [.] , neural resources supporting language and cognition ) ? 0 ###LEFT-WALL### 1 is 0 ###LEFT-WALL### 23 ? 1 is 5 brain 1 is 6 fundamentally 1 is 7 similar 2 the 5 brain 3 developing 5 brain 4 bilingual 5 brain 7 similar 8 to 8 to 11 brain 9 the 11 brain 10 monolingual 11 brain 11 brain 20 and 12 ( 20 and 13 e.g 15 , 13 e.g 17 resources 16 neural 17 resources 17 resources 18 supporting 17 resources 20 and 18 supporting 19 language 20 and 21 cognition 20 and 22 ) or , does early - life bilingual language experience change the brain ? 0 ###LEFT-WALL### 1 or 0 ###LEFT-WALL### 13 ? 1 or 2 , 1 or 3 does 1 or 10 change 3 does 9 experience 3 does 10 change 4 early 5 - 4 early 6 life 6 life 9 experience 7 bilingual 8 language 8 language 9 experience 10 change 12 brain 11 the 12 brain [if] so , how does age of first bilingual exposure impact neural activation for language ? 0 ###LEFT-WALL### 2 so 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 16 ? 3 , 4 how 3 , 11 impact 4 how 5 does 5 does 6 age 5 does 11 impact 6 age 7 of 7 of 10 exposure 8 first 10 exposure 9 bilingual 10 exposure 11 impact 13 activation 12 neural 13 activation 13 activation 14 for 14 for 15 language we compared [how] [typically] - developing bilingual and monolingual children ( ages 7 - 10 ) and adults recruit brain areas during sentence processing using functional near infrared spectroscopy ( fnirs ) brain imaging . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 35 . 1 we 2 compared 5 - 10 children 5 - 17 and 6 developing 10 children 7 bilingual 8 and 8 and 9 monolingual 8 and 10 children 10 children 12 ages 11 ( 12 ages 12 ages 13 7 12 ages 15 10 12 ages 16 ) 14 - 15 10 15 10 16 ) 17 and 21 areas 17 and 33 brain 18 adults 21 areas 19 recruit 20 brain 20 brain 21 areas 21 areas 22 during 21 areas 33 brain 22 during 29 spectroscopy 23 sentence 29 spectroscopy 24 processing 29 spectroscopy 25 using 29 spectroscopy 26 functional 29 spectroscopy 27 near 28 infrared 28 infrared 29 spectroscopy 29 spectroscopy 31 fnirs 30 ( 31 fnirs 31 fnirs 32 ) 33 brain 34 imaging bilingual participants included early - exposed ( bilingual exposure from birth ) [and] later [-] exposed individuals ( bilingual exposure between ages 4 - 6 ) . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 16 exposed 0 ###LEFT-WALL### 27 . 1 bilingual 2 participants 2 participants 3 included 2 participants 9 exposure 2 participants 16 exposed 3 included 4 early 3 included 5 - 3 included 6 exposed 7 ( 9 exposure 8 bilingual 9 exposure 9 exposure 10 from 9 exposure 12 ) 10 from 11 birth 14 later 16 exposed 16 exposed 17 individuals 17 individuals 20 exposure 18 ( 20 exposure 19 bilingual 20 exposure 20 exposure 21 between 20 exposure 25 6 20 exposure 26 ) 21 between 22 ages 22 ages 23 4 24 - 25 6 25 6 26 ) both bilingual children and adults showed greater neural activation in left - hemisphere classic language areas , and additionally , right - hemisphere homologues [(] right superior temporal gyrus , right inferior frontal gyrus ) . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 36 . 1 both 3 children 2 bilingual 3 children 3 children 4 and 4 and 5 adults 4 and 6 showed 6 showed 9 activation 6 showed 10 in 7 greater 9 activation 8 neural 9 activation 10 in 16 areas 11 left 12 - 11 left 13 hemisphere 13 hemisphere 14 classic 14 classic 16 areas 15 language 16 areas 17 , 18 and 18 and 19 additionally 18 and 24 homologues 18 and 26 right 20 , 21 right 21 right 22 - 21 right 24 homologues 23 hemisphere 24 homologues 24 homologues 26 right 26 right 29 gyrus 27 superior 28 temporal 28 temporal 29 gyrus 29 gyrus 34 gyrus 30 , 34 gyrus 31 right 32 inferior 32 inferior 33 frontal 33 frontal 34 gyrus 34 gyrus 35 ) however , important differences were observed between early - exposed [and] later - exposed bilinguals in their earliest - exposed language . 0 ###LEFT-WALL### 4 differences 0 ###LEFT-WALL### 6 observed 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 4 differences 3 important 4 differences 4 differences 5 were 5 were 6 observed 6 observed 7 between 6 observed 16 in 7 between 15 bilinguals 8 early 9 - 8 early 15 bilinguals 10 exposed 15 bilinguals 12 later 13 - 12 later 15 bilinguals 14 exposed 15 bilinguals 16 in 21 language 17 their 18 earliest 17 their 21 language 18 earliest 19 - 20 exposed 21 language early bilingual exposure imparts fundamental changes to classic language areas instead of alterations to brain regions governing higher cognitive executive functions . 0 ###LEFT-WALL### 3 exposure 0 ###LEFT-WALL### 4 imparts 0 ###LEFT-WALL### 22 . 1 early 3 exposure 2 bilingual 3 exposure 3 exposure 4 imparts 4 imparts 6 changes 4 imparts 7 to 4 imparts 12 of 4 imparts 14 to 5 fundamental 6 changes 7 to 10 areas 8 classic 9 language 9 language 10 areas 11 instead 12 of 12 of 13 alterations 14 to 16 regions 15 brain 16 regions 16 regions 17 governing 17 governing 21 functions 18 higher 20 executive 19 cognitive 20 executive 20 executive 21 functions however , age of first bilingual exposure does matter . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 8 does 0 ###LEFT-WALL### 10 . 1 however 2 , 1 however 3 age 3 age 4 of 3 age 8 does 4 of 7 exposure 5 first 7 exposure 6 bilingual 7 exposure 8 does 9 matter later - exposed bilinguals [showed] [greater] [recruitment] of the prefrontal cortex relative to early - exposed bilinguals and monolinguals . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 20 . 1 later 2 - 1 later 4 bilinguals 3 exposed 4 bilinguals 4 bilinguals 8 of 4 bilinguals 18 and 8 of 11 cortex 9 the 11 cortex 10 prefrontal 11 cortex 11 cortex 12 relative 12 relative 13 to 13 to 17 bilinguals 14 early 15 - 14 early 17 bilinguals 16 exposed 17 bilinguals 18 and 19 monolinguals the findings provide fascinating insight into the neural resources that facilitate bilingual language use and [are] discussed in terms of how early - life language experiences can modify the neural systems underlying human language processing . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 35 processing 0 ###LEFT-WALL### 36 . 1 the 2 findings 2 findings 3 provide 3 provide 5 insight 3 provide 18 in 4 fascinating 5 insight 5 insight 6 into 6 into 9 resources 7 the 9 resources 8 neural 9 resources 9 resources 10 that 9 resources 15 and 10 that 15 and 11 facilitate 14 use 11 facilitate 15 and 12 bilingual 14 use 13 language 14 use 15 and 17 discussed 18 in 19 terms 19 terms 20 of 20 of 21 how 21 how 22 early 23 - 24 life 24 life 26 experiences 24 life 35 processing 25 language 26 experiences 26 experiences 27 can 27 can 28 modify 28 modify 31 systems 29 the 31 systems 30 neural 31 systems 31 systems 32 underlying 31 systems 35 processing 32 underlying 34 language 33 human 34 language background : hospitalised older people are at risk for poor functioning after hospital discharge . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 people 2 : 6 are 2 : 15 . 3 hospitalised 5 people 4 older 5 people 5 people 6 are 6 are 7 at 6 are 12 after 7 at 8 risk 8 risk 9 for 9 for 11 functioning 10 poor 11 functioning 12 after 14 discharge 13 hospital 14 discharge we aimed to validate the predictive ability of the identification seniors at risk - hospitalized patients ( isar - [hp] [ )(screening questionnaire to identify older patients at risk for functional dependence by comparing groups with different isar - [hp] scores on cognitive and physical functioning , mortality , health - related quality of life ( hrqol ) and loneliness . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 1 we 2 aimed 2 aimed 3 to 3 to 4 validate 4 validate 7 ability 5 the 7 ability 6 predictive 7 ability 7 ability 8 of 8 of 13 risk 9 the 13 risk 10 identification 11 seniors 11 seniors 12 at 12 at 13 risk 13 risk 18 isar 13 risk 22 )(screening 14 - 18 isar 15 hospitalized 18 isar 16 patients 18 isar 17 ( 18 isar 18 isar 19 - 19 - 22 )(screening 22 )(screening 23 questionnaire 23 questionnaire 24 to 23 questionnaire 35 groups 24 to 25 identify 25 identify 27 patients 25 identify 30 for 26 older 27 patients 27 patients 28 at 28 at 29 risk 30 for 32 dependence 31 functional 32 dependence 32 dependence 33 by 32 dependence 35 groups 33 by 34 comparing 35 groups 36 with 36 with 38 isar 36 with 48 mortality 37 different 38 isar 38 isar 41 scores 39 - 41 scores 41 scores 42 on 41 scores 47 , 42 on 44 and 43 cognitive 44 and 44 and 45 physical 44 and 47 , 45 physical 46 functioning 48 mortality 50 health 49 , 50 health 50 health 59 and 50 health 61 . 51 - 59 and 52 related 53 quality 53 quality 54 of 53 quality 59 and 54 of 55 life 55 life 57 hrqol 56 ( 57 hrqol 57 hrqol 58 ) 59 and 60 loneliness 59 and 61 . design : a longitudinal prospective cohort study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 . 1 design 2 : 2 : 7 study 3 a 4 longitudinal 3 a 7 study 4 longitudinal 6 cohort 5 prospective 6 cohort 6 cohort 7 study setting : a 450 [-] bed hospital in the netherlands . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 . 1 setting 2 : 2 : 7 hospital 3 a 7 hospital 4 450 7 hospital 6 bed 7 hospital 7 hospital 8 in 8 in 10 netherlands 9 the 10 netherlands subjects : four hundred and sixty patients 65 years or older admitted between june 2010 and october 2010 . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 12 admitted 0 ###LEFT-WALL### 19 . 1 subjects 2 : 2 : 10 or 2 : 12 admitted 3 four 4 hundred 4 hundred 5 and 5 and 6 sixty 6 sixty 9 years 7 patients 9 years 8 65 9 years 9 years 10 or 10 or 11 older 12 admitted 13 between 13 between 16 and 14 june 15 2010 14 june 16 and 16 and 17 october 17 october 18 2010 methods : participants were classified into five risk groups at hospital admission using the isar [-] [hp] . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 participants 2 : 4 were 2 : 18 . 3 participants 4 were 4 were 5 classified 5 classified 6 into 5 classified 10 at 5 classified 13 using 6 into 9 groups 7 five 9 groups 8 risk 9 groups 10 at 12 admission 11 hospital 12 admission 13 using 15 isar 14 the 15 isar we interviewed patients at hospital admission and at 3 and 12 months after admission using validated questionnaires to score hrqol , physical functioning , cognitive functioning and loneliness . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 interviewed 0 ###LEFT-WALL### 29 . 1 we 2 interviewed 2 interviewed 3 patients 2 interviewed 7 and 2 interviewed 13 after 4 at 6 admission 4 at 7 and 5 hospital 6 admission 7 and 8 at 8 at 10 and 9 3 10 and 10 and 11 12 11 12 12 months 12 months 13 after 13 after 27 and 14 admission 15 using 14 admission 21 , 15 using 17 questionnaires 15 using 18 to 16 validated 17 questionnaires 18 to 19 score 19 score 20 hrqol 21 , 23 functioning 21 , 24 , 22 physical 23 functioning 24 , 26 functioning 24 , 27 and 25 cognitive 26 functioning 27 and 28 loneliness differences in survival were quantified by a concordance statistic [(] [c] [ )( 0 ###LEFT-WALL### 1 differences 0 ###LEFT-WALL### 5 quantified 0 ###LEFT-WALL### 13 )( 1 differences 2 in 1 differences 4 were 2 in 3 survival 4 were 5 quantified 5 quantified 6 by 6 by 9 statistic 7 a 9 statistic 8 concordance 9 statistic results : cognitive functioning , [physical] functioning , loneliness and hrqol differed significantly between groups during the 1 - [year] follow - up after hospital admission ( all comparisons p < 0.05 ) , with high - risk groups having lower scores than low - risk groups for functioning and loneliness , [although] [not] always for hrqol . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 1 results 2 : 2 : 4 functioning 3 cognitive 4 functioning 4 functioning 7 functioning 5 , 7 functioning 7 functioning 8 , 8 , 10 and 8 , 12 differed 8 , 19 - 9 loneliness 10 and 10 and 11 hrqol 10 and 12 differed 12 differed 13 significantly 12 differed 14 between 12 differed 16 during 14 between 15 groups 16 during 18 1 17 the 18 1 19 - 21 follow 19 - 22 - 22 - 23 up 23 up 24 after 23 up 26 admission 23 up 35 with 24 after 25 hospital 26 admission 29 comparisons 27 ( 29 comparisons 28 all 29 comparisons 29 comparisons 31 < 29 comparisons 34 , 30 p 31 < 31 < 32 0.05 31 < 33 ) 35 with 39 groups 35 with 43 than 35 with 47 groups 36 high 37 - 36 high 39 groups 38 risk 39 groups 39 groups 40 having 40 having 42 scores 41 lower 42 scores 44 low 45 - 44 low 47 groups 46 risk 47 groups 47 groups 48 for 48 for 50 and 49 functioning 50 and 50 and 51 loneliness 50 and 52 , 50 and 56 for 52 , 55 always 52 , 56 for 56 for 57 hrqol 56 for 58 . the lowest risk group ( isar - [hp] = 0 ) scored consistently higher on functioning and hrqol than all other groups . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 12 scored 0 ###LEFT-WALL### 23 . 1 the 2 lowest 1 the 4 group 3 risk 4 group 4 group 6 isar 4 group 10 0 4 group 12 scored 5 ( 6 isar 6 isar 7 - 7 - 10 0 9 = 10 0 10 0 11 ) 12 scored 14 higher 13 consistently 14 higher 14 higher 15 on 14 higher 19 than 15 on 17 and 16 functioning 17 and 17 and 18 hrqol 19 than 22 groups 20 all 21 other 21 other 22 groups mortality differed significantly between groups ( p < 0.001 , c = 0.67 ) . 0 ###LEFT-WALL### 1 mortality 0 ###LEFT-WALL### 2 differed 0 ###LEFT-WALL### 15 . 1 mortality 2 differed 2 differed 3 significantly 2 differed 4 between 4 between 5 groups 5 groups 8 < 5 groups 12 = 6 ( 8 < 7 p 8 < 8 < 9 0.001 8 < 10 , 10 , 12 = 11 c 12 = 12 = 13 0.67 12 = 14 ) conclusions : the isar - [hp] can readily distinguish well [-] functioning older patients from patients with low functioning and low hrqol after hospital admission . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 isar 2 : 5 - 3 the 4 isar 5 - 20 and 7 can 9 distinguish 7 can 20 and 8 readily 9 distinguish 9 distinguish 14 patients 10 well 12 functioning 12 functioning 14 patients 13 older 14 patients 14 patients 15 from 15 from 16 patients 16 patients 17 with 17 with 19 functioning 18 low 19 functioning 20 and 21 low 21 low 22 hrqol 21 low 23 after 23 after 25 admission 24 hospital 25 admission the isar [-] [hp] may hence assist in selecting patients who may benefit from individually tailored reactivation treatment that is provided next to treatment of their medical condition . 0 ###LEFT-WALL### 2 isar 0 ###LEFT-WALL### 7 assist 0 ###LEFT-WALL### 29 . 1 the 2 isar 2 isar 5 may 5 may 7 assist 6 hence 7 assist 7 assist 8 in 7 assist 14 from 8 in 9 selecting 9 selecting 10 patients 10 patients 11 who 10 patients 12 may 11 who 12 may 12 may 13 benefit 14 from 18 treatment 15 individually 16 tailored 16 tailored 18 treatment 17 reactivation 18 treatment 18 treatment 21 provided 19 that 20 is 20 is 21 provided 21 provided 23 to 22 next 23 to 23 to 24 treatment 24 treatment 25 of 25 of 28 condition 26 their 28 condition 27 medical 28 condition people may reach the upper limits of the human life span at least partly because they have maintained more appropriate immune function [,] avoiding changes to immunity termed " immunosenescence . " 0 ###LEFT-WALL### 1 people 0 ###LEFT-WALL### 3 reach 0 ###LEFT-WALL### 31 . 1 people 2 may 2 may 3 reach 3 reach 5 upper 4 the 5 upper 5 upper 6 limits 5 upper 11 span 6 limits 7 of 6 limits 11 span 7 of 10 life 8 the 10 life 9 human 10 life 11 span 13 least 11 span 14 partly 11 span 26 to 12 at 13 least 14 partly 15 because 15 because 16 they 15 because 18 maintained 16 they 17 have 17 have 18 maintained 18 maintained 25 changes 19 more 20 appropriate 20 appropriate 22 function 21 immune 22 function 22 function 25 changes 24 avoiding 25 changes 26 to 27 immunity 27 immunity 28 termed 28 termed 29 " 28 termed 30 immunosenescence 31 . 32 " exceptionally long - [lived] people may be enriched for genes that contribute to their longevity , some of which may [bear] [on] [immune] function . 0 ###LEFT-WALL### 5 people 0 ###LEFT-WALL### 8 enriched 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 exceptionally 2 long 2 long 3 - 2 long 5 people 5 people 6 may 6 may 7 be 7 be 8 enriched 8 enriched 9 for 9 for 10 genes 10 genes 11 that 10 genes 12 contribute 11 that 12 contribute 12 contribute 13 to 13 to 15 longevity 14 their 15 longevity 16 , 17 some 16 , 24 function 17 some 18 of 17 some 24 function 18 of 19 which 18 of 20 may 19 which 20 may centenarian offspring would be expected to inherit some of these , which might be reflected in their resistance to immunosenescence , and contribute to their potential longevity . 0 ###LEFT-WALL### 2 offspring 0 ###LEFT-WALL### 5 expected 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 28 . 1 centenarian 2 offspring 2 offspring 3 would 3 would 4 be 4 be 5 expected 5 expected 6 to 5 expected 7 inherit 6 to 7 inherit 7 inherit 10 these 8 some 9 of 8 some 10 these 9 of 10 these 11 , 12 which 11 , 22 and 12 which 13 might 13 might 22 and 14 be 15 reflected 14 be 22 and 15 reflected 16 in 15 reflected 19 to 16 in 18 resistance 17 their 18 resistance 19 to 20 immunosenescence 21 , 22 and 22 and 23 contribute 22 and 24 to 24 to 27 longevity 25 their 27 longevity 26 potential 27 longevity we have tested this hypothesis by comparing centenarian offspring with age - matched controls . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 tested 0 ###LEFT-WALL### 12 - 1 we 2 have 2 have 3 tested 3 tested 5 hypothesis 3 tested 6 by 4 this 5 hypothesis 6 by 7 comparing 7 comparing 9 offspring 7 comparing 10 with 8 centenarian 9 offspring 10 with 11 age 12 - 14 controls 12 - 15 . 13 matched 14 controls we report differences in the numbers and proportions of both cd4 ( [+] [ )(and cd8 ( [+] [ )(early - and late - differentiated [t] cells , as well as potentially senescent cd8 [(] + [ )( cells , suggesting that the adaptive [t] - cell arm of the immune system is more " youthful " in centenarian offspring than controls [.] 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 report 0 ###LEFT-WALL### 7 and 1 we 2 report 2 report 3 differences 3 differences 4 in 4 in 6 numbers 5 the 6 numbers 7 and 15 )(and 8 proportions 9 of 8 proportions 15 )(and 9 of 11 cd4 10 both 11 cd4 12 ( 15 )(and 15 )(and 16 cd8 15 )(and 22 and 15 )(and 25 differentiated 17 ( 22 and 20 )(early 22 and 21 - 22 and 22 and 23 late 22 and 24 - 25 differentiated 27 cells 27 cells 36 + 28 , 36 + 29 as 30 well 29 as 36 + 30 well 31 as 30 well 36 + 31 as 34 cd8 32 potentially 33 senescent 33 senescent 34 cd8 36 + 39 cells 39 cells 41 suggesting 40 , 41 suggesting 41 suggesting 42 that 42 that 48 arm 42 that 53 is 43 the 48 arm 44 adaptive 46 - 44 adaptive 48 arm 47 cell 48 arm 48 arm 49 of 48 arm 53 is 49 of 52 system 50 the 52 system 51 immune 52 system 53 is 56 youthful 54 more 55 " 54 more 56 youthful 56 youthful 57 " 56 youthful 58 in 56 youthful 61 than 58 in 60 offspring 59 centenarian 60 offspring 61 than 62 controls this might reflect a superior ability to mount effective responses against newly encountered antigens and thus contribute to better protection against infection and to greater longevity . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 19 better 0 ###LEFT-WALL### 27 . 1 this 2 might 2 might 3 reflect 3 reflect 6 ability 4 a 5 superior 4 a 6 ability 5 superior 6 ability 6 ability 7 to 6 ability 15 and 7 to 15 and 8 mount 10 responses 8 mount 11 against 8 mount 15 and 9 effective 10 responses 11 against 14 antigens 12 newly 13 encountered 13 encountered 14 antigens 15 and 17 contribute 16 thus 17 contribute 17 contribute 18 to 18 to 19 better 19 better 20 protection 20 protection 23 and 21 against 22 infection 21 against 23 and 23 and 24 to 24 to 26 longevity 25 greater 26 longevity background : whether insulin secretion and insulin sensitivity in older chinese differ from younger persons without diabetes has not been examined and is unknown to us . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 22 and 2 : 27 . 3 whether 6 and 3 whether 12 differ 3 whether 22 and 4 insulin 5 secretion 5 secretion 6 and 6 and 8 sensitivity 6 and 9 in 6 and 12 differ 7 insulin 8 sensitivity 9 in 11 chinese 10 older 11 chinese 12 differ 13 from 12 differ 16 without 13 from 15 persons 14 younger 15 persons 16 without 17 diabetes 18 has 19 not 18 has 20 been 18 has 22 and 20 been 21 examined 22 and 23 is 23 is 24 unknown 24 unknown 25 to 25 to 26 us methods : oral glucose tolerance [test] was performed in a total of 32,245 chinese without diabetes history . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 tolerance 2 : 8 performed 2 : 18 . 3 oral 5 tolerance 4 glucose 5 tolerance 5 tolerance 7 was 7 was 8 performed 8 performed 9 in 9 in 11 total 10 a 11 total 11 total 12 of 12 of 13 32,245 13 32,245 14 chinese 14 chinese 15 without 15 without 17 history 16 diabetes 17 history insulin sensitivity was estimated by matsuda 's insulin sensitivity index ( matsuda isi ) , and insulin secretion was measured by the insulinogenic index . 0 ###LEFT-WALL### 2 sensitivity 0 ###LEFT-WALL### 4 estimated 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 . 1 insulin 2 sensitivity 2 sensitivity 3 was 3 was 4 estimated 4 estimated 5 by 5 by 10 index 6 matsuda 7 's 7 's 10 index 8 insulin 10 index 9 sensitivity 10 index 10 index 13 isi 11 ( 13 isi 12 matsuda 13 isi 13 isi 14 ) 15 , 16 and 16 and 18 secretion 16 and 19 was 17 insulin 18 secretion 18 secretion 19 was 19 was 20 measured 20 measured 21 by 21 by 24 index 22 the 24 index 23 insulinogenic 24 index the insulin secretion and sensitivity were compared among three age groups : 20 - 39 ( the young ) , 40 - 59 ( the middle [ )(, and greater than [or] equal to 60 years [(] [the] [older] ) . 0 ###LEFT-WALL### 2 insulin 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 41 . 1 the 2 insulin 2 insulin 4 and 2 insulin 6 were 2 insulin 7 compared 2 insulin 8 among 2 insulin 12 : 3 secretion 4 and 4 and 5 sensitivity 4 and 6 were 8 among 11 groups 9 three 10 age 10 age 11 groups 12 : 13 20 13 20 15 39 14 - 15 39 15 39 18 young 15 39 19 ) 16 ( 18 young 17 the 18 young 18 young 19 ) 20 , 21 40 20 , 22 - 22 - 23 59 23 59 36 years 24 ( 36 years 25 the 26 middle 26 middle 29 and 28 )(, 29 and 29 and 30 greater 29 and 36 years 30 greater 31 than 31 than 33 equal 31 than 34 to 34 to 35 60 36 years 40 ) results : a higher proportion of postchallenge hyperglycemia ( ph ) , both in prediabetes and in diabetes [stage] , was associated with older age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 proportion 2 : 22 associated 2 : 26 . 3 a 5 proportion 4 higher 5 proportion 5 proportion 6 of 5 proportion 21 was 6 of 8 hyperglycemia 7 postchallenge 8 hyperglycemia 8 hyperglycemia 10 ph 8 hyperglycemia 13 both 9 ( 10 ph 10 ph 11 ) 12 , 13 both 13 both 16 and 13 both 20 , 14 in 15 prediabetes 14 in 16 and 16 and 17 in 17 in 18 diabetes 21 was 22 associated 22 associated 23 with 23 with 25 age 24 older 25 age in the young , middle , and older age groups , the insulinogenic index median was 10.64 , 8.40 , and [6.67] , respectively , in individuals with normal glucose tolerance ( ngt ) [;] [it] was 8.56 [,] 6.12 [,] and 4.98 in individuals with prediabetes , respectively [(] [p] < [.] 001 vs the young group [ )( 0 ###LEFT-WALL### 10 groups 0 ###LEFT-WALL### 11 , 1 in 10 groups 2 the 5 middle 3 young 4 , 3 young 5 middle 5 middle 7 and 6 , 7 and 7 and 8 older 7 and 10 groups 9 age 10 groups 11 , 15 median 11 , 16 was 11 , 21 and 12 the 15 median 13 insulinogenic 15 median 14 index 15 median 15 median 16 was 16 was 17 10.64 17 10.64 19 8.40 18 , 19 8.40 19 8.40 20 , 21 and 23 , 21 and 24 respectively 21 and 31 tolerance 23 , 24 respectively 24 respectively 25 , 26 in 27 individuals 26 in 31 tolerance 27 individuals 28 with 28 with 30 glucose 29 normal 30 glucose 31 tolerance 33 ngt 31 tolerance 37 was 32 ( 33 ngt 33 ngt 34 ) 37 was 45 individuals 38 8.56 45 individuals 40 6.12 42 and 42 and 43 4.98 42 and 44 in 44 in 45 individuals 45 individuals 46 with 46 with 47 prediabetes 47 prediabetes 54 001 48 , 49 respectively 48 , 54 001 52 < 54 001 54 001 55 vs 54 001 60 )( 55 vs 58 group 56 the 58 group 57 young 58 group in these three age groups , the matsuda insulin sensitivity index was 8.20 , 8.39 , and 8.84 in individuals with normal glucose tolerance , and it [was] [5.23] , 5.94 , and 6.33 in individuals with prediabetes , respectively [(] [p] < [.] 05 vs the young group [ )( 0 ###LEFT-WALL### 4 age 0 ###LEFT-WALL### 5 groups 0 ###LEFT-WALL### 6 , 1 in 3 three 1 in 4 age 2 these 3 three 4 age 5 groups 6 , 17 and 7 the 10 sensitivity 8 matsuda 9 insulin 9 insulin 10 sensitivity 10 sensitivity 17 and 11 index 12 was 12 was 13 8.20 13 8.20 15 8.39 14 , 15 8.39 15 8.39 16 , 16 , 17 and 17 and 20 individuals 18 8.84 19 in 19 in 20 individuals 20 individuals 21 with 21 with 33 and 22 normal 23 glucose 23 glucose 24 tolerance 24 tolerance 26 and 25 , 26 and 26 and 27 it 26 and 31 5.94 26 and 33 and 30 , 31 5.94 31 5.94 32 , 33 and 36 individuals 33 and 37 with 34 6.33 35 in 35 in 36 individuals 37 with 38 prediabetes 38 prediabetes 45 05 39 , 40 respectively 39 , 45 05 43 < 45 05 45 05 46 vs 45 05 51 )( 46 vs 49 group 47 the 49 group 48 young 49 group [these] differences [were] independent [of] body mass index [and] waist circumference . 0 ###LEFT-WALL### 11 circumference 0 ###LEFT-WALL### 12 . 2 differences 11 circumference 4 independent 6 body 6 body 11 circumference 7 mass 11 circumference 8 index 11 circumference 10 waist 11 circumference conclusions : older chinese without diabetes [are] characterized with worse insulin secretion and better insulin sensitivity . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 1 conclusions 2 : 2 : 16 sensitivity 3 older 4 chinese 4 chinese 5 without 4 chinese 8 characterized 4 chinese 13 and 5 without 6 diabetes 8 characterized 9 with 9 with 12 secretion 10 worse 11 insulin 11 insulin 12 secretion 13 and 14 better 13 and 15 insulin 15 insulin 16 sensitivity insulin insufficiency and insulin resistance may contribute disproportionately to abnormal glucose tolerance in people of different age . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 7 contribute 0 ###LEFT-WALL### 18 . 1 insulin 2 insufficiency 2 insufficiency 3 and 3 and 5 resistance 3 and 6 may 4 insulin 5 resistance 6 may 7 contribute 7 contribute 8 disproportionately 7 contribute 9 to 7 contribute 13 in 9 to 12 tolerance 10 abnormal 11 glucose 11 glucose 12 tolerance 13 in 14 people 14 people 15 of 15 of 17 age 16 different 17 age cdkn1a ( p21 ) and cdkn2a ( p16 ) inhibit cdk4/6 , initiating senescence . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 inhibit 1 cdkn1a 3 p21 1 cdkn1a 5 and 2 ( 3 p21 3 p21 4 ) 5 and 6 cdkn2a 5 and 10 inhibit 6 cdkn2a 8 p16 7 ( 8 p16 8 p16 9 ) 10 inhibit 11 cdk4/6 11 cdk4/6 13 initiating 12 , 13 initiating 13 initiating 14 senescence 13 initiating 15 . according to our view on senescence , the role of p21 and p16 is to cause cell cycle arrest , whereas mtor ( mechanistic target [of] rapamycin ) drives geroconversion to senescence . 0 ###LEFT-WALL### 9 role 0 ###LEFT-WALL### 29 drives 0 ###LEFT-WALL### 33 . 1 according 2 to 2 to 4 view 2 to 9 role 3 our 4 view 5 on 6 senescence 5 on 7 , 5 on 9 role 8 the 9 role 9 role 10 of 9 role 14 is 10 of 12 and 11 p21 12 and 12 and 13 p16 14 is 15 to 14 is 16 cause 15 to 16 cause 16 cause 19 arrest 16 cause 21 whereas 17 cell 19 arrest 18 cycle 19 arrest 20 , 21 whereas 21 whereas 22 mtor 22 mtor 27 rapamycin 22 mtor 29 drives 23 ( 27 rapamycin 24 mechanistic 25 target 25 target 27 rapamycin 27 rapamycin 28 ) 29 drives 30 geroconversion 30 geroconversion 31 to 31 to 32 senescence recently we demonstrated that one of the markers of p21 - and p16 - initiated senescence is mek - dependent hyper - elevation of cyclin d1 . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 19 - 0 ###LEFT-WALL### 27 . 1 recently 2 we 2 we 3 demonstrated 3 demonstrated 4 that 3 demonstrated 17 is 4 that 12 and 4 that 15 initiated 4 that 17 is 5 one 6 of 5 one 9 of 5 one 12 and 6 of 8 markers 7 the 8 markers 9 of 10 p21 11 - 12 and 12 and 13 p16 12 and 14 - 12 and 15 initiated 15 initiated 16 senescence 17 is 18 mek 19 - 23 elevation 20 dependent 23 elevation 21 hyper 22 - 21 hyper 23 elevation 23 elevation 24 of 24 of 26 d1 25 cyclin 26 d1 we noticed that a synthetic inhibitor of cdk 4/6 ( pd0332991 ) also induced cyclin d1 - positive senescence . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 noticed 0 ###LEFT-WALL### 17 - 0 ###LEFT-WALL### 20 . 1 we 2 noticed 2 noticed 3 that 3 that 6 inhibitor 3 that 14 induced 4 a 5 synthetic 4 a 6 inhibitor 5 synthetic 6 inhibitor 6 inhibitor 7 of 6 inhibitor 14 induced 7 of 8 cdk 8 cdk 9 4/6 8 cdk 11 pd0332991 10 ( 11 pd0332991 11 pd0332991 12 ) 13 also 14 induced 14 induced 16 d1 15 cyclin 16 d1 17 - 19 senescence 18 positive 19 senescence we demonstrated that pd0332991 and p21 caused almost identical senescence phenotypes . p21 , p16 , and pd0332991 do not inhibit mtor , and rapamycin decelerates geroconversion caused by all 3 molecules . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 demonstrated 0 ###LEFT-WALL### 12 . 1 we 2 demonstrated 2 demonstrated 5 and 3 that 5 and 4 pd0332991 5 and 5 and 6 p21 5 and 7 caused 5 and 10 senescence 5 and 11 phenotypes 8 almost 9 identical 9 identical 10 senescence 10 senescence 11 phenotypes 12 . 17 and 12 . 21 inhibit 12 . 24 and 12 . 33 . 13 p21 14 , 13 p21 15 p16 15 p16 17 and 16 , 17 and 17 and 18 pd0332991 17 and 19 do 19 do 20 not 19 do 21 inhibit 21 inhibit 22 mtor 23 , 24 and 24 and 25 rapamycin 24 and 26 decelerates 25 rapamycin 26 decelerates 26 decelerates 27 geroconversion 27 geroconversion 28 caused 27 geroconversion 29 by 29 by 32 molecules 30 all 31 3 31 3 32 molecules like p21 , pd0332991 initiated senescence at any concentration that inhibited cell proliferation . 0 ###LEFT-WALL### 1 like 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 14 . 1 like 2 p21 3 , 4 pd0332991 3 , 5 initiated 4 pd0332991 5 initiated 5 initiated 6 senescence 5 initiated 7 at 7 at 13 proliferation 8 any 13 proliferation 9 concentration 13 proliferation 10 that 11 inhibited 11 inhibited 12 cell 12 cell 13 proliferation this confirms the notion that a mere arrest in the presence of active mtor may lead to senescence . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 confirms 0 ###LEFT-WALL### 19 . 1 this 2 confirms 2 confirms 4 notion 3 the 4 notion 4 notion 5 that 5 that 8 arrest 5 that 16 lead 6 a 7 mere 6 a 8 arrest 7 mere 8 arrest 8 arrest 9 in 8 arrest 15 may 9 in 11 presence 10 the 11 presence 11 presence 12 of 12 of 14 mtor 13 active 14 mtor 15 may 16 lead 16 lead 17 to 17 to 18 senescence [none] background & aims : life expectancy is an important consideration when assessing appropriateness of preventive programs for older individuals . 0 ###LEFT-WALL### 4 aims 0 ###LEFT-WALL### 5 : 2 background 3 & 3 & 4 aims 5 : 7 expectancy 5 : 8 is 5 : 21 . 6 life 7 expectancy 7 expectancy 8 is 8 is 11 consideration 8 is 12 when 9 an 10 important 9 an 11 consideration 10 important 11 consideration 12 when 13 assessing 13 assessing 14 appropriateness 14 appropriateness 15 of 15 of 17 programs 16 preventive 17 programs 17 programs 18 for 18 for 20 individuals 19 older 20 individuals most studies on this subject have used age cutoffs as a proxy for life expectancy . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 7 used 0 ###LEFT-WALL### 16 . 1 most 2 studies 2 studies 3 on 2 studies 6 have 3 on 5 subject 4 this 5 subject 6 have 7 used 7 used 9 cutoffs 7 used 10 as 8 age 9 cutoffs 10 as 12 proxy 11 a 12 proxy 12 proxy 13 for 13 for 15 expectancy 14 life 15 expectancy we analyzed patterns of utilization of screening colonoscopy in medicare enrollees by using estimated life expectancy . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 analyzed 0 ###LEFT-WALL### 17 . 1 we 2 analyzed 2 analyzed 3 patterns 2 analyzed 9 in 2 analyzed 12 by 3 patterns 4 of 3 patterns 6 of 4 of 5 utilization 6 of 7 screening 7 screening 8 colonoscopy 9 in 11 enrollees 10 medicare 11 enrollees 12 by 13 using 13 using 16 expectancy 14 estimated 15 life 15 life 16 expectancy methods : we used a 5 % random national sample of medicare claims data to identify average - risk patients who underwent screening colonoscopies from 2008 to 2010 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 identify 0 ###LEFT-WALL### 29 . 2 : 3 we 2 : 4 used 3 we 4 used 4 used 10 sample 4 used 15 to 5 a 10 sample 6 5 7 % 7 % 10 sample 8 random 10 sample 9 national 10 sample 10 sample 11 of 11 of 14 data 12 medicare 14 data 13 claims 14 data 15 to 16 identify 16 identify 20 patients 17 average 18 - 17 average 20 patients 19 risk 20 patients 20 patients 21 who 20 patients 22 underwent 20 patients 23 screening 21 who 22 underwent 23 screening 24 colonoscopies 23 screening 27 to 25 from 27 to 26 2008 27 to 27 to 28 2010 colonoscopies were considered to be screening colonoscopies in the absence of diagnoses for nonscreening indications , which were based on either colonoscopies or any claims in the preceding 3 months . 0 ###LEFT-WALL### 1 colonoscopies 0 ###LEFT-WALL### 3 considered 1 colonoscopies 2 were 2 were 3 considered 3 considered 4 to 3 considered 5 be 4 to 5 be 5 be 6 screening 6 screening 7 colonoscopies 7 colonoscopies 8 in 7 colonoscopies 13 for 8 in 10 absence 9 the 10 absence 10 absence 11 of 11 of 12 diagnoses 13 for 15 indications 14 nonscreening 15 indications 15 indications 17 which 16 , 17 which 17 which 18 were 17 which 31 . 18 were 19 based 19 based 20 on 20 on 23 or 21 either 23 or 22 colonoscopies 23 or 23 or 25 claims 23 or 26 in 24 any 25 claims 26 in 30 months 27 the 30 months 28 preceding 30 months 29 3 30 months we estimated life expectancies by using a model that combined age , sex , and comorbidity . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 estimated 0 ###LEFT-WALL### 17 . 1 we 2 estimated 2 estimated 4 expectancies 2 estimated 5 by 3 life 4 expectancies 5 by 6 using 6 using 8 model 7 a 8 model 8 model 9 that 8 model 10 combined 9 that 10 combined 10 combined 15 and 11 age 12 , 12 , 13 sex 12 , 15 and 14 , 15 and 15 and 16 comorbidity among patients who underwent screening colonoscopies , we calculated the percentage of those with life expectancies < 10 years . 0 ###LEFT-WALL### 11 percentage 0 ###LEFT-WALL### 17 < 0 ###LEFT-WALL### 20 . 1 among 2 patients 1 among 11 percentage 2 patients 3 who 2 patients 4 underwent 3 who 4 underwent 5 screening 6 colonoscopies 5 screening 7 , 5 screening 11 percentage 7 , 9 calculated 8 we 9 calculated 9 calculated 11 percentage 10 the 11 percentage 11 percentage 12 of 11 percentage 17 < 12 of 13 those 13 those 14 with 14 with 16 expectancies 15 life 16 expectancies 17 < 19 years 18 10 19 years results : among the 57,597 medicare beneficiaries 66 years old or [older] who received at [least] 1 screening colonoscopy , 24.8 % had an estimated life expectancy of < 10 years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 14 received 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 32 . 1 results 2 : 2 : 3 among 2 : 14 received 3 among 11 or 4 the 5 57,597 5 57,597 7 beneficiaries 6 medicare 7 beneficiaries 7 beneficiaries 10 old 7 beneficiaries 11 or 8 66 9 years 9 years 10 old 11 or 13 who 14 received 15 at 14 received 19 colonoscopy 15 at 18 screening 17 1 18 screening 20 , 22 % 20 , 23 had 21 24.8 22 % 22 % 23 had 23 had 27 expectancy 24 an 27 expectancy 25 estimated 26 life 26 life 27 expectancy 27 expectancy 28 of 28 of 31 years 29 < 30 10 30 10 31 years in a multivariable analysis , men were substantially more likely than women to have limited life expectancy at the time of screening colonoscopy ( odds [ratio] , 2.25 ; 95 % confidence interval , 2.16 - 2.34 [ )( 0 ###LEFT-WALL### 6 men 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 29 ; 0 ###LEFT-WALL### 39 )( 1 in 4 analysis 1 in 5 , 1 in 6 men 2 a 3 multivariable 2 a 4 analysis 3 multivariable 4 analysis 6 men 7 were 7 were 8 substantially 7 were 10 likely 9 more 10 likely 10 likely 11 than 10 likely 13 to 10 likely 15 limited 11 than 12 women 13 to 14 have 14 have 15 limited 15 limited 17 expectancy 15 limited 18 at 16 life 17 expectancy 18 at 20 time 19 the 20 time 20 time 21 of 20 time 25 odds 21 of 22 screening 22 screening 23 colonoscopy 24 ( 25 odds 25 odds 28 2.25 25 odds 29 ; 27 , 28 2.25 28 2.25 29 ; 29 ; 33 interval 29 ; 34 , 30 95 31 % 31 % 32 confidence 32 confidence 33 interval 34 , 35 2.16 34 , 36 - 35 2.16 36 - 36 - 37 2.34 conclusions : nearly 25 % of medicare beneficiaries , especially men , had life expectancies [<] 10 years at the time of screening colonoscopies . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 1 conclusions 2 : 2 : 3 nearly 2 : 5 % 4 25 5 % 5 % 6 of 6 of 7 medicare 7 medicare 8 beneficiaries 7 medicare 23 screening 8 beneficiaries 11 men 8 beneficiaries 13 had 9 , 10 especially 9 , 11 men 11 men 12 , 13 had 18 years 13 had 19 at 14 life 18 years 15 expectancies 18 years 17 10 18 years 19 at 21 time 20 the 21 time 21 time 22 of 22 of 23 screening 23 screening 24 colonoscopies life expectancy should therefore be incorporated in decision [-] making for preventive services . 0 ###LEFT-WALL### 2 expectancy 0 ###LEFT-WALL### 6 incorporated 0 ###LEFT-WALL### 14 . 1 life 2 expectancy 2 expectancy 3 should 3 should 5 be 4 therefore 5 be 5 be 6 incorporated 6 incorporated 7 in 7 in 10 making 8 decision 10 making 10 making 11 for 11 for 13 services 12 preventive 13 services ethnopharmacological relevance : baicalin is one of the principal flavonoids isolated from the dried root of scutellaria baicalensis georgi that has long been used to treat [ischemic] stroke . 0 ###LEFT-WALL### 2 relevance 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 29 . 1 ethnopharmacological 2 relevance 3 : 4 baicalin 3 : 5 is 4 baicalin 5 is 5 is 6 one 6 one 7 of 6 one 11 isolated 7 of 10 flavonoids 8 the 10 flavonoids 9 principal 10 flavonoids 11 isolated 12 from 12 from 15 root 13 the 15 root 14 dried 15 root 15 root 16 of 15 root 18 baicalensis 15 root 28 stroke 16 of 17 scutellaria 18 baicalensis 19 georgi 18 baicalensis 26 treat 18 baicalensis 28 stroke 19 georgi 20 that 19 georgi 23 been 19 georgi 24 used 20 that 21 has 21 has 23 been 22 long 23 been 24 used 25 to 24 used 26 treat 25 to 26 treat however , its neuroprotective mechanisms against cerebral ischemia injury are poorly understood . 0 ###LEFT-WALL### 5 mechanisms 0 ###LEFT-WALL### 12 understood 0 ###LEFT-WALL### 13 . 1 however 2 , 1 however 5 mechanisms 3 its 5 mechanisms 4 neuroprotective 5 mechanisms 5 mechanisms 6 against 5 mechanisms 10 are 6 against 9 injury 7 cerebral 9 injury 8 ischemia 9 injury 10 are 12 understood 11 poorly 12 understood aim of the study : to explore the neuroprotective mechanisms of baicalin against cerebral ischemia reperfusion injury . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 : 1 aim 2 of 2 of 3 the 3 the 4 study 5 : 6 to 5 : 7 explore 5 : 18 . 6 to 7 explore 7 explore 10 mechanisms 7 explore 13 against 8 the 10 mechanisms 9 neuroprotective 10 mechanisms 10 mechanisms 11 of 11 of 12 baicalin 13 against 17 injury 14 cerebral 15 ischemia 15 ischemia 17 injury 16 reperfusion 17 injury material and methods : in chemical systems , we conducted electron paramagnetic resonance ( epr ) spin trapping experiments to evaluate the scavenging effects of baicalin on superoxide and nitric oxide , and mass spectrometry [(] [ms] ) studies on the reaction of baicalin and peroxynitrite . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 47 . 1 material 2 and 2 and 3 methods 4 : 7 systems 4 : 8 , 4 : 33 and 5 in 6 chemical 6 chemical 7 systems 8 , 9 we 8 , 19 experiments 9 we 10 conducted 10 conducted 13 resonance 11 electron 13 resonance 12 paramagnetic 13 resonance 13 resonance 15 epr 14 ( 15 epr 15 epr 16 ) 17 spin 18 trapping 18 trapping 19 experiments 19 experiments 20 to 20 to 33 and 21 evaluate 29 and 21 evaluate 33 and 22 the 29 and 23 scavenging 24 effects 24 effects 25 of 24 effects 29 and 25 of 26 baicalin 26 baicalin 27 on 27 on 28 superoxide 29 and 31 oxide 30 nitric 31 oxide 32 , 33 and 33 and 34 mass 33 and 40 on 34 mass 39 studies 35 spectrometry 38 ) 35 spectrometry 39 studies 40 on 42 reaction 41 the 42 reaction 42 reaction 43 of 43 of 45 and 44 baicalin 45 and 45 and 46 peroxynitrite in cellular experiments , we investigated the effects of baicalin against extraneous and endogenous peroxynitrite mediated neurotoxicity in sh - sy5y cells treated with peroxynitrite [donor] , synthesized peroxynitrite and exposed to oxygen glucose deprivation and reoxygenation ( ogd/ro ) in vitro . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 31 exposed 0 ###LEFT-WALL### 43 . 1 in 3 experiments 1 in 4 , 1 in 5 we 2 cellular 3 experiments 5 we 6 investigated 6 investigated 8 effects 6 investigated 11 against 7 the 8 effects 8 effects 9 of 9 of 10 baicalin 11 against 15 peroxynitrite 12 extraneous 13 and 13 and 14 endogenous 13 and 15 peroxynitrite 15 peroxynitrite 16 mediated 15 peroxynitrite 17 neurotoxicity 15 peroxynitrite 31 exposed 17 neurotoxicity 18 in 17 neurotoxicity 30 and 18 in 19 sh 19 sh 22 cells 20 - 22 cells 21 sy5y 22 cells 22 cells 23 treated 22 cells 24 with 22 cells 27 , 24 with 25 peroxynitrite 28 synthesized 29 peroxynitrite 28 synthesized 30 and 30 and 31 exposed 31 exposed 32 to 31 exposed 42 vitro 32 to 36 and 33 oxygen 35 deprivation 34 glucose 35 deprivation 35 deprivation 36 and 36 and 37 reoxygenation 36 and 39 ogd/ro 38 ( 39 ogd/ro 39 ogd/ro 40 ) 41 in 42 vitro moreover , we studied the neuroprotective effects of baicalin by using a rat model of middle cerebral artery occlusion in vivo . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 studied 0 ###LEFT-WALL### 22 . 1 moreover 2 , 1 moreover 3 we 3 we 4 studied 4 studied 7 effects 4 studied 10 by 5 the 7 effects 6 neuroprotective 7 effects 7 effects 8 of 8 of 9 baicalin 10 by 11 using 11 using 14 model 11 using 21 vivo 12 a 14 model 13 rat 14 model 14 model 15 of 15 of 19 occlusion 16 middle 19 occlusion 17 cerebral 18 artery 18 artery 19 occlusion 20 in 21 vivo fetmpyp , a peroxynitrite decomposition catalyst , was used as positive control . 0 ###LEFT-WALL### 1 fetmpyp 0 ###LEFT-WALL### 9 used 0 ###LEFT-WALL### 13 . 1 fetmpyp 6 catalyst 1 fetmpyp 8 was 2 , 6 catalyst 3 a 4 peroxynitrite 3 a 6 catalyst 4 peroxynitrite 5 decomposition 5 decomposition 6 catalyst 6 catalyst 7 , 8 was 9 used 9 used 10 as 10 as 12 control 11 positive 12 control cell viability and apoptotic cell death was accessed by mtt [assay] and tunel assay respectively ; 3 - nitrotyrosine formation and infarction volume were detected by immunostaining experiments and ttc staining respectively . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 16 ; 0 ###LEFT-WALL### 33 . 1 cell 2 viability 2 viability 3 and 3 and 5 cell 3 and 6 death 3 and 7 was 3 and 8 accessed 4 apoptotic 5 cell 6 death 7 was 8 accessed 9 by 8 accessed 15 respectively 9 by 12 and 10 mtt 12 and 12 and 14 assay 13 tunel 14 assay 16 ; 17 3 16 ; 18 - 17 3 18 - 18 - 29 and 19 nitrotyrosine 20 formation 20 formation 21 and 21 and 22 infarction 21 and 23 volume 21 and 27 immunostaining 21 and 29 and 23 volume 24 were 24 were 25 detected 25 detected 26 by 26 by 27 immunostaining 27 immunostaining 28 experiments 29 and 30 ttc 30 ttc 31 staining 31 staining 32 respectively results : baicalin revealed strong antioxidant ability by directly scavenging superoxide and reacting with peroxynitrite . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 3 baicalin 2 : 4 revealed 3 baicalin 4 revealed 4 revealed 7 ability 5 strong 7 ability 6 antioxidant 7 ability 7 ability 8 by 8 by 12 and 9 directly 10 scavenging 10 scavenging 11 superoxide 11 superoxide 12 and 12 and 13 reacting 12 and 14 with 14 with 15 peroxynitrite baicalin protected the neuronal cells from extraneous and endogenous peroxynitrite - induced neurotoxicity . 0 ###LEFT-WALL### 1 baicalin 0 ###LEFT-WALL### 2 protected 0 ###LEFT-WALL### 14 . 1 baicalin 2 protected 2 protected 5 cells 3 the 5 cells 4 neuronal 5 cells 5 cells 6 from 6 from 13 neurotoxicity 7 extraneous 8 and 8 and 9 endogenous 8 and 13 neurotoxicity 10 peroxynitrite 11 - 10 peroxynitrite 13 neurotoxicity 12 induced 13 neurotoxicity in ischemia - reperfused brains , baicalin inhibited the formation of 3 - nitrotyrosine , reduced infarct size and attenuated apoptotic cell death , whose effects were similar to fetmpyp . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 17 infarct 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 31 . 1 in 7 baicalin 1 in 17 infarct 2 ischemia 5 brains 2 ischemia 6 , 2 ischemia 7 baicalin 3 - 5 brains 4 reperfused 5 brains 5 brains 6 , 7 baicalin 8 inhibited 7 baicalin 10 formation 7 baicalin 16 reduced 9 the 10 formation 10 formation 11 of 10 formation 14 nitrotyrosine 10 formation 16 reduced 11 of 12 3 13 - 14 nitrotyrosine 14 nitrotyrosine 15 , 17 infarct 19 and 18 size 19 and 19 and 23 death 20 attenuated 22 cell 21 apoptotic 22 cell 22 cell 23 death 24 , 25 whose 24 , 27 were 25 whose 26 effects 26 effects 27 were 27 were 28 similar 28 similar 29 to 29 to 30 fetmpyp conclusions : baicalin can directly scavenge peroxynitrite and the peroxynitrite - scavenging ability contributes to its neuroprotective mechanisms against cerebral ischemia reperfusion injury . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 3 baicalin 2 : 6 scavenge 2 : 11 - 3 baicalin 4 can 4 can 6 scavenge 5 directly 6 scavenge 6 scavenge 8 and 7 peroxynitrite 8 and 8 and 10 peroxynitrite 9 the 10 peroxynitrite 11 - 13 ability 11 - 14 contributes 12 scavenging 13 ability 13 ability 14 contributes 14 contributes 15 to 14 contributes 19 against 15 to 18 mechanisms 16 its 18 mechanisms 17 neuroprotective 18 mechanisms 19 against 23 injury 20 cerebral 21 ischemia 21 ischemia 23 injury 22 reperfusion 23 injury behavioral , cognitive , and motivational development entails co - constructive interactions between the environmental and social influences from the developmental context , on the one hand , and the individual 's neurobiological inheritance , on the other hand . 0 ###LEFT-WALL### 7 development 0 ###LEFT-WALL### 8 entails 1 behavioral 2 , 1 behavioral 7 development 3 cognitive 5 and 4 , 5 and 5 and 6 motivational 5 and 7 development 7 development 8 entails 8 entails 12 interactions 8 entails 13 between 8 entails 19 from 9 co 10 - 9 co 12 interactions 11 constructive 12 interactions 13 between 18 influences 14 the 18 influences 15 environmental 16 and 16 and 17 social 16 and 18 influences 19 from 22 context 20 the 22 context 21 developmental 22 context 22 context 24 on 22 context 36 on 23 , 24 on 24 on 29 and 24 on 35 , 25 the 26 one 26 one 27 hand 27 hand 29 and 28 , 29 and 29 and 34 inheritance 29 and 35 , 30 the 31 individual 31 individual 32 's 32 's 34 inheritance 33 neurobiological 34 inheritance 35 , 36 on 36 on 39 hand 36 on 40 . 37 the 38 other 38 other 39 hand key brain networks underlying cognition , emotion , and motivation are innervated by major transmitter systems ( e.g [.] , the catecholamines and acetylcholine ) . 0 ###LEFT-WALL### 1 key 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 26 . 1 key 3 networks 2 brain 3 networks 3 networks 4 underlying 4 underlying 5 cognition 6 , 9 and 6 , 12 innervated 7 emotion 9 and 8 , 9 and 9 and 10 motivation 9 and 11 are 11 are 12 innervated 12 innervated 13 by 13 by 16 systems 14 major 16 systems 15 transmitter 16 systems 16 systems 23 and 17 ( 23 and 18 e.g 20 , 20 , 22 catecholamines 20 , 23 and 21 the 22 catecholamines 23 and 24 acetylcholine 23 and 25 ) thus , the maturation and senescence of neurotransmitter systems have direct implications for lifespan development . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 have 0 ###LEFT-WALL### 16 . 1 thus 2 , 1 thus 5 and 3 the 4 maturation 4 maturation 5 and 5 and 6 senescence 5 and 7 of 5 and 10 have 7 of 9 systems 8 neurotransmitter 9 systems 10 have 12 implications 11 direct 12 implications 12 implications 13 for 13 for 15 development 14 lifespan 15 development in addition to reviewing evidence on life age differences in dopaminergic modulation and cognitive development , this brief review selectively highlights recent findings on how important influences from the developmental context , such as reward - mediated motivational processes , transgenerational stress transmission , psychosocial stress , and cognitive interventions [,] may [,] [in] part , exert their effects on brain and behavioral development through their effects on neuromodulatory mechanisms . 0 ###LEFT-WALL### 5 evidence 1 in 2 addition 1 in 5 evidence 2 addition 3 to 3 to 4 reviewing 5 evidence 6 on 5 evidence 9 differences 6 on 8 age 7 life 8 age 9 differences 10 in 9 differences 19 review 9 differences 21 highlights 10 in 13 and 11 dopaminergic 12 modulation 12 modulation 13 and 13 and 15 development 13 and 16 , 14 cognitive 15 development 17 this 18 brief 18 brief 19 review 19 review 21 highlights 20 selectively 21 highlights 21 highlights 23 findings 21 highlights 24 on 22 recent 23 findings 24 on 25 how 25 how 27 influences 25 how 37 mediated 26 important 27 influences 27 influences 28 from 27 influences 34 as 27 influences 37 mediated 28 from 31 context 29 the 31 context 30 developmental 31 context 32 , 34 as 33 such 34 as 34 as 35 reward 34 as 36 - 37 mediated 48 and 38 motivational 39 processes 39 processes 40 , 40 , 43 transmission 40 , 44 , 41 transgenerational 42 stress 42 stress 43 transmission 44 , 46 stress 44 , 48 and 45 psychosocial 46 stress 47 , 48 and 48 and 49 cognitive 48 and 50 interventions 48 and 57 exert 50 interventions 52 may 52 may 56 , 55 part 56 , 56 , 57 exert 57 exert 59 effects 57 exert 60 on 58 their 59 effects 60 on 62 and 61 brain 62 and 62 and 64 development 62 and 71 . 63 behavioral 64 development 64 development 65 through 64 development 68 on 65 through 67 effects 66 their 67 effects 68 on 70 mechanisms 69 neuromodulatory 70 mechanisms objective : to identify the neuromuscular attributes that are associated with self [-] reported mobility status among older primary care patients . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 to 2 : 4 identify 3 to 4 identify 4 identify 7 attributes 4 identify 11 with 5 the 7 attributes 6 neuromuscular 7 attributes 7 attributes 8 that 7 attributes 9 are 8 that 9 are 9 are 10 associated 11 with 16 status 12 self 14 reported 14 reported 16 status 15 mobility 16 status 16 status 17 among 17 among 21 patients 18 older 20 care 19 primary 20 care 20 care 21 patients design : cohort study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 . 1 design 2 : 2 : 4 study 3 cohort 4 study setting : metropolitan - based health care system . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 . 2 : 8 system 3 metropolitan 4 - 3 metropolitan 6 health 5 based 6 health 6 health 8 system 7 care 8 system participants : community - dwelling primary care patients aged ≥65 years ( n=430 ) , with [self] - reported modification of mobility tasks resulting from underlying health conditions . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 1 participants 2 : 2 : 3 community 2 : 16 with 3 community 11 years 4 - 11 years 5 dwelling 7 care 6 primary 7 care 7 care 11 years 8 patients 11 years 9 aged 10 ≥65 10 ≥65 11 years 11 years 13 n=430 11 years 15 , 12 ( 13 n=430 13 n=430 14 ) 16 with 24 resulting 18 - 19 reported 19 reported 20 modification 19 reported 24 resulting 20 modification 21 of 21 of 23 tasks 22 mobility 23 tasks 24 resulting 25 from 25 from 26 underlying 26 underlying 28 conditions 27 health 28 conditions interventions : not applicable . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 . 1 interventions 2 : 2 : 3 not 2 : 4 applicable main outcome measures : basic and advanced [lower] extremity function as measured by the late life function and disability instrument . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 21 . 1 main 2 outcome 2 outcome 3 measures 3 measures 4 : 4 : 10 function 5 basic 6 and 6 and 7 advanced 7 advanced 9 extremity 9 extremity 10 function 10 function 12 measured 11 as 12 measured 12 measured 13 by 13 by 18 and 14 the 17 function 15 late 16 life 16 life 17 function 17 function 18 and 18 and 20 instrument 19 disability 20 instrument results : we constructed multivariable linear regression models evaluating both outcomes . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 constructed 2 : 12 . 3 we 4 constructed 4 constructed 8 models 5 multivariable 7 regression 6 linear 7 regression 7 regression 8 models 8 models 9 evaluating 9 evaluating 11 outcomes 10 both 11 outcomes for basic [lower] extremity function , leg strength , leg velocity , trunk extensor muscle endurance , and ankle range of motion ( rom ) were statistically significant predictors ( p<.001 , [r] ( 2 )=.21 ) . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 26 were 0 ###LEFT-WALL### 38 . 1 for 4 extremity 1 for 18 and 2 basic 4 extremity 5 function 8 strength 5 function 18 and 6 , 8 strength 7 leg 8 strength 8 strength 11 velocity 8 strength 17 , 9 , 11 velocity 10 leg 11 velocity 11 velocity 16 endurance 11 velocity 17 , 12 , 16 endurance 13 trunk 14 extensor 14 extensor 16 endurance 15 muscle 16 endurance 16 endurance 17 , 18 and 20 range 18 and 21 of 18 and 26 were 19 ankle 20 range 21 of 22 motion 22 motion 24 rom 23 ( 24 rom 24 rom 25 ) 26 were 27 statistically 26 were 29 predictors 28 significant 29 predictors 29 predictors 31 p<.001 29 predictors 36 )=.21 30 ( 31 p<.001 31 p<.001 32 , 34 ( 36 )=.21 35 2 36 )=.21 36 )=.21 37 ) for advanced [lower] extremity function , leg strength , leg strength asymmetry , leg velocity , trunk extensor muscle endurance , and knee flexion rom were statistically significant predictors ( p<.001 , [r] ( 2 )=.39 ) . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 26 were 0 ###LEFT-WALL### 38 . 1 for 5 function 1 for 6 , 1 for 22 and 2 advanced 4 extremity 4 extremity 5 function 7 leg 8 strength 8 strength 9 , 9 , 12 asymmetry 9 , 13 , 10 leg 11 strength 11 strength 12 asymmetry 13 , 15 velocity 13 , 16 , 14 leg 15 velocity 16 , 20 endurance 16 , 22 and 17 trunk 18 extensor 18 extensor 20 endurance 19 muscle 20 endurance 21 , 22 and 22 and 25 rom 22 and 26 were 23 knee 24 flexion 24 flexion 25 rom 26 were 27 statistically 26 were 29 predictors 28 significant 29 predictors 29 predictors 31 p<.001 29 predictors 36 )=.39 30 ( 31 p<.001 31 p<.001 32 , 34 ( 36 )=.39 35 2 36 )=.39 36 )=.39 37 ) sensitivity analyses conducted using multiple imputations to account for missing data confirmed these findings . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 12 confirmed 0 ###LEFT-WALL### 15 . 1 sensitivity 2 analyses 2 analyses 3 conducted 2 analyses 9 for 2 analyses 12 confirmed 3 conducted 4 using 3 conducted 7 to 4 using 6 imputations 5 multiple 6 imputations 7 to 8 account 9 for 10 missing 10 missing 11 data 12 confirmed 14 findings 13 these 14 findings conclusions : this analysis highlights the relevance and importance of 5 categories of neuromuscular attributes : strength , speed of movement , rom , asymmetry , and trunk stability . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 4 analysis 2 : 5 highlights 2 : 8 and 2 : 22 , 3 this 4 analysis 4 analysis 5 highlights 5 highlights 7 relevance 6 the 7 relevance 8 and 9 importance 8 and 16 : 9 importance 10 of 9 importance 16 : 10 of 12 categories 11 5 12 categories 12 categories 13 of 13 of 15 attributes 14 neuromuscular 15 attributes 16 : 17 strength 17 strength 19 speed 18 , 19 speed 19 speed 20 of 19 speed 22 , 20 of 21 movement 22 , 27 and 23 rom 25 asymmetry 23 rom 27 and 24 , 25 asymmetry 25 asymmetry 26 , 26 , 27 and 27 and 29 stability 28 trunk 29 stability it identifies novel attributes ( leg velocity and trunk extensor muscle endurance ) relevant to mobility and highlights that impairment profiles vary by the level of mobility assessed . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 identifies 1 it 2 identifies 2 identifies 4 attributes 3 novel 4 attributes 4 attributes 8 and 5 ( 8 and 6 leg 7 velocity 7 velocity 8 and 8 and 12 endurance 8 and 13 ) 8 and 14 relevant 8 and 19 that 8 and 22 vary 8 and 29 . 9 trunk 12 endurance 10 extensor 12 endurance 11 muscle 12 endurance 14 relevant 15 to 15 to 17 and 16 mobility 17 and 17 and 18 highlights 19 that 21 profiles 19 that 22 vary 20 impairment 21 profiles 21 profiles 22 vary 22 vary 23 by 23 by 25 level 24 the 25 level 25 level 26 of 26 of 27 mobility 27 mobility 28 assessed these findings will inform the design of more thorough and potentially more effective disability prevention strategies . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 inform 0 ###LEFT-WALL### 17 . 1 these 2 findings 2 findings 3 will 3 will 4 inform 4 inform 6 design 5 the 6 design 6 design 7 of 7 of 16 strategies 8 more 16 strategies 9 thorough 10 and 10 and 11 potentially 10 and 12 more 10 and 14 disability 13 effective 14 disability 14 disability 16 strategies 15 prevention 16 strategies mutations in ubqln2 have been shown to be a cause of dominant [x] - linked amyotrophic lateral sclerosis ( als ) . 0 ###LEFT-WALL### 1 mutations 0 ###LEFT-WALL### 8 be 0 ###LEFT-WALL### 22 . 1 mutations 2 in 1 mutations 4 have 2 in 3 ubqln2 4 have 5 been 5 been 6 shown 6 shown 7 to 7 to 8 be 8 be 10 cause 9 a 10 cause 10 cause 11 of 11 of 18 sclerosis 12 dominant 14 - 12 dominant 18 sclerosis 15 linked 18 sclerosis 16 amyotrophic 18 sclerosis 17 lateral 18 sclerosis 18 sclerosis 20 als 19 ( 20 als 20 als 21 ) occurrences of mutations in this gene vary across als populations . 0 ###LEFT-WALL### 1 occurrences 0 ###LEFT-WALL### 7 vary 0 ###LEFT-WALL### 11 . 1 occurrences 2 of 1 occurrences 7 vary 2 of 3 mutations 3 mutations 4 in 4 in 6 gene 5 this 6 gene 7 vary 8 across 8 across 10 populations 9 als 10 populations we screened ubqln2 for mutations in a final cohort of 150 irish als patients . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 screened 0 ###LEFT-WALL### 15 . 1 we 2 screened 2 screened 3 ubqln2 2 screened 6 in 3 ubqln2 4 for 4 for 5 mutations 6 in 9 cohort 7 a 8 final 7 a 9 cohort 8 final 9 cohort 9 cohort 10 of 10 of 14 patients 11 150 14 patients 12 irish 13 als 13 als 14 patients individuals who were from families with male - [to] [-] male transmission or who carried pathogenic hexanucleotide repeat expansions in c9orf72 were excluded . 0 ###LEFT-WALL### 1 individuals 0 ###LEFT-WALL### 23 excluded 0 ###LEFT-WALL### 24 . 1 individuals 2 who 1 individuals 3 were 1 individuals 22 were 2 who 3 were 3 were 4 from 3 were 6 with 4 from 5 families 6 with 13 or 6 with 19 expansions 7 male 8 - 7 male 12 transmission 11 male 12 transmission 12 transmission 13 or 13 or 14 who 13 or 15 carried 16 pathogenic 19 expansions 17 hexanucleotide 19 expansions 18 repeat 19 expansions 19 expansions 20 in 20 in 21 c9orf72 22 were 23 excluded apart from common synonymous variation , no sequence variants in ubqln2 were observed . 0 ###LEFT-WALL### 9 variants 0 ###LEFT-WALL### 13 observed 0 ###LEFT-WALL### 14 . 1 apart 2 from 2 from 5 variation 2 from 6 , 2 from 9 variants 3 common 5 variation 4 synonymous 5 variation 7 no 9 variants 8 sequence 9 variants 9 variants 10 in 9 variants 12 were 10 in 11 ubqln2 12 were 13 observed mutations in ubqln2 are therefore not a frequent cause of als in the irish population . 0 ###LEFT-WALL### 1 mutations 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 16 . 1 mutations 2 in 1 mutations 4 are 2 in 3 ubqln2 4 are 5 therefore 4 are 6 not 4 are 9 cause 7 a 8 frequent 7 a 9 cause 8 frequent 9 cause 9 cause 10 of 10 of 11 als 11 als 12 in 12 in 15 population 13 the 15 population 14 irish 15 population the plk1 - interacting checkpoint helicase ( pich ) protein localizes to ultrafine anaphase bridges ( ufbs ) in mitosis alongside a complex of dna repair proteins , including the bloom 's syndrome protein ( blm ) . 0 ###LEFT-WALL### 2 plk1 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 38 . 1 the 2 plk1 3 - 10 protein 3 - 11 localizes 4 interacting 6 helicase 4 interacting 9 ) 4 interacting 10 protein 5 checkpoint 6 helicase 6 helicase 8 pich 7 ( 8 pich 8 pich 9 ) 10 protein 11 localizes 11 localizes 12 to 11 localizes 19 in 12 to 15 bridges 13 ultrafine 14 anaphase 14 anaphase 15 bridges 15 bridges 17 ufbs 16 ( 17 ufbs 17 ufbs 18 ) 19 in 20 mitosis 20 mitosis 21 alongside 20 mitosis 24 of 21 alongside 23 complex 22 a 23 complex 24 of 27 proteins 25 dna 26 repair 26 repair 27 proteins 27 proteins 29 including 28 , 29 including 29 including 34 protein 29 including 37 ) 30 the 31 bloom 31 bloom 32 's 32 's 34 protein 33 syndrome 34 protein 34 protein 36 blm 35 ( 36 blm 36 blm 37 ) however , very little is known about the function of pich or how it is recruited to ufbs . 0 ###LEFT-WALL### 4 little 0 ###LEFT-WALL### 6 known 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 4 little 3 very 4 little 4 little 5 is 5 is 6 known 6 known 7 about 7 about 9 function 8 the 9 function 9 function 10 of 10 of 12 or 11 pich 12 or 12 or 13 how 12 or 14 it 12 or 15 is 12 or 16 recruited 14 it 15 is 16 recruited 17 to 17 to 18 ufbs using a combination of microfluidics , fluorescence microscopy , and optical tweezers , we have defined the properties of pich in an in [vitro] [model] of an anaphase bridge . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 16 defined 0 ###LEFT-WALL### 30 . 1 using 3 combination 1 using 13 , 1 using 14 we 2 a 3 combination 3 combination 4 of 3 combination 10 and 4 of 5 microfluidics 6 , 10 and 7 fluorescence 8 microscopy 8 microscopy 10 and 9 , 10 and 10 and 12 tweezers 10 and 13 , 11 optical 12 tweezers 14 we 15 have 15 have 16 defined 16 defined 18 properties 16 defined 21 in 17 the 18 properties 18 properties 19 of 19 of 20 pich 21 in 23 in 22 an 23 in 23 in 26 of 26 of 29 bridge 27 an 29 bridge 28 anaphase 29 bridge we show that pich binds with a remarkably high affinity to duplex dna , resulting in atp - dependent protein translocation and extension of the dna . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 27 . 1 we 2 show 2 show 3 that 3 that 4 pich 3 that 5 binds 4 pich 5 binds 5 binds 6 with 5 binds 11 to 5 binds 15 resulting 6 with 10 affinity 7 a 10 affinity 8 remarkably 9 high 9 high 10 affinity 11 to 12 duplex 12 duplex 13 dna 14 , 15 resulting 15 resulting 16 in 15 resulting 18 - 16 in 17 atp 18 - 22 and 19 dependent 20 protein 20 protein 21 translocation 21 translocation 22 and 22 and 23 extension 22 and 24 of 24 of 26 dna 25 the 26 dna most strikingly , the affinity of pich for binding dna increases with tension - induced dna stretching , which mimics the effect of the mitotic spindle on a ufb . 0 ###LEFT-WALL### 5 affinity 0 ###LEFT-WALL### 11 increases 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 30 . 1 most 2 strikingly 2 strikingly 3 , 2 strikingly 5 affinity 4 the 5 affinity 5 affinity 6 of 5 affinity 11 increases 6 of 7 pich 7 pich 8 for 8 for 9 binding 9 binding 10 dna 11 increases 12 with 12 with 13 tension 13 tension 17 stretching 14 - 17 stretching 15 induced 16 dna 16 dna 17 stretching 18 , 19 which 18 , 20 mimics 19 which 20 mimics 20 mimics 22 effect 21 the 22 effect 22 effect 23 of 23 of 26 spindle 24 the 26 spindle 25 mitotic 26 spindle 26 spindle 27 on 27 on 29 ufb 28 a 29 ufb pich binding also appears to diminish force - induced dna melting . 0 ###LEFT-WALL### 1 pich 0 ###LEFT-WALL### 4 appears 0 ###LEFT-WALL### 12 . 1 pich 2 binding 1 pich 4 appears 3 also 4 appears 4 appears 5 to 4 appears 6 diminish 5 to 6 diminish 6 diminish 7 force 7 force 11 melting 8 - 11 melting 9 induced 10 dna 10 dna 11 melting we propose a model in which pich recognizes and stabilizes dna under tension during anaphase , thereby facilitating the resolution of entangled sister chromatids . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 propose 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 we 2 propose 2 propose 4 model 3 a 4 model 4 model 5 in 5 in 6 which 5 in 7 pich 5 in 9 and 7 pich 9 and 8 recognizes 9 and 9 and 10 stabilizes 9 and 11 dna 11 dna 12 under 11 dna 14 during 12 under 13 tension 14 during 15 anaphase 16 , 18 facilitating 16 , 24 chromatids 17 thereby 18 facilitating 18 facilitating 20 resolution 18 facilitating 24 chromatids 19 the 20 resolution 20 resolution 21 of 21 of 23 sister 22 entangled 23 sister objectives : growing evidence shows several possible relations between religiousness and late - life depression . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 growing 2 : 5 shows 2 : 16 . 3 growing 4 evidence 3 growing 5 shows 5 shows 8 relations 5 shows 11 and 6 several 8 relations 7 possible 8 relations 8 relations 9 between 9 between 10 religiousness 11 and 14 life 11 and 15 depression 12 late 13 - 12 late 14 life emotional aspects of religiousness such as facets of the perceived relationship with god can be crucial in this connection . 0 ###LEFT-WALL### 2 aspects 0 ###LEFT-WALL### 15 be 0 ###LEFT-WALL### 20 . 1 emotional 2 aspects 2 aspects 3 of 2 aspects 14 can 3 of 4 religiousness 4 religiousness 6 as 5 such 6 as 6 as 7 facets 7 facets 8 of 8 of 11 relationship 9 the 11 relationship 10 perceived 11 relationship 11 relationship 12 with 12 with 13 god 14 can 15 be 15 be 16 crucial 16 crucial 17 in 17 in 19 connection 18 this 19 connection the aim of the current study was to examine the association between the course of late - life depression and feelings about god and religious coping . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 27 . 1 the 2 aim 2 aim 3 of 2 aim 7 was 3 of 6 study 4 the 6 study 5 current 6 study 7 was 8 to 7 was 9 examine 8 to 9 examine 9 examine 11 association 9 examine 12 between 9 examine 22 about 10 the 11 association 12 between 14 course 13 the 14 course 14 course 15 of 15 of 20 and 16 late 17 - 16 late 18 life 18 life 19 depression 19 depression 20 and 20 and 21 feelings 22 about 24 and 23 god 24 and 24 and 25 religious 24 and 26 coping design : longitudinal survey study ; [naturalistic] [;] 12 - [year] follow - up . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 ; 1 design 2 : 2 : 5 study 3 longitudinal 4 survey 4 survey 5 study 6 ; 9 12 6 ; 10 - 9 12 10 - 10 - 12 follow 12 follow 14 up 13 - 14 up 14 up 15 . setting : longitudinal aging study amsterdam [;] population - based , in three regions in the netherlands . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 setting 2 : 2 : 8 population 2 : 10 based 2 : 12 in 2 : 15 in 3 longitudinal 4 aging 4 aging 5 study 5 study 6 amsterdam 6 amsterdam 8 population 9 - 10 based 10 based 11 , 12 in 14 regions 13 three 14 regions 15 in 17 netherlands 16 the 17 netherlands participants : a subsample of 343 respondents ( mean age [:] 77.2 years ) , including all respondents with high levels of depressive symptoms at any measurement cycle between 1992 and 2003 ( assessed by using the center for epidemiologic studies depression scale and the diagnostic interview schedule ) and a random sample of nondepressed respondents who completed a postal questionnaire in 2005 . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 1 participants 2 : 2 : 4 subsample 2 : 16 including 3 a 4 subsample 4 subsample 5 of 5 of 7 respondents 6 343 7 respondents 7 respondents 13 years 8 ( 13 years 9 mean 10 age 10 age 13 years 12 77.2 13 years 13 years 14 ) 15 , 16 including 16 including 50 and 16 including 64 . 17 all 18 respondents 18 respondents 19 with 18 respondents 50 and 19 with 21 levels 20 high 21 levels 21 levels 22 of 21 levels 25 at 22 of 24 symptoms 23 depressive 24 symptoms 25 at 28 cycle 26 any 28 cycle 27 measurement 28 cycle 28 cycle 29 between 29 between 31 and 30 1992 31 and 31 and 32 2003 31 and 34 assessed 33 ( 34 assessed 34 assessed 35 by 34 assessed 39 for 34 assessed 49 ) 35 by 36 using 36 using 38 center 37 the 38 center 39 for 44 and 40 epidemiologic 41 studies 41 studies 42 depression 42 depression 43 scale 43 scale 44 and 44 and 48 schedule 45 the 48 schedule 46 diagnostic 47 interview 47 interview 48 schedule 50 and 53 sample 51 a 52 random 51 a 53 sample 52 random 53 sample 53 sample 54 of 54 of 56 respondents 55 nondepressed 56 respondents 56 respondents 57 who 56 respondents 58 completed 57 who 58 completed 58 completed 61 questionnaire 58 completed 62 in 59 a 61 questionnaire 60 postal 61 questionnaire 62 in 63 2005 measurements : scales on god image and religious coping . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 . 1 measurements 2 : 2 : 3 scales 3 scales 4 on 4 on 7 and 5 god 6 image 6 image 7 and 7 and 9 coping 8 religious 9 coping twelve - year depression course trajectories serve as predicting variables and [are] specified according to recency and seriousness . 0 ###LEFT-WALL### 1 twelve 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 19 . 2 - 6 trajectories 2 - 11 and 3 year 6 trajectories 4 depression 6 trajectories 5 course 6 trajectories 6 trajectories 11 and 7 serve 8 as 7 serve 11 and 8 as 10 variables 9 predicting 10 variables 11 and 13 specified 11 and 15 to 14 according 15 to 15 to 17 and 16 recency 17 and 17 and 18 seriousness results : persistent and emergent depression are significantly associated with fear of god , feeling wronged by god , and negative religious coping . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 4 and 2 : 9 associated 3 persistent 4 and 4 and 6 depression 4 and 7 are 5 emergent 6 depression 7 are 9 associated 8 significantly 9 associated 9 associated 10 with 9 associated 23 coping 10 with 11 fear 10 with 22 religious 11 fear 12 of 12 of 20 and 13 god 15 feeling 13 god 20 and 14 , 15 feeling 15 feeling 16 wronged 15 feeling 19 , 16 wronged 18 god 17 by 18 god 19 , 20 and 20 and 21 negative in terms of negative religious coping , significant associations were observed after adjustment for concurrent depression with a history of repeated minor depression and previous major depression . 0 ###LEFT-WALL### 9 associations 0 ###LEFT-WALL### 11 observed 0 ###LEFT-WALL### 28 . 1 in 2 terms 1 in 7 , 1 in 9 associations 2 terms 3 of 3 of 6 coping 4 negative 6 coping 5 religious 6 coping 8 significant 9 associations 9 associations 10 were 10 were 11 observed 11 observed 12 after 11 observed 14 for 11 observed 17 with 12 after 13 adjustment 14 for 16 depression 15 concurrent 16 depression 17 with 24 and 18 a 19 history 19 history 20 of 19 history 24 and 20 of 23 depression 21 repeated 23 depression 22 minor 23 depression 24 and 27 depression 25 previous 27 depression 26 major 27 depression conclusions : late - life depression seems to maintain a pervasive relationship over time with affective aspects of religiousness . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 6 depression 2 : 7 seems 3 late 4 - 3 late 5 life 5 life 6 depression 6 depression 7 seems 7 seems 8 to 7 seems 9 maintain 8 to 9 maintain 9 maintain 12 relationship 9 maintain 13 over 9 maintain 15 with 10 a 12 relationship 11 pervasive 12 relationship 13 over 14 time 15 with 17 aspects 16 affective 17 aspects 17 aspects 18 of 18 of 19 religiousness religious feelings may parallel the symptoms of anhedonia or a dysphoric mood and could represent the experience of an existential void . 0 ###LEFT-WALL### 2 feelings 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 22 . 1 religious 2 feelings 2 feelings 3 may 3 may 13 and 4 parallel 6 symptoms 4 parallel 13 and 5 the 6 symptoms 6 symptoms 7 of 7 of 9 or 8 anhedonia 9 or 9 or 12 mood 10 a 11 dysphoric 10 a 12 mood 11 dysphoric 12 mood 13 and 14 could 14 could 15 represent 15 represent 17 experience 16 the 17 experience 17 experience 18 of 18 of 21 void 19 an 20 existential 19 an 21 void 20 existential 21 void objectives : to examine alcohol consumption among older primary care patients with generalized anxiety disorder ( gad ) ; its relationship to demographic variables , insomnia , worry , and anxiety [;] and its moderating role on the anxiety - insomnia relationship . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 43 . 2 : 3 to 2 : 4 examine 2 : 19 ; 3 to 4 examine 4 examine 6 consumption 4 examine 7 among 4 examine 12 with 5 alcohol 6 consumption 7 among 11 patients 8 older 11 patients 9 primary 10 care 10 care 11 patients 12 with 15 disorder 13 generalized 15 disorder 14 anxiety 15 disorder 15 disorder 17 gad 16 ( 17 gad 17 gad 18 ) 19 ; 33 and 19 ; 40 - 20 its 21 relationship 21 relationship 22 to 21 relationship 25 , 22 to 24 variables 23 demographic 24 variables 25 , 26 insomnia 25 , 27 , 27 , 28 worry 27 , 30 and 29 , 30 and 30 and 31 anxiety 30 and 33 and 33 and 36 role 33 and 37 on 34 its 36 role 35 moderating 36 role 37 on 39 anxiety 38 the 39 anxiety 40 - 42 relationship 41 insomnia 42 relationship we expected alcohol use to be similar to previous reports , correlate with higher anxiety and insomnia , and worsen the anxiety - insomnia relationship . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 expected 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 26 . 1 we 2 expected 2 expected 4 use 2 expected 5 to 2 expected 11 , 3 alcohol 4 use 5 to 11 , 6 be 7 similar 6 be 11 , 7 similar 8 to 8 to 10 reports 9 previous 10 reports 11 , 19 and 12 correlate 13 with 12 correlate 19 and 13 with 16 and 14 higher 15 anxiety 15 anxiety 16 and 16 and 17 insomnia 18 , 19 and 19 and 20 worsen 20 worsen 22 anxiety 21 the 22 anxiety 23 - 25 relationship 24 insomnia 25 relationship design : baseline data from a randomized controlled trial . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 . 1 design 2 : 2 : 4 data 3 baseline 4 data 4 data 5 from 5 from 9 trial 6 a 9 trial 7 randomized 9 trial 8 controlled 9 trial setting : michael [e] . debakey va medical center and baylor college of medicine . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 . 1 setting 2 : 2 : 3 michael 5 . 10 and 5 . 15 . 6 debakey 7 va 7 va 8 medical 8 medical 9 center 9 center 10 and 10 and 12 college 10 and 13 of 11 baylor 12 college 13 of 14 medicine participants : 223 patients , 60 years and older , with gad . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 1 participants 2 : 2 : 8 and 3 223 4 patients 4 patients 5 , 5 , 7 years 5 , 8 and 6 60 7 years 8 and 9 older 9 older 11 with 10 , 11 with 11 with 12 gad 11 with 13 . measurements : frequency of alcohol use , insomnia ( insomnia severity index ) , worry ( penn state worry questionnaire - abbreviated , generalized anxiety disorder severity scale ) , and anxiety ( state - trait anxiety inventory - trait subscale , structured interview guide for the hamilton anxiety rating scale [ sigh - a ] ) . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 58 . 2 : 31 and 3 frequency 4 of 3 frequency 31 and 4 of 6 use 5 alcohol 6 use 6 use 8 insomnia 7 , 8 insomnia 8 insomnia 12 index 8 insomnia 15 worry 8 insomnia 29 ) 9 ( 12 index 10 insomnia 11 severity 11 severity 12 index 12 index 13 ) 14 , 15 worry 15 worry 20 questionnaire 15 worry 28 scale 15 worry 29 ) 16 ( 20 questionnaire 17 penn 18 state 18 state 19 worry 19 worry 20 questionnaire 20 questionnaire 22 abbreviated 20 questionnaire 23 , 21 - 22 abbreviated 22 abbreviated 23 , 23 , 28 scale 24 generalized 25 anxiety 25 anxiety 26 disorder 26 disorder 27 severity 27 severity 28 scale 28 scale 29 ) 30 , 31 and 31 and 32 anxiety 31 and 34 state 31 and 41 subscale 33 ( 34 state 34 state 38 inventory 34 state 39 - 35 - 38 inventory 36 trait 37 anxiety 37 anxiety 38 inventory 38 inventory 39 - 39 - 41 subscale 40 trait 41 subscale 41 subscale 51 scale 41 subscale 57 ) 42 , 51 scale 43 structured 44 interview 44 interview 45 guide 45 guide 46 for 45 guide 50 rating 46 for 49 anxiety 47 the 49 anxiety 48 hamilton 49 anxiety 50 rating 51 scale 51 scale 54 - 51 scale 56 ] 52 [ 54 - 53 sigh 54 - 54 - 55 a 54 - 56 ] results : most patients endorsed alcohol use , but frequency was low . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 patients 2 : 5 endorsed 2 : 9 but 2 : 13 . 3 most 4 patients 4 patients 5 endorsed 5 endorsed 7 use 6 alcohol 7 use 8 , 9 but 9 but 10 frequency 9 but 11 was 10 frequency 11 was 11 was 12 low presence and frequency were greater than in previous reports of primary care samples . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 14 . 1 presence 2 and 2 and 3 frequency 2 and 4 were 4 were 5 greater 5 greater 6 than 6 than 7 in 7 in 9 reports 8 previous 9 reports 9 reports 10 of 10 of 13 samples 11 primary 12 care 12 care 13 samples alcohol use was associated with higher education , female gender , less severe insomnia , and lower worry ( generalized anxiety disorder severity scale ) and anxiety ( state - trait anxiety inventory - trait subscale [;] sigh - a ) . 0 ###LEFT-WALL### 2 use 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 42 . 1 alcohol 2 use 2 use 3 was 3 was 4 associated 4 associated 5 with 5 with 7 education 6 higher 7 education 7 education 10 gender 8 , 10 gender 9 female 10 gender 10 gender 26 and 10 gender 41 ) 11 , 26 and 12 less 13 severe 13 severe 14 insomnia 14 insomnia 16 and 15 , 16 and 16 and 18 worry 16 and 24 scale 16 and 26 and 17 lower 18 worry 19 ( 24 scale 20 generalized 24 scale 21 anxiety 22 disorder 22 disorder 23 severity 23 severity 24 scale 24 scale 25 ) 26 and 27 anxiety 26 and 29 state 26 and 33 inventory 26 and 41 ) 28 ( 29 state 29 state 30 - 30 - 33 inventory 31 trait 32 anxiety 32 anxiety 33 inventory 33 inventory 39 - 33 inventory 41 ) 34 - 39 - 35 trait 38 sigh 36 subscale 38 sigh 38 sigh 39 - 39 - 40 a 39 - 41 ) whites reported more drinks/week than african - americans . 0 ###LEFT-WALL### 1 whites 0 ###LEFT-WALL### 2 reported 0 ###LEFT-WALL### 7 - 1 whites 2 reported 2 reported 4 drinks/week 2 reported 5 than 3 more 4 drinks/week 5 than 6 african 7 - 8 americans 7 - 9 . more drinks/week were associated with higher education and lower anxiety ( sigh - a ) . 0 ###LEFT-WALL### 2 drinks/week 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 16 . 1 more 2 drinks/week 2 drinks/week 3 were 3 were 4 associated 4 associated 5 with 5 with 8 and 6 higher 7 education 7 education 8 and 8 and 10 anxiety 8 and 13 - 9 lower 10 anxiety 11 ( 13 - 12 sigh 13 - 13 - 14 a 13 - 15 ) weaker relationships between worry/anxiety and insomnia occurred for those drinking . 0 ###LEFT-WALL### 2 relationships 0 ###LEFT-WALL### 7 occurred 0 ###LEFT-WALL### 11 . 1 weaker 2 relationships 2 relationships 3 between 2 relationships 7 occurred 3 between 5 and 4 worry/anxiety 5 and 5 and 6 insomnia 7 occurred 8 for 8 for 9 those 9 those 10 drinking drink frequency moderated the positive association between the penn state worry questionnaire - [abbreviated] and insomnia , which was lower with higher frequency of drinking . 0 ###LEFT-WALL### 2 frequency 0 ###LEFT-WALL### 3 moderated 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 26 . 1 drink 2 frequency 2 frequency 3 moderated 3 moderated 6 association 3 moderated 7 between 4 the 6 association 5 positive 6 association 7 between 15 and 8 the 12 questionnaire 9 penn 10 state 10 state 11 worry 11 worry 12 questionnaire 12 questionnaire 15 and 13 - 15 and 15 and 16 insomnia 17 , 18 which 17 , 19 was 18 which 19 was 19 was 20 lower 20 lower 21 with 21 with 23 frequency 22 higher 23 frequency 23 frequency 24 of 24 of 25 drinking conclusions : older adults with gad use alcohol at an increased rate , but mild [to] moderate drinkers do not experience sleep difficulties . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 4 adults 2 : 14 but 3 older 4 adults 4 adults 5 with 4 adults 14 but 5 with 6 gad 7 use 8 alcohol 7 use 14 but 8 alcohol 9 at 9 at 12 rate 10 an 12 rate 11 increased 12 rate 13 , 14 but 14 but 21 experience 15 mild 18 drinkers 17 moderate 18 drinkers 18 drinkers 19 do 19 do 20 not 19 do 21 experience 21 experience 23 difficulties 22 sleep 23 difficulties a modest amount of alcohol may minimize the association between anxiety/worry and insomnia among this group . 0 ###LEFT-WALL### 3 amount 0 ###LEFT-WALL### 7 minimize 0 ###LEFT-WALL### 17 . 1 a 2 modest 1 a 3 amount 2 modest 3 amount 3 amount 4 of 3 amount 6 may 4 of 5 alcohol 6 may 7 minimize 7 minimize 9 association 7 minimize 10 between 7 minimize 14 among 8 the 9 association 10 between 12 and 11 anxiety/worry 12 and 12 and 13 insomnia 14 among 16 group 15 this 16 group objective : to identify salient characteristics of frailty that increase risk of death in depressed elders . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 identify 2 : 17 . 3 to 4 identify 4 identify 6 characteristics 5 salient 6 characteristics 6 characteristics 7 of 6 characteristics 9 that 6 characteristics 10 increase 7 of 8 frailty 9 that 10 increase 10 increase 11 risk 10 increase 14 in 11 risk 12 of 12 of 13 death 14 in 16 elders 15 depressed 16 elders methods : data were from the nordic research on ageing study from research sites in denmark , sweden , and finland . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 data 2 : 4 were 3 data 4 were 4 were 5 from 4 were 9 on 4 were 12 from 5 from 8 research 6 the 8 research 7 nordic 8 research 9 on 11 study 10 ageing 11 study 12 from 14 sites 13 research 14 sites 14 sites 15 in 15 in 20 and 16 denmark 17 , 17 , 18 sweden 17 , 20 and 19 , 20 and 20 and 21 finland participants were 1,027 adults aged 75 years ( 436 men and 591 women ) . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 15 . 1 participants 2 were 2 were 4 adults 2 were 7 years 3 1,027 4 adults 4 adults 5 aged 5 aged 6 75 7 years 11 and 8 ( 11 and 9 436 10 men 10 men 11 and 11 and 13 women 11 and 14 ) 12 591 13 women time of death was obtained , providing a maximum survival time of 11.08 years ( initial evaluation [took] [place] between 1988 and 1991 ) . 0 ###LEFT-WALL### 1 time 0 ###LEFT-WALL### 5 obtained 0 ###LEFT-WALL### 25 . 1 time 2 of 1 time 4 was 2 of 3 death 4 was 5 obtained 5 obtained 7 providing 6 , 7 providing 7 providing 11 time 7 providing 24 ) 8 a 9 maximum 8 a 11 time 9 maximum 10 survival 10 survival 11 time 11 time 12 of 12 of 14 years 13 11.08 14 years 14 years 17 evaluation 15 ( 17 evaluation 16 initial 17 evaluation 17 evaluation 22 and 17 evaluation 24 ) 20 between 22 and 21 1988 22 and 22 and 23 1991 results : depressed elders showed greater baseline impairments in each frailty characteristic ( gait speed , grip strength , physical activity levels , and fatigue ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 27 . 2 : 3 depressed 3 depressed 4 elders 3 depressed 5 showed 4 elders 5 showed 5 showed 7 baseline 5 showed 8 impairments 5 showed 9 in 6 greater 7 baseline 9 in 18 strength 10 each 18 strength 11 frailty 18 strength 12 characteristic 15 speed 12 characteristic 17 grip 13 ( 15 speed 14 gait 15 speed 15 speed 16 , 17 grip 18 strength 18 strength 24 and 19 , 24 and 20 physical 21 activity 21 activity 22 levels 22 levels 24 and 23 , 24 and 24 and 25 fatigue 24 and 26 ) in women , the effect [of] impaired gait speed on mortality rates nearly doubled when depression was present ( nondepressed women : no gait impairment = 26 % ; slow gait = 40 % [;] depressed women : no gait impairment = 32 % [;] slow gait = 58 % [ )( 0 ###LEFT-WALL### 5 effect 0 ###LEFT-WALL### 7 impaired 0 ###LEFT-WALL### 22 : 0 ###LEFT-WALL### 48 = 0 ###LEFT-WALL### 52 )( 1 in 2 women 1 in 3 , 1 in 5 effect 4 the 5 effect 5 effect 7 impaired 7 impaired 9 speed 7 impaired 10 on 8 gait 9 speed 10 on 12 rates 11 mortality 12 rates 12 rates 14 doubled 12 rates 21 women 13 nearly 14 doubled 14 doubled 15 when 15 when 16 depression 15 when 17 was 16 depression 17 was 17 was 18 present 19 ( 21 women 20 nondepressed 21 women 21 women 22 : 22 : 25 impairment 22 : 26 = 22 : 29 ; 22 : 38 : 23 no 25 impairment 24 gait 25 impairment 25 impairment 26 = 26 = 28 % 27 26 28 % 29 ; 31 gait 30 slow 31 gait 32 = 33 40 33 40 34 % 33 40 38 : 34 % 36 depressed 36 depressed 37 women 38 : 47 gait 39 no 47 gait 40 gait 47 gait 41 impairment 47 gait 42 = 43 32 43 32 44 % 44 % 47 gait 46 slow 47 gait 47 gait 48 = 48 = 50 % 49 58 50 % a similar pattern was observed for fatigue . 0 ###LEFT-WALL### 3 pattern 0 ###LEFT-WALL### 5 observed 0 ###LEFT-WALL### 8 . 1 a 2 similar 1 a 3 pattern 2 similar 3 pattern 3 pattern 4 was 4 was 5 observed 5 observed 6 for 6 for 7 fatigue conclusion : the confluence of specific characteristics of frailty ( fatigue and slow gait speed ) and depressive illness is associated with an increased risk of death in older adults ; this association is particularly strong in older depressed women . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 4 confluence 2 : 21 associated 2 : 31 ; 3 the 4 confluence 4 confluence 5 of 4 confluence 20 is 5 of 17 and 6 specific 7 characteristics 7 characteristics 8 of 7 characteristics 17 and 8 of 9 frailty 9 frailty 12 and 10 ( 12 and 11 fatigue 12 and 12 and 15 speed 12 and 16 ) 13 slow 15 speed 14 gait 15 speed 17 and 19 illness 18 depressive 19 illness 20 is 21 associated 21 associated 22 with 21 associated 28 in 22 with 25 risk 23 an 25 risk 24 increased 25 risk 25 risk 26 of 26 of 27 death 28 in 30 adults 29 older 30 adults 31 ; 33 association 31 ; 34 is 32 this 33 association 33 association 34 is 34 is 36 strong 35 particularly 36 strong 36 strong 37 in 37 in 40 women 38 older 40 women 39 depressed 40 women future research should investigate whether multimodal interventions targeting depressive illness , mobility deficits , and fatigue can decrease mortality and improve quality of life in older depressed individuals with characteristics of the syndrome of frailty . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 investigate 0 ###LEFT-WALL### 36 . 1 future 2 research 2 research 3 should 3 should 4 investigate 4 investigate 5 whether 5 whether 15 and 5 whether 20 and 6 multimodal 7 interventions 7 interventions 8 targeting 7 interventions 11 , 8 targeting 10 illness 9 depressive 10 illness 11 , 13 deficits 11 , 15 and 12 mobility 13 deficits 14 , 15 and 15 and 17 can 15 and 20 and 16 fatigue 17 can 18 decrease 19 mortality 18 decrease 20 and 20 and 21 improve 20 and 25 in 20 and 29 with 21 improve 22 quality 22 quality 23 of 23 of 24 life 25 in 28 individuals 26 older 28 individuals 27 depressed 28 individuals 29 with 30 characteristics 30 characteristics 31 of 31 of 33 syndrome 32 the 33 syndrome 33 syndrome 34 of 34 of 35 frailty objective : to describe the frequency of bone marrow lesions ( bmls ) detected by magnetic resonance imaging ( mri ) , and to examine the association of bmls with knee pain severity in community residents in korea . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 25 examine 0 ###LEFT-WALL### 39 . 1 objective 2 : 2 : 3 to 2 : 4 describe 3 to 4 describe 4 describe 6 frequency 5 the 6 frequency 6 frequency 7 of 7 of 9 marrow 8 bone 9 marrow 9 marrow 10 lesions 9 marrow 25 examine 10 lesions 12 bmls 10 lesions 23 and 11 ( 12 bmls 12 bmls 13 ) 14 detected 15 by 14 detected 18 imaging 14 detected 23 and 15 by 17 resonance 16 magnetic 17 resonance 18 imaging 20 mri 19 ( 20 mri 20 mri 21 ) 22 , 23 and 23 and 25 examine 24 to 25 examine 25 examine 27 association 25 examine 30 with 26 the 27 association 27 association 28 of 28 of 29 bmls 30 with 33 severity 31 knee 32 pain 32 pain 33 severity 33 severity 34 in 33 severity 37 in 34 in 36 residents 35 community 36 residents 37 in 38 korea methods : participants were randomly chosen from the population - based hallym aging study , irrespective of whether they had knee osteoarthritis ( oa ) or pain . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 participants 2 : 6 chosen 2 : 10 - 3 participants 4 were 4 were 5 randomly 4 were 6 chosen 6 chosen 7 from 7 from 9 population 8 the 9 population 10 - 26 or 10 - 28 . 11 based 14 study 11 based 17 of 11 based 26 or 12 hallym 13 aging 13 aging 14 study 15 , 17 of 16 irrespective 17 of 17 of 18 whether 17 of 25 ) 18 whether 19 they 18 whether 20 had 19 they 20 had 20 had 22 osteoarthritis 21 knee 22 osteoarthritis 22 osteoarthritis 24 oa 23 ( 24 oa 24 oa 25 ) 26 or 27 pain demographic and knee pain data were obtained by questionnaire . 0 ###LEFT-WALL### 9 questionnaire 0 ###LEFT-WALL### 10 . 1 demographic 2 and 2 and 3 knee 2 and 5 data 2 and 8 by 2 and 9 questionnaire 4 pain 5 data 5 data 6 were 6 were 7 obtained 7 obtained 8 by radiographic evaluations consisted of weight - bearing knee anteroposterior [radiographs] and 1.5 - t mri scans . 0 ###LEFT-WALL### 2 evaluations 0 ###LEFT-WALL### 3 consisted 0 ###LEFT-WALL### 6 - 1 radiographic 2 evaluations 2 evaluations 3 consisted 3 consisted 4 of 4 of 5 weight 6 - 9 anteroposterior 6 - 11 and 6 - 17 . 7 bearing 9 anteroposterior 8 knee 9 anteroposterior 11 and 12 1.5 11 and 16 scans 12 1.5 13 - 13 - 14 t 13 - 15 mri 15 mri 16 scans mri was performed in the dominant knees of subjects without knee pain and in the more symptomatic knees of subjects with knee pain . 0 ###LEFT-WALL### 1 mri 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 24 . 1 mri 2 was 2 was 3 performed 3 performed 4 in 3 performed 21 with 4 in 7 knees 5 the 7 knees 6 dominant 7 knees 7 knees 8 of 8 of 9 subjects 9 subjects 13 and 10 without 12 pain 10 without 13 and 11 knee 12 pain 13 and 14 in 14 in 18 knees 15 the 18 knees 16 more 17 symptomatic 17 symptomatic 18 knees 18 knees 19 of 19 of 20 subjects 21 with 23 pain 22 knee 23 pain bmls were graded according to the whole - organ mri score . 0 ###LEFT-WALL### 1 bmls 0 ###LEFT-WALL### 3 graded 0 ###LEFT-WALL### 8 - 1 bmls 2 were 2 were 3 graded 3 graded 5 to 4 according 5 to 5 to 7 whole 6 the 7 whole 8 - 11 score 8 - 12 . 9 organ 11 score 10 mri 11 score results : the mean age of the 358 study subjects was 71.8 years , and 34.5 % of subjects had radiographically detected knee oa . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 5 age 2 : 11 was 2 : 15 and 3 the 5 age 4 mean 5 age 5 age 6 of 5 age 11 was 6 of 10 subjects 7 the 8 358 8 358 10 subjects 9 study 10 subjects 11 was 13 years 12 71.8 13 years 14 , 15 and 15 and 17 % 15 and 22 detected 16 34.5 17 % 17 % 18 of 17 % 20 had 18 of 19 subjects 20 had 22 detected 21 radiographically 22 detected 22 detected 24 oa 23 knee 24 oa the prevalences of bmls and large bmls in the tibiofemoral compartments were 80.3 [%] and 40.4 % , respectively . 0 ###LEFT-WALL### 2 prevalences 0 ###LEFT-WALL### 12 were 1 the 2 prevalences 2 prevalences 3 of 2 prevalences 12 were 3 of 5 and 4 bmls 5 and 5 and 7 bmls 5 and 8 in 6 large 7 bmls 8 in 11 compartments 9 the 11 compartments 10 tibiofemoral 11 compartments 12 were 17 % 12 were 19 respectively 13 80.3 15 and 15 and 16 40.4 15 and 17 % 18 , 19 respectively 19 respectively 20 . after adjusting for age , sex , and body mass index , total and medial compartment bml scores were significantly associated with the presence of knee pain , and the association was stronger as the summary score for bml increased . 0 ###LEFT-WALL### 26 knee 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 41 . 1 after 14 and 1 after 26 knee 2 adjusting 3 for 2 adjusting 8 and 3 for 4 age 4 age 6 sex 5 , 6 sex 6 sex 7 , 7 , 8 and 8 and 11 index 8 and 12 , 9 body 10 mass 10 mass 11 index 12 , 13 total 12 , 14 and 14 and 16 compartment 14 and 17 bml 14 and 25 of 15 medial 16 compartment 17 bml 18 scores 17 bml 19 were 17 bml 21 associated 18 scores 19 were 19 were 20 significantly 21 associated 22 with 22 with 24 presence 23 the 24 presence 24 presence 25 of 26 knee 27 pain 28 , 29 and 29 and 31 association 29 and 32 was 30 the 31 association 31 association 32 was 32 was 33 stronger 33 stronger 34 as 33 stronger 38 for 34 as 37 score 35 the 37 score 36 summary 37 score 38 for 39 bml 39 bml 40 increased in proportional regression analysis , knee pain severity increased with bml severity in any compartment and in the medial compartment . 0 ###LEFT-WALL### 8 severity 0 ###LEFT-WALL### 9 increased 0 ###LEFT-WALL### 21 . 1 in 4 analysis 1 in 5 , 1 in 8 severity 2 proportional 3 regression 3 regression 4 analysis 6 knee 8 severity 7 pain 8 severity 8 severity 9 increased 9 increased 10 with 9 increased 16 and 10 with 12 severity 11 bml 12 severity 13 in 15 compartment 13 in 16 and 14 any 15 compartment 16 and 17 in 17 in 20 compartment 18 the 20 compartment 19 medial 20 compartment conclusion : bmls detected by mri were highly prevalent in this elderly asian population . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 bmls 2 : 7 were 2 : 15 . 3 bmls 4 detected 3 bmls 7 were 4 detected 5 by 5 by 6 mri 7 were 9 prevalent 8 highly 9 prevalent 9 prevalent 10 in 10 in 14 population 11 this 12 elderly 12 elderly 13 asian 13 asian 14 population bmls were significantly linked to knee pain , and bml severity correlated with knee pain severity . 0 ###LEFT-WALL### 1 bmls 0 ###LEFT-WALL### 4 linked 0 ###LEFT-WALL### 17 . 1 bmls 2 were 2 were 3 significantly 2 were 4 linked 4 linked 5 to 4 linked 13 with 5 to 9 and 6 knee 7 pain 7 pain 9 and 8 , 9 and 9 and 11 severity 9 and 12 correlated 10 bml 11 severity 13 with 16 severity 14 knee 16 severity 15 pain 16 severity bmls may be important surrogate targets for monitoring pain and structure modification in oa therapeutics . 0 ###LEFT-WALL### 1 bmls 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 16 . 1 bmls 10 and 2 may 3 be 2 may 10 and 3 be 6 targets 4 important 5 surrogate 5 surrogate 6 targets 6 targets 7 for 7 for 8 monitoring 8 monitoring 9 pain 10 and 11 structure 10 and 13 in 10 and 15 therapeutics 11 structure 12 modification 13 in 14 oa executive impairment is prominent in schizophrenia [,] in conditions such as parkinson 's disease and dementia and in healthy aging . 0 ###LEFT-WALL### 2 impairment 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 21 . 1 executive 2 impairment 2 impairment 3 is 3 is 4 prominent 4 prominent 5 in 5 in 6 schizophrenia 6 schizophrenia 17 and 8 in 9 conditions 8 in 17 and 9 conditions 11 as 10 such 11 as 11 as 15 and 12 parkinson 13 's 13 's 14 disease 14 disease 15 and 15 and 16 dementia 17 and 18 in 18 in 20 aging 19 healthy 20 aging identifying processes that critically constrain executive function can advance investigation of their biological basis and treatment planning . 0 ###LEFT-WALL### 1 identifying 0 ###LEFT-WALL### 7 function 0 ###LEFT-WALL### 18 . 1 identifying 2 processes 1 identifying 7 function 2 processes 3 that 2 processes 5 constrain 3 that 5 constrain 4 critically 5 constrain 5 constrain 6 executive 7 function 15 and 8 can 10 investigation 9 advance 10 investigation 10 investigation 11 of 10 investigation 15 and 11 of 14 basis 12 their 14 basis 13 biological 14 basis 15 and 16 treatment 15 and 17 planning recent findings that elderly healthy individuals showed similar impairment on conditional exclusion task as schizophrenia patients raised the question whether similar processes are impaired . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 13 task 0 ###LEFT-WALL### 25 . 1 recent 2 findings 2 findings 3 that 2 findings 13 task 3 that 6 individuals 3 that 7 showed 4 elderly 6 individuals 5 healthy 6 individuals 6 individuals 7 showed 7 showed 9 impairment 7 showed 10 on 8 similar 9 impairment 10 on 12 exclusion 11 conditional 12 exclusion 13 task 14 as 13 task 19 question 13 task 20 whether 14 as 15 schizophrenia 15 schizophrenia 16 patients 15 schizophrenia 17 raised 16 patients 17 raised 18 the 19 question 20 whether 22 processes 20 whether 24 impaired 21 similar 22 processes 22 processes 23 are 23 are 24 impaired to test [this] we compared 56 schizophrenia patients , 57 elderly and 77 young healthy individuals on three executive tests : conditional exclusion , abstraction and inhibition and tests of working memory and psychomotor speed . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 21 : 0 ###LEFT-WALL### 35 speed 0 ###LEFT-WALL### 36 . 1 to 2 test 2 test 4 we 2 test 5 compared 4 we 5 compared 5 compared 8 patients 6 56 8 patients 7 schizophrenia 8 patients 8 patients 20 tests 9 , 20 tests 10 57 20 tests 11 elderly 12 and 12 and 16 individuals 12 and 17 on 12 and 20 tests 13 77 16 individuals 14 young 16 individuals 15 healthy 16 individuals 17 on 18 three 19 executive 20 tests 20 tests 21 : 21 : 28 and 22 conditional 23 exclusion 23 exclusion 24 , 24 , 25 abstraction 24 , 26 and 26 and 27 inhibition 26 and 28 and 28 and 29 tests 28 and 30 of 28 and 33 and 28 and 35 speed 30 of 31 working 32 memory 33 and 33 and 34 psychomotor 33 and 35 speed schizophrenia patients performed worse than elderly healthy on abstraction , inhibition and verbal working memory . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 16 . 1 schizophrenia 2 patients 2 patients 3 performed 3 performed 4 worse 4 worse 5 than 5 than 12 and 6 elderly 7 healthy 6 elderly 10 , 7 healthy 8 on 8 on 9 abstraction 10 , 11 inhibition 10 , 12 and 12 and 15 memory 13 verbal 15 memory 14 working 15 memory they were similarly impaired on penn conditional exclusion test ( pcet ) outcome measures but differed in performance characteristics . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 20 . 1 they 15 but 2 were 4 impaired 2 were 15 but 3 similarly 4 impaired 4 impaired 5 on 5 on 14 measures 6 penn 7 conditional 7 conditional 8 exclusion 8 exclusion 9 test 9 test 11 pcet 10 ( 11 pcet 11 pcet 12 ) 11 pcet 14 measures 13 outcome 14 measures 15 but 16 differed 16 differed 17 in 17 in 19 characteristics 18 performance 19 characteristics schizophrenia patients needed relatively more trials to learn the first pcet category than the second [or] [the] third . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 needed 0 ###LEFT-WALL### 19 . 1 schizophrenia 2 patients 2 patients 3 needed 3 needed 6 trials 3 needed 7 to 3 needed 8 learn 4 relatively 5 more 5 more 6 trials 7 to 8 learn 8 learn 12 category 8 learn 13 than 9 the 10 first 9 the 12 category 11 pcet 12 category 13 than 18 third 14 the 15 second 14 the 18 third this correlated with other cognitive impairments , particularly in working memory . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 correlated 1 this 2 correlated 2 correlated 3 with 3 with 6 impairments 4 other 6 impairments 5 cognitive 6 impairments 6 impairments 9 in 7 , 8 particularly 7 , 9 in 9 in 10 working 9 in 12 . 10 working 11 memory elderly healthy individuals found it most difficult to learn the last category . 0 ###LEFT-WALL### 3 individuals 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 13 . 1 elderly 3 individuals 2 healthy 3 individuals 3 individuals 4 found 4 found 5 it 5 it 7 difficult 6 most 7 difficult 7 difficult 8 to 7 difficult 9 learn 8 to 9 learn 9 learn 12 category 10 the 12 category 11 last 12 category the two groups showed different error patterns . 0 ###LEFT-WALL### 3 groups 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 8 . 1 the 2 two 2 two 3 groups 3 groups 4 showed 4 showed 6 error 4 showed 7 patterns 5 different 6 error we propose that schizophrenia patients have particular difficulty in early [(] probabilistic ) learning ( " what to do " ) while aging individuals have selective impairment in executive integration . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 propose 0 ###LEFT-WALL### 31 . 1 we 2 propose 2 propose 3 that 3 that 5 patients 3 that 6 have 4 schizophrenia 5 patients 5 patients 6 have 6 have 8 difficulty 6 have 9 in 6 have 22 while 7 particular 8 difficulty 9 in 14 learning 10 early 14 learning 12 probabilistic 13 ) 12 probabilistic 14 learning 14 learning 17 what 15 ( 16 " 15 ( 17 what 17 what 18 to 17 what 19 do 17 what 21 ) 18 to 19 do 19 do 20 " 22 while 24 individuals 22 while 25 have 23 aging 24 individuals 24 individuals 25 have 25 have 27 impairment 25 have 28 in 26 selective 27 impairment 28 in 30 integration 29 executive 30 integration these constitute distinct targets for customized treatment in the two conditions . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 constitute 0 ###LEFT-WALL### 12 . 1 these 2 constitute 2 constitute 4 targets 2 constitute 8 in 3 distinct 4 targets 4 targets 5 for 5 for 7 treatment 6 customized 7 treatment 8 in 11 conditions 9 the 10 two 10 two 11 conditions using the pubmed database , we performed a detailed literature search for structural magnetic resonance imaging studies on patients with schizophrenia , investigating the relationship between macroscopic and microscopic structural parameters and age , to delineate an age - related trajectory . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 performed 0 ###LEFT-WALL### 39 - 0 ###LEFT-WALL### 42 . 1 using 4 database 1 using 5 , 1 using 6 we 2 the 4 database 3 pubmed 4 database 6 we 7 performed 7 performed 11 search 8 a 9 detailed 8 a 11 search 9 detailed 10 literature 10 literature 11 search 11 search 12 for 11 search 16 imaging 12 for 15 resonance 13 structural 15 resonance 14 magnetic 15 resonance 16 imaging 17 studies 16 imaging 18 on 16 imaging 20 with 16 imaging 35 to 18 on 19 patients 20 with 21 schizophrenia 21 schizophrenia 23 investigating 22 , 23 investigating 23 investigating 32 and 23 investigating 34 , 24 the 25 relationship 25 relationship 26 between 25 relationship 32 and 26 between 31 parameters 27 macroscopic 28 and 28 and 29 microscopic 28 and 31 parameters 30 structural 31 parameters 32 and 33 age 35 to 36 delineate 36 delineate 38 age 37 an 38 age 39 - 41 trajectory 40 related 41 trajectory twenty - six studies were considered for the review [,] from january 2000 to june 2012 . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 considered 0 ###LEFT-WALL### 17 . 1 twenty 2 - 2 - 3 six 2 - 4 studies 4 studies 5 were 5 were 6 considered 6 considered 7 for 6 considered 14 to 7 for 9 review 8 the 9 review 9 review 11 from 11 from 12 january 12 january 13 2000 14 to 15 june 15 june 16 2012 research results are heterogeneous because of the multifactorial features of schizophrenia and the multiplicity of the methodological approaches adopted . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 20 . 1 research 2 results 2 results 3 are 3 are 4 heterogeneous 4 heterogeneous 5 because 5 because 6 of 6 of 12 and 7 the 9 features 8 multifactorial 9 features 9 features 10 of 9 features 12 and 10 of 11 schizophrenia 12 and 14 multiplicity 12 and 15 of 13 the 14 multiplicity 15 of 18 approaches 16 the 18 approaches 17 methodological 18 approaches 18 approaches 19 adopted some areas , within the amygdala - hippocampus complex , which are affected early in life by schizophrenia , age in a physiological way . 0 ###LEFT-WALL### 2 areas 0 ###LEFT-WALL### 20 age 0 ###LEFT-WALL### 25 . 1 some 2 areas 2 areas 4 within 2 areas 11 which 2 areas 20 age 3 , 4 within 4 within 9 complex 4 within 10 , 5 the 9 complex 6 amygdala 7 - 6 amygdala 8 hippocampus 8 hippocampus 9 complex 10 , 11 which 11 which 12 are 11 which 19 , 12 are 13 affected 13 affected 14 early 14 early 15 in 14 early 17 by 15 in 16 life 17 by 18 schizophrenia 20 age 21 in 21 in 24 way 22 a 23 physiological 22 a 24 way 23 physiological 24 way other regions , such as the superior temporal gyrus , appear already impaired at the onset of symptoms , undergo a worsening in the acute phase but later [stabilize] , progressing physiologically over years . 0 ###LEFT-WALL### 2 regions 0 ###LEFT-WALL### 19 , 1 other 2 regions 2 regions 5 as 2 regions 19 , 3 , 5 as 4 such 5 as 5 as 9 gyrus 5 as 10 , 6 the 9 gyrus 7 superior 9 gyrus 8 temporal 9 gyrus 11 appear 13 impaired 11 appear 19 , 12 already 13 impaired 13 impaired 14 at 14 at 16 onset 15 the 16 onset 16 onset 17 of 17 of 18 symptoms 19 , 20 undergo 20 undergo 23 in 20 undergo 27 but 20 undergo 31 progressing 21 a 23 in 22 worsening 23 in 24 the 26 phase 25 acute 26 phase 26 phase 27 but 27 but 28 later 30 , 31 progressing 31 progressing 32 physiologically 31 progressing 33 over 31 progressing 35 . 33 over 34 years finally , there are regions , such as the uncinate fasciculus , which are not altered early in life , [but] [are] affected around the onset of schizophrenia , with their impairment continuously worsening over time . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 37 . 1 finally 2 , 1 finally 3 there 3 there 4 are 4 are 5 regions 5 regions 8 as 6 , 8 as 7 such 8 as 8 as 11 fasciculus 8 as 12 , 9 the 11 fasciculus 10 uncinate 11 fasciculus 12 , 13 which 12 , 14 are 13 which 14 are 14 are 15 not 14 are 17 early 15 not 16 altered 17 early 18 in 17 early 23 affected 17 early 30 with 18 in 19 life 20 , 23 affected 23 affected 24 around 23 affected 29 , 24 around 26 onset 25 the 26 onset 26 onset 27 of 27 of 28 schizophrenia 30 with 32 impairment 31 their 32 impairment 32 impairment 34 worsening 33 continuously 34 worsening 34 worsening 35 over 35 over 36 time further extensive longitudinal studies are needed to understand the timing and the possible degenerative characteristics of structural impairment associated with schizophrenia . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 needed 0 ###LEFT-WALL### 22 . 1 further 4 studies 2 extensive 4 studies 3 longitudinal 4 studies 4 studies 5 are 5 are 6 needed 6 needed 7 to 7 to 8 understand 8 understand 11 and 8 understand 20 with 9 the 10 timing 10 timing 11 and 11 and 15 characteristics 11 and 16 of 12 the 15 characteristics 13 possible 15 characteristics 14 degenerative 15 characteristics 16 of 18 impairment 17 structural 18 impairment 18 impairment 19 associated 20 with 21 schizophrenia impaired insight into illness is a common [but] poorly understood phenomenon in schizophrenia . 0 ###LEFT-WALL### 2 insight 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 14 . 1 impaired 2 insight 2 insight 3 into 2 insight 5 is 3 into 4 illness 5 is 11 phenomenon 6 a 7 common 6 a 11 phenomenon 7 common 11 phenomenon 9 poorly 10 understood 10 understood 11 phenomenon 11 phenomenon 12 in 12 in 13 schizophrenia several studies in midlife adults with schizophrenia have reported an association between impaired insight and illness severity , executive dysfunction , premorbid intellectual function , and [to] a lesser degree attention . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 9 reported 0 ###LEFT-WALL### 32 . 1 several 2 studies 2 studies 3 in 2 studies 8 have 3 in 5 adults 4 midlife 5 adults 5 adults 6 with 6 with 7 schizophrenia 8 have 9 reported 9 reported 11 association 9 reported 12 between 10 an 11 association 12 between 15 and 13 impaired 14 insight 14 insight 15 and 15 and 31 attention 16 illness 31 attention 17 severity 18 , 18 , 20 dysfunction 18 , 21 , 19 executive 20 dysfunction 21 , 24 function 21 , 26 and 22 premorbid 24 function 23 intellectual 24 function 25 , 26 and 26 and 30 degree 26 and 31 attention 28 a 30 degree 29 lesser 30 degree aging is associated with a decline in attention and executive function . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 3 associated 0 ###LEFT-WALL### 12 . 1 aging 2 is 2 is 3 associated 3 associated 4 with 3 associated 7 in 4 with 6 decline 5 a 6 decline 7 in 9 and 8 attention 9 and 9 and 11 function 10 executive 11 function thus , the relationship between cognition and insight is expected to differ between younger and older adults with schizophrenia . 0 ###LEFT-WALL### 4 relationship 0 ###LEFT-WALL### 10 expected 0 ###LEFT-WALL### 20 . 1 thus 2 , 1 thus 4 relationship 3 the 4 relationship 4 relationship 5 between 4 relationship 9 is 5 between 7 and 6 cognition 7 and 7 and 8 insight 9 is 10 expected 10 expected 11 to 10 expected 12 differ 11 to 12 differ 12 differ 13 between 12 differ 18 with 13 between 17 adults 14 younger 15 and 15 and 16 older 15 and 17 adults 18 with 19 schizophrenia this study assessed this relationship among 50 patients with schizophrenia 60 years and older . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 15 . 1 this 2 study 2 study 3 assessed 3 assessed 5 relationship 3 assessed 6 among 3 assessed 9 with 3 assessed 13 and 4 this 5 relationship 6 among 8 patients 7 50 8 patients 9 with 10 schizophrenia 10 schizophrenia 11 60 12 years 13 and 13 and 14 older insight was explained by illness severity ( 16.2 % of the variance [ )(and premorbid intellectual function ( 23.9 % of the variance ) , but not by attention or executive function . 0 ###LEFT-WALL### 1 insight 0 ###LEFT-WALL### 3 explained 0 ###LEFT-WALL### 33 . 1 insight 2 was 2 was 3 explained 3 explained 4 by 3 explained 26 but 3 explained 28 by 4 by 6 severity 5 illness 6 severity 6 severity 9 % 7 ( 9 % 8 16.2 9 % 9 % 10 of 9 % 25 , 10 of 14 )(and 11 the 12 variance 12 variance 14 )(and 14 )(and 17 function 14 )(and 20 % 15 premorbid 17 function 16 intellectual 17 function 18 ( 20 % 19 23.9 20 % 20 % 21 of 20 % 24 ) 21 of 23 variance 22 the 23 variance 26 but 27 not 28 by 30 or 29 attention 30 or 30 or 32 function 31 executive 32 function our findings suggest that the predictors of insight in schizophrenia differ early and later in life . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 17 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 6 predictors 4 that 11 differ 5 the 6 predictors 6 predictors 7 of 7 of 8 insight 8 insight 9 in 9 in 10 schizophrenia 11 differ 13 and 11 differ 15 in 12 early 13 and 13 and 14 later 15 in 16 life in particular , insight 's association with attention and executive function observed in younger patients is attenuated by age - related changes in cognition . 0 ###LEFT-WALL### 6 association 0 ###LEFT-WALL### 17 attenuated 0 ###LEFT-WALL### 21 related 1 in 2 particular 2 particular 3 , 2 particular 6 association 4 insight 5 's 5 's 6 association 6 association 7 with 6 association 16 is 7 with 9 and 8 attention 9 and 9 and 11 function 9 and 12 observed 10 executive 11 function 12 observed 13 in 13 in 15 patients 14 younger 15 patients 16 is 17 attenuated 17 attenuated 18 by 18 by 19 age 20 - 21 related 21 related 22 changes 21 related 23 in 21 related 25 . 23 in 24 cognition in contrast , premorbid [intellectual] [function] continues to be a strong predictor of insight in late life , which highlights the need to better understand and enhance cognitive [function] early in the course of schizophrenia . 0 ###LEFT-WALL### 4 premorbid 0 ###LEFT-WALL### 7 continues 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 36 . 1 in 2 contrast 1 in 3 , 1 in 4 premorbid 4 premorbid 7 continues 7 continues 8 to 8 to 9 be 9 be 12 predictor 9 be 15 in 10 a 12 predictor 11 strong 12 predictor 12 predictor 13 of 13 of 14 insight 15 in 17 life 16 late 17 life 18 , 19 which 18 , 20 highlights 19 which 20 highlights 20 highlights 22 need 21 the 22 need 22 need 23 to 22 need 26 and 22 need 28 cognitive 23 to 26 and 24 better 25 understand 25 understand 26 and 26 and 27 enhance 28 cognitive 30 early 28 cognitive 31 in 31 in 33 course 32 the 33 course 33 course 34 of 34 of 35 schizophrenia context : we have reconceptualized advance care planning ( acp ) as a multistep process focused on preparing patients with skills needed for communication and in [-] the [-] moment decision making . 0 ###LEFT-WALL### 1 context 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 3 we 2 : 5 reconceptualized 3 we 4 have 4 have 5 reconceptualized 5 reconceptualized 7 care 5 reconceptualized 25 and 6 advance 7 care 7 care 8 planning 7 care 10 acp 7 care 22 needed 9 ( 10 acp 10 acp 11 ) 12 as 15 process 12 as 22 needed 13 a 15 process 14 multistep 15 process 15 process 16 focused 16 focused 17 on 17 on 18 preparing 18 preparing 19 patients 18 preparing 20 with 20 with 21 skills 20 with 22 needed 23 for 24 communication 23 for 25 and 25 and 26 in 26 in 31 decision 28 the 31 decision 30 moment 31 decision 31 decision 32 making objectives : to operationalize this paradigm , we created an easy [-] [to] - use acp [website] ( prepareforyourcare.org ) based on a theoretical framework of behavior change and pilot - tested its efficacy to engage older adults in acp . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 41 . 2 : 3 to 2 : 4 operationalize 2 : 7 , 2 : 32 tested 3 to 4 operationalize 4 operationalize 6 paradigm 5 this 6 paradigm 7 , 8 we 7 , 9 created 8 we 9 created 9 created 15 use 9 created 22 on 10 an 11 easy 10 an 15 use 11 easy 14 - 11 easy 15 use 15 use 21 based 16 acp 19 prepareforyourcare.org 16 acp 21 based 18 ( 19 prepareforyourcare.org 19 prepareforyourcare.org 20 ) 22 on 25 framework 23 a 25 framework 24 theoretical 25 framework 25 framework 26 of 26 of 27 behavior 27 behavior 29 and 27 behavior 32 tested 28 change 29 and 29 and 30 pilot 29 and 31 - 29 and 32 tested 32 tested 34 efficacy 33 its 34 efficacy 34 efficacy 35 to 34 efficacy 36 engage 35 to 36 engage 36 engage 38 adults 36 engage 39 in 37 older 38 adults 39 in 40 acp methods : at baseline and 1 week after viewing the prepare website , we assessed behavior change in acp by using a validated survey that includes process measures ( knowledge , contemplation , self - efficacy , and readiness , 5 - point likert scales ) and action measures [(] yes/no whether an acp behavior was completed ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 59 . 1 methods 2 : 2 : 5 and 3 at 4 baseline 3 at 5 and 5 and 8 after 6 1 7 week 7 week 8 after 8 after 9 viewing 9 viewing 12 website 10 the 12 website 11 prepare 12 website 13 , 14 we 13 , 15 assessed 13 , 33 , 14 we 15 assessed 15 assessed 17 change 15 assessed 18 in 16 behavior 17 change 18 in 19 acp 19 acp 20 by 19 acp 32 contemplation 20 by 21 using 21 using 24 survey 22 a 24 survey 23 validated 24 survey 24 survey 25 that 24 survey 26 includes 24 survey 30 knowledge 25 that 26 includes 26 includes 28 measures 27 process 28 measures 29 ( 30 knowledge 30 knowledge 31 , 31 , 32 contemplation 32 contemplation 33 , 33 , 34 self 33 , 35 - 35 - 47 and 35 - 51 yes/no 36 efficacy 38 and 37 , 38 and 38 and 39 readiness 38 and 41 5 38 and 47 and 40 , 41 5 41 5 45 scales 41 5 46 ) 42 - 45 scales 43 point 45 scales 44 likert 45 scales 45 scales 46 ) 47 and 49 measures 47 and 51 yes/no 48 action 49 measures 51 yes/no 52 whether 52 whether 55 behavior 52 whether 57 completed 53 an 55 behavior 54 acp 55 behavior 55 behavior 56 was 56 was 57 completed 57 completed 58 ) we also assigned participants into behavior change stages ( i.e [.] , precontemplation , contemplation , preparation , action , maintenance ) and determined the percentage of participants who moved from precontemplation at baseline to higher stages at 1 week . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 41 . 1 we 23 and 2 also 3 assigned 3 assigned 4 participants 3 assigned 13 precontemplation 3 assigned 23 and 4 participants 5 into 4 participants 10 i.e 5 into 8 stages 6 behavior 8 stages 7 change 8 stages 9 ( 10 i.e 10 i.e 12 , 13 precontemplation 15 contemplation 13 precontemplation 17 preparation 13 precontemplation 21 maintenance 14 , 15 contemplation 15 contemplation 16 , 16 , 17 preparation 17 preparation 19 action 17 preparation 20 , 18 , 19 action 19 action 20 , 20 , 21 maintenance 21 maintenance 22 ) 23 and 24 determined 23 and 35 to 23 and 38 at 24 determined 26 percentage 24 determined 33 at 25 the 26 percentage 26 percentage 27 of 26 percentage 29 who 26 percentage 30 moved 27 of 28 participants 29 who 30 moved 30 moved 31 from 31 from 32 precontemplation 33 at 34 baseline 35 to 37 stages 36 higher 37 stages 38 at 40 week 39 1 40 week we also assessed prepare ease - of [-] use ( 10 - point scale [,] 10 being the easiest ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 21 . 1 we 3 assessed 2 also 3 assessed 3 assessed 5 ease 4 prepare 5 ease 5 ease 7 of 6 - 7 of 7 of 9 use 7 of 20 ) 9 use 12 - 10 ( 12 - 11 10 12 - 12 - 14 scale 12 - 20 ) 13 point 14 scale 14 scale 16 10 14 scale 17 being 17 being 19 easiest 18 the 19 easiest changes were assessed with wilcoxon signed rank sum tests and mcnemar 's tests . 0 ###LEFT-WALL### 1 changes 0 ###LEFT-WALL### 3 assessed 0 ###LEFT-WALL### 14 . 1 changes 2 were 2 were 3 assessed 3 assessed 4 with 4 with 10 and 5 wilcoxon 6 signed 6 signed 7 rank 7 rank 9 tests 8 sum 9 tests 9 tests 10 and 10 and 13 tests 11 mcnemar 12 's 12 's 13 tests results : mean age of the participants was 68.4 years ( sd [6.6] ) , and 65 % were nonwhite . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 mean 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 21 . 1 results 2 : 2 : 3 mean 3 mean 4 age 3 mean 8 was 4 age 5 of 4 age 8 was 5 of 7 participants 6 the 7 participants 8 was 10 years 9 68.4 10 years 10 years 12 sd 11 ( 12 sd 12 sd 14 ) 15 , 16 and 16 and 18 % 16 and 19 were 17 65 18 % 18 % 19 were 19 were 20 nonwhite behavior change process measures average likert scores increased from 3.1 ( 0.9 ) to 3.7 ( 0.7 ) , p < 0.001 . 0 ###LEFT-WALL### 4 measures 0 ###LEFT-WALL### 5 average 0 ###LEFT-WALL### 23 . 1 behavior 2 change 2 change 3 process 3 process 4 measures 4 measures 5 average 5 average 7 scores 5 average 9 from 5 average 14 to 6 likert 7 scores 7 scores 8 increased 9 from 10 3.1 10 3.1 12 0.9 11 ( 12 0.9 12 0.9 13 ) 14 to 15 3.7 15 3.7 17 0.7 15 3.7 21 < 16 ( 17 0.7 17 0.7 18 ) 19 , 21 < 20 p 21 < 21 < 22 0.001 action measures did not change significantly . 0 ###LEFT-WALL### 2 measures 0 ###LEFT-WALL### 5 change 0 ###LEFT-WALL### 7 . 1 action 2 measures 2 measures 3 did 3 did 4 not 3 did 5 change 5 change 6 significantly however , precontemplation significantly decreased for most actions ( e.g [.] , talking to doctor about desired medical care , 61 % to 35 % , p < 0.003 ) , with a mean decrease of 21 % ( range , 16 % - 33 % ) . 0 ###LEFT-WALL### 3 precontemplation 0 ###LEFT-WALL### 17 desired 1 however 2 , 1 however 3 precontemplation 3 precontemplation 5 decreased 3 precontemplation 13 talking 3 precontemplation 14 to 3 precontemplation 15 doctor 3 precontemplation 17 desired 4 significantly 5 decreased 5 decreased 6 for 6 for 8 actions 7 most 8 actions 8 actions 10 e.g 9 ( 10 e.g 10 e.g 12 , 14 to 15 doctor 15 doctor 16 about 17 desired 19 care 18 medical 19 care 19 care 22 % 20 , 22 % 21 61 22 % 22 % 23 to 22 % 48 . 23 to 25 % 24 35 25 % 25 % 28 < 25 % 32 with 26 , 28 < 27 p 28 < 28 < 29 0.003 28 < 30 ) 31 , 32 with 32 with 35 decrease 32 with 47 ) 33 a 35 decrease 34 mean 35 decrease 35 decrease 36 of 36 of 38 % 37 21 38 % 38 % 40 range 38 % 43 % 39 ( 40 range 40 range 41 , 41 , 43 % 42 16 43 % 43 % 46 % 43 % 47 ) 44 - 46 % 45 33 46 % 46 % 47 ) prepare was rated [a] [nine] of ten ( ±1.9 ) for ease - of [-] use . 0 ###LEFT-WALL### 1 prepare 0 ###LEFT-WALL### 3 rated 1 prepare 2 was 2 was 3 rated 3 rated 6 of 3 rated 11 for 6 of 7 ten 7 ten 9 ±1.9 8 ( 9 ±1.9 9 ±1.9 10 ) 11 for 12 ease 12 ease 14 of 13 - 14 of 14 of 16 use 14 of 17 . conclusion : a new , patient - centered acp website that focuses on preparing patients for communication and decision making significantly improves engagement in the process of acp and behavior change . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 12 focuses 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 32 . 1 conclusion 2 : 2 : 10 website 3 a 4 new 3 a 10 website 4 new 5 , 4 new 10 website 6 patient 7 - 6 patient 10 website 8 centered 10 website 9 acp 10 website 10 website 11 that 10 website 12 focuses 11 that 12 focuses 12 focuses 13 on 13 on 14 preparing 14 preparing 15 patients 14 preparing 16 for 16 for 17 communication 18 and 20 making 18 and 22 improves 19 decision 20 making 20 making 22 improves 21 significantly 22 improves 22 improves 23 engagement 22 improves 24 in 24 in 29 and 25 the 26 process 26 process 27 of 26 process 29 and 27 of 28 acp 29 and 31 change 30 behavior 31 change a clinical trial of prepare is currently underway . 0 ###LEFT-WALL### 3 trial 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 9 . 1 a 2 clinical 1 a 3 trial 2 clinical 3 trial 3 trial 4 of 3 trial 6 is 4 of 5 prepare 6 is 7 currently 6 is 8 underway near [falls] ( nfs ) [are] more [frequent] than falls , and may occur before [falls] , potentially predicting fall risk . 0 ###LEFT-WALL### 7 more 0 ###LEFT-WALL### 12 and 1 near 7 more 3 ( 4 nfs 4 nfs 5 ) 4 nfs 7 more 7 more 12 and 9 than 10 falls 10 falls 12 and 11 , 12 and 12 and 13 may 13 may 14 occur 14 occur 15 before 14 occur 19 predicting 17 , 19 predicting 18 potentially 19 predicting 19 predicting 21 risk 19 predicting 22 . 20 fall 21 risk [as] such [,] identification of a nf is important . 0 ###LEFT-WALL### 4 identification 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 10 . 2 such 4 identification 4 identification 5 of 4 identification 8 is 5 of 7 nf 6 a 7 nf 8 is 9 important we aimed to assess [intra] [and] [inter] [-] rater reliability of the traditional definition of a nf and to demonstrate the potential utility of a new definition . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 28 . 1 we 18 and 2 aimed 3 to 2 aimed 4 assess 2 aimed 18 and 3 to 4 assess 4 assess 10 reliability 9 rater 10 reliability 10 reliability 11 of 11 of 14 definition 12 the 14 definition 13 traditional 14 definition 14 definition 15 of 15 of 17 nf 16 a 17 nf 18 and 19 to 18 and 20 demonstrate 19 to 20 demonstrate 20 demonstrate 23 utility 21 the 23 utility 22 potential 23 utility 23 utility 24 of 24 of 27 definition 25 a 26 new 25 a 27 definition 26 new 27 definition to this end , 10 older adults , 10 idiopathic elderly fallers , and 10 patients with parkinson 's disease ( pd ) walked in an obstacle course while wearing a safety harness . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 24 walked 0 ###LEFT-WALL### 34 . 1 to 3 end 1 to 4 , 1 to 14 and 2 this 3 end 5 10 7 adults 6 older 7 adults 7 adults 8 , 8 , 12 fallers 8 , 14 and 9 10 12 fallers 10 idiopathic 12 fallers 11 elderly 12 fallers 13 , 14 and 14 and 16 patients 14 and 17 with 14 and 22 pd 14 and 24 walked 15 10 16 patients 17 with 20 disease 18 parkinson 19 's 19 's 20 disease 21 ( 22 pd 22 pd 23 ) 24 walked 25 in 24 walked 28 course 24 walked 29 while 26 an 28 course 27 obstacle 28 course 29 while 30 wearing 30 wearing 33 harness 31 a 33 harness 32 safety 33 harness all walks were videotaped . 0 ###LEFT-WALL### 2 walks 0 ###LEFT-WALL### 4 videotaped 0 ###LEFT-WALL### 5 . 1 all 2 walks 2 walks 3 were 3 were 4 videotaped forty - nine video segments were extracted to create 2 clips each of 8.48 min . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 7 extracted 0 ###LEFT-WALL### 16 . 1 forty 2 - 2 - 3 nine 2 - 5 segments 2 - 6 were 2 - 7 extracted 4 video 5 segments 5 segments 6 were 7 extracted 8 to 7 extracted 12 each 8 to 9 create 9 create 11 clips 10 2 11 clips 12 each 13 of 13 of 15 min 14 8.48 15 min four raters scored each event using the traditional definition [and] , two weeks later , using the new definition . 0 ###LEFT-WALL### 2 raters 0 ###LEFT-WALL### 3 scored 0 ###LEFT-WALL### 20 . 1 four 2 raters 2 raters 3 scored 3 scored 5 event 4 each 5 event 5 event 6 using 6 using 9 definition 6 using 16 using 7 the 9 definition 8 traditional 9 definition 9 definition 14 later 11 , 14 later 12 two 13 weeks 13 weeks 14 later 14 later 15 , 16 using 19 definition 17 the 19 definition 18 new 19 definition a fifth rater used only the new definition . 0 ###LEFT-WALL### 3 rater 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 9 . 1 a 3 rater 2 fifth 3 rater 3 rater 4 used 4 used 5 only 4 used 8 definition 6 the 8 definition 7 new 8 definition [intra] - rater reliability was determined using kappa ( k ) statistics and inter - rater reliability was determined using icc . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 15 - 2 - 4 reliability 3 rater 4 reliability 4 reliability 5 was 5 was 13 and 6 determined 7 using 6 determined 12 statistics 6 determined 13 and 7 using 8 kappa 8 kappa 10 k 9 ( 10 k 10 k 11 ) 13 and 14 inter 15 - 17 reliability 15 - 18 was 15 - 22 . 16 rater 17 reliability 17 reliability 18 was 18 was 19 determined 19 determined 20 using 20 using 21 icc using the traditional definition , three raters had poor [intra] - rater reliability ( k<0.054 , p>0.137 ) and one rater had moderate [intra] - rater reliability ( k=0.624 , p<0.001 ) . 0 ###LEFT-WALL### 7 raters 0 ###LEFT-WALL### 8 had 0 ###LEFT-WALL### 33 . 1 using 4 definition 1 using 5 , 1 using 7 raters 2 the 4 definition 3 traditional 4 definition 6 three 7 raters 7 raters 8 had 8 had 13 reliability 9 poor 11 - 9 poor 12 rater 12 rater 13 reliability 13 reliability 19 and 14 ( 19 and 15 k<0.054 17 p>0.137 15 k<0.054 19 and 16 , 17 p>0.137 17 p>0.137 18 ) 19 and 20 one 19 and 21 rater 19 and 22 had 19 and 27 reliability 19 and 32 ) 21 rater 22 had 22 had 23 moderate 25 - 27 reliability 26 rater 27 reliability 27 reliability 29 k=0.624 27 reliability 32 ) 28 ( 29 k=0.624 29 k=0.624 31 p<0.001 29 k=0.624 32 ) 30 , 31 p<0.001 31 p<0.001 32 ) with the traditional definition , inter [-] rater reliability between the four raters was moderate ( icc=0.667 , p<0.001 ) . 0 ###LEFT-WALL### 6 inter 0 ###LEFT-WALL### 21 . 1 with 4 definition 1 with 5 , 1 with 6 inter 2 the 4 definition 3 traditional 4 definition 6 inter 8 rater 8 rater 9 reliability 8 rater 15 moderate 8 rater 17 icc=0.667 8 rater 19 p<0.001 9 reliability 10 between 9 reliability 14 was 10 between 13 raters 11 the 12 four 12 four 13 raters 14 was 15 moderate 16 ( 17 icc=0.667 17 icc=0.667 18 , 18 , 19 p<0.001 19 p<0.001 20 ) in contrast , the new nf definition showed high [intra] - rater ( k>0.601 , p<0.001 ) and excellent [inter] - rater reliability ( icc=0.815 , p<0.001 ) . 0 ###LEFT-WALL### 7 definition 0 ###LEFT-WALL### 8 showed 0 ###LEFT-WALL### 29 . 1 in 2 contrast 1 in 3 , 1 in 7 definition 4 the 7 definition 5 new 7 definition 6 nf 7 definition 7 definition 8 showed 8 showed 12 rater 8 showed 18 and 9 high 11 - 9 high 12 rater 12 rater 14 k>0.601 12 rater 16 p<0.001 13 ( 14 k>0.601 14 k>0.601 15 , 15 , 16 p<0.001 16 p<0.001 17 ) 18 and 22 rater 18 and 23 reliability 19 excellent 21 - 19 excellent 22 rater 23 reliability 25 icc=0.815 24 ( 25 icc=0.815 25 icc=0.815 27 p<0.001 25 icc=0.815 28 ) 26 , 27 p<0.001 27 p<0.001 28 ) a priori , it is easy to distinguish [falls] from usual walking and nfs , but it is more challenging to distinguish nfs from obstacle negotiation and usual walking . 0 ###LEFT-WALL### 4 it 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 30 . 1 a 2 priori 2 priori 3 , 2 priori 4 it 4 it 5 is 5 is 6 easy 6 easy 7 to 6 easy 8 distinguish 7 to 8 distinguish 8 distinguish 10 from 10 from 13 and 11 usual 12 walking 11 usual 13 and 13 and 14 nfs 15 , 16 but 15 , 29 walking 16 but 17 it 16 but 18 is 17 it 18 is 18 is 20 challenging 19 more 20 challenging 20 challenging 21 to 20 challenging 29 walking 21 to 22 distinguish 22 distinguish 23 nfs 22 distinguish 24 from 24 from 27 and 25 obstacle 26 negotiation 26 negotiation 27 and 27 and 28 usual 27 and 29 walking therefore , a more precise definition of nf is required . 0 ###LEFT-WALL### 6 definition 0 ###LEFT-WALL### 10 required 0 ###LEFT-WALL### 11 . 1 therefore 2 , 1 therefore 6 definition 3 a 6 definition 4 more 5 precise 5 precise 6 definition 6 definition 7 of 6 definition 9 is 7 of 8 nf 9 is 10 required the results of the present study suggest that the proposed new definition increases [intra] and inter - rater reliability , a critical step for using nfs to quantify fall risk . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 17 - 0 ###LEFT-WALL### 18 rater 1 the 2 results 2 results 3 of 2 results 15 and 3 of 6 study 4 the 6 study 5 present 6 study 7 suggest 8 that 7 suggest 15 and 8 that 12 definition 8 that 13 increases 9 the 12 definition 10 proposed 12 definition 11 new 12 definition 12 definition 13 increases 15 and 16 inter 17 - 18 rater 18 rater 19 reliability 19 reliability 23 step 20 , 23 step 21 a 22 critical 21 a 23 step 22 critical 23 step 23 step 24 for 23 step 31 . 24 for 25 using 25 using 26 nfs 25 using 27 to 25 using 28 quantify 27 to 28 quantify 28 quantify 30 risk 29 fall 30 risk background [:] in adults , left [ventricular] [(] lv ) systolic [twist] is an important factor that determines lv filling , both at rest and during exercise . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 28 . 1 background 3 in 1 background 11 systolic 1 background 13 is 3 in 4 adults 4 adults 6 left 5 , 6 left 6 left 9 lv 6 left 10 ) 13 is 16 factor 14 an 15 important 14 an 16 factor 15 important 16 factor 16 factor 20 filling 17 that 18 determines 18 determines 19 lv 18 determines 20 filling 19 lv 20 filling 21 , 22 both 22 both 25 and 23 at 24 rest 23 at 25 and 25 and 26 during 26 during 27 exercise in children , [lower] lv [twist] has been demonstrated at rest , but its adaptation during exercise and its functional consequences on lv filling are unknown . 0 ###LEFT-WALL### 5 lv 0 ###LEFT-WALL### 9 demonstrated 0 ###LEFT-WALL### 13 but 0 ###LEFT-WALL### 27 . 1 in 2 children 1 in 3 , 1 in 5 lv 5 lv 7 has 7 has 8 been 8 been 9 demonstrated 9 demonstrated 10 at 10 at 11 rest 12 , 13 but 13 but 18 and 13 but 25 are 14 its 15 adaptation 15 adaptation 16 during 15 adaptation 18 and 16 during 17 exercise 18 and 21 consequences 18 and 22 on 18 and 24 filling 18 and 25 are 19 its 21 consequences 20 functional 21 consequences 22 on 23 lv 25 are 26 unknown results : at rest , lv [twist] was lower in children , because of a higher temporal dispersion of peak rotation between base and apex . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 1 results 2 : 2 : 3 at 3 at 4 rest 5 , 6 lv 5 , 8 was 6 lv 8 was 8 was 9 lower 9 lower 10 in 9 lower 13 because 10 in 11 children 12 , 13 because 13 because 14 of 13 because 26 . 14 of 18 dispersion 15 a 18 dispersion 16 higher 18 dispersion 17 temporal 18 dispersion 18 dispersion 19 of 19 of 21 rotation 20 peak 21 rotation 21 rotation 22 between 22 between 24 and 23 base 24 and 24 and 25 apex during exercise , the increase of basal rotation was blunted in children compared with adults ( - 6.7 ± [2.7] ° [vs] - 9.0 ± 2.0 ° at 40 % of maximal aerobic power , p < . 05 [ )( 0 ###LEFT-WALL### 5 increase 0 ###LEFT-WALL### 10 blunted 0 ###LEFT-WALL### 23 - 1 during 2 exercise 1 during 3 , 1 during 5 increase 4 the 5 increase 5 increase 6 of 5 increase 9 was 6 of 8 rotation 7 basal 8 rotation 9 was 10 blunted 10 blunted 11 in 10 blunted 14 with 11 in 12 children 12 children 13 compared 14 with 15 adults 15 adults 21 ° 16 ( 21 ° 17 - 18 6.7 18 6.7 21 ° 19 ± 21 ° 21 ° 23 - 23 - 24 9.0 23 - 25 ± 23 - 35 , 23 - 38 . 24 9.0 25 ± 25 ± 27 ° 25 ± 28 at 26 2.0 27 ° 28 at 30 % 29 40 30 % 30 % 31 of 31 of 34 power 32 maximal 34 power 33 aerobic 34 power 35 , 36 p 35 , 37 < 36 p 37 < 38 . 39 05 38 . 41 )( consequently , lv [twist] increased to a lesser extent ( 13.0 ± 5.0 [°] vs 15.8 ± [4.5] ° at 40 % of maximal aerobic power , p < . 05 [ )( 0 ###LEFT-WALL### 3 lv 0 ###LEFT-WALL### 5 increased 0 ###LEFT-WALL### 27 , 0 ###LEFT-WALL### 30 . 1 consequently 2 , 1 consequently 3 lv 3 lv 5 increased 5 increased 6 to 6 to 9 extent 7 a 8 lesser 7 a 9 extent 8 lesser 9 extent 9 extent 12 ± 10 ( 12 ± 11 13.0 12 ± 12 ± 13 5.0 12 ± 15 vs 12 ± 23 of 12 ± 27 , 15 vs 19 ° 16 15.8 19 ° 17 ± 19 ° 19 ° 20 at 20 at 22 % 21 40 22 % 23 of 26 power 24 maximal 26 power 25 aerobic 26 power 27 , 28 p 27 , 29 < 28 p 29 < 30 . 31 05 30 . 33 )( the increase in lv untwisting rates during exercise was also lower in children , leading to a lower percentage of untwisting during early diastole [(] 8 ± 8 % vs 29 ± 20 % at 40 % of maximal aerobic power , p < [.] 001 ) . 0 ###LEFT-WALL### 2 increase 0 ###LEFT-WALL### 9 was 0 ###LEFT-WALL### 48 . 1 the 2 increase 2 increase 3 in 2 increase 5 untwisting 2 increase 7 during 2 increase 9 was 3 in 4 lv 5 untwisting 6 rates 7 during 8 exercise 9 was 10 also 9 was 11 lower 11 lower 12 in 11 lower 15 leading 12 in 13 children 14 , 15 leading 15 leading 16 to 15 leading 22 during 15 leading 34 % 15 leading 47 ) 16 to 19 percentage 17 a 19 percentage 18 lower 19 percentage 19 percentage 20 of 20 of 21 untwisting 22 during 27 ± 23 early 24 diastole 24 diastole 27 ± 26 8 27 ± 27 ± 29 % 27 ± 32 ± 28 8 29 % 29 % 30 vs 29 % 32 ± 30 vs 31 29 33 20 34 % 34 % 35 at 34 % 38 of 34 % 44 < 35 at 37 % 36 40 37 % 38 of 41 power 39 maximal 41 power 40 aerobic 41 power 42 , 44 < 43 p 44 < 44 < 46 001 44 < 47 ) consequently , during early diastole , the normal timing of diastolic events observed in young adults , with [untwist] occurring before radial displacement , was blunted in children . 0 ###LEFT-WALL### 9 timing 0 ###LEFT-WALL### 26 blunted 0 ###LEFT-WALL### 29 . 1 consequently 2 , 1 consequently 9 timing 2 , 3 during 3 during 5 diastole 3 during 6 , 3 during 9 timing 4 early 5 diastole 7 the 9 timing 8 normal 9 timing 9 timing 10 of 9 timing 25 was 10 of 12 events 11 diastolic 12 events 12 events 13 observed 13 observed 14 in 13 observed 18 with 14 in 16 adults 15 young 16 adults 17 , 18 with 18 with 20 occurring 18 with 24 , 20 occurring 21 before 21 before 23 displacement 22 radial 23 displacement 25 was 26 blunted 26 blunted 27 in 27 in 28 children nevertheless , children exhibited normal [lv] filling due to higher diastolic radial and longitudinal strain rates . 0 ###LEFT-WALL### 3 children 0 ###LEFT-WALL### 4 exhibited 0 ###LEFT-WALL### 17 . 1 nevertheless 2 , 1 nevertheless 3 children 3 children 4 exhibited 4 exhibited 7 filling 4 exhibited 9 to 5 normal 7 filling 8 due 9 to 9 to 16 rates 10 higher 15 strain 11 diastolic 15 strain 12 radial 13 and 13 and 14 longitudinal 13 and 15 strain 15 strain 16 rates conclusions : twist - [untwist] mechanics may evolve with advancing age . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 conclusions 2 : 2 : 3 twist 4 - 6 mechanics 4 - 8 evolve 4 - 12 . 6 mechanics 7 may 7 may 8 evolve 8 evolve 9 with 9 with 10 advancing 10 advancing 11 age in children , early diastolic [lv] untwisting appears to be less important than in adults . 0 ###LEFT-WALL### 7 untwisting 0 ###LEFT-WALL### 8 appears 0 ###LEFT-WALL### 16 . 1 in 2 children 1 in 3 , 1 in 7 untwisting 4 early 7 untwisting 5 diastolic 7 untwisting 7 untwisting 8 appears 8 appears 9 to 8 appears 10 be 9 to 10 be 10 be 12 important 11 less 12 important 12 important 13 than 13 than 14 in 14 in 15 adults [their] better lv intrinsic myocardial relaxation may ensure [adequate] lv filling during exercise without dependence on the additional effect of suction resulting from lv [energy] [recoil] . 0 ###LEFT-WALL### 2 better 0 ###LEFT-WALL### 27 . 2 better 3 lv 2 better 12 during 2 better 14 without 2 better 16 on 3 lv 11 filling 4 intrinsic 6 relaxation 5 myocardial 6 relaxation 6 relaxation 7 may 7 may 8 ensure 8 ensure 10 lv 8 ensure 11 filling 10 lv 11 filling 12 during 13 exercise 14 without 15 dependence 16 on 19 effect 17 the 19 effect 18 additional 19 effect 19 effect 20 of 20 of 21 suction 21 suction 22 resulting 22 resulting 23 from 23 from 24 lv objectives : there is a widespread consensus that diabetes impairs cognitive functioning . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 there 2 : 4 is 2 : 13 . 3 there 4 is 4 is 7 consensus 5 a 6 widespread 5 a 7 consensus 6 widespread 7 consensus 7 consensus 8 that 8 that 9 diabetes 8 that 10 impairs 9 diabetes 10 impairs 10 impairs 12 functioning 11 cognitive 12 functioning however , some recent findings have shown that many health conditions generally thought to be detrimental to cognitive functioning are in fact linked to pre - morbid cognitive ability , suggesting reverse causation . 0 ###LEFT-WALL### 5 findings 0 ###LEFT-WALL### 7 shown 0 ###LEFT-WALL### 34 . 1 however 2 , 1 however 5 findings 3 some 5 findings 4 recent 5 findings 5 findings 6 have 6 have 7 shown 7 shown 11 conditions 7 shown 20 are 8 that 9 many 9 many 11 conditions 10 health 11 conditions 11 conditions 13 thought 11 conditions 20 are 12 generally 13 thought 13 thought 14 to 13 thought 17 to 14 to 15 be 15 be 16 detrimental 17 to 19 functioning 18 cognitive 19 functioning 20 are 21 in 20 are 31 suggesting 21 in 22 fact 22 fact 23 linked 23 linked 24 to 24 to 25 pre 25 pre 29 ability 26 - 29 ability 27 morbid 29 ability 28 cognitive 29 ability 29 ability 30 , 31 suggesting 33 causation 32 reverse 33 causation to better understand the causality in diabetes - cognition relationship , this study investigates the association of older - age diabetes with concurrent and childhood cognitive functioning . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 3 understand 0 ###LEFT-WALL### 8 - 1 to 3 understand 2 better 3 understand 3 understand 5 causality 4 the 5 causality 5 causality 6 in 6 in 7 diabetes 8 - 10 relationship 8 - 11 , 8 - 28 . 9 cognition 10 relationship 11 , 13 study 11 , 14 investigates 12 this 13 study 13 study 14 investigates 14 investigates 16 association 14 investigates 22 with 15 the 16 association 16 association 17 of 17 of 21 diabetes 18 older 19 - 18 older 20 age 20 age 21 diabetes 22 with 24 and 23 concurrent 24 and 24 and 27 functioning 25 childhood 27 functioning 26 cognitive 27 functioning methods : lothian birth cohort 1936 participants ( n=1017 ) completed the same general cognitive ability test at ages 11 and 70 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 1 methods 2 : 2 : 5 cohort 2 : 18 at 3 lothian 4 birth 4 birth 5 cohort 5 cohort 6 1936 5 cohort 7 participants 5 cohort 11 completed 7 participants 9 n=1017 7 participants 11 completed 8 ( 9 n=1017 9 n=1017 10 ) 11 completed 17 test 12 the 13 same 12 the 17 test 14 general 16 ability 15 cognitive 16 ability 16 ability 17 test 18 at 21 and 19 ages 20 11 19 ages 21 and 21 and 23 years 22 70 23 years scores were compared between those [with] and without diabetes at age 70 . 0 ###LEFT-WALL### 1 scores 0 ###LEFT-WALL### 3 compared 0 ###LEFT-WALL### 13 . 1 scores 2 were 2 were 3 compared 3 compared 7 and 3 compared 10 at 4 between 5 those 4 between 7 and 7 and 8 without 8 without 9 diabetes 10 at 11 age 11 age 12 70 diabetes status was based on self [-] reports and haemoglobin a1c levels . 0 ###LEFT-WALL### 2 status 0 ###LEFT-WALL### 4 based 0 ###LEFT-WALL### 13 . 1 diabetes 2 status 2 status 3 was 3 was 4 based 4 based 5 on 5 on 9 and 6 self 8 reports 8 reports 9 and 9 and 12 levels 10 haemoglobin 12 levels 11 a1c 12 levels results : people with diabetes had lower mean cognitive ability scores at ages 11 and 70 when compared with those without diabetes . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 people 2 : 6 had 2 : 23 . 3 people 4 with 3 people 6 had 4 with 5 diabetes 6 had 11 scores 6 had 12 at 6 had 17 when 7 lower 10 ability 8 mean 10 ability 9 cognitive 10 ability 10 ability 11 scores 12 at 13 ages 13 ages 15 and 14 11 15 and 15 and 16 70 17 when 18 compared 18 compared 19 with 18 compared 21 without 19 with 20 those 21 without 22 diabetes the effect size was roughly similar at both ages ( cohen 's d≈0.32 ) . 0 ###LEFT-WALL### 3 size 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 15 . 1 the 3 size 2 effect 3 size 3 size 4 was 4 was 6 similar 5 roughly 6 similar 6 similar 7 at 7 at 9 ages 8 both 9 ages 9 ages 13 d≈0.32 10 ( 13 d≈0.32 11 cohen 12 's 12 's 13 d≈0.32 13 d≈0.32 14 ) when adjusted for age - 11 cognitive ability , diabetes status was not associated with cognitive ability at age 70 . 0 ###LEFT-WALL### 11 status 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 21 . 1 when 2 adjusted 1 when 9 , 1 when 11 status 2 adjusted 3 for 3 for 4 age 4 age 8 ability 5 - 8 ability 6 11 8 ability 7 cognitive 8 ability 8 ability 9 , 10 diabetes 11 status 11 status 12 was 12 was 13 not 12 was 15 with 12 was 18 at 13 not 14 associated 15 with 17 ability 16 cognitive 17 ability 18 at 19 age 19 age 20 70 the association between childhood cognitive ability and older - age diabetes was partly accounted for by body mass index [and] cholesterol level in older - age . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 15 for 0 ###LEFT-WALL### 27 . 1 the 2 association 2 association 3 between 2 association 12 was 3 between 7 and 4 childhood 6 ability 5 cognitive 6 ability 6 ability 7 and 7 and 11 diabetes 8 older 9 - 8 older 10 age 10 age 11 diabetes 12 was 15 for 13 partly 15 for 14 accounted 15 for 15 for 16 by 16 by 21 cholesterol 17 body 19 index 18 mass 19 index 19 index 21 cholesterol 21 cholesterol 22 level 22 level 23 in 23 in 26 age 24 older 25 - 24 older 26 age conclusion : in this sample , diabetes was associated with poorer cognitive ability in old age but this was because of life - long lower cognitive ability in people with diabetes instead of diabetes impairing cognitive functioning . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 38 . 2 : 7 diabetes 2 : 9 associated 2 : 17 but 2 : 23 - 3 in 5 sample 3 in 6 , 3 in 7 diabetes 4 this 5 sample 7 diabetes 8 was 8 was 9 associated 9 associated 10 with 9 associated 14 in 10 with 13 ability 11 poorer 13 ability 12 cognitive 13 ability 14 in 16 age 15 old 16 age 17 but 18 this 17 but 19 was 18 this 19 was 19 was 21 of 20 because 21 of 21 of 22 life 23 - 25 lower 24 long 25 lower 25 lower 27 ability 25 lower 28 in 25 lower 30 with 25 lower 33 of 26 cognitive 27 ability 28 in 29 people 30 with 31 diabetes 32 instead 33 of 33 of 34 diabetes 34 diabetes 35 impairing 35 impairing 37 functioning 36 cognitive 37 functioning background : retired athletes with a history of sports concussions experience cognitive and motor declines with aging , and the risk of severe neurodegenerative conditions is magnified in this population . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 13 and 2 : 19 and 3 retired 4 athletes 3 retired 5 with 3 retired 13 and 5 with 7 history 5 with 12 cognitive 6 a 7 history 7 history 8 of 8 of 9 sports 9 sports 10 concussions 9 sports 11 experience 10 concussions 11 experience 13 and 14 motor 14 motor 15 declines 14 motor 16 with 16 with 17 aging 18 , 19 and 19 and 21 risk 19 and 27 magnified 20 the 21 risk 21 risk 22 of 21 risk 26 is 22 of 25 conditions 23 severe 25 conditions 24 neurodegenerative 25 conditions 26 is 27 magnified 27 magnified 28 in 28 in 30 population 29 this 30 population the present study investigated the effects of aging on motor system metabolism and function in former university [-] level athletes who sustained their last concussion several decades prior to testing . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 31 . 1 the 3 study 2 present 3 study 3 study 4 investigated 4 investigated 13 and 4 investigated 15 in 4 investigated 29 to 5 the 13 and 6 effects 7 of 6 effects 13 and 7 of 8 aging 8 aging 9 on 9 on 12 metabolism 10 motor 11 system 11 system 12 metabolism 13 and 14 function 15 in 20 athletes 16 former 19 level 17 university 19 level 19 level 20 athletes 20 athletes 21 who 20 athletes 22 sustained 21 who 22 sustained 22 sustained 27 decades 23 their 27 decades 24 last 25 concussion 25 concussion 27 decades 26 several 27 decades 28 prior 29 to 29 to 30 testing methods : to test the hypothesis that age and remote concussions induce functional as well as metabolic alterations of the motor system , we used proton magnetic resonance spectroscopy to detect metabolic abnormalities in the primary motor cortex and the serial reaction time task ( srtt ) to evaluate motor learning . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 49 evaluate 0 ###LEFT-WALL### 52 . 2 : 24 we 2 : 25 used 3 to 4 test 3 to 23 , 3 to 24 we 4 test 6 hypothesis 5 the 6 hypothesis 6 hypothesis 7 that 6 hypothesis 12 induce 7 that 9 and 7 that 12 induce 8 age 9 and 9 and 11 concussions 9 and 12 induce 10 remote 11 concussions 12 induce 18 alterations 12 induce 23 , 13 functional 18 alterations 14 as 15 well 15 well 17 metabolic 16 as 17 metabolic 17 metabolic 18 alterations 18 alterations 19 of 19 of 22 system 20 the 22 system 21 motor 22 system 24 we 25 used 25 used 29 spectroscopy 25 used 30 to 25 used 34 in 25 used 48 to 26 proton 29 spectroscopy 27 magnetic 28 resonance 28 resonance 29 spectroscopy 30 to 31 detect 31 detect 33 abnormalities 32 metabolic 33 abnormalities 34 in 39 and 35 the 38 cortex 36 primary 37 motor 37 motor 38 cortex 38 cortex 39 and 39 and 44 task 39 and 46 srtt 40 the 44 task 41 serial 44 task 42 reaction 44 task 43 time 44 task 45 ( 46 srtt 46 srtt 47 ) 48 to 49 evaluate 49 evaluate 51 learning 50 motor 51 learning results : our results indicate that motor learning is significantly reduced in former concussed athletes relative to controls . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 indicate 2 : 19 . 3 our 4 results 4 results 5 indicate 5 indicate 7 motor 5 indicate 11 reduced 6 that 7 motor 7 motor 8 learning 7 motor 9 is 9 is 10 significantly 9 is 11 reduced 11 reduced 12 in 12 in 15 athletes 13 former 15 athletes 14 concussed 15 athletes 15 athletes 16 relative 16 relative 17 to 17 to 18 controls in addition , glutamate/h2o [ratio] in m1 was disproportionately reduced in concussed athletes with advancing age and was found to strongly correlate with motor learning impairments . 0 ###LEFT-WALL### 4 glutamate/h2o 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 27 . 1 in 2 addition 1 in 3 , 1 in 4 glutamate/h2o 4 glutamate/h2o 6 in 4 glutamate/h2o 17 and 6 in 7 m1 8 was 10 reduced 8 was 17 and 9 disproportionately 10 reduced 10 reduced 11 in 10 reduced 14 with 11 in 13 athletes 12 concussed 13 athletes 14 with 15 advancing 15 advancing 16 age 17 and 18 was 17 and 23 with 18 was 19 found 19 found 20 to 20 to 22 correlate 21 strongly 22 correlate 23 with 26 impairments 24 motor 26 impairments 25 learning 26 impairments conclusion : findings from this study provide evidence that the acquisition of a repeated motor sequence is compromised in the aging concussed brain and that its physiological underpinnings could implicate disproportionate reductions of m1 glutamate concentrations with advancing age . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 3 findings 2 : 30 implicate 3 findings 4 from 3 findings 7 provide 4 from 6 study 5 this 6 study 7 provide 8 evidence 8 evidence 9 that 9 that 11 acquisition 9 that 18 compromised 10 the 11 acquisition 11 acquisition 12 of 11 acquisition 18 compromised 12 of 15 motor 13 a 15 motor 14 repeated 15 motor 15 motor 16 sequence 15 motor 17 is 16 sequence 17 is 18 compromised 19 in 19 in 24 and 20 the 23 brain 21 aging 23 brain 22 concussed 23 brain 23 brain 24 and 24 and 25 that 24 and 28 underpinnings 24 and 30 implicate 26 its 28 underpinnings 27 physiological 28 underpinnings 28 underpinnings 29 could 29 could 30 implicate 30 implicate 32 reductions 30 implicate 37 with 31 disproportionate 32 reductions 32 reductions 33 of 33 of 36 concentrations 34 m1 36 concentrations 35 glutamate 36 concentrations 37 with 38 advancing 38 advancing 39 age quality [improvement] ( qi ) initiatives are critical in the care of older adults who are more vulnerable to substandard care . 0 ###LEFT-WALL### 6 initiatives 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 22 . 1 quality 4 qi 3 ( 4 qi 4 qi 5 ) 4 qi 6 initiatives 6 initiatives 7 are 7 are 8 critical 8 critical 9 in 8 critical 12 of 9 in 11 care 10 the 11 care 12 of 14 adults 13 older 14 adults 14 adults 15 who 14 adults 16 are 15 who 16 are 16 are 18 vulnerable 17 more 18 vulnerable 18 vulnerable 19 to 19 to 21 care 20 substandard 21 care qi education meets aspects of core accreditation council of graduate medical education competencies and prepares learners for the rising focus on performance measurement in health care . 0 ###LEFT-WALL### 1 qi 0 ###LEFT-WALL### 6 core 0 ###LEFT-WALL### 27 . 1 qi 2 education 1 qi 5 of 1 qi 6 core 2 education 3 meets 3 meets 4 aspects 4 aspects 5 of 6 core 8 council 6 core 17 for 6 core 21 on 6 core 24 in 7 accreditation 8 council 8 council 9 of 8 council 14 and 9 of 12 education 10 graduate 11 medical 11 medical 12 education 13 competencies 14 and 14 and 15 prepares 14 and 16 learners 17 for 20 focus 18 the 20 focus 19 rising 20 focus 21 on 23 measurement 22 performance 23 measurement 24 in 26 care 25 health 26 care the authors developed , implemented , and evaluated a qi curriculum for geriatrics fellows . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 . 1 the 2 authors 2 authors 7 and 3 developed 5 implemented 3 developed 7 and 4 , 5 implemented 5 implemented 6 , 6 , 7 and 7 and 8 evaluated 8 evaluated 11 curriculum 9 a 11 curriculum 10 qi 11 curriculum 11 curriculum 12 for 12 for 14 fellows 13 geriatrics 14 fellows the evidence - based curriculum included didactics and a fellow - led qi intervention based on audit [and] feedback through the practice improvement module in care of the vulnerable elderly . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 12 led 0 ###LEFT-WALL### 31 . 1 the 2 evidence 2 evidence 8 and 2 evidence 12 led 3 - 8 and 4 based 7 didactics 5 curriculum 6 included 6 included 7 didactics 7 didactics 8 and 8 and 10 fellow 8 and 11 - 9 a 10 fellow 12 led 14 intervention 12 led 16 on 12 led 20 through 13 qi 14 intervention 14 intervention 15 based 16 on 19 feedback 17 audit 19 feedback 20 through 24 module 21 the 24 module 22 practice 23 improvement 23 improvement 24 module 24 module 25 in 24 module 27 of 25 in 26 care 27 of 30 elderly 28 the 30 elderly 29 vulnerable 30 elderly qi knowledge , attitudes , and behaviors were assessed before and after the improvement project . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 assessed 0 ###LEFT-WALL### 16 . 1 qi 2 knowledge 2 knowledge 3 , 3 , 4 attitudes 3 , 6 and 5 , 6 and 6 and 7 behaviors 6 and 8 were 8 were 9 assessed 9 assessed 11 and 10 before 11 and 11 and 12 after 12 after 15 project 13 the 15 project 14 improvement 15 project fellows ' knowledge of qi improved ( p = [.] 0156 ) , but behavior did not change significantly across a short - term improvement project . 0 ###LEFT-WALL### 3 knowledge 0 ###LEFT-WALL### 6 improved 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 27 . 1 fellows 2 ' 2 ' 3 knowledge 3 knowledge 4 of 3 knowledge 6 improved 4 of 5 qi 6 improved 9 = 7 ( 9 = 8 p 9 = 9 = 11 0156 9 = 12 ) 13 , 14 but 14 but 15 behavior 14 but 18 change 15 behavior 16 did 16 did 17 not 16 did 18 change 18 change 19 significantly 18 change 20 across 20 across 26 project 21 a 22 short 21 a 26 project 22 short 23 - 22 short 24 term 24 term 26 project 25 improvement 26 project a structured focus group with fellows revealed themes of accountability and the importance of interprofessional teamwork in qi . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 7 revealed 0 ###LEFT-WALL### 19 . 1 a 4 group 2 structured 3 focus 3 focus 4 group 4 group 5 with 4 group 7 revealed 5 with 6 fellows 7 revealed 8 themes 7 revealed 17 in 8 themes 9 of 9 of 11 and 10 accountability 11 and 11 and 13 importance 11 and 14 of 12 the 13 importance 14 of 16 teamwork 15 interprofessional 16 teamwork 17 in 18 qi qi education for geriatrics fellows can be feasible , well received , and prepare future physician leaders for patient - centered care , performance measurement , and effecting systems change . 0 ###LEFT-WALL### 2 education 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 31 . 1 qi 2 education 2 education 3 for 2 education 6 can 3 for 5 fellows 4 geriatrics 5 fellows 6 can 13 and 7 be 11 received 7 be 13 and 8 feasible 9 , 8 feasible 10 well 10 well 11 received 12 , 13 and 13 and 14 prepare 14 prepare 17 leaders 15 future 17 leaders 16 physician 17 leaders 17 leaders 18 for 17 leaders 25 measurement 18 for 22 care 19 patient 20 - 19 patient 22 care 21 centered 22 care 23 , 25 measurement 24 performance 25 measurement 25 measurement 26 , 26 , 27 and 27 and 29 systems 27 and 30 change 28 effecting 29 systems 29 systems 30 change the goals of this study were to determine the learning impact of an assignment that consisted of interviewing and analyzing older people 's life stories , and to explore [how] the assignment was evaluated by students . 0 ###LEFT-WALL### 2 goals 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 37 . 1 the 2 goals 2 goals 3 of 2 goals 6 were 3 of 5 study 4 this 5 study 6 were 7 to 6 were 8 determine 7 to 8 determine 8 determine 19 and 9 the 11 impact 10 learning 11 impact 11 impact 12 of 11 impact 19 and 12 of 14 assignment 13 an 14 assignment 14 assignment 15 that 14 assignment 16 consisted 15 that 16 consisted 16 consisted 17 of 17 of 18 interviewing 19 and 25 stories 19 and 26 , 20 analyzing 22 people 21 older 22 people 22 people 23 's 23 's 25 stories 24 life 25 stories 27 and 28 to 27 and 34 evaluated 28 to 29 explore 28 to 33 was 29 explore 32 assignment 31 the 32 assignment 33 was 34 evaluated 34 evaluated 35 by 35 by 36 students participants in the study were 122 first - year social education students enrolled in an adult development and aging course . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 21 . 1 participants 2 in 1 participants 5 were 2 in 4 study 3 the 4 study 5 were 6 122 5 were 7 first 8 - 18 and 9 year 10 social 10 social 12 students 11 education 12 students 12 students 13 enrolled 12 students 18 and 13 enrolled 14 in 14 in 17 development 15 an 17 development 16 adult 17 development 18 and 20 course 19 aging 20 course they evaluated the assignment using an eight [-] adjective questionnaire and were asked about the benefits of the task . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 20 . 1 they 11 and 2 evaluated 4 assignment 2 evaluated 11 and 3 the 4 assignment 4 assignment 5 using 5 using 10 questionnaire 6 an 10 questionnaire 7 eight 9 adjective 9 adjective 10 questionnaire 11 and 12 were 12 were 13 asked 13 asked 14 about 14 about 16 benefits 15 the 16 benefits 16 benefits 17 of 17 of 19 task 18 the 19 task their answers to the questionnaire were then reviewed using content analysis . 0 ###LEFT-WALL### 2 answers 0 ###LEFT-WALL### 8 reviewed 0 ###LEFT-WALL### 12 . 1 their 2 answers 2 answers 3 to 2 answers 6 were 3 to 5 questionnaire 4 the 5 questionnaire 6 were 8 reviewed 7 then 8 reviewed 8 reviewed 9 using 9 using 11 analysis 10 content 11 analysis the results indicated that marks on the life story assignment predicted marks on an exam about basic course concepts . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicated 0 ###LEFT-WALL### 20 . 1 the 2 results 2 results 3 indicated 3 indicated 4 that 4 that 5 marks 4 that 11 predicted 5 marks 6 on 5 marks 11 predicted 6 on 10 assignment 7 the 10 assignment 8 life 10 assignment 9 story 10 assignment 11 predicted 12 marks 11 predicted 13 on 11 predicted 16 about 13 on 15 exam 14 an 15 exam 16 about 19 concepts 17 basic 18 course 18 course 19 concepts students considered that the assignment was interesting , useful , [and] integrated into the course , although most of them also thought that it was [very] time - consuming . 0 ###LEFT-WALL### 1 students 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 30 . 1 students 2 considered 2 considered 3 that 3 that 5 assignment 3 that 6 was 4 the 5 assignment 5 assignment 6 was 6 was 7 interesting 8 , 24 it 8 , 25 was 8 , 28 - 9 useful 12 integrated 9 useful 16 , 9 useful 24 it 10 , 12 integrated 12 integrated 13 into 12 integrated 16 , 13 into 15 course 14 the 15 course 17 although 18 most 17 although 22 thought 17 although 24 it 18 most 19 of 18 most 22 thought 19 of 20 them 21 also 22 thought 22 thought 23 that 24 it 25 was 25 was 27 time 28 - 29 consuming they identified benefits related to the explicit goals of the course ( improvement in the learning of developmental concepts , the acquisition of research - related skills , and the deactivation of aging stereotypes ) and personal , growth - related benefits . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 identified 0 ###LEFT-WALL### 26 related 0 ###LEFT-WALL### 40 - 1 they 2 identified 2 identified 3 benefits 2 identified 5 to 3 benefits 4 related 5 to 8 goals 6 the 8 goals 7 explicit 8 goals 8 goals 9 of 8 goals 22 acquisition 9 of 11 course 10 the 11 course 11 course 13 improvement 12 ( 13 improvement 13 improvement 14 in 13 improvement 20 , 14 in 16 learning 15 the 16 learning 16 learning 17 of 17 of 19 concepts 18 developmental 19 concepts 20 , 22 acquisition 21 the 22 acquisition 22 acquisition 23 of 22 acquisition 25 - 23 of 24 research 25 - 26 related 26 related 36 and 27 skills 29 and 28 , 29 and 29 and 31 deactivation 29 and 35 ) 29 and 36 and 30 the 31 deactivation 31 deactivation 32 of 32 of 33 aging 33 aging 34 stereotypes 36 and 39 growth 37 personal 38 , 37 personal 39 growth 40 - 42 benefits 40 - 43 . 41 related 42 benefits the authors discuss the difficulties posed by the assignment and its usefulness as a complement to more traditional , lecture - based teaching methods in adult development and aging courses . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 discuss 0 ###LEFT-WALL### 21 - 1 the 2 authors 2 authors 3 discuss 3 discuss 20 lecture 4 the 20 lecture 5 difficulties 6 posed 5 difficulties 10 and 6 posed 7 by 7 by 9 assignment 8 the 9 assignment 10 and 12 usefulness 10 and 13 as 10 and 20 lecture 11 its 12 usefulness 13 as 15 complement 14 a 15 complement 15 complement 16 to 16 to 17 more 18 traditional 19 , 18 traditional 20 lecture 21 - 28 and 21 - 31 . 22 based 23 teaching 23 teaching 24 methods 24 methods 25 in 24 methods 28 and 25 in 27 development 26 adult 27 development 28 and 30 courses 29 aging 30 courses medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population . 0 ###LEFT-WALL### 2 schools 0 ###LEFT-WALL### 4 consider 0 ###LEFT-WALL### 19 . 1 medical 2 schools 2 schools 3 must 3 must 4 consider 4 consider 6 ways 4 consider 7 to 4 consider 13 to 4 consider 14 care 5 innovative 6 ways 7 to 8 ensure 8 ensure 9 that 9 that 10 graduates 9 that 11 are 10 graduates 11 are 11 are 12 prepared 13 to 14 care 14 care 15 for 15 for 18 population 16 the 18 population 17 aging 18 population one way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school 's internal medicine rotation requirement . 0 ###LEFT-WALL### 2 way 0 ###LEFT-WALL### 19 's 0 ###LEFT-WALL### 24 . 1 one 2 way 2 way 3 is 3 is 4 to 3 is 5 offer 4 to 5 offer 5 offer 8 clerkship 5 offer 9 as 6 a 8 clerkship 7 geriatrics 8 clerkship 9 as 11 option 9 as 19 's 10 an 11 option 11 option 12 for 11 option 19 's 12 for 14 fulfillment 13 the 14 fulfillment 14 fulfillment 15 of 15 of 18 school 16 a 17 medical 16 a 18 school 17 medical 18 school 19 's 23 requirement 20 internal 21 medicine 21 medicine 23 requirement 22 rotation 23 requirement the authors ' purpose was to evaluate the geriatrics clerkship's impact on internal medicine knowledge and medical student attitudes toward older adults . 0 ###LEFT-WALL### 4 purpose 0 ###LEFT-WALL### 23 . 1 the 2 authors 2 authors 3 ' 3 ' 4 purpose 4 purpose 5 was 5 was 6 to 5 was 7 evaluate 6 to 7 evaluate 7 evaluate 9 geriatrics 7 evaluate 10 clerkship's 8 the 9 geriatrics 9 geriatrics 10 clerkship's 10 clerkship's 11 impact 10 clerkship's 12 on 12 on 16 and 13 internal 14 medicine 14 medicine 15 knowledge 15 knowledge 16 and 16 and 19 attitudes 16 and 20 toward 17 medical 18 student 18 student 19 attitudes 20 toward 22 adults 21 older 22 adults mean national board of medical examiners ( nbme ) internal medicine subject exam scores from geriatrics and internal medicine students who matriculated from 2005 to 2011 were compared using student ['s] [t] - tests . 0 ###LEFT-WALL### 30 student 0 ###LEFT-WALL### 33 - 1 mean 2 national 2 national 3 board 3 board 4 of 3 board 17 and 4 of 14 scores 5 medical 6 examiners 6 examiners 8 nbme 7 ( 8 nbme 8 nbme 9 ) 8 nbme 14 scores 10 internal 12 subject 11 medicine 12 subject 12 subject 14 scores 13 exam 14 scores 14 scores 15 from 15 from 16 geriatrics 17 and 19 medicine 17 and 20 students 17 and 27 were 17 and 28 compared 17 and 30 student 18 internal 19 medicine 20 students 21 who 20 students 22 matriculated 20 students 27 were 21 who 22 matriculated 22 matriculated 25 to 23 from 25 to 24 2005 25 to 25 to 26 2011 29 using 30 student 33 - 34 tests 33 - 35 . academic performance was controlled for using the united states medical licensing exam step 1 exam scores . 0 ###LEFT-WALL### 2 performance 0 ###LEFT-WALL### 4 controlled 0 ###LEFT-WALL### 17 . 1 academic 2 performance 2 performance 3 was 3 was 4 controlled 4 controlled 5 for 5 for 6 using 6 using 13 step 7 the 13 step 8 united 9 states 9 states 10 medical 10 medical 11 licensing 11 licensing 12 exam 12 exam 13 step 13 step 15 exam 13 step 16 scores 14 1 15 exam 15 exam 16 scores focus groups were conducted to explore student attitudes . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 9 . 1 focus 2 groups 2 groups 3 were 3 were 4 conducted 4 conducted 5 to 5 to 6 explore 6 explore 8 attitudes 7 student 8 attitudes geriatrics students performed just as well on the nbme exam as their internal medicine colleagues , but reported greater comfort with elder care . 0 ###LEFT-WALL### 2 students 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 24 . 1 geriatrics 2 students 2 students 17 but 3 performed 4 just 3 performed 17 but 4 just 5 as 4 just 7 on 4 just 11 as 5 as 6 well 7 on 10 exam 8 the 10 exam 9 nbme 10 exam 11 as 15 colleagues 12 their 15 colleagues 13 internal 14 medicine 14 medicine 15 colleagues 16 , 17 but 17 but 18 reported 18 reported 20 comfort 18 reported 21 with 19 greater 20 comfort 21 with 23 care 22 elder 23 care geriatrics students also reported more positive attitudes toward older adults . 0 ###LEFT-WALL### 2 students 0 ###LEFT-WALL### 4 reported 0 ###LEFT-WALL### 11 . 1 geriatrics 2 students 2 students 4 reported 3 also 4 reported 4 reported 7 attitudes 4 reported 8 toward 5 more 6 positive 6 positive 7 attitudes 8 toward 10 adults 9 older 10 adults completing an internal medicine requirement using a geriatrics clerkship is an innovation for medical school curriculum structure . 0 ###LEFT-WALL### 1 completing 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 18 . 1 completing 5 requirement 1 completing 6 using 1 completing 10 is 2 an 3 internal 2 an 5 requirement 3 internal 4 medicine 4 medicine 5 requirement 6 using 9 clerkship 7 a 9 clerkship 8 geriatrics 9 clerkship 10 is 12 innovation 11 an 12 innovation 12 innovation 13 for 13 for 17 structure 14 medical 15 school 15 school 17 structure 16 curriculum 17 structure to explore the experience of leaving cuba , 2 cuban american émigrés interviewed 20 cuban exiles aged 65 or older , who left cuba between 1959 and 1971 . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 explore 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 29 . 1 to 2 explore 2 explore 4 experience 3 the 4 experience 4 experience 5 of 5 of 6 leaving 6 leaving 7 cuba 7 cuba 12 émigrés 8 , 12 émigrés 9 2 12 émigrés 10 cuban 12 émigrés 11 american 12 émigrés 12 émigrés 13 interviewed 12 émigrés 21 , 13 interviewed 19 or 14 20 16 exiles 15 cuban 16 exiles 16 exiles 17 aged 16 exiles 19 or 17 aged 18 65 19 or 20 older 21 , 22 who 21 , 23 left 22 who 23 left 23 left 24 cuba 23 left 25 between 25 between 27 and 26 1959 27 and 27 and 28 1971 the interviews were conducted in new york and new jersey using a phenomenological approach ( moutsakas , 1994 ) . 0 ###LEFT-WALL### 2 interviews 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 20 . 1 the 2 interviews 2 interviews 3 were 3 were 4 conducted 4 conducted 5 in 5 in 8 and 6 new 7 york 7 york 8 and 8 and 10 jersey 8 and 11 using 9 new 10 jersey 11 using 14 approach 12 a 13 phenomenological 12 a 14 approach 13 phenomenological 14 approach 14 approach 16 moutsakas 14 approach 18 1994 15 ( 16 moutsakas 16 moutsakas 17 , 17 , 18 1994 18 1994 19 ) themes included feeling betrayed by the revolution , the inevitability of leaving , the expectation of a temporary refuge , and longing for [and] idealizing the past . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 28 . 1 themes 2 included 1 themes 5 by 1 themes 21 and 2 included 4 betrayed 3 feeling 4 betrayed 5 by 7 revolution 6 the 7 revolution 7 revolution 10 inevitability 7 revolution 15 expectation 8 , 10 inevitability 9 the 10 inevitability 10 inevitability 11 of 10 inevitability 13 , 11 of 12 leaving 13 , 15 expectation 14 the 15 expectation 15 expectation 16 of 15 expectation 20 , 16 of 19 refuge 17 a 19 refuge 18 temporary 19 refuge 20 , 21 and 21 and 22 longing 21 and 23 for 23 for 25 idealizing 25 idealizing 27 past 26 the 27 past the psychological presence that participants expressed , along with an endless sense of loss , resonates with ambiguous loss theory ( boss , 2006 ) - themes that have yet to be explored in the literature and that have research and practice implications . 0 ###LEFT-WALL### 3 presence 0 ###LEFT-WALL### 16 resonates 0 ###LEFT-WALL### 26 - 1 the 3 presence 2 psychological 3 presence 3 presence 4 that 3 presence 6 expressed 3 presence 16 resonates 4 that 5 participants 4 that 6 expressed 5 participants 6 expressed 6 expressed 9 with 7 , 9 with 8 along 9 with 9 with 12 sense 9 with 15 , 10 an 11 endless 10 an 12 sense 11 endless 12 sense 12 sense 13 of 13 of 14 loss 16 resonates 17 with 17 with 20 theory 18 ambiguous 19 loss 19 loss 20 theory 20 theory 22 boss 21 ( 22 boss 22 boss 24 2006 22 boss 26 - 23 , 24 2006 24 2006 25 ) 26 - 27 themes 26 - 41 and 26 - 44 . 27 themes 28 that 27 themes 29 have 27 themes 41 and 28 that 29 have 29 have 30 yet 29 have 31 to 29 have 33 explored 31 to 32 be 32 be 33 explored 33 explored 34 in 34 in 37 and 35 the 36 literature 36 literature 37 and 37 and 38 that 39 have 40 research 39 have 41 and 41 and 42 practice 42 practice 43 implications objectives : to describe the current state of knowledge about detection and treatment of major depressive disorder ( mdd ) by family physicians ( fps ) , and to [identify] gaps in practice and current and future challenges . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 39 . 1 objectives 2 : 2 : 3 to 2 : 4 describe 3 to 4 describe 4 describe 12 and 4 describe 28 and 5 the 7 state 6 current 7 state 7 state 8 of 7 state 12 and 8 of 9 knowledge 9 knowledge 10 about 10 about 11 detection 12 and 13 treatment 12 and 14 of 12 and 19 mdd 14 of 17 disorder 15 major 17 disorder 16 depressive 17 disorder 18 ( 19 mdd 19 mdd 20 ) 21 by 23 physicians 21 by 28 and 22 family 23 physicians 23 physicians 25 fps 24 ( 25 fps 25 fps 26 ) 27 , 28 and 28 and 29 to 29 to 31 gaps 31 gaps 32 in 32 in 36 and 33 practice 34 and 34 and 35 current 34 and 36 and 36 and 38 challenges 37 future 38 challenges methods : we reviewed the recent literature on mdd [(] diagnostic and statistical manual of mental disorders , fourth edition , or international classification of diseases , revision 10 ) in primary care , with an emphasis on systematic reviews and meta - analyses addressing prevalence , the impact of an aging population and [of] chronic disease on mdd rates in primary care , detection and treatment rates by fps , adequacy of treatment , and interventions that could improve recognition and treatment . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 reviewed 2 : 3 we 3 we 4 reviewed 4 reviewed 12 and 5 the 7 literature 6 recent 7 literature 7 literature 8 on 7 literature 12 and 8 on 11 diagnostic 9 mdd 11 diagnostic 12 and 14 manual 12 and 15 of 13 statistical 14 manual 15 of 22 or 16 mental 17 disorders 17 disorders 18 , 18 , 20 edition 18 , 22 or 19 fourth 20 edition 21 , 22 or 22 or 24 classification 22 or 25 of 22 or 31 in 23 international 24 classification 25 of 26 diseases 26 diseases 28 revision 27 , 28 revision 28 revision 29 10 28 revision 30 ) 31 in 32 primary 32 primary 33 care 32 primary 44 analyses 33 care 35 with 33 care 44 analyses 34 , 35 with 35 with 37 emphasis 35 with 43 - 36 an 37 emphasis 37 emphasis 38 on 38 on 41 and 39 systematic 40 reviews 40 reviews 41 and 41 and 42 meta 44 analyses 54 and 45 addressing 46 prevalence 46 prevalence 47 , 47 , 49 impact 47 , 54 and 48 the 49 impact 49 impact 50 of 50 of 53 population 51 an 53 population 52 aging 53 population 54 and 56 chronic 54 and 57 disease 54 and 60 rates 57 disease 58 on 57 disease 60 rates 58 on 59 mdd 60 rates 61 in 60 rates 69 by 61 in 66 and 62 primary 63 care 63 care 64 , 64 , 65 detection 64 , 66 and 66 and 68 rates 67 treatment 68 rates 69 by 70 fps 70 fps 82 and 71 , 82 and 72 adequacy 73 of 72 adequacy 76 and 73 of 74 treatment 75 , 76 and 76 and 77 interventions 76 and 78 that 76 and 79 could 76 and 82 and 78 that 79 could 79 could 80 improve 80 improve 81 recognition 82 and 83 treatment 82 and 84 . results : about 10 % of primary care patients are likely to meet criteria for mdd . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 about 2 : 10 are 2 : 17 . 3 about 5 % 3 about 10 are 4 10 5 % 5 % 6 of 6 of 8 care 7 primary 8 care 9 patients 10 are 10 are 11 likely 11 likely 12 to 11 likely 13 meet 12 to 13 meet 13 meet 14 criteria 13 meet 15 for 15 for 16 mdd the number of cases will increase as the baby boomer cohort ages and as the prevalence [of] chronic disease increases . 0 ###LEFT-WALL### 4 cases 0 ###LEFT-WALL### 6 increase 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 21 . 1 the 2 number 2 number 3 of 2 number 4 cases 3 of 4 cases 4 cases 5 will 5 will 6 increase 6 increase 7 as 7 as 12 ages 8 the 12 ages 9 baby 10 boomer 10 boomer 12 ages 11 cohort 12 ages 13 and 19 disease 13 and 20 increases 14 as 16 prevalence 14 as 19 disease 15 the 16 prevalence 18 chronic 19 disease 19 disease 20 increases the bidirectional relation between mdd and chronic disease is now firmly established . 0 ###LEFT-WALL### 3 relation 0 ###LEFT-WALL### 12 established 0 ###LEFT-WALL### 13 . 1 the 3 relation 2 bidirectional 3 relation 3 relation 4 between 3 relation 9 is 4 between 6 and 5 mdd 6 and 6 and 8 disease 7 chronic 8 disease 9 is 10 now 9 is 12 established 11 firmly 12 established detection and treatment rates in primary care remain low . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 8 remain 0 ###LEFT-WALL### 10 . 1 detection 2 and 2 and 4 rates 2 and 5 in 2 and 8 remain 3 treatment 4 rates 5 in 7 care 6 primary 7 care 8 remain 9 low treatment quality is frequently inadequate in terms of [follow] - up and monitoring . 0 ###LEFT-WALL### 2 quality 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 14 . 1 treatment 2 quality 2 quality 3 is 3 is 4 frequently 3 is 5 inadequate 5 inadequate 6 in 6 in 12 and 7 terms 8 of 7 terms 12 and 8 of 11 up 10 - 11 up 12 and 13 monitoring formal case management and collaborative care interventions are likely to provide some benefits . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 14 . 1 formal 2 case 2 case 3 management 3 management 4 and 4 and 6 care 4 and 7 interventions 4 and 11 provide 5 collaborative 6 care 7 interventions 8 are 8 are 9 likely 9 likely 10 to 9 likely 11 provide 10 to 11 provide 11 provide 13 benefits 12 some 13 benefits conclusions : low detection rates and low treatment rates need to be addressed . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 3 low 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 14 . 1 conclusions 2 : 2 : 3 low 3 low 5 rates 4 detection 5 rates 6 and 9 rates 6 and 10 need 7 low 9 rates 8 treatment 9 rates 9 rates 10 need 10 need 11 to 10 need 12 be 11 to 12 be 12 be 13 addressed planned reassessment may improve detection rates when the fp is uncertain whether mdd is present , but further research is needed to determine why fps frequently do not initiate treatment , even when mdd is detected . 0 ###LEFT-WALL### 2 reassessment 0 ###LEFT-WALL### 4 improve 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 23 determine 0 ###LEFT-WALL### 37 . 1 planned 2 reassessment 2 reassessment 3 may 3 may 4 improve 4 improve 6 rates 4 improve 7 when 5 detection 6 rates 7 when 9 fp 7 when 10 is 8 the 9 fp 9 fp 10 is 10 is 11 uncertain 11 uncertain 12 whether 12 whether 13 mdd 12 whether 14 is 13 mdd 14 is 14 is 15 present 16 , 17 but 17 but 19 research 17 but 21 needed 18 further 19 research 19 research 20 is 20 is 21 needed 21 needed 22 to 22 to 23 determine 23 determine 24 why 23 determine 33 when 24 why 25 fps 24 why 31 , 25 fps 27 do 26 frequently 27 do 27 do 28 not 27 do 31 , 29 initiate 30 treatment 29 initiate 31 , 31 , 32 even 33 when 34 mdd 33 when 35 is 34 mdd 35 is 35 is 36 detected [a] caring , attentive fp who monitors depressed patients is likely to have considerable placebo effect . 0 ###LEFT-WALL### 5 fp 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 17 . 2 caring 3 , 2 caring 5 fp 4 attentive 5 fp 5 fp 6 who 5 fp 7 monitors 5 fp 10 is 6 who 7 monitors 7 monitors 9 patients 8 depressed 9 patients 10 is 11 likely 11 likely 12 to 11 likely 13 have 12 to 13 have 13 have 16 effect 14 considerable 15 placebo 15 placebo 16 effect greater focus on integrated [,] concurrent treatment for mdd and chronic physical diseases in the middle - aged and elderly is also required . 0 ###LEFT-WALL### 2 focus 0 ###LEFT-WALL### 23 required 0 ###LEFT-WALL### 24 . 1 greater 2 focus 2 focus 3 on 2 focus 8 for 2 focus 21 is 3 on 7 treatment 4 integrated 7 treatment 6 concurrent 7 treatment 8 for 19 and 9 mdd 10 and 10 and 13 diseases 10 and 17 - 10 and 18 aged 10 and 19 and 11 chronic 13 diseases 12 physical 13 diseases 13 diseases 14 in 14 in 16 middle 15 the 16 middle 19 and 20 elderly 21 is 22 also 21 is 23 required background : texture within biological specimens may reveal critical insights , while being very difficult to quantify . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 texture 2 : 8 reveal 3 texture 4 within 3 texture 7 may 4 within 6 specimens 5 biological 6 specimens 7 may 8 reveal 8 reveal 10 insights 8 reveal 12 while 9 critical 10 insights 11 , 12 while 12 while 13 being 12 while 18 . 13 being 15 difficult 14 very 15 difficult 15 difficult 16 to 15 difficult 17 quantify 16 to 17 quantify this is a particular problem in histological analysis . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 9 . 1 this 2 is 2 is 5 problem 3 a 4 particular 3 a 5 problem 4 particular 5 problem 5 problem 6 in 6 in 8 analysis 7 histological 8 analysis for example , cross - polar images of picrosirius stained skin reveal exquisite structure , allowing changes in the basketweave conformation of healthy collagen to be assessed . 0 ###LEFT-WALL### 4 cross 0 ###LEFT-WALL### 5 - 1 for 2 example 2 example 3 , 2 example 4 cross 5 - 7 images 5 - 12 reveal 6 polar 7 images 7 images 8 of 7 images 12 reveal 8 of 11 skin 9 picrosirius 10 stained 10 stained 11 skin 12 reveal 14 structure 13 exquisite 14 structure 14 structure 16 allowing 15 , 16 allowing 16 allowing 17 changes 16 allowing 18 in 16 allowing 25 to 16 allowing 27 assessed 16 allowing 28 . 18 in 21 conformation 19 the 21 conformation 20 basketweave 21 conformation 21 conformation 22 of 22 of 24 collagen 23 healthy 24 collagen 25 to 26 be 26 be 27 assessed existing techniques measure gross pathological changes , [such] [as] fibrosis , but [are] not [sufficiently] sensitive to detect more subtle and progressive pathological changes in the dermis , such as those seen in ageing . 0 ###LEFT-WALL### 2 techniques 0 ###LEFT-WALL### 18 detect 1 existing 2 techniques 2 techniques 3 measure 3 measure 12 but 3 measure 17 to 4 gross 6 changes 5 pathological 6 changes 6 changes 7 , 7 , 10 fibrosis 7 , 12 but 11 , 12 but 12 but 14 not 12 but 16 sensitive 17 to 18 detect 18 detect 24 changes 18 detect 30 as 19 more 24 changes 20 subtle 21 and 21 and 22 progressive 21 and 24 changes 23 pathological 24 changes 24 changes 25 in 25 in 27 dermis 26 the 27 dermis 28 , 30 as 29 such 30 as 30 as 31 those 30 as 35 . 31 those 32 seen 32 seen 33 in 33 in 34 ageing moreover , screening methods for cutaneous therapeutics require accurate , unsupervised and high - throughput image analysis techniques . 0 ###LEFT-WALL### 4 methods 0 ###LEFT-WALL### 16 image 0 ###LEFT-WALL### 19 . 1 moreover 2 , 1 moreover 4 methods 3 screening 4 methods 4 methods 5 for 4 methods 8 require 5 for 7 therapeutics 6 cutaneous 7 therapeutics 8 require 15 throughput 8 require 16 image 9 accurate 12 and 9 accurate 14 - 9 accurate 15 throughput 10 , 12 and 11 unsupervised 12 and 12 and 13 high 12 and 14 - 16 image 18 techniques 17 analysis 18 techniques results : by analyzing spectra of images post gabor filtering and fast fourier transform , we were able to measure subtle changes in collagen fibre orientation intractable to existing techniques . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 measure 0 ###LEFT-WALL### 31 . 2 : 8 post 3 by 4 analyzing 3 by 8 post 4 analyzing 5 spectra 5 spectra 6 of 6 of 7 images 8 post 11 and 9 gabor 10 filtering 9 gabor 11 and 11 and 14 transform 11 and 15 , 11 and 16 we 11 and 20 measure 12 fast 13 fourier 13 fourier 14 transform 16 we 17 were 17 were 18 able 18 able 19 to 19 to 20 measure 20 measure 22 changes 21 subtle 22 changes 22 changes 23 in 23 in 26 orientation 24 collagen 25 fibre 25 fibre 26 orientation 26 orientation 27 intractable 27 intractable 28 to 28 to 29 existing 29 existing 30 techniques we detected the progressive loss of collagen basketweave structure in a series of chronologically aged skin samples , as well as in skin derived from a model of type 2 diabetes mellitus . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 detected 0 ###LEFT-WALL### 33 . 1 we 2 detected 2 detected 5 loss 2 detected 10 in 2 detected 25 from 3 the 5 loss 4 progressive 5 loss 5 loss 6 of 6 of 9 structure 7 collagen 9 structure 8 basketweave 9 structure 10 in 12 series 11 a 12 series 12 series 13 of 12 series 24 derived 13 of 17 samples 14 chronologically 15 aged 15 aged 16 skin 16 skin 17 samples 18 , 19 as 19 as 20 well 19 as 24 derived 20 well 21 as 20 well 24 derived 21 as 22 in 22 in 23 skin 25 from 27 model 26 a 27 model 27 model 28 of 28 of 32 mellitus 29 type 32 mellitus 30 2 32 mellitus 31 diabetes 32 mellitus conclusions : we describe a novel bioimaging approach with implications for the evaluation of pathology in a broader range of biological situations . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 3 we 2 : 4 describe 3 we 4 describe 4 describe 8 approach 4 describe 9 with 4 describe 16 in 5 a 8 approach 6 novel 8 approach 7 bioimaging 8 approach 9 with 10 implications 10 implications 11 for 10 implications 14 of 11 for 13 evaluation 12 the 13 evaluation 14 of 15 pathology 16 in 19 range 17 a 19 range 18 broader 19 range 19 range 20 of 20 of 22 situations 21 biological 22 situations the rhythms of activity across the 24 - h sleep [-] wake cycle , determined in part by the circadian clock , change with aging . 0 ###LEFT-WALL### 2 rhythms 0 ###LEFT-WALL### 23 change 0 ###LEFT-WALL### 26 . 1 the 2 rhythms 2 rhythms 3 of 2 rhythms 23 change 3 of 4 activity 4 activity 5 across 5 across 13 cycle 6 the 13 cycle 7 24 8 - 8 - 9 h 8 - 13 cycle 10 sleep 13 cycle 12 wake 13 cycle 13 cycle 15 determined 14 , 15 determined 15 determined 17 part 15 determined 22 , 16 in 17 part 17 part 18 by 18 by 21 clock 19 the 21 clock 20 circadian 21 clock 23 change 24 with 24 with 25 aging few large - scale studies measured the activity rhythm objectively in the general population . 0 ###LEFT-WALL### 5 studies 0 ###LEFT-WALL### 6 measured 0 ###LEFT-WALL### 15 . 1 few 5 studies 2 large 3 - 2 large 4 scale 4 scale 5 studies 5 studies 6 measured 6 measured 9 rhythm 6 measured 10 objectively 6 measured 11 in 7 the 9 rhythm 8 activity 9 rhythm 11 in 14 population 12 the 14 population 13 general 14 population the present population - based study in middle [-] aged and elderly persons evaluated how activity rhythms change with age , and additionally investigated sociodemographics , mental health , lifestyle , and sleep characteristics as determinants of rhythms of activity . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 41 . 1 the 3 population 2 present 3 population 4 - 6 study 4 - 14 evaluated 5 based 6 study 6 study 7 in 6 study 14 evaluated 7 in 13 persons 8 middle 13 persons 10 aged 11 and 11 and 12 elderly 11 and 13 persons 14 evaluated 15 how 14 evaluated 35 as 15 how 17 rhythms 15 how 22 and 16 activity 17 rhythms 17 rhythms 22 and 18 change 19 with 18 change 22 and 19 with 20 age 21 , 22 and 22 and 24 investigated 23 additionally 24 investigated 24 investigated 32 and 25 sociodemographics 26 , 26 , 28 health 26 , 29 , 27 mental 28 health 29 , 30 lifestyle 29 , 32 and 31 , 32 and 32 and 34 characteristics 33 sleep 34 characteristics 35 as 36 determinants 36 determinants 37 of 37 of 38 rhythms 38 rhythms 39 of 39 of 40 activity activity rhythms were measured objectively with actigraphy . 0 ###LEFT-WALL### 2 rhythms 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 8 . 1 activity 2 rhythms 2 rhythms 3 were 3 were 4 measured 4 measured 5 objectively 4 measured 6 with 6 with 7 actigraphy recordings of at least 96 h ( 138 ± [14] h , mean ± sd ) were collected from 1734 people ( age : 62 ± 9.4 yrs [ )(participating in the rotterdam study . 0 ###LEFT-WALL### 1 recordings 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 24 : 1 recordings 2 of 1 recordings 11 h 1 recordings 15 sd 1 recordings 17 were 2 of 6 h 3 at 4 least 4 least 5 96 5 96 6 h 7 ( 11 h 8 138 11 h 9 ± 11 h 11 h 12 , 12 , 15 sd 13 mean 15 sd 14 ± 15 sd 15 sd 16 ) 17 were 18 collected 18 collected 19 from 19 from 21 people 20 1734 21 people 21 people 23 age 22 ( 23 age 23 age 24 : 24 : 25 62 24 : 26 ± 24 : 35 . 25 62 26 ± 26 ± 30 )(participating 27 9.4 28 yrs 28 yrs 30 )(participating 30 )(participating 31 in 31 in 34 study 32 the 34 study 33 rotterdam 34 study activity rhythms were quantified by calculating interdaily stability , i.e . [,] the stability of the rhythm over days , and [intradaily] variability , i.e [.] , the fragmentation of the rhythm relative to its 24 - h amplitude . 0 ###LEFT-WALL### 2 rhythms 0 ###LEFT-WALL### 4 quantified 0 ###LEFT-WALL### 11 . 1 activity 2 rhythms 2 rhythms 3 were 3 were 4 quantified 4 quantified 5 by 4 quantified 9 , 4 quantified 10 i.e 5 by 6 calculating 6 calculating 7 interdaily 6 calculating 8 stability 11 . 21 and 13 the 14 stability 14 stability 15 of 14 stability 18 over 14 stability 21 and 15 of 17 rhythm 16 the 17 rhythm 18 over 19 days 20 , 21 and 21 and 23 variability 21 and 25 i.e 21 and 29 fragmentation 24 , 25 i.e 25 i.e 27 , 27 , 29 fragmentation 28 the 29 fragmentation 29 fragmentation 30 of 29 fragmentation 33 relative 29 fragmentation 40 . 30 of 32 rhythm 31 the 32 rhythm 33 relative 34 to 34 to 39 amplitude 35 its 39 amplitude 36 24 37 - 37 - 38 h 37 - 39 amplitude we assessed age , gender , presence of a partner , employment , [cognitive] functioning , depressive symptoms , body mass index [(] bmi ) , coffee use , alcohol use , and smoking as determinants . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 assessed 0 ###LEFT-WALL### 37 . 1 we 2 assessed 2 assessed 33 and 2 assessed 35 as 3 age 4 , 4 , 5 gender 4 , 6 , 6 , 7 presence 6 , 33 and 7 presence 8 of 8 of 10 partner 9 a 10 partner 10 partner 12 employment 10 partner 15 functioning 10 partner 18 symptoms 11 , 12 employment 12 employment 13 , 13 , 15 functioning 15 functioning 16 , 16 , 18 symptoms 17 depressive 18 symptoms 18 symptoms 24 bmi 18 symptoms 28 use 18 symptoms 31 use 18 symptoms 32 , 19 , 24 bmi 20 body 21 mass 21 mass 24 bmi 22 index 24 bmi 24 bmi 25 ) 26 , 28 use 27 coffee 28 use 28 use 29 , 29 , 31 use 30 alcohol 31 use 31 use 32 , 33 and 34 smoking 35 as 36 determinants the results indicate that older age is associated with a more stable 24 - h activity profile ( β [=] 0.07 , p = 0.02 ) , but also with a more [fragmented] distribution of periods of activity and inactivity [(] β = 0.20 , p < 0.001 ) . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 50 . 1 the 2 results 2 results 3 indicate 3 indicate 4 that 4 that 6 age 4 that 8 associated 5 older 6 age 6 age 7 is 7 is 8 associated 8 associated 9 with 8 associated 28 but 8 associated 30 with 8 associated 47 < 9 with 17 profile 10 a 17 profile 11 more 12 stable 12 stable 16 activity 13 24 14 - 14 - 15 h 14 - 16 activity 16 activity 17 profile 17 profile 19 β 18 ( 19 β 19 β 24 = 19 β 27 , 21 0.07 24 = 22 , 24 = 23 p 24 = 24 = 25 0.02 24 = 26 ) 28 but 29 also 30 with 42 β 30 with 44 0.20 31 a 42 β 32 more 34 distribution 34 distribution 35 of 34 distribution 39 and 35 of 36 periods 36 periods 37 of 37 of 38 activity 39 and 40 inactivity 39 and 42 β 43 = 44 0.20 45 , 47 < 46 p 47 < 47 < 48 0.001 47 < 49 ) having more depressive symptoms was related to less stable ( β [=] - 0.07 , p = 0.005 ) and more fragmented [(] β [=] 0.10 , p < 0.001 ) rhythms . 0 ###LEFT-WALL### 1 having 0 ###LEFT-WALL### 6 related 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 33 . 1 having 4 symptoms 1 having 5 was 2 more 3 depressive 3 depressive 4 symptoms 5 was 6 related 6 related 7 to 6 related 9 stable 7 to 8 less 9 stable 13 - 9 stable 17 = 10 ( 13 - 11 β 13 - 13 - 14 0.07 13 - 15 , 16 p 17 = 17 = 18 0.005 17 = 19 ) 20 and 21 more 20 and 22 fragmented 21 more 22 fragmented 22 fragmented 32 rhythms 24 β 29 < 24 β 31 ) 24 β 32 rhythms 26 0.10 29 < 27 , 29 < 28 p 29 < 29 < 30 0.001 29 < 31 ) a high bmi and smoking were also associated with less stable rhythms ( bmi : β = - 0.11 , p < 0.001 ; smoking : β = - 0.11 , p < 0.001 ) and more fragmented rhythms ( bmi : β = 0.09 , p < 0.001 ; smoking : β = 0.11 , p < 0.001 ) . 0 ###LEFT-WALL### 2 high 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 15 : 1 a 2 high 2 high 4 and 2 high 6 were 2 high 8 associated 3 bmi 4 and 4 and 5 smoking 4 and 6 were 6 were 7 also 8 associated 9 with 9 with 10 less 9 with 12 rhythms 11 stable 12 rhythms 12 rhythms 14 bmi 13 ( 14 bmi 14 bmi 15 : 15 : 16 β 15 : 17 = 15 : 24 ; 16 β 17 = 17 = 19 0.11 18 - 19 0.11 19 0.11 22 < 20 , 22 < 21 p 22 < 22 < 23 0.001 22 < 24 ; 24 ; 25 smoking 24 ; 26 : 26 : 27 β 26 : 28 = 26 : 36 and 26 : 42 : 27 β 28 = 28 = 30 0.11 28 = 33 < 29 - 30 0.11 31 , 33 < 32 p 33 < 33 < 34 0.001 33 < 35 ) 36 and 37 more 36 and 38 fragmented 37 more 38 fragmented 38 fragmented 39 rhythms 39 rhythms 41 bmi 40 ( 41 bmi 41 bmi 42 : 42 : 43 β 42 : 44 = 42 : 50 ; 42 : 52 : 43 β 44 = 44 = 45 0.09 45 0.09 48 < 46 , 48 < 47 p 48 < 48 < 49 0.001 48 < 50 ; 50 ; 51 smoking 52 : 53 β 52 : 54 = 52 : 61 . 53 β 54 = 54 = 55 0.11 55 0.11 58 < 56 , 58 < 57 p 58 < 58 < 59 0.001 58 < 60 ) we conclude that with older age the 24 - h activity rhythm becomes more rigid , whereas the ability to maintain either an active or inactive state for a longer period of time is compromised . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 conclude 1 we 2 conclude 2 conclude 3 that 3 that 12 rhythm 3 that 13 becomes 4 with 6 age 4 with 12 rhythm 5 older 6 age 7 the 12 rhythm 8 24 9 - 9 - 10 h 9 - 11 activity 11 activity 12 rhythm 12 rhythm 13 becomes 13 becomes 15 rigid 14 more 15 rigid 15 rigid 17 whereas 16 , 17 whereas 17 whereas 19 ability 17 whereas 35 compromised 17 whereas 36 . 18 the 19 ability 19 ability 20 to 19 ability 21 maintain 19 ability 35 compromised 20 to 21 maintain 21 maintain 22 either 21 maintain 27 state 21 maintain 34 is 23 an 27 state 24 active 25 or 25 or 26 inactive 25 or 27 state 27 state 28 for 27 state 32 of 27 state 34 is 28 for 31 period 29 a 31 period 30 longer 31 period 32 of 33 time both characteristics appear to be important for major health issues in old age . 0 ###LEFT-WALL### 2 characteristics 0 ###LEFT-WALL### 3 appear 0 ###LEFT-WALL### 14 . 1 both 2 characteristics 2 characteristics 3 appear 3 appear 4 to 3 appear 5 be 4 to 5 be 5 be 6 important 6 important 7 for 6 important 11 in 7 for 10 issues 8 major 9 health 9 health 10 issues 11 in 13 age 12 old 13 age this study evaluated readiness to change drug use in young adult patients aged 18 - 25 years who were provided screening and brief intervention as part of a substance abuse and mental health services administration ( samhsa ) treatment capacity expansion project . 0 ###LEFT-WALL### 4 readiness 0 ###LEFT-WALL### 13 aged 0 ###LEFT-WALL### 43 . 1 this 4 readiness 2 study 3 evaluated 3 evaluated 4 readiness 4 readiness 5 to 4 readiness 6 change 4 readiness 13 aged 5 to 6 change 6 change 8 use 6 change 9 in 7 drug 8 use 9 in 12 patients 10 young 12 patients 11 adult 12 patients 13 aged 24 intervention 13 aged 25 as 14 18 15 - 15 - 16 25 15 - 24 intervention 17 years 18 who 17 years 19 were 17 years 22 and 18 who 19 were 19 were 21 screening 20 provided 21 screening 22 and 23 brief 22 and 24 intervention 25 as 26 part 26 part 27 of 27 of 42 project 28 a 42 project 29 substance 30 abuse 30 abuse 31 and 31 and 32 mental 32 mental 33 health 33 health 34 services 34 services 35 administration 35 administration 37 samhsa 36 ( 37 samhsa 37 samhsa 38 ) 37 samhsa 39 treatment 39 treatment 40 capacity 40 capacity 41 expansion 41 expansion 42 project [non] - treatment - seeking young adults at risk for drug problems ( n = 1,560 ) were assessed for readiness to change . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 19 assessed 0 ###LEFT-WALL### 24 . 2 - 3 treatment 3 treatment 5 seeking 3 treatment 18 were 4 - 5 seeking 5 seeking 7 adults 5 seeking 17 ) 6 young 7 adults 7 adults 8 at 7 adults 10 for 8 at 9 risk 10 for 12 problems 11 drug 12 problems 12 problems 15 = 13 ( 15 = 14 n 15 = 15 = 16 1,560 18 were 19 assessed 19 assessed 20 for 20 for 21 readiness 21 readiness 22 to 21 readiness 23 change 22 to 23 change structural equation modeling examined latent constructs : emotional distress , age , drug use severity , criminal behavior , gender , and race/ethnicity . 0 ###LEFT-WALL### 3 modeling 0 ###LEFT-WALL### 4 examined 0 ###LEFT-WALL### 7 : 1 structural 2 equation 2 equation 3 modeling 3 modeling 4 examined 4 examined 6 constructs 5 latent 6 constructs 7 : 22 and 7 : 24 . 8 emotional 9 distress 9 distress 10 , 10 , 11 age 10 , 12 , 12 , 15 severity 12 , 16 , 13 drug 15 severity 14 use 15 severity 16 , 18 behavior 16 , 19 , 17 criminal 18 behavior 19 , 20 gender 19 , 22 and 21 , 22 and 22 and 23 race/ethnicity drug use severity fully mediated the relationship between emotional distress and readiness . 0 ###LEFT-WALL### 3 severity 0 ###LEFT-WALL### 5 mediated 0 ###LEFT-WALL### 13 . 1 drug 3 severity 2 use 3 severity 3 severity 5 mediated 4 fully 5 mediated 5 mediated 7 relationship 5 mediated 8 between 6 the 7 relationship 8 between 11 and 9 emotional 10 distress 10 distress 11 and 11 and 12 readiness in addition , females and young adults with more severe drug problems may be more amenable to behavior change . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 14 be 0 ###LEFT-WALL### 20 . 1 in 5 and 1 in 14 be 2 addition 3 , 3 , 4 females 3 , 5 and 5 and 7 adults 5 and 8 with 6 young 7 adults 8 with 9 more 10 severe 11 drug 11 drug 12 problems 12 problems 13 may 13 may 14 be 14 be 16 amenable 15 more 16 amenable 16 amenable 17 to 17 to 19 change 18 behavior 19 change age - related macular degeneration ( armd ) is the leading cause of irreversible blindness in developed countries . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 19 . 1 age 9 is 2 - 3 related 3 related 5 degeneration 3 related 8 ) 3 related 9 is 4 macular 5 degeneration 5 degeneration 7 armd 6 ( 7 armd 7 armd 8 ) 9 is 12 cause 10 the 12 cause 11 leading 12 cause 12 cause 13 of 13 of 15 blindness 14 irreversible 15 blindness 15 blindness 16 in 16 in 18 countries 17 developed 18 countries there are currently no cures , but there are promising potential therapies that target the underlying disease mechanisms of dry armd . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 22 . 1 there 2 are 2 are 3 currently 2 are 5 cures 4 no 5 cures 6 , 7 but 6 , 9 are 7 but 8 there 7 but 9 are 9 are 12 therapies 10 promising 12 therapies 11 potential 12 therapies 12 therapies 13 that 12 therapies 14 target 13 that 14 target 14 target 18 mechanisms 15 the 18 mechanisms 16 underlying 17 disease 17 disease 18 mechanisms 18 mechanisms 19 of 19 of 21 armd 20 dry 21 armd stem cells , ciliary neurotrophic factor , rheopheresis , ozonated autohemotherapy and prostaglandins show promise in stabilizing or improving visual acuity . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 14 show 0 ###LEFT-WALL### 22 . 1 stem 2 cells 2 cells 3 , 3 , 6 factor 3 , 7 , 4 ciliary 6 factor 5 neurotrophic 6 factor 7 , 8 rheopheresis 7 , 9 , 9 , 11 autohemotherapy 9 , 12 and 10 ozonated 11 autohemotherapy 12 and 13 prostaglandins 12 and 14 show 14 show 18 or 15 promise 16 in 15 promise 18 or 16 in 17 stabilizing 18 or 21 acuity 19 improving 21 acuity 20 visual 21 acuity age - related eye disease study vitamins may reduce progression to severe armd . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 3 related 2 - 3 related 3 related 6 study 3 related 14 . 4 eye 5 disease 5 disease 6 study 6 study 7 vitamins 6 study 9 reduce 7 vitamins 8 may 8 may 9 reduce 9 reduce 10 progression 9 reduce 11 to 11 to 13 armd 12 severe 13 armd adjuvant therapy like low vision rehabilitation and implantable miniature telescopes may help patients adjust to the sequelae of their disease , and herbal supplementation with saffron , zinc monocysteine and phototrop may be helpful . 0 ###LEFT-WALL### 2 therapy 0 ###LEFT-WALL### 33 be 0 ###LEFT-WALL### 35 . 1 adjuvant 2 therapy 2 therapy 3 like 2 therapy 10 telescopes 2 therapy 14 adjust 2 therapy 32 may 3 like 7 and 4 low 6 rehabilitation 5 vision 6 rehabilitation 6 rehabilitation 7 and 7 and 9 miniature 8 implantable 9 miniature 10 telescopes 11 may 11 may 12 help 12 help 13 patients 12 help 14 adjust 14 adjust 15 to 14 adjust 25 with 15 to 17 sequelae 16 the 17 sequelae 17 sequelae 18 of 18 of 22 and 19 their 20 disease 20 disease 22 and 21 , 22 and 22 and 24 supplementation 23 herbal 24 supplementation 25 with 30 and 26 saffron 27 , 27 , 29 monocysteine 27 , 30 and 28 zinc 29 monocysteine 30 and 31 phototrop 32 may 33 be 33 be 34 helpful therapies that are currently in clinical trials include brimonidine , doxycycline , anti - amyloid antibodies ( gsk933776 and rn6g ) , rpe65 [inhibitor] ( acu - 4429 ) , complement inhibitors ( arc1905 , fcfd4514s ) , hydroxychloroquine , intravitreal fluocinolone acetate and vasodilators like sildenafil , moxaverine and mc - 1101 . 0 ###LEFT-WALL### 1 therapies 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 54 . 1 therapies 2 that 1 therapies 3 are 1 therapies 30 , 2 that 3 are 3 are 4 currently 3 are 5 in 5 in 7 trials 6 clinical 7 trials 8 include 9 brimonidine 8 include 30 , 9 brimonidine 11 doxycycline 10 , 11 doxycycline 11 doxycycline 16 antibodies 11 doxycycline 29 ) 12 , 16 antibodies 13 anti 14 - 13 anti 15 amyloid 15 amyloid 16 antibodies 16 antibodies 19 and 16 antibodies 26 acu 16 antibodies 28 4429 16 antibodies 29 ) 17 ( 19 and 18 gsk933776 19 and 19 and 20 rn6g 19 and 21 ) 22 , 26 acu 23 rpe65 26 acu 25 ( 26 acu 26 acu 27 - 27 - 28 4429 28 4429 29 ) 30 , 31 complement 30 , 53 1101 31 complement 32 inhibitors 32 inhibitors 34 arc1905 32 inhibitors 44 and 33 ( 34 arc1905 34 arc1905 36 fcfd4514s 34 arc1905 37 ) 35 , 36 fcfd4514s 36 fcfd4514s 37 ) 38 , 44 and 39 hydroxychloroquine 40 , 40 , 43 acetate 40 , 44 and 41 intravitreal 42 fluocinolone 42 fluocinolone 43 acetate 44 and 45 vasodilators 44 and 46 like 44 and 52 - 46 like 50 and 47 sildenafil 48 , 48 , 49 moxaverine 48 , 50 and 50 and 51 mc therapies that have not been shown to be effective include pot - 4 , eculizumab , tandospirone , anecortave acetate , the antioxidant ot - 551 , sirolimus and vitamin e . none the objective of this study was to identify differences between geriatricians and hospitalists in caring for hospitalized older adults , so [as] to inform faculty development programs that have the goal of improving older patient care [.] 0 ###LEFT-WALL### 1 therapies 0 ###LEFT-WALL### 12 - 1 therapies 2 that 1 therapies 3 have 1 therapies 10 include 2 that 3 have 3 have 4 not 3 have 5 been 5 been 6 shown 6 shown 7 to 7 to 8 be 8 be 9 effective 10 include 11 pot 12 - 13 4 12 - 14 , 12 - 15 eculizumab 12 - 16 , 14 , 15 eculizumab 16 , 20 acetate 16 , 21 , 17 tandospirone 18 , 17 tandospirone 20 acetate 19 anecortave 20 acetate 21 , 24 ot 21 , 25 - 22 the 24 ot 23 antioxidant 24 ot 25 - 26 551 25 - 27 , 25 - 32 . 27 , 29 and 28 sirolimus 29 and 29 and 30 vitamin 30 vitamin 31 e 32 . 33 none 33 none 35 objective 33 none 40 to 33 none 41 identify 34 the 35 objective 35 objective 36 of 35 objective 39 was 36 of 38 study 37 this 38 study 39 was 40 to 41 identify 45 and 42 differences 43 between 42 differences 45 and 43 between 44 geriatricians 45 and 46 hospitalists 45 and 56 to 46 hospitalists 47 in 47 in 48 caring 48 caring 49 for 49 for 52 adults 50 hospitalized 52 adults 51 older 52 adults 53 , 56 to 54 so 56 to 56 to 57 inform 57 inform 60 programs 57 inform 65 of 58 faculty 59 development 59 development 60 programs 60 programs 61 that 60 programs 62 have 61 that 62 have 62 have 64 goal 63 the 64 goal 65 of 69 care 66 improving 69 care 67 older 69 care 68 patient 69 care eleven hospitalists and 13 geriatricians were surveyed regarding knowledge , confidence , and practice patterns in caring for hospitalized older adults , targeting areas previously defined as central to taking care of older hospitalized patients . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 13 and 1 eleven 2 hospitalists 2 hospitalists 3 and 3 and 5 geriatricians 3 and 6 were 4 13 5 geriatricians 6 were 13 and 7 surveyed 9 knowledge 7 surveyed 13 and 8 regarding 9 knowledge 9 knowledge 11 confidence 10 , 11 confidence 11 confidence 12 , 13 and 14 practice 13 and 16 in 14 practice 15 patterns 16 in 17 caring 17 caring 18 for 17 caring 23 targeting 18 for 21 adults 19 hospitalized 21 adults 20 older 21 adults 22 , 23 targeting 23 targeting 24 areas 23 targeting 36 . 24 areas 26 defined 24 areas 28 central 24 areas 32 of 25 previously 26 defined 27 as 28 central 28 central 29 to 29 to 30 taking 30 taking 31 care 32 of 35 patients 33 older 35 patients 34 hospitalized 35 patients overall , geriatricians had more confidence and more knowledge in caring for older hospitalized adults . 0 ###LEFT-WALL### 3 geriatricians 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 16 . 1 overall 2 , 1 overall 3 geriatricians 3 geriatricians 4 had 4 had 9 knowledge 4 had 10 in 5 more 9 knowledge 6 confidence 7 and 7 and 8 more 7 and 9 knowledge 10 in 11 caring 11 caring 12 for 12 for 15 adults 13 older 15 adults 14 hospitalized 15 adults the areas in which hospitalists expressed the least confidence were in caring for patients with dementia , self - care issues , and care planning . 0 ###LEFT-WALL### 2 areas 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 26 . 1 the 2 areas 2 areas 3 in 2 areas 10 were 3 in 4 which 3 in 5 hospitalists 3 in 6 expressed 5 hospitalists 6 expressed 6 expressed 8 least 6 expressed 9 confidence 7 the 8 least 10 were 11 in 10 were 15 with 11 in 12 caring 12 caring 13 for 13 for 14 patients 15 with 16 dementia 17 , 18 self 17 , 19 - 19 - 23 and 20 care 21 issues 21 issues 23 and 22 , 23 and 23 and 24 care 23 and 25 planning geriatricians reported more routine medication reviews , functional and cognitive assessments , and fall evaluations . 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 16 . 1 geriatricians 6 reviews 2 reported 5 medication 3 more 4 routine 4 routine 5 medication 5 medication 6 reviews 6 reviews 7 , 7 , 8 functional 7 , 9 and 9 and 11 assessments 9 and 13 and 10 cognitive 11 assessments 12 , 13 and 13 and 15 evaluations 14 fall 15 evaluations geriatricians and hospitalists differ in their approach to older adults . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 4 differ 0 ###LEFT-WALL### 11 . 1 geriatricians 2 and 2 and 3 hospitalists 2 and 4 differ 4 differ 5 in 4 differ 8 to 5 in 7 approach 6 their 7 approach 8 to 10 adults 9 older 10 adults where these differences reflect lack of knowledge or experience , they set the stage for developing curricula to help narrow these gaps . 0 ###LEFT-WALL### 11 they 0 ###LEFT-WALL### 12 set 0 ###LEFT-WALL### 23 . 1 where 3 differences 1 where 8 or 1 where 10 , 1 where 11 they 2 these 3 differences 3 differences 8 or 4 reflect 5 lack 4 reflect 8 or 5 lack 6 of 6 of 7 knowledge 8 or 9 experience 11 they 12 set 12 set 14 stage 13 the 14 stage 14 stage 15 for 14 stage 17 curricula 15 for 16 developing 17 curricula 18 to 17 curricula 19 help 18 to 19 help 19 help 20 narrow 20 narrow 22 gaps 21 these 22 gaps mitochondria [are] implicated in a variety of degenerative disorders and aging . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 12 . 1 mitochondria 3 implicated 1 mitochondria 10 and 3 implicated 4 in 4 in 6 variety 5 a 6 variety 6 variety 7 of 7 of 9 disorders 8 degenerative 9 disorders 10 and 11 aging mitochondria [are] responsive to the oxygen in their environment [,] yet tissue culture is performed at atmospheric ( 21 % ) oxygen and not at physiological ( 1 - 11 % ) oxygen levels found in tissues . 0 ###LEFT-WALL### 1 mitochondria 0 ###LEFT-WALL### 15 performed 0 ###LEFT-WALL### 38 . 1 mitochondria 3 responsive 1 mitochondria 13 culture 1 mitochondria 14 is 1 mitochondria 15 performed 3 responsive 4 to 3 responsive 11 yet 4 to 6 oxygen 5 the 6 oxygen 6 oxygen 7 in 7 in 9 environment 8 their 9 environment 12 tissue 13 culture 13 culture 14 is 15 performed 23 and 16 at 22 oxygen 16 at 23 and 17 atmospheric 20 % 17 atmospheric 21 ) 17 atmospheric 22 oxygen 18 ( 20 % 19 21 20 % 20 % 21 ) 23 and 24 not 23 and 25 at 25 at 34 levels 26 physiological 31 % 26 physiological 33 oxygen 27 ( 31 % 28 1 29 - 29 - 30 11 29 - 31 % 31 % 32 ) 33 oxygen 34 levels 34 levels 35 found 35 found 36 in 36 in 37 tissues sh - sy5y cells cultured in physiological 5 % oxygen exhibited the lowest reactive oxygen species ( ros ) [production] , indicating that culture at 5 % oxygen is favored ; these results were mimicked in primary human cells . 0 ###LEFT-WALL### 4 cells 0 ###LEFT-WALL### 11 exhibited 0 ###LEFT-WALL### 31 ; 0 ###LEFT-WALL### 40 . 1 sh 2 - 1 sh 4 cells 3 sy5y 4 cells 4 cells 5 cultured 4 cells 11 exhibited 5 cultured 6 in 6 in 10 oxygen 7 physiological 10 oxygen 8 5 9 % 9 % 10 oxygen 11 exhibited 16 species 12 the 13 lowest 12 the 16 species 14 reactive 16 species 15 oxygen 16 species 16 species 18 ros 16 species 22 indicating 17 ( 18 ros 18 ros 19 ) 21 , 22 indicating 22 indicating 23 that 22 indicating 31 ; 23 that 24 culture 23 that 30 favored 24 culture 25 at 24 culture 29 is 25 at 28 oxygen 26 5 27 % 27 % 28 oxygen 29 is 30 favored 31 ; 33 results 31 ; 35 mimicked 32 these 33 results 33 results 34 were 34 were 35 mimicked 35 mimicked 36 in 36 in 39 cells 37 primary 38 human 38 human 39 cells mass spectrometric analysis revealed extensive mitochondrial proteomic alterations in sh - sy5y cells based on oxygen culture condition . 0 ###LEFT-WALL### 1 mass 0 ###LEFT-WALL### 19 . 1 mass 3 analysis 1 mass 15 on 2 spectrometric 3 analysis 3 analysis 14 based 4 revealed 8 alterations 4 revealed 9 in 4 revealed 11 - 4 revealed 13 cells 4 revealed 14 based 5 extensive 8 alterations 6 mitochondrial 8 alterations 7 proteomic 8 alterations 9 in 10 sh 12 sy5y 13 cells 13 cells 14 based 15 on 18 condition 16 oxygen 18 condition 17 culture 18 condition among these , the rotenone - sensitive subunit of complex i ndufv3 was increased in cells cultured at 5 % oxygen . 0 ###LEFT-WALL### 8 subunit 0 ###LEFT-WALL### 14 increased 0 ###LEFT-WALL### 22 . 1 among 2 these 1 among 3 , 1 among 8 subunit 4 the 8 subunit 5 rotenone 6 - 5 rotenone 8 subunit 7 sensitive 8 subunit 8 subunit 9 of 8 subunit 14 increased 9 of 10 complex 10 complex 11 i 10 complex 12 ndufv3 10 complex 13 was 12 ndufv3 13 was 14 increased 15 in 15 in 16 cells 16 cells 17 cultured 17 cultured 18 at 18 at 21 oxygen 19 5 20 % 20 % 21 oxygen rotenone is a parkinson 's disease - linked toxin , and correspondingly sh - sy5y cells cultured at 5 % oxygen also exhibited over 10 times greater sensitivity to rotenone than those cultured in atmospheric , 21 % , oxygen . 0 ###LEFT-WALL### 1 rotenone 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 41 . 1 rotenone 2 is 2 is 5 's 2 is 6 disease 3 a 4 parkinson 4 parkinson 5 's 6 disease 9 toxin 7 - 9 toxin 8 linked 9 toxin 9 toxin 10 , 11 and 15 sy5y 11 and 23 exhibited 12 correspondingly 15 sy5y 13 sh 14 - 13 sh 15 sy5y 15 sy5y 16 cells 15 sy5y 17 cultured 15 sy5y 23 exhibited 16 cells 17 cultured 17 cultured 18 at 17 cultured 22 also 18 at 21 oxygen 19 5 21 oxygen 20 % 21 oxygen 23 exhibited 28 sensitivity 23 exhibited 29 to 23 exhibited 31 than 24 over 25 10 25 10 26 times 26 times 27 greater 27 greater 28 sensitivity 29 to 30 rotenone 31 than 33 cultured 31 than 34 in 32 those 33 cultured 34 in 40 oxygen 35 atmospheric 38 % 35 atmospheric 39 , 35 atmospheric 40 oxygen 36 , 38 % 37 21 38 % 38 % 39 , our results indicate that neuronal mitochondria are responsive to oxygen levels and produce differential responses under different oxygen levels . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 20 . 1 our 2 results 2 results 3 indicate 3 indicate 4 that 4 that 6 mitochondria 4 that 7 are 5 neuronal 6 mitochondria 6 mitochondria 7 are 7 are 12 and 7 are 16 under 8 responsive 9 to 8 responsive 12 and 9 to 11 levels 10 oxygen 11 levels 12 and 15 responses 13 produce 14 differential 14 differential 15 responses 16 under 19 levels 17 different 18 oxygen 18 oxygen 19 levels none osteoarthritis ( oa ) is closely associated with aging , but its underlying mechanism is unclear . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 12 but 0 ###LEFT-WALL### 18 . 1 none 4 oa 1 none 6 is 1 none 8 associated 2 osteoarthritis 4 oa 3 ( 4 oa 4 oa 5 ) 4 oa 6 is 7 closely 8 associated 8 associated 9 with 9 with 10 aging 11 , 12 but 12 but 15 mechanism 12 but 16 is 13 its 15 mechanism 14 underlying 15 mechanism 15 mechanism 16 is 16 is 17 unclear recent publications were reviewed to elucidate the connection between aging and oa . 0 ###LEFT-WALL### 2 publications 0 ###LEFT-WALL### 4 reviewed 0 ###LEFT-WALL### 13 . 1 recent 2 publications 2 publications 3 were 3 were 4 reviewed 4 reviewed 5 to 5 to 6 elucidate 6 elucidate 11 and 7 the 8 connection 8 connection 9 between 8 connection 11 and 9 between 10 aging 11 and 12 oa with increasing oa [incidence] , more senior people are facing heavy financial and social burdens . 0 ###LEFT-WALL### 8 people 0 ###LEFT-WALL### 9 are 0 ###LEFT-WALL### 16 . 1 with 2 increasing 1 with 8 people 3 oa 5 , 3 oa 8 people 6 more 7 senior 7 senior 8 people 8 people 9 are 9 are 15 burdens 10 facing 15 burdens 11 heavy 15 burdens 12 financial 13 and 13 and 14 social 13 and 15 burdens age - related oa pathogenesis is not well understood . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 10 . 1 age 6 is 2 - 3 related 3 related 5 pathogenesis 3 related 6 is 4 oa 5 pathogenesis 6 is 7 not 6 is 8 well 8 well 9 understood recently , it has been realized that age - related changes in other tissues besides articular cartilage may also contribute to oa development . 0 ###LEFT-WALL### 3 it 0 ###LEFT-WALL### 6 realized 0 ###LEFT-WALL### 24 . 1 recently 2 , 1 recently 3 it 3 it 4 has 4 has 5 been 5 been 6 realized 6 realized 7 that 7 that 8 age 7 that 20 contribute 8 age 18 may 9 - 10 related 10 related 11 changes 10 related 12 in 10 related 15 besides 10 related 18 may 12 in 14 tissues 13 other 14 tissues 15 besides 17 cartilage 16 articular 17 cartilage 18 may 20 contribute 19 also 20 contribute 20 contribute 21 to 21 to 23 development 22 oa 23 development many factors including senescence [-] related secretory phenotypes , chondrocytes ' low reactivity to growth factors , mitochondrial dysfunction and oxidative stress , and abnormal accumulation of advanced glycation end products ( ages ) may all play key roles in the pathogenesis of age - related oa . 0 ###LEFT-WALL### 1 many 0 ###LEFT-WALL### 9 , 1 many 2 factors 2 factors 3 including 3 including 4 senescence 3 including 8 phenotypes 4 senescence 6 related 4 senescence 7 secretory 4 senescence 8 phenotypes 9 , 11 ' 9 , 12 low 9 , 17 , 10 chondrocytes 11 ' 11 ' 12 low 12 low 13 reactivity 13 reactivity 14 to 14 to 16 factors 15 growth 16 factors 17 , 19 dysfunction 17 , 20 and 18 mitochondrial 19 dysfunction 20 and 24 and 21 oxidative 22 stress 22 stress 24 and 23 , 24 and 24 and 26 accumulation 24 and 35 may 25 abnormal 26 accumulation 26 accumulation 27 of 27 of 31 products 28 advanced 31 products 29 glycation 30 end 30 end 31 products 31 products 33 ages 32 ( 33 ages 33 ages 34 ) 35 may 37 play 36 all 37 play 37 play 39 roles 37 play 40 in 38 key 39 roles 40 in 42 pathogenesis 41 the 42 pathogenesis 42 pathogenesis 43 of 43 of 44 age 44 age 47 oa 45 - 47 oa 46 related 47 oa 47 oa 48 . lately , epigenetic regulation of gene expression was recognized for its impact on age - related oa pathogenesis . 0 ###LEFT-WALL### 4 regulation 0 ###LEFT-WALL### 9 recognized 0 ###LEFT-WALL### 16 related 1 lately 2 , 1 lately 4 regulation 3 epigenetic 4 regulation 4 regulation 5 of 4 regulation 8 was 5 of 7 expression 6 gene 7 expression 8 was 9 recognized 9 recognized 10 for 9 recognized 13 on 10 for 12 impact 11 its 12 impact 13 on 14 age 15 - 16 related 16 related 18 pathogenesis 16 related 19 . 17 oa 18 pathogenesis up to now , few studies have been reported about the role of mirna and long - noncoding rna ( lncrna ) in age - related oa . 0 ###LEFT-WALL### 1 up 0 ###LEFT-WALL### 26 related 1 up 2 to 1 up 19 rna 1 up 23 in 2 to 18 noncoding 3 now 18 noncoding 4 , 9 reported 5 few 6 studies 5 few 8 been 5 few 9 reported 6 studies 7 have 7 have 8 been 9 reported 10 about 9 reported 17 - 9 reported 18 noncoding 10 about 12 role 11 the 12 role 12 role 13 of 13 of 15 and 14 mirna 15 and 15 and 16 long 19 rna 21 lncrna 20 ( 21 lncrna 21 lncrna 22 ) 23 in 24 age 25 - 26 related 26 related 27 oa 26 related 28 . research focusing on this area may provide valuable insights into oa pathogenesis . 0 ###LEFT-WALL### 1 research 0 ###LEFT-WALL### 7 provide 0 ###LEFT-WALL### 13 . 1 research 2 focusing 1 research 6 may 2 focusing 3 on 3 on 5 area 4 this 5 area 6 may 7 provide 7 provide 9 insights 7 provide 10 into 8 valuable 9 insights 10 into 12 pathogenesis 11 oa 12 pathogenesis oa - induced financial and social burdens have become an increasingly severe threat to older population . 0 ###LEFT-WALL### 7 burdens 0 ###LEFT-WALL### 9 become 0 ###LEFT-WALL### 17 . 1 oa 2 - 1 oa 7 burdens 3 induced 7 burdens 4 financial 5 and 5 and 6 social 5 and 7 burdens 7 burdens 8 have 8 have 9 become 9 become 13 threat 9 become 14 to 10 an 13 threat 11 increasingly 12 severe 12 severe 13 threat 14 to 16 population 15 older 16 population age - related changes in noncartilage tissue should be incorporated in the understanding of oa development . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 10 incorporated 0 ###LEFT-WALL### 17 . 1 age 8 should 2 - 3 related 3 related 4 changes 3 related 5 in 3 related 8 should 5 in 7 tissue 6 noncartilage 7 tissue 8 should 9 be 9 be 10 incorporated 10 incorporated 11 in 11 in 13 understanding 12 the 13 understanding 13 understanding 14 of 14 of 16 development 15 oa 16 development growing attention on oxidative stress and epigenetics will provide more important clues for the better understanding of the age - related oa . 0 ###LEFT-WALL### 1 growing 0 ###LEFT-WALL### 9 provide 0 ###LEFT-WALL### 21 related 1 growing 2 attention 1 growing 8 will 2 attention 3 on 3 on 6 and 4 oxidative 5 stress 5 stress 6 and 6 and 7 epigenetics 8 will 9 provide 9 provide 12 clues 9 provide 13 for 10 more 11 important 11 important 12 clues 13 for 16 understanding 14 the 16 understanding 15 better 16 understanding 16 understanding 17 of 17 of 19 age 18 the 19 age 20 - 21 related 21 related 22 oa 21 related 23 . highly active antiretroviral therapy ( haart ) has considerably improved the prognosis of hiv - infected patients . 0 ###LEFT-WALL### 4 therapy 0 ###LEFT-WALL### 10 improved 0 ###LEFT-WALL### 15 - 1 highly 2 active 2 active 4 therapy 3 antiretroviral 4 therapy 4 therapy 6 haart 4 therapy 8 has 5 ( 6 haart 6 haart 7 ) 8 has 10 improved 9 considerably 10 improved 10 improved 12 prognosis 11 the 12 prognosis 12 prognosis 13 of 13 of 14 hiv 15 - 17 patients 15 - 18 . 16 infected 17 patients however , prolonged use of haart has been related to long - term adverse events that can compromise patient health such as hiv - associated lipodystrophy [syndrome] ( hals ) and nonalcoholic fatty liver disease ( nafld ) . 0 ###LEFT-WALL### 4 use 0 ###LEFT-WALL### 9 related 0 ###LEFT-WALL### 39 . 1 however 2 , 1 however 4 use 3 prolonged 4 use 4 use 5 of 4 use 7 has 5 of 6 haart 7 has 8 been 8 been 9 related 9 related 10 to 9 related 22 as 10 to 15 events 11 long 12 - 11 long 13 term 13 term 15 events 14 adverse 15 events 15 events 16 that 15 events 17 can 16 that 17 can 17 can 18 compromise 18 compromise 20 health 19 patient 20 health 21 such 22 as 22 as 31 and 23 hiv 26 lipodystrophy 23 hiv 31 and 24 - 26 lipodystrophy 25 associated 26 lipodystrophy 26 lipodystrophy 29 hals 26 lipodystrophy 30 ) 28 ( 29 hals 29 hals 30 ) 31 and 35 disease 31 and 37 nafld 32 nonalcoholic 34 liver 33 fatty 34 liver 34 liver 35 disease 36 ( 37 nafld 37 nafld 38 ) there is consistent evidence for a central role of mitochondrial dysfunction in these pathologies . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 15 . 1 there 2 is 2 is 4 evidence 3 consistent 4 evidence 4 evidence 5 for 5 for 8 role 6 a 7 central 6 a 8 role 7 central 8 role 8 role 9 of 9 of 11 dysfunction 10 mitochondrial 11 dysfunction 11 dysfunction 12 in 12 in 14 pathologies 13 these 14 pathologies nucleotide reverse transcriptase inhibitors ( nrtis ) have been described to be mainly responsible for mitochondrial dysfunction in adipose tissue and liver although nonnucleoside transcriptase inhibitors ( nnrtis [ )(or protease inhibitors ( pis ) have also showed mitochondrial toxicity , which is a major concern for the selection and the long - term adherence to a particular therapy . 0 ###LEFT-WALL### 4 inhibitors 0 ###LEFT-WALL### 10 described 0 ###LEFT-WALL### 41 , 0 ###LEFT-WALL### 60 . 1 nucleotide 2 reverse 2 reverse 4 inhibitors 3 transcriptase 4 inhibitors 4 inhibitors 6 nrtis 4 inhibitors 8 have 5 ( 6 nrtis 6 nrtis 7 ) 8 have 9 been 9 been 10 described 10 described 11 to 10 described 18 in 10 described 23 although 11 to 12 be 12 be 13 mainly 12 be 14 responsible 14 responsible 15 for 15 for 17 dysfunction 16 mitochondrial 17 dysfunction 18 in 21 and 19 adipose 20 tissue 20 tissue 21 and 21 and 22 liver 23 although 25 transcriptase 23 although 38 showed 24 nonnucleoside 25 transcriptase 25 transcriptase 26 inhibitors 25 transcriptase 36 have 25 transcriptase 38 showed 26 inhibitors 30 )(or 26 inhibitors 36 have 27 ( 30 )(or 28 nnrtis 30 )(or 30 )(or 32 inhibitors 30 )(or 34 pis 30 )(or 35 ) 31 protease 32 inhibitors 33 ( 34 pis 34 pis 35 ) 37 also 38 showed 38 showed 40 toxicity 39 mitochondrial 40 toxicity 41 , 42 which 41 , 43 is 42 which 43 is 43 is 46 concern 44 a 46 concern 45 major 46 concern 46 concern 47 for 47 for 59 therapy 48 the 49 selection 49 selection 50 and 50 and 55 adherence 50 and 56 to 50 and 59 therapy 51 the 55 adherence 52 long 53 - 52 long 54 term 54 term 55 adherence 56 to 58 particular 57 a 58 particular several mechanisms explain these deleterious effects of haart on mitochondria , and evidence points to other mechanisms beyond the " pol [-] [γ] hypothesis . " 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 25 . 1 several 2 mechanisms 2 mechanisms 12 and 3 explain 6 effects 3 explain 9 on 3 explain 12 and 4 these 6 effects 5 deleterious 6 effects 6 effects 7 of 7 of 8 haart 9 on 10 mitochondria 11 , 12 and 12 and 13 evidence 12 and 18 beyond 13 evidence 14 points 13 evidence 15 to 15 to 17 mechanisms 16 other 17 mechanisms 18 beyond 24 hypothesis 19 the 20 " 19 the 24 hypothesis 21 pol 24 hypothesis 25 . 26 " hiv infection has also direct effects on mitochondria . 0 ###LEFT-WALL### 1 hiv 0 ###LEFT-WALL### 5 direct 0 ###LEFT-WALL### 9 . 1 hiv 2 infection 1 hiv 3 has 1 hiv 5 direct 2 infection 3 has 3 has 4 also 5 direct 6 effects 5 direct 7 on 7 on 8 mitochondria mitochondria are intracellular organelles involved in atp synthesis , apoptosis , calcium signaling , metabolism , and the synthesis of critical metabolic cofactors . 0 ###LEFT-WALL### 1 mitochondria 0 ###LEFT-WALL### 2 are 1 mitochondria 2 are 2 are 4 organelles 2 are 8 synthesis 3 intracellular 4 organelles 4 organelles 5 involved 5 involved 6 in 6 in 7 atp 8 synthesis 10 apoptosis 8 synthesis 17 and 9 , 10 apoptosis 10 apoptosis 12 calcium 10 apoptosis 14 , 11 , 12 calcium 12 calcium 13 signaling 12 calcium 14 , 14 , 17 and 15 metabolism 17 and 16 , 17 and 17 and 19 synthesis 17 and 20 of 17 and 24 . 18 the 19 synthesis 20 of 23 cofactors 21 critical 23 cofactors 22 metabolic 23 cofactors mitochondrial dysfunction is associated with age - related degenerative diseases . 0 ###LEFT-WALL### 2 dysfunction 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 8 related 1 mitochondrial 2 dysfunction 2 dysfunction 3 is 3 is 4 associated 4 associated 5 with 5 with 6 age 7 - 8 related 8 related 10 diseases 8 related 11 . 9 degenerative 10 diseases how mitochondrial dysfunction causes cell degeneration is not well understood . 0 ###LEFT-WALL### 1 how 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 11 . 1 how 3 dysfunction 1 how 4 causes 1 how 7 is 2 mitochondrial 3 dysfunction 3 dysfunction 4 causes 4 causes 6 degeneration 5 cell 6 degeneration 7 is 8 not 7 is 9 well 9 well 10 understood recent studies have shown that mutations in the adenine nucleotide translocase ( ant ) cause aging - dependent degenerative cell death ( dcd ) in yeast , which is sequentially manifested by inner membrane stress , mitochondrial dna ( mtdna ) loss , and progressive loss of cell viability . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 shown 1 recent 2 studies 2 studies 3 have 3 have 4 shown 4 shown 5 that 5 that 6 mutations 5 that 15 cause 6 mutations 7 in 6 mutations 15 cause 7 in 11 translocase 8 the 11 translocase 9 adenine 11 translocase 10 nucleotide 11 translocase 11 translocase 13 ant 12 ( 13 ant 13 ant 14 ) 15 cause 16 aging 15 cause 25 in 16 aging 21 death 17 - 21 death 18 dependent 21 death 19 degenerative 21 death 20 cell 21 death 21 death 23 dcd 21 death 24 ) 22 ( 23 dcd 23 dcd 24 ) 25 in 26 yeast 26 yeast 28 which 26 yeast 38 dna 27 , 28 which 28 which 29 is 28 which 36 , 29 is 31 manifested 30 sequentially 31 manifested 31 manifested 32 by 32 by 35 stress 33 inner 34 membrane 34 membrane 35 stress 36 , 38 dna 37 mitochondrial 38 dna 38 dna 44 and 38 dna 50 . 39 ( 44 and 40 mtdna 41 ) 40 mtdna 42 loss 42 loss 44 and 43 , 44 and 44 and 46 loss 44 and 47 of 44 and 50 . 45 progressive 46 loss 47 of 49 viability 48 cell 49 viability ant is an abundant protein primarily involved in adp/atp exchange across the mitochondrial inner membrane . 0 ###LEFT-WALL### 1 ant 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 16 . 1 ant 2 is 2 is 5 protein 3 an 4 abundant 3 an 5 protein 4 abundant 5 protein 5 protein 7 involved 6 primarily 7 involved 7 involved 8 in 7 involved 11 across 8 in 10 exchange 9 adp/atp 10 exchange 11 across 15 membrane 12 the 15 membrane 13 mitochondrial 15 membrane 14 inner 15 membrane it also mediates [basal] [proton] [leak] and regulates the mitochondrial permeability transition pore . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 14 . 1 it 7 and 2 also 3 mediates 3 mediates 7 and 7 and 8 regulates 7 and 13 pore 9 the 13 pore 10 mitochondrial 11 permeability 11 permeability 13 pore 12 transition 13 pore missense mutations in the human ant1 cause several degenerative diseases which are commonly manifested by fractional mtdna deletions . 0 ###LEFT-WALL### 2 mutations 0 ###LEFT-WALL### 7 cause 0 ###LEFT-WALL### 19 . 1 missense 2 mutations 2 mutations 3 in 2 mutations 7 cause 3 in 6 ant1 4 the 5 human 5 human 6 ant1 7 cause 10 diseases 8 several 10 diseases 9 degenerative 10 diseases 10 diseases 11 which 10 diseases 12 are 11 which 12 are 12 are 14 manifested 13 commonly 14 manifested 14 manifested 15 by 15 by 18 deletions 16 fractional 18 deletions 17 mtdna 18 deletions multiple models have been proposed to explain the ant1 - induced pathogenesis . 0 ###LEFT-WALL### 2 models 0 ###LEFT-WALL### 5 proposed 0 ###LEFT-WALL### 10 - 1 multiple 2 models 2 models 3 have 3 have 4 been 4 been 5 proposed 5 proposed 6 to 6 to 7 explain 7 explain 9 ant1 8 the 9 ant1 10 - 12 pathogenesis 10 - 13 . 11 induced 12 pathogenesis studies from yeast have suggested that in addition to altered nucleotide transport properties , the mutant proteins cause a global stress on the inner membrane . 0 ###LEFT-WALL### 1 studies 0 ###LEFT-WALL### 5 suggested 0 ###LEFT-WALL### 26 . 1 studies 2 from 1 studies 4 have 2 from 3 yeast 4 have 5 suggested 5 suggested 6 that 6 that 17 proteins 6 that 18 cause 7 in 8 addition 7 in 14 , 7 in 17 proteins 8 addition 9 to 9 to 13 properties 10 altered 11 nucleotide 11 nucleotide 13 properties 12 transport 13 properties 15 the 17 proteins 16 mutant 17 proteins 17 proteins 18 cause 18 cause 21 stress 18 cause 22 on 19 a 20 global 19 a 21 stress 20 global 21 stress 22 on 25 membrane 23 the 25 membrane 24 inner 25 membrane the mutant proteins likely interfere with general mitochondrial biogenesis in a dominant - negative manner , which secondarily destabilizes mtdna . 0 ###LEFT-WALL### 3 proteins 0 ###LEFT-WALL### 5 interfere 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 21 . 1 the 3 proteins 2 mutant 3 proteins 3 proteins 5 interfere 4 likely 5 interfere 5 interfere 6 with 5 interfere 10 in 6 with 9 biogenesis 7 general 9 biogenesis 8 mitochondrial 9 biogenesis 10 in 15 manner 11 a 12 dominant 11 a 15 manner 12 dominant 13 - 12 dominant 15 manner 14 negative 15 manner 16 , 17 which 16 , 19 destabilizes 17 which 19 destabilizes 18 secondarily 19 destabilizes 19 destabilizes 20 mtdna more recent work revealed that the ant - [induced] dcd is suppressed by reduced cytosolic protein synthesis . 0 ###LEFT-WALL### 3 work 0 ###LEFT-WALL### 4 revealed 0 ###LEFT-WALL### 18 . 1 more 2 recent 2 recent 3 work 3 work 4 revealed 4 revealed 5 that 5 that 10 dcd 5 that 12 suppressed 6 the 10 dcd 7 ant 10 dcd 8 - 10 dcd 10 dcd 11 is 11 is 12 suppressed 12 suppressed 13 by 13 by 17 synthesis 14 reduced 16 protein 15 cytosolic 16 protein 16 protein 17 synthesis this finding suggests [a] proteostatic crosstalk between mitochondria and the cytosol , which may play an important role for cell survival during aging . 0 ###LEFT-WALL### 2 finding 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 24 . 1 this 2 finding 2 finding 3 suggests 3 suggests 6 crosstalk 3 suggests 7 between 5 proteostatic 6 crosstalk 7 between 9 and 8 mitochondria 9 and 9 and 11 cytosol 10 the 11 cytosol 12 , 13 which 12 , 15 play 13 which 14 may 14 may 15 play 15 play 18 role 15 play 19 for 15 play 22 during 16 an 18 role 17 important 18 role 19 for 21 survival 20 cell 21 survival 22 during 23 aging [none] the transient receptor potential vanilloid type 5 ( trpv5 ) [ca] ( 2+ ) [channel] facilitates transcellular ca ( 2+ ) transport in the distal convoluted tubule ( dct ) of the kidney . 0 ###LEFT-WALL### 7 type 0 ###LEFT-WALL### 17 facilitates 2 the 7 type 3 transient 7 type 4 receptor 7 type 5 potential 7 type 6 vanilloid 7 type 7 type 8 5 7 type 10 trpv5 7 type 14 2+ 7 type 17 facilitates 9 ( 10 trpv5 10 trpv5 11 ) 13 ( 14 2+ 14 2+ 15 ) 17 facilitates 19 ca 18 transcellular 19 ca 19 ca 23 transport 20 ( 23 transport 21 2+ 22 ) 21 2+ 23 transport 23 transport 24 in 23 transport 32 of 23 transport 35 . 24 in 28 tubule 25 the 28 tubule 26 distal 28 tubule 27 convoluted 28 tubule 28 tubule 30 dct 29 ( 30 dct 30 dct 31 ) 32 of 34 kidney 33 the 34 kidney the channel is glycosylated with a complex type n - glycan and it has been postulated [that] hydrolysis of the terminal sialic acid [(] [s] ) [stimulate] trpv5 activity . 0 ###LEFT-WALL### 2 channel 0 ###LEFT-WALL### 4 glycosylated 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 30 . 1 the 2 channel 2 channel 3 is 3 is 4 glycosylated 4 glycosylated 5 with 4 glycosylated 10 - 4 glycosylated 11 glycan 5 with 7 complex 5 with 8 type 6 a 7 complex 8 type 9 n 12 and 13 it 12 and 15 been 13 it 14 has 14 has 15 been 15 been 18 hydrolysis 16 postulated 18 hydrolysis 18 hydrolysis 19 of 19 of 29 activity 20 the 29 activity 21 terminal 29 activity 22 sialic 29 activity 23 acid 26 ) 23 acid 29 activity 28 trpv5 29 activity the present study delineates the role of [the] n - glycan in trpv5 activity using biochemical assays in human embryonic kidney 293 cells expressing trpv5 , isoelectric focusing and total internal reflection fluorescent microscopy . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 delineates 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 11 glycan 0 ###LEFT-WALL### 35 . 1 the 3 study 2 present 3 study 3 study 4 delineates 4 delineates 6 role 5 the 6 role 6 role 7 of 7 of 9 n 10 - 11 glycan 11 glycan 12 in 11 glycan 15 using 12 in 14 activity 13 trpv5 14 activity 15 using 17 assays 15 using 18 in 16 biochemical 17 assays 18 in 29 and 19 human 20 embryonic 20 embryonic 21 kidney 21 kidney 22 293 21 kidney 23 cells 23 cells 24 expressing 23 cells 26 , 24 expressing 25 trpv5 26 , 28 focusing 26 , 29 and 27 isoelectric 28 focusing 29 and 34 microscopy 30 total 32 reflection 31 internal 32 reflection 32 reflection 34 microscopy 33 fluorescent 34 microscopy the anti - aging hormone klotho and other glycosidases stimulate trpv5 - dependent ca ( 2+ ) uptake . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 10 stimulate 1 the 6 klotho 2 anti 3 - 2 anti 5 hormone 4 aging 5 hormone 5 hormone 6 klotho 6 klotho 7 and 7 and 9 glycosidases 7 and 10 stimulate 8 other 9 glycosidases 10 stimulate 11 trpv5 11 trpv5 14 ca 12 - 14 ca 13 dependent 14 ca 14 ca 18 uptake 14 ca 19 . 15 ( 18 uptake 16 2+ 17 ) 16 2+ 18 uptake 18 uptake 19 . klotho was found to increase the plasma membrane stability of trpv5 , via the trpv5 n - glycan . 0 ###LEFT-WALL### 1 klotho 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 17 - 0 ###LEFT-WALL### 19 . 1 klotho 2 was 2 was 3 found 3 found 4 to 4 to 5 increase 5 increase 9 stability 6 the 9 stability 7 plasma 9 stability 8 membrane 9 stability 9 stability 10 of 9 stability 13 via 10 of 11 trpv5 12 , 13 via 13 via 15 trpv5 13 via 17 - 14 the 15 trpv5 15 trpv5 16 n 17 - 18 glycan sialidase mimicked this stimulatory action . 0 ###LEFT-WALL### 1 sialidase 0 ###LEFT-WALL### 2 mimicked 0 ###LEFT-WALL### 6 . 1 sialidase 2 mimicked 2 mimicked 5 action 3 this 4 stimulatory 4 stimulatory 5 action however , this effect was independent [of] [the] n - glycosylation [state] of trpv5 , since the [n] [-] glycosylation mutant ( trpv5 ( n358q ) ) was activated to the same extent . 0 ###LEFT-WALL### 4 effect 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 34 . 1 however 2 , 1 however 4 effect 3 this 4 effect 4 effect 5 was 5 was 6 independent 5 was 16 since 5 was 30 to 6 independent 9 n 6 independent 11 glycosylation 10 - 11 glycosylation 11 glycosylation 13 of 11 glycosylation 15 , 13 of 14 trpv5 16 since 21 mutant 16 since 29 activated 17 the 21 mutant 20 glycosylation 21 mutant 21 mutant 23 trpv5 21 mutant 28 was 22 ( 23 trpv5 23 trpv5 25 n358q 23 trpv5 27 ) 24 ( 25 n358q 25 n358q 26 ) 28 was 29 activated 30 to 33 extent 31 the 32 same 31 the 33 extent we showed that the increased trpv5 activity after sialidase treatment is caused by inhibition of lipid raft [-] mediated internalization . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 showed 0 ###LEFT-WALL### 21 . 1 we 2 showed 2 showed 3 that 3 that 7 activity 3 that 12 caused 4 the 7 activity 5 increased 7 activity 6 trpv5 7 activity 7 activity 8 after 7 activity 11 is 8 after 10 treatment 9 sialidase 10 treatment 11 is 12 caused 12 caused 13 by 13 by 14 inhibition 14 inhibition 15 of 15 of 20 internalization 16 lipid 19 mediated 17 raft 19 mediated 19 mediated 20 internalization in addition , sialidase modified the [n] [-] glycan of transferrin , a model glycoprotein , differently from klotho . 0 ###LEFT-WALL### 4 sialidase 0 ###LEFT-WALL### 5 modified 0 ###LEFT-WALL### 20 . 1 in 2 addition 1 in 3 , 1 in 4 sialidase 4 sialidase 5 modified 5 modified 9 glycan 5 modified 17 differently 6 the 9 glycan 9 glycan 10 of 10 of 11 transferrin 11 transferrin 15 glycoprotein 12 , 15 glycoprotein 13 a 15 glycoprotein 14 model 15 glycoprotein 15 glycoprotein 16 , 17 differently 18 from 18 from 19 klotho previous studies showed that after klotho treatment , galectin - 1 binds the trpv5 n - [glycan] and thereby increases trpv5 activity . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 23 . 1 previous 2 studies 2 studies 3 showed 3 showed 4 that 3 showed 5 after 3 showed 11 1 3 showed 18 and 5 after 7 treatment 6 klotho 7 treatment 7 treatment 9 galectin 8 , 9 galectin 9 galectin 10 - 11 1 18 and 12 binds 14 trpv5 12 binds 18 and 13 the 14 trpv5 14 trpv5 15 n 16 - 18 and 18 and 20 increases 19 thereby 20 increases 20 increases 22 activity 21 trpv5 22 activity however , galectin - 3 , but not galectin - 1 , was expressed in the dct . 0 ###LEFT-WALL### 3 galectin 0 ###LEFT-WALL### 14 expressed 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 3 galectin 3 galectin 5 3 3 galectin 7 but 3 galectin 13 was 4 - 5 3 5 3 6 , 6 , 7 but 7 but 8 not 7 but 9 galectin 7 but 12 , 9 galectin 11 1 10 - 11 1 11 1 12 , 13 was 14 expressed 14 expressed 15 in 15 in 17 dct 16 the 17 dct furthermore , an increase in trpv5 - mediated ca ( 2+ ) uptake was detected after galectin - 3 treatment . 0 ###LEFT-WALL### 4 increase 0 ###LEFT-WALL### 15 detected 0 ###LEFT-WALL### 18 - 1 furthermore 2 , 1 furthermore 4 increase 3 an 4 increase 4 increase 5 in 4 increase 14 was 5 in 13 uptake 6 trpv5 9 ca 6 trpv5 13 uptake 7 - 9 ca 8 mediated 9 ca 9 ca 11 2+ 9 ca 12 ) 10 ( 11 2+ 11 2+ 12 ) 14 was 15 detected 15 detected 16 after 16 after 17 galectin 18 - 20 treatment 18 - 21 . 19 3 20 treatment in conclusion , two distinct trpv5 stimulatory mechanisms were demonstrated [;] a klotho - mediated effect that is dependent on [the] n - glycan of trpv5 and a sialidase - mediated stimulation that is lipid [raft] - dependent and independent of [the] n - glycan of trpv5 . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 1 in 2 conclusion 3 , 6 trpv5 4 two 6 trpv5 5 distinct 6 trpv5 6 trpv5 8 mechanisms 6 trpv5 9 were 6 trpv5 10 demonstrated 7 stimulatory 8 mechanisms 8 mechanisms 9 were 10 demonstrated 16 effect 12 a 13 klotho 12 a 16 effect 13 klotho 14 - 13 klotho 16 effect 15 mediated 16 effect 16 effect 17 that 16 effect 18 is 17 that 18 is 18 is 19 dependent 19 dependent 20 on 19 dependent 30 - 20 on 22 n 23 - 30 - 24 glycan 25 of 24 glycan 27 and 25 of 26 trpv5 27 and 29 sialidase 27 and 30 - 28 a 29 sialidase 30 - 32 stimulation 31 mediated 32 stimulation 32 stimulation 33 that 32 stimulation 34 is 33 that 34 is 34 is 35 lipid 34 is 44 - 37 - 44 - 38 dependent 39 and 39 and 40 independent 39 and 41 of 39 and 44 - 41 of 43 n 44 - 45 glycan 44 - 48 . 45 glycan 46 of 46 of 47 trpv5 purpose : to determine the thickness of bowman 's layer ( bl ) in vivo in a healthy population [and] to determine its variation with age . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 22 determine 0 ###LEFT-WALL### 27 . 1 purpose 2 : 2 : 3 to 2 : 4 determine 3 to 4 determine 4 determine 6 thickness 4 determine 15 vivo 4 determine 16 in 4 determine 21 to 5 the 6 thickness 6 thickness 7 of 6 thickness 12 bl 7 of 10 layer 8 bowman 9 's 9 's 10 layer 11 ( 12 bl 12 bl 13 ) 14 in 15 vivo 16 in 19 population 17 a 19 population 18 healthy 19 population 21 to 22 determine 22 determine 24 variation 22 determine 25 with 23 its 24 variation 25 with 26 age methods : eighty - two subjects aged 15 to 88 years with clear , healthy corneas were examined bilaterally with laser scanning in vivo confocal microscopy ( ivcm ) . 0 ###LEFT-WALL### 11 years 0 ###LEFT-WALL### 18 examined 0 ###LEFT-WALL### 30 . 1 methods 2 : 2 : 6 subjects 3 eighty 4 - 4 - 5 two 4 - 6 subjects 6 subjects 7 aged 7 aged 9 to 8 15 9 to 9 to 10 88 10 88 11 years 11 years 12 with 11 years 17 were 12 with 16 corneas 13 clear 14 , 13 clear 16 corneas 15 healthy 16 corneas 17 were 18 examined 18 examined 19 bilaterally 18 examined 20 with 20 with 26 microscopy 21 laser 22 scanning 22 scanning 26 microscopy 23 in 24 vivo 24 vivo 25 confocal 25 confocal 26 microscopy 26 microscopy 28 ivcm 27 ( 28 ivcm 28 ivcm 29 ) bowman 's layer thickness was determined from ivcm images of anterior and posterior bl boundaries . 0 ###LEFT-WALL### 4 thickness 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 16 . 1 bowman 2 's 2 's 4 thickness 3 layer 4 thickness 4 thickness 5 was 5 was 6 determined 6 determined 7 from 7 from 9 images 8 ivcm 9 images 9 images 10 of 10 of 15 boundaries 11 anterior 12 and 12 and 13 posterior 12 and 15 boundaries 14 bl 15 boundaries for a given eye , bl thickness was averaged across four central locations by two independent observers . 0 ###LEFT-WALL### 7 thickness 0 ###LEFT-WALL### 9 averaged 0 ###LEFT-WALL### 18 . 1 for 4 eye 1 for 5 , 1 for 7 thickness 2 a 4 eye 3 given 4 eye 6 bl 7 thickness 7 thickness 8 was 8 was 9 averaged 9 averaged 10 across 9 averaged 14 by 10 across 13 locations 11 four 13 locations 12 central 13 locations 14 by 17 observers 15 two 17 observers 16 independent 17 observers in addition , central corneal thickness was measured by time - domain optical coherence tomography . 0 ###LEFT-WALL### 6 thickness 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 16 . 1 in 2 addition 1 in 3 , 1 in 6 thickness 4 central 6 thickness 5 corneal 6 thickness 6 thickness 7 was 7 was 8 measured 8 measured 9 by 9 by 10 time 11 - 15 tomography 12 domain 15 tomography 13 optical 14 coherence 14 coherence 15 tomography results : a significant negative correlation of bl thickness with age was found in right eyes ( pearson r = - 0.579 , p < 0.0001 ) and in left eyes ( r = - 0.558 , p < 0.0001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 42 . 1 results 2 : 2 : 6 correlation 3 a 4 significant 3 a 6 correlation 4 significant 6 correlation 5 negative 6 correlation 6 correlation 7 of 6 correlation 9 thickness 6 correlation 13 found 7 of 8 bl 9 thickness 10 with 9 thickness 12 was 10 with 11 age 12 was 13 found 13 found 28 and 14 in 16 eyes 14 in 28 and 15 right 16 eyes 16 eyes 18 pearson 17 ( 18 pearson 18 pearson 20 = 18 pearson 25 < 18 pearson 27 ) 19 r 20 = 20 = 21 - 21 - 22 0.579 21 - 25 < 23 , 25 < 24 p 25 < 25 < 26 0.0001 25 < 27 ) 28 and 29 in 29 in 31 eyes 30 left 31 eyes 31 eyes 34 = 31 eyes 39 < 32 ( 34 = 33 r 34 = 34 = 35 - 35 - 36 0.558 35 - 39 < 37 , 39 < 38 p 39 < 39 < 40 0.0001 39 < 41 ) linear regression analysis yielded a decline in bl thickness of 0.06 μm per year . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 4 yielded 0 ###LEFT-WALL### 15 . 1 linear 2 regression 2 regression 3 analysis 3 analysis 4 yielded 4 yielded 6 decline 4 yielded 7 in 5 a 6 decline 7 in 9 thickness 8 bl 9 thickness 9 thickness 10 of 10 of 12 μm 11 0.06 12 μm 12 μm 13 per 13 per 14 year no correlation of corneal thickness with age or [of] bl thickness with corneal thickness was observed . 0 ###LEFT-WALL### 8 or 0 ###LEFT-WALL### 16 observed 0 ###LEFT-WALL### 17 . 1 no 2 correlation 2 correlation 3 of 2 correlation 8 or 3 of 5 thickness 4 corneal 5 thickness 5 thickness 6 with 6 with 7 age 8 or 11 thickness 8 or 12 with 8 or 15 was 10 bl 11 thickness 12 with 14 thickness 13 corneal 14 thickness 15 was 16 observed strong intereye correlations in bl thickness ( r = 0.771 , p < 0.0001 ) and corneal thickness ( r = 0.969 , p < 0.001 ) were found . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 29 found 0 ###LEFT-WALL### 30 . 1 strong 3 correlations 2 intereye 3 correlations 3 correlations 4 in 3 correlations 16 and 4 in 6 thickness 5 bl 6 thickness 6 thickness 9 = 6 thickness 13 < 7 ( 9 = 8 r 9 = 9 = 10 0.771 9 = 11 , 12 p 13 < 13 < 14 0.0001 13 < 15 ) 16 and 18 thickness 16 and 21 = 16 and 25 < 16 and 28 were 17 corneal 18 thickness 19 ( 21 = 20 r 21 = 21 = 22 0.969 23 , 25 < 24 p 25 < 25 < 26 0.001 25 < 27 ) 28 were 29 found conclusions : bowman 's layer thins with age in the normal cornea , losing one - [third] of its thickness between the ages of 20 and 80 years . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 layer 2 : 6 thins 2 : 29 . 3 bowman 4 's 4 's 5 layer 5 layer 6 thins 6 thins 7 with 6 thins 9 in 6 thins 21 between 7 with 8 age 9 in 12 cornea 10 the 12 cornea 11 normal 12 cornea 12 cornea 14 losing 12 cornea 18 of 13 , 14 losing 14 losing 15 one 14 losing 16 - 18 of 20 thickness 19 its 20 thickness 21 between 23 ages 22 the 23 ages 23 ages 24 of 24 of 28 years 25 20 26 and 26 and 27 80 26 and 28 years in vivo measurement of bl thickness by ivcm could aid in clinical assessment [and] planned treatments of the anterior cornea . 0 ###LEFT-WALL### 3 measurement 0 ###LEFT-WALL### 15 planned 0 ###LEFT-WALL### 21 . 1 in 2 vivo 2 vivo 3 measurement 3 measurement 4 of 3 measurement 15 planned 4 of 5 bl 5 bl 6 thickness 5 bl 10 aid 6 thickness 7 by 6 thickness 9 could 7 by 8 ivcm 9 could 10 aid 10 aid 11 in 11 in 13 assessment 12 clinical 13 assessment 15 planned 16 treatments 16 treatments 17 of 17 of 20 cornea 18 the 20 cornea 19 anterior 20 cornea this retrospective population - based study aimed to investigate associations between erectile dysfunction ( ed ) and the irritable bowel syndrome ( ibs ) using a taiwanese cohort . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 4 - 1 this 2 retrospective 2 retrospective 3 population 4 - 6 study 4 - 7 aimed 4 - 29 . 5 based 6 study 6 study 7 aimed 7 aimed 8 to 7 aimed 9 investigate 8 to 9 investigate 9 investigate 17 and 9 investigate 25 using 10 associations 11 between 10 associations 17 and 11 between 13 dysfunction 12 erectile 13 dysfunction 13 dysfunction 15 ed 14 ( 15 ed 15 ed 16 ) 17 and 21 syndrome 17 and 23 ibs 18 the 21 syndrome 19 irritable 20 bowel 20 bowel 21 syndrome 22 ( 23 ibs 23 ibs 24 ) 25 using 28 cohort 26 a 27 taiwanese 26 a 28 cohort 27 taiwanese 28 cohort we identified 17 608 male patients who were newly diagnosed with ibs from 1997 to 2010 . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 identified 0 ###LEFT-WALL### 17 . 1 we 2 identified 2 identified 6 patients 3 17 6 patients 4 608 6 patients 5 male 6 patients 6 patients 7 who 6 patients 8 were 7 who 8 were 8 were 10 diagnosed 9 newly 10 diagnosed 10 diagnosed 11 with 11 with 12 ibs 12 ibs 15 to 13 from 15 to 14 1997 15 to 15 to 16 2010 the date that the diagnosis of ibs had been made was the index date . 0 ###LEFT-WALL### 2 date 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 15 . 1 the 2 date 2 date 3 that 2 date 9 been 2 date 10 made 2 date 11 was 3 that 5 diagnosis 3 that 9 been 4 the 5 diagnosis 5 diagnosis 6 of 5 diagnosis 8 had 6 of 7 ibs 8 had 9 been 11 was 14 date 12 the 14 date 13 index 14 date ibs patients with a history of ed before the index date or with incomplete demographic information were excluded . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 18 excluded 0 ###LEFT-WALL### 19 . 1 ibs 2 patients 2 patients 3 with 2 patients 6 of 2 patients 17 were 3 with 5 history 4 a 5 history 6 of 7 ed 7 ed 12 or 8 before 11 date 8 before 12 or 9 the 11 date 10 index 11 date 12 or 13 with 13 with 16 information 14 incomplete 16 information 15 demographic 16 information 17 were 18 excluded both cohorts were followed until the end of 2010 or censored . 0 ###LEFT-WALL### 2 cohorts 0 ###LEFT-WALL### 10 or 0 ###LEFT-WALL### 12 . 1 both 2 cohorts 2 cohorts 10 or 3 were 4 followed 3 were 10 or 4 followed 5 until 5 until 7 end 6 the 7 end 7 end 8 of 8 of 9 2010 10 or 11 censored cox proportional hazard regression [model] was used to estimate the effects of ibs on ed risks . 0 ###LEFT-WALL### 1 cox 0 ###LEFT-WALL### 17 . 1 cox 3 hazard 2 proportional 3 hazard 3 hazard 4 regression 3 hazard 9 estimate 4 regression 6 was 6 was 7 used 7 used 8 to 7 used 9 estimate 8 to 9 estimate 9 estimate 11 effects 9 estimate 14 on 10 the 11 effects 11 effects 12 of 12 of 13 ibs 14 on 16 risks 15 ed 16 risks the incidence rate ratio of ed in the ibs cohort was 2.92 times higher than that in the [non] [-] ibs cohort ( 29.5 vs [.] 10.1 per 10 000 person - years ) , with an adjusted hazard ratio ( ahr ) of 2.58 ( 95 % confidence [interval] [ ci ] : 2.24 - 2.98 ) . 0 ###LEFT-WALL### 4 ratio 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 54 : 0 ###LEFT-WALL### 59 . 1 the 4 ratio 2 incidence 4 ratio 3 rate 4 ratio 4 ratio 5 of 4 ratio 11 was 5 of 6 ed 6 ed 7 in 7 in 10 cohort 8 the 10 cohort 9 ibs 10 cohort 11 was 14 higher 12 2.92 13 times 13 times 14 higher 14 higher 15 than 15 than 16 that 15 than 17 in 17 in 22 cohort 18 the 22 cohort 21 ibs 22 cohort 22 cohort 24 29.5 23 ( 24 29.5 24 29.5 25 vs 24 29.5 53 ] 25 vs 27 10.1 27 10.1 28 per 27 10.1 33 years 27 10.1 36 with 28 per 31 person 29 10 31 person 30 000 31 person 32 - 33 years 33 years 34 ) 35 , 36 with 36 with 40 ratio 36 with 53 ] 37 an 40 ratio 38 adjusted 39 hazard 39 hazard 40 ratio 40 ratio 42 ahr 40 ratio 44 of 41 ( 42 ahr 42 ahr 43 ) 44 of 45 2.58 45 2.58 49 confidence 46 ( 49 confidence 47 95 48 % 48 % 49 confidence 49 confidence 52 ci 49 confidence 53 ] 51 [ 52 ci 52 ci 53 ] 54 : 55 2.24 55 2.24 57 2.98 56 - 57 2.98 57 2.98 58 ) the risk of ed increased with increasing age and number of comorbidities . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 13 . 1 the 2 risk 2 risk 3 of 2 risk 9 and 3 of 4 ed 4 ed 5 increased 4 ed 6 with 6 with 7 increasing 7 increasing 8 age 9 and 10 number 9 and 11 of 11 of 12 comorbidities patients with depression were at a higher risk of ed ( ahr : 1.97 ; 95 % ci : 1.49 - 2.63 ) compared with the subjects without depression . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 13 : 1 patients 2 with 1 patients 4 were 2 with 3 depression 4 were 5 at 5 at 8 risk 6 a 8 risk 7 higher 8 risk 8 risk 9 of 9 of 10 ed 10 ed 12 ahr 11 ( 12 ahr 12 ahr 13 : 13 : 14 1.97 13 : 15 ; 15 ; 18 ci 15 ; 19 : 16 95 18 ci 17 % 18 ci 19 : 20 1.49 19 : 24 compared 19 : 30 . 20 1.49 22 2.63 20 1.49 24 compared 21 - 22 2.63 22 2.63 23 ) 24 compared 25 with 24 compared 28 without 25 with 27 subjects 26 the 27 subjects 28 without 29 depression ibs patients had a higher risk of developing ed compared with [non] - ibs subjects . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 13 - 1 ibs 2 patients 2 patients 3 had 3 had 6 risk 4 a 6 risk 5 higher 6 risk 6 risk 7 of 6 risk 9 ed 6 risk 11 with 7 of 8 developing 9 ed 10 compared 10 compared 11 with 13 - 15 subjects 13 - 16 . 14 ibs 15 subjects ageing and comorbidities including diabetes , cardiovascular disease , chronic kidney disease and depression were associated with the risk of ed . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 16 associated 0 ###LEFT-WALL### 22 . 1 ageing 2 and 2 and 3 comorbidities 2 and 4 including 2 and 15 were 4 including 13 and 5 diabetes 6 , 6 , 8 disease 6 , 9 , 7 cardiovascular 8 disease 9 , 12 disease 9 , 13 and 10 chronic 11 kidney 11 kidney 12 disease 13 and 14 depression 15 were 16 associated 16 associated 17 with 17 with 19 risk 18 the 19 risk 19 risk 20 of 20 of 21 ed background : frailty is commonly considered as a syndrome with several symptoms , including weight loss , exhaustion , weakness , slow walking speed and physical inactivity . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 frailty 2 : 6 considered 2 : 28 . 3 frailty 4 is 4 is 6 considered 5 commonly 6 considered 6 considered 7 as 6 considered 10 with 7 as 9 syndrome 8 a 9 syndrome 10 with 11 several 10 with 23 walking 11 several 12 symptoms 11 several 22 slow 12 symptoms 14 including 12 symptoms 22 slow 13 , 14 including 14 including 16 loss 14 including 21 , 15 weight 16 loss 16 loss 18 exhaustion 16 loss 20 weakness 17 , 18 exhaustion 18 exhaustion 19 , 19 , 20 weakness 20 weakness 21 , 23 walking 25 and 24 speed 25 and 25 and 27 inactivity 26 physical 27 inactivity it has been suggested that cognitive impairment should be included in the frailty index , however the association between frailty and cognition has not yet been fully established . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 suggested 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 29 . 1 it 2 has 2 has 3 been 3 been 4 suggested 4 suggested 5 that 5 that 7 impairment 5 that 10 included 6 cognitive 7 impairment 7 impairment 8 should 8 should 9 be 9 be 10 included 10 included 11 in 11 in 14 index 12 the 14 index 13 frailty 14 index 15 , 18 association 15 , 28 established 16 however 18 association 17 the 18 association 18 association 19 between 18 association 23 has 19 between 21 and 20 frailty 21 and 21 and 22 cognition 23 has 24 not 23 has 26 been 25 yet 26 been 26 been 28 established 27 fully 28 established objective : to investigate cross [-] sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 objective 2 : 2 : 3 to 2 : 18 dementia 3 to 4 investigate 4 investigate 7 sectionally 4 investigate 8 whether 5 cross 7 sectionally 8 whether 9 frailty 8 whether 15 or 9 frailty 10 is 10 is 15 or 11 associated 12 with 11 associated 15 or 12 with 14 impairment 13 cognitive 14 impairment 15 or 17 diagnosed 16 clinically 17 diagnosed 18 dementia 19 in 19 in 21 people 20 older 21 people methods : the study included a total of 654 persons aged 76 - 100 years ( mean 82 ± 4.6 ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 included 2 : 22 . 3 the 4 study 4 study 5 included 5 included 7 total 6 a 7 total 7 total 8 of 7 total 15 years 8 of 10 persons 9 654 10 persons 10 persons 11 aged 11 aged 12 76 13 - 15 years 14 100 15 years 15 years 19 ± 15 years 21 ) 16 ( 19 ± 17 mean 19 ± 18 82 19 ± 19 ± 20 4.6 19 ± 21 ) frailty status of the participants was assessed using the cardiovascular health study criteria . 0 ###LEFT-WALL### 2 status 0 ###LEFT-WALL### 7 assessed 0 ###LEFT-WALL### 14 . 1 frailty 2 status 2 status 3 of 2 status 6 was 3 of 5 participants 4 the 5 participants 6 was 7 assessed 7 assessed 8 using 8 using 13 criteria 9 the 13 criteria 10 cardiovascular 11 health 11 health 12 study 12 study 13 criteria cognitive [function] was assessed with the mini - mental state examination ( mmse ) . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 15 . 1 cognitive 3 was 3 was 4 assessed 4 assessed 5 with 5 with 7 mini 6 the 7 mini 7 mini 13 mmse 8 - 13 mmse 9 mental 10 state 10 state 11 examination 11 examination 13 mmse 12 ( 13 mmse 13 mmse 14 ) clinically diagnosed dementia was assessed by specialists using diagnostic criteria . 0 ###LEFT-WALL### 3 dementia 0 ###LEFT-WALL### 5 assessed 0 ###LEFT-WALL### 11 . 1 clinically 2 diagnosed 2 diagnosed 3 dementia 3 dementia 4 was 4 was 5 assessed 5 assessed 6 by 6 by 7 specialists 7 specialists 8 using 8 using 10 criteria 9 diagnostic 10 criteria the associations between frailty and cognition were investigated using logistic regression . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 8 investigated 0 ###LEFT-WALL### 12 . 1 the 2 associations 2 associations 3 between 2 associations 7 were 3 between 5 and 4 frailty 5 and 5 and 6 cognition 7 were 8 investigated 8 investigated 9 using 9 using 11 regression 10 logistic 11 regression results : a total of 93 ( 14 % ) participants were classified as frail . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 1 results 2 : 2 : 4 total 3 a 4 total 4 total 5 of 4 total 11 participants 4 total 12 were 4 total 13 classified 5 of 6 93 6 93 9 % 7 ( 9 % 8 14 9 % 9 % 10 ) 11 participants 12 were 13 classified 15 frail 14 as 15 frail cognitive impairment ( mmse score [<] 25 ) was observed among 171 ( 26 % ) persons and 134 ( 21 % ) [persons] had clinically diagnosed dementia . 0 ###LEFT-WALL### 1 cognitive 0 ###LEFT-WALL### 10 observed 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 29 . 1 cognitive 2 impairment 1 cognitive 9 was 1 cognitive 10 observed 2 impairment 5 score 2 impairment 9 was 3 ( 5 score 4 mmse 5 score 5 score 7 25 5 score 8 ) 10 observed 11 among 10 observed 17 persons 11 among 12 171 12 171 15 % 13 ( 15 % 14 26 15 % 15 % 16 ) 18 and 19 134 18 and 27 diagnosed 19 134 22 % 19 134 25 had 20 ( 22 % 21 21 22 % 22 % 23 ) 25 had 27 diagnosed 26 clinically 27 diagnosed 27 diagnosed 28 dementia conclusion : frailty is strongly associated with cognitive impairment and clinically diagnosed dementia among persons aged 76 and older . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 3 frailty 2 : 4 is 3 frailty 4 is 4 is 10 and 5 strongly 6 associated 6 associated 7 with 6 associated 10 and 7 with 9 impairment 8 cognitive 9 impairment 10 and 12 diagnosed 10 and 18 and 11 clinically 12 diagnosed 13 dementia 14 among 13 dementia 18 and 14 among 15 persons 15 persons 16 aged 16 aged 17 76 18 and 19 older it is possible that cognitive impairment is a clinical feature of frailty and therefore should be included in the frailty definition . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 22 . 1 it 2 is 2 is 3 possible 3 possible 4 that 4 that 6 impairment 4 that 13 and 5 cognitive 6 impairment 6 impairment 13 and 7 is 10 feature 7 is 13 and 8 a 9 clinical 8 a 10 feature 9 clinical 10 feature 10 feature 11 of 11 of 12 frailty 13 and 15 should 13 and 21 definition 14 therefore 15 should 15 should 16 be 16 be 17 included 17 included 18 in 18 in 20 frailty 19 the 20 frailty adult stem cells in mammalian organs play pivotal roles in the maintenance and repair of these organs throughout the life of the adult and maintain the proper homeostasis of a tissue or organ . 0 ###LEFT-WALL### 3 cells 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 34 . 1 adult 2 stem 2 stem 3 cells 3 cells 4 in 3 cells 24 and 4 in 6 organs 5 mammalian 6 organs 7 play 9 roles 7 play 10 in 7 play 18 throughout 7 play 24 and 8 pivotal 9 roles 10 in 13 and 11 the 12 maintenance 12 maintenance 13 and 13 and 14 repair 13 and 15 of 15 of 17 organs 16 these 17 organs 18 throughout 20 life 19 the 20 life 20 life 21 of 21 of 23 adult 22 the 23 adult 24 and 25 maintain 25 maintain 28 homeostasis 26 the 28 homeostasis 27 proper 28 homeostasis 28 homeostasis 29 of 29 of 32 or 30 a 31 tissue 31 tissue 32 or 32 or 33 organ among the adult stem cells described to date , mesenchymal stem cells ( mscs ) are highlighted for clinical applications because mscs have many advantages for cell therapy , including multilineage differentiation , homing , immune modulation and wound - healing effects . 0 ###LEFT-WALL### 12 cells 0 ###LEFT-WALL### 17 highlighted 1 among 5 cells 1 among 12 cells 2 the 5 cells 3 adult 4 stem 4 stem 5 cells 6 described 8 date 6 described 9 , 6 described 12 cells 7 to 8 date 10 mesenchymal 11 stem 11 stem 12 cells 12 cells 14 mscs 12 cells 16 are 13 ( 14 mscs 14 mscs 15 ) 16 are 17 highlighted 17 highlighted 18 for 17 highlighted 21 because 17 highlighted 30 including 18 for 20 applications 19 clinical 20 applications 21 because 22 mscs 21 because 23 have 22 mscs 23 have 23 have 25 advantages 24 many 25 advantages 25 advantages 26 for 26 for 28 therapy 27 cell 28 therapy 29 , 30 including 30 including 32 differentiation 30 including 41 healing 30 including 43 . 31 multilineage 32 differentiation 32 differentiation 38 and 33 , 38 and 34 homing 35 , 35 , 37 modulation 35 , 38 and 36 immune 37 modulation 38 and 39 wound 38 and 40 - 40 - 41 healing 41 healing 42 effects 41 healing 43 . however , as the aging of mscs leads to an age - associated [decline] in their number and function , it is important to clarify the age - associated factors and regulatory mechanism associated with the msc aging process . 0 ###LEFT-WALL### 31 and 0 ###LEFT-WALL### 34 associated 0 ###LEFT-WALL### 40 . 1 however 21 it 1 however 22 is 1 however 28 - 1 however 31 and 2 , 3 as 3 as 5 aging 3 as 8 leads 3 as 20 , 3 as 21 it 4 the 5 aging 5 aging 6 of 5 aging 8 leads 6 of 7 mscs 8 leads 9 to 9 to 11 age 10 an 11 age 11 age 13 associated 12 - 13 associated 13 associated 15 in 13 associated 20 , 15 in 18 and 16 their 17 number 17 number 18 and 18 and 19 function 21 it 22 is 22 is 23 important 23 important 24 to 24 to 25 clarify 25 clarify 27 age 26 the 27 age 29 associated 30 factors 30 factors 31 and 31 and 33 mechanism 31 and 34 associated 32 regulatory 33 mechanism 34 associated 35 with 35 with 37 msc 35 with 38 aging 36 the 37 msc 38 aging 39 process in this review , we amass [and] [discuss] the recent data related to age - associated genes in mscs . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 amass 0 ###LEFT-WALL### 15 - 0 ###LEFT-WALL### 20 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 amass 6 amass 11 data 9 the 11 data 10 recent 11 data 11 data 12 related 12 related 13 to 13 to 14 age 15 - 17 genes 16 associated 17 genes 17 genes 18 in 18 in 19 mscs in particular , the activities of epigenetic regulatory factors , including histone acetylase and dna methyltransferase , modulate gene expression and crosstalk with each other during the msc senescence process [.] p16 ( ink4a ) [and] high - mobility group a2 play important age - associated roles in the regulation of msc stemness , and lamin a - and prelamin a - dependent nuclear abnormalities have significant biological relevance in msc aging . 0 ###LEFT-WALL### 2 particular 0 ###LEFT-WALL### 3 , 1 in 2 particular 3 , 14 and 4 the 5 activities 5 activities 6 of 5 activities 10 , 6 of 9 factors 7 epigenetic 9 factors 8 regulatory 9 factors 10 , 13 acetylase 10 , 14 and 11 including 13 acetylase 12 histone 13 acetylase 14 and 16 methyltransferase 14 and 17 , 14 and 18 modulate 15 dna 16 methyltransferase 18 modulate 21 and 19 gene 20 expression 20 expression 21 and 21 and 22 crosstalk 21 and 23 with 21 and 26 during 23 with 25 other 24 each 25 other 26 during 37 high 27 the 37 high 28 msc 29 senescence 29 senescence 37 high 30 process 37 high 32 p16 34 ink4a 32 p16 35 ) 32 p16 37 high 33 ( 34 ink4a 34 ink4a 35 ) 37 high 45 - 38 - 45 - 39 mobility 40 group 40 group 42 play 41 a2 42 play 42 play 44 age 43 important 44 age 44 age 45 - 45 - 47 roles 46 associated 47 roles 47 roles 48 in 48 in 50 regulation 49 the 50 regulation 50 regulation 51 of 51 of 63 dependent 52 msc 53 stemness 53 stemness 55 and 54 , 55 and 55 and 56 lamin 55 and 59 and 56 lamin 57 a 58 - 59 and 59 and 60 prelamin 59 and 62 - 59 and 63 dependent 60 prelamin 61 a 63 dependent 65 abnormalities 63 dependent 70 in 63 dependent 72 aging 64 nuclear 65 abnormalities 65 abnormalities 66 have 66 have 69 relevance 66 have 70 in 67 significant 69 relevance 68 biological 69 relevance 71 msc 72 aging 72 aging 73 . taken together , the information described here , including the epigenetic regulatory factors , transcription factors and cell signaling , could be used toward the development of treatments for msc aging and related defects . 0 ###LEFT-WALL### 5 information 0 ###LEFT-WALL### 35 . 1 taken 2 together 1 taken 3 , 1 taken 5 information 4 the 5 information 5 information 6 described 5 information 17 and 5 information 21 could 6 described 7 here 6 described 9 including 8 , 9 including 9 including 13 factors 9 including 14 , 10 the 13 factors 11 epigenetic 13 factors 12 regulatory 13 factors 14 , 17 and 15 transcription 16 factors 16 factors 17 and 17 and 18 cell 17 and 19 signaling 17 and 20 , 21 could 32 and 22 be 23 used 22 be 32 and 23 used 24 toward 24 toward 26 development 25 the 26 development 26 development 27 of 27 of 28 treatments 28 treatments 29 for 29 for 30 msc 30 msc 31 aging 32 and 33 related 33 related 34 defects the histone lysine demethylase kdm5b plays key roles in gene repression by demethylating trimethylated lysine 4 of histone h3 ( h3k4me3 ) , a modification commonly found at the promoter region of actively transcribed genes . 0 ###LEFT-WALL### 6 plays 0 ###LEFT-WALL### 7 key 1 the 6 plays 2 histone 6 plays 3 lysine 6 plays 4 demethylase 6 plays 5 kdm5b 6 plays 6 plays 7 key 7 key 8 roles 7 key 9 in 7 key 12 by 9 in 11 repression 10 gene 11 repression 12 by 13 demethylating 13 demethylating 15 lysine 14 trimethylated 15 lysine 15 lysine 16 4 15 lysine 17 of 17 of 19 h3 18 histone 19 h3 19 h3 21 h3k4me3 19 h3 25 modification 20 ( 21 h3k4me3 21 h3k4me3 22 ) 23 , 25 modification 24 a 25 modification 25 modification 27 found 25 modification 32 of 25 modification 36 . 26 commonly 27 found 27 found 28 at 28 at 31 region 29 the 31 region 30 promoter 31 region 32 of 35 genes 33 actively 34 transcribed 34 transcribed 35 genes kdm5b is known to regulate the expression of genes involved in cell cycle progression ; however , little is known about the post - translational modifications that regulate kdm5b . 0 ###LEFT-WALL### 1 kdm5b 0 ###LEFT-WALL### 3 known 0 ###LEFT-WALL### 15 ; 0 ###LEFT-WALL### 30 . 1 kdm5b 2 is 2 is 3 known 3 known 4 to 3 known 5 regulate 4 to 5 regulate 5 regulate 7 expression 6 the 7 expression 7 expression 8 of 7 expression 10 involved 8 of 9 genes 10 involved 11 in 11 in 14 progression 12 cell 14 progression 13 cycle 14 progression 15 ; 18 little 15 ; 20 known 15 ; 24 - 16 however 17 , 16 however 18 little 18 little 19 is 19 is 20 known 20 known 21 about 21 about 23 post 22 the 23 post 24 - 26 modifications 25 translational 26 modifications 26 modifications 27 that 26 modifications 28 regulate 27 that 28 regulate 28 regulate 29 kdm5b herein , we report that kdm5b is sumoylated at lysine residues 242 and 278 and that the ectopic expression of the hpc2 sumo e3 ligase enhances this sumoylation . 0 ###LEFT-WALL### 1 herein 0 ###LEFT-WALL### 2 , 0 ###LEFT-WALL### 29 . 2 , 3 we 2 , 4 report 3 we 4 report 4 report 15 and 5 that 6 kdm5b 5 that 7 is 5 that 15 and 6 kdm5b 7 is 7 is 8 sumoylated 8 sumoylated 9 at 9 at 11 residues 10 lysine 11 residues 11 residues 13 and 12 242 13 and 13 and 14 278 15 and 16 that 16 that 19 expression 16 that 26 enhances 17 the 19 expression 18 ectopic 19 expression 19 expression 20 of 19 expression 26 enhances 20 of 25 ligase 21 the 25 ligase 22 hpc2 25 ligase 23 sumo 24 e3 24 e3 25 ligase 26 enhances 28 sumoylation 27 this 28 sumoylation interestingly , the levels of kdm5b and its sumoylated forms are regulated during the cell cycle . 0 ###LEFT-WALL### 4 levels 0 ###LEFT-WALL### 12 regulated 0 ###LEFT-WALL### 17 . 1 interestingly 2 , 1 interestingly 4 levels 3 the 4 levels 4 levels 5 of 4 levels 11 are 5 of 7 and 6 kdm5b 7 and 7 and 10 forms 8 its 10 forms 9 sumoylated 10 forms 11 are 12 regulated 12 regulated 13 during 13 during 16 cycle 14 the 16 cycle 15 cell 16 cycle kdm5b is modulated by rnf4 , an e3 ubiquitin ligase that targets sumo - modified proteins to proteasomal degradation . 0 ###LEFT-WALL### 1 kdm5b 0 ###LEFT-WALL### 3 modulated 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 20 . 1 kdm5b 2 is 2 is 3 modulated 3 modulated 4 by 4 by 5 rnf4 5 rnf4 10 ligase 6 , 10 ligase 7 an 10 ligase 8 e3 10 ligase 9 ubiquitin 10 ligase 10 ligase 11 that 10 ligase 12 targets 10 ligase 14 - 11 that 12 targets 12 targets 13 sumo 14 - 16 proteins 15 modified 16 proteins 16 proteins 17 to 17 to 19 degradation 18 proteasomal 19 degradation digital gene expression analyses showed that cells expressing the sumoylation - deficient kdm5b harbor repressed mrna expression profiles of cell cycle [and] dna repair genes . 0 ###LEFT-WALL### 4 analyses 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 26 . 1 digital 4 analyses 2 gene 3 expression 3 expression 4 analyses 4 analyses 5 showed 5 showed 6 that 5 showed 7 cells 7 cells 8 expressing 8 expressing 10 sumoylation 9 the 10 sumoylation 11 - 18 profiles 12 deficient 14 harbor 13 kdm5b 14 harbor 14 harbor 15 repressed 15 repressed 16 mrna 16 mrna 18 profiles 17 expression 18 profiles 18 profiles 19 of 19 of 25 genes 20 cell 21 cycle 21 cycle 25 genes 23 dna 24 repair 24 repair 25 genes chromatin immunoprecipitations confirmed some of these genes as kdm5b targets , as they displayed reduced h3k4me3 levels in cells ectopically expressing kdm5b . 0 ###LEFT-WALL### 1 chromatin 0 ###LEFT-WALL### 15 reduced 0 ###LEFT-WALL### 23 . 1 chromatin 2 immunoprecipitations 1 chromatin 14 displayed 1 chromatin 15 reduced 2 immunoprecipitations 3 confirmed 3 confirmed 4 some 3 confirmed 8 as 3 confirmed 12 as 4 some 5 of 5 of 7 genes 6 these 7 genes 8 as 10 targets 9 kdm5b 10 targets 11 , 12 as 12 as 13 they 12 as 14 displayed 13 they 14 displayed 15 reduced 17 levels 15 reduced 18 in 16 h3k4me3 17 levels 18 in 19 cells 19 cells 21 expressing 20 ectopically 21 expressing 21 expressing 22 kdm5b we propose that sumoylation by hpc2 regulates the activity of kdm5b . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 propose 0 ###LEFT-WALL### 12 . 1 we 2 propose 2 propose 3 that 3 that 4 sumoylation 3 that 7 regulates 4 sumoylation 5 by 4 sumoylation 7 regulates 5 by 6 hpc2 7 regulates 9 activity 8 the 9 activity 9 activity 10 of 10 of 11 kdm5b [none] none digital technologies are becoming more pervasive in all areas of society . 0 ###LEFT-WALL### 4 technologies 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 14 . 2 none 3 digital 3 digital 4 technologies 4 technologies 5 are 5 are 6 becoming 6 becoming 8 pervasive 7 more 8 pervasive 8 pervasive 9 in 9 in 11 areas 10 all 11 areas 11 areas 12 of 12 of 13 society enabling everyone to have access and capability to use the internet and associated digital technologies , summed up in the term ['] digital inclusion ['] , is seen to have wide - ranging benefits to the individual , to the economy and [to] society . 0 ###LEFT-WALL### 1 enabling 0 ###LEFT-WALL### 30 have 1 enabling 2 everyone 1 enabling 3 to 1 enabling 12 and 1 enabling 27 is 3 to 4 have 4 have 6 and 4 have 8 to 5 access 6 and 6 and 7 capability 8 to 12 and 9 use 11 internet 9 use 12 and 10 the 11 internet 12 and 13 associated 13 associated 15 technologies 14 digital 15 technologies 15 technologies 17 summed 16 , 17 summed 17 summed 18 up 17 summed 19 in 17 summed 26 , 19 in 24 inclusion 20 the 24 inclusion 21 term 24 inclusion 23 digital 24 inclusion 27 is 28 seen 28 seen 29 to 29 to 30 have 30 have 34 benefits 30 have 39 to 31 wide 32 - 31 wide 34 benefits 33 ranging 34 benefits 34 benefits 35 to 35 to 37 individual 36 the 37 individual 38 , 39 to 39 to 42 and 39 to 45 . 40 the 41 economy 41 economy 42 and 42 and 44 society for older people , being digitally included can help them to maintain their independence , social connectedness and sense of worth in the face of declining health or limited capabilities , as well as also offering new opportunities to improve their quality of life . 0 ###LEFT-WALL### 5 being 0 ###LEFT-WALL### 9 help 0 ###LEFT-WALL### 45 . 1 for 3 people 1 for 4 , 1 for 5 being 2 older 3 people 5 being 7 included 5 being 8 can 6 digitally 7 included 8 can 9 help 9 help 10 them 9 help 11 to 9 help 12 maintain 11 to 12 maintain 12 maintain 18 and 12 maintain 22 in 12 maintain 34 as 13 their 14 independence 14 independence 15 , 15 , 17 connectedness 15 , 18 and 16 social 17 connectedness 18 and 19 sense 18 and 20 of 20 of 21 worth 22 in 28 or 23 the 24 face 24 face 25 of 24 face 28 or 25 of 27 health 26 declining 27 health 28 or 30 capabilities 28 or 31 , 29 limited 30 capabilities 32 as 33 well 33 well 34 as 34 as 36 offering 35 also 36 offering 36 offering 38 opportunities 37 new 38 opportunities 38 opportunities 39 to 38 opportunities 40 improve 39 to 40 improve 40 improve 42 quality 41 their 42 quality 42 quality 43 of 43 of 44 life at present however , access to the technology and to the benefits is not equally distributed either [between] [or] within nations , and older people tend to be on the ['] wrong ['] side of what is termed the ['] digital [divide] ['] . 0 ###LEFT-WALL### 5 access 0 ###LEFT-WALL### 16 distributed 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 44 . 1 at 2 present 2 present 5 access 3 however 4 , 3 however 5 access 5 access 9 and 5 access 13 is 6 to 8 technology 6 to 9 and 7 the 8 technology 9 and 10 to 10 to 12 benefits 11 the 12 benefits 13 is 14 not 13 is 16 distributed 15 equally 16 distributed 16 distributed 17 either 16 distributed 20 within 20 within 21 nations 22 , 23 and 23 and 25 people 23 and 26 tend 24 older 25 people 25 people 26 tend 26 tend 27 to 26 tend 28 be 27 to 28 be 28 be 29 on 29 on 34 side 30 the 34 side 32 wrong 34 side 34 side 35 of 35 of 36 what 36 what 37 is 37 is 38 termed 38 termed 41 digital 39 the 41 digital governments globally are developing strategies to promote digital inclusion and indeed internet uptake is increasing steadily , [including] amongst older people . 0 ###LEFT-WALL### 1 governments 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 10 and 1 governments 3 are 2 globally 3 are 3 are 4 developing 4 developing 5 strategies 4 developing 6 to 6 to 7 promote 7 promote 9 inclusion 8 digital 9 inclusion 10 and 11 indeed 10 and 13 uptake 10 and 14 is 12 internet 13 uptake 13 uptake 14 is 14 is 15 increasing 15 increasing 16 steadily 15 increasing 19 amongst 17 , 19 amongst 19 amongst 21 people 19 amongst 22 . 20 older 21 people however , such strategies have focussed on getting people online , and there appears to be an assumption that once someone is online they will remain ['] digitally engaged ['] . 0 ###LEFT-WALL### 4 strategies 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 31 . 1 however 2 , 1 however 4 strategies 3 such 4 strategies 4 strategies 5 have 5 have 6 focussed 6 focussed 7 on 7 on 9 people 8 getting 9 people 9 people 10 online 11 , 12 and 12 and 13 there 12 and 16 be 13 there 14 appears 14 appears 15 to 15 to 16 be 16 be 18 assumption 17 an 18 assumption 18 assumption 19 that 18 assumption 29 engaged 19 that 24 they 19 that 26 remain 20 once 21 someone 20 once 22 is 20 once 24 they 21 someone 22 is 22 is 23 online 24 they 25 will 25 will 26 remain 28 digitally 29 engaged in fact statistics show that some users give up using the internet , and there is emerging evidence that older people are more vulnerable to the factors which can lead to this outcome . 0 ###LEFT-WALL### 3 statistics 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 34 . 1 in 2 fact 2 fact 3 statistics 3 statistics 4 show 4 show 5 that 4 show 6 some 4 show 10 using 6 some 7 users 6 some 8 give 7 users 8 give 8 give 9 up 10 using 12 internet 11 the 12 internet 13 , 14 and 14 and 15 there 14 and 16 is 15 there 16 is 16 is 18 evidence 17 emerging 18 evidence 18 evidence 19 that 19 that 21 people 19 that 22 are 20 older 21 people 21 people 22 are 22 are 23 more 22 are 24 vulnerable 24 vulnerable 25 to 25 to 27 factors 26 the 27 factors 27 factors 28 which 27 factors 29 can 28 which 29 can 29 can 30 lead 30 lead 31 to 31 to 33 outcome 32 this 33 outcome the authors see this phenomenon as a potential but largely unrecognised ['] fourth digital [divide] ['] [which] [has] serious implications for social inclusion . 0 ###LEFT-WALL### 2 authors 0 ###LEFT-WALL### 3 see 0 ###LEFT-WALL### 24 . 1 the 2 authors 2 authors 3 see 3 see 5 phenomenon 3 see 6 as 3 see 9 but 4 this 5 phenomenon 6 as 8 potential 7 a 8 potential 9 but 10 largely 9 but 20 implications 11 unrecognised 20 implications 13 fourth 20 implications 14 digital 20 implications 19 serious 20 implications 20 implications 21 for 21 for 23 inclusion 22 social 23 inclusion the objectives of this article are ( [a] [ )(to raise awareness of the phenomenon of digital disengagement by considering some of the emerging evidence , [(] [b] [ )(to explore some of the potential implications of [not] recognising [and] therefore [not] addressing the needs of the digitally disengaged older population , [and] [(] [c] [ )(to reveal the prevailing gap in knowledge which future research should address . 0 ###LEFT-WALL### 2 objectives 0 ###LEFT-WALL### 6 are 1 the 2 objectives 2 objectives 3 of 2 objectives 6 are 3 of 5 article 4 this 5 article 6 are 10 )(to 7 ( 10 )(to 10 )(to 11 raise 11 raise 12 awareness 11 raise 19 by 12 awareness 13 of 13 of 15 phenomenon 14 the 15 phenomenon 15 phenomenon 16 of 16 of 18 disengagement 17 digital 18 disengagement 19 by 20 considering 20 considering 21 some 20 considering 25 evidence 20 considering 32 some 21 some 22 of 22 of 24 emerging 23 the 24 emerging 25 evidence 30 )(to 26 , 30 )(to 30 )(to 31 explore 32 some 33 of 33 of 36 implications 34 the 36 implications 35 potential 36 implications 36 implications 37 of 36 implications 43 addressing 37 of 39 recognising 41 therefore 43 addressing 43 addressing 45 needs 44 the 45 needs 45 needs 46 of 45 needs 57 )(to 46 of 51 population 47 the 51 population 48 digitally 49 disengaged 49 disengaged 51 population 50 older 51 population 52 , 57 )(to 57 )(to 58 reveal 57 )(to 69 . 58 reveal 61 gap 58 reveal 62 in 59 the 61 gap 60 prevailing 61 gap 62 in 63 knowledge 63 knowledge 64 which 63 knowledge 68 address 64 which 66 research 64 which 68 address 65 future 66 research 66 research 67 should 67 should 68 address none intense interest in the ['] warburg effect ['] has been revived by the discovery that hypoxia - inducible factor 1 ( hif1 ) reprogrammes pyruvate oxidation to lactic acid conversion ; lactic acid is the end product of fermentative glycolysis . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 12 revived 0 ###LEFT-WALL### 32 ; 0 ###LEFT-WALL### 42 . 1 none 3 interest 1 none 11 been 1 none 12 revived 2 intense 3 interest 3 interest 4 in 3 interest 10 has 4 in 8 effect 5 the 8 effect 7 warburg 8 effect 10 has 11 been 12 revived 13 by 12 revived 28 to 13 by 15 discovery 14 the 15 discovery 15 discovery 16 that 16 that 20 factor 16 that 25 reprogrammes 17 hypoxia 18 - 17 hypoxia 20 factor 19 inducible 20 factor 20 factor 21 1 20 factor 23 hif1 20 factor 25 reprogrammes 22 ( 23 hif1 23 hif1 24 ) 25 reprogrammes 27 oxidation 26 pyruvate 27 oxidation 28 to 31 conversion 29 lactic 31 conversion 30 acid 31 conversion 32 ; 34 acid 32 ; 35 is 33 lactic 34 acid 34 acid 35 is 35 is 38 product 36 the 38 product 37 end 38 product 38 product 39 of 39 of 41 glycolysis 40 fermentative 41 glycolysis the most aggressive and invasive cancers , which are often hypoxic , rely on exacerbated glycolysis to meet the increased demand for atp and biosynthetic precursors and also rely on robust ph - regulating systems to combat the excessive generation of lactic and carbonic acids . 0 ###LEFT-WALL### 6 cancers 0 ###LEFT-WALL### 13 rely 1 the 2 most 2 most 6 cancers 3 aggressive 4 and 4 and 5 invasive 4 and 6 cancers 6 cancers 8 which 6 cancers 13 rely 7 , 8 which 8 which 9 are 8 which 12 , 9 are 10 often 9 are 11 hypoxic 13 rely 14 on 13 rely 17 to 13 rely 34 regulating 14 on 16 glycolysis 15 exacerbated 16 glycolysis 17 to 27 and 18 meet 21 demand 18 meet 22 for 18 meet 27 and 19 the 21 demand 20 increased 21 demand 22 for 24 and 23 atp 24 and 24 and 26 precursors 25 biosynthetic 26 precursors 27 and 29 rely 28 also 29 rely 29 rely 30 on 30 on 32 ph 31 robust 32 ph 33 - 34 regulating 34 regulating 35 systems 34 regulating 36 to 34 regulating 46 . 36 to 37 combat 37 combat 40 generation 38 the 40 generation 39 excessive 40 generation 40 generation 41 of 41 of 43 and 42 lactic 43 and 43 and 45 acids 44 carbonic 45 acids in this review , we present the key ph [-] regulating systems and synthesize recent advances in strategies that combine the disruption of ph control with bioenergetic mechanisms . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 29 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 13 and 6 present 9 ph 6 present 13 and 7 the 9 ph 8 key 9 ph 9 ph 11 regulating 11 regulating 12 systems 13 and 14 synthesize 14 synthesize 16 advances 14 synthesize 17 in 15 recent 16 advances 17 in 18 strategies 18 strategies 19 that 18 strategies 20 combine 19 that 20 combine 20 combine 22 disruption 20 combine 26 with 21 the 22 disruption 22 disruption 23 of 23 of 25 control 24 ph 25 control 26 with 28 mechanisms 27 bioenergetic 28 mechanisms we discuss the possibility of exploiting , in rapidly growing tumours , acute cell death by ['] metabolic catastrophe ['] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 discuss 0 ###LEFT-WALL### 21 . 1 we 2 discuss 2 discuss 4 possibility 3 the 4 possibility 4 possibility 5 of 5 of 6 exploiting 6 exploiting 8 in 6 exploiting 15 death 6 exploiting 16 by 7 , 8 in 8 in 10 growing 8 in 12 , 9 rapidly 10 growing 10 growing 11 tumours 13 acute 14 cell 14 cell 15 death 16 by 19 catastrophe 18 metabolic 19 catastrophe background : with aging , the probability of experiencing multiple chronic conditions has increased , along with symptoms associated with these conditions . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 1 background 2 : 2 : 3 with 3 with 4 aging 5 , 7 probability 5 , 14 increased 6 the 7 probability 7 probability 8 of 7 probability 13 has 8 of 9 experiencing 9 experiencing 12 conditions 10 multiple 12 conditions 11 chronic 12 conditions 13 has 14 increased 14 increased 17 with 15 , 17 with 16 along 17 with 17 with 18 symptoms 17 with 23 . 18 symptoms 19 associated 18 symptoms 20 with 20 with 22 conditions 21 these 22 conditions symptoms form a central component of illness burden , and distress . 0 ###LEFT-WALL### 1 symptoms 0 ###LEFT-WALL### 2 form 0 ###LEFT-WALL### 12 . 1 symptoms 2 form 2 form 5 component 3 a 4 central 3 a 5 component 4 central 5 component 5 component 6 of 6 of 10 and 7 illness 8 burden 8 burden 10 and 9 , 10 and 10 and 11 distress to date , most symptom measures have focused on a particular disease population . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 date 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 14 . 1 to 2 date 3 , 6 measures 3 , 8 focused 4 most 6 measures 5 symptom 6 measures 6 measures 7 have 7 have 8 focused 8 focused 9 on 9 on 13 population 10 a 11 particular 10 a 13 population 11 particular 12 disease 12 disease 13 population objective : we aimed to develop and evaluate a simple symptom screen using data obtained from a representative sample of community [-] dwelling older adults . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 3 we 2 : 4 aimed 3 we 4 aimed 4 aimed 5 to 4 aimed 7 and 5 to 7 and 6 develop 7 and 7 and 8 evaluate 7 and 13 using 8 evaluate 12 screen 9 a 10 simple 9 a 12 screen 10 simple 11 symptom 11 symptom 12 screen 13 using 14 data 14 data 15 obtained 14 data 16 from 14 data 20 of 16 from 19 sample 17 a 18 representative 17 a 19 sample 18 representative 19 sample 20 of 25 adults 21 community 23 dwelling 23 dwelling 25 adults 24 older 25 adults methods : psychometric analyses were conducted on 10 self [-] reported dichotomous symptom indicators collected during in [-] person interviews from a sample of 1000 community [-] dwelling older adults . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 . 2 : 3 psychometric 2 : 20 interviews 3 psychometric 4 analyses 3 psychometric 16 during 3 psychometric 20 interviews 4 analyses 5 were 5 were 6 conducted 6 conducted 7 on 6 conducted 15 collected 7 on 14 indicators 8 10 14 indicators 9 self 11 reported 11 reported 13 symptom 12 dichotomous 13 symptom 13 symptom 14 indicators 15 collected 16 during 17 in 19 person 19 person 20 interviews 20 interviews 21 from 21 from 23 sample 22 a 23 sample 23 sample 24 of 24 of 30 adults 25 1000 30 adults 26 community 28 dwelling 28 dwelling 30 adults 29 older 30 adults symptoms included shortness of breath , feeling tired or fatigued , problems with balance or dizziness , perceived weakness in legs , constipation , daily pain , stiffness , poor appetite , anxiety , and anhedonia . 0 ###LEFT-WALL### 1 symptoms 0 ###LEFT-WALL### 2 included 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 37 . 1 symptoms 2 included 2 included 3 shortness 3 shortness 4 of 4 of 5 breath 6 , 7 feeling 6 , 9 or 6 , 11 , 7 feeling 9 or 8 tired 9 or 9 or 10 fatigued 11 , 35 and 12 problems 13 with 12 problems 15 or 13 with 14 balance 15 or 16 dizziness 15 or 19 weakness 15 or 23 constipation 15 or 35 and 17 , 19 weakness 18 perceived 19 weakness 19 weakness 20 in 19 weakness 22 , 20 in 21 legs 22 , 23 constipation 23 constipation 26 pain 23 constipation 34 , 24 , 26 pain 25 daily 26 pain 26 pain 28 stiffness 26 pain 34 , 27 , 28 stiffness 28 stiffness 31 appetite 28 stiffness 33 anxiety 28 stiffness 34 , 29 , 31 appetite 30 poor 31 appetite 31 appetite 32 , 32 , 33 anxiety 33 anxiety 34 , 34 , 35 and 35 and 36 anhedonia results : over one third of the individuals ( 37.4 % ) had 5 [or] more concurrent symptoms . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 third 2 : 13 had 2 : 19 . 3 over 5 third 4 one 5 third 5 third 6 of 5 third 13 had 6 of 8 individuals 7 the 8 individuals 8 individuals 11 % 9 ( 11 % 10 37.4 11 % 11 % 12 ) 13 had 18 symptoms 14 5 16 more 16 more 18 symptoms 17 concurrent 18 symptoms stiffness and feeling tired were the most common symptoms . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 10 . 1 stiffness 2 and 2 and 3 feeling 2 and 4 tired 2 and 5 were 5 were 9 symptoms 6 the 7 most 7 most 9 symptoms 8 common 9 symptoms confirmatory factor analyses were performed on the 10 symptoms for single [factor] and bifactor ( physical and affective ) models of symptom reporting . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 5 performed 0 ###LEFT-WALL### 24 . 1 confirmatory 3 analyses 2 factor 3 analyses 3 analyses 4 were 4 were 5 performed 5 performed 6 on 5 performed 10 for 6 on 9 symptoms 7 the 8 10 8 10 9 symptoms 10 for 20 models 11 single 13 and 13 and 14 bifactor 13 and 17 and 13 and 20 models 15 ( 17 and 16 physical 17 and 17 and 18 affective 17 and 19 ) 20 models 21 of 21 of 23 reporting 22 symptom 23 reporting goodness - [of] - fit indices indicated better fit for the bifactor model ( χdf=10=89.6 ; p<0.001 [ )(, but the practical significance of the improvement [in] fit was negligible . 0 ###LEFT-WALL### 1 goodness 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 31 . 2 - 4 - 2 - 9 fit 2 - 16 ; 2 - 20 but 4 - 6 indices 5 fit 6 indices 6 indices 7 indicated 6 indices 9 fit 7 indicated 8 better 9 fit 10 for 10 for 13 model 11 the 13 model 12 bifactor 13 model 13 model 15 χdf=10=89.6 14 ( 15 χdf=10=89.6 15 χdf=10=89.6 16 ; 16 ; 17 p<0.001 19 )(, 20 but 20 but 23 significance 20 but 29 was 21 the 23 significance 22 practical 23 significance 23 significance 24 of 23 significance 29 was 24 of 28 fit 25 the 28 fit 26 improvement 28 fit 29 was 30 negligible differential item functioning analyses showed some differences of relatively high magnitude in location parameters by race ; however , because the differential item functioning was in different directions , the impact on the overall measure was most likely lessened . 0 ###LEFT-WALL### 4 analyses 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 40 . 1 differential 2 item 2 item 4 analyses 3 functioning 4 analyses 4 analyses 5 showed 5 showed 7 differences 6 some 7 differences 7 differences 8 of 7 differences 12 in 7 differences 15 by 8 of 11 magnitude 9 relatively 10 high 10 high 11 magnitude 12 in 14 parameters 13 location 14 parameters 15 by 16 race 17 ; 31 impact 17 ; 36 was 18 however 31 impact 19 , 20 because 20 because 23 item 20 because 25 was 20 because 29 , 20 because 31 impact 21 the 23 item 22 differential 23 item 23 item 24 functioning 23 item 25 was 25 was 26 in 26 in 28 directions 27 different 28 directions 30 the 31 impact 31 impact 32 on 31 impact 36 was 32 on 35 measure 33 the 35 measure 34 overall 35 measure 36 was 39 lessened 37 most 38 likely 38 likely 39 lessened conclusions : among community [-] dwelling older adults , a large proportion experienced multiple co - occurring symptoms . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 19 . 1 conclusions 2 : 2 : 3 among 3 among 8 adults 4 community 6 dwelling 6 dwelling 8 adults 7 older 8 adults 9 , 12 proportion 9 , 13 experienced 10 a 11 large 10 a 12 proportion 11 large 12 proportion 12 proportion 13 experienced 13 experienced 18 symptoms 14 multiple 18 symptoms 15 co 16 - 15 co 18 symptoms 17 occurring 18 symptoms this brief symptom screen can be used to quickly measure the overall symptom load in older adult populations , including those with multiple chronic conditions . 0 ###LEFT-WALL### 4 screen 0 ###LEFT-WALL### 7 used 1 this 4 screen 2 brief 3 symptom 3 symptom 4 screen 4 screen 5 can 5 can 6 be 6 be 7 used 7 used 8 to 7 used 10 measure 8 to 10 measure 9 quickly 10 measure 10 measure 14 load 11 the 14 load 12 overall 13 symptom 13 symptom 14 load 14 load 15 in 14 load 20 including 15 in 18 populations 16 older 17 adult 17 adult 18 populations 19 , 20 including 20 including 21 those 20 including 22 with 20 including 26 . 22 with 25 conditions 23 multiple 25 conditions 24 chronic 25 conditions age [-] related thymic [involution] is accompanied by a decrease in thymopoiesis and , thus , a deficiency in t [cell] [-] mediated immunity in the elderly . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 7 accompanied 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 28 . 1 age 3 related 1 age 6 is 3 related 4 thymic 6 is 7 accompanied 7 accompanied 8 by 7 accompanied 11 in 8 by 10 decrease 9 a 10 decrease 11 in 12 thymopoiesis 13 and 14 , 13 and 15 thus 13 and 18 deficiency 13 and 23 mediated 14 , 15 thus 15 thus 16 , 17 a 18 deficiency 18 deficiency 19 in 18 deficiency 23 mediated 19 in 20 t 23 mediated 24 immunity 23 mediated 25 in 25 in 27 elderly 26 the 27 elderly a number of events involved [in] [thymic] [involution] have been discovered ; however , it remains unclear as to whether they are causes or consequences [of] thymic involution . 0 ###LEFT-WALL### 2 number 0 ###LEFT-WALL### 11 discovered 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 29 . 1 a 2 number 2 number 3 of 2 number 5 involved 2 number 9 have 3 of 4 events 9 have 10 been 10 been 11 discovered 12 ; 15 it 12 ; 16 remains 13 however 14 , 13 however 15 it 15 it 16 remains 16 remains 17 unclear 17 unclear 19 to 18 as 19 to 19 to 20 whether 20 whether 21 they 20 whether 22 are 21 they 22 are 22 are 24 or 23 causes 24 or 24 or 28 involution 25 consequences 28 involution 27 thymic 28 involution these events include the degeneration of [t] cell progenitors , as well as the deterioration of the thymic stroma , which is a characteristic of thymic epithelial cell loss due to increased apoptosis and decreased cell proliferation . 0 ###LEFT-WALL### 2 events 0 ###LEFT-WALL### 3 include 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 38 . 1 these 2 events 2 events 3 include 3 include 5 degeneration 4 the 5 degeneration 5 degeneration 6 of 5 degeneration 11 as 6 of 9 progenitors 8 cell 9 progenitors 10 , 11 as 11 as 12 well 11 as 20 , 12 well 13 as 12 well 16 of 13 as 15 deterioration 14 the 15 deterioration 16 of 19 stroma 17 the 19 stroma 18 thymic 19 stroma 20 , 21 which 20 , 22 is 21 which 22 is 22 is 24 characteristic 22 is 31 to 23 a 24 characteristic 24 characteristic 25 of 25 of 29 loss 26 thymic 28 cell 27 epithelial 28 cell 28 cell 29 loss 30 due 31 to 31 to 34 and 32 increased 33 apoptosis 33 apoptosis 34 and 34 and 37 proliferation 35 decreased 36 cell 36 cell 37 proliferation micrornas ( mirnas ) are believed to play important roles in the regulation of cell death and proliferation during the aging process . 0 ###LEFT-WALL### 1 micrornas 0 ###LEFT-WALL### 6 believed 0 ###LEFT-WALL### 23 . 1 micrornas 3 mirnas 1 micrornas 5 are 2 ( 3 mirnas 3 mirnas 4 ) 5 are 6 believed 6 believed 7 to 6 believed 8 play 7 to 8 play 8 play 10 roles 8 play 11 in 8 play 19 during 9 important 10 roles 11 in 13 regulation 12 the 13 regulation 13 regulation 14 of 14 of 17 and 15 cell 16 death 16 death 17 and 17 and 18 proliferation 19 during 22 process 20 the 22 process 21 aging 22 process in the present study , we compared the transcriptional levels of various mirnas in tecs from young and aged mice using microarray analysis . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 compared 0 ###LEFT-WALL### 24 . 1 in 4 study 1 in 5 , 1 in 6 we 2 the 4 study 3 present 4 study 6 we 7 compared 7 compared 10 levels 7 compared 14 in 7 compared 16 from 8 the 10 levels 9 transcriptional 10 levels 10 levels 11 of 11 of 13 mirnas 12 various 13 mirnas 14 in 15 tecs 16 from 20 mice 17 young 18 and 18 and 19 aged 18 and 20 mice 20 mice 21 using 21 using 23 analysis 22 microarray 23 analysis quantitative pcr was performed to confirm the changes in the expression of mirnas in the different age groups . 0 ###LEFT-WALL### 2 pcr 0 ###LEFT-WALL### 4 performed 0 ###LEFT-WALL### 19 . 1 quantitative 2 pcr 2 pcr 3 was 3 was 4 performed 4 performed 5 to 4 performed 14 in 5 to 6 confirm 6 confirm 8 changes 6 confirm 9 in 7 the 8 changes 9 in 11 expression 10 the 11 expression 11 expression 12 of 12 of 13 mirnas 14 in 18 groups 15 the 18 groups 16 different 17 age 17 age 18 groups possible downstream targets and pathways of these mirnas were predicted by performing bioinformatics analysis . 0 ###LEFT-WALL### 3 targets 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 15 . 1 possible 3 targets 2 downstream 3 targets 4 and 5 pathways 4 and 10 predicted 5 pathways 6 of 5 pathways 9 were 6 of 8 mirnas 7 these 8 mirnas 9 were 10 predicted 10 predicted 11 by 11 by 12 performing 12 performing 14 analysis 13 bioinformatics 14 analysis to the best of our knowledge , this is the first study to systematically analyze the expression of mirnas in mouse tecs and to demonstrate that mirna expression is altered with thymic aging . 0 ###LEFT-WALL### 8 this 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 34 . 1 to 3 best 1 to 7 , 1 to 8 this 2 the 3 best 3 best 4 of 4 of 6 knowledge 5 our 6 knowledge 8 this 9 is 9 is 12 study 9 is 13 to 10 the 12 study 11 first 12 study 13 to 23 and 14 systematically 15 analyze 15 analyze 17 expression 15 analyze 23 and 16 the 17 expression 17 expression 18 of 18 of 19 mirnas 19 mirnas 20 in 20 in 22 tecs 21 mouse 22 tecs 23 and 24 to 23 and 25 demonstrate 23 and 31 with 24 to 25 demonstrate 25 demonstrate 26 that 26 that 27 mirna 26 that 30 altered 27 mirna 28 expression 27 mirna 29 is 27 mirna 30 altered 28 expression 29 is 31 with 33 aging 32 thymic 33 aging objective : we described a case of cerebral venous sinus thrombosis in a patient taking multiple supplements as part of a naturopathic anti - aging regimen . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 described 2 : 27 . 3 we 4 described 4 described 6 case 4 described 12 in 4 described 18 as 5 a 6 case 6 case 7 of 7 of 11 thrombosis 8 cerebral 10 sinus 9 venous 10 sinus 10 sinus 11 thrombosis 12 in 14 patient 13 a 14 patient 14 patient 15 taking 15 taking 17 supplements 16 multiple 17 supplements 18 as 19 part 19 part 20 of 20 of 26 regimen 21 a 22 naturopathic 21 a 26 regimen 22 naturopathic 26 regimen 23 anti 24 - 23 anti 26 regimen 25 aging 26 regimen methods : case report . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 report 2 : 5 . 3 case 4 report results : the patient presented [with] [a] thalamic [infarct] associated with a thrombus in the vein of galen . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 1 results 2 : 2 : 4 patient 3 the 4 patient 4 patient 5 presented 4 patient 10 associated 5 presented 8 thalamic 10 associated 11 with 10 associated 14 in 11 with 13 thrombus 12 a 13 thrombus 14 in 16 vein 15 the 16 vein 16 vein 17 of 17 of 18 galen he reported no previous history of endocrinopathy and no known hypercoagulability risk factors . 0 ###LEFT-WALL### 1 he 0 ###LEFT-WALL### 2 reported 0 ###LEFT-WALL### 14 . 1 he 2 reported 2 reported 8 and 2 reported 12 risk 3 no 5 history 4 previous 5 history 5 history 6 of 5 history 8 and 6 of 7 endocrinopathy 8 and 11 hypercoagulability 8 and 12 risk 9 no 11 hypercoagulability 10 known 11 hypercoagulability 12 risk 13 factors he was treated with therapeutic anticoagulation resulting in improvement . 0 ###LEFT-WALL### 1 he 0 ###LEFT-WALL### 3 treated 0 ###LEFT-WALL### 10 . 1 he 2 was 2 was 3 treated 3 treated 4 with 4 with 6 anticoagulation 5 therapeutic 6 anticoagulation 6 anticoagulation 7 resulting 7 resulting 8 in 8 in 9 improvement diagnostic workup revealed hyperthyroidism and gonadotrophic deficiency attributed to significant supplement medicine usage . 0 ###LEFT-WALL### 2 workup 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 14 . 1 diagnostic 2 workup 2 workup 3 revealed 3 revealed 5 and 3 revealed 9 to 4 hyperthyroidism 5 and 5 and 7 deficiency 5 and 8 attributed 6 gonadotrophic 7 deficiency 9 to 13 usage 10 significant 11 supplement 11 supplement 13 usage 12 medicine 13 usage conclusion : this case highlights a potential risk of dietary supplements . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 case 2 : 5 highlights 2 : 12 . 3 this 4 case 4 case 5 highlights 5 highlights 8 risk 6 a 7 potential 6 a 8 risk 7 potential 8 risk 8 risk 9 of 9 of 11 supplements 10 dietary 11 supplements use of these supplements may be a risk factor for idiopathic cerebral venous thrombosis . 0 ###LEFT-WALL### 1 use 0 ###LEFT-WALL### 6 be 0 ###LEFT-WALL### 15 . 1 use 2 of 1 use 5 may 2 of 4 supplements 3 these 4 supplements 5 may 6 be 6 be 9 factor 7 a 9 factor 8 risk 9 factor 9 factor 10 for 10 for 14 thrombosis 11 idiopathic 14 thrombosis 12 cerebral 14 thrombosis 13 venous 14 thrombosis primary [hypertension] is a very common disorder particularly in the aging population but hypertensive disorders can appear earlier in life , especially when obesity and unhealthy lifestyle are present . 0 ###LEFT-WALL### 1 primary 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 13 but 1 primary 3 is 3 is 7 disorder 3 is 8 particularly 4 a 5 very 4 a 7 disorder 5 very 6 common 6 common 7 disorder 8 particularly 9 in 9 in 12 population 10 the 12 population 11 aging 12 population 13 but 15 disorders 13 but 17 appear 14 hypertensive 15 disorders 15 disorders 16 can 16 can 17 appear 17 appear 18 earlier 17 appear 19 in 17 appear 23 when 19 in 20 life 21 , 22 especially 21 , 23 when 23 when 25 and 23 when 28 are 23 when 30 . 24 obesity 25 and 25 and 27 lifestyle 25 and 28 are 26 unhealthy 27 lifestyle 28 are 29 present also pregnant women can be at risk of developing gestational hypertension [and/or] pre - eclampsia , which causes complications in nearly 7 % of pregnancies . 0 ###LEFT-WALL### 3 women 0 ###LEFT-WALL### 5 be 0 ###LEFT-WALL### 26 . 1 also 3 women 2 pregnant 3 women 3 women 4 can 4 can 5 be 5 be 6 at 5 be 20 in 6 at 7 risk 7 risk 8 of 7 risk 17 which 7 risk 18 causes 8 of 9 developing 9 developing 13 pre 10 gestational 11 hypertension 11 hypertension 13 pre 13 pre 15 eclampsia 14 - 15 eclampsia 15 eclampsia 16 , 17 which 18 causes 18 causes 19 complications 20 in 23 % 21 nearly 22 7 22 7 23 % 23 % 24 of 24 of 25 pregnancies these " special " populations could be regarded as natural models suited to reveal mechanisms of hypertension development which are either common to other forms of [hypertension] , including primary [hypertension] or specific to these populations . 0 ###LEFT-WALL### 5 populations 0 ###LEFT-WALL### 8 regarded 1 these 2 " 1 these 5 populations 3 special 4 " 3 special 5 populations 5 populations 6 could 6 could 7 be 7 be 8 regarded 8 regarded 9 as 8 regarded 29 including 9 as 11 models 10 natural 11 models 11 models 12 suited 11 models 13 to 11 models 26 of 13 to 14 reveal 14 reveal 15 mechanisms 14 reveal 23 to 15 mechanisms 16 of 15 mechanisms 19 which 15 mechanisms 20 are 16 of 18 development 17 hypertension 18 development 19 which 20 are 20 are 21 either 20 are 22 common 23 to 25 forms 24 other 25 forms 25 forms 26 of 28 , 29 including 29 including 36 populations 29 including 37 . 30 primary 32 or 32 or 33 specific 32 or 36 populations 33 specific 34 to 34 to 35 these recent studies in the field of genetics of primary hypertension have used new powerful tools , [such] as genome - wide association studies ( [gwas] [ )(and sequencing , but studies about hypertension during childhood and in pregnancy [have] seldom used high - throughput technologies and the knowledge in this field comes mostly from the candidate gene approach [.] 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 11 have 1 recent 2 studies 2 studies 3 in 2 studies 8 of 2 studies 11 have 3 in 5 field 4 the 5 field 5 field 6 of 6 of 7 genetics 8 of 10 hypertension 9 primary 10 hypertension 11 have 15 tools 12 used 15 tools 13 new 15 tools 14 powerful 15 tools 15 tools 20 - 16 , 20 - 18 as 19 genome 18 as 20 - 19 genome 20 - 20 - 27 )(and 21 wide 23 studies 22 association 23 studies 23 studies 27 )(and 24 ( 27 )(and 27 )(and 28 sequencing 27 )(and 29 , 27 )(and 36 and 30 but 31 studies 30 but 36 and 31 studies 32 about 31 studies 34 during 32 about 33 hypertension 34 during 35 childhood 36 and 37 in 37 in 46 and 38 pregnancy 45 technologies 40 seldom 41 used 41 used 44 throughput 42 high 43 - 42 high 44 throughput 44 throughput 45 technologies 45 technologies 46 and 46 and 48 knowledge 46 and 49 in 46 and 51 field 46 and 52 comes 47 the 48 knowledge 49 in 50 this 51 field 52 comes 52 comes 53 mostly 53 mostly 54 from 54 from 58 approach 55 the 58 approach 56 candidate 58 approach 57 gene 58 approach in this review we summarize some interesting results from genetic studies conducted in childhood and adolescence and during pregnancy and underline the need to apply modern technologies in these potentially very fruitful populations . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 34 . 1 in 3 review 1 in 4 we 2 this 3 review 4 we 20 and 5 summarize 8 results 5 summarize 17 and 5 summarize 20 and 6 some 8 results 7 interesting 8 results 8 results 9 from 9 from 11 studies 10 genetic 11 studies 11 studies 12 conducted 13 in 15 and 13 in 17 and 14 childhood 15 and 15 and 16 adolescence 17 and 18 during 18 during 19 pregnancy 20 and 21 underline 21 underline 23 need 22 the 23 need 23 need 24 to 23 need 25 apply 24 to 25 apply 25 apply 27 technologies 25 apply 28 in 26 modern 27 technologies 28 in 33 populations 29 these 33 populations 30 potentially 32 fruitful 31 very 32 fruitful 32 fruitful 33 populations none one of the main difficulties in facial age estimation is that [the] learning algorithms cannot expect sufficient and complete training data . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 17 expect 0 ###LEFT-WALL### 23 . 1 none 2 one 1 none 14 learning 1 none 16 cannot 2 one 3 of 2 one 11 is 3 of 6 difficulties 4 the 6 difficulties 5 main 6 difficulties 6 difficulties 7 in 7 in 10 estimation 8 facial 9 age 9 age 10 estimation 11 is 12 that 12 that 14 learning 14 learning 15 algorithms 16 cannot 17 expect 17 expect 22 data 18 sufficient 19 and 19 and 20 complete 19 and 22 data 21 training 22 data fortunately , the faces at close ages look quite similar since aging is a slow and smooth process . 0 ###LEFT-WALL### 4 faces 0 ###LEFT-WALL### 8 look 0 ###LEFT-WALL### 19 . 1 fortunately 2 , 1 fortunately 4 faces 3 the 4 faces 4 faces 5 at 4 faces 8 look 5 at 7 ages 6 close 7 ages 8 look 10 similar 9 quite 10 similar 10 similar 11 since 11 since 12 aging 11 since 13 is 12 aging 13 is 13 is 18 process 14 a 18 process 15 slow 16 and 16 and 17 smooth 16 and 18 process inspired by this observation , instead of considering each face image as an instance with one label ( age ) , this paper regards each face image as an instance associated with a label distribution . 0 ###LEFT-WALL### 23 paper 0 ###LEFT-WALL### 24 regards 0 ###LEFT-WALL### 36 . 1 inspired 2 by 1 inspired 7 of 1 inspired 21 , 1 inspired 23 paper 2 by 4 observation 3 this 4 observation 5 , 7 of 6 instead 7 of 7 of 8 considering 7 of 20 ) 8 considering 11 image 8 considering 12 as 9 each 11 image 10 face 11 image 12 as 14 instance 13 an 14 instance 14 instance 15 with 15 with 17 label 16 one 17 label 17 label 19 age 18 ( 19 age 19 age 20 ) 22 this 23 paper 23 paper 24 regards 24 regards 27 image 24 regards 28 as 25 each 27 image 26 face 27 image 28 as 30 instance 29 an 30 instance 30 instance 31 associated 31 associated 32 with 32 with 35 distribution 33 a 35 distribution 34 label 35 distribution the label distribution covers a certain number of class labels , representing the degree that each [label] describes the instance . 0 ###LEFT-WALL### 3 distribution 0 ###LEFT-WALL### 4 covers 1 the 3 distribution 2 label 3 distribution 3 distribution 4 covers 4 covers 10 labels 5 a 6 certain 5 a 7 number 6 certain 7 number 7 number 8 of 7 number 10 labels 8 of 10 labels 9 class 10 labels 10 labels 12 representing 11 , 12 representing 12 representing 14 degree 12 representing 21 . 13 the 14 degree 14 degree 15 that 14 degree 18 describes 15 that 18 describes 16 each 18 describes 18 describes 20 instance 19 the 20 instance through this way , one face image can contribute [to] not only the learning of its chronological age , but also the learning of its adjacent ages . 0 ###LEFT-WALL### 7 image 0 ###LEFT-WALL### 9 contribute 0 ###LEFT-WALL### 28 . 1 through 3 way 1 through 4 , 1 through 7 image 2 this 3 way 5 one 7 image 6 face 7 image 7 image 8 can 8 can 9 contribute 9 contribute 21 also 11 not 12 only 12 only 21 also 13 the 14 learning 14 learning 15 of 14 learning 21 also 15 of 18 age 16 its 18 age 17 chronological 18 age 19 , 21 also 20 but 21 also 21 also 23 learning 22 the 23 learning 23 learning 24 of 24 of 27 ages 25 its 27 ages 26 adjacent 27 ages two algorithms , named iis - lld and cpnn , are proposed to learn from such label distributions . 0 ###LEFT-WALL### 2 algorithms 0 ###LEFT-WALL### 12 proposed 0 ###LEFT-WALL### 19 . 1 two 2 algorithms 2 algorithms 4 named 2 algorithms 11 are 3 , 4 named 4 named 9 cpnn 4 named 10 , 5 iis 7 lld 6 - 7 lld 7 lld 8 and 8 and 9 cpnn 11 are 12 proposed 12 proposed 13 to 12 proposed 15 from 13 to 14 learn 15 from 18 distributions 16 such 18 distributions 17 label 18 distributions experimental results on two aging face databases show remarkable advantages of the proposed label distribution learning algorithms over the compared single - label learning algorithms , either specially designed for age estimation or for general purpose . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 8 show 1 experimental 2 results 2 results 3 on 2 results 5 aging 2 results 8 show 3 on 4 two 5 aging 7 databases 6 face 7 databases 8 show 10 advantages 8 show 18 over 8 show 29 designed 9 remarkable 10 advantages 10 advantages 11 of 11 of 15 distribution 12 the 15 distribution 13 proposed 14 label 14 label 15 distribution 15 distribution 16 learning 16 learning 17 algorithms 18 over 23 label 19 the 23 label 20 compared 23 label 21 single 22 - 21 single 23 label 23 label 24 learning 24 learning 25 algorithms 26 , 29 designed 27 either 29 designed 28 specially 29 designed 29 designed 33 or 29 designed 37 . 30 for 32 estimation 30 for 33 or 31 age 32 estimation 33 or 34 for 34 for 36 purpose 35 general 36 purpose based on the two main frameworks for evaluating scientific evidence ( sec and grade ) european cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population - base [d] and high - risk strategies with diet as the cornerstone of prevention . 0 ###LEFT-WALL### 19 guidelines 0 ###LEFT-WALL### 46 . 1 based 2 on 1 based 7 for 1 based 15 ) 1 based 19 guidelines 2 on 6 frameworks 3 the 4 two 4 two 5 main 4 two 6 frameworks 7 for 8 evaluating 8 evaluating 10 evidence 9 scientific 10 evidence 10 evidence 14 grade 11 ( 14 grade 12 sec 13 and 13 and 14 grade 14 grade 15 ) 16 european 19 guidelines 17 cardiovascular 18 prevention 18 prevention 19 guidelines 19 guidelines 20 recommend 20 recommend 21 interventions 20 recommend 40 diet 21 interventions 22 across 21 interventions 40 diet 22 across 23 all 23 all 25 stages 23 all 39 with 24 life 25 stages 25 stages 26 using 25 stages 34 and 25 stages 37 risk 26 using 28 combination 27 a 28 combination 28 combination 29 of 29 of 30 population 31 - 34 and 32 base 34 and 34 and 35 high 34 and 36 - 37 risk 38 strategies 37 risk 39 with 40 diet 41 as 41 as 43 cornerstone 42 the 43 cornerstone 43 cornerstone 44 of 44 of 45 prevention the evaluation of cardiovascular risk ( cvr ) incorporates hdl levels and psychosocial factors , a very high risk category , and the concept of age - risk . 0 ###LEFT-WALL### 2 evaluation 0 ###LEFT-WALL### 9 incorporates 0 ###LEFT-WALL### 27 - 0 ###LEFT-WALL### 29 . 1 the 2 evaluation 2 evaluation 3 of 2 evaluation 7 cvr 2 evaluation 9 incorporates 3 of 5 risk 4 cardiovascular 5 risk 6 ( 7 cvr 7 cvr 8 ) 9 incorporates 22 and 10 hdl 11 levels 11 levels 12 and 12 and 14 factors 12 and 15 , 13 psychosocial 14 factors 15 , 20 category 15 , 22 and 16 a 17 very 16 a 20 category 17 very 18 high 19 risk 20 category 21 , 22 and 22 and 24 concept 22 and 25 of 23 the 24 concept 25 of 26 age 27 - 28 risk they also recommend cognitive - behavioural methods ( e.g [.] , motivational interviewing , psychological interventions ) led by health professionals and with the participation of the patient 's family , to counterbalance psychosocial stress and reduce cvr through the institution of positive habits such as a healthy diet , physical activity , smoking cessation , and adherence to treatment . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 31 , 0 ###LEFT-WALL### 61 . 1 they 31 , 2 also 3 recommend 3 recommend 13 interviewing 3 recommend 18 led 3 recommend 31 , 4 cognitive 7 methods 4 cognitive 13 interviewing 5 - 7 methods 6 behavioural 7 methods 7 methods 9 e.g 7 methods 11 , 8 ( 9 e.g 9 e.g 11 , 12 motivational 13 interviewing 13 interviewing 16 interventions 13 interviewing 18 led 14 , 16 interventions 15 psychological 16 interventions 16 interventions 17 ) 18 led 22 and 19 by 21 professionals 19 by 22 and 20 health 21 professionals 22 and 23 with 23 with 25 participation 24 the 25 participation 25 participation 26 of 26 of 30 family 27 the 28 patient 28 patient 29 's 29 's 30 family 31 , 32 to 31 , 36 and 31 , 39 through 31 , 46 as 32 to 36 and 33 counterbalance 35 stress 33 counterbalance 36 and 34 psychosocial 35 stress 36 and 37 reduce 37 reduce 38 cvr 39 through 41 institution 40 the 41 institution 41 institution 42 of 42 of 44 habits 43 positive 44 habits 45 such 46 as 46 as 57 and 47 a 48 healthy 47 a 49 diet 48 healthy 49 diet 49 diet 50 , 50 , 52 activity 50 , 53 , 51 physical 52 activity 53 , 55 cessation 53 , 57 and 54 smoking 55 cessation 56 , 57 and 57 and 58 adherence 57 and 59 to 59 to 60 treatment additionally , public health interventions - such as smoking ban [in] public areas or the elimination of trans fatty acids from the food chain - are also essential . 0 ###LEFT-WALL### 5 interventions 0 ###LEFT-WALL### 26 are 0 ###LEFT-WALL### 29 . 1 additionally 2 , 1 additionally 5 interventions 3 public 4 health 4 health 5 interventions 5 interventions 14 or 5 interventions 26 are 6 - 14 or 7 such 13 areas 8 as 9 smoking 9 smoking 10 ban 10 ban 13 areas 12 public 13 areas 13 areas 14 or 14 or 16 elimination 14 or 17 of 14 or 20 acids 14 or 24 chain 14 or 25 - 15 the 16 elimination 17 of 18 trans 19 fatty 20 acids 20 acids 21 from 20 acids 24 chain 21 from 23 food 22 the 23 food 26 are 27 also 26 are 28 essential other innovations [include] abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130 - 139/80 - 85 mmhg range in diabetic patients and individuals with high cvr . 0 ###LEFT-WALL### 2 innovations 0 ###LEFT-WALL### 16 pressure 0 ###LEFT-WALL### 34 . 1 other 2 innovations 2 innovations 4 abandoning 2 innovations 13 of 2 innovations 16 pressure 4 abandoning 6 therapy 4 abandoning 7 in 5 antiplatelet 6 therapy 7 in 10 and 8 primary 9 prevention 9 prevention 10 and 10 and 12 recommendation 11 the 12 recommendation 13 of 14 maintaining 14 maintaining 15 blood 16 pressure 17 within 16 pressure 22 - 16 pressure 25 range 16 pressure 26 in 16 pressure 31 with 17 within 19 130 18 the 19 130 20 - 21 139/80 21 139/80 22 - 22 - 23 85 23 85 24 mmhg 24 mmhg 25 range 26 in 29 and 27 diabetic 28 patients 28 patients 29 and 29 and 30 individuals 31 with 33 cvr 32 high 33 cvr finally , due to the significant impact on patient progress and medical costs , special emphasis is given to the low therapeutic adherence levels observed . 0 ###LEFT-WALL### 16 emphasis 0 ###LEFT-WALL### 18 given 0 ###LEFT-WALL### 25 observed 1 finally 16 emphasis 2 , 4 to 3 due 4 to 4 to 7 impact 4 to 14 , 4 to 16 emphasis 5 the 7 impact 6 significant 7 impact 7 impact 8 on 8 on 11 and 9 patient 10 progress 10 progress 11 and 11 and 13 costs 12 medical 13 costs 15 special 16 emphasis 16 emphasis 17 is 17 is 18 given 18 given 19 to 19 to 21 low 20 the 21 low 22 therapeutic 23 adherence 23 adherence 24 levels 24 levels 25 observed 25 observed 26 . in sum , improving cardiovascular prevention requires a true partnership among the political class , public administrations , scientific and professional associations , health foundations , consumer associations , patients and their families . 0 ###LEFT-WALL### 6 prevention 0 ###LEFT-WALL### 7 requires 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 34 . 1 in 2 sum 2 sum 3 , 2 sum 6 prevention 4 improving 6 prevention 5 cardiovascular 6 prevention 6 prevention 7 requires 7 requires 10 partnership 7 requires 11 among 8 a 10 partnership 9 true 10 partnership 11 among 14 class 12 the 14 class 13 political 14 class 14 class 17 administrations 14 class 22 associations 15 , 17 administrations 16 public 17 administrations 17 administrations 18 , 18 , 22 associations 19 scientific 20 and 20 and 21 professional 20 and 22 associations 22 associations 23 , 23 , 31 and 24 health 25 foundations 25 foundations 26 , 26 , 28 associations 26 , 29 , 27 consumer 28 associations 29 , 30 patients 29 , 31 and 31 and 33 families 32 their 33 families such partnership would promote population - [based] and individual strategies by taking advantage of the broad spectrum of scientific evidence available , from clinical trials to observational studies and mathematical models to evaluate population - based interventions , including cost - effectiveness analyses . 0 ###LEFT-WALL### 2 partnership 0 ###LEFT-WALL### 4 promote 1 such 2 partnership 2 partnership 3 would 3 would 4 promote 4 promote 29 and 4 promote 32 to 5 population 8 and 6 - 8 and 8 and 10 strategies 8 and 22 , 8 and 23 from 8 and 29 and 9 individual 10 strategies 10 strategies 11 by 11 by 12 taking 12 taking 13 advantage 13 advantage 14 of 14 of 17 spectrum 15 the 17 spectrum 16 broad 17 spectrum 17 spectrum 18 of 17 spectrum 21 available 18 of 20 evidence 19 scientific 20 evidence 23 from 25 trials 24 clinical 25 trials 25 trials 26 to 26 to 28 studies 27 observational 28 studies 29 and 31 models 30 mathematical 31 models 32 to 33 evaluate 33 evaluate 34 population 34 population 37 interventions 34 population 39 including 34 population 43 analyses 35 - 37 interventions 36 based 37 interventions 37 interventions 38 , 38 , 39 including 39 including 40 cost 39 including 41 - 41 - 43 analyses 42 effectiveness 43 analyses 43 analyses 44 . purpose of the study : the study investigates whether productive activities by older adults reduce bodily inflammation , as indicated by c - reactive protein ( crp ) , a biomeasure associated with the risk of cardiovascular diseases . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 : 1 purpose 2 of 2 of 3 the 3 the 4 study 5 : 7 study 5 : 8 investigates 5 : 23 - 5 : 39 . 6 the 7 study 7 study 8 investigates 8 investigates 9 whether 9 whether 11 activities 9 whether 15 reduce 10 productive 11 activities 11 activities 12 by 11 activities 15 reduce 12 by 14 adults 13 older 14 adults 15 reduce 17 inflammation 15 reduce 21 by 16 bodily 17 inflammation 17 inflammation 20 indicated 18 , 20 indicated 19 as 20 indicated 21 by 22 c 23 - 25 protein 23 - 29 , 24 reactive 25 protein 25 protein 27 crp 26 ( 27 crp 27 crp 28 ) 29 , 31 biomeasure 29 , 32 associated 30 a 31 biomeasure 31 biomeasure 32 associated 32 associated 33 with 33 with 35 risk 34 the 35 risk 35 risk 36 of 36 of 38 diseases 37 cardiovascular 38 diseases design and methods : the study uses a representative survey of adults aged 57 - 85 from the national social life , health , and aging project ( n = 1,790 ) . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 1 design 2 and 2 and 3 methods 4 : 6 study 4 : 7 uses 4 : 33 . 5 the 6 study 6 study 7 uses 7 uses 10 survey 7 uses 17 from 8 a 10 survey 9 representative 10 survey 10 survey 11 of 10 survey 13 aged 11 of 12 adults 13 aged 15 - 14 57 15 - 15 - 16 85 17 from 25 and 18 the 21 life 19 national 20 social 20 social 21 life 21 life 22 , 22 , 23 health 22 , 25 and 24 , 25 and 25 and 27 project 25 and 30 = 26 aging 27 project 28 ( 30 = 29 n 30 = 30 = 31 1,790 30 = 32 ) linear regression models were used to analyze the effects of multiple roles ( employment , volunteering , attending meetings , and caregiving ) and the frequency of activity within each role on log values of crp concentration ( [mg/l] [ )(drawn from assayed blood samples . 0 ###LEFT-WALL### 24 and 1 linear 16 volunteering 1 linear 17 , 2 regression 3 models 3 models 4 were 4 were 5 used 5 used 6 to 5 used 7 analyze 6 to 7 analyze 7 analyze 9 effects 7 analyze 16 volunteering 8 the 9 effects 9 effects 10 of 9 effects 14 employment 9 effects 16 volunteering 10 of 12 roles 11 multiple 12 roles 13 ( 14 employment 14 employment 15 , 17 , 19 meetings 17 , 21 and 18 attending 19 meetings 20 , 21 and 21 and 22 caregiving 21 and 23 ) 21 and 24 and 24 and 26 frequency 25 the 26 frequency 26 frequency 27 of 27 of 28 activity 28 activity 29 within 28 activity 35 of 28 activity 41 )(drawn 29 within 31 role 30 each 31 role 31 role 32 on 32 on 34 values 33 log 34 values 35 of 37 concentration 36 crp 37 concentration 38 ( 41 )(drawn 41 )(drawn 42 from 41 )(drawn 46 . 42 from 45 samples 43 assayed 44 blood 44 blood 45 samples results : number of roles for productive activities was associated with lower levels of crp net of chronic conditions , lifestyle factors , and socioeconomic resources . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 number 2 : 10 associated 2 : 27 . 3 number 4 of 3 number 9 was 4 of 5 roles 5 roles 6 for 6 for 8 activities 7 productive 8 activities 9 was 10 associated 10 associated 11 with 11 with 13 levels 12 lower 13 levels 13 levels 14 of 13 levels 17 of 14 of 16 net 15 crp 16 net 17 of 24 and 18 chronic 19 conditions 19 conditions 20 , 20 , 22 factors 20 , 24 and 21 lifestyle 22 factors 23 , 24 and 24 and 26 resources 25 socioeconomic 26 resources when specific types of activity were examined , volunteering manifested the strongest association with lower levels of inflammation , particularly in the 70+ group . 0 ###LEFT-WALL### 9 volunteering 0 ###LEFT-WALL### 10 manifested 1 when 4 of 1 when 7 examined 1 when 8 , 1 when 9 volunteering 2 specific 4 of 3 types 4 of 4 of 5 activity 4 of 6 were 6 were 7 examined 7 examined 8 , 9 volunteering 10 manifested 10 manifested 13 association 10 manifested 14 with 11 the 12 strongest 11 the 13 association 14 with 16 levels 15 lower 16 levels 16 levels 17 of 17 of 18 inflammation 18 inflammation 21 in 19 , 20 particularly 19 , 21 in 21 in 24 group 21 in 25 . 22 the 24 group 23 70+ 24 group there was no evidence that frequent engagement in volunteer activity was associated with heightened inflammation . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 16 . 1 there 2 was 2 was 4 evidence 3 no 4 evidence 4 evidence 5 that 5 that 7 engagement 5 that 12 associated 6 frequent 7 engagement 7 engagement 8 in 7 engagement 11 was 8 in 10 activity 9 volunteer 10 activity 11 was 12 associated 12 associated 13 with 13 with 15 inflammation 14 heightened 15 inflammation implications : productive activities - and frequent volunteering in particular - may protect individuals from inflammation that is associated with increased risk of hypertension [and] cardiovascular disease . 0 ###LEFT-WALL### 1 implications 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 6 and 2 : 13 protect 3 productive 4 activities 4 activities 6 and 5 - 6 and 6 and 8 volunteering 6 and 11 - 6 and 12 may 7 frequent 8 volunteering 8 volunteering 10 particular 9 in 10 particular 12 may 13 protect 13 protect 14 individuals 13 protect 15 from 15 from 16 inflammation 16 inflammation 17 that 16 inflammation 18 is 17 that 18 is 18 is 19 associated 19 associated 20 with 20 with 22 risk 21 increased 22 risk 22 risk 23 of 23 of 27 disease 24 hypertension 27 disease 26 cardiovascular 27 disease purpose of the study : the current study depicts improvement and decline in functioning among 3 population groups of israeli older adults : jews and veteran immigrants , former soviet union immigrants , and arabs . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 36 . 1 purpose 2 of 2 of 3 the 3 the 4 study 5 : 8 study 5 : 9 depicts 5 : 23 : 5 : 28 , 6 the 8 study 7 current 8 study 8 study 9 depicts 9 depicts 11 and 9 depicts 13 in 10 improvement 11 and 11 and 12 decline 13 in 14 functioning 14 functioning 15 among 15 among 18 groups 16 3 18 groups 17 population 18 groups 18 groups 19 of 19 of 22 adults 20 israeli 22 adults 21 older 22 adults 23 : 27 immigrants 24 jews 25 and 25 and 26 veteran 25 and 27 immigrants 28 , 34 and 29 former 30 soviet 30 soviet 32 immigrants 31 union 32 immigrants 32 immigrants 34 and 33 , 34 and 34 and 35 arabs older age , higher number of diseases and comorbidity , living with others ( not the spouse ) compared with living alone , receiving informal help and formal help with homemaking , and [declined] mental health and cognitive status predict deterioration in physical functioning . 0 ###LEFT-WALL### 2 age 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 45 . 1 older 2 age 3 , 8 and 3 , 19 compared 3 , 33 and 4 higher 5 number 5 number 6 of 5 number 8 and 6 of 7 diseases 8 and 9 comorbidity 8 and 10 , 8 and 11 living 8 and 19 compared 10 , 11 living 11 living 12 with 11 living 18 ) 12 with 13 others 13 others 17 spouse 14 ( 15 not 14 ( 17 spouse 16 the 17 spouse 17 spouse 18 ) 19 compared 20 with 19 compared 22 alone 19 compared 24 receiving 20 with 21 living 23 , 24 receiving 24 receiving 27 and 24 receiving 30 with 24 receiving 32 , 25 informal 26 help 26 help 27 and 27 and 29 help 28 formal 29 help 30 with 31 homemaking 32 , 33 and 33 and 37 and 33 and 40 predict 35 mental 36 health 36 health 37 and 37 and 39 status 37 and 40 predict 38 cognitive 39 status 40 predict 41 deterioration 41 deterioration 42 in 42 in 44 functioning 43 physical 44 functioning also , arab older adults are at higher risk of deterioration over time compared with jewish older adults . 0 ###LEFT-WALL### 5 adults 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 19 . 1 also 2 , 1 also 5 adults 3 arab 5 adults 4 older 5 adults 5 adults 6 are 6 are 7 at 6 are 12 over 7 at 9 risk 8 higher 9 risk 9 risk 10 of 10 of 11 deterioration 12 over 13 time 13 time 14 compared 14 compared 15 with 15 with 18 adults 16 jewish 18 adults 17 older 18 adults implications : findings imply that noncompatible assistance to older adults may " save [them] the hassle " of doing things by themselves and thus [,] weakens a potential functional rehabilitation process . 0 ###LEFT-WALL### 1 implications 0 ###LEFT-WALL### 2 : 2 : 3 findings 2 : 4 imply 2 : 32 . 3 findings 4 imply 4 imply 7 assistance 4 imply 8 to 5 that 6 noncompatible 6 noncompatible 7 assistance 8 to 10 adults 9 older 10 adults 10 adults 23 and 11 may 12 " 11 may 13 save 11 may 23 and 13 save 16 hassle 13 save 21 by 15 the 16 hassle 16 hassle 17 " 16 hassle 18 of 18 of 19 doing 19 doing 20 things 21 by 22 themselves 23 and 26 weakens 23 and 31 process 24 thus 26 weakens 26 weakens 28 potential 27 a 28 potential 29 functional 30 rehabilitation 30 rehabilitation 31 process there is a need to guide not only professional personnel but also nonprofessional home care workers and family members on how [to] encourage and retain older adults ' functions as much as possible in order to improve their quality of life . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 42 . 1 there 2 is 2 is 4 need 3 a 4 need 4 need 5 to 4 need 17 and 5 to 17 and 6 guide 12 also 6 guide 17 and 7 not 8 only 8 only 12 also 9 professional 10 personnel 10 personnel 12 also 11 but 12 also 12 also 16 workers 13 nonprofessional 14 home 14 home 16 workers 15 care 16 workers 17 and 24 and 18 family 19 members 19 members 20 on 19 members 23 encourage 20 on 21 how 23 encourage 24 and 24 and 25 retain 25 retain 29 functions 25 retain 36 to 26 older 27 adults 27 adults 28 ' 28 ' 29 functions 29 functions 30 as 29 functions 33 possible 30 as 31 much 32 as 33 possible 33 possible 34 in 34 in 35 order 36 to 37 improve 37 improve 39 quality 38 their 39 quality 39 quality 40 of 40 of 41 life another implication of investing in rehabilitation is that it might reduce the disability rate among older adults and thus save health expenditures on long - term care at the macrosocial level . 0 ###LEFT-WALL### 2 implication 0 ###LEFT-WALL### 32 . 1 another 2 implication 2 implication 3 of 2 implication 7 is 3 of 4 investing 4 investing 5 in 5 in 6 rehabilitation 7 is 8 that 8 that 9 it 8 that 18 and 9 it 10 might 10 might 18 and 11 reduce 14 rate 11 reduce 18 and 12 the 14 rate 13 disability 14 rate 14 rate 15 among 15 among 17 adults 16 older 17 adults 18 and 20 save 18 and 28 at 19 thus 20 save 20 save 22 expenditures 20 save 23 on 21 health 22 expenditures 23 on 27 care 24 long 25 - 24 long 26 term 26 term 27 care 28 at 31 level 29 the 31 level 30 macrosocial 31 level dr [.] sidney katz 's legacy to the field of gerontology is internationally recognized as his success at developing standardized measures and processes , beginning with the activities of daily living index , for the functional assessment of older adults with chronic conditions necessitating long - term services and supports . 1 dr 3 sidney 3 sidney 4 katz 4 katz 5 's 5 's 6 legacy 6 legacy 7 to 6 legacy 10 of 6 legacy 12 is 7 to 9 field 8 the 9 field 10 of 11 gerontology 12 is 22 and 13 internationally 14 recognized 14 recognized 15 as 14 recognized 17 success 14 recognized 18 at 14 recognized 22 and 15 as 16 his 18 at 19 developing 19 developing 21 measures 20 standardized 21 measures 22 and 23 processes 22 and 25 beginning 22 and 34 for 24 , 25 beginning 25 beginning 26 with 25 beginning 32 index 25 beginning 33 , 26 with 28 activities 27 the 28 activities 28 activities 29 of 29 of 30 daily 31 living 32 index 34 for 37 assessment 35 the 37 assessment 36 functional 37 assessment 37 assessment 38 of 38 of 49 and 39 older 40 adults 40 adults 41 with 40 adults 44 necessitating 40 adults 49 and 41 with 43 conditions 42 chronic 43 conditions 44 necessitating 48 services 45 long 46 - 45 long 47 term 47 term 48 services 49 and 50 supports 49 and 51 . [few] other scholars and researchers in the history of the field of aging can claim one , much less multiple monumental contributions leading to major advances in the treatment of chronic illness and the quality of long - term care . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 15 claim 0 ###LEFT-WALL### 17 , 2 other 3 scholars 3 scholars 4 and 4 and 5 researchers 4 and 6 in 4 and 9 of 4 and 12 of 4 and 14 can 6 in 8 history 7 the 8 history 9 of 11 field 10 the 11 field 12 of 13 aging 14 can 15 claim 15 claim 16 one 17 , 22 contributions 17 , 37 long 17 , 38 - 18 much 19 less 19 less 20 multiple 20 multiple 22 contributions 21 monumental 22 contributions 22 contributions 23 leading 22 contributions 36 of 22 contributions 37 long 23 leading 24 to 23 leading 26 advances 24 to 25 major 26 advances 27 in 27 in 33 and 28 the 29 treatment 29 treatment 30 of 29 treatment 33 and 30 of 32 illness 31 chronic 32 illness 33 and 35 quality 33 and 36 of 34 the 35 quality 38 - 40 care 38 - 41 . 39 term 40 care cellular senescence is an irreversible form of cell cycle arrest that provides a barrier to neoplastic transformation . 0 ###LEFT-WALL### 2 senescence 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 18 . 1 cellular 2 senescence 2 senescence 3 is 3 is 6 form 4 an 5 irreversible 4 an 6 form 5 irreversible 6 form 6 form 7 of 6 form 11 that 6 form 12 provides 7 of 10 arrest 8 cell 10 arrest 9 cycle 10 arrest 11 that 12 provides 12 provides 14 barrier 12 provides 15 to 13 a 14 barrier 15 to 17 transformation 16 neoplastic 17 transformation the integrity of the rb ( retinoblastoma ) pathway is necessary for the formation of the senescence - associated heterochromatin foci ( sahf ) that offers a molecular basis for the stability of the senescent state . 0 ###LEFT-WALL### 2 integrity 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 37 . 1 the 2 integrity 2 integrity 3 of 2 integrity 10 is 3 of 9 pathway 4 the 9 pathway 5 rb 7 retinoblastoma 5 rb 9 pathway 6 ( 7 retinoblastoma 7 retinoblastoma 8 ) 10 is 11 necessary 11 necessary 12 for 11 necessary 30 for 12 for 14 formation 13 the 14 formation 14 formation 15 of 14 formation 25 that 14 formation 26 offers 15 of 17 senescence 16 the 17 senescence 17 senescence 21 foci 18 - 21 foci 19 associated 20 heterochromatin 20 heterochromatin 21 foci 21 foci 23 sahf 21 foci 24 ) 22 ( 23 sahf 23 sahf 24 ) 25 that 26 offers 26 offers 29 basis 27 a 28 molecular 27 a 29 basis 28 molecular 29 basis 30 for 32 stability 31 the 32 stability 32 stability 33 of 33 of 36 state 34 the 36 state 35 senescent 36 state surprisingly , although high mobility group a2 protein ( hmga2 ) can promote tumorigenesis and inhibit rb [function] in tumor cells , high - level expression of hmga2 is sufficient to induce sahf formation in primary cells . 0 ###LEFT-WALL### 8 protein 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 38 . 1 surprisingly 2 , 1 surprisingly 8 protein 3 although 5 mobility 3 although 8 protein 4 high 5 mobility 6 group 8 protein 7 a2 8 protein 8 protein 10 hmga2 8 protein 12 can 9 ( 10 hmga2 10 hmga2 11 ) 12 can 15 and 13 promote 14 tumorigenesis 13 promote 15 and 15 and 22 , 15 and 35 in 16 inhibit 17 rb 16 inhibit 19 in 16 inhibit 22 , 19 in 21 cells 20 tumor 21 cells 22 , 32 induce 23 high 24 - 23 high 26 expression 25 level 26 expression 26 expression 27 of 26 expression 29 is 27 of 28 hmga2 29 is 30 sufficient 30 sufficient 31 to 31 to 32 induce 32 induce 34 formation 33 sahf 34 formation 35 in 37 cells 36 primary 37 cells it therefore becomes significant to determine whether rb protein is necessary in hmga2 - induced sahf formation . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 3 becomes 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 18 . 1 it 3 becomes 2 therefore 3 becomes 3 becomes 4 significant 4 significant 5 to 5 to 6 determine 6 determine 7 whether 7 whether 9 protein 7 whether 10 is 8 rb 9 protein 9 protein 10 is 10 is 11 necessary 11 necessary 12 in 12 in 13 hmga2 14 - 17 formation 15 induced 17 formation 16 sahf 17 formation in this study , we established the cellular senescence and sahf assembly wi38 cell model by ectopic expression of hmga2 , in which typical senescent markers were seen , including notable upregulation of p53 , p21 and p16 , and elevated sa - β - galactosidase staining together with downregulation of e2f target genes . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 established 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 55 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 established 6 established 10 and 7 the 10 and 8 cellular 9 senescence 9 senescence 10 and 10 and 15 model 10 and 16 by 10 and 19 of 11 sahf 12 assembly 12 assembly 15 model 13 wi38 15 model 14 cell 15 model 16 by 18 expression 17 ectopic 18 expression 19 of 20 hmga2 21 , 22 in 21 , 41 elevated 21 , 43 - 22 in 23 which 22 in 25 senescent 23 which 25 senescent 24 typical 25 senescent 25 senescent 26 markers 25 senescent 41 elevated 26 markers 40 and 27 were 28 seen 27 were 40 and 28 seen 30 including 28 seen 37 and 29 , 30 including 30 including 32 upregulation 30 including 35 , 31 notable 32 upregulation 32 upregulation 33 of 33 of 34 p53 36 p21 37 and 37 and 38 p16 39 , 40 and 40 and 41 elevated 41 elevated 42 sa 43 - 44 β 43 - 45 - 45 - 46 galactosidase 46 galactosidase 47 staining 46 galactosidase 48 together 46 galactosidase 49 with 46 galactosidase 51 of 49 with 50 downregulation 51 of 54 genes 52 e2f 54 genes 53 target 54 genes we then showed that the rb pathway inhibitor e7 protein was able to partly abolish the ability of sahf formation after hmga2 expression in wi38 cells , indicating that rb is a crucial factor for hmga2 - induced sahf formation . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 41 . 1 we 3 showed 2 then 3 showed 3 showed 4 that 4 that 6 rb 4 that 38 induced 5 the 6 rb 6 rb 10 protein 6 rb 15 abolish 6 rb 38 induced 7 pathway 10 protein 8 inhibitor 10 protein 9 e7 10 protein 10 protein 11 was 11 was 12 able 12 able 13 to 12 able 15 abolish 13 to 15 abolish 14 partly 15 abolish 15 abolish 17 ability 16 the 17 ability 17 ability 18 of 18 of 20 formation 19 sahf 20 formation 20 formation 21 after 20 formation 24 in 21 after 23 expression 22 hmga2 23 expression 24 in 26 cells 25 wi38 26 cells 26 cells 28 indicating 27 , 28 indicating 28 indicating 29 that 28 indicating 37 - 29 that 30 rb 29 that 31 is 30 rb 31 is 31 is 34 factor 32 a 34 factor 33 crucial 34 factor 34 factor 35 for 35 for 36 hmga2 38 induced 40 formation 39 sahf 40 formation however , rb depletion did not completely rescue the cell growth arrest induced by hmga2 , suggesting that rb is not an exclusive pathway for hmga2 - induced senescence in wi38 cells . 0 ###LEFT-WALL### 3 rb 0 ###LEFT-WALL### 28 induced 0 ###LEFT-WALL### 33 . 1 however 2 , 1 however 3 rb 3 rb 4 depletion 3 rb 8 rescue 3 rb 13 induced 3 rb 28 induced 4 depletion 5 did 5 did 6 not 5 did 8 rescue 7 completely 8 rescue 8 rescue 12 arrest 9 the 12 arrest 10 cell 11 growth 11 growth 12 arrest 13 induced 14 by 13 induced 17 suggesting 14 by 15 hmga2 16 , 17 suggesting 17 suggesting 18 that 17 suggesting 27 - 18 that 19 rb 18 that 20 is 19 rb 20 is 20 is 21 not 20 is 24 pathway 22 an 24 pathway 23 exclusive 24 pathway 24 pathway 25 for 25 for 26 hmga2 28 induced 29 senescence 28 induced 30 in 30 in 32 cells 31 wi38 32 cells unlabelled : hutchinson - gilford progeria [syndrome] ( hgps ) is a rare segmental premature aging disorder that recapitulates some biological and physical aspects of physiological aging . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 28 . 1 unlabelled 2 : 2 : 3 hutchinson 4 - 6 progeria 4 - 11 is 5 gilford 6 progeria 6 progeria 9 hgps 6 progeria 11 is 8 ( 9 hgps 9 hgps 10 ) 11 is 17 disorder 12 a 17 disorder 13 rare 17 disorder 14 segmental 17 disorder 15 premature 17 disorder 16 aging 17 disorder 17 disorder 18 that 17 disorder 19 recapitulates 18 that 19 recapitulates 19 recapitulates 24 aspects 20 some 24 aspects 21 biological 22 and 22 and 23 physical 22 and 24 aspects 24 aspects 25 of 25 of 27 aging 26 physiological 27 aging the disease is caused by a sporadic dominant mutation in the lmna gene that leads to the expression of progerin , a mutant form of lamin a that lacks 50 amino acids and retains a toxic farnesyl modification in its carboxy - terminus . 0 ###LEFT-WALL### 2 disease 0 ###LEFT-WALL### 4 caused 0 ###LEFT-WALL### 42 - 0 ###LEFT-WALL### 44 . 1 the 2 disease 2 disease 3 is 3 is 4 caused 4 caused 5 by 4 caused 16 to 5 by 9 mutation 6 a 7 sporadic 6 a 9 mutation 7 sporadic 9 mutation 8 dominant 9 mutation 9 mutation 10 in 9 mutation 14 that 9 mutation 15 leads 10 in 13 gene 11 the 13 gene 12 lmna 13 gene 14 that 15 leads 16 to 18 expression 17 the 18 expression 18 expression 19 of 19 of 20 progerin 20 progerin 24 form 21 , 24 form 22 a 24 form 23 mutant 24 form 24 form 25 of 24 form 28 that 24 form 33 and 24 form 42 - 25 of 26 lamin 26 lamin 27 a 28 that 33 and 29 lacks 32 acids 29 lacks 33 and 30 50 32 acids 31 amino 32 acids 33 and 34 retains 34 retains 38 modification 35 a 36 toxic 35 a 38 modification 36 toxic 37 farnesyl 37 farnesyl 38 modification 38 modification 39 in 39 in 41 carboxy 40 its 41 carboxy 42 - 43 terminus however , the mechanisms underlying cellular damage and senescence and accelerated aging in hgps are incompletely understood . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 17 understood 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 10 and 3 the 4 mechanisms 4 mechanisms 5 underlying 4 mechanisms 8 and 5 underlying 7 damage 6 cellular 7 damage 8 and 9 senescence 8 and 10 and 10 and 12 aging 10 and 13 in 10 and 15 are 11 accelerated 12 aging 13 in 14 hgps 15 are 16 incompletely 15 are 17 understood here , we analyzed fibroblasts from healthy subjects and hgps patients using silac ( stable isotope labeling [with] amino acids in cell culture ) . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 analyzed 0 ###LEFT-WALL### 25 . 1 here 2 , 1 here 3 we 3 we 4 analyzed 4 analyzed 5 fibroblasts 4 analyzed 6 from 4 analyzed 12 using 6 from 9 and 7 healthy 8 subjects 8 subjects 9 and 9 and 11 patients 10 hgps 11 patients 12 using 13 silac 13 silac 20 acids 14 ( 20 acids 15 stable 16 isotope 16 isotope 20 acids 17 labeling 20 acids 19 amino 20 acids 20 acids 21 in 20 acids 24 ) 21 in 23 culture 22 cell 23 culture we found in hgps cells a marked downregulation of mitochondrial oxidative phosphorylation proteins accompanied by mitochondrial dysfunction , a process thought to provoke broad organ decline during normal aging . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 30 . 1 we 2 found 2 found 3 in 2 found 5 cells 2 found 26 decline 3 in 4 hgps 5 cells 8 downregulation 5 cells 14 accompanied 5 cells 26 decline 6 a 8 downregulation 7 marked 8 downregulation 8 downregulation 9 of 8 downregulation 14 accompanied 9 of 13 proteins 10 mitochondrial 12 phosphorylation 11 oxidative 12 phosphorylation 12 phosphorylation 13 proteins 14 accompanied 15 by 14 accompanied 22 to 15 by 17 dysfunction 16 mitochondrial 17 dysfunction 18 , 21 thought 19 a 20 process 20 process 21 thought 21 thought 22 to 22 to 23 provoke 23 provoke 25 organ 24 broad 25 organ 26 decline 27 during 27 during 29 aging 28 normal 29 aging we also found mitochondrial dysfunction in fibroblasts from adult progeroid mice expressing progerin ( lmna ( g609g/g609g ) knock - in mice ) or prelamin a ( zmpste24 - null mice ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 33 . 1 we 3 found 2 also 3 found 3 found 24 or 4 mitochondrial 5 dysfunction 5 dysfunction 6 in 5 dysfunction 24 or 6 in 7 fibroblasts 7 fibroblasts 8 from 8 from 10 progeroid 9 adult 10 progeroid 10 progeroid 11 mice 10 progeroid 19 knock 11 mice 12 expressing 11 mice 19 knock 12 expressing 13 progerin 13 progerin 15 lmna 14 ( 15 lmna 15 lmna 17 g609g/g609g 15 lmna 18 ) 16 ( 17 g609g/g609g 17 g609g/g609g 18 ) 19 knock 21 in 20 - 21 in 21 in 22 mice 21 in 23 ) 24 or 25 prelamin 24 or 28 zmpste24 25 prelamin 26 a 27 ( 28 zmpste24 28 zmpste24 31 mice 28 zmpste24 32 ) 29 - 31 mice 30 null 31 mice 31 mice 32 ) analysis of tissues from these mouse models revealed that the damaging effect of these proteins on mitochondrial function [is] time - and dose - dependent . 0 ###LEFT-WALL### 1 analysis 0 ###LEFT-WALL### 8 revealed 0 ###LEFT-WALL### 24 - 1 analysis 2 of 1 analysis 8 revealed 2 of 3 tissues 3 tissues 4 from 4 from 7 models 5 these 7 models 6 mouse 7 models 8 revealed 22 and 9 that 22 and 10 the 12 effect 11 damaging 12 effect 12 effect 13 of 12 effect 22 and 13 of 15 proteins 14 these 15 proteins 15 proteins 16 on 16 on 20 time 17 mitochondrial 18 function 18 function 20 time 21 - 22 and 22 and 23 dose 24 - 25 dependent 24 - 26 . mitochondrial alterations were not observed in the brain , a tissue with extremely low progerin expression that seems to be unaffected in hgps . 0 ###LEFT-WALL### 2 alterations 0 ###LEFT-WALL### 3 were 1 mitochondrial 2 alterations 2 alterations 3 were 3 were 4 not 3 were 6 in 4 not 5 observed 6 in 8 brain 7 the 8 brain 8 brain 11 tissue 9 , 11 tissue 10 a 11 tissue 11 tissue 12 with 11 tissue 17 that 11 tissue 18 seems 11 tissue 24 . 12 with 16 expression 13 extremely 14 low 14 low 16 expression 15 progerin 16 expression 17 that 18 seems 18 seems 19 to 18 seems 20 be 19 to 20 be 20 be 21 unaffected 21 unaffected 22 in 22 in 23 hgps remarkably , mitochondrial function [was] restored [in] progeroid mouse fibroblasts treated with the isoprenylation inhibitors fti - 277 or pravastatin plus zoledronate , which are being tested in hgps clinical trials . 0 ###LEFT-WALL### 19 or 0 ###LEFT-WALL### 22 zoledronate 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 27 tested 0 ###LEFT-WALL### 32 . 1 remarkably 2 , 1 remarkably 19 or 3 mitochondrial 4 function 4 function 10 fibroblasts 6 restored 10 fibroblasts 8 progeroid 9 mouse 9 mouse 10 fibroblasts 10 fibroblasts 11 treated 10 fibroblasts 19 or 11 treated 12 with 12 with 16 fti 12 with 18 277 13 the 15 inhibitors 14 isoprenylation 15 inhibitors 15 inhibitors 16 fti 17 - 18 277 19 or 21 plus 19 or 22 zoledronate 20 pravastatin 21 plus 23 , 24 which 23 , 25 are 24 which 25 are 25 are 26 being 26 being 27 tested 27 tested 28 in 28 in 31 trials 29 hgps 31 trials 30 clinical 31 trials our results suggest that mitochondrial dysfunction contributes to premature organ [decline] and aging in hgps . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 16 . 1 our 2 results 2 results 3 suggest 3 suggest 4 that 4 that 6 dysfunction 4 that 7 contributes 5 mitochondrial 6 dysfunction 6 dysfunction 7 contributes 7 contributes 8 to 7 contributes 14 in 8 to 12 and 9 premature 10 organ 10 organ 12 and 12 and 13 aging 14 in 15 hgps beyond its effects on progeria , prelamin a and progerin may also contribute to mitochondrial dysfunction and organ damage during normal aging , since these proteins are expressed in cells and tissues from [non] [-] hgps individuals , most [prominently] at advanced ages . 1 beyond 3 effects 1 beyond 6 , 1 beyond 9 and 2 its 3 effects 3 effects 4 on 4 on 5 progeria 7 prelamin 8 a 7 prelamin 9 and 9 and 10 progerin 9 and 11 may 11 may 13 contribute 12 also 13 contribute 13 contribute 14 to 13 contribute 24 since 14 to 17 and 15 mitochondrial 16 dysfunction 16 dysfunction 17 and 17 and 19 damage 17 and 23 , 18 organ 19 damage 19 damage 20 during 20 during 22 aging 21 normal 22 aging 24 since 26 proteins 24 since 28 expressed 25 these 26 proteins 26 proteins 27 are 27 are 28 expressed 28 expressed 29 in 28 expressed 33 from 29 in 31 and 30 cells 31 and 31 and 32 tissues 33 from 37 individuals 36 hgps 37 individuals 37 individuals 39 most 38 , 39 most 39 most 41 at 39 most 44 . 41 at 43 ages 42 advanced 43 ages biological significance : mutations in lmna or defective processing of prelamin a causes premature aging disorders , including hutchinson - gilford progeria [syndrome] ( hgps ) . 0 ###LEFT-WALL### 2 significance 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 7 or 1 biological 2 significance 2 significance 3 : 3 : 4 mutations 4 mutations 5 in 5 in 6 lmna 7 or 9 processing 7 or 13 causes 8 defective 9 processing 9 processing 10 of 9 processing 13 causes 10 of 11 prelamin 11 prelamin 12 a 13 causes 16 disorders 13 causes 18 including 14 premature 16 disorders 15 aging 16 disorders 17 , 18 including 18 including 19 hutchinson 18 including 27 . 19 hutchinson 22 progeria 20 - 22 progeria 21 gilford 22 progeria 22 progeria 25 hgps 22 progeria 26 ) 24 ( 25 hgps 25 hgps 26 ) most hgps patients carry in heterozygosis [a] de [-] novo point mutation ( c.1824c>t : ggc>ggt ; p.g608g [ )(which causes the expression of the lamin a mutant protein called progerin . 0 ###LEFT-WALL### 3 patients 0 ###LEFT-WALL### 4 carry 0 ###LEFT-WALL### 15 : 0 ###LEFT-WALL### 32 . 1 most 3 patients 2 hgps 3 patients 3 patients 4 carry 4 carry 5 in 4 carry 10 novo 4 carry 12 mutation 5 in 6 heterozygosis 8 de 10 novo 11 point 12 mutation 12 mutation 14 c.1824c>t 13 ( 14 c.1824c>t 14 c.1824c>t 15 : 15 : 16 ggc>ggt 15 : 17 ; 17 ; 18 p.g608g 17 ; 30 called 18 p.g608g 20 )(which 18 p.g608g 21 causes 18 p.g608g 30 called 20 )(which 21 causes 21 causes 23 expression 22 the 23 expression 23 expression 24 of 24 of 29 protein 25 the 29 protein 26 lamin 27 a 26 lamin 29 protein 28 mutant 29 protein 30 called 31 progerin despite the importance of progerin and prelamin a in accelerated aging , the underlying molecular mechanisms remain largely unknown . 0 ###LEFT-WALL### 16 mechanisms 0 ###LEFT-WALL### 17 remain 0 ###LEFT-WALL### 20 . 1 despite 3 importance 1 despite 12 , 1 despite 16 mechanisms 2 the 3 importance 3 importance 4 of 4 of 6 and 5 progerin 6 and 6 and 7 prelamin 6 and 9 in 7 prelamin 8 a 9 in 11 aging 10 accelerated 11 aging 13 the 16 mechanisms 14 underlying 16 mechanisms 15 molecular 16 mechanisms 16 mechanisms 17 remain 17 remain 19 unknown 18 largely 19 unknown to tackle this question , we compared the proteome of skin - derived dermal fibroblast from hgps patients and age - matched controls using quantitative stable isotope labeling with amino acids in cell culture ( silac ) . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 compared 0 ###LEFT-WALL### 38 . 1 to 2 tackle 1 to 5 , 1 to 6 we 2 tackle 4 question 3 this 4 question 6 we 7 compared 7 compared 9 proteome 8 the 9 proteome 9 proteome 10 of 9 proteome 15 fibroblast 9 proteome 23 controls 10 of 11 skin 12 - 15 fibroblast 13 derived 15 fibroblast 14 dermal 15 fibroblast 15 fibroblast 16 from 15 fibroblast 21 - 16 from 19 and 17 hgps 18 patients 18 patients 19 and 19 and 20 age 21 - 23 controls 22 matched 23 controls 23 controls 24 using 23 controls 29 with 23 controls 36 silac 23 controls 37 ) 24 using 28 labeling 25 quantitative 28 labeling 26 stable 28 labeling 27 isotope 28 labeling 29 with 31 acids 30 amino 31 acids 31 acids 32 in 32 in 34 culture 33 cell 34 culture 35 ( 36 silac 36 silac 37 ) our results show a pronounced down - regulation of several components of the mitochondrial atpase complex accompanied by up - regulation of some glycolytic enzymes . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 26 . 1 our 2 results 2 results 3 show 3 show 8 regulation 4 a 8 regulation 5 pronounced 8 regulation 6 down 7 - 6 down 8 regulation 8 regulation 9 of 8 regulation 12 of 8 regulation 17 accompanied 9 of 11 components 10 several 11 components 12 of 16 complex 13 the 16 complex 14 mitochondrial 16 complex 15 atpase 16 complex 17 accompanied 18 by 18 by 21 regulation 19 up 20 - 19 up 21 regulation 21 regulation 22 of 22 of 25 enzymes 23 some 25 enzymes 24 glycolytic 25 enzymes accordingly , functional studies demonstrated mitochondrial dysfunction in hgps fibroblasts . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 demonstrated 0 ###LEFT-WALL### 11 . 1 accordingly 2 , 1 accordingly 4 studies 3 functional 4 studies 4 studies 5 demonstrated 5 demonstrated 7 dysfunction 5 demonstrated 10 fibroblasts 6 mitochondrial 7 dysfunction 7 dysfunction 8 in 7 dysfunction 10 fibroblasts 8 in 9 hgps moreover , our expression and functional studies using cellular and animal models confirmed that mitochondrial dysfunction is a feature of progeria which develops in a time - and dose - dependent manner . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 13 confirmed 1 moreover 2 , 1 moreover 5 and 3 our 4 expression 4 expression 5 and 5 and 7 studies 5 and 8 using 5 and 13 confirmed 6 functional 7 studies 8 using 12 models 9 cellular 10 and 10 and 11 animal 10 and 12 models 13 confirmed 16 dysfunction 13 confirmed 17 is 14 that 15 mitochondrial 15 mitochondrial 16 dysfunction 16 dysfunction 17 is 17 is 19 feature 17 is 24 in 18 a 19 feature 19 feature 20 of 19 feature 22 which 19 feature 23 develops 20 of 21 progeria 22 which 23 develops 24 in 28 and 25 a 26 time 26 time 28 and 27 - 28 and 28 and 29 dose 28 and 32 manner 30 - 32 manner 31 dependent 32 manner 32 manner 33 . finally , we demonstrate improved mitochondrial function [in] progeroid mouse cells treated with a combination of statins and aminobisphosphonates , two drugs that are being evaluated in ongoing hgps clinical trials . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 32 . 1 finally 2 , 1 finally 3 we 3 we 18 and 4 demonstrate 11 cells 4 demonstrate 13 with 4 demonstrate 18 and 5 improved 10 mouse 6 mitochondrial 10 mouse 7 function 10 mouse 9 progeroid 10 mouse 10 mouse 11 cells 11 cells 12 treated 13 with 15 combination 14 a 15 combination 15 combination 16 of 16 of 17 statins 18 and 19 aminobisphosphonates 18 and 25 being 18 and 27 in 18 and 31 trials 20 , 25 being 21 two 22 drugs 22 drugs 23 that 22 drugs 24 are 22 drugs 25 being 23 that 24 are 25 being 26 evaluated 27 in 29 hgps 28 ongoing 29 hgps 30 clinical 31 trials although further studies are needed to unravel the mechanisms through which progerin and prelamin a provoke mitochondrial abnormalities , our findings may pave the way to improved treatments of hgps . 0 ###LEFT-WALL### 21 findings 0 ###LEFT-WALL### 23 pave 0 ###LEFT-WALL### 31 . 1 although 3 studies 1 although 7 unravel 1 although 19 , 1 although 21 findings 2 further 3 studies 3 studies 4 are 4 are 5 needed 5 needed 6 to 6 to 7 unravel 7 unravel 9 mechanisms 8 the 9 mechanisms 9 mechanisms 10 through 10 through 11 which 10 through 13 and 10 through 16 provoke 12 progerin 13 and 13 and 14 prelamin 13 and 16 provoke 14 prelamin 15 a 16 provoke 18 abnormalities 17 mitochondrial 18 abnormalities 20 our 21 findings 21 findings 22 may 22 may 23 pave 23 pave 25 way 23 pave 26 to 24 the 25 way 26 to 28 treatments 27 improved 28 treatments 28 treatments 29 of 29 of 30 hgps these studies may also improve our knowledge of the mechanisms leading to mitochondrial dysfunction during normal aging , since both progerin and prelamin a have been found to accumulate during normal aging . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 5 improve 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 33 . 1 these 2 studies 2 studies 3 may 3 may 5 improve 4 also 5 improve 5 improve 7 knowledge 6 our 7 knowledge 7 knowledge 8 of 8 of 10 mechanisms 9 the 10 mechanisms 10 mechanisms 11 leading 11 leading 12 to 11 leading 15 during 12 to 14 dysfunction 13 mitochondrial 14 dysfunction 15 during 17 aging 16 normal 17 aging 18 , 22 and 18 , 27 found 19 since 20 both 19 since 22 and 21 progerin 22 and 22 and 23 prelamin 22 and 25 have 23 prelamin 24 a 25 have 26 been 26 been 27 found 27 found 28 to 28 to 29 accumulate 29 accumulate 30 during 30 during 32 aging 31 normal 32 aging unlabelled : telomerase inhibition causes progressive telomere shortening and cellular senescence , which constitutes a universal barrier to tumor growth and therefore an attractive target for tumor therapy . 0 ###LEFT-WALL### 1 unlabelled 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 9 and 2 : 12 , 3 telomerase 7 telomere 4 inhibition 7 telomere 5 causes 6 progressive 6 progressive 7 telomere 7 telomere 8 shortening 7 telomere 9 and 9 and 11 senescence 10 cellular 11 senescence 12 , 13 which 12 , 14 constitutes 13 which 14 constitutes 14 constitutes 21 and 14 constitutes 26 for 15 a 17 barrier 16 universal 17 barrier 17 barrier 18 to 17 barrier 21 and 18 to 20 growth 19 tumor 20 growth 21 and 22 therefore 21 and 25 target 23 an 24 attractive 23 an 25 target 24 attractive 25 target 26 for 28 therapy 27 tumor 28 therapy to expand our previous studies , we investigated the global effects of telomere dysfunction on the proteome of tumor cells in order to find novel senescence biomarkers . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 expand 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 24 find 0 ###LEFT-WALL### 28 . 1 to 2 expand 2 expand 5 studies 3 our 5 studies 4 previous 5 studies 6 , 7 we 6 , 8 investigated 7 we 8 investigated 8 investigated 11 effects 8 investigated 15 on 8 investigated 21 in 8 investigated 23 to 9 the 11 effects 10 global 11 effects 11 effects 12 of 12 of 14 dysfunction 13 telomere 14 dysfunction 15 on 17 proteome 16 the 17 proteome 17 proteome 18 of 18 of 20 cells 19 tumor 20 cells 21 in 22 order 23 to 24 find 24 find 26 senescence 24 find 27 biomarkers 25 novel 26 senescence 26 senescence 27 biomarkers telomerase - deficient hct - 116 cell clones were analyzed by a quantitative proteomic approach using isotope - coded protein labeling ( icpl ) and nanoflow - hplc - ms/ms . stringent reduction of the extensive proteomic data from this tumor cell model revealed a list of 59 markers including proteins identified in our former studies and a number of novel proteins involved in tumorigenesis and metastasis such as sfn , s100a4 , anxa2 , and lgals1 . 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 31 . 0 ###LEFT-WALL### 44 revealed 0 ###LEFT-WALL### 78 . 1 telomerase 4 hct 1 telomerase 25 and 2 - 4 hct 3 deficient 4 hct 4 hct 18 - 4 hct 24 ) 5 - 18 - 6 116 8 clones 6 116 9 were 6 116 10 analyzed 6 116 18 - 7 cell 8 clones 8 clones 9 were 10 analyzed 11 by 11 by 17 isotope 12 a 13 quantitative 12 a 17 isotope 13 quantitative 17 isotope 14 proteomic 17 isotope 15 approach 17 isotope 16 using 17 isotope 18 - 21 labeling 18 - 24 ) 19 coded 20 protein 20 protein 21 labeling 21 labeling 23 icpl 22 ( 23 icpl 23 icpl 24 ) 25 and 30 ms/ms 26 nanoflow 28 hplc 26 nanoflow 29 - 26 nanoflow 30 ms/ms 27 - 28 hplc 28 hplc 29 - 31 . 33 reduction 32 stringent 33 reduction 33 reduction 34 of 33 reduction 44 revealed 34 of 38 data 35 the 38 data 36 extensive 38 data 37 proteomic 38 data 38 data 39 from 39 from 43 model 40 this 43 model 41 tumor 43 model 42 cell 43 model 44 revealed 46 list 44 revealed 53 in 44 revealed 64 in 45 a 46 list 46 list 47 of 46 list 50 including 47 of 49 markers 48 59 49 markers 50 including 51 proteins 51 proteins 52 identified 53 in 57 and 54 our 56 studies 55 former 56 studies 56 studies 57 and 57 and 59 number 57 and 60 of 58 a 59 number 60 of 62 proteins 61 novel 62 proteins 62 proteins 63 involved 64 in 66 and 65 tumorigenesis 66 and 66 and 67 metastasis 66 and 69 as 68 such 69 as 69 as 76 and 70 sfn 71 , 71 , 72 s100a4 71 , 76 and 72 s100a4 74 anxa2 73 , 74 anxa2 74 anxa2 75 , 76 and 77 lgals1 a loss of the chromatin protein hmgb2 was [demonstrated] not only in various telomerase - inhibited clones of different tumor cell lines , but also in normal human fibroblasts undergoing replicative senescence and in aging telomerase knockout mice . 0 ###LEFT-WALL### 2 loss 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 39 . 1 a 2 loss 2 loss 3 of 2 loss 8 was 3 of 7 hmgb2 4 the 6 protein 5 chromatin 6 protein 6 protein 7 hmgb2 8 was 10 not 8 was 11 only 8 was 12 in 8 was 24 but 8 was 33 and 12 in 14 telomerase 13 various 14 telomerase 14 telomerase 17 clones 15 - 17 clones 16 inhibited 17 clones 17 clones 18 of 17 clones 23 , 18 of 22 lines 19 different 20 tumor 20 tumor 21 cell 21 cell 22 lines 24 but 25 also 26 in 29 fibroblasts 26 in 33 and 27 normal 29 fibroblasts 28 human 29 fibroblasts 29 fibroblasts 30 undergoing 30 undergoing 32 senescence 31 replicative 32 senescence 33 and 34 in 34 in 35 aging 35 aging 38 mice 36 telomerase 38 mice 37 knockout 38 mice impressively , a coherent and dense network of protein [-] protein interactions for the bulk of the markers and their implementation in signaling pathways involving key regulators for tumorigenesis were revealed . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 30 were 0 ###LEFT-WALL### 32 . 1 impressively 2 , 1 impressively 19 and 3 a 7 network 4 coherent 5 and 5 and 6 dense 5 and 7 network 7 network 8 of 7 network 19 and 8 of 12 interactions 9 protein 12 interactions 11 protein 12 interactions 12 interactions 13 for 12 interactions 16 of 13 for 15 bulk 14 the 15 bulk 16 of 18 markers 17 the 18 markers 19 and 21 implementation 19 and 22 in 19 and 25 involving 19 and 30 were 20 their 21 implementation 22 in 23 signaling 23 signaling 24 pathways 25 involving 27 regulators 26 key 27 regulators 27 regulators 28 for 28 for 29 tumorigenesis 30 were 31 revealed these results have an impact on the understanding of telomere - and senescence - related signal transduction in tumor cells in consideration of the general lack of senescence markers . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 15 related 0 ###LEFT-WALL### 30 . 1 these 2 results 2 results 3 have 3 have 5 impact 3 have 6 on 4 an 5 impact 6 on 8 understanding 7 the 8 understanding 8 understanding 9 of 9 of 12 and 10 telomere 12 and 11 - 12 and 12 and 13 senescence 14 - 15 related 15 related 17 transduction 15 related 18 in 15 related 21 in 16 signal 17 transduction 18 in 20 cells 19 tumor 20 cells 21 in 22 consideration 22 consideration 23 of 22 consideration 27 of 23 of 26 lack 24 the 26 lack 25 general 26 lack 27 of 29 markers 28 senescence 29 markers biological significance : induction of cellular senescence constitutes a potent concept for tumor therapy which interferes with immortalization and additional hallmarks of cancer . 0 ###LEFT-WALL### 2 significance 0 ###LEFT-WALL### 3 : 1 biological 2 significance 3 : 4 induction 3 : 8 constitutes 3 : 24 . 4 induction 5 of 4 induction 8 constitutes 5 of 7 senescence 6 cellular 7 senescence 8 constitutes 11 concept 8 constitutes 17 with 9 a 10 potent 9 a 11 concept 10 potent 11 concept 11 concept 12 for 12 for 14 therapy 13 tumor 14 therapy 14 therapy 15 which 14 therapy 16 interferes 15 which 16 interferes 17 with 19 and 18 immortalization 19 and 19 and 21 hallmarks 19 and 22 of 20 additional 21 hallmarks 22 of 23 cancer the application of a powerful quantitative proteomic approach using isotope [-] coded protein labeling to an approved model for senescence represented by telomerase inhibited tumor cells led to the identification of novel candidate biomarkers for telomere dysfunction and replicative senescence . 0 ###LEFT-WALL### 38 and 0 ###LEFT-WALL### 41 . 1 the 2 application 2 application 3 of 2 application 9 using 2 application 14 labeling 2 application 38 and 3 of 8 approach 4 a 8 approach 5 powerful 8 approach 6 quantitative 8 approach 7 proteomic 8 approach 9 using 13 protein 10 isotope 12 coded 12 coded 13 protein 14 labeling 15 to 14 labeling 26 cells 15 to 18 model 16 an 18 model 17 approved 18 model 18 model 19 for 19 for 20 senescence 20 senescence 21 represented 21 represented 22 by 21 represented 24 inhibited 22 by 23 telomerase 25 tumor 26 cells 26 cells 27 led 26 cells 35 for 27 led 28 to 28 to 30 identification 29 the 30 identification 30 identification 31 of 31 of 34 biomarkers 32 novel 33 candidate 33 candidate 34 biomarkers 35 for 37 dysfunction 36 telomere 37 dysfunction 38 and 40 senescence 39 replicative 40 senescence thereby , the identified markers not only fit in the context of the investigated processes with a relevance for additional hallmarks of cancer but [are] also involved in a strong interaction network and integrated in canonical pathways centered around key cancer - relevant proteins . 0 ###LEFT-WALL### 5 markers 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 45 . 1 thereby 2 , 1 thereby 5 markers 3 the 5 markers 4 identified 5 markers 5 markers 6 not 5 markers 19 for 5 markers 33 and 6 not 8 fit 7 only 8 fit 8 fit 9 in 8 fit 16 with 9 in 11 context 10 the 11 context 11 context 12 of 12 of 15 processes 13 the 15 processes 14 investigated 15 processes 16 with 18 relevance 17 a 18 relevance 19 for 21 hallmarks 20 additional 21 hallmarks 21 hallmarks 22 of 21 hallmarks 27 involved 22 of 23 cancer 23 cancer 24 but 24 but 26 also 27 involved 28 in 28 in 31 interaction 29 a 30 strong 29 a 31 interaction 30 strong 31 interaction 32 network 33 and 33 and 34 integrated 33 and 35 in 33 and 44 proteins 35 in 37 pathways 36 canonical 37 pathways 37 pathways 38 centered 38 centered 39 around 38 centered 42 - 38 centered 43 relevant 39 around 41 cancer 40 key 41 cancer these potential markers alone [or] in combination will significantly extend the view on telomere - associated signal transduction in tumor cells and contribute to the field of cellular senescence and aging in consideration of the general lack of biomarkers in this regard . 0 ###LEFT-WALL### 3 markers 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 43 . 1 these 3 markers 2 potential 3 markers 3 markers 4 alone 3 markers 22 and 4 alone 6 in 6 in 8 will 7 combination 8 will 9 significantly 10 extend 10 extend 12 view 10 extend 22 and 11 the 12 view 12 view 13 on 13 on 18 transduction 14 telomere 15 - 14 telomere 17 signal 16 associated 17 signal 17 signal 18 transduction 18 transduction 19 in 19 in 21 cells 20 tumor 21 cells 22 and 23 contribute 23 contribute 24 to 23 contribute 32 in 24 to 26 field 25 the 26 field 26 field 27 of 27 of 30 and 28 cellular 29 senescence 29 senescence 30 and 30 and 31 aging 32 in 33 consideration 33 consideration 34 of 33 consideration 40 in 34 of 37 lack 35 the 37 lack 36 general 37 lack 37 lack 38 of 38 of 39 biomarkers 40 in 42 regard 41 this 42 regard in [hypertension] ( htn [ )(, cerebral blood flow regulation limits are changed , and the threshold for blood pressure ( bp ) at which perfusion is safely maintained is higher . 0 ###LEFT-WALL### 11 limits 0 ###LEFT-WALL### 13 changed 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 32 . 1 in 4 htn 3 ( 4 htn 4 htn 6 )(, 4 htn 9 flow 7 cerebral 8 blood 8 blood 9 flow 9 flow 10 regulation 10 regulation 11 limits 11 limits 12 are 12 are 13 changed 14 , 15 and 15 and 17 threshold 15 and 30 is 16 the 17 threshold 17 threshold 18 for 17 threshold 24 at 17 threshold 30 is 18 for 20 pressure 19 blood 20 pressure 20 pressure 22 bp 21 ( 22 bp 22 bp 23 ) 24 at 25 which 24 at 26 perfusion 24 at 29 maintained 26 perfusion 27 is 27 is 28 safely 27 is 29 maintained 30 is 31 higher this shift may increase the brain 's vulnerability to lower bp in subjects with vascular disease . 0 ###LEFT-WALL### 2 shift 0 ###LEFT-WALL### 4 increase 0 ###LEFT-WALL### 17 . 1 this 2 shift 2 shift 3 may 3 may 4 increase 4 increase 8 vulnerability 5 the 6 brain 6 brain 7 's 7 's 8 vulnerability 8 vulnerability 9 to 8 vulnerability 10 lower 9 to 10 lower 10 lower 11 bp 10 lower 12 in 10 lower 14 with 12 in 13 subjects 14 with 16 disease 15 vascular 16 disease we investigated whether longitudinal reduction in mean arterial pressure ( map ) was related to changes in cerebrospinal fluid ( csf ) biomarkers of alzheimer 's disease in a group of cognitively healthy elderly [with] [and] [without] htn . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 39 . 1 we 2 investigated 2 investigated 3 whether 2 investigated 17 in 2 investigated 27 disease 2 investigated 28 in 3 whether 5 reduction 3 whether 14 related 4 longitudinal 5 reduction 5 reduction 6 in 5 reduction 11 map 5 reduction 13 was 6 in 9 pressure 7 mean 9 pressure 8 arterial 9 pressure 10 ( 11 map 11 map 12 ) 13 was 14 related 14 related 15 to 15 to 16 changes 17 in 23 biomarkers 18 cerebrospinal 23 biomarkers 19 fluid 21 csf 19 fluid 23 biomarkers 20 ( 21 csf 21 csf 22 ) 23 biomarkers 24 of 24 of 26 's 25 alzheimer 26 's 28 in 38 htn 29 a 30 group 30 group 31 of 30 group 38 htn 31 of 38 htn 32 cognitively 33 healthy 33 healthy 38 htn 34 elderly 38 htn the relationships among map , memory decline , and hippocampal atrophy were also examined . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 14 examined 0 ###LEFT-WALL### 15 . 1 the 2 relationships 2 relationships 3 among 2 relationships 5 , 3 among 4 map 5 , 7 decline 5 , 9 and 6 memory 7 decline 8 , 9 and 9 and 11 atrophy 9 and 12 were 10 hippocampal 11 atrophy 12 were 14 examined 13 also 14 examined seventy - seven subjects ( age 63.4 ± 9.4 , range 44 - 86 years ; education 16.9 ± 2.1 , range 10 - 22 years [;] 60 % women ) were assessed twice , 2 ± 0.5 years [apart] . 0 ###LEFT-WALL### 4 subjects 0 ###LEFT-WALL### 11 range 0 ###LEFT-WALL### 16 ; 0 ###LEFT-WALL### 41 . 1 seventy 2 - 2 - 3 seven 2 - 4 subjects 4 subjects 8 ± 4 subjects 11 range 5 ( 8 ± 6 age 8 ± 7 63.4 8 ± 8 ± 9 9.4 8 ± 10 , 11 range 12 44 12 44 15 years 13 - 15 years 14 86 15 years 15 years 16 ; 16 ; 17 education 16 ; 33 assessed 17 education 19 ± 17 education 32 were 17 education 33 assessed 18 16.9 19 ± 19 ± 20 2.1 19 ± 30 women 19 ± 32 were 21 , 30 women 22 range 30 women 23 10 24 - 24 - 26 years 24 - 30 women 25 22 26 years 28 60 29 % 29 % 30 women 30 women 31 ) 33 assessed 36 2 33 assessed 37 ± 34 twice 35 , 34 twice 36 2 36 2 37 ± 37 ± 39 years 38 0.5 39 years at both time points , all subjects underwent full medical and neuropsychological evaluations , lumbar punctures , and magnetic resonance imaging examinations . 0 ###LEFT-WALL### 7 subjects 0 ###LEFT-WALL### 8 underwent 0 ###LEFT-WALL### 23 . 1 at 4 points 1 at 5 , 1 at 7 subjects 2 both 4 points 3 time 4 points 6 all 7 subjects 7 subjects 8 underwent 8 underwent 18 and 9 full 13 evaluations 10 medical 11 and 11 and 12 neuropsychological 11 and 13 evaluations 13 evaluations 14 , 14 , 16 punctures 14 , 18 and 15 lumbar 16 punctures 17 , 18 and 18 and 20 resonance 18 and 21 imaging 19 magnetic 20 resonance 21 imaging 22 examinations twenty - five subjects had htn . 0 ###LEFT-WALL### 4 subjects 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 7 . 1 twenty 2 - 2 - 3 five 2 - 4 subjects 4 subjects 5 had 5 had 6 htn hyper - and normotensive subjects did not differ in their csf biomarkers , hippocampal volumes ( hipvs ) , or memory scores at baseline . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 8 differ 0 ###LEFT-WALL### 20 or 0 ###LEFT-WALL### 25 . 1 hyper 3 and 2 - 3 and 3 and 5 subjects 3 and 6 did 4 normotensive 5 subjects 6 did 7 not 6 did 8 differ 8 differ 9 in 9 in 12 biomarkers 10 their 12 biomarkers 11 csf 12 biomarkers 12 biomarkers 15 volumes 13 , 15 volumes 14 hippocampal 15 volumes 15 volumes 17 hipvs 15 volumes 19 , 16 ( 17 hipvs 17 hipvs 18 ) 19 , 20 or 20 or 21 memory 20 or 22 scores 21 memory 22 scores 22 scores 23 at 23 at 24 baseline in the entire study group , [the] [increase] in tau phosphorylated [at] threonine 181 ( p - tau ( 181 ) ) was associated with a decline in verbal episodic memory ( β [=] - 0.30 , p = 0.01 ) [and] hipv reduction [(] β = - 0.27 , p = 0.02 ) . 0 ###LEFT-WALL### 5 group 0 ###LEFT-WALL### 6 , 1 in 4 study 1 in 5 group 2 the 4 study 3 entire 4 study 6 , 14 181 9 in 10 tau 9 in 14 181 10 tau 11 phosphorylated 11 phosphorylated 13 threonine 14 181 17 - 14 181 23 was 15 ( 17 - 16 p 17 - 17 - 18 tau 17 - 22 ) 18 tau 20 181 19 ( 20 181 20 181 21 ) 23 was 24 associated 24 associated 25 with 24 associated 28 in 25 with 27 decline 26 a 27 decline 28 in 31 memory 29 verbal 31 memory 30 episodic 31 memory 31 memory 43 hipv 32 ( 43 hipv 33 β 36 0.30 33 β 41 ) 33 β 43 hipv 35 - 36 0.30 36 0.30 39 = 36 0.30 41 ) 37 , 39 = 38 p 39 = 39 = 40 0.01 39 = 41 ) 43 hipv 46 β 43 hipv 47 = 43 hipv 49 0.27 43 hipv 55 . 44 reduction 46 β 46 β 47 = 48 - 49 0.27 49 0.27 52 = 49 0.27 55 . 50 , 52 = 51 p 52 = 52 = 53 0.02 52 = 54 ) however , longitudinal decrease in map was related to memory decline [(] β = 0.50 , p = 0.01 ) [and] [an] increase in [p] [-] tau ( 181 ) ( β [=] - 0.50 , p = 0.01 [ )( in subjects with htn . 0 ###LEFT-WALL### 11 decline 1 however 2 , 1 however 11 decline 2 , 8 related 3 longitudinal 4 decrease 4 decrease 5 in 4 decrease 7 was 5 in 6 map 7 was 8 related 8 related 9 to 9 to 10 memory 11 decline 13 β 13 β 15 0.50 13 β 23 increase 14 = 15 0.50 15 0.50 18 = 15 0.50 23 increase 16 , 18 = 17 p 18 = 18 = 19 0.01 18 = 20 ) 23 increase 24 in 23 increase 34 - 24 in 27 tau 27 tau 29 181 28 ( 29 181 29 181 30 ) 31 ( 34 - 32 β 34 - 34 - 35 0.50 34 - 46 . 35 0.50 38 = 36 , 38 = 37 p 38 = 38 = 39 0.01 39 0.01 42 in 39 0.01 44 with 42 in 43 subjects 44 with 45 htn our findings suggest that the hypertensive group may be sensitive to bp reductions . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 14 . 1 our 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 7 group 4 that 9 be 5 the 7 group 6 hypertensive 7 group 7 group 8 may 8 may 9 be 9 be 10 sensitive 10 sensitive 11 to 11 to 13 reductions 12 bp 13 reductions objectives : to define the main features of patients treated with oral antidiabetics , evaluating monotherapy ( mt ) , loose - dose combination therapy ( ldct ) and fixed - dose combination therapy ( fdct ) ; to describe medication [adherence] to the different therapies [;] and to evaluate the differences in compliance with the prescribed therapy regimen among prevalent and incident patient cohorts . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 10 treated 0 ###LEFT-WALL### 20 , 1 objectives 2 : 2 : 3 to 2 : 10 treated 3 to 4 define 4 define 7 features 5 the 6 main 5 the 7 features 7 features 8 of 8 of 9 patients 10 treated 11 with 11 with 13 antidiabetics 12 oral 13 antidiabetics 13 antidiabetics 15 evaluating 14 , 15 evaluating 15 evaluating 16 monotherapy 15 evaluating 20 , 16 monotherapy 18 mt 17 ( 18 mt 18 mt 19 ) 20 , 29 and 20 , 31 - 21 loose 22 - 21 loose 29 and 23 dose 25 therapy 23 dose 29 and 24 combination 25 therapy 25 therapy 27 ldct 26 ( 27 ldct 27 ldct 28 ) 29 and 30 fixed 31 - 32 dose 31 - 38 ; 31 - 48 and 32 dose 34 therapy 33 combination 34 therapy 34 therapy 36 fdct 35 ( 36 fdct 36 fdct 37 ) 38 ; 39 to 39 to 48 and 40 describe 41 medication 40 describe 43 to 40 describe 48 and 43 to 46 therapies 44 the 46 therapies 45 different 46 therapies 48 and 49 to 48 and 50 evaluate 48 and 53 in 48 and 55 with 49 to 50 evaluate 50 evaluate 52 differences 51 the 52 differences 53 in 54 compliance 55 with 59 regimen 55 with 60 among 56 the 59 regimen 57 prescribed 59 regimen 58 therapy 59 regimen 60 among 62 and 61 prevalent 62 and 62 and 65 cohorts 62 and 66 . 63 incident 64 patient 64 patient 65 cohorts study design : this study was a retrospective cohort analysis based on the arno database , a national record that tracks reimbursable prescription claims submitted from selected pharmacies to the italian national health system . 0 ###LEFT-WALL### 2 design 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 35 . 1 study 2 design 3 : 5 study 3 : 6 was 3 : 16 , 4 this 5 study 5 study 6 was 6 was 10 analysis 7 a 10 analysis 8 retrospective 9 cohort 9 cohort 10 analysis 10 analysis 11 based 11 based 12 on 12 on 15 database 13 the 15 database 14 arno 15 database 16 , 19 record 16 , 25 submitted 17 a 18 national 17 a 19 record 18 national 19 record 19 record 20 that 19 record 21 tracks 19 record 25 submitted 20 that 21 tracks 21 tracks 24 claims 22 reimbursable 23 prescription 23 prescription 24 claims 25 submitted 26 from 25 submitted 29 to 26 from 28 pharmacies 27 selected 28 pharmacies 29 to 34 system 30 the 34 system 31 italian 32 national 32 national 34 system 33 health 34 system in total , 169,375 subjects , from an overall population of 4,040,624 were included in this study . 0 ###LEFT-WALL### 10 population 0 ###LEFT-WALL### 14 included 0 ###LEFT-WALL### 18 . 1 in 5 subjects 1 in 6 , 1 in 10 population 2 total 3 , 2 total 5 subjects 4 169,375 5 subjects 7 from 9 overall 7 from 10 population 8 an 9 overall 10 population 11 of 10 population 13 were 11 of 12 4,040,624 13 were 14 included 14 included 15 in 15 in 17 study 16 this 17 study the patients represented 12 different local health units . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 represented 0 ###LEFT-WALL### 9 . 1 the 2 patients 2 patients 3 represented 3 represented 8 units 4 12 8 units 5 different 6 local 6 local 8 units 7 health 8 units each patient had at least one oral antidiabetic prescription claim ( a10b atc code ) . 0 ###LEFT-WALL### 2 patient 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 16 . 1 each 2 patient 2 patient 3 had 3 had 10 claim 4 at 5 least 5 least 6 one 6 one 10 claim 7 oral 9 prescription 8 antidiabetic 9 prescription 9 prescription 10 claim 10 claim 14 code 11 ( 14 code 12 a10b 13 atc 13 atc 14 code 14 code 15 ) methods : patients were divided into four groups according to their treatment regimen during the recruitment period ( 1 january 2008 - 31 december 2008 ) : mt , fdct , ldct and switching therapy . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 patients 2 : 5 divided 2 : 27 : 2 : 36 . 3 patients 4 were 4 were 5 divided 5 divided 6 into 5 divided 10 to 6 into 8 groups 7 four 8 groups 9 according 10 to 10 to 13 regimen 11 their 13 regimen 12 treatment 13 regimen 13 regimen 14 during 14 during 17 period 15 the 17 period 16 recruitment 17 period 17 period 20 january 17 period 24 december 18 ( 20 january 19 1 20 january 20 january 21 2008 20 january 22 - 22 - 24 december 23 31 24 december 24 december 25 2008 24 december 26 ) 27 : 33 and 28 mt 29 , 29 , 32 ldct 29 , 33 and 30 fdct 32 ldct 31 , 32 ldct 33 and 35 therapy 34 switching 35 therapy a timespan of 5 years was considered , from 4 years before to 1 year after the index date [(] i.e [.] date of the prescription selected in the recruitment period ) . 0 ###LEFT-WALL### 2 timespan 0 ###LEFT-WALL### 7 considered 0 ###LEFT-WALL### 33 . 1 a 2 timespan 2 timespan 3 of 2 timespan 6 was 3 of 5 years 4 5 5 years 6 was 7 considered 7 considered 9 from 8 , 9 from 9 from 10 4 9 from 32 ) 10 4 12 before 10 4 13 to 10 4 24 of 11 years 12 before 13 to 15 year 14 1 15 year 15 year 16 after 16 after 23 date 17 the 23 date 18 index 23 date 19 date 23 date 21 i.e 23 date 24 of 26 prescription 25 the 26 prescription 26 prescription 27 selected 27 selected 28 in 28 in 31 period 29 the 31 period 30 recruitment 31 period a medication possession ratio [(] mpr [ )(with a cut [-] off value of 80 % was used to measure medication [adherence] . 0 ###LEFT-WALL### 6 mpr 0 ###LEFT-WALL### 18 used 0 ###LEFT-WALL### 23 . 1 a 2 medication 1 a 6 mpr 2 medication 6 mpr 3 possession 6 mpr 4 ratio 6 mpr 6 mpr 8 )(with 6 mpr 17 was 8 )(with 10 cut 9 a 10 cut 10 cut 12 off 10 cut 14 of 12 off 13 value 14 of 16 % 15 80 16 % 17 was 18 used 18 used 19 to 18 used 20 measure 19 to 20 measure 20 measure 21 medication descriptive statistics and multiple logistic regression were used to define the objectives , [while] p < 0.05 was considered to indicate significance . 0 ###LEFT-WALL### 1 descriptive 0 ###LEFT-WALL### 19 considered 0 ###LEFT-WALL### 23 . 1 descriptive 3 and 1 descriptive 10 define 1 descriptive 16 < 1 descriptive 18 was 2 statistics 3 and 3 and 6 regression 3 and 7 were 4 multiple 5 logistic 5 logistic 6 regression 7 were 8 used 8 used 9 to 9 to 10 define 10 define 12 objectives 11 the 12 objectives 13 , 16 < 15 p 16 < 16 < 17 0.05 18 was 19 considered 19 considered 20 to 19 considered 21 indicate 20 to 21 indicate 21 indicate 22 significance results : the median age of patients ( n = 169,375 , [prevalence] 4.2 % ) was 70 years [ interquartile range ( iqr ) [17] ] , and 49.1 % were females . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 5 age 2 : 17 was 2 : 29 and 3 the 5 age 4 median 5 age 5 age 6 of 5 age 10 = 5 age 15 % 5 age 17 was 6 of 7 patients 8 ( 10 = 9 n 10 = 10 = 11 169,375 12 , 15 % 14 4.2 15 % 15 % 16 ) 17 was 19 years 18 70 19 years 19 years 22 range 20 [ 22 range 21 interquartile 22 range 22 range 24 iqr 22 range 27 ] 23 ( 24 iqr 24 iqr 25 ) 28 , 29 and 29 and 31 % 29 and 32 were 30 49.1 31 % 31 % 32 were 32 were 33 females fdct and ldct were significantly correlated with mpr . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 6 correlated 0 ###LEFT-WALL### 9 . 1 fdct 2 and 2 and 3 ldct 2 and 4 were 4 were 5 significantly 4 were 6 correlated 6 correlated 7 with 7 with 8 mpr compliance was 48.9 % in the prevalent patient cohort [(] i.e . patients prescribed oral antidiabetic therapy in both prerecruitment and recruitment periods ) ; median mprs for the treatment regimens were : mt , 0.73 ( iqr 0.52 ) ; fdct , 1 ( iqr 0.28 ) [;] and ldct , 0.90 ( iqr 0.32 ) . 0 ###LEFT-WALL### 1 compliance 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 12 . 0 ###LEFT-WALL### 58 . 1 compliance 2 was 2 was 4 % 2 was 5 in 3 48.9 4 % 5 in 11 i.e 6 the 11 i.e 7 prevalent 9 cohort 8 patient 9 cohort 9 cohort 11 i.e 12 . 13 patients 12 . 14 prescribed 12 . 25 ; 13 patients 14 prescribed 14 prescribed 17 therapy 14 prescribed 18 in 15 oral 17 therapy 16 antidiabetic 17 therapy 18 in 21 and 19 both 21 and 20 prerecruitment 21 and 21 and 23 periods 21 and 24 ) 22 recruitment 23 periods 25 ; 26 median 25 ; 32 were 25 ; 33 : 26 median 32 were 27 mprs 28 for 27 mprs 32 were 28 for 31 regimens 29 the 31 regimens 30 treatment 31 regimens 33 : 34 mt 33 : 41 ; 34 mt 36 0.73 35 , 36 0.73 36 0.73 38 iqr 36 0.73 40 ) 37 ( 38 iqr 38 iqr 39 0.52 38 iqr 40 ) 41 ; 50 and 42 fdct 44 1 42 fdct 50 and 43 , 44 1 44 1 46 iqr 44 1 48 ) 45 ( 46 iqr 46 iqr 47 0.28 46 iqr 48 ) 50 and 51 ldct 50 and 57 ) 51 ldct 53 0.90 52 , 53 0.90 53 0.90 55 iqr 53 0.90 57 ) 54 ( 55 iqr 55 iqr 56 0.32 55 iqr 57 ) compliance was 43.0 % in the incident patient cohort ( i.e [.] patients who were first prescribed oral antidiabetic therapy in the recruitment period ) ; median mprs for the treatment regimens were : mt , 0.70 ( iqr , 0.58 ) ; fdct , 1 ( iqr 0.34 ) [;] and ldct , 0.64 ( iqr 0.39 ) . 0 ###LEFT-WALL### 1 compliance 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 26 ; 0 ###LEFT-WALL### 60 . 1 compliance 2 was 2 was 4 % 3 43.0 4 % 4 % 5 in 5 in 9 cohort 6 the 9 cohort 7 incident 8 patient 8 patient 9 cohort 9 cohort 13 patients 10 ( 13 patients 11 i.e 13 patients 13 patients 14 who 13 patients 15 were 13 patients 25 ) 14 who 15 were 15 were 20 therapy 15 were 21 in 16 first 17 prescribed 17 prescribed 20 therapy 18 oral 20 therapy 19 antidiabetic 20 therapy 21 in 24 period 22 the 24 period 23 recruitment 24 period 26 ; 27 median 26 ; 33 were 26 ; 34 : 27 median 33 were 28 mprs 29 for 28 mprs 33 were 29 for 32 regimens 30 the 32 regimens 31 treatment 32 regimens 34 : 35 mt 34 : 43 ; 35 mt 37 0.70 36 , 37 0.70 37 0.70 39 iqr 37 0.70 43 ; 38 ( 39 iqr 39 iqr 41 0.58 39 iqr 42 ) 40 , 41 0.58 41 0.58 42 ) 43 ; 52 and 44 fdct 46 1 44 fdct 52 and 45 , 46 1 46 1 48 iqr 46 1 50 ) 47 ( 48 iqr 48 iqr 49 0.34 48 iqr 50 ) 52 and 53 ldct 53 ldct 55 0.64 54 , 55 0.64 55 0.64 57 iqr 55 0.64 59 ) 56 ( 57 iqr 57 iqr 58 0.39 57 iqr 59 ) conclusions : compliance was better for fdct than the other therapeutic regimens in the study population . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 compliance 2 : 4 was 2 : 17 . 3 compliance 4 was 4 was 5 better 5 better 6 for 5 better 8 than 5 better 13 in 6 for 7 fdct 8 than 12 regimens 9 the 10 other 10 other 12 regimens 11 therapeutic 12 regimens 13 in 16 population 14 the 16 population 15 study 16 population the same trend was observed in both the prevalent and incident patient cohorts . 0 ###LEFT-WALL### 3 trend 0 ###LEFT-WALL### 5 observed 0 ###LEFT-WALL### 14 . 1 the 2 same 2 same 3 trend 3 trend 4 was 4 was 5 observed 5 observed 6 in 6 in 10 and 7 both 10 and 8 the 9 prevalent 9 prevalent 10 and 10 and 13 cohorts 11 incident 13 cohorts 12 patient 13 cohorts as type 2 diabetes is a chronic lifelong pathology , and multiple agents are often required to achieve glycaemic control , the preference for fdct in the population , [when] clinically applicable , could be an effective strategy for functional administration of clinical outcome [and] sources . 0 ###LEFT-WALL### 4 diabetes 0 ###LEFT-WALL### 5 is 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 35 be 0 ###LEFT-WALL### 47 . 1 as 2 type 1 as 4 diabetes 2 type 3 2 4 diabetes 5 is 5 is 20 control 6 a 20 control 7 chronic 9 pathology 8 lifelong 9 pathology 9 pathology 11 and 10 , 11 and 11 and 12 multiple 11 and 13 agents 11 and 18 achieve 11 and 20 control 13 agents 14 are 14 are 16 required 15 often 16 required 16 required 17 to 16 required 18 achieve 17 to 18 achieve 19 glycaemic 20 control 21 , 35 be 22 the 23 preference 23 preference 24 for 23 preference 26 in 23 preference 32 applicable 23 preference 34 could 24 for 25 fdct 26 in 28 population 27 the 28 population 29 , 32 applicable 31 clinically 32 applicable 32 applicable 33 , 34 could 35 be 35 be 38 strategy 36 an 38 strategy 37 effective 38 strategy 38 strategy 39 for 38 strategy 42 of 39 for 41 administration 40 functional 41 administration 42 of 46 sources 43 clinical 44 outcome 44 outcome 46 sources evaluation of specific population fractions ( age , sex , compliance , etc [.] ) and specific agents or drug combinations could also be relevant in order to reach the healthcare objectives . 0 ###LEFT-WALL### 24 be 0 ###LEFT-WALL### 33 . 1 evaluation 2 of 1 evaluation 16 and 2 of 5 fractions 3 specific 4 population 4 population 5 fractions 5 fractions 7 age 5 fractions 9 sex 5 fractions 11 compliance 5 fractions 13 etc 6 ( 7 age 7 age 8 , 8 , 9 sex 9 sex 10 , 10 , 11 compliance 11 compliance 12 , 12 , 13 etc 13 etc 15 ) 16 and 18 agents 16 and 19 or 17 specific 18 agents 19 or 21 combinations 19 or 22 could 20 drug 21 combinations 22 could 24 be 23 also 24 be 24 be 25 relevant 25 relevant 26 in 26 in 27 order 27 order 28 to 27 order 29 reach 28 to 29 reach 29 reach 32 objectives 30 the 32 objectives 31 healthcare 32 objectives [none] none the useful field of view [(] [®] [ )(( ufov ) and trail making test part b ( trails b ) are measures of divided attention . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 24 are 0 ###LEFT-WALL### 29 . 2 none 3 the 3 the 4 useful 4 useful 5 field 5 field 6 of 5 field 14 and 6 of 12 ufov 7 view 12 ufov 11 )(( 12 ufov 12 ufov 13 ) 14 and 18 part 14 and 21 trails 14 and 24 are 15 trail 16 making 16 making 17 test 17 test 18 part 18 part 19 b 20 ( 21 trails 21 trails 22 b 21 trails 23 ) 24 are 25 measures 25 measures 26 of 26 of 28 attention 27 divided 28 attention we determined which measure was more accurate in predicting on [-] road outcomes among drivers ( n = 198 , mean age = 73.86 , standard deviation [=] 6.05 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 determined 0 ###LEFT-WALL### 31 . 1 we 2 determined 2 determined 3 which 2 determined 8 in 3 which 4 measure 4 measure 5 was 5 was 7 accurate 6 more 7 accurate 8 in 9 predicting 9 predicting 22 age 9 predicting 23 = 10 on 13 outcomes 10 on 20 , 10 on 22 age 12 road 13 outcomes 13 outcomes 14 among 14 among 15 drivers 15 drivers 18 = 16 ( 18 = 17 n 18 = 18 = 19 198 18 = 20 , 21 mean 22 age 22 age 23 = 23 = 24 73.86 24 73.86 27 deviation 25 , 27 deviation 26 standard 27 deviation 27 deviation 29 6.05 27 deviation 30 ) receiver operating characteristic curves for the ufov ( risk index [ ri ] and subtests 1 - 3 ) and trails b significantly predicted on [-] road outcomes . 0 ###LEFT-WALL### 24 predicted 1 receiver 2 operating 1 receiver 14 and 2 operating 4 curves 2 operating 5 for 3 characteristic 4 curves 5 for 7 ufov 6 the 7 ufov 7 ufov 10 index 8 ( 10 index 9 risk 10 index 10 index 12 ri 10 index 13 ] 11 [ 12 ri 12 ri 13 ] 14 and 15 subtests 14 and 18 3 14 and 20 and 15 subtests 16 1 17 - 18 3 18 3 19 ) 20 and 21 trails 20 and 24 predicted 21 trails 22 b 23 significantly 24 predicted 24 predicted 25 on 24 predicted 29 . 25 on 28 outcomes 27 road 28 outcomes contrasting trails b with the ufov ri and subtests , the only difference was found between the ufov ri and trails b , indicating the ufov ri was the best predictor of on - road outcomes . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 37 . 1 contrasting 2 trails 2 trails 3 b 2 trails 4 with 2 trails 8 and 4 with 7 ri 5 the 7 ri 6 ufov 7 ri 8 and 9 subtests 10 , 13 difference 10 , 15 found 10 , 34 - 11 the 12 only 11 the 13 difference 13 difference 14 was 14 was 15 found 15 found 16 between 15 found 24 indicating 16 between 20 and 17 the 19 ri 18 ufov 19 ri 19 ri 20 and 20 and 21 trails 21 trails 22 b 23 , 24 indicating 24 indicating 26 ufov 24 indicating 34 - 25 the 26 ufov 26 ufov 27 ri 26 ufov 33 on 27 ri 28 was 28 was 31 predictor 29 the 30 best 29 the 31 predictor 31 predictor 32 of 32 of 33 on 34 - 36 outcomes 35 road 36 outcomes misclassifications of drivers totaled 28 for the ufov ri , 62 for trails b , and [58] for ufov subtest 2 . 0 ###LEFT-WALL### 1 misclassifications 0 ###LEFT-WALL### 4 totaled 0 ###LEFT-WALL### 22 . 1 misclassifications 2 of 1 misclassifications 4 totaled 2 of 3 drivers 4 totaled 5 28 5 28 16 and 6 for 9 ri 6 for 16 and 7 the 9 ri 8 ufov 9 ri 9 ri 11 62 10 , 11 62 11 62 12 for 11 62 15 , 12 for 13 trails 13 trails 14 b 15 , 16 and 16 and 18 for 18 for 20 subtest 19 ufov 20 subtest 20 subtest 21 2 the ufov ri is a superior test in predicting [on] - road outcomes , but the trails b has acceptable accuracy and is comparable to the other ufov subtests . 0 ###LEFT-WALL### 3 ri 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 30 . 1 the 3 ri 2 ufov 3 ri 3 ri 4 is 4 is 7 test 5 a 7 test 6 superior 7 test 7 test 8 in 7 test 13 outcomes 8 in 9 predicting 11 - 13 outcomes 12 road 13 outcomes 13 outcomes 14 , 15 but 17 trails 15 but 22 and 16 the 17 trails 17 trails 18 b 17 trails 22 and 19 has 21 accuracy 19 has 22 and 20 acceptable 21 accuracy 22 and 23 is 22 and 25 to 22 and 29 subtests 23 is 24 comparable 25 to 27 other 26 the 27 other 28 ufov 29 subtests proper brain [function] requires neuronal homeostasis over a range of environmental challenges . 0 ###LEFT-WALL### 2 brain 0 ###LEFT-WALL### 4 requires 0 ###LEFT-WALL### 13 . 1 proper 2 brain 2 brain 4 requires 4 requires 6 homeostasis 4 requires 7 over 5 neuronal 6 homeostasis 7 over 9 range 8 a 9 range 9 range 10 of 10 of 12 challenges 11 environmental 12 challenges neuronal activity , injury , and aging stress the nervous system , and lead to neuronal dysfunction and degeneration . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 20 . 1 neuronal 2 activity 2 activity 3 , 3 , 4 injury 3 , 6 and 5 , 6 and 6 and 7 aging 6 and 13 and 8 stress 11 system 8 stress 13 and 9 the 11 system 10 nervous 11 system 12 , 13 and 13 and 14 lead 14 lead 15 to 15 to 18 and 16 neuronal 17 dysfunction 17 dysfunction 18 and 18 and 19 degeneration nevertheless , most organisms maintain healthy neurons throughout life , implying the existence of active maintenance mechanisms . 0 ###LEFT-WALL### 4 organisms 0 ###LEFT-WALL### 5 maintain 1 nevertheless 2 , 1 nevertheless 4 organisms 3 most 4 organisms 4 organisms 5 maintain 5 maintain 7 neurons 5 maintain 8 throughout 6 healthy 7 neurons 8 throughout 9 life 9 life 11 implying 10 , 11 implying 11 implying 13 existence 11 implying 18 . 12 the 13 existence 13 existence 14 of 14 of 17 mechanisms 15 active 16 maintenance 16 maintenance 17 mechanisms recent studies have revealed a key neuronal maintenance and protective function for nicotinamide mononucleotide adenylyl transferases ( nmnats ) . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 revealed 0 ###LEFT-WALL### 20 . 1 recent 2 studies 2 studies 3 have 3 have 4 revealed 4 revealed 9 and 4 revealed 12 for 5 a 8 maintenance 6 key 8 maintenance 7 neuronal 8 maintenance 8 maintenance 9 and 9 and 11 function 10 protective 11 function 12 for 16 transferases 13 nicotinamide 15 adenylyl 14 mononucleotide 15 adenylyl 15 adenylyl 16 transferases 16 transferases 18 nmnats 17 ( 18 nmnats 18 nmnats 19 ) we review evidence that nmnats protect neurons through multiple mechanisms in different contexts , and highlight functions that either require or [are] independent of nmnat catalytic activity . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 28 . 1 we 2 review 2 review 3 evidence 2 review 8 through 2 review 11 in 3 evidence 4 that 4 that 5 nmnats 4 that 6 protect 5 nmnats 6 protect 6 protect 7 neurons 8 through 10 mechanisms 9 multiple 10 mechanisms 11 in 21 or 12 different 13 contexts 13 contexts 15 and 14 , 15 and 15 and 17 functions 15 and 18 that 15 and 20 require 15 and 21 or 16 highlight 17 functions 18 that 19 either 18 that 20 require 19 either 20 require 21 or 23 independent 21 or 24 of 24 of 27 activity 25 nmnat 27 activity 26 catalytic 27 activity we then summarize data supporting a role for nmnats in neuronal maintenance and raise intriguing questions on how nmnats preserve neuronal integrity and facilitate proper neural function [throughout] life . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 30 . 1 we 23 and 2 then 3 summarize 3 summarize 13 and 3 summarize 17 on 3 summarize 23 and 4 data 5 supporting 4 data 13 and 5 supporting 7 role 5 supporting 8 for 5 supporting 10 in 6 a 7 role 8 for 9 nmnats 10 in 12 maintenance 11 neuronal 12 maintenance 13 and 14 raise 13 and 15 intriguing 15 intriguing 16 questions 17 on 18 how 18 how 19 nmnats 18 how 20 preserve 19 nmnats 20 preserve 20 preserve 22 integrity 21 neuronal 22 integrity 23 and 24 facilitate 23 and 29 life 25 proper 27 function 26 neural 27 function 27 function 29 life objectives : across the developed world , wait lists for facility - based long - term care ( ltc ) beds continue to grow . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 21 beds 2 : 22 continue 2 : 25 . 3 across 6 world 3 across 21 beds 4 the 6 world 5 developed 6 world 6 world 9 lists 6 world 17 care 7 , 9 lists 8 wait 9 lists 9 lists 10 for 9 lists 13 based 9 lists 15 - 10 for 11 facility 12 - 13 based 13 based 14 long 13 based 15 - 15 - 17 care 16 term 17 care 17 care 19 ltc 17 care 20 ) 18 ( 19 ltc 19 ltc 20 ) 21 beds 22 continue 22 continue 23 to 22 continue 24 grow 23 to 24 grow wait lists are primarily driven by the needs of aging populations ( demand - side factors ) . 0 ###LEFT-WALL### 2 lists 0 ###LEFT-WALL### 5 driven 0 ###LEFT-WALL### 18 . 1 wait 2 lists 2 lists 3 are 3 are 5 driven 4 primarily 5 driven 5 driven 6 by 6 by 8 needs 7 the 8 needs 8 needs 9 of 9 of 10 aging 10 aging 11 populations 11 populations 13 demand 11 populations 16 factors 12 ( 13 demand 13 demand 14 - 14 - 16 factors 15 side 16 factors 16 factors 17 ) less attention has been given to system capacity to provide community alternatives to ltc ( supply - side factors ) . 0 ###LEFT-WALL### 2 attention 0 ###LEFT-WALL### 5 given 0 ###LEFT-WALL### 21 . 1 less 2 attention 2 attention 3 has 3 has 4 been 4 been 5 given 5 given 6 to 5 given 13 to 6 to 8 capacity 7 system 8 capacity 8 capacity 9 to 8 capacity 10 provide 9 to 10 provide 10 provide 12 alternatives 11 community 12 alternatives 13 to 14 ltc 14 ltc 16 supply 14 ltc 19 factors 15 ( 16 supply 16 supply 17 - 17 - 19 factors 18 side 19 factors 19 factors 20 ) we examine the role of both demand - and supply - side factors by comparing the characteristics of individuals who have been assessed and deemed eligible for ltc in urban and rural/underserviced parts of northwestern ontario , canada . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examine 1 we 2 examine 2 examine 4 role 3 the 4 role 4 role 5 of 4 role 13 factors 5 of 9 and 6 both 9 and 7 demand 9 and 8 - 9 and 9 and 10 supply 11 - 13 factors 12 side 13 factors 13 factors 14 by 13 factors 18 of 13 factors 26 eligible 13 factors 39 . 14 by 15 comparing 15 comparing 17 characteristics 16 the 17 characteristics 18 of 19 individuals 19 individuals 20 who 19 individuals 21 have 20 who 21 have 21 have 22 been 22 been 24 and 23 assessed 24 and 24 and 25 deemed 26 eligible 27 for 27 for 28 ltc 28 ltc 29 in 28 ltc 34 of 29 in 31 and 30 urban 31 and 31 and 33 parts 32 rural/underserviced 33 parts 34 of 36 ontario 35 northwestern 36 ontario 36 ontario 38 canada 37 , 38 canada 38 canada 39 . methods : home care assessment data were analyzed for all individuals waiting for ltc in northwestern ontario as of march 2008 ( n=858 ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 6 data 2 : 8 analyzed 2 : 25 . 3 home 5 assessment 4 care 5 assessment 5 assessment 6 data 6 data 7 were 7 were 8 analyzed 8 analyzed 9 for 9 for 11 individuals 10 all 11 individuals 11 individuals 12 waiting 11 individuals 15 in 11 individuals 23 n=858 12 waiting 13 for 13 for 14 ltc 15 in 17 ontario 16 northwestern 17 ontario 17 ontario 18 as 18 as 19 of 19 of 20 march 20 march 21 2008 22 ( 23 n=858 23 n=858 24 ) for the analysis , the sample was separated into urban and rural groups to account for geographical differences in [wait] list [location] . 0 ###LEFT-WALL### 6 sample 0 ###LEFT-WALL### 8 separated 0 ###LEFT-WALL### 23 . 1 for 3 analysis 1 for 4 , 1 for 6 sample 2 the 3 analysis 5 the 6 sample 6 sample 7 was 7 was 8 separated 8 separated 9 into 9 into 11 and 10 urban 11 and 11 and 12 rural 11 and 13 groups 11 and 21 list 13 groups 14 to 13 groups 19 in 13 groups 21 list 14 to 15 account 15 account 16 for 15 account 19 in 16 for 18 differences 17 geographical 18 differences characteristics between these two groups were compared . 0 ###LEFT-WALL### 1 characteristics 0 ###LEFT-WALL### 7 compared 0 ###LEFT-WALL### 8 . 1 characteristics 2 between 1 characteristics 6 were 2 between 5 groups 3 these 4 two 4 two 5 groups 6 were 7 compared results : individuals on ltc wait lists in the rural areas were significantly less impaired in activities of daily living and cognition than their counterparts in the urban area . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 30 . 2 : 3 individuals 2 : 15 impaired 3 individuals 4 on 3 individuals 8 in 3 individuals 12 were 4 on 7 lists 5 ltc 7 lists 6 wait 7 lists 8 in 11 areas 9 the 11 areas 10 rural 11 areas 12 were 14 less 12 were 15 impaired 13 significantly 14 less 15 impaired 16 in 15 impaired 23 than 15 impaired 26 in 16 in 21 and 17 activities 18 of 17 activities 21 and 18 of 20 living 19 daily 20 living 21 and 22 cognition 23 than 25 counterparts 24 their 25 counterparts 26 in 29 area 27 the 29 area 28 urban 29 area however , in both areas , impairments in lighter - care activities appeared to be a key wait list driver , and few people had an informal caregiver living in the home . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 25 had 0 ###LEFT-WALL### 33 . 1 however 7 impairments 1 however 13 appeared 1 however 22 and 2 , 3 in 3 in 5 areas 3 in 6 , 3 in 7 impairments 4 both 5 areas 7 impairments 8 in 7 impairments 13 appeared 8 in 12 activities 9 lighter 10 - 9 lighter 11 care 11 care 12 activities 13 appeared 14 to 13 appeared 15 be 14 to 15 be 16 a 20 driver 17 key 19 list 18 wait 19 list 19 list 20 driver 20 driver 22 and 21 , 22 and 22 and 24 people 22 and 25 had 23 few 24 people 25 had 29 living 25 had 30 in 26 an 29 living 27 informal 28 caregiver 28 caregiver 29 living 30 in 32 home 31 the 32 home conclusions : our data suggest that ltc wait lists reflect , at least to some extent , insufficient community capacity , not just need for ltc . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 reflect 2 : 4 data 2 : 5 suggest 3 our 4 data 4 data 5 suggest 5 suggest 6 that 6 that 9 lists 6 that 10 reflect 7 ltc 9 lists 8 wait 9 lists 10 reflect 14 to 10 reflect 20 capacity 11 , 13 least 11 , 14 to 12 at 13 least 14 to 16 extent 14 to 17 , 15 some 16 extent 18 insufficient 19 community 19 community 20 capacity 20 capacity 24 need 21 , 22 not 21 , 24 need 23 just 24 need 24 need 25 for 24 need 27 . 25 for 26 ltc older adults should be screened for fall risk annually . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 5 screened 0 ###LEFT-WALL### 10 . 1 older 2 adults 2 adults 3 should 3 should 4 be 4 be 5 screened 5 screened 6 for 5 screened 9 annually 6 for 8 risk 7 fall 8 risk community providers ( people without formal medical training who work with older adults in senior centers or aging services ) may be a viable group to expand the reach of screenings . 0 ###LEFT-WALL### 2 providers 0 ###LEFT-WALL### 22 be 0 ###LEFT-WALL### 32 . 1 community 2 providers 2 providers 4 people 2 providers 21 may 3 ( 4 people 4 people 5 without 4 people 9 who 4 people 10 work 4 people 11 with 4 people 20 ) 5 without 8 training 6 formal 8 training 7 medical 8 training 9 who 10 work 11 with 17 or 12 older 13 adults 13 adults 14 in 13 adults 17 or 14 in 16 centers 15 senior 16 centers 17 or 19 services 18 aging 19 services 21 may 22 be 22 be 25 group 22 be 26 to 23 a 25 group 24 viable 25 group 26 to 27 expand 27 expand 29 reach 28 the 29 reach 29 reach 30 of 30 of 31 screenings our community - academic partnership developed a program to increase and assess fall risk screenings by community providers . 0 ###LEFT-WALL### 2 community 0 ###LEFT-WALL### 3 - 1 our 2 community 3 - 5 partnership 3 - 6 developed 3 - 19 . 4 academic 5 partnership 5 partnership 6 developed 6 developed 8 program 6 developed 9 to 7 a 8 program 9 to 11 and 10 increase 11 and 11 and 12 assess 12 assess 14 risk 12 assess 15 screenings 13 fall 14 risk 14 risk 15 screenings 15 screenings 16 by 16 by 18 providers 17 community 18 providers community sites hosted training workshops and screening events . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 . 1 community 2 sites 2 sites 3 hosted 2 sites 4 training 2 sites 6 and 4 training 5 workshops 6 and 8 events 7 screening 8 events community screenings were well attended and received by providers and older adults . 0 ###LEFT-WALL### 2 screenings 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 13 . 1 community 2 screenings 2 screenings 6 and 3 were 4 well 3 were 6 and 4 well 5 attended 6 and 7 received 6 and 8 by 8 by 10 and 9 providers 10 and 10 and 12 adults 11 older 12 adults with administrative support from the regional fall prevention coalition and technical support from academia , community providers screened 161 older adults from a broad geographic area . 0 ###LEFT-WALL### 17 providers 0 ###LEFT-WALL### 18 screened 0 ###LEFT-WALL### 27 . 1 with 10 and 1 with 15 , 1 with 17 providers 2 administrative 3 support 3 support 4 from 3 support 10 and 4 from 9 coalition 5 the 9 coalition 6 regional 7 fall 7 fall 9 coalition 8 prevention 9 coalition 10 and 12 support 10 and 13 from 11 technical 12 support 13 from 14 academia 16 community 17 providers 17 providers 18 screened 18 screened 21 adults 19 161 21 adults 20 older 21 adults 21 adults 22 from 22 from 26 area 23 a 26 area 24 broad 26 area 25 geographic 26 area twenty - one community providers completed the training . 0 ###LEFT-WALL### 1 twenty 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 9 . 2 - 4 community 3 one 4 community 4 community 5 providers 4 community 6 completed 5 providers 6 completed 6 completed 8 training 7 the 8 training knowledge and confidence surveys demonstrated improvements before and after training ( p<.001 ) . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 demonstrated 0 ###LEFT-WALL### 14 . 1 knowledge 2 and 2 and 4 surveys 2 and 5 demonstrated 3 confidence 4 surveys 5 demonstrated 6 improvements 6 improvements 8 and 7 before 8 and 8 and 9 after 9 after 10 training 10 training 12 p<.001 11 ( 12 p<.001 12 p<.001 13 ) skills assessments demonstrated mastery of most skills , but some providers required additional training . 0 ###LEFT-WALL### 2 assessments 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 9 but 0 ###LEFT-WALL### 15 . 1 skills 2 assessments 2 assessments 3 demonstrated 3 demonstrated 4 mastery 4 mastery 5 of 5 of 7 skills 6 most 7 skills 8 , 9 but 9 but 11 providers 9 but 12 required 10 some 11 providers 11 providers 12 required 12 required 14 training 13 additional 14 training provider feedback indicated screening procedures were complex . 0 ###LEFT-WALL### 2 feedback 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 8 . 1 provider 2 feedback 2 feedback 3 indicated 2 feedback 4 screening 2 feedback 6 were 4 screening 5 procedures 6 were 7 complex future projects will examine this model using simplified screening procedures . 0 ###LEFT-WALL### 2 projects 0 ###LEFT-WALL### 4 examine 0 ###LEFT-WALL### 11 . 1 future 2 projects 2 projects 3 will 3 will 4 examine 4 examine 7 using 5 this 7 using 6 model 7 using 7 using 8 simplified 7 using 9 screening 9 screening 10 procedures the longevity regulator sirt1 is an enzyme catalyzing the deacetylation of protein substrates , in turn modulating their biological functions . 0 ###LEFT-WALL### 4 sirt1 0 ###LEFT-WALL### 5 is 1 the 3 regulator 2 longevity 3 regulator 3 regulator 4 sirt1 4 sirt1 5 is 5 is 7 enzyme 6 an 7 enzyme 7 enzyme 8 catalyzing 8 catalyzing 10 deacetylation 9 the 10 deacetylation 10 deacetylation 11 of 11 of 13 substrates 12 protein 13 substrates 13 substrates 17 modulating 14 , 17 modulating 15 in 16 turn 16 turn 17 modulating 17 modulating 20 functions 17 modulating 21 . 18 their 20 functions 19 biological 20 functions in endothelial cells , downregulation of sirt1 evokes cellular senescence . 0 ###LEFT-WALL### 5 downregulation 0 ###LEFT-WALL### 8 evokes 0 ###LEFT-WALL### 11 . 1 in 3 cells 1 in 4 , 1 in 5 downregulation 2 endothelial 3 cells 5 downregulation 6 of 5 downregulation 8 evokes 6 of 7 sirt1 8 evokes 10 senescence 9 cellular 10 senescence in aged arteries , sirt1 expression and activity is blunted , [which] contributes to the development of atherosclerosis and abnormal vascular responses . 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 23 . 1 in 7 and 1 in 11 , 2 aged 3 arteries 3 arteries 4 , 4 , 6 expression 4 , 7 and 5 sirt1 6 expression 7 and 8 activity 9 is 10 blunted 9 is 11 , 11 , 13 contributes 13 contributes 14 to 14 to 16 development 15 the 16 development 16 development 17 of 17 of 19 and 18 atherosclerosis 19 and 19 and 22 responses 20 abnormal 22 responses 21 vascular 22 responses a recent study suggests that cyclin - dependent kinase 5 ( cdk5 ) is responsible for the phosphorylation of sirt1 at the serine 47 residue . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 suggests 0 ###LEFT-WALL### 26 . 1 a 2 recent 1 a 3 study 2 recent 3 study 3 study 4 suggests 4 suggests 5 that 5 that 6 cyclin 5 that 14 is 6 cyclin 9 kinase 6 cyclin 14 is 7 - 9 kinase 8 dependent 9 kinase 9 kinase 10 5 9 kinase 12 cdk5 9 kinase 13 ) 11 ( 12 cdk5 12 cdk5 13 ) 14 is 15 responsible 15 responsible 16 for 15 responsible 21 at 16 for 18 phosphorylation 17 the 18 phosphorylation 18 phosphorylation 19 of 19 of 20 sirt1 21 at 25 residue 22 the 25 residue 23 serine 24 47 23 serine 25 residue this modification blocks the anti - senescence activity of sirt1 and plays a critical role in the loss - of [-] sirt1 function during vascular ageing . 0 ###LEFT-WALL### 2 modification 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 19 - 1 this 2 modification 2 modification 11 and 3 blocks 8 activity 3 blocks 11 and 4 the 8 activity 5 anti 6 - 5 anti 7 senescence 7 senescence 8 activity 8 activity 9 of 9 of 10 sirt1 11 and 12 plays 12 plays 15 role 12 plays 16 in 13 a 14 critical 13 a 15 role 14 critical 15 role 16 in 18 loss 17 the 18 loss 19 - 23 function 19 - 27 . 20 of 22 sirt1 20 of 23 function 23 function 24 during 24 during 26 ageing 25 vascular 26 ageing thus , by inhibiting cdk5 , sirt1 [function] can be improved , in turn preventing the development of atherosclerosis and slowing down the process of vascular ageing . 0 ###LEFT-WALL### 7 sirt1 0 ###LEFT-WALL### 11 improved 1 thus 2 , 1 thus 7 sirt1 3 by 4 inhibiting 3 by 6 , 3 by 7 sirt1 4 inhibiting 5 cdk5 7 sirt1 9 can 9 can 10 be 10 be 11 improved 11 improved 15 preventing 12 , 15 preventing 13 in 14 turn 14 turn 15 preventing 15 preventing 17 development 15 preventing 22 down 15 preventing 28 . 16 the 17 development 17 development 18 of 18 of 20 and 19 atherosclerosis 20 and 20 and 21 slowing 22 down 24 process 23 the 24 process 24 process 25 of 25 of 27 ageing 26 vascular 27 ageing background : poor self - rated health has been associated with poorer objective health outcomes across a range of conditions including stroke . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 self 2 : 5 - 3 poor 4 self 5 - 7 health 5 - 10 associated 5 - 23 . 6 rated 7 health 7 health 8 has 8 has 9 been 9 been 10 associated 10 associated 11 with 11 with 14 health 12 poorer 14 health 13 objective 14 health 14 health 15 outcomes 14 health 22 stroke 15 outcomes 16 across 15 outcomes 19 of 15 outcomes 22 stroke 16 across 18 range 17 a 18 range 19 of 21 including 20 conditions 21 including identification of factors associated with poor self [-] rated health in stroke survivors has received little attention compared to that in other older individuals . 0 ###LEFT-WALL### 1 identification 0 ###LEFT-WALL### 15 received 0 ###LEFT-WALL### 25 . 1 identification 2 of 1 identification 14 has 2 of 3 factors 3 factors 4 associated 4 associated 5 with 4 associated 11 in 5 with 10 health 6 poor 10 health 7 self 9 rated 9 rated 10 health 11 in 13 survivors 12 stroke 13 survivors 14 has 15 received 15 received 17 attention 15 received 19 to 15 received 21 in 16 little 17 attention 17 attention 18 compared 19 to 20 that 21 in 24 individuals 22 other 24 individuals 23 older 24 individuals this study identifies determinants of self [-] rated health in older individuals [with] or without a history of stroke participating in the population - representative mrc cognitive function and aging study ( mrc cfas ) . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 identifies 0 ###LEFT-WALL### 36 . 1 this 2 study 2 study 3 identifies 3 identifies 4 determinants 3 identifies 14 or 3 identifies 21 in 4 determinants 5 of 5 of 9 health 6 self 8 rated 8 rated 9 health 10 in 12 individuals 10 in 14 or 11 older 12 individuals 14 or 15 without 15 without 17 history 16 a 17 history 17 history 18 of 18 of 20 participating 19 stroke 20 participating 21 in 23 population 22 the 23 population 23 population 34 cfas 24 - 34 cfas 25 representative 34 cfas 26 mrc 27 cognitive 27 cognitive 28 function 28 function 29 and 29 and 30 aging 30 aging 31 study 31 study 33 mrc 32 ( 33 mrc 33 mrc 34 cfas 34 cfas 35 ) methods : the mrc cfas is a multicentred longitudinal survey of a population representative sample of people in their 65th year and older at baseline . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 cfas 2 : 6 is 2 : 26 . 3 the 5 cfas 4 mrc 5 cfas 5 cfas 6 is 6 is 22 and 7 a 10 survey 8 multicentred 10 survey 9 longitudinal 10 survey 10 survey 11 of 10 survey 22 and 11 of 15 sample 12 a 15 sample 13 population 15 sample 14 representative 15 sample 15 sample 16 of 16 of 17 people 17 people 18 in 18 in 21 year 19 their 21 year 20 65th 21 year 22 and 23 older 23 older 24 at 24 at 25 baseline baseline interview included questions about functional disability , psychiatric history , independent living status , social interactions , and cognitive function . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 22 . 1 baseline 3 included 2 interview 3 included 3 included 4 questions 4 questions 5 about 4 questions 19 and 5 about 7 disability 6 functional 7 disability 7 disability 10 history 7 disability 14 status 8 , 10 history 9 psychiatric 10 history 10 history 11 , 11 , 14 status 12 independent 13 living 13 living 14 status 14 status 17 interactions 14 status 18 , 15 , 17 interactions 16 social 17 interactions 17 interactions 18 , 19 and 21 function 20 cognitive 21 function multiple logistic regression was used to determine associations between demographic , physical , cognitive , psychological and social factors with poor self [-] rated health among those [with] and [without] stroke . 0 ###LEFT-WALL### 3 regression 0 ###LEFT-WALL### 32 . 1 multiple 3 regression 2 logistic 3 regression 3 regression 4 was 4 was 5 used 5 used 6 to 5 used 9 between 5 used 20 with 6 to 7 determine 7 determine 8 associations 9 between 19 factors 10 demographic 11 , 10 demographic 19 factors 12 physical 13 , 12 physical 19 factors 14 cognitive 15 , 14 cognitive 19 factors 16 psychological 17 and 17 and 18 social 17 and 19 factors 20 with 25 health 21 poor 22 self 22 self 24 rated 24 rated 25 health 25 health 26 among 26 among 29 and 27 those 29 and 29 and 31 stroke results : after excluding those with impaired cognitive function [,] 776 individuals out of 11,957 reported a stroke . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 12 individuals 2 : 16 reported 3 after 4 excluding 3 after 12 individuals 4 excluding 5 those 4 excluding 6 with 6 with 9 function 7 impaired 9 function 8 cognitive 9 function 9 function 11 776 12 individuals 14 of 12 individuals 16 reported 13 out 14 of 14 of 15 11,957 16 reported 18 stroke 17 a 18 stroke factors associated with self [-] rated health were similar between those [with] or without a stroke in older individuals . 0 ###LEFT-WALL### 1 factors 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 20 . 1 factors 2 associated 1 factors 8 were 2 associated 3 with 3 with 7 health 4 self 6 rated 6 rated 7 health 8 were 9 similar 9 similar 13 or 9 similar 17 in 10 between 11 those 10 between 13 or 13 or 14 without 14 without 16 stroke 15 a 16 stroke 17 in 19 individuals 18 older 19 individuals poorer self - rated health in those who had suffered a stroke was associated [predominantly] with the presence of comorbidity with diabetes ( or 3.5 [;] 95 % ci 1.5 - 8.1 [ )( not " getting out [and] about " ( or 2.6 [;] 95 % ci 1.7 - 4.1 [ )(even after adjustment for disability levels and for depression . 0 ###LEFT-WALL### 2 self 0 ###LEFT-WALL### 3 - 1 poorer 2 self 3 - 5 health 3 - 14 associated 4 rated 5 health 5 health 6 in 5 health 13 was 6 in 7 those 7 those 8 who 7 those 9 had 8 who 9 had 9 had 10 suffered 10 suffered 12 stroke 11 a 12 stroke 13 was 14 associated 14 associated 16 with 14 associated 21 with 16 with 18 presence 17 the 18 presence 18 presence 19 of 19 of 20 comorbidity 21 with 22 diabetes 22 diabetes 31 - 23 ( 31 - 24 or 25 3.5 24 or 29 ci 27 95 29 ci 28 % 29 ci 29 ci 30 1.5 29 ci 31 - 31 - 32 8.1 32 8.1 35 not 35 not 36 " 35 not 37 getting 37 getting 38 out 37 getting 40 about 40 about 41 " 40 about 50 - 42 ( 50 - 43 or 48 ci 44 2.6 48 ci 46 95 48 ci 47 % 48 ci 48 ci 49 1.7 48 ci 50 - 50 - 51 4.1 50 - 62 . 51 4.1 53 )(even 53 )(even 54 after 53 )(even 59 and 54 after 55 adjustment 56 for 58 levels 56 for 59 and 57 disability 58 levels 59 and 60 for 60 for 61 depression in those without a stroke the most important determinants were disability ( or 3.9 ; 95 % ci [3.2] - 4.8 [ )( not " getting out [and] about " ( or 2.9 [;] 95 % ci 2.5 - 3.3 ) . 0 ###LEFT-WALL### 9 determinants 0 ###LEFT-WALL### 10 were 0 ###LEFT-WALL### 15 ; 0 ###LEFT-WALL### 26 getting 0 ###LEFT-WALL### 42 . 1 in 2 those 1 in 9 determinants 2 those 3 without 3 without 5 stroke 4 a 5 stroke 6 the 7 most 7 most 9 determinants 8 important 9 determinants 9 determinants 10 were 10 were 11 disability 11 disability 13 or 12 ( 13 or 13 or 14 3.9 13 or 15 ; 15 ; 18 ci 15 ; 20 - 16 95 18 ci 17 % 18 ci 20 - 21 4.8 21 4.8 24 not 24 not 25 " 24 not 26 getting 26 getting 27 out 27 out 29 about 29 about 30 " 29 about 39 - 31 ( 39 - 32 or 33 2.9 32 or 37 ci 35 95 37 ci 36 % 37 ci 37 ci 38 2.5 37 ci 39 - 39 - 40 3.3 39 - 41 ) conclusions : self - rated health is determined by a range of psychological and social factors in addition to disability in older patients [with] stroke . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 conclusions 2 : 2 : 3 self 4 - 6 health 4 - 7 is 4 - 26 . 5 rated 6 health 6 health 7 is 7 is 8 determined 8 determined 9 by 9 by 11 range 10 a 11 range 11 range 12 of 12 of 14 and 13 psychological 14 and 14 and 15 social 14 and 16 factors 14 and 25 stroke 16 factors 17 in 16 factors 19 to 16 factors 25 stroke 17 in 18 addition 19 to 20 disability 20 disability 21 in 21 in 23 patients 22 older 23 patients addressing social integration and mobility out of the home is an important element of rehabilitation for older people with stroke [as] well as those [without] . 0 ###LEFT-WALL### 1 addressing 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 26 . 1 addressing 4 and 1 addressing 7 of 1 addressing 10 is 2 social 3 integration 3 integration 4 and 4 and 5 mobility 6 out 7 of 7 of 9 home 8 the 9 home 10 is 13 element 10 is 19 with 10 is 23 as 11 an 12 important 11 an 13 element 12 important 13 element 13 element 14 of 14 of 15 rehabilitation 15 rehabilitation 16 for 16 for 18 people 17 older 18 people 19 with 22 well 20 stroke 22 well 23 as 24 those aging of the extracellular matrix ( ecm ) , the protein matrix [that] surrounds and penetrates the tissues and binds the body together , contributes significantly to functional aging of tissues . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 25 contributes 0 ###LEFT-WALL### 32 . 1 aging 2 of 1 aging 25 contributes 2 of 5 matrix 3 the 5 matrix 4 extracellular 5 matrix 5 matrix 7 ecm 5 matrix 12 matrix 6 ( 7 ecm 7 ecm 8 ) 9 , 12 matrix 10 the 12 matrix 11 protein 12 matrix 12 matrix 15 and 12 matrix 24 , 14 surrounds 15 and 15 and 19 and 15 and 23 together 16 penetrates 18 tissues 16 penetrates 19 and 17 the 18 tissues 19 and 20 binds 19 and 22 body 21 the 22 body 25 contributes 26 significantly 25 contributes 27 to 27 to 29 aging 28 functional 29 aging 29 aging 30 of 30 of 31 tissues ecm proteins become increasingly cross - linked with age , and this cross - linking is probably important in the decline of the ecm 's function . 0 ###LEFT-WALL### 2 proteins 0 ###LEFT-WALL### 5 cross 0 ###LEFT-WALL### 14 - 1 ecm 2 proteins 2 proteins 3 become 2 proteins 5 cross 4 increasingly 5 cross 5 cross 7 linked 6 - 7 linked 7 linked 8 with 7 linked 14 - 8 with 11 and 9 age 11 and 10 , 11 and 11 and 13 cross 12 this 13 cross 14 - 15 linking 14 - 16 is 14 - 27 . 15 linking 16 is 16 is 17 probably 16 is 18 important 18 important 19 in 19 in 21 decline 20 the 21 decline 21 decline 22 of 22 of 26 function 23 the 24 ecm 24 ecm 25 's 25 's 26 function this article reviews the role [of] [ε] - [(] [γ] [-] glutamyl ) - lysine ( eggl ) , a cross - link formed by transglutaminase enzymes , and particularly [the] widely expressed isozyme transglutaminase 2 ( tg2 ) , in the aging ecm . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 reviews 0 ###LEFT-WALL### 22 - 1 this 2 article 2 article 3 reviews 3 reviews 5 role 4 the 5 role 5 role 12 glutamyl 5 role 15 lysine 5 role 21 cross 8 - 12 glutamyl 12 glutamyl 13 ) 14 - 15 lysine 15 lysine 17 eggl 15 lysine 19 , 16 ( 17 eggl 17 eggl 18 ) 19 , 21 cross 20 a 21 cross 21 cross 22 - 22 - 23 link 23 link 24 formed 23 link 25 by 25 by 29 and 26 transglutaminase 27 enzymes 27 enzymes 29 and 28 , 29 and 29 and 35 transglutaminase 29 and 38 tg2 29 and 41 in 30 particularly 32 widely 32 widely 33 expressed 33 expressed 35 transglutaminase 34 isozyme 35 transglutaminase 35 transglutaminase 36 2 37 ( 38 tg2 38 tg2 39 ) 40 , 41 in 41 in 44 ecm 41 in 45 . 42 the 44 ecm 43 aging 44 ecm there is little direct data on eggl accumulation with age , and no direct evidence of a role of eggl in the aging of the ecm with pathology . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 29 . 1 there 2 is 2 is 5 data 3 little 5 data 4 direct 5 data 5 data 6 on 5 data 9 with 5 data 19 of 6 on 8 accumulation 7 eggl 8 accumulation 9 with 12 and 10 age 12 and 11 , 12 and 12 and 15 evidence 13 no 15 evidence 14 direct 15 evidence 15 evidence 16 of 16 of 18 role 17 a 18 role 19 of 20 eggl 20 eggl 21 in 20 eggl 24 of 21 in 23 aging 22 the 23 aging 24 of 26 ecm 25 the 26 ecm 26 ecm 27 with 27 with 28 pathology however , several lines of circumstantial evidence suggest that eggl accumulates with age , and its association with pathology suggests that this might [reflect] degradation of ecm function . 0 ###LEFT-WALL### 4 lines 0 ###LEFT-WALL### 8 suggest 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 29 . 1 however 2 , 1 however 4 lines 3 several 4 lines 4 lines 5 of 4 lines 8 suggest 5 of 7 evidence 6 circumstantial 7 evidence 8 suggest 9 that 9 that 10 eggl 9 that 11 accumulates 10 eggl 11 accumulates 11 accumulates 12 with 12 with 13 age 14 , 15 and 15 and 23 might 15 and 28 function 16 its 17 association 17 association 18 with 17 association 20 suggests 18 with 19 pathology 20 suggests 21 that 21 that 22 this 21 that 23 might 23 might 25 degradation 23 might 28 function 25 degradation 26 of 26 of 27 ecm tg activity increases with age in many circumstances . 0 ###LEFT-WALL### 2 activity 0 ###LEFT-WALL### 3 increases 0 ###LEFT-WALL### 9 . 1 tg 2 activity 2 activity 3 increases 3 increases 4 with 3 increases 6 in 4 with 5 age 6 in 8 circumstances 7 many 8 circumstances ecm protein [turnover] is such that some eggl made by tg is likely to remain in place for years , if not decades , in healthy tissue , and both eggl and tg levels are enhanced by age - related diseases . 0 ###LEFT-WALL### 1 ecm 0 ###LEFT-WALL### 40 related 0 ###LEFT-WALL### 42 . 1 ecm 2 protein 1 ecm 4 is 1 ecm 12 is 2 protein 4 is 4 is 6 that 5 such 6 that 6 that 8 eggl 6 that 9 made 7 some 8 eggl 8 eggl 9 made 9 made 10 by 9 made 11 tg 12 is 14 to 12 is 15 remain 13 likely 14 to 14 to 15 remain 15 remain 17 place 15 remain 18 for 16 in 17 place 18 for 21 if 19 years 21 if 20 , 21 if 21 if 22 not 21 if 38 age 21 if 39 - 21 if 40 related 23 decades 25 in 23 decades 29 and 24 , 25 in 25 in 27 tissue 25 in 28 , 26 healthy 27 tissue 29 and 30 both 29 and 38 age 31 eggl 32 and 32 and 33 tg 32 and 34 levels 32 and 37 by 32 and 38 age 34 levels 35 are 35 are 36 enhanced 36 enhanced 37 by 40 related 41 diseases if further research shows eggl does accumulate with age [,] removing it could be of therapeutic benefit . 0 ###LEFT-WALL### 17 benefit 0 ###LEFT-WALL### 18 . 1 if 3 research 1 if 4 shows 1 if 17 benefit 2 further 3 research 3 research 4 shows 4 shows 5 eggl 4 shows 7 accumulate 5 eggl 6 does 6 does 7 accumulate 7 accumulate 8 with 8 with 9 age 8 with 16 therapeutic 9 age 11 removing 9 age 15 of 11 removing 12 it 11 removing 13 could 13 could 14 be 14 be 15 of also reviewed is the blockade of tg and active removal of eggl as therapeutic strategies , with the conclusion that both [have] promise . 0 ###LEFT-WALL### 2 reviewed 0 ###LEFT-WALL### 3 is 1 also 2 reviewed 2 reviewed 3 is 3 is 5 blockade 4 the 5 blockade 5 blockade 6 of 5 blockade 11 of 6 of 8 and 7 tg 8 and 8 and 10 removal 9 active 10 removal 11 of 12 eggl 12 eggl 13 as 12 eggl 17 with 13 as 15 strategies 14 therapeutic 15 strategies 16 , 17 with 17 with 19 conclusion 17 with 24 . 18 the 19 conclusion 19 conclusion 20 that 20 that 21 both 20 that 23 promise 21 both 23 promise eggl removal may have benefit for acute fibrotic diseases , such as tendinopathy , and for treating generalized decline [in] ecm function with old age . 0 ###LEFT-WALL### 1 eggl 0 ###LEFT-WALL### 22 function 0 ###LEFT-WALL### 26 . 1 eggl 2 removal 1 eggl 4 have 1 eggl 22 function 2 removal 3 may 3 may 4 have 4 have 5 benefit 5 benefit 15 and 6 for 9 diseases 6 for 15 and 7 acute 9 diseases 8 fibrotic 9 diseases 9 diseases 12 as 10 , 12 as 11 such 12 as 12 as 13 tendinopathy 12 as 14 , 14 , 15 and 15 and 16 for 16 for 17 treating 17 treating 21 ecm 18 generalized 19 decline 19 decline 21 ecm 22 function 23 with 23 with 25 age 24 old 25 age extracellular tg2 and eggl are therefore therapeutic targets [both] for specific and more generalized diseases of aging . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 18 . 1 extracellular 2 tg2 2 tg2 3 and 3 and 4 eggl 3 and 5 are 5 are 6 therefore 5 are 8 targets 5 are 10 for 7 therapeutic 8 targets 10 for 12 and 11 specific 12 and 12 and 15 diseases 12 and 16 of 13 more 15 diseases 14 generalized 15 diseases 16 of 17 aging none lateralized brain regions subserve functions such as language and visuospatial processing . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 6 functions 0 ###LEFT-WALL### 13 . 1 none 4 regions 1 none 5 subserve 1 none 6 functions 2 lateralized 4 regions 3 brain 4 regions 4 regions 5 subserve 6 functions 8 as 7 such 8 as 8 as 10 and 9 language 10 and 10 and 12 processing 11 visuospatial 12 processing it has [been] conjectured that individuals may be left - brain dominant or right - brain dominant based on personality and cognitive style , but neuroimaging data has not provided clear evidence whether such phenotypic differences in the strength of left - dominant or right - dominant networks exist . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 16 brain 1 it 2 has 2 has 4 conjectured 4 conjectured 5 that 5 that 6 individuals 5 that 9 left 6 individuals 7 may 7 may 8 be 8 be 9 left 10 - 11 brain 11 brain 13 or 11 brain 16 brain 12 dominant 13 or 13 or 14 right 13 or 15 - 13 or 16 brain 16 brain 21 and 17 dominant 18 based 17 dominant 21 and 18 based 19 on 19 on 20 personality 21 and 23 style 21 and 25 but 22 cognitive 23 style 24 , 25 but 25 but 26 neuroimaging 25 but 50 . 26 neuroimaging 27 data 26 neuroimaging 30 provided 27 data 28 has 28 has 29 not 28 has 30 provided 30 provided 32 evidence 30 provided 33 whether 31 clear 32 evidence 33 whether 36 differences 33 whether 49 exist 34 such 36 differences 35 phenotypic 36 differences 36 differences 37 in 36 differences 49 exist 37 in 39 strength 38 the 39 strength 39 strength 40 of 40 of 48 networks 41 left 44 or 41 left 48 networks 42 - 44 or 43 dominant 44 or 44 or 45 right 44 or 46 - 47 dominant 48 networks we evaluated whether strongly lateralized connections covaried within the same individuals . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 evaluated 0 ###LEFT-WALL### 12 . 1 we 2 evaluated 2 evaluated 3 whether 3 whether 6 connections 3 whether 7 covaried 4 strongly 5 lateralized 5 lateralized 6 connections 6 connections 7 covaried 7 covaried 8 within 8 within 11 individuals 9 the 10 same 10 same 11 individuals data were analyzed from publicly available resting state [scans] [for] 1011 individuals between the ages of 7 and 29 . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 analyzed 0 ###LEFT-WALL### 20 . 1 data 2 were 2 were 3 analyzed 3 analyzed 4 from 3 analyzed 13 between 4 from 12 individuals 5 publicly 6 available 6 available 8 state 7 resting 8 state 8 state 12 individuals 11 1011 12 individuals 13 between 15 ages 14 the 15 ages 15 ages 16 of 16 of 18 and 17 7 18 and 18 and 19 29 for each subject , functional lateralization was measured for each pair of 7266 regions covering the gray matter at 5 [-] mm [resolution] as a difference [in] correlation before and after inverting images across the midsagittal plane . 0 ###LEFT-WALL### 1 for 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 38 . 1 for 2 each 1 for 7 was 3 subject 4 , 3 subject 6 lateralization 5 functional 6 lateralization 6 lateralization 7 was 7 was 8 measured 8 measured 9 for 8 measured 24 as 9 for 11 pair 10 each 11 pair 11 pair 12 of 12 of 14 regions 13 7266 14 regions 14 regions 15 covering 15 covering 18 matter 16 the 18 matter 17 gray 18 matter 18 matter 19 at 19 at 22 mm 20 5 22 mm 24 as 28 correlation 25 a 28 correlation 26 difference 28 correlation 28 correlation 30 and 28 correlation 34 across 29 before 30 and 30 and 31 after 31 after 32 inverting 32 inverting 33 images 34 across 37 plane 35 the 37 plane 36 midsagittal 37 plane the difference in gray matter density between homotopic coordinates was used as a regressor to reduce the effect of structural asymmetries on functional lateralization . 0 ###LEFT-WALL### 2 difference 0 ###LEFT-WALL### 11 used 0 ###LEFT-WALL### 25 . 1 the 2 difference 2 difference 3 in 2 difference 10 was 3 in 6 density 4 gray 5 matter 5 matter 6 density 6 density 7 between 7 between 9 coordinates 8 homotopic 9 coordinates 10 was 11 used 11 used 12 as 11 used 15 to 11 used 16 reduce 12 as 14 regressor 13 a 14 regressor 15 to 16 reduce 16 reduce 18 effect 16 reduce 22 on 17 the 18 effect 18 effect 19 of 19 of 21 asymmetries 20 structural 21 asymmetries 22 on 24 lateralization 23 functional 24 lateralization nine left - and 11 right - lateralized hubs were identified as peaks in the degree map from the graph of significantly lateralized connections . 0 ###LEFT-WALL### 1 nine 0 ###LEFT-WALL### 2 left 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 25 . 1 nine 2 left 3 - 4 and 4 and 9 hubs 4 and 11 identified 5 11 9 hubs 6 right 7 - 6 right 9 hubs 8 lateralized 9 hubs 9 hubs 10 were 10 were 11 identified 11 identified 12 as 11 identified 14 in 12 as 13 peaks 14 in 17 map 15 the 17 map 16 degree 17 map 17 map 18 from 18 from 20 graph 19 the 20 graph 20 graph 21 of 21 of 24 connections 22 significantly 23 lateralized 23 lateralized 24 connections left - and right - lateralized hubs formed two separable networks of mutually lateralized regions . 0 ###LEFT-WALL### 1 left 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 16 . 2 - 3 and 3 and 7 hubs 3 and 8 formed 4 right 5 - 4 right 7 hubs 6 lateralized 7 hubs 7 hubs 8 formed 8 formed 11 networks 9 two 11 networks 10 separable 11 networks 11 networks 12 of 12 of 15 regions 13 mutually 14 lateralized 14 lateralized 15 regions connections involving only left - or only right - lateralized hubs [showed] positive [correlation] across subjects , but only for connections sharing a node . 0 ###LEFT-WALL### 1 connections 0 ###LEFT-WALL### 10 lateralized 0 ###LEFT-WALL### 25 . 1 connections 2 involving 1 connections 10 lateralized 2 involving 3 only 2 involving 6 or 4 left 6 or 5 - 6 or 6 or 7 only 6 or 8 right 6 or 9 - 10 lateralized 11 hubs 11 hubs 13 positive 13 positive 18 but 15 across 16 subjects 15 across 18 but 17 , 18 but 18 but 19 only 18 but 20 for 20 for 21 connections 21 connections 22 sharing 22 sharing 24 node 23 a 24 node lateralization of brain connections appears to be a local rather than global property of brain networks , and our data are not consistent with a whole - brain phenotype of greater " left - brained " [or] greater " right - brained " network strength across individuals . 0 ###LEFT-WALL### 1 lateralization 0 ###LEFT-WALL### 5 appears 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 48 . 1 lateralization 2 of 1 lateralization 5 appears 2 of 4 connections 3 brain 4 connections 5 appears 6 to 5 appears 7 be 6 to 7 be 7 be 9 local 7 be 11 than 8 a 9 local 10 rather 11 than 11 than 13 property 12 global 13 property 13 property 14 of 14 of 16 networks 15 brain 16 networks 17 , 18 and 18 and 20 data 18 and 21 are 19 our 20 data 20 data 21 are 21 are 22 not 21 are 24 with 22 not 23 consistent 24 with 29 phenotype 25 a 26 whole 25 a 29 phenotype 26 whole 27 - 26 whole 29 phenotype 28 brain 29 phenotype 29 phenotype 30 of 30 of 45 strength 31 greater 32 " 31 greater 44 network 33 left 40 right 33 left 44 network 34 - 40 right 35 brained 36 " 35 brained 40 right 38 greater 39 " 38 greater 40 right 40 right 41 - 42 brained 43 " 42 brained 44 network 44 network 45 strength 45 strength 46 across 46 across 47 individuals small increases in lateralization with age were seen , but no differences in gender were observed . 0 ###LEFT-WALL### 2 increases 0 ###LEFT-WALL### 8 seen 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 17 . 1 small 2 increases 2 increases 3 in 2 increases 7 were 3 in 4 lateralization 4 lateralization 5 with 5 with 6 age 7 were 8 seen 9 , 10 but 10 but 12 differences 10 but 16 observed 11 no 12 differences 12 differences 13 in 12 differences 15 were 13 in 14 gender 15 were 16 observed molecular mechanisms leading to pressure ulcer development are scarce in spite of high mortality of patients . 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 17 . 1 molecular 2 mechanisms 2 mechanisms 3 leading 2 mechanisms 8 are 3 leading 4 to 4 to 5 pressure 5 pressure 7 development 6 ulcer 7 development 8 are 9 scarce 9 scarce 10 in 10 in 11 spite 11 spite 12 of 12 of 14 mortality 13 high 14 mortality 14 mortality 15 of 15 of 16 patients development of pressure ulcers that is initially observed as deep tissue injury is multifactorial . 0 ###LEFT-WALL### 1 development 0 ###LEFT-WALL### 8 observed 0 ###LEFT-WALL### 15 . 1 development 2 of 1 development 8 observed 2 of 4 ulcers 3 pressure 4 ulcers 5 that 6 is 6 is 8 observed 7 initially 8 observed 8 observed 12 injury 8 observed 13 is 9 as 11 tissue 9 as 12 injury 10 deep 11 tissue 12 injury 13 is 13 is 14 multifactorial we postulate that biomechanical forces and inflammasome activation , together with ischemia and aging , may play a role in pressure ulcer development . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 24 . 1 we 6 and 2 postulate 5 forces 2 postulate 6 and 3 that 4 biomechanical 4 biomechanical 5 forces 6 and 17 play 7 inflammasome 8 activation 8 activation 11 with 8 activation 16 may 9 , 11 with 10 together 11 with 11 with 13 and 11 with 15 , 12 ischemia 13 and 13 and 14 aging 16 may 17 play 17 play 19 role 17 play 20 in 18 a 19 role 20 in 23 development 21 pressure 23 development 22 ulcer 23 development collagen orientation was assessed using polarized light , whereas inflammasome proteins were quantified by immunoblotting . 0 ###LEFT-WALL### 2 orientation 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 16 . 1 collagen 2 orientation 2 orientation 3 was 3 was 4 assessed 4 assessed 5 using 5 using 7 light 6 polarized 7 light 8 , 11 proteins 8 , 13 quantified 9 whereas 10 inflammasome 9 whereas 11 proteins 11 proteins 12 were 12 were 13 quantified 13 quantified 14 by 14 by 15 immunoblotting loaded skin showed marked changes in morphology and nlrp3 inflammasome protein expression . 0 ###LEFT-WALL### 2 skin 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 13 . 1 loaded 2 skin 2 skin 3 showed 3 showed 8 and 3 showed 10 inflammasome 4 marked 5 changes 5 changes 6 in 5 changes 8 and 6 in 7 morphology 8 and 9 nlrp3 8 and 10 inflammasome 10 inflammasome 12 expression 11 protein 12 expression sub - epidermal separations and altered orientation of collagen fibers were observed in aged skin at earlier time points . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 12 observed 0 ###LEFT-WALL### 20 . 1 sub 2 - 1 sub 5 and 3 epidermal 4 separations 4 separations 5 and 5 and 7 orientation 5 and 8 of 5 and 11 were 6 altered 7 orientation 8 of 10 fibers 9 collagen 10 fibers 11 were 12 observed 12 observed 13 in 12 observed 16 at 13 in 15 skin 14 aged 15 skin 16 at 19 points 17 earlier 19 points 18 time 19 points aged skin showed significant decreases in the levels of nlrp3 inflammasome proteins . 0 ###LEFT-WALL### 2 skin 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 13 . 1 aged 2 skin 2 skin 3 showed 3 showed 5 decreases 3 showed 11 inflammasome 4 significant 5 decreases 5 decreases 6 in 5 decreases 11 inflammasome 6 in 8 levels 7 the 8 levels 8 levels 9 of 9 of 10 nlrp3 11 inflammasome 12 proteins loading did not alter nlrp3 inflammasome proteins expression in aged skin , whereas it significantly increased their levels in young skin . 0 ###LEFT-WALL### 1 loading 0 ###LEFT-WALL### 16 increased 0 ###LEFT-WALL### 22 . 1 loading 2 did 2 did 3 not 2 did 4 alter 4 alter 8 expression 4 alter 9 in 4 alter 13 whereas 5 nlrp3 8 expression 6 inflammasome 8 expression 7 proteins 8 expression 9 in 11 skin 10 aged 11 skin 12 , 13 whereas 13 whereas 14 it 14 it 16 increased 15 significantly 16 increased 16 increased 18 levels 16 increased 19 in 17 their 18 levels 19 in 21 skin 20 young 21 skin we conclude that aging contributes to rapid morphological changes and decrease in inflammasome proteins in response to tissue damage , suggesting that a decline in the innate inflammatory response in elderly skin could contribute to pressure ulcer pathogenesis . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 10 and 1 we 10 and 2 conclude 3 that 2 conclude 10 and 3 that 4 aging 3 that 5 contributes 4 aging 5 contributes 5 contributes 6 to 6 to 9 changes 7 rapid 9 changes 8 morphological 9 changes 10 and 11 decrease 10 and 21 suggesting 11 decrease 12 in 11 decrease 17 to 12 in 14 proteins 13 inflammasome 14 proteins 15 in 16 response 16 response 17 to 17 to 19 damage 18 tissue 19 damage 20 , 21 suggesting 21 suggesting 22 that 21 suggesting 39 . 22 that 24 decline 22 that 34 contribute 23 a 24 decline 24 decline 25 in 24 decline 30 in 24 decline 33 could 25 in 29 response 26 the 29 response 27 innate 29 response 28 inflammatory 29 response 30 in 32 skin 31 elderly 32 skin 33 could 34 contribute 34 contribute 35 to 35 to 36 pressure 36 pressure 38 pathogenesis 37 ulcer 38 pathogenesis observed morphological changes suggest that tissue damage upon loading may not be entirely preventable . 0 ###LEFT-WALL### 3 changes 0 ###LEFT-WALL### 4 suggest 0 ###LEFT-WALL### 15 . 1 observed 3 changes 2 morphological 3 changes 3 changes 4 suggest 4 suggest 5 that 5 that 7 damage 5 that 12 be 6 tissue 7 damage 7 damage 8 upon 7 damage 10 may 8 upon 9 loading 10 may 11 not 10 may 12 be 12 be 14 preventable 13 entirely 14 preventable furthermore , newly developed model described [here] [may] [be] very useful [in] understanding [the] mechanisms of deep tissue injury that may lead towards development of pressure ulcers . 0 ###LEFT-WALL### 15 mechanisms 0 ###LEFT-WALL### 26 pressure 0 ###LEFT-WALL### 28 . 1 furthermore 2 , 1 furthermore 15 mechanisms 3 newly 4 developed 4 developed 5 model 5 model 15 mechanisms 6 described 15 mechanisms 10 very 11 useful 11 useful 15 mechanisms 13 understanding 15 mechanisms 15 mechanisms 16 of 15 mechanisms 26 pressure 16 of 19 injury 17 deep 18 tissue 18 tissue 19 injury 19 injury 20 that 19 injury 25 of 20 that 21 may 21 may 22 lead 22 lead 23 towards 23 towards 24 development 24 development 25 of 26 pressure 27 ulcers aims : to evaluate the complication rate differences between elderly and younger patients who receive a permanent pacemaker implantation . 0 ###LEFT-WALL### 1 aims 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 2 : 20 . 3 to 4 evaluate 4 evaluate 8 differences 4 evaluate 9 between 5 the 8 differences 6 complication 8 differences 7 rate 8 differences 9 between 13 patients 10 elderly 11 and 11 and 12 younger 11 and 13 patients 13 patients 14 who 13 patients 15 receive 14 who 15 receive 15 receive 19 implantation 16 a 17 permanent 16 a 19 implantation 17 permanent 18 pacemaker 18 pacemaker 19 implantation methods : we reviewed all cases admitted to our institution between january 2008 and june 2009 with symptomatic bradyarrhythmia for whom a permanent pacemaker was implanted . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 admitted 2 : 3 we 2 : 4 reviewed 3 we 4 reviewed 4 reviewed 5 all 5 all 6 cases 5 all 7 admitted 6 cases 7 admitted 7 admitted 8 to 7 admitted 11 between 7 admitted 17 with 8 to 10 institution 9 our 10 institution 11 between 14 and 12 january 13 2008 12 january 14 and 14 and 15 june 15 june 16 2009 17 with 19 bradyarrhythmia 18 symptomatic 19 bradyarrhythmia 19 bradyarrhythmia 20 for 20 for 21 whom 20 for 24 pacemaker 20 for 26 implanted 22 a 23 permanent 22 a 24 pacemaker 23 permanent 24 pacemaker 24 pacemaker 25 was 25 was 26 implanted 26 implanted 27 . beginning in june 2009 , we prospectively collected data from all patients with the same diagnosis and procedure . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 8 collected 0 ###LEFT-WALL### 19 . 1 beginning 2 in 1 beginning 5 , 1 beginning 6 we 2 in 3 june 3 june 4 2009 6 we 8 collected 7 prospectively 8 collected 8 collected 9 data 8 collected 13 with 9 data 10 from 10 from 12 patients 11 all 12 patients 13 with 17 and 14 the 15 same 15 same 16 diagnosis 16 diagnosis 17 and 17 and 18 procedure the frequency of complications due to the pacemaker implantation procedure was evaluated and compared between young ( < 70 years old ) and elderly ( ≥70 years old ) patients . 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 31 . 1 the 2 frequency 2 frequency 3 of 2 frequency 23 and 3 of 4 complications 4 complications 5 due 4 complications 19 70 5 due 6 to 5 due 16 young 6 to 9 implantation 7 the 9 implantation 8 pacemaker 9 implantation 9 implantation 10 procedure 9 implantation 15 between 10 procedure 11 was 11 was 13 and 12 evaluated 13 and 13 and 14 compared 13 and 15 between 17 ( 19 70 18 < 19 70 19 70 21 old 19 70 22 ) 20 years 21 old 23 and 30 patients 24 elderly 26 ≥70 24 elderly 30 patients 25 ( 26 ≥70 26 ≥70 28 old 26 ≥70 29 ) 27 years 28 old results : among 574 patients with a permanent pacemaker , 259 patients ( 45.1 % ) were below and 315 patients ( 54.9 % ) were above or at 70 years of age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 34 . 1 results 2 : 2 : 3 among 2 : 6 with 3 among 5 patients 4 574 5 patients 6 with 9 pacemaker 7 a 8 permanent 7 a 9 pacemaker 8 permanent 9 pacemaker 10 , 12 patients 10 , 17 were 10 , 19 and 11 259 12 patients 12 patients 15 % 12 patients 17 were 13 ( 15 % 14 45.1 15 % 15 % 16 ) 17 were 18 below 19 and 21 patients 19 and 26 were 20 315 21 patients 21 patients 24 % 21 patients 26 were 22 ( 24 % 23 54.9 24 % 24 % 25 ) 26 were 28 or 27 above 28 or 28 or 29 at 29 at 31 years 30 70 31 years 31 years 32 of 32 of 33 age there were 240 ( 92.7 % [ )(and 19 ( 7.3 % ) dual - chamber pacemaker [(] ddd [ )(and single - chamber pacemaker ( vvi ) implanted patients in the younger group [,] [and] 291 ( [76.8] [%] [ )(and 73 [(] 23.2 % [ )(ddd and vvi pacemaker implanted patients in the elderly group , respectively . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 1 there 2 were 2 were 3 240 2 were 14 dual 3 240 8 )(and 4 ( 8 )(and 5 92.7 6 % 5 92.7 8 )(and 8 )(and 9 19 8 )(and 12 % 8 )(and 13 ) 10 ( 12 % 11 7.3 12 % 12 % 13 ) 14 dual 23 - 15 - 23 - 16 chamber 17 pacemaker 17 pacemaker 19 ddd 19 ddd 21 )(and 21 )(and 22 single 21 )(and 23 - 23 - 24 chamber 24 chamber 25 pacemaker 24 chamber 29 implanted 25 pacemaker 27 vvi 25 pacemaker 29 implanted 26 ( 27 vvi 27 vvi 28 ) 29 implanted 30 patients 29 implanted 31 in 31 in 42 )(and 32 the 34 group 33 younger 34 group 34 group 37 291 34 group 42 )(and 38 ( 42 )(and 42 )(and 50 vvi 42 )(and 51 pacemaker 42 )(and 52 implanted 43 73 50 vvi 45 23.2 50 vvi 46 % 50 vvi 48 )(ddd 49 and 49 and 50 vvi 51 pacemaker 52 implanted 52 implanted 53 patients 52 implanted 54 in 52 implanted 59 respectively 54 in 57 group 55 the 57 group 56 elderly 57 group 58 , 59 respectively 59 respectively 60 . the complication rate was 39 ( 15.1 % ) out of 259 young patients [and] 24 ( 7.6 % ) out of 315 elderly patients . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 26 . 1 the 3 rate 2 complication 3 rate 3 rate 4 was 4 was 5 39 4 was 11 of 4 was 22 of 5 39 8 % 6 ( 8 % 7 15.1 8 % 8 % 9 ) 10 out 11 of 11 of 14 patients 12 259 14 patients 13 young 14 patients 14 patients 16 24 14 patients 19 % 17 ( 19 % 18 7.6 19 % 19 % 20 ) 21 out 22 of 22 of 25 patients 23 315 25 patients 24 elderly 25 patients postprocedural complications were statistically lower in the elderly patients than in younger patients ( p = 0.005 ) . 0 ###LEFT-WALL### 2 complications 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 19 . 1 postprocedural 2 complications 2 complications 3 were 3 were 4 statistically 3 were 5 lower 5 lower 6 in 5 lower 10 than 6 in 9 patients 7 the 9 patients 8 elderly 9 patients 10 than 11 in 11 in 13 patients 12 younger 13 patients 13 patients 16 = 14 ( 16 = 15 p 16 = 16 = 17 0.005 16 = 18 ) conclusion : a pacemaker implantation performed by an experienced operator is a safe procedure for patients of advanced age . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 5 implantation 2 : 11 is 3 a 5 implantation 4 pacemaker 5 implantation 5 implantation 6 performed 5 implantation 11 is 6 performed 7 by 7 by 10 operator 8 an 10 operator 9 experienced 10 operator 11 is 14 procedure 12 a 13 safe 12 a 14 procedure 13 safe 14 procedure 14 procedure 15 for 14 procedure 17 of 15 for 16 patients 17 of 19 age 18 advanced 19 age the patients who are above 70 years old may have less complication rates than the younger patients . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 18 . 1 the 2 patients 2 patients 3 who 2 patients 4 are 2 patients 9 may 3 who 4 are 4 are 5 above 4 are 8 old 6 70 7 years 7 years 8 old 9 may 10 have 10 have 11 less 10 have 13 rates 10 have 14 than 12 complication 13 rates 14 than 17 patients 15 the 17 patients 16 younger 17 patients background : compelling evidence has shown that the incidence of lumbar disc herniation ( ldh ) increases with age . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 evidence 2 : 6 shown 2 : 20 . 3 compelling 4 evidence 4 evidence 5 has 5 has 6 shown 6 shown 7 that 7 that 9 incidence 7 that 17 increases 8 the 9 incidence 9 incidence 10 of 9 incidence 17 increases 10 of 13 herniation 11 lumbar 12 disc 12 disc 13 herniation 13 herniation 15 ldh 14 ( 15 ldh 15 ldh 16 ) 17 increases 18 with 18 with 19 age in this study , retrospective clinical analysis of 601 cases of ldh has been conducted to investigate the role of age in the incidence of ldh in the elderly . 0 ###LEFT-WALL### 7 analysis 0 ###LEFT-WALL### 15 conducted 0 ###LEFT-WALL### 30 . 1 in 3 study 1 in 4 , 1 in 7 analysis 2 this 3 study 5 retrospective 7 analysis 6 clinical 7 analysis 7 analysis 8 of 7 analysis 11 of 7 analysis 13 has 8 of 10 cases 9 601 10 cases 11 of 12 ldh 13 has 14 been 14 been 15 conducted 15 conducted 16 to 15 conducted 22 in 15 conducted 27 in 16 to 17 investigate 17 investigate 19 role 18 the 19 role 19 role 20 of 20 of 21 age 22 in 24 incidence 23 the 24 incidence 24 incidence 25 of 25 of 26 ldh 27 in 29 elderly 28 the 29 elderly the aim of the study is to investigate the relationship between the process of aging and the occurrence of ldh in old adults . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 24 . 1 the 2 aim 2 aim 3 of 2 aim 6 is 3 of 5 study 4 the 5 study 6 is 7 to 6 is 8 investigate 7 to 8 investigate 8 investigate 10 relationship 8 investigate 11 between 9 the 10 relationship 11 between 16 and 12 the 13 process 13 process 14 of 13 process 16 and 14 of 15 aging 16 and 18 occurrence 17 the 18 occurrence 18 occurrence 19 of 19 of 20 ldh 20 ldh 21 in 21 in 23 adults 22 old 23 adults methods : clinical cases ( n = 601 [ )(of ldh were retrospectively analyzed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 . 2 : 4 cases 2 : 12 were 3 clinical 4 cases 4 cases 7 = 4 cases 12 were 5 ( 7 = 6 n 7 = 7 = 8 601 8 601 10 )(of 10 )(of 11 ldh 12 were 13 retrospectively 12 were 14 analyzed results : [the] imaging examination with computed tomography and/or magnetic resonance imaging showed the occurrence of degeneration in ldh patients over 65 years of age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 13 showed 0 ###LEFT-WALL### 26 . 1 results 2 : 2 : 4 imaging 4 imaging 5 examination 4 imaging 6 with 4 imaging 9 and/or 6 with 8 tomography 7 computed 8 tomography 9 and/or 12 imaging 10 magnetic 11 resonance 11 resonance 12 imaging 12 imaging 13 showed 13 showed 15 occurrence 13 showed 20 patients 13 showed 21 over 14 the 15 occurrence 15 occurrence 16 of 15 occurrence 18 in 16 of 17 degeneration 18 in 19 ldh 21 over 23 years 22 65 23 years 23 years 24 of 24 of 25 age the most common site of ldh is toward the bottom of the spine at l4 - l5 [and/or] l5 - s1 . 0 ###LEFT-WALL### 4 site 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 20 - 1 the 4 site 2 most 3 common 3 common 4 site 4 site 5 of 4 site 7 is 5 of 6 ldh 7 is 8 toward 7 is 14 at 8 toward 10 bottom 9 the 10 bottom 10 bottom 11 of 11 of 13 spine 12 the 13 spine 14 at 15 l4 15 l4 19 l5 16 - 19 l5 17 l5 19 l5 19 l5 20 - 20 - 21 s1 20 - 22 . the incidence of ldh drops with age in the elderly , especially after the age of 80 years . 0 ###LEFT-WALL### 2 incidence 0 ###LEFT-WALL### 5 drops 1 the 2 incidence 2 incidence 3 of 2 incidence 5 drops 3 of 4 ldh 5 drops 6 with 5 drops 8 in 5 drops 13 after 6 with 7 age 8 in 10 elderly 9 the 10 elderly 11 , 12 especially 11 , 13 after 13 after 15 age 13 after 19 . 14 the 15 age 15 age 16 of 16 of 18 years 17 80 18 years there is an obvious decrease in ldh in the elderly female . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 12 . 1 there 2 is 2 is 5 decrease 3 an 4 obvious 3 an 5 decrease 4 obvious 5 decrease 5 decrease 6 in 6 in 7 ldh 7 ldh 8 in 8 in 11 female 9 the 11 female 10 elderly 11 female conclusion : a decreasing incidence of ldh with aging occurs in the elderly . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 incidence 2 : 10 occurs 2 : 14 . 3 a 5 incidence 4 decreasing 5 incidence 5 incidence 6 of 5 incidence 10 occurs 6 of 7 ldh 7 ldh 8 with 8 with 9 aging 10 occurs 11 in 11 in 13 elderly 12 the 13 elderly this investigation indicates that aging is not a contributor to the performance of ldh in the elderly although the incidence of ldh is proportional to age . 0 ###LEFT-WALL### 2 investigation 0 ###LEFT-WALL### 3 indicates 0 ###LEFT-WALL### 27 . 1 this 2 investigation 2 investigation 3 indicates 3 indicates 4 that 4 that 5 aging 4 that 6 is 5 aging 6 is 6 is 7 not 6 is 9 contributor 6 is 18 although 8 a 9 contributor 9 contributor 10 to 9 contributor 13 of 10 to 12 performance 11 the 12 performance 13 of 14 ldh 14 ldh 15 in 15 in 17 elderly 16 the 17 elderly 18 although 20 incidence 18 although 23 is 19 the 20 incidence 20 incidence 21 of 20 incidence 23 is 21 of 22 ldh 23 is 24 proportional 24 proportional 25 to 25 to 26 age methods : the study involved a total number of 122 patients ( 122 eyes ) with senile cataracts . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 involved 2 : 19 . 3 the 4 study 4 study 5 involved 5 involved 11 patients 5 involved 16 with 6 a 7 total 6 a 8 number 7 total 8 number 8 number 9 of 8 number 11 patients 9 of 11 patients 10 122 11 patients 11 patients 14 eyes 12 ( 14 eyes 13 122 14 eyes 14 eyes 15 ) 16 with 18 cataracts 17 senile 18 cataracts the mean age of patients was 91.2 ± 2.3 years ( range 90 - 100 years old ) . 0 ###LEFT-WALL### 3 age 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 19 . 1 the 3 age 2 mean 3 age 3 age 4 of 3 age 6 was 4 of 5 patients 6 was 10 years 7 91.2 10 years 8 ± 10 years 9 2.3 10 years 10 years 12 range 11 ( 12 range 12 range 13 90 12 range 17 old 12 range 18 ) 14 - 15 100 15 100 16 years 16 years 17 old phacoemulsification ( phaco ) was done on 113 of 122 eyes , and 9 of 122 eyes had extracapsular cataract extraction ( ecce ) . 0 ###LEFT-WALL### 1 phacoemulsification 0 ###LEFT-WALL### 5 was 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 25 . 1 phacoemulsification 3 phaco 1 phacoemulsification 5 was 2 ( 3 phaco 3 phaco 4 ) 5 was 6 done 6 done 7 on 7 on 8 113 8 113 9 of 9 of 11 eyes 10 122 11 eyes 12 , 13 and 13 and 14 9 13 and 18 had 14 9 15 of 14 9 18 had 15 of 17 eyes 16 122 17 eyes 18 had 21 extraction 19 extracapsular 20 cataract 20 cataract 21 extraction 21 extraction 23 ecce 22 ( 23 ecce 23 ecce 24 ) postoperative visual acuity and intraocular pressure ( iop ) were analyzed on the first postoperative day , 3 months after surgery , and 6 months after surgery . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 11 analyzed 0 ###LEFT-WALL### 28 . 1 postoperative 3 acuity 2 visual 3 acuity 3 acuity 4 and 4 and 6 pressure 4 and 8 iop 4 and 10 were 5 intraocular 6 pressure 7 ( 8 iop 8 iop 9 ) 10 were 11 analyzed 11 analyzed 23 and 12 on 16 day 12 on 23 and 13 the 16 day 14 first 16 day 15 postoperative 16 day 16 day 18 3 17 , 18 3 18 3 20 after 18 3 22 , 19 months 20 after 20 after 21 surgery 22 , 23 and 23 and 26 after 24 6 25 months 25 months 26 after 26 after 27 surgery results : best corrected visual acuity ( bcva ) improved in 100 of 122 eyes ( 82.0 % ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 acuity 2 : 10 improved 2 : 20 . 3 best 4 corrected 4 corrected 6 acuity 5 visual 6 acuity 6 acuity 8 bcva 6 acuity 10 improved 7 ( 8 bcva 8 bcva 9 ) 10 improved 11 in 11 in 12 100 12 100 13 of 13 of 15 eyes 14 122 15 eyes 15 eyes 18 % 16 ( 18 % 17 82.0 18 % 18 % 19 ) bcva remained the same in 20 of 122 eyes ( 16.4 % ) and decreased in 2 of 122 eyes ( 1.6 % ) , mainly because of coexisting age - related macular degeneration ( amd ) . 0 ###LEFT-WALL### 1 bcva 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 32 related 0 ###LEFT-WALL### 38 . 1 bcva 14 and 2 remained 4 same 2 remained 5 in 2 remained 14 and 3 the 4 same 5 in 6 20 6 20 7 of 6 20 12 % 7 of 9 eyes 8 122 9 eyes 10 ( 12 % 11 16.4 12 % 12 % 13 ) 14 and 15 decreased 15 decreased 16 in 15 decreased 28 of 16 in 17 2 17 2 18 of 18 of 20 eyes 19 122 20 eyes 20 eyes 23 % 21 ( 23 % 22 1.6 23 % 23 % 24 ) 25 , 26 mainly 25 , 28 of 27 because 28 of 28 of 29 coexisting 28 of 31 - 29 coexisting 30 age 31 - 32 related 32 related 34 degeneration 33 macular 34 degeneration 34 degeneration 36 amd 35 ( 36 amd 36 amd 37 ) the bcva 3 months after surgery was ≥0.8 in 23 of 122 eyes ( 18.9 % ) , between 0.5 and 0.7 in 28 of 122 eyes ( 22.3 % ) , and between 0.2 and 0.4 in 33 of 122 eyes ( 27.1 % ) . 0 ###LEFT-WALL### 2 bcva 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 47 . 1 the 2 bcva 2 bcva 5 after 2 bcva 7 was 3 3 4 months 4 months 5 after 5 after 6 surgery 7 was 8 ≥0.8 8 ≥0.8 9 in 9 in 10 23 10 23 11 of 11 of 13 eyes 12 122 13 eyes 13 eyes 16 % 13 eyes 21 and 14 ( 16 % 15 18.9 16 % 16 % 17 ) 18 , 21 and 19 between 21 and 20 0.5 21 and 21 and 22 0.7 21 and 33 and 21 and 46 ) 23 in 24 28 23 in 33 and 24 28 25 of 24 28 30 % 25 of 27 eyes 26 122 27 eyes 28 ( 30 % 29 22.3 30 % 30 % 31 ) 32 , 33 and 33 and 34 between 34 between 36 and 35 0.2 36 and 36 and 37 0.4 36 and 40 of 36 and 45 % 37 0.4 38 in 38 in 39 33 40 of 42 eyes 41 122 42 eyes 43 ( 45 % 44 27.1 45 % 45 % 46 ) we found significant implications of cataract surgery on decreasing iop in the studied group of patients suffering from glaucoma compared to the patients without glaucoma . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 26 . 1 we 2 found 2 found 4 implications 2 found 8 on 2 found 17 suffering 3 significant 4 implications 4 implications 5 of 5 of 7 surgery 6 cataract 7 surgery 8 on 9 decreasing 9 decreasing 10 iop 9 decreasing 11 in 11 in 16 patients 12 the 14 group 13 studied 14 group 14 group 15 of 14 group 16 patients 15 of 16 patients 17 suffering 18 from 17 suffering 21 to 17 suffering 24 without 18 from 19 glaucoma 19 glaucoma 20 compared 21 to 23 patients 22 the 23 patients 24 without 25 glaucoma conclusion : advanced age is not a contraindication for cataract surgery . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 age 2 : 5 is 2 : 12 . 3 advanced 4 age 4 age 5 is 5 is 6 not 5 is 8 contraindication 7 a 8 contraindication 8 contraindication 9 for 9 for 11 surgery 10 cataract 11 surgery the results of the study showed that when systemic conditions are stable , both phaco and ecce with iol for very elderly patients are effective and safe . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 28 . 1 the 2 results 2 results 3 of 2 results 6 showed 3 of 5 study 4 the 5 study 6 showed 7 that 6 showed 8 when 8 when 10 conditions 8 when 11 are 9 systemic 10 conditions 10 conditions 11 are 11 are 12 stable 13 , 16 and 13 , 24 are 14 both 16 and 15 phaco 16 and 16 and 17 ecce 16 and 20 for 16 and 24 are 17 ecce 18 with 18 with 19 iol 20 for 23 patients 21 very 22 elderly 22 elderly 23 patients 24 are 26 and 25 effective 26 and 26 and 27 safe background : methicillin - resistant staphylococcus aureus ( mrsa ) infections are associated with significant mortality and health care costs . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 11 infections 2 : 13 associated 3 methicillin 7 aureus 3 methicillin 11 infections 4 - 7 aureus 5 resistant 7 aureus 6 staphylococcus 7 aureus 7 aureus 9 mrsa 7 aureus 10 ) 8 ( 9 mrsa 9 mrsa 10 ) 11 infections 12 are 12 are 13 associated 13 associated 14 with 14 with 17 and 15 significant 16 mortality 16 mortality 17 and 17 and 20 costs 18 health 19 care 19 care 20 costs to improve treatment outcomes for mrsa , a better understanding of the pharmacokinetic/pharmacodynamic parameters of vancomycin is required to develop optimal dosing strategies , particularly in elderly patients ( ≥75 years of age [ )( limited renal [function] . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 improve 0 ###LEFT-WALL### 7 , 1 to 2 improve 2 improve 4 outcomes 2 improve 5 for 3 treatment 4 outcomes 5 for 6 mrsa 7 , 10 understanding 7 , 18 required 8 a 10 understanding 9 better 10 understanding 10 understanding 11 of 10 understanding 15 of 10 understanding 17 is 11 of 14 parameters 12 the 14 parameters 13 pharmacokinetic/pharmacodynamic 14 parameters 15 of 16 vancomycin 17 is 18 required 18 required 19 to 18 required 20 develop 19 to 20 develop 20 develop 23 strategies 21 optimal 23 strategies 22 dosing 23 strategies 23 strategies 26 in 24 , 25 particularly 24 , 26 in 26 in 28 patients 26 in 39 . 27 elderly 28 patients 28 patients 31 years 29 ( 31 years 30 ≥75 31 years 31 years 32 of 31 years 36 limited 31 years 39 . 32 of 33 age 36 limited 37 renal the purpose of this study was to determine whether pharmacokinetic indices for vancomycin are associated with mortality from mrsa hospital [-] acquired pneumonia in elderly patients . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 27 . 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 determine 7 to 8 determine 8 determine 9 whether 9 whether 11 indices 9 whether 15 associated 10 pharmacokinetic 11 indices 11 indices 12 for 11 indices 14 are 12 for 13 vancomycin 14 are 15 associated 15 associated 16 with 15 associated 24 in 16 with 17 mortality 16 with 18 from 18 from 23 pneumonia 19 mrsa 22 acquired 20 hospital 22 acquired 22 acquired 23 pneumonia 24 in 26 patients 25 elderly 26 patients methods : we conducted a retrospective observational study with 28 - day mortality as the primary outcome for 94 patients with mrsa [hospital] - acquired pneumonia who had been treated with vancomycin from january 2006 through december 2012 . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 conducted 2 : 24 - 2 : 39 . 3 we 4 conducted 4 conducted 8 study 5 a 6 retrospective 5 a 8 study 6 retrospective 8 study 7 observational 8 study 8 study 9 with 9 with 10 28 10 28 13 mortality 11 - 13 mortality 12 day 13 mortality 13 mortality 14 as 13 mortality 24 - 14 as 17 outcome 15 the 17 outcome 16 primary 17 outcome 17 outcome 18 for 17 outcome 21 with 18 for 20 patients 19 94 20 patients 21 with 22 mrsa 24 - 26 pneumonia 25 acquired 26 pneumonia 26 pneumonia 27 who 26 pneumonia 28 had 27 who 28 had 28 had 29 been 29 been 30 treated 30 treated 31 with 30 treated 33 from 30 treated 36 through 31 with 32 vancomycin 33 from 34 january 34 january 35 2006 36 through 37 december 37 december 38 2012 our most recent sampling of mrsa isolates [had] a minimum inhibitory concentration ( mic ) for vancomycin of 1 μg / [ml] ( 86 % ) , indicating that the area under the curve ( auc ) was equal to the auc/mic in these [isolates] . 0 ###LEFT-WALL### 4 sampling 0 ###LEFT-WALL### 7 isolates 1 our 4 sampling 2 most 4 sampling 3 recent 4 sampling 4 sampling 5 of 4 sampling 7 isolates 5 of 6 mrsa 7 isolates 12 concentration 7 isolates 16 for 7 isolates 28 indicating 9 a 10 minimum 9 a 12 concentration 10 minimum 12 concentration 11 inhibitory 12 concentration 12 concentration 14 mic 13 ( 14 mic 14 mic 15 ) 16 for 17 vancomycin 17 vancomycin 18 of 18 of 21 / 19 1 20 μg 20 μg 21 / 21 / 25 % 23 ( 25 % 24 86 25 % 25 % 26 ) 27 , 28 indicating 28 indicating 29 that 28 indicating 46 . 29 that 31 area 29 that 38 was 30 the 31 area 31 area 32 under 31 area 38 was 32 under 34 curve 33 the 34 curve 34 curve 36 auc 35 ( 36 auc 36 auc 37 ) 38 was 39 equal 39 equal 40 to 39 equal 43 in 40 to 42 auc/mic 41 the 42 auc/mic 43 in 44 these the primary data from 28 [-] day survivors and nonsurvivors were compared . 0 ###LEFT-WALL### 3 data 0 ###LEFT-WALL### 12 compared 0 ###LEFT-WALL### 13 . 1 the 3 data 2 primary 3 data 3 data 4 from 3 data 11 were 4 from 9 and 5 28 7 day 7 day 8 survivors 8 survivors 9 and 9 and 10 nonsurvivors 11 were 12 compared results : among 94 elderly patients , the mean age was 82 ( 75 - 99 ) years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 19 . 1 results 2 : 2 : 3 among 3 among 6 patients 4 94 6 patients 5 elderly 6 patients 7 , 10 age 7 , 11 was 8 the 10 age 9 mean 10 age 10 age 11 was 11 was 18 years 12 82 18 years 13 ( 15 - 14 75 15 - 15 - 16 99 15 - 17 ) 15 - 18 years multivariate analyses revealed that , among the factors examined , only the nonoptimal auc ( < 250 , >450 μg*h/ml ) was an independent predictor of 28 - day mortality in elderly patients ( odds ratio 23.156 , 95 % confidence interval 6.814 - 78.687 , p < 0.001 ) . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 3 revealed 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 51 . 1 multivariate 2 analyses 2 analyses 3 revealed 3 revealed 4 that 3 revealed 6 among 5 , 6 among 6 among 8 factors 6 among 10 , 7 the 8 factors 8 factors 9 examined 10 , 11 only 10 , 22 was 11 only 14 auc 12 the 14 auc 13 nonoptimal 14 auc 14 auc 17 250 14 auc 22 was 15 ( 17 250 16 < 17 250 17 250 20 μg*h/ml 17 250 21 ) 18 , 20 μg*h/ml 19 >450 20 μg*h/ml 20 μg*h/ml 21 ) 22 was 25 predictor 22 was 48 < 23 an 25 predictor 24 independent 25 predictor 25 predictor 26 of 26 of 27 28 27 28 30 mortality 28 - 30 mortality 29 day 30 mortality 30 mortality 31 in 30 mortality 46 , 31 in 33 patients 32 elderly 33 patients 33 patients 36 ratio 33 patients 42 interval 34 ( 36 ratio 35 odds 36 ratio 36 ratio 37 23.156 36 ratio 38 , 38 , 42 interval 39 95 42 interval 40 % 41 confidence 41 confidence 42 interval 42 interval 44 - 42 interval 46 , 43 6.814 44 - 44 - 45 78.687 47 p 48 < 48 < 49 0.001 48 < 50 ) we detected a significant difference for increasing nephrotoxicity in nonsurvivors ( nine of 32 patients [ 28 % ] ) compared with survivors ( three of 62 patients [ 4.8 % ] , p = 0.003 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 detected 0 ###LEFT-WALL### 38 . 1 we 2 detected 2 detected 5 difference 3 a 4 significant 3 a 5 difference 4 significant 5 difference 5 difference 6 for 5 difference 21 compared 6 for 7 increasing 7 increasing 8 nephrotoxicity 7 increasing 9 in 9 in 10 nonsurvivors 10 nonsurvivors 12 nine 11 ( 12 nine 12 nine 13 of 12 nine 18 % 12 nine 20 ) 13 of 15 patients 14 32 15 patients 16 [ 18 % 17 28 18 % 18 % 19 ] 21 compared 22 with 22 with 23 survivors 23 survivors 25 three 23 survivors 35 = 24 ( 25 three 25 three 26 of 25 three 33 , 26 of 28 patients 27 62 28 patients 28 patients 31 % 29 [ 31 % 30 4.8 31 % 31 % 32 ] 33 , 35 = 34 p 35 = 35 = 36 0.003 35 = 37 ) conclusion : this finding indicates that patients [with] potentially poor renal function [are] likely to have increased auc values and a poor prognosis . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 finding 2 : 5 indicates 2 : 24 . 3 this 4 finding 4 finding 5 indicates 5 indicates 12 function 6 that 12 function 7 patients 12 function 9 potentially 10 poor 10 poor 12 function 11 renal 12 function 12 function 14 likely 14 likely 15 to 14 likely 17 increased 15 to 16 have 16 have 17 increased 17 increased 20 and 18 auc 19 values 19 values 20 and 20 and 23 prognosis 21 a 22 poor 21 a 23 prognosis 22 poor 23 prognosis consideration of the pharmacokinetics/pharmacodynamics of vancomycin and targeting an auc/mic value of 250 - 450 μg*h/ml may result in improved treatment outcomes for elderly patients with mrsa hospital [-] acquired pneumonia . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 20 improved 0 ###LEFT-WALL### 32 . 1 consideration 2 of 1 consideration 7 and 2 of 4 pharmacokinetics/pharmacodynamics 3 the 4 pharmacokinetics/pharmacodynamics 4 pharmacokinetics/pharmacodynamics 5 of 5 of 6 vancomycin 7 and 8 targeting 7 and 11 value 7 and 19 in 7 and 20 improved 9 an 11 value 10 auc/mic 11 value 11 value 12 of 11 value 17 may 12 of 16 μg*h/ml 13 250 14 - 14 - 15 450 14 - 16 μg*h/ml 17 may 18 result 18 result 19 in 20 improved 22 outcomes 20 improved 23 for 20 improved 26 with 21 treatment 22 outcomes 23 for 25 patients 24 elderly 25 patients 26 with 31 pneumonia 27 mrsa 30 acquired 28 hospital 30 acquired 30 acquired 31 pneumonia fossil evidence for longitudinal arches in the foot is frequently used to constrain the origins of terrestrial bipedality in human ancestors . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 11 used 0 ###LEFT-WALL### 22 . 1 fossil 2 evidence 2 evidence 3 for 2 evidence 9 is 3 for 5 arches 4 longitudinal 5 arches 5 arches 6 in 6 in 8 foot 7 the 8 foot 9 is 10 frequently 9 is 11 used 11 used 12 to 11 used 13 constrain 12 to 13 constrain 13 constrain 15 origins 13 constrain 19 in 14 the 15 origins 15 origins 16 of 16 of 18 bipedality 17 terrestrial 18 bipedality 19 in 21 ancestors 20 human 21 ancestors this approach rests on the prevailing concept that human feet are unique in functioning with a relatively stiff lateral mid - foot , lacking the significant flexion and high plantar pressures present [in] [non] - human apes . 0 ###LEFT-WALL### 2 approach 0 ###LEFT-WALL### 3 rests 1 this 2 approach 2 approach 3 rests 3 rests 4 on 3 rests 13 in 4 on 7 concept 5 the 7 concept 6 prevailing 7 concept 7 concept 8 that 8 that 10 feet 8 that 11 are 9 human 10 feet 10 feet 11 are 11 are 12 unique 13 in 14 functioning 14 functioning 15 with 14 functioning 24 lacking 15 with 22 foot 16 a 22 foot 17 relatively 18 stiff 18 stiff 22 foot 19 lateral 22 foot 20 mid 21 - 20 mid 22 foot 23 , 24 lacking 24 lacking 28 and 24 lacking 38 . 25 the 27 flexion 26 significant 27 flexion 27 flexion 28 and 28 and 32 present 28 and 37 apes 29 high 32 present 30 plantar 32 present 31 pressures 32 present 35 - 37 apes 36 human 37 apes 37 apes 38 . this paradigm has stood for more than 70 years but has yet to be tested objectively with quantitative data . 0 ###LEFT-WALL### 2 paradigm 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 20 . 1 this 2 paradigm 2 paradigm 10 but 3 has 4 stood 3 has 10 but 4 stood 5 for 5 for 9 years 6 more 7 than 7 than 8 70 8 70 9 years 10 but 11 has 11 has 13 to 11 has 15 tested 12 yet 13 to 13 to 14 be 14 be 15 tested 15 tested 16 objectively 15 tested 17 with 17 with 19 data 18 quantitative 19 data herein , we show that plantar pressure records with elevated lateral mid - foot pressures occur frequently in healthy , habitually shod humans , with magnitudes in some individuals approaching absolute maxima across the foot . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 show 1 herein 2 , 1 herein 3 we 3 we 4 show 4 show 5 that 5 that 8 records 5 that 16 occur 6 plantar 7 pressure 7 pressure 8 records 8 records 9 with 8 records 16 occur 9 with 15 pressures 10 elevated 15 pressures 11 lateral 14 foot 12 mid 13 - 12 mid 14 foot 14 foot 15 pressures 16 occur 17 frequently 16 occur 18 in 16 occur 25 with 18 in 23 humans 19 healthy 20 , 19 healthy 23 humans 21 habitually 22 shod 22 shod 23 humans 24 , 25 with 25 with 26 magnitudes 25 with 36 . 26 magnitudes 27 in 26 magnitudes 30 approaching 27 in 29 individuals 28 some 29 individuals 30 approaching 32 maxima 30 approaching 33 across 31 absolute 32 maxima 33 across 35 foot 34 the 35 foot furthermore , the same astonishing pressure range is present in bonobos and the orangutan ( the most arboreal great ape ) , yielding overlap with human pressures . 0 ###LEFT-WALL### 4 same 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 28 . 1 furthermore 2 , 1 furthermore 4 same 3 the 4 same 4 same 5 astonishing 4 same 8 is 5 astonishing 7 range 6 pressure 7 range 8 is 9 present 9 present 10 in 9 present 25 with 10 in 12 and 11 bonobos 12 and 12 and 24 overlap 13 the 24 overlap 14 orangutan 20 ape 14 orangutan 22 , 14 orangutan 24 overlap 15 ( 20 ape 16 the 20 ape 17 most 18 arboreal 18 arboreal 20 ape 19 great 20 ape 20 ape 21 ) 23 yielding 24 overlap 25 with 27 pressures 26 human 27 pressures thus , while the mean tendency of habitual mechanics of the mid - foot in healthy humans is indeed consistent with the traditional concept of the lateral mid - foot as a relatively rigid [or] stabilized structure , it is clear that lateral arch stabilization in humans is not obligate and is often transient . 0 ###LEFT-WALL### 39 it 0 ###LEFT-WALL### 51 and 0 ###LEFT-WALL### 55 . 1 thus 2 , 1 thus 39 it 3 while 6 tendency 3 while 18 is 3 while 39 it 4 the 6 tendency 5 mean 6 tendency 6 tendency 7 of 6 tendency 10 of 6 tendency 18 is 7 of 9 mechanics 8 habitual 9 mechanics 10 of 14 foot 11 the 14 foot 12 mid 13 - 12 mid 14 foot 14 foot 15 in 15 in 17 humans 16 healthy 17 humans 18 is 19 indeed 18 is 20 consistent 20 consistent 21 with 21 with 24 concept 22 the 24 concept 23 traditional 24 concept 24 concept 25 of 25 of 30 foot 26 the 30 foot 27 lateral 30 foot 28 mid 29 - 28 mid 30 foot 31 as 37 structure 31 as 38 , 31 as 39 it 32 a 33 relatively 32 a 37 structure 33 relatively 34 rigid 34 rigid 37 structure 36 stabilized 37 structure 39 it 51 and 40 is 41 clear 40 is 51 and 41 clear 44 arch 42 that 44 arch 43 lateral 44 arch 44 arch 45 stabilization 44 arch 50 obligate 45 stabilization 46 in 45 stabilization 48 is 46 in 47 humans 48 is 49 not 48 is 50 obligate 51 and 52 is 52 is 53 often 52 is 54 transient these findings suggest a level of detachment between foot stiffness during gait [and] osteological structure , hence [fossilized] bone morphology by itself may only provide a crude indication [of] mid - foot function in extinct hominins . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 37 . 1 these 2 findings 2 findings 3 suggest 3 suggest 5 level 3 suggest 8 between 4 a 5 level 5 level 6 of 6 of 7 detachment 8 between 10 stiffness 9 foot 10 stiffness 10 stiffness 11 during 11 during 15 structure 12 gait 15 structure 14 osteological 15 structure 16 , 20 morphology 16 , 25 provide 17 hence 20 morphology 19 bone 20 morphology 20 morphology 21 by 20 morphology 23 may 21 by 22 itself 23 may 25 provide 24 only 25 provide 25 provide 33 function 25 provide 34 in 26 a 27 crude 26 a 33 function 27 crude 28 indication 28 indication 33 function 30 mid 31 - 30 mid 32 foot 32 foot 33 function 34 in 36 hominins 35 extinct 36 hominins evidence for thick plantar tissues in ardipithecus ramidus suggests that a human - [like] combination of active and passive modulation of foot compliance by soft tissues extends back into an arboreal context , supporting an arboreal origin of hominin bipedalism in compressive orthogrady . 0 ###LEFT-WALL### 1 evidence 0 ###LEFT-WALL### 9 suggests 1 evidence 2 for 1 evidence 9 suggests 2 for 5 tissues 3 thick 5 tissues 4 plantar 5 tissues 5 tissues 6 in 6 in 8 ramidus 7 ardipithecus 8 ramidus 9 suggests 10 that 10 that 15 combination 10 that 27 extends 11 a 12 human 11 a 15 combination 12 human 13 - 12 human 15 combination 15 combination 16 of 15 combination 27 extends 16 of 20 modulation 17 active 18 and 18 and 19 passive 18 and 20 modulation 20 modulation 21 of 21 of 23 compliance 22 foot 23 compliance 23 compliance 24 by 24 by 26 tissues 25 soft 26 tissues 27 extends 28 back 27 extends 34 supporting 28 back 29 into 29 into 32 context 30 an 31 arboreal 30 an 32 context 31 arboreal 32 context 33 , 34 supporting 34 supporting 37 origin 34 supporting 44 . 35 an 36 arboreal 35 an 37 origin 36 arboreal 37 origin 37 origin 38 of 37 origin 40 bipedalism 38 of 39 hominin 40 bipedalism 41 in 41 in 43 orthogrady 42 compressive 43 orthogrady we propose that the musculoskeletal conformation of the modern human mid - foot evolved under selection for a functionally tuneable , rather [than] obligatory stiff structure . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 propose 0 ###LEFT-WALL### 27 . 1 we 2 propose 2 propose 3 that 3 that 6 conformation 3 that 14 evolved 4 the 6 conformation 5 musculoskeletal 6 conformation 6 conformation 7 of 6 conformation 14 evolved 7 of 13 foot 8 the 13 foot 9 modern 13 foot 10 human 13 foot 11 mid 12 - 11 mid 13 foot 14 evolved 15 under 15 under 16 selection 16 selection 17 for 17 for 26 structure 18 a 19 functionally 18 a 26 structure 19 functionally 20 tuneable 20 tuneable 21 , 20 tuneable 26 structure 22 rather 24 obligatory 24 obligatory 26 structure 25 stiff 26 structure background : low muscle strength is related to an increased risk for several chronic diseases . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 strength 2 : 7 related 2 : 16 . 3 low 4 muscle 4 muscle 5 strength 5 strength 6 is 6 is 7 related 7 related 8 to 8 to 11 risk 9 an 11 risk 10 increased 11 risk 11 risk 12 for 12 for 15 diseases 13 several 15 diseases 14 chronic 15 diseases increased muscle strength improves daily function [and] quality of life . 0 ###LEFT-WALL### 3 strength 0 ###LEFT-WALL### 4 improves 0 ###LEFT-WALL### 11 . 1 increased 2 muscle 2 muscle 3 strength 3 strength 4 improves 4 improves 8 quality 5 daily 6 function 6 function 8 quality 8 quality 9 of 9 of 10 life methods : female patients ( n=178 , 22 - 83 years ) with musculoskeletal disorders , metabolic risk factors and other chronic diseases were recruited from primary care . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 29 . 1 methods 2 : 2 : 4 patients 3 female 4 patients 4 patients 6 n=178 5 ( 6 n=178 6 n=178 9 - 6 n=178 13 with 6 n=178 16 , 7 , 9 - 8 22 9 - 9 - 11 years 9 - 12 ) 10 83 11 years 13 with 15 disorders 14 musculoskeletal 15 disorders 16 , 19 factors 16 , 20 and 17 metabolic 19 factors 18 risk 19 factors 20 and 23 diseases 20 and 25 recruited 21 other 23 diseases 22 chronic 23 diseases 23 diseases 24 were 24 were 25 recruited 25 recruited 26 from 26 from 28 care 27 primary 28 care maximal step - up height ( standardised step - up without a kick - off with the floor foot [ )(, anthropometric variables , vo₂ - max and self - reported physical function ( short form 36 ( sf - 36 ) ) were assessed before and after [a] 3 - month group training intervention programme . 0 ###LEFT-WALL### 2 step 0 ###LEFT-WALL### 3 - 1 maximal 2 step 3 - 4 up 3 - 14 - 4 up 5 height 5 height 8 step 6 ( 8 step 7 standardised 8 step 8 step 10 up 8 step 14 - 9 - 10 up 10 up 11 without 10 up 14 - 11 without 13 kick 12 a 13 kick 14 - 19 foot 14 - 21 )(, 14 - 24 , 15 off 16 with 15 off 19 foot 16 with 18 floor 17 the 18 floor 21 )(, 23 variables 22 anthropometric 23 variables 24 , 25 vo₂ 24 , 26 - 26 - 28 and 26 - 30 - 27 max 28 and 28 and 29 self 30 - 33 function 31 reported 33 function 32 physical 33 function 33 function 36 form 33 function 44 were 34 ( 36 form 35 short 36 form 36 form 37 36 36 form 39 sf 36 form 43 ) 38 ( 39 sf 39 sf 41 36 39 sf 43 ) 40 - 41 36 41 36 42 ) 44 were 45 assessed 45 assessed 47 and 46 before 47 and 47 and 48 after 48 after 50 3 50 3 56 programme 51 - 56 programme 52 month 56 programme 53 group 56 programme 54 training 55 intervention 55 intervention 56 programme 56 programme 57 . associations between maximal [step] - up height and other variables were examined using univariate and multivariate methods . 0 ###LEFT-WALL### 1 associations 0 ###LEFT-WALL### 12 examined 0 ###LEFT-WALL### 18 . 1 associations 2 between 1 associations 11 were 2 between 8 and 3 maximal 5 - 3 maximal 7 height 6 up 7 height 7 height 8 and 8 and 10 variables 9 other 10 variables 11 were 12 examined 12 examined 13 using 13 using 15 and 14 univariate 15 and 15 and 17 methods 16 multivariate 17 methods results : at baseline and after intervention , maximal step - up height was negatively correlated to age , waist circumference and body weight and positively correlated to vo₂ - max , self - reported physical function [and] height . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 40 . 1 results 2 : 2 : 5 and 3 at 4 baseline 3 at 5 and 5 and 6 after 6 after 7 intervention 8 , 10 step 8 , 11 - 9 maximal 10 step 11 - 13 height 11 - 29 vo₂ 11 - 30 - 12 up 13 height 13 height 25 and 14 was 16 correlated 14 was 25 and 15 negatively 16 correlated 16 correlated 17 to 17 to 22 and 18 age 19 , 19 , 21 circumference 19 , 22 and 20 waist 21 circumference 22 and 24 weight 23 body 24 weight 25 and 27 correlated 25 and 28 to 26 positively 27 correlated 28 to 29 vo₂ 30 - 33 self 30 - 35 reported 31 max 32 , 31 max 33 self 34 - 35 reported 35 reported 39 height 36 physical 37 function 37 function 39 height furthermore , maximal [step] - up height correlated to training [intensity] at [follow] - up . 0 ###LEFT-WALL### 7 height 0 ###LEFT-WALL### 8 correlated 0 ###LEFT-WALL### 16 . 1 furthermore 2 , 1 furthermore 7 height 3 maximal 5 - 3 maximal 7 height 6 up 7 height 7 height 8 correlated 8 correlated 9 to 8 correlated 12 at 9 to 10 training 12 at 15 up 14 - 15 up variations in changes in maximal [step] - up height were significantly explained by changes [in] [waist] [circumference] and physical function , regardless of age and changes in [vo₂] - max . 0 ###LEFT-WALL### 1 variations 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 31 . 1 variations 2 in 1 variations 4 in 1 variations 25 and 2 in 3 changes 4 in 9 height 5 maximal 7 - 5 maximal 9 height 8 up 9 height 10 were 12 explained 10 were 25 and 11 significantly 12 explained 12 explained 13 by 12 explained 23 of 13 by 18 and 14 changes 18 and 18 and 20 function 18 and 21 , 19 physical 20 function 22 regardless 23 of 23 of 24 age 25 and 26 changes 26 changes 27 in 26 changes 29 - 26 changes 30 max maximal step - up height below 24 cm discriminated patients with self [-] reported severe limitation [in] physical [function] . 0 ###LEFT-WALL### 2 step 0 ###LEFT-WALL### 3 - 1 maximal 2 step 3 - 5 height 3 - 9 discriminated 3 - 20 . 4 up 5 height 5 height 6 below 5 height 9 discriminated 6 below 8 cm 7 24 8 cm 9 discriminated 10 patients 9 discriminated 11 with 11 with 16 limitation 11 with 18 physical 12 self 14 reported 14 reported 16 limitation 15 severe 16 limitation conclusions : maximal step - up height , assessed simply with a standardised step - up test , [may] function as a relevant indicator of health since it correlated negatively to the metabolic risk factors , waist circumference , body weight and age , and positively to vo₂ - max and physical function . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 54 . 2 : 4 step 2 : 5 - 3 maximal 4 step 5 - 7 height 5 - 15 - 6 up 7 height 7 height 9 assessed 8 , 9 assessed 9 assessed 10 simply 9 assessed 15 - 10 simply 11 with 11 with 14 step 12 a 14 step 13 standardised 14 step 15 - 17 test 15 - 18 , 15 - 36 , 16 up 17 test 18 , 20 function 20 function 21 as 21 as 24 indicator 22 a 23 relevant 22 a 24 indicator 23 relevant 24 indicator 24 indicator 25 of 25 of 26 health 26 health 27 since 26 health 29 correlated 27 since 28 it 29 correlated 30 negatively 29 correlated 31 to 31 to 35 factors 32 the 35 factors 33 metabolic 35 factors 34 risk 35 factors 36 , 38 circumference 36 , 39 , 37 waist 38 circumference 39 , 42 and 39 , 45 and 40 body 41 weight 41 weight 42 and 42 and 43 age 42 and 44 , 44 , 45 and 45 and 51 and 45 and 53 function 46 positively 51 and 47 to 48 vo₂ 47 to 49 - 47 to 51 and 50 max 51 and 51 and 52 physical 51 and 53 function errors in chromosome segregation in oocytes and early embryos lead to embryo aneuploidy , which contributes to early pregnancy loss . 0 ###LEFT-WALL### 1 errors 0 ###LEFT-WALL### 10 lead 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 21 . 1 errors 2 in 1 errors 10 lead 2 in 4 segregation 3 chromosome 4 segregation 4 segregation 5 in 5 in 7 and 6 oocytes 7 and 7 and 9 embryos 8 early 9 embryos 10 lead 11 to 11 to 13 aneuploidy 12 embryo 13 aneuploidy 14 , 15 which 14 , 16 contributes 15 which 16 contributes 16 contributes 17 to 17 to 20 loss 18 early 19 pregnancy 19 pregnancy 20 loss at the heart of chromosome segregation is the spindle , a dynamic biomechanical machine fashioned from microtubules , which is tasked with gathering and sorting chromosomes and [dispatching] them to the daughter cells at the time of cell division . 0 ###LEFT-WALL### 1 at 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 40 . 1 at 3 heart 1 at 7 is 2 the 3 heart 3 heart 4 of 4 of 6 segregation 5 chromosome 6 segregation 7 is 9 spindle 7 is 19 which 7 is 22 with 8 the 9 spindle 9 spindle 14 machine 10 , 14 machine 11 a 14 machine 12 dynamic 14 machine 13 biomechanical 14 machine 14 machine 15 fashioned 14 machine 16 from 14 machine 18 , 16 from 17 microtubules 19 which 20 is 20 is 21 tasked 22 with 27 and 23 gathering 24 and 24 and 26 chromosomes 24 and 27 and 25 sorting 26 chromosomes 27 and 29 them 27 and 30 to 27 and 37 of 30 to 33 cells 31 the 33 cells 32 daughter 33 cells 33 cells 34 at 34 at 36 time 35 the 36 time 37 of 39 division 38 cell 39 division understanding the causes of segregation error in the oocyte and early embryo will undoubtedly hinge on a thorough understanding of the mechanism [of] spindle assembly and function in these highly specialized cellular environments . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 31 specialized 0 ###LEFT-WALL### 34 . 1 understanding 10 and 1 understanding 15 hinge 1 understanding 31 specialized 2 the 3 causes 3 causes 4 of 3 causes 10 and 4 of 6 error 5 segregation 6 error 6 error 7 in 7 in 9 oocyte 8 the 9 oocyte 10 and 12 embryo 10 and 13 will 11 early 12 embryo 13 will 15 hinge 14 undoubtedly 15 hinge 15 hinge 16 on 15 hinge 28 in 15 hinge 30 highly 16 on 26 and 17 a 18 thorough 17 a 19 understanding 18 thorough 19 understanding 19 understanding 20 of 19 understanding 26 and 20 of 25 assembly 21 the 25 assembly 22 mechanism 25 assembly 24 spindle 25 assembly 26 and 27 function 28 in 29 these 31 specialized 33 environments 32 cellular 33 environments the recent advent of live imaging approaches to observe chromosome segregation in real - time in oocytes and embryos , paired with gene [-] silencing techniques and specific inhibition for assessing the function of a protein of interest , has led to a substantial advance in our understanding of chromosome segregation in early mammalian development . 0 ###LEFT-WALL### 3 advent 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 56 . 1 the 3 advent 2 recent 3 advent 3 advent 4 of 3 advent 20 , 4 of 6 imaging 5 live 6 imaging 7 approaches 8 to 7 approaches 16 in 7 approaches 20 , 8 to 9 observe 9 observe 11 segregation 10 chromosome 11 segregation 11 segregation 12 in 12 in 15 time 13 real 14 - 13 real 15 time 16 in 18 and 17 oocytes 18 and 18 and 19 embryos 20 , 39 , 20 , 46 in 21 paired 22 with 21 paired 30 for 21 paired 39 , 22 with 27 and 23 gene 26 techniques 25 silencing 26 techniques 26 techniques 27 and 27 and 29 inhibition 28 specific 29 inhibition 30 for 31 assessing 31 assessing 33 function 32 the 33 function 33 function 34 of 33 function 37 of 34 of 36 protein 35 a 36 protein 37 of 38 interest 39 , 40 has 40 has 41 led 41 led 42 to 42 to 45 advance 43 a 45 advance 44 substantial 45 advance 46 in 48 understanding 47 our 48 understanding 48 understanding 49 of 48 understanding 52 in 49 of 51 segregation 50 chromosome 51 segregation 52 in 55 development 53 early 55 development 54 mammalian 55 development these studies have uncovered numerous mechanistic differences between oocytes , embryos , and traditional model systems . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 17 . 1 these 2 studies 2 studies 3 have 3 have 7 differences 3 have 8 between 4 uncovered 7 differences 5 numerous 7 differences 6 mechanistic 7 differences 8 between 13 and 9 oocytes 10 , 10 , 11 embryos 10 , 13 and 12 , 13 and 13 and 16 systems 14 traditional 15 model 15 model 16 systems in addition , a flurry of recent studies using naturally aged mice as the model for human aging have begun to shed light on the increased levels of aneuploidy seen in embryos from older mothers . 0 ###LEFT-WALL### 5 flurry 0 ###LEFT-WALL### 22 shed 0 ###LEFT-WALL### 36 . 1 in 2 addition 1 in 3 , 1 in 5 flurry 4 a 5 flurry 5 flurry 6 of 5 flurry 12 mice 5 flurry 21 to 5 flurry 22 shed 6 of 8 studies 7 recent 8 studies 9 using 12 mice 10 naturally 11 aged 11 aged 12 mice 12 mice 13 as 12 mice 19 have 13 as 15 model 14 the 15 model 15 model 16 for 16 for 18 aging 17 human 18 aging 19 have 20 begun 20 begun 21 to 22 shed 23 light 22 shed 24 on 22 shed 31 in 24 on 27 levels 25 the 27 levels 26 increased 27 levels 27 levels 28 of 28 of 29 aneuploidy 29 aneuploidy 30 seen 31 in 32 embryos 32 embryos 33 from 33 from 35 mothers 34 older 35 mothers here we review these recent developments and consider what has been learned about the causes of chromosome missegregation in early development . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 22 . 1 here 2 we 2 we 7 and 3 review 6 developments 3 review 7 and 4 these 6 developments 5 recent 6 developments 7 and 8 consider 8 consider 9 what 9 what 10 has 10 has 11 been 11 been 12 learned 12 learned 13 about 12 learned 19 in 13 about 15 causes 14 the 15 causes 15 causes 16 of 16 of 18 missegregation 17 chromosome 18 missegregation 19 in 21 development 20 early 21 development objective : to inform whether the alzheimer 's disease neuroimaging initiative ( adni ) should change its policy of not returning research results to adni participants , we surveyed investigators and research staff about disclosing adni biomarker information to research participants , with particular emphasis on amyloid imaging results . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 not 1 objective 2 : 2 : 3 to 3 to 4 inform 4 inform 5 whether 4 inform 10 neuroimaging 5 whether 7 alzheimer 5 whether 8 's 6 the 7 alzheimer 7 alzheimer 8 's 8 's 9 disease 10 neuroimaging 11 initiative 10 neuroimaging 19 of 11 initiative 13 adni 11 initiative 15 should 12 ( 13 adni 13 adni 14 ) 15 should 16 change 16 change 18 policy 17 its 18 policy 18 policy 19 of 20 not 28 we 20 not 31 and 21 returning 23 results 21 returning 24 to 21 returning 27 , 21 returning 28 we 22 research 23 results 24 to 26 participants 25 adni 26 participants 28 we 31 and 29 surveyed 30 investigators 29 surveyed 31 and 31 and 32 research 32 research 33 staff 33 staff 34 about 33 staff 39 to 34 about 35 disclosing 35 disclosing 38 information 36 adni 37 biomarker 37 biomarker 38 information 39 to 41 participants 40 research 41 participants 41 participants 43 with 42 , 43 with 43 with 45 emphasis 43 with 50 . 44 particular 45 emphasis 45 emphasis 46 on 45 emphasis 48 imaging 46 on 47 amyloid 48 imaging 49 results methods : in april 2012 , just before food and drug administration approval of the amyloid - binding radiotracer , florbetapir , all adni investigators and personnel were recruited to complete an anonymous online survey that contained fixed choice and free - text questions . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 31 complete 0 ###LEFT-WALL### 45 . 2 : 10 and 2 : 19 radiotracer 2 : 20 , 2 : 29 recruited 3 in 4 april 3 in 6 , 3 in 10 and 4 april 5 2012 7 just 8 before 7 just 10 and 8 before 9 food 10 and 13 approval 10 and 17 - 10 and 18 binding 10 and 19 radiotracer 11 drug 12 administration 12 administration 13 approval 13 approval 14 of 14 of 16 amyloid 15 the 16 amyloid 20 , 21 florbetapir 20 , 22 , 22 , 24 adni 23 all 24 adni 25 investigators 26 and 26 and 27 personnel 26 and 28 were 28 were 29 recruited 29 recruited 30 to 30 to 31 complete 31 complete 35 survey 32 an 35 survey 33 anonymous 35 survey 34 online 35 survey 35 survey 36 that 35 survey 37 contained 36 that 37 contained 37 contained 40 and 38 fixed 39 choice 39 choice 40 and 40 and 44 questions 41 free 42 - 41 free 43 text 43 text 44 questions results : although adni participants often requested amyloid imaging results ( the proportions of investigators [who] reported requests from more than half of their participants with normal cognition or mild cognitive impairment were 20 % and 22 % , respectively ) [,] [across] all diagnostic groups , the majority of adni investigators ( approximately 90 % ) did not return amyloid imaging results to adni participants [.] 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 requested 2 : 5 participants 3 although 4 adni 3 although 5 participants 5 participants 7 requested 6 often 7 requested 7 requested 8 amyloid 7 requested 18 requests 8 amyloid 9 imaging 8 amyloid 18 requests 9 imaging 10 results 11 ( 17 reported 12 the 13 proportions 13 proportions 14 of 13 proportions 17 reported 14 of 15 investigators 17 reported 18 requests 18 requests 19 from 18 requests 21 than 18 requests 22 half 18 requests 26 with 19 from 20 more 22 half 23 of 23 of 25 participants 24 their 25 participants 26 with 29 or 26 with 36 and 27 normal 28 cognition 28 cognition 29 or 29 or 30 mild 29 or 32 impairment 29 or 33 were 31 cognitive 32 impairment 32 impairment 33 were 34 20 35 % 34 20 36 and 36 and 37 22 37 22 38 % 38 % 46 groups 39 , 40 respectively 40 respectively 41 ) 40 respectively 45 diagnostic 44 all 45 diagnostic 45 diagnostic 46 groups 46 groups 52 investigators 46 groups 58 did 47 , 52 investigators 48 the 49 majority 49 majority 50 of 49 majority 52 investigators 50 of 52 investigators 51 adni 52 investigators 52 investigators 56 % 52 investigators 57 ) 53 ( 56 % 54 approximately 55 90 55 90 56 % 56 % 57 ) 58 did 59 not 58 did 60 return 60 return 63 results 61 amyloid 63 results 62 imaging 63 results 63 results 64 to 64 to 66 participants 65 adni 66 participants conclusions : a majority of adni investigators support returning amyloid imaging results to adni participants . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 7 investigators 2 : 8 support 2 : 16 . 3 a 4 majority 4 majority 5 of 4 majority 7 investigators 5 of 7 investigators 6 adni 7 investigators 7 investigators 8 support 8 support 10 amyloid 8 support 13 to 9 returning 10 amyloid 10 amyloid 11 imaging 11 imaging 12 results 13 to 15 participants 14 adni 15 participants the findings that they want guidance on how to do this and research on the impact of disclosure suggest [how] to develop and monitor a disclosure process . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 19 suggest 0 ###LEFT-WALL### 28 . 1 the 2 findings 2 findings 3 that 2 findings 19 suggest 3 that 4 they 3 that 12 and 4 they 12 and 5 want 6 guidance 5 want 12 and 6 guidance 7 on 7 on 8 how 8 how 9 to 8 how 10 do 9 to 10 do 10 do 11 this 12 and 13 research 12 and 14 on 14 on 16 impact 15 the 16 impact 16 impact 17 of 17 of 18 disclosure 19 suggest 21 to 19 suggest 27 process 21 to 23 and 22 develop 23 and 23 and 24 monitor 25 a 27 process 26 disclosure 27 process context : estrogen deficiency , systemic low - grade inflammation , and reduction of adrenal gland function [have] central roles in noncommunicable chronic disease ( ncd ) development . 0 ###LEFT-WALL### 1 context 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 1 context 2 : 2 : 28 development 3 estrogen 4 deficiency 4 deficiency 5 , 5 , 10 inflammation 5 , 12 and 6 systemic 9 grade 7 low 8 - 7 low 9 grade 9 grade 10 inflammation 11 , 12 and 12 and 13 reduction 12 and 14 of 12 and 28 development 14 of 20 roles 15 adrenal 16 gland 16 gland 20 roles 17 function 20 roles 19 central 20 roles 20 roles 21 in 21 in 24 disease 22 noncommunicable 24 disease 23 chronic 24 disease 24 disease 26 ncd 25 ( 26 ncd 26 ncd 27 ) with angiotensin - converting enzyme ( ace ) insertion/deletion ( i/d ) [polymorphism] , the deletion variant [(] [dd] ) is related to higher levels of circulating angiotensin ii than i allele carriers ( ii/id ) , which might interact with all of these molecular pathways to increase ncds risk . 0 ###LEFT-WALL### 9 insertion/deletion 0 ###LEFT-WALL### 22 related 0 ###LEFT-WALL### 30 than 1 with 2 angiotensin 1 with 8 ) 1 with 9 insertion/deletion 2 angiotensin 4 converting 3 - 4 converting 4 converting 5 enzyme 4 converting 8 ) 5 enzyme 7 ace 6 ( 7 ace 7 ace 8 ) 9 insertion/deletion 11 i/d 9 insertion/deletion 17 variant 9 insertion/deletion 21 is 10 ( 11 i/d 11 i/d 12 ) 14 , 17 variant 15 the 17 variant 16 deletion 17 variant 17 variant 20 ) 21 is 22 related 22 related 23 to 23 to 25 levels 24 higher 25 levels 25 levels 26 of 26 of 27 circulating 27 circulating 28 angiotensin 28 angiotensin 29 ii 30 than 31 i 30 than 32 allele 31 i 32 allele 32 allele 33 carriers 33 carriers 35 ii/id 33 carriers 38 which 34 ( 35 ii/id 35 ii/id 36 ) 37 , 38 which 38 which 39 might 38 which 51 . 39 might 40 interact 40 interact 41 with 40 interact 47 to 41 with 42 all 42 all 43 of 43 of 46 pathways 44 these 46 pathways 45 molecular 46 pathways 47 to 48 increase 48 increase 50 risk 49 ncds 50 risk on the other hand , physical exercise counteracts the occurrence of ncds , potentially acting on the same pathways . 0 ###LEFT-WALL### 7 exercise 0 ###LEFT-WALL### 8 counteracts 1 on 4 hand 1 on 5 , 1 on 7 exercise 2 the 3 other 3 other 4 hand 6 physical 7 exercise 7 exercise 8 counteracts 8 counteracts 10 occurrence 9 the 10 occurrence 10 occurrence 11 of 11 of 12 ncds 12 ncds 15 acting 13 , 15 acting 14 potentially 15 acting 15 acting 16 on 15 acting 20 . 16 on 19 pathways 17 the 18 same 18 same 19 pathways objectives : the aim of the study was to investigate the effects of walking training on adrenal steroid [and] cytokine levels and on cardiovascular parameters in postmenopausal women with ace i/d genotypes . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 32 genotypes 2 : 33 . 3 the 4 aim 4 aim 5 of 4 aim 8 was 5 of 7 study 6 the 7 study 8 was 9 to 8 was 10 investigate 9 to 10 investigate 10 investigate 12 effects 10 investigate 26 in 11 the 12 effects 12 effects 13 of 12 effects 22 and 13 of 14 walking 14 walking 15 training 16 on 21 levels 16 on 22 and 17 adrenal 21 levels 18 steroid 20 cytokine 20 cytokine 21 levels 22 and 23 on 23 on 25 parameters 24 cardiovascular 25 parameters 26 in 28 women 27 postmenopausal 28 women 28 women 29 with 28 women 31 i/d 28 women 32 genotypes 29 with 30 ace 31 i/d 32 genotypes methods [:] thirty - six ( dd = 15 , ii/id = 21 [ )(sedentary postmenopausal women ( mean age , 56 ± 4 [y] [ )(participated in a 13 [-] week program of walking training at moderate [intensity] . 0 ###LEFT-WALL### 7 dd 0 ###LEFT-WALL### 8 = 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 40 . 1 methods 4 - 1 methods 7 dd 3 thirty 4 - 4 - 5 six 6 ( 7 dd 7 dd 8 = 8 = 9 15 10 , 11 ii/id 10 , 12 = 10 , 21 , 11 ii/id 12 = 12 = 17 women 13 21 17 women 15 )(sedentary 17 women 16 postmenopausal 17 women 17 women 20 age 18 ( 20 age 19 mean 20 age 20 age 21 , 21 , 22 56 21 , 38 moderate 22 56 23 ± 22 56 37 at 22 56 38 moderate 23 ± 24 4 23 ± 27 )(participated 27 )(participated 28 in 28 in 33 program 29 a 33 program 30 13 33 program 32 week 33 program 33 program 34 of 34 of 35 walking 35 walking 36 training 35 walking 37 at heart rate , blood pressure , double product , tnf - α , dehydroepiandrosterone [sulfate] ( dhea - s ) , and cortisol were evaluated before and after the intervention program . 0 ###LEFT-WALL### 2 rate 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 32 . 1 heart 2 rate 3 , 22 and 3 , 25 evaluated 4 blood 5 pressure 5 pressure 6 , 6 , 8 product 6 , 9 , 7 double 8 product 9 , 10 tnf 9 , 22 and 10 tnf 14 dehydroepiandrosterone 11 - 14 dehydroepiandrosterone 12 α 13 , 12 α 14 dehydroepiandrosterone 14 dehydroepiandrosterone 17 dhea 14 dehydroepiandrosterone 21 , 16 ( 17 dhea 17 dhea 19 s 17 dhea 21 , 18 - 19 s 19 s 20 ) 22 and 23 cortisol 22 and 24 were 24 were 25 evaluated 25 evaluated 27 and 26 before 27 and 27 and 28 after 28 after 31 program 29 the 31 program 30 intervention 31 program results : before walking training , the ace dd [genotype] showed significantly higher tnf - α ( p = [.] 007 ) and lower dhea - [s] concentrations ( p = [.] 022 ) than the ace ii/id individuals . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 9 dd 2 : 11 showed 2 : 40 . 3 before 4 walking 3 before 6 , 3 before 9 dd 4 walking 5 training 7 the 9 dd 8 ace 9 dd 9 dd 11 showed 11 showed 13 higher 11 showed 23 and 11 showed 25 dhea 11 showed 35 than 12 significantly 13 higher 14 tnf 16 α 14 tnf 23 and 15 - 16 α 16 α 19 = 16 α 22 ) 17 ( 19 = 18 p 19 = 19 = 21 007 19 = 22 ) 23 and 24 lower 25 dhea 28 concentrations 26 - 28 concentrations 28 concentrations 31 = 28 concentrations 34 ) 29 ( 31 = 30 p 31 = 31 = 33 022 31 = 34 ) 35 than 39 individuals 36 the 39 individuals 37 ace 38 ii/id 38 ii/id 39 individuals after walking training , both subgroups significantly decreased tnf - α plasma levels and cortisol/dhea - [s] ratio [(] p = . 001 and p = . 016 , respectively ) [and] significantly increased dhea - s levels ( p < [.] 001 ) . 0 ###LEFT-WALL### 6 subgroups 0 ###LEFT-WALL### 8 decreased 0 ###LEFT-WALL### 10 - 1 after 2 walking 1 after 4 , 1 after 6 subgroups 2 walking 3 training 5 both 6 subgroups 6 subgroups 8 decreased 7 significantly 8 decreased 8 decreased 9 tnf 10 - 14 and 10 - 22 . 10 - 36 - 11 α 13 levels 12 plasma 13 levels 13 levels 14 and 14 and 18 ratio 14 and 20 p 14 and 21 = 15 cortisol/dhea 16 - 15 cortisol/dhea 18 ratio 20 p 21 = 22 . 23 001 22 . 24 and 22 . 27 . 24 and 25 p 24 and 26 = 25 p 26 = 27 . 35 dhea 28 016 35 dhea 29 , 30 respectively 30 respectively 31 ) 30 respectively 34 increased 33 significantly 34 increased 34 increased 35 dhea 36 - 37 s 36 - 38 levels 36 - 45 . 37 s 38 levels 38 levels 41 < 39 ( 41 < 40 p 41 < 41 < 43 001 41 < 44 ) moreover , all the cardiovascular parameters were significantly reduced in the ace dd participants ( [p] ≤ [.] 05 ) , [whereas] the ace i - allele carriers showed a decrease in heart rate ( [p] ≤ [.] 05 [ )(and the double product ( [p] ≤ [.] 05 ) . 1 moreover 2 , 1 moreover 3 all 3 all 4 the 3 all 6 parameters 3 all 7 were 4 the 6 parameters 5 cardiovascular 6 parameters 7 were 8 significantly 7 were 9 reduced 9 reduced 10 in 10 in 14 participants 11 the 14 participants 12 ace 13 dd 13 dd 14 participants 14 participants 17 ≤ 14 participants 26 - 15 ( 17 ≤ 17 ≤ 19 05 17 ≤ 20 ) 21 , 26 - 23 the 24 ace 24 ace 25 i 24 ace 26 - 26 - 27 allele 27 allele 28 carriers 27 allele 29 showed 28 carriers 29 showed 29 showed 31 decrease 29 showed 32 in 30 a 31 decrease 32 in 34 rate 33 heart 34 rate 34 rate 41 )(and 35 ( 41 )(and 37 ≤ 39 05 37 ≤ 41 )(and 41 )(and 44 product 41 )(and 47 ≤ 41 )(and 51 . 42 the 44 product 43 double 44 product 45 ( 47 ≤ 47 ≤ 49 05 47 ≤ 50 ) conclusion : ace i/d [polymorphism] is linked to different adrenal steroid [and] cytokine levels , and ace i - allele carriers show a better adrenal activity and systemic inflammatory profile . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 i/d 2 : 7 linked 2 : 19 - 3 ace 4 i/d 4 i/d 6 is 6 is 7 linked 7 linked 8 to 8 to 16 and 9 different 11 steroid 10 adrenal 11 steroid 11 steroid 14 levels 13 cytokine 14 levels 14 levels 16 and 15 , 16 and 16 and 17 ace 16 and 19 - 17 ace 18 i 19 - 21 carriers 19 - 22 show 19 - 31 . 20 allele 21 carriers 21 carriers 22 show 22 show 26 activity 22 show 27 and 23 a 26 activity 24 better 26 activity 25 adrenal 26 activity 27 and 30 profile 28 systemic 30 profile 29 inflammatory 30 profile the introduction of walking training positively influences the menopause immune - neuroendocrine changes , independent of ace i/d [genotype] . 0 ###LEFT-WALL### 2 introduction 0 ###LEFT-WALL### 7 influences 0 ###LEFT-WALL### 20 . 1 the 2 introduction 2 introduction 3 of 2 introduction 7 influences 3 of 4 walking 4 walking 5 training 6 positively 7 influences 7 influences 15 independent 8 the 15 independent 9 menopause 15 independent 10 immune 13 changes 10 immune 14 , 10 immune 15 independent 11 - 13 changes 12 neuroendocrine 13 changes 13 changes 14 , 15 independent 16 of 16 of 18 i/d 17 ace 18 i/d none none none background : the relationship between aging and increased life expectancy in the overall population likely contributes to a higher frequency rate and incidence of illnesses and functional disabilities . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 32 . 1 none 4 background 1 none 8 between 1 none 9 aging 2 none 3 none 3 none 4 background 4 background 5 : 5 : 7 relationship 5 : 8 between 6 the 7 relationship 10 and 13 expectancy 10 and 19 contributes 11 increased 12 life 12 life 13 expectancy 13 expectancy 14 in 13 expectancy 19 contributes 14 in 17 population 15 the 17 population 16 overall 17 population 18 likely 19 contributes 19 contributes 20 to 20 to 25 and 21 a 24 rate 22 higher 23 frequency 23 frequency 24 rate 24 rate 25 and 25 and 26 incidence 25 and 27 of 27 of 29 and 28 illnesses 29 and 29 and 31 disabilities 30 functional 31 disabilities physical dependence and cognitive impairment might hinder the performance of activities and result in [an] overload of care duties for the patient 's family and the healthcare system . 0 ###LEFT-WALL### 1 physical 0 ###LEFT-WALL### 23 's 0 ###LEFT-WALL### 29 . 1 physical 3 and 1 physical 16 overload 1 physical 17 of 1 physical 23 's 2 dependence 3 and 3 and 4 cognitive 3 and 5 impairment 3 and 14 in 3 and 16 overload 5 impairment 6 might 6 might 7 hinder 7 hinder 9 performance 7 hinder 14 in 8 the 9 performance 9 performance 10 of 10 of 12 and 11 activities 12 and 12 and 13 result 17 of 19 duties 18 care 19 duties 19 duties 20 for 20 for 22 patient 21 the 22 patient 23 's 25 and 24 family 25 and 25 and 28 system 26 the 28 system 27 healthcare 28 system objective : the aim of this study was to compare the functional and cognitive changes exhibited by the elderly over a 6 [-] month period . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 . 2 : 4 aim 2 : 16 exhibited 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 16 exhibited 9 to 10 compare 10 compare 13 and 11 the 12 functional 12 functional 13 and 13 and 15 changes 14 cognitive 15 changes 16 exhibited 17 by 16 exhibited 20 over 17 by 19 elderly 18 the 19 elderly 20 over 25 period 21 a 25 period 22 6 24 month 24 month 25 period method : this longitudinal and observational study was conducted in a sample of 167 elderly people , who were selected from the database of the network of studies on frailty in brazilian elderly , universidade federal de minas gerais - ufmg . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 7 study 2 : 9 conducted 2 : 17 , 3 this 7 study 4 longitudinal 5 and 5 and 6 observational 5 and 7 study 7 study 8 was 8 was 9 conducted 9 conducted 10 in 10 in 12 sample 11 a 12 sample 12 sample 13 of 13 of 16 people 14 167 16 people 15 elderly 16 people 17 , 18 who 17 , 20 selected 18 who 19 were 19 were 20 selected 20 selected 21 from 20 selected 29 on 21 from 23 database 22 the 23 database 23 database 24 of 23 database 27 of 24 of 26 network 25 the 26 network 27 of 28 studies 29 on 41 ufmg 30 frailty 31 in 30 frailty 41 ufmg 31 in 33 elderly 32 brazilian 33 elderly 33 elderly 39 gerais 34 , 39 gerais 35 universidade 36 federal 36 federal 37 de 37 de 38 minas 38 minas 39 gerais 39 gerais 40 - 40 - 41 ufmg 41 ufmg 42 . the participants submitted to the mini mental state examination ( mmse ) , katz index , lawton and brody 's scale and responded to items on advanced activities of daily living ( aadls ) . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 35 . 1 the 2 participants 2 participants 22 and 3 submitted 4 to 3 submitted 22 and 4 to 18 and 5 the 11 mmse 6 mini 7 mental 7 mental 8 state 8 state 9 examination 9 examination 11 mmse 10 ( 11 mmse 11 mmse 12 ) 11 mmse 13 , 13 , 15 index 13 , 16 , 14 katz 15 index 16 , 17 lawton 16 , 18 and 18 and 21 scale 19 brody 20 's 20 's 21 scale 22 and 23 responded 22 and 24 to 22 and 26 on 24 to 25 items 26 on 28 activities 27 advanced 28 activities 28 activities 29 of 29 of 31 living 30 daily 31 living 31 living 33 aadls 32 ( 33 aadls 33 aadls 34 ) we analyzed the data using multivariate regression models . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 analyzed 0 ###LEFT-WALL### 9 . 1 we 2 analyzed 2 analyzed 4 data 3 the 4 data 4 data 5 using 5 using 8 models 6 multivariate 8 models 7 regression 8 models results : the participants ' functional capacity exhibited reduced performance of specific instrumental activities of daily living ( iadls ) , p=0.002 , and basic activities of daily living ( badls ) , p=0.038 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 , 0 ###LEFT-WALL### 34 p=0.038 0 ###LEFT-WALL### 35 . 1 results 2 : 2 : 10 performance 3 the 4 participants 4 participants 5 ' 5 ' 10 performance 6 functional 7 capacity 7 capacity 8 exhibited 8 exhibited 10 performance 9 reduced 10 performance 10 performance 11 of 10 performance 15 of 11 of 14 activities 12 specific 14 activities 13 instrumental 14 activities 15 of 17 living 16 daily 17 living 17 living 19 iadls 17 living 24 and 18 ( 19 iadls 19 iadls 20 ) 21 , 24 and 22 p=0.002 24 and 23 , 24 and 24 and 26 activities 24 and 31 badls 24 and 33 , 25 basic 26 activities 26 activities 27 of 27 of 29 living 28 daily 29 living 30 ( 31 badls 31 badls 32 ) 33 , 34 p=0.038 living [alone] ( odds [ratio] ( or ) , 2.53 [;] 95 % confidence [interval] ( ci ) , 1.09 - 5.87 ) and work status ( or , 2.52 ; 95 % ci , 1.18 - 5.41 ) were associated with changes in the iadls . 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 31 ; 0 ###LEFT-WALL### 47 . 1 living 4 odds 1 living 24 and 3 ( 4 odds 4 odds 7 or 4 odds 14 confidence 4 odds 23 ) 6 ( 7 or 7 or 8 ) 9 , 14 confidence 10 2.53 14 confidence 12 95 13 % 13 % 14 confidence 14 confidence 17 ci 14 confidence 21 - 14 confidence 23 ) 16 ( 17 ci 17 ci 18 ) 19 , 21 - 20 1.09 21 - 21 - 22 5.87 21 - 23 ) 24 and 26 status 24 and 28 or 25 work 26 status 27 ( 28 or 28 or 30 2.52 28 or 31 ; 29 , 30 2.52 30 2.52 31 ; 31 ; 34 ci 31 ; 35 , 32 95 34 ci 33 % 34 ci 35 , 36 1.18 35 , 41 associated 36 1.18 38 5.41 36 1.18 40 were 37 - 38 5.41 38 5.41 39 ) 40 were 41 associated 41 associated 42 with 41 associated 44 in 42 with 43 changes 44 in 46 iadls 45 the 46 iadls the scores in the aadl scale ( p=0.163 ) and mmse ( p=0.059 ) did not exhibit any significant difference during the study period . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 17 exhibit 0 ###LEFT-WALL### 25 . 1 the 2 scores 2 scores 3 in 2 scores 10 and 3 in 6 scale 4 the 6 scale 5 aadl 6 scale 6 scale 8 p=0.163 7 ( 8 p=0.163 8 p=0.163 9 ) 10 and 11 mmse 10 and 15 did 11 mmse 13 p=0.059 12 ( 13 p=0.059 13 p=0.059 14 ) 15 did 16 not 15 did 17 exhibit 17 exhibit 20 difference 17 exhibit 21 during 18 any 20 difference 19 significant 20 difference 21 during 24 period 22 the 24 period 23 study 24 period the participants [with] better cognitive function were more independent in their performance of aadls and iadls . 0 ###LEFT-WALL### 6 function 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 17 . 1 the 6 function 2 participants 6 function 4 better 6 function 5 cognitive 6 function 6 function 7 were 7 were 9 independent 8 more 9 independent 9 independent 10 in 10 in 12 performance 11 their 12 performance 12 performance 13 of 13 of 15 and 14 aadls 15 and 15 and 16 iadls conclusion : the results depict specific patterns of loss and stability of functional capacity in community [-] dwelling [elderly] . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 4 results 2 : 5 depict 3 the 4 results 4 results 5 depict 5 depict 10 and 5 depict 15 in 6 specific 7 patterns 7 patterns 8 of 7 patterns 10 and 8 of 9 loss 10 and 11 stability 10 and 12 of 12 of 14 capacity 13 functional 14 capacity 15 in 18 dwelling 16 community 18 dwelling background : changes arising from the aging process , particularly changes in body composition , contribute to the functional decline of the elderly . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 24 . 1 background 2 : 2 : 3 changes 3 changes 4 arising 4 arising 5 from 5 from 8 process 6 the 8 process 7 aging 8 process 9 , 15 , 10 particularly 11 changes 11 changes 12 in 11 changes 15 , 12 in 14 composition 13 body 14 composition 15 , 16 contribute 16 contribute 17 to 17 to 20 decline 18 the 20 decline 19 functional 20 decline 20 decline 21 of 21 of 23 elderly 22 the 23 elderly objective : to compare the body composition and muscle strength , mobility and quality in active elderly women according to the distance walked during the 6 [-] minute walk test ( 6 [mw] t ) . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 3 to 2 : 8 and 3 to 8 and 4 compare 7 composition 4 compare 8 and 5 the 7 composition 6 body 7 composition 8 and 9 muscle 9 muscle 13 and 9 muscle 15 in 9 muscle 20 to 9 muscle 24 during 10 strength 11 , 11 , 12 mobility 11 , 13 and 13 and 14 quality 15 in 18 women 16 active 18 women 17 elderly 18 women 19 according 20 to 20 to 22 distance 21 the 22 distance 22 distance 23 walked 24 during 30 test 25 the 30 test 26 6 29 walk 28 minute 29 walk 29 walk 30 test 30 test 34 t 31 ( 34 t 32 6 34 t 34 t 35 ) method : the study included 77 active elderly women aged 65 to 80 years , who were divided into tertiles [(] a , [b] and [c] ) according to the distance covered in the 6 mw [t] . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 included 2 : 25 and 2 : 38 . 3 the 4 study 4 study 5 included 5 included 9 women 5 included 12 to 6 77 9 women 7 active 9 women 8 elderly 9 women 9 women 10 aged 10 aged 11 65 12 to 14 years 13 80 14 years 14 years 16 who 15 , 16 who 16 who 17 were 16 who 23 , 17 were 18 divided 18 divided 19 into 19 into 20 tertiles 20 tertiles 22 a 23 , 25 and 25 and 27 ) 25 and 28 according 25 and 32 covered 28 according 29 to 28 according 32 covered 29 to 31 distance 30 the 31 distance 32 covered 33 in 32 covered 36 mw 34 the 36 mw 35 6 36 mw we performed anthropometric and clinical evaluations . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 performed 0 ###LEFT-WALL### 7 . 1 we 2 performed 2 performed 6 evaluations 3 anthropometric 4 and 4 and 5 clinical 4 and 6 evaluations body composition was determined by dual energy x - ray absorptiometry ( dxa ) . 0 ###LEFT-WALL### 2 composition 0 ###LEFT-WALL### 9 - 0 ###LEFT-WALL### 15 . 1 body 2 composition 2 composition 3 was 3 was 4 determined 4 determined 5 by 5 by 7 energy 6 dual 7 energy 7 energy 8 x 8 x 9 - 9 - 10 ray 10 ray 11 absorptiometry 11 absorptiometry 13 dxa 12 ( 13 dxa 13 dxa 14 ) handgrip strength ( hgs ) was measured with a portable dynamometer ( saehan ) , and knee extension strength ( kes ) was measured with the one repetition maximum test ( 1 - rm ) . 0 ###LEFT-WALL### 2 strength 0 ###LEFT-WALL### 7 measured 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 36 . 1 handgrip 2 strength 2 strength 4 hgs 2 strength 6 was 3 ( 4 hgs 4 hgs 5 ) 6 was 7 measured 7 measured 8 with 8 with 11 dynamometer 9 a 10 portable 9 a 11 dynamometer 10 portable 11 dynamometer 11 dynamometer 13 saehan 12 ( 13 saehan 13 saehan 14 ) 15 , 16 and 16 and 19 strength 16 and 23 was 17 knee 18 extension 18 extension 19 strength 19 strength 21 kes 19 strength 23 was 20 ( 21 kes 21 kes 22 ) 23 was 24 measured 24 measured 25 with 24 measured 33 - 25 with 30 test 26 the 27 one 27 one 30 test 28 repetition 30 test 29 maximum 30 test 31 ( 33 - 32 1 33 - 33 - 34 rm 33 - 35 ) functional mobility was assessed by the timed up and go ( tug ) test , and body balance was assessed by the berg balance scale ( bbs ) . 0 ###LEFT-WALL### 2 mobility 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 29 . 1 functional 2 mobility 2 mobility 3 was 3 was 4 assessed 4 assessed 5 by 5 by 9 and 6 the 8 up 7 timed 8 up 8 up 9 and 9 and 14 test 9 and 15 , 10 go 12 tug 11 ( 12 tug 12 tug 13 ) 12 tug 14 test 16 and 18 balance 16 and 20 assessed 17 body 18 balance 18 balance 19 was 19 was 20 assessed 20 assessed 21 by 21 by 27 bbs 22 the 27 bbs 23 berg 24 balance 24 balance 25 scale 25 scale 27 bbs 26 ( 27 bbs 27 bbs 28 ) muscle quality was defined by the ratio between muscle strength ( kgf ) and muscle mass [(] [kg] ) . 0 ###LEFT-WALL### 2 quality 0 ###LEFT-WALL### 4 defined 0 ###LEFT-WALL### 20 . 1 muscle 2 quality 2 quality 3 was 3 was 4 defined 4 defined 5 by 5 by 14 and 6 the 7 ratio 7 ratio 8 between 7 ratio 14 and 8 between 10 strength 9 muscle 10 strength 10 strength 12 kgf 11 ( 12 kgf 12 kgf 13 ) 14 and 16 mass 14 and 19 ) 15 muscle 16 mass there was no significant difference between muscle [mass] ( p=0.25 ) and lean mass ( p=0.26 ) . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 18 . 1 there 2 was 2 was 12 and 3 no 5 difference 4 significant 5 difference 5 difference 6 between 5 difference 12 and 6 between 7 muscle 7 muscle 10 p=0.25 9 ( 10 p=0.25 10 p=0.25 11 ) 12 and 14 mass 12 and 16 p=0.26 13 lean 14 mass 15 ( 16 p=0.26 16 p=0.26 17 ) conclusion : body fat has a negative influence on functional performance , even among active elderly women . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 2 : 4 fat 2 : 5 has 2 : 12 , 3 body 4 fat 4 fat 5 has 5 has 8 influence 5 has 9 on 6 a 8 influence 7 negative 8 influence 9 on 11 performance 10 functional 11 performance 12 , 13 even 13 even 14 among 14 among 17 women 15 active 17 women 16 elderly 17 women objectives : the aim of this study was to evaluate whether spinal canal depth ( scd ) , measured using ultrasound , could be estimated from simple body measurements in a sample of children . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 aim 2 : 8 was 2 : 35 . 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 evaluate 10 evaluate 11 whether 11 whether 14 depth 11 whether 25 estimated 12 spinal 13 canal 13 canal 14 depth 14 depth 16 scd 14 depth 19 measured 14 depth 23 could 15 ( 16 scd 16 scd 17 ) 18 , 19 measured 19 measured 20 using 19 measured 22 , 20 using 21 ultrasound 23 could 24 be 24 be 25 estimated 25 estimated 26 from 25 estimated 30 in 26 from 29 measurements 27 simple 28 body 28 body 29 measurements 30 in 32 sample 31 a 32 sample 32 sample 33 of 33 of 34 children methods : we measured scd in a group of 225 children aged 0 - 18 years in the curved left lateral position using ultrasound . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 16 years 3 we 4 measured 4 measured 5 scd 5 scd 6 in 5 scd 9 of 5 scd 12 aged 6 in 8 group 7 a 8 group 9 of 11 children 10 225 11 children 12 aged 14 - 13 0 14 - 14 - 15 18 15 18 16 years 16 years 17 in 17 in 22 position 18 the 22 position 19 curved 22 position 20 left 22 position 21 lateral 22 position 22 position 23 using 23 using 24 ultrasound statistical analysis was performed using pearson 's correlation coefficient at the 5 % level of significance . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 4 performed 0 ###LEFT-WALL### 17 . 1 statistical 2 analysis 2 analysis 3 was 3 was 4 performed 4 performed 5 using 5 using 9 coefficient 5 using 10 at 6 pearson 7 's 7 's 9 coefficient 8 correlation 9 coefficient 10 at 14 level 11 the 14 level 12 5 13 % 13 % 14 level 14 level 15 of 15 of 16 significance we also performed linear regression analyses ( analysis of variance ) for mid - spinal canal depth ( mscd ) , including five potential predictors of age , gender , height , weight and body surface area , in each model . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 performed 1 we 3 performed 2 also 3 performed 3 performed 6 analyses 3 performed 12 for 3 performed 22 including 4 linear 5 regression 5 regression 6 analyses 6 analyses 8 analysis 7 ( 8 analysis 8 analysis 9 of 8 analysis 11 ) 9 of 10 variance 12 for 17 depth 13 mid 14 - 13 mid 16 canal 15 spinal 16 canal 16 canal 17 depth 17 depth 19 mscd 18 ( 19 mscd 19 mscd 20 ) 21 , 22 including 22 including 25 predictors 22 including 39 in 22 including 42 . 23 five 25 predictors 24 potential 25 predictors 25 predictors 26 of 26 of 34 and 27 age 28 , 28 , 29 gender 28 , 30 , 30 , 31 height 30 , 32 , 32 , 33 weight 32 , 34 and 34 and 37 area 35 body 37 area 36 surface 37 area 38 , 39 in 39 in 41 model 39 in 42 . 40 each 41 model results : the mean mscd was 33.0 mm ( 18.1 - 56.4 ) across the whole cohort . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 mscd 2 : 6 was 2 : 18 . 3 the 4 mean 4 mean 5 mscd 5 mscd 6 was 6 was 8 mm 6 was 11 - 6 was 14 across 7 33.0 8 mm 9 ( 11 - 10 18.1 11 - 11 - 12 56.4 11 - 13 ) 14 across 17 cohort 15 the 17 cohort 16 whole 17 cohort the best linear correlation of mscd [(] [mm] [ )(was found with weight ( w [;] [kg] ) , approximating the formula mscd=0.4w+20 [(] r ( 2 )=0.72 ) . 0 ###LEFT-WALL### 4 correlation 0 ###LEFT-WALL### 11 found 0 ###LEFT-WALL### 30 . 1 the 2 best 1 the 4 correlation 3 linear 4 correlation 4 correlation 5 of 4 correlation 10 )(was 5 of 6 mscd 10 )(was 11 found 11 found 12 with 12 with 13 weight 13 weight 15 w 13 weight 20 approximating 14 ( 15 w 15 w 18 ) 19 , 20 approximating 20 approximating 23 mscd=0.4w+20 20 approximating 29 ) 21 the 22 formula 22 formula 23 mscd=0.4w+20 23 mscd=0.4w+20 25 r 23 mscd=0.4w+20 28 )=0.72 26 ( 28 )=0.72 27 2 28 )=0.72 28 )=0.72 29 ) body weight accounted for 85 % of the variance in the data [(] adjusted [r] ( 2 )=0.72 ) . 0 ###LEFT-WALL### 2 weight 0 ###LEFT-WALL### 3 accounted 0 ###LEFT-WALL### 20 . 1 body 2 weight 2 weight 3 accounted 3 accounted 4 for 3 accounted 10 in 4 for 6 % 5 85 6 % 6 % 7 of 7 of 9 variance 8 the 9 variance 10 in 12 data 11 the 12 data 12 data 14 adjusted 12 data 18 )=0.72 16 ( 18 )=0.72 17 2 18 )=0.72 18 )=0.72 19 ) our formula gives values outside of the actual measured scd range in 23/225 ( 10.2 % ) of cases and estimates mscd at 24 mm at 10 kg , 32 mm at 30 kg and 40 mm at 50 kg . 0 ###LEFT-WALL### 2 formula 0 ###LEFT-WALL### 3 gives 0 ###LEFT-WALL### 41 . 1 our 2 formula 2 formula 3 gives 3 gives 4 values 3 gives 31 mm 3 gives 32 at 3 gives 38 at 4 values 5 outside 4 values 6 of 6 of 11 range 7 the 11 range 8 actual 11 range 9 measured 11 range 10 scd 11 range 11 range 12 in 11 range 18 of 12 in 13 23/225 13 23/225 16 % 14 ( 16 % 15 10.2 16 % 16 % 17 ) 18 of 20 and 19 cases 20 and 20 and 22 mscd 20 and 29 , 21 estimates 22 mscd 22 mscd 23 at 23 at 25 mm 24 24 25 mm 25 mm 26 at 26 at 28 kg 27 10 28 kg 30 32 31 mm 32 at 35 and 33 30 34 kg 34 kg 35 and 35 and 37 mm 36 40 37 mm 38 at 40 kg 39 50 40 kg conclusions : we demonstrate a good correlation between weight and mscd in a large group of children . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 demonstrate 2 : 18 . 3 we 4 demonstrate 4 demonstrate 7 correlation 4 demonstrate 8 between 4 demonstrate 12 in 5 a 6 good 5 a 7 correlation 6 good 7 correlation 8 between 10 and 9 weight 10 and 10 and 11 mscd 12 in 17 children 13 a 15 group 14 large 15 group 15 group 16 of 15 group 17 children 16 of 17 children use of the simple formula mscd ( [mm] )=0.4 w+20 could improve the success rates of lumbar [puncture] in the paediatric population , [but] remains to be validated . 0 ###LEFT-WALL### 1 use 0 ###LEFT-WALL### 25 remains 0 ###LEFT-WALL### 29 . 1 use 2 of 1 use 25 remains 2 of 6 mscd 3 the 6 mscd 4 simple 6 mscd 5 formula 6 mscd 6 mscd 9 )=0.4 7 ( 9 )=0.4 9 )=0.4 10 w+20 9 )=0.4 16 of 9 )=0.4 17 lumbar 9 )=0.4 23 , 10 w+20 11 could 11 could 12 improve 12 improve 15 rates 13 the 15 rates 14 success 15 rates 15 rates 16 of 17 lumbar 19 in 19 in 22 population 20 the 22 population 21 paediatric 22 population 25 remains 26 to 26 to 27 be 27 be 28 validated oxidative stress is both the cause and consequence of impaired functional homeostasis characterizing human aging . 0 ###LEFT-WALL### 2 stress 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 16 . 1 oxidative 2 stress 2 stress 3 is 3 is 15 aging 4 both 7 and 5 the 6 cause 6 cause 7 and 7 and 8 consequence 7 and 9 of 7 and 15 aging 9 of 12 homeostasis 10 impaired 12 homeostasis 11 functional 12 homeostasis 13 characterizing 15 aging 14 human 15 aging the worsening efficiency of stress response [with] age represents a health risk and leads to the onset and accrual of major age - related diseases . 0 ###LEFT-WALL### 3 efficiency 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 related 0 ###LEFT-WALL### 26 . 1 the 3 efficiency 2 worsening 3 efficiency 3 efficiency 4 of 3 efficiency 13 and 4 of 8 age 5 stress 6 response 6 response 8 age 9 represents 12 risk 9 represents 13 and 10 a 12 risk 11 health 12 risk 13 and 14 leads 13 and 15 to 15 to 18 and 16 the 17 onset 17 onset 18 and 18 and 19 accrual 18 and 20 of 20 of 22 age 21 major 22 age 23 - 24 related 24 related 25 diseases in contrast , centenarians seem to have evolved conservative stress response mechanisms , probably derived from a combination of a diet rich in natural antioxidants , an active lifestyle and a favorable genetic background , particularly rich in genetic variants able to counteract the stress overload at the level of both nuclear and mitochondrial dna . 0 ###LEFT-WALL### 4 centenarians 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 56 . 1 in 2 contrast 1 in 3 , 1 in 4 centenarians 4 centenarians 5 seem 5 seem 6 to 5 seem 7 have 6 to 7 have 7 have 12 mechanisms 8 evolved 12 mechanisms 9 conservative 10 stress 10 stress 12 mechanisms 11 response 12 mechanisms 13 , 30 and 13 , 46 overload 14 probably 15 derived 15 derived 16 from 15 derived 26 , 15 derived 30 and 16 from 18 combination 17 a 18 combination 18 combination 19 of 19 of 21 diet 20 a 21 diet 21 diet 22 rich 22 rich 23 in 23 in 25 antioxidants 24 natural 25 antioxidants 27 an 28 active 27 an 29 lifestyle 28 active 29 lifestyle 29 lifestyle 30 and 30 and 34 background 30 and 35 , 30 and 37 rich 30 and 46 overload 31 a 34 background 32 favorable 34 background 33 genetic 34 background 36 particularly 37 rich 37 rich 38 in 38 in 40 variants 39 genetic 40 variants 40 variants 41 able 41 able 42 to 41 able 43 counteract 42 to 43 counteract 43 counteract 45 stress 44 the 45 stress 46 overload 47 at 46 overload 53 and 46 overload 55 dna 47 at 49 level 48 the 49 level 49 level 50 of 50 of 51 both 52 nuclear 53 and 53 and 54 mitochondrial the integration of these factors could allow centenarians to maintain moderate levels of free radicals that exert beneficial signaling and modulator effects on cellular metabolism . 0 ###LEFT-WALL### 2 integration 0 ###LEFT-WALL### 7 allow 0 ###LEFT-WALL### 26 . 1 the 2 integration 2 integration 3 of 2 integration 6 could 3 of 5 factors 4 these 5 factors 6 could 7 allow 7 allow 8 centenarians 7 allow 9 to 7 allow 10 maintain 9 to 10 maintain 10 maintain 12 levels 11 moderate 12 levels 12 levels 13 of 13 of 15 radicals 14 free 15 radicals 15 radicals 16 that 15 radicals 17 exert 16 that 17 exert 17 exert 20 and 17 exert 23 on 18 beneficial 19 signaling 18 beneficial 20 and 20 and 22 effects 21 modulator 22 effects 23 on 25 metabolism 24 cellular 25 metabolism considering the hot debate on the efficacy of antioxidant supplementation in promoting healthy aging , in this review we gathered the existing information regarding genetic variability and lifestyle factors which potentially modulate the stress response at old age . 0 ###LEFT-WALL### 19 we 0 ###LEFT-WALL### 20 gathered 0 ###LEFT-WALL### 39 . 1 considering 4 debate 1 considering 11 in 1 considering 15 , 1 considering 19 we 2 the 4 debate 3 hot 4 debate 4 debate 5 on 4 debate 8 of 5 on 7 efficacy 6 the 7 efficacy 8 of 10 supplementation 9 antioxidant 10 supplementation 11 in 12 promoting 12 promoting 14 aging 13 healthy 14 aging 16 in 18 review 16 in 19 we 17 this 18 review 19 we 20 gathered 20 gathered 27 and 20 gathered 36 at 21 the 27 and 22 existing 23 information 23 information 24 regarding 23 information 27 and 24 regarding 26 variability 25 genetic 26 variability 27 and 29 factors 27 and 30 which 27 and 32 modulate 28 lifestyle 29 factors 30 which 32 modulate 31 potentially 32 modulate 32 modulate 35 response 33 the 35 response 34 stress 35 response 36 at 38 age 37 old 38 age evidence reported here suggests that the integration of lifestyle factors ( moderate physical activity and healthy nutrition ) and genetic background could shift the balance in favor of the antioxidant cellular machinery by activating appropriate defense mechanisms in response to exceeding external and internal stress levels , [and] thus possibly achieving the prospect of living a longer life . 0 ###LEFT-WALL### 1 evidence 0 ###LEFT-WALL### 4 suggests 0 ###LEFT-WALL### 59 . 1 evidence 2 reported 1 evidence 3 here 1 evidence 4 suggests 4 suggests 5 that 5 that 19 and 5 that 23 shift 6 the 7 integration 7 integration 8 of 7 integration 19 and 8 of 10 factors 9 lifestyle 10 factors 10 factors 15 and 11 ( 15 and 12 moderate 14 activity 13 physical 14 activity 14 activity 15 and 15 and 17 nutrition 15 and 18 ) 16 healthy 17 nutrition 19 and 21 background 19 and 22 could 20 genetic 21 background 22 could 23 shift 23 shift 25 balance 23 shift 39 response 23 shift 40 to 24 the 25 balance 25 balance 26 in 25 balance 28 of 26 in 27 favor 28 of 32 machinery 29 the 32 machinery 30 antioxidant 32 machinery 31 cellular 32 machinery 32 machinery 33 by 33 by 34 activating 34 activating 37 mechanisms 35 appropriate 37 mechanisms 36 defense 37 mechanisms 38 in 39 response 40 to 41 exceeding 41 exceeding 43 and 42 external 43 and 43 and 46 levels 43 and 47 , 43 and 51 achieving 43 and 54 of 44 internal 46 levels 45 stress 46 levels 49 thus 51 achieving 50 possibly 51 achieving 51 achieving 53 prospect 52 the 53 prospect 54 of 55 living 55 living 58 life 56 a 58 life 57 longer 58 life objective : in this study , we examined whether coronary spastic angina ( csa ) is associated with insulin resistance . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 21 . 1 objective 2 : 2 : 3 in 3 in 5 study 4 this 5 study 6 , 7 we 6 , 8 examined 7 we 8 examined 8 examined 9 whether 9 whether 12 angina 9 whether 17 associated 10 coronary 12 angina 11 spastic 12 angina 12 angina 14 csa 12 angina 16 is 13 ( 14 csa 14 csa 15 ) 16 is 17 associated 17 associated 18 with 18 with 20 resistance 19 insulin 20 resistance background : there is increasing evidence that insulin resistance is associated with endothelial dysfunction . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 . 2 : 3 there 2 : 4 is 3 there 4 is 4 is 6 evidence 4 is 12 with 5 increasing 6 evidence 6 evidence 7 that 7 that 9 resistance 7 that 10 is 8 insulin 9 resistance 9 resistance 10 is 10 is 11 associated 12 with 14 dysfunction 13 endothelial 14 dysfunction patients with csa show endothelial dysfunction . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 4 show 0 ###LEFT-WALL### 7 . 1 patients 2 with 1 patients 4 show 2 with 3 csa 4 show 6 dysfunction 5 endothelial 6 dysfunction methods : the study participants include 111 csa patients ( 81 men and 30 women , mean age 62±12 years ) and 53 participants without csa ( 24 men and 29 women , mean age 63±10 years ) , serving as the controls . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 study 3 the 4 study 4 study 5 participants 4 study 6 include 5 participants 6 include 6 include 9 patients 7 111 9 patients 8 csa 9 patients 9 patients 22 and 10 ( 22 and 11 81 12 men 12 men 13 and 13 and 15 women 13 and 20 years 13 and 22 and 14 30 15 women 16 , 20 years 17 mean 18 age 18 age 20 years 19 62±12 20 years 20 years 21 ) 22 and 24 participants 22 and 25 without 22 and 44 . 23 53 24 participants 25 without 26 csa 26 csa 30 and 27 ( 30 and 28 24 29 men 29 men 30 and 30 and 32 women 30 and 37 years 30 and 40 serving 30 and 44 . 31 29 32 women 33 , 37 years 34 mean 35 age 35 age 36 63±10 36 63±10 37 years 37 years 38 ) 39 , 40 serving 40 serving 41 as 40 serving 44 . 41 as 43 controls 42 the 43 controls the oral glucose tolerance test was performed , and anthropometric parameters , plasma glucose and insulin levels , lipid profiles , and other laboratory parameters were evaluated . 0 ###LEFT-WALL### 5 test 0 ###LEFT-WALL### 7 performed 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 28 . 1 the 5 test 2 oral 4 tolerance 3 glucose 4 tolerance 4 tolerance 5 test 5 test 6 was 6 was 7 performed 8 , 9 and 9 and 22 and 9 and 27 evaluated 10 anthropometric 11 parameters 11 parameters 12 , 12 , 14 glucose 12 , 15 and 13 plasma 14 glucose 15 and 17 levels 15 and 20 profiles 15 and 22 and 16 insulin 17 levels 18 , 20 profiles 19 lipid 20 profiles 20 profiles 21 , 21 , 22 and 22 and 25 parameters 22 and 26 were 23 other 25 parameters 24 laboratory 25 parameters 26 were 27 evaluated results : homeostasis model assessment of insulin resistance ( homa - ir ) , log homa - ir , the quantitative insulin sensitivity check index , the insulin sensitivity index , and insulin resistance 60 - 120 min after glucose load ( log post - glucose - ir ) were calculated as surrogate markers of insulin resistance . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 51 calculated 1 results 2 : 2 : 32 and 3 homeostasis 5 assessment 4 model 5 assessment 5 assessment 6 of 5 assessment 32 and 6 of 8 resistance 7 insulin 8 resistance 8 resistance 10 homa 8 resistance 16 homa 9 ( 10 homa 10 homa 12 ir 10 homa 13 ) 11 - 12 ir 12 ir 13 ) 14 , 16 homa 15 log 16 homa 16 homa 18 ir 16 homa 25 index 16 homa 31 , 17 - 18 ir 18 ir 19 , 19 , 25 index 20 the 25 index 21 quantitative 25 index 22 insulin 23 sensitivity 23 sensitivity 25 index 24 check 25 index 25 index 30 index 25 index 31 , 26 , 30 index 27 the 30 index 28 insulin 29 sensitivity 29 sensitivity 30 index 30 index 31 , 32 and 33 insulin 34 resistance 35 60 34 resistance 50 were 34 resistance 51 calculated 35 60 37 120 35 60 41 load 35 60 44 post 35 60 46 glucose 35 60 50 were 36 - 37 120 37 120 38 min 37 120 41 load 38 min 39 after 39 after 40 glucose 42 ( 44 post 43 log 44 post 44 post 45 - 45 - 46 glucose 46 glucose 48 ir 46 glucose 49 ) 47 - 48 ir 48 ir 49 ) 51 calculated 52 as 51 calculated 58 . 52 as 54 markers 53 surrogate 54 markers 54 markers 55 of 55 of 57 resistance 56 insulin 57 resistance the number of men , the number of smokers , log post - glucose - ir , the insulin sensitivity index , and fasting plasma glucose levels were higher in csa patients compared with controls ( p=0.001 , 0.001 , 0.004 , 0.012 [,] and 0.013 , respectively ) , whereas plasma high - density lipoprotein cholesterol levels were lower [(] p<0.001 ) . 0 ###LEFT-WALL### 2 number 0 ###LEFT-WALL### 11 log 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 64 . 1 the 2 number 2 number 3 of 2 number 9 smokers 2 number 11 log 3 of 4 men 5 , 9 smokers 6 the 7 number 7 number 8 of 7 number 9 smokers 8 of 9 smokers 9 smokers 10 , 11 log 12 post 13 - 14 glucose 14 glucose 23 and 15 - 23 and 16 ir 17 , 17 , 21 index 17 , 23 and 18 the 21 index 19 insulin 20 sensitivity 20 sensitivity 21 index 22 , 23 and 23 and 25 plasma 23 and 27 levels 23 and 28 were 23 and 33 compared 23 and 63 ) 24 fasting 25 plasma 26 glucose 27 levels 27 levels 28 were 28 were 29 higher 28 were 30 in 30 in 32 patients 31 csa 32 patients 33 compared 34 with 33 compared 48 respectively 33 compared 51 whereas 34 with 35 controls 35 controls 37 p=0.001 36 ( 37 p=0.001 37 p=0.001 39 0.001 37 p=0.001 47 , 38 , 39 0.001 39 0.001 41 0.004 39 0.001 47 , 40 , 41 0.004 41 0.004 45 and 41 0.004 47 , 42 , 45 and 43 0.012 45 and 45 and 46 0.013 45 and 47 , 47 , 48 respectively 48 respectively 49 ) 50 , 51 whereas 51 whereas 58 levels 51 whereas 59 were 51 whereas 63 ) 52 plasma 56 lipoprotein 53 high 54 - 53 high 55 density 55 density 56 lipoprotein 56 lipoprotein 58 levels 57 cholesterol 58 levels 58 levels 59 were 59 were 62 p<0.001 60 lower 62 p<0.001 conclusion : insulin resistance on glucose load [(] log post - glucose - ir ) , plasma high - density lipoprotein cholesterol levels , and smoking were significantly associated with csa ( r=0.225 , p=0.004 ; r= - 0.313 , p<0.001 [;] and r=0.258 , p=0.001 , respectively ) . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 r= 0 ###LEFT-WALL### 50 . 2 : 25 and 2 : 29 associated 2 : 36 ; 3 insulin 25 and 4 resistance 5 on 4 resistance 25 and 5 on 10 post 6 glucose 10 post 7 load 10 post 9 log 10 post 10 post 12 glucose 11 - 12 glucose 12 glucose 14 ir 12 glucose 23 levels 12 glucose 24 , 13 - 14 ir 14 ir 15 ) 16 , 23 levels 17 plasma 21 lipoprotein 18 high 19 - 18 high 20 density 20 density 21 lipoprotein 21 lipoprotein 23 levels 22 cholesterol 23 levels 23 levels 24 , 25 and 26 smoking 25 and 27 were 27 were 29 associated 28 significantly 29 associated 29 associated 30 with 30 with 31 csa 31 csa 33 r=0.225 32 ( 33 r=0.225 33 r=0.225 35 p=0.004 33 r=0.225 36 ; 34 , 35 p=0.004 35 p=0.004 36 ; 36 ; 37 r= 37 r= 39 0.313 37 r= 48 respectively 38 - 39 0.313 39 0.313 43 and 40 , 43 and 41 p<0.001 43 and 43 and 44 r=0.258 43 and 46 p=0.001 43 and 47 , 45 , 46 p=0.001 46 p=0.001 47 , 47 , 48 respectively 48 respectively 49 ) to identify pathologic characteristics that are associated [with] [outcome] , we performed a retrospective analysis of the clinical , radiologic , and pathologic features of 44 children [with] isolated focal cortical dysplasia ( fcd ) after epilepsy surgery . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 12 performed 0 ###LEFT-WALL### 39 . 1 to 2 identify 1 to 10 , 1 to 11 we 2 identify 4 characteristics 3 pathologic 4 characteristics 4 characteristics 5 that 4 characteristics 6 are 5 that 6 are 6 are 7 associated 11 we 12 performed 12 performed 15 analysis 12 performed 36 after 13 a 14 retrospective 13 a 15 analysis 14 retrospective 15 analysis 15 analysis 16 of 16 of 32 dysplasia 17 the 32 dysplasia 18 clinical 19 , 19 , 20 radiologic 19 , 22 and 21 , 22 and 22 and 24 features 22 and 29 isolated 23 pathologic 24 features 24 features 25 of 25 of 27 children 26 44 27 children 29 isolated 32 dysplasia 30 focal 32 dysplasia 31 cortical 32 dysplasia 32 dysplasia 34 fcd 33 ( 34 fcd 34 fcd 35 ) 36 after 38 surgery 37 epilepsy 38 surgery based on the international league against epilepsy classification , 16 patients had fcd type i and 28 subjects had fcd type ii . 0 ###LEFT-WALL### 11 patients 0 ###LEFT-WALL### 12 had 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 23 . 1 based 2 on 1 based 9 , 1 based 11 patients 2 on 8 classification 3 the 8 classification 4 international 5 league 5 league 6 against 6 against 7 epilepsy 7 epilepsy 8 classification 10 16 11 patients 11 patients 12 had 12 had 14 type 13 fcd 14 type 14 type 15 i 16 and 18 subjects 16 and 19 had 17 28 18 subjects 18 subjects 19 had 19 had 21 type 20 fcd 21 type 21 type 22 ii a significantly higher percentage of subjects with fcd type iib versus types i and iia were seizure - free after surgery . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 16 were 1 a 4 percentage 2 significantly 3 higher 3 higher 4 percentage 4 percentage 5 of 4 percentage 14 and 5 of 6 subjects 6 subjects 7 with 7 with 10 iib 8 fcd 9 type 9 type 10 iib 10 iib 11 versus 11 versus 12 types 12 types 13 i 14 and 15 iia 14 and 16 were 16 were 17 seizure 17 seizure 19 free 18 - 19 free 19 free 20 after 19 free 22 . 20 after 21 surgery akt ( also known as protein kinase b ) is the main downstream target of phosphatidylinositol 3 ['] - [kinase] and has been implicated in epilepsy pathogenesis . 0 ###LEFT-WALL### 1 akt 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 28 . 1 akt 4 known 1 akt 21 and 2 ( 4 known 3 also 4 known 4 known 5 as 4 known 9 ) 5 as 7 kinase 6 protein 7 kinase 7 kinase 8 b 10 is 14 target 10 is 21 and 11 the 12 main 11 the 14 target 13 downstream 14 target 14 target 15 of 15 of 16 phosphatidylinositol 16 phosphatidylinositol 17 3 19 - 21 and 21 and 22 has 21 and 27 pathogenesis 22 has 23 been 23 been 24 implicated 24 implicated 25 in 25 in 26 epilepsy semiquantitative analysis of cortical gliosis and quantitation of akt1 - immunoreactive neurons indicated that individuals with fcd type ii were more likely to have diffuse astrogliosis and higher counts of akt1 - positive neurons versus those with fcd type i . a logistic regression model , including akt1 - positive neurons , age at surgery , and the interaction of these factors , was significantly associated with seizure - free outcome . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 32 - 0 ###LEFT-WALL### 41 . 1 semiquantitative 2 analysis 2 analysis 3 of 2 analysis 6 and 3 of 5 gliosis 4 cortical 5 gliosis 6 and 7 quantitation 6 and 8 of 8 of 9 akt1 9 akt1 12 neurons 10 - 12 neurons 11 immunoreactive 12 neurons 12 neurons 13 indicated 12 neurons 14 that 12 neurons 20 were 12 neurons 32 - 14 that 15 individuals 14 that 20 were 15 individuals 16 with 15 individuals 20 were 16 with 18 type 17 fcd 18 type 18 type 19 ii 20 were 21 more 20 were 23 to 22 likely 23 to 23 to 24 have 24 have 29 counts 25 diffuse 29 counts 26 astrogliosis 27 and 27 and 28 higher 27 and 29 counts 29 counts 30 of 30 of 31 akt1 32 - 34 neurons 33 positive 34 neurons 34 neurons 35 versus 34 neurons 37 with 35 versus 36 those 37 with 39 type 38 fcd 39 type 39 type 40 i 41 . 45 model 41 . 66 associated 41 . 69 - 42 a 45 model 43 logistic 44 regression 44 regression 45 model 45 model 47 including 45 model 57 and 45 model 64 was 46 , 47 including 47 including 48 akt1 47 including 52 , 48 akt1 51 neurons 49 - 51 neurons 50 positive 51 neurons 51 neurons 52 , 52 , 57 and 53 age 54 at 53 age 57 and 54 at 55 surgery 56 , 57 and 57 and 59 interaction 57 and 60 of 57 and 63 , 58 the 59 interaction 60 of 62 factors 61 these 62 factors 64 was 66 associated 65 significantly 66 associated 66 associated 67 with 67 with 68 seizure 69 - 71 outcome 69 - 72 . 70 free 71 outcome this study provides evidence that astrogliosis and overexpression of neuronal akt1 protein may be important factors in the pathogenesis of fcd and suggests that the pathogenesis of fcd type i may differ from that of fcd type ii in children . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 41 . 1 this 2 study 2 study 3 provides 3 provides 4 evidence 3 provides 33 from 3 provides 39 in 4 evidence 5 that 5 that 7 and 5 that 22 and 6 astrogliosis 7 and 7 and 8 overexpression 7 and 9 of 7 and 13 may 9 of 12 protein 10 neuronal 12 protein 11 akt1 12 protein 13 may 22 and 14 be 16 factors 14 be 22 and 15 important 16 factors 16 factors 17 in 17 in 19 pathogenesis 18 the 19 pathogenesis 19 pathogenesis 20 of 20 of 21 fcd 22 and 23 suggests 23 suggests 24 that 24 that 26 pathogenesis 24 that 32 differ 25 the 26 pathogenesis 26 pathogenesis 27 of 26 pathogenesis 31 may 27 of 29 type 28 fcd 29 type 29 type 30 i 31 may 32 differ 33 from 34 that 34 that 35 of 35 of 37 type 36 fcd 37 type 37 type 38 ii 39 in 40 children caspase - 6 ( casp6 ) activation in the brain is implicated early in the pathogenesis of alzheimer disease ( ad ) . 0 ###LEFT-WALL### 7 activation 0 ###LEFT-WALL### 12 implicated 0 ###LEFT-WALL### 23 . 1 caspase 3 6 1 caspase 7 activation 2 - 3 6 3 6 5 casp6 3 6 6 ) 4 ( 5 casp6 5 casp6 6 ) 7 activation 8 in 7 activation 11 is 8 in 10 brain 9 the 10 brain 11 is 12 implicated 12 implicated 13 early 13 early 14 in 14 in 16 pathogenesis 15 the 16 pathogenesis 16 pathogenesis 17 of 17 of 19 disease 18 alzheimer 19 disease 19 disease 21 ad 20 ( 21 ad 21 ad 22 ) in view of the need for early ad diagnosis , brain casp6 activity was investigated by measuring tau cleaved by casp6 ( tauδcasp6 ) protein in postmortem cerebrospinal fluid ( csf [ )(of 7 [non] - cognitively impaired [;] 5 mild cognitively impaired [;] and [12] mild , moderate , and severe ad patients . 0 ###LEFT-WALL### 11 brain 1 in 2 view 1 in 10 , 1 in 11 brain 2 view 3 of 3 of 5 need 4 the 5 need 5 need 6 for 6 for 9 diagnosis 7 early 9 diagnosis 8 ad 9 diagnosis 11 brain 12 casp6 12 casp6 13 activity 12 casp6 17 measuring 13 activity 14 was 14 was 15 investigated 15 investigated 16 by 16 by 17 measuring 17 measuring 18 tau 18 tau 19 cleaved 18 tau 26 in 19 cleaved 20 by 20 by 25 protein 21 casp6 23 tauδcasp6 21 casp6 25 protein 22 ( 23 tauδcasp6 23 tauδcasp6 24 ) 26 in 27 postmortem 27 postmortem 29 fluid 27 postmortem 38 impaired 28 cerebrospinal 29 fluid 29 fluid 31 csf 29 fluid 38 impaired 30 ( 31 csf 31 csf 33 )(of 31 csf 36 - 33 )(of 34 7 37 cognitively 38 impaired 38 impaired 45 and 40 5 45 and 41 mild 43 impaired 41 mild 45 and 42 cognitively 43 impaired 45 and 47 mild 45 and 48 , 45 and 54 patients 48 , 54 patients 49 moderate 51 and 50 , 51 and 51 and 53 ad 51 and 54 patients 52 severe 53 ad 54 patients 55 . levels of tauδcasp6 in csf accurately reflected the levels of active casp6 and tauδcasp6 detected using immunohistochemistry in hippocampal sections from the same individuals . 0 ###LEFT-WALL### 1 levels 0 ###LEFT-WALL### 7 reflected 0 ###LEFT-WALL### 25 . 1 levels 2 of 1 levels 7 reflected 2 of 3 tauδcasp6 3 tauδcasp6 4 in 4 in 5 csf 6 accurately 7 reflected 7 reflected 9 levels 7 reflected 16 using 8 the 9 levels 9 levels 10 of 10 of 13 and 11 active 12 casp6 12 casp6 13 and 13 and 14 tauδcasp6 13 and 15 detected 16 using 17 immunohistochemistry 17 immunohistochemistry 18 in 17 immunohistochemistry 21 from 18 in 20 sections 19 hippocampal 20 sections 21 from 24 individuals 22 the 23 same 22 the 24 individuals levels of csf tauδcasp6 significantly correlated with ad severity and with lower global cognitive scores ; mini - mental state examination scores ; and episodic , semantic , and working memory scores . 0 ###LEFT-WALL### 1 levels 0 ###LEFT-WALL### 6 correlated 0 ###LEFT-WALL### 16 ; 1 levels 2 of 1 levels 6 correlated 2 of 4 tauδcasp6 3 csf 4 tauδcasp6 5 significantly 6 correlated 6 correlated 10 and 7 with 9 severity 7 with 10 and 8 ad 9 severity 10 and 11 with 11 with 15 scores 12 lower 15 scores 13 global 14 cognitive 14 cognitive 15 scores 16 ; 17 mini 16 ; 18 - 18 - 21 examination 18 - 22 scores 18 - 23 ; 18 - 33 . 19 mental 20 state 20 state 21 examination 21 examination 22 scores 23 ; 24 and 24 and 31 memory 24 and 32 scores 25 episodic 26 , 25 episodic 31 memory 27 semantic 29 and 28 , 29 and 29 and 30 working 29 and 31 memory 31 memory 32 scores regression analyses suggested that the csf tauδcasp6 levels combined with tauδcasp6 brain pathology predict cognitive performance . 0 ###LEFT-WALL### 2 analyses 0 ###LEFT-WALL### 14 predict 0 ###LEFT-WALL### 17 . 1 regression 2 analyses 2 analyses 3 suggested 2 analyses 4 that 2 analyses 12 brain 2 analyses 14 predict 4 that 8 levels 4 that 12 brain 5 the 8 levels 6 csf 7 tauδcasp6 7 tauδcasp6 8 levels 8 levels 9 combined 8 levels 10 with 8 levels 12 brain 10 with 11 tauδcasp6 12 brain 13 pathology 14 predict 16 performance 15 cognitive 16 performance these results indicate that csf tauδcasp6 levels hold promise as a novel early biomarker of ad . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 9 promise 1 these 2 results 2 results 3 indicate 3 indicate 4 that 4 that 5 csf 4 that 9 promise 5 csf 7 levels 5 csf 8 hold 5 csf 9 promise 6 tauδcasp6 7 levels 7 levels 8 hold 9 promise 10 as 9 promise 17 . 10 as 14 biomarker 11 a 14 biomarker 12 novel 14 biomarker 13 early 14 biomarker 14 biomarker 15 of 15 of 16 ad [none] none objective : patients with obstructive sleep apnea syndrome exhibit accelerated vascular aging and renal damage . 0 ###LEFT-WALL### 3 objective 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 18 . 2 none 3 objective 4 : 15 and 5 patients 6 with 5 patients 15 and 6 with 14 aging 7 obstructive 8 sleep 8 sleep 12 accelerated 9 apnea 10 syndrome 10 syndrome 12 accelerated 11 exhibit 12 accelerated 12 accelerated 14 aging 13 vascular 14 aging 15 and 17 damage 16 renal 17 damage aim of the study was to investigate whether vascular dysfunction is a feature of obstructive sleep apnea [syndrome] per se or instead related to the presence of traditional cardiovascular risk factors . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 21 or 0 ###LEFT-WALL### 32 . 1 aim 2 of 1 aim 21 or 2 of 4 study 3 the 4 study 5 was 6 to 5 was 7 investigate 5 was 21 or 6 to 7 investigate 7 investigate 8 whether 7 investigate 17 apnea 7 investigate 20 se 8 whether 10 dysfunction 8 whether 11 is 9 vascular 10 dysfunction 10 dysfunction 11 is 11 is 13 feature 12 a 13 feature 13 feature 14 of 14 of 16 sleep 15 obstructive 16 sleep 19 per 20 se 21 or 23 related 21 or 24 to 21 or 31 factors 22 instead 23 related 24 to 26 presence 25 the 26 presence 26 presence 27 of 27 of 30 risk 28 traditional 30 risk 29 cardiovascular 30 risk methods : forty patients with moderate - severe obstructive sleep apnea syndrome [(] 20 with , 20 without traditional risk factors ) and 20 matched healthy controls were enrolled . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 30 . 1 methods 2 : 2 : 3 forty 3 forty 4 patients 3 forty 15 with 3 forty 17 20 4 patients 5 with 4 patients 11 apnea 5 with 10 sleep 6 moderate 7 - 6 moderate 10 sleep 8 severe 10 sleep 9 obstructive 10 sleep 11 apnea 12 syndrome 11 apnea 15 with 12 syndrome 14 20 16 , 17 20 17 20 18 without 17 20 22 ) 18 without 21 factors 19 traditional 21 factors 20 risk 21 factors 23 and 27 controls 23 and 29 enrolled 24 20 27 controls 25 matched 27 controls 26 healthy 27 controls 27 controls 28 were 28 were 29 enrolled renal vasodilating capacity , endothelium - dependent vasodilation in the brachial artery , carotid - femoral pulse wave velocity and carotid stiffness were measured . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 23 were 0 ###LEFT-WALL### 25 . 1 renal 20 and 2 vasodilating 3 capacity 2 vasodilating 6 - 2 vasodilating 20 and 3 capacity 5 endothelium 4 , 5 endothelium 5 endothelium 6 - 7 dependent 8 vasodilation 8 vasodilation 9 in 8 vasodilation 13 , 9 in 12 artery 10 the 12 artery 11 brachial 12 artery 13 , 19 velocity 13 , 20 and 14 carotid 15 - 14 carotid 17 pulse 16 femoral 17 pulse 17 pulse 18 wave 18 wave 19 velocity 20 and 22 stiffness 20 and 23 were 21 carotid 22 stiffness 23 were 24 measured oxidative stress , endothelial biomarkers and leukocyte adhesion molecule levels were also evaluated . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 13 evaluated 0 ###LEFT-WALL### 14 . 1 oxidative 2 stress 2 stress 3 , 3 , 5 biomarkers 3 , 6 and 4 endothelial 5 biomarkers 6 and 10 levels 6 and 11 were 7 leukocyte 10 levels 8 adhesion 10 levels 9 molecule 10 levels 11 were 12 also 11 were 13 evaluated results : apneic patients without traditional cardiovascular risk factors presented reduced endothelium - dependent vasodilation ( 3.7±2.1 versus 6.1±3.0 % , p<0.05 ) , increased serum e - selectin ( 49.8±11.5 versus 38.9±17.9 [ng/ml] , p<0.05 ) , and impaired renal vasodilating capacity ( 6.0±4.3 versus 10.4±6.1 % , p<0.05 ) , as compared to healthy controls . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 patients 2 : 10 presented 2 : 24 , 2 : 58 . 3 apneic 4 patients 4 patients 5 without 4 patients 10 presented 5 without 9 factors 6 traditional 9 factors 7 cardiovascular 9 factors 8 risk 9 factors 10 presented 12 endothelium 11 reduced 12 endothelium 12 endothelium 15 vasodilation 13 - 15 vasodilation 14 dependent 15 vasodilation 15 vasodilation 17 3.7±2.1 15 vasodilation 22 p<0.05 15 vasodilation 23 ) 16 ( 17 3.7±2.1 17 3.7±2.1 18 versus 17 3.7±2.1 21 , 18 versus 20 % 19 6.1±3.0 20 % 21 , 22 p<0.05 22 p<0.05 23 ) 24 , 39 and 25 increased 26 serum 25 increased 39 and 26 serum 27 e 26 serum 29 selectin 28 - 29 selectin 29 selectin 31 49.8±11.5 29 selectin 38 , 30 ( 31 49.8±11.5 31 49.8±11.5 32 versus 31 49.8±11.5 38 , 32 versus 33 38.9±17.9 33 38.9±17.9 36 p<0.05 35 , 36 p<0.05 36 p<0.05 37 ) 39 and 40 impaired 40 impaired 43 capacity 40 impaired 55 to 41 renal 43 capacity 42 vasodilating 43 capacity 43 capacity 45 6.0±4.3 43 capacity 54 compared 44 ( 45 6.0±4.3 45 6.0±4.3 46 versus 45 6.0±4.3 50 p<0.05 45 6.0±4.3 52 , 46 versus 48 % 47 10.4±6.1 48 % 49 , 50 p<0.05 50 p<0.05 51 ) 53 as 54 compared 55 to 57 controls 56 healthy 57 controls endothelial no synthase expression was reduced [(] 0.0133 versus 0.0221×10 copies/μg rna , p<0.05 ) , whereas oxidative stress parameters and leukocyte adhesion molecules were similar to controls . 0 ###LEFT-WALL### 2 no 0 ###LEFT-WALL### 25 were 0 ###LEFT-WALL### 29 . 1 endothelial 2 no 2 no 4 expression 2 no 5 was 2 no 6 reduced 3 synthase 4 expression 4 expression 5 was 6 reduced 8 0.0133 6 reduced 17 whereas 8 0.0133 9 versus 9 versus 12 rna 10 0.0221×10 11 copies/μg 11 copies/μg 12 rna 12 rna 14 p<0.05 13 , 14 p<0.05 14 p<0.05 15 ) 16 , 17 whereas 17 whereas 21 and 18 oxidative 19 stress 19 stress 20 parameters 20 parameters 21 and 21 and 24 molecules 21 and 25 were 22 leukocyte 24 molecules 23 adhesion 24 molecules 25 were 26 similar 26 similar 27 to 27 to 28 controls patients with obstructive sleep apnea [syndrome] and traditional risk factors also exhibit increased aortic and carotid stiffness , increased renal resistive index and intima - media thickness , and reduced expression of the endothelial progenitor cell marker cd34 : however , these parameters were similar to those of healthy controls in patients with isolated obstructive sleep apnea [syndrome] . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 5 apnea 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 59 . 1 patients 2 with 1 patients 5 apnea 2 with 4 sleep 3 obstructive 4 sleep 7 and 9 risk 7 and 29 and 8 traditional 9 risk 9 risk 29 and 10 factors 11 also 10 factors 23 and 10 factors 29 and 12 exhibit 13 increased 13 increased 17 stiffness 14 aortic 15 and 15 and 16 carotid 15 and 17 stiffness 17 stiffness 18 , 18 , 22 index 18 , 23 and 19 increased 22 index 20 renal 22 index 21 resistive 22 index 23 and 27 thickness 24 intima 25 - 24 intima 26 media 26 media 27 thickness 28 , 29 and 29 and 30 reduced 30 reduced 31 expression 31 expression 32 of 31 expression 43 parameters 31 expression 44 were 31 expression 45 similar 32 of 35 progenitor 33 the 35 progenitor 34 endothelial 35 progenitor 35 progenitor 38 cd34 35 progenitor 39 : 36 cell 37 marker 37 marker 38 cd34 38 cd34 39 : 39 : 40 however 40 however 41 , 42 these 43 parameters 43 parameters 44 were 45 similar 46 to 45 similar 53 with 46 to 47 those 47 those 48 of 48 of 50 controls 49 healthy 50 controls 50 controls 51 in 51 in 52 patients 53 with 57 apnea 54 isolated 56 sleep 55 obstructive 56 sleep 56 sleep 57 apnea conclusion : obstructive sleep apnea [syndrome] is characterized by endothelial dysfunction and activation and impaired renal vasodilating capacity even in the absence of traditional cardiovascular risk factors , possibly due to reduced endothelial no synthase expression . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 4 sleep 3 obstructive 4 sleep 4 sleep 5 apnea 4 sleep 15 impaired 5 apnea 14 and 7 is 8 characterized 7 is 14 and 8 characterized 9 by 9 by 12 and 10 endothelial 11 dysfunction 11 dysfunction 12 and 12 and 13 activation 14 and 15 impaired 15 impaired 18 capacity 15 impaired 28 , 15 impaired 31 to 16 renal 18 capacity 17 vasodilating 18 capacity 19 even 20 in 19 even 28 , 20 in 22 absence 21 the 22 absence 22 absence 23 of 23 of 27 factors 24 traditional 27 factors 25 cardiovascular 27 factors 26 risk 27 factors 28 , 29 possibly 28 , 30 due 31 to 36 expression 32 reduced 36 expression 33 endothelial 36 expression 34 no 36 expression 35 synthase 36 expression aim : the cardio - ankle vascular index ( cavi ) reflects arterial stiffness from the aorta to the ankle , [independent] of blood pressure ( bp ) . 0 ###LEFT-WALL### 1 aim 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 8 index 2 : 12 reflects 3 the 8 index 4 cardio 5 - 4 cardio 6 ankle 6 ankle 8 index 7 vascular 8 index 8 index 10 cavi 8 index 12 reflects 9 ( 10 cavi 10 cavi 11 ) 12 reflects 14 stiffness 12 reflects 18 to 13 arterial 14 stiffness 14 stiffness 15 from 15 from 17 aorta 16 the 17 aorta 18 to 20 ankle 19 the 20 ankle 20 ankle 23 of 21 , 23 of 23 of 25 pressure 23 of 28 ) 24 blood 25 pressure 25 pressure 27 bp 26 ( 27 bp 27 bp 28 ) we investigated the age - stratified cavi in healthy , normotensive individuals to evaluate the effects of age on arterial stiffness . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 5 - 0 ###LEFT-WALL### 22 . 1 we 2 investigated 2 investigated 4 age 3 the 4 age 5 - 7 cavi 6 stratified 7 cavi 7 cavi 8 in 8 in 12 individuals 9 healthy 10 , 9 healthy 12 individuals 11 normotensive 12 individuals 12 individuals 13 to 12 individuals 14 evaluate 13 to 14 evaluate 14 evaluate 16 effects 14 evaluate 19 on 15 the 16 effects 16 effects 17 of 17 of 18 age 19 on 21 stiffness 20 arterial 21 stiffness methods : the cavi and peripheral bp were determined in healthy , normotensive koreans 20 to 79 years of age . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 1 methods 2 : 2 : 18 years 3 the 18 years 4 cavi 5 and 5 and 7 bp 5 and 8 were 6 peripheral 7 bp 8 were 9 determined 9 determined 10 in 9 determined 16 to 10 in 14 koreans 11 healthy 12 , 11 healthy 14 koreans 13 normotensive 14 koreans 15 20 16 to 16 to 17 79 17 79 18 years 18 years 19 of 19 of 20 age the subjects had no history of cardiovascular disease and did not take any medications for hypertension [,] diabetes mellitus or dyslipidemia ( n = 1,380 ; 44.1 % in men [ )( 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 12 take 0 ###LEFT-WALL### 26 ; 0 ###LEFT-WALL### 32 )( 1 the 2 subjects 2 subjects 9 and 3 had 5 history 3 had 9 and 4 no 5 history 5 history 6 of 6 of 8 disease 7 cardiovascular 8 disease 9 and 10 did 10 did 11 not 10 did 12 take 12 take 14 medications 12 take 15 for 13 any 14 medications 15 for 20 or 16 hypertension 19 mellitus 18 diabetes 19 mellitus 19 mellitus 20 or 20 or 21 dyslipidemia 20 or 24 = 22 ( 24 = 23 n 24 = 24 = 25 1,380 24 = 26 ; 26 ; 30 men 27 44.1 29 in 28 % 29 in 29 in 30 men results : the mean systolic blood pressure ( sbp ) , diastolic blood pressure ( dbp ) and pulse pressure ( pp ) were 117 , 75 and 42 mmhg , respectively . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 7 pressure 2 : 18 and 3 the 7 pressure 4 mean 7 pressure 5 systolic 6 blood 6 blood 7 pressure 7 pressure 9 sbp 7 pressure 14 pressure 8 ( 9 sbp 9 sbp 10 ) 11 , 14 pressure 12 diastolic 13 blood 13 blood 14 pressure 14 pressure 16 dbp 14 pressure 17 ) 15 ( 16 dbp 16 dbp 17 ) 18 and 20 pressure 18 and 24 were 19 pulse 20 pressure 20 pressure 22 pp 20 pressure 24 were 21 ( 22 pp 22 pp 23 ) 24 were 25 117 24 were 32 respectively 25 117 30 mmhg 26 , 30 mmhg 27 75 28 and 28 and 29 42 28 and 30 mmhg 30 mmhg 31 , the cavi increased linearly with age and was determined using the following equation : cavi = 5.0 + 0.048 × age ( year [ )( men [(] [r] ( 2 ) = 0.395 , p < 0.001 ) , cavi [=] 4.8 + 0.045 × age ( year [ )( women [(] [r] ( 2 ) = 0.450 , p < 0.001 [ )( 0 ###LEFT-WALL### 2 cavi 0 ###LEFT-WALL### 7 and 1 the 2 cavi 2 cavi 7 and 3 increased 4 linearly 3 increased 5 with 3 increased 7 and 5 with 6 age 7 and 8 was 8 was 9 determined 9 determined 10 using 9 determined 14 : 10 using 13 equation 11 the 12 following 11 the 13 equation 14 : 15 cavi 14 : 16 = 15 cavi 16 = 16 = 20 × 17 5.0 18 + 18 + 19 0.048 18 + 20 × 20 × 21 age 20 × 32 = 21 age 26 men 21 age 32 = 22 ( 26 men 23 year 26 men 26 men 30 2 26 men 31 ) 29 ( 30 2 30 2 31 ) 32 = 36 < 32 = 43 + 33 0.395 36 < 34 , 36 < 35 p 36 < 36 < 37 0.001 36 < 38 ) 39 , 43 + 40 cavi 42 4.8 40 cavi 43 + 43 + 45 × 44 0.045 45 × 45 × 46 age 45 × 57 = 46 age 51 women 46 age 57 = 47 ( 51 women 48 year 51 women 51 women 55 2 51 women 56 ) 54 ( 55 2 55 2 56 ) 57 = 61 < 58 0.450 61 < 59 , 61 < 60 p 61 < 61 < 62 0.001 61 < 64 )( however , sbp , dbp and pp did not change progressively with age . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 change 0 ###LEFT-WALL### 14 . 1 however 2 , 1 however 6 and 3 sbp 4 , 4 , 5 dbp 4 , 6 and 6 and 7 pp 6 and 8 did 8 did 9 not 8 did 10 change 10 change 11 progressively 10 change 12 with 12 with 13 age age emerged as the major determinant of the cavi in a stepwise multiple regression analysis [(] r ( 2 [ )( = 43.1 [%] ) . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 2 emerged 0 ###LEFT-WALL### 26 . 1 age 2 emerged 2 emerged 3 as 3 as 6 determinant 4 the 6 determinant 5 major 6 determinant 6 determinant 7 of 7 of 9 cavi 8 the 9 cavi 9 cavi 10 in 10 in 15 analysis 11 a 12 stepwise 11 a 15 analysis 12 stepwise 15 analysis 13 multiple 15 analysis 14 regression 15 analysis 15 analysis 22 = 17 r 22 = 18 ( 22 = 19 2 22 = 22 = 23 43.1 22 = 25 ) conclusions : the cavi scores increased with age in the healthy , normotensive individuals , whereas sbp , dbp and pp did [not] . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 1 conclusions 2 : 2 : 5 scores 3 the 5 scores 4 cavi 5 scores 5 scores 6 increased 6 increased 7 with 6 increased 9 in 6 increased 16 whereas 7 with 8 age 9 in 14 individuals 10 the 14 individuals 11 healthy 12 , 11 healthy 14 individuals 13 normotensive 14 individuals 15 , 16 whereas 16 whereas 21 pp 16 whereas 22 did 16 whereas 24 . 17 sbp 19 dbp 18 , 19 dbp 19 dbp 20 and 20 and 21 pp 21 pp 22 did age was the dominant risk factor for the progression of arterial stiffness . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 13 . 1 age 2 was 2 was 6 factor 3 the 6 factor 4 dominant 6 factor 5 risk 6 factor 6 factor 7 for 7 for 9 progression 8 the 9 progression 9 progression 10 of 10 of 12 stiffness 11 arterial 12 stiffness these data suggest that the cavi is a sensitive marker of the arterial aging process [,] above and beyond conventional upper arm bp . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 24 . 1 these 2 data 2 data 3 suggest 3 suggest 4 that 4 that 6 cavi 4 that 7 is 5 the 6 cavi 6 cavi 7 is 7 is 10 marker 8 a 9 sensitive 8 a 10 marker 9 sensitive 10 marker 10 marker 11 of 11 of 15 process 12 the 15 process 13 arterial 15 process 14 aging 15 process 15 process 18 and 17 above 18 and 18 and 19 beyond 19 beyond 23 bp 20 conventional 21 upper 21 upper 22 arm 22 arm 23 bp objective : to explore the association between baseline life - space mobility and nursing home ( nh ) admission among community [-] dwelling older adults over 6 years . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 explore 2 : 10 - 2 : 29 . 3 to 4 explore 4 explore 6 association 4 explore 7 between 5 the 6 association 7 between 9 life 8 baseline 9 life 10 - 11 space 11 space 19 admission 11 space 20 among 11 space 26 over 12 mobility 13 and 13 and 15 home 13 and 17 nh 13 and 19 admission 14 nursing 15 home 16 ( 17 nh 17 nh 18 ) 20 among 25 adults 21 community 23 dwelling 23 dwelling 25 adults 24 older 25 adults 26 over 28 years 27 6 28 years methods : using data from a prospective , observational cohort study consisting of a random sample of 1,000 medicare beneficiaries ≥ 65 years of age stratified by race ( african american [and] [non] - hispanic white ) , sex , and rural/urban residence . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 44 . 2 : 4 data 2 : 21 ≥ 3 using 4 data 4 data 5 from 4 data 21 ≥ 5 from 11 study 6 a 7 prospective 6 a 11 study 7 prospective 8 , 7 prospective 10 cohort 9 observational 10 cohort 10 cohort 11 study 11 study 12 consisting 11 study 17 of 12 consisting 13 of 13 of 16 sample 14 a 15 random 14 a 16 sample 15 random 16 sample 17 of 20 beneficiaries 18 1,000 20 beneficiaries 19 medicare 20 beneficiaries 21 ≥ 41 and 22 65 23 years 23 years 24 of 23 years 41 and 24 of 25 age 25 age 26 stratified 25 age 27 by 27 by 28 race 28 race 39 sex 29 ( 39 sex 30 african 39 sex 31 american 36 white 31 american 38 , 31 american 39 sex 34 - 36 white 35 hispanic 36 white 36 white 37 ) 39 sex 40 , 41 and 43 residence 42 rural/urban 43 residence baseline life - space mobility was assessed during [in] - home interviews . 0 ###LEFT-WALL### 2 life 0 ###LEFT-WALL### 3 - 1 baseline 2 life 3 - 4 space 3 - 10 - 4 space 5 mobility 4 space 8 during 5 mobility 6 was 6 was 7 assessed 7 assessed 8 during 10 - 11 home 10 - 13 . 11 home 12 interviews participants were contacted by telephone every 6 months to ascertain nh admissions , life - space assessment ( lsa ) scores , and vital status ( living [or] [deceased] ) . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 contacted 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 31 . 1 participants 2 were 2 were 3 contacted 3 contacted 5 telephone 3 contacted 6 every 3 contacted 9 to 4 by 5 telephone 6 every 8 months 7 6 8 months 9 to 10 ascertain 10 ascertain 12 admissions 11 nh 12 admissions 13 , 23 and 14 life 21 scores 14 life 23 and 15 - 21 scores 16 space 21 scores 17 assessment 19 lsa 18 ( 19 lsa 19 lsa 20 ) 19 lsa 21 scores 21 scores 22 , 22 , 23 and 23 and 25 status 23 and 27 living 24 vital 25 status 26 ( 27 living 27 living 30 ) using multivariate logistic regression , the significance and independence of the relationship of life - space mobility with nh admission were examined . 0 ###LEFT-WALL### 17 mobility 0 ###LEFT-WALL### 21 were 0 ###LEFT-WALL### 23 . 1 using 8 and 1 using 15 - 1 using 17 mobility 2 multivariate 4 regression 3 logistic 4 regression 4 regression 5 , 5 , 7 significance 5 , 8 and 6 the 7 significance 8 and 9 independence 8 and 10 of 10 of 12 relationship 11 the 12 relationship 12 relationship 13 of 13 of 14 life 16 space 17 mobility 17 mobility 18 with 17 mobility 21 were 18 with 20 admission 19 nh 20 admission 21 were 22 examined results : over 6 years , the odds of nh admission increased 2 % for every one point lower baseline life [-] space score independent of previously recognized risk factors . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 odds 2 : 12 increased 2 : 31 . 3 over 5 years 3 over 6 , 3 over 8 odds 4 6 5 years 7 the 8 odds 8 odds 9 of 8 odds 12 increased 9 of 11 admission 10 nh 11 admission 12 increased 14 % 13 2 14 % 14 % 15 for 14 % 26 of 15 for 25 independent 16 every 25 independent 17 one 18 point 18 point 19 lower 19 lower 25 independent 20 baseline 21 life 21 life 24 score 23 space 24 score 24 score 25 independent 26 of 30 factors 27 previously 28 recognized 28 recognized 30 factors 29 risk 30 factors discussion : the lsa may be a useful tool to identify older adults at risk of nh admission . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 4 lsa 2 : 6 be 2 : 19 . 3 the 4 lsa 4 lsa 5 may 5 may 6 be 6 be 9 tool 7 a 9 tool 8 useful 9 tool 9 tool 10 to 9 tool 11 identify 10 to 11 identify 11 identify 13 adults 11 identify 14 at 12 older 13 adults 14 at 15 risk 15 risk 16 of 16 of 18 admission 17 nh 18 admission objective : studies have shown a correlation between cancer and cognition referred to as " chemo brain . " 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 studies 2 : 5 shown 2 : 13 to 2 : 18 . 3 studies 4 have 4 have 5 shown 5 shown 10 and 5 shown 13 to 6 a 7 correlation 7 correlation 8 between 7 correlation 10 and 8 between 9 cancer 10 and 11 cognition 10 and 13 to 12 referred 13 to 13 to 17 brain 14 as 15 " 14 as 16 chemo 16 chemo 17 brain 18 . 19 " this study investigated the relationship between cancer and later - life cognition using nationally representative data . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 17 . 1 this 2 study 2 study 3 investigated 3 investigated 5 relationship 3 investigated 6 between 4 the 5 relationship 6 between 8 and 7 cancer 8 and 8 and 12 cognition 8 and 13 using 9 later 10 - 9 later 11 life 11 life 12 cognition 13 using 16 data 14 nationally 15 representative 15 representative 16 data method : analysis of the 2006 health and retirement study investigated the [(] [a] [ )(effects of cancer survivorship on the total cognition score using linear regression in adults age 65+ ( n = 9,814 ) and [(] [b] [ )(the effects of cancer treatment on the total recall index using linear regression in adults age 50+ ( n = 657 [ )( 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 investigated 1 method 2 : 2 : 3 analysis 3 analysis 4 of 4 of 7 health 5 the 6 2006 6 2006 7 health 8 and 10 study 9 retirement 10 study 10 study 11 investigated 11 investigated 16 )(effects 12 the 16 )(effects 16 )(effects 17 of 17 of 18 cancer 18 cancer 19 survivorship 18 cancer 25 using 19 survivorship 20 on 20 on 24 score 21 the 24 score 22 total 24 score 23 cognition 24 score 25 using 37 and 26 linear 27 regression 27 regression 28 in 27 regression 37 and 28 in 31 65+ 29 adults 31 65+ 30 age 31 65+ 31 65+ 34 = 32 ( 34 = 33 n 34 = 34 = 35 9,814 34 = 36 ) 37 and 42 effects 41 )(the 42 effects 42 effects 43 of 43 of 45 treatment 44 cancer 45 treatment 45 treatment 46 on 46 on 53 regression 47 the 53 regression 48 total 49 recall 49 recall 50 index 50 index 53 regression 51 using 53 regression 52 linear 53 regression 53 regression 54 in 53 regression 60 = 54 in 57 50+ 55 adults 56 age 56 age 57 50+ 58 ( 60 = 59 n 60 = 60 = 61 657 60 = 63 )( results : total cognition [score] is not associated with cancer survivorship . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 cognition 2 : 6 is 2 : 12 . 3 total 4 cognition 4 cognition 6 is 6 is 7 not 6 is 9 with 6 is 11 survivorship 7 not 8 associated 9 with 10 cancer the association between long - term cancer survivorship and cognition score was significant ( p < [.] 05 [;] b = [.] 276 ) . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 25 . 1 the 2 association 2 association 3 between 2 association 12 was 3 between 9 and 4 long 5 - 4 long 6 term 6 term 8 survivorship 7 cancer 8 survivorship 8 survivorship 9 and 9 and 11 score 10 cognition 11 score 12 was 13 significant 13 significant 16 < 14 ( 16 < 15 p 16 < 16 < 18 05 18 05 21 = 20 b 21 = 21 = 23 276 21 = 24 ) total recall [index] is not associated with chemotherapy . 0 ###LEFT-WALL### 2 recall 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 9 . 1 total 2 recall 2 recall 4 is 4 is 5 not 4 is 7 with 5 not 6 associated 7 with 8 chemotherapy discussion : these results support other research suggesting that chemo brain may be biased by expectation as well as favored by research that relies upon self [-] reported cognitive measures versus cognitive testing . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 4 results 2 : 20 favored 3 these 4 results 4 results 5 support 5 support 7 research 6 other 7 research 7 research 8 suggesting 7 research 11 brain 7 research 20 favored 8 suggesting 9 that 10 chemo 11 brain 11 brain 12 may 12 may 13 be 13 be 14 biased 14 biased 15 by 14 biased 17 as 14 biased 19 as 15 by 16 expectation 17 as 18 well 19 as 20 favored 20 favored 21 by 20 favored 25 upon 21 by 22 research 22 research 23 that 22 research 24 relies 23 that 24 relies 25 upon 30 measures 26 self 28 reported 28 reported 30 measures 29 cognitive 30 measures 30 measures 31 versus 31 versus 33 testing 32 cognitive 33 testing the study was limited by the cross - sectional design . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 11 . 1 the 2 study 2 study 3 was 3 was 4 limited 4 limited 5 by 5 by 7 cross 6 the 7 cross 8 - 10 design 9 sectional 10 design background : apolipoprotein e ε4 ( apoe4 ) has been associated with an increased risk of alzheimer 's disease ( ad ) , amyloid deposition and hypometabolism . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 5 ε4 2 : 11 associated 3 apolipoprotein 4 e 3 apolipoprotein 5 ε4 5 ε4 7 apoe4 5 ε4 9 has 6 ( 7 apoe4 7 apoe4 8 ) 9 has 10 been 10 been 11 associated 11 associated 12 with 12 with 26 and 13 an 15 risk 14 increased 15 risk 15 risk 16 of 15 risk 23 , 16 of 19 disease 17 alzheimer 18 's 18 's 19 disease 19 disease 21 ad 20 ( 21 ad 21 ad 22 ) 23 , 25 deposition 23 , 26 and 24 amyloid 25 deposition 26 and 27 hypometabolism apoe4 is less prevalent in [non] [-] amnestic ad variants suggesting a direct effect on the clinical phenotype . 0 ###LEFT-WALL### 1 apoe4 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 19 . 1 apoe4 2 is 2 is 4 prevalent 3 less 4 prevalent 4 prevalent 5 in 5 in 10 variants 8 amnestic 10 variants 9 ad 10 variants 10 variants 11 suggesting 11 suggesting 14 effect 11 suggesting 15 on 12 a 13 direct 12 a 14 effect 13 direct 14 effect 15 on 18 phenotype 16 the 18 phenotype 17 clinical 18 phenotype however , the impact of apoe4 on amyloid burden and glucose metabolism across different clinical ad syndromes is not well understood . 0 ###LEFT-WALL### 4 impact 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 4 impact 3 the 4 impact 4 impact 5 of 4 impact 18 is 5 of 10 and 6 apoe4 7 on 6 apoe4 10 and 7 on 9 burden 8 amyloid 9 burden 10 and 12 metabolism 10 and 13 across 11 glucose 12 metabolism 13 across 17 syndromes 14 different 17 syndromes 15 clinical 17 syndromes 16 ad 17 syndromes 18 is 19 not 18 is 20 well 20 well 21 understood we aimed to assess the relationship between amyloid deposition , glucose metabolism and apoe4 genotype in a clinically heterogeneous population of ad patients . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 24 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 assess 3 to 4 assess 4 assess 13 and 4 assess 15 genotype 5 the 6 relationship 6 relationship 7 between 6 relationship 10 , 7 between 9 deposition 8 amyloid 9 deposition 10 , 12 metabolism 10 , 13 and 11 glucose 12 metabolism 13 and 14 apoe4 13 and 15 genotype 15 genotype 16 in 15 genotype 23 patients 16 in 20 population 17 a 18 clinically 17 a 20 population 18 clinically 19 heterogeneous 19 heterogeneous 20 population 20 population 21 of 21 of 22 ad methods : 52 patients with probable ad ( national institute on aging - alzheimer 's association [ )(underwent [[] [(] 11 )c ]pittsburgh compound b ( pib ) [and] [ [(] 18 )f ]fluorodeoxyglucose ( fdg ) positron emission tomography ( pet ) scans . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 patients 2 : 13 - 3 52 4 patients 4 patients 5 with 4 patients 10 institute 5 with 7 ad 6 probable 7 ad 8 ( 10 institute 9 national 10 institute 10 institute 11 on 10 institute 13 - 11 on 12 aging 13 - 16 association 13 - 18 )(underwent 14 alzheimer 15 's 15 's 16 association 16 association 18 )(underwent 18 )(underwent 24 compound 21 11 23 ]pittsburgh 22 )c 23 ]pittsburgh 23 ]pittsburgh 24 compound 24 compound 25 b 24 compound 27 pib 24 compound 33 )f 26 ( 27 pib 27 pib 28 ) 30 [ 33 )f 32 18 33 )f 33 )f 40 tomography 33 )f 44 scans 33 )f 45 . 34 ]fluorodeoxyglucose 36 fdg 34 ]fluorodeoxyglucose 40 tomography 35 ( 36 fdg 36 fdg 37 ) 38 positron 40 tomography 39 emission 40 tomography 40 tomography 42 pet 40 tomography 44 scans 41 ( 42 pet 42 pet 43 ) all patients had positive pib - pet scans . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 6 - 1 all 2 patients 2 patients 3 had 3 had 5 pib 4 positive 5 pib 6 - 7 pet 6 - 8 scans 6 - 9 . 7 pet 8 scans groups consisted of language - variant ad , visual - variant ad and ad patients with amnestic and dysexecutive deficits . 0 ###LEFT-WALL### 1 groups 0 ###LEFT-WALL### 2 consisted 0 ###LEFT-WALL### 5 - 1 groups 2 consisted 2 consisted 3 of 3 of 4 language 5 - 7 ad 5 - 8 , 5 - 21 . 6 variant 7 ad 8 , 13 and 9 visual 10 - 9 visual 11 variant 11 variant 12 ad 12 ad 13 and 13 and 15 patients 13 and 16 with 14 ad 15 patients 16 with 20 deficits 17 amnestic 18 and 18 and 19 dysexecutive 18 and 20 deficits fdg and pib uptake was compared between groups on a voxel - wise basis and in regions of interest . 0 ###LEFT-WALL### 4 uptake 0 ###LEFT-WALL### 6 compared 0 ###LEFT-WALL### 20 . 1 fdg 2 and 2 and 3 pib 3 pib 4 uptake 4 uptake 5 was 5 was 6 compared 6 compared 7 between 7 between 8 groups 8 groups 15 and 9 on 14 basis 9 on 15 and 10 a 11 voxel 10 a 14 basis 11 voxel 12 - 11 voxel 14 basis 13 wise 14 basis 15 and 16 in 16 in 17 regions 17 regions 18 of 18 of 19 interest results : while pib patterns were diffuse in both patient groups , apoe4 - patients showed higher pib uptake than apoe4+ patients across the cortex . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 15 patients 2 : 16 showed 2 : 26 . 3 while 5 patterns 3 while 6 were 3 while 14 - 3 while 15 patients 4 pib 5 patterns 5 patterns 6 were 6 were 7 diffuse 7 diffuse 8 in 8 in 11 groups 9 both 11 groups 10 patient 11 groups 11 groups 13 apoe4 12 , 13 apoe4 13 apoe4 14 - 15 patients 16 showed 16 showed 18 pib 16 showed 19 uptake 16 showed 20 than 17 higher 18 pib 20 than 22 patients 20 than 23 across 21 apoe4+ 22 patients 23 across 25 cortex 24 the 25 cortex higher pib uptake in apoe4 [-] patients was particularly significant in right lateral frontotemporal regions . 0 ###LEFT-WALL### 3 uptake 0 ###LEFT-WALL### 8 was 0 ###LEFT-WALL### 16 . 1 higher 3 uptake 2 pib 3 uptake 3 uptake 4 in 3 uptake 8 was 4 in 7 patients 5 apoe4 7 patients 8 was 10 significant 9 particularly 10 significant 10 significant 11 in 11 in 15 regions 12 right 15 regions 13 lateral 15 regions 14 frontotemporal 15 regions in contrast , similar patterns of hypometabolism relative to controls were found in both patient groups , mainly [involving] lateral temporoparietal cortex , precuneus , posterior cingulate cortex and middle frontal gyrus . 0 ###LEFT-WALL### 5 patterns 0 ###LEFT-WALL### 12 found 0 ###LEFT-WALL### 33 . 1 in 2 contrast 1 in 3 , 1 in 5 patterns 4 similar 5 patterns 5 patterns 6 of 5 patterns 8 relative 5 patterns 11 were 6 of 7 hypometabolism 8 relative 9 to 9 to 10 controls 11 were 12 found 12 found 13 in 13 in 29 and 14 both 29 and 15 patient 16 groups 16 groups 17 , 17 , 22 cortex 17 , 23 , 18 mainly 20 lateral 20 lateral 22 cortex 21 temporoparietal 22 cortex 23 , 24 precuneus 23 , 25 , 25 , 28 cortex 25 , 29 and 26 posterior 28 cortex 27 cingulate 28 cortex 29 and 32 gyrus 30 middle 32 gyrus 31 frontal 32 gyrus comparing patient groups , apoe4+ subjects showed greater hypometabolism in bilateral medial temporal and right lateral temporal regions , and apoe4 - patients showed greater hypometabolism in cortical areas , including supplementary motor cortex and superior frontal gyrus . 0 ###LEFT-WALL### 6 subjects 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 39 . 1 comparing 3 groups 1 comparing 4 , 1 comparing 6 subjects 2 patient 3 groups 5 apoe4+ 6 subjects 6 subjects 7 showed 7 showed 9 hypometabolism 8 greater 9 hypometabolism 9 hypometabolism 10 in 10 in 18 regions 11 bilateral 18 regions 12 medial 18 regions 13 temporal 14 and 14 and 15 right 14 and 18 regions 16 lateral 18 regions 17 temporal 18 regions 19 , 20 and 20 and 23 patients 20 and 24 showed 21 apoe4 22 - 21 apoe4 23 patients 23 patients 24 showed 24 showed 26 hypometabolism 24 showed 27 in 25 greater 26 hypometabolism 27 in 35 and 28 cortical 29 areas 29 areas 30 , 30 , 34 cortex 30 , 35 and 31 including 34 cortex 32 supplementary 33 motor 33 motor 34 cortex 35 and 38 gyrus 36 superior 38 gyrus 37 frontal 38 gyrus conclusions : apoe4+ ad patients showed lower global amyloid burden and greater medial temporal hypometabolism compared with matched apoe4 - patients . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 3 apoe4+ 2 : 3 apoe4+ 3 apoe4+ 4 ad 3 apoe4+ 17 with 4 ad 16 compared 5 patients 6 showed 6 showed 7 lower 6 showed 15 hypometabolism 6 showed 16 compared 8 global 15 hypometabolism 9 amyloid 15 hypometabolism 10 burden 11 and 11 and 12 greater 11 and 15 hypometabolism 13 medial 15 hypometabolism 14 temporal 15 hypometabolism 15 hypometabolism 16 compared 17 with 19 apoe4 18 matched 19 apoe4 19 apoe4 21 patients 20 - 21 patients 21 patients 22 . these findings suggest that apoe4 may increase susceptibility to molecular pathology and modulate the anatomic pattern of neurodegeneration in ad . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 21 . 1 these 2 findings 2 findings 12 and 3 suggest 4 that 3 suggest 12 and 4 that 5 apoe4 4 that 7 increase 5 apoe4 6 may 6 may 7 increase 7 increase 8 susceptibility 7 increase 9 to 9 to 11 pathology 10 molecular 11 pathology 12 and 13 modulate 13 modulate 16 pattern 13 modulate 19 in 14 the 16 pattern 15 anatomic 16 pattern 16 pattern 17 of 17 of 18 neurodegeneration 19 in 20 ad for more than 50 years , the free radical theory served as the paradigm guiding most investigations of ageing . 0 ###LEFT-WALL### 10 theory 0 ###LEFT-WALL### 11 served 0 ###LEFT-WALL### 20 . 1 for 5 years 1 for 6 , 1 for 10 theory 2 more 3 than 3 than 4 50 4 50 5 years 7 the 10 theory 8 free 10 theory 9 radical 10 theory 10 theory 11 served 11 served 12 as 12 as 14 paradigm 13 the 14 paradigm 14 paradigm 15 guiding 15 guiding 17 investigations 16 most 17 investigations 17 investigations 18 of 18 of 19 ageing however , recent studies in a variety of organisms have identified conceptual and practical limitations to this theory . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 11 identified 0 ###LEFT-WALL### 19 . 1 however 2 , 1 however 4 studies 3 recent 4 studies 4 studies 5 in 4 studies 10 have 5 in 7 variety 6 a 7 variety 7 variety 8 of 8 of 9 organisms 10 have 11 identified 11 identified 15 limitations 11 identified 16 to 12 conceptual 13 and 13 and 14 practical 13 and 15 limitations 16 to 18 theory 17 this 18 theory some of these limitations are related to the recent discovery that caloric restriction and other experimental manipulations promote longevity by inducing hormesis effects in association with increased reactive oxygen species ( ros ) . 0 ###LEFT-WALL### 4 limitations 0 ###LEFT-WALL### 34 . 1 some 2 of 1 some 4 limitations 2 of 4 limitations 3 these 4 limitations 4 limitations 5 are 5 are 6 related 6 related 7 to 6 related 20 by 6 related 25 association 6 related 26 with 7 to 10 discovery 8 the 10 discovery 9 recent 10 discovery 10 discovery 11 that 11 that 14 and 11 that 18 promote 12 caloric 13 restriction 13 restriction 14 and 14 and 17 manipulations 14 and 18 promote 15 other 17 manipulations 16 experimental 17 manipulations 18 promote 19 longevity 20 by 21 inducing 21 inducing 23 effects 22 hormesis 23 effects 24 in 25 association 26 with 30 species 27 increased 29 oxygen 28 reactive 29 oxygen 29 oxygen 30 species 30 species 32 ros 31 ( 32 ros 32 ros 33 ) the beneficial role of ros in lifespan extension is consistent with the essential role of these molecules in cell signalling . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 21 . 1 the 3 role 2 beneficial 3 role 3 role 4 of 3 role 9 is 4 of 5 ros 5 ros 6 in 6 in 8 extension 7 lifespan 8 extension 9 is 10 consistent 10 consistent 11 with 10 consistent 18 in 11 with 14 role 12 the 14 role 13 essential 14 role 14 role 15 of 15 of 17 molecules 16 these 17 molecules 18 in 20 signalling 19 cell 20 signalling however , the identity of specific forms of ros that promote longevity remains unclear . 0 ###LEFT-WALL### 4 identity 0 ###LEFT-WALL### 13 remains 0 ###LEFT-WALL### 15 . 1 however 2 , 1 however 4 identity 3 the 4 identity 4 identity 5 of 4 identity 13 remains 5 of 7 forms 6 specific 7 forms 7 forms 8 of 7 forms 10 that 7 forms 11 promote 8 of 9 ros 10 that 11 promote 11 promote 12 longevity 13 remains 14 unclear in this article , we argue that in several model systems , hydrogen peroxide plays a crucial role in the induction of hormesis . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 argue 0 ###LEFT-WALL### 24 . 1 in 3 article 1 in 4 , 1 in 5 we 2 this 3 article 5 we 6 argue 6 argue 7 that 7 that 14 peroxide 7 that 15 plays 8 in 11 systems 8 in 12 , 8 in 14 peroxide 9 several 11 systems 10 model 11 systems 13 hydrogen 14 peroxide 14 peroxide 15 plays 15 plays 18 role 15 plays 19 in 16 a 17 crucial 16 a 18 role 17 crucial 18 role 19 in 21 induction 20 the 21 induction 21 induction 22 of 22 of 23 hormesis acetyl - l - carnitine ( alc ) is a molecule derived from acetylation of carnitine in the mitochondria . 0 ###LEFT-WALL### 1 acetyl 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 20 . 1 acetyl 3 l 1 acetyl 5 carnitine 1 acetyl 9 is 2 - 3 l 3 l 4 - 4 - 5 carnitine 5 carnitine 7 alc 5 carnitine 8 ) 6 ( 7 alc 7 alc 8 ) 9 is 11 molecule 10 a 11 molecule 11 molecule 12 derived 11 molecule 13 from 11 molecule 15 of 13 from 14 acetylation 15 of 16 carnitine 16 carnitine 17 in 17 in 19 mitochondria 18 the 19 mitochondria carnitine acetylation enables the function of coa and facilitates elimination of oxidative products . 0 ###LEFT-WALL### 2 acetylation 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 14 . 1 carnitine 2 acetylation 2 acetylation 8 and 3 enables 5 function 3 enables 8 and 4 the 5 function 5 function 6 of 6 of 7 coa 8 and 9 facilitates 9 facilitates 10 elimination 10 elimination 11 of 11 of 13 products 12 oxidative 13 products beyond this metabolic activity , alc provides acetyl groups for acetylcholine synthesis , exerts a cholinergic effect and optimizes the balance of energy processes . 0 ###LEFT-WALL### 6 alc 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 25 . 1 beyond 4 activity 1 beyond 5 , 1 beyond 6 alc 2 this 3 metabolic 3 metabolic 4 activity 6 alc 13 , 7 provides 9 groups 7 provides 13 , 8 acetyl 9 groups 9 groups 10 for 10 for 12 synthesis 11 acetylcholine 12 synthesis 13 , 18 and 14 exerts 17 effect 14 exerts 18 and 15 a 16 cholinergic 15 a 17 effect 16 cholinergic 17 effect 18 and 19 optimizes 19 optimizes 21 balance 20 the 21 balance 21 balance 22 of 22 of 24 processes 23 energy 24 processes acetylcarnitine supplementation induces neuroprotective , neurotrophic and analgesic effects in the peripheral nervous system . 0 ###LEFT-WALL### 2 supplementation 0 ###LEFT-WALL### 3 induces 0 ###LEFT-WALL### 15 . 1 acetylcarnitine 2 supplementation 2 supplementation 3 induces 3 induces 7 and 3 induces 10 in 4 neuroprotective 5 , 5 , 6 neurotrophic 5 , 7 and 7 and 9 effects 8 analgesic 9 effects 10 in 14 system 11 the 14 system 12 peripheral 14 system 13 nervous 14 system in the recent studies , alc , by acting [as] a donor of acetyl groups to nf - [kb] p65/rela , enhanced the transcription of the grm2 gene encoding the mglu2 receptors , inducing long - term upregulation of the mglur2 , evidencing therefore that [its] long - term analgesic effects are dependent on epigenetic modifications . 1 in 4 studies 1 in 12 donor 2 the 4 studies 3 recent 4 studies 5 , 6 alc 6 alc 7 , 6 alc 12 donor 8 by 9 acting 8 by 12 donor 11 a 12 donor 12 donor 13 of 12 donor 22 enhanced 13 of 15 groups 14 acetyl 15 groups 15 groups 16 to 16 to 17 nf 17 nf 20 p65/rela 18 - 20 p65/rela 20 p65/rela 21 , 22 enhanced 24 transcription 23 the 24 transcription 24 transcription 25 of 24 transcription 34 inducing 25 of 28 gene 26 the 28 gene 27 grm2 28 gene 28 gene 29 encoding 29 encoding 32 receptors 30 the 32 receptors 31 mglu2 32 receptors 33 , 34 inducing 34 inducing 38 upregulation 35 long 36 - 35 long 37 term 37 term 38 upregulation 38 upregulation 39 of 39 of 41 mglur2 40 the 41 mglur2 41 mglur2 49 term 42 , 49 term 43 evidencing 49 term 44 therefore 47 long 45 that 47 long 47 long 48 - 47 long 49 term 49 term 51 effects 49 term 52 are 49 term 53 dependent 49 term 57 . 50 analgesic 51 effects 51 effects 52 are 53 dependent 54 on 54 on 56 modifications 55 epigenetic 56 modifications several studies , including double - blind , placebo - controlled , parallel group studies and few open studies showed the effect of alc in diseases characterized by neuropathies and neuropathic pain : the studies included diabetic neuropathy , hiv and antiretroviral therapy - induced neuropathies , neuropathies due to compression and chemotherapeutic agents . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 55 . 1 several 2 studies 3 , 9 placebo 3 , 10 - 4 including 9 placebo 5 double 6 - 5 double 9 placebo 7 blind 8 , 7 blind 9 placebo 10 - 16 and 10 - 20 showed 10 - 33 : 10 - 39 , 11 controlled 12 , 11 controlled 16 and 13 parallel 15 studies 14 group 15 studies 15 studies 16 and 16 and 19 studies 16 and 20 showed 17 few 19 studies 18 open 19 studies 20 showed 30 and 21 the 22 effect 22 effect 23 of 22 effect 30 and 23 of 24 alc 24 alc 25 in 25 in 26 diseases 26 diseases 27 characterized 26 diseases 28 by 28 by 29 neuropathies 30 and 32 pain 30 and 33 : 31 neuropathic 32 pain 33 : 35 studies 33 : 38 neuropathy 34 the 35 studies 35 studies 36 included 35 studies 38 neuropathy 36 included 37 diabetic 39 , 41 and 39 , 47 , 40 hiv 41 and 41 and 43 therapy 41 and 44 - 41 and 45 induced 41 and 47 , 42 antiretroviral 43 therapy 46 neuropathies 47 , 47 , 48 neuropathies 47 , 50 to 49 due 50 to 50 to 52 and 51 compression 52 and 52 and 54 agents 53 chemotherapeutic 54 agents double - blinded studies involved 1773 patients . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 5 involved 0 ###LEFT-WALL### 8 . 1 double 2 - 1 double 4 studies 3 blinded 4 studies 4 studies 5 involved 5 involved 7 patients 6 1773 7 patients statistical evaluations evidenced reduction of pain , improvements of nerve [function] and trophism . 0 ###LEFT-WALL### 2 evaluations 0 ###LEFT-WALL### 3 evidenced 0 ###LEFT-WALL### 14 . 1 statistical 2 evaluations 2 evaluations 3 evidenced 3 evidenced 4 reduction 4 reduction 5 of 5 of 12 and 6 pain 7 , 7 , 8 improvements 7 , 12 and 8 improvements 9 of 9 of 10 nerve 12 and 13 trophism in conclusion , alc represents a consistent therapeutic option for peripheral neuropathies , and its complex effects , neurotrophic and analgesic , based on epigenetic [mechanism] , open new pathways in the study of peripheral nerve disease management . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 23 based 0 ###LEFT-WALL### 39 . 1 in 2 conclusion 3 , 4 alc 3 , 5 represents 4 alc 5 represents 5 represents 9 option 5 represents 10 for 6 a 7 consistent 6 a 9 option 7 consistent 9 option 8 therapeutic 9 option 10 for 14 and 11 peripheral 12 neuropathies 12 neuropathies 14 and 13 , 14 and 14 and 16 complex 14 and 17 effects 14 and 23 based 15 its 16 complex 17 effects 20 and 17 effects 23 based 18 , 20 and 19 neurotrophic 20 and 20 and 21 analgesic 20 and 22 , 23 based 24 on 23 based 31 in 24 on 30 pathways 25 epigenetic 27 , 25 epigenetic 30 pathways 28 open 30 pathways 29 new 30 pathways 31 in 33 study 32 the 33 study 33 study 34 of 34 of 38 management 35 peripheral 36 nerve 36 nerve 37 disease 37 disease 38 management objectives : this study aimed to develop and pilot the alzheimer 's disease and ageing perception scale ( adaps ) , examine theory - consistent differences and convergent validity , and identify misconceptions of the cognitive effects of ageing and mild alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 and 0 ###LEFT-WALL### 43 's 0 ###LEFT-WALL### 48 . 1 objectives 2 : 2 : 4 study 3 this 4 study 4 study 5 aimed 5 aimed 6 to 6 to 8 and 7 develop 8 and 8 and 21 , 9 pilot 14 and 9 pilot 21 , 10 the 11 alzheimer 11 alzheimer 12 's 12 's 14 and 13 disease 14 and 14 and 19 adaps 15 ageing 16 perception 16 perception 17 scale 17 scale 19 adaps 18 ( 19 adaps 19 adaps 20 ) 21 , 31 and 22 examine 23 theory 22 examine 31 and 23 theory 27 and 24 - 27 and 25 consistent 26 differences 26 differences 27 and 27 and 29 validity 27 and 30 , 28 convergent 29 validity 30 , 31 and 31 and 32 identify 32 identify 33 misconceptions 33 misconceptions 34 of 34 of 37 effects 35 the 37 effects 36 cognitive 37 effects 37 effects 38 of 38 of 39 ageing 40 and 42 alzheimer 40 and 43 's 41 mild 42 alzheimer 42 alzheimer 43 's 43 's 44 disease 44 disease 46 ad 45 ( 46 ad 46 ad 47 ) method : after piloting a large pool of items with a panel of ageing and dementia experts ( n = 6 [ )(, an item analysis yielded [a] [25] - item version of the adaps ( [α] = [.] 70 ) , comprising a normal ageing subscale ( α [=] [.] 68 [ )(and mild ad subscale ( α [=] [.] 74 ) . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 1 method 2 : 2 : 3 after 2 : 10 with 3 after 4 piloting 4 piloting 7 pool 5 a 7 pool 6 large 7 pool 7 pool 8 of 8 of 9 items 10 with 12 panel 11 a 12 panel 12 panel 13 of 12 panel 20 = 13 of 15 and 14 ageing 15 and 15 and 17 experts 16 dementia 17 experts 18 ( 20 = 19 n 20 = 20 = 21 6 21 6 30 - 23 )(, 30 - 24 an 26 analysis 25 item 26 analysis 26 analysis 27 yielded 26 analysis 30 - 30 - 32 version 31 item 32 version 32 version 33 of 32 version 40 70 32 version 43 comprising 33 of 35 adaps 34 the 35 adaps 36 ( 40 70 38 = 40 70 40 70 41 ) 42 , 43 comprising 43 comprising 47 subscale 44 a 47 subscale 45 normal 47 subscale 46 ageing 47 subscale 47 subscale 54 )(and 48 ( 54 )(and 49 α 52 68 49 α 54 )(and 54 )(and 57 subscale 54 )(and 59 α 54 )(and 64 . 55 mild 56 ad 56 ad 57 subscale 58 ( 59 α 59 α 62 74 59 α 63 ) participants from the general community ( n = 251 ) and aged care professionals ( n = 59 ) completed the adaps , knowledge of memory ageing questionnaire ( kmaq ) , and the alzheimer 's disease knowledge scale ( adks ) . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 20 completed 0 ###LEFT-WALL### 33 and 0 ###LEFT-WALL### 36 's 0 ###LEFT-WALL### 43 . 1 participants 2 from 1 participants 11 and 2 from 5 community 3 the 5 community 4 general 5 community 5 community 8 = 6 ( 8 = 7 n 8 = 8 = 9 251 8 = 10 ) 11 and 14 professionals 11 and 17 = 11 and 20 completed 12 aged 13 care 13 care 14 professionals 15 ( 17 = 16 n 17 = 17 = 18 59 17 = 19 ) 20 completed 22 adaps 21 the 22 adaps 22 adaps 24 knowledge 23 , 24 knowledge 24 knowledge 25 of 24 knowledge 31 ) 25 of 30 kmaq 26 memory 27 ageing 27 ageing 28 questionnaire 28 questionnaire 30 kmaq 29 ( 30 kmaq 32 , 33 and 33 and 35 alzheimer 33 and 36 's 34 the 35 alzheimer 35 alzheimer 36 's 36 's 41 adks 37 disease 38 knowledge 38 knowledge 39 scale 39 scale 41 adks 40 ( 41 adks 41 adks 42 ) results : compared to matched controls , aged care professionals demonstrated greater accuracy of knowledge on the mild ad subscale ( p < [.] 05 ) , but not the normal ageing subscale ( p > [.] 05 [ )(of the adaps . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 27 , 2 : 43 . 3 compared 4 to 3 compared 27 , 4 to 6 controls 5 matched 6 controls 6 controls 9 care 7 , 9 care 8 aged 9 care 9 care 10 professionals 9 care 11 demonstrated 9 care 26 ) 10 professionals 11 demonstrated 11 demonstrated 13 accuracy 11 demonstrated 16 on 11 demonstrated 23 < 12 greater 13 accuracy 13 accuracy 14 of 14 of 15 knowledge 16 on 20 subscale 17 the 20 subscale 18 mild 19 ad 19 ad 20 subscale 21 ( 23 < 22 p 23 < 23 < 25 05 27 , 29 not 28 but 29 not 29 not 33 subscale 30 the 33 subscale 31 normal 33 subscale 32 ageing 33 subscale 33 subscale 36 > 34 ( 36 > 35 p 36 > 36 > 38 05 38 05 40 )(of 40 )(of 42 adaps 41 the 42 adaps the pattern of significant correlations between the adaps , kmaq , and adks supported the convergent validity of the adaps . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 14 supported 0 ###LEFT-WALL### 21 . 1 the 2 pattern 2 pattern 3 of 2 pattern 6 between 2 pattern 12 and 3 of 5 correlations 4 significant 5 correlations 6 between 10 kmaq 7 the 10 kmaq 8 adaps 10 kmaq 9 , 10 kmaq 10 kmaq 11 , 12 and 13 adks 12 and 14 supported 14 supported 17 validity 15 the 17 validity 16 convergent 17 validity 17 validity 18 of 18 of 20 adaps 19 the 20 adaps the most common misconceptions on the adaps indicated a tendency for participants to overgeneralise the cognitive effects of normal ageing . 0 ###LEFT-WALL### 4 misconceptions 0 ###LEFT-WALL### 8 indicated 0 ###LEFT-WALL### 21 . 1 the 2 most 2 most 4 misconceptions 3 common 4 misconceptions 4 misconceptions 5 on 4 misconceptions 8 indicated 5 on 7 adaps 6 the 7 adaps 8 indicated 10 tendency 8 indicated 13 to 9 a 10 tendency 10 tendency 11 for 11 for 12 participants 13 to 14 overgeneralise 14 overgeneralise 17 effects 15 the 17 effects 16 cognitive 17 effects 17 effects 18 of 18 of 20 ageing 19 normal 20 ageing conclusion : this preliminary study introduces a new tool for assessing accuracy of knowledge of cognitive effects associated with normal ageing and mild ad , and may assist in identifying misconceptions of the ageing process . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 study 2 : 6 introduces 2 : 36 . 3 this 4 preliminary 4 preliminary 5 study 5 study 6 introduces 6 introduces 9 tool 7 a 8 new 7 a 9 tool 8 new 9 tool 9 tool 10 for 9 tool 13 of 9 tool 15 of 10 for 11 assessing 11 assessing 12 accuracy 13 of 14 knowledge 15 of 17 effects 16 cognitive 17 effects 17 effects 26 and 18 associated 19 with 18 associated 26 and 19 with 22 and 20 normal 21 ageing 21 ageing 22 and 22 and 24 ad 22 and 25 , 23 mild 24 ad 26 and 27 may 26 and 29 in 27 may 28 assist 29 in 30 identifying 30 identifying 31 misconceptions 31 misconceptions 32 of 32 of 35 process 33 the 35 process 34 ageing 35 process guided by rigorous methodology and a life - course perspective , the goal of this research is to address a gap in current knowledge on whether , when , and how strongly intergenerational continuity of substance use exists when examining age - equivalent and developmentally specific stages of the life course . 0 ###LEFT-WALL### 13 goal 0 ###LEFT-WALL### 17 is 0 ###LEFT-WALL### 42 - 0 ###LEFT-WALL### 52 . 1 guided 2 by 1 guided 11 , 1 guided 13 goal 2 by 5 and 3 rigorous 4 methodology 4 methodology 5 and 5 and 7 life 5 and 10 perspective 6 a 7 life 8 - 10 perspective 9 course 10 perspective 10 perspective 11 , 12 the 13 goal 13 goal 14 of 13 goal 17 is 14 of 16 research 15 this 16 research 17 is 18 to 17 is 25 on 18 to 19 address 19 address 21 gap 20 a 21 gap 21 gap 22 in 22 in 24 knowledge 23 current 24 knowledge 25 on 30 and 26 whether 27 , 27 , 28 when 27 , 30 and 29 , 30 and 30 and 31 how 30 and 34 continuity 30 and 41 age 32 strongly 33 intergenerational 33 intergenerational 34 continuity 34 continuity 35 of 34 continuity 38 exists 35 of 37 use 36 substance 37 use 38 exists 39 when 39 when 40 examining 40 examining 41 age 42 - 47 stages 43 equivalent 44 and 44 and 46 specific 44 and 47 stages 45 developmentally 46 specific 47 stages 48 of 48 of 51 course 49 the 51 course 50 life 51 course annual self - reported substance use measures were analyzed from a prospective , longitudinal , and nationally representative sample that originally consisted of 1,725 respondents and their families , who were then interviewed over a 27 [-] year period from 1977 to 2004 . 0 ###LEFT-WALL### 2 self 0 ###LEFT-WALL### 4 reported 0 ###LEFT-WALL### 44 . 1 annual 2 self 3 - 4 reported 4 reported 5 substance 4 reported 34 over 5 substance 6 use 5 substance 9 analyzed 5 substance 10 from 6 use 7 measures 6 use 8 were 6 use 9 analyzed 7 measures 8 were 10 from 19 sample 11 a 19 sample 12 prospective 13 , 12 prospective 19 sample 14 longitudinal 16 and 15 , 16 and 16 and 18 representative 16 and 19 sample 17 nationally 18 representative 19 sample 20 that 19 sample 22 consisted 20 that 22 consisted 21 originally 22 consisted 22 consisted 23 of 23 of 26 and 24 1,725 25 respondents 25 respondents 26 and 26 and 28 families 26 and 29 , 26 and 30 who 26 and 31 were 27 their 28 families 30 who 31 were 31 were 32 then 31 were 33 interviewed 34 over 39 period 35 a 39 period 36 27 38 year 38 year 39 period 39 period 42 to 40 from 42 to 41 1977 42 to 42 to 43 2004 findings from multilevel random - [intercept] regression models provide support for intergenerational continuity when substance use occurs in emerging adulthood but not when limited to adolescence . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 9 provide 0 ###LEFT-WALL### 27 . 1 findings 2 from 1 findings 9 provide 2 from 8 models 3 multilevel 7 regression 4 random 5 - 4 random 7 regression 7 regression 8 models 9 provide 10 support 10 support 11 for 11 for 13 continuity 12 intergenerational 13 continuity 13 continuity 14 when 13 continuity 24 limited 14 when 16 use 14 when 17 occurs 15 substance 16 use 16 use 17 occurs 17 occurs 18 in 18 in 19 emerging 19 emerging 21 but 20 adulthood 21 but 21 but 22 not 21 but 23 when 24 limited 25 to 25 to 26 adolescence implications , limitations , and future research directions are discussed . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 10 discussed 0 ###LEFT-WALL### 11 . 1 implications 2 , 2 , 3 limitations 2 , 5 and 4 , 5 and 5 and 8 directions 5 and 9 are 6 future 7 research 7 research 8 directions 9 are 10 discussed background : the world health organization ( who ) recommends exclusive breastfeeding , defined as receiving only breastmilk , through the first 6 months of life to optimize survival , health , and development . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 8 who 2 : 13 , 3 the 8 who 4 world 5 health 5 health 6 organization 6 organization 8 who 7 ( 8 who 8 who 9 ) 8 who 13 , 10 recommends 12 breastfeeding 10 recommends 13 , 11 exclusive 12 breastfeeding 13 , 14 defined 14 defined 15 as 14 defined 17 only 14 defined 18 breastmilk 15 as 16 receiving 18 breastmilk 20 through 19 , 20 through 20 through 33 and 20 through 35 . 21 the 22 first 21 the 23 6 23 6 24 months 24 months 25 of 24 months 30 , 25 of 26 life 26 life 27 to 26 life 28 optimize 27 to 28 optimize 28 optimize 29 survival 30 , 31 health 30 , 33 and 32 , 33 and 33 and 34 development objective : to assess exclusive and predominant breastfeeding rates , as defined by who , in a sample of guatemalan infants using three dietary assessment methods . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 defined 2 : 3 to 2 : 4 assess 3 to 4 assess 4 assess 6 and 5 exclusive 6 and 6 and 7 predominant 6 and 8 breastfeeding 6 and 12 defined 8 breastfeeding 9 rates 9 rates 11 as 10 , 11 as 11 as 12 defined 12 defined 13 by 12 defined 16 in 13 by 14 who 15 , 16 in 16 in 18 sample 16 in 27 . 17 a 18 sample 18 sample 19 of 19 of 21 infants 20 guatemalan 21 infants 21 infants 22 using 22 using 26 methods 23 three 26 methods 24 dietary 25 assessment 25 assessment 26 methods methods : mothers of 156 infants ( 78 boys and 78 girls ) in the 6th month of life , attending a public health center in quetzaltenango , an urban area located in the highlands of guatemala , were recruited . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 mothers 2 : 40 recruited 2 : 41 . 3 mothers 4 of 3 mothers 14 in 3 mothers 18 of 3 mothers 39 were 4 of 6 infants 5 156 6 infants 6 infants 10 and 7 ( 10 and 8 78 9 boys 9 boys 10 and 10 and 12 girls 10 and 13 ) 11 78 12 girls 14 in 17 month 15 the 17 month 16 6th 17 month 18 of 19 life 19 life 21 attending 20 , 21 attending 21 attending 25 center 21 attending 38 , 22 a 23 public 22 a 25 center 23 public 24 health 24 health 25 center 25 center 26 in 26 in 27 quetzaltenango 27 quetzaltenango 31 area 28 , 31 area 29 an 30 urban 29 an 31 area 30 urban 31 area 31 area 32 located 31 area 33 in 31 area 38 , 33 in 35 highlands 34 the 35 highlands 35 highlands 36 of 36 of 37 guatemala 39 were 40 recruited a single face - to - face interview was performed to assess infant dietary intake using three methods : previous day [dietary] recall ( as [suggested] by who ) , current feeding practices , and recall of feeding practices since birth . 0 ###LEFT-WALL### 3 face 0 ###LEFT-WALL### 4 - 0 ###LEFT-WALL### 12 assess 1 a 2 single 1 a 3 face 2 single 3 face 4 - 5 to 4 - 10 performed 5 to 6 - 7 face 8 interview 8 interview 9 was 9 was 10 performed 10 performed 11 to 11 to 12 assess 12 assess 15 intake 12 assess 19 : 13 infant 15 intake 14 dietary 15 intake 15 intake 16 using 15 intake 19 : 16 using 18 methods 17 three 18 methods 19 : 23 recall 20 previous 23 recall 21 day 23 recall 23 recall 25 as 23 recall 31 current 24 ( 25 as 25 as 27 by 25 as 29 ) 27 by 28 who 30 , 31 current 31 current 32 feeding 31 current 39 practices 31 current 40 since 31 current 42 . 32 feeding 35 and 32 feeding 39 practices 33 practices 35 and 34 , 35 and 35 and 36 recall 35 and 37 of 37 of 38 feeding 40 since 41 birth results : based on the previous day dietary recall method , exclusive breastfeeding was reported by 87 ( 56 % [ )(of the mothers . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 based 0 ###LEFT-WALL### 11 , 1 results 2 : 2 : 3 based 3 based 4 on 4 on 10 method 5 the 6 previous 5 the 10 method 7 day 10 method 8 dietary 9 recall 9 recall 10 method 11 , 13 breastfeeding 11 , 15 reported 12 exclusive 13 breastfeeding 13 breastfeeding 14 was 14 was 15 reported 15 reported 16 by 16 by 17 87 17 87 20 % 18 ( 20 % 19 56 20 % 20 % 22 )(of 20 % 25 . 22 )(of 24 mothers 23 the 24 mothers exclusive breastfeeding rates were much lower when estimated by current feeding practices questions ( 20 % ) and even lower when based on recall of feeding practices since birth ( 9 % ) . 0 ###LEFT-WALL### 3 rates 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 34 . 1 exclusive 3 rates 2 breastfeeding 3 rates 3 rates 18 and 4 were 6 lower 4 were 18 and 5 much 6 lower 6 lower 7 when 6 lower 9 by 7 when 8 estimated 9 by 13 questions 10 current 11 feeding 11 feeding 13 questions 12 practices 13 questions 13 questions 16 % 14 ( 16 % 15 20 16 % 16 % 17 ) 18 and 19 even 18 and 27 practices 19 even 20 lower 19 even 21 when 21 when 22 based 22 based 23 on 23 on 24 recall 24 recall 25 of 25 of 26 feeding 27 practices 28 since 28 since 29 birth 29 birth 32 % 30 ( 32 % 31 9 32 % 32 % 33 ) the sum of exclusive and predominant breastfeeding ( [full] breastfeeding ) rates was 58 % , 49 % , and 31 % based on previous day dietary recall , current feeding practices , and recall of feeding practices since birth , respectively . 0 ###LEFT-WALL### 2 sum 0 ###LEFT-WALL### 13 was 0 ###LEFT-WALL### 20 and 1 the 2 sum 2 sum 3 of 2 sum 7 breastfeeding 2 sum 12 rates 2 sum 13 was 3 of 5 and 4 exclusive 5 and 5 and 6 predominant 7 breastfeeding 10 breastfeeding 7 breastfeeding 12 rates 8 ( 10 breastfeeding 10 breastfeeding 11 ) 13 was 15 % 14 58 15 % 15 % 18 % 16 , 18 % 17 49 18 % 18 % 19 , 19 , 20 and 20 and 22 % 20 and 23 based 21 31 22 % 22 % 23 based 23 based 24 on 23 based 34 and 24 on 26 day 25 previous 26 day 27 dietary 28 recall 28 recall 29 , 29 , 32 practices 29 , 34 and 30 current 32 practices 31 feeding 32 practices 33 , 34 and 34 and 35 recall 34 and 36 of 36 of 37 feeding 37 feeding 38 practices 37 feeding 42 respectively 38 practices 39 since 39 since 40 birth 41 , 42 respectively 42 respectively 43 . conclusions : the who method of dietary assessment , based solely on the previous day dietary recall , overestimates the exclusive breastfeeding rate compared with recall of feeding practices since birth . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 1 conclusions 2 : 2 : 4 who 3 the 4 who 4 who 5 method 4 who 19 overestimates 5 method 6 of 5 method 10 based 5 method 19 overestimates 6 of 8 assessment 7 dietary 8 assessment 9 , 10 based 10 based 11 solely 10 based 18 , 11 solely 12 on 12 on 17 recall 13 the 14 previous 13 the 17 recall 15 day 17 recall 16 dietary 17 recall 19 overestimates 23 rate 19 overestimates 25 with 19 overestimates 30 since 20 the 23 rate 21 exclusive 23 rate 22 breastfeeding 23 rate 23 rate 24 compared 25 with 26 recall 26 recall 27 of 27 of 28 feeding 28 feeding 29 practices 30 since 31 birth in our population sample [,] adherence to the who guidelines for feeding in the first semester of infancy was less than ideal [and] in need of strengthening . 0 ###LEFT-WALL### 16 semester 0 ###LEFT-WALL### 19 was 0 ###LEFT-WALL### 28 . 1 in 6 adherence 1 in 16 semester 2 our 6 adherence 3 population 4 sample 4 sample 6 adherence 6 adherence 7 to 6 adherence 11 for 7 to 10 guidelines 8 the 10 guidelines 9 who 10 guidelines 11 for 12 feeding 12 feeding 13 in 14 the 16 semester 15 first 16 semester 16 semester 17 of 16 semester 19 was 17 of 18 infancy 19 was 20 less 19 was 21 than 21 than 22 ideal 21 than 24 in 24 in 25 need 25 need 26 of 26 of 27 strengthening none none purpose : with its population rapidly aging , china needs prompt action to facilitate the middle - aged and senior citizens ' utilization of health care . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 28 care 0 ###LEFT-WALL### 29 . 1 none 3 purpose 1 none 4 : 1 none 28 care 2 none 3 purpose 3 purpose 4 : 4 : 5 with 5 with 7 population 5 with 25 utilization 6 its 7 population 7 population 9 aging 7 population 11 china 8 rapidly 9 aging 10 , 11 china 11 china 12 needs 11 china 16 facilitate 11 china 19 - 12 needs 13 prompt 13 prompt 14 action 13 prompt 15 to 13 prompt 16 facilitate 15 to 16 facilitate 16 facilitate 18 middle 17 the 18 middle 20 aged 21 and 21 and 22 senior 21 and 23 citizens 23 citizens 24 ' 24 ' 25 utilization 25 utilization 26 of 26 of 27 health the new rural cooperative medical scheme ( ncms ) , a health care reform initiative started in 2003 , is currently china 's primary insurance program for the rural population . 0 ###LEFT-WALL### 6 scheme 0 ###LEFT-WALL### 20 is 0 ###LEFT-WALL### 31 . 1 the 6 scheme 2 new 3 rural 3 rural 4 cooperative 4 cooperative 5 medical 5 medical 6 scheme 6 scheme 8 ncms 6 scheme 15 initiative 6 scheme 20 is 7 ( 8 ncms 8 ncms 9 ) 10 , 15 initiative 11 a 15 initiative 12 health 15 initiative 13 care 14 reform 14 reform 15 initiative 15 initiative 16 started 15 initiative 19 , 16 started 17 in 17 in 18 2003 20 is 21 currently 20 is 26 program 22 china 23 's 23 's 26 program 24 primary 26 program 25 insurance 26 program 26 program 27 for 27 for 30 population 28 the 30 population 29 rural 30 population methods : with a 2 [-] province pilot sample ( gansu , the poorest province , and zhejiang , one of the richest ) of people over age 45 from the china health and retirement longitudinal study ( charls ) , this paper used logistic regressions to examine the association between the coverage of new rural cooperative medical scheme and the underutilization of medical care . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 43 paper 2 : 66 . 3 with 9 sample 3 with 42 this 3 with 43 paper 4 a 9 sample 5 2 7 province 7 province 9 sample 8 pilot 9 sample 9 sample 17 and 10 ( 17 and 11 gansu 15 province 11 gansu 17 and 12 , 15 province 13 the 14 poorest 13 the 15 province 15 province 16 , 17 and 18 zhejiang 17 and 30 from 17 and 41 , 18 zhejiang 20 one 18 zhejiang 25 of 19 , 20 one 20 one 21 of 20 one 24 ) 21 of 23 richest 22 the 23 richest 25 of 26 people 26 people 27 over 27 over 28 age 28 age 29 45 30 from 34 and 31 the 33 health 32 china 33 health 33 health 34 and 34 and 37 study 34 and 39 charls 35 retirement 36 longitudinal 36 longitudinal 37 study 38 ( 39 charls 39 charls 40 ) 43 paper 46 regressions 44 used 45 logistic 45 logistic 46 regressions 46 regressions 47 to 46 regressions 48 examine 46 regressions 54 of 47 to 48 examine 48 examine 50 association 48 examine 51 between 49 the 50 association 51 between 53 coverage 52 the 53 coverage 54 of 60 and 55 new 56 rural 56 rural 57 cooperative 57 cooperative 58 medical 58 medical 59 scheme 59 scheme 60 and 60 and 62 underutilization 60 and 63 of 61 the 62 underutilization 63 of 65 care 64 medical 65 care findings : among those who had a need to visit a health care provider during the previous month , people covered by ncms were more likely to underutilize outpatient care than the uninsured ( odds ratio = 5.610 , 2.035 - 15.466 ) . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 : 2 : 36 ratio 2 : 37 = 2 : 44 . 3 among 4 those 3 among 36 ratio 4 those 5 who 4 those 19 , 5 who 19 , 6 had 8 need 6 had 19 , 7 a 8 need 8 need 9 to 8 need 10 visit 9 to 10 visit 10 visit 14 provider 11 a 14 provider 12 health 13 care 13 care 14 provider 14 provider 15 during 15 during 18 month 16 the 18 month 17 previous 18 month 19 , 28 underutilize 20 people 21 covered 20 people 24 were 21 covered 22 by 22 by 23 ncms 24 were 26 likely 25 more 26 likely 26 likely 27 to 27 to 28 underutilize 28 underutilize 30 care 28 underutilize 31 than 29 outpatient 30 care 31 than 33 uninsured 32 the 33 uninsured 34 ( 35 odds 35 odds 36 ratio 36 ratio 37 = 37 = 38 5.610 37 = 41 - 39 , 41 - 40 2.035 41 - 41 - 42 15.466 41 - 43 ) as for those who had a need to be hospitalized in the past year , the association between ncms coverage and the underutilization of inpatient care was not statistically significant ( odds ratio = 1.907 , 0.335 - 10.862 ) . 0 ###LEFT-WALL### 33 ratio 0 ###LEFT-WALL### 34 = 0 ###LEFT-WALL### 41 . 1 as 8 to 1 as 27 was 1 as 33 ratio 2 for 3 those 2 for 8 to 3 those 4 who 3 those 5 had 4 who 5 had 5 had 7 need 6 a 7 need 8 to 9 be 8 to 27 was 9 be 10 hospitalized 10 hospitalized 11 in 11 in 21 and 12 the 14 year 13 past 14 year 14 year 15 , 15 , 17 association 15 , 21 and 16 the 17 association 17 association 18 between 18 between 20 coverage 19 ncms 20 coverage 21 and 23 underutilization 21 and 24 of 22 the 23 underutilization 24 of 26 care 25 inpatient 26 care 27 was 28 not 27 was 30 significant 29 statistically 30 significant 31 ( 32 odds 32 odds 33 ratio 33 ratio 34 = 34 = 35 1.907 35 1.907 38 - 36 , 38 - 37 0.335 38 - 38 - 39 10.862 38 - 40 ) low total household expenditure per capita , living in the inland province of gansu , and being an urban resident were also associated with underutilizing outpatient care . 0 ###LEFT-WALL### 1 low 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 28 . 1 low 4 expenditure 2 total 3 household 3 household 4 expenditure 4 expenditure 5 per 4 expenditure 8 living 5 per 6 capita 7 , 8 living 8 living 9 in 8 living 15 , 9 in 12 province 10 the 12 province 11 inland 12 province 12 province 13 of 13 of 14 gansu 16 and 17 being 16 and 23 associated 17 being 20 resident 17 being 21 were 18 an 19 urban 18 an 20 resident 19 urban 20 resident 21 were 22 also 21 were 23 associated 23 associated 24 with 24 with 25 underutilizing 25 underutilizing 27 care 26 outpatient 27 care conclusion : further research is needed to understand the negative association between ncms coverage and outpatient care utilization . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 4 research 2 : 6 needed 3 further 4 research 4 research 5 is 5 is 6 needed 6 needed 7 to 7 to 8 understand 8 understand 11 association 8 understand 12 between 9 the 11 association 10 negative 11 association 12 between 15 and 13 ncms 14 coverage 14 coverage 15 and 15 and 18 utilization 16 outpatient 18 utilization 17 care 18 utilization the majority of neural stem cells ( nscs ) in the adult brain are quiescent , and this fraction increases with aging . 0 ###LEFT-WALL### 2 majority 0 ###LEFT-WALL### 14 are 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 23 . 1 the 2 majority 2 majority 3 of 2 majority 10 in 2 majority 14 are 3 of 6 cells 4 neural 5 stem 5 stem 6 cells 6 cells 8 nscs 7 ( 8 nscs 8 nscs 9 ) 10 in 13 brain 11 the 13 brain 12 adult 13 brain 14 are 15 quiescent 16 , 17 and 17 and 19 fraction 17 and 20 increases 18 this 19 fraction 19 fraction 20 increases 20 increases 21 with 21 with 22 aging although signaling pathways that promote nsc quiescence have been identified , the transcriptional mechanisms involved are mostly unknown , largely due to lack of a cell culture model . 0 ###LEFT-WALL### 14 mechanisms 0 ###LEFT-WALL### 16 are 0 ###LEFT-WALL### 29 . 1 although 3 pathways 1 although 10 identified 1 although 11 , 1 although 14 mechanisms 2 signaling 3 pathways 3 pathways 4 that 3 pathways 5 promote 3 pathways 8 have 4 that 5 promote 5 promote 7 quiescence 6 nsc 7 quiescence 8 have 9 been 9 been 10 identified 10 identified 11 , 12 the 14 mechanisms 13 transcriptional 14 mechanisms 14 mechanisms 15 involved 14 mechanisms 16 are 16 are 17 mostly 16 are 19 , 18 unknown 19 , 19 , 20 largely 19 , 21 due 21 due 22 to 22 to 23 lack 23 lack 24 of 24 of 28 model 25 a 28 model 26 cell 28 model 27 culture 28 model in this study , we first demonstrate that nsc cultures ( ns cells ) exposed to bmp4 acquire cellular and transcriptional characteristics of quiescent cells . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 7 demonstrate 0 ###LEFT-WALL### 26 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 7 demonstrate 6 first 7 demonstrate 7 demonstrate 8 that 8 that 9 nsc 8 that 18 acquire 9 nsc 10 cultures 9 nsc 15 exposed 9 nsc 18 acquire 10 cultures 13 cells 10 cultures 15 exposed 11 ( 13 cells 12 ns 13 cells 13 cells 14 ) 15 exposed 16 to 16 to 17 bmp4 18 acquire 22 characteristics 19 cellular 20 and 20 and 21 transcriptional 20 and 22 characteristics 22 characteristics 23 of 23 of 25 cells 24 quiescent 25 cells we then use epigenomic profiling to identify enhancers associated with the quiescent ns cell state . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 use 0 ###LEFT-WALL### 16 . 1 we 3 use 2 then 3 use 3 use 5 profiling 3 use 6 to 3 use 7 identify 4 epigenomic 5 profiling 6 to 7 identify 7 identify 8 enhancers 8 enhancers 9 associated 9 associated 10 with 10 with 15 state 11 the 15 state 12 quiescent 15 state 13 ns 15 state 14 cell 15 state motif enrichment analysis of these enhancers predicts a major role for the nuclear factor one ( nfi ) [family] in the gene regulatory network controlling ns cell quiescence . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 7 predicts 0 ###LEFT-WALL### 29 . 1 motif 3 analysis 2 enrichment 3 analysis 3 analysis 4 of 3 analysis 7 predicts 4 of 6 enhancers 5 these 6 enhancers 7 predicts 10 role 7 predicts 20 in 8 a 9 major 8 a 10 role 9 major 10 role 10 role 11 for 10 role 17 nfi 11 for 14 factor 12 the 14 factor 13 nuclear 14 factor 14 factor 15 one 16 ( 17 nfi 17 nfi 18 ) 20 in 24 network 21 the 24 network 22 gene 24 network 23 regulatory 24 network 24 network 25 controlling 25 controlling 28 quiescence 26 ns 27 cell 27 cell 28 quiescence interestingly , we found that the family member nfix is robustly induced when ns cells enter quiescence . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 18 . 1 interestingly 2 , 1 interestingly 3 we 3 we 4 found 4 found 5 that 5 that 9 nfix 5 that 12 induced 6 the 9 nfix 7 family 9 nfix 8 member 9 nfix 9 nfix 10 is 10 is 12 induced 11 robustly 12 induced 12 induced 13 when 13 when 15 cells 13 when 16 enter 14 ns 15 cells 15 cells 16 enter 16 enter 17 quiescence using genome - wide location analysis and overexpression and silencing experiments , we demonstrate that nfix has a major role in the induction of quiescence in cultured nscs . 0 ###LEFT-WALL### 2 genome 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 29 . 1 using 2 genome 3 - 7 and 3 - 9 and 4 wide 6 analysis 5 location 6 analysis 6 analysis 7 and 7 and 8 overexpression 9 and 13 we 9 and 14 demonstrate 10 silencing 11 experiments 10 silencing 12 , 10 silencing 13 we 13 we 14 demonstrate 14 demonstrate 15 that 15 that 16 nfix 15 that 17 has 16 nfix 17 has 17 has 20 role 18 a 20 role 19 major 20 role 20 role 21 in 21 in 23 induction 22 the 23 induction 23 induction 24 of 24 of 25 quiescence 25 quiescence 26 in 26 in 28 nscs 27 cultured 28 nscs transcript profiling of ns cells overexpressing [or] silenced for nfix and the phenotypic analysis of the hippocampus of nfix mutant mice suggest that nfix controls the quiescent state by regulating the interactions of nscs with their microenvironment . 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 38 . 1 transcript 2 profiling 2 profiling 3 of 2 profiling 8 silenced 2 profiling 11 and 3 of 6 overexpressing 4 ns 5 cells 5 cells 6 overexpressing 8 silenced 9 for 9 for 10 nfix 11 and 14 analysis 12 the 14 analysis 13 phenotypic 14 analysis 14 analysis 15 of 15 of 17 hippocampus 16 the 17 hippocampus 17 hippocampus 18 of 17 hippocampus 21 mice 17 hippocampus 25 controls 18 of 19 nfix 20 mutant 21 mice 21 mice 22 suggest 22 suggest 23 that 23 that 24 nfix 23 that 25 controls 24 nfix 25 controls 25 controls 28 state 25 controls 29 by 26 the 28 state 27 quiescent 28 state 29 by 30 regulating 30 regulating 32 interactions 30 regulating 35 with 31 the 32 interactions 32 interactions 33 of 33 of 34 nscs 35 with 37 microenvironment 36 their 37 microenvironment lysosomal enzymes function optimally at low ph ; as accumulation of waste material contributes to cell aging and disease , dysregulation of lysosomal ph may represent an early step in several pathologies . 0 ###LEFT-WALL### 2 enzymes 0 ###LEFT-WALL### 3 function 0 ###LEFT-WALL### 8 ; 0 ###LEFT-WALL### 33 . 1 lysosomal 2 enzymes 2 enzymes 3 function 3 function 4 optimally 3 function 5 at 5 at 7 ph 6 low 7 ph 8 ; 13 material 8 ; 14 contributes 8 ; 20 , 9 as 10 accumulation 9 as 13 material 10 accumulation 11 of 11 of 12 waste 13 material 14 contributes 14 contributes 15 to 15 to 18 and 16 cell 17 aging 17 aging 18 and 18 and 19 disease 20 , 21 dysregulation 20 , 26 represent 21 dysregulation 22 of 21 dysregulation 25 may 22 of 24 ph 23 lysosomal 24 ph 25 may 26 represent 26 represent 29 step 26 represent 30 in 27 an 29 step 28 early 29 step 30 in 32 pathologies 31 several 32 pathologies here , we demonstrate that stimulation of the p2x7 receptor ( p2x7r ) for atp alkalinizes lysosomes in cultured human retinal pigmented epithelial ( rpe ) cells and [impairs] lysosomal function . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 demonstrate 0 ###LEFT-WALL### 32 . 1 here 2 , 1 here 3 we 3 we 4 demonstrate 4 demonstrate 5 that 5 that 6 stimulation 5 that 16 alkalinizes 6 stimulation 7 of 6 stimulation 14 for 6 stimulation 16 alkalinizes 7 of 10 receptor 8 the 10 receptor 9 p2x7 10 receptor 10 receptor 12 p2x7r 11 ( 12 p2x7r 12 p2x7r 13 ) 14 for 15 atp 16 alkalinizes 17 lysosomes 16 alkalinizes 18 in 18 in 28 and 19 cultured 20 human 20 human 27 cells 21 retinal 27 cells 22 pigmented 27 cells 23 epithelial 25 rpe 23 epithelial 27 cells 24 ( 25 rpe 25 rpe 26 ) 27 cells 28 and 28 and 31 function 30 lysosomal 31 function p2x7r stimulation did not kill rpe cells but alkalinized lysosomes by [0.3] u . receptor stimulation also elevated cytoplasmic ca ( 2+ ) ; ca ( 2+ ) [influx] was necessary but not sufficient for lysosomal alkalinization . 0 ###LEFT-WALL### 2 stimulation 0 ###LEFT-WALL### 8 but 0 ###LEFT-WALL### 14 . 1 p2x7r 2 stimulation 2 stimulation 3 did 3 did 4 not 3 did 8 but 5 kill 7 cells 5 kill 8 but 6 rpe 7 cells 8 but 9 alkalinized 9 alkalinized 10 lysosomes 10 lysosomes 11 by 11 by 13 u 14 . 16 stimulation 14 . 18 elevated 14 . 24 ; 14 . 38 . 15 receptor 16 stimulation 16 stimulation 18 elevated 17 also 18 elevated 18 elevated 20 ca 19 cytoplasmic 20 ca 20 ca 22 2+ 21 ( 22 2+ 22 2+ 23 ) 24 ; 25 ca 24 ; 30 was 25 ca 27 2+ 25 ca 30 was 26 ( 27 2+ 27 2+ 28 ) 30 was 32 but 31 necessary 32 but 32 but 33 not 32 but 34 sufficient 33 not 34 sufficient 34 sufficient 35 for 35 for 37 alkalinization 36 lysosomal 37 alkalinization p2x7r stimulation decreased access to the active site of cathepsin d . interestingly , lysosomal alkalinization was accompanied by a rise in lipid oxidation that was prevented by p2x7r antagonism . 0 ###LEFT-WALL### 2 stimulation 0 ###LEFT-WALL### 3 decreased 0 ###LEFT-WALL### 12 . 1 p2x7r 2 stimulation 2 stimulation 3 decreased 3 decreased 4 access 3 decreased 5 to 5 to 8 site 6 the 8 site 7 active 8 site 8 site 9 of 9 of 10 cathepsin 10 cathepsin 11 d 12 . 16 alkalinization 12 . 18 accompanied 12 . 31 . 13 interestingly 14 , 13 interestingly 16 alkalinization 15 lysosomal 16 alkalinization 16 alkalinization 17 was 17 was 18 accompanied 18 accompanied 19 by 18 accompanied 22 in 19 by 21 rise 20 a 21 rise 22 in 24 oxidation 23 lipid 24 oxidation 24 oxidation 25 that 24 oxidation 26 was 25 that 26 was 26 was 27 prevented 27 prevented 28 by 28 by 30 antagonism 29 p2x7r 30 antagonism likewise , the autofluorescence of phagocytosed photoreceptor outer segments increased by lysosomal alkalinization [was] restored 73 % by a p2x7r antagonist . 0 ###LEFT-WALL### 4 autofluorescence 0 ###LEFT-WALL### 15 restored 0 ###LEFT-WALL### 22 . 1 likewise 2 , 1 likewise 4 autofluorescence 3 the 4 autofluorescence 4 autofluorescence 5 of 4 autofluorescence 15 restored 5 of 9 segments 6 phagocytosed 7 photoreceptor 7 photoreceptor 9 segments 8 outer 9 segments 9 segments 10 increased 10 increased 11 by 11 by 13 alkalinization 12 lysosomal 13 alkalinization 15 restored 17 % 15 restored 18 by 16 73 17 % 18 by 21 antagonist 19 a 21 antagonist 20 p2x7r 21 antagonist together , this suggests that endogenous autostimulation of the p2x7r may oxidize lipids and impede clearance . 0 ###LEFT-WALL### 3 this 0 ###LEFT-WALL### 4 suggests 0 ###LEFT-WALL### 17 . 1 together 2 , 1 together 3 this 3 this 4 suggests 4 suggests 5 that 5 that 7 autostimulation 5 that 14 and 6 endogenous 7 autostimulation 7 autostimulation 8 of 8 of 10 p2x7r 9 the 10 p2x7r 11 may 12 oxidize 11 may 14 and 12 oxidize 13 lipids 14 and 15 impede 15 impede 16 clearance the p2x7r was expressed on apical and basolateral membranes of mouse rpe ; mrna expression of p2x7r and extracellular atp marker ntpdase1 was raised in rpe tissue from the abca4 [(] [-] / [-] [ )(mouse model of stargardt 's retinal degeneration . 0 ###LEFT-WALL### 2 p2x7r 0 ###LEFT-WALL### 4 expressed 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 40 's 0 ###LEFT-WALL### 43 . 1 the 2 p2x7r 2 p2x7r 3 was 3 was 4 expressed 4 expressed 5 on 5 on 9 membranes 6 apical 7 and 7 and 8 basolateral 7 and 9 membranes 9 membranes 10 of 10 of 12 rpe 11 mouse 12 rpe 13 ; 14 mrna 13 ; 18 and 14 mrna 15 expression 15 expression 16 of 16 of 17 p2x7r 18 and 22 ntpdase1 18 and 40 's 19 extracellular 21 marker 20 atp 21 marker 21 marker 22 ntpdase1 22 ntpdase1 23 was 23 was 24 raised 24 raised 25 in 25 in 26 rpe 27 tissue 28 from 27 tissue 33 / 27 tissue 38 of 27 tissue 40 's 28 from 30 abca4 29 the 30 abca4 33 / 37 model 36 )(mouse 37 model 38 of 39 stargardt 40 's 42 degeneration 41 retinal 42 degeneration in summary , p2x7r stimulation raises lysosomal ph and [impedes] lysosomal function , suggesting a possible role for overstimulation in diseases of accumulation . 0 ###LEFT-WALL### 5 stimulation 0 ###LEFT-WALL### 6 raises 1 in 4 p2x7r 1 in 5 stimulation 2 summary 3 , 2 summary 4 p2x7r 5 stimulation 6 raises 6 raises 9 and 7 lysosomal 8 ph 8 ph 9 and 9 and 12 function 9 and 14 suggesting 11 lysosomal 12 function 13 , 14 suggesting 14 suggesting 17 role 14 suggesting 20 in 14 suggesting 24 . 15 a 16 possible 15 a 17 role 16 possible 17 role 17 role 18 for 18 for 19 overstimulation 20 in 21 diseases 21 diseases 22 of 22 of 23 accumulation neural stem cells ( nscs ) in the [ventricular] domain of the subventricular zone ( v - svz ) of rodents produce neurons throughout life while those in humans become largely inactive or may be lost during infancy . 0 ###LEFT-WALL### 1 neural 0 ###LEFT-WALL### 23 neurons 0 ###LEFT-WALL### 39 . 1 neural 2 stem 1 neural 7 in 2 stem 3 cells 3 cells 5 nscs 4 ( 5 nscs 5 nscs 6 ) 7 in 10 domain 8 the 10 domain 10 domain 11 of 11 of 14 zone 12 the 14 zone 13 subventricular 14 zone 14 zone 16 v 14 zone 18 svz 14 zone 20 of 15 ( 16 v 16 v 17 - 17 - 18 svz 18 svz 19 ) 20 of 21 rodents 21 rodents 22 produce 21 rodents 23 neurons 22 produce 23 neurons 23 neurons 24 throughout 23 neurons 26 while 23 neurons 37 during 24 throughout 25 life 26 while 27 those 26 while 33 or 27 those 28 in 27 those 33 or 28 in 29 humans 30 become 32 inactive 30 become 33 or 31 largely 32 inactive 33 or 34 may 34 may 35 be 35 be 36 lost 37 during 38 infancy most adult nscs [are] quiescent , express glial markers , [and] depend on notch signaling for their self - renewal and the generation of neurons . 0 ###LEFT-WALL### 9 markers 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 26 . 1 most 9 markers 2 adult 9 markers 3 nscs 9 markers 5 quiescent 6 , 5 quiescent 7 express 7 express 9 markers 8 glial 9 markers 10 , 12 depend 10 , 19 - 12 depend 13 on 13 on 14 notch 14 notch 15 signaling 15 signaling 16 for 16 for 18 self 17 their 18 self 19 - 21 and 20 renewal 21 and 21 and 23 generation 21 and 24 of 22 the 23 generation 24 of 25 neurons using genetic markers and lineage tracing , we identified subpopulations of adult v - svz nscs ( type 1 , 2 [,] and 3 ) indicating a striking heterogeneity including activated , brain lipid binding protein ( blbp , fabp7 ) expressing stem cells . 0 ###LEFT-WALL### 8 we 0 ###LEFT-WALL### 32 , 1 using 4 and 1 using 7 , 1 using 8 we 2 genetic 3 markers 3 markers 4 and 4 and 5 lineage 4 and 6 tracing 8 we 32 , 9 identified 10 subpopulations 9 identified 32 , 10 subpopulations 11 of 10 subpopulations 26 indicating 11 of 12 adult 12 adult 13 v 12 adult 16 nscs 12 adult 23 and 14 - 16 nscs 15 svz 16 nscs 16 nscs 18 type 16 nscs 20 , 17 ( 18 type 18 type 19 1 18 type 20 , 20 , 23 and 21 2 23 and 23 and 24 3 23 and 25 ) 26 indicating 29 heterogeneity 27 a 29 heterogeneity 28 striking 29 heterogeneity 29 heterogeneity 30 including 29 heterogeneity 31 activated 30 including 31 activated 32 , 33 brain 33 brain 36 protein 34 lipid 35 binding 35 binding 36 protein 36 protein 44 cells 37 ( 44 cells 38 blbp 40 fabp7 38 blbp 42 expressing 39 , 40 fabp7 40 fabp7 41 ) 42 expressing 43 stem 43 stem 44 cells 44 cells 45 . blbp [(] [+] ) nscs are mitotically active components of pinwheel structures in the lateral ventricle walls and persistently generate neurons in adulthood . 0 ###LEFT-WALL### 5 nscs 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 24 . 1 blbp 4 ) 1 blbp 5 nscs 5 nscs 6 are 6 are 9 components 7 mitotically 8 active 8 active 9 components 9 components 10 of 10 of 11 pinwheel 11 pinwheel 12 structures 11 pinwheel 18 and 12 structures 13 in 12 structures 18 and 13 in 16 ventricle 14 the 16 ventricle 15 lateral 16 ventricle 17 walls 18 and 18 and 20 generate 19 persistently 20 generate 20 generate 21 neurons 20 generate 22 in 22 in 23 adulthood blbp ( [+] [ )(nscs express epidermal growth factor [(] egf ) receptor , proliferate in response to egf , and [are] a major clonogenic population in the svz . 0 ###LEFT-WALL### 13 receptor 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 30 . 1 blbp 11 egf 1 blbp 13 receptor 2 ( 11 egf 5 )(nscs 6 express 6 express 11 egf 7 epidermal 8 growth 8 growth 11 egf 9 factor 11 egf 11 egf 12 ) 14 , 15 proliferate 15 proliferate 18 to 16 in 17 response 17 response 18 to 18 to 21 and 19 egf 21 and 20 , 21 and 21 and 26 population 21 and 27 in 23 a 24 major 23 a 26 population 24 major 26 population 25 clonogenic 26 population 27 in 29 svz 28 the 29 svz we also find blbp expressed by proliferative [ventricular] and subventricular progenitors in the fetal and postnatal human brain . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 find 0 ###LEFT-WALL### 19 . 1 we 3 find 2 also 3 find 3 find 4 blbp 4 blbp 5 expressed 5 expressed 6 by 6 by 11 progenitors 7 proliferative 9 and 9 and 10 subventricular 9 and 11 progenitors 11 progenitors 12 in 12 in 18 brain 13 the 18 brain 14 fetal 15 and 15 and 16 postnatal 15 and 18 brain 17 human 18 brain loss of blbp [(] [+] [ )(stem/progenitor cells correlates with reduced neurogenesis in aging rodents and postnatal humans . 0 ###LEFT-WALL### 1 loss 0 ###LEFT-WALL### 9 correlates 0 ###LEFT-WALL### 19 . 1 loss 2 of 1 loss 9 correlates 2 of 8 cells 3 blbp 8 cells 7 )(stem/progenitor 8 cells 9 correlates 10 with 10 with 16 and 11 reduced 12 neurogenesis 12 neurogenesis 13 in 12 neurogenesis 16 and 13 in 14 aging 14 aging 15 rodents 16 and 18 humans 17 postnatal 18 humans these findings of molecular heterogeneity and proliferative differences subdivide the nsc population and have implications for neurogenesis in the forebrain of mammals during aging . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 25 . 1 these 2 findings 2 findings 3 of 2 findings 13 and 3 of 6 and 4 molecular 5 heterogeneity 5 heterogeneity 6 and 6 and 8 differences 7 proliferative 8 differences 9 subdivide 12 population 9 subdivide 13 and 10 the 12 population 11 nsc 12 population 13 and 14 have 14 have 15 implications 14 have 16 for 14 have 18 in 14 have 23 during 16 for 17 neurogenesis 18 in 20 forebrain 19 the 20 forebrain 20 forebrain 21 of 21 of 22 mammals 23 during 24 aging osteoporosis is [predominantly] a condition of the elderly with a consequent increase in bone fragility and susceptibility to fracture . 0 ###LEFT-WALL### 1 osteoporosis 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 20 . 1 osteoporosis 2 is 2 is 5 condition 2 is 9 with 2 is 13 in 2 is 18 to 4 a 5 condition 5 condition 6 of 6 of 8 elderly 7 the 8 elderly 9 with 12 increase 10 a 11 consequent 10 a 12 increase 11 consequent 12 increase 13 in 16 and 14 bone 15 fragility 15 fragility 16 and 16 and 17 susceptibility 18 to 19 fracture a number of clinical as well as biological studies have been pivotal in providing us with an understanding of the pathophysiology of this condition . 0 ###LEFT-WALL### 9 studies 0 ###LEFT-WALL### 11 been 0 ###LEFT-WALL### 25 . 1 a 2 number 2 number 3 of 2 number 9 studies 3 of 9 studies 4 clinical 9 studies 5 as 6 well 6 well 8 biological 7 as 8 biological 8 biological 9 studies 9 studies 10 have 10 have 11 been 11 been 12 pivotal 12 pivotal 13 in 13 in 14 providing 14 providing 15 us 14 providing 16 with 16 with 18 understanding 17 an 18 understanding 18 understanding 19 of 19 of 21 pathophysiology 20 the 21 pathophysiology 21 pathophysiology 22 of 22 of 24 condition 23 this 24 condition this article discusses the current concepts of age - related osteoporosis . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 discusses 0 ###LEFT-WALL### 10 related 1 this 2 article 2 article 3 discusses 3 discusses 6 concepts 4 the 6 concepts 5 current 6 concepts 6 concepts 7 of 7 of 8 age 9 - 10 related 10 related 11 osteoporosis 10 related 12 . we have investigated whether dietary fat modifies the postprandial oxidative stress in adipose tissue of elderly people . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 investigated 0 ###LEFT-WALL### 18 . 1 we 2 have 2 have 3 investigated 3 investigated 4 whether 4 whether 6 fat 4 whether 7 modifies 5 dietary 6 fat 6 fat 7 modifies 7 modifies 11 stress 7 modifies 12 in 8 the 11 stress 9 postprandial 11 stress 10 oxidative 11 stress 12 in 14 tissue 13 adipose 14 tissue 14 tissue 15 of 15 of 17 people 16 elderly 17 people twenty participants received three diets for 4 weeks each : sfa - rich diet , mediterranean ( med ) diet [enriched] in mufa with virgin olive oil , and a low - fat , high - carbohydrate diet enriched in n - 3 pufa ( α - linolenic acid from plant origin ) ( cho - pufa diet ) . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 3 received 0 ###LEFT-WALL### 10 : 1 twenty 2 participants 2 participants 3 received 3 received 5 diets 3 received 9 each 4 three 5 diets 5 diets 6 for 6 for 8 weeks 7 4 8 weeks 10 : 11 sfa 10 : 20 diet 11 sfa 14 diet 11 sfa 16 mediterranean 11 sfa 20 diet 12 - 14 diet 13 rich 14 diet 14 diet 15 , 15 , 16 mediterranean 16 mediterranean 18 med 16 mediterranean 19 ) 17 ( 18 med 18 med 19 ) 20 diet 22 in 22 in 29 and 23 mufa 24 with 23 mufa 29 and 24 with 27 oil 25 virgin 27 oil 26 olive 27 oil 28 , 29 and 29 and 37 carbohydrate 29 and 38 diet 29 and 39 enriched 30 a 37 carbohydrate 31 low 32 - 31 low 37 carbohydrate 33 fat 34 , 33 fat 37 carbohydrate 35 high 36 - 35 high 37 carbohydrate 38 diet 39 enriched 39 enriched 40 in 40 in 44 pufa 41 n 42 - 42 - 43 3 42 - 44 pufa 44 pufa 49 acid 44 pufa 55 cho 45 ( 49 acid 46 α 47 - 46 α 49 acid 48 linolenic 49 acid 49 acid 50 from 49 acid 53 ) 50 from 52 origin 51 plant 52 origin 54 ( 55 cho 55 cho 58 diet 55 cho 60 . 56 - 58 diet 57 pufa 58 diet 58 diet 59 ) after 12 h of fasting , volunteers received a breakfast reflecting the fatty acid composition of the diet ingested in the preceding dietary period . 0 ###LEFT-WALL### 7 volunteers 0 ###LEFT-WALL### 8 received 0 ###LEFT-WALL### 25 . 1 after 3 h 1 after 6 , 1 after 7 volunteers 2 12 3 h 3 h 4 of 4 of 5 fasting 7 volunteers 8 received 8 received 10 breakfast 9 a 10 breakfast 10 breakfast 11 reflecting 10 breakfast 16 of 11 reflecting 15 composition 12 the 15 composition 13 fatty 15 composition 14 acid 15 composition 16 of 18 diet 17 the 18 diet 18 diet 19 ingested 19 ingested 20 in 20 in 24 period 21 the 24 period 22 preceding 24 period 23 dietary 24 period med diet induced higher postprandial sod2 and trxr mrna levels , and cho - pufa diet induced higher gpx1 and trxr mrna levels compared with sfa - rich diet . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 29 diet 0 ###LEFT-WALL### 30 . 1 med 3 induced 2 diet 3 induced 3 induced 6 sod2 4 higher 6 sod2 5 postprandial 6 sod2 6 sod2 7 and 7 and 10 levels 7 and 12 and 8 trxr 9 mrna 9 mrna 10 levels 11 , 12 and 12 and 21 trxr 12 and 22 mrna 12 and 23 levels 12 and 24 compared 12 and 29 diet 13 cho 15 pufa 14 - 15 pufa 15 pufa 17 induced 16 diet 17 induced 17 induced 21 trxr 18 higher 21 trxr 19 gpx1 20 and 20 and 21 trxr 22 mrna 23 levels 24 compared 25 with 24 compared 27 - 24 compared 28 rich 25 with 26 sfa med and cho - pufa breakfasts induced a postprandial increase in plasma reduced glutathione ( gsh ) , and a greater postprandial gsh/oxidized glutathione ratio compared to the sfa - rich diet . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 32 diet 0 ###LEFT-WALL### 33 . 1 med 2 and 2 and 3 cho 2 and 19 and 3 cho 5 pufa 4 - 5 pufa 5 pufa 6 breakfasts 5 pufa 14 glutathione 5 pufa 16 gsh 5 pufa 18 , 6 breakfasts 7 induced 6 breakfasts 10 increase 6 breakfasts 13 reduced 6 breakfasts 14 glutathione 8 a 10 increase 9 postprandial 10 increase 10 increase 11 in 10 increase 13 reduced 11 in 12 plasma 15 ( 16 gsh 16 gsh 17 ) 19 and 25 ratio 19 and 26 compared 19 and 32 diet 20 a 25 ratio 21 greater 25 ratio 22 postprandial 25 ratio 23 gsh/oxidized 24 glutathione 24 glutathione 25 ratio 26 compared 27 to 26 compared 30 - 26 compared 31 rich 27 to 29 sfa 28 the 29 sfa our study suggests that the consumption of med and cho - pufa diets may reduce postprandial oxidative stress compared to an sfa - rich diet , which may be due to higher antioxidant enzymes gene expression in adipose tissue . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 26 , 0 ###LEFT-WALL### 40 . 1 our 2 study 2 study 3 suggests 3 suggests 4 that 4 that 9 and 4 that 25 diet 5 the 6 consumption 6 consumption 7 of 6 consumption 9 and 7 of 8 med 9 and 12 pufa 9 and 13 diets 9 and 15 reduce 9 and 25 diet 10 cho 12 pufa 11 - 12 pufa 13 diets 14 may 14 may 15 reduce 15 reduce 18 stress 16 postprandial 18 stress 17 oxidative 18 stress 18 stress 19 compared 19 compared 20 to 19 compared 23 - 19 compared 24 rich 20 to 22 sfa 21 an 22 sfa 26 , 27 which 26 , 29 be 27 which 28 may 28 may 29 be 29 be 31 to 29 be 37 in 30 due 31 to 31 to 36 expression 32 higher 33 antioxidant 33 antioxidant 36 expression 34 enzymes 36 expression 35 gene 36 expression 37 in 39 tissue 38 adipose 39 tissue objective : our primary objective was to determine the long - term effects of physical activity ( pa ) and weight loss ( wl ) on body composition in overweight/obese older adults . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 33 . 2 : 5 objective 2 : 6 was 3 our 5 objective 4 primary 5 objective 5 objective 6 was 6 was 7 to 7 to 20 and 8 determine 13 effects 8 determine 20 and 9 the 13 effects 10 long 11 - 10 long 12 term 12 term 13 effects 13 effects 14 of 14 of 16 activity 15 physical 16 activity 16 activity 18 pa 17 ( 18 pa 18 pa 19 ) 20 and 21 weight 20 and 32 adults 21 weight 22 loss 21 weight 26 on 21 weight 29 in 22 loss 24 wl 23 ( 24 wl 24 wl 25 ) 26 on 28 composition 27 body 28 composition 29 in 30 overweight/obese 31 older 32 adults secondarily , the association between change in body mass [and] composition on change in several cardiometabolic risk factors and mobility was evaluated . 0 ###LEFT-WALL### 4 association 0 ###LEFT-WALL### 22 evaluated 0 ###LEFT-WALL### 23 . 1 secondarily 2 , 1 secondarily 4 association 3 the 4 association 4 association 5 between 4 association 7 in 4 association 21 was 5 between 6 change 7 in 11 composition 8 body 11 composition 9 mass 11 composition 11 composition 12 on 11 composition 14 in 12 on 13 change 14 in 19 and 15 several 18 factors 16 cardiometabolic 18 factors 17 risk 18 factors 18 factors 19 and 19 and 20 mobility 21 was 22 evaluated treatment groups included pa [+] wl ( n = 98 ) , pa - only [(] n = 97 ) , and a successful [aging] ( sa ) health education control ( n = 93 ) . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 3 included 0 ###LEFT-WALL### 37 . 1 treatment 2 groups 2 groups 3 included 3 included 6 wl 4 pa 6 wl 6 wl 9 = 6 wl 22 and 7 ( 9 = 8 n 9 = 9 = 10 98 9 = 11 ) 12 , 22 and 13 pa 18 = 13 pa 22 and 14 - 15 only 14 - 18 = 17 n 18 = 18 = 19 97 18 = 20 ) 21 , 22 and 22 and 31 control 22 and 34 = 22 and 36 ) 23 a 24 successful 23 a 31 control 24 successful 27 sa 24 successful 28 ) 24 successful 29 health 26 ( 27 sa 27 sa 28 ) 29 health 31 control 30 education 31 control 32 ( 34 = 33 n 34 = 34 = 35 93 34 = 36 ) dxa - acquired body composition measures ( total body fat and lean mass ) , conventional biomarkers of cardiometabolic risk , and 400 - m walk time were obtained at baseline and 18 months . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 29 obtained 0 ###LEFT-WALL### 35 . 1 dxa 6 measures 1 dxa 22 and 2 - 6 measures 3 acquired 4 body 4 body 5 composition 5 composition 6 measures 6 measures 11 and 6 measures 17 biomarkers 6 measures 21 , 7 ( 11 and 8 total 10 fat 9 body 10 fat 10 fat 11 and 11 and 13 mass 11 and 14 ) 12 lean 13 mass 15 , 17 biomarkers 16 conventional 17 biomarkers 17 biomarkers 18 of 17 biomarkers 21 , 18 of 20 risk 19 cardiometabolic 20 risk 22 and 27 time 22 and 28 were 23 400 24 - 24 - 25 m 24 - 27 time 26 walk 27 time 28 were 29 obtained 29 obtained 30 at 30 at 32 and 31 baseline 32 and 32 and 34 months 33 18 34 months results [:] fat [mass] was significantly reduced from [(] x ± se [ )(36.5 ± 8.9 kg to 31.7 ± [9.0] kg in the pa [+] wl group ( p < 0.01 ) , but remained unchanged from baseline in [the] pa - only [(] - 0.8 ± [3.8] kg ) and sa ( - 0.0 ± [3.9] kg ) group . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 7 reduced 1 results 3 fat 1 results 5 was 1 results 7 reduced 3 fat 5 was 5 was 6 significantly 7 reduced 8 from 7 reduced 18 to 8 from 15 ± 10 x 15 ± 11 ± 15 ± 12 se 14 )(36.5 12 se 15 ± 16 8.9 17 kg 17 kg 18 to 18 to 22 kg 18 to 23 in 19 31.7 22 kg 20 ± 22 kg 23 in 25 pa 24 the 25 pa 25 pa 27 wl 25 pa 36 remained 25 pa 37 unchanged 27 wl 35 but 28 group 31 < 28 group 35 but 29 ( 31 < 30 p 31 < 31 < 32 0.01 31 < 33 ) 34 , 35 but 35 but 36 remained 37 unchanged 38 from 37 unchanged 40 in 38 from 39 baseline 40 in 52 and 42 pa 50 kg 42 pa 52 and 43 - 44 only 43 - 50 kg 46 - 47 0.8 47 0.8 50 kg 48 ± 50 kg 50 kg 51 ) 52 and 61 group 52 and 62 . 53 sa 59 kg 53 sa 61 group 54 ( 59 kg 55 - 56 0.0 56 0.0 59 kg 57 ± 59 kg 59 kg 60 ) fat mass loss was primarily responsible for wl - associated improvements in cardiometabolic risk factors , while [reduction] in body weight , regardless [of] compartment , was significantly associated with improved mobility . 0 ###LEFT-WALL### 3 loss 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 9 - 1 fat 2 mass 2 mass 3 loss 3 loss 4 was 4 was 5 primarily 4 was 6 responsible 6 responsible 7 for 7 for 8 wl 9 - 26 , 9 - 33 . 10 associated 11 improvements 10 associated 12 in 10 associated 26 , 12 in 14 risk 13 cardiometabolic 14 risk 14 risk 15 factors 14 risk 25 compartment 15 factors 25 compartment 16 , 17 while 17 while 19 in 17 while 22 , 17 while 25 compartment 19 in 21 weight 20 body 21 weight 23 regardless 25 compartment 26 , 27 was 27 was 29 associated 28 significantly 29 associated 29 associated 30 with 30 with 32 mobility 31 improved 32 mobility conclusion : this 18 [-] month pa [+] wl program resulted in a significant reduction in percent body fat with a concomitant increase in percent body lean [mass] . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 10 program 2 : 11 resulted 3 this 10 program 4 18 6 month 6 month 10 program 7 pa 9 wl 9 wl 10 program 10 program 11 resulted 11 resulted 12 in 11 resulted 16 in 11 resulted 20 with 11 resulted 24 in 12 in 15 reduction 13 a 15 reduction 14 significant 15 reduction 16 in 19 fat 17 percent 18 body 18 body 19 fat 20 with 23 increase 21 a 22 concomitant 21 a 23 increase 22 concomitant 23 increase 24 in 27 lean 25 percent 26 body 26 body 27 lean shifts in body weight and composition were associated with favorable changes in clinical parameters of cardiometabolic risk and mobility . 0 ###LEFT-WALL### 1 shifts 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 20 . 1 shifts 2 in 1 shifts 7 were 2 in 5 and 3 body 4 weight 4 weight 5 and 5 and 6 composition 7 were 8 associated 8 associated 9 with 8 associated 12 in 9 with 11 changes 10 favorable 11 changes 12 in 14 parameters 13 clinical 14 parameters 14 parameters 15 of 15 of 18 and 16 cardiometabolic 17 risk 17 risk 18 and 18 and 19 mobility moderate pa without wl had no effect on body composition . 0 ###LEFT-WALL### 2 pa 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 11 . 1 moderate 2 pa 2 pa 3 without 2 pa 5 had 3 without 4 wl 5 had 7 effect 5 had 8 on 6 no 7 effect 8 on 10 composition 9 body 10 composition purpose : in parkinson 's disease ( pd ) patients , rem sleep behavior disorder ( rbd ) might precede pd or develop [with] [or] after the onset of pd . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 10 patients 2 : 22 or 2 : 31 . 3 in 6 disease 3 in 10 patients 4 parkinson 5 's 5 's 6 disease 7 ( 8 pd 8 pd 9 ) 8 pd 10 patients 10 patients 15 disorder 10 patients 19 might 11 , 15 disorder 12 rem 14 behavior 13 sleep 14 behavior 14 behavior 15 disorder 15 disorder 17 rbd 15 disorder 18 ) 16 ( 17 rbd 17 rbd 18 ) 19 might 22 or 20 precede 21 pd 20 precede 22 or 22 or 23 develop 23 develop 26 after 26 after 28 onset 27 the 28 onset 28 onset 29 of 29 of 30 pd no previous study has explored differences between these two groups . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 5 explored 0 ###LEFT-WALL### 11 . 1 no 3 study 2 previous 3 study 3 study 4 has 4 has 5 explored 5 explored 6 differences 5 explored 7 between 7 between 10 groups 8 these 9 two 9 two 10 groups method : twenty - seven consecutive pd patients ( mean age 67.9 years ) were enrolled . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 8 patients 2 : 16 enrolled 2 : 17 . 3 twenty 4 - 4 - 5 seven 4 - 8 patients 6 consecutive 8 patients 7 pd 8 patients 8 patients 13 years 8 patients 15 were 9 ( 13 years 10 mean 11 age 11 age 13 years 12 67.9 13 years 13 years 14 ) 15 were 16 enrolled detailed clinical , laboratory , and polysomnographic studies were obtained in all participants . 0 ###LEFT-WALL### 4 laboratory 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 14 . 1 detailed 4 laboratory 2 clinical 3 , 2 clinical 4 laboratory 5 , 6 and 6 and 8 studies 6 and 10 obtained 7 polysomnographic 8 studies 8 studies 9 were 9 were 10 obtained 10 obtained 11 in 11 in 13 participants 12 all 13 participants results : sixteen of the 27 patients were affected by rbd . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 sixteen 2 : 9 affected 2 : 12 . 3 sixteen 4 of 3 sixteen 8 were 4 of 7 patients 5 the 6 27 6 27 7 patients 8 were 9 affected 9 affected 10 by 10 by 11 rbd these had a significantly higher stage of pd and took significantly higher doses of dopaminergic therapy ; their disease duration tended to be longer , and their cognitive status tended to be lower . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 17 ; 0 ###LEFT-WALL### 34 . 1 these 9 and 2 had 6 stage 2 had 9 and 3 a 6 stage 4 significantly 5 higher 5 higher 6 stage 6 stage 7 of 7 of 8 pd 9 and 10 took 10 took 13 doses 11 significantly 12 higher 12 higher 13 doses 13 doses 14 of 14 of 16 therapy 15 dopaminergic 16 therapy 17 ; 19 disease 17 ; 23 be 17 ; 26 and 18 their 19 disease 19 disease 20 duration 19 disease 22 to 19 disease 23 be 20 duration 21 tended 21 tended 22 to 23 be 24 longer 25 , 26 and 26 and 29 status 26 and 32 be 27 their 29 status 28 cognitive 29 status 29 status 31 to 29 status 32 be 30 tended 31 to 32 be 33 lower pd patients in whom rbd preceded pd ( n = 6 ) did not differ from pd patients without rbd in disease parameters [,] while pd patients in [whom] rbd developed [with] [or] after pd ( n = 10 ) showed a significantly higher disease stage , [took] significantly higher dopaminergic therapy , and [had] a longer disease duration . 1 pd 2 patients 2 patients 3 in 2 patients 10 = 2 patients 13 did 3 in 4 whom 3 in 5 rbd 3 in 6 preceded 5 rbd 6 preceded 6 preceded 7 pd 8 ( 10 = 9 n 10 = 10 = 11 6 10 = 12 ) 13 did 14 not 13 did 15 differ 15 differ 16 from 15 differ 25 while 16 from 18 patients 17 pd 18 patients 18 patients 19 without 18 patients 21 in 19 without 20 rbd 21 in 23 parameters 22 disease 23 parameters 25 while 27 patients 25 while 31 developed 26 pd 27 patients 27 patients 28 in 27 patients 31 developed 28 in 30 rbd 31 developed 34 after 34 after 35 pd 34 after 41 showed 35 pd 38 = 35 pd 41 showed 36 ( 38 = 37 n 38 = 38 = 39 10 38 = 40 ) 41 showed 45 disease 41 showed 46 stage 42 a 45 disease 43 significantly 44 higher 44 higher 45 disease 46 stage 54 and 47 , 49 significantly 47 , 54 and 50 higher 52 therapy 51 dopaminergic 52 therapy 52 therapy 54 and 53 , 54 and 54 and 59 duration 54 and 60 . 56 a 59 duration 57 longer 59 duration 58 disease 59 duration background : few studies of older adults have compared environmental [correlates] of walking and physical activity in women who may be more influenced by the environment . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 studies 2 : 9 compared 2 : 27 . 3 few 4 studies 4 studies 5 of 4 studies 8 have 5 of 7 adults 6 older 7 adults 8 have 9 compared 9 compared 14 and 10 environmental 12 of 10 environmental 14 and 12 of 13 walking 14 and 16 activity 14 and 17 in 14 and 19 who 14 and 20 may 15 physical 16 activity 17 in 18 women 19 who 20 may 20 may 21 be 21 be 22 more 21 be 23 influenced 23 influenced 24 by 24 by 26 environment 25 the 26 environment environmental measures at different spatial levels have seldom been compared . 0 ###LEFT-WALL### 2 measures 0 ###LEFT-WALL### 10 compared 0 ###LEFT-WALL### 11 . 1 environmental 2 measures 2 measures 3 at 2 measures 7 have 3 at 6 levels 4 different 6 levels 5 spatial 6 levels 7 have 9 been 8 seldom 9 been 9 been 10 compared findings from previous studies are generally inconsistent . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 8 . 1 findings 2 from 1 findings 5 are 2 from 4 studies 3 previous 4 studies 5 are 6 generally 5 are 7 inconsistent methods : this study investigated the relationship between the built environment and physical activity in older women from the women 's health initiative cohort in san diego county ( n = 5401 ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 4 study 2 : 5 investigated 3 this 4 study 4 study 5 investigated 5 investigated 7 relationship 5 investigated 8 between 5 investigated 15 in 5 investigated 25 in 6 the 7 relationship 8 between 12 and 9 the 11 environment 10 built 11 environment 11 environment 12 and 12 and 14 activity 13 physical 14 activity 15 in 17 women 16 older 17 women 17 women 18 from 18 from 24 cohort 19 the 20 women 20 women 21 's 21 's 24 cohort 22 health 23 initiative 23 initiative 24 cohort 25 in 28 county 26 san 27 diego 27 diego 28 county 28 county 31 = 29 ( 31 = 30 n 31 = 31 = 32 5401 31 = 33 ) built environment measures were created for 3 buffers around participants ' residential address . 0 ###LEFT-WALL### 3 measures 0 ###LEFT-WALL### 5 created 0 ###LEFT-WALL### 14 . 1 built 2 environment 2 environment 3 measures 3 measures 4 were 4 were 5 created 5 created 6 for 5 created 9 around 6 for 8 buffers 7 3 8 buffers 9 around 13 address 10 participants 11 ' 11 ' 13 address 12 residential 13 address linear regression analyses investigated the relationship between the built environment features and self - reported physical activity and walking . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 20 . 1 linear 2 regression 2 regression 3 analyses 3 analyses 4 investigated 4 investigated 6 relationship 4 investigated 7 between 5 the 6 relationship 7 between 12 and 8 the 11 features 9 built 10 environment 10 environment 11 features 11 features 12 and 12 and 13 self 12 and 14 - 12 and 18 and 15 reported 17 activity 15 reported 18 and 16 physical 17 activity 18 and 19 walking results : total walking was significantly positively associated with the walkability index ( [β] = [.] 050 [:] [half] - mile buffer [ )( recreation facility density ( β [=] [.] [036] [:] 1 - mile buffer [ )(, and distance to the coast [(] β = - [.] 064 [;] [p] - values [<] [.] 05 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 total 2 : 8 associated 3 total 4 walking 3 total 5 was 5 was 8 associated 6 significantly 8 associated 7 positively 8 associated 8 associated 9 with 9 with 12 index 10 the 12 index 11 walkability 12 index 12 index 20 - 13 ( 20 - 15 = 17 050 17 050 20 - 20 - 27 density 21 mile 22 buffer 22 buffer 26 facility 25 recreation 26 facility 26 facility 27 density 27 density 35 - 28 ( 35 - 29 β 34 1 29 β 35 - 35 - 40 and 36 mile 37 buffer 37 buffer 40 and 39 )(, 40 and 40 and 41 distance 40 and 42 to 40 and 50 064 42 to 44 coast 43 the 44 coast 44 coast 46 β 44 coast 47 = 46 β 47 = 48 - 50 064 50 064 54 values 50 064 59 . 53 - 54 values 54 values 57 05 54 values 58 ) total physical activity was significantly negatively associated [with] [distance] to the coast and positively with recreation facility density [(] β = . 036 : 1 - mile buffer ; p < . 05 [ )( 0 ###LEFT-WALL### 3 activity 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 22 . 1 total 3 activity 2 physical 3 activity 3 activity 4 was 4 was 5 significantly 4 was 7 associated 6 negatively 7 associated 7 associated 10 to 10 to 12 coast 11 the 12 coast 13 and 20 β 13 and 21 = 14 positively 20 β 15 with 18 density 15 with 20 β 16 recreation 18 density 17 facility 18 density 20 β 21 = 22 . 23 036 22 . 24 : 24 : 25 1 24 : 26 - 24 : 29 ; 24 : 32 . 25 1 26 - 26 - 28 buffer 27 mile 28 buffer 29 ; 30 p 29 ; 31 < 30 p 31 < 32 . 33 05 32 . 35 )( conclusions : although effect sizes were small , we did find important relationships between walkability [and] walking in older adults , which supports recommendations for community design features to include age friendly elements . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 34 . 1 conclusions 2 : 2 : 3 although 2 : 7 small 3 although 5 sizes 3 although 6 were 4 effect 5 sizes 5 sizes 6 were 8 , 9 we 8 , 11 find 8 , 21 , 9 we 10 did 10 did 11 find 11 find 13 relationships 11 find 17 walking 12 important 13 relationships 13 relationships 14 between 14 between 15 walkability 17 walking 18 in 18 in 20 adults 19 older 20 adults 21 , 22 which 21 , 23 supports 22 which 23 supports 23 supports 24 recommendations 23 supports 29 to 24 recommendations 25 for 25 for 28 features 26 community 27 design 27 design 28 features 29 to 30 include 30 include 33 elements 31 age 33 elements 32 friendly 33 elements more intense physical activity may occur in recreational settings than neighborhood streets . 0 ###LEFT-WALL### 4 activity 0 ###LEFT-WALL### 6 occur 0 ###LEFT-WALL### 13 . 1 more 2 intense 2 intense 4 activity 3 physical 4 activity 4 activity 5 may 5 may 6 occur 6 occur 7 in 6 occur 10 than 7 in 9 settings 8 recreational 9 settings 10 than 12 streets 11 neighborhood 12 streets the telomerase enzyme plays a critical role in human aging and cancer biology by maintaining telomere length and extending the proliferative lifespan of most stem cells and cancer cells . 0 ###LEFT-WALL### 3 enzyme 0 ###LEFT-WALL### 4 plays 0 ###LEFT-WALL### 30 . 1 the 3 enzyme 2 telomerase 3 enzyme 3 enzyme 4 plays 4 plays 7 role 4 plays 8 in 4 plays 14 by 5 a 7 role 6 critical 7 role 8 in 11 and 9 human 10 aging 9 human 11 and 11 and 13 biology 12 cancer 13 biology 14 by 15 maintaining 15 maintaining 18 and 16 telomere 17 length 17 length 18 and 18 and 29 cells 19 extending 29 cells 20 the 22 lifespan 21 proliferative 22 lifespan 22 lifespan 23 of 22 lifespan 27 and 23 of 26 cells 24 most 26 cells 25 stem 26 cells 27 and 28 cancer 27 and 29 cells despite the importance of this enzyme , our understanding of the mechanisms that regulate its activity and establish telomere length homeostasis in mammalian cells is incomplete , in part because the perfect repetitive nature of telomeric sequence hampers in situ detection of telomere elongation patterns . 0 ###LEFT-WALL### 9 understanding 0 ###LEFT-WALL### 25 is 1 despite 3 importance 1 despite 7 , 1 despite 9 understanding 2 the 3 importance 3 importance 4 of 4 of 6 enzyme 5 this 6 enzyme 8 our 9 understanding 9 understanding 10 of 9 understanding 22 in 9 understanding 25 is 10 of 12 mechanisms 11 the 12 mechanisms 12 mechanisms 13 that 12 mechanisms 17 and 13 that 17 and 14 regulate 16 activity 14 regulate 17 and 15 its 16 activity 17 and 18 establish 18 establish 21 homeostasis 19 telomere 20 length 20 length 21 homeostasis 22 in 24 cells 23 mammalian 24 cells 25 is 26 incomplete 26 incomplete 30 because 27 , 29 part 27 , 30 because 28 in 29 part 30 because 34 nature 30 because 38 hampers 30 because 46 . 31 the 34 nature 32 perfect 34 nature 33 repetitive 34 nature 34 nature 35 of 34 nature 38 hampers 35 of 37 sequence 36 telomeric 37 sequence 38 hampers 40 situ 38 hampers 41 detection 39 in 40 situ 41 detection 42 of 42 of 45 patterns 43 telomere 45 patterns 44 elongation 45 patterns here , we describe a novel assay using a mutant telomerase that adds a well - tolerated variant telomeric repeat sequence to telomere ends . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 describe 0 ###LEFT-WALL### 16 - 1 here 2 , 1 here 3 we 3 we 4 describe 4 describe 7 assay 4 describe 8 using 5 a 6 novel 5 a 7 assay 6 novel 7 assay 8 using 11 telomerase 9 a 11 telomerase 10 mutant 11 telomerase 11 telomerase 12 that 11 telomerase 13 adds 12 that 13 adds 13 adds 15 well 14 a 15 well 16 - 21 sequence 16 - 24 ends 16 - 25 . 17 tolerated 20 repeat 18 variant 20 repeat 19 telomeric 20 repeat 20 repeat 21 sequence 21 sequence 22 to 21 sequence 23 telomere 21 sequence 24 ends 22 to 23 telomere by specifically detecting the addition of these variant repeats , we can directly visualize telomere elongation events in human cells . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 14 visualize 0 ###LEFT-WALL### 21 . 1 by 3 detecting 1 by 10 , 1 by 11 we 2 specifically 3 detecting 3 detecting 5 addition 4 the 5 addition 5 addition 6 of 6 of 9 repeats 7 these 9 repeats 8 variant 9 repeats 11 we 12 can 12 can 14 visualize 13 directly 14 visualize 14 visualize 17 events 14 visualize 18 in 15 telomere 16 elongation 16 elongation 17 events 18 in 20 cells 19 human 20 cells we validate this approach [by] in [situ] mapping of telomere elongation patterns within individual nuclei and across a population of cells . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 validate 0 ###LEFT-WALL### 22 . 1 we 2 validate 2 validate 4 approach 2 validate 6 in 3 this 4 approach 6 in 8 mapping 8 mapping 9 of 9 of 12 patterns 10 telomere 11 elongation 11 elongation 12 patterns 12 patterns 16 and 13 within 15 nuclei 13 within 16 and 14 individual 15 nuclei 16 and 17 across 17 across 19 population 18 a 19 population 19 population 20 of 20 of 21 cells in the aging process , people are at increasing risk of visual abnormalities such as cataracts , glaucoma , age - related macular degeneration , and other retinal defects . 0 ###LEFT-WALL### 6 people 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 22 related 1 in 4 process 1 in 5 , 1 in 6 people 2 the 4 process 3 aging 4 process 6 people 7 are 7 are 8 at 8 at 9 increasing 9 increasing 10 risk 9 increasing 15 as 10 risk 11 of 11 of 13 abnormalities 12 visual 13 abnormalities 14 such 15 as 15 as 16 cataracts 16 cataracts 18 glaucoma 17 , 18 glaucoma 18 glaucoma 20 age 18 glaucoma 21 - 19 , 20 age 20 age 21 - 21 - 22 related 22 related 26 and 22 related 30 . 23 macular 24 degeneration 24 degeneration 26 and 25 , 26 and 26 and 29 defects 27 other 29 defects 28 retinal 29 defects this holds [true] for geriatric psychiatric patients as well . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 holds 0 ###LEFT-WALL### 10 . 1 this 2 holds 2 holds 4 for 2 holds 8 as 4 for 7 patients 5 geriatric 7 patients 6 psychiatric 7 patients 8 as 9 well these ophthalmic problems may increase risk [of] [falls] or increase the comorbidity from dementing processes and depression . 0 ###LEFT-WALL### 3 problems 0 ###LEFT-WALL### 9 or 0 ###LEFT-WALL### 18 . 1 these 3 problems 2 ophthalmic 3 problems 3 problems 9 or 4 may 5 increase 4 may 9 or 5 increase 6 risk 9 or 10 increase 10 increase 12 comorbidity 11 the 12 comorbidity 12 comorbidity 13 from 13 from 16 and 14 dementing 15 processes 15 processes 16 and 16 and 17 depression geriatric patients presenting for psychiatric treatment may also be misdiagnosed or [under] [-] diagnosed as a result of these visual problems . 0 ###LEFT-WALL### 3 presenting 0 ###LEFT-WALL### 11 or 0 ###LEFT-WALL### 22 . 1 geriatric 2 patients 2 patients 3 presenting 3 presenting 4 for 3 presenting 7 may 4 for 6 treatment 5 psychiatric 6 treatment 7 may 11 or 8 also 9 be 9 be 10 misdiagnosed 9 be 11 or 11 or 14 diagnosed 11 or 15 as 15 as 17 result 16 a 17 result 17 result 18 of 18 of 21 problems 19 these 21 problems 20 visual 21 problems this quality assurance review of 25 consecutive geriatric psychiatric inpatients demonstrated discrepancies between chart documentation and actual ophthalmologic pathology present in the patients . 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 11 demonstrated 0 ###LEFT-WALL### 24 . 1 this 4 review 2 quality 4 review 3 assurance 4 review 4 review 5 of 4 review 11 demonstrated 5 of 10 inpatients 6 25 10 inpatients 7 consecutive 10 inpatients 8 geriatric 10 inpatients 9 psychiatric 10 inpatients 11 demonstrated 12 discrepancies 11 demonstrated 13 between 11 demonstrated 21 in 13 between 16 and 14 chart 15 documentation 15 documentation 16 and 16 and 20 present 17 actual 19 pathology 18 ophthalmologic 19 pathology 19 pathology 20 present 21 in 23 patients 22 the 23 patients doing [a] simple but complete ophthalmologic screening as part of the general physical examination on admission to an inpatient psychiatric unit can identify those patients who will need more in depth examination of their eyes and promote more accurate differential diagnoses for the patients . 0 ###LEFT-WALL### 1 doing 0 ###LEFT-WALL### 23 identify 0 ###LEFT-WALL### 45 . 1 doing 7 screening 1 doing 8 as 1 doing 15 on 1 doing 22 can 3 simple 4 but 4 but 5 complete 4 but 7 screening 6 ophthalmologic 7 screening 8 as 14 examination 9 part 10 of 9 part 14 examination 10 of 14 examination 11 the 14 examination 12 general 14 examination 13 physical 14 examination 15 on 16 admission 16 admission 17 to 17 to 21 unit 18 an 21 unit 19 inpatient 21 unit 20 psychiatric 21 unit 22 can 23 identify 23 identify 25 patients 24 those 25 patients 25 patients 26 who 25 patients 27 will 26 who 27 will 27 will 36 and 28 need 29 more 28 need 30 in 28 need 36 and 30 in 32 examination 31 depth 32 examination 32 examination 33 of 33 of 35 eyes 34 their 35 eyes 36 and 37 promote 37 promote 41 diagnoses 38 more 41 diagnoses 39 accurate 41 diagnoses 40 differential 41 diagnoses 41 diagnoses 42 for 42 for 44 patients 43 the 44 patients poor oral health , including caries , tooth loss , and periodontitis , is ubiquitous worldwide , and is potentially treatable and preventable . 0 ###LEFT-WALL### 3 health 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 24 . 1 poor 3 health 2 oral 3 health 3 health 5 including 3 health 11 and 3 health 18 and 4 , 5 including 5 including 6 caries 5 including 7 , 7 , 11 and 8 tooth 9 loss 9 loss 11 and 10 , 11 and 11 and 12 periodontitis 11 and 13 , 14 is 15 ubiquitous 14 is 18 and 15 ubiquitous 16 worldwide 17 , 18 and 18 and 19 is 19 is 20 potentially 19 is 22 and 21 treatable 22 and 22 and 23 preventable like adverse oral health conditions , alzheimer disease and related disorders are also very common among aging populations . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 12 are 0 ###LEFT-WALL### 19 . 1 like 4 health 1 like 9 and 2 adverse 4 health 3 oral 4 health 5 conditions 6 , 6 , 8 disease 6 , 9 and 7 alzheimer 8 disease 9 and 11 disorders 9 and 12 are 10 related 11 disorders 12 are 13 also 12 are 15 common 14 very 15 common 15 common 16 among 16 among 17 aging 17 aging 18 populations established risk factors for alzheimer disease include cerebrovascular disease and its vascular risk factors , many of which share associations with evidence of systemic inflammation also identified in periodontitis and other poor oral health states . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 36 . 1 established 3 factors 2 risk 3 factors 3 factors 4 for 3 factors 10 and 4 for 9 disease 5 alzheimer 6 disease 6 disease 7 include 7 include 9 disease 8 cerebrovascular 9 disease 10 and 14 factors 11 its 14 factors 12 vascular 14 factors 13 risk 14 factors 15 , 16 many 15 , 19 share 16 many 17 of 16 many 19 share 17 of 18 which 19 share 20 associations 19 share 21 with 19 share 28 in 21 with 22 evidence 22 evidence 23 of 22 evidence 27 identified 23 of 25 inflammation 24 systemic 25 inflammation 26 also 27 identified 28 in 30 and 29 periodontitis 30 and 30 and 35 states 31 other 35 states 32 poor 33 oral 33 oral 34 health 34 health 35 states in this review , we present epidemiologic evidence of links between poor oral health and both prevalent and incident cognitive impairment , and review plausible mechanisms linking these conditions , including evidence from compelling animal models . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 23 and 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 23 and 6 present 8 evidence 6 present 11 between 6 present 23 and 7 epidemiologic 8 evidence 8 evidence 9 of 9 of 10 links 11 between 15 and 12 poor 14 health 13 oral 14 health 14 health 15 and 15 and 21 impairment 15 and 22 , 16 both 18 and 17 prevalent 18 and 18 and 19 incident 18 and 21 impairment 20 cognitive 21 impairment 23 and 24 review 24 review 26 mechanisms 25 plausible 26 mechanisms 26 mechanisms 27 linking 26 mechanisms 31 including 27 linking 29 conditions 28 these 29 conditions 30 , 31 including 31 including 32 evidence 31 including 37 . 32 evidence 33 from 33 from 36 models 34 compelling 36 models 35 animal 36 models considering that a large etiologic fraction of dementia remains unexplained , these studies argue for further multidisciplinary research between oral health conditions , including translational , epidemiologic , and possibly clinical treatment studies . 0 ###LEFT-WALL### 13 studies 0 ###LEFT-WALL### 14 argue 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 34 . 1 considering 2 that 1 considering 11 , 1 considering 13 studies 2 that 6 fraction 2 that 9 remains 3 a 4 large 3 a 6 fraction 4 large 6 fraction 5 etiologic 6 fraction 6 fraction 7 of 6 fraction 9 remains 7 of 8 dementia 9 remains 10 unexplained 12 these 13 studies 13 studies 14 argue 14 argue 15 for 14 argue 19 between 15 for 18 research 16 further 18 research 17 multidisciplinary 18 research 19 between 22 conditions 20 oral 22 conditions 21 health 22 conditions 23 , 24 including 23 , 33 studies 24 including 32 treatment 24 including 33 studies 25 translational 26 , 25 translational 32 treatment 27 epidemiologic 29 and 28 , 29 and 29 and 30 possibly 29 and 31 clinical 29 and 32 treatment aging of the brain is characterized by several neurochemical modifications involving structural proteins , neurotransmitters , neuropeptides and related receptors . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 6 characterized 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 21 . 1 aging 2 of 1 aging 5 is 2 of 4 brain 3 the 4 brain 5 is 6 characterized 6 characterized 7 by 7 by 10 modifications 8 several 10 modifications 9 neurochemical 10 modifications 10 modifications 11 involving 11 involving 13 proteins 12 structural 13 proteins 14 , 18 and 15 neurotransmitters 16 , 16 , 17 neuropeptides 16 , 18 and 18 and 20 receptors 19 related 20 receptors alterations of neurochemical indices of synaptic function [are] indicators of age - related impairment of central functions , such as locomotion , memory and sensory performances . 0 ###LEFT-WALL### 24 and 0 ###LEFT-WALL### 27 . 1 alterations 2 of 1 alterations 22 , 2 of 4 indices 3 neurochemical 4 indices 4 indices 5 of 5 of 9 indicators 6 synaptic 7 function 7 function 9 indicators 9 indicators 10 of 9 indicators 20 as 10 of 11 age 11 age 14 impairment 12 - 14 impairment 13 related 14 impairment 14 impairment 15 of 14 impairment 18 , 15 of 17 functions 16 central 17 functions 19 such 20 as 20 as 21 locomotion 22 , 23 memory 22 , 24 and 24 and 26 performances 25 sensory 26 performances several studies demonstrate that ionotropic gaba receptors , glutamate decarboxylase ( gad ) , and somatostatinergic subpopulations of gabaergic neurons are markedly decreased in experimental animal brains during aging . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 demonstrate 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 30 . 1 several 2 studies 2 studies 3 demonstrate 3 demonstrate 7 receptors 4 that 5 ionotropic 5 ionotropic 7 receptors 6 gaba 7 receptors 7 receptors 10 decarboxylase 8 , 10 decarboxylase 9 glutamate 10 decarboxylase 10 decarboxylase 12 gad 10 decarboxylase 13 ) 11 ( 12 gad 12 gad 13 ) 14 , 15 and 15 and 17 subpopulations 15 and 23 decreased 16 somatostatinergic 17 subpopulations 17 subpopulations 18 of 17 subpopulations 21 are 18 of 20 neurons 19 gabaergic 20 neurons 21 are 23 decreased 22 markedly 23 decreased 23 decreased 24 in 23 decreased 28 during 24 in 27 brains 25 experimental 26 animal 26 animal 27 brains 28 during 29 aging additionally , levels of several neuropeptides co - expressed with gad decrease during aging . 0 ###LEFT-WALL### 3 levels 0 ###LEFT-WALL### 7 co 1 additionally 2 , 1 additionally 3 levels 3 levels 4 of 3 levels 7 co 4 of 6 neuropeptides 5 several 6 neuropeptides 7 co 9 expressed 8 - 9 expressed 9 expressed 10 with 9 expressed 13 during 9 expressed 15 . 10 with 12 decrease 11 gad 12 decrease 13 during 14 aging thus , the age [-] related decline in cognitive functions could be attributable , at least [in] [part] , [to] decrements in gaba inhibitory neurotransmission . 0 ###LEFT-WALL### 7 decline 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 26 . 1 thus 2 , 1 thus 7 decline 3 the 7 decline 4 age 6 related 6 related 7 decline 7 decline 8 in 7 decline 19 , 8 in 10 functions 9 cognitive 10 functions 11 could 12 be 11 could 19 , 12 be 13 attributable 14 , 16 least 14 , 19 , 15 at 16 least 19 , 21 decrements 19 , 22 in 19 , 25 neurotransmission 22 in 23 gaba 24 inhibitory 25 neurotransmission in this study , we showed that chronic supplementation of taurine to aged mice significantly ameliorated the age [-] dependent decline in spatial memory acquisition and retention . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 28 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 showed 6 showed 9 supplementation 6 showed 16 ameliorated 7 that 8 chronic 8 chronic 9 supplementation 9 supplementation 10 of 9 supplementation 12 to 9 supplementation 16 ameliorated 10 of 11 taurine 12 to 14 mice 13 aged 14 mice 15 significantly 16 ameliorated 16 ameliorated 21 decline 16 ameliorated 22 in 17 the 21 decline 18 age 21 decline 20 dependent 21 decline 22 in 26 and 23 spatial 24 memory 24 memory 25 acquisition 25 acquisition 26 and 26 and 27 retention we also demonstrated that concomitant with the amelioration in cognitive function [,] taurine caused significant alterations in the gabaergic and somatostatinergic system . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 demonstrated 0 ###LEFT-WALL### 23 . 1 we 3 demonstrated 2 also 3 demonstrated 3 demonstrated 4 that 3 demonstrated 14 caused 4 that 5 concomitant 4 that 14 caused 5 concomitant 6 with 5 concomitant 9 in 6 with 8 amelioration 7 the 8 amelioration 9 in 13 taurine 10 cognitive 11 function 11 function 13 taurine 14 caused 16 alterations 14 caused 17 in 15 significant 16 alterations 17 in 20 and 18 the 19 gabaergic 19 gabaergic 20 and 20 and 22 system 21 somatostatinergic 22 system these specific alterations of the inhibitory system caused by taurine treatment oppose those naturally occurring in the aging brain , suggesting a protective role of taurine in this process . 0 ###LEFT-WALL### 3 alterations 0 ###LEFT-WALL### 12 oppose 1 these 3 alterations 2 specific 3 alterations 3 alterations 4 of 3 alterations 12 oppose 4 of 7 system 5 the 7 system 6 inhibitory 7 system 7 system 8 caused 8 caused 9 by 9 by 11 treatment 10 taurine 11 treatment 12 oppose 13 those 12 oppose 16 in 13 those 15 occurring 14 naturally 15 occurring 16 in 19 brain 17 the 19 brain 18 aging 19 brain 19 brain 21 suggesting 20 , 21 suggesting 21 suggesting 24 role 21 suggesting 27 in 21 suggesting 30 . 22 a 23 protective 22 a 24 role 23 protective 24 role 24 role 25 of 25 of 26 taurine 27 in 29 process 28 this 29 process an increased understanding of age - related neurochemical changes in the gabaergic system will be important in elucidating the underpinnings of the functional changes of aging . 0 ###LEFT-WALL### 3 understanding 0 ###LEFT-WALL### 15 be 0 ###LEFT-WALL### 27 . 1 an 3 understanding 2 increased 3 understanding 3 understanding 4 of 3 understanding 14 will 4 of 5 age 6 - 7 related 7 related 9 changes 7 related 14 will 8 neurochemical 9 changes 9 changes 10 in 10 in 13 system 11 the 13 system 12 gabaergic 13 system 14 will 15 be 15 be 16 important 16 important 17 in 17 in 18 elucidating 18 elucidating 20 underpinnings 19 the 20 underpinnings 20 underpinnings 21 of 20 underpinnings 25 of 21 of 24 changes 22 the 24 changes 23 functional 24 changes 25 of 26 aging taurine supplementation might help forestall the age [-] related decline in cognitive functions through interaction with the gabaergic system . 0 ###LEFT-WALL### 2 supplementation 0 ###LEFT-WALL### 4 help 0 ###LEFT-WALL### 20 . 1 taurine 2 supplementation 2 supplementation 3 might 3 might 4 help 4 help 5 forestall 5 forestall 10 decline 5 forestall 11 in 5 forestall 14 through 5 forestall 16 with 6 the 10 decline 7 age 9 related 9 related 10 decline 11 in 13 functions 12 cognitive 13 functions 14 through 15 interaction 16 with 19 system 17 the 19 system 18 gabaergic 19 system the discovery of induced pluripotent stem cells ( ipscs ) has the potential to revolutionize the field of regenerative medicine . 0 ###LEFT-WALL### 2 discovery 0 ###LEFT-WALL### 11 has 0 ###LEFT-WALL### 21 . 1 the 2 discovery 2 discovery 3 of 2 discovery 11 has 3 of 7 cells 4 induced 5 pluripotent 5 pluripotent 7 cells 6 stem 7 cells 7 cells 9 ipscs 8 ( 9 ipscs 9 ipscs 10 ) 11 has 13 potential 11 has 14 to 12 the 13 potential 14 to 15 revolutionize 15 revolutionize 17 field 16 the 17 field 17 field 18 of 18 of 20 medicine 19 regenerative 20 medicine in the past few years , ipscs have been the subject of intensive research towards their application in disease modeling and drug screening . 0 ###LEFT-WALL### 7 ipscs 0 ###LEFT-WALL### 9 been 0 ###LEFT-WALL### 24 . 1 in 5 years 1 in 6 , 1 in 7 ipscs 2 the 3 past 2 the 4 few 4 few 5 years 7 ipscs 8 have 8 have 9 been 9 been 11 subject 10 the 11 subject 11 subject 12 of 11 subject 18 in 12 of 14 research 13 intensive 14 research 14 research 15 towards 15 towards 17 application 16 their 17 application 18 in 21 and 19 disease 20 modeling 20 modeling 21 and 21 and 23 screening 22 drug 23 screening in the future , these cells may be applied in cell therapy to replace or regenerate tissues by autologous transplantation . 0 ###LEFT-WALL### 6 cells 0 ###LEFT-WALL### 15 or 0 ###LEFT-WALL### 21 . 1 in 3 future 1 in 4 , 1 in 6 cells 2 the 3 future 5 these 6 cells 6 cells 15 or 7 may 8 be 7 may 15 or 8 be 9 applied 9 applied 10 in 10 in 12 therapy 11 cell 12 therapy 12 therapy 13 to 12 therapy 14 replace 13 to 14 replace 15 or 16 regenerate 16 regenerate 17 tissues 16 regenerate 18 by 18 by 20 transplantation 19 autologous 20 transplantation however , two major hurdles need to be resolved in order to reach the later goal : the low reprogramming efficiency and the safety risks , such as the integration of foreign dna into the genome of the cells and the tumor formation potential arising from transplantation of residual undifferentiated cells . 0 ###LEFT-WALL### 5 hurdles 0 ###LEFT-WALL### 6 need 0 ###LEFT-WALL### 17 : 0 ###LEFT-WALL### 25 risks 1 however 2 , 1 however 5 hurdles 3 two 5 hurdles 4 major 5 hurdles 5 hurdles 6 need 6 need 7 to 6 need 10 in 6 need 12 to 6 need 17 : 7 to 8 be 8 be 9 resolved 10 in 11 order 12 to 13 reach 13 reach 16 goal 14 the 16 goal 15 later 16 goal 17 : 19 low 18 the 19 low 19 low 20 reprogramming 19 low 25 risks 20 reprogramming 22 and 20 reprogramming 25 risks 21 efficiency 22 and 22 and 24 safety 23 the 24 safety 25 risks 28 as 26 , 28 as 27 such 28 as 28 as 40 and 28 as 52 . 29 the 30 integration 30 integration 31 of 30 integration 37 of 30 integration 40 and 31 of 33 dna 32 foreign 33 dna 33 dna 34 into 34 into 36 genome 35 the 36 genome 37 of 39 cells 38 the 39 cells 40 and 44 potential 41 the 44 potential 42 tumor 43 formation 43 formation 44 potential 44 potential 45 arising 44 potential 46 from 46 from 47 transplantation 47 transplantation 48 of 48 of 51 cells 49 residual 51 cells 50 undifferentiated 51 cells recently , aging emerged as one of the barriers that accounts , at least [in] part , for the low reprogramming efficiency of bona fide ipscs . 0 ###LEFT-WALL### 3 aging 0 ###LEFT-WALL### 4 emerged 0 ###LEFT-WALL### 12 , 1 recently 2 , 1 recently 3 aging 3 aging 4 emerged 4 emerged 5 as 5 as 6 one 6 one 7 of 6 one 10 that 6 one 11 accounts 7 of 9 barriers 8 the 9 barriers 10 that 11 accounts 12 , 16 part 13 at 14 least 14 least 16 part 16 part 18 for 17 , 18 for 18 for 20 low 18 for 27 . 19 the 20 low 20 low 21 reprogramming 21 reprogramming 22 efficiency 22 efficiency 23 of 23 of 26 ipscs 24 bona 25 fide 25 fide 26 ipscs here , we review the molecular pathways linking aging and reprogramming along with the unanswered questions in the field . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 20 . 1 here 2 , 1 here 3 we 3 we 4 review 4 review 10 and 4 review 13 with 4 review 17 in 5 the 7 pathways 6 molecular 7 pathways 7 pathways 8 linking 7 pathways 10 and 8 linking 9 aging 10 and 11 reprogramming 12 along 13 with 13 with 16 questions 14 the 16 questions 15 unanswered 16 questions 17 in 19 field 18 the 19 field we discuss whether reprogramming rejuvenates the molecular and cellular features associated with age , and present the recent advances with ipsc - based models , contributing to our understanding of physiological and premature aging . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 discuss 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 35 . 1 we 2 discuss 2 discuss 3 whether 3 whether 4 reprogramming 3 whether 5 rejuvenates 4 reprogramming 5 rejuvenates 5 rejuvenates 7 molecular 6 the 7 molecular 8 and 10 features 8 and 15 and 9 cellular 10 features 10 features 15 and 11 associated 12 with 11 associated 15 and 12 with 13 age 14 , 15 and 15 and 16 present 16 present 19 advances 17 the 19 advances 18 recent 19 advances 19 advances 20 with 19 advances 26 contributing 20 with 21 ipsc 21 ipsc 24 models 22 - 24 models 23 based 24 models 24 models 25 , 26 contributing 27 to 27 to 29 understanding 28 our 29 understanding 29 understanding 30 of 30 of 34 aging 31 physiological 32 and 32 and 33 premature 32 and 34 aging the retinal vasculature supplies cells of the inner and middle layers of the retina with oxygen and nutrients . 0 ###LEFT-WALL### 3 vasculature 0 ###LEFT-WALL### 4 supplies 0 ###LEFT-WALL### 19 . 1 the 3 vasculature 2 retinal 3 vasculature 3 vasculature 4 supplies 4 supplies 5 cells 4 supplies 15 with 5 cells 6 of 6 of 9 and 7 the 8 inner 8 inner 9 and 9 and 11 layers 9 and 12 of 10 middle 11 layers 12 of 14 retina 13 the 14 retina 15 with 17 and 16 oxygen 17 and 17 and 18 nutrients photic stimulation dilates retinal arterioles producing blood flow increases , a response termed functional hyperemia . 0 ###LEFT-WALL### 2 stimulation 0 ###LEFT-WALL### 3 dilates 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 16 . 1 photic 2 stimulation 2 stimulation 3 dilates 3 dilates 5 arterioles 4 retinal 5 arterioles 5 arterioles 6 producing 6 producing 9 increases 7 blood 9 increases 8 flow 9 increases 10 , 12 response 10 , 13 termed 11 a 12 response 12 response 13 termed 13 termed 15 hyperemia 14 functional 15 hyperemia despite recent advances , the neurovascular coupling mechanisms mediating the functional hyperemia response in the retina remain unclear . 0 ###LEFT-WALL### 8 mechanisms 0 ###LEFT-WALL### 17 remain 0 ###LEFT-WALL### 19 . 1 despite 3 advances 1 despite 4 , 1 despite 8 mechanisms 2 recent 3 advances 5 the 8 mechanisms 6 neurovascular 7 coupling 7 coupling 8 mechanisms 8 mechanisms 9 mediating 8 mechanisms 17 remain 9 mediating 13 response 9 mediating 14 in 10 the 13 response 11 functional 13 response 12 hyperemia 13 response 14 in 16 retina 15 the 16 retina 17 remain 18 unclear in this review , the retinal functional hyperemia response is described , and the cellular mechanisms that may mediate the response are assessed . 0 ###LEFT-WALL### 9 response 0 ###LEFT-WALL### 11 described 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 24 . 1 in 3 review 1 in 4 , 1 in 9 response 2 this 3 review 5 the 9 response 6 retinal 9 response 7 functional 9 response 8 hyperemia 9 response 9 response 10 is 10 is 11 described 12 , 13 and 13 and 16 mechanisms 13 and 23 assessed 14 the 16 mechanisms 15 cellular 16 mechanisms 16 mechanisms 17 that 16 mechanisms 18 may 16 mechanisms 22 are 17 that 18 may 18 may 19 mediate 19 mediate 21 response 20 the 21 response 22 are 23 assessed these neurovascular coupling mechanisms include neuronal stimulation of glial cells , leading to the release of vasoactive arachidonic acid metabolites onto blood vessels [,] release of potassium from glial cells onto vessels , and production and release of nitric oxide ( no ) , [lactate] , [and] adenosine from neurons and glia . 0 ###LEFT-WALL### 4 mechanisms 0 ###LEFT-WALL### 5 include 0 ###LEFT-WALL### 11 , 1 these 4 mechanisms 2 neurovascular 4 mechanisms 3 coupling 4 mechanisms 4 mechanisms 5 include 5 include 7 stimulation 6 neuronal 7 stimulation 7 stimulation 8 of 8 of 10 cells 9 glial 10 cells 11 , 12 leading 11 , 20 metabolites 12 leading 13 to 12 leading 20 metabolites 13 to 15 release 14 the 15 release 15 release 16 of 16 of 19 acid 17 vasoactive 19 acid 18 arachidonic 19 acid 20 metabolites 21 onto 20 metabolites 31 onto 21 onto 22 blood 22 blood 23 vessels 22 blood 25 release 22 blood 26 of 22 blood 28 from 23 vessels 25 release 26 of 27 potassium 28 from 30 cells 29 glial 30 cells 31 onto 36 and 32 vessels 34 and 33 , 34 and 34 and 35 production 34 and 36 and 36 and 37 release 36 and 44 , 36 and 48 adenosine 37 release 38 of 38 of 40 oxide 39 nitric 40 oxide 40 oxide 42 no 41 ( 42 no 42 no 43 ) 46 , 48 adenosine 48 adenosine 49 from 48 adenosine 53 . 49 from 51 and 50 neurons 51 and 51 and 52 glia 51 and 53 . the modulation of neurovascular coupling by oxygen and no are described , and changes in functional hyperemia that occur with aging and in diabetic retinopathy , glaucoma , and other pathologies , are reviewed . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 described 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 35 . 1 the 2 modulation 2 modulation 3 of 2 modulation 8 and 3 of 5 coupling 4 neurovascular 5 coupling 5 coupling 6 by 6 by 7 oxygen 8 and 9 no 8 and 10 are 10 are 11 described 12 , 13 and 13 and 14 changes 13 and 34 reviewed 14 changes 15 in 14 changes 18 that 14 changes 19 occur 14 changes 33 are 15 in 17 hyperemia 16 functional 17 hyperemia 18 that 19 occur 19 occur 22 and 20 with 21 aging 20 with 22 and 22 and 23 in 23 in 25 retinopathy 24 diabetic 25 retinopathy 25 retinopathy 29 and 26 , 29 and 27 glaucoma 29 and 28 , 29 and 29 and 31 pathologies 29 and 32 , 30 other 31 pathologies 33 are 34 reviewed finally , outstanding questions concerning retinal blood flow in health and disease are discussed . 0 ###LEFT-WALL### 4 questions 0 ###LEFT-WALL### 14 discussed 0 ###LEFT-WALL### 15 . 1 finally 2 , 1 finally 4 questions 3 outstanding 4 questions 4 questions 5 concerning 4 questions 13 are 5 concerning 8 flow 5 concerning 9 in 6 retinal 7 blood 7 blood 8 flow 9 in 11 and 10 health 11 and 11 and 12 disease 13 are 14 discussed background and purpose : age - related impairments in cerebral blood flow and cerebrovascular reactivity to carbon dioxide ( cvrco2 ) are established risk factors for stroke that respond favorably to aerobic training . 0 ###LEFT-WALL### 3 purpose 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 6 - 1 background 2 and 2 and 3 purpose 3 purpose 4 : 4 : 5 age 6 - 8 impairments 6 - 29 respond 6 - 34 . 7 related 8 impairments 8 impairments 9 in 8 impairments 29 respond 9 in 11 blood 10 cerebral 11 blood 11 blood 13 and 11 blood 27 stroke 12 flow 13 and 13 and 15 reactivity 13 and 16 to 13 and 27 stroke 14 cerebrovascular 15 reactivity 16 to 17 carbon 17 carbon 18 dioxide 17 carbon 26 for 18 dioxide 20 cvrco2 18 dioxide 22 are 19 ( 20 cvrco2 20 cvrco2 21 ) 22 are 25 factors 22 are 26 for 23 established 25 factors 24 risk 25 factors 27 stroke 28 that 29 respond 30 favorably 29 respond 31 to 31 to 33 training 32 aerobic 33 training the present study examined to what extent cerebral hemodynamics are improved when training is sustained throughout the adult lifespan . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 11 improved 0 ###LEFT-WALL### 20 . 1 the 3 study 2 present 3 study 3 study 4 examined 3 study 5 to 3 study 11 improved 5 to 6 what 5 to 7 extent 5 to 9 hemodynamics 5 to 10 are 6 what 7 extent 8 cerebral 9 hemodynamics 9 hemodynamics 10 are 11 improved 12 when 12 when 13 training 12 when 15 sustained 13 training 14 is 14 is 15 sustained 15 sustained 16 throughout 15 sustained 19 lifespan 16 throughout 18 adult 17 the 18 adult methods : eighty - one healthy males were prospectively assigned to 1 of 4 groups based on their age ( young , ≤30 years versus old , ≥60 years ) and lifetime physical activity levels ( trained , ≥150 minutes recreational aerobic activity/week versus sedentary , no activity ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 eighty 2 : 4 - 2 : 50 . 4 - 5 one 4 - 10 assigned 5 one 7 males 5 one 8 were 5 one 10 assigned 6 healthy 7 males 7 males 8 were 8 were 9 prospectively 10 assigned 11 to 10 assigned 31 and 11 to 12 1 12 1 13 of 13 of 14 4 15 groups 16 based 15 groups 31 and 16 based 17 on 17 on 19 age 18 their 19 age 19 age 24 years 20 ( 24 years 21 young 22 , 21 young 23 ≤30 23 ≤30 24 years 24 years 25 versus 24 years 30 ) 25 versus 29 years 26 old 27 , 26 old 29 years 28 ≥60 29 years 31 and 35 levels 31 and 37 trained 31 and 43 activity/week 32 lifetime 35 levels 33 physical 34 activity 34 activity 35 levels 36 ( 37 trained 37 trained 38 , 38 , 43 activity/week 39 ≥150 43 activity/week 40 minutes 43 activity/week 41 recreational 43 activity/week 42 aerobic 43 activity/week 43 activity/week 44 versus 43 activity/week 49 ) 44 versus 48 activity 45 sedentary 46 , 45 sedentary 48 activity 47 no 48 activity middle cerebral artery blood velocity ( mcav , transcranial doppler ultrasound ) , mean arterial pressure ( map , finger photoplethysmography ) , and end - tidal partial pressure of carbon dioxide ( petco2 , capnography ) were recorded during normocapnia and 3 mins of iso - oxic hypercapnea ( 5 % co2 ) . 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 55 . 1 middle 5 velocity 1 middle 13 , 2 cerebral 5 velocity 3 artery 5 velocity 4 blood 5 velocity 5 velocity 7 mcav 6 ( 7 mcav 7 mcav 11 ultrasound 7 mcav 12 ) 8 , 11 ultrasound 9 transcranial 11 ultrasound 10 doppler 11 ultrasound 11 ultrasound 12 ) 13 , 14 mean 14 mean 16 pressure 14 mean 39 recorded 15 arterial 16 pressure 16 pressure 24 and 16 pressure 38 were 17 ( 24 and 18 map 21 photoplethysmography 18 map 24 and 19 , 21 photoplethysmography 20 finger 21 photoplethysmography 21 photoplethysmography 22 ) 23 , 24 and 24 and 25 end 24 and 29 pressure 24 and 36 capnography 24 and 37 ) 26 - 29 pressure 27 tidal 29 pressure 28 partial 29 pressure 29 pressure 30 of 29 pressure 35 , 30 of 32 dioxide 31 carbon 32 dioxide 32 dioxide 34 petco2 33 ( 34 petco2 34 petco2 35 , 35 , 36 capnography 36 capnography 37 ) 38 were 39 recorded 39 recorded 40 during 40 during 42 and 41 normocapnia 42 and 42 and 44 mins 42 and 53 co2 43 3 44 mins 44 mins 45 of 45 of 49 hypercapnea 46 iso 47 - 46 iso 49 hypercapnea 48 oxic 49 hypercapnea 50 ( 53 co2 51 5 53 co2 52 % 53 co2 53 co2 54 ) cerebrovascular resistance/conductance indices ( cvri/cvci ) were calculated as map/mcav and mcav/map , respectively [,] and cvrco2 as the percentage increase in mcav from baseline per millimeter of mercury [(] [mm] [hg] ) increase in petco2 . 0 ###LEFT-WALL### 3 indices 0 ###LEFT-WALL### 8 calculated 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 37 . 1 cerebrovascular 3 indices 2 resistance/conductance 3 indices 3 indices 5 cvri/cvci 3 indices 7 were 4 ( 5 cvri/cvci 5 cvri/cvci 6 ) 7 were 8 calculated 8 calculated 9 as 9 as 10 map/mcav 11 and 16 and 11 and 34 increase 12 mcav/map 16 and 13 , 14 respectively 13 , 16 and 16 and 17 cvrco2 16 and 33 ) 16 and 34 increase 17 cvrco2 18 as 18 as 21 increase 19 the 21 increase 20 percentage 21 increase 21 increase 22 in 21 increase 24 from 21 increase 28 of 22 in 23 mcav 24 from 25 baseline 25 baseline 26 per 26 per 27 millimeter 28 of 29 mercury 34 increase 35 in 35 in 36 petco2 maximal oxygen consumption ( o2max , online respiratory gas analysis ) was determined during cycling ergometry . 0 ###LEFT-WALL### 3 consumption 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 17 . 1 maximal 3 consumption 2 oxygen 3 consumption 3 consumption 5 o2max 3 consumption 10 analysis 3 consumption 12 was 4 ( 5 o2max 5 o2max 6 , 6 , 10 analysis 7 online 9 gas 8 respiratory 9 gas 9 gas 10 analysis 10 analysis 11 ) 12 was 13 determined 13 determined 14 during 14 during 16 ergometry 15 cycling 16 ergometry results : by design , older participants [were] active for longer ( 49±5 versus 6±4 years , p<0.05 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 results 2 : 2 : 3 by 3 by 4 design 4 design 7 participants 5 , 7 participants 6 older 7 participants 7 participants 9 active 7 participants 13 49±5 7 participants 18 p<0.05 7 participants 19 ) 9 active 10 for 10 for 11 longer 12 ( 13 49±5 13 49±5 14 versus 13 49±5 17 , 14 versus 16 years 15 6±4 16 years 17 , 18 p<0.05 18 p<0.05 19 ) physical activity attenuated the age - related declines in o2max , mcav , cvci , and cvrco2 and increase in cvri ( p<0.05 [versus] [sedentary] ) . 0 ###LEFT-WALL### 2 activity 0 ###LEFT-WALL### 3 attenuated 0 ###LEFT-WALL### 7 related 0 ###LEFT-WALL### 27 . 1 physical 2 activity 2 activity 3 attenuated 3 attenuated 5 age 4 the 5 age 6 - 7 related 7 related 18 and 7 related 20 in 8 declines 9 in 8 declines 11 , 9 in 10 o2max 11 , 12 mcav 11 , 16 and 12 mcav 14 cvci 13 , 14 cvci 14 cvci 15 , 16 and 17 cvrco2 16 and 18 and 18 and 19 increase 20 in 21 cvri 21 cvri 23 p<0.05 22 ( 23 p<0.05 23 p<0.05 26 ) linear relationships were observed between o2max and both mcav and cvrco2 ( r=0.58 - 0.77 , p<0.05 ) . 0 ###LEFT-WALL### 2 relationships 0 ###LEFT-WALL### 4 observed 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 19 . 1 linear 2 relationships 2 relationships 3 were 3 were 4 observed 4 observed 5 between 5 between 10 and 6 o2max 7 and 7 and 9 mcav 7 and 10 and 8 both 9 mcav 10 and 11 cvrco2 11 cvrco2 13 r=0.58 12 ( 13 r=0.58 13 r=0.58 14 - 14 - 15 0.77 15 0.77 17 p<0.05 16 , 17 p<0.05 17 p<0.05 18 ) conclusions : these findings highlight the importance of maintaining aerobic fitness throughout the lifespan given its capacity to improve cerebral hemodynamics in later - life . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 findings 2 : 5 highlight 2 : 26 . 3 these 4 findings 4 findings 5 highlight 5 highlight 7 importance 6 the 7 importance 7 importance 8 of 8 of 9 maintaining 9 maintaining 11 fitness 9 maintaining 12 throughout 9 maintaining 22 in 10 aerobic 11 fitness 12 throughout 14 lifespan 13 the 14 lifespan 14 lifespan 15 given 15 given 17 capacity 16 its 17 capacity 17 capacity 18 to 17 capacity 19 improve 18 to 19 improve 19 improve 21 hemodynamics 20 cerebral 21 hemodynamics 22 in 25 life 23 later 24 - 23 later 25 life although many studies have demonstrated decline in attention and executive function ( especially in inhibitory control ) in healthy aging and alzheimer 's disease ( ad ) , similar studies concerning mild cognitive impairment ( mci ) are scarce . 0 ###LEFT-WALL### 30 studies 0 ###LEFT-WALL### 38 are 0 ###LEFT-WALL### 40 . 1 although 2 many 1 although 28 , 1 although 30 studies 2 many 3 studies 2 many 6 decline 3 studies 4 have 4 have 5 demonstrated 5 demonstrated 6 decline 6 decline 7 in 6 decline 18 in 7 in 9 and 8 attention 9 and 9 and 11 function 9 and 14 in 10 executive 11 function 12 ( 13 especially 12 ( 14 in 14 in 16 control 14 in 17 ) 15 inhibitory 16 control 18 in 21 and 19 healthy 20 aging 19 healthy 21 and 21 and 24 disease 21 and 26 ad 22 alzheimer 23 's 23 's 24 disease 25 ( 26 ad 26 ad 27 ) 29 similar 30 studies 30 studies 31 concerning 30 studies 38 are 31 concerning 34 impairment 32 mild 34 impairment 33 cognitive 34 impairment 34 impairment 36 mci 35 ( 36 mci 36 mci 37 ) 38 are 39 scarce in the present study , we evaluated how the cognitive decline associated with [amnestic] mci ( amci ) affects these processes , analyzing the n2 and p3 components [of] event - related potentials ( erps ) during the response ( [go] [ )(and inhibition [of] response ( nogo ) to different stimuli . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 evaluated 0 ###LEFT-WALL### 22 , 0 ###LEFT-WALL### 53 . 1 in 4 study 1 in 5 , 1 in 6 we 2 the 4 study 3 present 4 study 6 we 7 evaluated 7 evaluated 8 how 8 how 11 decline 8 how 19 affects 9 the 11 decline 10 cognitive 11 decline 11 decline 12 associated 11 decline 17 amci 11 decline 19 affects 12 associated 13 with 13 with 15 mci 16 ( 17 amci 17 amci 18 ) 19 affects 21 processes 20 these 21 processes 22 , 23 analyzing 22 , 32 related 23 analyzing 26 and 23 analyzing 32 related 24 the 25 n2 25 n2 26 and 26 and 30 event 26 and 31 - 27 p3 28 components 28 components 30 event 32 related 33 potentials 32 related 37 during 32 related 50 to 33 potentials 35 erps 34 ( 35 erps 35 erps 36 ) 37 during 43 )(and 38 the 39 response 39 response 43 )(and 40 ( 43 )(and 43 )(and 46 response 43 )(and 48 nogo 44 inhibition 46 response 47 ( 48 nogo 48 nogo 49 ) 50 to 52 stimuli 51 different 52 stimuli erps were analyzed in 63 healthy and 30 amci adults ( aged 50 to 87 years ) during performance of a go/nogo auditory - visual attention - distraction task . amci adults showed poorer execution ( longer response times and fewer correct responses ) and smaller go - n2 and nogo - n2 amplitudes than control adults , whereas p3 amplitudes and n2 and p3 latencies did not differ between the groups . 0 ###LEFT-WALL### 1 erps 0 ###LEFT-WALL### 3 analyzed 0 ###LEFT-WALL### 30 . 0 ###LEFT-WALL### 33 showed 0 ###LEFT-WALL### 73 . 1 erps 2 were 2 were 3 analyzed 3 analyzed 4 in 3 analyzed 18 during 4 in 10 adults 5 63 10 adults 6 healthy 7 and 7 and 9 amci 7 and 10 adults 8 30 9 amci 10 adults 12 aged 11 ( 12 aged 12 aged 13 50 12 aged 14 to 12 aged 17 ) 14 to 16 years 15 87 16 years 18 during 19 performance 19 performance 20 of 20 of 29 task 21 a 29 task 22 go/nogo 29 task 23 auditory 26 attention 23 auditory 27 - 23 auditory 28 distraction 24 - 26 attention 25 visual 26 attention 26 attention 27 - 28 distraction 29 task 30 . 32 adults 31 amci 32 adults 32 adults 33 showed 33 showed 35 execution 33 showed 49 n2 33 showed 50 and 33 showed 59 whereas 33 showed 70 between 34 poorer 35 execution 35 execution 45 and 36 ( 45 and 37 longer 39 times 38 response 39 times 39 times 40 and 40 and 43 responses 40 and 44 ) 40 and 45 and 41 fewer 43 responses 42 correct 43 responses 45 and 47 go 45 and 48 - 46 smaller 47 go 50 and 51 nogo 51 nogo 53 n2 52 - 53 n2 53 n2 54 amplitudes 53 n2 56 control 53 n2 58 , 54 amplitudes 56 control 55 than 56 control 56 control 57 adults 59 whereas 62 and 59 whereas 69 differ 60 p3 61 amplitudes 60 p3 62 and 62 and 66 latencies 63 n2 64 and 64 and 65 p3 65 p3 66 latencies 66 latencies 67 did 67 did 68 not 67 did 69 differ 70 between 72 groups 71 the 72 groups these results [show] that amci is associated with decline in executive [function] and stimuli evaluation in working memory . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 9 decline 0 ###LEFT-WALL### 19 . 1 these 2 results 2 results 4 that 2 results 8 with 2 results 9 decline 4 that 5 amci 4 that 7 associated 5 amci 6 is 6 is 7 associated 7 associated 8 with 9 decline 10 in 9 decline 16 in 10 in 13 and 11 executive 13 and 13 and 15 evaluation 14 stimuli 15 evaluation 16 in 17 working 17 working 18 memory background and objective : poor back endurance is a predictor of low back pain . 0 ###LEFT-WALL### 3 objective 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 objective 4 : 7 endurance 4 : 8 is 4 : 15 . 5 poor 6 back 6 back 7 endurance 7 endurance 8 is 8 is 10 predictor 9 a 10 predictor 10 predictor 11 of 11 of 14 pain 12 low 13 back 13 back 14 pain few studies have investigated back muscle fatigue in older people . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 11 . 1 few 2 studies 2 studies 3 have 3 have 4 investigated 4 investigated 7 fatigue 4 investigated 8 in 5 back 7 fatigue 6 muscle 7 fatigue 8 in 10 people 9 older 10 people the purpose of this study was to compare the back muscle fatigue by endurance time and perceived effort between young and older adults during dynamic exercise . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 27 . 1 the 2 purpose 2 purpose 3 of 2 purpose 16 and 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 compare 6 was 16 and 7 to 8 compare 8 compare 12 fatigue 8 compare 13 by 9 the 12 fatigue 10 back 11 muscle 11 muscle 12 fatigue 13 by 15 time 14 endurance 15 time 16 and 17 perceived 16 and 19 between 16 and 24 during 17 perceived 18 effort 19 between 23 adults 20 young 21 and 21 and 22 older 21 and 23 adults 24 during 26 exercise 25 dynamic 26 exercise method : sixteen [older] and 16 young adults , all healthy , participated in this study . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 8 adults 2 : 13 participated 2 : 17 . 3 sixteen 5 and 5 and 6 16 5 and 8 adults 7 young 8 adults 8 adults 11 healthy 8 adults 13 participated 9 , 11 healthy 10 all 11 healthy 11 healthy 12 , 13 participated 14 in 14 in 16 study 15 this 16 study the subjects performed a fatiguing trunk extension - flexion exercise on a roman chair until exhaustion . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 performed 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 17 . 1 the 2 subjects 2 subjects 3 performed 3 performed 7 extension 4 a 7 extension 5 fatiguing 7 extension 6 trunk 7 extension 8 - 10 exercise 9 flexion 10 exercise 10 exercise 11 on 11 on 14 chair 12 a 13 roman 12 a 14 chair 13 roman 14 chair 14 chair 15 until 15 until 16 exhaustion endurance time and perceived muscle fatigue ( borg cr - 10 scale ) were used as fatigue criteria . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 15 used 0 ###LEFT-WALL### 19 . 1 endurance 2 time 2 time 3 and 3 and 6 fatigue 3 and 9 cr 3 and 14 were 4 perceived 5 muscle 5 muscle 6 fatigue 7 ( 9 cr 8 borg 9 cr 9 cr 11 10 9 cr 12 scale 9 cr 13 ) 10 - 11 10 11 10 12 scale 14 were 15 used 15 used 16 as 16 as 18 criteria 17 fatigue 18 criteria results : the older adults were significantly ( t] _ { ( 30 ) } = - 2,073 [;] p = 0.039 ) more [resistant] to back muscle fatigue ( time in mean 133 ± 52 [s] ) than the young adults ( mean 97 ± 27 [s] ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 52 . 2 : 5 adults 2 : 6 were 3 the 5 adults 4 older 5 adults 5 adults 6 were 6 were 7 significantly 6 were 19 - 6 were 26 more 6 were 28 to 6 were 41 than 8 ( 19 - 9 t 11 _ 18 = 12 { 14 30 12 { 15 ) 12 { 16 } 19 - 20 2,073 19 - 25 ) 20 2,073 23 = 22 p 23 = 23 = 24 0.039 23 = 25 ) 28 to 29 back 29 back 31 fatigue 30 muscle 31 fatigue 31 fatigue 33 time 32 ( 33 time 33 time 34 in 33 time 40 ) 34 in 37 ± 35 mean 37 ± 36 133 37 ± 37 ± 38 52 41 than 44 adults 42 the 44 adults 43 young 44 adults 44 adults 48 ± 45 ( 48 ± 46 mean 48 ± 47 97 48 ± 48 ± 49 27 48 ± 51 ) in general , both groups had the same perception of high - level fatigue during the exercise bout ( t _ { ( 29 [ )( > = 1.73 ; p=0.092 [ )( 0 ###LEFT-WALL### 5 groups 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 31 ; 0 ###LEFT-WALL### 34 )( 1 in 2 general 2 general 3 , 2 general 5 groups 4 both 5 groups 5 groups 6 had 6 had 9 perception 6 had 15 during 7 the 8 same 8 same 9 perception 9 perception 10 of 10 of 14 fatigue 11 high 12 - 11 high 13 level 13 level 14 fatigue 15 during 18 bout 16 the 18 bout 17 exercise 18 bout 18 bout 29 = 19 ( 29 = 20 t 21 > 22 _ 22 _ 23 { 23 { 28 > 24 ( 28 > 25 29 28 > 28 > 29 = 29 = 30 1.73 29 = 31 ; 31 ; 32 p=0.092 conclusion : the older adults presented better back endurance than young adults during a dynamic trunk extension exercise . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 5 adults 2 : 7 better 3 the 5 adults 4 older 5 adults 5 adults 6 presented 5 adults 7 better 7 better 9 endurance 7 better 10 than 7 better 13 during 8 back 9 endurance 10 than 12 adults 11 young 12 adults 13 during 18 exercise 14 a 18 exercise 15 dynamic 17 extension 16 trunk 17 extension 17 extension 18 exercise these results have implications for back endurance in the primary prevention of low back pain in both young and older adults . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 have 0 ###LEFT-WALL### 22 . 1 these 2 results 2 results 3 have 3 have 4 implications 3 have 8 in 3 have 16 in 4 implications 5 for 5 for 7 endurance 6 back 7 endurance 8 in 11 prevention 9 the 11 prevention 10 primary 11 prevention 11 prevention 12 of 12 of 15 pain 13 low 15 pain 14 back 15 pain 16 in 21 adults 17 both 21 adults 18 young 19 and 19 and 20 older 19 and 21 adults none background and aims : aging with comorbidities , obesity , and rapid recovery from operation may increase the need for laparoscopic cholecystectomy , but long - term use of statins may be associated with a decreased risk of gallstones . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 25 but 0 ###LEFT-WALL### 27 - 0 ###LEFT-WALL### 33 be 0 ###LEFT-WALL### 41 . 1 none 4 aims 1 none 6 aging 1 none 25 but 2 background 3 and 3 and 4 aims 4 aims 5 : 5 : 6 aging 6 aging 7 with 6 aging 15 from 7 with 12 and 8 comorbidities 9 , 9 , 10 obesity 9 , 12 and 11 , 12 and 12 and 14 recovery 13 rapid 14 recovery 15 from 16 operation 17 may 18 increase 17 may 25 but 18 increase 20 need 18 increase 21 for 19 the 20 need 21 for 23 cholecystectomy 22 laparoscopic 23 cholecystectomy 24 , 25 but 25 but 26 long 27 - 33 be 28 term 29 use 29 use 30 of 29 use 32 may 30 of 31 statins 32 may 33 be 33 be 34 associated 34 associated 35 with 35 with 38 risk 36 a 38 risk 37 decreased 38 risk 38 risk 39 of 39 of 40 gallstones this population - based cohort study presents the changing rate and causative factors of laparoscopic cholecystectomy in finland during the era of statin use . 0 ###LEFT-WALL### 2 population 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 25 . 1 this 2 population 3 - 6 study 3 - 7 presents 4 based 5 cohort 5 cohort 6 study 6 study 7 presents 7 presents 11 and 7 presents 17 in 7 presents 19 during 8 the 10 rate 9 changing 10 rate 10 rate 11 and 11 and 13 factors 11 and 14 of 12 causative 13 factors 14 of 16 cholecystectomy 15 laparoscopic 16 cholecystectomy 17 in 18 finland 19 during 21 era 20 the 21 era 21 era 22 of 22 of 24 use 23 statin 24 use materials and methods : age structure of the population , changes in body mass index [and] diabetes , and the number of all cholecystectomies in 1995 - 2009 were retrieved from the registers of national institute for health and welfare . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 5 age 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 41 . 1 materials 2 and 2 and 3 methods 3 methods 4 : 4 : 5 age 5 age 6 structure 6 structure 7 of 7 of 9 population 8 the 9 population 10 , 11 changes 10 , 30 retrieved 11 changes 12 in 11 changes 22 of 11 changes 25 in 11 changes 29 were 12 in 19 and 13 body 14 mass 14 mass 15 index 15 index 17 diabetes 17 diabetes 19 and 18 , 19 and 19 and 21 number 20 the 21 number 22 of 24 cholecystectomies 23 all 24 cholecystectomies 25 in 27 - 26 1995 27 - 27 - 28 2009 29 were 30 retrieved 30 retrieved 31 from 30 retrieved 37 for 31 from 33 registers 32 the 33 registers 33 registers 34 of 34 of 36 institute 35 national 36 institute 37 for 40 welfare 38 health 39 and 39 and 40 welfare additionally , these results were supplemented by a population [-] based retrospective cohort ( 1581 laparoscopic cholecystectomy ) in one community - based hospital area . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 6 supplemented 0 ###LEFT-WALL### 22 - 0 ###LEFT-WALL### 26 . 1 additionally 2 , 1 additionally 4 results 3 these 4 results 4 results 5 were 5 were 6 supplemented 6 supplemented 7 by 6 supplemented 19 in 7 by 13 cohort 8 a 9 population 8 a 13 cohort 9 population 11 based 11 based 13 cohort 12 retrospective 13 cohort 13 cohort 17 cholecystectomy 14 ( 17 cholecystectomy 15 1581 17 cholecystectomy 16 laparoscopic 17 cholecystectomy 17 cholecystectomy 18 ) 19 in 21 community 20 one 21 community 22 - 25 area 23 based 24 hospital 24 hospital 25 area the risk factors for laparoscopic cholecystectomy , use of statins , and surgical outcome were analyzed . 0 ###LEFT-WALL### 3 factors 0 ###LEFT-WALL### 16 analyzed 0 ###LEFT-WALL### 17 . 1 the 3 factors 2 risk 3 factors 3 factors 4 for 3 factors 15 were 4 for 8 use 5 laparoscopic 8 use 6 cholecystectomy 7 , 6 cholecystectomy 8 use 8 use 9 of 9 of 12 and 10 statins 12 and 11 , 12 and 12 and 14 outcome 13 surgical 14 outcome 15 were 16 analyzed results : during the 15 years , 123,794 cholecystectomies were performed in finland , of which 94,740 ( 76.5 % ) were performed using laparoscopic technique . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 27 . 1 results 2 : 2 : 3 during 3 during 6 years 4 the 5 15 5 15 6 years 7 , 9 cholecystectomies 7 , 11 performed 7 , 14 , 8 123,794 9 cholecystectomies 9 cholecystectomies 10 were 10 were 11 performed 11 performed 12 in 12 in 13 finland 14 , 17 94,740 14 , 23 performed 15 of 16 which 15 of 17 94,740 17 94,740 20 % 17 94,740 22 were 18 ( 20 % 19 76.5 20 % 20 % 21 ) 22 were 23 performed 23 performed 24 using 24 using 26 technique 25 laparoscopic 26 technique the median rate of laparoscopic cholecystectomy varied between 110 and 140 operations [per] 100,000 inhabitants . 0 ###LEFT-WALL### 3 rate 0 ###LEFT-WALL### 7 varied 0 ###LEFT-WALL### 16 . 1 the 3 rate 2 median 3 rate 3 rate 4 of 3 rate 7 varied 4 of 6 cholecystectomy 5 laparoscopic 6 cholecystectomy 7 varied 8 between 7 varied 15 inhabitants 8 between 12 operations 9 110 10 and 10 and 11 140 10 and 12 operations 14 100,000 15 inhabitants in 1995 - 2009 , the annual number of cholecystectomies decreased from 8600 to 7500 , the number of laparoscopic cholecystectomies increased by 10 % , and the number of open cholecystectomies declined by 60 % . 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 33 declined 0 ###LEFT-WALL### 37 . 1 in 2 1995 1 in 27 and 2 1995 4 2009 3 - 4 2009 4 2009 5 , 6 the 8 number 7 annual 8 number 8 number 9 of 8 number 27 and 9 of 10 cholecystectomies 10 cholecystectomies 11 decreased 10 cholecystectomies 12 from 10 cholecystectomies 18 number 12 from 14 to 13 8600 14 to 14 to 15 7500 16 , 18 number 17 the 18 number 18 number 19 of 18 number 22 increased 18 number 26 , 19 of 21 cholecystectomies 20 laparoscopic 21 cholecystectomies 22 increased 23 by 23 by 25 % 24 10 25 % 27 and 29 number 27 and 30 of 27 and 33 declined 28 the 29 number 30 of 32 cholecystectomies 31 open 32 cholecystectomies 33 declined 34 by 34 by 36 % 35 60 36 % use of statins increased more than fourfold during the 15 years . 0 ###LEFT-WALL### 1 use 0 ###LEFT-WALL### 4 increased 0 ###LEFT-WALL### 12 . 1 use 2 of 1 use 4 increased 2 of 3 statins 4 increased 7 fourfold 4 increased 8 during 5 more 6 than 6 than 7 fourfold 8 during 11 years 9 the 10 15 10 15 11 years conclusions : the rates of all cholecystectomies decreased [despite] marked increase in laparoscopic cholecystectomies performed . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 2 : 4 rates 2 : 11 increase 3 the 4 rates 4 rates 5 of 4 rates 11 increase 5 of 7 cholecystectomies 6 all 7 cholecystectomies 7 cholecystectomies 8 decreased 7 cholecystectomies 10 marked 11 increase 12 in 12 in 14 cholecystectomies 13 laparoscopic 14 cholecystectomies 14 cholecystectomies 15 performed the increase in risk factors for gallstones in finland implied more [marked] increase in laparoscopic cholecystectomies . 0 ###LEFT-WALL### 2 increase 0 ###LEFT-WALL### 10 implied 0 ###LEFT-WALL### 17 . 1 the 2 increase 2 increase 3 in 2 increase 10 implied 3 in 5 factors 4 risk 5 factors 5 factors 6 for 5 factors 8 in 6 for 7 gallstones 8 in 9 finland 10 implied 11 more 10 implied 13 increase 11 more 13 increase 13 increase 14 in 14 in 16 cholecystectomies 15 laparoscopic 16 cholecystectomies the possible role of statins on gallstone disease is discussed . 0 ###LEFT-WALL### 3 role 0 ###LEFT-WALL### 10 discussed 0 ###LEFT-WALL### 11 . 1 the 3 role 2 possible 3 role 3 role 4 of 3 role 9 is 4 of 5 statins 5 statins 6 on 6 on 8 disease 7 gallstone 8 disease 9 is 10 discussed study design : narrative [overview] of the focus issue on cervical spondylotic myelopathy ( csm ) . 0 ###LEFT-WALL### 2 design 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 17 . 1 study 2 design 2 design 3 : 3 : 4 narrative 4 narrative 6 of 6 of 9 issue 7 the 9 issue 8 focus 9 issue 9 issue 10 on 10 on 13 myelopathy 11 cervical 13 myelopathy 12 spondylotic 13 myelopathy 13 myelopathy 15 csm 14 ( 15 csm 15 csm 16 ) objective : to provide an introduction to this special focus issue of spine [journal] that deals with csm . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 . 2 : 3 to 2 : 4 provide 3 to 4 provide 4 provide 6 introduction 4 provide 7 to 4 provide 17 with 5 an 6 introduction 7 to 11 issue 8 this 11 issue 9 special 10 focus 10 focus 11 issue 11 issue 12 of 12 of 13 spine 13 spine 15 that 13 spine 16 deals 15 that 16 deals 17 with 18 csm summary of background data : csm is a progressive spine disease and the leading cause of spinal cord dysfunction worldwide . 0 ###LEFT-WALL### 4 data 0 ###LEFT-WALL### 5 : 1 summary 2 of 2 of 3 background 3 background 4 data 5 : 6 csm 5 : 7 is 5 : 21 . 6 csm 7 is 7 is 19 dysfunction 7 is 20 worldwide 8 a 19 dysfunction 9 progressive 10 spine 10 spine 19 dysfunction 11 disease 12 and 12 and 15 cause 12 and 16 of 12 and 19 dysfunction 13 the 15 cause 14 leading 15 cause 16 of 18 cord 17 spinal 18 cord the shift in population demographics in many parts of the world has motivated the development of this focus issue . 0 ###LEFT-WALL### 2 shift 0 ###LEFT-WALL### 13 motivated 0 ###LEFT-WALL### 20 . 1 the 2 shift 2 shift 3 in 2 shift 12 has 3 in 5 demographics 4 population 5 demographics 5 demographics 6 in 6 in 8 parts 7 many 8 parts 8 parts 9 of 9 of 11 world 10 the 11 world 12 has 13 motivated 13 motivated 15 development 14 the 15 development 15 development 16 of 16 of 19 issue 17 this 19 issue 18 focus 19 issue with the overall aging of the population , we can predict that global health care systems will be confronted with an increase in patients presenting with degenerative spine changes and various stages of cervical myelopathy . 0 ###LEFT-WALL### 9 we 0 ###LEFT-WALL### 25 presenting 0 ###LEFT-WALL### 36 . 1 with 3 overall 1 with 8 , 1 with 9 we 2 the 3 overall 3 overall 4 aging 3 overall 5 of 5 of 7 population 6 the 7 population 9 we 10 can 10 can 11 predict 11 predict 14 health 12 that 14 health 13 global 14 health 14 health 16 systems 14 health 25 presenting 15 care 16 systems 16 systems 17 will 17 will 18 be 18 be 19 confronted 19 confronted 20 with 20 with 22 increase 20 with 25 presenting 21 an 22 increase 22 increase 23 in 23 in 24 patients 25 presenting 26 with 26 with 30 and 27 degenerative 29 changes 28 spine 29 changes 29 changes 30 and 30 and 32 stages 31 various 32 stages 32 stages 33 of 33 of 35 myelopathy 34 cervical 35 myelopathy methods : the articles in this issue vary in their methods - there are systematic reviews , narrative reviews , a study protocol , and 2 primary research articles . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 articles 2 : 8 vary 2 : 12 - 2 : 30 . 3 the 4 articles 4 articles 5 in 4 articles 8 vary 5 in 7 issue 6 this 7 issue 8 vary 9 in 9 in 11 methods 10 their 11 methods 12 - 13 there 12 - 14 are 13 there 14 are 14 are 25 and 15 systematic 16 reviews 16 reviews 17 , 17 , 19 reviews 17 , 20 , 18 narrative 19 reviews 20 , 23 protocol 20 , 25 and 21 a 22 study 21 a 23 protocol 22 study 23 protocol 24 , 25 and 25 and 29 articles 26 2 29 articles 27 primary 28 research 28 research 29 articles results : a summary of the findings of each article is provided as a table within this introduction . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 summary 2 : 12 provided 2 : 19 . 3 a 4 summary 4 summary 5 of 4 summary 11 is 5 of 7 findings 6 the 7 findings 7 findings 8 of 8 of 10 article 9 each 10 article 11 is 12 provided 12 provided 13 as 12 provided 16 within 13 as 15 table 14 a 15 table 16 within 18 introduction 17 this 18 introduction conclusion : by way of this issue , we have summarized current knowledge gaps and limitations in the evidence to provide direction for future research and investigation . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 21 provide 0 ###LEFT-WALL### 28 . 1 conclusion 2 : 2 : 5 of 3 by 4 way 4 way 5 of 5 of 7 issue 6 this 7 issue 8 , 9 we 8 , 11 summarized 9 we 10 have 10 have 11 summarized 11 summarized 15 and 11 summarized 17 in 11 summarized 20 to 12 current 14 gaps 13 knowledge 14 gaps 14 gaps 15 and 15 and 16 limitations 17 in 19 evidence 18 the 19 evidence 20 to 21 provide 21 provide 22 direction 21 provide 23 for 23 for 26 and 24 future 25 research 25 research 26 and 26 and 27 investigation these include the need for a unified nomenclature for referring to csm , the need to specify the incidence of myelopathy and the prevalence of ossification of the posterior longitudinal ligament , and the need to explore both the safety and efficacy of neuroprotective and neuroreparative pharmacological strategies . 0 ###LEFT-WALL### 1 these 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 49 . 1 these 2 include 2 include 33 and 2 include 36 to 3 the 4 need 4 need 5 for 4 need 9 for 4 need 33 and 5 for 8 nomenclature 6 a 8 nomenclature 7 unified 8 nomenclature 9 for 10 referring 10 referring 11 to 11 to 12 csm 12 csm 15 need 13 , 15 need 14 the 15 need 15 need 16 to 15 need 17 specify 15 need 20 of 15 need 32 , 16 to 17 specify 17 specify 19 incidence 18 the 19 incidence 20 of 22 and 21 myelopathy 22 and 22 and 24 prevalence 22 and 32 , 23 the 24 prevalence 24 prevalence 25 of 25 of 26 ossification 26 ossification 27 of 27 of 31 ligament 28 the 31 ligament 29 posterior 31 ligament 30 longitudinal 31 ligament 33 and 35 need 34 the 35 need 36 to 37 explore 37 explore 41 and 38 both 41 and 39 the 40 safety 40 safety 41 and 41 and 42 efficacy 41 and 43 of 43 of 45 and 44 neuroprotective 45 and 45 and 48 strategies 46 neuroreparative 48 strategies 47 pharmacological 48 strategies further work is also required to optimize the management of patients with minimal symptoms . 0 ###LEFT-WALL### 2 work 0 ###LEFT-WALL### 5 required 0 ###LEFT-WALL### 15 . 1 further 2 work 2 work 3 is 3 is 4 also 3 is 5 required 5 required 6 to 5 required 7 optimize 6 to 7 optimize 7 optimize 9 management 7 optimize 12 with 8 the 9 management 9 management 10 of 10 of 11 patients 12 with 14 symptoms 13 minimal 14 symptoms none recent studies on development of visual working memory ( vwm ) [predominantly] focus on vwm capacity and spatial - based information filtering in vwm . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 14 focus 0 ###LEFT-WALL### 26 . 1 none 2 recent 1 none 3 studies 1 none 11 vwm 1 none 14 focus 2 recent 3 studies 3 studies 4 on 4 on 5 development 5 development 6 of 6 of 9 memory 7 visual 9 memory 8 working 9 memory 10 ( 11 vwm 11 vwm 12 ) 14 focus 15 on 14 focus 18 and 15 on 16 vwm 17 capacity 18 and 18 and 22 information 18 and 23 filtering 19 spatial 20 - 19 spatial 22 information 21 based 22 information 23 filtering 24 in 24 in 25 vwm here we explored another new aspect of vwm development : object - based encoding ( obe ) , which refers to the fact that even if one feature dimension is required to be selected into vwm , the other irrelevant dimensions are also extracted . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 explored 0 ###LEFT-WALL### 10 : 1 here 2 we 2 we 3 explored 3 explored 6 aspect 4 another 6 aspect 5 new 6 aspect 6 aspect 7 of 7 of 9 development 8 vwm 9 development 10 : 11 object 10 : 12 - 10 : 45 . 12 - 14 encoding 12 - 18 , 13 based 14 encoding 14 encoding 16 obe 15 ( 16 obe 16 obe 17 ) 18 , 19 which 18 , 20 refers 19 which 20 refers 20 refers 21 to 21 to 23 fact 22 the 23 fact 23 fact 24 that 24 that 25 even 24 that 41 dimensions 24 that 44 extracted 26 if 29 dimension 26 if 31 required 26 if 41 dimensions 27 one 29 dimension 28 feature 29 dimension 29 dimension 30 is 30 is 31 required 31 required 32 to 31 required 33 be 32 to 33 be 33 be 34 selected 35 into 36 vwm 35 into 37 , 35 into 41 dimensions 38 the 39 other 39 other 41 dimensions 40 irrelevant 41 dimensions 41 dimensions 42 are 42 are 44 extracted 43 also 44 extracted we explored the obe in children , young adults , and old adults , by probing an " irrelevant - change distracting effect " in which [a] change of stored irrelevant feature dramatically affects the performance of task - relevant features in a change - detection task . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 explored 0 ###LEFT-WALL### 7 , 1 we 2 explored 2 explored 4 obe 3 the 4 obe 4 obe 5 in 5 in 6 children 7 , 11 and 7 , 14 , 8 young 9 adults 9 adults 11 and 10 , 11 and 11 and 13 adults 12 old 13 adults 14 , 22 distracting 15 by 16 probing 15 by 22 distracting 16 probing 21 change 17 an 18 " 17 an 21 change 19 irrelevant 20 - 19 irrelevant 21 change 22 distracting 23 effect 22 distracting 25 in 22 distracting 34 affects 23 effect 24 " 25 in 26 which 25 in 28 change 26 which 28 change 28 change 29 of 29 of 32 feature 30 stored 32 feature 31 irrelevant 32 feature 33 dramatically 34 affects 34 affects 36 performance 35 the 36 performance 36 performance 37 of 37 of 38 task 38 task 41 features 38 task 47 task 39 - 41 features 40 relevant 41 features 41 features 42 in 41 features 45 - 42 in 44 change 43 a 44 change 45 - 47 task 46 detection 47 task 47 task 48 . participants were required to remember two or four simple colored shapes , while color was used as the relevant dimension . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 required 1 participants 2 were 2 were 3 required 3 required 4 to 3 required 5 remember 4 to 5 remember 5 remember 11 shapes 5 remember 13 while 6 two 7 or 7 or 8 four 7 or 11 shapes 9 simple 11 shapes 10 colored 11 shapes 12 , 13 while 13 while 14 color 13 while 16 used 13 while 21 . 14 color 15 was 15 was 16 used 16 used 17 as 17 as 20 dimension 18 the 20 dimension 19 relevant 20 dimension we found that changes to irrelevant shapes led to a significant distracting effect across the three age groups in both load conditions ; however , children showed a greater degree of obe than did young and old adults . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 23 ; 0 ###LEFT-WALL### 39 . 1 we 2 found 2 found 3 that 3 that 4 changes 3 that 17 age 4 changes 5 to 4 changes 14 across 4 changes 17 age 5 to 7 shapes 6 irrelevant 7 shapes 7 shapes 8 led 8 led 9 to 9 to 13 effect 10 a 13 effect 11 significant 13 effect 12 distracting 13 effect 14 across 16 three 15 the 16 three 17 age 18 groups 18 groups 19 in 19 in 22 conditions 20 both 22 conditions 21 load 22 conditions 23 ; 26 children 23 ; 27 showed 24 however 25 , 24 however 26 children 26 children 27 showed 27 showed 32 obe 27 showed 33 than 28 a 30 degree 29 greater 30 degree 30 degree 31 of 30 degree 32 obe 31 of 32 obe 33 than 34 did 34 did 38 adults 35 young 36 and 36 and 37 old 36 and 38 adults these results suggest that obe exists in vwm over the life span ( 6 - 67 years ) , yet continues to develop along with vwm . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 27 . 1 these 2 results 2 results 19 , 3 suggest 4 that 3 suggest 19 , 4 that 5 obe 4 that 6 exists 5 obe 6 exists 6 exists 7 in 7 in 8 vwm 8 vwm 9 over 8 vwm 17 years 9 over 12 span 10 the 12 span 11 life 12 span 13 ( 17 years 14 6 15 - 15 - 16 67 15 - 17 years 17 years 18 ) 19 , 21 continues 19 , 25 with 20 yet 21 continues 21 continues 22 to 21 continues 23 develop 22 to 23 develop 24 along 25 with 25 with 26 vwm objective : spinal mobility is assessed frequently in patients with as/axial spa using the basmi to provide baseline measurement and monitor change over time . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 4 mobility 2 : 6 assessed 3 spinal 4 mobility 4 mobility 5 is 5 is 6 assessed 6 assessed 7 frequently 6 assessed 8 in 8 in 20 and 9 patients 10 with 9 patients 13 using 9 patients 20 and 10 with 12 spa 11 as/axial 12 spa 13 using 15 basmi 13 using 16 to 13 using 17 provide 14 the 15 basmi 16 to 17 provide 17 provide 19 measurement 18 baseline 19 measurement 20 and 22 change 21 monitor 22 change 22 change 23 over 23 over 24 time the interpretation of basmi scores has been hindered by the absence of normative values . 0 ###LEFT-WALL### 2 interpretation 0 ###LEFT-WALL### 8 hindered 0 ###LEFT-WALL### 15 . 1 the 2 interpretation 2 interpretation 3 of 2 interpretation 6 has 3 of 5 scores 4 basmi 5 scores 6 has 7 been 7 been 8 hindered 8 hindered 9 by 9 by 11 absence 10 the 11 absence 11 absence 12 of 12 of 14 values 13 normative 14 values we aimed to obtain normative values for the basmi in healthy men and women in a uk population . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 19 . 1 we 2 aimed 2 aimed 3 to 2 aimed 4 obtain 3 to 4 obtain 4 obtain 6 values 4 obtain 10 in 4 obtain 15 in 5 normative 6 values 6 values 7 for 7 for 9 basmi 8 the 9 basmi 10 in 13 and 11 healthy 12 men 12 men 13 and 13 and 14 women 15 in 18 population 16 a 18 population 17 uk 18 population methods : a cross - sectional study of 168 volunteers stratified by gender and age was completed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 - 1 methods 2 : 2 : 4 cross 3 a 4 cross 5 - 7 study 5 - 17 completed 5 - 18 . 6 sectional 7 study 7 study 8 of 7 study 16 was 8 of 10 volunteers 9 168 10 volunteers 10 volunteers 11 stratified 10 volunteers 12 by 12 by 14 and 13 gender 14 and 14 and 15 age 16 was 17 completed exclusion criteria comprised factors potentially influencing spinal mobility . 0 ###LEFT-WALL### 2 criteria 0 ###LEFT-WALL### 3 comprised 0 ###LEFT-WALL### 9 . 1 exclusion 2 criteria 2 criteria 3 comprised 3 comprised 4 factors 4 factors 6 influencing 5 potentially 6 influencing 6 influencing 8 mobility 7 spinal 8 mobility each component of the basmi was assessed , with the total score computed using the 10 - point scoring system . 0 ###LEFT-WALL### 2 component 0 ###LEFT-WALL### 7 assessed 0 ###LEFT-WALL### 17 - 1 each 2 component 2 component 3 of 2 component 6 was 3 of 5 basmi 4 the 5 basmi 6 was 7 assessed 7 assessed 9 with 8 , 9 with 9 with 12 score 9 with 17 - 10 the 12 score 11 total 12 score 12 score 13 computed 13 computed 14 using 14 using 16 10 15 the 16 10 17 - 20 system 17 - 21 . 18 point 19 scoring 19 scoring 20 system measurements were taken by physiotherapists following [an] [agreed] protocol . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 3 taken 0 ###LEFT-WALL### 10 . 1 measurements 2 were 2 were 3 taken 3 taken 4 by 4 by 5 physiotherapists 5 physiotherapists 6 following 6 following 9 protocol data were summarized and analysed with age - specific centiles and cis calculated . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 13 calculated 1 data 2 were 2 were 4 and 3 summarized 4 and 4 and 5 analysed 4 and 6 with 6 with 7 age 8 - 13 calculated 9 specific 10 centiles 10 centiles 11 and 11 and 12 cis 11 and 13 calculated 13 calculated 14 . results : total basmi scores ranged from 0 to 4.4 , with only 1.2 % of the sample having a score of 0 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 5 scores 3 total 4 basmi 4 basmi 5 scores 5 scores 6 ranged 6 ranged 7 from 6 ranged 12 with 7 from 9 to 8 0 9 to 9 to 10 4.4 11 , 12 with 12 with 15 % 12 with 19 having 12 with 24 . 13 only 14 1.2 14 1.2 15 % 15 % 16 of 16 of 18 sample 17 the 18 sample 19 having 21 score 20 a 21 score 21 score 22 of 22 of 23 0 the estimated median score for an individual [age] 25 years was 0.9 , increasing with age to 2.1 for an individual age 65 years . 0 ###LEFT-WALL### 4 score 0 ###LEFT-WALL### 11 was 1 the 4 score 2 estimated 4 score 3 median 4 score 4 score 5 for 4 score 11 was 5 for 10 years 6 an 7 individual 6 an 10 years 7 individual 10 years 9 25 10 years 11 was 12 0.9 12 0.9 14 increasing 13 , 14 increasing 14 increasing 15 with 14 increasing 17 to 14 increasing 24 years 14 increasing 25 . 15 with 16 age 17 to 18 2.1 18 2.1 19 for 19 for 22 age 20 an 22 age 21 individual 22 age 23 65 24 years there was a corresponding increase in component basmi scores , which was more pronounced for some components than others . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 20 . 1 there 2 was 2 was 5 increase 3 a 4 corresponding 3 a 5 increase 4 corresponding 5 increase 5 increase 6 in 6 in 9 scores 7 component 9 scores 8 basmi 9 scores 10 , 11 which 10 , 14 pronounced 11 which 12 was 12 was 13 more 12 was 14 pronounced 14 pronounced 15 for 14 pronounced 18 than 15 for 17 components 16 some 17 components 18 than 19 others conclusion : our data indicate that it is unusual for healthy individuals to score zero on the basmi , which has implications for the interpretation of scores , especially at baseline . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 32 . 2 : 4 data 2 : 5 indicate 3 our 4 data 4 data 5 indicate 5 indicate 6 that 6 that 7 it 6 that 8 is 7 it 8 is 8 is 9 unusual 9 unusual 10 for 9 unusual 13 to 9 unusual 14 score 10 for 12 individuals 11 healthy 12 individuals 13 to 14 score 14 score 15 zero 14 score 16 on 14 score 29 especially 16 on 18 basmi 17 the 18 basmi 18 basmi 20 which 19 , 20 which 20 which 21 has 20 which 28 , 21 has 22 implications 22 implications 23 for 22 implications 26 of 23 for 25 interpretation 24 the 25 interpretation 26 of 27 scores 29 especially 30 at 30 at 31 baseline the generation of normative values has the potential to inform clinical assessment of spinal mobility and assist patients in understanding how their spinal mobility compares with that of a healthy age - matched population . 0 ###LEFT-WALL### 2 generation 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 32 - 0 ###LEFT-WALL### 35 . 1 the 2 generation 2 generation 3 of 2 generation 6 has 3 of 5 values 4 normative 5 values 6 has 8 potential 6 has 9 to 7 the 8 potential 9 to 16 and 10 inform 12 assessment 10 inform 16 and 11 clinical 12 assessment 12 assessment 13 of 13 of 15 mobility 14 spinal 15 mobility 16 and 17 assist 17 assist 18 patients 18 patients 19 in 18 patients 28 of 19 in 20 understanding 20 understanding 21 how 21 how 24 mobility 21 how 25 compares 22 their 24 mobility 23 spinal 24 mobility 24 mobility 25 compares 25 compares 26 with 26 with 27 that 28 of 31 age 29 a 30 healthy 29 a 31 age 30 healthy 31 age 32 - 34 population 33 matched 34 population practitioners are encouraged to consider a shift in their philosophy regarding the manner in which interdisciplinary health care teams ask questions of seniors and their caregivers in the hospital discharge process . 0 ###LEFT-WALL### 1 practitioners 0 ###LEFT-WALL### 5 consider 0 ###LEFT-WALL### 20 ask 0 ###LEFT-WALL### 32 . 1 practitioners 2 are 2 are 3 encouraged 3 encouraged 4 to 4 to 5 consider 5 consider 7 shift 5 consider 8 in 6 a 7 shift 8 in 10 philosophy 9 their 10 philosophy 10 philosophy 11 regarding 11 regarding 13 manner 12 the 13 manner 13 manner 14 in 14 in 15 which 14 in 17 health 14 in 18 care 14 in 20 ask 15 which 17 health 16 interdisciplinary 17 health 18 care 19 teams 20 ask 21 questions 20 ask 27 in 21 questions 22 of 22 of 24 and 23 seniors 24 and 24 and 26 caregivers 25 their 26 caregivers 27 in 31 process 28 the 31 process 29 hospital 31 process 30 discharge 31 process by engaging with a discharge framework that encompasses a social - determinants - [of] - health lens , discharge planning teams can begin to systematically ask questions that move beyond the traditional medical focus on prescriptions , rehabilitation , and treatments . 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 37 , 0 ###LEFT-WALL### 42 . 1 by 2 engaging 1 by 18 , 2 engaging 3 with 2 engaging 7 that 3 with 6 framework 4 a 5 discharge 4 a 6 framework 5 discharge 6 framework 8 encompasses 17 lens 8 encompasses 18 , 9 a 10 social 9 a 17 lens 10 social 12 determinants 10 social 15 - 10 social 16 health 11 - 12 determinants 12 determinants 13 - 16 health 17 lens 18 , 23 begin 19 discharge 21 teams 20 planning 21 teams 21 teams 22 can 22 can 23 begin 23 begin 24 to 23 begin 26 ask 24 to 26 ask 25 systematically 26 ask 26 ask 27 questions 26 ask 30 beyond 26 ask 35 on 27 questions 28 that 27 questions 29 move 28 that 29 move 30 beyond 34 focus 31 the 34 focus 32 traditional 34 focus 33 medical 34 focus 35 on 36 prescriptions 37 , 40 and 38 rehabilitation 40 and 39 , 40 and 40 and 41 treatments this approach may reveal strengths and also expose health and social inequities that seniors might face upon their arrival home . 0 ###LEFT-WALL### 2 approach 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 21 . 1 this 2 approach 2 approach 3 may 3 may 6 and 4 reveal 5 strengths 4 reveal 6 and 6 and 8 expose 6 and 12 inequities 7 also 8 expose 8 expose 10 and 9 health 10 and 10 and 11 social 12 inequities 13 that 12 inequities 16 face 13 that 14 seniors 13 that 16 face 14 seniors 15 might 15 might 16 face 16 face 17 upon 16 face 20 home 17 upon 19 arrival 18 their 19 arrival this information may open a gateway for connecting seniors to social and economic resources that will support them in remaining productive and healthy . 0 ###LEFT-WALL### 2 information 0 ###LEFT-WALL### 4 open 0 ###LEFT-WALL### 24 . 1 this 2 information 2 information 3 may 3 may 4 open 4 open 6 gateway 4 open 19 in 5 a 6 gateway 6 gateway 7 for 6 gateway 10 to 7 for 8 connecting 8 connecting 9 seniors 10 to 14 resources 11 social 12 and 12 and 13 economic 12 and 14 resources 14 resources 15 that 14 resources 16 will 15 that 16 will 16 will 17 support 17 support 18 them 19 in 20 remaining 20 remaining 22 and 21 productive 22 and 22 and 23 healthy this study sought to determine [(] 1 [ )(if measures of social [position] are associated with frailty [;] ( 2 ) if any observed association between social position and frailty is a threshold or gradient effect [;] [and] ( 3 ) if any observed association is independent of possible confounders [.] 1 this 2 study 2 study 3 sought 3 sought 4 to 3 sought 5 determine 4 to 5 determine 5 determine 7 1 5 determine 9 )(if 9 )(if 10 measures 9 )(if 15 associated 10 measures 11 of 10 measures 14 are 11 of 12 social 14 are 15 associated 15 associated 16 with 15 associated 22 if 16 with 17 frailty 17 frailty 20 2 19 ( 20 2 20 2 21 ) 22 if 23 any 22 if 24 observed 23 any 24 observed 24 observed 25 association 24 observed 31 is 25 association 26 between 25 association 31 is 26 between 29 and 27 social 28 position 28 position 29 and 29 and 30 frailty 31 is 36 effect 31 is 42 if 32 a 33 threshold 33 threshold 34 or 34 or 35 gradient 34 or 36 effect 36 effect 40 3 39 ( 40 3 40 3 41 ) 42 if 43 any 42 if 44 observed 43 any 44 observed 44 observed 45 association 44 observed 46 is 45 association 46 is 46 is 47 independent 47 independent 48 of 48 of 50 confounders 49 possible 50 confounders data were drawn from a sample of 1,751 [community] - dwelling adults , aged 65 and older , living in the canadian province of manitoba in 1991 . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 drawn 0 ###LEFT-WALL### 28 . 1 data 2 were 2 were 3 drawn 3 drawn 4 from 3 drawn 20 in 3 drawn 26 in 4 from 16 and 5 a 6 sample 6 sample 7 of 6 sample 14 aged 6 sample 16 and 7 of 8 1,751 8 1,751 12 adults 10 - 12 adults 11 dwelling 12 adults 12 adults 13 , 14 aged 15 65 16 and 19 living 17 older 18 , 17 older 19 living 20 in 23 province 21 the 23 province 22 canadian 23 province 23 province 24 of 24 of 25 manitoba 26 in 27 1991 education , self [-] reported income adequacy , and self - reported income satisfaction were used as measures of social position . 0 ###LEFT-WALL### 21 position 0 ###LEFT-WALL### 22 . 1 education 2 , 2 , 7 adequacy 2 , 9 and 3 self 5 reported 5 reported 7 adequacy 6 income 7 adequacy 8 , 9 and 9 and 10 self 9 and 11 - 9 and 14 satisfaction 9 and 19 of 9 and 21 position 12 reported 13 income 13 income 14 satisfaction 14 satisfaction 15 were 15 were 16 used 16 used 17 as 17 as 18 measures 18 measures 19 of 20 social 21 position frailty was graded [based] on functional loss , cognition , and urinary incontinence . 0 ###LEFT-WALL### 1 frailty 0 ###LEFT-WALL### 3 graded 0 ###LEFT-WALL### 14 . 1 frailty 2 was 2 was 3 graded 3 graded 5 on 5 on 11 and 6 functional 7 loss 7 loss 8 , 8 , 9 cognition 8 , 11 and 10 , 11 and 11 and 13 incontinence 12 urinary 13 incontinence multivariate regression analyses revealed , after adjusting for possible confounding factors , that [all] measures [of] social position were strongly associated with frailty in a gradient , rather than a threshold , manner . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 4 revealed 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 34 . 1 multivariate 2 regression 3 analyses 4 revealed 4 revealed 6 after 5 , 6 after 6 after 7 adjusting 6 after 12 , 7 adjusting 8 for 7 adjusting 11 factors 8 for 10 confounding 9 possible 10 confounding 12 , 18 position 12 , 21 associated 12 , 32 , 13 that 18 position 15 measures 18 position 17 social 18 position 18 position 19 were 19 were 20 strongly 19 were 21 associated 21 associated 22 with 21 associated 29 than 22 with 23 frailty 23 frailty 24 in 24 in 26 gradient 25 a 26 gradient 27 , 29 than 28 rather 29 than 29 than 31 threshold 29 than 32 , 30 a 31 threshold 32 , 33 manner we conclude that social gradients for frailty are present in older adults , although a causal mechanism is not yet clear . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 18 is 0 ###LEFT-WALL### 22 . 1 we 2 conclude 2 conclude 3 that 3 that 5 gradients 3 that 8 are 4 social 5 gradients 5 gradients 6 for 5 gradients 8 are 6 for 7 frailty 8 are 9 present 8 are 14 although 9 present 10 in 10 in 12 adults 11 older 12 adults 13 , 14 although 14 although 17 mechanism 15 a 16 causal 15 a 17 mechanism 16 causal 17 mechanism 17 mechanism 18 is 18 is 19 not 18 is 20 yet 18 is 21 clear micrornas ( mirnas ) are small , noncoding rnas that function in complex networks to regulate protein expression . 0 ###LEFT-WALL### 1 micrornas 0 ###LEFT-WALL### 5 are 1 micrornas 3 mirnas 1 micrornas 5 are 2 ( 3 mirnas 3 mirnas 4 ) 5 are 6 small 6 small 8 noncoding 7 , 8 noncoding 8 noncoding 9 rnas 8 noncoding 19 . 9 rnas 10 that 9 rnas 11 function 10 that 11 function 11 function 12 in 11 function 15 to 12 in 14 networks 13 complex 14 networks 15 to 16 regulate 16 regulate 18 expression 17 protein 18 expression in the brain , they are involved in development and synaptic plasticity . 0 ###LEFT-WALL### 5 they 0 ###LEFT-WALL### 7 involved 0 ###LEFT-WALL### 13 . 1 in 3 brain 1 in 4 , 1 in 5 they 2 the 3 brain 5 they 6 are 6 are 7 involved 7 involved 8 in 8 in 10 and 9 development 10 and 10 and 12 plasticity 11 synaptic 12 plasticity in this study , we aimed to identify mirnas with a differential expression in either hippocampus or cerebrospinal fluid ( csf ) from alzheimer 's disease ( ad ) patients and age - matched nondemented control subjects using quantitative polymerase chain reaction . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 31 and 0 ###LEFT-WALL### 33 - 0 ###LEFT-WALL### 43 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 31 and 6 aimed 7 to 6 aimed 8 identify 6 aimed 31 and 7 to 8 identify 8 identify 9 mirnas 8 identify 10 with 10 with 13 expression 10 with 30 patients 11 a 12 differential 11 a 13 expression 12 differential 13 expression 13 expression 14 in 13 expression 23 from 13 expression 28 ad 14 in 17 or 15 either 16 hippocampus 16 hippocampus 17 or 17 or 19 fluid 17 or 21 csf 18 cerebrospinal 19 fluid 20 ( 21 csf 21 csf 22 ) 23 from 26 disease 24 alzheimer 25 's 25 's 26 disease 27 ( 28 ad 28 ad 29 ) 31 and 32 age 33 - 36 control 33 - 37 subjects 34 matched 36 control 35 nondemented 36 control 36 control 37 subjects 37 subjects 38 using 37 subjects 42 reaction 38 using 41 chain 39 quantitative 40 polymerase 40 polymerase 41 chain in hippocampus , we also differentiated between ad patients with an intermediate stage , according to braak iii/iv [stage] , and a late stage , characterized according to braak vi stage . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 6 differentiated 1 in 2 hippocampus 1 in 3 , 1 in 4 we 4 we 6 differentiated 5 also 6 differentiated 6 differentiated 7 between 6 differentiated 10 with 6 differentiated 16 to 7 between 9 patients 8 ad 9 patients 10 with 13 stage 11 an 12 intermediate 11 an 13 stage 12 intermediate 13 stage 14 , 16 to 15 according 16 to 16 to 17 braak 16 to 32 . 17 braak 21 and 17 braak 31 stage 18 iii/iv 21 and 20 , 21 and 21 and 24 stage 21 and 25 , 21 and 26 characterized 21 and 31 stage 22 a 23 late 22 a 24 stage 23 late 24 stage 26 characterized 28 to 27 according 28 to 28 to 29 braak 29 braak 30 vi eight selected mirnas were analyzed in hippocampus , and the expression of mir - 16 , mir - 34c , mir - 107 , mir - 128a , and mir - 146a were differentially regulated . 0 ###LEFT-WALL### 1 eight 0 ###LEFT-WALL### 5 analyzed 0 ###LEFT-WALL### 36 . 1 eight 3 mirnas 1 eight 4 were 1 eight 5 analyzed 2 selected 3 mirnas 3 mirnas 4 were 5 analyzed 6 in 5 analyzed 29 and 5 analyzed 33 were 6 in 9 and 7 hippocampus 9 and 8 , 9 and 9 and 11 expression 10 the 11 expression 12 of 13 mir 12 of 29 and 13 mir 15 16 13 mir 17 mir 14 - 15 16 15 16 16 , 16 , 17 mir 17 mir 18 - 19 34c 20 , 20 , 27 128a 20 , 29 and 21 mir 23 107 21 mir 27 128a 22 - 23 107 23 107 24 , 25 mir 26 - 25 mir 27 128a 28 , 29 and 29 and 32 146a 29 and 33 were 30 mir 31 - 30 mir 32 146a 33 were 34 differentially 33 were 35 regulated in csf , out of 8 selected mirnas only mir - 16 and mir - 146a could be reliably detected . 0 ###LEFT-WALL### 8 mirnas 0 ###LEFT-WALL### 10 mir 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 21 . 1 in 2 csf 1 in 3 , 1 in 8 mirnas 4 out 5 of 5 of 6 8 5 of 8 mirnas 6 8 7 selected 8 mirnas 10 mir 9 only 10 mir 10 mir 12 16 11 - 12 16 13 and 16 146a 13 and 20 detected 14 mir 15 - 14 mir 16 146a 16 146a 17 could 17 could 18 be 18 be 19 reliably 18 be 20 detected in addition , we identified an effect of blood contamination on the csf levels of mir - 16 , mir - 24 , and mir - 146a . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 identified 0 ###LEFT-WALL### 28 . 1 in 2 addition 1 in 3 , 1 in 4 we 4 we 5 identified 5 identified 7 effect 5 identified 11 on 6 an 7 effect 7 effect 8 of 8 of 10 contamination 9 blood 10 contamination 11 on 24 and 12 the 14 levels 13 csf 14 levels 14 levels 15 of 14 levels 24 and 15 of 16 mir 16 mir 18 16 16 mir 20 mir 17 - 18 16 18 16 19 , 19 , 20 mir 20 mir 22 24 20 mir 23 , 21 - 22 24 22 24 23 , 24 and 27 146a 25 mir 26 - 25 mir 27 146a for group comparisons , we therefore selected csf samples absent [of] , or containing only low numbers of blood cells . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 7 selected 0 ###LEFT-WALL### 21 . 1 for 3 comparisons 1 for 4 , 1 for 5 we 2 group 3 comparisons 5 we 7 selected 6 therefore 7 selected 7 selected 9 samples 8 csf 9 samples 9 samples 13 or 9 samples 16 low 10 absent 13 or 12 , 13 or 13 or 14 containing 13 or 16 low 15 only 16 low 16 low 20 cells 17 numbers 18 of 17 numbers 20 cells 18 of 20 cells 19 blood 20 cells levels of mir - 146a were significantly decreased in csf of ad patients . 0 ###LEFT-WALL### 1 levels 0 ###LEFT-WALL### 8 decreased 0 ###LEFT-WALL### 14 . 1 levels 2 of 1 levels 6 were 2 of 5 146a 3 mir 4 - 3 mir 5 146a 6 were 7 significantly 6 were 8 decreased 8 decreased 9 in 9 in 10 csf 10 csf 11 of 11 of 13 patients 12 ad 13 patients in conclusion , the abnormal expression of several mirnas in hippocampus of intermediate - and late - stage ad patients suggests their involvement in ad pathogenesis , and low levels of mir - 146a in csf were associated with ad . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 41 . 1 in 2 conclusion 3 , 6 expression 3 , 21 suggests 3 , 28 and 4 the 6 expression 5 abnormal 6 expression 6 expression 7 of 6 expression 12 of 6 expression 21 suggests 7 of 9 mirnas 8 several 9 mirnas 9 mirnas 10 in 10 in 11 hippocampus 12 of 15 and 13 intermediate 15 and 14 - 15 and 15 and 20 patients 16 late 17 - 16 late 18 stage 18 stage 20 patients 19 ad 20 patients 21 suggests 23 involvement 22 their 23 involvement 23 involvement 24 in 24 in 26 pathogenesis 25 ad 26 pathogenesis 27 , 28 and 28 and 30 levels 28 and 38 associated 29 low 30 levels 30 levels 31 of 30 levels 35 in 30 levels 37 were 31 of 34 146a 32 mir 33 - 32 mir 34 146a 35 in 36 csf 37 were 38 associated 38 associated 39 with 39 with 40 ad the best validated susceptibility variants for parkinson 's disease [are] located in the α - synuclein ( snca ) and microtubule - associated protein tau ( mapt ) genes . 0 ###LEFT-WALL### 2 best 0 ###LEFT-WALL### 3 validated 0 ###LEFT-WALL### 30 . 1 the 2 best 2 best 3 validated 3 validated 5 variants 3 validated 6 for 4 susceptibility 5 variants 6 for 20 and 7 parkinson 8 's 8 's 9 disease 9 disease 11 located 9 disease 20 and 11 located 12 in 12 in 16 synuclein 13 the 16 synuclein 14 α 15 - 14 α 16 synuclein 16 synuclein 18 snca 17 ( 18 snca 18 snca 19 ) 20 and 29 genes 21 microtubule 25 tau 21 microtubule 28 ) 21 microtubule 29 genes 22 - 25 tau 23 associated 24 protein 24 protein 25 tau 25 tau 27 mapt 25 tau 28 ) 26 ( 27 mapt 27 mapt 28 ) recently , a protective p.n551 [k] - r1398h - k1423k haplotype in the leucine - rich repeat kinase 2 ( lrrk2 ) [gene] was identified , with p.r1398h appearing to be the most likely functional variant . 0 ###LEFT-WALL### 18 kinase 0 ###LEFT-WALL### 25 identified 1 recently 2 , 1 recently 18 kinase 3 a 4 protective 3 a 18 kinase 4 protective 17 repeat 5 p.n551 8 r1398h 5 p.n551 15 - 5 p.n551 17 repeat 7 - 8 r1398h 8 r1398h 10 k1423k 8 r1398h 15 - 9 - 10 k1423k 10 k1423k 11 haplotype 10 k1423k 15 - 11 haplotype 12 in 12 in 14 leucine 13 the 14 leucine 16 rich 17 repeat 17 repeat 18 kinase 18 kinase 19 2 18 kinase 21 lrrk2 18 kinase 24 was 20 ( 21 lrrk2 21 lrrk2 22 ) 24 was 25 identified 25 identified 27 with 26 , 27 with 27 with 28 p.r1398h 27 with 29 appearing 27 with 37 . 29 appearing 30 to 29 appearing 31 be 30 to 31 be 31 be 36 variant 32 the 36 variant 33 most 34 likely 34 likely 36 variant 35 functional 36 variant to date , the consistency of the protective effect of lrrk2 p.r1398h across mapt and snca variant genotypes has not been assessed . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 date 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 23 . 1 to 2 date 3 , 5 consistency 3 , 22 assessed 4 the 5 consistency 5 consistency 6 of 5 consistency 19 has 6 of 9 effect 7 the 9 effect 8 protective 9 effect 9 effect 10 of 10 of 11 lrrk2 11 lrrk2 12 p.r1398h 11 lrrk2 18 genotypes 12 p.r1398h 13 across 12 p.r1398h 18 genotypes 13 across 15 and 14 mapt 15 and 15 and 17 variant 16 snca 17 variant 19 has 20 not 19 has 21 been 21 been 22 assessed to address this , we examined 4 snca variants ( rs181489 , rs356219 , rs11931074 , and rs2583988 ) , the mapt h1 - haplotype - defining variant rs1052553 , and lrrk2 p.r1398h ( rs7133914 ) in caucasian ( n = 10,322 ) and asian ( n = 2289 ) series . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 address 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 52 . 1 to 2 address 2 address 3 this 4 , 5 we 4 , 6 examined 4 , 14 , 5 we 6 examined 6 examined 9 variants 7 4 9 variants 8 snca 9 variants 9 variants 13 rs356219 10 ( 13 rs356219 11 rs181489 12 , 11 rs181489 13 rs356219 13 rs356219 14 , 14 , 51 series 15 rs11931074 17 and 16 , 17 and 17 and 18 rs2583988 17 and 19 ) 17 and 23 h1 17 and 44 and 20 , 23 h1 21 the 23 h1 22 mapt 23 h1 23 h1 25 haplotype 23 h1 43 ) 24 - 25 haplotype 25 haplotype 27 defining 25 haplotype 43 ) 26 - 27 defining 27 defining 33 p.r1398h 27 defining 37 in 27 defining 41 = 27 defining 43 ) 28 variant 33 p.r1398h 29 rs1052553 31 and 30 , 31 and 31 and 32 lrrk2 31 and 33 p.r1398h 33 p.r1398h 35 rs7133914 34 ( 35 rs7133914 35 rs7133914 36 ) 37 in 38 caucasian 39 ( 41 = 40 n 41 = 41 = 42 10,322 41 = 43 ) 44 and 45 asian 44 and 48 = 44 and 51 series 46 ( 48 = 47 n 48 = 48 = 49 2289 48 = 50 ) there was no evidence of an interaction of lrrk2 p.r1398h with mapt or snca variants [(] all [p] ≥ 0.10 [ )( the protective effect of p.r1398h was observed at similar magnitude across mapt and snca [genotypes] , and the risk effects of mapt and snca variants [were] observed consistently for lrrk2 p.r1398h genotypes . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 was 1 there 2 was 2 was 4 evidence 3 no 4 evidence 4 evidence 5 of 4 evidence 8 of 5 of 7 interaction 6 an 7 interaction 8 of 9 lrrk2 9 lrrk2 10 p.r1398h 10 p.r1398h 11 with 11 with 13 or 11 with 19 ≥ 12 mapt 13 or 13 or 15 variants 14 snca 15 variants 17 all 19 ≥ 19 ≥ 20 0.10 19 ≥ 29 observed 19 ≥ 30 at 20 0.10 25 effect 20 0.10 28 was 20 0.10 29 observed 23 the 25 effect 24 protective 25 effect 25 effect 26 of 25 effect 28 was 26 of 27 p.r1398h 30 at 39 and 31 similar 32 magnitude 32 magnitude 33 across 32 magnitude 39 and 33 across 35 and 34 mapt 35 and 35 and 36 snca 38 , 39 and 39 and 42 effects 39 and 43 of 40 the 42 effects 41 risk 42 effects 43 of 45 and 44 mapt 45 and 45 and 47 variants 45 and 55 . 46 snca 47 variants 47 variants 49 observed 47 variants 51 for 49 observed 50 consistently 51 for 52 lrrk2 52 lrrk2 53 p.r1398h 52 lrrk2 54 genotypes 53 p.r1398h 54 genotypes our results indicate that the association of lrrk2 p.r1398h with parkinson 's disease is independent of snca and mapt variants , and vice versa , in caucasian and asian populations . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 indicate 0 ###LEFT-WALL### 31 . 1 our 2 results 2 results 3 indicate 3 indicate 4 that 4 that 6 association 4 that 14 is 5 the 6 association 6 association 7 of 6 association 10 with 6 association 14 is 7 of 9 p.r1398h 8 lrrk2 9 p.r1398h 10 with 13 disease 11 parkinson 12 's 12 's 13 disease 14 is 22 and 14 is 26 in 15 independent 16 of 15 independent 18 and 16 of 17 snca 18 and 20 variants 18 and 22 and 19 mapt 20 variants 21 , 22 and 22 and 24 versa 22 and 25 , 23 vice 24 versa 26 in 28 and 27 caucasian 28 and 28 and 30 populations 29 asian 30 populations amyotrophic lateral sclerosis ( als ) is the most common motor neuron disease in populations of european descent . 0 ###LEFT-WALL### 3 sclerosis 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 19 . 1 amyotrophic 3 sclerosis 2 lateral 3 sclerosis 3 sclerosis 5 als 3 sclerosis 7 is 4 ( 5 als 5 als 6 ) 7 is 13 disease 8 the 9 most 9 most 13 disease 10 common 11 motor 11 motor 13 disease 12 neuron 13 disease 13 disease 14 in 14 in 15 populations 15 populations 16 of 16 of 18 descent 17 european 18 descent it was recently [found] that a hexanucleotide repeat expansion in c9orf72 is its most common cause in these populations . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 20 . 1 it 2 was 2 was 3 recently 2 was 5 that 5 that 9 expansion 5 that 12 is 6 a 9 expansion 7 hexanucleotide 9 expansion 8 repeat 9 expansion 9 expansion 10 in 9 expansion 12 is 10 in 11 c9orf72 12 is 16 cause 13 its 16 cause 14 most 15 common 15 common 16 cause 16 cause 17 in 17 in 19 populations 18 these 19 populations the contribution of c9orf72 to als is notably lower in the far east , but its role in other populations is unknown . 0 ###LEFT-WALL### 2 contribution 0 ###LEFT-WALL### 7 is 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 23 . 1 the 2 contribution 2 contribution 3 of 2 contribution 7 is 3 of 4 c9orf72 4 c9orf72 5 to 5 to 6 als 7 is 8 notably 7 is 9 lower 9 lower 10 in 10 in 13 east 11 the 13 east 12 far 13 east 14 , 15 but 15 but 17 role 15 but 21 is 16 its 17 role 17 role 18 in 17 role 21 is 18 in 20 populations 19 other 20 populations 21 is 22 unknown results of c9orf72 screening in 78 unrelated iranian als patients are reported here . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 12 reported 0 ###LEFT-WALL### 14 . 1 results 2 of 1 results 11 are 2 of 3 c9orf72 3 c9orf72 4 screening 4 screening 5 in 4 screening 10 patients 6 78 10 patients 7 unrelated 8 iranian 8 iranian 10 patients 9 als 10 patients 11 are 12 reported 12 reported 13 here the repeat expansion was observed in only 1 ( 5.9 % [ )(of the [familial] [and] 1 ( 1.6 % ) of the sporadic cases . 0 ###LEFT-WALL### 3 expansion 0 ###LEFT-WALL### 5 observed 1 the 3 expansion 2 repeat 3 expansion 3 expansion 4 was 4 was 5 observed 5 observed 6 in 6 in 8 1 7 only 8 1 8 1 11 % 9 ( 11 % 10 5.9 11 % 11 % 13 )(of 11 % 22 of 11 % 26 . 13 )(of 17 1 14 the 17 1 17 1 20 % 18 ( 20 % 19 1.6 20 % 20 % 21 ) 22 of 25 cases 23 the 25 cases 24 sporadic 25 cases these figures are to be compared , respectively , with 30 [%] and 6.9 % among patients of european ethnicity . 0 ###LEFT-WALL### 2 figures 0 ###LEFT-WALL### 21 . 1 these 2 figures 2 figures 3 are 3 are 4 to 3 are 6 compared 4 to 5 be 5 be 6 compared 6 compared 8 respectively 6 compared 10 with 6 compared 16 among 7 , 8 respectively 8 respectively 9 , 10 with 15 % 11 30 13 and 13 and 14 6.9 13 and 15 % 16 among 17 patients 17 patients 18 of 18 of 20 ethnicity 19 european 20 ethnicity screenings of c9orf72 in other middle east countries will reveal whether the low contribution of c9orf72 to als is a feature of the entire region . 0 ###LEFT-WALL### 1 screenings 0 ###LEFT-WALL### 10 reveal 0 ###LEFT-WALL### 26 . 1 screenings 2 of 1 screenings 9 will 2 of 3 c9orf72 3 c9orf72 4 in 4 in 8 countries 5 other 8 countries 6 middle 7 east 7 east 8 countries 9 will 10 reveal 10 reveal 11 whether 11 whether 14 contribution 11 whether 19 is 12 the 14 contribution 13 low 14 contribution 14 contribution 15 of 14 contribution 19 is 15 of 16 c9orf72 16 c9orf72 17 to 17 to 18 als 19 is 21 feature 20 a 21 feature 21 feature 22 of 22 of 25 region 23 the 25 region 24 entire 25 region during the screenings , it was noted that in a single family , 3 individuals affected with als , parkinson 's disease , or frontotemporal dementia all carried the repeat expansion . 0 ###LEFT-WALL### 5 it 0 ###LEFT-WALL### 7 noted 0 ###LEFT-WALL### 32 . 1 during 3 screenings 1 during 4 , 1 during 5 it 2 the 3 screenings 5 it 6 was 6 was 7 noted 7 noted 8 that 8 that 24 or 8 that 28 carried 9 in 11 single 9 in 24 or 10 a 11 single 12 family 13 , 13 , 15 individuals 13 , 24 or 14 3 15 individuals 15 individuals 16 affected 16 affected 17 with 17 with 18 als 18 als 22 disease 19 , 22 disease 20 parkinson 21 's 21 's 22 disease 22 disease 23 , 24 or 26 dementia 24 or 28 carried 25 frontotemporal 26 dementia 27 all 28 carried 28 carried 31 expansion 29 the 31 expansion 30 repeat 31 expansion the finding suggests the mutation does rarely contribute to the etiology of parkinson 's disease . 0 ###LEFT-WALL### 2 finding 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 16 . 1 the 2 finding 2 finding 3 suggests 3 suggests 5 mutation 3 suggests 8 contribute 4 the 5 mutation 5 mutation 6 does 6 does 8 contribute 7 rarely 8 contribute 8 contribute 9 to 9 to 11 etiology 10 the 11 etiology 11 etiology 12 of 12 of 15 disease 13 parkinson 14 's 14 's 15 disease objective : to develop and validate a prognostic model for incident knee osteoarthritis ( koa ) in a general population and determine the value of different risk factor groups to prediction . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 5 and 2 : 32 . 3 to 5 and 4 develop 5 and 5 and 21 and 6 validate 9 model 6 validate 17 in 6 validate 21 and 7 a 8 prognostic 7 a 9 model 8 prognostic 9 model 9 model 10 for 9 model 15 koa 10 for 13 osteoarthritis 11 incident 13 osteoarthritis 12 knee 13 osteoarthritis 14 ( 15 koa 15 koa 16 ) 17 in 20 population 18 a 19 general 18 a 20 population 19 general 20 population 21 and 22 determine 22 determine 24 value 22 determine 30 to 23 the 24 value 24 value 25 of 25 of 29 groups 26 different 29 groups 27 risk 28 factor 28 factor 29 groups 30 to 31 prediction methods : the prognostic model was developed in 2628 individuals from the rotterdam study [-] i ( rs - i ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 model 2 : 7 developed 2 : 22 . 3 the 5 model 4 prognostic 5 model 5 model 6 was 6 was 7 developed 7 developed 8 in 8 in 10 individuals 9 2628 10 individuals 10 individuals 11 from 11 from 14 study 12 the 14 study 13 rotterdam 14 study 14 study 16 i 14 study 19 - 17 ( 19 - 18 rs 19 - 19 - 20 i 19 - 21 ) univariate and multivariate analyses were performed for questionnaire/easily obtainable variables , imaging variables , genetic and biochemical markers . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 6 performed 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 19 . 1 univariate 2 and 2 and 3 multivariate 2 and 4 analyses 2 and 5 were 2 and 6 performed 4 analyses 5 were 6 performed 7 for 6 performed 12 imaging 7 for 10 variables 8 questionnaire/easily 9 obtainable 9 obtainable 10 variables 11 , 12 imaging 12 imaging 13 variables 12 imaging 14 , 14 , 18 markers 15 genetic 16 and 16 and 17 biochemical 16 and 18 markers the extended multivariate model was tested on discrimination ( receiver operating characteristic curve [and] area under the curve ( auc ) ) in two other population [-] based cohorts : rotterdam study [-] ii and chingford study . 0 ###LEFT-WALL### 4 model 0 ###LEFT-WALL### 6 tested 0 ###LEFT-WALL### 30 : 1 the 4 model 2 extended 4 model 3 multivariate 4 model 4 model 5 was 5 was 6 tested 6 tested 7 on 6 tested 23 in 7 on 8 discrimination 8 discrimination 15 area 9 ( 15 area 10 receiver 11 operating 11 operating 15 area 12 characteristic 15 area 13 curve 15 area 15 area 16 under 15 area 22 ) 16 under 18 curve 17 the 18 curve 18 curve 20 auc 19 ( 20 auc 20 auc 21 ) 23 in 29 cohorts 24 two 25 other 25 other 29 cohorts 26 population 28 based 28 based 29 cohorts 30 : 35 and 30 : 38 . 31 rotterdam 32 study 32 study 34 ii 32 study 35 and 35 and 37 study 36 chingford 37 study results : in rs [-] i , there was moderate predictive value for incident koa based on the genetic score alone in subjects aged < 65 years ( auc 0.65 ) , while it was only 0.55 for subjects aged ≥65 years . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 20 score 1 results 2 : 2 : 3 in 3 in 4 rs 4 rs 6 i 7 , 8 there 7 , 9 was 8 there 9 was 9 was 12 value 9 was 13 for 10 moderate 12 value 11 predictive 12 value 13 for 15 koa 14 incident 15 koa 15 koa 16 based 15 koa 17 on 15 koa 20 score 17 on 19 genetic 18 the 19 genetic 20 score 21 alone 20 score 22 in 20 score 27 years 20 score 33 while 22 in 23 subjects 23 subjects 24 aged 25 < 26 65 26 65 27 years 27 years 29 auc 28 ( 29 auc 29 auc 30 0.65 29 auc 31 ) 32 , 33 while 33 while 34 it 33 while 35 was 33 while 43 . 34 it 35 was 35 was 36 only 35 was 37 0.55 35 was 38 for 38 for 42 years 39 subjects 40 aged 40 aged 41 ≥65 41 ≥65 42 years the auc for gender , age and body mass index ( bmi ) in prediction for koa was 0.66 . 0 ###LEFT-WALL### 2 auc 0 ###LEFT-WALL### 18 was 0 ###LEFT-WALL### 20 . 1 the 2 auc 2 auc 3 for 2 auc 14 in 2 auc 18 was 3 for 7 and 4 gender 5 , 5 , 6 age 5 , 7 and 7 and 10 index 7 and 12 bmi 8 body 10 index 9 mass 10 index 11 ( 12 bmi 12 bmi 13 ) 14 in 15 prediction 15 prediction 16 for 16 for 17 koa 18 was 19 0.66 addition of the questionnaire variables , genetic score or biochemical marker urinary [c] - terminal cross - linked telopeptide of type ii collagen to the model did not change the auc . 0 ###LEFT-WALL### 9 or 0 ###LEFT-WALL### 16 cross 0 ###LEFT-WALL### 17 - 1 addition 2 of 1 addition 6 , 2 of 5 variables 3 the 5 variables 4 questionnaire 5 variables 6 , 8 score 6 , 9 or 7 genetic 8 score 9 or 15 terminal 9 or 16 cross 10 biochemical 11 marker 11 marker 15 terminal 12 urinary 14 - 12 urinary 15 terminal 17 - 19 telopeptide 17 - 29 change 17 - 32 . 18 linked 19 telopeptide 19 telopeptide 20 of 19 telopeptide 27 did 20 of 21 type 21 type 22 ii 21 type 23 collagen 23 collagen 24 to 24 to 26 model 25 the 26 model 27 did 28 not 27 did 29 change 29 change 31 auc 30 the 31 auc however , when adding the knee baseline kl score to the model the auc increased to 0.79 . 0 ###LEFT-WALL### 14 auc 0 ###LEFT-WALL### 15 increased 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 14 auc 3 when 4 adding 3 when 14 auc 4 adding 8 kl 4 adding 9 score 5 the 8 kl 6 knee 8 kl 7 baseline 8 kl 8 kl 9 score 9 score 10 to 10 to 12 model 11 the 12 model 13 the 14 auc 14 auc 15 increased 15 increased 16 to 16 to 17 0.79 applying external validation , similar results were observed in the rotterdam study [-] ii and the chingford study . 0 ###LEFT-WALL### 6 results 0 ###LEFT-WALL### 8 observed 0 ###LEFT-WALL### 19 . 1 applying 3 validation 1 applying 4 , 1 applying 6 results 2 external 3 validation 5 similar 6 results 6 results 7 were 7 were 8 observed 8 observed 9 in 9 in 15 and 10 the 12 study 11 rotterdam 12 study 12 study 14 ii 12 study 15 and 15 and 18 study 16 the 18 study 17 chingford 18 study conclusions : easy obtainable ['] questionnaire ['] variables , genetic markers , oa at other joint sites and biochemical markers add only modestly to the prediction of koa incidence using age , gender and bmi in an elderly population . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 18 and 2 : 21 add 2 : 40 . 3 easy 8 variables 4 obtainable 8 variables 6 questionnaire 8 variables 8 variables 9 , 9 , 11 markers 9 , 12 , 10 genetic 11 markers 12 , 13 oa 12 , 18 and 13 oa 14 at 14 at 17 sites 15 other 17 sites 16 joint 17 sites 18 and 20 markers 18 and 21 add 19 biochemical 20 markers 21 add 22 only 21 add 23 modestly 21 add 24 to 24 to 34 and 25 the 26 prediction 26 prediction 27 of 26 prediction 32 , 27 of 31 age 28 koa 31 age 29 incidence 31 age 30 using 31 age 32 , 33 gender 32 , 34 and 34 and 35 bmi 34 and 36 in 36 in 39 population 37 an 38 elderly 37 an 39 population 38 elderly 39 population doubtful minor radiographic degenerative features in the knee , however , are a very strong predictor of future koa . 0 ###LEFT-WALL### 5 features 0 ###LEFT-WALL### 12 are 0 ###LEFT-WALL### 20 . 1 doubtful 5 features 2 minor 5 features 3 radiographic 5 features 4 degenerative 5 features 5 features 6 in 5 features 12 are 6 in 8 knee 7 the 8 knee 9 , 10 however 10 however 11 , 10 however 12 are 12 are 16 predictor 13 a 14 very 13 a 16 predictor 14 very 15 strong 15 strong 16 predictor 16 predictor 17 of 17 of 19 koa 18 future 19 koa this is an important finding , as many radiologists do not report minor degenerative changes in the knee . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 19 . 1 this 2 is 2 is 5 finding 3 an 4 important 3 an 5 finding 4 important 5 finding 6 , 9 radiologists 6 , 12 report 7 as 8 many 8 many 9 radiologists 9 radiologists 10 do 10 do 11 not 10 do 12 report 12 report 15 changes 12 report 16 in 13 minor 15 changes 14 degenerative 15 changes 16 in 18 knee 17 the 18 knee none objectives : the sociocultural model of stress and coping , which despite receiving support from several studies conducted with diverse ethnic groups , has yet to be tested longitudinally or used within the context of positive caregiver outcomes . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 40 . 1 none 2 objectives 1 none 7 of 1 none 8 stress 2 objectives 3 : 3 : 6 model 4 the 6 model 5 sociocultural 6 model 6 model 7 of 9 and 10 coping 9 and 31 or 10 coping 12 which 10 coping 31 or 11 , 12 which 12 which 13 despite 12 which 19 conducted 12 which 24 , 13 despite 14 receiving 14 receiving 15 support 15 support 16 from 16 from 17 several 18 studies 19 conducted 19 conducted 20 with 20 with 23 groups 21 diverse 23 groups 22 ethnic 23 groups 25 has 26 yet 25 has 27 to 25 has 29 tested 25 has 31 or 27 to 28 be 28 be 29 tested 29 tested 30 longitudinally 31 or 32 used 31 or 33 within 31 or 39 outcomes 33 within 35 context 34 the 35 context 35 context 36 of 36 of 38 caregiver 37 positive 38 caregiver the aim of the current study was to test a specific component of the model , which posits that caregiver coping will be influenced by the cultural value of familism ( feelings of solidarity and loyalty among family members ) , which will in turn affect caregiver outcomes . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 41 , 0 ###LEFT-WALL### 49 . 1 the 2 aim 2 aim 3 of 2 aim 7 was 3 of 6 study 4 the 6 study 5 current 6 study 7 was 8 to 8 to 9 test 9 test 12 component 10 a 12 component 11 specific 12 component 12 component 13 of 12 component 17 which 13 of 15 model 14 the 15 model 16 , 17 which 17 which 18 posits 17 which 41 , 18 posits 19 that 19 that 20 caregiver 19 that 24 influenced 20 caregiver 21 coping 20 caregiver 22 will 22 will 23 be 23 be 24 influenced 24 influenced 25 by 25 by 28 value 26 the 28 value 27 cultural 28 value 28 value 29 of 29 of 30 familism 30 familism 35 and 31 ( 35 and 32 feelings 33 of 32 feelings 35 and 33 of 34 solidarity 35 and 36 loyalty 35 and 37 among 35 and 40 ) 37 among 39 members 38 family 39 members 41 , 42 which 41 , 46 affect 42 which 43 will 43 will 46 affect 44 in 45 turn 45 turn 46 affect 46 affect 48 outcomes 47 caregiver 48 outcomes method : a questionnaire was completed by 123 family caregivers in the uk assessing familism , use of coping strategies , caregiver gains , anxiety and depression at three time points over nine months . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 4 questionnaire 2 : 14 assessing 2 : 21 , 2 : 35 . 3 a 4 questionnaire 4 questionnaire 5 was 5 was 6 completed 6 completed 7 by 7 by 8 123 8 123 9 family 8 123 14 assessing 9 family 10 caregivers 10 caregivers 11 in 11 in 13 uk 12 the 13 uk 13 uk 14 assessing 14 assessing 15 familism 15 familism 17 use 16 , 17 use 17 use 18 of 17 use 21 , 18 of 20 strategies 19 coping 20 strategies 21 , 26 and 21 , 30 time 22 caregiver 23 gains 23 gains 24 , 24 , 25 anxiety 24 , 26 and 26 and 27 depression 26 and 30 time 27 depression 28 at 28 at 29 three 30 time 31 points 30 time 32 over 32 over 34 months 33 nine 34 months results : mediation analysis followed guidelines proposed by baron and kenny . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 proposed 1 results 2 : 2 : 5 followed 3 mediation 5 followed 4 analysis 5 followed 6 guidelines 7 proposed 7 proposed 8 by 7 proposed 12 . 8 by 11 kenny 9 baron 10 and 10 and 11 kenny religious coping and positive reframing at time 2 ( t2 ) were found to significantly mediate between familism values at time 1 ( t1 ) and caregiver gains at time 3 ( t3 ) . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 35 . 1 religious 2 coping 1 religious 3 and 3 and 4 positive 3 and 5 reframing 5 reframing 6 at 5 reframing 14 to 5 reframing 20 at 5 reframing 22 1 6 at 7 time 7 time 8 2 7 time 13 found 8 2 10 t2 8 2 12 were 9 ( 10 t2 10 t2 11 ) 12 were 13 found 14 to 16 mediate 15 significantly 16 mediate 16 mediate 17 between 17 between 19 values 18 familism 19 values 20 at 21 time 22 1 24 t1 23 ( 24 t1 24 t1 25 ) 26 and 27 caregiver 26 and 28 gains 27 caregiver 28 gains 28 gains 29 at 28 gains 31 3 29 at 30 time 31 3 33 t3 32 ( 33 t3 33 t3 34 ) behavioural disengagement at t2 was found to mediate between familism at t1 and caregiver depression at t3 . 0 ###LEFT-WALL### 2 disengagement 0 ###LEFT-WALL### 8 mediate 0 ###LEFT-WALL### 18 . 1 behavioural 2 disengagement 2 disengagement 3 at 2 disengagement 5 was 3 at 4 t2 5 was 6 found 6 found 7 to 7 to 8 mediate 8 mediate 9 between 8 mediate 11 at 8 mediate 16 at 9 between 10 familism 11 at 13 and 12 t1 13 and 13 and 15 depression 14 caregiver 15 depression 16 at 17 t3 additionally familism was found to be positively associated with both negative and positive aspects of caregiving . 0 ###LEFT-WALL### 2 familism 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 17 . 1 additionally 2 familism 2 familism 3 was 3 was 4 found 4 found 5 to 5 to 6 be 6 be 7 positively 6 be 8 associated 8 associated 9 with 9 with 14 aspects 10 both 14 aspects 11 negative 12 and 12 and 13 positive 12 and 14 aspects 14 aspects 15 of 15 of 16 caregiving conclusion : our longitudinal findings suggest that interventions and services acknowledging caregiver values and the associated coping responses may prove beneficial . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 prove 0 ###LEFT-WALL### 22 . 2 : 5 findings 2 : 6 suggest 3 our 5 findings 4 longitudinal 5 findings 5 findings 6 suggest 6 suggest 7 that 7 that 9 and 7 that 20 prove 8 interventions 9 and 9 and 10 services 9 and 11 acknowledging 9 and 20 prove 11 acknowledging 14 and 11 acknowledging 19 may 12 caregiver 13 values 13 values 14 and 14 and 18 responses 14 and 19 may 15 the 18 responses 16 associated 18 responses 17 coping 18 responses 20 prove 21 beneficial background : functional [decline] ( fd ) is a largely preventable feature of aging , characterized as gradual erosion of functional autonomy . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 2 : 6 fd 2 : 15 , 3 functional 6 fd 5 ( 6 fd 6 fd 7 ) 6 fd 15 , 8 is 12 feature 8 is 15 , 9 a 10 largely 9 a 12 feature 10 largely 11 preventable 11 preventable 12 feature 12 feature 13 of 13 of 14 aging 15 , 16 characterized 15 , 17 as 17 as 19 erosion 18 gradual 19 erosion 19 erosion 20 of 20 of 22 autonomy 21 functional 22 autonomy this reduces an older person 's capacity for safe , independent community living . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 reduces 0 ###LEFT-WALL### 14 . 1 this 2 reduces 2 reduces 7 capacity 3 an 5 person 4 older 5 person 5 person 6 's 6 's 7 capacity 7 capacity 8 for 8 for 13 living 9 safe 10 , 9 safe 11 independent 11 independent 13 living 12 community 13 living the healthcare needs of an unprecedented aging population places pressure on health systems to develop innovative approaches to ensuring older people live healthy and independent lives for as long as possible . 0 ###LEFT-WALL### 3 needs 0 ###LEFT-WALL### 22 live 0 ###LEFT-WALL### 32 . 1 the 3 needs 2 healthcare 3 needs 3 needs 4 of 3 needs 9 places 3 needs 10 pressure 3 needs 22 live 4 of 8 population 5 an 6 unprecedented 5 an 8 population 6 unprecedented 8 population 7 aging 8 population 9 places 10 pressure 10 pressure 11 on 10 pressure 14 to 10 pressure 18 to 11 on 13 systems 12 health 13 systems 14 to 15 develop 15 develop 17 approaches 16 innovative 17 approaches 18 to 19 ensuring 19 ensuring 21 people 20 older 21 people 22 live 26 lives 22 live 27 for 22 live 30 as 23 healthy 24 and 24 and 25 independent 24 and 26 lives 27 for 29 long 28 as 29 long 30 as 31 possible triifl aims to demonstrate that : 1 . 0 ###LEFT-WALL### 1 triifl 0 ###LEFT-WALL### 2 aims 0 ###LEFT-WALL### 8 . 1 triifl 2 aims 2 aims 3 to 2 aims 4 demonstrate 3 to 4 demonstrate 4 demonstrate 5 that 4 demonstrate 6 : 5 that 6 : 6 : 7 1 incipient fd in older people can be identified using a simple telephone - screening process within four weeks of discharge from an emergency department presentation for a minor health event ; [and] 2 . 0 ###LEFT-WALL### 2 fd 0 ###LEFT-WALL### 8 identified 0 ###LEFT-WALL### 31 ; 0 ###LEFT-WALL### 34 . 1 incipient 2 fd 2 fd 3 in 2 fd 6 can 3 in 5 people 4 older 5 people 6 can 7 be 7 be 8 identified 8 identified 9 using 9 using 12 telephone 10 a 11 simple 10 a 12 telephone 11 simple 12 telephone 12 telephone 14 screening 13 - 14 screening 14 screening 15 process 14 screening 31 ; 15 process 16 within 15 process 19 of 15 process 26 for 16 within 18 weeks 17 four 18 weeks 19 of 20 discharge 20 discharge 21 from 21 from 25 presentation 22 an 25 presentation 23 emergency 25 presentation 24 department 25 presentation 26 for 30 event 27 a 28 minor 27 a 30 event 28 minor 29 health 29 health 30 event 31 ; 33 2 early engagement into a person [-] centered individualized intervention arrests or reduces the rate of fd over the next 12 months . 0 ###LEFT-WALL### 2 engagement 0 ###LEFT-WALL### 11 or 0 ###LEFT-WALL### 22 . 1 early 2 engagement 2 engagement 3 into 2 engagement 11 or 3 into 5 person 4 a 5 person 5 person 7 centered 8 individualized 10 arrests 8 individualized 11 or 9 intervention 10 arrests 11 or 12 reduces 11 or 17 over 12 reduces 14 rate 13 the 14 rate 14 rate 15 of 15 of 16 fd 17 over 21 months 18 the 19 next 18 the 20 12 20 12 21 months methods/design : a randomized controlled trial ( rct ) nested within a 13 [-] month longitudinal cohort study . 0 ###LEFT-WALL### 1 methods/design 0 ###LEFT-WALL### 2 : 2 : 6 trial 2 : 10 nested 2 : 19 . 3 a 6 trial 4 randomized 6 trial 5 controlled 6 trial 6 trial 8 rct 6 trial 10 nested 7 ( 8 rct 8 rct 9 ) 10 nested 11 within 11 within 18 study 12 a 18 study 13 13 15 month 15 month 18 study 16 longitudinal 17 cohort 17 cohort 18 study the rct ( conducted over 12 months ) tests the effectiveness of a novel , early , home - based , personalized program ( compared with no intervention ) in arresting or slowing fd . 0 ###LEFT-WALL### 2 rct 0 ###LEFT-WALL### 9 tests 0 ###LEFT-WALL### 35 . 1 the 2 rct 2 rct 4 conducted 2 rct 9 tests 3 ( 4 conducted 4 conducted 5 over 4 conducted 8 ) 5 over 7 months 6 12 7 months 9 tests 11 effectiveness 9 tests 25 compared 9 tests 30 in 10 the 11 effectiveness 11 effectiveness 12 of 12 of 23 program 13 a 23 program 14 novel 15 , 14 novel 23 program 16 early 18 home 16 early 21 , 16 early 23 program 17 , 18 home 18 home 20 based 18 home 21 , 19 - 20 based 20 based 21 , 22 personalized 23 program 24 ( 25 compared 25 compared 26 with 25 compared 29 ) 26 with 28 intervention 27 no 28 intervention 30 in 32 or 31 arresting 32 or 32 or 34 fd 33 slowing 34 fd triifl focuses on older adults living independently in the community , who have not yet had a serious health event , yet are potentially on the cusp of fd . 0 ###LEFT-WALL### 2 focuses 0 ###LEFT-WALL### 23 are 0 ###LEFT-WALL### 30 . 1 triifl 2 focuses 2 focuses 3 on 2 focuses 6 living 2 focuses 12 who 2 focuses 23 are 3 on 5 adults 4 older 5 adults 6 living 7 independently 6 living 8 in 8 in 10 community 9 the 10 community 11 , 12 who 12 who 13 have 12 who 21 , 13 have 14 not 13 have 16 had 15 yet 16 had 16 had 20 event 17 a 18 serious 17 a 20 event 18 serious 20 event 19 health 20 event 22 yet 23 are 23 are 24 potentially 23 are 25 on 25 on 27 cusp 26 the 27 cusp 27 cusp 28 of 28 of 29 fd participants in the longitudinal cohort study will be recruited as they present to one large tertiary hospital emergency department , providing they are not subsequently admitted to a ward . 0 ###LEFT-WALL### 21 providing 0 ###LEFT-WALL### 26 admitted 1 participants 21 providing 2 in 6 study 2 in 21 providing 3 the 6 study 4 longitudinal 5 cohort 5 cohort 6 study 6 study 7 will 6 study 12 present 7 will 8 be 8 be 9 recruited 9 recruited 10 as 10 as 11 they 10 as 12 present 11 they 12 present 12 present 13 to 13 to 17 hospital 14 one 17 hospital 15 large 17 hospital 16 tertiary 17 hospital 18 emergency 21 providing 19 department 20 , 19 department 21 providing 21 providing 26 admitted 22 they 23 are 23 are 24 not 24 not 25 subsequently 25 subsequently 26 admitted 26 admitted 27 to 26 admitted 30 . 27 to 29 ward 28 a 29 ward sample size calculations indicate that 570 participants need to be recruited into the longitudinal study , with 100 participants randomized into the trial arms . 0 ###LEFT-WALL### 3 calculations 0 ###LEFT-WALL### 4 indicate 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 25 . 1 sample 3 calculations 2 size 3 calculations 3 calculations 4 indicate 4 indicate 5 that 5 that 7 participants 5 that 8 need 6 570 7 participants 7 participants 8 need 8 need 9 to 8 need 16 , 9 to 10 be 10 be 11 recruited 11 recruited 12 into 12 into 15 study 13 the 15 study 14 longitudinal 15 study 16 , 19 participants 16 , 20 randomized 17 with 18 100 17 with 19 participants 19 participants 20 randomized 20 randomized 21 into 20 randomized 24 arms 21 into 23 trial 22 the 23 trial measures from all subjects will be taken face - to [-] face at baseline [(] [recruitment] ) , then subsequently [by] telephone at one , four , seven and thirteen months later . 0 ###LEFT-WALL### 1 measures 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 33 . 1 measures 2 from 1 measures 7 taken 1 measures 18 , 2 from 4 subjects 3 all 4 subjects 4 subjects 5 will 4 subjects 6 be 5 will 6 be 8 face 10 to 8 face 18 , 9 - 10 to 10 to 12 face 10 to 17 ) 12 face 13 at 13 at 14 baseline 18 , 22 telephone 18 , 32 later 19 then 22 telephone 20 subsequently 22 telephone 22 telephone 23 at 23 at 24 one 24 one 26 four 25 , 26 four 26 four 27 , 28 seven 29 and 29 and 30 thirteen 29 and 31 months 31 months 32 later measures include functional abilities , quality of life , recent [falls] , mobility dependence , community supports and health service usage . 0 ###LEFT-WALL### 1 measures 0 ###LEFT-WALL### 2 include 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 22 . 1 measures 2 include 2 include 4 abilities 3 functional 4 abilities 4 abilities 6 quality 5 , 6 quality 6 quality 7 of 6 quality 9 , 7 of 8 life 9 , 18 and 9 , 20 service 10 recent 14 dependence 10 recent 15 , 10 recent 16 community 12 , 14 dependence 13 mobility 14 dependence 14 dependence 15 , 16 community 17 supports 17 supports 18 and 18 and 19 health 18 and 20 service 20 service 21 usage trials registration : australian [&] new zealand clinical trials registry : actrn12613000234718 . 0 ###LEFT-WALL### 2 registration 0 ###LEFT-WALL### 3 : 0 ###LEFT-WALL### 11 : 1 trials 2 registration 2 registration 3 : 3 : 10 registry 4 australian 10 registry 6 new 7 zealand 7 zealand 8 clinical 8 clinical 9 trials 9 trials 10 registry 11 : 12 actrn12613000234718 11 : 13 . cytomegalovirus ( cmv ) infection has been implicated in accelerated [t] cell ageing . 0 ###LEFT-WALL### 5 infection 0 ###LEFT-WALL### 8 implicated 0 ###LEFT-WALL### 14 . 1 cytomegalovirus 3 cmv 1 cytomegalovirus 5 infection 2 ( 3 cmv 3 cmv 4 ) 5 infection 6 has 6 has 7 been 7 been 8 implicated 8 implicated 9 in 9 in 13 ageing 10 accelerated 12 cell 12 cell 13 ageing end - stage renal disease ( esrd ) patients have a severely immunologically aged [t] cell compartment but also a high prevalence of cmv infection . 0 ###LEFT-WALL### 9 patients 0 ###LEFT-WALL### 10 have 0 ###LEFT-WALL### 26 . 1 end 5 disease 1 end 9 patients 2 - 5 disease 3 stage 5 disease 4 renal 5 disease 5 disease 7 esrd 5 disease 8 ) 6 ( 7 esrd 7 esrd 8 ) 9 patients 10 have 10 have 16 cell 10 have 17 compartment 11 a 16 cell 12 severely 14 aged 13 immunologically 14 aged 14 aged 16 cell 17 compartment 18 but 17 compartment 25 infection 18 but 19 also 18 but 22 prevalence 20 a 21 high 20 a 22 prevalence 21 high 22 prevalence 22 prevalence 23 of 23 of 24 cmv we investigated whether cmv [infection] contributes to t cell ageing in esrd patients . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 14 . 1 we 2 investigated 2 investigated 3 whether 3 whether 4 cmv 3 whether 6 contributes 4 cmv 6 contributes 6 contributes 7 to 6 contributes 10 ageing 6 contributes 11 in 7 to 8 t 9 cell 10 ageing 11 in 13 patients 12 esrd 13 patients we determined the thymic output by the [t] cell receptor excision circle ( trec ) content and percentage of cd31+ naïve [t] cells . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 determined 0 ###LEFT-WALL### 24 . 1 we 2 determined 2 determined 4 thymic 2 determined 5 output 3 the 4 thymic 4 thymic 5 output 5 output 6 by 5 output 17 and 6 by 12 circle 7 the 12 circle 9 cell 12 circle 10 receptor 12 circle 11 excision 12 circle 12 circle 14 trec 13 ( 14 trec 14 trec 15 ) 16 content 17 and 17 and 18 percentage 17 and 19 of 19 of 23 cells 20 cd31+ 23 cells 21 naïve 23 cells the proliferative history of the [t] cell compartment by determination of the relative telomere length ( rtl ) and the [t] cell differentiation status was determined by immunophenotyping . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 29 . 1 the 3 history 2 proliferative 3 history 3 history 4 of 3 history 9 by 3 history 19 and 4 of 8 compartment 5 the 8 compartment 7 cell 8 compartment 9 by 10 determination 10 determination 11 of 11 of 15 length 12 the 15 length 13 relative 15 length 14 telomere 15 length 15 length 17 rtl 16 ( 17 rtl 17 rtl 18 ) 19 and 23 differentiation 19 and 24 status 19 and 28 immunophenotyping 20 the 23 differentiation 22 cell 23 differentiation 24 status 25 was 25 was 26 determined 26 determined 27 by 27 by 28 immunophenotyping it appeared that cmv [infection] did not affect thymic output but reduced rtl of cd8+ [t] cells in esrd patients . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 appeared 0 ###LEFT-WALL### 21 . 1 it 2 appeared 2 appeared 3 that 3 that 4 cmv 3 that 11 but 4 cmv 6 did 6 did 7 not 6 did 11 but 8 affect 10 output 8 affect 11 but 9 thymic 10 output 11 but 12 reduced 12 reduced 13 rtl 12 reduced 18 in 13 rtl 14 of 14 of 17 cells 15 cd8+ 17 cells 18 in 20 patients 19 esrd 20 patients moreover , increased [t] cell differentiation was observed with higher percentages of cd57+ and cd28null cd4+ and cd8+ memory t cells . 0 ###LEFT-WALL### 6 differentiation 0 ###LEFT-WALL### 8 observed 0 ###LEFT-WALL### 22 . 1 moreover 2 , 1 moreover 6 differentiation 3 increased 5 cell 5 cell 6 differentiation 6 differentiation 7 was 7 was 8 observed 8 observed 9 with 9 with 17 and 10 higher 11 percentages 11 percentages 12 of 11 percentages 14 and 12 of 13 cd57+ 14 and 16 cd4+ 14 and 17 and 15 cd28null 16 cd4+ 17 and 21 cells 18 cd8+ 19 memory 19 memory 20 t 19 memory 21 cells these cd28null t cells had significantly shorter telomeres compared to cd28+ [t] cells . 0 ###LEFT-WALL### 4 cells 0 ###LEFT-WALL### 5 had 0 ###LEFT-WALL### 14 . 1 these 4 cells 2 cd28null 3 t 2 cd28null 4 cells 4 cells 5 had 5 had 8 telomeres 6 significantly 7 shorter 7 shorter 8 telomeres 8 telomeres 9 compared 9 compared 10 to 10 to 13 cells 11 cd28+ 13 cells therefore we concluded that cmv [infection] does not affect the decreased thymic output but increases [t] cell differentiation as observed in esrd - related premature [t] cell ageing . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 24 related 0 ###LEFT-WALL### 29 . 1 therefore 2 we 2 we 14 but 3 concluded 4 that 3 concluded 14 but 4 that 5 cmv 4 that 9 affect 5 cmv 7 does 7 does 8 not 7 does 9 affect 9 affect 13 output 10 the 13 output 11 decreased 13 output 12 thymic 13 output 14 but 15 increases 15 increases 18 differentiation 15 increases 21 in 17 cell 18 differentiation 18 differentiation 20 observed 19 as 20 observed 21 in 22 esrd 23 - 24 related 24 related 28 ageing 25 premature 27 cell 27 cell 28 ageing this is a case study of an 88 [-] year [-] old man who presented with agenesis of the corpus callosum [and] colpocephaly . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 24 . 1 this 2 is 2 is 5 study 3 a 5 study 4 case 5 study 5 study 6 of 6 of 13 man 7 an 13 man 8 88 10 year 10 year 13 man 12 old 13 man 13 man 14 who 13 man 15 presented 14 who 15 presented 15 presented 16 with 15 presented 21 callosum 15 presented 23 colpocephaly 16 with 17 agenesis 17 agenesis 18 of 18 of 20 corpus 19 the 20 corpus symptomatically , he reported a sudden onset of mild , intermittent left hand apraxia , but denied any previous manifestations consistent with this type of brain malformation . 0 ###LEFT-WALL### 3 he 0 ###LEFT-WALL### 16 but 0 ###LEFT-WALL### 28 . 1 symptomatically 2 , 1 symptomatically 3 he 3 he 16 but 4 reported 7 onset 4 reported 16 but 5 a 6 sudden 5 a 7 onset 6 sudden 7 onset 7 onset 8 of 8 of 14 apraxia 9 mild 10 , 9 mild 14 apraxia 11 intermittent 13 hand 12 left 13 hand 13 hand 14 apraxia 15 , 16 but 16 but 17 denied 17 denied 20 manifestations 18 any 20 manifestations 19 previous 20 manifestations 20 manifestations 21 consistent 21 consistent 22 with 22 with 27 malformation 23 this 24 type 24 type 25 of 24 type 27 malformation 25 of 27 malformation 26 brain 27 malformation the patient underwent neuroimaging , evaluation [by] neurology , and comprehensive neuropsychological testing to determine the nature of any other associated impairments . 0 ###LEFT-WALL### 2 patient 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 23 . 1 the 2 patient 2 patient 3 underwent 3 underwent 10 and 3 underwent 14 to 4 neuroimaging 5 , 5 , 8 neurology 5 , 10 and 6 evaluation 8 neurology 9 , 10 and 10 and 13 testing 11 comprehensive 13 testing 12 neuropsychological 13 testing 14 to 15 determine 15 determine 17 nature 15 determine 21 associated 16 the 17 nature 17 nature 18 of 17 nature 21 associated 18 of 20 other 19 any 20 other 21 associated 22 impairments test results indicated that he was , with a few exceptions , neuropsychologically normal . 0 ###LEFT-WALL### 1 test 0 ###LEFT-WALL### 15 . 1 test 2 results 1 test 3 indicated 2 results 3 indicated 3 indicated 4 that 4 that 5 he 4 that 6 was 5 he 6 was 6 was 8 with 6 was 14 normal 7 , 8 with 8 with 11 exceptions 8 with 12 , 9 a 10 few 10 few 11 exceptions 13 neuropsychologically 14 normal he performed well on tests that are highly sensitive to acquired brain dysfunction . 0 ###LEFT-WALL### 1 he 0 ###LEFT-WALL### 2 performed 0 ###LEFT-WALL### 14 . 1 he 2 performed 2 performed 3 well 2 performed 4 on 4 on 5 tests 5 tests 6 that 5 tests 7 are 6 that 7 are 7 are 9 sensitive 8 highly 9 sensitive 9 sensitive 10 to 10 to 13 dysfunction 11 acquired 12 brain 12 brain 13 dysfunction his most notable deficit was failed performance in the simultaneous and coordinated use of both hands in using tactile and proprioceptive feedback on the tactual performance test . 0 ###LEFT-WALL### 4 deficit 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 28 . 1 his 4 deficit 2 most 3 notable 3 notable 4 deficit 4 deficit 11 and 5 was 7 performance 5 was 8 in 5 was 11 and 6 failed 7 performance 8 in 10 simultaneous 9 the 10 simultaneous 11 and 12 coordinated 11 and 17 in 11 and 23 on 12 coordinated 13 use 13 use 14 of 14 of 16 hands 15 both 16 hands 17 in 18 using 18 using 22 feedback 19 tactile 20 and 20 and 21 proprioceptive 20 and 22 feedback 23 on 27 test 24 the 27 test 25 tactual 26 performance 26 performance 27 test this case is discussed in terms of plasticity of the developing brain , including compensatory mechanisms , highlighting the variability [in] clinical outcome in the context of congenital brain malformation . 0 ###LEFT-WALL### 2 case 0 ###LEFT-WALL### 4 discussed 0 ###LEFT-WALL### 31 . 1 this 2 case 2 case 3 is 3 is 4 discussed 4 discussed 5 in 5 in 6 terms 6 terms 7 of 7 of 8 plasticity 8 plasticity 9 of 8 plasticity 18 highlighting 9 of 12 brain 10 the 12 brain 11 developing 12 brain 12 brain 14 including 13 , 14 including 14 including 16 mechanisms 14 including 17 , 15 compensatory 16 mechanisms 18 highlighting 23 outcome 18 highlighting 24 in 19 the 23 outcome 20 variability 23 outcome 22 clinical 23 outcome 24 in 26 context 25 the 26 context 26 context 27 of 27 of 30 malformation 28 congenital 29 brain 29 brain 30 malformation this case study illustrates the strong influence of cerebral plasticity as well as a possible circumscribed manifestation of interhemispheric disconnection . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 illustrates 0 ###LEFT-WALL### 21 . 1 this 3 study 2 case 3 study 3 study 4 illustrates 4 illustrates 7 influence 5 the 7 influence 6 strong 7 influence 7 influence 8 of 8 of 10 plasticity 9 cerebral 10 plasticity 10 plasticity 13 as 11 as 12 well 12 well 13 as 13 as 17 manifestation 14 a 15 possible 14 a 17 manifestation 15 possible 17 manifestation 16 circumscribed 17 manifestation 17 manifestation 18 of 18 of 20 disconnection 19 interhemispheric 20 disconnection alzheimer 's disease ( ad ) is characterized by the presence of abnormal , straight filaments and paired helical filaments ( phfs ) that [are] coated with amorphous aggregates . 0 ###LEFT-WALL### 3 disease 0 ###LEFT-WALL### 8 characterized 0 ###LEFT-WALL### 30 . 1 alzheimer 2 's 2 's 3 disease 3 disease 5 ad 3 disease 7 is 4 ( 5 ad 5 ad 6 ) 7 is 8 characterized 8 characterized 9 by 8 characterized 27 with 9 by 11 presence 10 the 11 presence 11 presence 12 of 11 presence 22 phfs 11 presence 26 coated 12 of 17 and 13 abnormal 14 , 13 abnormal 16 filaments 15 straight 16 filaments 16 filaments 17 and 17 and 20 filaments 18 paired 20 filaments 19 helical 20 filaments 21 ( 22 phfs 22 phfs 23 ) 24 that 26 coated 27 with 29 aggregates 28 amorphous 29 aggregates when phfs are treated with alkali , they untwist and form filaments with a ribbonlike morphology . 0 ###LEFT-WALL### 8 they 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 17 . 1 when 2 phfs 1 when 4 treated 1 when 7 , 1 when 8 they 2 phfs 3 are 3 are 4 treated 4 treated 5 with 5 with 6 alkali 8 they 10 and 9 untwist 10 and 10 and 11 form 10 and 16 morphology 11 form 12 filaments 11 form 13 with 13 with 15 ribbonlike 14 a 15 ribbonlike tau protein is the major component of all of these ultrastructures . 0 ###LEFT-WALL### 2 protein 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 12 . 1 tau 2 protein 2 protein 3 is 3 is 6 component 4 the 6 component 5 major 6 component 6 component 7 of 7 of 8 all 8 all 9 of 9 of 11 ultrastructures 10 these 11 ultrastructures the molecular basis of the association of 14 - 3 - 3ζ within nfts and [the] pathological significance of its association are not known . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 24 known 0 ###LEFT-WALL### 25 . 1 the 3 basis 2 molecular 3 basis 3 basis 4 of 3 basis 15 and 4 of 6 association 5 the 6 association 6 association 7 of 6 association 12 3ζ 7 of 8 14 8 14 10 3 9 - 10 3 10 3 11 - 12 3ζ 13 within 13 within 14 nfts 15 and 18 significance 15 and 19 of 15 and 22 are 17 pathological 18 significance 19 of 21 association 20 its 21 association 22 are 23 not 22 are 24 known in this study , we have found that 14 - 3 - 3ζ is copurified and co [-] immunoprecipitates with tau from nfts of ad brain extract . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 14 is 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 28 . 1 in 3 study 1 in 14 is 2 this 3 study 3 study 10 - 4 , 10 - 5 we 6 have 6 have 7 found 7 found 8 that 8 that 9 14 8 that 10 - 9 14 10 - 10 - 11 3 10 - 12 - 13 3ζ 14 is 14 is 15 copurified 16 and 17 co 16 and 19 immunoprecipitates 17 co 19 immunoprecipitates 19 immunoprecipitates 20 with 20 with 21 tau 21 tau 22 from 22 from 27 extract 23 nfts 24 of 23 nfts 27 extract 24 of 25 ad 26 brain 27 extract in vitro , tau binds to both phosphorylated and nonphosphorylated tau . 0 ###LEFT-WALL### 4 tau 0 ###LEFT-WALL### 5 binds 0 ###LEFT-WALL### 12 . 1 in 2 vitro 2 vitro 3 , 2 vitro 4 tau 4 tau 5 binds 5 binds 6 to 6 to 9 and 7 both 8 phosphorylated 8 phosphorylated 9 and 9 and 10 nonphosphorylated 9 and 11 tau when incubated with 14 - 3 - 3ζ , tau forms amorphous aggregates , single - stranded , straight filaments , ribbonlike filaments , and phf - like filaments , all of which resemble the corresponding ultrastructures found in ad brain . 0 ###LEFT-WALL### 10 tau 0 ###LEFT-WALL### 11 forms 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 42 . 1 when 2 incubated 1 when 7 - 1 when 10 tau 2 incubated 3 with 3 with 4 14 4 14 6 3 5 - 6 3 6 3 7 - 8 3ζ 9 , 8 3ζ 10 tau 10 tau 11 forms 11 forms 13 aggregates 12 amorphous 13 aggregates 14 , 15 single 14 , 16 - 16 - 25 and 16 - 38 found 17 stranded 18 , 17 stranded 25 and 19 straight 20 filaments 20 filaments 21 , 21 , 23 filaments 21 , 25 and 22 ribbonlike 23 filaments 24 , 25 and 25 and 26 phf 25 and 30 , 25 and 31 all 25 and 34 resemble 25 and 38 found 26 phf 28 like 27 - 28 like 28 like 29 filaments 28 like 30 , 31 all 32 of 31 all 34 resemble 32 of 33 which 34 resemble 37 ultrastructures 35 the 37 ultrastructures 36 corresponding 37 ultrastructures 38 found 39 in 38 found 41 brain 40 ad 41 brain [immuno] - electron microscopy determined that both tau and 14 - 3 [-] 3ζ are present in these ultrastructures and that they are formed in an incubation time - dependent manner . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 5 determined 0 ###LEFT-WALL### 29 - 0 ###LEFT-WALL### 32 . 2 - 4 microscopy 3 electron 4 microscopy 4 microscopy 5 determined 5 determined 20 and 6 that 9 and 6 that 15 are 6 that 20 and 7 both 9 and 8 tau 9 and 9 and 14 3ζ 9 and 15 are 10 14 11 - 11 - 12 3 11 - 14 3ζ 15 are 16 present 16 present 17 in 17 in 19 ultrastructures 18 these 19 ultrastructures 20 and 21 that 21 that 22 they 21 that 24 formed 22 they 23 are 23 are 24 formed 24 formed 25 in 24 formed 28 time 25 in 27 incubation 26 an 27 incubation 29 - 31 manner 30 dependent 31 manner amorphous aggregates are formed first . 0 ###LEFT-WALL### 2 aggregates 0 ###LEFT-WALL### 4 formed 0 ###LEFT-WALL### 6 . 1 amorphous 2 aggregates 2 aggregates 3 are 3 are 4 formed 4 formed 5 first as the incubation time increases , the size of amorphous aggregates increases and they are incorporated into single - stranded filaments . 0 ###LEFT-WALL### 8 size 0 ###LEFT-WALL### 12 increases 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 22 . 1 as 4 time 1 as 5 increases 1 as 6 , 1 as 8 size 2 the 4 time 3 incubation 4 time 4 time 5 increases 7 the 8 size 8 size 9 of 8 size 12 increases 9 of 11 aggregates 10 amorphous 11 aggregates 13 and 14 they 13 and 16 incorporated 14 they 15 are 15 are 16 incorporated 16 incorporated 17 into 17 into 21 filaments 18 single 19 - 18 single 21 filaments 20 stranded 21 filaments single - stranded filaments laterally associate to form double - stranded [,] ribbonlike , and phf - like filaments . 0 ###LEFT-WALL### 1 single 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 20 . 2 - 4 filaments 2 - 6 associate 3 stranded 4 filaments 4 filaments 6 associate 5 laterally 6 associate 6 associate 7 to 7 to 15 and 8 form 13 ribbonlike 8 form 15 and 9 double 10 - 9 double 13 ribbonlike 11 stranded 13 ribbonlike 14 , 15 and 15 and 18 like 16 phf 17 - 16 phf 18 like 18 like 19 filaments both tau and phosphorylated tau aggregate in a similar manner when they are incubated with 14 - 3 - 3ζ . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 aggregate 0 ###LEFT-WALL### 21 . 1 both 3 and 2 tau 3 and 3 and 5 tau 3 and 6 aggregate 4 phosphorylated 5 tau 6 aggregate 7 in 6 aggregate 11 when 7 in 10 manner 8 a 9 similar 8 a 10 manner 9 similar 10 manner 11 when 12 they 11 when 14 incubated 12 they 13 are 13 are 14 incubated 14 incubated 15 with 14 incubated 20 3ζ 15 with 16 14 16 14 18 3 17 - 18 3 18 3 19 - our data suggest that 14 - 3 - 3ζ has a role in the fibrillization of tau in ad brain , and that tau phosphorylation does not affect 14 - 3 - 3ζ - induced tau aggregation . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 30 - 1 our 2 data 2 data 22 and 3 suggest 4 that 3 suggest 10 has 3 suggest 22 and 4 that 5 14 4 that 9 3ζ 4 that 10 has 5 14 7 3 5 14 9 3ζ 6 - 7 3 7 3 8 - 10 has 12 role 10 has 13 in 10 has 18 in 11 a 12 role 13 in 15 fibrillization 14 the 15 fibrillization 15 fibrillization 16 of 16 of 17 tau 18 in 20 brain 19 ad 20 brain 21 , 22 and 22 and 28 affect 23 that 25 phosphorylation 24 tau 25 phosphorylation 25 phosphorylation 26 does 26 does 27 not 26 does 28 affect 28 affect 29 14 30 - 31 3 30 - 35 induced 30 - 38 . 31 3 33 3ζ 31 3 35 induced 32 - 33 3ζ 33 3ζ 34 - 35 induced 37 aggregation 36 tau 37 aggregation there are approximately 5,700 hospitals in the united states , 3,000 - 4,000 that are antiquated or obsolescing . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 1 there 2 are 2 are 5 hospitals 3 approximately 4 5,700 4 5,700 5 hospitals 5 hospitals 6 in 6 in 9 states 7 the 9 states 8 united 9 states 9 states 12 - 10 , 12 - 11 3,000 12 - 12 - 13 4,000 12 - 14 that 12 - 15 are 12 - 19 . 14 that 15 are 15 are 17 or 16 antiquated 17 or 17 or 18 obsolescing to meet increased service demands , remain financially viable ; meet needs to upgrade aging infrastructure and incorporate medical and technology advancements , healthcare facilities are in a perpetual state of construction . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 33 . 1 to 6 , 2 meet 5 demands 2 meet 6 , 3 increased 4 service 4 service 5 demands 6 , 7 remain 7 remain 8 financially 7 remain 9 viable 10 ; 11 meet 10 ; 23 , 11 meet 12 needs 12 needs 13 to 12 needs 17 and 13 to 17 and 14 upgrade 16 infrastructure 14 upgrade 17 and 15 aging 16 infrastructure 17 and 18 incorporate 18 incorporate 20 and 19 medical 20 and 20 and 22 advancements 21 technology 22 advancements 23 , 25 facilities 23 , 26 are 24 healthcare 25 facilities 25 facilities 26 are 26 are 27 in 27 in 30 state 28 a 30 state 29 perpetual 30 state 30 state 31 of 31 of 32 construction outbreaks of nosocomial infections have historically been documented in association with construction and renovation actives within health care facilities . 0 ###LEFT-WALL### 1 outbreaks 0 ###LEFT-WALL### 8 documented 0 ###LEFT-WALL### 20 . 1 outbreaks 2 of 1 outbreaks 5 have 2 of 4 infections 3 nosocomial 4 infections 5 have 7 been 6 historically 7 been 7 been 8 documented 8 documented 10 association 8 documented 11 with 8 documented 16 within 9 in 10 association 11 with 13 and 12 construction 13 and 13 and 15 actives 14 renovation 15 actives 16 within 19 facilities 17 health 19 facilities 18 care 19 facilities for most healthy individuals , environmental exposures to etiological agents , results in no adverse effects but [in] [immune] [-] compromised patient , they are left susceptible to inadvertent exposures during construction to opportunistic bacteria , fungi and viruses . 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 40 . 1 for 4 individuals 1 for 17 but 2 most 3 healthy 3 healthy 4 individuals 4 individuals 7 exposures 5 , 7 exposures 6 environmental 7 exposures 7 exposures 8 to 7 exposures 11 , 8 to 10 agents 9 etiological 10 agents 12 results 13 in 12 results 17 but 13 in 16 effects 14 no 16 effects 15 adverse 16 effects 17 but 21 compromised 21 compromised 22 patient 23 , 24 they 23 , 25 are 24 they 25 are 25 are 26 left 25 are 27 susceptible 27 susceptible 28 to 27 susceptible 31 during 27 susceptible 33 to 28 to 30 exposures 29 inadvertent 30 exposures 31 during 32 construction 33 to 38 and 34 opportunistic 35 bacteria 35 bacteria 36 , 36 , 37 fungi 36 , 38 and 38 and 39 viruses evidence scientifically linking construction work and nosocomial infections as well as the efficacy and clinical relevance of infection control precautions is somewhat lacking but the empirical evidence and recommendations to support protective measures is steadily growing . 0 ###LEFT-WALL### 1 evidence 0 ###LEFT-WALL### 37 . 1 evidence 3 linking 1 evidence 34 is 2 scientifically 3 linking 3 linking 6 and 3 linking 10 well 3 linking 11 as 4 construction 5 work 5 work 6 and 6 and 8 infections 7 nosocomial 8 infections 9 as 10 well 11 as 16 relevance 11 as 31 support 12 the 16 relevance 13 efficacy 14 and 14 and 15 clinical 14 and 16 relevance 16 relevance 17 of 16 relevance 21 is 17 of 20 precautions 18 infection 20 precautions 19 control 20 precautions 21 is 22 somewhat 21 is 23 lacking 23 lacking 24 but 23 lacking 30 to 24 but 28 and 25 the 27 evidence 26 empirical 27 evidence 27 evidence 28 and 28 and 29 recommendations 30 to 31 support 31 support 33 measures 32 protective 33 measures 34 is 35 steadily 34 is 36 growing clinically significant hoarding behaviors ( hb ) have been defined as acquisition [of] , and failure to discard , large numbers of items , which limits the use of one's home and causes functional impairment or distress . 0 ###LEFT-WALL### 4 behaviors 0 ###LEFT-WALL### 10 defined 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 38 . 1 clinically 4 behaviors 2 significant 4 behaviors 3 hoarding 4 behaviors 4 behaviors 6 hb 4 behaviors 8 have 5 ( 6 hb 6 hb 7 ) 8 have 9 been 9 been 10 defined 10 defined 11 as 11 as 15 and 12 acquisition 15 and 14 , 15 and 15 and 16 failure 15 and 17 to 15 and 18 discard 15 and 23 items 17 to 18 discard 19 , 23 items 20 large 21 numbers 21 numbers 22 of 21 numbers 23 items 22 of 23 items 23 items 24 , 24 , 25 which 24 , 32 and 25 which 32 and 26 limits 28 use 26 limits 31 home 26 limits 32 and 27 the 28 use 28 use 29 of 29 of 30 one's 32 and 36 or 33 causes 35 impairment 33 causes 36 or 34 functional 35 impairment 36 or 37 distress hb disproportionally affect adults aged 55 and older , and although research on hb has accelerated in the past decade , few studies focus on older adults . 0 ###LEFT-WALL### 1 hb 0 ###LEFT-WALL### 3 affect 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 28 . 1 hb 3 affect 2 disproportionally 3 affect 3 affect 4 adults 3 affect 7 and 5 aged 6 55 5 aged 7 and 7 and 8 older 9 , 10 and 10 and 23 studies 10 and 24 focus 11 although 12 research 11 although 16 accelerated 11 although 21 , 11 although 23 studies 12 research 13 on 12 research 15 has 13 on 14 hb 15 has 16 accelerated 16 accelerated 17 in 17 in 20 decade 18 the 19 past 18 the 20 decade 22 few 23 studies 23 studies 24 focus 24 focus 25 on 25 on 27 adults 26 older 27 adults this qualitative study , based on grounded theory methodology , utilized interview data from 22 older adults with hb to understand the dynamic interaction between hb and the aging process . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 21 understand 0 ###LEFT-WALL### 31 . 1 this 3 study 2 qualitative 3 study 3 study 5 based 3 study 11 utilized 4 , 5 based 5 based 6 on 5 based 10 , 6 on 9 methodology 7 grounded 9 methodology 8 theory 9 methodology 11 utilized 13 data 11 utilized 20 to 12 interview 13 data 13 data 14 from 14 from 17 adults 15 22 17 adults 16 older 17 adults 17 adults 18 with 18 with 19 hb 20 to 21 understand 21 understand 24 interaction 21 understand 25 between 22 the 24 interaction 23 dynamic 24 interaction 25 between 27 and 26 hb 27 and 27 and 30 process 28 the 30 process 29 aging 30 process participants described the specific ways that their chronic hb were complicated by changes in their health status , social context , and home setting , resulting in greater functional impairment and distress . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 33 . 1 participants 2 described 1 participants 12 by 1 participants 18 , 2 described 5 ways 3 the 5 ways 4 specific 5 ways 5 ways 6 that 6 that 9 hb 6 that 10 were 7 their 9 hb 8 chronic 9 hb 9 hb 10 were 10 were 11 complicated 12 by 13 changes 13 changes 14 in 14 in 17 status 15 their 17 status 16 health 17 status 18 , 20 context 18 , 22 and 19 social 20 context 21 , 22 and 22 and 24 setting 22 and 25 , 22 and 26 resulting 23 home 24 setting 26 resulting 27 in 27 in 31 and 28 greater 30 impairment 29 functional 30 impairment 30 impairment 31 and 31 and 32 distress by identifying these changes that commonly occur with age and their synergistic relationship with hb , nurses and other health professionals can develop targeted interventions to improve home safety and support the independence of these older adults . 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 38 . 1 by 2 identifying 1 by 16 , 1 by 18 and 2 identifying 4 changes 3 these 4 changes 4 changes 5 that 4 changes 7 occur 5 that 7 occur 6 commonly 7 occur 7 occur 8 with 7 occur 14 with 8 with 10 and 9 age 10 and 10 and 13 relationship 11 their 13 relationship 12 synergistic 13 relationship 14 with 15 hb 17 nurses 18 and 18 and 30 and 19 other 21 professionals 20 health 21 professionals 21 professionals 22 can 22 can 23 develop 23 develop 25 interventions 23 develop 26 to 24 targeted 25 interventions 26 to 30 and 27 improve 29 safety 27 improve 30 and 28 home 29 safety 30 and 31 support 31 support 33 independence 32 the 33 independence 33 independence 34 of 34 of 37 adults 35 these 37 adults 36 older 37 adults the von economo neurons ( vens ) are large bipolar layer v projection neurons found chiefly in the anterior cingulate and frontoinsular cortices . 0 ###LEFT-WALL### 4 neurons 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 24 . 1 the 4 neurons 2 von 3 economo 3 economo 4 neurons 4 neurons 6 vens 4 neurons 8 are 5 ( 6 vens 6 vens 7 ) 8 are 14 neurons 9 large 14 neurons 10 bipolar 14 neurons 11 layer 12 v 11 layer 13 projection 13 projection 14 neurons 14 neurons 15 found 15 found 16 chiefly 16 chiefly 17 in 17 in 21 and 18 the 20 cingulate 19 anterior 20 cingulate 20 cingulate 21 and 21 and 23 cortices 22 frontoinsular 23 cortices although vens have been linked to prevalent illnesses such as frontotemporal dementia , autism , and schizophrenia , little is known about ven identity , including their major projection targets . 0 ###LEFT-WALL### 19 little 0 ###LEFT-WALL### 21 known 1 although 2 vens 1 although 5 linked 1 although 18 , 1 although 19 little 2 vens 3 have 3 have 4 been 4 been 5 linked 5 linked 6 to 6 to 8 illnesses 7 prevalent 8 illnesses 8 illnesses 10 as 9 such 10 as 10 as 16 and 11 frontotemporal 14 autism 12 dementia 13 , 12 dementia 14 autism 14 autism 16 and 15 , 16 and 16 and 17 schizophrenia 19 little 20 is 20 is 21 known 21 known 22 about 22 about 24 identity 23 ven 24 identity 24 identity 26 including 25 , 26 including 26 including 30 targets 26 including 31 . 27 their 30 targets 28 major 30 targets 29 projection 30 targets here , we undertook a developmental transcription factor expression study , focusing on markers associated with specific classes of layer v projection neurons . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 undertook 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 24 . 1 here 2 , 1 here 3 we 3 we 4 undertook 4 undertook 10 study 5 a 6 developmental 5 a 10 study 6 developmental 7 transcription 7 transcription 10 study 8 factor 10 study 9 expression 10 study 11 , 12 focusing 11 , 15 associated 12 focusing 13 on 12 focusing 15 associated 13 on 14 markers 15 associated 16 with 16 with 18 classes 17 specific 18 classes 18 classes 19 of 19 of 23 neurons 20 layer 21 v 20 layer 22 projection 22 projection 23 neurons using mrna in situ [hybridization] , we found that vens prominently express fezf2 and ctip2 , transcription factors that regulate the fate and differentiation of subcerebral projection neurons , in humans aged 3 months to 65 years . 0 ###LEFT-WALL### 7 we 0 ###LEFT-WALL### 8 found 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 38 . 1 using 2 mrna 1 using 4 situ 1 using 6 , 1 using 7 we 3 in 4 situ 7 we 8 found 8 found 9 that 9 that 10 vens 9 that 12 express 10 vens 12 express 11 prominently 12 express 12 express 14 and 13 fezf2 14 and 14 and 15 ctip2 16 , 18 factors 16 , 32 aged 17 transcription 18 factors 18 factors 19 that 18 factors 20 regulate 18 factors 32 aged 19 that 20 regulate 20 regulate 23 and 20 regulate 30 in 21 the 22 fate 22 fate 23 and 23 and 24 differentiation 23 and 29 , 24 differentiation 25 of 25 of 28 neurons 26 subcerebral 28 neurons 27 projection 28 neurons 30 in 31 humans 32 aged 35 to 33 3 34 months 34 months 35 to 35 to 37 years 36 65 37 years in contrast , few vens expressed markers associated with callosal or corticothalamic projections . 0 ###LEFT-WALL### 7 markers 0 ###LEFT-WALL### 8 associated 0 ###LEFT-WALL### 14 . 1 in 2 contrast 1 in 3 , 1 in 7 markers 4 few 7 markers 5 vens 6 expressed 6 expressed 7 markers 7 markers 8 associated 8 associated 9 with 9 with 13 projections 10 callosal 11 or 11 or 12 corticothalamic 11 or 13 projections these findings suggest that vens may represent a [specialized] layer v projection neuron for linking cortical autonomic control sites to brainstem or spinal cord regions . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 26 . 1 these 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 5 vens 4 that 7 represent 5 vens 6 may 6 may 7 represent 7 represent 13 neuron 7 represent 14 for 8 a 13 neuron 10 layer 11 v 10 layer 12 projection 12 projection 13 neuron 14 for 15 linking 15 linking 19 sites 15 linking 20 to 16 cortical 18 control 17 autonomic 18 control 18 control 19 sites 20 to 22 or 21 brainstem 22 or 22 or 25 regions 23 spinal 24 cord 24 cord 25 regions increased frontal cortex activation during cognitive task performance is common in aging but remains poorly understood . 0 ###LEFT-WALL### 4 activation 0 ###LEFT-WALL### 13 but 0 ###LEFT-WALL### 17 . 1 increased 3 cortex 2 frontal 3 cortex 3 cortex 4 activation 4 activation 5 during 4 activation 13 but 5 during 8 performance 6 cognitive 7 task 7 task 8 performance 9 is 10 common 9 is 13 but 10 common 11 in 11 in 12 aging 13 but 14 remains 14 remains 16 understood 15 poorly 16 understood here we explored patterns of age - related frontal brain activations under multiple task performance conditions and their relationship to white matter ( wm ) microstructure . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 explored 0 ###LEFT-WALL### 8 related 0 ###LEFT-WALL### 27 . 1 here 2 we 2 we 3 explored 3 explored 4 patterns 4 patterns 5 of 5 of 6 age 7 - 8 related 8 related 11 activations 9 frontal 10 brain 10 brain 11 activations 11 activations 12 under 11 activations 17 and 11 activations 26 microstructure 12 under 15 performance 13 multiple 15 performance 14 task 15 performance 16 conditions 17 and 17 and 19 relationship 17 and 20 to 17 and 26 microstructure 18 their 19 relationship 20 to 22 matter 21 white 22 matter 22 matter 24 wm 23 ( 24 wm 24 wm 25 ) groups of younger ( [n] [=] [28] [ )(and older ( n = 33 ) participants completed a task - switching [paradigm] while functional magnetic resonance imaging ( fmri ) was performed , and rested while diffusion tensor imaging was performed . 0 ###LEFT-WALL### 1 groups 0 ###LEFT-WALL### 34 and 0 ###LEFT-WALL### 42 . 1 groups 2 of 1 groups 34 and 2 of 16 participants 3 younger 9 )(and 4 ( 9 )(and 9 )(and 10 older 9 )(and 15 ) 9 )(and 16 participants 10 older 13 = 11 ( 13 = 12 n 13 = 13 = 14 33 17 completed 19 task 17 completed 21 switching 17 completed 34 and 18 a 19 task 20 - 21 switching 21 switching 23 while 21 switching 33 , 23 while 27 imaging 23 while 31 was 24 functional 26 resonance 25 magnetic 26 resonance 26 resonance 27 imaging 27 imaging 29 fmri 27 imaging 31 was 28 ( 29 fmri 29 fmri 30 ) 31 was 32 performed 34 and 35 rested 35 rested 36 while 36 while 39 imaging 36 while 41 performed 37 diffusion 39 imaging 38 tensor 39 imaging 39 imaging 40 was 40 was 41 performed results from fmri analyses indicated age - related increases in frontal brain activations under conditions of poorer performance in the older group ( the nonswitch and switch conditions ) and for a contrast in which behavioral performance was equated ( older group nonswitch condition vs [.] younger group switch condition ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 4 analyses 0 ###LEFT-WALL### 8 related 0 ###LEFT-WALL### 52 . 1 results 2 from 1 results 4 analyses 2 from 3 fmri 4 analyses 6 age 5 indicated 6 age 7 - 8 related 8 related 9 increases 8 related 30 and 9 increases 10 in 9 increases 14 under 10 in 13 activations 11 frontal 13 activations 12 brain 13 activations 14 under 15 conditions 15 conditions 16 of 16 of 18 performance 17 poorer 18 performance 19 in 22 group 19 in 30 and 20 the 22 group 21 older 22 group 22 group 26 and 23 ( 26 and 24 the 25 nonswitch 25 nonswitch 26 and 26 and 28 conditions 26 and 29 ) 27 switch 28 conditions 30 and 31 for 31 for 33 contrast 32 a 33 contrast 33 contrast 34 in 33 contrast 44 condition 34 in 35 which 34 in 37 performance 34 in 39 equated 36 behavioral 37 performance 37 performance 38 was 38 was 39 equated 40 ( 44 condition 41 older 44 condition 42 group 44 condition 43 nonswitch 44 condition 44 condition 45 vs 44 condition 51 ) 45 vs 50 condition 47 younger 48 group 48 group 50 condition 49 switch 50 condition within the older adult group , higher frontal activation was associated with poorer behavioral performance under all task conditions . 0 ###LEFT-WALL### 9 activation 0 ###LEFT-WALL### 11 associated 0 ###LEFT-WALL### 20 . 1 within 5 group 1 within 6 , 1 within 9 activation 2 the 5 group 3 older 4 adult 4 adult 5 group 7 higher 9 activation 8 frontal 9 activation 9 activation 10 was 10 was 11 associated 11 associated 12 with 11 associated 16 under 12 with 15 performance 13 poorer 15 performance 14 behavioral 15 performance 16 under 19 conditions 17 all 19 conditions 18 task 19 conditions in 2 regions in right frontal cortex [,] blood oxygen level - dependent ( bold ) magnitudes were negatively correlated with wm integrity in tracts connecting these structures with other task [-] relevant frontoparietal and striatal regions . 0 ###LEFT-WALL### 3 regions 0 ###LEFT-WALL### 11 level 0 ###LEFT-WALL### 12 - 1 in 2 2 1 in 3 regions 3 regions 4 in 3 regions 11 level 4 in 10 oxygen 5 right 7 cortex 6 frontal 7 cortex 7 cortex 10 oxygen 9 blood 10 oxygen 12 - 17 magnitudes 12 - 20 correlated 12 - 38 . 13 dependent 15 bold 13 dependent 17 magnitudes 14 ( 15 bold 15 bold 16 ) 17 magnitudes 18 were 18 were 19 negatively 18 were 20 correlated 20 correlated 21 with 21 with 23 integrity 21 with 28 structures 22 wm 23 integrity 23 integrity 24 in 23 integrity 26 connecting 24 in 25 tracts 27 these 28 structures 28 structures 29 with 29 with 37 regions 30 other 37 regions 31 task 37 regions 33 relevant 37 regions 34 frontoparietal 35 and 35 and 36 striatal 35 and 37 regions our results link age - related declines in the efficiency of frontal cortex functioning with lower wm integrity in aging . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 link 0 ###LEFT-WALL### 6 related 1 our 2 results 2 results 3 link 3 link 4 age 5 - 6 related 6 related 7 declines 6 related 8 in 6 related 15 with 6 related 21 . 8 in 10 efficiency 9 the 10 efficiency 10 efficiency 11 of 11 of 14 functioning 12 frontal 13 cortex 13 cortex 14 functioning 15 with 18 integrity 16 lower 18 integrity 17 wm 18 integrity 18 integrity 19 in 19 in 20 aging purpose : cns - directed chemotherapy ( ct [ )(and cranial radiotherapy ( crt ) for childhood acute lymphoblastic leukemia or lymphoma have various neurotoxic properties . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 21 or 2 : 23 have 3 cns 6 chemotherapy 3 cns 16 for 3 cns 21 or 4 - 6 chemotherapy 5 directed 6 chemotherapy 6 chemotherapy 10 )(and 6 chemotherapy 15 ) 7 ( 10 )(and 8 ct 10 )(and 10 )(and 12 radiotherapy 10 )(and 14 crt 10 )(and 15 ) 11 cranial 12 radiotherapy 13 ( 14 crt 14 crt 15 ) 16 for 20 leukemia 17 childhood 20 leukemia 18 acute 20 leukemia 19 lymphoblastic 20 leukemia 21 or 22 lymphoma 21 or 23 have 23 have 26 properties 24 various 26 properties 25 neurotoxic 26 properties this study aimed to assess their impact on the maturing brain 20 to 30 years after diagnosis , providing a much stronger perspective on long - term quality of life than previous studies . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 aimed 1 this 2 study 2 study 3 aimed 3 aimed 4 to 3 aimed 5 assess 4 to 5 assess 5 assess 7 impact 5 assess 16 after 6 their 7 impact 7 impact 8 on 8 on 11 brain 9 the 11 brain 10 maturing 11 brain 12 20 13 to 13 to 14 30 13 to 15 years 15 years 16 after 16 after 17 diagnosis 17 diagnosis 19 providing 18 , 19 providing 19 providing 23 perspective 19 providing 24 on 19 providing 31 than 19 providing 34 . 20 a 23 perspective 21 much 22 stronger 22 stronger 23 perspective 24 on 28 quality 25 long 26 - 25 long 27 term 27 term 28 quality 28 quality 29 of 29 of 30 life 31 than 33 studies 32 previous 33 studies patients and methods : ninety - three patients treated between 1978 and 1990 at various intensities , [with] and without crt , and 49 healthy controls [were] assessed with magnetic resonance diffusion tensor imaging ( dti ) and neuropsychological tests . 0 ###LEFT-WALL### 3 methods 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 41 . 1 patients 3 methods 2 and 3 methods 3 methods 4 : 4 : 38 and 5 ninety 6 - 6 - 7 three 6 - 8 patients 8 patients 9 treated 8 patients 10 between 8 patients 19 and 8 patients 23 and 10 between 12 and 11 1978 12 and 12 and 13 1990 14 at 16 intensities 14 at 19 and 15 various 16 intensities 17 , 19 and 19 and 20 without 20 without 21 crt 22 , 23 and 23 and 26 controls 23 and 28 assessed 23 and 36 dti 23 and 38 and 24 49 26 controls 25 healthy 26 controls 28 assessed 29 with 29 with 34 imaging 30 magnetic 31 resonance 31 resonance 32 diffusion 32 diffusion 34 imaging 33 tensor 34 imaging 35 ( 36 dti 36 dti 37 ) 38 and 40 tests 39 neuropsychological 40 tests differences in fractional anisotropy ( fa ) - a dti measure describing white matter ( wm ) microstructure - [were] analyzed by using whole brain voxel - based analysis . 0 ###LEFT-WALL### 1 differences 0 ###LEFT-WALL### 18 microstructure 0 ###LEFT-WALL### 27 - 1 differences 2 in 1 differences 18 microstructure 2 in 4 anisotropy 3 fractional 4 anisotropy 4 anisotropy 6 fa 4 anisotropy 11 measure 5 ( 6 fa 6 fa 7 ) 8 - 11 measure 9 a 11 measure 10 dti 11 measure 11 measure 12 describing 11 measure 17 ) 12 describing 14 matter 13 white 14 matter 14 matter 16 wm 15 ( 16 wm 16 wm 17 ) 18 microstructure 21 analyzed 19 - 21 analyzed 21 analyzed 22 by 21 analyzed 27 - 22 by 23 using 23 using 26 voxel 24 whole 25 brain 25 brain 26 voxel 27 - 29 analysis 27 - 30 . 28 based 29 analysis results : crt - treated survivors demonstrated significantly decreased fa compared with controls in frontal , parietal , and temporal wm tracts . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 - 1 results 2 : 2 : 3 crt 4 - 6 survivors 4 - 7 demonstrated 4 - 23 . 5 treated 6 survivors 6 survivors 7 demonstrated 7 demonstrated 10 fa 7 demonstrated 12 with 7 demonstrated 14 in 8 significantly 9 decreased 9 decreased 10 fa 10 fa 11 compared 12 with 13 controls 14 in 22 tracts 15 frontal 16 , 15 frontal 22 tracts 17 parietal 19 and 18 , 19 and 19 and 20 temporal 19 and 22 tracts 21 wm 22 tracts trends for lower fa were seen in the ct - treated survivors . 0 ###LEFT-WALL### 1 trends 0 ###LEFT-WALL### 6 seen 0 ###LEFT-WALL### 10 - 1 trends 2 for 1 trends 5 were 2 for 4 fa 3 lower 4 fa 5 were 6 seen 6 seen 7 in 7 in 9 ct 8 the 9 ct 10 - 12 survivors 10 - 13 . 11 treated 12 survivors decreases in fa correlated well with neuropsychological dysfunction . 0 ###LEFT-WALL### 1 decreases 0 ###LEFT-WALL### 4 correlated 0 ###LEFT-WALL### 9 . 1 decreases 2 in 1 decreases 4 correlated 2 in 3 fa 4 correlated 5 well 4 correlated 6 with 6 with 8 dysfunction 7 neuropsychological 8 dysfunction in contrast to the ct group and controls , the crt group showed a steep decline of fa with age at assessment . 0 ###LEFT-WALL### 12 group 0 ###LEFT-WALL### 13 showed 0 ###LEFT-WALL### 23 . 1 in 2 contrast 1 in 9 , 1 in 12 group 2 contrast 3 to 3 to 7 and 4 the 6 group 5 ct 6 group 6 group 7 and 7 and 8 controls 10 the 12 group 11 crt 12 group 12 group 13 showed 13 showed 16 decline 14 a 15 steep 14 a 16 decline 15 steep 16 decline 16 decline 17 of 17 of 18 fa 18 fa 19 with 19 with 20 age 20 age 21 at 21 at 22 assessment younger age at cranial irradiation and higher dosage were associated with worse outcome [of] wm integrity . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 10 associated 0 ###LEFT-WALL### 17 . 1 younger 2 age 2 age 3 at 2 age 6 and 3 at 5 irradiation 4 cranial 5 irradiation 6 and 8 dosage 6 and 9 were 7 higher 8 dosage 9 were 10 associated 10 associated 11 with 11 with 16 integrity 12 worse 13 outcome 13 outcome 16 integrity 15 wm 16 integrity conclusion : crt - treated survivors show decreased wm integrity reflected by significantly decreased fa and associated neuropsychological dysfunction 25 years after treatment , although effects of ct alone seem mild . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 reflected 1 conclusion 2 : 2 : 3 crt 4 - 11 reflected 5 treated 6 survivors 6 survivors 7 show 7 show 9 wm 7 show 10 integrity 7 show 11 reflected 8 decreased 9 wm 10 integrity 11 reflected 11 reflected 12 by 12 by 16 and 13 significantly 14 decreased 14 decreased 15 fa 14 decreased 16 and 16 and 17 associated 17 associated 19 dysfunction 17 associated 25 although 18 neuropsychological 19 dysfunction 19 dysfunction 22 after 20 25 21 years 21 years 22 after 22 after 23 treatment 24 , 25 although 25 although 26 effects 25 although 30 seem 25 although 32 . 26 effects 27 of 26 effects 30 seem 27 of 28 ct 29 alone 30 seem 30 seem 31 mild accelerated aging of the brain and increased risk of early onset dementia [are] suspected after crt , but not after ct . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 22 . 1 accelerated 2 aging 1 accelerated 6 and 2 aging 3 of 3 of 5 brain 4 the 5 brain 6 and 7 increased 7 increased 8 risk 8 risk 9 of 9 of 12 dementia 10 early 11 onset 11 onset 12 dementia 12 dementia 14 suspected 14 suspected 18 but 15 after 16 crt 15 after 18 but 17 , 18 but 18 but 19 not 18 but 20 after 20 after 21 ct [a] wealth of evidence has revealed that the heart can be " conditioned " and rendered less vulnerable to ischemia - reperfusion injury via the upregulation of endogenous protective signaling pathways . 0 ###LEFT-WALL### 2 wealth 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 32 . 2 wealth 3 of 2 wealth 5 has 3 of 4 evidence 5 has 15 and 6 revealed 7 that 6 revealed 15 and 7 that 9 heart 7 that 13 conditioned 8 the 9 heart 9 heart 10 can 10 can 11 be 11 be 12 " 11 be 13 conditioned 13 conditioned 14 " 15 and 16 rendered 15 and 24 via 16 rendered 17 less 16 rendered 18 vulnerable 18 vulnerable 19 to 19 to 23 injury 20 ischemia 21 - 20 ischemia 22 reperfusion 22 reperfusion 23 injury 24 via 26 upregulation 25 the 26 upregulation 26 upregulation 27 of 27 of 31 pathways 28 endogenous 31 pathways 29 protective 31 pathways 30 signaling 31 pathways three distinct conditioning strategies have been identified : [(] 1 [ )(preconditioning , the phenomenon [where] brief episodes of myocardial ischemia ( too brief to cause cardiomyocyte death ) limit necrosis caused by a subsequent sustained ischemic insult [;] ( 2 ) postconditioning [,] the concept that relief of myocardial ischemia in [a] staged or stuttered manner attenuates lethal ischemia - reperfusion injury [;] [and] ( 3 ) remote conditioning [,] [or] upregulation of a cardioprotective phenotype initiated by ischemia in a remote organ or tissue and " transported " [to] [the] heart . 0 ###LEFT-WALL### 4 strategies 0 ###LEFT-WALL### 8 : 1 three 4 strategies 2 distinct 4 strategies 3 conditioning 4 strategies 4 strategies 5 have 5 have 6 been 6 been 7 identified 8 : 12 )(preconditioning 8 : 13 , 10 1 12 )(preconditioning 13 , 18 episodes 14 the 18 episodes 15 phenomenon 18 episodes 17 brief 18 episodes 18 episodes 19 of 18 episodes 24 brief 18 episodes 30 limit 19 of 21 ischemia 20 myocardial 21 ischemia 22 ( 24 brief 23 too 24 brief 24 brief 25 to 24 brief 29 ) 25 to 28 death 26 cause 28 death 27 cardiomyocyte 28 death 30 limit 31 necrosis 31 necrosis 32 caused 31 necrosis 33 by 31 necrosis 43 postconditioning 33 by 38 insult 34 a 35 subsequent 34 a 38 insult 35 subsequent 38 insult 36 sustained 38 insult 37 ischemic 38 insult 38 insult 41 2 40 ( 41 2 41 2 42 ) 43 postconditioning 46 concept 45 the 46 concept 46 concept 47 that 47 that 48 relief 47 that 58 attenuates 48 relief 49 of 48 relief 58 attenuates 49 of 51 ischemia 50 myocardial 51 ischemia 51 ischemia 52 in 52 in 55 or 54 staged 55 or 55 or 56 stuttered 56 stuttered 57 manner 58 attenuates 70 conditioning 59 lethal 70 conditioning 60 ischemia 63 injury 60 ischemia 68 ) 60 ischemia 70 conditioning 61 - 63 injury 62 reperfusion 63 injury 63 injury 67 3 63 injury 68 ) 66 ( 67 3 67 3 68 ) 69 remote 70 conditioning 70 conditioning 73 upregulation 70 conditioning 78 initiated 73 upregulation 74 of 73 upregulation 78 initiated 74 of 77 phenotype 75 a 77 phenotype 76 cardioprotective 77 phenotype 78 initiated 79 by 79 by 87 and 80 ischemia 81 in 80 ischemia 87 and 81 in 85 or 82 a 84 organ 83 remote 84 organ 84 organ 85 or 85 or 86 tissue 87 and 88 " 87 and 93 heart 87 and 94 . 89 transported 90 " 89 transported 93 heart progress has been made in defining the technical requirements and limitations of each of the 3 ischemic conditioning models ( including the timing and severity of the protective stimulus [ )(, as well as elucidating the molecular mechanisms ( in particular , the receptor - mediated signaling pathways [ )(responsible for conditioning - induced myocardial protection . 0 ###LEFT-WALL### 1 progress 0 ###LEFT-WALL### 4 made 1 progress 2 has 2 has 3 been 3 been 4 made 4 made 5 in 5 in 6 defining 6 defining 10 and 7 the 9 requirements 8 technical 9 requirements 9 requirements 10 and 10 and 11 limitations 10 and 12 of 10 and 14 of 12 of 13 each 14 of 16 3 15 the 16 3 16 3 18 conditioning 16 3 19 models 17 ischemic 18 conditioning 18 conditioning 19 models 19 models 21 including 20 ( 21 including 21 including 24 and 22 the 24 and 23 timing 24 and 24 and 25 severity 24 and 31 )(, 24 and 34 as 25 severity 26 of 26 of 29 stimulus 27 the 29 stimulus 28 protective 29 stimulus 32 as 33 well 33 well 34 as 34 as 35 elucidating 35 elucidating 38 mechanisms 36 the 38 mechanisms 37 molecular 38 mechanisms 38 mechanisms 41 particular 38 mechanisms 45 - 39 ( 41 particular 40 in 41 particular 41 particular 42 , 42 , 45 - 43 the 44 receptor 44 receptor 45 - 45 - 48 pathways 46 mediated 48 pathways 47 signaling 48 pathways 48 pathways 50 )(responsible 50 )(responsible 51 for 51 for 52 conditioning 52 conditioning 56 protection 53 - 56 protection 54 induced 56 protection 55 myocardial 56 protection 56 protection 57 . moreover , phase iii clinical trials [are] in progress , seeking to capitalize on the protection that can be achieved by postconditioning and remote conditioning , and applying these strategies in patients undergoing cardiac surgery or angioplasty for the treatment of acute myocardial infarction . 0 ###LEFT-WALL### 3 phase 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 45 . 1 moreover 2 , 1 moreover 3 phase 3 phase 4 iii 3 phase 6 trials 3 phase 8 in 5 clinical 6 trials 8 in 9 progress 10 , 11 seeking 10 , 20 achieved 11 seeking 12 to 11 seeking 13 capitalize 11 seeking 20 achieved 12 to 13 capitalize 13 capitalize 14 on 14 on 16 protection 15 the 16 protection 16 protection 17 that 16 protection 19 be 17 that 18 can 18 can 19 be 20 achieved 21 by 20 achieved 30 strategies 21 by 27 and 22 postconditioning 23 and 23 and 25 conditioning 23 and 27 and 24 remote 25 conditioning 26 , 27 and 27 and 28 applying 29 these 30 strategies 30 strategies 31 in 30 strategies 33 undergoing 31 in 32 patients 33 undergoing 36 or 34 cardiac 35 surgery 35 surgery 36 or 36 or 37 angioplasty 36 or 38 for 38 for 40 treatment 39 the 40 treatment 40 treatment 41 of 41 of 44 infarction 42 acute 44 infarction 43 myocardial 44 infarction successful clinical application of myocardial conditioning will therefore require an understanding of the potential confounding consequences of these comorbidities on the " conditioned " phenotype . 0 ###LEFT-WALL### 3 application 0 ###LEFT-WALL### 9 require 0 ###LEFT-WALL### 26 . 1 successful 3 application 2 clinical 3 application 3 application 4 of 3 application 7 will 4 of 6 conditioning 5 myocardial 6 conditioning 7 will 9 require 8 therefore 9 require 9 require 11 understanding 9 require 20 on 10 an 11 understanding 11 understanding 12 of 11 understanding 15 confounding 12 of 14 potential 13 the 14 potential 15 confounding 16 consequences 16 consequences 17 of 17 of 19 comorbidities 18 these 19 comorbidities 20 on 25 phenotype 21 the 22 " 21 the 25 phenotype 23 conditioned 24 " 23 conditioned 25 phenotype in 1984 , newell and coworkers were the first to suggest that testicular cancer might have a viral etiology since it showed similar characteristics to hodgkin 's lymphoma . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 29 . 1 in 2 1984 1 in 3 , 1 in 5 and 4 newell 5 and 5 and 6 coworkers 5 and 7 were 7 were 9 first 8 the 9 first 9 first 10 to 9 first 22 showed 10 to 11 suggest 11 suggest 14 cancer 11 suggest 22 showed 12 that 13 testicular 13 testicular 14 cancer 14 cancer 15 might 15 might 16 have 16 have 18 viral 17 a 18 viral 19 etiology 20 since 19 etiology 22 showed 20 since 21 it 22 showed 24 characteristics 22 showed 25 to 23 similar 24 characteristics 25 to 28 lymphoma 26 hodgkin 27 's 27 's 28 lymphoma a systematic literature review and meta - analysis was conducted to investigate a possible association between viral infections ( ebv , cmv , parvovirus b19 , hpv , and hiv ) and testicular cancer . 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 35 . 1 a 2 systematic 1 a 4 review 2 systematic 3 literature 3 literature 4 review 5 and 8 analysis 5 and 12 investigate 6 meta 7 - 6 meta 8 analysis 8 analysis 9 was 9 was 10 conducted 10 conducted 11 to 11 to 12 investigate 12 investigate 32 and 13 a 14 possible 13 a 15 association 14 possible 15 association 15 association 16 between 15 association 29 and 16 between 18 infections 17 viral 18 infections 18 infections 20 ebv 18 infections 22 cmv 18 infections 27 hpv 19 ( 20 ebv 20 ebv 21 , 21 , 22 cmv 22 cmv 23 , 23 , 27 hpv 24 parvovirus 25 b19 25 b19 27 hpv 26 , 27 hpv 27 hpv 28 , 28 , 29 and 29 and 30 hiv 29 and 31 ) 29 and 32 and 32 and 34 cancer 33 testicular 34 cancer articles published from 1985 through june 2010 were located from medline and embase databases , 21 articles were finally included in the review . 0 ###LEFT-WALL### 1 articles 0 ###LEFT-WALL### 9 located 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 24 . 1 articles 2 published 1 articles 3 from 1 articles 5 through 1 articles 8 were 3 from 4 1985 5 through 6 june 6 june 7 2010 8 were 9 located 9 located 10 from 10 from 12 and 11 medline 12 and 12 and 14 databases 13 embase 14 databases 15 , 17 articles 15 , 20 included 16 21 17 articles 17 articles 18 were 18 were 20 included 19 finally 20 included 20 included 21 in 21 in 23 review 22 the 23 review for infection with ebv , cmv , parvovirus b19 , and hiv the pooled or were 4.80 ( 95 % ci 0.98 - 23.54 ) , 1.85 ( 95 % ci 0.92 - 3.70 ) , 2.86 ( 95 % ci 0.35 - 23.17 ) , [and] 1.79 ( 95 % ci 1.45 - 2.21 ) respectively . 0 ###LEFT-WALL### 15 or 0 ###LEFT-WALL### 16 were 0 ###LEFT-WALL### 58 . 1 for 11 and 1 for 15 or 2 infection 3 with 2 infection 11 and 3 with 4 ebv 4 ebv 6 cmv 5 , 6 cmv 6 cmv 9 b19 6 cmv 10 , 7 , 9 b19 8 parvovirus 9 b19 9 b19 10 , 11 and 12 hiv 13 the 15 or 14 pooled 15 or 15 or 16 were 16 were 17 4.80 16 were 57 respectively 17 4.80 21 ci 18 ( 21 ci 19 95 21 ci 20 % 21 ci 21 ci 22 0.98 21 ci 24 23.54 21 ci 27 1.85 21 ci 56 ) 23 - 24 23.54 24 23.54 25 ) 26 , 27 1.85 27 1.85 31 ci 27 1.85 56 ) 28 ( 31 ci 29 95 31 ci 30 % 31 ci 31 ci 32 0.92 31 ci 34 3.70 31 ci 37 2.86 31 ci 56 ) 33 - 34 3.70 34 3.70 35 ) 36 , 37 2.86 37 2.86 41 ci 37 2.86 56 ) 38 ( 41 ci 39 95 41 ci 40 % 41 ci 41 ci 42 0.35 41 ci 44 23.17 41 ci 48 1.79 41 ci 56 ) 43 - 44 23.17 44 23.17 45 ) 46 , 48 1.79 48 1.79 52 ci 48 1.79 56 ) 49 ( 52 ci 50 95 52 ci 51 % 52 ci 52 ci 54 - 52 ci 56 ) 53 1.45 54 - 54 - 55 2.21 no pooling was possible for hpv infection studies due to small numbers . 0 ###LEFT-WALL### 2 pooling 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 13 . 1 no 2 pooling 2 pooling 3 was 3 was 4 possible 4 possible 5 for 4 possible 10 to 5 for 8 studies 6 hpv 8 studies 7 infection 8 studies 9 due 10 to 10 to 12 numbers 11 small 12 numbers the results support a possible association , but more epidemiological studies with better viral identification and localization methods are needed to verify these findings . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 25 . 1 the 2 results 2 results 16 and 3 support 11 studies 3 support 12 with 3 support 16 and 4 a 5 possible 4 a 6 association 5 possible 6 association 6 association 8 but 7 , 8 but 8 but 9 more 8 but 11 studies 10 epidemiological 11 studies 12 with 15 identification 13 better 15 identification 14 viral 15 identification 16 and 22 verify 17 localization 18 methods 18 methods 19 are 19 are 20 needed 20 needed 21 to 21 to 22 verify 22 verify 24 findings 23 these 24 findings age [-] associated losses in muscle [mass] , or sarcopenia , are marked by accompanying decrements in strength and muscle quality , impairing balance and increasing the risk [for] falls . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 31 . 1 age 3 associated 1 age 9 or 1 age 15 accompanying 1 age 16 decrements 4 losses 5 in 4 losses 9 or 5 in 6 muscle 8 , 9 or 9 or 10 sarcopenia 9 or 11 , 9 or 12 are 12 are 13 marked 13 marked 14 by 14 by 15 accompanying 16 decrements 17 in 17 in 19 and 18 strength 19 and 19 and 21 quality 19 and 22 , 19 and 23 impairing 20 muscle 21 quality 23 impairing 24 balance 25 and 26 increasing 25 and 30 falls 26 increasing 28 risk 26 increasing 30 falls 27 the 28 risk although progressive resistance training has been widely accepted as an appropriate modality for the treatment of sarcopenia , it has yet to offer consistent results in terms of improved balance . 0 ###LEFT-WALL### 4 training 0 ###LEFT-WALL### 8 accepted 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 31 . 1 although 3 resistance 1 although 4 training 2 progressive 3 resistance 4 training 5 has 5 has 6 been 6 been 7 widely 6 been 8 accepted 8 accepted 9 as 9 as 12 modality 10 an 11 appropriate 10 an 12 modality 11 appropriate 12 modality 12 modality 13 for 12 modality 16 of 13 for 15 treatment 14 the 15 treatment 16 of 17 sarcopenia 18 , 19 it 18 , 20 has 19 it 20 has 20 has 22 to 20 has 23 offer 21 yet 22 to 22 to 23 offer 23 offer 25 results 23 offer 26 in 24 consistent 25 results 26 in 27 terms 27 terms 28 of 28 of 30 balance 29 improved 30 balance the purpose of the present research was to investigate the effects on static balance performance following a 6 [-] week full - body progressive resistance training program in untrained older adults . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 32 . 1 the 2 purpose 2 purpose 3 of 2 purpose 7 was 3 of 6 research 4 the 6 research 5 present 6 research 7 was 8 to 7 was 9 investigate 8 to 9 investigate 9 investigate 11 effects 10 the 11 effects 11 effects 12 on 12 on 15 performance 13 static 14 balance 14 balance 15 performance 15 performance 16 following 16 following 27 program 16 following 28 in 17 a 27 program 18 6 20 week 20 week 24 progressive 21 full 22 - 21 full 23 body 23 body 24 progressive 24 progressive 27 program 25 resistance 27 program 26 training 27 program 28 in 31 adults 29 untrained 31 adults 30 older 31 adults evaluation of magnitude - based inferences indicated the progressive resistance training intervention to be likely beneficial for improving static balance performance . 0 ###LEFT-WALL### 6 inferences 0 ###LEFT-WALL### 7 indicated 0 ###LEFT-WALL### 22 . 1 evaluation 6 inferences 2 of 3 magnitude 2 of 4 - 2 of 6 inferences 5 based 6 inferences 6 inferences 7 indicated 7 indicated 10 resistance 8 the 10 resistance 9 progressive 10 resistance 10 resistance 11 training 10 resistance 16 beneficial 11 training 12 intervention 11 training 13 to 11 training 14 be 13 to 14 be 14 be 15 likely 16 beneficial 17 for 17 for 18 improving 18 improving 21 performance 19 static 20 balance 20 balance 21 performance these results were likely related to the strengthening of all major muscle groups by the incorporation of both free weights and resistance machines in the exercise regimen . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 19 free 0 ###LEFT-WALL### 28 . 1 these 2 results 2 results 3 were 3 were 5 related 4 likely 5 related 5 related 6 to 6 to 8 strengthening 7 the 8 strengthening 8 strengthening 9 of 8 strengthening 13 groups 8 strengthening 19 free 9 of 12 muscle 10 all 12 muscle 11 major 12 muscle 13 groups 14 by 13 groups 19 free 14 by 16 incorporation 15 the 16 incorporation 16 incorporation 17 of 17 of 18 both 19 free 21 and 19 free 24 in 20 weights 21 and 21 and 23 machines 22 resistance 23 machines 24 in 27 regimen 25 the 27 regimen 26 exercise 27 regimen our findings support the use of progressive resistance training for untrained older adults to improve balance . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 support 0 ###LEFT-WALL### 17 . 1 our 2 findings 2 findings 3 support 3 support 5 use 3 support 14 to 4 the 5 use 5 use 6 of 6 of 9 training 7 progressive 8 resistance 8 resistance 9 training 9 training 10 for 10 for 13 adults 11 untrained 13 adults 12 older 13 adults 14 to 15 improve 15 improve 16 balance background and aims : glycemic control in geriatric patients with type 2 diabetes ( t2dm ) remains clinically challenging . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 aims 4 : 6 control 4 : 17 remains 4 : 20 . 5 glycemic 6 control 6 control 7 in 6 control 17 remains 7 in 9 patients 8 geriatric 9 patients 9 patients 10 with 10 with 13 diabetes 11 type 13 diabetes 12 2 13 diabetes 13 diabetes 15 t2dm 14 ( 15 t2dm 15 t2dm 16 ) 17 remains 18 clinically 17 remains 19 challenging methods : this is a retrospective analysis of predefined endpoints from an integrated database of seven rcts of t2dm patients treated with insulin lispro . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 . 2 : 3 this 2 : 4 is 3 this 4 is 4 is 7 analysis 5 a 6 retrospective 5 a 7 analysis 6 retrospective 7 analysis 7 analysis 8 of 7 analysis 15 of 7 analysis 21 treated 8 of 10 endpoints 9 predefined 10 endpoints 10 endpoints 11 from 11 from 14 database 12 an 14 database 13 integrated 14 database 15 of 20 patients 16 seven 20 patients 17 rcts 18 of 17 rcts 20 patients 18 of 19 t2dm 21 treated 22 with 22 with 23 insulin 22 with 24 lispro changes in hba1c from baseline were evaluated with an analysis of covariance [model] . 0 ###LEFT-WALL### 1 changes 0 ###LEFT-WALL### 7 evaluated 0 ###LEFT-WALL### 14 . 1 changes 2 in 1 changes 6 were 2 in 3 hba1c 3 hba1c 4 from 4 from 5 baseline 6 were 7 evaluated 7 evaluated 8 with 8 with 10 analysis 9 an 10 analysis 10 analysis 11 of 11 of 12 covariance secondary measures included [incidence] and rate of hypoglycemia , and incidence of cardiovascular events . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 15 . 1 secondary 2 measures 2 measures 3 included 2 measures 5 and 5 and 6 rate 5 and 7 of 7 of 10 and 8 hypoglycemia 10 and 9 , 10 and 10 and 11 incidence 10 and 12 of 12 of 14 events 13 cardiovascular 14 events results : mean change in hba1c from baseline to month 3 was similar for geriatric ( - 0.97 % ) [and] [non] - geriatric patients ( - 1.05 % [ )( [least] - square ( ls ) mean difference [(] 95 % ci [ )(was 0.02 % ( - 0.11 , 0.15 % [;] p = 0.756 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 mean 2 : 12 was 3 mean 12 was 4 change 5 in 4 change 7 from 4 change 12 was 5 in 6 hba1c 7 from 8 baseline 8 baseline 9 to 9 to 10 month 10 month 11 3 12 was 13 similar 13 similar 14 for 14 for 25 patients 15 geriatric 19 % 15 geriatric 23 - 15 geriatric 25 patients 16 ( 19 % 17 - 18 0.97 18 0.97 19 % 19 % 20 ) 24 geriatric 25 patients 25 patients 33 - 26 ( 33 - 27 - 28 1.05 28 1.05 29 % 29 % 33 - 33 - 43 ci 34 square 36 ls 34 square 39 difference 35 ( 36 ls 36 ls 37 ) 38 mean 39 difference 39 difference 43 ci 41 95 43 ci 42 % 43 ci 43 ci 53 % 45 )(was 47 % 46 0.02 47 % 47 % 50 0.11 48 ( 50 0.11 49 - 50 0.11 50 0.11 51 , 51 , 53 % 52 0.15 53 % 53 % 56 = 53 % 59 . 55 p 56 = 56 = 57 0.756 56 = 58 ) similar results were observed in patients treated up to month 6 ; ls mean difference [(] 95 % ci [ )(was 0.07 % ( - 0.12 , 0.26 % [;] p = 0.490 ) . 0 ###LEFT-WALL### 1 similar 0 ###LEFT-WALL### 4 observed 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 35 . 1 similar 2 results 1 similar 3 were 1 similar 4 observed 2 results 3 were 4 observed 5 in 4 observed 12 ; 5 in 6 patients 6 patients 7 treated 7 treated 8 up 8 up 9 to 9 to 10 month 10 month 11 6 12 ; 19 ci 12 ; 21 )(was 13 ls 19 ci 14 mean 15 difference 15 difference 19 ci 17 95 19 ci 18 % 19 ci 19 ci 21 )(was 21 )(was 23 % 22 0.07 23 % 23 % 26 0.12 24 ( 26 0.12 25 - 26 0.12 26 0.12 29 % 26 0.12 34 ) 27 , 29 % 28 0.26 29 % 29 % 32 = 29 % 34 ) 31 p 32 = 32 = 33 0.490 32 = 34 ) decrease in hba1c from baseline to months 3 and 6 was [non] [-] inferior in geriatric [compared] [with] [non] - geriatric patients . 0 ###LEFT-WALL### 1 decrease 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 23 . 1 decrease 2 in 1 decrease 11 was 2 in 3 hba1c 3 hba1c 4 from 4 from 5 baseline 5 baseline 6 to 6 to 7 months 7 months 9 and 8 3 9 and 9 and 10 6 11 was 14 inferior 14 inferior 15 in 15 in 22 patients 16 geriatric 20 - 16 geriatric 22 patients 21 geriatric 22 patients there were no significant differences in the incidence and the rate of hypoglycemia , incidence of cardiovascular events , or other serious adverse events including malignancy , post - baseline between the two cohorts . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 29 - 0 ###LEFT-WALL### 35 . 1 there 2 were 2 were 20 or 3 no 15 incidence 4 significant 5 differences 5 differences 6 in 5 differences 9 and 6 in 8 incidence 7 the 8 incidence 9 and 11 rate 9 and 14 , 9 and 15 incidence 10 the 11 rate 11 rate 12 of 12 of 13 hypoglycemia 15 incidence 16 of 15 incidence 20 or 16 of 18 events 17 cardiovascular 18 events 19 , 20 or 20 or 24 events 21 other 24 events 22 serious 24 events 23 adverse 24 events 24 events 25 including 25 including 26 malignancy 26 malignancy 28 post 27 , 28 post 28 post 29 - 29 - 30 baseline 30 baseline 31 between 31 between 34 cohorts 32 the 33 two 33 two 34 cohorts conclusion : key measures of efficacy and safety in geriatric patients with t2dm were not significantly different from [non] - geriatric patients [when] utilizing insulin lispro . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 26 lispro 0 ###LEFT-WALL### 27 . 2 : 7 and 2 : 20 - 3 key 4 measures 4 measures 5 of 4 measures 7 and 5 of 6 efficacy 7 and 8 safety 7 and 9 in 7 and 14 were 9 in 11 patients 10 geriatric 11 patients 11 patients 12 with 12 with 13 t2dm 14 were 15 not 14 were 16 significantly 14 were 17 different 15 not 16 significantly 18 from 20 - 20 - 22 patients 21 geriatric 22 patients 22 patients 24 utilizing 22 patients 26 lispro 24 utilizing 25 insulin insulin lispro may be considered a safe and efficacious therapeutic option for the management of t2dm in geriatric patients . 0 ###LEFT-WALL### 2 lispro 0 ###LEFT-WALL### 5 considered 0 ###LEFT-WALL### 20 . 1 insulin 2 lispro 2 lispro 3 may 3 may 4 be 4 be 5 considered 5 considered 11 option 6 a 11 option 7 safe 8 and 8 and 9 efficacious 8 and 11 option 10 therapeutic 11 option 11 option 12 for 11 option 15 of 11 option 17 in 12 for 14 management 13 the 14 management 15 of 16 t2dm 17 in 19 patients 18 geriatric 19 patients aim of the study : in contrast to the general population , individuals with primarily persistent elevation of inflammatory activity display a significant association between inflammatory biomarkers and atherosclerotic burden . 0 ###LEFT-WALL### 4 study 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 31 . 1 aim 2 of 2 of 3 the 3 the 4 study 4 study 5 : 5 : 6 in 6 in 7 contrast 7 contrast 8 to 8 to 11 population 9 the 11 population 10 general 11 population 12 , 13 individuals 12 , 21 display 13 individuals 14 with 13 individuals 21 display 14 with 17 elevation 15 primarily 16 persistent 16 persistent 17 elevation 17 elevation 18 of 18 of 20 activity 19 inflammatory 20 activity 21 display 24 association 21 display 25 between 22 a 23 significant 22 a 24 association 23 significant 24 association 25 between 28 and 26 inflammatory 27 biomarkers 27 biomarkers 28 and 28 and 30 burden 29 atherosclerotic 30 burden in older individuals , immunosenescence upregulates the innate response [and] [,] by this way , may hypothetically favor the presence of this association . 0 ###LEFT-WALL### 5 immunosenescence 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 24 . 1 in 3 individuals 1 in 4 , 1 in 5 immunosenescence 2 older 3 individuals 5 immunosenescence 15 , 6 upregulates 9 response 6 upregulates 12 by 6 upregulates 15 , 7 the 9 response 8 innate 9 response 12 by 14 way 13 this 14 way 15 , 16 may 16 may 18 favor 17 hypothetically 18 favor 18 favor 20 presence 19 the 20 presence 20 presence 21 of 21 of 23 association 22 this 23 association the aim of this study was to evaluate this hypothesis in healthy octogenarians . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 14 . 1 the 2 aim 2 aim 3 of 2 aim 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 evaluate 7 to 8 evaluate 8 evaluate 10 hypothesis 8 evaluate 11 in 9 this 10 hypothesis 11 in 13 octogenarians 12 healthy 13 octogenarians methods : participants ( n = 208 ) aged 80 years or older , asymptomatic and [without] medical and laboratory evidence of chronic diseases or use of anti - inflammatory treatments were included in the study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 37 . 1 methods 2 : 2 : 3 participants 2 : 6 = 2 : 16 and 4 ( 6 = 5 n 6 = 6 = 7 208 6 = 8 ) 9 aged 10 80 9 aged 12 or 9 aged 14 , 11 years 12 or 12 or 13 older 14 , 15 asymptomatic 14 , 16 and 16 and 18 medical 19 and 21 evidence 19 and 33 included 20 laboratory 21 evidence 21 evidence 22 of 21 evidence 27 of 21 evidence 32 were 22 of 25 or 23 chronic 24 diseases 24 diseases 25 or 25 or 26 use 27 of 31 treatments 28 anti 29 - 28 anti 31 treatments 30 inflammatory 31 treatments 32 were 33 included 33 included 34 in 34 in 36 study 35 the 36 study lipid profile and plasma c - reactive protein ( crp ) were measured at baseline and cardiac computed tomography was performed within 1 [-] week interval for measuring coronary calcium [score] ( ccs ) . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 12 were 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 35 . 1 lipid 2 profile 2 profile 3 and 3 and 4 plasma 3 and 8 protein 3 and 12 were 4 plasma 5 c 6 - 8 protein 7 reactive 8 protein 8 protein 10 crp 8 protein 11 ) 9 ( 10 crp 10 crp 11 ) 12 were 13 measured 13 measured 14 at 14 at 15 baseline 16 and 19 tomography 16 and 21 performed 17 cardiac 19 tomography 18 computed 19 tomography 19 tomography 20 was 20 was 21 performed 21 performed 22 within 21 performed 27 for 22 within 26 interval 23 1 26 interval 25 week 26 interval 27 for 28 measuring 28 measuring 30 calcium 29 coronary 30 calcium 30 calcium 33 ccs 32 ( 33 ccs 33 ccs 34 ) results : the median plasma crp was 1.9 [mg/l] ( 1.0 – 3.4 [ )(and 33 % of the participants had elevated crp defined as c3 [mg/l] [.] among those with high crp [,] there was an increased frequency of high ccs ( c100 ) as compared with their counterparts ( 71 vs 50 % , p = 0.001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 6 crp 2 : 7 was 2 : 12 – 3 the 6 crp 4 median 5 plasma 5 plasma 6 crp 6 crp 7 was 7 was 8 1.9 8 1.9 11 1.0 10 ( 11 1.0 11 1.0 12 – 12 – 15 )(and 13 3.4 15 )(and 15 )(and 16 33 15 )(and 22 elevated 15 )(and 23 crp 15 )(and 24 defined 16 33 17 % 17 % 18 of 17 % 21 had 18 of 20 participants 19 the 20 participants 23 crp 24 defined 24 defined 25 as 24 defined 31 with 25 as 26 c3 26 c3 29 among 29 among 30 those 31 with 33 crp 31 with 39 frequency 32 high 33 crp 33 crp 35 there 33 crp 36 was 35 there 36 was 37 an 39 frequency 38 increased 39 frequency 39 frequency 40 of 39 frequency 48 with 40 of 42 ccs 41 high 42 ccs 42 ccs 44 c100 42 ccs 47 compared 43 ( 44 c100 44 c100 45 ) 46 as 47 compared 48 with 50 counterparts 49 their 50 counterparts 50 counterparts 52 71 51 ( 52 71 52 71 53 vs 52 71 61 . 53 vs 55 % 54 50 55 % 55 % 58 = 56 , 58 = 57 p 58 = 58 = 59 0.001 58 = 60 ) the association between crp and ccs persisted even after adjustment for age , sex , cardiovascular risk factors and statin therapy . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 7 persisted 0 ###LEFT-WALL### 22 . 1 the 2 association 2 association 3 between 2 association 5 and 3 between 4 crp 5 and 6 ccs 5 and 7 persisted 7 persisted 8 even 8 even 9 after 9 after 10 adjustment 10 adjustment 11 for 11 for 19 and 12 age 13 , 13 , 14 sex 13 , 15 , 15 , 18 factors 15 , 19 and 16 cardiovascular 18 factors 17 risk 18 factors 19 and 21 therapy 20 statin 21 therapy the area under the receiver [-] operating curve for crp was 0.606 using ccs c100 as a binary outcome . 0 ###LEFT-WALL### 2 area 0 ###LEFT-WALL### 11 was 0 ###LEFT-WALL### 20 . 1 the 2 area 2 area 3 under 2 area 11 was 3 under 8 curve 4 the 8 curve 5 receiver 7 operating 7 operating 8 curve 8 curve 9 for 9 for 10 crp 11 was 12 0.606 12 0.606 13 using 13 using 15 c100 13 using 16 as 14 ccs 15 c100 16 as 19 outcome 17 a 18 binary 17 a 19 outcome 18 binary 19 outcome the sensitivities for ccs c100 were 40 and 74 % for the cutoff points of crp c3 [or] 1 [mg/l] , respectively . 0 ###LEFT-WALL### 2 sensitivities 0 ###LEFT-WALL### 6 were 1 the 2 sensitivities 2 sensitivities 3 for 2 sensitivities 6 were 3 for 5 c100 4 ccs 5 c100 6 were 10 % 6 were 22 respectively 7 40 8 and 8 and 9 74 8 and 10 % 10 % 11 for 11 for 14 points 12 the 14 points 13 cutoff 14 points 14 points 15 of 15 of 17 c3 16 crp 17 c3 17 c3 19 1 21 , 22 respectively 22 respectively 23 . conclusion : the present study was able to confirm that in very elderly individuals , systemic inflammatory activity is independently associated with coronary atherosclerosis burden . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 5 study 2 : 6 was 2 : 26 . 3 the 5 study 4 present 5 study 5 study 6 was 6 was 7 able 7 able 8 to 7 able 9 confirm 8 to 9 confirm 9 confirm 10 that 10 that 18 activity 10 that 21 associated 11 in 14 individuals 11 in 15 , 11 in 18 activity 12 very 13 elderly 13 elderly 14 individuals 16 systemic 18 activity 17 inflammatory 18 activity 18 activity 19 is 19 is 21 associated 20 independently 21 associated 21 associated 22 with 22 with 24 atherosclerosis 22 with 25 burden 23 coronary 24 atherosclerosis background and aim : how cortisol , a stress biological marker , differs according to depressive symptoms has mostly been examined in high - income countries . 0 ###LEFT-WALL### 3 aim 0 ###LEFT-WALL### 4 : 1 background 2 and 2 and 3 aim 4 : 5 how 4 : 21 examined 4 : 27 . 5 how 6 cortisol 5 how 13 differs 5 how 18 has 6 cortisol 11 marker 6 cortisol 13 differs 7 , 11 marker 8 a 9 stress 8 a 11 marker 9 stress 11 marker 10 biological 11 marker 11 marker 12 , 13 differs 15 to 14 according 15 to 15 to 17 symptoms 16 depressive 17 symptoms 18 has 20 been 19 mostly 20 been 20 been 21 examined 21 examined 22 in 22 in 26 countries 23 high 24 - 23 high 25 income 25 income 26 countries including low - and middle - income countries in research on this matter would allow examining a wider range of exposure to adversity and improving the estimates of the associations between diurnal cortisol and depression . 0 ###LEFT-WALL### 8 countries 0 ###LEFT-WALL### 15 allow 0 ###LEFT-WALL### 36 . 1 including 4 and 1 including 6 - 1 including 8 countries 2 low 4 and 3 - 4 and 4 and 5 middle 7 income 8 countries 8 countries 9 in 8 countries 14 would 9 in 10 research 10 research 11 on 11 on 13 matter 12 this 13 matter 14 would 15 allow 15 allow 16 examining 15 allow 19 range 15 allow 24 and 15 allow 31 between 17 a 19 range 18 wider 19 range 19 range 20 of 20 of 21 exposure 21 exposure 22 to 22 to 23 adversity 24 and 25 improving 24 and 27 estimates 26 the 27 estimates 27 estimates 28 of 28 of 30 associations 29 the 30 associations 31 between 34 and 32 diurnal 33 cortisol 33 cortisol 34 and 34 and 35 depression the aim of this study is to compare the profile of diurnal cortisol and depressive symptoms in 65 - to 74 - year - old residents of santa cruz ( in an underdeveloped region , northeast brazil , n = 64 ) [and] saint - bruno ( a suburban area , qc , canada , n = 60 ) . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 60 . 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 23 year 9 the 23 year 10 profile 11 of 10 profile 14 and 11 of 13 cortisol 12 diurnal 13 cortisol 14 and 16 symptoms 14 and 17 in 14 and 20 to 14 and 23 year 15 depressive 16 symptoms 17 in 18 65 19 - 20 to 20 to 21 74 20 to 22 - 23 year 26 residents 24 - 26 residents 25 old 26 residents 26 residents 27 of 26 residents 31 in 26 residents 59 ) 27 of 29 cruz 28 santa 29 cruz 30 ( 31 in 31 in 34 region 31 in 59 ) 32 an 34 region 33 underdeveloped 34 region 34 region 44 saint 34 region 46 bruno 35 , 44 saint 36 northeast 44 saint 37 brazil 40 = 37 brazil 44 saint 38 , 40 = 39 n 40 = 40 = 41 64 40 = 42 ) 44 saint 45 - 45 - 46 bruno 46 bruno 50 area 46 bruno 52 qc 46 bruno 57 = 46 bruno 59 ) 47 ( 50 area 48 a 49 suburban 48 a 50 area 49 suburban 50 area 50 area 51 , 51 , 52 qc 52 qc 54 canada 52 qc 55 , 53 , 54 canada 54 canada 55 , 56 n 57 = 57 = 58 60 methods : home interviews included assessments of socioeconomic variables , health behaviors , depressive symptoms ( center for epidemiologic studies depression scale , ces - d ) and cortisol awakening response ( car : awakening , 30 , 60 min afterward ) , and at 1500 hours and bedtime from saliva collected over 2 days . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 home 2 : 4 interviews 2 : 44 and 2 : 56 . 3 home 4 interviews 4 interviews 6 assessments 5 included 6 assessments 6 assessments 7 of 7 of 9 variables 8 socioeconomic 9 variables 9 variables 12 behaviors 9 variables 15 symptoms 10 , 12 behaviors 11 health 12 behaviors 12 behaviors 13 , 13 , 15 symptoms 14 depressive 15 symptoms 15 symptoms 28 and 15 symptoms 42 ) 16 ( 28 and 17 center 18 for 17 center 28 and 18 for 22 scale 19 epidemiologic 20 studies 20 studies 21 depression 21 depression 22 scale 22 scale 25 - 23 , 25 - 24 ces 25 - 25 - 26 d 25 - 27 ) 28 and 30 awakening 28 and 33 car 28 and 35 awakening 28 and 37 30 28 and 39 60 28 and 42 ) 29 cortisol 30 awakening 31 response 33 car 32 ( 33 car 33 car 34 : 34 : 35 awakening 36 , 37 30 37 30 38 , 38 , 39 60 39 60 40 min 39 60 42 ) 40 min 41 afterward 43 , 44 and 44 and 48 and 44 and 52 collected 45 at 46 1500 45 at 48 and 47 hours 48 and 48 and 49 bedtime 48 and 50 from 48 and 52 collected 50 from 51 saliva 52 collected 53 over 52 collected 55 days 53 over 54 2 mixed linear models were used to estimate the associations between diurnal cortisol and depressive symptoms . 0 ###LEFT-WALL### 3 models 0 ###LEFT-WALL### 5 used 0 ###LEFT-WALL### 16 . 1 mixed 3 models 2 linear 3 models 3 models 4 were 4 were 5 used 5 used 6 to 5 used 7 estimate 6 to 7 estimate 7 estimate 9 associations 7 estimate 10 between 8 the 9 associations 10 between 13 and 11 diurnal 12 cortisol 12 cortisol 13 and 13 and 15 symptoms 14 depressive 15 symptoms results : santa cruz residents had lower cortisol levels upon awakening ( β [=] - 1.24 , p = 0.04 ) and elevated bedtime levels ( β [=] 20.29 , p < 0.001 ) indicating chronic stress compared [to] saint - bruno residents . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 residents 2 : 6 had 2 : 41 - 2 : 44 . 3 santa 4 cruz 4 cruz 5 residents 5 residents 6 had 6 had 8 cortisol 6 had 22 and 7 lower 8 cortisol 9 levels 10 upon 9 levels 11 awakening 9 levels 22 and 11 awakening 13 β 11 awakening 19 = 12 ( 13 β 13 β 15 - 16 1.24 19 = 17 , 19 = 18 p 19 = 19 = 20 0.04 19 = 21 ) 22 and 23 elevated 23 elevated 25 levels 24 bedtime 25 levels 25 levels 40 saint 26 ( 40 saint 27 β 32 < 27 β 34 ) 27 β 40 saint 29 20.29 32 < 30 , 32 < 31 p 32 < 32 < 33 0.001 32 < 34 ) 35 indicating 37 stress 36 chronic 37 stress 37 stress 38 compared 38 compared 40 saint 40 saint 41 - 41 - 43 residents 42 bruno 43 residents elevated depressive symptoms were associated with a blunted car ( [flatter] slope , indicative [of] chronic stress [ )(in santa cruz residents ( β [=] - 0.19 , p = 0.04 ) , [while] greater diurnal cortisol levels ( larger area under the curve ) , indicative [of] moderate stress [,] were observed in [saint] [-] bruno residents ( β [=] 1.96 , p = 0.047 ) . 1 elevated 2 depressive 2 depressive 3 symptoms 3 symptoms 4 were 4 were 5 associated 5 associated 6 with 6 with 9 car 6 with 17 stress 7 a 9 car 8 blunted 9 car 9 car 12 slope 10 ( 12 slope 12 slope 13 , 14 indicative 17 stress 16 chronic 17 stress 17 stress 19 )(in 17 stress 26 - 19 )(in 22 residents 20 santa 21 cruz 21 cruz 22 residents 23 ( 26 - 24 β 26 - 26 - 27 0.19 27 0.19 30 = 27 0.19 38 levels 28 , 30 = 29 p 30 = 30 = 31 0.04 30 = 32 ) 33 , 38 levels 35 greater 38 levels 36 diurnal 37 cortisol 37 cortisol 38 levels 38 levels 41 area 38 levels 46 , 39 ( 41 area 40 larger 41 area 41 area 42 under 41 area 45 ) 42 under 44 curve 43 the 44 curve 46 , 53 observed 47 indicative 50 stress 49 moderate 50 stress 50 stress 52 were 52 were 53 observed 53 observed 54 in 54 in 58 residents 57 bruno 58 residents 58 residents 60 β 59 ( 60 β 60 β 65 = 60 β 68 . 62 1.96 65 = 63 , 65 = 64 p 65 = 65 = 66 0.047 65 = 67 ) conclusion : adverse living conditions in this remote area of brazil may lead to a state of chronic stress and a different relationship with elevated depressive symptoms from persons aging in a canadian suburban area . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 3 adverse 2 : 13 lead 3 adverse 4 living 3 adverse 10 of 3 adverse 12 may 4 living 5 conditions 5 conditions 6 in 6 in 9 area 7 this 9 area 8 remote 9 area 10 of 11 brazil 12 may 13 lead 13 lead 14 to 13 lead 35 area 14 to 16 state 15 a 16 state 16 state 17 of 16 state 24 with 17 of 20 and 18 chronic 19 stress 19 stress 20 and 20 and 23 relationship 21 a 23 relationship 22 different 23 relationship 24 with 27 symptoms 25 elevated 27 symptoms 26 depressive 27 symptoms 27 symptoms 28 from 27 symptoms 31 in 28 from 29 persons 29 persons 30 aging 31 in 33 canadian 32 a 33 canadian 34 suburban 35 area background : polypharmacy , and specifically the use of multiple fall - risk - increasing drugs ( frid ) , have been associated with increased risk of falling in older age . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 32 . 1 background 2 : 2 : 5 and 3 polypharmacy 5 and 4 , 5 and 5 and 6 specifically 5 and 8 use 7 the 8 use 8 use 9 of 9 of 11 fall 10 multiple 11 fall 11 fall 13 risk 11 fall 15 increasing 12 - 13 risk 13 risk 14 - 14 - 15 increasing 15 increasing 16 drugs 15 increasing 20 , 16 drugs 18 frid 17 ( 18 frid 18 frid 19 ) 20 , 21 have 21 have 22 been 22 been 23 associated 23 associated 24 with 23 associated 29 in 24 with 26 risk 25 increased 26 risk 26 risk 27 of 27 of 28 falling 29 in 31 age 30 older 31 age however , it is not yet clear whether the known set of frids can be extrapolated to recurrent fallers , since they form a distinct group of more vulnerable older persons with different characteristics . 0 ###LEFT-WALL### 3 it 0 ###LEFT-WALL### 4 is 1 however 2 , 1 however 3 it 3 it 4 is 4 is 5 not 4 is 6 yet 4 is 7 clear 7 clear 8 whether 8 whether 11 set 8 whether 16 extrapolated 9 the 11 set 10 known 11 set 11 set 12 of 11 set 14 can 12 of 13 frids 14 can 15 be 15 be 16 extrapolated 16 extrapolated 17 to 16 extrapolated 21 since 17 to 19 fallers 18 recurrent 19 fallers 20 , 21 since 21 since 22 they 21 since 23 form 21 since 35 . 22 they 23 form 23 form 31 persons 23 form 32 with 24 a 25 distinct 24 a 26 group 25 distinct 26 group 26 group 27 of 26 group 31 persons 27 of 31 persons 28 more 29 vulnerable 29 vulnerable 31 persons 30 older 31 persons 32 with 34 characteristics 33 different 34 characteristics objectives : we aim to investigate [which] classes [of] medications are associated with recurrent [falls] in elderly patients visiting the emergency department ( ed ) after a fall . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 3 we 2 : 4 aim 2 : 29 . 3 we 4 aim 4 aim 5 to 4 aim 6 investigate 5 to 6 investigate 6 investigate 8 classes 8 classes 10 medications 8 classes 13 with 8 classes 14 recurrent 8 classes 19 visiting 10 medications 11 are 11 are 12 associated 12 associated 13 with 14 recurrent 16 in 16 in 18 patients 17 elderly 18 patients 19 visiting 22 department 19 visiting 26 after 20 the 22 department 21 emergency 22 department 22 department 24 ed 23 ( 24 ed 24 ed 25 ) 26 after 28 fall 27 a 28 fall methods : this study had a cross - sectional design [and] was conducted in the ed of an academic medical center . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 4 study 2 : 5 had 2 : 8 - 3 this 4 study 4 study 5 had 5 had 7 cross 6 a 7 cross 8 - 10 design 8 - 13 conducted 8 - 22 . 9 sectional 10 design 10 design 12 was 12 was 13 conducted 13 conducted 14 in 14 in 16 ed 15 the 16 ed 16 ed 17 of 17 of 21 center 18 an 19 academic 18 an 21 center 19 academic 21 center 20 medical 21 center patients [who] sustained a fall , 65 years or older , and who visited the ed between 2004 and 2010 were invited to fill in a validated fall questionnaire designed to assess patient and fall characteristics ( carefall triage instrument [ cti ] ) . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 45 . 1 patients 3 sustained 1 patients 12 and 3 sustained 9 or 4 a 5 fall 5 fall 6 , 6 , 8 years 6 , 9 or 7 65 8 years 9 or 10 older 11 , 12 and 12 and 13 who 12 and 14 visited 12 and 16 ed 12 and 24 fill 15 the 16 ed 16 ed 19 and 16 ed 21 were 17 between 19 and 18 2004 19 and 19 and 20 2010 21 were 22 invited 22 invited 23 to 22 invited 24 fill 23 to 24 fill 24 fill 25 in 25 in 29 questionnaire 26 a 29 questionnaire 27 validated 28 fall 28 fall 29 questionnaire 29 questionnaire 30 designed 29 questionnaire 40 instrument 30 designed 31 to 30 designed 32 assess 31 to 32 assess 32 assess 34 and 33 patient 34 and 34 and 36 characteristics 35 fall 36 characteristics 37 ( 40 instrument 38 carefall 39 triage 39 triage 40 instrument 40 instrument 42 cti 40 instrument 44 ) 41 [ 42 cti 42 cti 43 ] we translated [self] - reported medications to anatomical therapeutic chemical ( atc ) codes ( at the second level ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 translated 0 ###LEFT-WALL### 5 reported 1 we 2 translated 4 - 5 reported 5 reported 6 medications 5 reported 7 to 5 reported 21 . 7 to 14 codes 8 anatomical 14 codes 9 therapeutic 14 codes 10 chemical 12 atc 10 chemical 13 ) 10 chemical 14 codes 11 ( 12 atc 12 atc 13 ) 14 codes 16 at 15 ( 16 at 16 at 19 level 16 at 20 ) 17 the 18 second 17 the 19 level univariate logistic regression analysis was performed to explore the association between medication classes and the outcome parameter ( recurrent fall ) . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 6 performed 0 ###LEFT-WALL### 22 . 1 univariate 4 analysis 2 logistic 3 regression 3 regression 4 analysis 4 analysis 5 was 5 was 6 performed 6 performed 7 to 6 performed 11 between 7 to 8 explore 8 explore 10 association 9 the 10 association 11 between 14 and 12 medication 13 classes 13 classes 14 and 14 and 17 parameter 14 and 20 fall 15 the 17 parameter 16 outcome 17 parameter 18 ( 20 fall 19 recurrent 20 fall 20 fall 21 ) multivariate logistic regression was used to assess the associations after adjustment to potential confounders . 0 ###LEFT-WALL### 1 multivariate 0 ###LEFT-WALL### 14 confounders 0 ###LEFT-WALL### 15 . 1 multivariate 3 regression 1 multivariate 7 assess 1 multivariate 14 confounders 2 logistic 3 regression 3 regression 4 was 4 was 5 used 5 used 6 to 5 used 7 assess 6 to 7 assess 7 assess 9 associations 7 assess 10 after 7 assess 12 to 8 the 9 associations 10 after 11 adjustment 12 to 13 potential results : in total 2,258 patients participated in our study [,] of whom 39 % ( 873 ) had sustained two or more falls within the previous year . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 29 . 2 : 6 patients 2 : 7 participated 2 : 22 or 3 in 4 total 3 in 6 patients 4 total 5 2,258 6 patients 7 participated 7 participated 8 in 8 in 10 study 9 our 10 study 10 study 12 of 12 of 13 whom 13 whom 15 % 13 whom 20 sustained 14 39 15 % 15 % 17 873 15 % 19 had 16 ( 17 873 17 873 18 ) 19 had 20 sustained 20 sustained 21 two 22 or 23 more 22 or 24 falls 23 more 24 falls 24 falls 25 within 25 within 28 year 26 the 28 year 27 previous 28 year conclusions [:] known frids , such as psychotropic drugs , also increase the risk of [recurrent] falls . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 17 falls 0 ###LEFT-WALL### 18 . 1 conclusions 3 known 1 conclusions 4 frids 1 conclusions 15 of 1 conclusions 17 falls 4 frids 7 as 4 frids 12 increase 5 , 7 as 6 such 7 as 7 as 9 drugs 7 as 10 , 8 psychotropic 9 drugs 11 also 12 increase 12 increase 14 risk 13 the 14 risk 14 risk 15 of however , we found four relatively new classes that showed [significant] [association] with recurrent [falls] . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 16 . 1 however 2 , 1 however 3 we 3 we 4 found 4 found 8 classes 4 found 14 recurrent 5 four 8 classes 6 relatively 7 new 7 new 8 classes 8 classes 9 that 8 classes 13 with 9 that 10 showed 10 showed 13 with in part , these classes may act as markers of frailty and comorbidity , or they may reflect differences in the risk factors affecting the older , frailer population that tends to sustain [recurrent] [falls] . 0 ###LEFT-WALL### 2 part 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 33 sustain 0 ###LEFT-WALL### 36 . 1 in 2 part 3 , 5 classes 3 , 12 and 4 these 5 classes 5 classes 6 may 6 may 12 and 7 act 8 as 7 act 12 and 8 as 9 markers 9 markers 10 of 10 of 11 frailty 12 and 18 reflect 13 comorbidity 15 or 14 , 15 or 15 or 16 they 15 or 17 may 17 may 18 reflect 18 reflect 19 differences 19 differences 20 in 19 differences 30 that 19 differences 33 sustain 20 in 23 factors 21 the 23 factors 22 risk 23 factors 23 factors 24 affecting 24 affecting 29 population 25 the 29 population 26 older 27 , 26 older 29 population 28 frailer 29 population 30 that 31 tends 31 tends 32 to 32 to 33 sustain further investigation is [needed] to elucidate causes and ways to prevent recurrent [falls] . 0 ###LEFT-WALL### 2 investigation 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 14 . 1 further 2 investigation 2 investigation 3 is 3 is 5 to 3 is 12 recurrent 5 to 6 elucidate 6 elucidate 8 and 7 causes 8 and 8 and 9 ways 8 and 10 to 8 and 11 prevent 10 to 11 prevent introduction : older adults are generally considered to be at greater risk for medication [non] - adherence due to factors such as medication complexity , side effects , cost , and cognitive decline . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 4 adults 2 : 7 considered 2 : 16 - 3 older 4 adults 4 adults 5 are 5 are 7 considered 6 generally 7 considered 7 considered 8 to 7 considered 9 be 8 to 9 be 9 be 10 at 10 at 12 risk 11 greater 12 risk 12 risk 13 for 13 for 14 medication 16 - 33 decline 16 - 34 . 17 adherence 33 decline 18 due 19 to 18 due 31 and 19 to 20 factors 20 factors 22 as 21 such 22 as 22 as 24 complexity 23 medication 24 complexity 24 complexity 27 effects 24 complexity 29 cost 25 , 27 effects 26 side 27 effects 27 effects 28 , 28 , 29 cost 29 cost 30 , 30 , 31 and 31 and 32 cognitive 31 and 33 decline however , this generalization may not apply to older adults with human immunodeficiency virus ( hiv ) . 0 ###LEFT-WALL### 4 generalization 0 ###LEFT-WALL### 7 apply 0 ###LEFT-WALL### 18 . 1 however 2 , 1 however 4 generalization 3 this 4 generalization 4 generalization 5 may 5 may 6 not 5 may 7 apply 7 apply 8 to 7 apply 11 with 8 to 10 adults 9 older 10 adults 11 with 14 virus 12 human 13 immunodeficiency 13 immunodeficiency 14 virus 14 virus 16 hiv 15 ( 16 hiv 16 hiv 17 ) regardless of age , suboptimal [adherence] to antiretroviral therapy ( art ) can lead to increased viral [load] , immunosuppression , drug - resistant viral strains , co - morbidities , and opportunistic infections . 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 35 . 1 regardless 2 of 2 of 3 age 2 of 21 , 3 age 5 suboptimal 4 , 5 suboptimal 5 suboptimal 7 to 5 suboptimal 12 ) 7 to 9 therapy 8 antiretroviral 9 therapy 9 therapy 11 art 10 ( 11 art 11 art 12 ) 13 can 14 lead 13 can 21 , 14 lead 15 to 15 to 20 immunosuppression 16 increased 20 immunosuppression 17 viral 19 , 17 viral 20 immunosuppression 21 , 22 drug 23 - 32 and 24 resistant 26 strains 25 viral 26 strains 26 strains 27 , 27 , 30 morbidities 27 , 32 and 28 co 29 - 28 co 30 morbidities 31 , 32 and 32 and 34 infections 33 opportunistic 34 infections understanding trends of [adherence] to art among older adults is critical , especially as the population of people living with hiv grows older . 0 ###LEFT-WALL### 1 understanding 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 24 . 1 understanding 2 trends 1 understanding 10 is 2 trends 3 of 3 of 5 to 5 to 6 art 6 art 7 among 7 among 9 adults 8 older 9 adults 10 is 11 critical 12 , 19 living 12 , 22 grows 13 especially 19 living 14 as 16 population 14 as 19 living 15 the 16 population 16 population 17 of 17 of 18 people 19 living 20 with 19 living 22 grows 20 with 21 hiv 22 grows 23 older objectives : the purpose of this systematic review and meta - analysis is to determine if older individuals with hiv are less likely to be [non] - adherent [to] antiretroviral therapy than younger individuals with hiv . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 - 1 objectives 2 : 2 : 4 purpose 3 the 4 purpose 4 purpose 5 of 5 of 9 and 6 this 8 review 7 systematic 8 review 8 review 9 and 9 and 10 meta 11 - 12 analysis 11 - 13 is 11 - 27 - 11 - 37 . 12 analysis 13 is 13 is 14 to 13 is 23 likely 14 to 15 determine 15 determine 16 if 16 if 18 individuals 16 if 21 are 17 older 18 individuals 18 individuals 19 with 18 individuals 21 are 19 with 20 hiv 22 less 23 likely 23 likely 24 to 23 likely 25 be 24 to 25 be 27 - 34 individuals 28 adherent 34 individuals 30 antiretroviral 31 therapy 31 therapy 34 individuals 32 than 33 younger 33 younger 34 individuals 34 individuals 35 with 35 with 36 hiv design : a systematic search in pubmed , embase , and psycinfo was conducted to identify peer [-] reviewed articles evaluating adherence [to] art in older adults . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 2 : 5 search 2 : 16 identify 2 : 28 . 3 a 5 search 4 systematic 5 search 5 search 6 in 5 search 13 was 6 in 11 and 7 pubmed 9 embase 7 pubmed 11 and 8 , 9 embase 9 embase 10 , 10 , 11 and 11 and 12 psycinfo 13 was 14 conducted 14 conducted 15 to 15 to 16 identify 16 identify 20 articles 17 peer 19 reviewed 19 reviewed 20 articles 20 articles 21 evaluating 21 evaluating 24 art 22 adherence 24 art 24 art 25 in 25 in 27 adults 26 older 27 adults two independent reviewers screened abstracts , applied inclusion criteria , and appraised study quality . 0 ###LEFT-WALL### 3 reviewers 0 ###LEFT-WALL### 13 study 0 ###LEFT-WALL### 15 . 1 two 3 reviewers 2 independent 3 reviewers 3 reviewers 11 and 3 reviewers 13 study 4 screened 5 abstracts 4 screened 11 and 5 abstracts 9 criteria 6 , 9 criteria 7 applied 8 inclusion 8 inclusion 9 criteria 9 criteria 10 , 11 and 12 appraised 13 study 14 quality the bibliographies of qualifying studies were searched . 0 ###LEFT-WALL### 2 bibliographies 0 ###LEFT-WALL### 7 searched 0 ###LEFT-WALL### 8 . 1 the 2 bibliographies 2 bibliographies 3 of 2 bibliographies 6 were 3 of 4 qualifying 4 qualifying 5 studies 6 were 7 searched data were abstracted from studies by two independent authors . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 10 . 1 data 2 were 2 were 3 abstracted 3 abstracted 4 from 3 abstracted 6 by 4 from 5 studies 6 by 9 authors 7 two 9 authors 8 independent 9 authors meta - analyses were conducted , and adherence levels were reported as the relative risk of [non] - [adherence] in older individuals compared to younger individuals . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 5 conducted 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 23 compared 0 ###LEFT-WALL### 27 . 1 meta 2 - 1 meta 3 analyses 3 analyses 4 were 4 were 5 conducted 6 , 7 and 7 and 9 levels 7 and 11 reported 8 adherence 9 levels 9 levels 10 were 10 were 11 reported 11 reported 12 as 12 as 15 risk 13 the 15 risk 14 relative 15 risk 15 risk 16 of 15 risk 22 individuals 15 risk 23 compared 16 of 20 in 18 - 20 in 21 older 22 individuals 22 individuals 23 compared 23 compared 24 to 24 to 26 individuals 25 younger 26 individuals results : the systematic search yielded 1,848 abstracts . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 5 search 2 : 6 yielded 2 : 9 . 3 the 5 search 4 systematic 5 search 5 search 6 yielded 6 yielded 8 abstracts 7 1,848 8 abstracts twelve studies met full inclusion criteria . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 met 0 ###LEFT-WALL### 7 . 1 twelve 2 studies 2 studies 3 met 3 met 6 criteria 4 full 5 inclusion 5 inclusion 6 criteria the overall meta - analysis found that older age reduced risk for nonadherence by 27 % ( relative risk ( [rr] [ )(0.72 , 95 % confidence [interval] ( ci ) 0.64 – 0.82 ) . 0 ###LEFT-WALL### 5 analysis 0 ###LEFT-WALL### 6 found 0 ###LEFT-WALL### 36 . 1 the 5 analysis 2 overall 5 analysis 3 meta 4 - 3 meta 5 analysis 5 analysis 6 found 6 found 11 risk 6 found 32 0.64 7 that 11 risk 8 older 11 risk 9 age 10 reduced 10 reduced 11 risk 11 risk 12 for 11 risk 14 by 12 for 13 nonadherence 14 by 16 % 15 27 16 % 16 % 19 risk 16 % 27 confidence 17 ( 19 risk 18 relative 19 risk 19 risk 23 )(0.72 19 risk 24 , 20 ( 23 )(0.72 23 )(0.72 24 , 24 , 27 confidence 25 95 26 % 26 % 27 confidence 27 confidence 30 ci 27 confidence 31 ) 29 ( 30 ci 30 ci 31 ) 32 0.64 34 0.82 33 – 34 0.82 34 0.82 35 ) studies assessing both short - [term] and long - term adherence demonstrated a significant reduction [in] [non] - [adherence] among older patients ( [rr] 0.75 , 95 % ci 0.64 – 0.87 and [rr] 0.65 , 95 % ci 0.50 – 0.85 , respectively ) . 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 12 demonstrated 0 ###LEFT-WALL### 46 . 1 studies 2 assessing 1 studies 7 and 2 assessing 3 both 2 assessing 4 short 5 - 7 and 7 and 11 adherence 7 and 12 demonstrated 8 long 9 - 8 long 10 term 10 term 11 adherence 12 demonstrated 15 reduction 12 demonstrated 44 respectively 13 a 14 significant 13 a 15 reduction 14 significant 15 reduction 15 reduction 20 among 15 reduction 29 ci 18 - 20 among 20 among 22 patients 20 among 26 , 21 older 22 patients 22 patients 25 0.75 23 ( 25 0.75 25 0.75 26 , 26 , 29 ci 27 95 29 ci 28 % 29 ci 29 ci 30 0.64 29 ci 33 and 29 ci 39 ci 29 ci 43 , 31 – 33 and 32 0.87 33 and 33 and 35 0.65 33 and 36 , 36 , 39 ci 37 95 39 ci 38 % 39 ci 39 ci 40 0.50 39 ci 42 0.85 39 ci 43 , 41 – 42 0.85 42 0.85 43 , 43 , 44 respectively 44 respectively 45 ) conclusions : older adults with hiv have a reduced risk for [non] [-] adherence [to] art than their younger counterparts . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 4 adults 2 : 7 have 3 older 4 adults 4 adults 5 with 4 adults 7 have 5 with 6 hiv 7 have 10 risk 7 have 17 than 8 a 10 risk 9 reduced 10 risk 10 risk 11 for 11 for 16 art 14 adherence 16 art 17 than 20 counterparts 18 their 20 counterparts 19 younger 20 counterparts future studies should seek to elucidate contributing factors of [adherence] among older individuals with hiv . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 seek 0 ###LEFT-WALL### 16 . 1 future 2 studies 2 studies 3 should 3 should 4 seek 4 seek 5 to 4 seek 6 elucidate 5 to 6 elucidate 6 elucidate 8 factors 6 elucidate 14 with 7 contributing 8 factors 8 factors 9 of 9 of 11 among 11 among 13 individuals 12 older 13 individuals 14 with 15 hiv questions/purposes : the aims of our study [were] ( 1 ) to confirm the prevalence of radiographic trapeziometacarpal arthrosis in a very large sample [and] to determine if age and sex are associated with [(] 2 [ )(any radiographic evidence of trapeziometacarpal arthrosis [;] [and] ( 3 [ )(radiographic evidence of severe trapeziometacarpal arthrosis . 0 ###LEFT-WALL### 1 questions/purposes 0 ###LEFT-WALL### 2 : 1 questions/purposes 2 : 2 : 4 aims 3 the 4 aims 4 aims 5 of 4 aims 12 to 4 aims 13 confirm 5 of 7 study 6 our 7 study 7 study 10 1 9 ( 10 1 10 1 11 ) 12 to 13 confirm 13 confirm 15 prevalence 14 the 15 prevalence 15 prevalence 16 of 15 prevalence 20 in 15 prevalence 26 to 15 prevalence 27 determine 16 of 19 arthrosis 17 radiographic 19 arthrosis 18 trapeziometacarpal 19 arthrosis 20 in 24 sample 21 a 22 very 21 a 24 sample 22 very 23 large 23 large 24 sample 26 to 27 determine 27 determine 28 if 28 if 30 and 28 if 33 associated 29 age 30 and 30 and 31 sex 30 and 32 are 32 are 33 associated 33 associated 34 with 34 with 36 2 34 with 40 evidence 38 )(any 40 evidence 39 radiographic 40 evidence 40 evidence 41 of 41 of 43 arthrosis 42 trapeziometacarpal 43 arthrosis 43 arthrosis 50 evidence 46 ( 50 evidence 47 3 50 evidence 49 )(radiographic 50 evidence 50 evidence 51 of 50 evidence 55 . 51 of 54 arthrosis 52 severe 54 arthrosis 53 trapeziometacarpal 54 arthrosis methods : a total of 2321 patients 31 years or older [with] [radiographs] obtained during treatment of a distal radius fracture at a tertiary care medical center emergency department between 2002 and 2012 were analyzed . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 14 obtained 0 ###LEFT-WALL### 32 and 0 ###LEFT-WALL### 36 . 1 methods 2 : 2 : 10 or 2 : 14 obtained 3 a 4 total 4 total 5 of 4 total 10 or 5 of 9 years 6 2321 9 years 7 patients 9 years 8 31 9 years 10 or 11 older 14 obtained 15 during 14 obtained 22 at 15 during 16 treatment 16 treatment 17 of 17 of 21 fracture 18 a 21 fracture 19 distal 20 radius 20 radius 21 fracture 22 at 29 department 23 a 24 tertiary 23 a 29 department 24 tertiary 25 care 25 care 28 emergency 26 medical 27 center 27 center 28 emergency 28 emergency 29 department 29 department 30 between 30 between 31 2002 32 and 33 2012 32 and 34 were 33 2012 34 were 34 were 35 analyzed trapeziometacarpal [arthrosis] was graded using the 3 [-] point scale of sodha et al . ( none , definite , destroyed trapeziometacarpal joint [ )(; we used regression analyses to determine the association of age ( in 10 - year age groups ) and sex with the presence of trapeziometacarpal arthrosis . 0 ###LEFT-WALL### 1 trapeziometacarpal 0 ###LEFT-WALL### 4 graded 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 27 used 0 ###LEFT-WALL### 52 . 1 trapeziometacarpal 3 was 3 was 4 graded 4 graded 5 using 4 graded 18 , 4 graded 19 definite 5 using 10 scale 6 the 10 scale 7 3 9 point 9 point 10 scale 10 scale 11 of 11 of 14 al 12 sodha 14 al 13 et 14 al 14 al 15 . 14 al 17 none 16 ( 17 none 17 none 18 , 20 , 23 joint 20 , 25 )(; 21 destroyed 23 joint 22 trapeziometacarpal 23 joint 25 )(; 26 we 26 we 27 used 27 used 29 analyses 27 used 30 to 27 used 31 determine 28 regression 29 analyses 30 to 31 determine 31 determine 44 and 31 determine 46 with 32 the 33 association 33 association 34 of 33 association 44 and 34 of 35 age 35 age 37 in 36 ( 37 in 37 in 38 10 37 in 43 ) 38 10 42 groups 39 - 42 groups 40 year 42 groups 41 age 42 groups 42 groups 43 ) 44 and 45 sex 46 with 48 presence 47 the 48 presence 48 presence 49 of 49 of 51 arthrosis 50 trapeziometacarpal 51 arthrosis results : the prevalence of trapeziometacarpal arthrosis steadily increased to 85 % between the ages of 71 and 80 years and reached 100 % in women ( with 50 % of them being classified as severe ) aged 91 years or older and 93 % in men of 81 years or older . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 53 . 1 results 2 : 2 : 51 or 3 the 4 prevalence 4 prevalence 5 of 4 prevalence 43 and 5 of 7 arthrosis 6 trapeziometacarpal 7 arthrosis 7 arthrosis 21 and 8 steadily 9 increased 9 increased 10 to 9 increased 13 between 9 increased 21 and 10 to 12 % 11 85 12 % 13 between 15 ages 14 the 15 ages 15 ages 16 of 16 of 20 years 17 71 18 and 18 and 19 80 18 and 20 years 21 and 22 reached 21 and 26 women 21 and 28 with 21 and 41 or 23 100 25 in 24 % 25 in 25 in 26 women 27 ( 28 with 28 with 30 % 28 with 36 severe 28 with 37 ) 29 50 30 % 30 % 31 of 30 % 33 being 31 of 32 them 33 being 34 classified 35 as 36 severe 38 aged 40 years 39 91 40 years 40 years 41 or 41 or 42 older 43 and 47 men 43 and 51 or 44 93 46 in 45 % 46 in 46 in 47 men 47 men 48 of 48 of 50 years 49 81 50 years 51 or 52 older severe arthrosis [was] more prevalent at earlier ages among women and reached 35 % in women and 34 % in men who were 81 years or older . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 28 . 1 severe 2 arthrosis 2 arthrosis 5 prevalent 2 arthrosis 15 in 2 arthrosis 17 and 4 more 5 prevalent 5 prevalent 6 at 6 at 11 and 7 earlier 8 ages 8 ages 9 among 8 ages 11 and 9 among 10 women 11 and 12 reached 11 and 14 % 13 35 14 % 15 in 16 women 17 and 21 men 17 and 22 who 17 and 23 were 18 34 20 in 19 % 20 in 20 in 21 men 22 who 23 were 23 were 26 or 24 81 25 years 25 years 26 or 26 or 27 older logistic regression identified higher age as the strongest factor associated with trapeziometacarpal arthrosis , but sex was also a factor . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 3 identified 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 21 . 1 logistic 2 regression 2 regression 3 identified 3 identified 5 age 3 identified 6 as 4 higher 5 age 6 as 9 factor 7 the 8 strongest 7 the 9 factor 9 factor 10 associated 10 associated 11 with 11 with 13 arthrosis 12 trapeziometacarpal 13 arthrosis 14 , 15 but 15 but 16 sex 15 but 17 was 16 sex 17 was 17 was 18 also 17 was 20 factor 19 a 20 factor conclusions : radiographic [trapeziometacarpal] [arthrosis] is an expected part of human aging . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 3 radiographic 2 : 6 is 2 : 13 . 3 radiographic 6 is 6 is 9 part 7 an 9 part 8 expected 9 part 9 part 10 of 10 of 12 aging 11 human 12 aging given [that] only three patients in this large cohort [had] evidence of prior surgery , it seems that most people adapt to trapeziometacarpal arthrosis . 0 ###LEFT-WALL### 16 it 0 ###LEFT-WALL### 17 seems 0 ###LEFT-WALL### 25 . 1 given 5 patients 1 given 6 in 1 given 15 , 1 given 16 it 3 only 4 three 4 three 5 patients 6 in 11 evidence 7 this 8 large 8 large 9 cohort 9 cohort 11 evidence 11 evidence 12 of 12 of 14 surgery 13 prior 14 surgery 16 it 17 seems 17 seems 18 that 18 that 20 people 18 that 21 adapt 19 most 20 people 20 people 21 adapt 21 adapt 22 to 22 to 24 arthrosis 23 trapeziometacarpal 24 arthrosis treatments that optimize adaptation in patients [who] present with trapeziometacarpal arthrosis - related symptoms and disability merit additional study . 0 ###LEFT-WALL### 1 treatments 0 ###LEFT-WALL### 17 merit 0 ###LEFT-WALL### 20 . 1 treatments 2 that 1 treatments 3 optimize 1 treatments 17 merit 2 that 3 optimize 3 optimize 4 adaptation 3 optimize 5 in 5 in 6 patients 6 patients 8 present 8 present 9 with 9 with 11 arthrosis 10 trapeziometacarpal 11 arthrosis 12 - 13 related 13 related 15 and 13 related 17 merit 14 symptoms 15 and 15 and 16 disability 17 merit 19 study 18 additional 19 study telomeres repress the dna damage response at the natural chromosome ends to prevent cell [-] cycle arrest and maintain genome stability . 0 ###LEFT-WALL### 1 telomeres 0 ###LEFT-WALL### 18 and 0 ###LEFT-WALL### 22 . 1 telomeres 18 and 2 repress 6 response 2 repress 7 at 2 repress 12 to 2 repress 18 and 3 the 6 response 4 dna 6 response 5 damage 6 response 7 at 11 ends 8 the 11 ends 9 natural 11 ends 10 chromosome 11 ends 12 to 13 prevent 13 prevent 17 arrest 14 cell 17 arrest 16 cycle 17 arrest 18 and 19 maintain 18 and 21 stability 20 genome 21 stability telomeres are elongated by telomerase in a tightly regulated manner to ensure a sufficient number of cell divisions throughout life , yet prevent unlimited cell division and cancer development . 0 ###LEFT-WALL### 1 telomeres 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 30 . 1 telomeres 2 are 2 are 3 elongated 3 elongated 4 by 3 elongated 6 in 3 elongated 11 to 4 by 5 telomerase 6 in 10 manner 7 a 10 manner 8 tightly 9 regulated 9 regulated 10 manner 11 to 21 , 12 ensure 18 divisions 12 ensure 19 throughout 12 ensure 21 , 13 a 14 sufficient 13 a 15 number 14 sufficient 15 number 15 number 16 of 15 number 18 divisions 16 of 18 divisions 17 cell 18 divisions 19 throughout 20 life 21 , 23 prevent 22 yet 23 prevent 23 prevent 27 and 24 unlimited 26 division 25 cell 26 division 26 division 27 and 27 and 29 development 28 cancer 29 development hoyeraal - hreidarsson [syndrome] ( hhs ) is characterized by accelerated telomere shortening and a broad range of pathologies , including bone marrow failure , immunodeficiency , and developmental defects . 0 ###LEFT-WALL### 3 hreidarsson 0 ###LEFT-WALL### 9 characterized 0 ###LEFT-WALL### 31 . 1 hoyeraal 2 - 1 hoyeraal 3 hreidarsson 3 hreidarsson 6 hhs 3 hreidarsson 8 is 5 ( 6 hhs 6 hhs 7 ) 8 is 9 characterized 9 characterized 10 by 10 by 14 and 11 accelerated 13 shortening 12 telomere 13 shortening 13 shortening 14 and 14 and 17 range 14 and 18 of 15 a 16 broad 15 a 17 range 16 broad 17 range 18 of 28 and 19 pathologies 20 , 20 , 24 failure 20 , 25 , 21 including 23 marrow 22 bone 23 marrow 23 marrow 24 failure 25 , 26 immunodeficiency 25 , 28 and 27 , 28 and 28 and 30 defects 29 developmental 30 defects hhs - causing mutations have previously been found in telomerase and the shelterin component telomeric repeat binding factor 1 ( trf1 ) - interacting nuclear factor 2 ( tin2 ) . 0 ###LEFT-WALL### 1 hhs 0 ###LEFT-WALL### 2 - 2 - 4 mutations 2 - 8 found 2 - 31 . 3 causing 4 mutations 4 mutations 5 have 5 have 7 been 6 previously 7 been 7 been 8 found 8 found 9 in 9 in 11 and 10 telomerase 11 and 11 and 16 repeat 11 and 17 binding 12 the 16 repeat 13 shelterin 16 repeat 14 component 16 repeat 15 telomeric 16 repeat 17 binding 18 factor 18 factor 19 1 18 factor 21 trf1 18 factor 26 factor 20 ( 21 trf1 21 trf1 22 ) 23 - 26 factor 24 interacting 26 factor 25 nuclear 26 factor 26 factor 27 2 26 factor 29 tin2 26 factor 30 ) 28 ( 29 tin2 29 tin2 30 ) we identified by whole - genome exome sequencing compound heterozygous mutations in four siblings affected with hhs , in the gene encoding the regulator of telomere elongation helicase 1 ( rtel1 ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 identified 0 ###LEFT-WALL### 33 . 1 we 2 identified 2 identified 3 by 2 identified 11 mutations 3 by 7 exome 4 whole 5 - 4 whole 6 genome 6 genome 7 exome 7 exome 8 sequencing 8 sequencing 9 compound 10 heterozygous 11 mutations 11 mutations 12 in 12 in 14 siblings 13 four 14 siblings 14 siblings 15 affected 15 affected 16 with 15 affected 19 in 16 with 17 hhs 18 , 19 in 19 in 21 gene 19 in 32 ) 20 the 21 gene 21 gene 22 encoding 21 gene 31 rtel1 22 encoding 24 regulator 23 the 24 regulator 24 regulator 25 of 25 of 28 helicase 26 telomere 28 helicase 27 elongation 28 helicase 28 helicase 29 1 30 ( 31 rtel1 31 rtel1 32 ) rtel1 was identified in [mouse] [by] its genetic association with telomere length . 0 ###LEFT-WALL### 1 rtel1 0 ###LEFT-WALL### 3 identified 0 ###LEFT-WALL### 13 . 1 rtel1 2 was 2 was 3 identified 3 identified 4 in 3 identified 10 with 4 in 9 association 7 its 9 association 8 genetic 9 association 10 with 12 length 11 telomere 12 length however , its mechanism of action and whether it regulates telomere length in [human] remained unknown . 0 ###LEFT-WALL### 4 mechanism 0 ###LEFT-WALL### 15 remained 0 ###LEFT-WALL### 17 . 1 however 2 , 1 however 4 mechanism 3 its 4 mechanism 4 mechanism 5 of 4 mechanism 15 remained 5 of 7 and 6 action 7 and 7 and 8 whether 7 and 9 it 7 and 13 in 9 it 10 regulates 10 regulates 12 length 10 regulates 13 in 11 telomere 12 length 15 remained 16 unknown lymphoblastoid cell lines obtained from a patient and from the healthy parents carrying heterozygous rtel1 mutations displayed telomere shortening , fragility and fusion , and growth defects in culture . 0 ###LEFT-WALL### 25 and 0 ###LEFT-WALL### 30 . 1 lymphoblastoid 2 cell 2 cell 3 lines 3 lines 4 obtained 3 lines 13 carrying 3 lines 20 , 4 obtained 8 and 5 from 7 patient 5 from 8 and 6 a 7 patient 8 and 9 from 9 from 12 parents 10 the 12 parents 11 healthy 12 parents 13 carrying 16 mutations 14 heterozygous 16 mutations 15 rtel1 16 mutations 16 mutations 17 displayed 16 mutations 19 shortening 17 displayed 18 telomere 20 , 21 fragility 20 , 22 and 22 and 23 fusion 22 and 25 and 24 , 25 and 25 and 27 defects 25 and 28 in 26 growth 27 defects 28 in 29 culture ectopic expression of wt rtel1 suppressed the telomere shortening and growth defect , confirming the causal role of the rtel1 mutations in hhs and [demonstrating] the essential function of human rtel1 in telomere protection and elongation . 0 ###LEFT-WALL### 2 expression 0 ###LEFT-WALL### 6 suppressed 1 ectopic 2 expression 2 expression 3 of 2 expression 6 suppressed 3 of 5 rtel1 4 wt 5 rtel1 6 suppressed 10 and 7 the 10 and 8 telomere 9 shortening 8 telomere 10 and 10 and 12 defect 10 and 14 confirming 11 growth 12 defect 13 , 14 confirming 14 confirming 17 role 14 confirming 22 in 14 confirming 32 in 14 confirming 37 . 15 the 17 role 16 causal 17 role 17 role 18 of 18 of 21 mutations 19 the 21 mutations 20 rtel1 21 mutations 22 in 24 and 23 hhs 24 and 24 and 28 function 26 the 28 function 27 essential 28 function 28 function 29 of 29 of 31 rtel1 30 human 31 rtel1 32 in 35 and 33 telomere 34 protection 34 protection 35 and 35 and 36 elongation finally , we show that human rtel1 interacts with the shelterin protein trf1 , providing a potential recruitment mechanism of rtel1 to telomeres . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 show 1 finally 2 , 1 finally 3 we 3 we 4 show 4 show 6 human 4 show 7 rtel1 4 show 8 interacts 5 that 6 human 7 rtel1 8 interacts 8 interacts 9 with 9 with 13 trf1 10 the 12 protein 11 shelterin 12 protein 12 protein 13 trf1 13 trf1 15 providing 14 , 15 providing 15 providing 19 mechanism 15 providing 22 to 15 providing 24 . 16 a 19 mechanism 17 potential 19 mechanism 18 recruitment 19 mechanism 19 mechanism 20 of 20 of 21 rtel1 22 to 23 telomeres whereas amyloid - β ( aβ ) accumulates in the brain of normal animals dosed with low levels of copper [(] [cu] ) [,] the mechanism is not completely known . 0 ###LEFT-WALL### 26 mechanism 0 ###LEFT-WALL### 30 known 0 ###LEFT-WALL### 31 . 1 whereas 4 β 1 whereas 8 accumulates 1 whereas 23 ) 1 whereas 26 mechanism 2 amyloid 3 - 2 amyloid 4 β 4 β 6 aβ 4 β 8 accumulates 5 ( 6 aβ 6 aβ 7 ) 8 accumulates 9 in 8 accumulates 16 with 9 in 11 brain 10 the 11 brain 11 brain 12 of 12 of 14 animals 13 normal 14 animals 14 animals 15 dosed 16 with 18 levels 17 low 18 levels 18 levels 19 of 19 of 20 copper 25 the 26 mechanism 26 mechanism 27 is 27 is 28 not 27 is 30 known 29 completely 30 known [cu] [could] contribute to aβ accumulation by altering its clearance [and/or] its production . 0 ###LEFT-WALL### 3 contribute 0 ###LEFT-WALL### 14 . 3 contribute 4 to 3 contribute 7 by 3 contribute 13 production 4 to 6 accumulation 5 aβ 6 accumulation 7 by 8 altering 8 altering 10 clearance 9 its 10 clearance 12 its 13 production because cu homeostasis [is] altered in transgenic mice overexpressing aβ precursor protein ( app ) , the objective of this study was to elucidate the mechanism of cu - induced aβ accumulation in brains of normal mice and then to explore cu 's effects in a mouse model of alzheimer 's disease . 0 ###LEFT-WALL### 42 cu 0 ###LEFT-WALL### 43 's 0 ###LEFT-WALL### 53 . 1 because 3 homeostasis 1 because 38 and 1 because 42 cu 2 cu 3 homeostasis 3 homeostasis 5 altered 3 homeostasis 6 in 3 homeostasis 9 overexpressing 3 homeostasis 38 and 6 in 8 mice 7 transgenic 8 mice 9 overexpressing 12 protein 10 aβ 12 protein 11 precursor 12 protein 12 protein 14 app 12 protein 18 objective 13 ( 14 app 14 app 15 ) 16 , 18 objective 17 the 18 objective 18 objective 19 of 18 objective 21 study 18 objective 24 elucidate 18 objective 29 - 19 of 20 this 21 study 22 was 22 was 23 to 22 was 24 elucidate 23 to 24 elucidate 24 elucidate 26 mechanism 25 the 26 mechanism 26 mechanism 27 of 27 of 28 cu 30 induced 32 accumulation 30 induced 33 in 30 induced 38 and 31 aβ 32 accumulation 33 in 34 brains 34 brains 35 of 35 of 37 mice 36 normal 37 mice 38 and 40 to 38 and 41 explore 39 then 40 to 40 to 41 explore 42 cu 43 's 43 's 44 effects 43 's 45 in 45 in 48 model 46 a 48 model 47 mouse 48 model 48 model 49 of 49 of 52 disease 50 alzheimer 51 's 51 's 52 disease in aging mice , accumulation of cu in brain capillaries was associated with its reduction [in] low - density lipoprotein receptor - related protein 1 ( lrp1 ) , an aβ transporter , and higher brain aβ levels . 0 ###LEFT-WALL### 5 accumulation 0 ###LEFT-WALL### 12 associated 0 ###LEFT-WALL### 23 related 0 ###LEFT-WALL### 29 , 0 ###LEFT-WALL### 38 levels 0 ###LEFT-WALL### 39 . 1 in 2 aging 1 in 4 , 1 in 5 accumulation 2 aging 3 mice 5 accumulation 6 of 5 accumulation 8 in 5 accumulation 11 was 6 of 7 cu 8 in 10 capillaries 9 brain 10 capillaries 11 was 12 associated 12 associated 13 with 13 with 21 receptor 14 its 21 receptor 15 reduction 21 receptor 17 low 18 - 17 low 19 density 19 density 21 receptor 20 lipoprotein 21 receptor 22 - 23 related 23 related 24 protein 23 related 28 ) 24 protein 25 1 24 protein 27 lrp1 26 ( 27 lrp1 27 lrp1 28 ) 29 , 34 and 30 an 32 transporter 31 aβ 32 transporter 32 transporter 34 and 33 , 34 and 34 and 36 brain 34 and 37 aβ 34 and 38 levels 35 higher 36 brain 37 aβ 38 levels these effects were reproduced by chronic dosing with low levels of cu via drinking water without changes in aβ synthesis or degradation . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 4 reproduced 0 ###LEFT-WALL### 23 . 1 these 2 effects 2 effects 3 were 3 were 4 reproduced 4 reproduced 5 by 4 reproduced 8 with 4 reproduced 13 via 4 reproduced 18 in 5 by 7 dosing 6 chronic 7 dosing 8 with 10 levels 9 low 10 levels 10 levels 11 of 11 of 12 cu 13 via 15 water 14 drinking 15 water 15 water 16 without 16 without 17 changes 18 in 21 or 19 aβ 20 synthesis 20 synthesis 21 or 21 or 22 degradation in human brain endothelial cells , cu , at its normal labile levels , caused lrp1 - specific down - regulation by inducing its nitrotyrosination and subsequent proteosomal - dependent degradation due in part to cu/cellular prion protein/lrp1 interaction . 0 ###LEFT-WALL### 5 cells 0 ###LEFT-WALL### 15 caused 0 ###LEFT-WALL### 17 - 0 ###LEFT-WALL### 40 . 1 in 3 brain 1 in 5 cells 2 human 3 brain 4 endothelial 5 cells 5 cells 7 cu 5 cells 9 at 5 cells 15 caused 6 , 7 cu 7 cu 8 , 8 , 9 at 9 at 13 levels 9 at 14 , 10 its 13 levels 11 normal 13 levels 12 labile 13 levels 15 caused 16 lrp1 17 - 26 and 18 specific 21 regulation 19 down 20 - 19 down 21 regulation 21 regulation 22 by 21 regulation 26 and 22 by 23 inducing 23 inducing 25 nitrotyrosination 24 its 25 nitrotyrosination 26 and 31 degradation 26 and 32 due 27 subsequent 30 dependent 28 proteosomal 29 - 28 proteosomal 30 dependent 30 dependent 31 degradation 32 due 34 part 33 in 34 part 34 part 35 to 35 to 39 interaction 36 cu/cellular 39 interaction 37 prion 39 interaction 38 protein/lrp1 39 interaction in app ( sw/0 ) mice , cu not only down - regulated lrp1 in brain capillaries but also increased aβ production and neuroinflammation because cu accumulated in brain capillaries [and] , [unlike] in control mice , in the parenchyma . 0 ###LEFT-WALL### 6 mice 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 41 . 1 in 2 app 2 app 4 sw/0 2 app 6 mice 3 ( 4 sw/0 4 sw/0 5 ) 7 , 8 cu 7 , 9 not 9 not 10 only 9 not 20 increased 10 only 14 lrp1 11 down 12 - 11 down 14 lrp1 13 regulated 14 lrp1 14 lrp1 15 in 14 lrp1 20 increased 15 in 17 capillaries 16 brain 17 capillaries 17 capillaries 18 but 18 but 19 also 20 increased 23 and 20 increased 25 because 20 increased 28 in 20 increased 38 in 21 aβ 22 production 22 production 23 and 23 and 24 neuroinflammation 25 because 26 cu 25 because 27 accumulated 26 cu 27 accumulated 28 in 30 capillaries 29 brain 30 capillaries 30 capillaries 34 in 32 , 34 in 34 in 36 mice 34 in 37 , 35 control 36 mice 38 in 40 parenchyma 39 the 40 parenchyma thus , we have demonstrated that cu 's effect on brain aβ homeostasis depends on whether it is accumulated in the capillaries or in the parenchyma . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 5 demonstrated 0 ###LEFT-WALL### 27 . 1 thus 2 , 1 thus 3 we 3 we 4 have 4 have 5 demonstrated 5 demonstrated 6 that 6 that 9 effect 6 that 14 depends 7 cu 8 's 8 's 9 effect 9 effect 10 on 9 effect 14 depends 10 on 13 homeostasis 11 brain 13 homeostasis 12 aβ 13 homeostasis 14 depends 15 on 15 on 16 whether 16 whether 17 it 16 whether 19 accumulated 17 it 18 is 18 is 19 accumulated 19 accumulated 23 or 20 in 22 capillaries 20 in 23 or 21 the 22 capillaries 23 or 24 in 24 in 26 parenchyma 25 the 26 parenchyma these findings should provide unique insights into preventative [and/or] therapeutic approaches to control neurotoxic aβ levels in the aging brain . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 provide 0 ###LEFT-WALL### 21 . 1 these 2 findings 2 findings 3 should 3 should 4 provide 4 provide 6 insights 4 provide 7 into 4 provide 12 to 5 unique 6 insights 7 into 11 approaches 8 preventative 11 approaches 10 therapeutic 11 approaches 12 to 13 control 13 control 16 levels 13 control 17 in 14 neurotoxic 16 levels 15 aβ 16 levels 17 in 20 brain 18 the 20 brain 19 aging 20 brain progranulin ( pgrn ) is a highly unusual molecule with both neuronal and microglial expression with two seemingly unrelated functions , i.e [.] , as a neuronal growth factor and a modulator of neuroinflammation . 0 ###LEFT-WALL### 3 pgrn 0 ###LEFT-WALL### 5 is 1 progranulin 3 pgrn 2 ( 3 pgrn 3 pgrn 4 ) 3 pgrn 5 is 5 is 9 molecule 5 is 10 with 5 is 16 with 6 a 9 molecule 7 highly 8 unusual 8 unusual 9 molecule 10 with 13 and 11 both 13 and 12 neuronal 13 and 13 and 15 expression 14 microglial 15 expression 16 with 20 functions 17 two 20 functions 18 seemingly 19 unrelated 19 unrelated 20 functions 20 functions 22 i.e 20 functions 25 as 21 , 22 i.e 22 i.e 24 , 24 , 25 as 25 as 30 and 25 as 35 . 26 a 29 factor 27 neuronal 28 growth 28 growth 29 factor 29 factor 30 and 30 and 32 modulator 30 and 33 of 31 a 32 modulator 33 of 34 neuroinflammation [haploinsufficiency] due to loss of function mutations lead to a fatal presenile dementing illness ( frontotemporal lobar degeneration ) , indicating that adequate expression of pgrn is essential for successful aging . 0 ###LEFT-WALL### 8 lead 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 32 . 2 due 3 to 3 to 4 loss 3 to 8 lead 4 loss 5 of 5 of 7 mutations 6 function 7 mutations 8 lead 9 to 9 to 12 presenile 10 a 11 fatal 10 a 12 presenile 11 fatal 12 presenile 12 presenile 13 dementing 13 dementing 14 illness 14 illness 18 degeneration 15 ( 18 degeneration 16 frontotemporal 18 degeneration 17 lobar 18 degeneration 18 degeneration 19 ) 20 , 21 indicating 20 , 27 is 21 indicating 24 expression 21 indicating 27 is 22 that 23 adequate 23 adequate 24 expression 24 expression 25 of 25 of 26 pgrn 27 is 28 essential 28 essential 29 for 29 for 31 aging 30 successful 31 aging pgrn might be a particularly relevant factor in the pathogenesis of hivencephalitis ( hive ) and hiv - associated neurocognitive disorders ( hand ) . 0 ###LEFT-WALL### 1 pgrn 0 ###LEFT-WALL### 3 be 0 ###LEFT-WALL### 25 . 1 pgrn 2 might 2 might 3 be 3 be 16 and 4 a 5 particularly 4 a 7 factor 5 particularly 6 relevant 6 relevant 7 factor 7 factor 8 in 7 factor 11 of 7 factor 16 and 8 in 10 pathogenesis 9 the 10 pathogenesis 11 of 14 hive 12 hivencephalitis 14 hive 13 ( 14 hive 14 hive 15 ) 16 and 17 hiv 17 hiv 21 disorders 18 - 21 disorders 19 associated 21 disorders 20 neurocognitive 21 disorders 21 disorders 23 hand 21 disorders 24 ) 22 ( 23 hand 23 hand 24 ) we present emerging data and a review of the literature which show that cells of myeloid lineage such as macrophages and microglia are the primary sources of pgrn and that pgrn expression contributes to pathogenesis of cns diseases . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 29 and 0 ###LEFT-WALL### 39 . 1 we 2 present 2 present 3 emerging 2 present 5 and 3 emerging 4 data 5 and 7 review 5 and 8 of 5 and 11 which 5 and 12 show 6 a 7 review 8 of 10 literature 9 the 10 literature 11 which 12 show 12 show 13 that 13 that 14 cells 13 that 23 are 14 cells 15 of 14 cells 19 as 14 cells 23 are 15 of 17 lineage 16 myeloid 17 lineage 18 such 19 as 19 as 21 and 20 macrophages 21 and 21 and 22 microglia 23 are 26 sources 24 the 26 sources 25 primary 26 sources 26 sources 27 of 27 of 28 pgrn 29 and 32 expression 29 and 33 contributes 30 that 32 expression 31 pgrn 32 expression 32 expression 33 contributes 33 contributes 34 to 34 to 35 pathogenesis 35 pathogenesis 36 of 36 of 38 diseases 37 cns 38 diseases we also present evidence that pgrn is a macrophage antiviral cytokine . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 present 0 ###LEFT-WALL### 12 . 1 we 3 present 2 also 3 present 3 present 4 evidence 4 evidence 5 that 5 that 6 pgrn 5 that 7 is 6 pgrn 7 is 7 is 11 cytokine 8 a 9 macrophage 8 a 11 cytokine 9 macrophage 11 cytokine 10 antiviral 11 cytokine for example , pgrn mrna and protein expression are significantly upregulated in brain specimens with hive , and in hiv infected microglia in vitro . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 upregulated 0 ###LEFT-WALL### 25 . 1 for 2 example 2 example 3 , 2 example 6 and 3 , 4 pgrn 4 pgrn 6 and 5 mrna 6 and 6 and 8 expression 6 and 9 are 7 protein 8 expression 9 are 10 significantly 9 are 11 upregulated 11 upregulated 12 in 11 upregulated 18 and 11 upregulated 22 microglia 12 in 14 specimens 13 brain 14 specimens 15 with 16 hive 15 with 18 and 17 , 18 and 18 and 19 in 19 in 20 hiv 20 hiv 21 infected 22 microglia 24 vitro 23 in 24 vitro paradoxically , our preliminary charter data analyses indicate that lower pgrn levels in csf trended towards an association with hand , particularly in those without detectable virus . 0 ###LEFT-WALL### 7 analyses 0 ###LEFT-WALL### 8 indicate 1 paradoxically 2 , 1 paradoxically 7 analyses 3 our 7 analyses 4 preliminary 6 data 5 charter 6 data 6 data 7 analyses 7 analyses 8 indicate 8 indicate 9 that 9 that 11 pgrn 9 that 12 levels 10 lower 11 pgrn 11 pgrn 12 levels 12 levels 13 in 12 levels 19 with 13 in 14 csf 14 csf 15 trended 15 trended 16 towards 16 towards 18 association 17 an 18 association 19 with 20 hand 20 hand 23 in 21 , 22 particularly 21 , 23 in 23 in 24 those 23 in 28 . 24 those 25 without 25 without 27 virus 26 detectable 27 virus based upon these findings , we introduce the hypothesis that pgrn plays dual roles in modulating antiviral immunity and neuronal dysfunction in the context of hiv infection . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 7 introduce 0 ###LEFT-WALL### 28 . 1 based 2 upon 1 based 5 , 1 based 6 we 2 upon 4 findings 3 these 4 findings 6 we 7 introduce 7 introduce 9 hypothesis 8 the 9 hypothesis 9 hypothesis 10 that 10 that 11 pgrn 10 that 12 plays 11 pgrn 12 plays 12 plays 14 roles 12 plays 15 in 12 plays 22 in 13 dual 14 roles 15 in 19 and 16 modulating 18 immunity 17 antiviral 18 immunity 18 immunity 19 and 19 and 21 dysfunction 20 neuronal 21 dysfunction 22 in 24 context 23 the 24 context 24 context 25 of 25 of 27 infection 26 hiv 27 infection in the presence of active viral replication [,] pgrn expression is increased functioning as an anti - viral factor as well as a neuroprotectant . 0 ###LEFT-WALL### 1 in 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 25 . 1 in 3 presence 1 in 11 is 2 the 3 presence 3 presence 4 of 4 of 10 expression 5 active 6 viral 6 viral 10 expression 7 replication 10 expression 9 pgrn 10 expression 11 is 13 functioning 12 increased 13 functioning 13 functioning 14 as 14 as 19 factor 15 an 16 anti 15 an 19 factor 16 anti 17 - 16 anti 19 factor 18 viral 19 factor 19 factor 22 as 20 as 21 well 21 well 22 as 22 as 24 neuroprotectant 23 a 24 neuroprotectant in the absence of active hiv [replication] , ongoing inflammation or other stressors suppress pgrn production from macrophages/microglia contributing to neurocognitive dysfunction . 0 ###LEFT-WALL### 11 or 0 ###LEFT-WALL### 14 suppress 0 ###LEFT-WALL### 23 . 1 in 3 absence 1 in 8 , 1 in 11 or 2 the 3 absence 3 absence 4 of 4 of 6 hiv 5 active 6 hiv 9 ongoing 10 inflammation 10 inflammation 11 or 11 or 13 stressors 11 or 14 suppress 12 other 13 stressors 14 suppress 16 production 14 suppress 17 from 15 pgrn 16 production 17 from 18 macrophages/microglia 18 macrophages/microglia 19 contributing 19 contributing 20 to 20 to 22 dysfunction 21 neurocognitive 22 dysfunction [we] [propose] [.] background : longitudinal associations between depressive symptoms and blood pressure have been inconsistent . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 4 associations 2 : 12 been 2 : 14 . 3 longitudinal 4 associations 4 associations 5 between 4 associations 11 have 5 between 8 and 6 depressive 7 symptoms 7 symptoms 8 and 8 and 10 pressure 9 blood 10 pressure 11 have 12 been 12 been 13 inconsistent most studies have examined [incident] [hypertension] as an outcome , and few have examined effect modification . 0 ###LEFT-WALL### 1 most 0 ###LEFT-WALL### 15 effect 0 ###LEFT-WALL### 17 . 1 most 2 studies 1 most 4 examined 1 most 15 effect 2 studies 3 have 3 have 4 examined 4 examined 7 as 7 as 14 examined 8 an 9 outcome 9 outcome 11 and 10 , 11 and 11 and 12 few 11 and 13 have 13 have 14 examined 15 effect 16 modification methods : this study examined moderating influences of sex and age on coincident trajectories of depressive symptoms and blood pressure among 2,087 participants from the baltimore longitudinal study of aging ( aged 19 - 97 years ; 53 % men ; 74 % white [ )( 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 - 0 ###LEFT-WALL### 46 )( 1 methods 2 : 2 : 4 study 2 : 12 on 2 : 21 among 3 this 4 study 4 study 5 examined 4 study 6 moderating 4 study 8 of 6 moderating 7 influences 8 of 10 and 9 sex 10 and 10 and 11 age 12 on 20 pressure 13 coincident 14 trajectories 14 trajectories 15 of 14 trajectories 18 and 15 of 17 symptoms 16 depressive 17 symptoms 18 and 19 blood 18 and 20 pressure 21 among 23 participants 22 2,087 23 participants 23 participants 24 from 23 participants 32 aged 24 from 28 study 25 the 28 study 26 baltimore 27 longitudinal 27 longitudinal 28 study 28 study 29 of 29 of 30 aging 31 ( 32 aged 32 aged 33 19 32 aged 34 - 34 - 36 years 34 - 37 ; 35 97 36 years 37 ; 40 men 37 ; 41 ; 38 53 39 % 39 % 40 men 41 ; 44 white 42 74 44 white 43 % 44 white ces [-] d was log - transformed ( ces - d [(] [log] ) ) for analyses . 0 ###LEFT-WALL### 1 ces 0 ###LEFT-WALL### 5 log 0 ###LEFT-WALL### 18 . 1 ces 3 d 1 ces 4 was 4 was 5 log 5 log 7 transformed 5 log 16 for 6 - 7 transformed 7 transformed 10 - 7 transformed 15 ) 8 ( 10 - 9 ces 10 - 10 - 11 d 10 - 14 ) 16 for 17 analyses results : mixed - effects regression revealed that prospective relations of ces [-] d ( log ) to diastolic blood pressure differed by age in women ( b = 0.095 [;] p = 0.001 ) but not men [;] greater ces [-] d ( log ) attenuated the expected age - related decline in diastolic blood pressure . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 10 relations 3 mixed 4 - 3 mixed 10 relations 4 - 7 revealed 5 effects 6 regression 6 regression 7 revealed 7 revealed 10 relations 8 that 9 prospective 9 prospective 10 relations 10 relations 11 of 10 relations 18 to 10 relations 22 differed 11 of 12 ces 12 ces 14 d 12 ces 16 log 15 ( 16 log 16 log 17 ) 18 to 21 pressure 19 diastolic 20 blood 20 blood 21 pressure 22 differed 23 by 23 by 24 age 24 age 25 in 24 age 36 but 25 in 26 women 26 women 29 = 26 women 33 = 27 ( 29 = 28 b 29 = 29 = 30 0.095 32 p 33 = 33 = 34 0.001 33 = 35 ) 36 but 37 not 36 but 38 men 38 men 41 ces 38 men 47 attenuated 40 greater 41 ces 41 ces 43 d 41 ces 45 log 41 ces 47 attenuated 44 ( 45 log 45 log 46 ) 47 attenuated 50 age 48 the 50 age 49 expected 50 age 50 age 53 decline 51 - 53 decline 52 related 53 decline 53 decline 54 in 53 decline 58 . 54 in 57 pressure 55 diastolic 57 pressure 56 blood 57 pressure across all testing sessions , greater ces - d [(] [log] ) was associated significantly with higher average systolic blood pressure for women ( b = 2.238 [;] p = 0.006 ) but not men . 0 ###LEFT-WALL### 3 testing 0 ###LEFT-WALL### 14 associated 0 ###LEFT-WALL### 36 . 1 across 2 all 1 across 3 testing 3 testing 4 sessions 3 testing 13 was 4 sessions 8 - 5 , 8 - 6 greater 7 ces 7 ces 8 - 8 - 9 d 8 - 12 ) 13 was 14 associated 14 associated 15 significantly 14 associated 16 with 16 with 20 blood 16 with 33 but 17 higher 20 blood 18 average 20 blood 19 systolic 20 blood 21 pressure 22 for 21 pressure 33 but 22 for 23 women 23 women 26 = 23 women 30 = 24 ( 26 = 25 b 26 = 26 = 27 2.238 29 p 30 = 30 = 31 0.006 30 = 32 ) 33 but 34 not 33 but 35 men age - stratified analyses showed that greater ces - d [(] [log] ) was associated significantly [with] higher average systolic ( b = 3.348 [;] p = 0.02 ) and diastolic ( b = 1.730 ; p < 0.03 [ )(blood pressure for older adults ( ≥58.8 years at first visit ) . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 15 associated 0 ###LEFT-WALL### 36 ; 0 ###LEFT-WALL### 38 < 0 ###LEFT-WALL### 53 . 1 age 9 - 1 age 14 was 2 - 9 - 3 stratified 4 analyses 4 analyses 5 showed 5 showed 8 ces 5 showed 9 - 6 that 8 ces 7 greater 8 ces 8 ces 9 - 9 - 10 d 9 - 13 ) 14 was 15 associated 15 associated 18 higher 15 associated 19 average 16 significantly 18 higher 19 average 30 and 20 systolic 23 = 20 systolic 30 and 21 ( 23 = 22 b 23 = 23 = 24 3.348 24 3.348 27 = 26 p 27 = 27 = 28 0.02 27 = 29 ) 30 and 31 diastolic 31 diastolic 34 = 32 ( 34 = 33 b 34 = 34 = 35 1.730 34 = 36 ; 36 ; 37 p 37 p 38 < 38 < 42 pressure 38 < 43 for 39 0.03 42 pressure 41 )(blood 42 pressure 43 for 45 adults 44 older 45 adults 45 adults 47 ≥58.8 46 ( 47 ≥58.8 47 ≥58.8 48 years 47 ≥58.8 51 visit 47 ≥58.8 52 ) 48 years 51 visit 49 at 50 first 50 first 51 visit conclusions : results demonstrate sex and age differences in the relation between depressive symptoms and blood pressure . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 2 : 3 results 2 : 6 and 3 results 6 and 4 demonstrate 5 sex 4 demonstrate 6 and 6 and 7 age 6 and 12 between 6 and 17 pressure 7 age 8 differences 7 age 9 in 9 in 11 relation 10 the 11 relation 12 between 15 and 13 depressive 14 symptoms 14 symptoms 15 and 15 and 16 blood findings suggest the potential importance of preventing , detecting , and lowering depressive symptoms to prevent hypertension among women and older adults . 0 ###LEFT-WALL### 1 findings 0 ###LEFT-WALL### 2 suggest 0 ###LEFT-WALL### 23 . 1 findings 2 suggest 2 suggest 17 hypertension 2 suggest 18 among 3 the 17 hypertension 4 potential 17 hypertension 5 importance 6 of 5 importance 8 , 6 of 7 preventing 8 , 9 detecting 8 , 11 and 10 , 11 and 11 and 14 symptoms 11 and 15 to 11 and 16 prevent 11 and 17 hypertension 12 lowering 14 symptoms 13 depressive 14 symptoms 15 to 16 prevent 18 among 20 and 19 women 20 and 20 and 22 adults 21 older 22 adults cardiovascular disease ( cvd ) , both clinical and subclinical , has been proposed as one of the mechanisms underlying frailty . 0 ###LEFT-WALL### 2 disease 0 ###LEFT-WALL### 14 proposed 0 ###LEFT-WALL### 22 . 1 cardiovascular 2 disease 2 disease 4 cvd 2 disease 9 and 2 disease 12 has 3 ( 4 cvd 4 cvd 5 ) 6 , 9 and 7 both 9 and 8 clinical 9 and 9 and 10 subclinical 9 and 11 , 12 has 13 been 13 been 14 proposed 14 proposed 15 as 15 as 16 one 16 one 17 of 17 of 19 mechanisms 18 the 19 mechanisms 19 mechanisms 20 underlying 20 underlying 21 frailty however , there is no evidence addressing the relationship between the earliest stage of cvd ( endothelial dysfunction ) and frailty . 0 ###LEFT-WALL### 3 there 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 22 . 1 however 2 , 1 however 3 there 3 there 4 is 4 is 6 evidence 5 no 6 evidence 6 evidence 7 addressing 7 addressing 9 relationship 7 addressing 10 between 8 the 9 relationship 10 between 13 stage 11 the 12 earliest 11 the 13 stage 13 stage 14 of 14 of 20 and 15 cvd 18 dysfunction 15 cvd 20 and 16 ( 18 dysfunction 17 endothelial 18 dysfunction 18 dysfunction 19 ) 20 and 21 frailty the goal of the study was to analyze the association between endothelial dysfunction , evaluated by asymmetric dimethylarginine ( adma ) levels , and frailty . 0 ###LEFT-WALL### 2 goal 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 26 . 1 the 2 goal 2 goal 3 of 2 goal 14 , 3 of 5 study 4 the 5 study 6 was 7 to 6 was 8 analyze 6 was 14 , 7 to 8 analyze 8 analyze 10 association 8 analyze 11 between 9 the 10 association 11 between 13 dysfunction 12 endothelial 13 dysfunction 14 , 15 evaluated 14 , 16 by 14 , 24 and 16 by 18 dimethylarginine 17 asymmetric 18 dimethylarginine 18 dimethylarginine 20 adma 19 ( 20 adma 20 adma 21 ) 22 levels 24 and 23 , 24 and 24 and 25 frailty we used data from the toledo study for healthy aging , a prospective spanish cohort study . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 used 0 ###LEFT-WALL### 11 , 0 ###LEFT-WALL### 17 . 1 we 2 used 2 used 3 data 2 used 4 from 4 from 7 study 5 the 7 study 6 toledo 7 study 7 study 8 for 8 for 10 aging 9 healthy 10 aging 11 , 16 study 12 a 13 prospective 12 a 16 study 13 prospective 15 cohort 14 spanish 15 cohort 15 cohort 16 study biological samples were obtained and adma levels [were] determined using an enzyme immunoassay method . 0 ###LEFT-WALL### 2 samples 0 ###LEFT-WALL### 4 obtained 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 15 . 1 biological 2 samples 2 samples 3 were 3 were 4 obtained 5 and 7 levels 5 and 13 immunoassay 6 adma 7 levels 7 levels 9 determined 7 levels 13 immunoassay 9 determined 10 using 10 using 12 enzyme 11 an 12 enzyme 13 immunoassay 14 method logistic regression was used to estimate the odds ratio ( or ) and 95 % confidence intervals of frailty associated with adma . 0 ###LEFT-WALL### 2 regression 0 ###LEFT-WALL### 4 used 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 . 1 logistic 2 regression 2 regression 3 was 3 was 4 used 4 used 5 to 4 used 6 estimate 5 to 6 estimate 6 estimate 9 ratio 7 the 9 ratio 8 odds 9 ratio 9 ratio 11 or 10 ( 11 or 11 or 12 ) 13 and 17 intervals 13 and 20 associated 14 95 17 intervals 15 % 16 confidence 16 confidence 17 intervals 17 intervals 18 of 17 intervals 20 associated 18 of 19 frailty 20 associated 21 with 21 with 22 adma adjustments were made for age , gender , cardiovascular risk factors , and presence of atherosclerotic disease ( assessed by ankle [–] brachial index [;] abi ) . 0 ###LEFT-WALL### 1 adjustments 0 ###LEFT-WALL### 3 made 0 ###LEFT-WALL### 28 . 1 adjustments 2 were 2 were 3 made 3 made 4 for 4 for 13 and 5 age 6 , 6 , 7 gender 6 , 8 , 8 , 11 factors 8 , 13 and 9 cardiovascular 11 factors 10 risk 11 factors 12 , 13 and 13 and 14 presence 13 and 15 of 15 of 17 disease 16 atherosclerotic 17 disease 17 disease 19 assessed 18 ( 19 assessed 19 assessed 20 by 19 assessed 27 ) 20 by 26 abi 21 ankle 26 abi 23 brachial 24 index 24 index 26 abi one thousand [two] hundred eighty - seven [community] - [dwelling] [elderly] were included . 0 ###LEFT-WALL### 5 eighty 0 ###LEFT-WALL### 13 included 0 ###LEFT-WALL### 14 . 1 one 2 thousand 2 thousand 4 hundred 4 hundred 5 eighty 5 eighty 7 seven 5 eighty 12 were 6 - 7 seven 7 seven 9 - 12 were 13 included one hundred seven ( 8.3 % ) were [identified] as frail , 542 ( 42.1 % ) [as] pre [-] frail , [and] 638 ( 49.6 % ) [as] [non] - [frail] . 0 ###LEFT-WALL### 3 seven 0 ###LEFT-WALL### 8 were 0 ###LEFT-WALL### 33 . 1 one 2 hundred 2 hundred 3 seven 3 seven 6 % 3 seven 8 were 4 ( 6 % 5 8.3 6 % 6 % 7 ) 8 were 10 as 10 as 19 pre 11 frail 13 542 11 frail 19 pre 12 , 13 542 13 542 16 % 13 542 17 ) 14 ( 16 % 15 42.1 16 % 16 % 17 ) 19 pre 21 frail 19 pre 24 638 22 , 24 638 24 638 27 % 24 638 31 - 25 ( 27 % 26 49.6 27 % 27 % 28 ) admavalues were higher in frail subjects than in [non] - frail ones . 0 ###LEFT-WALL### 1 admavalues 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 13 . 1 admavalues 2 were 2 were 3 higher 3 higher 4 in 3 higher 7 than 4 in 6 subjects 5 frail 6 subjects 7 than 8 in 10 - 12 ones 11 frail 12 ones in addition , an interaction between the presence of atherosclerotic disease and adma on the odds of frailty ( p=0.045 ) was detected . 0 ###LEFT-WALL### 5 interaction 0 ###LEFT-WALL### 23 detected 0 ###LEFT-WALL### 24 . 1 in 2 addition 1 in 3 , 1 in 5 interaction 4 an 5 interaction 5 interaction 6 between 5 interaction 9 of 5 interaction 22 was 6 between 8 presence 7 the 8 presence 9 of 12 and 10 atherosclerotic 11 disease 11 disease 12 and 12 and 13 adma 12 and 14 on 14 on 16 odds 15 the 16 odds 16 odds 17 of 16 odds 20 p=0.045 17 of 18 frailty 19 ( 20 p=0.045 20 p=0.045 21 ) 22 was 23 detected after adjustments for age , classical cardiovascular risk factors , and abi , the risk of frailty was associated with increasing levels of adma in subjects without atherosclerotic disease [ or for 1 standard deviation increase in adma=1.14 ( 1.01 – 1.28 ) , p=0.032 ] but not in those with atherosclerotic disease . 0 ###LEFT-WALL### 15 risk 0 ###LEFT-WALL### 19 associated 0 ###LEFT-WALL### 54 . 1 after 2 adjustments 1 after 15 risk 3 for 11 and 3 for 13 , 3 for 15 risk 4 age 5 , 5 , 9 factors 5 , 11 and 6 classical 9 factors 7 cardiovascular 9 factors 8 risk 9 factors 10 , 11 and 11 and 12 abi 11 and 13 , 14 the 15 risk 15 risk 16 of 15 risk 18 was 16 of 17 frailty 18 was 19 associated 19 associated 20 with 19 associated 49 in 20 with 21 increasing 21 increasing 22 levels 21 increasing 25 in 21 increasing 27 without 21 increasing 47 but 22 levels 23 of 23 of 24 adma 25 in 26 subjects 27 without 29 disease 28 atherosclerotic 29 disease 29 disease 31 or 30 [ 31 or 31 or 32 for 31 or 37 in 31 or 46 ] 32 for 36 increase 33 1 36 increase 34 standard 36 increase 35 deviation 36 increase 37 in 38 adma=1.14 38 adma=1.14 40 1.01 39 ( 40 1.01 40 1.01 42 1.28 40 1.01 45 p=0.032 40 1.01 46 ] 41 – 42 1.28 42 1.28 43 ) 44 , 45 p=0.032 45 p=0.032 46 ] 47 but 48 not 49 in 50 those 50 those 51 with 51 with 53 disease 52 atherosclerotic 53 disease in our study , endothelial dysfunction , assessed by adma levels , is associated with frailty . 0 ###LEFT-WALL### 6 dysfunction 0 ###LEFT-WALL### 14 associated 0 ###LEFT-WALL### 17 . 1 in 3 study 1 in 4 , 1 in 6 dysfunction 2 our 3 study 5 endothelial 6 dysfunction 6 dysfunction 8 assessed 6 dysfunction 13 is 7 , 8 assessed 8 assessed 9 by 8 assessed 12 , 9 by 11 levels 10 adma 11 levels 13 is 14 associated 14 associated 15 with 15 with 16 frailty these findings provide additional support for a relevant role [of] vascular system since its earliest stage in frailty . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 19 . 1 these 2 findings 2 findings 3 provide 3 provide 5 support 3 provide 13 since 3 provide 17 in 4 additional 5 support 5 support 6 for 6 for 12 system 7 a 8 relevant 7 a 12 system 8 relevant 9 role 9 role 12 system 11 vascular 12 system 13 since 16 stage 14 its 15 earliest 14 its 16 stage 17 in 18 frailty purpose : the incremental shuttle walk test ( iswt ) is an important functional and prognostic marker in chronic disease . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 2 : 9 iswt 2 : 11 is 2 : 21 . 3 the 9 iswt 4 incremental 5 shuttle 5 shuttle 6 walk 6 walk 7 test 7 test 9 iswt 8 ( 9 iswt 9 iswt 10 ) 9 iswt 11 is 11 is 17 marker 12 an 13 important 12 an 17 marker 13 important 17 marker 14 functional 15 and 15 and 16 prognostic 15 and 17 marker 17 marker 18 in 18 in 20 disease 19 chronic 20 disease aging has a detrimental effect on exercise performance . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 2 has 0 ###LEFT-WALL### 9 . 1 aging 2 has 2 has 5 effect 2 has 6 on 3 a 4 detrimental 3 a 5 effect 4 detrimental 5 effect 6 on 8 performance 7 exercise 8 performance the objective of this study was to produce normal [age] - specific values for the iswt in a healthy british population and to explore whether additional variables improve the accuracy of a predictive equation . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 35 . 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 22 and 7 to 22 and 8 produce 13 values 8 produce 22 and 9 normal 11 - 9 normal 13 values 12 specific 13 values 13 values 14 for 13 values 17 in 14 for 16 iswt 15 the 16 iswt 17 in 21 population 18 a 21 population 19 healthy 20 british 20 british 21 population 22 and 23 to 22 and 24 explore 22 and 25 whether 23 to 24 explore 25 whether 27 variables 25 whether 28 improve 26 additional 27 variables 27 variables 28 improve 28 improve 30 accuracy 29 the 30 accuracy 30 accuracy 31 of 31 of 34 equation 32 a 33 predictive 32 a 34 equation 33 predictive 34 equation methods : healthy subjects ( n = 152 ) , aged 40 to 90 years , were recruited . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 19 . 1 methods 2 : 2 : 4 subjects 3 healthy 4 subjects 4 subjects 7 = 5 ( 7 = 6 n 7 = 7 = 8 152 7 = 9 ) 10 , 16 , 11 aged 15 years 11 aged 16 , 12 40 13 to 13 to 14 90 13 to 15 years 16 , 17 were 17 were 18 recruited data [collection] occurred over 2 study visits . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 3 occurred 0 ###LEFT-WALL### 8 . 1 data 3 occurred 3 occurred 4 over 4 over 7 visits 5 2 7 visits 6 study 7 visits anthropometric and demographic data were collected , and lung function and quadriceps maximal voluntary contraction were measured . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 17 measured 0 ###LEFT-WALL### 18 . 1 anthropometric 2 and 2 and 4 data 2 and 11 and 2 and 16 were 3 demographic 4 data 5 were 8 and 5 were 11 and 6 collected 8 and 7 , 8 and 8 and 10 function 9 lung 10 function 11 and 12 quadriceps 12 quadriceps 15 contraction 13 maximal 14 voluntary 14 voluntary 15 contraction 16 were 17 measured an accelerometer was worn for 2 consecutive days at home . 0 ###LEFT-WALL### 2 accelerometer 0 ###LEFT-WALL### 4 worn 0 ###LEFT-WALL### 11 . 1 an 2 accelerometer 2 accelerometer 3 was 3 was 4 worn 4 worn 5 for 4 worn 9 at 5 for 8 days 6 2 8 days 7 consecutive 8 days 9 at 10 home the duke activity status index was completed , and the greatest distance from 2 iswts was recorded . 0 ###LEFT-WALL### 5 index 0 ###LEFT-WALL### 7 completed 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 18 . 1 the 5 index 2 duke 3 activity 3 activity 4 status 4 status 5 index 5 index 6 was 6 was 7 completed 8 , 9 and 9 and 12 distance 9 and 17 recorded 10 the 11 greatest 10 the 12 distance 12 distance 13 from 12 distance 16 was 13 from 15 iswts 14 2 15 iswts 16 was 17 recorded results : one hundred forty subjects ( 56 men [ )(with mean age ( sd ) of 59.4 ( 11.0 ) years completed 2 iswts . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 1 results 2 : 2 : 6 subjects 3 one 4 hundred 4 hundred 5 forty 5 forty 6 subjects 6 subjects 9 men 7 ( 9 men 8 56 9 men 9 men 11 )(with 9 men 17 of 9 men 22 years 9 men 23 completed 9 men 26 . 11 )(with 13 age 12 mean 13 age 13 age 15 sd 14 ( 15 sd 15 sd 16 ) 17 of 18 59.4 18 59.4 20 11.0 19 ( 20 11.0 20 11.0 21 ) 22 years 23 completed 23 completed 25 iswts 24 2 25 iswts forced expiratory volume in 1 second ( fev ( 1 ) ) was 109.1 % ( 14.56 % ) predicted and iswt [distance] was 737 [m] ( 183 m ) . 0 ###LEFT-WALL### 3 volume 0 ###LEFT-WALL### 13 was 0 ###LEFT-WALL### 20 predicted 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 31 . 1 forced 3 volume 2 expiratory 3 volume 3 volume 4 in 3 volume 13 was 4 in 6 second 5 1 6 second 6 second 8 fev 7 ( 8 fev 8 fev 10 1 8 fev 12 ) 9 ( 10 1 10 1 11 ) 14 109.1 15 % 15 % 18 % 15 % 20 predicted 16 ( 18 % 17 14.56 18 % 18 % 19 ) 21 and 22 iswt 21 and 24 was 22 iswt 24 was 24 was 25 737 25 737 29 m 27 ( 29 m 28 183 29 m 29 m 30 ) a predictive equation was developed from 114 subjects . 0 ###LEFT-WALL### 3 equation 0 ###LEFT-WALL### 5 developed 0 ###LEFT-WALL### 9 . 1 a 2 predictive 1 a 3 equation 2 predictive 3 equation 3 equation 4 was 4 was 5 developed 5 developed 6 from 6 from 8 subjects 7 114 8 subjects age , body mass index , fev ( 1 ) , quadriceps maximal voluntary contraction , and duke activity status index contributed to iswt distance predicting 50.4 % of the variation in performance . 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 22 contributed 0 ###LEFT-WALL### 34 . 1 age 2 , 2 , 5 index 2 , 6 , 3 body 5 index 4 mass 5 index 6 , 7 fev 6 , 11 , 7 fev 9 1 8 ( 9 1 9 1 10 ) 11 , 15 contraction 11 , 17 and 12 quadriceps 15 contraction 13 maximal 14 voluntary 14 voluntary 15 contraction 16 , 17 and 17 and 21 index 17 and 22 contributed 18 duke 19 activity 19 activity 20 status 20 status 21 index 22 contributed 23 to 22 contributed 28 % 22 contributed 32 in 23 to 26 predicting 24 iswt 26 predicting 25 distance 26 predicting 27 50.4 28 % 28 % 29 of 29 of 31 variation 30 the 31 variation 32 in 33 performance conclusion : we have developed age - specific normal values for performance on the iswt in a healthy british population . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 3 we 2 : 5 developed 2 : 7 - 3 we 4 have 4 have 5 developed 5 developed 6 age 7 - 10 values 8 specific 10 values 9 normal 10 values 10 values 11 for 10 values 13 on 11 for 12 performance 13 on 15 iswt 14 the 15 iswt 15 iswt 16 in 16 in 20 population 17 a 18 healthy 17 a 20 population 18 healthy 20 population 19 british 20 population however , even using practical , clinically relevant variables , it is not possible to accurately predict exercise capacity from a regression equation . 0 ###LEFT-WALL### 11 it 0 ###LEFT-WALL### 17 predict 0 ###LEFT-WALL### 24 . 1 however 2 , 1 however 11 it 2 , 3 even 3 even 4 using 3 even 10 , 3 even 11 it 4 using 9 variables 5 practical 6 , 5 practical 9 variables 7 clinically 8 relevant 8 relevant 9 variables 11 it 12 is 12 is 13 not 12 is 14 possible 13 not 14 possible 14 possible 15 to 14 possible 17 predict 15 to 17 predict 16 accurately 17 predict 17 predict 19 capacity 17 predict 20 from 18 exercise 19 capacity 20 from 23 equation 21 a 22 regression 21 a 23 equation 22 regression 23 equation most previous neuroimaging studies of age - related brain structural changes in older individuals have been cross - sectional [and/or] restricted [to] clinical samples . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 17 cross 0 ###LEFT-WALL### 18 - 1 most 4 studies 2 previous 4 studies 3 neuroimaging 4 studies 4 studies 5 of 4 studies 15 have 5 of 6 age 7 - 8 related 8 related 11 changes 8 related 12 in 8 related 15 have 9 brain 11 changes 10 structural 11 changes 12 in 14 individuals 13 older 14 individuals 15 have 16 been 16 been 17 cross 18 - 24 samples 18 - 25 . 19 sectional 24 samples 21 restricted 24 samples 23 clinical 24 samples the present study [of] 345 community - dwelling [non] - demented individuals aged 70 - 90 years aimed to examine age - related brain volumetric changes over two years . 0 ###LEFT-WALL### 6 community 0 ###LEFT-WALL### 23 related 0 ###LEFT-WALL### 30 . 1 the 6 community 2 present 3 study 3 study 6 community 5 345 6 community 6 community 8 dwelling 6 community 12 individuals 6 community 23 related 7 - 8 dwelling 8 dwelling 10 - 10 - 12 individuals 11 demented 12 individuals 12 individuals 13 aged 12 individuals 22 - 13 aged 15 - 14 70 15 - 15 - 16 90 16 90 17 years 17 years 18 aimed 18 aimed 19 to 19 to 20 examine 20 examine 21 age 23 related 26 changes 23 related 27 over 24 brain 26 changes 25 volumetric 26 changes 27 over 29 years 28 two 29 years t1 - weighted magnetic resonance imaging scans were obtained at baseline and at 2 - [year] follow - up and analyzed using the fmrib software library and freesurfer to investigate cortical thickness and shape and volumetric changes of subcortical structures . 0 ###LEFT-WALL### 1 t1 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 41 . 2 - 5 resonance 2 - 9 obtained 2 - 15 - 3 weighted 5 resonance 4 magnetic 5 resonance 5 resonance 6 imaging 5 resonance 7 scans 5 resonance 8 were 6 imaging 7 scans 8 were 9 obtained 9 obtained 12 and 10 at 11 baseline 10 at 12 and 12 and 13 at 13 at 14 2 15 - 17 follow 15 - 18 - 18 - 20 and 19 up 20 and 20 and 37 changes 21 analyzed 37 changes 22 using 37 changes 23 the 26 library 24 fmrib 25 software 25 software 26 library 26 library 27 and 27 and 28 freesurfer 27 and 29 to 27 and 34 shape 27 and 35 and 29 to 33 and 30 investigate 32 thickness 30 investigate 33 and 31 cortical 32 thickness 33 and 34 shape 35 and 36 volumetric 35 and 37 changes 37 changes 38 of 38 of 40 structures 39 subcortical 40 structures the results showed significant atrophy across much of the cerebral cortex with bilateral transverse temporal regions shrinking the fastest . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 20 . 1 the 2 results 2 results 3 showed 3 showed 5 atrophy 3 showed 6 across 3 showed 12 with 4 significant 5 atrophy 6 across 7 much 7 much 8 of 8 of 11 cortex 9 the 11 cortex 10 cerebral 11 cortex 12 with 16 regions 13 bilateral 16 regions 14 transverse 16 regions 15 temporal 16 regions 16 regions 17 shrinking 17 shrinking 19 fastest 18 the 19 fastest atrophy was also found in a number of subcortical structures , including the ca1 and subiculum subfields of the hippocampus . 0 ###LEFT-WALL### 1 atrophy 0 ###LEFT-WALL### 4 found 1 atrophy 2 was 2 was 4 found 3 also 4 found 4 found 5 in 5 in 10 structures 6 a 7 number 7 number 8 of 7 number 10 structures 8 of 10 structures 9 subcortical 10 structures 10 structures 12 including 11 , 12 including 12 including 15 and 12 including 21 . 13 the 15 and 14 ca1 15 and 15 and 17 subfields 15 and 18 of 16 subiculum 17 subfields 18 of 20 hippocampus 19 the 20 hippocampus in some regions , such as left and right entorhinal cortices , right hippocampus and right precentral area , the rate of atrophy increased with age . 0 ###LEFT-WALL### 3 regions 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 27 . 1 in 2 some 1 in 3 regions 3 regions 6 as 3 regions 15 and 4 , 6 as 5 such 6 as 6 as 11 cortices 6 as 12 , 7 left 8 and 8 and 9 right 8 and 11 cortices 10 entorhinal 11 cortices 13 right 14 hippocampus 13 right 15 and 15 and 16 right 16 right 18 area 17 precentral 18 area 19 , 21 rate 19 , 24 increased 20 the 21 rate 21 rate 22 of 21 rate 24 increased 22 of 23 atrophy 24 increased 25 with 25 with 26 age our analysis also showed that rostral middle frontal regions were thicker bilaterally in older participants , which may indicate its ability to compensate for medial temporal lobe atrophy . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 16 , 0 ###LEFT-WALL### 29 . 1 our 2 analysis 2 analysis 4 showed 3 also 4 showed 4 showed 9 regions 4 showed 10 were 5 that 6 rostral 6 rostral 7 middle 7 middle 9 regions 8 frontal 9 regions 9 regions 10 were 10 were 11 thicker 11 thicker 12 bilaterally 11 thicker 13 in 13 in 15 participants 14 older 15 participants 16 , 17 which 16 , 19 indicate 17 which 18 may 18 may 19 indicate 19 indicate 21 ability 20 its 21 ability 21 ability 22 to 21 ability 23 compensate 22 to 23 compensate 23 compensate 24 for 24 for 28 atrophy 25 medial 27 lobe 26 temporal 27 lobe 27 lobe 28 atrophy compared to men , women had thicker cortical regions but greater rates of cortical atrophy . 0 ###LEFT-WALL### 5 women 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 16 . 1 compared 2 to 1 compared 4 , 1 compared 5 women 2 to 3 men 5 women 6 had 6 had 12 rates 7 thicker 9 regions 8 cortical 9 regions 9 regions 10 but 10 but 11 greater 10 but 12 rates 12 rates 13 of 13 of 15 atrophy 14 cortical 15 atrophy women also had smaller subcortical structures . 0 ###LEFT-WALL### 1 women 0 ###LEFT-WALL### 3 had 0 ###LEFT-WALL### 7 . 1 women 3 had 2 also 3 had 3 had 6 structures 4 smaller 6 structures 5 subcortical 6 structures a longer period of education was associated with greater thickness in a number of cortical regions . 0 ###LEFT-WALL### 3 period 0 ###LEFT-WALL### 7 associated 0 ###LEFT-WALL### 17 . 1 a 3 period 2 longer 3 period 3 period 4 of 3 period 6 was 4 of 5 education 6 was 7 associated 7 associated 8 with 7 associated 11 in 8 with 10 thickness 9 greater 10 thickness 11 in 16 regions 12 a 13 number 13 number 14 of 13 number 16 regions 14 of 16 regions 15 cortical 16 regions our results suggest a pattern of brain atrophy with [non] [-] demented people that resembles a less extreme form of the changes associated with alzheimer 's disease ( ad ) . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 31 . 1 our 2 results 2 results 3 suggest 3 suggest 5 pattern 3 suggest 23 associated 4 a 5 pattern 5 pattern 6 of 5 pattern 14 that 5 pattern 15 resembles 5 pattern 23 associated 6 of 8 atrophy 7 brain 8 atrophy 8 atrophy 9 with 9 with 13 people 12 demented 13 people 14 that 15 resembles 15 resembles 19 form 16 a 19 form 17 less 18 extreme 18 extreme 19 form 19 form 20 of 20 of 22 changes 21 the 22 changes 23 associated 24 with 24 with 27 disease 25 alzheimer 26 's 26 's 27 disease 27 disease 29 ad 28 ( 29 ad 29 ad 30 ) the uncinate fasciculus is a major white matter tract that provides a crucial link between areas of the human brain that underlie emotion processing and regulation . 0 ###LEFT-WALL### 3 fasciculus 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 27 . 1 the 3 fasciculus 2 uncinate 3 fasciculus 3 fasciculus 4 is 4 is 9 tract 4 is 15 between 5 a 6 major 5 a 9 tract 6 major 7 white 7 white 9 tract 8 matter 9 tract 9 tract 10 that 9 tract 11 provides 10 that 11 provides 11 provides 14 link 12 a 13 crucial 12 a 14 link 13 crucial 14 link 15 between 16 areas 16 areas 17 of 16 areas 21 that 16 areas 22 underlie 17 of 20 brain 18 the 20 brain 19 human 20 brain 21 that 22 underlie 22 underlie 25 and 23 emotion 24 processing 24 processing 25 and 25 and 26 regulation specifically , the uncinate fasciculus is the major direct fiber tract that connects the prefrontal cortex and the amygdala . 0 ###LEFT-WALL### 5 fasciculus 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 20 . 1 specifically 2 , 1 specifically 5 fasciculus 3 the 5 fasciculus 4 uncinate 5 fasciculus 5 fasciculus 6 is 6 is 11 tract 7 the 11 tract 8 major 10 fiber 9 direct 10 fiber 10 fiber 11 tract 11 tract 12 that 11 tract 13 connects 12 that 13 connects 13 connects 17 and 14 the 16 cortex 15 prefrontal 16 cortex 16 cortex 17 and 17 and 19 amygdala 18 the 19 amygdala the aim of the present study was to use a multi - modal imaging approach in order to simultaneously examine the relation between structural connectivity of the uncinate fasciculus and functional activation of the amygdala in a youth sample ( children and adolescents ) . 0 ###LEFT-WALL### 30 and 0 ###LEFT-WALL### 45 . 1 the 2 aim 2 aim 3 of 2 aim 30 and 3 of 5 present 4 the 5 present 5 present 6 study 5 present 20 examine 6 study 7 was 7 was 8 to 7 was 20 examine 8 to 9 use 9 use 15 approach 10 a 11 multi 10 a 15 approach 11 multi 12 - 11 multi 15 approach 13 modal 15 approach 14 imaging 15 approach 15 approach 16 in 16 in 17 order 18 to 20 examine 19 simultaneously 20 examine 20 examine 22 relation 21 the 22 relation 22 relation 23 between 22 relation 26 of 23 between 25 connectivity 24 structural 25 connectivity 26 of 29 fasciculus 27 the 29 fasciculus 28 uncinate 29 fasciculus 30 and 32 activation 30 and 33 of 30 and 36 in 31 functional 32 activation 33 of 35 amygdala 34 the 35 amygdala 36 in 39 sample 37 a 38 youth 37 a 39 sample 38 youth 39 sample 39 sample 42 and 40 ( 42 and 41 children 42 and 42 and 43 adolescents 42 and 44 ) participants were 9 to 19 years old and underwent diffusion tensor imaging ( dti ) and functional magnetic resonance imaging ( fmri ) . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 24 . 1 participants 8 and 1 participants 16 and 2 were 7 old 2 were 8 and 3 9 4 to 4 to 5 19 4 to 6 years 6 years 7 old 8 and 9 underwent 8 and 12 imaging 9 underwent 10 diffusion 11 tensor 12 imaging 12 imaging 14 dti 13 ( 14 dti 14 dti 15 ) 16 and 20 imaging 16 and 22 fmri 17 functional 19 resonance 18 magnetic 19 resonance 19 resonance 20 imaging 21 ( 22 fmri 22 fmri 23 ) results indicate that greater structural connectivity of the uncinate fasciculus predicts reduced amygdala activation to sad and happy faces . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 indicate 0 ###LEFT-WALL### 20 . 1 results 2 indicate 2 indicate 3 that 3 that 6 connectivity 3 that 11 predicts 4 greater 6 connectivity 5 structural 6 connectivity 6 connectivity 7 of 6 connectivity 11 predicts 7 of 10 fasciculus 8 the 10 fasciculus 9 uncinate 10 fasciculus 11 predicts 14 activation 12 reduced 14 activation 13 amygdala 14 activation 14 activation 15 to 15 to 19 faces 16 sad 17 and 17 and 18 happy 17 and 19 faces this effect is moderated by age , with younger participants exhibiting a stronger relation . 0 ###LEFT-WALL### 2 effect 0 ###LEFT-WALL### 4 moderated 1 this 2 effect 2 effect 3 is 3 is 4 moderated 4 moderated 5 by 5 by 6 age 6 age 8 with 7 , 8 with 8 with 10 participants 8 with 15 . 9 younger 10 participants 10 participants 11 exhibiting 11 exhibiting 14 relation 12 a 14 relation 13 stronger 14 relation further , decreased amygdala activation to sad faces predicts lower internalizing symptoms . 0 ###LEFT-WALL### 5 activation 0 ###LEFT-WALL### 9 predicts 0 ###LEFT-WALL### 13 . 1 further 2 , 1 further 5 activation 3 decreased 5 activation 4 amygdala 5 activation 5 activation 6 to 5 activation 9 predicts 6 to 8 faces 7 sad 8 faces 9 predicts 12 symptoms 10 lower 12 symptoms 11 internalizing 12 symptoms these results provide important insights into brain structure - function relationships during adolescence , and suggest that greater structural connectivity of the uncinate fasciculus may facilitate regulation of the amygdala , particularly during early adolescence . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 15 and 1 these 2 results 2 results 15 and 3 provide 5 insights 3 provide 6 into 3 provide 15 and 4 important 5 insights 6 into 8 structure 7 brain 8 structure 8 structure 11 relationships 9 - 11 relationships 10 function 11 relationships 11 relationships 12 during 11 relationships 14 , 12 during 13 adolescence 14 , 15 and 15 and 16 suggest 16 suggest 17 that 17 that 20 connectivity 17 that 26 facilitate 18 greater 20 connectivity 19 structural 20 connectivity 20 connectivity 21 of 20 connectivity 25 may 21 of 24 fasciculus 22 the 24 fasciculus 23 uncinate 24 fasciculus 25 may 26 facilitate 26 facilitate 27 regulation 27 regulation 28 of 28 of 30 amygdala 29 the 30 amygdala 30 amygdala 33 during 31 , 32 particularly 31 , 33 during 33 during 35 adolescence 33 during 36 . 34 early 35 adolescence these findings also have implications for understanding the relation between brain structure , function , and the development of emotion regulation difficulties , such as internalizing symptoms . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 have 1 these 2 findings 2 findings 4 have 3 also 4 have 4 have 5 implications 4 have 10 between 5 implications 6 for 6 for 7 understanding 7 understanding 9 relation 8 the 9 relation 10 between 16 and 11 brain 12 structure 12 structure 13 , 13 , 14 function 13 , 16 and 15 , 16 and 16 and 18 development 16 and 19 of 17 the 18 development 19 of 22 difficulties 20 emotion 22 difficulties 21 regulation 22 difficulties 22 difficulties 25 as 23 , 25 as 24 such 25 as 25 as 27 symptoms 25 as 28 . 26 internalizing 27 symptoms background : unfavorable living conditions in old age have negative physical , psychological and social implications and increase the risk of institutionalization . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 conditions 2 : 17 and 2 : 23 . 3 unfavorable 4 living 4 living 5 conditions 5 conditions 6 in 5 conditions 17 and 6 in 8 age 7 old 8 age 9 have 16 implications 9 have 17 and 10 negative 16 implications 11 physical 12 , 11 physical 16 implications 13 psychological 14 and 14 and 15 social 14 and 16 implications 17 and 18 increase 18 increase 20 risk 19 the 20 risk 20 risk 21 of 21 of 22 institutionalization the aim of this study is to examine older adults ’ readiness to relocate to age - appropriate housing versus the wish to stay where they are . 0 ###LEFT-WALL### 2 aim 0 ###LEFT-WALL### 14 relocate 0 ###LEFT-WALL### 17 - 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 examine 7 to 8 examine 8 examine 12 readiness 8 examine 13 to 9 older 10 adults 10 adults 11 ’ 11 ’ 12 readiness 13 to 14 relocate 14 relocate 15 to 15 to 16 age 17 - 18 appropriate 17 - 28 . 18 appropriate 19 housing 18 appropriate 23 to 18 appropriate 25 where 19 housing 20 versus 20 versus 22 wish 21 the 22 wish 23 to 24 stay 25 where 26 they 25 where 27 are 26 they 27 are methods : a total of 103 older men and women were questioned prospectively , face - to [-] face , regarding their readiness to relocate . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 9 and 2 : 14 , 3 a 4 total 4 total 5 of 4 total 9 and 5 of 8 men 6 103 8 men 7 older 8 men 9 and 10 women 9 and 14 , 11 were 12 questioned 11 were 14 , 12 questioned 13 prospectively 14 , 15 face 15 face 17 to 15 face 21 regarding 16 - 17 to 17 to 19 face 17 to 20 , 20 , 21 regarding 21 regarding 23 readiness 21 regarding 26 . 22 their 23 readiness 23 readiness 24 to 23 readiness 25 relocate 24 to 25 relocate in addition to assessing several established predictors of residential mobility , data on objective living situations were collected . 0 ###LEFT-WALL### 12 data 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 19 . 1 in 2 addition 1 in 11 , 1 in 12 data 2 addition 3 to 2 addition 8 of 3 to 4 assessing 4 assessing 7 predictors 5 several 7 predictors 6 established 7 predictors 8 of 10 mobility 9 residential 10 mobility 12 data 13 on 12 data 17 were 13 on 16 situations 14 objective 15 living 15 living 16 situations 17 were 18 collected the data were subjected to bi - and multivariate analysis . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 4 subjected 0 ###LEFT-WALL### 11 . 1 the 2 data 2 data 3 were 3 were 4 subjected 4 subjected 5 to 5 to 8 and 6 bi 8 and 7 - 8 and 8 and 10 analysis 9 multivariate 10 analysis results : at 70.9 % , the proportion of respondents who are not willing to move ( stayers ) [far] exceeds the proportion of those who are ( movers , 29.1 % ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 34 . 1 results 2 : 2 : 3 at 3 at 5 % 4 70.9 5 % 6 , 8 proportion 6 , 21 exceeds 7 the 8 proportion 8 proportion 9 of 8 proportion 21 exceeds 9 of 10 respondents 10 respondents 11 who 10 respondents 12 are 10 respondents 18 stayers 11 who 12 are 12 are 13 not 12 are 14 willing 13 not 14 willing 14 willing 15 to 15 to 16 move 17 ( 18 stayers 18 stayers 19 ) 21 exceeds 23 proportion 22 the 23 proportion 23 proportion 24 of 23 proportion 32 % 24 of 25 those 25 those 26 who 25 those 27 are 25 those 29 movers 26 who 27 are 28 ( 29 movers 29 movers 30 , 30 , 32 % 31 29.1 32 % 32 % 33 ) older respondents are more satisfied with their living situation and less likely to move . 0 ###LEFT-WALL### 2 respondents 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 15 . 1 older 2 respondents 2 respondents 3 are 3 are 4 more 3 are 10 and 5 satisfied 6 with 5 satisfied 10 and 6 with 9 situation 7 their 9 situation 8 living 9 situation 10 and 12 likely 11 less 12 likely 12 likely 13 to 12 likely 14 move 13 to 14 move this study provides empirical evidence for the " satisfaction paradox " with respect to living conditions and for the importance of the subjective standard of living for quality of life in old age . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 provides 0 ###LEFT-WALL### 34 . 1 this 2 study 2 study 3 provides 3 provides 5 evidence 4 empirical 5 evidence 5 evidence 6 for 6 for 10 paradox 7 the 8 " 7 the 10 paradox 9 satisfaction 10 paradox 10 paradox 11 " 10 paradox 12 with 10 paradox 25 of 12 with 13 respect 13 respect 17 and 13 respect 21 of 14 to 16 conditions 14 to 17 and 15 living 16 conditions 17 and 18 for 18 for 20 importance 19 the 20 importance 21 of 24 standard 22 the 24 standard 23 subjective 24 standard 25 of 26 living 26 living 27 for 26 living 31 in 27 for 28 quality 28 quality 29 of 29 of 30 life 31 in 33 age 32 old 33 age conclusion : modern housing counseling should more strongly reflect the variety of needs , requirements and living situations of older people today than it has done in the past . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 9 reflect 0 ###LEFT-WALL### 30 . 1 conclusion 2 : 2 : 3 modern 3 modern 5 counseling 3 modern 9 reflect 4 housing 5 counseling 5 counseling 6 should 6 should 9 reflect 7 more 8 strongly 8 strongly 9 reflect 9 reflect 11 variety 9 reflect 23 than 10 the 11 variety 11 variety 12 of 11 variety 22 today 12 of 16 and 13 needs 14 , 14 , 15 requirements 14 , 16 and 16 and 18 situations 16 and 19 of 17 living 18 situations 19 of 21 people 20 older 21 people 23 than 24 it 23 than 26 done 23 than 27 in 24 it 25 has 25 has 26 done 27 in 29 past 28 the 29 past it is therefore recommended that the [currently] dominating paradigm of " aging in place " be critically [re] - evaluated . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 4 recommended 1 it 2 is 2 is 4 recommended 3 therefore 4 recommended 4 recommended 5 that 5 that 9 paradigm 5 that 16 be 6 the 9 paradigm 8 dominating 9 paradigm 9 paradigm 10 of 10 of 11 " 10 of 12 aging 12 aging 13 in 13 in 14 place 14 place 15 " 16 be 17 critically 16 be 20 evaluated 19 - 20 evaluated 20 evaluated 21 . the endothelium is located in a strategic anatomical position within the blood vessel wall and thus constitutes a barrier between the blood and all tissues . 0 ###LEFT-WALL### 2 endothelium 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 26 . 1 the 2 endothelium 2 endothelium 3 is 3 is 15 and 4 located 5 in 4 located 10 within 4 located 15 and 5 in 9 position 6 a 9 position 7 strategic 9 position 8 anatomical 9 position 10 within 14 wall 11 the 14 wall 12 blood 14 wall 13 vessel 14 wall 15 and 17 constitutes 15 and 19 barrier 15 and 20 between 16 thus 17 constitutes 18 a 19 barrier 20 between 23 and 21 the 22 blood 22 blood 23 and 23 and 25 tissues 24 all 25 tissues the integrity of the endothelial cells , which line the entire circulatory system like wallpaper , is essential to prevent the onset of cardiovascular disorders . 0 ###LEFT-WALL### 2 integrity 0 ###LEFT-WALL### 17 is 0 ###LEFT-WALL### 26 . 1 the 2 integrity 2 integrity 3 of 2 integrity 17 is 3 of 6 cells 4 the 6 cells 5 endothelial 6 cells 6 cells 8 which 7 , 8 which 8 which 9 line 8 which 16 , 9 line 13 system 9 line 14 like 10 the 13 system 11 entire 13 system 12 circulatory 13 system 14 like 15 wallpaper 17 is 18 essential 18 essential 19 to 18 essential 20 prevent 19 to 20 prevent 20 prevent 22 onset 21 the 22 onset 22 onset 23 of 23 of 25 disorders 24 cardiovascular 25 disorders aging is one of the major risk factors for the development of heart and vascular diseases . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 17 . 1 aging 2 is 2 is 3 one 3 one 4 of 3 one 12 of 4 of 8 factors 5 the 8 factors 6 major 8 factors 7 risk 8 factors 8 factors 9 for 9 for 11 development 10 the 11 development 12 of 14 and 13 heart 14 and 14 and 16 diseases 15 vascular 16 diseases however , over the past years it has become clear that the functional capacity of endothelial cells declines with age and that physiological aging occurs independently of pathological changes . 0 ###LEFT-WALL### 24 aging 0 ###LEFT-WALL### 25 occurs 0 ###LEFT-WALL### 30 . 1 however 2 , 1 however 24 aging 3 over 6 years 3 over 24 aging 4 the 6 years 5 past 6 years 6 years 7 it 6 years 9 become 7 it 8 has 8 has 9 become 9 become 10 clear 10 clear 11 that 11 that 14 capacity 11 that 18 declines 12 the 14 capacity 13 functional 14 capacity 14 capacity 15 of 14 capacity 18 declines 15 of 17 cells 16 endothelial 17 cells 19 with 21 and 19 with 23 physiological 19 with 24 aging 20 age 21 and 21 and 22 that 24 aging 25 occurs 25 occurs 26 independently 26 independently 27 of 27 of 29 changes 28 pathological 29 changes one important mechanism contributing to the onset of the aging [.] process is the disturbance of the cellular redox homeostasis . 0 ###LEFT-WALL### 3 mechanism 0 ###LEFT-WALL### 13 is 0 ###LEFT-WALL### 21 . 1 one 3 mechanism 2 important 3 mechanism 3 mechanism 4 contributing 3 mechanism 13 is 4 contributing 5 to 5 to 7 onset 6 the 7 onset 7 onset 8 of 8 of 12 process 9 the 12 process 10 aging 12 process 13 is 15 disturbance 14 the 15 disturbance 15 disturbance 16 of 16 of 20 homeostasis 17 the 20 homeostasis 18 cellular 20 homeostasis 19 redox 20 homeostasis two key molecules involved in maintaining the delicate balance between oxidative and antioxidative systems are nadph oxidase 4 , an enzyme whose sole function is to produce reactive oxygen species and the oxidoreductase thioredoxin - 1 , which reduces oxidized proteins . 1 two 2 key 2 key 3 molecules 3 molecules 4 involved 3 molecules 5 in 3 molecules 15 are 5 in 6 maintaining 6 maintaining 9 balance 6 maintaining 10 between 7 the 9 balance 8 delicate 9 balance 10 between 14 systems 11 oxidative 12 and 12 and 13 antioxidative 12 and 14 systems 15 are 31 and 16 nadph 17 oxidase 17 oxidase 18 4 17 oxidase 19 , 19 , 21 enzyme 19 , 31 and 20 an 21 enzyme 21 enzyme 22 whose 22 whose 24 function 23 sole 24 function 24 function 25 is 25 is 26 to 25 is 27 produce 26 to 27 produce 27 produce 30 species 28 reactive 30 species 29 oxygen 30 species 31 and 34 thioredoxin 31 and 36 1 32 the 34 thioredoxin 33 oxidoreductase 34 thioredoxin 35 - 36 1 36 1 38 which 36 1 42 . 37 , 38 which 38 which 39 reduces 38 which 42 . 39 reduces 41 proteins 40 oxidized 41 proteins therefore , this review will focus on the role of these two proteins in cardiovascular aging . 0 ###LEFT-WALL### 4 review 0 ###LEFT-WALL### 6 focus 0 ###LEFT-WALL### 17 . 1 therefore 2 , 1 therefore 4 review 3 this 4 review 4 review 5 will 5 will 6 focus 6 focus 7 on 6 focus 14 in 7 on 9 role 8 the 9 role 9 role 10 of 10 of 13 proteins 11 these 12 two 12 two 13 proteins 14 in 16 aging 15 cardiovascular 16 aging aberrant dna methylation patterns are a characteristic feature of cancer including myeloid malignancies such as acute myeloid leukemia ( aml ) . 0 ###LEFT-WALL### 4 patterns 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 22 . 1 aberrant 2 dna 2 dna 4 patterns 3 methylation 4 patterns 4 patterns 5 are 5 are 8 feature 6 a 7 characteristic 6 a 8 feature 7 characteristic 8 feature 8 feature 9 of 8 feature 15 as 9 of 10 cancer 10 cancer 11 including 11 including 13 malignancies 12 myeloid 13 malignancies 14 such 15 as 15 as 18 leukemia 16 acute 18 leukemia 17 myeloid 18 leukemia 18 leukemia 20 aml 19 ( 20 aml 20 aml 21 ) the mechanisms behind aberrant dna methylation have long remained obscure . 0 ###LEFT-WALL### 2 mechanisms 0 ###LEFT-WALL### 9 remained 0 ###LEFT-WALL### 11 . 1 the 2 mechanisms 2 mechanisms 3 behind 2 mechanisms 7 have 3 behind 6 methylation 4 aberrant 6 methylation 5 dna 6 methylation 7 have 9 remained 8 long 9 remained 9 remained 10 obscure new genome - wide studies have elucidated the genome and epigenome of solid tumors and aml . 0 ###LEFT-WALL### 2 genome 0 ###LEFT-WALL### 3 - 1 new 2 genome 3 - 5 studies 3 - 7 elucidated 3 - 17 . 4 wide 5 studies 5 studies 6 have 6 have 7 elucidated 7 elucidated 10 and 8 the 9 genome 9 genome 10 and 10 and 11 epigenome 10 and 12 of 12 of 15 and 13 solid 14 tumors 14 tumors 15 and 15 and 16 aml molecular [subtypes] of aml were found to exhibit highly distinct dna methylation profiles . 0 ###LEFT-WALL### 1 molecular 0 ###LEFT-WALL### 6 found 0 ###LEFT-WALL### 14 . 1 molecular 3 of 1 molecular 5 were 3 of 4 aml 5 were 6 found 6 found 7 to 7 to 8 exhibit 8 exhibit 13 profiles 9 highly 10 distinct 10 distinct 13 profiles 11 dna 13 profiles 12 methylation 13 profiles clonal evolution patterns of aml were recently dissected and might shape epigenetic dysregulation . 0 ###LEFT-WALL### 3 patterns 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 14 . 1 clonal 2 evolution 2 evolution 3 patterns 3 patterns 4 of 3 patterns 6 were 4 of 5 aml 6 were 7 recently 6 were 9 and 8 dissected 9 and 9 and 10 might 9 and 13 dysregulation 10 might 11 shape 12 epigenetic 13 dysregulation also , recurrent mutations in epigenetic modifying enzymes were identified in aml and linked to distinct dna methylation signatures . 0 ###LEFT-WALL### 4 mutations 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 20 . 1 also 2 , 1 also 4 mutations 3 recurrent 4 mutations 4 mutations 5 in 4 mutations 13 and 5 in 8 enzymes 6 epigenetic 8 enzymes 7 modifying 8 enzymes 9 were 10 identified 9 were 13 and 10 identified 11 in 11 in 12 aml 13 and 14 linked 13 and 15 to 13 and 19 signatures 15 to 17 dna 16 distinct 17 dna 18 methylation 19 signatures the genetic background , thus , takes [center] [stage] as a driver of epigenetic dysregulation in aml . 0 ###LEFT-WALL### 3 background 0 ###LEFT-WALL### 7 takes 0 ###LEFT-WALL### 18 . 1 the 3 background 2 genetic 3 background 3 background 7 takes 4 , 5 thus 5 thus 6 , 5 thus 7 takes 7 takes 10 as 7 takes 16 in 10 as 12 driver 11 a 12 driver 12 driver 13 of 13 of 15 dysregulation 14 epigenetic 15 dysregulation 16 in 17 aml first mechanistic insights into the dysregulation of dna methylation by recurrent mutations have already been gained . 0 ###LEFT-WALL### 3 insights 0 ###LEFT-WALL### 16 gained 0 ###LEFT-WALL### 17 . 1 first 3 insights 2 mechanistic 3 insights 3 insights 4 into 3 insights 13 have 4 into 6 dysregulation 5 the 6 dysregulation 6 dysregulation 7 of 7 of 9 methylation 8 dna 9 methylation 9 methylation 10 by 10 by 12 mutations 11 recurrent 12 mutations 13 have 15 been 14 already 15 been 15 been 16 gained other studies suggest that epigenomic plasticity and aging - associated changes in dna methylation also contribute extensively to aberrant dna methylation in cancer . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 24 . 1 other 2 studies 2 studies 3 suggest 3 suggest 6 plasticity 4 that 5 epigenomic 5 epigenomic 6 plasticity 7 and 11 changes 7 and 16 contribute 8 aging 9 - 8 aging 11 changes 10 associated 11 changes 11 changes 12 in 11 changes 16 contribute 12 in 14 methylation 13 dna 14 methylation 15 also 16 contribute 16 contribute 17 extensively 16 contribute 18 to 16 contribute 22 in 18 to 21 methylation 19 aberrant 21 methylation 20 dna 21 methylation 22 in 23 cancer epigenetic dysregulation , therefore , seems to also occur independently of the genetic background . 0 ###LEFT-WALL### 2 dysregulation 0 ###LEFT-WALL### 6 seems 0 ###LEFT-WALL### 15 . 1 epigenetic 2 dysregulation 2 dysregulation 6 seems 3 , 4 therefore 4 therefore 5 , 4 therefore 6 seems 6 seems 7 to 6 seems 9 occur 7 to 9 occur 8 also 9 occur 9 occur 10 independently 10 independently 11 of 11 of 14 background 12 the 14 background 13 genetic 14 background furthermore , global changes in chromatin [conformation] and nuclear organization have also been proposed as potential contributors to aberrant dna methylation . 0 ###LEFT-WALL### 4 changes 0 ###LEFT-WALL### 14 proposed 0 ###LEFT-WALL### 22 . 1 furthermore 2 , 1 furthermore 4 changes 3 global 4 changes 4 changes 5 in 4 changes 11 have 5 in 8 and 6 chromatin 8 and 8 and 10 organization 9 nuclear 10 organization 11 have 13 been 12 also 13 been 13 been 14 proposed 14 proposed 15 as 14 proposed 18 to 15 as 17 contributors 16 potential 17 contributors 18 to 21 methylation 19 aberrant 21 methylation 20 dna 21 methylation [this] review will [summarize] and discuss current concepts regarding the mechanisms behind aberrant dna methylation in cancer and specifically aml . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 21 . 2 review 3 will 2 review 5 and 5 and 6 discuss 6 discuss 18 and 7 current 8 concepts 8 concepts 9 regarding 8 concepts 18 and 9 regarding 11 mechanisms 9 regarding 12 behind 9 regarding 16 in 10 the 11 mechanisms 12 behind 15 methylation 13 aberrant 15 methylation 14 dna 15 methylation 16 in 17 cancer 18 and 19 specifically 18 and 20 aml objective : to investigate the relation between lumbar disc degeneration ( ldd ) and all type [of] osteoporotic ( op ) fractures including [vertebral] . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 investigate 2 : 14 and 2 : 25 . 3 to 4 investigate 4 investigate 6 relation 4 investigate 7 between 5 the 6 relation 7 between 10 degeneration 8 lumbar 10 degeneration 9 disc 10 degeneration 10 degeneration 12 ldd 11 ( 12 ldd 12 ldd 13 ) 14 and 15 all 14 and 16 type 15 all 16 type 16 type 23 including 18 osteoporotic 20 op 18 osteoporotic 21 ) 18 osteoporotic 22 fractures 19 ( 20 op 20 op 21 ) 22 fractures 23 including methods : this study is part of the rotterdam study , a large prospective population - based cohort study among men and women aged 55years [and] [over] . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 28 . 2 : 4 study 2 : 5 is 3 this 4 study 4 study 5 is 5 is 25 55years 6 part 7 of 6 part 20 among 6 part 22 and 7 of 9 rotterdam 8 the 9 rotterdam 9 rotterdam 10 study 9 rotterdam 17 based 10 study 15 population 10 study 17 based 11 , 15 population 12 a 13 large 12 a 15 population 13 large 15 population 14 prospective 15 population 15 population 16 - 17 based 19 study 18 cohort 19 study 20 among 21 men 22 and 23 women 22 and 24 aged 22 and 25 55years in 2819 participants [spine] [radiographs] were scored for ldd ( osteophytes and disc space narrowing ( dsn ) ) from l1 till s1 , using the lane atlas . 0 ###LEFT-WALL### 3 participants 0 ###LEFT-WALL### 7 scored 1 in 2 2819 1 in 3 participants 3 participants 6 were 6 were 7 scored 7 scored 8 for 7 scored 20 from 7 scored 22 till 8 for 9 ldd 9 ldd 12 and 10 ( 12 and 11 osteophytes 12 and 12 and 14 space 12 and 15 narrowing 12 and 17 dsn 12 and 19 ) 13 disc 14 space 16 ( 17 dsn 17 dsn 18 ) 20 from 21 l1 22 till 23 s1 23 s1 25 using 24 , 25 using 25 using 28 atlas 25 using 29 . 26 the 28 atlas 27 lane 28 atlas osteoporotic ( op ) fracture data were collected and verified by specialists during 12.8 years . 0 ###LEFT-WALL### 6 data 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 16 . 1 osteoporotic 3 op 2 ( 3 op 3 op 4 ) 3 op 6 data 5 fracture 6 data 6 data 7 were 7 were 9 and 8 collected 9 and 9 and 10 verified 9 and 11 by 9 and 12 specialists 9 and 13 during 13 during 15 years 14 12.8 15 years we considered two types of vertebral fractures ( vfx ) : clinical [vfx] ( symptomatic fractures recorded by medical practitioners ) and radiographic vfx ( using the mccloskey - kanis method ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 considered 0 ###LEFT-WALL### 11 : 1 we 2 considered 2 considered 4 types 3 two 4 types 4 types 5 of 5 of 7 fractures 6 vertebral 7 fractures 7 fractures 9 vfx 8 ( 9 vfx 9 vfx 10 ) 11 : 22 and 11 : 33 . 12 clinical 16 fractures 12 clinical 22 and 14 ( 16 fractures 15 symptomatic 16 fractures 16 fractures 17 recorded 16 fractures 21 ) 17 recorded 18 by 18 by 20 practitioners 19 medical 20 practitioners 22 and 24 vfx 22 and 26 using 23 radiographic 24 vfx 25 ( 26 using 26 using 28 mccloskey 26 using 32 ) 27 the 28 mccloskey 28 mccloskey 31 method 29 - 31 method 30 kanis 31 method 31 method 32 ) meta - analysis of published studies reporting an association of ldd features and vfx was performed . 0 ###LEFT-WALL### 3 analysis 0 ###LEFT-WALL### 16 performed 0 ###LEFT-WALL### 17 . 1 meta 2 - 1 meta 3 analysis 3 analysis 4 of 3 analysis 15 was 4 of 6 studies 5 published 6 studies 6 studies 7 reporting 7 reporting 9 association 8 an 9 association 9 association 10 of 10 of 13 and 11 ldd 12 features 12 features 13 and 13 and 14 vfx 15 was 16 performed differences in bone mineral density ( bmd ) between participants [with] and without ldd features were analyzed using anova . 0 ###LEFT-WALL### 1 differences 0 ###LEFT-WALL### 17 analyzed 0 ###LEFT-WALL### 20 . 1 differences 2 in 1 differences 12 and 1 differences 16 were 2 in 7 bmd 3 bone 4 mineral 4 mineral 5 density 5 density 7 bmd 6 ( 7 bmd 7 bmd 8 ) 9 between 10 participants 9 between 12 and 12 and 13 without 13 without 15 features 14 ldd 15 features 16 were 17 analyzed 17 analyzed 18 using 18 using 19 anova risk of op [-] fractures was analyzed using cox regression . 0 ###LEFT-WALL### 1 risk 0 ###LEFT-WALL### 7 analyzed 0 ###LEFT-WALL### 11 . 1 risk 2 of 1 risk 6 was 2 of 5 fractures 3 op 5 fractures 6 was 7 analyzed 7 analyzed 8 using 8 using 10 regression 9 cox 10 regression results : in a total of 2385 participants , during 12.8 years follow - up , 558 suffered an op - fracture . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 1 results 2 : 2 : 3 in 3 in 5 total 4 a 5 total 5 total 6 of 6 of 8 participants 7 2385 8 participants 9 , 13 follow 9 , 16 , 10 during 12 years 10 during 13 follow 11 12.8 12 years 13 follow 15 up 14 - 15 up 15 up 16 , 16 , 17 558 16 , 18 suffered 16 , 21 - 17 558 18 suffered 18 suffered 20 op 19 an 20 op 21 - 22 fracture 21 - 23 . subjects with ldd had an increased op fracture risk compared to subjects without ldd ( hr : 1.29 , ci : 1.04 - 1.60 ) . 0 ###LEFT-WALL### 1 subjects 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 17 : 1 subjects 2 with 1 subjects 4 had 2 with 3 ldd 4 had 9 risk 4 had 11 to 4 had 13 without 5 an 9 risk 6 increased 9 risk 7 op 9 risk 8 fracture 9 risk 9 risk 10 compared 11 to 12 subjects 13 without 14 ldd 14 ldd 16 hr 15 ( 16 hr 16 hr 17 : 17 : 18 1.29 17 : 19 , 17 : 26 . 19 , 20 ci 19 , 21 : 20 ci 21 : 21 : 22 1.04 22 1.04 24 1.60 23 - 24 1.60 24 1.60 25 ) ldd - cases have between 0.3 and 0.72 standard deviations more bmd than [non] - cases in all analyzed regions including total body bmd and skull bmd ( p<0.001 ) . 0 ###LEFT-WALL### 3 cases 0 ###LEFT-WALL### 15 - 1 ldd 2 - 1 ldd 3 cases 3 cases 4 have 4 have 5 between 4 have 11 more 4 have 12 bmd 4 have 13 than 5 between 10 deviations 6 0.3 7 and 7 and 8 0.72 7 and 10 deviations 9 standard 10 deviations 15 - 25 and 15 - 31 . 16 cases 17 in 16 cases 25 and 17 in 20 regions 18 all 20 regions 19 analyzed 20 regions 20 regions 21 including 21 including 24 bmd 22 total 24 bmd 23 body 24 bmd 25 and 27 bmd 25 and 29 p<0.001 26 skull 27 bmd 28 ( 29 p<0.001 29 p<0.001 30 ) only males with ldd had increased risk for op - fractures compared to males without ldd ( adjusted - hr : 1.80 , 95%ci : 1.20 - 2.70 , p=0.005 ) . 0 ###LEFT-WALL### 1 only 0 ###LEFT-WALL### 6 increased 0 ###LEFT-WALL### 21 : 1 only 2 males 2 males 3 with 2 males 5 had 3 with 4 ldd 5 had 6 increased 6 increased 7 risk 7 risk 8 for 8 for 9 op 9 op 11 fractures 10 - 11 fractures 11 fractures 12 compared 11 fractures 21 : 12 compared 13 to 12 compared 15 without 13 to 14 males 15 without 16 ldd 16 ldd 18 adjusted 16 ldd 20 hr 17 ( 18 adjusted 18 adjusted 19 - 19 - 20 hr 20 hr 21 : 21 : 22 1.80 21 : 23 , 21 : 32 . 23 , 24 95%ci 23 , 25 : 24 95%ci 25 : 25 : 27 - 26 1.20 27 - 27 - 28 2.70 27 - 30 p=0.005 29 , 30 p=0.005 30 p=0.005 31 ) the risk was also higher for vfx in males ( hr : 1.64 , ci : 1.03 - 2.60 , p : 0.04 [ )( 0 ###LEFT-WALL### 2 risk 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 12 : 1 the 2 risk 2 risk 3 was 3 was 4 also 3 was 5 higher 5 higher 6 for 5 higher 8 in 6 for 7 vfx 8 in 9 males 9 males 11 hr 10 ( 11 hr 11 hr 12 : 12 : 13 1.64 12 : 14 , 14 , 15 ci 14 , 16 : 14 , 22 : 15 ci 16 : 16 : 18 - 17 1.03 18 - 18 - 19 2.60 18 - 21 p 20 , 21 p 21 p 22 : 22 : 23 0.04 22 : 25 )( the association ldd - op - fractures in females was lower and not significant ( adjusted - hr : 1.08 , 95%ci [:] 0.82 - 1.41 ) . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 10 was 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 28 . 1 the 2 association 2 association 3 ldd 2 association 7 fractures 2 association 10 was 3 ldd 5 op 3 ldd 7 fractures 4 - 5 op 5 op 6 - 7 fractures 8 in 8 in 9 females 10 was 11 lower 12 and 13 not 12 and 18 hr 12 and 19 : 13 not 14 significant 14 significant 16 adjusted 14 significant 17 - 14 significant 18 hr 15 ( 16 adjusted 16 adjusted 17 - 18 hr 19 : 19 : 20 1.08 20 1.08 22 95%ci 21 , 22 95%ci 22 95%ci 25 - 22 95%ci 27 ) 24 0.82 25 - 25 - 26 1.41 meta - analyses showed that the risk of vfx in subjects with ldd has been studied only in women and there is not enough evidence to confidently analyze the relationship between ldd - features ( dsn or/and oph ) and vfx due to low power and heterogeneity in phenotype definition in the collected studies . 0 ###LEFT-WALL### 3 analyses 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 55 . 1 meta 2 - 1 meta 3 analyses 3 analyses 4 showed 4 showed 5 that 5 that 7 risk 5 that 16 studied 6 the 7 risk 7 risk 8 of 7 risk 10 in 7 risk 14 has 8 of 9 vfx 10 in 11 subjects 11 subjects 12 with 12 with 13 ldd 14 has 15 been 15 been 16 studied 16 studied 17 only 16 studied 18 in 18 in 19 women 20 and 21 there 20 and 22 is 21 there 22 is 22 is 23 not 22 is 25 evidence 22 is 26 to 22 is 43 to 24 enough 25 evidence 26 to 28 analyze 27 confidently 28 analyze 28 analyze 30 relationship 29 the 30 relationship 30 relationship 31 between 31 between 40 and 32 ldd 34 features 32 ldd 40 and 33 - 34 features 34 features 38 oph 34 features 39 ) 35 ( 38 oph 36 dsn 38 oph 37 or/and 38 oph 38 oph 39 ) 40 and 41 vfx 42 due 43 to 43 to 46 and 44 low 45 power 45 power 46 and 46 and 47 heterogeneity 46 and 48 in 46 and 51 in 48 in 50 definition 49 phenotype 50 definition 51 in 54 studies 52 the 54 studies 53 collected 54 studies conclusions : male subjects with ldd have a higher osteoporotic fracture risk , in spite of systemically higher bmd . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 subjects 2 : 7 have 3 male 4 subjects 4 subjects 5 with 4 subjects 7 have 5 with 6 ldd 7 have 12 risk 8 a 12 risk 9 higher 11 fracture 10 osteoporotic 11 fracture 11 fracture 12 risk 12 risk 14 in 13 , 14 in 14 in 15 spite 14 in 20 . 15 spite 16 of 16 of 19 bmd 17 systemically 18 higher 18 higher 19 bmd background : glutathione - s - transferase [gene] ( gst ) polymorphisms can result in variable ability of these enzymes to remove electrophilic substrates . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 12 polymorphisms 2 : 14 result 2 : 25 . 3 glutathione 5 s 3 glutathione 7 transferase 3 glutathione 12 polymorphisms 4 - 5 s 5 s 6 - 6 - 7 transferase 7 transferase 10 gst 7 transferase 11 ) 9 ( 10 gst 10 gst 11 ) 12 polymorphisms 13 can 13 can 14 result 14 result 15 in 15 in 17 ability 16 variable 17 ability 17 ability 18 of 17 ability 21 to 17 ability 22 remove 18 of 20 enzymes 19 these 20 enzymes 21 to 22 remove 22 remove 24 substrates 23 electrophilic 24 substrates we investigated whether the gstp1 val105 and gstm1 deletion polymorphisms modify the lead - cognitive function association . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 investigated 0 ###LEFT-WALL### 14 - 1 we 2 investigated 2 investigated 3 whether 3 whether 7 and 3 whether 11 modify 4 the 6 val105 5 gstp1 6 val105 6 val105 7 and 7 and 10 polymorphisms 7 and 11 modify 8 gstm1 10 polymorphisms 9 deletion 10 polymorphisms 11 modify 13 lead 12 the 13 lead 14 - 17 association 14 - 18 . 15 cognitive 16 function 16 function 17 association methods : we used repeated measures [analysis] to compare the association between cumulative lead biomarkers - bone lead measured using k - shell x - ray fluorescence - and mini - mental state exam ( mmse ) score by gst variants , adjusted for covariates , among normative aging study participants , a boston - based prospective cohort of men . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 4 used 2 : 3 we 3 we 4 used 4 used 6 measures 4 used 8 to 5 repeated 6 measures 8 to 9 compare 9 compare 11 association 9 compare 12 between 10 the 11 association 12 between 14 lead 13 cumulative 14 lead 14 lead 15 biomarkers 14 lead 26 ray 15 biomarkers 18 lead 15 biomarkers 26 ray 16 - 18 lead 17 bone 18 lead 18 lead 19 measured 18 lead 20 using 18 lead 23 shell 18 lead 25 - 20 using 21 k 22 - 23 shell 23 shell 24 x 23 shell 25 - 26 ray 29 and 27 fluorescence 29 and 28 - 29 and 29 and 38 score 29 and 39 by 30 mini 34 exam 30 mini 38 score 31 - 34 exam 32 mental 34 exam 33 state 34 exam 34 exam 36 mmse 34 exam 37 ) 35 ( 36 mmse 36 mmse 37 ) 39 by 41 variants 40 gst 41 variants 41 variants 43 adjusted 42 , 43 adjusted 43 adjusted 44 for 44 for 45 covariates 45 covariates 47 among 45 covariates 54 boston 46 , 47 among 47 among 51 participants 47 among 52 , 48 normative 49 aging 49 aging 50 study 50 study 51 participants 52 , 54 boston 53 a 54 boston 54 boston 58 cohort 54 boston 61 . 55 - 58 cohort 56 based 58 cohort 57 prospective 58 cohort 58 cohort 59 of 58 cohort 61 . 59 of 60 men we had complete data for 698 men ( providing 1292 observations ) for gstm1 analyses and 595 men ( providing 1142 observations ) for gstp1 analyses . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 had 0 ###LEFT-WALL### 27 . 1 we 2 had 2 had 4 data 2 had 24 for 3 complete 4 data 4 data 5 for 4 data 13 for 5 for 7 men 6 698 7 men 7 men 9 providing 8 ( 9 providing 9 providing 11 observations 9 providing 12 ) 10 1292 11 observations 13 for 16 and 14 gstm1 15 analyses 15 analyses 16 and 16 and 18 men 16 and 20 providing 17 595 18 men 19 ( 20 providing 20 providing 22 observations 20 providing 23 ) 21 1142 22 observations 24 for 26 analyses 25 gstp1 26 analyses results : a 15 [μg] / g higher tibia lead concentration ( interquartile range of tibia lead ) was associated with a 0.24 point [decrement] [in] mmse score among gstp1 val105 variant carriers , which was significantly stronger than the association among men with only wild - type alleles ( p=0.01 [ )( 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 11 concentration 3 a 11 concentration 4 15 7 g 6 / 7 g 7 g 11 concentration 8 higher 9 tibia 9 tibia 11 concentration 10 lead 11 concentration 11 concentration 14 range 11 concentration 19 was 12 ( 14 range 13 interquartile 14 range 14 range 15 of 14 range 18 ) 15 of 17 lead 16 tibia 17 lead 19 was 20 associated 20 associated 21 with 21 with 24 point 22 a 24 point 23 0.24 24 point 24 point 27 mmse 24 point 28 score 24 point 35 which 27 mmse 28 score 28 score 29 among 29 among 33 carriers 30 gstp1 31 val105 31 val105 33 carriers 32 variant 33 carriers 34 , 35 which 35 which 36 was 36 was 37 significantly 36 was 38 stronger 38 stronger 39 than 38 stronger 42 among 39 than 41 association 40 the 41 association 42 among 43 men 43 men 44 with 43 men 51 p=0.01 44 with 49 alleles 45 only 46 wild 46 wild 47 - 46 wild 48 type 48 type 49 alleles 50 ( 51 p=0.01 51 p=0.01 53 )( the association among gstp1 val105 carriers was comparable to that of 3 years of age in baseline mmse scores . 0 ###LEFT-WALL### 2 association 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 20 . 1 the 2 association 2 association 3 among 2 association 7 was 3 among 6 carriers 4 gstp1 5 val105 5 val105 6 carriers 7 was 8 comparable 8 comparable 9 to 8 comparable 16 in 9 to 10 that 10 that 11 of 11 of 13 years 12 3 13 years 13 years 14 of 14 of 15 age 16 in 17 baseline 17 baseline 18 mmse 17 baseline 19 scores 18 mmse 19 scores the association [between] tibia lead and mmse score appeared progressively steeper in participants with [increasingly] more gstp1 val105 alleles . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 9 appeared 0 ###LEFT-WALL### 20 . 1 the 5 lead 2 association 5 lead 4 tibia 5 lead 5 lead 6 and 6 and 8 score 6 and 9 appeared 7 mmse 8 score 9 appeared 11 steeper 10 progressively 11 steeper 11 steeper 12 in 11 steeper 14 with 12 in 13 participants 14 with 19 alleles 16 more 19 alleles 17 gstp1 18 val105 18 val105 19 alleles a modest association between tibia [lead] and lower mmse score was seen among participants with the gstm1 deletion polymorphism . 0 ###LEFT-WALL### 3 association 0 ###LEFT-WALL### 12 seen 0 ###LEFT-WALL### 20 . 1 a 2 modest 1 a 3 association 2 modest 3 association 3 association 4 between 3 association 11 was 4 between 7 and 5 tibia 7 and 7 and 10 score 8 lower 10 score 9 mmse 10 score 11 was 12 seen 12 seen 13 among 12 seen 15 with 13 among 14 participants 15 with 19 polymorphism 16 the 19 polymorphism 17 gstm1 19 polymorphism 18 deletion 19 polymorphism neither of the glutathione [s] - transferase variants was independently associated with cognitive [function] , [nor] [with] lead biomarker measures . 0 ###LEFT-WALL### 1 neither 0 ###LEFT-WALL### 11 associated 0 ###LEFT-WALL### 21 . 1 neither 2 of 1 neither 9 was 2 of 8 variants 3 the 8 variants 4 glutathione 6 - 4 glutathione 7 transferase 7 transferase 8 variants 9 was 11 associated 10 independently 11 associated 11 associated 12 with 12 with 20 measures 13 cognitive 15 , 13 cognitive 18 lead 18 lead 19 biomarker 19 biomarker 20 measures the results pertaining to [patella] lead were similar to those observed for tibia lead . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 14 lead 0 ###LEFT-WALL### 15 . 1 the 2 results 2 results 3 pertaining 2 results 7 were 2 results 8 similar 2 results 14 lead 3 pertaining 4 to 3 pertaining 7 were 4 to 6 lead 8 similar 9 to 9 to 10 those 10 those 11 observed 11 observed 12 for 12 for 13 tibia conclusion : our results suggest that the gstp1 val105 polymorphism confers excess susceptibility to the cognitive effects of cumulative lead exposure . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 suggest 2 : 22 . 3 our 4 results 4 results 5 suggest 5 suggest 6 that 6 that 10 polymorphism 6 that 11 confers 7 the 10 polymorphism 8 gstp1 9 val105 9 val105 10 polymorphism 10 polymorphism 11 confers 11 confers 13 susceptibility 11 confers 14 to 12 excess 13 susceptibility 14 to 17 effects 15 the 17 effects 16 cognitive 17 effects 17 effects 18 of 18 of 21 exposure 19 cumulative 20 lead 20 lead 21 exposure cross - sectional neuroimaging studies are an important first step in examining developmental differences in brain function between adults and youth with bipolar disorder ( bd ) . 0 ###LEFT-WALL### 5 studies 0 ###LEFT-WALL### 6 are 0 ###LEFT-WALL### 28 . 1 cross 2 - 1 cross 5 studies 3 sectional 5 studies 4 neuroimaging 5 studies 5 studies 6 are 6 are 10 step 7 an 8 important 7 an 10 step 8 important 10 step 9 first 10 step 10 step 11 in 11 in 12 examining 12 examining 14 differences 12 examining 17 function 13 developmental 14 differences 14 differences 15 in 14 differences 17 function 15 in 16 brain 17 function 18 between 17 function 22 with 18 between 20 and 19 adults 20 and 20 and 21 youth 22 with 24 disorder 23 bipolar 24 disorder 24 disorder 26 bd 25 ( 26 bd 26 bd 27 ) impaired response flexibility may contribute to reduced ability to modify goal [-] directed behavior in bd appropriately . 0 ###LEFT-WALL### 3 flexibility 0 ###LEFT-WALL### 5 contribute 0 ###LEFT-WALL### 18 . 1 impaired 2 response 2 response 3 flexibility 3 flexibility 4 may 4 may 5 contribute 5 contribute 6 to 6 to 8 ability 7 reduced 8 ability 8 ability 9 to 8 ability 10 modify 9 to 10 modify 10 modify 14 behavior 10 modify 15 in 10 modify 17 appropriately 11 goal 13 directed 13 directed 14 behavior 15 in 16 bd we compared neural circuitry mediating this process in child ( cbd ) vs [.] adult bd ( abd ) and age - matched healthy subjects [.] fmri [data] from 15 cbd , 23 abd , 20 healthy children , and 27 healthy adults [were] acquired during a response flexibility paradigm , a task where subjects inhibit a prepotent response and execute an alternative response . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 compared 1 we 2 compared 2 compared 4 circuitry 2 compared 8 in 3 neural 4 circuitry 4 circuitry 5 mediating 5 mediating 7 process 6 this 7 process 8 in 20 and 9 child 11 cbd 10 ( 11 cbd 11 cbd 12 ) 11 cbd 13 vs 11 cbd 20 and 13 vs 18 abd 15 adult 18 abd 16 bd 18 abd 17 ( 18 abd 18 abd 19 ) 20 and 21 age 20 and 22 - 20 and 25 subjects 20 and 27 fmri 23 matched 25 subjects 24 healthy 25 subjects 25 subjects 27 fmri 27 fmri 29 from 29 from 40 and 30 15 31 cbd 31 cbd 32 , 32 , 34 abd 32 , 35 , 33 23 34 abd 35 , 38 children 35 , 40 and 36 20 38 children 37 healthy 38 children 39 , 40 and 40 and 43 adults 40 and 45 acquired 41 27 43 adults 42 healthy 43 adults 45 acquired 46 during 46 during 50 paradigm 47 a 50 paradigm 48 response 50 paradigm 49 flexibility 50 paradigm 50 paradigm 53 task 51 , 53 task 52 a 53 task 53 task 54 where 53 task 65 . 54 where 55 subjects 54 where 60 and 55 subjects 60 and 56 inhibit 59 response 56 inhibit 60 and 57 a 59 response 58 prepotent 59 response 60 and 61 execute 60 and 64 response 62 an 64 response 63 alternative 64 response when successfully executing an alternate response , cbd showed frontal , parietal , and temporal hyperactivation relative to healthy children and abd , while abd hypoactivated these regions relative to healthy adults . 0 ###LEFT-WALL### 8 cbd 0 ###LEFT-WALL### 9 showed 0 ###LEFT-WALL### 33 . 1 when 3 executing 1 when 7 , 1 when 8 cbd 2 successfully 3 executing 3 executing 6 response 4 an 6 response 5 alternate 6 response 8 cbd 9 showed 9 showed 14 and 9 showed 16 hyperactivation 10 frontal 11 , 11 , 12 parietal 11 , 14 and 13 , 14 and 14 and 15 temporal 16 hyperactivation 17 relative 16 hyperactivation 29 relative 17 relative 18 to 17 relative 24 while 18 to 21 and 19 healthy 20 children 20 children 21 and 21 and 22 abd 21 and 23 , 24 while 25 abd 24 while 26 hypoactivated 25 abd 26 hypoactivated 26 hypoactivated 28 regions 27 these 28 regions 29 relative 30 to 30 to 32 adults 31 healthy 32 adults previous studies of response flexibility in healthy volunteers revealed frontal , temporal , and parietal cortex hyperactivation in children and hypoactivation in adults . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 9 revealed 0 ###LEFT-WALL### 24 . 1 previous 2 studies 2 studies 3 of 2 studies 6 in 2 studies 9 revealed 3 of 5 flexibility 4 response 5 flexibility 6 in 8 volunteers 7 healthy 8 volunteers 9 revealed 17 hyperactivation 9 revealed 18 in 9 revealed 22 in 10 frontal 11 , 11 , 12 temporal 11 , 14 and 13 , 14 and 14 and 15 parietal 14 and 16 cortex 16 cortex 17 hyperactivation 18 in 20 and 19 children 20 and 20 and 21 hypoactivation 22 in 23 adults relative to age - matched healthy subjects , we found hyperactivation in these regions in cbd and hypoactivation in abd . 0 ###LEFT-WALL### 9 we 0 ###LEFT-WALL### 10 found 0 ###LEFT-WALL### 21 . 1 relative 2 to 1 relative 8 , 1 relative 9 we 2 to 3 age 3 age 7 subjects 4 - 7 subjects 5 matched 7 subjects 6 healthy 7 subjects 7 subjects 8 , 9 we 10 found 10 found 11 hyperactivation 10 found 19 in 11 hyperactivation 12 in 11 hyperactivation 15 in 12 in 14 regions 13 these 14 regions 15 in 17 and 16 cbd 17 and 17 and 18 hypoactivation 19 in 20 abd this suggests that our findings in patients may represent the extreme extension of the age - related response flexibility activation differences found in healthy subjects . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 suggests 0 ###LEFT-WALL### 17 related 1 this 2 suggests 2 suggests 3 that 3 that 5 findings 3 that 9 represent 4 our 5 findings 5 findings 6 in 5 findings 8 may 6 in 7 patients 8 may 9 represent 9 represent 12 extension 10 the 12 extension 11 extreme 12 extension 12 extension 13 of 13 of 15 age 14 the 15 age 16 - 17 related 17 related 21 differences 17 related 26 . 18 response 21 differences 19 flexibility 21 differences 20 activation 21 differences 21 differences 22 found 22 found 23 in 23 in 25 subjects 24 healthy 25 subjects future studies should use longitudinal fmri to examine the developmental trajectory of the neural circuitry mediating response flexibility in bd . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 use 0 ###LEFT-WALL### 21 . 1 future 2 studies 2 studies 3 should 3 should 4 use 4 use 6 fmri 4 use 7 to 4 use 8 examine 5 longitudinal 6 fmri 7 to 8 examine 8 examine 11 trajectory 8 examine 19 in 9 the 11 trajectory 10 developmental 11 trajectory 11 trajectory 12 of 12 of 15 circuitry 13 the 15 circuitry 14 neural 15 circuitry 15 circuitry 16 mediating 16 mediating 18 flexibility 17 response 18 flexibility 19 in 20 bd background : despite extensive research funding in the field of dementia , deficits in the quality of dementia care still exist . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 21 exist 2 : 22 . 3 despite 5 research 3 despite 21 exist 4 extensive 5 research 5 research 6 funding 6 funding 7 in 6 funding 14 in 6 funding 19 care 7 in 9 field 8 the 9 field 9 field 10 of 10 of 13 deficits 11 dementia 12 , 11 dementia 13 deficits 14 in 16 quality 15 the 16 quality 16 quality 17 of 17 of 18 dementia 20 still 21 exist in order to project different alternative futures of health care for people with dementia ( pwd ) in germany , we have initiated a multidisciplinary scenario process ( sce - dem ) . 0 ###LEFT-WALL### 7 futures 0 ###LEFT-WALL### 10 care 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 33 . 1 in 2 order 1 in 7 futures 2 order 3 to 2 order 4 project 3 to 4 project 5 different 6 alternative 6 alternative 7 futures 7 futures 8 of 7 futures 10 care 8 of 9 health 10 care 11 for 10 care 18 in 11 for 12 people 12 people 13 with 13 with 14 dementia 14 dementia 16 pwd 15 ( 16 pwd 16 pwd 17 ) 18 in 19 germany 20 , 21 we 20 , 23 initiated 21 we 22 have 22 have 23 initiated 23 initiated 27 process 24 a 27 process 25 multidisciplinary 26 scenario 26 scenario 27 process 27 process 29 sce 28 ( 29 sce 29 sce 31 dem 29 sce 32 ) 30 - 31 dem 31 dem 32 ) results : as a result of the scenario process , five consistent scenarios were developed . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 13 scenarios 2 : 15 developed 2 : 16 . 3 as 5 result 3 as 10 , 3 as 13 scenarios 4 a 5 result 5 result 6 of 6 of 9 process 7 the 9 process 8 scenario 9 process 11 five 13 scenarios 12 consistent 13 scenarios 13 scenarios 14 were 14 were 15 developed two of these could be described as dark scenarios with very poor prospects . 0 ###LEFT-WALL### 1 two 0 ###LEFT-WALL### 6 described 0 ###LEFT-WALL### 14 . 1 two 2 of 1 two 4 could 2 of 3 these 4 could 5 be 5 be 6 described 6 described 7 as 6 described 10 with 7 as 9 scenarios 8 dark 9 scenarios 10 with 13 prospects 11 very 12 poor 12 poor 13 prospects a third one has been referred [to] as " well - meant , but badly done " . 0 ###LEFT-WALL### 3 one 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 18 . 1 a 3 one 2 third 3 one 3 one 4 has 4 has 5 been 5 been 14 but 6 referred 8 as 6 referred 14 but 8 as 9 " 8 as 10 well 10 well 12 meant 11 - 12 meant 12 meant 13 , 14 but 16 done 15 badly 16 done 16 done 17 " two scenarios entail mostly positive aspects but one of them has a tendency towards [,] a " health control " state . 0 ###LEFT-WALL### 2 scenarios 0 ###LEFT-WALL### 3 entail 0 ###LEFT-WALL### 7 but 0 ###LEFT-WALL### 22 . 1 two 2 scenarios 2 scenarios 3 entail 3 entail 6 aspects 4 mostly 5 positive 5 positive 6 aspects 7 but 8 one 7 but 11 has 8 one 9 of 8 one 11 has 9 of 10 them 11 has 13 tendency 11 has 14 towards 12 a 13 tendency 14 towards 21 state 16 a 17 " 16 a 21 state 18 health 21 state 19 control 20 " 19 control 21 state conclusion : the more positive scenarios provide a framework for determining relevant actions in research , society , and politics . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 6 scenarios 2 : 7 provide 2 : 21 . 3 the 6 scenarios 4 more 5 positive 5 positive 6 scenarios 6 scenarios 7 provide 7 provide 9 framework 7 provide 14 in 8 a 9 framework 9 framework 10 for 10 for 11 determining 11 determining 13 actions 12 relevant 13 actions 14 in 19 and 15 research 16 , 16 , 17 society 16 , 19 and 18 , 19 and 19 and 20 politics objective : to evaluate the effects of case management in community aged care ( cmcac ) interventions on service use and costs . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 2 : 23 . 3 to 4 evaluate 4 evaluate 21 and 5 the 6 effects 6 effects 7 of 6 effects 21 and 7 of 9 management 8 case 9 management 9 management 10 in 9 management 17 interventions 9 management 20 use 10 in 13 care 11 community 12 aged 12 aged 13 care 13 care 15 cmcac 14 ( 15 cmcac 15 cmcac 16 ) 17 interventions 18 on 17 interventions 20 use 18 on 19 service 21 and 22 costs method : five databases were searched from [inception] to 2011 july to include randomized control trials and comparative observational english studies . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 22 . 1 method 2 : 2 : 3 five 2 : 9 to 2 : 12 to 3 five 4 databases 3 five 7 from 4 databases 5 were 5 were 6 searched 6 searched 7 from 9 to 11 july 10 2011 11 july 12 to 13 include 13 include 16 trials 14 randomized 15 control 15 control 16 trials 17 and 20 english 17 and 21 studies 18 comparative 20 english 19 observational 20 english 20 english 21 studies results were summarized by using the best - evidence synthesis approach . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 summarized 0 ###LEFT-WALL### 12 . 1 results 2 were 2 were 3 summarized 3 summarized 4 by 4 by 5 using 5 using 9 evidence 6 the 7 best 6 the 9 evidence 7 best 8 - 9 evidence 10 synthesis 9 evidence 11 approach 10 synthesis 11 approach results : twenty - one studies were included . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 twenty 2 : 8 included 2 : 9 . 3 twenty 5 one 3 twenty 6 studies 3 twenty 7 were 4 - 5 one 5 one 6 studies 7 were 8 included available studies supported improvements in clients ' use of case management services [(] all of the four studies [ )( some community services [(] 8 of the 10 [ )(and nursing home admission and stay ( around one [half] ) [,] delay of nursing home placement ( all of the two studies ) , [and] achieving cost neutrality ( 8 of the 11 ) . 0 ###LEFT-WALL### 1 available 0 ###LEFT-WALL### 2 studies 1 available 2 studies 2 studies 4 improvements 2 studies 5 in 3 supported 4 improvements 5 in 8 use 6 clients 7 ' 7 ' 8 use 8 use 9 of 9 of 12 services 10 case 11 management 11 management 12 services 12 services 14 all 12 services 18 studies 14 all 15 of 14 all 18 studies 15 of 17 four 16 the 17 four 18 studies 30 )(and 21 some 30 )(and 22 community 23 services 23 services 25 8 23 services 26 of 23 services 30 )(and 26 of 28 10 27 the 28 10 30 )(and 42 delay 31 nursing 42 delay 32 home 33 admission 33 admission 34 and 34 and 35 stay 34 and 37 around 34 and 42 delay 36 ( 37 around 37 around 38 one 37 around 40 ) 42 delay 43 of 43 of 44 nursing 44 nursing 45 home 44 nursing 46 placement 44 nursing 56 achieving 46 placement 52 studies 47 ( 52 studies 48 all 49 of 48 all 52 studies 49 of 52 studies 50 the 51 two 51 two 52 studies 52 studies 53 ) 54 , 56 achieving 56 achieving 58 neutrality 56 achieving 65 . 57 cost 58 neutrality 58 neutrality 60 8 59 ( 60 8 60 8 61 of 60 8 64 ) 61 of 63 11 62 the 63 11 the effects on medical care utilization were varying . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 9 . 1 the 2 effects 2 effects 3 on 2 effects 7 were 3 on 6 utilization 4 medical 5 care 5 care 6 utilization 7 were 8 varying discussion : in general , these positive effects justify the further development and refinement of cmcac programs . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 18 . 1 discussion 2 : 2 : 4 general 3 in 4 general 5 , 8 effects 5 , 9 justify 6 these 8 effects 7 positive 8 effects 8 effects 9 justify 9 justify 13 and 10 the 13 and 11 further 12 development 12 development 13 and 13 and 14 refinement 13 and 15 of 15 of 17 programs 16 cmcac 17 programs result applicability is limited by only including english studies . 0 ###LEFT-WALL### 2 applicability 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 10 . 1 result 2 applicability 2 applicability 3 is 3 is 4 limited 4 limited 5 by 5 by 7 including 6 only 7 including 7 including 9 studies 8 english 9 studies cost studies applying a societal perspective , and full economic appraisals [where] appropriate are warranted . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 15 warranted 0 ###LEFT-WALL### 16 . 1 cost 2 studies 2 studies 3 applying 2 studies 8 and 3 applying 6 perspective 4 a 6 perspective 5 societal 6 perspective 7 , 8 and 8 and 9 full 8 and 11 appraisals 8 and 13 appropriate 8 and 14 are 10 economic 11 appraisals 11 appraisals 13 appropriate 14 are 15 warranted [none] background : impaired tissue responsiveness to nitric oxide ( no ) occurs in many cardiovascular diseases as well as with advanced age and is [a] correlate [of] poor outcomes . 0 ###LEFT-WALL### 2 background 0 ###LEFT-WALL### 3 : 3 : 6 responsiveness 3 : 24 and 3 : 31 . 4 impaired 5 tissue 5 tissue 6 responsiveness 6 responsiveness 7 to 6 responsiveness 24 and 7 to 9 oxide 8 nitric 9 oxide 9 oxide 11 no 10 ( 11 no 11 no 12 ) 13 occurs 14 in 13 occurs 18 as 13 occurs 20 as 13 occurs 24 and 14 in 17 diseases 15 many 17 diseases 16 cardiovascular 17 diseases 18 as 19 well 20 as 21 with 21 with 23 age 22 advanced 23 age 24 and 25 is 24 and 30 outcomes 25 is 27 correlate 29 poor 30 outcomes this phenomenon results from oxidative stress , with no " scavenging " and dysfunction of soluble guanylate cyclase ( sgc ) . 0 ###LEFT-WALL### 2 phenomenon 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 22 . 1 this 2 phenomenon 2 phenomenon 3 results 3 results 4 from 3 results 8 with 4 from 6 stress 5 oxidative 6 stress 7 , 8 with 8 with 13 and 8 with 21 ) 9 no 10 " 9 no 11 scavenging 9 no 13 and 11 scavenging 12 " 13 and 14 dysfunction 13 and 15 of 15 of 18 cyclase 16 soluble 18 cyclase 17 guanylate 18 cyclase 18 cyclase 20 sgc 19 ( 20 sgc 20 sgc 21 ) thioredoxin - interacting protein ( txnip ) is a major intracellular regulator of inflammatory activation and redox stress , but its interactions with no/sgc are poorly understood . 0 ###LEFT-WALL### 4 protein 0 ###LEFT-WALL### 8 is 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 28 . 1 thioredoxin 2 - 1 thioredoxin 4 protein 3 interacting 4 protein 4 protein 6 txnip 4 protein 8 is 5 ( 6 txnip 6 txnip 7 ) 8 is 12 regulator 9 a 12 regulator 10 major 12 regulator 11 intracellular 12 regulator 12 regulator 13 of 13 of 16 and 14 inflammatory 15 activation 15 activation 16 and 16 and 18 stress 17 redox 18 stress 19 , 20 but 20 but 22 interactions 20 but 27 understood 21 its 22 interactions 22 interactions 23 with 22 interactions 25 are 23 with 24 no/sgc 25 are 26 poorly 25 are 27 understood we have now evaluated the relationship between platelet txnip expression and function of the no/sgc axis in subjects of varying age and during therapy with ramipril . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 27 . 1 we 2 have 2 have 4 evaluated 3 now 4 evaluated 4 evaluated 6 relationship 4 evaluated 7 between 4 evaluated 25 with 5 the 6 relationship 7 between 11 and 8 platelet 10 expression 9 txnip 10 expression 10 expression 11 and 11 and 12 function 11 and 13 of 13 of 16 axis 14 the 16 axis 15 no/sgc 16 axis 16 axis 22 and 17 in 18 subjects 17 in 22 and 18 subjects 19 of 19 of 20 varying 20 varying 21 age 22 and 23 during 23 during 24 therapy 25 with 26 ramipril methods & results : young ( n=42 ) and aging ( n=49 ) subjects underwent evaluation [of] platelet txnip content . 0 ###LEFT-WALL### 3 results 0 ###LEFT-WALL### 4 : 1 methods 2 & 2 & 3 results 4 : 14 subjects 4 : 15 underwent 4 : 21 . 5 young 7 n=42 5 young 9 and 6 ( 7 n=42 7 n=42 8 ) 9 and 10 aging 9 and 12 n=49 9 and 14 subjects 11 ( 12 n=49 12 n=49 13 ) 14 subjects 15 underwent 15 underwent 20 content 16 evaluation 20 content 18 platelet 20 content 19 txnip 20 content aging subjects additionally had measurements of platelet no responsiveness and routine biochemistry . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 13 . 1 aging 2 subjects 1 aging 4 had 3 additionally 4 had 4 had 5 measurements 5 measurements 6 of 6 of 10 and 7 platelet 9 responsiveness 8 no 9 responsiveness 9 responsiveness 10 and 10 and 12 biochemistry 11 routine 12 biochemistry platelet txnip content was greater [(] 376±33 units [ )(in the aging compared to younger subjects ( 289±13 units ; p<0.05 [ )( 0 ###LEFT-WALL### 3 content 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 20 ; 0 ###LEFT-WALL### 23 )( 1 platelet 2 txnip 2 txnip 3 content 3 content 4 was 4 was 8 units 4 was 10 )(in 5 greater 8 units 7 376±33 8 units 10 )(in 12 aging 11 the 12 aging 12 aging 13 compared 12 aging 19 units 13 compared 14 to 14 to 16 subjects 15 younger 16 subjects 17 ( 19 units 18 289±13 19 units 19 units 20 ; 20 ; 21 p<0.05 in the aging subjects there was a significant negative correlation ( r= - 0.50 , p<0.001 ) between platelet txnip content and no responsiveness . 0 ###LEFT-WALL### 5 there 0 ###LEFT-WALL### 6 was 0 ###LEFT-WALL### 25 . 1 in 4 subjects 1 in 5 there 2 the 4 subjects 3 aging 4 subjects 5 there 6 was 6 was 10 correlation 6 was 18 between 7 a 8 significant 7 a 10 correlation 8 significant 9 negative 9 negative 10 correlation 10 correlation 16 p<0.001 11 ( 16 p<0.001 12 r= 14 0.50 12 r= 15 , 12 r= 16 p<0.001 13 - 14 0.50 14 0.50 15 , 16 p<0.001 17 ) 18 between 22 and 19 platelet 21 content 20 txnip 21 content 21 content 22 and 22 and 24 responsiveness 23 no 24 responsiveness in a separate cohort of 15 subjects two week treatment with ramipril , which reversed platelet no resistance and potentiated sgc activity , also decreased platelet txnip content by 40 % ( p=0.011 ) . 0 ###LEFT-WALL### 10 treatment 0 ###LEFT-WALL### 25 decreased 0 ###LEFT-WALL### 35 . 1 in 4 cohort 1 in 10 treatment 2 a 4 cohort 3 separate 4 cohort 4 cohort 5 of 5 of 7 subjects 6 15 7 subjects 8 two 9 week 9 week 10 treatment 10 treatment 11 with 10 treatment 14 which 10 treatment 25 decreased 11 with 12 ramipril 13 , 14 which 14 which 19 and 14 which 23 , 15 reversed 18 resistance 15 reversed 19 and 16 platelet 18 resistance 17 no 18 resistance 19 and 20 potentiated 20 potentiated 22 activity 21 sgc 22 activity 24 also 25 decreased 25 decreased 27 txnip 26 platelet 27 txnip 27 txnip 28 content 28 content 29 by 29 by 31 % 30 40 31 % 31 % 33 p=0.011 32 ( 33 p=0.011 33 p=0.011 34 ) conclusions : platelet txnip content increases with aging , varies inversely with responsiveness to no , and diminishes rapidly following treatment with ramipril . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 1 conclusions 2 : 2 : 4 txnip 3 platelet 4 txnip 4 txnip 5 content 4 txnip 18 diminishes 4 txnip 20 following 5 content 9 , 6 increases 7 with 6 increases 9 , 7 with 8 aging 9 , 17 and 10 varies 11 inversely 10 varies 12 with 10 varies 14 to 10 varies 17 and 12 with 13 responsiveness 14 to 15 no 16 , 17 and 17 and 18 diminishes 19 rapidly 20 following 20 following 21 treatment 20 following 22 with 22 with 23 ramipril these data suggest that txnip - induced oxidative stress may be a critical modulator of tissue resistance to no , a fundamental basis for cardiovascular disease . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 6 - 1 these 2 data 2 data 3 suggest 3 suggest 5 txnip 4 that 5 txnip 6 - 9 stress 6 - 11 be 7 induced 9 stress 8 oxidative 9 stress 9 stress 10 may 10 may 11 be 11 be 14 modulator 12 a 14 modulator 13 critical 14 modulator 14 modulator 15 of 15 of 17 resistance 16 tissue 17 resistance 17 resistance 18 to 18 to 19 no 19 no 23 basis 20 , 23 basis 21 a 22 fundamental 21 a 23 basis 22 fundamental 23 basis 23 basis 24 for 23 basis 27 . 24 for 26 disease 25 cardiovascular 26 disease analogously suppression of txnip expression can potentially be utilized as an index of restoration of cardiovascular homeostasis . 0 ###LEFT-WALL### 2 suppression 0 ###LEFT-WALL### 9 utilized 0 ###LEFT-WALL### 18 . 1 analogously 2 suppression 2 suppression 3 of 2 suppression 6 can 3 of 5 expression 4 txnip 5 expression 6 can 8 be 7 potentially 8 be 8 be 9 utilized 9 utilized 10 as 10 as 12 index 11 an 12 index 12 index 13 of 13 of 14 restoration 14 restoration 15 of 15 of 17 homeostasis 16 cardiovascular 17 homeostasis [non] - hodgkin lymphoma ( nhl ) occurs worldwide although there is notable geographical variation in incidence [and] [subtype] distribution . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 8 occurs 0 ###LEFT-WALL### 21 . 2 - 6 nhl 3 hodgkin 4 lymphoma 4 lymphoma 6 nhl 5 ( 6 nhl 6 nhl 7 ) 6 nhl 8 occurs 8 occurs 9 worldwide 8 occurs 10 although 8 occurs 16 in 10 although 11 there 10 although 12 is 11 there 12 is 12 is 15 variation 13 notable 15 variation 14 geographical 15 variation 16 in 20 distribution 17 incidence 20 distribution these differences are due to a combination of demographic , environmental and other unidentified factors . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 16 . 1 these 2 differences 2 differences 3 are 3 are 5 to 4 due 5 to 5 to 7 combination 6 a 7 combination 7 combination 8 of 8 of 12 and 9 demographic 10 , 10 , 11 environmental 10 , 12 and 12 and 15 factors 13 other 15 factors 14 unidentified 15 factors a dramatic increase in nhl [incidence] was seen starting around 1970 , with subsequent stabilization 10 years ago . 0 ###LEFT-WALL### 3 increase 0 ###LEFT-WALL### 8 seen 1 a 2 dramatic 1 a 3 increase 2 dramatic 3 increase 3 increase 4 in 3 increase 7 was 4 in 5 nhl 7 was 8 seen 8 seen 9 starting 9 starting 10 around 9 starting 13 with 10 around 11 1970 12 , 13 with 13 with 15 stabilization 13 with 19 . 14 subsequent 15 stabilization 15 stabilization 18 ago 16 10 17 years 17 years 18 ago despite this plateau , the number of new cases in many countries will increase significantly in coming years due primarily to aging populations . 0 ###LEFT-WALL### 9 cases 0 ###LEFT-WALL### 14 increase 0 ###LEFT-WALL### 24 . 1 despite 3 plateau 1 despite 4 , 1 despite 9 cases 2 this 3 plateau 5 the 6 number 6 number 7 of 6 number 9 cases 7 of 9 cases 8 new 9 cases 9 cases 10 in 9 cases 13 will 10 in 12 countries 11 many 12 countries 13 will 14 increase 14 increase 15 significantly 14 increase 16 in 16 in 18 years 17 coming 18 years 18 years 19 due 19 due 20 primarily 20 primarily 21 to 21 to 22 aging 22 aging 23 populations in the majority of cases , strong risk factors are not identifiable . 0 ###LEFT-WALL### 9 factors 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 13 . 1 in 5 cases 1 in 6 , 1 in 9 factors 2 the 3 majority 3 majority 4 of 3 majority 5 cases 4 of 5 cases 7 strong 9 factors 8 risk 9 factors 9 factors 10 are 10 are 11 not 10 are 12 identifiable there is significant epidemiological heterogeneity between nhl [subtypes] , yet cancer registries have tended to consider nhl as a single entity . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 16 consider 0 ###LEFT-WALL### 22 . 1 there 2 is 2 is 5 heterogeneity 3 significant 5 heterogeneity 4 epidemiological 5 heterogeneity 5 heterogeneity 6 between 6 between 7 nhl 9 , 10 yet 9 , 14 tended 10 yet 12 registries 11 cancer 12 registries 12 registries 13 have 13 have 14 tended 14 tended 15 to 15 to 16 consider 16 consider 17 nhl 16 consider 18 as 18 as 21 entity 19 a 20 single 19 a 21 entity 20 single 21 entity this is one of several epidemiological obstacles discussed . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 9 . 1 this 2 is 2 is 3 one 3 one 4 of 4 of 7 obstacles 5 several 7 obstacles 6 epidemiological 7 obstacles 7 obstacles 8 discussed objective : the aim of this study was to assess the effects of oral [triiodothyronine] ( t3 ) therapy on postoperative thyroid hormone concentrations , hemodynamic variables , and outcomes . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 assess 0 ###LEFT-WALL### 31 . 2 : 4 aim 3 the 4 aim 4 aim 5 of 4 aim 7 study 4 aim 10 assess 5 of 6 this 7 study 8 was 8 was 9 to 8 was 10 assess 9 to 10 assess 10 assess 12 effects 10 assess 20 on 11 the 12 effects 12 effects 13 of 13 of 19 therapy 14 oral 17 t3 14 oral 19 therapy 16 ( 17 t3 17 t3 18 ) 20 on 29 and 21 postoperative 22 thyroid 22 thyroid 24 concentrations 23 hormone 24 concentrations 24 concentrations 25 , 25 , 27 variables 25 , 29 and 26 hemodynamic 27 variables 28 , 29 and 29 and 30 outcomes design : [a] prospective , randomized , controlled , double - blind study . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 14 . 1 design 2 : 2 : 4 prospective 4 prospective 6 randomized 4 prospective 8 controlled 5 , 6 randomized 6 randomized 7 , 7 , 8 controlled 8 controlled 9 , 9 , 13 study 10 double 11 - 10 double 13 study 12 blind 13 study setting : cardiac operating room at a single institution . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 . 1 setting 2 : 2 : 3 cardiac 3 cardiac 4 operating 4 operating 5 room 4 operating 6 at 6 at 9 institution 7 a 8 single 7 a 9 institution 8 single 9 institution participants : one hundred patients undergoing elective [off] - pump coronary artery bypass graft surgery . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 16 . 1 participants 2 : 2 : 5 patients 3 one 4 hundred 4 hundred 5 patients 5 patients 6 undergoing 6 undergoing 15 surgery 7 elective 9 - 7 elective 10 pump 10 pump 14 graft 11 coronary 12 artery 12 artery 14 graft 13 bypass 14 graft 14 graft 15 surgery interventions : patients received either 20 μg of oral t3 or placebo every 12 hours starting 20 minutes before anesthetic induction , for a total of 4 doses . 0 ###LEFT-WALL### 1 interventions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 minutes 2 : 3 patients 2 : 4 received 3 patients 4 received 4 received 5 either 4 received 7 μg 6 20 7 μg 7 μg 8 of 8 of 11 or 9 oral 10 t3 10 t3 11 or 11 or 12 placebo 11 or 13 every 11 or 16 starting 11 or 18 minutes 13 every 15 hours 14 12 15 hours 16 starting 17 20 16 starting 18 minutes 18 minutes 19 before 18 minutes 23 for 19 before 21 induction 20 anesthetic 21 induction 22 , 23 for 23 for 25 total 23 for 29 . 24 a 25 total 25 total 26 of 26 of 28 doses 27 4 28 doses measurements and main results : plasma concentrations of thyroid hormones were measured serially before surgery , upon [arrival] [in] the intensive care unit , [and] 12 , 24 , and 36 hours after surgery . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 35 . 1 measurements 2 and 2 and 3 main 3 main 4 results 5 : 7 concentrations 5 : 11 were 6 plasma 7 concentrations 7 concentrations 8 of 7 concentrations 11 were 8 of 10 hormones 9 thyroid 10 hormones 11 were 12 measured 12 measured 13 serially 12 measured 30 and 14 before 15 surgery 14 before 30 and 15 surgery 17 upon 15 surgery 26 12 15 surgery 28 24 16 , 17 upon 17 upon 23 unit 17 upon 24 , 20 the 23 unit 21 intensive 22 care 22 care 23 unit 24 , 26 12 26 12 27 , 27 , 28 24 28 24 29 , 29 , 30 and 30 and 33 after 31 36 32 hours 32 hours 33 after 33 after 34 surgery hemodynamic variables also were recorded serially . 0 ###LEFT-WALL### 2 variables 0 ###LEFT-WALL### 5 recorded 0 ###LEFT-WALL### 7 . 1 hemodynamic 2 variables 2 variables 4 were 3 also 4 were 4 were 5 recorded 5 recorded 6 serially postoperative inotrope requirement and major morbidity endpoints were assessed . 0 ###LEFT-WALL### 7 endpoints 0 ###LEFT-WALL### 9 assessed 0 ###LEFT-WALL### 10 . 1 postoperative 7 endpoints 2 inotrope 7 endpoints 3 requirement 4 and 4 and 5 major 4 and 7 endpoints 6 morbidity 7 endpoints 7 endpoints 8 were 8 were 9 assessed serum t3 concentrations were significantly higher with fewer patients having t3 concentrations below the normal range in the t3 group than the placebo group throughout the postoperative period . 0 ###LEFT-WALL### 3 concentrations 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 29 . 1 serum 3 concentrations 2 t3 3 concentrations 3 concentrations 4 were 4 were 6 higher 5 significantly 6 higher 6 higher 7 with 7 with 9 patients 7 with 10 having 8 fewer 9 patients 10 having 11 t3 11 t3 12 concentrations 11 t3 20 group 12 concentrations 13 below 12 concentrations 17 in 12 concentrations 20 group 13 below 16 range 14 the 16 range 15 normal 16 range 17 in 19 t3 18 the 19 t3 20 group 21 than 20 group 25 throughout 21 than 24 group 22 the 24 group 23 placebo 24 group 25 throughout 28 period 26 the 28 period 27 postoperative 28 period hemodynamic variables , postoperative inotrope requirement , and outcome variables showed no differences between the groups . 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 11 showed 0 ###LEFT-WALL### 17 . 1 hemodynamic 2 variables 2 variables 3 , 3 , 6 requirement 3 , 8 and 4 postoperative 6 requirement 5 inotrope 6 requirement 7 , 8 and 8 and 10 variables 8 and 11 showed 9 outcome 10 variables 11 showed 13 differences 11 showed 14 between 12 no 13 differences 14 between 16 groups 15 the 16 groups conclusions : oral t3 therapy significantly attenuated the postoperative decline in t3 concentrations in patients undergoing off - pump coronary artery bypass graft surgery . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 - 1 conclusions 2 : 2 : 4 t3 3 oral 4 t3 4 t3 5 therapy 4 t3 17 off 5 therapy 7 attenuated 6 significantly 7 attenuated 7 attenuated 10 decline 7 attenuated 11 in 7 attenuated 14 in 7 attenuated 17 off 8 the 10 decline 9 postoperative 10 decline 11 in 13 concentrations 12 t3 13 concentrations 14 in 16 undergoing 15 patients 16 undergoing 18 - 19 pump 18 - 25 . 19 pump 24 surgery 20 coronary 21 artery 21 artery 24 surgery 22 bypass 23 graft 23 graft 24 surgery the lack [of] apparent clinical benefit merits further investigations in patients with reduced cardiac performance . 0 ###LEFT-WALL### 7 merits 0 ###LEFT-WALL### 8 further 0 ###LEFT-WALL### 16 . 1 the 7 merits 2 lack 7 merits 4 apparent 6 benefit 5 clinical 6 benefit 6 benefit 7 merits 7 merits 8 further 8 further 9 investigations 8 further 10 in 8 further 12 with 10 in 11 patients 12 with 15 performance 13 reduced 15 performance 14 cardiac 15 performance background : numerous clinical trials [in] [stroke] have failed , most probably partially due to preclinical studies using young , healthy male rodents with little [relevance] to the heterogenic conditions [of] human stroke . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 1 background 2 : 2 : 3 numerous 3 numerous 5 trials 3 numerous 9 failed 3 numerous 14 due 4 clinical 5 trials 5 trials 8 have 8 have 9 failed 10 , 14 due 11 most 12 probably 12 probably 14 due 13 partially 14 due 14 due 15 to 14 due 18 using 14 due 34 . 15 to 17 studies 16 preclinical 17 studies 18 using 23 rodents 18 using 24 with 18 using 27 to 19 young 20 , 19 young 22 male 21 healthy 22 male 22 male 23 rodents 24 with 25 little 27 to 33 stroke 28 the 33 stroke 29 heterogenic 33 stroke 30 conditions 33 stroke 32 human 33 stroke [co] - morbid conditions such as atherosclerosis and infections coupled with advanced age are known to contribute to increased risk of cerebrovascular diseases . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 15 known 0 ###LEFT-WALL### 24 . 2 - 8 and 3 morbid 4 conditions 4 conditions 6 as 4 conditions 8 and 5 such 6 as 6 as 7 atherosclerosis 8 and 9 infections 8 and 10 coupled 8 and 14 are 10 coupled 11 with 11 with 13 age 12 advanced 13 age 14 are 15 known 15 known 16 to 15 known 17 contribute 16 to 17 contribute 17 contribute 18 to 18 to 20 risk 19 increased 20 risk 20 risk 21 of 21 of 23 diseases 22 cerebrovascular 23 diseases clinical and preclinical studies have shown that the e4 allele of human apolipoprotein ( apoe4 ) is linked to poorer [outcome] in various conditions of brain injury and neurodegeneration , including cerebral ischemia . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 6 shown 1 clinical 2 and 2 and 3 preclinical 2 and 4 studies 4 studies 5 have 5 have 6 shown 6 shown 7 that 6 shown 9 e4 6 shown 28 and 6 shown 31 including 8 the 9 e4 9 e4 10 allele 9 e4 19 to 9 e4 20 poorer 10 allele 11 of 10 allele 15 apoe4 10 allele 17 is 11 of 13 apolipoprotein 12 human 13 apolipoprotein 14 ( 15 apoe4 15 apoe4 16 ) 17 is 18 linked 18 linked 19 to 20 poorer 22 in 22 in 24 conditions 23 various 24 conditions 24 conditions 25 of 25 of 27 injury 26 brain 27 injury 28 and 29 neurodegeneration 30 , 31 including 31 including 33 ischemia 31 including 34 . 32 cerebral 33 ischemia since apoe is a known regulator of lipid homeostasis , we studied the impact of a high - cholesterol diet in aged mice in the context of relevant human apoe isoforms on the outcome of focal brain ischemia . 0 ###LEFT-WALL### 11 we 0 ###LEFT-WALL### 12 studied 0 ###LEFT-WALL### 39 . 1 since 2 apoe 1 since 3 is 1 since 10 , 1 since 11 we 2 apoe 3 is 3 is 6 regulator 4 a 6 regulator 5 known 6 regulator 6 regulator 7 of 7 of 9 homeostasis 8 lipid 9 homeostasis 11 we 12 studied 12 studied 14 impact 12 studied 21 in 12 studied 24 in 12 studied 32 on 13 the 14 impact 14 impact 15 of 15 of 20 diet 16 a 17 high 16 a 20 diet 17 high 18 - 17 high 19 cholesterol 19 cholesterol 20 diet 21 in 23 mice 22 aged 23 mice 24 in 26 context 25 the 26 context 26 context 27 of 27 of 31 isoforms 28 relevant 29 human 29 human 31 isoforms 30 apoe 31 isoforms 32 on 34 outcome 33 the 34 outcome 34 outcome 35 of 35 of 38 ischemia 36 focal 38 ischemia 37 brain 38 ischemia methods : aged mice expressing human e3 and e4 isoforms of apoe in c57bl/6j background and c57bl/6j mice fed on either a high - fat diet or a normal diet underwent permanent middle cerebral artery occlusion . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 37 . 2 : 15 background 2 : 16 and 3 aged 15 background 4 mice 5 expressing 5 expressing 6 human 6 human 15 background 7 e3 8 and 8 and 10 isoforms 8 and 11 of 8 and 15 background 9 e4 10 isoforms 11 of 12 apoe 12 apoe 13 in 13 in 14 c57bl/6j 16 and 18 mice 16 and 31 underwent 17 c57bl/6j 18 mice 18 mice 19 fed 18 mice 20 on 18 mice 31 underwent 20 on 27 or 21 either 27 or 22 a 26 diet 23 high 24 - 23 high 25 fat 25 fat 26 diet 26 diet 27 or 27 or 30 diet 28 a 29 normal 28 a 30 diet 29 normal 30 diet 31 underwent 36 occlusion 32 permanent 33 middle 33 middle 36 occlusion 34 cerebral 35 artery 35 artery 36 occlusion the impact of a high - cholesterol diet was assessed by measuring the serum cholesterol level and the infarction volume was determined by magnetic resonance imaging . 0 ###LEFT-WALL### 2 impact 0 ###LEFT-WALL### 10 assessed 0 ###LEFT-WALL### 27 . 1 the 2 impact 2 impact 3 of 2 impact 9 was 3 of 8 diet 4 a 8 diet 5 high 6 - 5 high 7 cholesterol 7 cholesterol 8 diet 9 was 10 assessed 10 assessed 11 by 11 by 12 measuring 12 measuring 17 and 13 the 16 level 14 serum 16 level 15 cholesterol 16 level 16 level 17 and 17 and 19 infarction 17 and 20 volume 17 and 26 imaging 18 the 19 infarction 20 volume 21 was 21 was 22 determined 22 determined 23 by 23 by 25 resonance 24 magnetic 25 resonance 25 resonance 26 imaging sensorimotor deficits were assessed using an adhesive removal test and the findings were correlated with inflammatory markers . 0 ###LEFT-WALL### 2 deficits 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 18 . 1 sensorimotor 2 deficits 2 deficits 3 were 3 were 4 assessed 4 assessed 5 using 5 using 9 test 6 an 7 adhesive 6 an 9 test 7 adhesive 8 removal 8 removal 9 test 10 and 12 findings 10 and 14 correlated 11 the 12 findings 12 findings 13 were 13 were 14 correlated 14 correlated 15 with 15 with 17 markers 16 inflammatory 17 markers results : we show that expression of human apoe4 renders aged mice fed with a western - type diet more susceptible [to] sensorimotor deficits upon [stroke] . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 we 2 : 4 show 2 : 17 - 3 we 4 show 4 show 5 that 5 that 6 expression 5 that 10 renders 6 expression 7 of 6 expression 10 renders 7 of 9 apoe4 8 human 9 apoe4 10 renders 12 mice 11 aged 12 mice 12 mice 13 fed 12 mice 14 with 14 with 16 western 15 a 16 western 17 - 18 type 18 type 24 deficits 18 type 25 upon 19 diet 24 deficits 20 more 21 susceptible 21 susceptible 23 sensorimotor 23 sensorimotor 24 deficits these deficits are not associated with atherosclerosis but [are] accompanied with altered astroglial activation , neurogenesis , cyclooxygenase - 2 immunoreactivity and increased plasma il - 6 . 0 ###LEFT-WALL### 2 deficits 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 28 . 1 these 2 deficits 2 deficits 3 are 3 are 4 not 3 are 6 with 3 are 8 but 4 not 5 associated 6 with 7 atherosclerosis 8 but 22 and 10 accompanied 11 with 10 accompanied 21 immunoreactivity 10 accompanied 22 and 11 with 14 activation 12 altered 14 activation 13 astroglial 14 activation 14 activation 16 neurogenesis 14 activation 18 cyclooxygenase 15 , 16 neurogenesis 16 neurogenesis 17 , 17 , 18 cyclooxygenase 18 cyclooxygenase 19 - 20 2 21 immunoreactivity 22 and 23 increased 22 and 27 6 23 increased 25 il 24 plasma 25 il 26 - 27 6 conclusions : our results support the hypothesis that apoe alleles modify the inflammatory responses in the brain and the periphery , thus contributing to altered functional outcome following stroke . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 support 2 : 30 . 3 our 4 results 4 results 5 support 5 support 7 hypothesis 5 support 15 in 6 the 7 hypothesis 7 hypothesis 8 that 8 that 10 alleles 8 that 11 modify 9 apoe 10 alleles 10 alleles 11 modify 11 modify 14 responses 12 the 14 responses 13 inflammatory 14 responses 15 in 29 stroke 16 the 29 stroke 17 brain 18 and 18 and 20 periphery 18 and 21 , 18 and 23 contributing 18 and 29 stroke 19 the 20 periphery 22 thus 23 contributing 23 contributing 24 to 24 to 28 following 25 altered 27 outcome 26 functional 27 outcome 27 outcome 28 following introduction : to evaluate surgical risk and post - operative quality of living status in patients over 85 years of age after transurethral vaporization resection of the prostate ( tuvrp ) . 0 ###LEFT-WALL### 1 introduction 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 7 and 2 : 9 - 2 : 32 . 3 to 7 and 4 evaluate 6 risk 4 evaluate 7 and 5 surgical 6 risk 7 and 8 post 9 - 11 quality 10 operative 11 quality 11 quality 12 of 12 of 13 living 13 living 14 status 13 living 15 in 13 living 17 over 13 living 22 after 15 in 16 patients 17 over 19 years 18 85 19 years 19 years 20 of 20 of 21 age 22 after 25 resection 23 transurethral 24 vaporization 24 vaporization 25 resection 25 resection 26 of 25 resection 30 tuvrp 26 of 28 prostate 27 the 28 prostate 29 ( 30 tuvrp 30 tuvrp 31 ) methods : sixty patients over 85 years of age underwent tuvrp were compared with 228 patients less than the age of 80 years . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 4 patients 3 sixty 4 patients 4 patients 5 over 4 patients 11 tuvrp 4 patients 12 were 4 patients 13 compared 5 over 6 85 6 85 7 years 6 85 10 underwent 7 years 8 of 7 years 10 underwent 8 of 9 age 11 tuvrp 12 were 13 compared 14 with 13 compared 17 less 13 compared 18 than 14 with 16 patients 15 228 16 patients 18 than 20 age 18 than 21 of 19 the 20 age 21 of 23 years 22 80 23 years group a was 60 patients greater than 85 years of age , group b was 137 patients from 71 to 79 years of age , and group c was 91 patients from 60 to 70 years of age . 0 ###LEFT-WALL### 1 group 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 39 . 1 group 2 a 1 group 3 was 3 was 5 patients 4 60 5 patients 5 patients 6 greater 5 patients 10 of 6 greater 7 than 7 than 9 years 8 85 9 years 10 of 11 age 12 , 13 group 12 , 15 was 12 , 26 and 13 group 14 b 13 group 15 was 15 was 17 patients 15 was 18 from 16 137 17 patients 18 from 22 years 19 71 20 to 20 to 21 79 20 to 22 years 22 years 23 of 23 of 24 age 25 , 26 and 26 and 27 group 26 and 29 was 27 group 28 c 27 group 29 was 29 was 31 patients 30 91 31 patients 31 patients 32 from 31 patients 37 of 32 from 36 years 33 60 34 to 34 to 35 70 34 to 36 years 37 of 38 age results : in group a , pre - operative asa grade was higher than the other two groups , compared with group c , p < 0.01 . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 than 0 ###LEFT-WALL### 28 . 1 results 2 : 2 : 3 in 2 : 9 operative 3 in 4 group 4 group 5 a 4 group 7 pre 6 , 7 pre 7 pre 8 - 10 asa 11 grade 11 grade 12 was 12 was 13 higher 13 higher 14 than 14 than 17 two 14 than 19 , 15 the 16 other 16 other 17 two 17 two 19 , 18 groups 19 , 19 , 20 compared 20 compared 21 with 20 compared 26 < 21 with 22 group 23 c 26 < 24 , 26 < 25 p 26 < 26 < 27 0.01 operating time was 40.03 ± 18.90 min , compared in the three groups , p > 0.05 . 0 ###LEFT-WALL### 1 operating 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 18 . 1 operating 2 time 1 operating 3 was 3 was 5 ± 4 40.03 5 ± 5 ± 6 18.90 5 ± 7 min 7 min 9 compared 7 min 16 > 8 , 9 compared 9 compared 10 in 9 compared 14 , 10 in 13 groups 11 the 13 groups 12 three 13 groups 15 p 16 > 16 > 17 0.05 follow - up [was] [obtained] in 49 ( 81.67 % ) patients ; of them 10 patients were deaths with a survival time of 22.90 ± 11.14 months . 0 ###LEFT-WALL### 1 follow 0 ###LEFT-WALL### 2 - 2 - 3 up 2 - 13 ; 2 - 29 . 3 up 6 in 3 up 12 patients 6 in 7 49 7 49 10 % 8 ( 10 % 9 81.67 10 % 10 % 11 ) 13 ; 17 patients 13 ; 18 were 14 of 15 them 14 of 17 patients 16 10 17 patients 17 patients 18 were 18 were 19 deaths 19 deaths 20 with 20 with 23 time 21 a 22 survival 21 a 23 time 22 survival 23 time 23 time 24 of 24 of 28 months 25 22.90 28 months 26 ± 28 months 27 11.14 28 months in the 39 survivors , post - operative ipss score [was] 11.17 ± 6.9 , compared with group b , p > 0.05 and group c , p < 0.01 . 0 ###LEFT-WALL### 6 post 0 ###LEFT-WALL### 16 compared 0 ###LEFT-WALL### 31 . 1 in 4 survivors 1 in 5 , 1 in 6 post 2 the 3 39 3 39 4 survivors 6 post 13 ± 6 post 16 compared 7 - 13 ± 8 operative 10 score 9 ipss 10 score 10 score 13 ± 12 11.17 13 ± 13 ± 14 6.9 13 ± 15 , 16 compared 17 with 16 compared 29 < 17 with 24 and 18 group 22 > 18 group 24 and 19 b 22 > 20 , 22 > 21 p 22 > 22 > 23 0.05 24 and 25 group 26 c 29 < 27 , 29 < 28 p 29 < 29 < 30 0.01 quality of life ( qol ) index [was] 1.11 ± 0.80 , compared with group b , p < 0.001 and group c , p < 0.01 . 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 28 . 1 quality 2 of 1 quality 21 and 2 of 10 ± 3 life 5 qol 4 ( 5 qol 5 qol 6 ) 5 qol 10 ± 7 index 10 ± 9 1.11 10 ± 10 ± 11 0.80 10 ± 13 compared 10 ± 19 < 12 , 13 compared 13 compared 14 with 13 compared 17 , 14 with 15 group 15 group 16 b 17 , 19 < 18 p 19 < 19 < 20 0.001 21 and 22 group 22 group 26 < 23 c 26 < 24 , 26 < 25 p 26 < 26 < 27 0.01 barthel index [score] in 16 patients was >60 and the score was 82.81 ± 8.56 pre - operatively . 0 ###LEFT-WALL### 2 index 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 9 and 1 barthel 2 index 2 index 4 in 2 index 7 was 4 in 6 patients 5 16 6 patients 7 was 8 >60 9 and 11 score 9 and 12 was 10 the 11 score 11 score 12 was 12 was 14 ± 13 82.81 14 ± 14 ± 15 8.56 14 ± 16 pre 15 8.56 16 pre 16 pre 18 operatively 17 - 18 operatively 18 operatively 19 . the patients with >60 were increased to 19 cases and the score was improved to 90.93 ± 7.58 ( p < 0.001 ) in [follow] - up . 0 ###LEFT-WALL### 2 patients 0 ###LEFT-WALL### 6 increased 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 28 . 1 the 2 patients 2 patients 3 with 2 patients 5 were 3 with 4 >60 5 were 6 increased 6 increased 7 to 7 to 9 cases 8 19 9 cases 10 and 12 score 10 and 14 improved 11 the 12 score 12 score 13 was 13 was 14 improved 14 improved 15 to 14 improved 26 - 14 improved 27 up 15 to 24 in 16 90.93 24 in 17 ± 21 < 17 ± 23 ) 17 ± 24 in 18 7.58 21 < 19 ( 21 < 20 p 21 < 21 < 22 0.001 conclusion : surgical risk in patients over 85 years of age was higher than patients less than the age of 80 years . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 4 risk 2 : 12 was 2 : 23 . 3 surgical 4 risk 4 risk 5 in 4 risk 7 over 4 risk 12 was 5 in 6 patients 7 over 9 years 8 85 9 years 9 years 10 of 10 of 11 age 12 was 13 higher 13 higher 14 than 13 higher 16 less 13 higher 17 than 14 than 15 patients 17 than 19 age 18 the 19 age 19 age 20 of 20 of 22 years 21 80 22 years a safety tuvrp could improve their voiding function and activities of daily living . 0 ###LEFT-WALL### 3 tuvrp 0 ###LEFT-WALL### 5 improve 0 ###LEFT-WALL### 14 . 1 a 3 tuvrp 2 safety 3 tuvrp 3 tuvrp 4 could 4 could 5 improve 5 improve 9 and 6 their 8 function 7 voiding 8 function 8 function 9 and 9 and 10 activities 9 and 11 of 11 of 13 living 12 daily 13 living background : it seems appropriate to assume , that for a full and strong global shoulder function [a] normally innervated and active deltoid muscle is indispensable . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 27 . 2 : 3 it 2 : 4 seems 2 : 8 , 3 it 4 seems 4 seems 5 appropriate 5 appropriate 6 to 5 appropriate 7 assume 6 to 7 assume 8 , 9 that 8 , 25 is 9 that 10 for 9 that 25 is 10 for 21 and 11 a 17 function 12 full 13 and 13 and 14 strong 13 and 17 function 15 global 17 function 16 shoulder 17 function 17 function 20 innervated 17 function 21 and 19 normally 20 innervated 21 and 24 muscle 22 active 24 muscle 23 deltoid 24 muscle 25 is 26 indispensable we set out to analyse the size and shape of the deltoid muscle on mr - arthrographies , and analyse its influence [on] shoulder function and its adaption [(] i.e . atrophy [ )( reduced shoulder function . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 31 . 0 ###LEFT-WALL### 38 . 1 we 2 set 2 set 3 out 2 set 4 to 4 to 19 and 5 analyse 8 and 5 analyse 19 and 6 the 7 size 7 size 8 and 8 and 9 shape 8 and 10 of 10 of 13 muscle 11 the 13 muscle 12 deltoid 13 muscle 13 muscle 14 on 14 on 15 mr 15 mr 17 arthrographies 16 - 17 arthrographies 17 arthrographies 18 , 19 and 20 analyse 20 analyse 26 and 20 analyse 30 i.e 21 its 25 function 22 influence 25 function 24 shoulder 25 function 25 function 26 and 26 and 28 adaption 26 and 30 i.e 27 its 28 adaption 31 . 37 function 32 atrophy 35 reduced 35 reduced 36 shoulder 36 shoulder 37 function methods : the fatty infiltration ( goutallier stages ) , atrophy [(] tangent sign [ )(and selective myotendinous retraction of the rotator cuff , as well as the thickness and the area of seven anatomically defined segments of the deltoid muscle were measured on mr - arthrographies [and] correlated with shoulder function ( i.e [.] active abduction ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 5 infiltration 3 the 5 infiltration 4 fatty 5 infiltration 5 infiltration 8 stages 5 infiltration 16 )(and 6 ( 8 stages 7 goutallier 8 stages 8 stages 9 ) 10 , 16 )(and 11 atrophy 14 sign 13 tangent 14 sign 14 sign 16 )(and 16 )(and 19 retraction 16 )(and 24 , 17 selective 19 retraction 18 myotendinous 19 retraction 19 retraction 20 of 20 of 23 cuff 21 the 23 cuff 22 rotator 23 cuff 24 , 25 as 25 as 30 and 25 as 36 defined 26 well 27 as 26 well 30 and 27 as 29 thickness 28 the 29 thickness 30 and 32 area 30 and 33 of 30 and 36 defined 31 the 32 area 33 of 34 seven 35 anatomically 36 defined 36 defined 37 segments 36 defined 44 on 37 segments 38 of 37 segments 41 muscle 37 segments 42 were 37 segments 43 measured 38 of 40 deltoid 39 the 40 deltoid 41 muscle 42 were 44 on 45 mr 45 mr 47 arthrographies 46 - 47 arthrographies 47 arthrographies 49 correlated 47 arthrographies 50 with 47 arthrographies 57 abduction 47 arthrographies 59 . 50 with 52 function 51 shoulder 52 function 53 ( 57 abduction 54 i.e 57 abduction 56 active 57 abduction 57 abduction 58 ) included were 116 patients , suffering of a rotator cuff tear with shoulder mobility ranging from pseudoparalysis to free mobility . 0 ###LEFT-WALL### 1 included 0 ###LEFT-WALL### 2 were 1 included 2 were 2 were 4 patients 3 116 4 patients 4 patients 6 suffering 5 , 6 suffering 6 suffering 7 of 6 suffering 12 with 6 suffering 21 . 7 of 11 tear 8 a 11 tear 9 rotator 11 tear 10 cuff 11 tear 12 with 14 mobility 13 shoulder 14 mobility 14 mobility 15 ranging 14 mobility 18 to 14 mobility 19 free 15 ranging 16 from 16 from 17 pseudoparalysis 18 to 19 free 19 free 20 mobility kolmogorov - smirnov [test] was used to determine the distribution of the data before either spearman or pearson correlation and a multiple regression was applied to reveal the correlations . 0 ###LEFT-WALL### 3 smirnov 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 27 reveal 0 ###LEFT-WALL### 30 . 1 kolmogorov 2 - 1 kolmogorov 3 smirnov 3 smirnov 5 was 5 was 6 used 6 used 7 to 6 used 8 determine 7 to 8 determine 8 determine 10 distribution 8 determine 14 before 9 the 10 distribution 10 distribution 11 of 11 of 13 data 12 the 13 data 14 before 17 or 15 either 17 or 16 spearman 17 or 17 or 19 correlation 18 pearson 19 correlation 20 and 23 regression 20 and 25 applied 21 a 23 regression 22 multiple 23 regression 23 regression 24 was 24 was 25 applied 25 applied 26 to 26 to 27 reveal 27 reveal 29 correlations 28 the 29 correlations results : our developed method for measuring deltoid area and thickness showed to be reproducible with excellent interobserver correlations ( r = 0.814 - 0.982 ).the analysis of influencing factors on active abduction revealed a weak influence of the amount of ssp tendon ( r = - 0.25 [;] [p] < 0.01 [ )( muscle retraction ( r = - 0.27 [;] p < 0.01 ) as well as the stage of fatty muscle infiltration ( gfdi : r = - 0.36 [;] p < 0.01 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 10 and 2 : 12 showed 3 our 5 method 4 developed 5 method 5 method 6 for 5 method 10 and 6 for 9 area 7 measuring 9 area 8 deltoid 9 area 10 and 11 thickness 10 and 12 showed 12 showed 13 to 12 showed 19 correlations 13 to 14 be 14 be 15 reproducible 15 reproducible 16 with 16 with 18 interobserver 17 excellent 18 interobserver 19 correlations 22 = 20 ( 22 = 21 r 22 = 22 = 23 0.814 23 0.814 25 0.982 23 0.814 34 revealed 24 - 25 0.982 25 0.982 27 analysis 25 0.982 30 factors 25 0.982 34 revealed 26 ).the 27 analysis 27 analysis 28 of 27 analysis 30 factors 28 of 29 influencing 30 factors 31 on 31 on 33 abduction 32 active 33 abduction 34 revealed 37 influence 34 revealed 46 = 35 a 36 weak 35 a 37 influence 36 weak 37 influence 37 influence 38 of 38 of 40 amount 39 the 40 amount 40 amount 41 of 41 of 43 tendon 42 ssp 43 tendon 44 ( 46 = 45 r 46 = 46 = 48 0.25 47 - 48 0.25 48 0.25 52 0.01 48 0.25 55 muscle 51 < 52 0.01 52 0.01 55 muscle 55 muscle 56 retraction 55 muscle 64 < 55 muscle 67 as 56 retraction 60 - 57 ( 60 - 58 r 59 = 59 = 60 - 60 - 61 0.27 63 p 64 < 64 < 65 0.01 64 < 66 ) 67 as 68 well 68 well 69 as 68 well 72 of 69 as 71 stage 70 the 71 stage 72 of 75 infiltration 73 fatty 74 muscle 74 muscle 75 infiltration 75 infiltration 81 - 76 ( 81 - 77 gfdi 78 : 78 : 80 = 79 r 80 = 80 = 81 - 81 - 82 0.36 81 - 88 . 82 0.36 85 < 84 p 85 < 85 < 86 0.01 85 < 87 ) unexpectedly however , we were unable to detect a relation of the deltoid muscle shape with the degree [of] active glenohumeral abduction . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 23 . 1 unexpectedly 4 we 2 however 3 , 2 however 4 we 4 we 5 were 5 were 6 unable 6 unable 7 to 6 unable 8 detect 7 to 8 detect 8 detect 10 relation 8 detect 16 with 9 a 10 relation 10 relation 11 of 11 of 15 shape 12 the 15 shape 13 deltoid 14 muscle 14 muscle 15 shape 16 with 22 abduction 17 the 22 abduction 18 degree 22 abduction 20 active 22 abduction 21 glenohumeral 22 abduction furthermore , long - standing rotator cuff tears did not appear to influence the deltoid shape , i.e [.] did not lead to muscle atrophy . 0 ###LEFT-WALL### 8 tears 0 ###LEFT-WALL### 11 appear 0 ###LEFT-WALL### 26 . 1 furthermore 2 , 1 furthermore 8 tears 3 long 4 - 3 long 5 standing 5 standing 8 tears 6 rotator 8 tears 7 cuff 8 tears 8 tears 9 did 9 did 10 not 9 did 11 appear 11 appear 12 to 11 appear 24 muscle 12 to 17 , 13 influence 16 shape 13 influence 17 , 14 the 16 shape 15 deltoid 16 shape 17 , 22 lead 18 i.e 20 did 20 did 21 not 20 did 22 lead 22 lead 23 to 23 to 24 muscle 24 muscle 25 atrophy conclusions : our data support that in chronic rotator cuff tears , there seems to be no disadvantage to exhausting conservative treatment and to delay implantation of reverse total shoulder arthroplasty , [as] the shape of deltoid muscle seems only to be influenced by natural aging , but to be independent of reduced shoulder motion . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 data 2 : 12 , 3 our 4 data 4 data 5 support 5 support 6 that 5 support 7 in 7 in 11 tears 8 chronic 10 cuff 9 rotator 10 cuff 10 cuff 11 tears 12 , 13 there 12 , 23 and 13 there 14 seems 14 seems 15 to 14 seems 16 be 15 to 16 be 16 be 18 disadvantage 16 be 19 to 17 no 18 disadvantage 19 to 20 exhausting 20 exhausting 22 treatment 21 conservative 22 treatment 23 and 35 shape 24 to 26 implantation 24 to 35 shape 25 delay 26 implantation 27 of 31 arthroplasty 27 of 32 , 27 of 35 shape 28 reverse 31 arthroplasty 29 total 30 shoulder 30 shoulder 31 arthroplasty 34 the 35 shape 35 shape 36 of 35 shape 39 seems 36 of 38 muscle 37 deltoid 38 muscle 39 seems 41 to 39 seems 43 influenced 40 only 41 to 41 to 42 be 42 be 43 influenced 43 influenced 44 by 44 by 45 natural 45 natural 46 aging 46 aging 48 but 47 , 48 but 48 but 49 to 48 but 50 be 48 but 56 . 49 to 50 be 50 be 51 independent 51 independent 52 of 52 of 55 motion 53 reduced 54 shoulder 54 shoulder 55 motion young and older adults searched for a unique face in a set of three schematic faces and identified a secondary feature of the target . 0 ###LEFT-WALL### 4 adults 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 25 . 1 young 2 and 2 and 3 older 2 and 4 adults 4 adults 17 and 5 searched 6 for 5 searched 17 and 6 for 9 face 7 a 9 face 8 unique 9 face 9 face 10 in 9 face 13 of 10 in 12 set 11 a 12 set 13 of 16 faces 14 three 16 faces 15 schematic 16 faces 17 and 18 identified 18 identified 21 feature 19 a 21 feature 20 secondary 21 feature 21 feature 22 of 22 of 24 target 23 the 24 target the faces could be negative , positive , or neutral . 0 ###LEFT-WALL### 2 faces 0 ###LEFT-WALL### 4 be 0 ###LEFT-WALL### 11 . 1 the 2 faces 2 faces 3 could 3 could 4 be 4 be 9 or 5 negative 6 , 6 , 7 positive 6 , 9 or 8 , 9 or 9 or 10 neutral young adults were slower and less accurate in searching for a negative face among neutral faces when they had previewed a display of negative faces than when they had previewed neutral faces , indicating an emotional distractor previewing effect ( dpe ) , but this effect was eliminated with inverted faces . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 44 but 0 ###LEFT-WALL### 52 . 1 young 2 adults 2 adults 3 were 3 were 5 and 3 were 7 accurate 4 slower 5 and 5 and 6 less 7 accurate 8 in 7 accurate 17 when 8 in 9 searching 9 searching 10 for 9 searching 14 among 10 for 13 face 11 a 13 face 12 negative 13 face 14 among 16 faces 15 neutral 16 faces 17 when 18 they 17 when 20 previewed 18 they 19 had 19 had 20 previewed 20 previewed 22 display 20 previewed 26 than 20 previewed 27 when 20 previewed 34 indicating 21 a 22 display 22 display 23 of 23 of 25 faces 24 negative 25 faces 27 when 28 they 27 when 30 previewed 28 they 29 had 29 had 30 previewed 30 previewed 32 faces 31 neutral 32 faces 33 , 34 indicating 34 indicating 37 distractor 34 indicating 43 , 35 an 36 emotional 35 an 37 distractor 36 emotional 37 distractor 37 distractor 38 previewing 38 previewing 39 effect 39 effect 41 dpe 40 ( 41 dpe 41 dpe 42 ) 44 but 46 effect 44 but 48 eliminated 45 this 46 effect 46 effect 47 was 47 was 48 eliminated 48 eliminated 49 with 49 with 51 faces 50 inverted 51 faces the dpe is an index [of] [inter] - trial inhibition to keep attention away from previewed , [non] - target information . 0 ###LEFT-WALL### 2 dpe 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 19 - 1 the 2 dpe 2 dpe 3 is 3 is 5 index 4 an 5 index 5 index 10 inhibition 8 - 10 inhibition 9 trial 10 inhibition 10 inhibition 11 to 10 inhibition 15 from 10 inhibition 16 previewed 10 inhibition 17 , 11 to 12 keep 12 keep 13 attention 12 keep 14 away 12 keep 15 from 19 - 20 target 19 - 22 . 20 target 21 information older adults also showed such an emotional dpe , but it was present with both upright and inverted faces . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 4 showed 0 ###LEFT-WALL### 10 but 0 ###LEFT-WALL### 20 . 1 older 2 adults 2 adults 4 showed 3 also 4 showed 4 showed 8 dpe 5 such 6 an 6 an 7 emotional 6 an 8 dpe 7 emotional 8 dpe 9 , 10 but 10 but 11 it 10 but 17 and 11 it 17 and 12 was 13 present 12 was 17 and 13 present 14 with 13 present 16 upright 14 with 15 both 17 and 18 inverted 17 and 19 faces these results show that , in general , both young and old participants are sensitive to trial history , yet the different patterns of results suggest that these two groups remember and use different types of perceptual information when searching through emotional faces . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 show 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 26 suggest 0 ###LEFT-WALL### 44 . 1 these 2 results 2 results 3 show 3 show 4 that 3 show 7 general 5 , 7 general 6 in 7 general 7 general 8 , 8 , 13 participants 8 , 14 are 9 both 13 participants 10 young 11 and 11 and 12 old 11 and 13 participants 13 participants 14 are 14 are 15 sensitive 14 are 20 yet 15 sensitive 16 to 16 to 18 history 17 trial 18 history 19 , 20 yet 20 yet 23 patterns 21 the 23 patterns 22 different 23 patterns 23 patterns 24 of 23 patterns 26 suggest 24 of 25 results 26 suggest 27 that 27 that 30 groups 27 that 32 and 28 these 29 two 29 two 30 groups 30 groups 32 and 31 remember 32 and 32 and 33 use 32 and 39 when 33 use 38 information 34 different 35 types 35 types 36 of 35 types 38 information 36 of 38 information 37 perceptual 38 information 39 when 40 searching 40 searching 41 through 41 through 43 faces 42 emotional 43 faces collagen fibrils become resistant to cleavage [over] time . 0 ###LEFT-WALL### 2 fibrils 0 ###LEFT-WALL### 3 become 0 ###LEFT-WALL### 9 . 1 collagen 2 fibrils 2 fibrils 3 become 3 become 4 resistant 4 resistant 5 to 5 to 8 time 6 cleavage 8 time we hypothesized that resistance to type i collagen proteolysis not only marks biological aging but also drives it . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesized 0 ###LEFT-WALL### 19 . 1 we 2 hypothesized 2 hypothesized 4 resistance 2 hypothesized 5 to 3 that 4 resistance 5 to 6 type 6 type 7 i 6 type 9 proteolysis 6 type 17 drives 8 collagen 9 proteolysis 9 proteolysis 16 also 10 not 11 only 11 only 16 also 12 marks 14 aging 12 marks 16 also 13 biological 14 aging 15 but 16 also 16 also 17 drives 17 drives 18 it to test this , we followed mice with a targeted mutation ( col1a1 ( r/r ) ) that yields collagenase - resistant type [i] collagen . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 26 . 1 to 2 test 2 test 3 this 4 , 5 we 4 , 6 followed 4 , 21 - 5 we 6 followed 6 followed 7 mice 6 followed 8 with 8 with 11 mutation 8 with 20 collagenase 9 a 11 mutation 10 targeted 11 mutation 11 mutation 13 col1a1 12 ( 13 col1a1 13 col1a1 15 r/r 13 col1a1 17 ) 14 ( 15 r/r 15 r/r 16 ) 18 that 20 collagenase 19 yields 20 collagenase 21 - 25 collagen 22 resistant 23 type 23 type 25 collagen compared with wild - type littermates , col1a1 ( r/r ) mice had a shortened lifespan and developed features of premature aging including kyphosis , weight loss , decreased bone mineral density , and hypertension . 0 ###LEFT-WALL### 8 col1a1 0 ###LEFT-WALL### 29 decreased 0 ###LEFT-WALL### 36 . 1 compared 2 with 1 compared 7 , 1 compared 8 col1a1 2 with 6 littermates 3 wild 4 - 3 wild 5 type 5 type 6 littermates 8 col1a1 12 mice 8 col1a1 29 decreased 9 ( 12 mice 10 r/r 11 ) 10 r/r 12 mice 12 mice 17 and 12 mice 20 of 12 mice 27 loss 12 mice 28 , 13 had 16 lifespan 13 had 17 and 14 a 16 lifespan 15 shortened 16 lifespan 17 and 18 developed 17 and 19 features 20 of 22 aging 21 premature 22 aging 22 aging 23 including 23 including 24 kyphosis 25 , 27 loss 26 weight 27 loss 27 loss 28 , 29 decreased 34 and 30 bone 32 density 31 mineral 32 density 32 density 34 and 33 , 34 and 34 and 35 hypertension we also found that vascular smooth muscle cells ( smcs ) in the aortic wall of col1a1 ( r/r ) mice were susceptible to stress - induced senescence , displaying senescence - associated ß - galactosidase ( sa - ßgal ) activity and upregulated p16 ( ink4a ) in response to angiotensin ii infusion . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 3 found 1 we 3 found 2 also 3 found 3 found 8 cells 3 found 12 in 3 found 25 stress 4 that 5 vascular 5 vascular 7 muscle 6 smooth 7 muscle 7 muscle 8 cells 8 cells 10 smcs 9 ( 10 smcs 10 smcs 11 ) 12 in 15 wall 13 the 15 wall 14 aortic 15 wall 15 wall 16 of 15 wall 21 mice 15 wall 24 to 16 of 17 col1a1 17 col1a1 19 r/r 18 ( 19 r/r 19 r/r 20 ) 21 mice 22 were 22 were 23 susceptible 23 susceptible 24 to 25 stress 28 senescence 25 stress 30 displaying 26 - 28 senescence 27 induced 28 senescence 28 senescence 29 , 29 , 30 displaying 30 displaying 31 senescence 30 displaying 51 to 30 displaying 55 . 31 senescence 43 and 32 - 43 and 33 associated 42 activity 34 ß 36 galactosidase 34 ß 42 activity 35 - 36 galactosidase 36 galactosidase 38 sa 36 galactosidase 39 - 37 ( 38 sa 38 sa 39 - 40 ßgal 41 ) 40 ßgal 42 activity 42 activity 43 and 43 and 45 p16 43 and 47 ink4a 43 and 48 ) 44 upregulated 45 p16 46 ( 47 ink4a 47 ink4a 48 ) 49 in 50 response 50 response 51 to 51 to 54 infusion 52 angiotensin 53 ii 52 angiotensin 54 infusion to elucidate the basis of this pro - aging effect , vascular smcs from twelve patients undergoing coronary artery bypass surgery were cultured on collagen derived from col1a1 ( r/r ) or wild - type mice . 0 ###LEFT-WALL### 13 smcs 0 ###LEFT-WALL### 22 were 0 ###LEFT-WALL### 37 . 1 to 2 elucidate 1 to 11 , 1 to 13 smcs 2 elucidate 4 basis 2 elucidate 9 aging 3 the 4 basis 4 basis 5 of 5 of 7 pro 6 this 7 pro 8 - 9 aging 9 aging 10 effect 9 aging 11 , 12 vascular 13 smcs 13 smcs 14 from 13 smcs 22 were 14 from 16 patients 15 twelve 16 patients 16 patients 17 undergoing 17 undergoing 21 surgery 18 coronary 21 surgery 19 artery 20 bypass 20 bypass 21 surgery 22 were 23 cultured 23 cultured 24 on 24 on 25 collagen 25 collagen 26 derived 25 collagen 27 from 27 from 32 or 28 col1a1 30 r/r 28 col1a1 32 or 29 ( 30 r/r 30 r/r 31 ) 32 or 36 mice 33 wild 34 - 33 wild 35 type 35 type 36 mice this revealed that mutant collagen directly reduced replicative lifespan and increased stress - induced sa - ßgal activity , p16 ( ink4a ) expression , and p21 ( cip1 ) expression . 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 32 . 1 this 5 collagen 2 revealed 5 collagen 3 that 4 mutant 4 mutant 5 collagen 5 collagen 10 and 5 collagen 26 and 6 directly 7 reduced 7 reduced 9 lifespan 7 reduced 10 and 8 replicative 9 lifespan 10 and 11 increased 10 and 12 stress 12 stress 15 sa 12 stress 18 activity 13 - 15 sa 14 induced 15 sa 15 sa 16 - 16 - 18 activity 17 ßgal 18 activity 18 activity 24 expression 18 activity 25 , 19 , 24 expression 20 p16 22 ink4a 20 p16 23 ) 20 p16 24 expression 21 ( 22 ink4a 22 ink4a 23 ) 24 expression 25 , 26 and 31 expression 27 p21 29 cip1 27 p21 31 expression 28 ( 29 cip1 29 cip1 30 ) the pro - senescence effect of mutant collagen was blocked by vitronectin , [a] ligand for αvß3 integrin that is presented by denatured but not native collagen . 0 ###LEFT-WALL### 2 pro 0 ###LEFT-WALL### 3 - 1 the 2 pro 3 - 5 effect 3 - 13 , 3 - 28 . 4 senescence 5 effect 5 effect 6 of 5 effect 9 was 6 of 8 collagen 7 mutant 8 collagen 9 was 13 , 10 blocked 11 by 10 blocked 12 vitronectin 10 blocked 13 , 13 , 15 ligand 15 ligand 16 for 15 ligand 22 by 16 for 18 integrin 17 αvß3 18 integrin 18 integrin 21 presented 19 that 20 is 20 is 21 presented 22 by 27 collagen 23 denatured 24 but 24 but 25 not 24 but 26 native 24 but 27 collagen 25 not 26 native moreover , inhibition of αvß3 with echistatin or [with] αvß3 - blocking antibody increased senescence of smcs on wild - type collagen . 0 ###LEFT-WALL### 8 or 0 ###LEFT-WALL### 21 type 0 ###LEFT-WALL### 23 . 1 moreover 2 , 1 moreover 8 or 3 inhibition 4 of 3 inhibition 8 or 4 of 5 αvß3 5 αvß3 6 with 6 with 7 echistatin 8 or 10 αvß3 8 or 12 blocking 8 or 21 type 11 - 12 blocking 12 blocking 15 senescence 12 blocking 18 on 12 blocking 19 wild 12 blocking 20 - 13 antibody 14 increased 14 increased 15 senescence 15 senescence 16 of 16 of 17 smcs 21 type 22 collagen these findings reveal a novel aging cascade whereby resistance to collagen [cleavage] accelerates cellular aging . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 reveal 0 ###LEFT-WALL### 16 . 1 these 2 findings 2 findings 3 reveal 3 reveal 7 cascade 3 reveal 8 whereby 4 a 5 novel 4 a 7 cascade 5 novel 7 cascade 6 aging 7 cascade 8 whereby 9 resistance 8 whereby 13 accelerates 9 resistance 10 to 9 resistance 11 collagen 9 resistance 13 accelerates 10 to 11 collagen 13 accelerates 15 aging 14 cellular 15 aging this interplay between extracellular and cellular compartments could hasten mammalian aging and the progression of aging - related diseases . 0 ###LEFT-WALL### 2 interplay 0 ###LEFT-WALL### 9 hasten 0 ###LEFT-WALL### 18 related 1 this 2 interplay 2 interplay 3 between 2 interplay 8 could 3 between 7 compartments 4 extracellular 5 and 5 and 6 cellular 5 and 7 compartments 8 could 9 hasten 9 hasten 12 and 10 mammalian 11 aging 10 mammalian 12 and 12 and 14 progression 12 and 15 of 13 the 14 progression 15 of 16 aging 17 - 18 related 18 related 19 diseases 18 related 20 . objectives : depression and anxiety related to stroke are caused by vascular lesions and psychological reactions . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 2 : 4 and 2 : 10 caused 2 : 17 . 3 depression 4 and 4 and 5 anxiety 4 and 6 related 4 and 7 to 4 and 8 stroke 4 and 9 are 7 to 8 stroke 9 are 10 caused 10 caused 11 by 11 by 14 and 12 vascular 13 lesions 13 lesions 14 and 14 and 16 reactions 15 psychological 16 reactions treatment of vascular and modifiable behavioral risk factors reduces the risk [of] stroke and may also reduce the risk of emotional changes [after] [stroke] . 0 ###LEFT-WALL### 1 treatment 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 treatment 2 of 1 treatment 14 and 2 of 8 factors 3 vascular 4 and 4 and 5 modifiable 4 and 8 factors 6 behavioral 8 factors 7 risk 8 factors 9 reduces 13 stroke 9 reduces 14 and 10 the 13 stroke 11 risk 13 stroke 14 and 15 may 15 may 17 reduce 16 also 17 reduce 17 reduce 19 risk 18 the 19 risk 19 risk 20 of 20 of 22 changes 21 emotional 22 changes we aimed to investigate whether a multifactorial risk factor intervention program in patients with first - [ever] [stroke] or transient ischemic attack ( tia ) can influence post - stroke anxiety and depressive symptoms in patients one year post - stroke . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 aimed 0 ###LEFT-WALL### 40 - 1 we 2 aimed 2 aimed 3 to 3 to 4 investigate 4 investigate 5 whether 5 whether 11 program 5 whether 27 influence 6 a 7 multifactorial 6 a 11 program 7 multifactorial 9 factor 8 risk 9 factor 9 factor 10 intervention 10 intervention 11 program 11 program 12 in 11 program 24 tia 11 program 26 can 12 in 19 or 13 patients 14 with 13 patients 19 or 14 with 15 first 16 - 19 or 19 or 22 attack 20 transient 22 attack 21 ischemic 22 attack 23 ( 24 tia 24 tia 25 ) 26 can 27 influence 27 influence 28 post 28 post 32 and 29 - 32 and 30 stroke 31 anxiety 31 anxiety 32 and 32 and 34 symptoms 32 and 35 in 32 and 40 - 33 depressive 34 symptoms 35 in 39 post 36 patients 39 post 37 one 38 year 38 year 39 post 40 - 41 stroke 40 - 42 . method : the study population consisted of first - ever stroke and tia patients allocated in a randomized [,] evaluator - blinded , controlled trial to care as usual or a structured [and] multidisciplinary follow - up including intensive treatment of vascular risk . 0 ###LEFT-WALL### 1 method 0 ###LEFT-WALL### 2 : 2 : 5 population 2 : 6 consisted 2 : 9 - 3 the 5 population 4 study 5 population 5 population 6 consisted 6 consisted 7 of 7 of 8 first 9 - 14 patients 10 ever 12 and 10 ever 14 patients 11 stroke 12 and 12 and 13 tia 14 patients 15 allocated 14 patients 22 blinded 14 patients 24 controlled 15 allocated 16 in 16 in 20 evaluator 17 a 20 evaluator 18 randomized 20 evaluator 21 - 22 blinded 22 blinded 23 , 24 controlled 25 trial 24 controlled 26 to 26 to 27 care 27 care 30 or 27 care 35 follow 28 as 29 usual 29 usual 30 or 30 or 34 multidisciplinary 30 or 35 follow 31 a 34 multidisciplinary 32 structured 34 multidisciplinary 35 follow 37 up 36 - 37 up 37 up 40 treatment 37 up 44 . 38 including 40 treatment 39 intensive 40 treatment 40 treatment 41 of 41 of 43 risk 42 vascular 43 risk the primary endpoint ( cognition ) has previously been reported . 0 ###LEFT-WALL### 3 endpoint 0 ###LEFT-WALL### 10 reported 0 ###LEFT-WALL### 11 . 1 the 3 endpoint 2 primary 3 endpoint 3 endpoint 5 cognition 3 endpoint 7 has 4 ( 5 cognition 5 cognition 6 ) 7 has 9 been 8 previously 9 been 9 been 10 reported the secondary endpoint , reported here , was changes in the hospital anxiety and depression scale ( hads ) from baseline to 12 [-] month follow - up . 0 ###LEFT-WALL### 3 endpoint 0 ###LEFT-WALL### 8 was 1 the 3 endpoint 2 secondary 3 endpoint 3 endpoint 5 reported 3 endpoint 8 was 4 , 5 reported 5 reported 6 here 5 reported 7 , 8 was 9 changes 8 was 10 in 10 in 12 hospital 11 the 12 hospital 12 hospital 14 and 12 hospital 26 follow 12 hospital 28 up 13 anxiety 14 and 14 and 18 hads 14 and 20 from 14 and 22 to 14 and 26 follow 15 depression 16 scale 16 scale 18 hads 17 ( 18 hads 18 hads 19 ) 20 from 21 baseline 22 to 25 month 23 12 25 month 27 - 28 up 28 up 29 . results : one hundred and ninety - five patients were randomized . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 12 . 1 results 2 : 2 : 4 hundred 3 one 4 hundred 5 and 9 patients 5 and 11 randomized 6 ninety 7 - 7 - 8 five 7 - 9 patients 9 patients 10 were 10 were 11 randomized the estimated difference between treatment groups , in changes in hads , from baseline to 12 months was - 1.32 ( 95 % confidence [interval] : - 2.61 , - 0.04 [;] p = 0.044 ) in favor of the intervention group . 0 ###LEFT-WALL### 3 difference 0 ###LEFT-WALL### 18 was 0 ###LEFT-WALL### 43 . 1 the 3 difference 2 estimated 3 difference 3 difference 4 between 3 difference 13 from 3 difference 18 was 4 between 6 groups 5 treatment 6 groups 6 groups 8 in 7 , 8 in 8 in 9 changes 8 in 12 , 9 changes 10 in 10 in 11 hads 13 from 14 baseline 14 baseline 15 to 15 to 17 months 16 12 17 months 18 was 20 1.32 18 was 34 = 18 was 37 in 19 - 20 1.32 20 1.32 23 % 21 ( 23 % 22 95 23 % 23 % 24 confidence 23 % 26 : 23 % 28 2.61 23 % 30 - 24 confidence 26 : 27 - 28 2.61 28 2.61 29 , 31 0.04 34 = 33 p 34 = 34 = 35 0.044 34 = 36 ) 37 in 38 favor 38 favor 39 of 39 of 42 group 40 the 42 group 41 intervention 42 group one year post - stroke , 4/85 [(] 4.7 % [ )(patients in the intervention group [and] 12/89 ( 13.5 % ) in the control group suffered from depression ( p = 0.045 [ )(, while 7/85 [(] 8.2 % [ )(patients in the intervention group [and] 13/89 ( 14.6 % ) [patients] in the control group suffered from anxiety ( p = 0.19 [ )( 0 ###LEFT-WALL### 3 post 0 ###LEFT-WALL### 4 - 1 one 2 year 2 year 3 post 4 - 5 stroke 4 - 6 , 6 , 12 )(patients 6 , 16 group 7 4/85 12 )(patients 9 4.7 10 % 10 % 12 )(patients 12 )(patients 13 in 12 )(patients 16 group 13 in 15 intervention 14 the 15 intervention 16 group 18 12/89 16 group 23 in 18 12/89 21 % 19 ( 21 % 20 13.5 21 % 21 % 22 ) 23 in 26 group 24 the 26 group 25 control 26 group 26 group 27 suffered 27 suffered 28 from 27 suffered 36 while 28 from 29 depression 29 depression 32 = 30 ( 32 = 31 p 32 = 32 = 33 0.045 32 = 35 )(, 36 while 42 )(patients 36 while 46 group 37 7/85 42 )(patients 39 8.2 40 % 40 % 42 )(patients 42 )(patients 43 in 42 )(patients 46 group 43 in 45 intervention 44 the 45 intervention 46 group 48 13/89 46 group 54 in 48 13/89 51 % 49 ( 51 % 50 14.6 51 % 51 % 52 ) 54 in 57 group 55 the 57 group 56 control 57 group 57 group 58 suffered 57 group 63 = 58 suffered 59 from 59 from 60 anxiety 61 ( 63 = 62 p 63 = 63 = 64 0.19 63 = 66 )( conclusion : a structured [,] multidisciplinary , multifactorial risk factor program including vascular risk factor management may be associated with reduced hads scores and a lower prevalence of depressive symptoms one year [after] stroke . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 35 . 2 : 11 program 2 : 19 associated 3 a 11 program 4 structured 10 factor 6 multidisciplinary 7 , 6 multidisciplinary 10 factor 8 multifactorial 10 factor 9 risk 10 factor 10 factor 11 program 11 program 12 including 11 program 19 associated 12 including 14 risk 13 vascular 14 risk 14 risk 16 management 14 risk 18 be 15 factor 16 management 16 management 17 may 17 may 18 be 19 associated 20 with 19 associated 34 stroke 20 with 24 and 21 reduced 23 scores 22 hads 23 scores 23 scores 24 and 24 and 27 prevalence 24 and 28 of 25 a 27 prevalence 26 lower 27 prevalence 28 of 30 symptoms 29 depressive 30 symptoms 31 one 34 stroke 32 year 34 stroke negative age stereotypes are pervasive and [threaten] older adults ' self - esteem . 0 ###LEFT-WALL### 3 stereotypes 0 ###LEFT-WALL### 4 are 0 ###LEFT-WALL### 12 - 0 ###LEFT-WALL### 14 . 1 negative 2 age 2 age 3 stereotypes 3 stereotypes 4 are 4 are 11 self 5 pervasive 6 and 6 and 8 older 6 and 9 adults 9 adults 10 ' 10 ' 11 self 12 - 13 esteem two experiments tested the hypothesis that differentiation from one 's age group reduces the impact of negative age - related information on older adults ' self - evaluation . 0 ###LEFT-WALL### 2 experiments 0 ###LEFT-WALL### 3 tested 0 ###LEFT-WALL### 20 related 0 ###LEFT-WALL### 27 - 1 two 2 experiments 2 experiments 3 tested 3 tested 5 hypothesis 4 the 5 hypothesis 5 hypothesis 6 that 6 that 7 differentiation 6 that 13 reduces 7 differentiation 8 from 7 differentiation 13 reduces 8 from 12 group 9 one 10 's 10 's 12 group 11 age 12 group 13 reduces 15 impact 14 the 15 impact 15 impact 16 of 16 of 18 age 17 negative 18 age 19 - 20 related 20 related 21 information 20 related 22 on 22 on 26 self 23 older 24 adults 24 adults 25 ' 25 ' 26 self 27 - 28 evaluation 27 - 29 . in experiment 1 , older adults ( n = 83 , m = 71.9 years ) were confronted with neutral or negative age - related information followed by a manipulation of self [-] differentiation . 0 ###LEFT-WALL### 6 adults 0 ###LEFT-WALL### 18 confronted 0 ###LEFT-WALL### 25 related 1 in 2 experiment 1 in 4 , 1 in 6 adults 2 experiment 3 1 5 older 6 adults 6 adults 9 = 6 adults 17 were 7 ( 9 = 8 n 9 = 9 = 10 83 10 83 13 = 11 , 13 = 12 m 13 = 13 = 15 years 13 = 16 ) 14 71.9 15 years 17 were 18 confronted 18 confronted 19 with 19 with 23 age 20 neutral 21 or 21 or 22 negative 21 or 23 age 24 - 25 related 25 related 26 information 25 related 28 by 25 related 35 . 26 information 27 followed 28 by 30 manipulation 29 a 30 manipulation 30 manipulation 31 of 31 of 34 differentiation 32 self 34 differentiation experiment 2 ( n = 44 , m = 73.55 years ) tested the moderating role of self [-] differentiation in the relationship of implicit attitudes toward older adults and implicit self - esteem . 0 ###LEFT-WALL### 1 experiment 0 ###LEFT-WALL### 13 tested 0 ###LEFT-WALL### 33 - 1 experiment 5 = 1 experiment 9 = 1 experiment 13 tested 2 2 5 = 3 ( 5 = 4 n 5 = 5 = 6 44 5 = 7 , 8 m 9 = 9 = 11 years 9 = 12 ) 10 73.55 11 years 13 tested 16 role 13 tested 21 in 13 tested 27 toward 14 the 16 role 15 moderating 16 role 16 role 17 of 17 of 20 differentiation 18 self 20 differentiation 21 in 23 relationship 22 the 23 relationship 23 relationship 24 of 24 of 26 attitudes 25 implicit 26 attitudes 27 toward 30 and 28 older 29 adults 29 adults 30 and 30 and 32 self 31 implicit 32 self 33 - 34 esteem 33 - 35 . results suggest that self - differentiation prevents the impact of negative age - related information on older adults ' self - esteem . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 suggest 0 ###LEFT-WALL### 5 - 1 results 2 suggest 2 suggest 4 self 3 that 4 self 5 - 6 differentiation 5 - 7 prevents 5 - 14 related 5 - 21 - 5 - 23 . 6 differentiation 7 prevents 7 prevents 9 impact 8 the 9 impact 9 impact 10 of 10 of 12 age 11 negative 12 age 13 - 14 related 14 related 15 information 14 related 16 on 14 related 21 - 16 on 20 self 17 older 18 adults 18 adults 19 ' 19 ' 20 self 21 - 22 esteem reductions in the integrity of white matter microstructure are thought to be a significant cause of age - related [decline] in mnemonic abilities , including working memory ( wm ) and long - term episodic memory ( ltm ) . 0 ###LEFT-WALL### 12 be 0 ###LEFT-WALL### 40 . 1 reductions 2 in 1 reductions 5 of 1 reductions 9 are 2 in 4 integrity 3 the 4 integrity 5 of 8 microstructure 6 white 8 microstructure 7 matter 8 microstructure 9 are 10 thought 10 thought 11 to 11 to 12 be 12 be 31 and 13 a 15 cause 14 significant 15 cause 15 cause 16 of 15 cause 25 including 15 cause 31 and 16 of 17 age 17 age 19 related 18 - 19 related 19 related 21 in 19 related 24 , 21 in 23 abilities 22 mnemonic 23 abilities 25 including 27 memory 26 working 27 memory 27 memory 29 wm 28 ( 29 wm 29 wm 30 ) 31 and 32 long 31 and 36 memory 33 - 36 memory 34 term 36 memory 35 episodic 36 memory 36 memory 38 ltm 36 memory 39 ) 37 ( 38 ltm 38 ltm 39 ) this study uses tract - based spatial statistics ( tbss ) applied to diffusion tensor magnetic resonance images to explore correlations between white matter microstructure and verbal wm and ltm in a sample of 98 normal older adults . 0 ###LEFT-WALL### 4 tract 0 ###LEFT-WALL### 12 applied 0 ###LEFT-WALL### 39 . 1 this 4 tract 2 study 3 uses 3 uses 4 tract 4 tract 8 statistics 4 tract 12 applied 5 - 8 statistics 6 based 8 statistics 7 spatial 8 statistics 8 statistics 10 tbss 8 statistics 11 ) 9 ( 10 tbss 10 tbss 11 ) 12 applied 13 to 12 applied 19 to 12 applied 26 and 12 applied 30 ltm 13 to 18 images 14 diffusion 18 images 15 tensor 17 resonance 16 magnetic 17 resonance 17 resonance 18 images 19 to 20 explore 20 explore 21 correlations 20 explore 22 between 22 between 24 matter 23 white 24 matter 25 microstructure 26 and 26 and 27 verbal 28 wm 29 and 29 and 30 ltm 30 ltm 31 in 30 ltm 34 of 31 in 33 sample 32 a 33 sample 34 of 38 adults 35 98 38 adults 36 normal 38 adults 37 older 38 adults wm performance was associated with microstructure in left fronto - parietal pathways and ltm was associated with bilateral fronto - temporal pathways . 0 ###LEFT-WALL### 1 wm 0 ###LEFT-WALL### 4 associated 0 ###LEFT-WALL### 13 and 0 ###LEFT-WALL### 23 . 1 wm 2 performance 1 wm 3 was 1 wm 4 associated 2 performance 3 was 4 associated 5 with 4 associated 7 in 5 with 6 microstructure 7 in 12 pathways 8 left 12 pathways 9 fronto 10 - 9 fronto 12 pathways 11 parietal 12 pathways 13 and 14 ltm 13 and 16 associated 14 ltm 15 was 15 was 16 associated 16 associated 17 with 17 with 22 pathways 18 bilateral 22 pathways 19 fronto 20 - 19 fronto 22 pathways 21 temporal 22 pathways interhemispheric - frontal pathways ( genu of the corpus callosum ) were associated with both types of mnemonic function . 0 ###LEFT-WALL### 4 pathways 0 ###LEFT-WALL### 13 associated 0 ###LEFT-WALL### 20 . 1 interhemispheric 2 - 1 interhemispheric 4 pathways 3 frontal 4 pathways 4 pathways 6 genu 4 pathways 12 were 5 ( 6 genu 6 genu 7 of 6 genu 11 ) 7 of 10 callosum 8 the 10 callosum 9 corpus 10 callosum 12 were 13 associated 13 associated 14 with 14 with 17 of 15 both 17 of 16 types 17 of 17 of 19 function 18 mnemonic 19 function we hypothesize that in normal aging , damage to certain white matter pathways may reduce the dynamic efficiency of mnemonic abilities by disrupting the connections within multiple distributed networks . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 hypothesize 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 30 . 1 we 2 hypothesize 2 hypothesize 3 that 2 hypothesize 4 in 4 in 6 aging 5 normal 6 aging 7 , 8 damage 7 , 15 reduce 8 damage 9 to 8 damage 14 may 9 to 13 pathways 10 certain 12 matter 11 white 12 matter 12 matter 13 pathways 14 may 15 reduce 15 reduce 18 efficiency 15 reduce 22 by 15 reduce 26 within 16 the 18 efficiency 17 dynamic 18 efficiency 18 efficiency 19 of 19 of 21 abilities 20 mnemonic 21 abilities 22 by 23 disrupting 23 disrupting 25 connections 24 the 25 connections 26 within 29 networks 27 multiple 28 distributed 28 distributed 29 networks by correlating white matter with two mnemonic functions in the same analysis , we have demonstrated that regional white matter networks may share common mnemonic functions but also may be differentiated for memory types . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 27 but 0 ###LEFT-WALL### 35 . 1 by 2 correlating 1 by 13 , 1 by 14 we 2 correlating 4 matter 2 correlating 5 with 3 white 4 matter 5 with 8 functions 6 two 8 functions 7 mnemonic 8 functions 8 functions 9 in 9 in 12 analysis 10 the 11 same 11 same 12 analysis 14 we 27 but 15 have 20 matter 15 have 27 but 16 demonstrated 20 matter 17 that 18 regional 18 regional 19 white 19 white 20 matter 20 matter 21 networks 20 matter 23 share 21 networks 22 may 22 may 23 share 23 share 26 functions 24 common 26 functions 25 mnemonic 26 functions 27 but 29 may 28 also 29 may 29 may 30 be 30 be 31 differentiated 31 differentiated 32 for 32 for 34 types 33 memory 34 types literacy is an important determinant of health and well - being across the life span but is critical in aging , when many influential health and financial decisions are made . 0 ###LEFT-WALL### 1 literacy 0 ###LEFT-WALL### 16 but 1 literacy 16 but 2 is 5 determinant 2 is 16 but 3 an 4 important 3 an 5 determinant 4 important 5 determinant 5 determinant 6 of 5 determinant 11 being 6 of 8 and 7 health 8 and 8 and 9 well 8 and 10 - 11 being 12 across 12 across 15 span 13 the 15 span 14 life 15 span 16 but 17 is 17 is 18 critical 18 critical 19 in 19 in 20 aging 20 aging 22 when 21 , 22 when 22 when 28 decisions 22 when 30 made 22 when 31 . 23 many 28 decisions 24 influential 25 health 25 health 26 and 26 and 27 financial 26 and 28 decisions 28 decisions 29 are 29 are 30 made prior studies suggest that older persons exhibit lower literacy than younger persons , particularly in the domains of financial and health literacy , but the reasons [why] remain unknown . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 24 but 0 ###LEFT-WALL### 30 . 1 prior 2 studies 2 studies 3 suggest 3 suggest 4 that 4 that 6 persons 4 that 7 exhibit 5 older 6 persons 7 exhibit 9 literacy 7 exhibit 10 than 8 lower 9 literacy 10 than 12 persons 11 younger 12 persons 12 persons 15 in 13 , 14 particularly 13 , 15 in 15 in 17 domains 15 in 23 , 16 the 17 domains 17 domains 18 of 18 of 20 and 19 financial 20 and 20 and 22 literacy 20 and 23 , 21 health 22 literacy 24 but 26 reasons 24 but 28 remain 25 the 26 reasons 26 reasons 28 remain 28 remain 29 unknown in addition [,] executive [function] had an indirect effect on literacy via decision making style ( i.e [.] , risk aversion ) , and education and word knowledge had independent effects on literacy . 0 ###LEFT-WALL### 2 addition 0 ###LEFT-WALL### 6 had 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 34 . 1 in 2 addition 2 addition 4 executive 2 addition 6 had 6 had 9 effect 6 had 10 on 6 had 12 via 7 an 8 indirect 7 an 9 effect 8 indirect 9 effect 10 on 11 literacy 12 via 24 and 13 decision 14 making 13 decision 24 and 14 making 15 style 15 style 17 i.e 16 ( 17 i.e 17 i.e 21 aversion 17 i.e 23 , 19 , 21 aversion 20 risk 21 aversion 21 aversion 22 ) 24 and 25 education 26 and 28 knowledge 26 and 29 had 27 word 28 knowledge 28 knowledge 29 had 29 had 31 effects 29 had 32 on 30 independent 31 effects 32 on 33 literacy these findings suggest that diverse individual resources contribute to financial and health literacy and lower literacy in old age is partially due to declines in executive [function] and episodic memory . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 31 . 1 these 2 findings 2 findings 3 suggest 3 suggest 4 that 4 that 7 resources 4 that 8 contribute 5 diverse 7 resources 6 individual 7 resources 7 resources 8 contribute 8 contribute 9 to 9 to 11 and 10 financial 11 and 11 and 13 literacy 12 health 13 literacy 14 and 16 literacy 14 and 20 is 15 lower 16 literacy 16 literacy 17 in 16 literacy 20 is 17 in 19 age 18 old 19 age 20 is 21 partially 20 is 23 to 22 due 23 to 23 to 24 declines 24 declines 25 in 25 in 30 memory 26 executive 28 and 28 and 29 episodic 28 and 30 memory age - related decline [in] processing speed has long been considered a key driver of cognitive aging . 0 ###LEFT-WALL### 1 age 0 ###LEFT-WALL### 11 considered 0 ###LEFT-WALL### 18 . 1 age 8 has 2 - 3 related 3 related 7 speed 3 related 8 has 4 decline 7 speed 6 processing 7 speed 8 has 10 been 9 long 10 been 10 been 11 considered 11 considered 14 driver 12 a 14 driver 13 key 14 driver 14 driver 15 of 15 of 17 aging 16 cognitive 17 aging while the majority of empirical evidence for the processing speed hypothesis has been obtained from analyses of between [-] person age differences , longitudinal studies provide a direct test of within [-] person change . 0 ###LEFT-WALL### 25 studies 0 ###LEFT-WALL### 26 provide 0 ###LEFT-WALL### 35 . 1 while 3 majority 1 while 14 obtained 1 while 25 studies 2 the 3 majority 3 majority 4 of 3 majority 12 has 4 of 6 evidence 5 empirical 6 evidence 6 evidence 7 for 7 for 11 hypothesis 8 the 11 hypothesis 9 processing 11 hypothesis 10 speed 11 hypothesis 12 has 13 been 13 been 14 obtained 14 obtained 15 from 14 obtained 23 , 14 obtained 24 longitudinal 15 from 16 analyses 16 analyses 17 of 17 of 18 between 18 between 22 differences 20 person 22 differences 21 age 22 differences 25 studies 26 provide 26 provide 29 test 27 a 28 direct 27 a 29 test 28 direct 29 test 29 test 30 of 30 of 31 within 31 within 34 change 33 person 34 change using recent developments in longitudinal mediation analysis , we examine the speed [-] mediation hypothesis at both [the] [within] - and between [-] person levels in two longitudinal studies , longitudinal aging study amsterdam ( lasa ) and origins of variance in the oldest - old ( octo - twin ) . 0 ###LEFT-WALL### 9 we 0 ###LEFT-WALL### 10 examine 1 using 3 developments 1 using 4 in 1 using 8 , 1 using 9 we 2 recent 3 developments 4 in 7 analysis 5 longitudinal 6 mediation 6 mediation 7 analysis 9 we 10 examine 10 examine 15 hypothesis 10 examine 21 and 11 the 15 hypothesis 12 speed 15 hypothesis 14 mediation 15 hypothesis 16 at 17 both 16 at 21 and 20 - 21 and 21 and 22 between 22 between 25 levels 24 person 25 levels 25 levels 26 in 26 in 38 and 27 two 29 studies 28 longitudinal 29 studies 29 studies 30 , 30 , 36 lasa 30 , 38 and 31 longitudinal 32 aging 32 aging 33 study 33 study 34 amsterdam 34 amsterdam 36 lasa 35 ( 36 lasa 36 lasa 37 ) 38 and 39 origins 38 and 40 of 38 and 46 old 40 of 41 variance 41 variance 42 in 42 in 44 oldest 43 the 44 oldest 45 - 46 old 46 old 48 octo 46 old 52 . 47 ( 48 octo 48 octo 50 twin 48 octo 52 . 49 - 50 twin 50 twin 51 ) we found significant [within] - person indirect effects of change in age , such that increasing age was related to lower speed , which in turn relates to lower performance across repeated measures on other cognitive outcomes . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 38 . 1 we 2 found 2 found 8 effects 3 significant 5 - 3 significant 6 person 6 person 8 effects 7 indirect 8 effects 8 effects 9 of 9 of 10 change 10 change 11 in 11 in 12 age 13 , 17 age 13 , 19 related 13 , 23 , 14 such 17 age 15 that 16 increasing 16 increasing 17 age 17 age 18 was 18 was 19 related 19 related 20 to 20 to 22 speed 21 lower 22 speed 23 , 24 which 23 , 27 relates 24 which 27 relates 25 in 26 turn 26 turn 27 relates 27 relates 28 to 27 relates 31 across 27 relates 34 on 28 to 29 lower 29 lower 30 performance 31 across 33 measures 32 repeated 33 measures 34 on 37 outcomes 35 other 37 outcomes 36 cognitive 37 outcomes although [between] [-] person indirect effects were also significant in lasa , they were not in octo - twin which is not unexpected given the age homogeneous nature of the octo - twin data . 0 ###LEFT-WALL### 13 they 0 ###LEFT-WALL### 14 were 0 ###LEFT-WALL### 32 - 0 ###LEFT-WALL### 35 . 1 although 6 effects 1 although 7 were 1 although 12 , 1 although 13 they 4 person 6 effects 5 indirect 6 effects 6 effects 7 were 7 were 8 also 7 were 9 significant 9 significant 10 in 10 in 11 lasa 13 they 14 were 14 were 15 not 14 were 16 in 16 in 17 octo 17 octo 19 twin 18 - 19 twin 19 twin 20 which 19 twin 21 is 19 twin 24 given 19 twin 29 of 19 twin 32 - 20 which 21 is 21 is 22 not 21 is 23 unexpected 24 given 28 nature 25 the 28 nature 26 age 28 nature 27 homogeneous 28 nature 29 of 31 octo 30 the 31 octo 32 - 34 data 33 twin 34 data a [more] in [-] depth examination through measures of effect size suggests that , for the lasa study , [the] [within] - person indirect effects were small [and] between - person indirect effects were consistently larger . 0 ###LEFT-WALL### 6 examination 0 ###LEFT-WALL### 12 suggests 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 34 were 0 ###LEFT-WALL### 37 . 1 a 3 in 3 in 5 depth 5 depth 6 examination 6 examination 7 through 6 examination 12 suggests 7 through 8 measures 8 measures 9 of 9 of 11 size 10 effect 11 size 12 suggests 13 that 12 suggests 15 for 14 , 15 for 15 for 18 study 15 for 19 , 16 the 18 study 17 lasa 18 study 19 , 22 - 19 , 30 - 22 - 25 effects 23 person 25 effects 24 indirect 25 effects 25 effects 26 were 26 were 27 small 29 between 30 - 30 - 33 effects 31 person 33 effects 32 indirect 33 effects 33 effects 34 were 34 were 36 larger 35 consistently 36 larger these differing magnitudes of direct and indirect effects across levels demonstrate the importance of separating between - [and] within [-] person effects in evaluating theoretical models of age - related change . 0 ###LEFT-WALL### 3 magnitudes 0 ###LEFT-WALL### 30 related 0 ###LEFT-WALL### 32 . 1 these 3 magnitudes 2 differing 3 magnitudes 3 magnitudes 4 of 3 magnitudes 8 effects 3 magnitudes 16 between 3 magnitudes 19 within 3 magnitudes 30 related 4 of 6 and 5 direct 6 and 6 and 7 indirect 8 effects 9 across 8 effects 11 demonstrate 9 across 10 levels 11 demonstrate 13 importance 12 the 13 importance 13 importance 14 of 14 of 15 separating 15 separating 16 between 17 - 19 within 19 within 22 effects 19 within 29 - 21 person 22 effects 22 effects 23 in 22 effects 27 of 23 in 24 evaluating 24 evaluating 26 models 25 theoretical 26 models 27 of 28 age 30 related 31 change the goal for this study was to examine within [-] person processes driving individual development related to social goals . 0 ###LEFT-WALL### 16 related 1 the 2 goal 2 goal 3 for 2 goal 6 was 3 for 5 study 4 this 5 study 6 was 7 to 6 was 8 examine 7 to 8 examine 8 examine 13 driving 8 examine 16 related 9 within 12 processes 9 within 13 driving 11 person 12 processes 13 driving 15 development 13 driving 16 related 14 individual 15 development 16 related 17 to 16 related 20 . 17 to 19 goals 18 social 19 goals we examined how social regulatory processes travel together over time to understand whether daily social goal progress is sensitive to variation in experiences of support and hindrance and the extent to which maintenance or achievement goal orientation explains differences in sensitivity to social experiences . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 45 . 1 we 2 examined 2 examined 3 how 2 examined 18 is 3 how 6 processes 3 how 7 travel 3 how 18 is 4 social 6 processes 5 regulatory 6 processes 6 processes 7 travel 7 travel 8 together 7 travel 9 over 9 over 10 time 10 time 11 to 10 time 12 understand 11 to 12 understand 12 understand 13 whether 12 understand 17 progress 13 whether 14 daily 15 social 16 goal 16 goal 17 progress 18 is 28 and 19 sensitive 20 to 19 sensitive 26 and 20 to 21 variation 21 variation 22 in 21 variation 24 of 22 in 23 experiences 24 of 25 support 26 and 27 hindrance 26 and 28 and 28 and 30 extent 29 the 30 extent 30 extent 31 to 31 to 32 which 31 to 36 goal 31 to 37 orientation 31 to 38 explains 32 which 36 goal 33 maintenance 34 or 34 or 35 achievement 34 or 36 goal 37 orientation 38 explains 38 explains 39 differences 38 explains 42 to 39 differences 40 in 40 in 41 sensitivity 42 to 44 experiences 43 social 44 experiences a sample of 105 adults over the age of 50 years chose an individually meaningful social goal to track over time , which they coded as achievement [or] maintenance oriented . 0 ###LEFT-WALL### 2 sample 0 ###LEFT-WALL### 12 chose 1 a 2 sample 2 sample 3 of 2 sample 6 over 2 sample 9 of 2 sample 12 chose 3 of 5 adults 4 105 5 adults 6 over 8 age 7 the 8 age 9 of 11 years 10 50 11 years 12 chose 17 goal 12 chose 18 to 12 chose 19 track 13 an 17 goal 14 individually 15 meaningful 15 meaningful 17 goal 16 social 17 goal 18 to 19 track 19 track 20 over 19 track 21 time 21 time 23 which 22 , 23 which 23 which 25 coded 23 which 31 . 24 they 25 coded 25 coded 26 as 26 as 29 maintenance 27 achievement 29 maintenance 29 maintenance 30 oriented participants then reported their daily progress and experiences of support and hindrance toward that goal over a 100 [-] day study period . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 reported 0 ###LEFT-WALL### 23 . 1 participants 3 reported 2 then 3 reported 3 reported 7 and 3 reported 13 toward 3 reported 16 over 4 their 6 progress 5 daily 6 progress 6 progress 7 and 7 and 8 experiences 7 and 9 of 9 of 11 and 10 support 11 and 11 and 12 hindrance 13 toward 15 goal 14 that 15 goal 16 over 22 period 17 a 22 period 18 100 20 day 20 day 22 period 21 study 22 period we found social goal progress to positively covary with support and negatively covary with [hindrance] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 16 . 1 we 2 found 2 found 5 progress 3 social 4 goal 4 goal 5 progress 5 progress 6 to 5 progress 14 with 6 to 11 and 7 positively 8 covary 8 covary 9 with 8 covary 11 and 9 with 10 support 11 and 13 covary 12 negatively 13 covary 13 covary 14 with these linkages , which we termed sensitivity , varied significantly across participants . 0 ###LEFT-WALL### 2 linkages 0 ###LEFT-WALL### 9 varied 0 ###LEFT-WALL### 13 . 1 these 2 linkages 2 linkages 4 which 2 linkages 9 varied 3 , 4 which 4 which 6 termed 4 which 8 , 5 we 6 termed 6 termed 7 sensitivity 9 varied 10 significantly 9 varied 11 across 11 across 12 participants this variation was partially explained by differences in goal orientation . 0 ###LEFT-WALL### 2 variation 0 ###LEFT-WALL### 5 explained 0 ###LEFT-WALL### 11 . 1 this 2 variation 2 variation 3 was 3 was 4 partially 3 was 5 explained 5 explained 6 by 5 explained 8 in 6 by 7 differences 8 in 10 orientation 9 goal 10 orientation those with an achievement goal made lower goal progress and were more sensitive to support and less sensitive [to] hindrance than those with a maintenance - oriented goal . 0 ###LEFT-WALL### 1 those 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 26 - 1 those 2 with 1 those 6 made 1 those 10 and 2 with 5 goal 3 an 5 goal 4 achievement 5 goal 7 lower 9 progress 7 lower 10 and 8 goal 9 progress 10 and 11 were 11 were 13 sensitive 12 more 13 sensitive 13 sensitive 14 to 13 sensitive 21 than 13 sensitive 23 with 14 to 16 and 15 support 16 and 16 and 20 hindrance 17 less 18 sensitive 18 sensitive 20 hindrance 21 than 22 those 23 with 25 maintenance 24 a 25 maintenance 26 - 28 goal 26 - 29 . 27 oriented 28 goal our findings partially explain the processes by which older adults work toward their social goals . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 4 explain 0 ###LEFT-WALL### 16 . 1 our 2 findings 2 findings 4 explain 3 partially 4 explain 4 explain 6 processes 5 the 6 processes 6 processes 7 by 7 by 8 which 7 by 10 adults 7 by 11 work 9 older 10 adults 10 adults 11 work 11 work 12 toward 12 toward 15 goals 13 their 15 goals 14 social 15 goals daily goal progress is contingent on daily social experiences , but these sensitivities are in part [shaped] by goal orientation . 0 ###LEFT-WALL### 3 progress 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 11 but 0 ###LEFT-WALL### 21 . 1 daily 3 progress 2 goal 3 progress 3 progress 4 is 4 is 5 contingent 5 contingent 6 on 6 on 9 experiences 7 daily 9 experiences 8 social 9 experiences 10 , 11 but 11 but 13 sensitivities 11 but 14 are 12 these 13 sensitivities 13 sensitivities 14 are 14 are 16 part 14 are 18 by 15 in 16 part 18 by 20 orientation 19 goal 20 orientation difficulty with memory retrieval is a salient feature of cognitive aging and may be related to a reduction in the ability to suppress items that compete for retrieval . 0 ###LEFT-WALL### 1 difficulty 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 29 . 1 difficulty 2 with 1 difficulty 12 and 2 with 4 retrieval 3 memory 4 retrieval 5 is 8 feature 5 is 12 and 6 a 7 salient 6 a 8 feature 7 salient 8 feature 8 feature 9 of 9 of 11 aging 10 cognitive 11 aging 12 and 13 may 13 may 14 be 14 be 15 related 15 related 16 to 15 related 19 in 16 to 18 reduction 17 a 18 reduction 19 in 21 ability 20 the 21 ability 21 ability 22 to 21 ability 23 suppress 22 to 23 suppress 23 suppress 24 items 23 suppress 27 for 24 items 25 that 24 items 26 compete 25 that 26 compete 27 for 28 retrieval to test this hypothesis directly , we presented a series of words for shallow coding that included pairs of orthographically similar words ( e.g [.] , allergy and analogy ) . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 test 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 31 . 1 to 2 test 2 test 4 hypothesis 2 test 5 directly 3 this 4 hypothesis 6 , 7 we 6 , 8 presented 7 we 8 presented 8 presented 10 series 8 presented 13 for 9 a 10 series 10 series 11 of 11 of 12 words 13 for 18 pairs 14 shallow 18 pairs 15 coding 18 pairs 16 that 17 included 17 included 18 pairs 18 pairs 19 of 18 pairs 24 e.g 19 of 22 words 20 orthographically 21 similar 21 similar 22 words 23 ( 24 e.g 24 e.g 29 analogy 24 e.g 30 ) 26 , 29 analogy 27 allergy 28 and 28 and 29 analogy 29 analogy 30 ) after a delay , participants solved word fragments ( e.g [.] , [a] _ [l] _ _ gy ) that resembled both words in a pair but could only be completed by one . 0 ###LEFT-WALL### 20 that 0 ###LEFT-WALL### 27 but 0 ###LEFT-WALL### 34 . 1 after 3 delay 1 after 19 ) 1 after 20 that 2 a 3 delay 3 delay 8 fragments 3 delay 18 gy 4 , 8 fragments 5 participants 6 solved 6 solved 8 fragments 7 word 8 fragments 8 fragments 10 e.g 8 fragments 12 , 9 ( 10 e.g 10 e.g 12 , 12 , 18 gy 14 _ 16 _ 16 _ 18 gy 17 _ 18 gy 18 gy 19 ) 20 that 27 but 21 resembled 23 words 21 resembled 24 in 21 resembled 27 but 22 both 23 words 24 in 26 pair 25 a 26 pair 27 but 28 could 28 could 30 be 29 only 30 be 30 be 31 completed 31 completed 32 by 32 by 33 one we measured the consequence of having successfully resolved competition by having participants read a list of words including the rejected competitors as quickly as possible . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 11 having 0 ###LEFT-WALL### 26 . 1 we 2 measured 2 measured 4 consequence 2 measured 10 by 3 the 4 consequence 4 consequence 5 of 5 of 6 having 6 having 8 resolved 7 successfully 8 resolved 8 resolved 9 competition 10 by 11 having 11 having 12 participants 12 participants 13 read 12 participants 16 of 13 read 15 list 14 a 15 list 16 of 17 words 17 words 18 including 18 including 21 competitors 18 including 23 quickly 18 including 24 as 19 the 21 competitors 20 rejected 21 competitors 22 as 23 quickly 24 as 25 possible response time was compared with control conditions that did not require resolving competition . 0 ###LEFT-WALL### 2 time 0 ###LEFT-WALL### 4 compared 0 ###LEFT-WALL### 14 . 1 response 2 time 2 time 3 was 3 was 4 compared 4 compared 5 with 5 with 7 conditions 5 with 12 resolving 6 control 7 conditions 7 conditions 8 that 7 conditions 11 require 8 that 9 did 9 did 10 not 9 did 11 require 12 resolving 13 competition older adults showed no evidence of suppression ; instead they showed priming for the competitors , in sharp contrast to strong suppression effects previously observed in younger adults . 0 ###LEFT-WALL### 2 adults 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 8 ; 1 older 2 adults 2 adults 3 showed 3 showed 5 evidence 4 no 5 evidence 5 evidence 6 of 6 of 7 suppression 8 ; 10 they 8 ; 11 showed 9 instead 10 they 10 they 11 showed 11 showed 12 priming 12 priming 13 for 13 for 15 competitors 14 the 15 competitors 15 competitors 17 in 16 , 17 in 17 in 19 contrast 17 in 29 . 18 sharp 19 contrast 19 contrast 20 to 19 contrast 25 observed 20 to 23 effects 21 strong 22 suppression 22 suppression 23 effects 24 previously 25 observed 25 observed 26 in 26 in 28 adults 27 younger 28 adults whereas previous studies have provided clear evidence for suppression deficits by examining the ability to produce targets in high interference situations , here we provide direct evidence for a suppression deficit by examining the accessibility of rejected competitors . 0 ###LEFT-WALL### 24 we 0 ###LEFT-WALL### 25 provide 0 ###LEFT-WALL### 39 . 1 whereas 3 studies 1 whereas 16 produce 1 whereas 22 , 1 whereas 24 we 2 previous 3 studies 3 studies 4 have 4 have 5 provided 5 provided 7 evidence 5 provided 8 for 5 provided 11 by 6 clear 7 evidence 8 for 10 deficits 9 suppression 10 deficits 11 by 12 examining 12 examining 14 ability 12 examining 15 to 13 the 14 ability 15 to 16 produce 16 produce 17 targets 16 produce 18 in 18 in 21 situations 19 high 20 interference 20 interference 21 situations 23 here 24 we 24 we 25 provide 25 provide 27 evidence 25 provide 32 by 26 direct 27 evidence 27 evidence 28 for 28 for 31 deficit 29 a 30 suppression 29 a 31 deficit 30 suppression 31 deficit 32 by 33 examining 33 examining 35 accessibility 34 the 35 accessibility 35 accessibility 36 of 36 of 38 competitors 37 rejected 38 competitors none [introduction] : inadequacies in pain assessment and management in long - term care have been well documented . 0 ###LEFT-WALL### 1 none 0 ###LEFT-WALL### 3 : 3 : 8 and 3 : 16 been 3 : 19 . 4 inadequacies 5 in 4 inadequacies 8 and 5 in 7 assessment 6 pain 7 assessment 8 and 9 management 8 and 10 in 8 and 15 have 10 in 14 care 11 long 12 - 11 long 13 term 13 term 14 care 15 have 16 been 16 been 17 well 17 well 18 documented insufficient pain education and inaccurate beliefs about the nature of pain and aging have been identified as possible contributors . 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 16 identified 0 ###LEFT-WALL### 20 . 1 insufficient 2 pain 2 pain 3 education 3 education 4 and 4 and 6 beliefs 4 and 12 and 5 inaccurate 6 beliefs 6 beliefs 7 about 7 about 9 nature 8 the 9 nature 9 nature 10 of 10 of 11 pain 12 and 13 aging 12 and 14 have 14 have 15 been 15 been 16 identified 16 identified 17 as 17 as 19 contributors 18 possible 19 contributors the present study addresses the need for improved , efficient and feasible continuing pain education through the use of an assessment training video . 0 ###LEFT-WALL### 2 present 0 ###LEFT-WALL### 8 improved 0 ###LEFT-WALL### 9 , 0 ###LEFT-WALL### 24 . 1 the 2 present 2 present 3 study 2 present 7 for 2 present 8 improved 3 study 4 addresses 4 addresses 6 need 4 addresses 7 for 5 the 6 need 9 , 11 and 10 efficient 11 and 11 and 15 education 11 and 16 through 11 and 19 of 12 feasible 14 pain 13 continuing 14 pain 14 pain 15 education 16 through 18 use 17 the 18 use 19 of 21 assessment 20 an 21 assessment 21 assessment 22 training 22 training 23 video methods : a total of 148 long - term care staff viewed and evaluated the training video . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 18 . 1 methods 2 : 2 : 4 total 3 a 4 total 4 total 5 of 4 total 13 and 5 of 11 staff 6 148 10 care 7 long 8 - 7 long 9 term 9 term 10 care 10 care 11 staff 12 viewed 13 and 13 and 14 evaluated 13 and 17 video 15 the 17 video 16 training 17 video knowledge changes and pain beliefs were assessed postvideo and [at] a four [-] week follow - up . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 were 0 ###LEFT-WALL### 9 and 1 knowledge 2 changes 2 changes 3 and 3 and 5 beliefs 3 and 6 were 4 pain 5 beliefs 6 were 8 postvideo 7 assessed 8 postvideo 9 and 14 week 9 and 15 follow 11 a 14 week 12 four 14 week 14 week 15 follow 15 follow 17 up 16 - 17 up 17 up 18 . beliefs about pain , as well as pain and aging , were also examined using multivariate procedures to determine whether these variables influenced participants ' evaluation of the video . 0 ###LEFT-WALL### 1 beliefs 0 ###LEFT-WALL### 14 examined 0 ###LEFT-WALL### 30 . 1 beliefs 2 about 1 beliefs 7 as 1 beliefs 12 were 2 about 3 pain 4 , 7 as 5 as 6 well 6 well 7 as 7 as 9 and 7 as 11 , 8 pain 9 and 9 and 10 aging 12 were 14 examined 13 also 14 examined 14 examined 15 using 15 using 17 procedures 15 using 18 to 16 multivariate 17 procedures 18 to 19 determine 19 determine 20 whether 20 whether 22 variables 20 whether 23 influenced 21 these 22 variables 22 variables 23 influenced 23 influenced 26 evaluation 24 participants 25 ' 25 ' 26 evaluation 26 evaluation 27 of 27 of 29 video 28 the 29 video focus groups were also conducted , and transcripts were analyzed using thematic content analysis . 0 ###LEFT-WALL### 2 groups 0 ###LEFT-WALL### 5 conducted 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 15 . 1 focus 2 groups 2 groups 3 were 3 were 5 conducted 4 also 5 conducted 6 , 7 and 7 and 8 transcripts 7 and 10 analyzed 8 transcripts 9 were 9 were 10 analyzed 10 analyzed 11 using 11 using 14 analysis 12 thematic 14 analysis 13 content 14 analysis results : pain assessment knowledge improved postvideo and [at] the four [-] week follow - up . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 . 2 : 5 knowledge 2 : 6 improved 2 : 8 and 2 : 15 - 3 pain 5 knowledge 4 assessment 5 knowledge 5 knowledge 6 improved 6 improved 7 postvideo 8 and 13 week 8 and 14 follow 10 the 13 week 11 four 13 week 13 week 14 follow 15 - 16 up participants positively evaluated the content and quality of the video . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 3 evaluated 0 ###LEFT-WALL### 11 . 1 participants 3 evaluated 2 positively 3 evaluated 3 evaluated 6 and 4 the 5 content 5 content 6 and 6 and 7 quality 6 and 8 of 8 of 10 video 9 the 10 video individuals who held stronger beliefs ( at baseline ) about the organic nature of pain provided more positive evaluations . 0 ###LEFT-WALL### 1 individuals 0 ###LEFT-WALL### 16 provided 0 ###LEFT-WALL### 20 . 1 individuals 2 who 1 individuals 3 held 1 individuals 16 provided 2 who 3 held 3 held 5 beliefs 3 held 10 about 4 stronger 5 beliefs 5 beliefs 7 at 6 ( 7 at 7 at 8 baseline 7 at 9 ) 10 about 13 nature 11 the 13 nature 12 organic 13 nature 13 nature 14 of 14 of 15 pain 16 provided 19 evaluations 17 more 18 positive 18 positive 19 evaluations barriers to implementation of practices in the video identified by the focus groups ( and qualitative analysis ) included time , workload and resistance to change . 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 19 included 0 ###LEFT-WALL### 27 . 1 barriers 2 to 1 barriers 15 and 2 to 3 implementation 3 implementation 4 of 4 of 5 practices 5 practices 6 in 6 in 8 video 7 the 8 video 8 video 9 identified 9 identified 10 by 10 by 13 groups 11 the 13 groups 12 focus 13 groups 14 ( 15 and 15 and 17 analysis 15 and 18 ) 15 and 19 included 16 qualitative 17 analysis 19 included 23 and 19 included 25 to 20 time 21 , 21 , 22 workload 21 , 23 and 23 and 24 resistance 25 to 26 change facilitators to implementation included continued management support [and] observing the benefits to implementation . 0 ###LEFT-WALL### 1 facilitators 0 ###LEFT-WALL### 5 continued 0 ###LEFT-WALL### 14 . 1 facilitators 2 to 1 facilitators 5 continued 2 to 3 implementation 3 implementation 4 included 5 continued 7 support 5 continued 12 to 6 management 7 support 7 support 9 observing 9 observing 11 benefits 10 the 11 benefits 12 to 13 implementation discussion : the present study provides support for the use of video training . 0 ###LEFT-WALL### 1 discussion 0 ###LEFT-WALL### 2 : 2 : 5 study 2 : 6 provides 2 : 14 . 3 the 5 study 4 present 5 study 5 study 6 provides 6 provides 7 support 6 provides 8 for 8 for 10 use 9 the 10 use 10 use 11 of 11 of 13 training 12 video 13 training however , based on the focus group results , top - down implementation approaches with ongoing management involvement throughout the implementation process may be needed to achieve sustained changes in pain assessment practices . 0 ###LEFT-WALL### 13 implementation 0 ###LEFT-WALL### 34 . 1 however 2 , 1 however 13 implementation 3 based 4 on 3 based 9 , 3 based 13 implementation 4 on 8 results 5 the 8 results 6 focus 8 results 7 group 8 results 10 top 11 - 10 top 13 implementation 12 down 13 implementation 13 implementation 14 approaches 14 approaches 15 with 14 approaches 19 throughout 15 with 18 involvement 16 ongoing 17 management 17 management 18 involvement 19 throughout 21 implementation 20 the 21 implementation 21 implementation 22 process 21 implementation 27 achieve 22 process 23 may 23 may 24 be 24 be 25 needed 25 needed 26 to 26 to 27 achieve 27 achieve 29 changes 27 achieve 30 in 28 sustained 29 changes 30 in 33 practices 31 pain 32 assessment 32 assessment 33 practices a model useful for sustained implementation was proposed and discussed , and is hoped to facilitate future research . 0 ###LEFT-WALL### 2 model 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 19 . 1 a 2 model 2 model 3 useful 2 model 12 and 3 useful 4 for 4 for 6 implementation 5 sustained 6 implementation 7 was 9 and 7 was 12 and 8 proposed 9 and 9 and 10 discussed 11 , 12 and 12 and 13 is 13 is 14 hoped 14 hoped 15 to 15 to 16 facilitate 16 facilitate 18 research 17 future 18 research telomeres are ribonucleoprotein structures capping the end of every linear chromosome . 0 ###LEFT-WALL### 1 telomeres 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 12 . 1 telomeres 2 are 2 are 4 structures 3 ribonucleoprotein 4 structures 4 structures 5 capping 5 capping 7 end 6 the 7 end 7 end 8 of 8 of 11 chromosome 9 every 11 chromosome 10 linear 11 chromosome in all vertebrates , they are composed of ttaggg repeats coated with specific protecting proteins . 0 ###LEFT-WALL### 5 they 0 ###LEFT-WALL### 7 composed 0 ###LEFT-WALL### 16 . 1 in 3 vertebrates 1 in 4 , 1 in 5 they 2 all 3 vertebrates 5 they 6 are 6 are 7 composed 7 composed 8 of 8 of 10 repeats 9 ttaggg 10 repeats 10 repeats 11 coated 11 coated 12 with 12 with 15 proteins 13 specific 15 proteins 14 protecting 15 proteins telomeres shorten with each mitotic cell division , but telomerase , a reverse transcriptase , elongate telomeres in very specific cells , such as embryonic and adult stem cells . 0 ###LEFT-WALL### 1 telomeres 0 ###LEFT-WALL### 15 , 1 telomeres 15 , 2 shorten 3 with 2 shorten 15 , 3 with 7 division 3 with 14 transcriptase 4 each 7 division 5 mitotic 6 cell 6 cell 7 division 7 division 9 but 8 , 9 but 9 but 10 telomerase 9 but 11 , 12 a 14 transcriptase 13 reverse 14 transcriptase 15 , 16 elongate 16 elongate 17 telomeres 16 elongate 18 in 18 in 21 cells 19 very 20 specific 20 specific 21 cells 21 cells 24 as 22 , 24 as 23 such 24 as 24 as 26 and 24 as 30 . 25 embryonic 26 and 26 and 29 cells 27 adult 29 cells 28 stem 29 cells although telomere sequence is identical in mice and humans and telomeres serve the same role of protecting chromosomes and genetic information from damage and erosion in both species , abnormalities in telomere maintenance and [in] telomerase function do not coincide in phenotype [in] humans and mice . 0 ###LEFT-WALL### 3 sequence 0 ###LEFT-WALL### 4 is 0 ###LEFT-WALL### 8 and 0 ###LEFT-WALL### 47 . 1 although 2 telomere 1 although 3 sequence 3 sequence 4 is 4 is 5 identical 5 identical 6 in 6 in 7 mice 8 and 10 and 8 and 29 , 9 humans 10 and 10 and 11 telomeres 10 and 29 , 12 serve 19 and 12 serve 22 from 12 serve 29 , 13 the 14 same 13 the 15 role 15 role 16 of 15 role 19 and 16 of 17 protecting 17 protecting 18 chromosomes 19 and 21 information 20 genetic 21 information 22 from 24 and 23 damage 24 and 24 and 25 erosion 24 and 26 in 26 in 28 species 27 both 28 species 29 , 40 coincide 29 , 41 in 30 abnormalities 31 in 30 abnormalities 38 do 31 in 34 and 32 telomere 33 maintenance 33 maintenance 34 and 34 and 37 function 36 telomerase 37 function 38 do 39 not 38 do 40 coincide 41 in 45 and 42 phenotype 44 humans 44 humans 45 and 45 and 46 mice the telomeres of most laboratory mice are 5 to 10 times longer than in humans , but their lifespan is 30 times shorter . 0 ###LEFT-WALL### 2 telomeres 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 17 but 0 ###LEFT-WALL### 24 . 1 the 2 telomeres 2 telomeres 3 of 2 telomeres 7 are 3 of 6 mice 4 most 6 mice 5 laboratory 6 mice 7 are 12 longer 8 5 9 to 9 to 10 10 9 to 11 times 11 times 12 longer 12 longer 13 than 13 than 14 in 14 in 15 humans 16 , 17 but 17 but 19 lifespan 17 but 20 is 18 their 19 lifespan 19 lifespan 20 is 20 is 23 shorter 21 30 22 times 22 times 23 shorter complete [absence] of telomerase has little expression in [phenotype] over several generations in mice , whereas heterozygosity for telomerase mutations in humans is sufficient to result in organ regeneration [defect] and cancer development . 0 ###LEFT-WALL### 1 complete 0 ###LEFT-WALL### 5 has 1 complete 3 of 1 complete 5 has 3 of 4 telomerase 5 has 7 expression 5 has 8 in 5 has 13 in 5 has 16 whereas 6 little 7 expression 8 in 12 generations 10 over 11 several 11 several 12 generations 13 in 14 mice 15 , 16 whereas 16 whereas 17 heterozygosity 16 whereas 26 result 16 whereas 34 . 17 heterozygosity 18 for 17 heterozygosity 23 is 18 for 20 mutations 19 telomerase 20 mutations 20 mutations 21 in 21 in 22 humans 23 is 24 sufficient 24 sufficient 25 to 25 to 26 result 26 result 27 in 27 in 31 and 28 organ 29 regeneration 29 regeneration 31 and 31 and 33 development 32 cancer 33 development patients with telomerase deficiency and very short telomeres may develop aplastic anemia , pulmonary fibrosis , or cirrhosis , whereas telomerase - null murine models display only modest hematopoietic deficiency and develop emphysema when exposed to cigarette smoke . 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 10 develop 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 39 . 1 patients 2 with 1 patients 9 may 2 with 5 and 3 telomerase 4 deficiency 4 deficiency 5 and 5 and 8 telomeres 6 very 7 short 7 short 8 telomeres 9 may 10 develop 10 develop 17 or 11 aplastic 12 anemia 12 anemia 13 , 13 , 15 fibrosis 13 , 17 or 14 pulmonary 15 fibrosis 16 , 17 or 17 or 18 cirrhosis 19 , 25 models 19 , 31 and 20 whereas 21 telomerase 20 whereas 22 - 20 whereas 25 models 23 null 24 murine 24 murine 25 models 25 models 31 and 26 display 30 deficiency 26 display 31 and 27 only 28 modest 28 modest 30 deficiency 29 hematopoietic 30 deficiency 31 and 32 develop 32 develop 33 emphysema 32 develop 34 when 34 when 35 exposed 35 exposed 36 to 36 to 38 smoke 37 cigarette 38 smoke in summary , telomerase deficiency in both humans and mice accelerate telomere shortening , but its consequences in the different organs and in the organism diverge , mainly due to telomere length differences . 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 11 accelerate 0 ###LEFT-WALL### 15 but 1 in 5 deficiency 1 in 9 and 2 summary 3 , 2 summary 4 telomerase 4 telomerase 5 deficiency 5 deficiency 6 in 6 in 7 both 8 humans 9 and 9 and 10 mice 9 and 11 accelerate 11 accelerate 13 shortening 12 telomere 13 shortening 14 , 15 but 15 but 17 consequences 15 but 26 diverge 16 its 17 consequences 17 consequences 22 and 17 consequences 26 diverge 18 in 21 organs 18 in 22 and 19 the 21 organs 20 different 21 organs 22 and 23 in 23 in 25 organism 24 the 25 organism 26 diverge 30 to 27 , 28 mainly 27 , 30 to 29 due 30 to 30 to 33 differences 30 to 34 . 31 telomere 32 length 32 length 33 differences [none] none [to] explore the possible mechanisms underlying sex - specific differences in skeletal fragility that may be obscured by two - dimensional areal bone mineral density ( abmd ) measures , we compared quantitative computed tomography ( qct ) - based vertebral bone measures among pairs of men and women from the framingham heart study multidetector computed tomography study who were matched for age and spine abmd . 0 ###LEFT-WALL### 4 explore 0 ###LEFT-WALL### 10 - 0 ###LEFT-WALL### 69 . 2 none 4 explore 4 explore 7 mechanisms 5 the 7 mechanisms 6 possible 7 mechanisms 7 mechanisms 8 underlying 8 underlying 9 sex 10 - 12 differences 10 - 19 obscured 10 - 32 , 11 specific 12 differences 12 differences 13 in 12 differences 16 that 12 differences 17 may 12 differences 18 be 13 in 15 fragility 14 skeletal 15 fragility 16 that 17 may 18 be 19 obscured 19 obscured 20 by 20 by 21 two 21 two 27 density 22 - 27 density 23 dimensional 26 mineral 24 areal 26 mineral 25 bone 26 mineral 26 mineral 27 density 27 density 31 measures 27 density 32 , 28 ( 31 measures 29 abmd 30 ) 29 abmd 31 measures 31 measures 32 , 32 , 33 we 32 , 34 compared 32 , 50 and 33 we 34 compared 34 compared 45 measures 35 quantitative 45 measures 36 computed 45 measures 37 tomography 39 qct 37 tomography 41 - 37 tomography 45 measures 38 ( 39 qct 39 qct 40 ) 42 based 44 bone 43 vertebral 44 bone 44 bone 45 measures 45 measures 46 among 45 measures 48 of 46 among 47 pairs 48 of 49 men 50 and 51 women 50 and 68 abmd 51 women 52 from 51 women 61 who 51 women 62 were 51 women 68 abmd 52 from 60 study 53 the 60 study 54 framingham 55 heart 55 heart 56 study 56 study 57 multidetector 57 multidetector 58 computed 58 computed 59 tomography 59 tomography 60 study 61 who 62 were 62 were 63 matched 63 matched 64 for 64 for 66 and 65 age 66 and 66 and 67 spine we identified 981 male - female pairs ( 1:1 matching ) matched on age ( ± 1 year [ )(and qct - derived abmd of l3 ( [±] 1 % ) , with an average age of 51 years ( range 34 to 81 years ) . 1 we 2 identified 2 identified 3 981 2 identified 13 on 2 identified 33 with 3 981 7 pairs 3 981 12 matched 4 male 5 - 4 male 7 pairs 6 female 7 pairs 7 pairs 9 1:1 7 pairs 12 matched 8 ( 9 1:1 9 1:1 10 matching 9 1:1 11 ) 13 on 14 age 14 age 24 abmd 15 ( 24 abmd 16 ± 24 abmd 17 1 18 year 18 year 20 )(and 20 )(and 21 qct 20 )(and 22 - 20 )(and 23 derived 20 )(and 24 abmd 24 abmd 25 of 24 abmd 31 ) 25 of 26 l3 26 l3 30 % 27 ( 30 % 29 1 30 % 30 % 31 ) 32 , 33 with 33 with 36 age 33 with 47 . 34 an 36 age 35 average 36 age 36 age 37 of 37 of 39 years 38 51 39 years 39 years 41 range 40 ( 41 range 41 range 42 34 41 range 43 to 41 range 46 ) 43 to 45 years 44 81 45 years after adjusting for height and weight , the differences in csa and volumetric bone mineral density ( vbmd ) between men and women were attenuated but remained significant , whereas compressive strength was no longer different . 0 ###LEFT-WALL### 9 differences 0 ###LEFT-WALL### 14 bone 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 33 was 0 ###LEFT-WALL### 37 . 1 after 2 adjusting 1 after 7 , 1 after 9 differences 2 adjusting 3 for 3 for 5 and 4 height 5 and 5 and 6 weight 8 the 9 differences 9 differences 10 in 9 differences 14 bone 10 in 12 and 11 csa 12 and 12 and 13 volumetric 14 bone 16 density 14 bone 20 between 15 mineral 16 density 16 density 18 vbmd 17 ( 18 vbmd 18 vbmd 19 ) 20 between 21 men 22 and 23 women 22 and 26 but 23 women 24 were 24 were 26 but 25 attenuated 26 but 26 but 27 remained 26 but 30 whereas 27 remained 28 significant 29 , 30 whereas 30 whereas 32 strength 31 compressive 32 strength 32 strength 33 was 33 was 35 longer 33 was 36 different 34 no 35 longer in conclusion , vertebral size , morphology , and density differ significantly between men and women matched for age and spine abmd , suggesting that men and women attain the same abmd by different mechanisms . 0 ###LEFT-WALL### 11 differ 0 ###LEFT-WALL### 36 . 1 in 9 and 1 in 11 differ 2 conclusion 3 , 3 , 5 size 3 , 6 , 4 vertebral 5 size 6 , 7 morphology 6 , 9 and 8 , 9 and 9 and 10 density 11 differ 12 significantly 11 differ 13 between 13 between 20 and 14 men 15 and 15 and 16 women 15 and 17 matched 15 and 20 and 17 matched 18 for 18 for 19 age 20 and 22 abmd 20 and 23 , 20 and 24 suggesting 20 and 32 abmd 21 spine 22 abmd 24 suggesting 25 that 25 that 27 and 25 that 29 attain 26 men 27 and 27 and 28 women 29 attain 31 same 30 the 31 same 32 abmd 33 by 33 by 35 mechanisms 34 different 35 mechanisms these results provide novel information regarding sex - specific differences in mechanisms that underlie vertebral fragility . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 17 . 1 these 2 results 2 results 3 provide 3 provide 5 information 4 novel 5 information 5 information 6 regarding 6 regarding 7 sex 8 - 10 differences 9 specific 10 differences 10 differences 11 in 11 in 12 mechanisms 12 mechanisms 13 that 12 mechanisms 14 underlie 13 that 14 underlie 14 underlie 16 fragility 15 vertebral 16 fragility modern society is witnessing a widespread tendency to postpone parenthood due to a number of socioeconomic factors . 0 ###LEFT-WALL### 2 society 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 18 . 1 modern 2 society 2 society 3 is 3 is 4 witnessing 4 witnessing 7 tendency 4 witnessing 8 to 4 witnessing 12 to 5 a 7 tendency 6 widespread 7 tendency 8 to 9 postpone 9 postpone 10 parenthood 11 due 12 to 12 to 17 factors 13 a 14 number 14 number 15 of 14 number 17 factors 15 of 17 factors 16 socioeconomic 17 factors this ever [-] increasing trend relates to both women and men and raises many concerns about the risks and consequences lying beneath the natural process of aging . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 28 . 1 this 5 trend 2 ever 4 increasing 4 increasing 5 trend 5 trend 12 and 5 trend 19 and 6 relates 7 to 6 relates 12 and 7 to 10 and 8 both 9 women 9 women 10 and 10 and 11 men 12 and 13 raises 12 and 16 about 13 raises 15 concerns 14 many 15 concerns 16 about 18 risks 17 the 18 risks 19 and 20 consequences 19 and 21 lying 19 and 26 of 21 lying 22 beneath 22 beneath 25 process 23 the 25 process 24 natural 25 process 26 of 27 aging the negative influence of the advanced maternal age has been thoroughly demonstrated , while the paternal age has attracted comparatively less attention . 0 ###LEFT-WALL### 3 influence 0 ###LEFT-WALL### 12 demonstrated 1 the 3 influence 2 negative 3 influence 3 influence 4 of 3 influence 9 has 4 of 8 age 5 the 8 age 6 advanced 8 age 7 maternal 8 age 9 has 10 been 10 been 11 thoroughly 10 been 12 demonstrated 12 demonstrated 14 while 13 , 14 while 14 while 17 age 14 while 19 attracted 14 while 23 . 15 the 17 age 16 paternal 17 age 17 age 18 has 18 has 19 attracted 19 attracted 20 comparatively 19 attracted 22 attention 21 less 22 attention a problematic issue of defining whether advanced paternal age can be considered an independent risk factor , [not] only for a man 's fertility but also for the offspring 's health , is represented by the difficulty , linked to reproductive studies , in characterizing the impact of maternal and paternal age , separately . 0 ###LEFT-WALL### 3 issue 0 ###LEFT-WALL### 34 represented 0 ###LEFT-WALL### 55 . 1 a 2 problematic 1 a 3 issue 2 problematic 3 issue 3 issue 4 of 3 issue 33 is 4 of 5 defining 5 defining 6 whether 5 defining 16 factor 6 whether 9 age 6 whether 12 considered 7 advanced 9 age 8 paternal 9 age 9 age 10 can 10 can 11 be 11 be 12 considered 13 an 16 factor 14 independent 16 factor 15 risk 16 factor 16 factor 20 for 17 , 19 only 17 , 20 for 20 for 24 fertility 20 for 32 , 21 a 22 man 22 man 23 's 23 's 24 fertility 24 fertility 25 but 24 fertility 27 for 25 but 26 also 27 for 31 health 28 the 29 offspring 29 offspring 30 's 30 's 31 health 33 is 34 represented 34 represented 35 by 34 represented 39 linked 34 represented 54 separately 35 by 37 difficulty 36 the 37 difficulty 38 , 39 linked 39 linked 40 to 39 linked 44 in 39 linked 53 , 40 to 42 studies 41 reproductive 42 studies 43 , 44 in 44 in 45 characterizing 44 in 53 , 45 characterizing 47 impact 46 the 47 impact 47 impact 48 of 48 of 50 and 49 maternal 50 and 50 and 52 age 51 paternal 52 age researchers are now trying to overcome this obstacle by directly analyzing the male germ cell , and emerging data prove this sperm - specific [approach] to be a valid tool for providing novel insights on the effects of aging on the spermatozoa and , thus , on the reproductive outcome of an aging male . 0 ###LEFT-WALL### 1 researchers 0 ###LEFT-WALL### 2 are 1 researchers 2 are 2 are 3 now 2 are 4 trying 4 trying 5 to 4 trying 6 overcome 5 to 6 overcome 6 overcome 8 obstacle 7 this 8 obstacle 8 obstacle 9 by 8 obstacle 24 specific 9 by 11 analyzing 10 directly 11 analyzing 11 analyzing 17 and 11 analyzing 20 prove 12 the 15 cell 13 male 15 cell 14 germ 15 cell 15 cell 17 and 16 , 17 and 17 and 19 data 17 and 20 prove 18 emerging 19 data 20 prove 22 sperm 21 this 22 sperm 23 - 24 specific 24 specific 26 to 24 specific 31 for 24 specific 55 . 26 to 27 be 27 be 30 tool 28 a 29 valid 28 a 30 tool 29 valid 30 tool 31 for 32 providing 32 providing 34 insights 32 providing 35 on 32 providing 43 and 33 novel 34 insights 35 on 37 effects 36 the 37 effects 37 effects 38 of 38 of 39 aging 40 on 42 spermatozoa 40 on 43 and 41 the 42 spermatozoa 43 and 45 thus 43 and 47 on 44 , 45 thus 45 thus 46 , 47 on 50 outcome 48 the 50 outcome 49 reproductive 50 outcome 50 outcome 51 of 51 of 54 male 52 an 54 male 53 aging 54 male the purpose of this chapter is to summarize most of what is known about the relationship between male aging and changes in the spermatozoa , giving special focus on the events occurring with age at the genomic level . 0 ###LEFT-WALL### 2 purpose 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 39 . 1 the 2 purpose 2 purpose 3 of 2 purpose 20 and 3 of 5 chapter 4 this 5 chapter 6 is 7 to 6 is 8 summarize 6 is 20 and 7 to 8 summarize 8 summarize 9 most 9 most 10 of 10 of 11 what 11 what 12 is 12 is 13 known 13 known 14 about 13 known 17 between 14 about 16 relationship 15 the 16 relationship 17 between 19 aging 18 male 19 aging 20 and 21 changes 20 and 22 in 20 and 28 focus 22 in 26 giving 23 the 26 giving 24 spermatozoa 25 , 24 spermatozoa 26 giving 27 special 28 focus 28 focus 29 on 28 focus 35 at 29 on 31 events 30 the 31 events 31 events 32 occurring 31 events 33 with 33 with 34 age 35 at 38 level 36 the 38 level 37 genomic 38 level objective : given the impact [of] recurrent [falls] in older people , risk evaluation [for] falling is an important part of geriatric assessment . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 24 . 1 objective 2 : 2 : 3 given 3 given 5 impact 4 the 5 impact 5 impact 7 recurrent 7 recurrent 9 in 9 in 11 people 10 older 11 people 12 , 16 falling 12 , 17 is 13 risk 16 falling 14 evaluation 16 falling 16 falling 17 is 17 is 23 assessment 18 an 20 part 19 important 20 part 20 part 21 of 20 part 23 assessment 21 of 23 assessment 22 geriatric 23 assessment available clinical tools usually do not include patients ' self - perceived risk of falling . 0 ###LEFT-WALL### 3 tools 0 ###LEFT-WALL### 7 include 0 ###LEFT-WALL### 11 - 0 ###LEFT-WALL### 16 . 1 available 3 tools 2 clinical 3 tools 3 tools 5 do 4 usually 5 do 5 do 6 not 5 do 7 include 7 include 10 self 8 patients 9 ' 9 ' 10 self 11 - 13 risk 12 perceived 13 risk 13 risk 14 of 14 of 15 falling the objective of this study was to evaluate [association] with [and] predictive capacity of self [-] perceived risk of falling in recurrent falls . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 23 falls 0 ###LEFT-WALL### 24 . 1 the 2 objective 2 objective 3 of 2 objective 5 study 2 objective 8 evaluate 2 objective 23 falls 3 of 4 this 5 study 6 was 6 was 7 to 6 was 8 evaluate 7 to 8 evaluate 8 evaluate 10 with 10 with 13 capacity 10 with 22 recurrent 12 predictive 13 capacity 13 capacity 14 of 14 of 18 risk 15 self 17 perceived 17 perceived 18 risk 18 risk 19 of 19 of 20 falling 20 falling 21 in methods : prospective cohort study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 . 1 methods 2 : 2 : 5 study 3 prospective 4 cohort 4 cohort 5 study patients attending a geriatric outpatients ' clinic were recruited [(] pfeiffer score < 5 [ )( 0 ###LEFT-WALL### 1 patients 0 ###LEFT-WALL### 12 score 0 ###LEFT-WALL### 16 )( 1 patients 2 attending 1 patients 12 score 2 attending 11 pfeiffer 3 a 4 geriatric 3 a 11 pfeiffer 4 geriatric 5 outpatients 5 outpatients 6 ' 6 ' 7 clinic 7 clinic 8 were 8 were 9 recruited 12 score 14 5 13 < 14 5 a baseline assessment and [follow] - up over 14 months [was] scheduled for each patient . 0 ###LEFT-WALL### 3 assessment 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 16 . 1 a 3 assessment 2 baseline 3 assessment 4 and 6 - 4 and 12 scheduled 6 - 7 up 7 up 9 14 8 over 9 14 9 14 10 months 9 14 12 scheduled 10 months 12 scheduled 12 scheduled 13 for 13 for 15 patient 14 each 15 patient self - perceived risk of falling was assessed through four questions . 0 ###LEFT-WALL### 4 risk 0 ###LEFT-WALL### 8 assessed 0 ###LEFT-WALL### 12 . 1 self 2 - 1 self 4 risk 3 perceived 4 risk 4 risk 5 of 4 risk 7 was 5 of 6 falling 7 was 8 assessed 8 assessed 9 through 9 through 11 questions 10 four 11 questions association [with] [falls] was evaluated through relative risk , survival curves ( kaplan - meier ) , and cox regression ( recurrent [falls] as outcome variables ) . 0 ###LEFT-WALL### 1 association 0 ###LEFT-WALL### 5 evaluated 0 ###LEFT-WALL### 28 . 1 association 4 was 4 was 5 evaluated 5 evaluated 6 through 6 through 8 risk 7 relative 8 risk 8 risk 11 curves 9 , 11 curves 10 survival 11 curves 11 curves 18 and 11 curves 27 ) 12 ( 18 and 13 kaplan 15 meier 13 kaplan 18 and 14 - 15 meier 15 meier 16 ) 17 , 18 and 18 and 20 regression 18 and 22 recurrent 18 and 27 ) 19 cox 20 regression 21 ( 22 recurrent 22 recurrent 24 as 22 recurrent 27 ) 24 as 26 variables 25 outcome 26 variables predictive capacity was evaluated through sensitivity , specificity , and predictive values . 0 ###LEFT-WALL### 2 capacity 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 13 . 1 predictive 2 capacity 2 capacity 3 was 3 was 4 evaluated 4 evaluated 5 through 5 through 10 and 6 sensitivity 7 , 7 , 8 specificity 7 , 10 and 9 , 10 and 10 and 12 values 11 predictive 12 values results : 52 participants answered all 4 questions , and 15 participants ( 27.2 % ) presented recurrent falls . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 3 52 2 : 19 falls 2 : 20 . 3 52 4 participants 3 52 5 answered 3 52 17 presented 3 52 19 falls 4 participants 5 answered 5 answered 10 and 6 all 7 4 7 4 8 questions 8 questions 10 and 9 , 10 and 10 and 12 participants 10 and 15 % 11 15 12 participants 13 ( 15 % 14 27.2 15 % 15 % 16 ) 17 presented 18 recurrent question 1 ( do you think [you] may fall in the next few months ? [ )(was associated with the occurrence of recurrent [falls] according to relative risk [ 3.88 ( ci95 %:1.48 - 10.09 ) ] and survival curves ( log rank , [p] 0.004 ) . 0 ###LEFT-WALL### 1 question 0 ###LEFT-WALL### 48 . 1 question 2 1 1 question 18 associated 2 1 4 do 2 1 17 )(was 3 ( 4 do 4 do 5 you 4 do 8 may 4 do 15 ? 5 you 6 think 6 think 8 may 8 may 9 fall 9 fall 10 in 10 in 14 months 11 the 12 next 11 the 13 few 13 few 14 months 17 )(was 18 associated 18 associated 19 with 19 with 21 occurrence 20 the 21 occurrence 21 occurrence 22 of 22 of 38 and 23 recurrent 25 according 25 according 26 to 25 according 38 and 26 to 28 risk 27 relative 28 risk 28 risk 30 3.88 29 [ 30 3.88 30 3.88 33 %:1.48 30 3.88 35 10.09 30 3.88 37 ] 31 ( 33 %:1.48 32 ci95 33 %:1.48 33 %:1.48 34 - 34 - 35 10.09 35 10.09 36 ) 38 and 40 curves 38 and 43 rank 39 survival 40 curves 41 ( 43 rank 42 log 43 rank 43 rank 46 0.004 43 rank 47 ) 44 , 46 0.004 46 0.004 47 ) [such] [relationship] is maintained [over] time . 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 7 . 3 is 6 time 4 maintained 6 time cox - regression also showed significant difference [in] relation to the answer for question [1] and recurrent [falls] [ hazard ratio 4.044 ( ci : 1.410 - 11.597 ) ; [p] 0.009 []] . 0 ###LEFT-WALL### 3 regression 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 25 : 0 ###LEFT-WALL### 34 . 1 cox 2 - 1 cox 3 regression 3 regression 5 showed 4 also 5 showed 5 showed 9 relation 5 showed 10 to 6 significant 7 difference 7 difference 9 relation 10 to 12 answer 11 the 12 answer 12 answer 13 for 13 for 16 and 14 question 16 and 16 and 17 recurrent 16 and 21 ratio 19 [ 21 ratio 20 hazard 21 ratio 21 ratio 22 4.044 21 ratio 24 ci 21 ratio 25 : 23 ( 24 ci 24 ci 25 : 25 : 26 1.410 25 : 30 ; 26 1.410 28 11.597 27 - 28 11.597 28 11.597 29 ) 30 ; 32 0.009 sensitivity , specificity , positive and negative predictive values ( [question] 1 ) were 53.3 % ( ci95 %:28.1 - 78.6 ) , 84.2 % ( ci95 %:72.6 - 95.8 ) , 57.1 % ( ci95 %:31.2 - 83.1 ) , [and] 82.1 % ( ci95 %:70.0 - 94.1 ) , respectively . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 14 were 1 sensitivity 2 , 2 , 3 specificity 2 , 4 , 4 , 5 positive 4 , 6 and 6 and 9 values 6 and 12 1 6 and 14 were 7 negative 9 values 8 predictive 9 values 10 ( 12 1 12 1 13 ) 14 were 16 % 14 were 52 respectively 15 53.3 16 % 16 % 19 %:28.1 17 ( 19 %:28.1 18 ci95 19 %:28.1 19 %:28.1 21 78.6 19 %:28.1 25 % 19 %:28.1 51 , 20 - 21 78.6 21 78.6 22 ) 23 , 25 % 24 84.2 25 % 25 % 28 %:72.6 25 % 50 ) 26 ( 28 %:72.6 27 ci95 28 %:72.6 28 %:72.6 30 95.8 28 %:72.6 34 % 28 %:72.6 44 % 28 %:72.6 50 ) 29 - 30 95.8 30 95.8 31 ) 32 , 34 % 33 57.1 34 % 34 % 37 %:31.2 34 % 41 , 35 ( 37 %:31.2 36 ci95 37 %:31.2 37 %:31.2 39 83.1 37 %:31.2 40 ) 38 - 39 83.1 39 83.1 40 ) 41 , 44 % 43 82.1 44 % 44 % 48 - 44 % 50 ) 45 ( 48 - 46 ci95 47 %:70.0 47 %:70.0 48 - 48 - 49 94.1 48 - 50 ) 51 , 52 respectively 52 respectively 53 . conclusions : patients ' self - perceived risk [of] falling is related to [recurrent] falls amongst people with a high risk of falling and this parameter might be useful in falling risk evaluation . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 - 0 ###LEFT-WALL### 34 . 1 conclusions 2 : 2 : 5 self 3 patients 4 ' 4 ' 5 self 6 - 8 risk 6 - 15 falls 7 perceived 8 risk 8 risk 10 falling 8 risk 13 to 8 risk 15 falls 10 falling 11 is 11 is 12 related 12 related 13 to 15 falls 16 amongst 16 amongst 17 people 17 people 18 with 18 with 33 evaluation 19 a 20 high 19 a 33 evaluation 20 high 21 risk 21 risk 22 of 21 risk 27 might 22 of 24 and 23 falling 24 and 24 and 26 parameter 25 this 26 parameter 27 might 28 be 28 be 29 useful 29 useful 30 in 30 in 31 falling 32 risk 33 evaluation objective : to evaluate the correlation between chronological and biological age by comparing the normograms of afc , amh , and fsh . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 3 to 2 : 4 evaluate 3 to 4 evaluate 4 evaluate 6 correlation 4 evaluate 7 between 4 evaluate 12 by 5 the 6 correlation 7 between 11 age 8 chronological 9 and 9 and 10 biological 9 and 11 age 12 by 13 comparing 13 comparing 15 normograms 14 the 15 normograms 15 normograms 16 of 16 of 22 fsh 17 afc 19 amh 18 , 19 amh 19 amh 20 , 19 amh 21 and 21 and 22 fsh 22 fsh 23 . design : retrospective study setting : data were taken from patients who visited the infertility clinic at dr [.] cipto mangunkusumo general hospital jakarta , indonesia , between january 2008 and december 2010 . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 : 1 design 2 : 2 : 5 setting 3 retrospective 4 study 4 study 5 setting 6 : 7 data 6 : 9 taken 6 : 34 . 7 data 8 were 8 were 9 taken 9 taken 10 from 9 taken 17 at 9 taken 28 between 10 from 11 patients 11 patients 12 who 11 patients 13 visited 12 who 13 visited 13 visited 16 clinic 14 the 16 clinic 15 infertility 16 clinic 17 at 24 jakarta 18 dr 20 cipto 20 cipto 21 mangunkusumo 21 mangunkusumo 22 general 22 general 24 jakarta 23 hospital 24 jakarta 24 jakarta 26 indonesia 25 , 26 indonesia 26 indonesia 27 , 28 between 31 and 29 january 30 2008 29 january 31 and 31 and 32 december 32 december 33 2010 patient ( s ) : infertile women who visited the infertility clinic . 0 ###LEFT-WALL### 1 patient 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 13 . 1 patient 3 s 1 patient 5 : 2 ( 3 s 3 s 4 ) 5 : 7 women 6 infertile 7 women 7 women 8 who 7 women 9 visited 8 who 9 visited 9 visited 12 clinic 10 the 12 clinic 11 infertility 12 clinic 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 ) : normogram of afc ( n = 366 ) , amh ( n = 1616 ) and fsh ( n = 415 ) . 0 ###LEFT-WALL### 3 measure 0 ###LEFT-WALL### 7 : 0 ###LEFT-WALL### 30 . 1 main 2 outcome 2 outcome 3 measure 3 measure 5 s 3 measure 7 : 4 ( 5 s 5 s 6 ) 7 : 8 normogram 7 : 27 = 8 normogram 9 of 9 of 23 and 10 afc 13 = 10 afc 16 , 11 ( 13 = 12 n 13 = 13 = 14 366 13 = 15 ) 16 , 17 amh 16 , 23 and 17 amh 20 = 18 ( 20 = 19 n 20 = 20 = 21 1616 20 = 22 ) 23 and 24 fsh 25 ( 27 = 26 n 27 = 27 = 28 415 27 = 29 ) result ( s ) : the correlations among afc , amh , fsh , and age are statistically significant . 0 ###LEFT-WALL### 1 result 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 20 . 1 result 3 s 1 result 5 : 2 ( 3 s 3 s 4 ) 5 : 7 correlations 6 the 7 correlations 7 correlations 8 among 8 among 9 afc 10 , 15 and 10 , 17 are 11 amh 13 fsh 12 , 13 fsh 13 fsh 14 , 13 fsh 15 and 14 , 15 and 15 and 16 age 15 and 17 are 17 are 19 significant 18 statistically 19 significant normograms of afc and amh with 3rd , 10th , 25th , 50th , 75th , 90th , and 97th percentiles showed a decrease in age where fsh increased . 0 ###LEFT-WALL### 4 and 0 ###LEFT-WALL### 22 showed 0 ###LEFT-WALL### 30 . 1 normograms 2 of 1 normograms 4 and 2 of 3 afc 4 and 5 amh 4 and 6 with 4 and 22 showed 6 with 21 percentiles 7 3rd 8 , 8 , 9 10th 8 , 10 , 10 , 11 25th 10 , 12 , 12 , 13 50th 12 , 14 , 14 , 15 75th 14 , 16 , 16 , 17 90th 16 , 19 and 18 , 19 and 19 and 20 97th 19 and 21 percentiles 22 showed 24 decrease 22 showed 25 in 22 showed 27 where 23 a 24 decrease 25 in 26 age 27 where 28 fsh 27 where 29 increased 28 fsh 29 increased a cut [-] off value of afc , amh , and fsh for poor responders was plotted at the 50th percentile of each normogram . 0 ###LEFT-WALL### 2 cut 0 ###LEFT-WALL### 17 plotted 0 ###LEFT-WALL### 25 . 1 a 2 cut 2 cut 4 off 2 cut 6 of 2 cut 16 was 4 off 5 value 6 of 12 fsh 7 afc 9 amh 8 , 9 amh 9 amh 10 , 9 amh 11 and 11 and 12 fsh 12 fsh 13 for 13 for 15 responders 14 poor 15 responders 16 was 17 plotted 17 plotted 18 at 18 at 21 percentile 19 the 21 percentile 20 50th 21 percentile 21 percentile 22 of 22 of 24 normogram 23 each 24 normogram serum amh and afc started to decline in women between 34 and 35 years old . 0 ###LEFT-WALL### 4 afc 0 ###LEFT-WALL### 5 started 0 ###LEFT-WALL### 16 . 1 serum 2 amh 2 amh 3 and 3 and 4 afc 4 afc 5 started 5 started 6 to 5 started 7 decline 6 to 7 decline 7 decline 8 in 8 in 9 women 9 women 12 and 9 women 15 old 10 between 12 and 11 34 12 and 12 and 13 35 14 years 15 old we found a relatively lower slope increase of fsh in older patients compared to that of afc and amh . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 20 . 1 we 2 found 2 found 7 increase 2 found 10 in 2 found 14 to 3 a 7 increase 4 relatively 5 lower 5 lower 6 slope 6 slope 7 increase 7 increase 8 of 8 of 9 fsh 10 in 12 patients 11 older 12 patients 12 patients 13 compared 14 to 18 and 15 that 16 of 15 that 18 and 16 of 17 afc 18 and 19 amh fsh was observed to be a later predictor of biological age [than] amh and afc . 0 ###LEFT-WALL### 1 fsh 0 ###LEFT-WALL### 5 be 1 fsh 2 was 2 was 3 observed 3 observed 4 to 4 to 5 be 5 be 8 predictor 6 a 8 predictor 7 later 8 predictor 8 predictor 9 of 9 of 15 afc 10 biological 11 age 11 age 15 afc 13 amh 14 and 14 and 15 afc 15 afc 16 . conclusion ( s ) : amh predicted biological age earlier than fsh or afc . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 5 : 0 ###LEFT-WALL### 15 . 1 conclusion 3 s 1 conclusion 5 : 2 ( 3 s 3 s 4 ) 5 : 9 age 5 : 10 earlier 5 : 11 than 6 amh 7 predicted 7 predicted 9 age 8 biological 9 age 11 than 13 or 12 fsh 13 or 13 or 14 afc normograms can provide a reference guide for physicians to counsel infertile women . 0 ###LEFT-WALL### 1 normograms 0 ###LEFT-WALL### 3 provide 0 ###LEFT-WALL### 13 . 1 normograms 2 can 2 can 3 provide 3 provide 6 guide 3 provide 9 to 4 a 6 guide 5 reference 6 guide 6 guide 7 for 7 for 8 physicians 9 to 10 counsel 10 counsel 12 women 11 infertile 12 women however , future validation with longitudinal data is still needed . 0 ###LEFT-WALL### 4 validation 0 ###LEFT-WALL### 10 needed 0 ###LEFT-WALL### 11 . 1 however 2 , 1 however 4 validation 3 future 4 validation 4 validation 5 with 4 validation 8 is 5 with 7 data 6 longitudinal 7 data 8 is 10 needed 9 still 10 needed head and neck paragangliomas , rare neoplasms of the paraganglia composed of nests of neurosecretory and glial cells embedded in vascular stroma , provide a remarkable example of organoid tumor architecture . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 24 provide 0 ###LEFT-WALL### 32 . 1 head 2 and 2 and 4 paragangliomas 2 and 16 and 2 and 24 provide 3 neck 4 paragangliomas 5 , 16 and 6 rare 7 neoplasms 7 neoplasms 8 of 7 neoplasms 16 and 8 of 10 paraganglia 9 the 10 paraganglia 10 paraganglia 11 composed 10 paraganglia 12 of 10 paraganglia 14 of 12 of 13 nests 14 of 15 neurosecretory 16 and 18 cells 16 and 19 embedded 16 and 23 , 17 glial 18 cells 19 embedded 20 in 20 in 22 stroma 21 vascular 22 stroma 24 provide 27 example 25 a 26 remarkable 25 a 27 example 26 remarkable 27 example 27 example 28 of 28 of 31 architecture 29 organoid 31 architecture 30 tumor 31 architecture to identify genes and pathways commonly deregulated in head [and] neck paraganglioma , we integrated high - density [genome] - wide copy number variation ( cnv ) analysis with microrna and immunomorphological studies . 0 ###LEFT-WALL### 14 we 0 ###LEFT-WALL### 15 integrated 0 ###LEFT-WALL### 34 . 1 to 2 identify 1 to 13 , 1 to 14 we 2 identify 4 and 2 identify 8 in 3 genes 4 and 4 and 5 pathways 4 and 7 deregulated 6 commonly 7 deregulated 8 in 12 paraganglioma 9 head 12 paraganglioma 11 neck 12 paraganglioma 14 we 15 integrated 15 integrated 31 and 16 high 18 density 16 high 28 analysis 17 - 18 density 18 density 24 variation 18 density 27 ) 20 - 24 variation 21 wide 22 copy 22 copy 24 variation 23 number 24 variation 24 variation 26 cnv 24 variation 27 ) 25 ( 26 cnv 26 cnv 27 ) 28 analysis 29 with 28 analysis 31 and 29 with 30 microrna 31 and 33 studies 32 immunomorphological 33 studies gene - centric cnv analysis of 24 cases identified a list of 104 genes most significantly targeted by tumor [-] associated alterations . 0 ###LEFT-WALL### 1 gene 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 23 . 2 - 5 analysis 2 - 9 identified 3 centric 5 analysis 4 cnv 5 analysis 5 analysis 6 of 5 analysis 9 identified 6 of 8 cases 7 24 8 cases 9 identified 11 list 10 a 11 list 11 list 12 of 11 list 18 by 12 of 14 genes 13 104 14 genes 14 genes 17 targeted 15 most 16 significantly 16 significantly 17 targeted 18 by 22 alterations 19 tumor 21 associated 21 associated 22 alterations the " notch signaling pathway " was the most significantly enriched term in the list ( p = 0.002 after bonferroni or benjamini correction ) . 0 ###LEFT-WALL### 5 pathway 0 ###LEFT-WALL### 7 was 0 ###LEFT-WALL### 26 . 1 the 2 " 1 the 5 pathway 3 notch 5 pathway 4 signaling 5 pathway 5 pathway 6 " 5 pathway 7 was 7 was 12 term 8 the 12 term 9 most 10 significantly 10 significantly 11 enriched 11 enriched 12 term 12 term 13 in 12 term 20 after 13 in 15 list 14 the 15 list 15 list 18 = 16 ( 18 = 17 p 18 = 18 = 19 0.002 20 after 22 or 21 bonferroni 22 or 22 or 24 correction 22 or 25 ) 23 benjamini 24 correction expression of the relevant notch pathway proteins in sustentacular [(] glial [ )(, chief ( neuroendocrine ) [and] endothelial cells was confirmed by immunohistochemistry in 47 head and neck paraganglioma cases . 0 ###LEFT-WALL### 1 expression 0 ###LEFT-WALL### 28 and 0 ###LEFT-WALL### 32 . 1 expression 2 of 1 expression 21 was 2 of 7 proteins 3 the 7 proteins 4 relevant 7 proteins 5 notch 7 proteins 6 pathway 7 proteins 7 proteins 8 in 8 in 20 cells 9 sustentacular 20 cells 11 glial 13 )(, 11 glial 20 cells 14 chief 16 neuroendocrine 14 chief 17 ) 14 chief 20 cells 15 ( 16 neuroendocrine 16 neuroendocrine 17 ) 19 endothelial 20 cells 21 was 28 and 22 confirmed 23 by 22 confirmed 25 in 22 confirmed 27 head 22 confirmed 28 and 23 by 24 immunohistochemistry 25 in 26 47 28 and 29 neck 29 neck 31 cases 30 paraganglioma 31 cases there were no relationships between level and pattern of notch1/jag2 protein expression and germline mutation status in the sdh genes , implicated in paraganglioma [predisposition] , or the presence/absence of immunostaining for sdhb , a surrogate marker of sdh mutations . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 1 there 2 were 2 were 13 and 3 no 13 and 4 relationships 5 between 4 relationships 7 and 5 between 6 level 7 and 8 pattern 7 and 9 of 7 and 13 and 9 of 12 expression 10 notch1/jag2 11 protein 11 protein 12 expression 13 and 16 status 13 and 17 in 13 and 22 implicated 14 germline 16 status 15 mutation 16 status 17 in 20 genes 18 the 20 genes 19 sdh 20 genes 21 , 22 implicated 22 implicated 23 in 22 implicated 32 for 22 implicated 41 . 23 in 27 or 24 paraganglioma 27 or 26 , 27 or 27 or 29 presence/absence 27 or 30 of 28 the 29 presence/absence 30 of 31 immunostaining 32 for 33 sdhb 33 sdhb 37 marker 34 , 37 marker 35 a 37 marker 36 surrogate 37 marker 37 marker 38 of 37 marker 41 . 38 of 40 mutations 39 sdh 40 mutations interestingly , notch upregulation was observed also in cases with no evidence of cnvs at notch signaling genes , suggesting altered epigenetic modulation of this pathway . 0 ###LEFT-WALL### 4 upregulation 0 ###LEFT-WALL### 6 observed 1 interestingly 2 , 1 interestingly 4 upregulation 3 notch 4 upregulation 4 upregulation 5 was 5 was 6 observed 6 observed 7 also 6 observed 8 in 6 observed 10 with 6 observed 15 at 8 in 9 cases 10 with 12 evidence 11 no 12 evidence 12 evidence 13 of 13 of 14 cnvs 15 at 16 notch 16 notch 17 signaling 16 notch 20 suggesting 17 signaling 18 genes 19 , 20 suggesting 20 suggesting 23 modulation 20 suggesting 27 . 21 altered 23 modulation 22 epigenetic 23 modulation 23 modulation 24 of 24 of 26 pathway 25 this 26 pathway to address this issue [we] performed microarray - based microrna expression analyses . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 address 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 13 . 1 to 2 address 2 address 7 microarray 3 this 7 microarray 4 issue 6 performed 6 performed 7 microarray 8 - 12 analyses 9 based 11 expression 10 microrna 11 expression 11 expression 12 analyses notably 5 micrornas ( mir - 200a,b,c and mir - 34b,c ) , including those most downregulated in the tumors , correlated to notch signaling and directly targeted notch1 in in vitro [experiments] using sh - sy5y neuroblastoma cells . 0 ###LEFT-WALL### 3 micrornas 0 ###LEFT-WALL### 26 and 1 notably 3 micrornas 2 5 3 micrornas 3 micrornas 8 and 3 micrornas 26 and 4 ( 8 and 5 mir 6 - 5 mir 7 200a,b,c 7 200a,b,c 8 and 8 and 11 34b,c 8 and 12 ) 8 and 14 including 8 and 21 , 9 mir 10 - 9 mir 11 34b,c 13 , 14 including 14 including 15 those 14 including 21 , 15 those 16 most 15 those 17 downregulated 16 most 17 downregulated 17 downregulated 18 in 18 in 20 tumors 19 the 20 tumors 22 correlated 23 to 22 correlated 26 and 23 to 24 notch 24 notch 25 signaling 26 and 28 targeted 27 directly 28 targeted 28 targeted 29 notch1 29 notch1 30 in 29 notch1 39 cells 30 in 34 using 31 in 32 vitro 32 vitro 34 using 34 using 35 sh 36 - 39 cells 37 sy5y 39 cells 38 neuroblastoma 39 cells 39 cells 40 . furthermore , lentiviral transduction of [mir] - 200 s and [mir] - 34 s in patient - derived primary tympano - jugular paraganglioma cell cultures was associated with notch1 downregulation and increased levels of markers of cell toxicity and cell death . 0 ###LEFT-WALL### 4 transduction 0 ###LEFT-WALL### 26 was 0 ###LEFT-WALL### 42 . 1 furthermore 2 , 1 furthermore 4 transduction 3 lentiviral 4 transduction 4 transduction 5 of 4 transduction 26 was 5 of 10 and 7 - 8 200 8 200 9 s 9 s 10 and 10 and 14 s 10 and 15 in 12 - 13 34 13 34 14 s 15 in 25 cultures 16 patient 17 - 16 patient 19 primary 18 derived 19 primary 19 primary 25 cultures 20 tympano 21 - 20 tympano 24 cell 22 jugular 24 cell 23 paraganglioma 24 cell 24 cell 25 cultures 26 was 31 and 27 associated 28 with 27 associated 31 and 28 with 30 downregulation 29 notch1 30 downregulation 31 and 32 increased 31 and 33 levels 33 levels 34 of 34 of 35 markers 35 markers 36 of 36 of 39 and 37 cell 38 toxicity 38 toxicity 39 and 39 and 41 death 40 cell 41 death taken together , our results provide an integrated view of common molecular alterations associated with head [and] neck paraganglioma and reveal an essential role of notch pathway deregulation in this tumor type . 0 ###LEFT-WALL### 5 results 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 33 . 1 taken 2 together 1 taken 3 , 1 taken 5 results 4 our 5 results 5 results 20 and 6 provide 9 view 6 provide 20 and 7 an 9 view 8 integrated 9 view 9 view 10 of 10 of 13 alterations 11 common 13 alterations 12 molecular 13 alterations 13 alterations 14 associated 14 associated 15 with 15 with 19 paraganglioma 16 head 18 neck 18 neck 19 paraganglioma 20 and 21 reveal 20 and 28 deregulation 21 reveal 24 role 22 an 24 role 23 essential 24 role 24 role 25 of 25 of 26 notch 27 pathway 28 deregulation 28 deregulation 29 in 29 in 32 type 30 this 32 type 31 tumor 32 type objective : brain tissue integrity is highly heritable , and its decline is a common phenomenon of ageing . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 2 : 5 integrity 2 : 6 is 2 : 10 and 2 : 19 . 3 brain 5 integrity 4 tissue 5 integrity 5 integrity 6 is 6 is 8 heritable 7 highly 8 heritable 9 , 10 and 10 and 12 decline 10 and 13 is 11 its 12 decline 12 decline 13 is 13 is 16 phenomenon 14 a 15 common 14 a 16 phenomenon 15 common 16 phenomenon 16 phenomenon 17 of 17 of 18 ageing this study aimed to determine whether the phenotype of familial longevity is marked by a relative preservation of brain tissue microstructure . 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 17 preservation 4 to 5 determine 5 determine 6 whether 6 whether 8 phenotype 6 whether 13 marked 7 the 8 phenotype 8 phenotype 9 of 8 phenotype 12 is 9 of 11 longevity 10 familial 11 longevity 12 is 13 marked 13 marked 14 by 14 by 16 relative 15 a 16 relative 17 preservation 18 of 18 of 21 microstructure 19 brain 21 microstructure 20 tissue 21 microstructure methods : participants were enrolled in the leiden longevity study . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 participants 2 : 5 enrolled 2 : 11 . 3 participants 4 were 4 were 5 enrolled 5 enrolled 6 in 6 in 10 study 7 the 10 study 8 leiden 9 longevity 9 longevity 10 study in total , 185 middle - aged to elderly offspring of nonagenarian siblings , who were enriched for familial factors of longevity , were contrasted with 171 [environment] - and age - matched controls . 0 ###LEFT-WALL### 4 185 0 ###LEFT-WALL### 5 middle 0 ###LEFT-WALL### 35 . 1 in 2 total 2 total 3 , 2 total 4 185 4 185 5 middle 5 middle 7 aged 5 middle 34 controls 6 - 7 aged 7 aged 8 to 7 aged 32 - 8 to 10 offspring 9 elderly 10 offspring 10 offspring 11 of 11 of 13 siblings 12 nonagenarian 13 siblings 13 siblings 15 who 14 , 15 who 15 who 23 , 15 who 32 - 16 were 17 enriched 16 were 23 , 17 enriched 18 for 18 for 20 factors 19 familial 20 factors 20 factors 21 of 21 of 22 longevity 23 , 30 and 24 were 25 contrasted 24 were 30 and 25 contrasted 26 with 26 with 27 171 29 - 30 and 30 and 31 age 33 matched 34 controls all subjects underwent 3 t whole brain magnetic resonance diffusion tensor imaging . 0 ###LEFT-WALL### 2 subjects 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 13 . 1 all 2 subjects 2 subjects 3 underwent 3 underwent 12 imaging 4 3 5 t 5 t 12 imaging 6 whole 7 brain 7 brain 12 imaging 8 magnetic 9 resonance 9 resonance 12 imaging 10 diffusion 12 imaging 11 tensor 12 imaging results : voxel - wise analysis revealed widespread age - related decrease of white matter fractional anisotropy and increases of axial , radial , and mean diffusivity ( [all] p < 0.003 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 11 related 1 results 2 : 2 : 3 voxel 3 voxel 9 age 4 - 9 age 5 wise 6 analysis 6 analysis 7 revealed 7 revealed 9 age 8 widespread 9 age 9 age 10 - 10 - 11 related 11 related 18 and 11 related 31 < 11 related 34 . 12 decrease 13 of 12 decrease 18 and 13 of 17 anisotropy 14 white 15 matter 15 matter 17 anisotropy 16 fractional 17 anisotropy 18 and 19 increases 18 and 20 of 20 of 27 diffusivity 21 axial 22 , 22 , 23 radial 22 , 25 and 24 , 25 and 25 and 26 mean 25 and 27 diffusivity 28 ( 31 < 30 p 31 < 31 < 32 0.003 31 < 33 ) when differences in white matter diffusion parameters between offspring and control subjects were assessed voxel - wise , offspring showed higher white matter fractional anisotropy and lower white matter radial diffusivity [predominantly] in the callosal genu and body ( [both] p < 0.003 ) . 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 14 assessed 0 ###LEFT-WALL### 45 . 1 when 2 differences 1 when 5 matter 1 when 10 and 2 differences 3 in 2 differences 5 matter 3 in 4 white 6 diffusion 7 parameters 7 parameters 8 between 7 parameters 10 and 8 between 9 offspring 10 and 11 control 10 and 12 subjects 10 and 13 were 10 and 14 assessed 12 subjects 13 were 14 assessed 19 offspring 14 assessed 20 showed 15 voxel 16 - 15 voxel 19 offspring 17 wise 18 , 17 wise 19 offspring 19 offspring 20 showed 20 showed 23 matter 20 showed 25 anisotropy 20 showed 26 and 21 higher 22 white 22 white 23 matter 24 fractional 25 anisotropy 26 and 31 diffusivity 27 lower 28 white 28 white 29 matter 29 matter 31 diffusivity 30 radial 31 diffusivity 31 diffusivity 33 in 33 in 37 and 34 the 36 genu 35 callosal 36 genu 36 genu 37 and 37 and 38 body 37 and 42 < 39 ( 42 < 41 p 42 < 42 < 43 0.003 42 < 44 ) with the effect of chronological age on white matter microstructure taken into account , offspring can be considered 4.5 years " biologically younger " compared [to] control subjects with regard to white matter integrity . 0 ###LEFT-WALL### 15 offspring 0 ###LEFT-WALL### 35 . 1 with 3 effect 1 with 14 , 1 with 15 offspring 2 the 3 effect 3 effect 4 of 4 of 6 age 5 chronological 6 age 6 age 7 on 7 on 10 microstructure 8 white 10 microstructure 9 matter 10 microstructure 10 microstructure 11 taken 11 taken 13 account 12 into 13 account 15 offspring 16 can 16 can 17 be 17 be 18 considered 18 considered 20 years 19 4.5 20 years 20 years 21 " 20 years 27 control 20 years 28 subjects 22 biologically 27 control 23 younger 24 " 23 younger 27 control 25 compared 27 control 27 control 28 subjects 28 subjects 29 with 28 subjects 34 integrity 29 with 30 regard 30 regard 31 to 31 to 33 matter 32 white 33 matter interpretation : both middle - aged to elderly offspring of nonagenarian siblings and control subjects show common age - related decline [of] white matter integrity , but it is less marked in the callosal genu and body in the offspring . 0 ###LEFT-WALL### 1 interpretation 0 ###LEFT-WALL### 27 but 0 ###LEFT-WALL### 41 . 1 interpretation 2 : 2 : 4 middle 3 both 4 middle 4 middle 6 aged 4 middle 25 integrity 5 - 6 aged 6 aged 7 to 6 aged 19 - 7 to 13 and 8 elderly 9 offspring 9 offspring 10 of 9 offspring 13 and 10 of 12 siblings 11 nonagenarian 12 siblings 13 and 18 age 14 control 18 age 15 subjects 18 age 16 show 18 age 17 common 18 age 20 related 21 decline 21 decline 25 integrity 23 white 25 integrity 24 matter 25 integrity 26 , 27 but 27 but 28 it 27 but 31 marked 28 it 29 is 29 is 30 less 29 is 31 marked 31 marked 32 in 31 marked 38 in 32 in 36 and 33 the 35 genu 34 callosal 35 genu 35 genu 36 and 36 and 37 body 38 in 40 offspring 39 the 40 offspring this corresponds to a biological age benefit of 4.5 years of the offspring as compared to the control subjects . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 corresponds 0 ###LEFT-WALL### 20 . 1 this 2 corresponds 2 corresponds 3 to 2 corresponds 16 to 3 to 7 benefit 4 a 5 biological 4 a 7 benefit 5 biological 6 age 6 age 7 benefit 7 benefit 8 of 7 benefit 11 of 8 of 10 years 9 4.5 10 years 11 of 13 offspring 12 the 13 offspring 13 offspring 15 compared 14 as 15 compared 16 to 19 subjects 17 the 19 subjects 18 control 19 subjects avanafil ( stendra ™ , spedra ™ , zepeeed ™ ) is an oral phosphodiesterase type 5 inhibitor indicated for the treatment of erectile dysfunction . 0 ###LEFT-WALL### 4 ™ 0 ###LEFT-WALL### 12 is 0 ###LEFT-WALL### 26 . 1 avanafil 3 stendra 2 ( 3 stendra 3 stendra 4 ™ 4 ™ 7 ™ 4 ™ 12 is 5 , 7 ™ 6 spedra 7 ™ 7 ™ 10 ™ 7 ™ 11 ) 8 , 10 ™ 9 zepeeed 10 ™ 10 ™ 11 ) 12 is 18 inhibitor 12 is 20 for 13 an 18 inhibitor 14 oral 18 inhibitor 15 phosphodiesterase 16 type 16 type 18 inhibitor 17 5 18 inhibitor 18 inhibitor 19 indicated 20 for 22 treatment 21 the 22 treatment 22 treatment 23 of 23 of 25 dysfunction 24 erectile 25 dysfunction avanafil is rapidly absorbed after oral administration , with a median time to maximum plasma concentration of 30 to 45 min . 0 ###LEFT-WALL### 1 avanafil 0 ###LEFT-WALL### 4 absorbed 1 avanafil 2 is 2 is 3 rapidly 2 is 4 absorbed 4 absorbed 5 after 4 absorbed 9 with 5 after 7 administration 6 oral 7 administration 8 , 9 with 9 with 12 time 10 a 12 time 11 median 12 time 12 time 13 to 13 to 16 concentration 14 maximum 15 plasma 15 plasma 16 concentration 16 concentration 17 of 17 of 21 min 18 30 19 to 19 to 20 45 19 to 21 min 21 min 22 . in a 12 [-] week , randomized , double - blind , placebo - controlled , multicentre trial in patients with erectile dysfunction , avanafil 50 , 100 and 200 mg recipients had significantly greater improvements from baseline than placebo recipients in mean international index of erectile dysfunction - erectile function domain scores and [in] successful vaginal penetration and sexual intercourse attempts ( coprimary endpoints ) . 0 ###LEFT-WALL### 9 double 0 ###LEFT-WALL### 10 - 1 in 5 week 1 in 9 double 2 a 5 week 3 12 5 week 5 week 7 randomized 6 , 7 randomized 7 randomized 8 , 10 - 13 placebo 10 - 16 , 11 blind 12 , 11 blind 13 placebo 13 placebo 15 controlled 14 - 15 controlled 16 , 17 multicentre 17 multicentre 18 trial 17 multicentre 19 in 17 multicentre 21 with 19 in 20 patients 21 with 23 dysfunction 21 with 29 and 22 erectile 23 dysfunction 23 dysfunction 25 avanafil 24 , 25 avanafil 25 avanafil 26 50 25 avanafil 27 , 28 100 29 and 29 and 30 200 30 200 31 mg 31 mg 32 recipients 32 recipients 33 had 33 had 36 improvements 33 had 37 from 33 had 39 than 34 significantly 35 greater 35 greater 36 improvements 37 from 38 baseline 39 than 41 recipients 39 than 45 index 39 than 46 of 40 placebo 41 recipients 41 recipients 42 in 41 recipients 45 index 42 in 44 international 43 mean 44 international 46 of 48 dysfunction 47 erectile 48 dysfunction 48 dysfunction 59 and 49 - 59 and 50 erectile 51 function 51 function 53 scores 52 domain 53 scores 53 scores 54 and 54 and 58 penetration 54 and 59 and 56 successful 58 penetration 57 vaginal 58 penetration 59 and 60 sexual 59 and 61 intercourse 59 and 62 attempts 59 and 65 endpoints 59 and 67 . 61 intercourse 62 attempts 63 ( 65 endpoints 64 coprimary 65 endpoints 65 endpoints 66 ) treatment effects were significantly larger in avanafil 100 and 200 mg recipients than 50 mg recipients . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 3 were 0 ###LEFT-WALL### 17 . 1 treatment 2 effects 2 effects 3 were 3 were 5 larger 4 significantly 5 larger 5 larger 6 in 5 larger 13 than 6 in 9 and 7 avanafil 8 100 7 avanafil 9 and 9 and 12 recipients 10 200 11 mg 11 mg 12 recipients 13 than 16 recipients 14 50 15 mg 15 mg 16 recipients for avanafil recipients , approximately two [-] thirds of attempts at sexual intercourse that were made prior to 15 min , or more than 6 h , after drug administration were successful , compared with approximately one - quarter of attempts made during these time periods by placebo recipients . 1 for 3 recipients 1 for 4 , 1 for 8 thirds 2 avanafil 3 recipients 5 approximately 8 thirds 6 two 8 thirds 8 thirds 9 of 8 thirds 14 that 8 thirds 15 were 8 thirds 16 made 9 of 10 attempts 10 attempts 11 at 11 at 13 intercourse 12 sexual 13 intercourse 14 that 15 were 16 made 17 prior 17 prior 18 to 17 prior 22 or 18 to 19 15 20 min 22 or 21 , 22 or 22 or 23 more 22 or 24 than 22 or 28 after 22 or 34 compared 24 than 26 h 25 6 26 h 27 , 28 after 28 after 30 administration 28 after 31 were 28 after 33 , 29 drug 30 administration 30 administration 31 were 31 were 32 successful 33 , 34 compared 34 compared 35 with 35 with 37 one 36 approximately 37 one 37 one 39 quarter 38 - 39 quarter 39 quarter 40 of 39 quarter 42 made 39 quarter 50 . 40 of 41 attempts 42 made 43 during 42 made 47 by 43 during 46 periods 44 these 46 periods 45 time 46 periods 47 by 49 recipients 48 placebo 49 recipients in trials in patients with erectile dysfunction in association with diabetes mellitus , and after nerve - sparing radical prostatectomy , avanafil 100 or 200 [mg] was significantly more efficacious than placebo for primary and most secondary endpoints . 0 ###LEFT-WALL### 18 sparing 0 ###LEFT-WALL### 27 was 0 ###LEFT-WALL### 39 . 1 in 2 trials 1 in 14 and 2 trials 3 in 2 trials 5 with 2 trials 9 association 2 trials 10 with 3 in 4 patients 5 with 7 dysfunction 6 erectile 7 dysfunction 8 in 9 association 10 with 12 mellitus 11 diabetes 12 mellitus 13 , 14 and 14 and 15 after 14 and 17 - 14 and 18 sparing 15 after 16 nerve 18 sparing 22 avanafil 18 sparing 27 was 19 radical 22 avanafil 20 prostatectomy 21 , 20 prostatectomy 22 avanafil 22 avanafil 24 or 23 100 24 or 24 or 25 200 27 was 28 significantly 27 was 30 efficacious 29 more 30 efficacious 30 efficacious 31 than 30 efficacious 33 for 31 than 32 placebo 33 for 38 endpoints 34 primary 35 and 35 and 37 secondary 35 and 38 endpoints 36 most 37 secondary avanafil was generally well tolerated in the [above] [-] mentioned studies . 0 ###LEFT-WALL### 1 avanafil 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 12 . 1 avanafil 2 was 2 was 3 generally 2 was 4 well 4 well 5 tolerated 5 tolerated 6 in 6 in 11 studies 7 the 11 studies 10 mentioned 11 studies in a pooled analysis of three clinical trials , ≤2 % [of] avanafil and placebo recipients discontinued treatment because of adverse events . 0 ###LEFT-WALL### 16 recipients 0 ###LEFT-WALL### 17 discontinued 0 ###LEFT-WALL### 23 . 1 in 4 analysis 1 in 16 recipients 2 a 4 analysis 3 pooled 4 analysis 4 analysis 5 of 5 of 14 and 6 three 8 trials 7 clinical 8 trials 8 trials 9 , 9 , 13 avanafil 9 , 14 and 10 ≤2 13 avanafil 11 % 13 avanafil 14 and 15 placebo 16 recipients 17 discontinued 17 discontinued 18 treatment 17 discontinued 19 because 19 because 20 of 20 of 22 events 21 adverse 22 events during extended treatment with avanafil for >52 weeks , 2.8 % of patients discontinued treatment because of adverse reactions and [there] were no drug - related serious adverse events . 0 ###LEFT-WALL### 11 % 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 26 related 1 during 3 treatment 1 during 9 , 1 during 11 % 2 extended 3 treatment 3 treatment 4 with 4 with 5 avanafil 5 avanafil 6 for 6 for 8 weeks 7 >52 8 weeks 10 2.8 11 % 11 % 12 of 11 % 20 and 12 of 13 patients 14 discontinued 15 treatment 14 discontinued 16 because 14 discontinued 20 and 16 because 17 of 17 of 19 reactions 18 adverse 19 reactions 20 and 22 were 22 were 24 drug 23 no 24 drug 25 - 26 related 26 related 29 events 26 related 30 . 27 serious 29 events 28 adverse 29 events a deeper understanding of brain macrostructure and its associations with cognition in persons who are considered cognitively healthy is critical to the early detection of persons at risk of developing dementia . 0 ###LEFT-WALL### 3 understanding 0 ###LEFT-WALL### 19 is 0 ###LEFT-WALL### 32 . 1 a 3 understanding 2 deeper 3 understanding 3 understanding 4 of 3 understanding 10 with 3 understanding 12 in 3 understanding 16 considered 3 understanding 19 is 4 of 7 and 5 brain 6 macrostructure 6 macrostructure 7 and 7 and 9 associations 8 its 9 associations 10 with 11 cognition 12 in 13 persons 13 persons 14 who 13 persons 15 are 14 who 15 are 16 considered 17 cognitively 16 considered 18 healthy 19 is 20 critical 20 critical 21 to 20 critical 27 at 21 to 24 detection 22 the 24 detection 23 early 24 detection 24 detection 25 of 25 of 26 persons 27 at 28 risk 28 risk 29 of 29 of 30 developing 30 developing 31 dementia few studies have examined the associations of all three gray - matter macrostructural brain indices ( volume , thickness , surface area ) with age and cognition , in the same persons who are over the age of 65 and do not have cognitive impairment . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 46 . 1 few 2 studies 2 studies 40 and 3 have 4 examined 3 have 40 and 4 examined 6 associations 4 examined 24 with 5 the 6 associations 6 associations 7 of 7 of 15 indices 8 all 9 three 9 three 15 indices 10 gray 11 - 10 gray 12 matter 12 matter 15 indices 13 macrostructural 14 brain 14 brain 15 indices 15 indices 17 volume 15 indices 19 thickness 16 ( 17 volume 17 volume 18 , 18 , 19 thickness 19 thickness 22 area 19 thickness 23 ) 20 , 22 area 21 surface 22 area 22 area 23 ) 24 with 26 and 25 age 26 and 26 and 27 cognition 26 and 28 , 26 and 29 in 26 and 38 of 29 in 32 persons 30 the 31 same 31 same 32 persons 32 persons 33 who 32 persons 34 are 33 who 34 are 34 are 35 over 35 over 37 age 36 the 37 age 38 of 39 65 40 and 41 do 41 do 42 not 41 do 43 have 43 have 45 impairment 44 cognitive 45 impairment we performed automated morphometric reconstruction of total gray matter , cortical gray matter , subcortical gray matter and 84 individual regions in 186 persons ( 60 % over the age of 80 ) without cognitive impairment . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 performed 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 37 . 1 we 2 performed 2 performed 5 reconstruction 3 automated 5 reconstruction 4 morphometric 5 reconstruction 5 reconstruction 6 of 6 of 9 matter 7 total 8 gray 8 gray 9 matter 10 , 18 and 11 cortical 12 gray 12 gray 13 matter 13 matter 14 , 14 , 17 matter 14 , 18 and 15 subcortical 17 matter 16 gray 17 matter 18 and 21 regions 18 and 22 in 18 and 34 without 19 84 21 regions 20 individual 21 regions 22 in 24 persons 23 186 24 persons 24 persons 27 % 25 ( 27 % 26 60 27 % 27 % 28 over 27 % 31 of 27 % 33 ) 28 over 30 age 29 the 30 age 31 of 32 80 34 without 36 impairment 35 cognitive 36 impairment morphometric measures were scaled and expressed as [difference] per decade of age and an adjusted score was created to identify those regions in which there was greater atrophy per decade of age compared to cortical or subcortical brain averages . 0 ###LEFT-WALL### 1 morphometric 0 ###LEFT-WALL### 33 compared 1 morphometric 2 measures 1 morphometric 5 and 1 morphometric 7 as 1 morphometric 11 of 1 morphometric 17 was 2 measures 3 were 3 were 5 and 4 scaled 5 and 5 and 6 expressed 7 as 9 per 9 per 10 decade 11 of 13 and 12 age 13 and 13 and 16 score 14 an 16 score 15 adjusted 16 score 17 was 18 created 18 created 19 to 19 to 20 identify 20 identify 21 those 21 those 22 regions 21 those 33 compared 22 regions 23 in 22 regions 33 compared 23 in 24 which 23 in 25 there 23 in 26 was 25 there 26 was 26 was 28 atrophy 27 greater 28 atrophy 28 atrophy 29 per 28 atrophy 31 of 29 per 30 decade 31 of 32 age 33 compared 34 to 34 to 36 or 35 cortical 36 or 36 or 39 averages 36 or 40 . 37 subcortical 38 brain 38 brain 39 averages the results showed that there is substantial total volume loss and cortical thinning in cognitively healthy older persons . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 showed 0 ###LEFT-WALL### 19 . 1 the 2 results 2 results 3 showed 3 showed 4 that 3 showed 5 there 3 showed 6 is 5 there 6 is 6 is 11 and 7 substantial 8 total 8 total 10 loss 9 volume 10 loss 10 loss 11 and 11 and 12 cortical 11 and 13 thinning 13 thinning 14 in 14 in 18 persons 15 cognitively 16 healthy 16 healthy 18 persons 17 older 18 persons thinning was more widespread than volume loss , but volume loss , particularly in temporoparietal and hippocampal regions , was more strongly associated with cognition . 0 ###LEFT-WALL### 1 thinning 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 26 . 1 thinning 19 , 2 was 4 widespread 2 was 19 , 3 more 4 widespread 4 widespread 5 than 4 widespread 13 particularly 5 than 7 loss 6 volume 7 loss 7 loss 9 but 8 , 9 but 9 but 11 loss 9 but 12 , 10 volume 11 loss 13 particularly 14 in 14 in 18 regions 15 temporoparietal 16 and 16 and 17 hippocampal 16 and 18 regions 19 , 20 was 20 was 23 associated 21 more 22 strongly 22 strongly 23 associated 23 associated 24 with 24 with 25 cognition in a recent review article , selman and colleagues ( trends ecol evol 27:570 - 577 , 2012 ) discuss the status quo of the oxidative stress theory of aging ( osta ) and how it links to life history evolution . 0 ###LEFT-WALL### 16 577 0 ###LEFT-WALL### 20 discuss 0 ###LEFT-WALL### 42 . 1 in 8 and 1 in 16 577 2 a 5 article 3 recent 4 review 4 review 5 article 5 article 6 , 6 , 7 selman 6 , 8 and 8 and 9 colleagues 8 and 14 27:570 10 ( 14 27:570 11 trends 12 ecol 12 ecol 13 evol 13 evol 14 27:570 14 27:570 15 - 16 577 18 2012 16 577 20 discuss 17 , 18 2012 18 2012 19 ) 20 discuss 23 quo 20 discuss 38 to 21 the 23 quo 22 status 23 quo 23 quo 24 of 23 quo 36 it 23 quo 37 links 24 of 34 and 25 the 28 theory 26 oxidative 28 theory 27 stress 28 theory 28 theory 29 of 28 theory 34 and 29 of 30 aging 30 aging 32 osta 31 ( 32 osta 32 osta 33 ) 34 and 35 how 36 it 37 links 38 to 41 evolution 39 life 40 history 40 history 41 evolution they suggest that the osta should be tested in wild populations which might show effects masked in laboratory settings . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 2 suggest 0 ###LEFT-WALL### 20 . 1 they 2 suggest 2 suggest 3 that 3 that 5 osta 3 that 8 tested 4 the 5 osta 5 osta 6 should 6 should 7 be 7 be 8 tested 8 tested 9 in 9 in 11 populations 10 wild 11 populations 11 populations 12 which 11 populations 13 might 12 which 13 might 13 might 14 show 14 show 15 effects 15 effects 16 masked 16 masked 17 in 17 in 19 settings 18 laboratory 19 settings we disagree with their propositions for several reasons . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 disagree 0 ###LEFT-WALL### 9 . 1 we 2 disagree 2 disagree 3 with 3 with 5 propositions 4 their 5 propositions 5 propositions 6 for 6 for 8 reasons 7 several 8 reasons we argue that there is increasing evidence that reactive oxygen species ( ros ) are not causally linked with aging and that ros do not play a straightforward role in shaping life history evolution . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 21 and 0 ###LEFT-WALL### 35 . 1 we 21 and 2 argue 3 that 2 argue 20 aging 2 argue 21 and 3 that 4 there 3 that 5 is 5 is 7 evidence 6 increasing 7 evidence 7 evidence 11 species 7 evidence 20 aging 8 that 9 reactive 9 reactive 11 species 10 oxygen 11 species 11 species 13 ros 11 species 15 are 12 ( 13 ros 13 ros 14 ) 15 are 16 not 15 are 18 linked 17 causally 18 linked 18 linked 19 with 19 with 20 aging 21 and 26 play 22 that 23 ros 23 ros 24 do 24 do 25 not 24 do 26 play 26 play 29 role 26 play 30 in 27 a 29 role 28 straightforward 29 role 30 in 31 shaping 31 shaping 34 evolution 32 life 34 evolution 33 history 34 evolution we propose that laboratory animals and semi - wild [populations] rather than wild animals are suited best to test any hypothesized effect of reactive oxygen species . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 19 test 0 ###LEFT-WALL### 27 . 1 we 2 propose 2 propose 3 that 3 that 6 and 3 that 16 suited 4 laboratory 5 animals 5 animals 6 and 6 and 7 semi 6 and 8 - 6 and 9 wild 6 and 15 are 9 wild 12 than 11 rather 12 than 12 than 14 animals 13 wild 14 animals 15 are 16 suited 16 suited 17 best 16 suited 18 to 18 to 19 test 19 test 20 any 19 test 21 hypothesized 20 any 21 hypothesized 21 hypothesized 22 effect 22 effect 23 of 23 of 26 species 24 reactive 25 oxygen 25 oxygen 26 species this is because data from controlled manipulative experiments rather [than] observational correlations are preferred to solve this issue . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 19 . 1 this 2 is 2 is 3 because 3 because 4 data 3 because 14 preferred 4 data 5 from 4 data 14 preferred 5 from 8 experiments 6 controlled 8 experiments 7 manipulative 8 experiments 8 experiments 12 correlations 8 experiments 13 are 9 rather 11 observational 11 observational 12 correlations 12 correlations 13 are 14 preferred 15 to 14 preferred 16 solve 15 to 16 solve 16 solve 18 issue 17 this 18 issue in addition , nonconventional model organisms will be useful in answering [the] question how relevant the osta could be for life history evolution . 0 ###LEFT-WALL### 6 organisms 0 ###LEFT-WALL### 13 question 0 ###LEFT-WALL### 24 . 1 in 2 addition 1 in 3 , 1 in 6 organisms 4 nonconventional 5 model 5 model 6 organisms 6 organisms 7 will 6 organisms 11 answering 6 organisms 13 question 7 will 8 be 8 be 9 useful 9 useful 10 in 10 in 11 answering 13 question 14 how 14 how 15 relevant 15 relevant 19 be 15 relevant 20 for 16 the 17 osta 17 osta 18 could 18 could 19 be 20 for 23 evolution 21 life 23 evolution 22 history 23 evolution neurocognitive disorders are a feared complication of hiv infection , especially in the post - antiretroviral era [as] patients are living longer . 0 ###LEFT-WALL### 2 disorders 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 23 . 1 neurocognitive 2 disorders 2 disorders 3 are 3 are 6 complication 4 a 6 complication 5 feared 6 complication 6 complication 7 of 7 of 9 infection 8 hiv 9 infection 10 , 19 patients 10 , 20 are 11 especially 19 patients 12 in 14 post 12 in 15 - 12 in 19 patients 13 the 14 post 16 antiretroviral 17 era 17 era 19 patients 19 patients 20 are 20 are 21 living 21 living 22 longer these disorders are challenging in terms of diagnosis and treatment . 0 ###LEFT-WALL### 2 disorders 0 ###LEFT-WALL### 3 are 0 ###LEFT-WALL### 11 . 1 these 2 disorders 2 disorders 3 are 3 are 4 challenging 4 challenging 5 in 5 in 6 terms 6 terms 7 of 7 of 9 and 8 diagnosis 9 and 9 and 10 treatment the clinical syndrome has evolved , driven in part by comorbidities such as aging , drug abuse , psychiatric illnesses , and a metabolic syndrome associated with the use of antiretroviral drugs . 0 ###LEFT-WALL### 3 syndrome 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 33 . 1 the 3 syndrome 2 clinical 3 syndrome 3 syndrome 4 has 4 has 6 , 5 evolved 6 , 6 , 7 driven 6 , 9 part 6 , 13 as 8 in 9 part 9 part 10 by 10 by 11 comorbidities 12 such 13 as 13 as 22 and 14 aging 15 , 15 , 17 abuse 15 , 18 , 16 drug 17 abuse 18 , 20 illnesses 18 , 22 and 19 psychiatric 20 illnesses 21 , 22 and 22 and 25 syndrome 22 and 26 associated 22 and 30 of 23 a 24 metabolic 23 a 25 syndrome 24 metabolic 25 syndrome 26 associated 27 with 27 with 29 use 28 the 29 use 30 of 32 drugs 31 antiretroviral 32 drugs additionally some individuals may develop a fulminant immune reconstitution syndrome . 0 ###LEFT-WALL### 3 individuals 0 ###LEFT-WALL### 5 develop 0 ###LEFT-WALL### 11 . 1 additionally 3 individuals 2 some 3 individuals 3 individuals 4 may 4 may 5 develop 5 develop 10 syndrome 6 a 7 fulminant 6 a 10 syndrome 7 fulminant 9 reconstitution 8 immune 9 reconstitution 9 reconstitution 10 syndrome hence , treatment of these patients needs to be individualized . 0 ###LEFT-WALL### 3 treatment 0 ###LEFT-WALL### 7 needs 0 ###LEFT-WALL### 11 . 1 hence 2 , 1 hence 3 treatment 3 treatment 4 of 3 treatment 7 needs 4 of 6 patients 5 these 6 patients 7 needs 8 to 7 needs 10 individualized 8 to 9 be 9 be 10 individualized the focus of research in the hiv field has recently switched towards elimination of the hiv reservoir as a means of combating long - term hiv complications . 0 ###LEFT-WALL### 2 focus 0 ###LEFT-WALL### 11 switched 0 ###LEFT-WALL### 28 . 1 the 2 focus 2 focus 3 of 2 focus 9 has 3 of 4 research 4 research 5 in 5 in 8 field 6 the 8 field 7 hiv 8 field 9 has 11 switched 10 recently 11 switched 11 switched 12 towards 11 switched 18 as 12 towards 13 elimination 13 elimination 14 of 14 of 17 reservoir 15 the 17 reservoir 16 hiv 17 reservoir 18 as 20 means 19 a 20 means 20 means 21 of 21 of 22 combating 22 combating 27 complications 23 long 24 - 23 long 25 term 25 term 27 complications 26 hiv 27 complications however , these approaches may be suitable for limited populations and might not be applicable once the hiv reservoir has been established in the brain . 0 ###LEFT-WALL### 4 approaches 0 ###LEFT-WALL### 6 be 0 ###LEFT-WALL### 26 . 1 however 2 , 1 however 4 approaches 3 these 4 approaches 4 approaches 5 may 5 may 6 be 6 be 7 suitable 7 suitable 8 for 8 for 11 and 9 limited 10 populations 9 limited 11 and 11 and 12 might 12 might 13 not 12 might 14 be 14 be 15 applicable 15 applicable 16 once 16 once 19 reservoir 16 once 22 established 17 the 19 reservoir 18 hiv 19 reservoir 19 reservoir 20 has 20 has 21 been 21 been 22 established 22 established 23 in 23 in 25 brain 24 the 25 brain further , all clinical trials using neuroprotective or anti - inflammatory drugs for treatment of hiv - associated neurocognitive disorders have been unsuccessful . 0 ###LEFT-WALL### 5 trials 0 ###LEFT-WALL### 22 been 0 ###LEFT-WALL### 24 . 1 further 2 , 1 further 5 trials 3 all 5 trials 4 clinical 5 trials 5 trials 6 using 5 trials 21 have 6 using 8 or 7 neuroprotective 8 or 8 or 20 disorders 9 anti 12 drugs 9 anti 17 - 9 anti 20 disorders 10 - 12 drugs 11 inflammatory 12 drugs 12 drugs 13 for 12 drugs 15 of 12 drugs 17 - 13 for 14 treatment 15 of 16 hiv 18 associated 20 disorders 19 neurocognitive 20 disorders 21 have 22 been 22 been 23 unsuccessful hence , neurological complications of hiv infection are the biggest challenge facing hiv researchers , and there is a critical need to develop new diagnostics and approaches for treatment of these disorders . 0 ###LEFT-WALL### 4 complications 0 ###LEFT-WALL### 8 are 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 26 and 0 ###LEFT-WALL### 33 . 1 hence 2 , 1 hence 4 complications 3 neurological 4 complications 4 complications 5 of 4 complications 8 are 5 of 7 infection 6 hiv 7 infection 8 are 11 challenge 9 the 10 biggest 9 the 11 challenge 11 challenge 12 facing 12 facing 14 researchers 13 hiv 14 researchers 15 , 16 and 16 and 17 there 16 and 18 is 17 there 18 is 18 is 21 need 18 is 22 to 19 a 20 critical 19 a 21 need 20 critical 21 need 22 to 26 and 23 develop 25 diagnostics 23 develop 26 and 24 new 25 diagnostics 26 and 27 approaches 27 approaches 28 for 28 for 29 treatment 29 treatment 30 of 30 of 32 disorders 31 these 32 disorders the objective of this study was to compare the demographic and vascular characteristics and apoe genotypes [of] a dysexecutive subgroup of alzheimer disease ( ad ) with an amnestic subgroup of ad early in the disease course . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 38 . 1 the 2 objective 2 objective 3 of 2 objective 6 was 3 of 5 study 4 this 5 study 6 was 7 to 6 was 8 compare 7 to 8 compare 8 compare 13 characteristics 9 the 13 characteristics 10 demographic 11 and 11 and 12 vascular 11 and 13 characteristics 14 and 15 apoe 14 and 16 genotypes 15 apoe 16 genotypes 16 genotypes 20 subgroup 16 genotypes 27 with 18 a 19 dysexecutive 18 a 20 subgroup 19 dysexecutive 20 subgroup 20 subgroup 21 of 20 subgroup 25 ad 21 of 23 disease 22 alzheimer 23 disease 24 ( 25 ad 25 ad 26 ) 27 with 30 subgroup 28 an 30 subgroup 29 amnestic 30 subgroup 30 subgroup 31 of 31 of 32 ad 32 ad 33 early 33 early 34 in 34 in 37 course 35 the 37 course 36 disease 37 course a total of 2224 participants from the national alzheimer 's coordinating center database who carried a diagnosis of mild cognitive impairment ( n=1188 ) or mild ad ( clinical dementia rating ≤1 ) ( n=1036 ) were included in this study . 0 ###LEFT-WALL### 25 or 0 ###LEFT-WALL### 38 included 0 ###LEFT-WALL### 42 . 1 a 2 total 2 total 3 of 2 total 6 from 2 total 18 of 2 total 25 or 3 of 5 participants 4 2224 5 participants 6 from 13 database 7 the 9 alzheimer 8 national 9 alzheimer 9 alzheimer 10 's 10 's 13 database 11 coordinating 13 database 12 center 13 database 13 database 14 who 13 database 15 carried 14 who 15 carried 15 carried 17 diagnosis 16 a 17 diagnosis 18 of 21 impairment 19 mild 21 impairment 20 cognitive 21 impairment 21 impairment 23 n=1188 22 ( 23 n=1188 23 n=1188 24 ) 25 or 27 ad 25 or 32 ≤1 25 or 35 n=1036 25 or 37 were 26 mild 27 ad 28 ( 32 ≤1 29 clinical 31 rating 30 dementia 31 rating 31 rating 32 ≤1 32 ≤1 33 ) 34 ( 35 n=1036 35 n=1036 36 ) 37 were 38 included 38 included 39 in 39 in 41 study 40 this 41 study a subset of the mild cognitive impairment ( n=61 ) and mild ad ( n=79 ) participants underwent an autopsy . 0 ###LEFT-WALL### 17 participants 0 ###LEFT-WALL### 18 underwent 0 ###LEFT-WALL### 21 . 1 a 2 subset 2 subset 3 of 2 subset 11 and 3 of 7 impairment 4 the 7 impairment 5 mild 7 impairment 6 cognitive 7 impairment 7 impairment 9 n=61 8 ( 9 n=61 9 n=61 10 ) 11 and 13 ad 11 and 15 n=79 11 and 17 participants 12 mild 13 ad 14 ( 15 n=79 15 n=79 16 ) 17 participants 18 underwent 18 underwent 20 autopsy 19 an 20 autopsy a dysexecutive subgroup ( n=587 ) was defined as having executive performance >1 sd worse than memory performance , and an amnestic subgroup ( n=549 ) was defined [conversely] . 0 ###LEFT-WALL### 3 subgroup 0 ###LEFT-WALL### 8 defined 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 30 . 1 a 2 dysexecutive 1 a 3 subgroup 2 dysexecutive 3 subgroup 3 subgroup 5 n=587 3 subgroup 7 was 4 ( 5 n=587 5 n=587 6 ) 7 was 8 defined 8 defined 9 as 8 defined 15 worse 9 as 14 sd 10 having 11 executive 11 executive 12 performance 12 performance 13 >1 13 >1 14 sd 15 worse 16 than 16 than 18 performance 17 memory 18 performance 19 , 20 and 20 and 23 subgroup 20 and 28 defined 21 an 22 amnestic 21 an 23 subgroup 22 amnestic 23 subgroup 23 subgroup 25 n=549 23 subgroup 27 was 24 ( 25 n=549 25 n=549 26 ) 27 was 28 defined among the autopsy subset , the odds of an ad pathologic diagnosis were compared in the 2 subgroups . 0 ###LEFT-WALL### 7 odds 0 ###LEFT-WALL### 14 compared 0 ###LEFT-WALL### 19 . 1 among 4 subset 1 among 5 , 1 among 7 odds 2 the 4 subset 3 autopsy 4 subset 6 the 7 odds 7 odds 8 of 7 odds 13 were 8 of 12 diagnosis 9 an 12 diagnosis 10 ad 12 diagnosis 11 pathologic 12 diagnosis 13 were 14 compared 14 compared 15 in 15 in 18 subgroups 16 the 17 2 17 2 18 subgroups the demographics , apoe [ latin small letter open e ]4 status , and vascular risk factors were compared in the 2 subgroups . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 19 compared 0 ###LEFT-WALL### 24 . 1 the 2 demographics 2 demographics 3 , 3 , 4 apoe 3 , 14 and 4 apoe 12 status 5 [ 12 status 6 latin 11 ]4 7 small 8 letter 8 letter 9 open 9 open 10 e 9 open 11 ]4 11 ]4 12 status 12 status 13 , 13 , 14 and 14 and 17 factors 14 and 18 were 15 vascular 17 factors 16 risk 17 factors 18 were 19 compared 19 compared 20 in 20 in 23 subgroups 21 the 22 2 22 2 23 subgroups among the autopsy subset , the odds of having an ad pathologic diagnosis did not differ between the dysexecutive and amnestic subgroups . 0 ###LEFT-WALL### 7 odds 0 ###LEFT-WALL### 16 differ 0 ###LEFT-WALL### 23 . 1 among 4 subset 1 among 5 , 1 among 7 odds 2 the 4 subset 3 autopsy 4 subset 6 the 7 odds 7 odds 8 of 7 odds 14 did 8 of 9 having 9 having 13 diagnosis 10 an 13 diagnosis 11 ad 13 diagnosis 12 pathologic 13 diagnosis 14 did 15 not 14 did 16 differ 16 differ 17 between 17 between 22 subgroups 18 the 22 subgroups 19 dysexecutive 20 and 20 and 21 amnestic 20 and 22 subgroups under an additive model , participants in the dysexecutive subgroup possessed the apoe [ latin small letter open e ]4 allele less frequently compared with those in the amnestic subgroup . 0 ###LEFT-WALL### 6 participants 0 ###LEFT-WALL### 11 possessed 1 under 4 model 1 under 5 , 1 under 6 participants 2 an 4 model 3 additive 4 model 6 participants 7 in 6 participants 11 possessed 7 in 10 subgroup 8 the 10 subgroup 9 dysexecutive 10 subgroup 11 possessed 13 apoe 12 the 13 apoe 13 apoe 21 allele 14 [ 21 allele 15 latin 21 allele 16 small 17 letter 17 letter 18 open 18 open 19 e 18 open 21 allele 20 ]4 21 allele 21 allele 24 compared 21 allele 31 . 22 less 23 frequently 23 frequently 24 compared 24 compared 25 with 24 compared 27 in 25 with 26 those 27 in 30 subgroup 28 the 30 subgroup 29 amnestic 30 subgroup the dysexecutive subgroup had a history [of] hypertension less frequently compared with the amnestic subgroup . 0 ###LEFT-WALL### 3 subgroup 0 ###LEFT-WALL### 4 had 0 ###LEFT-WALL### 16 . 1 the 3 subgroup 2 dysexecutive 3 subgroup 3 subgroup 4 had 4 had 8 hypertension 5 a 6 history 5 a 8 hypertension 6 history 8 hypertension 8 hypertension 11 compared 9 less 10 frequently 10 frequently 11 compared 11 compared 12 with 12 with 15 subgroup 13 the 15 subgroup 14 amnestic 15 subgroup these distinct characteristics add to accumulating evidence that a dysexecutive subgroup of ad may have a unique underlying pathophysiology . 0 ###LEFT-WALL### 3 characteristics 0 ###LEFT-WALL### 4 add 0 ###LEFT-WALL### 20 . 1 these 3 characteristics 2 distinct 3 characteristics 3 characteristics 4 add 4 add 5 to 5 to 6 accumulating 6 accumulating 7 evidence 7 evidence 8 that 8 that 11 subgroup 8 that 15 have 9 a 10 dysexecutive 9 a 11 subgroup 10 dysexecutive 11 subgroup 11 subgroup 12 of 11 subgroup 14 may 12 of 13 ad 14 may 15 have 15 have 19 pathophysiology 16 a 19 pathophysiology 17 unique 19 pathophysiology 18 underlying 19 pathophysiology vascular calcifications and bone health seem to be etiologically linked via common risk factors such as aging and subclinical chronic inflammation . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 6 seem 0 ###LEFT-WALL### 22 . 1 vascular 2 calcifications 2 calcifications 3 and 3 and 5 health 3 and 6 seem 4 bone 5 health 6 seem 7 to 6 seem 10 linked 7 to 8 be 8 be 10 linked 9 etiologically 10 linked 10 linked 11 via 10 linked 16 as 11 via 14 factors 12 common 14 factors 13 risk 14 factors 15 such 16 as 16 as 18 and 17 aging 18 and 18 and 21 inflammation 19 subclinical 21 inflammation 20 chronic 21 inflammation epidemiologic studies have shown significant associations between low bone mineral density ( bmd ) , fragility fractures and calcifications of the coronary arteries and the abdominal aorta . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 shown 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 28 . 1 epidemiologic 2 studies 2 studies 3 have 3 have 4 shown 4 shown 6 associations 4 shown 7 between 5 significant 6 associations 7 between 11 density 8 low 11 density 9 bone 11 density 10 mineral 11 density 11 density 13 bmd 12 ( 13 bmd 13 bmd 14 ) 15 , 24 and 16 fragility 18 and 16 fragility 20 of 16 fragility 24 and 17 fractures 18 and 18 and 19 calcifications 20 of 23 arteries 21 the 23 arteries 22 coronary 23 arteries 24 and 27 aorta 25 the 27 aorta 26 abdominal 27 aorta in the last decade , high - resolution peripheral quantitative computed tomography ( hr - pqct ) has emerged as in [-] [vivo] research [tool] for the assessment of peripheral bone geometry , density , and microarchitecture . 0 ###LEFT-WALL### 12 tomography 0 ###LEFT-WALL### 19 emerged 0 ###LEFT-WALL### 33 , 0 ###LEFT-WALL### 38 . 1 in 4 decade 1 in 12 tomography 2 the 3 last 2 the 4 decade 5 , 6 high 6 high 7 - 6 high 12 tomography 8 resolution 12 tomography 9 peripheral 12 tomography 10 quantitative 12 tomography 11 computed 12 tomography 12 tomography 14 hr 12 tomography 16 pqct 12 tomography 18 has 13 ( 14 hr 14 hr 15 - 15 - 16 pqct 16 pqct 17 ) 18 has 19 emerged 19 emerged 20 as 20 as 21 in 21 in 24 research 24 research 26 for 24 research 29 of 26 for 28 assessment 27 the 28 assessment 29 of 32 geometry 30 peripheral 31 bone 31 bone 32 geometry 33 , 36 and 34 density 36 and 35 , 36 and 36 and 37 microarchitecture although vascular calcifications are frequently observed as incidental findings in hr - pqct scans , they have not yet been incorporated into quantitative hr - pqct analyses . 0 ###LEFT-WALL### 13 pqct 0 ###LEFT-WALL### 14 scans 0 ###LEFT-WALL### 15 , 0 ###LEFT-WALL### 26 pqct 0 ###LEFT-WALL### 28 . 1 although 3 calcifications 1 although 6 observed 1 although 12 - 1 although 13 pqct 2 vascular 3 calcifications 3 calcifications 4 are 4 are 5 frequently 4 are 6 observed 6 observed 7 as 6 observed 10 in 7 as 9 findings 8 incidental 9 findings 10 in 11 hr 13 pqct 14 scans 15 , 16 they 15 , 21 incorporated 15 , 25 - 16 they 17 have 17 have 18 not 17 have 20 been 19 yet 20 been 20 been 21 incorporated 21 incorporated 22 into 22 into 24 hr 23 quantitative 24 hr 25 - 26 pqct 26 pqct 27 analyses we developed a semi - automated algorithm to quantify lower leg arterial calcifications ( llacs ) , captured by hr - pqct . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 developed 0 ###LEFT-WALL### 21 - 0 ###LEFT-WALL### 22 pqct 0 ###LEFT-WALL### 23 . 1 we 2 developed 2 developed 7 algorithm 2 developed 8 to 3 a 4 semi 3 a 7 algorithm 4 semi 5 - 4 semi 7 algorithm 6 automated 7 algorithm 8 to 9 quantify 9 quantify 13 calcifications 10 lower 11 leg 11 leg 13 calcifications 12 arterial 13 calcifications 13 calcifications 15 llacs 13 calcifications 18 captured 14 ( 15 llacs 15 llacs 16 ) 17 , 18 captured 18 captured 19 by 18 captured 21 - 19 by 20 hr 21 - 22 pqct the objective of our study was to determine validity and reliability of the llac measure . 0 ###LEFT-WALL### 2 objective 0 ###LEFT-WALL### 16 . 1 the 2 objective 2 objective 3 of 2 objective 6 was 3 of 5 study 4 our 5 study 6 was 7 to 6 was 8 determine 7 to 8 determine 8 determine 10 and 9 validity 10 and 10 and 11 reliability 10 and 12 of 12 of 15 measure 13 the 15 measure 14 llac 15 measure hr - pqct [scans] were downscaled to a voxel size of 250 μm . 0 ###LEFT-WALL### 3 pqct 0 ###LEFT-WALL### 6 downscaled 0 ###LEFT-WALL### 14 . 1 hr 2 - 1 hr 3 pqct 3 pqct 5 were 5 were 6 downscaled 6 downscaled 7 to 7 to 10 size 8 a 9 voxel 8 a 10 size 9 voxel 10 size 10 size 11 of 11 of 13 μm 12 250 13 μm after subtraction of bone volumes [from] [the] scans , llacs were detected and contoured by a semi - automated , dual - threshold seed - point segmentation . 0 ###LEFT-WALL### 10 llacs 0 ###LEFT-WALL### 11 were 0 ###LEFT-WALL### 20 , 1 after 2 subtraction 1 after 8 scans 1 after 9 , 1 after 10 llacs 2 subtraction 3 of 2 subtraction 8 scans 3 of 5 volumes 4 bone 5 volumes 10 llacs 11 were 11 were 13 and 12 detected 13 and 13 and 14 contoured 13 and 15 by 15 by 17 semi 16 a 17 semi 17 semi 19 automated 18 - 19 automated 19 automated 20 , 20 , 24 seed 20 , 25 - 21 dual 22 - 21 dual 23 threshold 23 threshold 24 seed 25 - 26 point 25 - 28 . 26 point 27 segmentation llac mass ( in [mg] hydroxyapatite ; ha [ )(was calculated as the product of voxel - based calcification volume [(] [mm] ( 3 ) ) and mean calcification density ( mgha/cm ( 3 ) )/1000 . 0 ###LEFT-WALL### 1 llac 0 ###LEFT-WALL### 2 mass 0 ###LEFT-WALL### 7 ; 1 llac 2 mass 2 mass 4 in 3 ( 4 in 4 in 6 hydroxyapatite 4 in 7 ; 7 ; 8 ha 7 ; 11 calculated 8 ha 10 )(was 10 )(was 11 calculated 11 calculated 12 as 12 as 27 and 13 the 14 product 14 product 15 of 14 product 27 and 15 of 16 voxel 16 voxel 20 volume 17 - 20 volume 18 based 19 calcification 19 calcification 20 volume 20 volume 24 3 20 volume 26 ) 23 ( 24 3 24 3 25 ) 27 and 30 density 27 and 36 )/1000 28 mean 29 calcification 29 calcification 30 density 31 ( 36 )/1000 32 mgha/cm 34 3 32 mgha/cm 36 )/1000 33 ( 34 3 34 3 35 ) 36 )/1000 37 . to determine validity , we compared llacs to coronary artery calcifications ( cacs ) , [as] quantified by multi - detector computed tomography ( mdct ) and agatston scoring in forty - six patients on chronic hemodialysis . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 compared 0 ###LEFT-WALL### 38 . 1 to 2 determine 1 to 4 , 1 to 5 we 2 determine 3 validity 5 we 6 compared 6 compared 27 and 7 llacs 8 to 7 llacs 27 and 8 to 11 calcifications 9 coronary 11 calcifications 10 artery 11 calcifications 11 calcifications 13 cacs 11 calcifications 17 quantified 12 ( 13 cacs 13 cacs 14 ) 15 , 17 quantified 17 quantified 18 by 17 quantified 26 ) 18 by 23 tomography 19 multi 20 - 19 multi 21 detector 21 detector 22 computed 22 computed 23 tomography 23 tomography 25 mdct 24 ( 25 mdct 25 mdct 26 ) 27 and 28 agatston 28 agatston 29 scoring 29 scoring 30 in 29 scoring 35 on 30 in 34 patients 31 forty 32 - 32 - 33 six 32 - 34 patients 35 on 37 hemodialysis 36 chronic 37 hemodialysis moreover , we investigated associations of llacs with age , time on dialysis , type - 2 diabetes mellitus , history [of] stroke , and myocardial infarction . 0 ###LEFT-WALL### 3 we 0 ###LEFT-WALL### 4 investigated 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 28 . 1 moreover 2 , 1 moreover 3 we 3 we 4 investigated 4 investigated 5 associations 4 investigated 8 with 5 associations 6 of 6 of 7 llacs 8 with 9 age 9 age 11 time 10 , 11 time 11 time 12 on 11 time 14 , 12 on 13 dialysis 14 , 15 type 15 type 25 and 16 - 17 2 17 2 25 and 18 diabetes 19 mellitus 19 mellitus 20 , 20 , 23 stroke 20 , 25 and 21 history 23 stroke 24 , 25 and 25 and 27 infarction 26 myocardial 27 infarction in a second step , we determined [intra] - and inter [-] reader reliability of the llac measure . 0 ###LEFT-WALL### 6 we 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 19 . 1 in 4 step 1 in 5 , 1 in 6 we 2 a 4 step 3 second 4 step 6 we 10 and 7 determined 10 and 9 - 10 and 10 and 11 inter 10 and 14 reliability 11 inter 13 reader 14 reliability 15 of 15 of 18 measure 16 the 18 measure 17 llac 18 measure in the validity study [,] llacs were present ( >0mgha ) in 76 % of patients , 78 % of patients had cacs ( >0mgha ) . 0 ###LEFT-WALL### 19 % 0 ###LEFT-WALL### 22 had 0 ###LEFT-WALL### 27 . 1 in 4 study 1 in 19 % 2 the 4 study 3 validity 4 study 4 study 6 llacs 4 study 8 present 4 study 10 >0mgha 6 llacs 7 were 7 were 8 present 9 ( 10 >0mgha 10 >0mgha 11 ) 12 in 14 % 12 in 17 , 12 in 19 % 13 76 14 % 14 % 15 of 15 of 16 patients 18 78 19 % 19 % 20 of 19 % 22 had 20 of 21 patients 22 had 23 cacs 23 cacs 25 >0mgha 24 ( 25 >0mgha 25 >0mgha 26 ) median llac was 6.65 ( 0.08 - 24.40 )mgha and median cac [as] expressed by agatston score [was] 266.3 ( 15.88 - 1877.28 ) . 0 ###LEFT-WALL### 2 llac 0 ###LEFT-WALL### 3 was 1 median 2 llac 2 llac 3 was 3 was 4 6.65 4 6.65 10 and 5 ( 10 and 6 0.08 7 - 7 - 8 24.40 7 - 9 )mgha 9 )mgha 10 and 10 and 12 cac 10 and 15 by 10 and 22 - 10 and 25 . 11 median 12 cac 12 cac 14 expressed 15 by 17 score 16 agatston 17 score 17 score 19 266.3 20 ( 22 - 21 15.88 22 - 22 - 23 1877.28 22 - 24 ) we found a significant positive correlation between llac and cac ( rho=0.6 ; p<0.01 [ )( 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 found 0 ###LEFT-WALL### 13 ; 0 ###LEFT-WALL### 14 p<0.01 0 ###LEFT-WALL### 16 )( 1 we 2 found 2 found 6 correlation 2 found 7 between 3 a 4 significant 3 a 6 correlation 4 significant 6 correlation 5 positive 6 correlation 7 between 9 and 8 llac 9 and 9 and 10 cac 10 cac 12 rho=0.6 11 ( 12 rho=0.6 12 rho=0.6 13 ; 13 ; 14 p<0.01 llac was positively correlated with time on dialysis ( rho=0.337 , p=0.029 ) , there was a trend towards a positive association of llac and age ( rho=0.289 , p=0.053 ) . 0 ###LEFT-WALL### 1 llac 0 ###LEFT-WALL### 4 correlated 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 32 . 1 llac 2 was 2 was 3 positively 2 was 4 correlated 4 correlated 5 with 5 with 6 time 5 with 7 on 7 on 8 dialysis 8 dialysis 10 rho=0.337 8 dialysis 12 p=0.029 9 ( 10 rho=0.337 10 rho=0.337 11 , 11 , 12 p=0.029 12 p=0.029 13 ) 14 , 15 there 14 , 16 was 15 there 16 was 16 was 18 trend 16 was 19 towards 17 a 18 trend 19 towards 22 association 20 a 21 positive 20 a 22 association 21 positive 22 association 22 association 23 of 22 association 28 rho=0.289 23 of 25 and 24 llac 25 and 25 and 26 age 27 ( 28 rho=0.289 28 rho=0.289 30 p=0.053 28 rho=0.289 31 ) 29 , 30 p=0.053 30 p=0.053 31 ) the reliability study yielded excellent [intra] - [and] inter - reader agreement of the llac measure [(] [intra] - reader icc=0.999 , 95 % ci=0.998 - 1.000 ; inter [-] reader icc=0.998 , 95 % ci=0.994 - 0.999 ) . 0 ###LEFT-WALL### 3 study 0 ###LEFT-WALL### 4 yielded 0 ###LEFT-WALL### 7 - 1 the 3 study 2 reliability 3 study 3 study 4 yielded 4 yielded 5 excellent 7 - 9 inter 7 - 28 ; 7 - 40 . 9 inter 19 - 9 inter 25 ci=0.998 10 - 19 - 11 reader 12 agreement 12 agreement 13 of 12 agreement 19 - 13 of 16 measure 14 the 16 measure 15 llac 16 measure 19 - 21 icc=0.999 19 - 22 , 20 reader 21 icc=0.999 23 95 25 ci=0.998 24 % 25 ci=0.998 25 ci=0.998 27 1.000 26 - 27 1.000 27 1.000 28 ; 28 ; 29 inter 29 inter 32 icc=0.998 31 reader 32 icc=0.998 32 icc=0.998 36 ci=0.994 33 , 36 ci=0.994 34 95 36 ci=0.994 35 % 36 ci=0.994 36 ci=0.994 38 0.999 36 ci=0.994 39 ) 37 - 38 0.999 38 0.999 39 ) our study indicates that the llac measure has good validity and excellent reliability . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 indicates 0 ###LEFT-WALL### 14 . 1 our 2 study 2 study 3 indicates 3 indicates 4 that 4 that 7 measure 4 that 8 has 5 the 7 measure 6 llac 7 measure 7 measure 8 has 8 has 11 and 9 good 10 validity 10 validity 11 and 11 and 13 reliability 12 excellent 13 reliability the use of hr - pqct for the simultaneous evaluation of arterial calcifications , peripheral bone geometry , bone density , and bone microarchitecture should facilitate future research on osteo - vascular interactions and potential associations with cardiovascular events . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 26 facilitate 0 ###LEFT-WALL### 40 . 1 the 2 use 2 use 3 of 2 use 22 and 3 of 4 hr 4 hr 6 pqct 4 hr 20 density 5 - 6 pqct 6 pqct 7 for 6 pqct 18 , 7 for 10 evaluation 8 the 10 evaluation 9 simultaneous 10 evaluation 10 evaluation 11 of 10 evaluation 17 geometry 11 of 13 calcifications 12 arterial 13 calcifications 14 , 17 geometry 15 peripheral 17 geometry 16 bone 17 geometry 17 geometry 18 , 18 , 20 density 19 bone 20 density 20 density 21 , 22 and 24 microarchitecture 22 and 25 should 23 bone 24 microarchitecture 25 should 26 facilitate 26 facilitate 28 research 26 facilitate 29 on 26 facilitate 37 with 27 future 28 research 29 on 34 and 30 osteo 31 - 30 osteo 33 interactions 32 vascular 33 interactions 33 interactions 34 and 34 and 36 associations 35 potential 36 associations 37 with 39 events 38 cardiovascular 39 events within the next few decades , the number of older drivers operating a vehicle will increase rapidly [(] eurostat , 2011 ) . 0 ###LEFT-WALL### 11 drivers 0 ###LEFT-WALL### 16 increase 0 ###LEFT-WALL### 23 . 1 within 5 decades 1 within 6 , 1 within 11 drivers 2 the 3 next 2 the 4 few 4 few 5 decades 7 the 8 number 8 number 9 of 8 number 11 drivers 9 of 11 drivers 10 older 11 drivers 11 drivers 12 operating 11 drivers 15 will 12 operating 14 vehicle 13 a 14 vehicle 15 will 16 increase 16 increase 17 rapidly 16 increase 19 eurostat 19 eurostat 21 2011 20 , 21 2011 21 2011 22 ) as age [increases] so does physical vulnerability , age - related impairments , and the risk of being involved in [a] fatal crashes . 0 ###LEFT-WALL### 9 age 0 ###LEFT-WALL### 11 related 1 as 2 age 1 as 5 does 1 as 8 , 1 as 9 age 2 age 5 does 4 so 5 does 5 does 7 vulnerability 6 physical 7 vulnerability 10 - 11 related 11 related 14 and 11 related 24 . 12 impairments 14 and 13 , 14 and 14 and 16 risk 14 and 17 of 15 the 16 risk 17 of 18 being 18 being 19 involved 19 involved 20 in 20 in 23 crashes 22 fatal 23 crashes older drivers experience problems in driving situations that require divided attention and decision making under time pressure as reflected by their overrepresentation [in] at [-] fault crashes on intersections . 0 ###LEFT-WALL### 2 drivers 0 ###LEFT-WALL### 3 experience 0 ###LEFT-WALL### 19 reflected 0 ###LEFT-WALL### 30 . 1 older 2 drivers 2 drivers 3 experience 3 experience 4 problems 3 experience 5 in 3 experience 15 under 3 experience 18 as 5 in 6 driving 6 driving 7 situations 7 situations 8 that 7 situations 9 require 8 that 9 require 9 require 12 and 10 divided 11 attention 11 attention 12 and 12 and 13 decision 12 and 14 making 15 under 17 pressure 16 time 17 pressure 18 as 19 reflected 19 reflected 20 by 19 reflected 24 at 20 by 22 overrepresentation 21 their 22 overrepresentation 24 at 27 crashes 26 fault 27 crashes 27 crashes 28 on 28 on 29 intersections advanced driver assistance systems ( adas ) especially designed to support older drivers crossing intersections might counteract these difficulties . 0 ###LEFT-WALL### 2 driver 0 ###LEFT-WALL### 17 counteract 0 ###LEFT-WALL### 20 . 1 advanced 2 driver 2 driver 6 adas 2 driver 9 designed 2 driver 16 might 3 assistance 4 systems 4 systems 6 adas 5 ( 6 adas 6 adas 7 ) 6 adas 9 designed 8 especially 9 designed 9 designed 10 to 9 designed 11 support 10 to 11 support 11 support 13 drivers 12 older 13 drivers 13 drivers 14 crossing 14 crossing 15 intersections 16 might 17 counteract 17 counteract 19 difficulties 18 these 19 difficulties in a longer - term driving simulator study , the effects of an intersection assistant on driving were evaluated . 0 ###LEFT-WALL### 11 effects 0 ###LEFT-WALL### 19 evaluated 0 ###LEFT-WALL### 20 . 1 in 5 term 1 in 9 , 1 in 11 effects 2 a 5 term 3 longer 4 - 3 longer 5 term 5 term 6 driving 6 driving 8 study 7 simulator 8 study 10 the 11 effects 11 effects 12 of 11 effects 18 were 12 of 15 assistant 13 an 14 intersection 13 an 15 assistant 14 intersection 15 assistant 15 assistant 16 on 16 on 17 driving 18 were 19 evaluated in order to test the intersection assistance , eight intersections were depicted for further analyses . 0 ###LEFT-WALL### 10 intersections 0 ###LEFT-WALL### 12 depicted 0 ###LEFT-WALL### 16 . 1 in 2 order 1 in 8 , 1 in 10 intersections 2 order 3 to 2 order 4 test 3 to 4 test 4 test 7 assistance 5 the 7 assistance 6 intersection 7 assistance 9 eight 10 intersections 10 intersections 11 were 11 were 12 depicted 12 depicted 13 for 13 for 15 analyses 14 further 15 analyses results show that adas affects driving . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 7 . 1 results 2 show 2 show 3 that 3 that 4 adas 3 that 5 affects 4 adas 5 affects 5 affects 6 driving equipped with adas , drivers allocated more attention to the road center rather than the left and right , crossed intersections in shorter time , engaged in higher speeds , and crossed more often with a critical time - to [-] collision ( ttc ) value . 0 ###LEFT-WALL### 5 drivers 0 ###LEFT-WALL### 6 allocated 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 47 . 1 equipped 2 with 1 equipped 4 , 1 equipped 5 drivers 2 with 3 adas 5 drivers 6 allocated 6 allocated 8 attention 6 allocated 9 to 6 allocated 14 than 7 more 8 attention 9 to 12 center 10 the 12 center 11 road 12 center 13 rather 14 than 14 than 17 and 15 the 16 left 16 left 17 and 17 and 18 right 19 , 31 and 20 crossed 21 intersections 20 crossed 22 in 20 crossed 26 engaged 20 crossed 31 and 22 in 24 time 23 shorter 24 time 25 , 26 engaged 26 engaged 27 in 26 engaged 30 , 27 in 29 speeds 28 higher 29 speeds 31 and 32 crossed 32 crossed 34 often 32 crossed 35 with 32 crossed 46 value 33 more 34 often 35 with 38 time 36 a 37 critical 36 a 38 time 37 critical 38 time 38 time 40 to 39 - 40 to 40 to 42 collision 40 to 45 ) 42 collision 44 ttc 43 ( 44 ttc 44 ttc 45 ) the implications of results are discussed in terms of behavioral adaptation and safety . 0 ###LEFT-WALL### 2 implications 0 ###LEFT-WALL### 6 discussed 0 ###LEFT-WALL### 14 . 1 the 2 implications 2 implications 3 of 2 implications 5 are 3 of 4 results 5 are 6 discussed 6 discussed 7 in 7 in 8 terms 8 terms 9 of 9 of 12 and 10 behavioral 11 adaptation 11 adaptation 12 and 12 and 13 safety background & aims : obesity is associated with barrett 's esophagus ( be ) and with changes in circulating levels of adipokines ( leptin and adiponectin ) and cytokines . 0 ###LEFT-WALL### 3 aims 0 ###LEFT-WALL### 4 : 1 background 2 & 2 & 3 aims 4 : 5 obesity 4 : 7 associated 4 : 30 . 5 obesity 6 is 6 is 7 associated 7 associated 15 and 8 with 11 esophagus 8 with 15 and 9 barrett 10 's 10 's 11 esophagus 11 esophagus 13 be 12 ( 13 be 13 be 14 ) 15 and 16 with 16 with 28 and 17 changes 18 in 17 changes 28 and 18 in 19 circulating 19 circulating 20 levels 20 levels 21 of 21 of 22 adipokines 22 adipokines 25 and 23 ( 25 and 24 leptin 25 and 25 and 26 adiponectin 25 and 27 ) 28 and 29 cytokines although studies have reported that adipokines and inflammatory cytokines are necessary for the development of be , their role is controversial . 0 ###LEFT-WALL### 19 role 0 ###LEFT-WALL### 20 is 0 ###LEFT-WALL### 22 . 1 although 2 studies 1 although 4 reported 1 although 17 , 1 although 19 role 2 studies 3 have 3 have 4 reported 4 reported 5 that 5 that 7 and 5 that 10 are 6 adipokines 7 and 7 and 9 cytokines 7 and 10 are 8 inflammatory 9 cytokines 10 are 11 necessary 11 necessary 12 for 12 for 14 development 13 the 14 development 14 development 15 of 15 of 16 be 18 their 19 role 19 role 20 is 20 is 21 controversial methods : we performed a case - control study ; cases ( n = 141 ) were patients who underwent esophagogastroduodenoscopy and were found to have be , which was based on endoscopy and histology , and controls ( n = 139 ) were primary care patients eligible for screening colonoscopies who agreed to undergo esophagogastroduodenoscopy . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 17 were 0 ###LEFT-WALL### 57 . 2 : 3 we 2 : 4 performed 2 : 7 - 3 we 4 performed 4 performed 6 case 5 a 6 case 7 - 9 study 7 - 10 ; 8 control 9 study 10 ; 11 cases 11 cases 14 = 11 cases 17 were 12 ( 14 = 13 n 14 = 14 = 15 141 14 = 16 ) 17 were 18 patients 18 patients 19 who 18 patients 22 and 19 who 22 and 20 underwent 21 esophagogastroduodenoscopy 20 underwent 22 and 22 and 37 and 23 were 24 found 23 were 37 and 24 found 25 to 24 found 27 be 25 to 26 have 27 be 29 which 28 , 29 which 29 which 30 was 29 which 36 , 30 was 31 based 31 based 32 on 32 on 34 and 33 endoscopy 34 and 34 and 35 histology 37 and 55 undergo 38 controls 41 = 38 controls 44 were 39 ( 41 = 40 n 41 = 41 = 42 139 41 = 43 ) 44 were 47 patients 44 were 54 to 45 primary 46 care 46 care 47 patients 47 patients 48 eligible 47 patients 52 who 47 patients 53 agreed 48 eligible 49 for 49 for 50 screening 50 screening 51 colonoscopies 52 who 53 agreed 54 to 55 undergo 55 undergo 56 esophagogastroduodenoscopy we examined the association between be and circulating levels of adipokines and cytokines ( interleukin [ il ] - 1β , il - 6 , il - 8 , il - 10 , and il - 12p70 [;] tumor necrosis factor - α [;] and interferon - [γ] ) . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 50 . 1 we 2 examined 2 examined 4 association 2 examined 5 between 3 the 4 association 5 between 7 and 6 be 7 and 7 and 8 circulating 7 and 9 levels 7 and 20 1β 7 and 22 il 9 levels 10 of 9 levels 15 interleukin 9 levels 20 1β 10 of 12 and 11 adipokines 12 and 12 and 13 cytokines 14 ( 15 interleukin 15 interleukin 17 il 15 interleukin 19 - 16 [ 17 il 17 il 18 ] 21 , 22 il 22 il 26 il 22 il 49 ) 23 - 26 il 24 6 26 il 25 , 26 il 26 il 28 8 26 il 34 and 26 il 49 ) 27 - 28 8 28 8 29 , 29 , 34 and 30 il 32 10 30 il 34 and 31 - 32 10 32 10 33 , 33 , 34 and 34 and 35 il 34 and 45 and 34 and 47 - 35 il 37 12p70 36 - 37 12p70 37 12p70 40 necrosis 37 12p70 41 factor 37 12p70 42 - 39 tumor 40 necrosis 40 necrosis 41 factor 42 - 45 and 43 α 45 and 45 and 46 interferon 45 and 47 - cases and controls were compared by calculating odds ratios ( ors [ )(and 95 % confidence intervals ( cis ) and using unadjusted and multiple logistic regression , adjusting for age , sex , race , waist - hip ratio , use of proton pump inhibitors and nonsteroidal anti - inflammatory drugs , and helicobacter pylori infection . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 5 compared 0 ###LEFT-WALL### 28 , 1 cases 2 and 2 and 3 controls 2 and 4 were 4 were 5 compared 5 compared 6 by 6 by 7 calculating 7 calculating 9 ratios 8 odds 9 ratios 9 ratios 24 and 10 ( 24 and 11 ors 13 )(and 13 )(and 17 intervals 13 )(and 19 cis 13 )(and 21 and 14 95 17 intervals 15 % 16 confidence 16 confidence 17 intervals 18 ( 19 cis 19 cis 20 ) 21 and 22 using 21 and 23 unadjusted 21 and 24 and 24 and 27 regression 24 and 28 , 25 multiple 27 regression 26 logistic 27 regression 28 , 35 race 28 , 36 , 29 adjusting 30 for 29 adjusting 34 , 29 adjusting 35 race 30 for 31 age 31 age 33 sex 32 , 33 sex 33 sex 34 , 36 , 37 waist 36 , 38 - 38 - 40 ratio 38 - 41 , 39 hip 40 ratio 41 , 54 and 42 use 43 of 42 use 47 and 43 of 46 inhibitors 44 proton 46 inhibitors 45 pump 46 inhibitors 47 and 48 nonsteroidal 47 and 52 drugs 49 anti 50 - 49 anti 52 drugs 51 inflammatory 52 drugs 52 drugs 54 and 53 , 54 and 54 and 57 infection 54 and 58 . 55 helicobacter 57 infection 56 pylori 57 infection the adjusted or for be was 0.14 for [highest] quintile of il - 10 compared with [lowest] quintile ( 95 % ci , 0.05 - 0.35 [ )(and 0.03 for il - 1β ≥ median vs none detected ( 95 % ci , 0.006 - 0.13 ) . 0 ###LEFT-WALL### 3 or 0 ###LEFT-WALL### 6 was 1 the 3 or 2 adjusted 3 or 3 or 4 for 3 or 6 was 4 for 5 be 6 was 7 0.14 7 0.14 8 for 7 0.14 11 of 8 for 10 quintile 11 of 12 il 12 il 14 10 12 il 15 compared 13 - 14 10 14 10 15 compared 15 compared 16 with 16 with 18 quintile 16 with 24 0.05 18 quintile 22 ci 19 ( 22 ci 20 95 22 ci 21 % 22 ci 22 ci 23 , 24 0.05 32 - 25 - 32 - 26 0.35 28 )(and 28 )(and 29 0.03 28 )(and 30 for 28 )(and 32 - 30 for 31 il 32 - 35 median 33 1β 35 median 34 ≥ 35 median 35 median 36 vs 35 median 38 detected 35 median 42 ci 36 vs 37 none 39 ( 42 ci 40 95 42 ci 41 % 42 ci 42 ci 45 - 42 ci 48 . 43 , 45 - 44 0.006 45 - 45 - 46 0.13 45 - 47 ) higher levels of il [-] 8 and leptin and lower levels of il - 10 and il - 1β were associated with the presence of long - segment ( ≥3 [cm] ) and short - segment be . 0 ###LEFT-WALL### 9 and 1 higher 2 levels 2 levels 3 of 2 levels 7 and 3 of 4 il 4 il 6 8 7 and 8 leptin 7 and 9 and 9 and 11 levels 9 and 12 of 9 and 19 1β 9 and 20 were 9 and 21 associated 10 lower 11 levels 12 of 13 il 13 il 17 il 14 - 17 il 15 10 16 and 16 and 17 il 17 il 18 - 19 1β 20 were 21 associated 22 with 22 with 33 and 23 the 24 presence 24 presence 25 of 24 presence 33 and 25 of 28 segment 26 long 27 - 26 long 28 segment 28 segment 30 ≥3 29 ( 30 ≥3 30 ≥3 32 ) 33 and 34 short 33 and 37 be 35 - 37 be 36 segment 37 be 37 be 38 . there were no differences between cases and controls in levels of interferon [-] [γ] [,] tumor necrosis factor - α , adiponectin , or insulin . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 were 0 ###LEFT-WALL### 21 , 0 ###LEFT-WALL### 26 . 1 there 2 were 2 were 4 differences 3 no 4 differences 4 differences 5 between 4 differences 10 levels 4 differences 18 factor 4 differences 20 α 5 between 7 and 6 cases 7 and 7 and 8 controls 7 and 9 in 10 levels 11 of 10 levels 18 factor 11 of 17 necrosis 12 interferon 16 tumor 16 tumor 17 necrosis 19 - 20 α 20 α 21 , 21 , 24 or 22 adiponectin 24 or 23 , 24 or 24 or 25 insulin conclusions : be is associated with circulating inflammatory cytokines and leptin and low levels of anti - inflammatory cytokines . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 2 : 3 be 2 : 5 associated 3 be 4 is 4 is 5 associated 5 associated 6 with 6 with 12 and 7 circulating 9 cytokines 8 inflammatory 9 cytokines 9 cytokines 10 and 10 and 11 leptin 10 and 12 and 12 and 14 levels 12 and 15 of 13 low 14 levels 15 of 19 cytokines 16 anti 17 - 16 anti 19 cytokines 18 inflammatory 19 cytokines these findings could partly explain the effect of obesity on be . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 5 explain 0 ###LEFT-WALL### 12 . 1 these 2 findings 2 findings 3 could 3 could 5 explain 4 partly 5 explain 5 explain 7 effect 5 explain 10 on 6 the 7 effect 7 effect 8 of 8 of 9 obesity 10 on 11 be the function of p53 is best understood in response to genotoxic stress , but increasing evidence suggests that p53 also plays a key role in the regulation of metabolic homeostasis . p53 and its family members directly influence various metabolic pathways , enabling cells to respond to metabolic stress . 0 ###LEFT-WALL### 2 function 0 ###LEFT-WALL### 7 understood 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 31 . 1 the 2 function 2 function 3 of 2 function 5 is 3 of 4 p53 5 is 7 understood 6 best 7 understood 7 understood 9 response 7 understood 10 to 8 in 9 response 10 to 12 stress 11 genotoxic 12 stress 13 , 14 but 14 but 15 increasing 14 but 17 suggests 15 increasing 16 evidence 15 increasing 17 suggests 17 suggests 18 that 18 that 19 p53 18 that 21 plays 19 p53 21 plays 20 also 21 plays 21 plays 24 role 21 plays 25 in 22 a 24 role 23 key 24 role 25 in 27 regulation 26 the 27 regulation 27 regulation 28 of 28 of 30 homeostasis 29 metabolic 30 homeostasis 31 . 33 and 31 . 38 influence 32 p53 33 and 33 and 36 members 33 and 38 influence 34 its 36 members 35 family 36 members 37 directly 38 influence 38 influence 41 pathways 39 various 41 pathways 40 metabolic 41 pathways 41 pathways 43 enabling 42 , 43 enabling 43 enabling 44 cells 43 enabling 45 to 43 enabling 46 respond 43 enabling 50 . 45 to 46 respond 46 respond 47 to 47 to 49 stress 48 metabolic 49 stress these functions are likely to be important for restraining the development of cancer but could also have a profound effect on the development of metabolic diseases , including diabetes . 0 ###LEFT-WALL### 2 functions 0 ###LEFT-WALL### 3 are 1 these 2 functions 2 functions 3 are 3 are 4 likely 4 likely 5 to 4 likely 17 have 5 to 14 but 6 be 7 important 6 be 14 but 7 important 8 for 8 for 9 restraining 9 restraining 11 development 10 the 11 development 11 development 12 of 12 of 13 cancer 14 but 15 could 15 could 17 have 16 also 17 have 17 have 20 effect 17 have 21 on 18 a 19 profound 18 a 20 effect 19 profound 20 effect 21 on 23 development 22 the 23 development 23 development 24 of 23 development 28 including 24 of 26 diseases 25 metabolic 26 diseases 27 , 28 including 28 including 29 diabetes 28 including 30 . a better understanding of the metabolic functions of p53 family members may aid [in] the identification of therapeutic targets and reveal novel uses for p53 - modulating drugs . 0 ###LEFT-WALL### 3 understanding 0 ###LEFT-WALL### 20 and 1 a 3 understanding 2 better 3 understanding 3 understanding 4 of 3 understanding 12 may 4 of 7 functions 5 the 7 functions 6 metabolic 7 functions 7 functions 8 of 8 of 11 members 9 p53 11 members 10 family 11 members 12 may 20 and 13 aid 16 identification 13 aid 20 and 15 the 16 identification 16 identification 17 of 17 of 19 targets 18 therapeutic 19 targets 20 and 21 reveal 20 and 27 modulating 21 reveal 23 uses 22 novel 23 uses 23 uses 24 for 24 for 25 p53 26 - 27 modulating 27 modulating 28 drugs 27 modulating 29 . purpose : emerging evidence suggests that exposure to endocrine disruptors may initiate or exacerbate adiposity and associated health problems . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 purpose 2 : 2 : 4 evidence 3 emerging 4 evidence 4 evidence 16 and 5 suggests 6 that 5 suggests 16 and 6 that 7 exposure 6 that 13 or 7 exposure 8 to 7 exposure 11 may 8 to 10 disruptors 9 endocrine 10 disruptors 11 may 13 or 12 initiate 13 or 13 or 14 exacerbate 14 exacerbate 15 adiposity 16 and 17 associated 16 and 19 problems 17 associated 18 health this study examined sex differences in the association of urinary level of bisphenol [-] a ( bpa ) with selected indices of glucose homeostasis among u.s . adults . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 3 examined 0 ###LEFT-WALL### 27 . 0 ###LEFT-WALL### 29 . 1 this 2 study 2 study 3 examined 3 examined 5 differences 3 examined 6 in 3 examined 19 with 4 sex 5 differences 6 in 8 association 7 the 8 association 8 association 9 of 9 of 11 level 10 urinary 11 level 11 level 12 of 12 of 13 bisphenol 13 bisphenol 15 a 13 bisphenol 17 bpa 16 ( 17 bpa 17 bpa 18 ) 19 with 21 indices 20 selected 21 indices 21 indices 22 of 22 of 24 homeostasis 23 glucose 24 homeostasis 24 homeostasis 25 among 25 among 26 u.s 27 . 28 adults methods : data analyses were performed using a sample of 1586 participants from the 2005 to 2008 national health and nutrition examination surveys . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 3 data 2 : 6 performed 2 : 24 . 3 data 4 analyses 3 data 5 were 3 data 6 performed 4 analyses 5 were 6 performed 7 using 6 performed 13 from 7 using 9 sample 8 a 9 sample 9 sample 10 of 10 of 12 participants 11 1586 12 participants 13 from 20 and 14 the 16 to 15 2005 16 to 16 to 17 2008 16 to 19 health 18 national 19 health 19 health 20 and 20 and 23 surveys 21 nutrition 22 examination 22 examination 23 surveys bpa level and the ratio of bpa - to [-] creatinine level were defined as log [-] transformed variables and [in] quartiles . 0 ###LEFT-WALL### 3 and 1 bpa 2 level 2 level 3 and 3 and 5 ratio 4 the 5 ratio 5 ratio 6 of 6 of 7 bpa 7 bpa 9 to 8 - 9 to 9 to 12 level 9 to 23 . 11 creatinine 12 level 12 level 20 and 13 were 14 defined 13 were 20 and 14 defined 15 as 15 as 19 variables 16 log 18 transformed 18 transformed 19 variables 20 and 22 quartiles selected indices of glucose homeostasis were defined using fasting glucose and insulin data . 0 ###LEFT-WALL### 2 indices 0 ###LEFT-WALL### 7 defined 0 ###LEFT-WALL### 14 . 1 selected 2 indices 2 indices 3 of 2 indices 6 were 3 of 5 homeostasis 4 glucose 5 homeostasis 6 were 7 defined 7 defined 8 using 8 using 11 and 9 fasting 10 glucose 10 glucose 11 and 11 and 13 data 12 insulin 13 data multivariate linear and logistic regression models for the hypothesized relationships were constructed after controlling for age , sex , race , education , marital status , smoking status , physical activity , total dietary intake , and urinary creatinine concentration . 0 ###LEFT-WALL### 6 models 0 ###LEFT-WALL### 12 constructed 0 ###LEFT-WALL### 41 . 1 multivariate 6 models 2 linear 3 and 3 and 4 logistic 3 and 6 models 5 regression 6 models 6 models 7 for 6 models 11 were 7 for 10 relationships 8 the 10 relationships 9 hypothesized 10 relationships 11 were 12 constructed 12 constructed 13 after 13 after 14 controlling 14 controlling 15 for 14 controlling 27 smoking 14 controlling 37 and 15 for 16 age 16 age 18 sex 16 age 20 race 16 age 25 status 17 , 18 sex 18 sex 19 , 19 , 20 race 20 race 22 education 20 race 23 , 21 , 22 education 22 education 23 , 23 , 25 status 24 marital 25 status 25 status 26 , 26 , 27 smoking 27 smoking 28 status 27 smoking 29 , 30 physical 31 activity 31 activity 32 , 32 , 35 intake 32 , 37 and 33 total 35 intake 34 dietary 35 intake 36 , 37 and 37 and 40 concentration 38 urinary 40 concentration 39 creatinine 40 concentration irrespective of sex , the ratio of bpa - [to] - creatinine level was not predictive of indices of glucose homeostasis . 0 ###LEFT-WALL### 13 level 0 ###LEFT-WALL### 14 was 0 ###LEFT-WALL### 22 . 1 irrespective 2 of 2 of 3 sex 2 of 11 - 2 of 13 level 3 sex 6 ratio 4 , 6 ratio 5 the 6 ratio 6 ratio 7 of 6 ratio 9 - 7 of 8 bpa 12 creatinine 13 level 13 level 14 was 14 was 15 not 14 was 17 of 15 not 16 predictive 17 of 18 indices 18 indices 19 of 19 of 21 homeostasis 20 glucose 21 homeostasis conclusions : a complex association may exist between bpa and hyperinsulinemia among adult u.s . men . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 5 association 2 : 7 exist 2 : 15 . 3 a 4 complex 3 a 5 association 4 complex 5 association 5 association 6 may 6 may 7 exist 7 exist 8 between 7 exist 12 among 8 between 10 and 9 bpa 10 and 10 and 11 hyperinsulinemia 12 among 14 u.s 13 adult 14 u.s 15 . 16 men 15 . 17 . prospective cohort studies are needed to further elucidate endocrine disruptors as determinants of adiposity - related disturbances . 0 ###LEFT-WALL### 1 prospective 0 ###LEFT-WALL### 5 needed 0 ###LEFT-WALL### 16 related 0 ###LEFT-WALL### 18 . 1 prospective 3 studies 1 prospective 4 are 1 prospective 5 needed 2 cohort 3 studies 3 studies 4 are 5 needed 6 to 5 needed 15 - 6 to 8 elucidate 7 further 8 elucidate 8 elucidate 10 disruptors 8 elucidate 11 as 9 endocrine 10 disruptors 11 as 12 determinants 12 determinants 13 of 13 of 14 adiposity 15 - 16 related 16 related 17 disturbances in this chapter we focus on finding ways of modulating sphingolipids to prevent the development of age - associated diseases or delay their onset , both of which could improve health in elderly , fragile people . 0 ###LEFT-WALL### 21 or 0 ###LEFT-WALL### 37 . 1 in 3 chapter 1 in 18 - 1 in 21 or 2 this 3 chapter 3 chapter 4 we 3 chapter 7 finding 4 we 5 focus 5 focus 6 on 6 on 7 finding 7 finding 8 ways 8 ways 9 of 8 ways 12 to 8 ways 13 prevent 9 of 11 sphingolipids 10 modulating 11 sphingolipids 12 to 13 prevent 13 prevent 15 development 14 the 15 development 15 development 16 of 16 of 17 age 19 associated 20 diseases 19 associated 21 or 21 or 25 , 22 delay 24 onset 22 delay 25 , 23 their 24 onset 25 , 30 improve 26 both 27 of 26 both 29 could 27 of 28 which 29 could 30 improve 30 improve 31 health 30 improve 32 in 32 in 36 people 33 elderly 34 , 33 elderly 36 people 35 fragile 36 people reducing the incidence of [or] delaying the onset of diseases of aging has blossomed in the past decade because of advances in understanding signal transduction pathways and cellular processes , especially in model organisms , that are largely conserved in most eukaryotes and that can be modulated to reduce signs of aging and increase health span . 0 ###LEFT-WALL### 1 reducing 0 ###LEFT-WALL### 14 blossomed 0 ###LEFT-WALL### 30 , 0 ###LEFT-WALL### 57 . 1 reducing 3 incidence 1 reducing 13 has 2 the 3 incidence 3 incidence 4 of 3 incidence 11 of 4 of 6 delaying 6 delaying 8 onset 7 the 8 onset 8 onset 9 of 9 of 10 diseases 11 of 12 aging 13 has 14 blossomed 14 blossomed 15 in 14 blossomed 20 of 15 in 18 decade 16 the 18 decade 17 past 18 decade 19 because 20 of 20 of 21 advances 21 advances 22 in 22 in 23 understanding 23 understanding 27 and 24 signal 25 transduction 25 transduction 26 pathways 26 pathways 27 and 27 and 29 processes 28 cellular 29 processes 30 , 43 and 30 , 49 reduce 31 especially 43 and 32 in 34 organisms 32 in 43 and 33 model 34 organisms 34 organisms 36 that 34 organisms 37 are 35 , 36 that 36 that 37 are 37 are 39 conserved 38 largely 39 conserved 40 in 41 most 40 in 43 and 42 eukaryotes 43 and 43 and 45 can 43 and 46 be 44 that 45 can 46 be 47 modulated 47 modulated 48 to 48 to 49 reduce 49 reduce 53 and 50 signs 51 of 50 signs 53 and 51 of 52 aging 53 and 56 span 54 increase 55 health 55 health 56 span in model organisms such interventions must also increase lifespan to be considered significant , but this is not a requirement for use in humans . 0 ###LEFT-WALL### 5 interventions 0 ###LEFT-WALL### 12 considered 0 ###LEFT-WALL### 15 but 0 ###LEFT-WALL### 25 . 1 in 3 organisms 1 in 5 interventions 2 model 3 organisms 4 such 5 interventions 5 interventions 6 must 6 must 8 increase 7 also 8 increase 8 increase 9 lifespan 8 increase 10 to 10 to 11 be 11 be 12 considered 12 considered 13 significant 14 , 15 but 15 but 16 this 15 but 17 is 16 this 17 is 17 is 18 not 17 is 20 requirement 19 a 20 requirement 20 requirement 21 for 21 for 22 use 22 use 23 in 23 in 24 humans the most encouraging interventions in model organisms involve lowering the concentration of one or more sphingolipids so as to reduce the activity of key signaling pathways , one of the most promising being the target of rapamycin complex 1 ( torc1 ) protein kinase pathway . 0 ###LEFT-WALL### 4 interventions 0 ###LEFT-WALL### 8 involve 0 ###LEFT-WALL### 14 or 0 ###LEFT-WALL### 20 reduce 1 the 2 most 2 most 4 interventions 3 encouraging 4 interventions 4 interventions 5 in 4 interventions 8 involve 5 in 7 organisms 6 model 7 organisms 8 involve 9 lowering 9 lowering 11 concentration 10 the 11 concentration 11 concentration 12 of 12 of 13 one 14 or 15 more 14 or 16 sphingolipids 15 more 16 sphingolipids 16 sphingolipids 19 to 17 so 18 as 18 as 19 to 19 to 20 reduce 20 reduce 22 activity 21 the 22 activity 22 activity 23 of 23 of 26 pathways 24 key 26 pathways 25 signaling 26 pathways 26 pathways 28 one 27 , 28 one 28 one 29 of 28 one 46 . 29 of 31 most 30 the 31 most 31 most 32 promising 31 most 33 being 33 being 45 pathway 34 the 45 pathway 35 target 36 of 35 target 43 protein 36 of 38 complex 37 rapamycin 38 complex 38 complex 39 1 38 complex 41 torc1 40 ( 41 torc1 41 torc1 42 ) 43 protein 45 pathway 44 kinase 45 pathway other potential ways in which modulating sphingolipids may contribute to improving the health profile of the elderly is by reducing oxidative stresses , inflammatory responses and growth factor signaling . 0 ###LEFT-WALL### 3 ways 0 ###LEFT-WALL### 9 contribute 0 ###LEFT-WALL### 30 . 1 other 3 ways 2 potential 3 ways 3 ways 4 in 3 ways 9 contribute 4 in 5 which 4 in 6 modulating 4 in 8 may 6 modulating 7 sphingolipids 6 modulating 8 may 9 contribute 10 to 9 contribute 19 by 10 to 11 improving 11 improving 13 health 12 the 13 health 13 health 14 profile 13 health 18 is 14 profile 15 of 14 profile 18 is 15 of 17 elderly 16 the 17 elderly 19 by 20 reducing 20 reducing 26 and 21 oxidative 22 stresses 22 stresses 23 , 23 , 25 responses 23 , 26 and 24 inflammatory 25 responses 26 and 28 factor 26 and 29 signaling 27 growth 28 factor lastly , perhaps the most interesting way to modulate sphingolipids and promote longevity is by lowering the activity of serine palmitoyltransferase , the first enzyme in the de novo sphingolipid biosynthesis pathway . 0 ###LEFT-WALL### 7 way 0 ###LEFT-WALL### 14 is 1 lastly 2 , 1 lastly 7 way 3 perhaps 7 way 4 the 7 way 5 most 6 interesting 6 interesting 7 way 7 way 8 to 7 way 11 and 7 way 14 is 8 to 11 and 9 modulate 10 sphingolipids 9 modulate 11 and 11 and 12 promote 12 promote 13 longevity 14 is 15 by 15 by 16 lowering 16 lowering 18 activity 17 the 18 activity 18 activity 19 of 19 of 21 palmitoyltransferase 20 serine 21 palmitoyltransferase 21 palmitoyltransferase 25 enzyme 22 , 25 enzyme 23 the 24 first 23 the 25 enzyme 25 enzyme 26 in 25 enzyme 33 . 26 in 32 pathway 27 the 32 pathway 28 de 29 novo 29 novo 30 sphingolipid 30 sphingolipid 31 biosynthesis 31 biosynthesis 32 pathway available data in yeasts and rodents are encouraging and as we gain insights into molecular mechanisms the strategies for improving human health by modulating sphingolipids will become more apparent . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 30 . 1 available 2 data 2 data 3 in 2 data 7 are 3 in 5 and 4 yeasts 5 and 5 and 6 rodents 7 are 8 encouraging 9 and 18 strategies 9 and 27 become 10 as 11 we 10 as 12 gain 10 as 18 strategies 11 we 12 gain 12 gain 13 insights 12 gain 14 into 14 into 16 mechanisms 15 molecular 16 mechanisms 17 the 18 strategies 18 strategies 19 for 18 strategies 23 by 18 strategies 26 will 19 for 20 improving 20 improving 22 health 21 human 22 health 23 by 25 sphingolipids 24 modulating 25 sphingolipids 26 will 27 become 27 become 29 apparent 28 more 29 apparent this article is part of a special issue entitled new frontiers in sphingolipid biology . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 15 . 1 this 2 article 2 article 3 is 3 is 14 biology 4 part 5 of 4 part 14 biology 5 of 11 frontiers 6 a 11 frontiers 7 special 8 issue 8 issue 9 entitled 9 entitled 11 frontiers 10 new 11 frontiers 11 frontiers 12 in 12 in 14 biology 13 sphingolipid 14 biology background : short - term ( < 1 year ) calorie [restriction] ( cr ) has been reported to decrease physical activity and metabolic rate in humans [and] [non] - human primate models [;] [however] , studies examining the very long - term ( >10 [year] ) effect of cr on these parameters are lacking . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 11 calorie 3 short 5 term 3 short 10 ) 3 short 11 calorie 4 - 5 term 5 term 9 year 5 term 10 ) 6 ( 9 year 7 < 8 1 8 1 9 year 9 year 10 ) 11 calorie 14 cr 11 calorie 16 has 13 ( 14 cr 14 cr 15 ) 16 has 17 been 17 been 18 reported 18 reported 19 to 18 reported 20 decrease 19 to 20 decrease 20 decrease 23 and 20 decrease 26 in 21 physical 22 activity 22 activity 23 and 23 and 25 rate 24 metabolic 25 rate 26 in 27 humans 27 humans 38 examining 30 - 38 examining 31 human 32 primate 31 human 36 , 32 primate 36 , 33 models 36 , 36 , 37 studies 36 , 38 examining 38 examining 43 term 39 the 43 term 40 very 41 long 41 long 42 - 41 long 43 term 43 term 48 effect 44 ( 48 effect 45 >10 47 ) 45 >10 48 effect 48 effect 49 of 48 effect 53 parameters 48 effect 55 lacking 48 effect 56 . 49 of 50 cr 50 cr 51 on 51 on 52 these 53 parameters 54 are 54 are 55 lacking objective : the objective of this study was to examine metabolic and behavioral adaptations to long - term cr longitudinally in rhesus macaques . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 24 . 2 : 4 objective 2 : 16 long 2 : 17 - 3 the 4 objective 4 objective 5 of 4 objective 8 was 5 of 7 study 6 this 7 study 8 was 9 to 8 was 10 examine 9 to 10 examine 10 examine 14 adaptations 10 examine 15 to 11 metabolic 12 and 12 and 13 behavioral 12 and 14 adaptations 15 to 16 long 17 - 18 term 18 term 19 cr 18 term 20 longitudinally 18 term 21 in 21 in 23 macaques 22 rhesus 23 macaques energy expenditure ( ee ) was examined by doubly labeled water ( dlw ; tee [ )(and respiratory chamber ( 24 h ee ) . 0 ###LEFT-WALL### 2 expenditure 0 ###LEFT-WALL### 7 examined 0 ###LEFT-WALL### 14 ; 0 ###LEFT-WALL### 25 . 1 energy 2 expenditure 2 expenditure 4 ee 2 expenditure 6 was 3 ( 4 ee 4 ee 5 ) 6 was 7 examined 7 examined 8 by 8 by 11 water 9 doubly 10 labeled 10 labeled 11 water 11 water 13 dlw 12 ( 13 dlw 13 dlw 14 ; 14 ; 17 )(and 15 tee 17 )(and 17 )(and 19 chamber 17 )(and 23 ee 18 respiratory 19 chamber 20 ( 23 ee 21 24 22 h 22 h 23 ee 23 ee 24 ) physical activity was assessed both by metabolic equivalent [(] met [ )(in a respiratory chamber and by an accelerometer . 0 ###LEFT-WALL### 1 physical 0 ###LEFT-WALL### 4 assessed 0 ###LEFT-WALL### 20 . 1 physical 2 activity 1 physical 3 was 1 physical 4 assessed 2 activity 3 was 4 assessed 5 both 4 assessed 6 by 6 by 10 met 7 metabolic 8 equivalent 8 equivalent 10 met 10 met 16 and 12 )(in 15 chamber 12 )(in 16 and 13 a 14 respiratory 13 a 15 chamber 14 respiratory 15 chamber 16 and 17 by 17 by 19 accelerometer 18 an 19 accelerometer metabolic cost of movements during 24 h was also calculated . 0 ###LEFT-WALL### 2 cost 0 ###LEFT-WALL### 10 calculated 0 ###LEFT-WALL### 11 . 1 metabolic 2 cost 2 cost 3 of 2 cost 8 was 3 of 4 movements 4 movements 5 during 5 during 7 h 6 24 7 h 8 was 9 also 8 was 10 calculated age and fat - free mass were included as covariates . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 8 included 0 ###LEFT-WALL### 11 . 1 age 2 and 2 and 6 mass 2 and 7 were 3 fat 4 - 3 fat 6 mass 5 free 6 mass 7 were 8 included 8 included 9 as 9 as 10 covariates results [:] adjusted total and 24 h ee were not different between c and cr . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 16 . 1 results 3 adjusted 1 results 14 and 3 adjusted 5 and 4 total 5 and 5 and 11 different 6 24 7 h 7 h 8 ee 8 ee 9 were 9 were 10 not 10 not 11 different 11 different 12 between 12 between 13 c 14 and 15 cr sleeping metabolic [rate] [was] significantly lower , and physical activity level was higher in cr [than] in c independent from the cr - induced changes in body composition . 0 ###LEFT-WALL### 1 sleeping 0 ###LEFT-WALL### 12 was 0 ###LEFT-WALL### 23 - 0 ###LEFT-WALL### 29 . 1 sleeping 8 and 1 sleeping 12 was 2 metabolic 5 significantly 2 metabolic 6 lower 2 metabolic 8 and 7 , 8 and 8 and 9 physical 10 activity 11 level 11 level 12 was 12 was 13 higher 13 higher 14 in 14 in 15 cr 15 cr 17 in 15 cr 19 independent 17 in 18 c 19 independent 20 from 20 from 22 cr 21 the 22 cr 23 - 25 changes 24 induced 25 changes 25 changes 26 in 26 in 28 composition 27 body 28 composition the duration of physical activity above 1.6 mets was significantly higher in cr than in c , and cr had significantly higher accelerometer activity counts than c ..y metabolic cost of movements during 24 h was significantly lower in cr than in c . the accelerometer activity counts were significantly decreased after seven years in c animals , but not [in] cr animals . 0 ###LEFT-WALL### 2 duration 0 ###LEFT-WALL### 20 had 0 ###LEFT-WALL### 26 than 0 ###LEFT-WALL### 44 . 1 the 2 duration 2 duration 3 of 2 duration 20 had 3 of 18 and 4 physical 5 activity 5 activity 6 above 5 activity 11 higher 5 activity 18 and 6 above 7 1.6 7 1.6 8 mets 7 1.6 9 was 8 mets 9 was 10 significantly 11 higher 11 higher 12 in 11 higher 14 than 12 in 13 cr 14 than 15 in 15 in 16 c 17 , 18 and 18 and 19 cr 20 had 25 counts 21 significantly 22 higher 22 higher 23 accelerometer 23 accelerometer 25 counts 24 activity 25 counts 26 than 27 c 26 than 28 ..y 27 c 28 ..y 28 ..y 30 cost 29 metabolic 30 cost 30 cost 31 of 30 cost 36 was 31 of 32 movements 32 movements 33 during 33 during 35 h 34 24 35 h 36 was 37 significantly 36 was 38 lower 38 lower 39 in 38 lower 41 than 39 in 40 cr 41 than 42 in 42 in 43 c 44 . 46 accelerometer 44 . 51 decreased 45 the 46 accelerometer 46 accelerometer 48 counts 46 accelerometer 49 were 46 accelerometer 51 decreased 47 activity 48 counts 48 counts 49 were 50 significantly 51 decreased 51 decreased 52 after 51 decreased 55 in 51 decreased 57 animals 52 after 54 years 53 seven 54 years 55 in 56 c 57 animals 59 but 58 , 59 but 59 but 60 not 59 but 63 animals 59 but 64 . 62 cr 63 animals conclusions : the results suggest that long - term cr decreases basal metabolic rate , [but] maintains higher physical activity with lower metabolic cost of movements compared with c . objectives : the purpose of this paper was to assess whether statins reduce all - cause mortality and cardiovascular ( cv ) events in elderly people without established cv disease . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 results 2 : 5 suggest 2 : 17 maintains 2 : 45 - 3 the 4 results 4 results 5 suggest 5 suggest 14 rate 6 that 14 rate 7 long 8 - 7 long 9 term 9 term 11 decreases 10 cr 11 decreases 11 decreases 14 rate 12 basal 14 rate 13 metabolic 14 rate 15 , 17 maintains 17 maintains 20 activity 17 maintains 28 with 17 maintains 30 . 18 higher 20 activity 19 physical 20 activity 20 activity 21 with 20 activity 25 of 20 activity 27 compared 21 with 24 cost 22 lower 24 cost 23 metabolic 24 cost 25 of 26 movements 28 with 29 c 30 . 31 objectives 30 . 32 : 32 : 34 purpose 32 : 38 was 33 the 34 purpose 34 purpose 35 of 34 purpose 38 was 35 of 37 paper 36 this 37 paper 38 was 39 to 39 to 40 assess 40 assess 41 whether 41 whether 42 statins 41 whether 43 reduce 42 statins 43 reduce 43 reduce 44 all 45 - 46 cause 46 cause 48 and 47 mortality 48 and 48 and 53 events 48 and 61 . 49 cardiovascular 51 cv 49 cardiovascular 53 events 50 ( 51 cv 51 cv 52 ) 53 events 54 in 54 in 56 people 55 elderly 56 people 56 people 57 without 57 without 60 disease 58 established 60 disease 59 cv 60 disease background : because of population aging , prevention of cv disease in the elderly is relevant . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 17 . 1 background 2 : 2 : 4 of 3 because 4 of 4 of 5 population 5 population 6 aging 7 , 8 prevention 7 , 15 is 8 prevention 9 of 8 prevention 15 is 9 of 11 disease 10 cv 11 disease 11 disease 12 in 12 in 14 elderly 13 the 14 elderly 15 is 16 relevant in elderly patients with previous cv events , the use of statins is recommended by guidelines , whereas the benefits of these drugs in elderly subjects without previous cv events are still debated . 0 ###LEFT-WALL### 10 use 0 ###LEFT-WALL### 14 recommended 0 ###LEFT-WALL### 17 , 0 ###LEFT-WALL### 34 . 1 in 3 patients 1 in 8 , 1 in 10 use 2 elderly 3 patients 3 patients 4 with 4 with 7 events 5 previous 7 events 6 cv 7 events 9 the 10 use 10 use 11 of 10 use 13 is 11 of 12 statins 13 is 14 recommended 14 recommended 15 by 15 by 16 guidelines 17 , 30 events 17 , 33 debated 18 whereas 20 benefits 18 whereas 30 events 19 the 20 benefits 20 benefits 21 of 21 of 23 drugs 22 these 23 drugs 23 drugs 24 in 24 in 26 subjects 25 elderly 26 subjects 26 subjects 27 without 27 without 29 cv 28 previous 29 cv 30 events 31 are 31 are 33 debated 32 still 33 debated methods : randomized trials comparing statins versus placebo and [reporting] all - cause and cv mortality , myocardial infarction ( mi ) , stroke , and new cancer onset in elderly subjects ( age ≥ 65 years [ )(without established cv disease were included . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 2 : 9 and 2 : 12 - 3 randomized 6 statins 4 trials 5 comparing 5 comparing 6 statins 6 statins 7 versus 6 statins 9 and 7 versus 8 placebo 9 and 11 all 12 - 14 and 12 - 23 , 13 cause 14 and 14 and 16 mortality 14 and 17 , 14 and 19 infarction 15 cv 16 mortality 17 , 19 infarction 18 myocardial 19 infarction 19 infarction 21 mi 19 infarction 23 , 20 ( 21 mi 21 mi 22 ) 23 , 26 and 24 stroke 26 and 25 , 26 and 26 and 29 onset 26 and 30 in 27 new 28 cancer 28 cancer 29 onset 30 in 32 subjects 31 elderly 32 subjects 32 subjects 35 ≥ 33 ( 35 ≥ 34 age 35 ≥ 35 ≥ 36 65 35 ≥ 44 included 35 ≥ 45 . 37 years 39 )(without 37 years 42 disease 37 years 44 included 39 )(without 41 cv 40 established 41 cv 42 disease 43 were 43 were 44 included results : eight trials enrolling 24,674 subjects ( 42.7 % females ; mean age 73.0 ± 2.9 years ; mean [follow] up 3.5 ± 1.5 years [ )(were included in analyses . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 12 ; 0 ###LEFT-WALL### 32 . 1 results 2 : 2 : 4 trials 3 eight 4 trials 4 trials 5 enrolling 5 enrolling 7 subjects 6 24,674 7 subjects 7 subjects 11 females 8 ( 11 females 9 42.7 11 females 10 % 11 females 11 females 12 ; 12 ; 13 mean 12 ; 19 ; 13 mean 18 years 14 age 18 years 15 73.0 18 years 16 ± 18 years 17 2.9 18 years 19 ; 26 years 19 ; 29 included 20 mean 26 years 22 up 24 ± 23 3.5 24 ± 24 ± 26 years 25 1.5 26 years 26 years 28 )(were 28 )(were 29 included 29 included 30 in 30 in 31 analyses statins , compared with placebo , significantly reduced the risk of mi by 39.4 % ( relative risk [[] [rr] ] : 0.606 [[] 95 % confidence interval ( ci ) : 0.434 to 0.847 []] [;] p = [0.003] [ )( the risk of stroke by 23.8 % ( rr [:] 0.762 [[] 95 % ci [:] 0.626 to 0.926 []] [;] p = 0.006 ) . 0 ###LEFT-WALL### 1 statins 1 statins 2 , 1 statins 6 , 3 compared 4 with 3 compared 6 , 4 with 5 placebo 6 , 8 reduced 7 significantly 8 reduced 8 reduced 10 risk 9 the 10 risk 10 risk 11 of 10 risk 22 : 11 of 12 mi 12 mi 13 by 12 mi 18 risk 13 by 15 % 14 39.4 15 % 16 ( 18 risk 17 relative 18 risk 18 risk 21 ] 22 : 28 interval 22 : 32 : 23 0.606 27 confidence 25 95 26 % 26 % 27 confidence 27 confidence 28 interval 28 interval 30 ci 28 interval 32 : 29 ( 30 ci 30 ci 31 ) 32 : 34 to 32 : 39 = 33 0.434 34 to 34 to 35 0.847 38 p 39 = 39 = 44 risk 43 the 44 risk 44 risk 45 of 45 of 46 stroke 46 stroke 47 by 46 stroke 57 ci 47 by 49 % 48 23.8 49 % 50 ( 57 ci 51 rr 57 ci 53 0.762 57 ci 55 95 57 ci 56 % 57 ci 57 ci 60 to 57 ci 65 = 57 ci 68 . 59 0.626 60 to 60 to 61 0.926 64 p 65 = 65 = 66 0.006 65 = 67 ) in contrast , the risk of all - cause death [(] [rr] : 0.941 [ 95 % ci : 0.856 to 1.035 ] [;] p = 0.210 [ )( of cv death [(] rr [:] 0.907 [[] 95 % ci [:] 0.686 to 1.199 []] [;] p = 0.493 ) were not [significantly] reduced . 1 in 2 contrast 1 in 10 death 2 contrast 5 risk 3 , 5 risk 4 the 5 risk 5 risk 6 of 5 risk 8 - 6 of 7 all 9 cause 10 death 10 death 13 : 13 : 14 0.941 14 0.941 17 % 14 0.941 26 = 15 [ 17 % 16 95 17 % 17 % 18 ci 17 % 19 : 17 % 23 ] 18 ci 19 : 19 : 21 to 20 0.856 21 to 21 to 22 1.035 25 p 26 = 26 = 27 0.210 27 0.210 30 of 30 of 40 ci 31 cv 32 death 32 death 40 ci 34 rr 40 ci 36 0.907 40 ci 38 95 40 ci 39 % 40 ci 40 ci 42 0.686 40 ci 51 were 42 0.686 43 to 42 0.686 48 = 42 0.686 51 were 43 to 44 1.199 47 p 48 = 48 = 49 0.493 48 = 50 ) 51 were 52 not 52 not 54 reduced 54 reduced 55 . new cancer [onset] did not differ between statin - and placebo - treated subjects ( [rr] [:] 0.989 [ 95 % ci : 0.851 to 1.151 ] [;] p = 0.890 ) . 0 ###LEFT-WALL### 2 cancer 0 ###LEFT-WALL### 6 differ 0 ###LEFT-WALL### 33 . 1 new 2 cancer 2 cancer 4 did 4 did 5 not 4 did 6 differ 6 differ 7 between 7 between 10 and 8 statin 10 and 9 - 10 and 10 and 11 placebo 10 and 14 subjects 12 - 14 subjects 13 treated 14 subjects 14 subjects 18 0.989 14 subjects 30 = 14 subjects 32 ) 15 ( 18 0.989 18 0.989 21 % 18 0.989 27 ] 19 [ 21 % 20 95 21 % 21 % 22 ci 21 % 23 : 21 % 27 ] 22 ci 23 : 23 : 25 to 24 0.851 25 to 25 to 26 1.151 29 p 30 = 30 = 31 0.890 30 = 32 ) conclusions : in elderly subjects at high cv risk without established cv disease , statins significantly reduce the incidence of mi and stroke , but do not significantly prolong survival in the short - term . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 29 prolong 0 ###LEFT-WALL### 36 . 1 conclusions 2 : 2 : 3 in 2 : 6 at 2 : 10 without 3 in 5 subjects 4 elderly 5 subjects 6 at 9 risk 7 high 9 risk 8 cv 9 risk 10 without 13 disease 11 established 13 disease 12 cv 13 disease 14 , 15 statins 14 , 25 but 15 statins 25 but 16 significantly 17 reduce 17 reduce 19 incidence 17 reduce 25 but 18 the 19 incidence 19 incidence 20 of 20 of 22 and 21 mi 22 and 22 and 23 stroke 24 , 25 but 25 but 26 do 26 do 27 not 26 do 29 prolong 28 significantly 29 prolong 29 prolong 30 survival 30 survival 31 in 31 in 35 term 32 the 35 term 33 short 34 - 33 short 35 term in this study we compared pittsburgh compound - [b] ( pib ) positron emission tomography [(] pet [ )(amyloid imaging [,] fluorodeoxyglucose pet for metabolism , and magnetic resonance imaging ( mri ) for structure to predict conversion from amnestic mild cognitive impairment ( mci ) to alzheimer 's dementia using data from the alzheimer 's disease neuroimaging initiative cohort [.] 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 5 compared 0 ###LEFT-WALL### 8 - 1 in 3 study 1 in 4 we 2 this 3 study 4 we 5 compared 5 compared 7 compound 6 pittsburgh 7 compound 8 - 17 pet 8 - 19 )(amyloid 10 ( 11 pib 11 pib 12 ) 11 pib 17 pet 13 positron 14 emission 14 emission 15 tomography 15 tomography 17 pet 17 pet 19 )(amyloid 19 )(amyloid 23 pet 20 imaging 22 fluorodeoxyglucose 22 fluorodeoxyglucose 23 pet 23 pet 24 for 23 pet 34 for 24 for 27 and 25 metabolism 27 and 26 , 27 and 27 and 30 imaging 27 and 32 mri 28 magnetic 30 imaging 29 resonance 30 imaging 31 ( 32 mri 32 mri 33 ) 34 for 35 structure 35 structure 36 to 35 structure 37 predict 36 to 37 predict 37 predict 38 conversion 37 predict 47 to 38 conversion 39 from 39 from 43 impairment 40 amnestic 43 impairment 41 mild 43 impairment 42 cognitive 43 impairment 43 impairment 45 mci 44 ( 45 mci 45 mci 46 ) 47 to 50 dementia 48 alzheimer 49 's 49 's 50 dementia 50 dementia 51 using 51 using 52 data 52 data 53 from 53 from 60 cohort 54 the 55 alzheimer 55 alzheimer 56 's 56 's 60 cohort 57 disease 58 neuroimaging 58 neuroimaging 59 initiative 59 initiative 60 cohort numeric neuroimaging variables generated by the alzheimer 's disease neuroimaging initiative - funded laboratories for each neuroimaging modality along with apolipoprotein - e [genotype] ( n = 29 ) were analyzed . 0 ###LEFT-WALL### 3 variables 0 ###LEFT-WALL### 31 analyzed 0 ###LEFT-WALL### 32 . 1 numeric 3 variables 2 neuroimaging 3 variables 3 variables 4 generated 3 variables 30 were 4 generated 5 by 5 by 11 initiative 6 the 7 alzheimer 7 alzheimer 8 's 8 's 11 initiative 9 disease 10 neuroimaging 10 neuroimaging 11 initiative 11 initiative 14 laboratories 11 initiative 27 = 12 - 14 laboratories 13 funded 14 laboratories 14 laboratories 15 for 14 laboratories 20 with 14 laboratories 22 - 15 for 18 modality 16 each 18 modality 17 neuroimaging 18 modality 19 along 20 with 20 with 21 apolipoprotein 23 e 27 = 25 ( 27 = 26 n 27 = 27 = 28 29 27 = 29 ) 30 were 31 analyzed performance of these biomarkers for predicting conversion from mci to alzheimer 's dementia at 2 years was evaluated in 50 late amnestic [mci] subjects , 20 [of] [whom] converted . 0 ###LEFT-WALL### 13 dementia 0 ###LEFT-WALL### 18 evaluated 0 ###LEFT-WALL### 25 , 0 ###LEFT-WALL### 30 . 1 performance 13 dementia 2 of 4 biomarkers 2 of 13 dementia 3 these 4 biomarkers 4 biomarkers 5 for 5 for 6 predicting 6 predicting 7 conversion 7 conversion 8 from 7 conversion 10 to 8 from 9 mci 10 to 12 's 11 alzheimer 12 's 13 dementia 14 at 13 dementia 17 was 14 at 16 years 15 2 16 years 17 was 18 evaluated 18 evaluated 19 in 19 in 24 subjects 20 50 24 subjects 21 late 24 subjects 22 amnestic 24 subjects 25 , 26 20 25 , 29 converted 26 20 29 converted multivariate modeling found that among individual modalities , mri had the highest predictive accuracy ( 67 % ) [which] increased by 9 % to 76 % when combined with pib - pet , producing the highest accuracy among any biomarker combination . 0 ###LEFT-WALL### 2 modeling 0 ###LEFT-WALL### 3 found 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 42 . 1 multivariate 2 modeling 2 modeling 3 found 3 found 4 that 3 found 5 among 5 among 7 modalities 6 individual 7 modalities 8 , 9 mri 8 , 20 increased 9 mri 10 had 10 had 14 accuracy 10 had 20 increased 11 the 12 highest 11 the 14 accuracy 13 predictive 14 accuracy 14 accuracy 17 % 15 ( 17 % 16 67 17 % 17 % 18 ) 20 increased 21 by 20 increased 24 to 20 increased 27 when 21 by 23 % 22 9 23 % 24 to 26 % 25 76 26 % 27 when 28 combined 28 combined 29 with 28 combined 38 among 29 with 32 pet 29 with 34 producing 30 pib 32 pet 31 - 32 pet 32 pet 33 , 34 producing 37 accuracy 35 the 36 highest 35 the 37 accuracy 38 among 41 combination 39 any 41 combination 40 biomarker 41 combination individually , pib - pet generated the best sensitivity , and fluorodeoxyglucose pet had the lowest . 0 ###LEFT-WALL### 5 pet 0 ###LEFT-WALL### 6 generated 0 ###LEFT-WALL### 11 and 0 ###LEFT-WALL### 17 . 1 individually 2 , 1 individually 5 pet 3 pib 5 pet 4 - 5 pet 5 pet 6 generated 6 generated 9 sensitivity 7 the 8 best 7 the 9 sensitivity 10 , 11 and 11 and 13 pet 11 and 14 had 12 fluorodeoxyglucose 13 pet 13 pet 14 had 14 had 16 lowest 15 the 16 lowest among individual brain regions , the temporal cortex was found to be most predictive for mri and pib - pet . 0 ###LEFT-WALL### 8 cortex 0 ###LEFT-WALL### 10 found 1 among 4 regions 1 among 5 , 1 among 8 cortex 2 individual 4 regions 3 brain 4 regions 6 the 8 cortex 7 temporal 8 cortex 8 cortex 9 was 9 was 10 found 10 found 11 to 10 found 15 for 11 to 12 be 12 be 14 predictive 13 most 14 predictive 15 for 17 and 16 mri 17 and 17 and 20 pet 18 pib 20 pet 19 - 20 pet 20 pet 21 . the sod1 gene encoding the superoxide dismutase 1 ( sod1 ) [protein] is mutated in approximately 15 % of familial amyotrophic lateral sclerosis ( als ) and 3 % [of] sporadic als . 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 33 . 1 the 3 gene 2 sod1 3 gene 3 gene 4 encoding 3 gene 14 mutated 3 gene 27 and 4 encoding 6 superoxide 5 the 6 superoxide 6 superoxide 7 dismutase 6 superoxide 13 is 7 dismutase 8 1 7 dismutase 10 sod1 7 dismutase 13 is 9 ( 10 sod1 10 sod1 11 ) 14 mutated 15 in 15 in 18 % 16 approximately 17 15 17 15 18 % 18 % 19 of 19 of 23 sclerosis 20 familial 23 sclerosis 21 amyotrophic 23 sclerosis 22 lateral 23 sclerosis 23 sclerosis 25 als 24 ( 25 als 25 als 26 ) 27 and 32 als 28 3 32 als 29 % 32 als 31 sporadic 32 als we identified a novel mutation in sod1 in a man who presented at age 49 with lower limb stiffness , and at age 53 , a spastic paraparesia with distal muscular atrophy in the lower limbs and fasciculations in the quadriceps . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 identified 0 ###LEFT-WALL### 42 . 1 we 2 identified 2 identified 5 mutation 2 identified 6 in 2 identified 8 in 2 identified 21 and 2 identified 39 in 3 a 4 novel 3 a 5 mutation 4 novel 5 mutation 6 in 7 sod1 8 in 10 man 9 a 10 man 10 man 11 who 10 man 12 presented 11 who 12 presented 12 presented 13 at 12 presented 15 49 13 at 14 age 16 with 19 stiffness 16 with 21 and 17 lower 18 limb 18 limb 19 stiffness 20 , 21 and 21 and 22 at 22 at 37 and 23 age 24 53 23 age 25 , 25 , 28 paraparesia 25 , 37 and 26 a 28 paraparesia 27 spastic 28 paraparesia 28 paraparesia 29 with 29 with 32 atrophy 30 distal 32 atrophy 31 muscular 32 atrophy 32 atrophy 33 in 33 in 36 limbs 34 the 36 limbs 35 lower 36 limbs 37 and 38 fasciculations 39 in 41 quadriceps 40 the 41 quadriceps a diagnosis of als was established . 0 ###LEFT-WALL### 2 diagnosis 0 ###LEFT-WALL### 6 established 0 ###LEFT-WALL### 7 . 1 a 2 diagnosis 2 diagnosis 3 of 2 diagnosis 5 was 3 of 4 als 5 was 6 established eleven years after disease onset [his] condition continues gradually and slowly to deteriorate . 0 ###LEFT-WALL### 2 years 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 14 . 1 eleven 2 years 2 years 3 after 2 years 10 and 3 after 7 condition 4 disease 7 condition 5 onset 7 condition 8 continues 9 gradually 8 continues 10 and 10 and 12 to 10 and 13 deteriorate 11 slowly 12 to 12 to 13 deteriorate the heterozygous mutation observed in exon 2 resulted in a valine to alanine substitution at [position] 31 in the β - barrel domain of the sod1 protein . 0 ###LEFT-WALL### 3 mutation 0 ###LEFT-WALL### 8 resulted 0 ###LEFT-WALL### 28 . 1 the 3 mutation 2 heterozygous 3 mutation 3 mutation 4 observed 3 mutation 8 resulted 4 observed 5 in 5 in 6 exon 6 exon 7 2 8 resulted 9 in 8 resulted 12 to 8 resulted 15 at 8 resulted 18 in 9 in 11 valine 10 a 11 valine 12 to 14 substitution 13 alanine 14 substitution 15 at 17 31 18 in 23 domain 19 the 23 domain 20 β 21 - 20 β 22 barrel 22 barrel 23 domain 23 domain 24 of 24 of 27 protein 25 the 27 protein 26 sod1 27 protein functional analysis in nsc34 cells showed that the overexpression of the mutant form of sod1 ( v31a ) induced aggregates and decreased cell viability . 0 ###LEFT-WALL### 2 analysis 0 ###LEFT-WALL### 6 showed 0 ###LEFT-WALL### 25 . 1 functional 2 analysis 2 analysis 3 in 2 analysis 6 showed 3 in 5 cells 4 nsc34 5 cells 6 showed 7 that 6 showed 9 overexpression 6 showed 21 and 8 the 9 overexpression 9 overexpression 10 of 9 overexpression 21 and 10 of 13 form 11 the 13 form 12 mutant 13 form 13 form 14 of 13 form 19 induced 14 of 15 sod1 15 sod1 17 v31a 16 ( 17 v31a 17 v31a 18 ) 20 aggregates 21 and 21 and 22 decreased 21 and 24 viability 23 cell 24 viability this mutation is located outside of the regions carrying most of the als - related mutations ( i.e [.] , the catalytic center , the region of dimerization , and [the] loops between the β - strands of the β - barrel ) . 0 ###LEFT-WALL### 2 mutation 0 ###LEFT-WALL### 30 and 0 ###LEFT-WALL### 44 . 1 this 2 mutation 2 mutation 30 and 3 is 4 located 3 is 30 and 4 located 6 of 5 outside 6 of 6 of 8 regions 7 the 8 regions 8 regions 9 carrying 8 regions 11 of 8 regions 16 mutations 9 carrying 10 most 11 of 13 als 12 the 13 als 14 - 16 mutations 15 related 16 mutations 16 mutations 18 i.e 16 mutations 26 region 16 mutations 29 , 17 ( 18 i.e 18 i.e 23 center 18 i.e 24 , 20 , 23 center 21 the 23 center 22 catalytic 23 center 23 center 24 , 24 , 26 region 25 the 26 region 26 region 27 of 26 region 29 , 27 of 28 dimerization 29 , 30 and 30 and 32 loops 30 and 33 between 33 between 35 β 34 the 35 β 35 β 37 strands 36 - 37 strands 37 strands 38 of 37 strands 43 ) 38 of 42 barrel 39 the 42 barrel 40 β 41 - 40 β 42 barrel in conclusion , we identified a novel sod1 mutation in a patient with slow disease progression and supported the idea that different sod1 mutations can lead to distinct als phenotypes . 0 ###LEFT-WALL### 2 conclusion 0 ###LEFT-WALL### 3 , 0 ###LEFT-WALL### 31 . 1 in 2 conclusion 3 , 4 we 3 , 17 and 4 we 17 and 5 identified 9 mutation 5 identified 10 in 5 identified 13 with 5 identified 17 and 6 a 9 mutation 7 novel 9 mutation 8 sod1 9 mutation 10 in 12 patient 11 a 12 patient 13 with 16 progression 14 slow 15 disease 15 disease 16 progression 17 and 18 supported 18 supported 20 idea 19 the 20 idea 20 idea 21 that 20 idea 30 phenotypes 21 that 23 sod1 21 that 30 phenotypes 22 different 23 sod1 23 sod1 24 mutations 23 sod1 26 lead 23 sod1 30 phenotypes 24 mutations 25 can 25 can 26 lead 26 lead 27 to 27 to 29 als 28 distinct 29 als accumulation of the transactive response dna - binding protein 43 ( tdp - 43 ) is a major hallmark of several neurodegenerative disorders , collectively known as tdp - 43 proteinopathies . 0 ###LEFT-WALL### 1 accumulation 0 ###LEFT-WALL### 16 is 1 accumulation 2 of 1 accumulation 8 binding 1 accumulation 16 is 2 of 6 dna 3 the 6 dna 4 transactive 6 dna 5 response 6 dna 7 - 8 binding 8 binding 9 protein 8 binding 15 ) 9 protein 10 43 9 protein 12 tdp 11 ( 12 tdp 12 tdp 14 43 12 tdp 15 ) 13 - 14 43 14 43 15 ) 16 is 19 hallmark 16 is 26 known 17 a 18 major 17 a 19 hallmark 18 major 19 hallmark 19 hallmark 20 of 20 of 23 disorders 21 several 23 disorders 22 neurodegenerative 23 disorders 24 , 26 known 25 collectively 26 known 26 known 27 as 26 known 32 . 27 as 28 tdp 28 tdp 31 proteinopathies 29 - 31 proteinopathies 30 43 31 proteinopathies 31 proteinopathies 32 . the most common tdp - 43 proteinopathies , frontotemporal lobar degeneration with tdp - 43 - positive inclusions , and amyotrophic lateral sclerosis , share overlapping neuropathological and clinical phenotypes . 0 ###LEFT-WALL### 4 tdp 0 ###LEFT-WALL### 5 - 1 the 2 most 2 most 4 tdp 3 common 4 tdp 5 - 7 proteinopathies 5 - 16 - 6 43 7 proteinopathies 7 proteinopathies 11 degeneration 7 proteinopathies 15 43 8 , 11 degeneration 9 frontotemporal 11 degeneration 10 lobar 11 degeneration 11 degeneration 12 with 11 degeneration 14 - 12 with 13 tdp 14 - 15 43 15 43 16 - 16 - 20 and 16 - 31 . 17 positive 18 inclusions 18 inclusions 20 and 19 , 20 and 20 and 23 sclerosis 20 and 24 , 20 and 25 share 20 and 30 phenotypes 21 amyotrophic 23 sclerosis 22 lateral 23 sclerosis 25 share 26 overlapping 25 share 30 phenotypes 26 overlapping 28 and 27 neuropathological 28 and 28 and 29 clinical the development and detailed analysis of animal models of tdp - 43 proteinopathies are critical for understanding the pathogenesis of these disorders . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 23 . 1 the 2 development 2 development 3 and 3 and 5 analysis 3 and 6 of 3 and 9 of 3 and 13 proteinopathies 3 and 17 understanding 4 detailed 5 analysis 6 of 8 models 7 animal 8 models 9 of 10 tdp 11 - 12 43 12 43 13 proteinopathies 13 proteinopathies 14 are 14 are 15 critical 15 critical 16 for 16 for 17 understanding 17 understanding 19 pathogenesis 18 the 19 pathogenesis 19 pathogenesis 20 of 20 of 22 disorders 21 these 22 disorders transgenic mice overexpressing mutant human tdp - 43 ( herein referred to as htdp - 43 ) are characterized by neurodegeneration and reduced life span . 0 ###LEFT-WALL### 2 mice 0 ###LEFT-WALL### 19 characterized 0 ###LEFT-WALL### 26 . 1 transgenic 2 mice 2 mice 3 overexpressing 2 mice 8 43 2 mice 18 are 3 overexpressing 6 tdp 4 mutant 6 tdp 5 human 6 tdp 7 - 8 43 8 43 10 herein 8 43 17 ) 9 ( 10 herein 10 herein 12 to 10 herein 17 ) 11 referred 12 to 12 to 13 as 13 as 14 htdp 14 htdp 16 43 15 - 16 43 16 43 17 ) 18 are 19 characterized 19 characterized 20 by 20 by 22 and 21 neurodegeneration 22 and 22 and 25 span 23 reduced 24 life 24 life 25 span however , little is known about the behavioral phenotype of these mice . 0 ###LEFT-WALL### 3 little 0 ###LEFT-WALL### 5 known 0 ###LEFT-WALL### 13 . 1 however 2 , 1 however 3 little 3 little 4 is 4 is 5 known 5 known 6 about 6 about 9 phenotype 7 the 9 phenotype 8 behavioral 9 phenotype 9 phenotype 10 of 10 of 12 mice 11 these 12 mice here we report the novel finding that htdp - 43 mice develop deficits in cognition , motor performance , and coordination . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 3 report 0 ###LEFT-WALL### 22 . 1 here 2 we 2 we 3 report 3 report 6 finding 3 report 14 in 4 the 6 finding 5 novel 6 finding 6 finding 7 that 7 that 11 mice 7 that 12 develop 8 htdp 9 - 8 htdp 11 mice 10 43 11 mice 11 mice 12 develop 12 develop 13 deficits 14 in 20 and 15 cognition 16 , 16 , 18 performance 16 , 20 and 17 motor 18 performance 19 , 20 and 20 and 21 coordination we show that these behavioral deficits are associated with the accumulation of nuclear and cytosolic tdp - 43 [c] - terminal fragments , a decrease in endogenous tdp - 43 levels , and synaptic loss . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 show 0 ###LEFT-WALL### 20 - 0 ###LEFT-WALL### 36 . 1 we 2 show 2 show 3 that 3 that 6 deficits 3 that 8 associated 4 these 6 deficits 5 behavioral 6 deficits 6 deficits 7 are 7 are 8 associated 8 associated 9 with 9 with 11 accumulation 10 the 11 accumulation 11 accumulation 12 of 12 of 16 tdp 13 nuclear 14 and 14 and 15 cytosolic 14 and 16 tdp 16 tdp 18 43 17 - 18 43 18 43 20 - 20 - 33 and 21 terminal 22 fragments 22 fragments 23 , 23 , 25 decrease 23 , 33 and 24 a 25 decrease 25 decrease 26 in 26 in 28 tdp 27 endogenous 28 tdp 28 tdp 31 levels 29 - 31 levels 30 43 31 levels 31 levels 32 , 33 and 35 loss 34 synaptic 35 loss our findings provide critical insights into disease pathology , and will help guide future preclinical studies aimed at testing the effects of potential therapeutic agents on the onset and progression of tdp - 43 proteinopathies . 0 ###LEFT-WALL### 2 findings 0 ###LEFT-WALL### 10 and 1 our 2 findings 2 findings 10 and 3 provide 5 insights 3 provide 10 and 4 critical 5 insights 5 insights 6 into 6 into 8 pathology 7 disease 8 pathology 9 , 10 and 10 and 11 will 11 will 12 help 12 help 13 guide 13 guide 16 studies 13 guide 18 at 13 guide 26 on 14 future 16 studies 15 preclinical 16 studies 16 studies 17 aimed 18 at 19 testing 19 testing 21 effects 20 the 21 effects 21 effects 22 of 22 of 25 agents 23 potential 25 agents 24 therapeutic 25 agents 26 on 29 and 27 the 28 onset 28 onset 29 and 29 and 30 progression 29 and 31 of 31 of 32 tdp 32 tdp 35 proteinopathies 33 - 35 proteinopathies 34 43 35 proteinopathies 35 proteinopathies 36 . objective : sleep problems may adversely affect neuronal health . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 10 . 1 objective 2 : 2 : 3 sleep 3 sleep 4 problems 3 sleep 7 affect 4 problems 5 may 5 may 7 affect 6 adversely 7 affect 7 affect 9 health 8 neuronal 9 health we examined a subjective report of change ( reduced duration [and/or] depth ) in sleep [pattern] in relation to subsequent risk of incident all [-] cause dementia and alzheimer disease ( ad ) over 9 years . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 examined 0 ###LEFT-WALL### 37 . 1 we 2 examined 2 examined 5 report 2 examined 14 in 2 examined 19 to 3 a 5 report 4 subjective 5 report 5 report 6 of 5 report 12 depth 6 of 7 change 8 ( 12 depth 9 reduced 10 duration 10 duration 12 depth 12 depth 13 ) 14 in 15 sleep 17 in 18 relation 18 relation 19 to 19 to 21 risk 20 subsequent 21 risk 21 risk 22 of 21 risk 34 over 22 of 30 disease 23 incident 30 disease 24 all 27 dementia 26 cause 27 dementia 27 dementia 28 and 28 and 29 alzheimer 28 and 30 disease 30 disease 32 ad 31 ( 32 ad 32 ad 33 ) 34 over 36 years 35 9 36 years methods : this longitudinal study used data from a population [-] based sample of 214 swedish adults aged 75 and over who were dementia - free both at baseline and at first follow [-] up ( 3 years later ) . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 25 - 0 ###LEFT-WALL### 41 . 1 methods 2 : 2 : 7 data 2 : 20 and 3 this 4 longitudinal 4 longitudinal 5 study 5 study 6 used 6 used 7 data 8 from 13 sample 8 from 20 and 9 a 13 sample 10 population 12 based 12 based 13 sample 13 sample 14 of 14 of 17 adults 15 214 17 adults 16 swedish 17 adults 17 adults 18 aged 18 aged 19 75 20 and 21 over 21 over 22 who 22 who 23 were 23 were 24 dementia 25 - 30 and 26 free 27 both 26 free 28 at 26 free 30 and 28 at 29 baseline 30 and 33 follow 31 at 32 first 32 first 33 follow 33 follow 35 up 33 follow 39 later 36 ( 39 later 37 3 38 years 38 years 39 later 39 later 40 ) the sample was 80 % [female] and , on average , 83.4 years [of] age at baseline . 0 ###LEFT-WALL### 2 sample 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 7 and 0 ###LEFT-WALL### 18 . 1 the 2 sample 2 sample 3 was 3 was 5 % 4 80 5 % 7 and 8 , 7 and 13 years 7 and 15 age 9 on 10 average 10 average 11 , 10 average 13 years 12 83.4 13 years 13 years 15 age 15 age 16 at 16 at 17 baseline all participants underwent a thorough clinical examination to ascertain all - cause dementia and ad . 0 ###LEFT-WALL### 2 participants 0 ###LEFT-WALL### 3 underwent 0 ###LEFT-WALL### 11 - 1 all 2 participants 2 participants 3 underwent 3 underwent 7 examination 3 underwent 8 to 4 a 5 thorough 4 a 7 examination 5 thorough 7 examination 6 clinical 7 examination 8 to 9 ascertain 9 ascertain 10 all 11 - 14 and 11 - 16 . 12 cause 13 dementia 13 dementia 14 and 14 and 15 ad results : forty percent of participants reported a change in sleep duration at baseline . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 4 percent 2 : 7 reported 2 : 15 . 3 forty 4 percent 4 percent 5 of 4 percent 7 reported 5 of 6 participants 7 reported 9 change 7 reported 10 in 7 reported 13 at 8 a 9 change 10 in 12 duration 11 sleep 12 duration 13 at 14 baseline between the 6th and 9th year after baseline , 28.5 % were diagnosed with all - cause dementia , 22.0 % [of] [whom] had ad . 0 ###LEFT-WALL### 21 % 0 ###LEFT-WALL### 24 had 0 ###LEFT-WALL### 26 . 1 between 6 year 1 between 19 , 1 between 21 % 2 the 6 year 3 6th 4 and 4 and 5 9th 4 and 6 year 6 year 11 % 6 year 13 diagnosed 6 year 18 dementia 7 after 8 baseline 7 after 9 , 7 after 11 % 10 28.5 11 % 11 % 12 were 12 were 13 diagnosed 13 diagnosed 14 with 14 with 15 all 16 - 18 dementia 17 cause 18 dementia 18 dementia 19 , 20 22.0 21 % 21 % 24 had 24 had 25 ad reduced sleep was associated with [a] 75 % increased all - cause dementia risk ( hazard ratio : 1.75 ; 95 % confidence interval : 1.04 - 2.93 ; wald = 4.55 , df = 1 , p = 0.035 ) and [double] the risk of ad [(] hazard ratio : 2.01 [;] 95 % confidence interval : 1.12 - 3.61 [;] wald = 5.47 [,] df = 1 , p = 0.019 ) after adjusting for age , gender , and education . 0 ###LEFT-WALL### 2 sleep 0 ###LEFT-WALL### 11 - 1 reduced 2 sleep 2 sleep 3 was 3 was 4 associated 4 associated 5 with 5 with 8 % 5 with 10 all 7 75 8 % 8 % 9 increased 11 - 12 cause 11 - 18 : 12 cause 14 risk 13 dementia 14 risk 14 risk 17 ratio 15 ( 17 ratio 16 hazard 17 ratio 17 ratio 18 : 18 : 19 1.75 18 : 20 ; 20 ; 24 interval 20 ; 27 - 21 95 24 interval 22 % 23 confidence 23 confidence 24 interval 24 interval 25 : 25 : 26 1.04 27 - 28 2.93 27 - 29 ; 29 ; 30 wald 29 ; 31 = 29 ; 33 , 30 wald 31 = 31 = 32 4.55 33 , 34 df 33 , 35 = 33 , 42 and 34 df 35 = 35 = 36 1 35 = 39 = 37 , 39 = 38 p 39 = 39 = 40 0.035 39 = 41 ) 42 and 45 risk 44 the 45 risk 45 risk 46 of 45 risk 51 : 46 of 50 ratio 47 ad 49 hazard 49 hazard 50 ratio 51 : 57 interval 51 : 58 : 52 2.01 56 confidence 54 95 55 % 55 % 56 confidence 56 confidence 57 interval 58 : 63 wald 58 : 64 = 59 1.12 60 - 60 - 61 3.61 60 - 63 wald 63 wald 64 = 64 = 65 5.47 65 5.47 67 df 65 5.47 76 adjusting 67 df 68 = 68 = 69 1 68 = 75 after 69 1 72 = 70 , 72 = 71 p 72 = 72 = 73 0.019 72 = 74 ) 75 after 76 adjusting 76 adjusting 77 for 77 for 78 age 78 age 82 and 79 , 82 and 80 gender 82 and 81 , 82 and 82 and 83 education 82 and 84 . the results remained after adjusting for lifestyle and vascular factors but not after adjusting for depressive symptoms . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 remained 0 ###LEFT-WALL### 18 . 1 the 2 results 2 results 3 remained 3 remained 4 after 3 remained 11 but 3 remained 15 for 4 after 5 adjusting 6 for 8 and 6 for 11 but 7 lifestyle 8 and 8 and 10 factors 9 vascular 10 factors 11 but 12 not 11 but 13 after 13 after 14 adjusting 15 for 17 symptoms 16 depressive 17 symptoms no evidence supported a moderating effect of the use of sleeping pills , and the sleep - dementia [relationship] remained after controlling for the presence of the apolipoprotein e ε4 allele . 0 ###LEFT-WALL### 2 evidence 0 ###LEFT-WALL### 3 supported 0 ###LEFT-WALL### 17 - 1 no 2 evidence 2 evidence 3 supported 3 supported 6 effect 4 a 6 effect 5 moderating 6 effect 6 effect 7 of 7 of 9 use 8 the 9 use 9 use 10 of 10 of 14 and 11 sleeping 12 pills 12 pills 14 and 13 , 14 and 14 and 16 sleep 15 the 16 sleep 17 - 18 dementia 17 - 20 remained 17 - 32 . 18 dementia 20 remained 20 remained 21 after 21 after 22 controlling 22 controlling 23 for 22 controlling 31 allele 23 for 25 presence 24 the 25 presence 25 presence 26 of 26 of 30 ε4 27 the 30 ε4 28 apolipoprotein 29 e 28 apolipoprotein 30 ε4 conclusion : self - reported sleep problems may increase the risk for dementia , and depressive symptoms may explain this relationship . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 2 : 3 self 2 : 15 and 3 self 8 may 4 - 5 reported 5 reported 7 problems 5 reported 8 may 6 sleep 7 problems 8 may 15 and 9 increase 11 risk 9 increase 15 and 10 the 11 risk 11 risk 12 for 12 for 13 dementia 14 , 15 and 15 and 19 explain 16 depressive 17 symptoms 17 symptoms 18 may 18 may 19 explain 19 explain 21 relationship 20 this 21 relationship future research should determine whether treatment , in particular , behavioral or nonpharmacologic treatment , may represent one avenue toward reduction of dementia risk in late life . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 determine 0 ###LEFT-WALL### 28 . 1 future 2 research 2 research 3 should 3 should 4 determine 4 determine 5 whether 5 whether 6 treatment 5 whether 17 represent 6 treatment 9 particular 6 treatment 14 treatment 6 treatment 16 may 7 , 9 particular 8 in 9 particular 9 particular 10 , 10 , 14 treatment 11 behavioral 12 or 12 or 13 nonpharmacologic 12 or 14 treatment 14 treatment 15 , 16 may 17 represent 17 represent 19 avenue 17 represent 20 toward 17 represent 25 in 18 one 19 avenue 20 toward 21 reduction 21 reduction 22 of 22 of 24 risk 23 dementia 24 risk 25 in 27 life 26 late 27 life objectives : financial strain , defined as inadequate income to cover basic needs , is related to depression in minority populations . 0 ###LEFT-WALL### 1 objectives 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 5 , 0 ###LEFT-WALL### 16 related 0 ###LEFT-WALL### 22 . 1 objectives 2 : 2 : 4 strain 3 financial 4 strain 5 , 14 , 6 defined 9 income 6 defined 10 to 6 defined 14 , 7 as 8 inadequate 8 inadequate 9 income 10 to 11 cover 11 cover 13 needs 12 basic 13 needs 14 , 15 is 15 is 16 related 16 related 17 to 16 related 19 in 17 to 18 depression 19 in 21 populations 20 minority 21 populations it is unclear whether interventions can improve depression in those reporting financial strain . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 14 . 1 it 2 is 2 is 3 unclear 3 unclear 4 whether 4 whether 5 interventions 4 whether 7 improve 5 interventions 6 can 6 can 7 improve 7 improve 8 depression 7 improve 9 in 9 in 10 those 10 those 11 reporting 11 reporting 13 strain 12 financial 13 strain design : randomized controlled trial . 0 ###LEFT-WALL### 1 design 0 ###LEFT-WALL### 2 : 2 : 5 trial 2 : 6 . 3 randomized 5 trial 4 controlled 5 trial setting : philadelphia senior center . 0 ###LEFT-WALL### 1 setting 0 ###LEFT-WALL### 2 : 2 : 5 center 2 : 6 . 3 philadelphia 5 center 4 senior 5 center participants : a total of 208 african [-] american adults 55 years of age and older with mild [to] severe depressive symptoms . 0 ###LEFT-WALL### 1 participants 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 23 . 1 participants 2 : 2 : 4 total 3 a 4 total 4 total 5 of 5 of 10 adults 6 208 7 african 7 african 10 adults 9 american 10 adults 10 adults 11 55 10 adults 15 and 12 years 13 of 12 years 15 and 13 of 14 age 15 and 16 older 15 and 17 with 17 with 22 symptoms 18 mild 22 symptoms 20 severe 22 symptoms 21 depressive 22 symptoms measurements : beat the blues ( btb ) depression intervention , which includes care management , referral/linkage , stress reduction , depression education , and behavioral activation . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 28 . 1 measurements 2 : 2 : 18 , 3 beat 10 intervention 3 beat 17 referral/linkage 3 beat 18 , 4 the 10 intervention 5 blues 7 btb 6 ( 7 btb 7 btb 8 ) 7 btb 10 intervention 9 depression 10 intervention 10 intervention 12 which 11 , 12 which 12 which 13 includes 12 which 16 , 13 includes 15 management 14 care 15 management 18 , 19 stress 19 stress 25 and 20 reduction 21 , 21 , 23 education 21 , 25 and 22 depression 23 education 24 , 25 and 25 and 27 activation 26 behavioral 27 activation measurements included responses to the patient health questionnaire - 9 , financial strain , and age . 0 ###LEFT-WALL### 1 measurements 0 ###LEFT-WALL### 15 and 0 ###LEFT-WALL### 17 . 1 measurements 15 and 2 included 3 responses 2 included 4 to 2 included 15 and 4 to 8 questionnaire 5 the 8 questionnaire 6 patient 7 health 7 health 8 questionnaire 8 questionnaire 10 9 8 questionnaire 13 strain 9 - 10 9 10 9 11 , 11 , 13 strain 12 financial 13 strain 13 strain 14 , 15 and 16 age results : although financial strain was related to depressive symptoms at baseline , participants receiving btb at all levels of financial strain showed reduced depressive symptoms compared with a waitlist control group at 4 months . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 36 . 2 : 14 participants 2 : 23 showed 3 although 5 strain 3 although 7 related 3 although 14 participants 4 financial 5 strain 5 strain 6 was 6 was 7 related 8 to 10 symptoms 8 to 14 participants 9 depressive 10 symptoms 11 at 12 baseline 11 at 13 , 11 at 14 participants 14 participants 15 receiving 14 participants 23 showed 15 receiving 16 btb 15 receiving 17 at 17 at 19 levels 18 all 19 levels 19 levels 20 of 20 of 22 strain 21 financial 22 strain 23 showed 26 symptoms 24 reduced 26 symptoms 25 depressive 26 symptoms 26 symptoms 27 compared 26 symptoms 33 at 27 compared 28 with 28 with 32 group 29 a 30 waitlist 29 a 32 group 30 waitlist 31 control 31 control 32 group 33 at 35 months 34 4 35 months btb participants reporting financial strain had a mean ( standard deviation ) decrease of 6.4 ( 0.85 ) points on the patient health questionnaire - 9 , reflecting a clinically meaningful improvement . 0 ###LEFT-WALL### 1 btb 0 ###LEFT-WALL### 19 points 1 btb 2 participants 1 btb 13 decrease 1 btb 14 of 1 btb 19 points 2 participants 3 reporting 2 participants 13 decrease 3 reporting 5 strain 3 reporting 6 had 4 financial 5 strain 5 strain 6 had 6 had 8 mean 7 a 8 mean 8 mean 11 deviation 9 ( 11 deviation 10 standard 11 deviation 11 deviation 12 ) 14 of 15 6.4 15 6.4 17 0.85 16 ( 17 0.85 17 0.85 18 ) 19 points 20 on 19 points 24 questionnaire 19 points 28 reflecting 21 the 24 questionnaire 22 patient 23 health 23 health 24 questionnaire 24 questionnaire 26 9 25 - 26 9 26 9 27 , 27 , 28 reflecting 28 reflecting 32 improvement 28 reflecting 33 . 29 a 30 clinically 29 a 32 improvement 30 clinically 31 meaningful 31 meaningful 32 improvement conclusions : this nonpharmacologic intervention reduced depressive symptoms in both african [-] american subjects [with] and without financial strain . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 20 . 1 conclusions 2 : 2 : 8 symptoms 3 this 4 nonpharmacologic 4 nonpharmacologic 5 intervention 5 intervention 6 reduced 6 reduced 8 symptoms 7 depressive 8 symptoms 8 symptoms 16 and 9 in 14 subjects 9 in 16 and 10 both 14 subjects 11 african 14 subjects 13 american 14 subjects 16 and 17 without 17 without 19 strain 18 financial 19 strain however , screening for [and] helping people manage financial strain may boost the magnitude of intervention [benefit] for those with financial strain and should be explored as part of depression care . 0 ###LEFT-WALL### 3 screening 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 32 . 1 however 2 , 1 however 3 screening 3 screening 4 for 3 screening 23 and 4 for 6 helping 6 helping 7 people 6 helping 8 manage 8 manage 10 strain 9 financial 10 strain 11 may 12 boost 11 may 23 and 12 boost 16 intervention 12 boost 18 for 12 boost 20 with 13 the 14 magnitude 14 magnitude 15 of 14 magnitude 16 intervention 15 of 16 intervention 18 for 19 those 20 with 22 strain 21 financial 22 strain 23 and 24 should 23 and 27 as 23 and 31 care 24 should 25 be 25 be 26 explored 27 as 30 depression 28 part 29 of 28 part 30 depression 29 of 30 depression genomic instability is recognized as one of the primary mechanisms that lead to organismal aging . 0 ###LEFT-WALL### 2 instability 0 ###LEFT-WALL### 4 recognized 0 ###LEFT-WALL### 16 . 1 genomic 2 instability 2 instability 3 is 3 is 4 recognized 4 recognized 5 as 5 as 6 one 6 one 7 of 7 of 10 mechanisms 8 the 10 mechanisms 9 primary 10 mechanisms 10 mechanisms 11 that 10 mechanisms 12 lead 11 that 12 lead 12 lead 13 to 13 to 15 aging 14 organismal 15 aging when genomic maintenance systems , such as nucleotide excision repair , are defective , genomic instability is promoted , which causes accelerated aging ( progeria ) . 0 ###LEFT-WALL### 16 instability 0 ###LEFT-WALL### 18 promoted 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 27 . 1 when 4 systems 1 when 12 are 1 when 14 , 1 when 16 instability 2 genomic 3 maintenance 3 maintenance 4 systems 4 systems 7 as 4 systems 12 are 5 , 7 as 6 such 7 as 7 as 10 repair 7 as 11 , 8 nucleotide 10 repair 9 excision 10 repair 12 are 13 defective 15 genomic 16 instability 16 instability 17 is 17 is 18 promoted 19 , 20 which 19 , 22 accelerated 20 which 21 causes 21 causes 22 accelerated 22 accelerated 23 aging 23 aging 25 progeria 24 ( 25 progeria 25 progeria 26 ) this can be observed in humans as well as in mouse models of progeroid syndromes . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 4 observed 0 ###LEFT-WALL### 16 . 1 this 2 can 2 can 3 be 3 be 4 observed 4 observed 5 in 4 observed 7 as 4 observed 9 as 5 in 6 humans 7 as 8 well 9 as 10 in 10 in 12 models 11 mouse 12 models 12 models 13 of 13 of 15 syndromes 14 progeroid 15 syndromes the role of genomic instability related to nuclear dna is currently under investigation with respect to its role in cardiovascular disease , and in particular those cardiovascular diseases that are associated with vascular aging . 0 ###LEFT-WALL### 2 role 0 ###LEFT-WALL### 10 is 0 ###LEFT-WALL### 35 . 1 the 2 role 2 role 3 of 2 role 6 related 2 role 10 is 3 of 5 instability 4 genomic 5 instability 6 related 7 to 7 to 9 dna 8 nuclear 9 dna 10 is 11 currently 10 is 12 under 10 is 14 with 12 under 13 investigation 14 with 15 respect 14 with 28 diseases 15 respect 16 to 16 to 18 role 17 its 18 role 18 role 23 and 19 in 21 disease 19 in 23 and 20 cardiovascular 21 disease 22 , 23 and 23 and 25 particular 24 in 25 particular 26 those 28 diseases 27 cardiovascular 28 diseases 28 diseases 29 that 28 diseases 30 are 29 that 30 are 30 are 31 associated 31 associated 32 with 32 with 34 aging 33 vascular 34 aging in this review , we highlight the first findings in this field of research that come from experiments in nucleotide excision repair [-] defective mouse models and from genetic studies . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 highlight 0 ###LEFT-WALL### 31 . 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 highlight 6 highlight 9 findings 7 the 8 first 7 the 9 findings 9 findings 10 in 9 findings 15 that 9 findings 16 come 10 in 12 field 11 this 12 field 12 field 13 of 13 of 14 research 15 that 16 come 16 come 17 from 16 come 27 and 17 from 18 experiments 19 in 26 models 19 in 27 and 20 nucleotide 26 models 21 excision 26 models 22 repair 26 models 24 defective 25 mouse 25 mouse 26 models 27 and 28 from 28 from 30 studies 29 genetic 30 studies the musculoskeletal system functions because of the precise and coordinated assembly of its components , namely bones and joints , muscles , tendons and ligaments . 0 ###LEFT-WALL### 3 system 0 ###LEFT-WALL### 4 functions 0 ###LEFT-WALL### 20 , 0 ###LEFT-WALL### 26 . 1 the 3 system 2 musculoskeletal 3 system 3 system 4 functions 4 functions 5 because 5 because 6 of 6 of 9 and 7 the 8 precise 8 precise 9 and 9 and 11 assembly 9 and 12 of 9 and 16 namely 10 coordinated 11 assembly 12 of 14 components 13 its 14 components 15 , 16 namely 16 namely 18 and 16 namely 20 , 17 bones 18 and 18 and 19 joints 20 , 24 and 21 muscles 22 , 22 , 23 tendons 22 , 24 and 24 and 25 ligaments this coordination requires cross [-] talk between the tissues , which is mediated by various molecular and mechanical cues . 0 ###LEFT-WALL### 2 coordination 0 ###LEFT-WALL### 3 requires 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 20 . 1 this 2 coordination 2 coordination 3 requires 3 requires 6 talk 3 requires 7 between 4 cross 6 talk 7 between 9 tissues 8 the 9 tissues 10 , 11 which 10 , 13 mediated 11 which 12 is 12 is 13 mediated 13 mediated 14 by 14 by 19 cues 15 various 19 cues 16 molecular 17 and 17 and 18 mechanical 17 and 19 cues in this review , we summarize the progress that has been made in understanding the involvement of mechanical loads exerted by the musculature in the development of skeletal and tendinous tissues , in their integration into one functional unit and in the maintenance of this system . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 summarize 1 in 3 review 1 in 4 , 1 in 5 we 2 this 3 review 5 we 6 summarize 6 summarize 8 progress 7 the 8 progress 8 progress 9 that 8 progress 10 has 9 that 10 has 10 has 11 been 11 been 12 made 12 made 13 in 12 made 21 by 13 in 14 understanding 14 understanding 16 involvement 15 the 16 involvement 16 involvement 17 of 16 involvement 20 exerted 17 of 19 loads 18 mechanical 19 loads 21 by 23 musculature 22 the 23 musculature 23 musculature 24 in 24 in 26 development 25 the 26 development 26 development 27 of 27 of 31 tissues 28 skeletal 29 and 29 and 30 tendinous 29 and 31 tissues 31 tissues 33 in 32 , 33 in 33 in 35 integration 33 in 47 . 34 their 35 integration 35 integration 40 and 36 into 39 unit 36 into 40 and 37 one 39 unit 38 functional 39 unit 40 and 41 in 41 in 43 maintenance 42 the 43 maintenance 43 maintenance 44 of 44 of 46 system 45 this 46 system in addition , we discuss the possible role of muscle [load] in aging and propose new directions for future studies of the musculoskeletal system . 0 ###LEFT-WALL### 4 we 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 25 . 1 in 2 addition 1 in 3 , 1 in 4 we 4 we 14 and 5 discuss 8 role 5 discuss 12 in 5 discuss 14 and 6 the 8 role 7 possible 8 role 8 role 9 of 9 of 10 muscle 12 in 13 aging 14 and 15 propose 15 propose 17 directions 15 propose 18 for 16 new 17 directions 18 for 20 studies 19 future 20 studies 20 studies 21 of 21 of 24 system 22 the 24 system 23 musculoskeletal 24 system system - wide approaches are now being applied to study vaccine responses , whose mechanisms of action , and failure , are not well understood . 0 ###LEFT-WALL### 4 approaches 0 ###LEFT-WALL### 5 are 0 ###LEFT-WALL### 13 , 0 ###LEFT-WALL### 26 . 1 system 2 - 1 system 4 approaches 3 wide 4 approaches 4 approaches 5 are 5 are 6 now 5 are 7 being 7 being 8 applied 8 applied 9 to 9 to 10 study 10 study 12 responses 11 vaccine 12 responses 13 , 14 whose 13 , 25 understood 14 whose 15 mechanisms 15 mechanisms 16 of 15 mechanisms 19 and 16 of 17 action 18 , 19 and 19 and 20 failure 19 and 21 , 19 and 22 are 22 are 23 not 22 are 24 well 22 are 25 understood these works have repeatedly shown vaccine [response] to be an orchestrated process involving multiple arms of immunity most noticeable sensing and innate components . 0 ###LEFT-WALL### 2 works 0 ###LEFT-WALL### 5 shown 0 ###LEFT-WALL### 24 . 1 these 2 works 2 works 3 have 3 have 5 shown 4 repeatedly 5 shown 5 shown 6 vaccine 5 shown 20 sensing 5 shown 21 and 6 vaccine 8 to 6 vaccine 13 involving 8 to 9 be 9 be 12 process 10 an 12 process 11 orchestrated 12 process 12 process 13 involving 13 involving 15 arms 14 multiple 15 arms 15 arms 16 of 16 of 17 immunity 18 most 20 sensing 19 noticeable 20 sensing 21 and 23 components 22 innate 23 components prediction of vaccine responses based on system [-] wide measures is achievable , but challenges remain for robust population wide predictions based only on pre - vaccination measures , especially in partially efficacious vaccines such as influenza . 0 ###LEFT-WALL### 1 prediction 0 ###LEFT-WALL### 11 is 0 ###LEFT-WALL### 14 but 0 ###LEFT-WALL### 22 based 0 ###LEFT-WALL### 38 . 1 prediction 2 of 1 prediction 5 based 1 prediction 11 is 2 of 4 responses 3 vaccine 4 responses 5 based 6 on 6 on 10 measures 7 system 10 measures 9 wide 10 measures 11 is 12 achievable 13 , 14 but 14 but 15 challenges 14 but 16 remain 15 challenges 16 remain 16 remain 17 for 17 for 19 population 18 robust 19 population 19 population 21 predictions 19 population 22 based 20 wide 21 predictions 21 predictions 22 based 22 based 23 only 22 based 24 on 22 based 30 especially 22 based 36 as 24 on 25 pre 25 pre 28 measures 26 - 28 measures 27 vaccination 28 measures 28 measures 29 , 30 especially 31 in 31 in 34 vaccines 32 partially 33 efficacious 33 efficacious 34 vaccines 35 such 36 as 36 as 37 influenza this is especially true in older adults , who are often less responsive to vaccination and exhibit high level of variation compared to young in many components of immunity . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 is 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 30 . 1 this 2 is 2 is 3 especially 2 is 4 true 4 true 5 in 5 in 7 adults 6 older 7 adults 8 , 9 who 8 , 10 are 9 who 10 are 10 are 11 often 10 are 13 responsive 12 less 13 responsive 13 responsive 14 to 13 responsive 24 young 13 responsive 25 in 14 to 16 and 15 vaccination 16 and 16 and 17 exhibit 16 and 19 level 16 and 23 to 18 high 19 level 19 level 20 of 19 level 22 compared 20 of 21 variation 22 compared 23 to 25 in 27 components 26 many 27 components 27 components 28 of 28 of 29 immunity despite this increase in variation , most of the studies on aging use group averages [of] immune [phenotypes] to model immune system behavior . 0 ###LEFT-WALL### 10 studies 0 ###LEFT-WALL### 13 use 0 ###LEFT-WALL### 24 . 1 despite 3 increase 1 despite 10 studies 2 this 3 increase 4 in 5 variation 4 in 6 , 4 in 10 studies 7 most 8 of 7 most 10 studies 8 of 10 studies 9 the 10 studies 10 studies 11 on 10 studies 13 use 11 on 12 aging 13 use 15 averages 14 group 15 averages 15 averages 17 immune 17 immune 19 to 17 immune 20 model 19 to 20 model 20 model 23 behavior 21 immune 22 system 22 system 23 behavior using systems approaches , it is possible to exploit this variation to form distinguishable clusters of [phenotypes] within [and] across individuals to discover underlying immune states . 0 ###LEFT-WALL### 1 using 0 ###LEFT-WALL### 3 approaches 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 27 . 1 using 2 systems 1 using 3 approaches 4 , 5 it 4 , 6 is 5 it 6 is 6 is 7 possible 7 possible 8 to 7 possible 9 exploit 8 to 9 exploit 9 exploit 11 variation 9 exploit 20 across 10 this 11 variation 11 variation 12 to 11 variation 18 within 12 to 13 form 13 form 15 clusters 14 distinguishable 15 clusters 15 clusters 16 of 16 of 18 within 20 across 21 individuals 21 individuals 22 to 21 individuals 23 discover 21 individuals 24 underlying 22 to 23 discover 24 underlying 26 states 25 immune 26 states background : it has been argued that only 12 % of adults have the necessary health literacy to manage their health care effectively , which can lead to difficulties in self [-] care activities , such as medication [adherence] . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 40 . 2 : 3 it 2 : 6 argued 3 it 4 has 4 has 5 been 5 been 6 argued 6 argued 7 that 7 that 8 only 7 that 10 % 7 that 13 have 9 12 10 % 10 % 11 of 10 % 13 have 11 of 12 adults 13 have 17 literacy 13 have 37 as 14 the 17 literacy 15 necessary 16 health 16 health 17 literacy 17 literacy 18 to 17 literacy 19 manage 17 literacy 25 which 18 to 19 manage 19 manage 22 care 19 manage 23 effectively 20 their 22 care 21 health 22 care 24 , 25 which 25 which 26 can 25 which 35 , 26 can 27 lead 27 lead 28 to 27 lead 30 in 28 to 29 difficulties 30 in 34 activities 31 self 33 care 33 care 34 activities 36 such 37 as 37 as 38 medication prior research suggests that health literacy may influence knowledge , self - efficacy and self - care , but this has not been fully examined . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 3 suggests 0 ###LEFT-WALL### 10 , 0 ###LEFT-WALL### 26 . 1 prior 2 research 2 research 3 suggests 3 suggests 4 that 4 that 6 literacy 4 that 8 influence 5 health 6 literacy 6 literacy 7 may 7 may 8 influence 8 influence 9 knowledge 10 , 11 self 10 , 12 - 12 - 14 and 12 - 19 but 13 efficacy 14 and 14 and 15 self 14 and 17 care 16 - 17 care 17 care 18 , 18 , 19 but 19 but 20 this 19 but 25 examined 20 this 21 has 21 has 22 not 21 has 23 been 23 been 24 fully 23 been 25 examined objective : to test a model to explain the relationships between health literacy , heart failure knowledge , self - efficacy , and self - care . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 8 explain 0 ###LEFT-WALL### 14 , 0 ###LEFT-WALL### 27 . 1 objective 2 : 2 : 3 to 2 : 4 test 3 to 4 test 4 test 6 model 4 test 7 to 5 a 6 model 7 to 8 explain 8 explain 10 relationships 8 explain 11 between 9 the 10 relationships 11 between 13 literacy 12 health 13 literacy 14 , 15 heart 14 , 18 , 15 heart 17 knowledge 16 failure 17 knowledge 18 , 19 self 18 , 20 - 20 - 23 and 20 - 25 - 21 efficacy 23 and 22 , 23 and 23 and 24 self 25 - 26 care methods : prior to receiving [clinic] - based education , newly referred patients to 3 heart failure clinics completed assessments of health literacy , heart failure knowledge , self - efficacy , self - care , and demographics . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 - 0 ###LEFT-WALL### 39 . 1 methods 2 : 2 : 3 prior 3 prior 4 to 4 to 5 receiving 7 - 9 education 7 - 10 , 7 - 28 , 8 based 9 education 10 , 13 patients 10 , 19 completed 11 newly 12 referred 12 referred 13 patients 13 patients 14 to 13 patients 19 completed 14 to 18 clinics 15 3 18 clinics 16 heart 18 clinics 17 failure 18 clinics 19 completed 20 assessments 20 assessments 21 of 20 assessments 27 knowledge 21 of 23 literacy 22 health 23 literacy 24 , 27 knowledge 25 heart 27 knowledge 26 failure 27 knowledge 27 knowledge 28 , 28 , 29 self 28 , 30 - 30 - 31 efficacy 30 - 32 , 32 , 33 self 32 , 34 - 34 - 37 and 35 care 37 and 36 , 37 and 37 and 38 demographics structural equation modeling was completed to examine the strength of the [inter] [-] variable relationships . 0 ###LEFT-WALL### 3 modeling 0 ###LEFT-WALL### 7 examine 0 ###LEFT-WALL### 16 . 1 structural 2 equation 2 equation 3 modeling 3 modeling 4 was 4 was 5 completed 5 completed 6 to 6 to 7 examine 7 examine 9 strength 8 the 9 strength 9 strength 10 of 10 of 15 relationships 11 the 15 relationships 14 variable 15 relationships results : of 81 participants recruited , data from 63 patients were complete . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 7 , 0 ###LEFT-WALL### 14 . 1 results 2 : 2 : 3 of 3 of 5 participants 4 81 5 participants 5 participants 6 recruited 7 , 8 data 7 , 12 were 8 data 9 from 8 data 12 were 9 from 11 patients 10 63 11 patients 12 were 13 complete health literacy was independently associated with knowledge ( p < 0.001 ) . 0 ###LEFT-WALL### 2 literacy 0 ###LEFT-WALL### 5 associated 0 ###LEFT-WALL### 13 . 1 health 2 literacy 2 literacy 3 was 3 was 4 independently 3 was 5 associated 5 associated 6 with 6 with 7 knowledge 7 knowledge 10 < 8 ( 10 < 9 p 10 < 10 < 11 0.001 10 < 12 ) health literacy was not related to self [-] care . 0 ###LEFT-WALL### 2 literacy 0 ###LEFT-WALL### 3 was 0 ###LEFT-WALL### 10 . 1 health 2 literacy 2 literacy 3 was 3 was 4 not 3 was 6 to 4 not 5 related 6 to 9 care 7 self 9 care self - efficacy was independently - associated with self [-] care [adherence] ( p = 0.016 ) . 0 ###LEFT-WALL### 3 efficacy 0 ###LEFT-WALL### 4 was 0 ###LEFT-WALL### 18 . 1 self 2 - 1 self 3 efficacy 3 efficacy 4 was 4 was 5 independently 4 was 7 associated 6 - 7 associated 7 associated 8 with 7 associated 17 ) 8 with 11 care 9 self 11 care 11 care 15 = 13 ( 15 = 14 p 15 = 15 = 16 0.016 no other relationships were statistically significant . 0 ###LEFT-WALL### 3 relationships 0 ###LEFT-WALL### 4 were 0 ###LEFT-WALL### 7 . 1 no 2 other 2 other 3 relationships 3 relationships 4 were 4 were 5 statistically 4 were 6 significant the model had good fit [(] comparative fit index [=] 1.000 [ )(and explained 33.6 % of the variance in knowledge and 27.6 % in self - care . 0 ###LEFT-WALL### 22 and 0 ###LEFT-WALL### 27 - 0 ###LEFT-WALL### 29 . 1 the 2 model 2 model 13 )(and 2 model 22 and 3 had 9 index 3 had 13 )(and 4 good 9 index 5 fit 9 index 7 comparative 9 index 8 fit 9 index 9 index 11 1.000 13 )(and 14 explained 13 )(and 16 % 13 )(and 20 in 15 33.6 16 % 16 % 17 of 17 of 19 variance 18 the 19 variance 20 in 21 knowledge 22 and 26 self 23 27.6 25 in 24 % 25 in 25 in 26 self 27 - 28 care conclusions : health literacy influences knowledge about heart failure but not self - care adherence . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 2 : 4 literacy 2 : 5 influences 2 : 13 - 3 health 4 literacy 4 literacy 5 influences 5 influences 10 but 6 knowledge 7 about 6 knowledge 10 but 7 about 9 failure 8 heart 9 failure 10 but 11 not 10 but 12 self 13 - 15 adherence 13 - 16 . 14 care 15 adherence [instead] [,] self - efficacy influenced self - care adherence . 0 ###LEFT-WALL### 3 self 0 ###LEFT-WALL### 4 - 4 - 7 self 4 - 8 - 5 efficacy 6 influenced 6 influenced 7 self 8 - 10 adherence 8 - 11 . 9 care 10 adherence future research should incorporate additional factors that may better model the relationships between health literacy , knowledge , self - efficacy , and self - care . 0 ###LEFT-WALL### 2 research 0 ###LEFT-WALL### 4 incorporate 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 27 . 1 future 2 research 2 research 3 should 3 should 4 incorporate 4 incorporate 6 factors 4 incorporate 13 between 5 additional 6 factors 6 factors 7 that 6 factors 8 may 7 that 8 may 8 may 10 model 9 better 10 model 10 model 12 relationships 11 the 12 relationships 13 between 15 literacy 14 health 15 literacy 15 literacy 17 knowledge 16 , 17 knowledge 17 knowledge 18 , 18 , 19 self 18 , 20 - 20 - 23 and 20 - 26 care 21 efficacy 23 and 22 , 23 and 23 and 24 self 23 and 25 - 23 and 26 care life expectancy for people with haemophilia ( pwh ) has improved and is now approaching that of the general population . 0 ###LEFT-WALL### 2 expectancy 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 21 . 1 life 2 expectancy 2 expectancy 3 for 2 expectancy 12 and 3 for 4 people 4 people 5 with 5 with 6 haemophilia 6 haemophilia 8 pwh 7 ( 8 pwh 8 pwh 9 ) 10 has 11 improved 10 has 12 and 12 and 13 is 13 is 14 now 13 is 15 approaching 15 approaching 16 that 16 that 17 of 17 of 20 population 18 the 20 population 19 general 20 population the growing population of elderly pwh will therefore increasingly face the age - related morbidities such as cardiovascular diseases , malignant disease , liver disease , and bone and joint related diseases , as well as the lifestyle and psychosocial factors that accompany many of these conditions . 0 ###LEFT-WALL### 3 population 0 ###LEFT-WALL### 10 face 0 ###LEFT-WALL### 14 related 0 ###LEFT-WALL### 20 , 1 the 3 population 2 growing 3 population 3 population 4 of 3 population 7 will 4 of 6 pwh 5 elderly 6 pwh 7 will 10 face 8 therefore 10 face 9 increasingly 10 face 10 face 12 age 11 the 12 age 13 - 14 related 14 related 15 morbidities 14 related 17 as 14 related 20 , 16 such 17 as 17 as 19 diseases 18 cardiovascular 19 diseases 20 , 29 and 20 , 31 related 21 malignant 22 disease 22 disease 23 , 23 , 25 disease 23 , 27 and 24 liver 25 disease 26 , 27 and 27 and 28 bone 27 and 29 and 29 and 30 joint 29 and 31 related 31 related 32 diseases 32 diseases 36 as 33 , 36 as 34 as 35 well 35 well 36 as 36 as 39 and 36 as 48 . 37 the 38 lifestyle 38 lifestyle 39 and 39 and 41 factors 39 and 42 that 39 and 43 accompany 40 psychosocial 41 factors 42 that 43 accompany 43 accompany 44 many 44 many 45 of 45 of 47 conditions 46 these 47 conditions for many pwh , frequent contact with haemophilia specialists within the comprehensive care centres supplants the relationship [that] individuals in the general population have with their general practitioners . 0 ###LEFT-WALL### 6 contact 0 ###LEFT-WALL### 15 supplants 0 ###LEFT-WALL### 29 . 1 for 2 many 1 for 6 contact 3 pwh 4 , 3 pwh 6 contact 5 frequent 6 contact 6 contact 7 with 6 contact 10 within 6 contact 15 supplants 7 with 9 specialists 8 haemophilia 9 specialists 10 within 14 centres 11 the 14 centres 12 comprehensive 13 care 13 care 14 centres 15 supplants 17 relationship 16 the 17 relationship 17 relationship 19 individuals 17 relationship 24 have 19 individuals 20 in 19 individuals 24 have 20 in 23 population 21 the 23 population 22 general 23 population 24 have 25 with 25 with 28 practitioners 26 their 28 practitioners 27 general 28 practitioners as a result , there is a risk that elderly pwh may miss the chronic disease screening opportunities offered to the general population . 0 ###LEFT-WALL### 5 there 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 24 . 1 as 3 result 1 as 4 , 1 as 5 there 2 a 3 result 5 there 6 is 6 is 8 risk 7 a 8 risk 8 risk 9 that 9 that 11 pwh 9 that 13 miss 10 elderly 11 pwh 11 pwh 12 may 12 may 13 miss 13 miss 16 disease 13 miss 20 to 14 the 16 disease 15 chronic 16 disease 16 disease 17 screening 17 screening 18 opportunities 18 opportunities 19 offered 20 to 23 population 21 the 23 population 22 general 23 population this review focuses on the screening tests and examinations recommended for age - related comorbidities in the general population that may be applicable to the growing population of older people with haemophilia . 0 ###LEFT-WALL### 2 review 0 ###LEFT-WALL### 3 focuses 0 ###LEFT-WALL### 14 related 0 ###LEFT-WALL### 33 . 1 this 2 review 2 review 3 focuses 3 focuses 4 on 3 focuses 11 for 4 on 8 and 5 the 7 tests 6 screening 7 tests 7 tests 8 and 8 and 9 examinations 8 and 10 recommended 11 for 12 age 13 - 14 related 14 related 15 comorbidities 15 comorbidities 16 in 15 comorbidities 20 that 15 comorbidities 21 may 16 in 19 population 17 the 19 population 18 general 19 population 20 that 21 may 21 may 22 be 22 be 23 applicable 23 applicable 24 to 24 to 27 population 25 the 27 population 26 growing 27 population 27 population 28 of 27 population 31 with 28 of 30 people 29 older 30 people 31 with 32 haemophilia [non] - steroidal anti - inflammatory drugs ( nsaids ) are a chemically heterogeneous group of compounds that provide unmistakable and significant health benefits in the treatment of pain and inflammation . 0 ###LEFT-WALL### 2 - 0 ###LEFT-WALL### 11 are 0 ###LEFT-WALL### 32 . 2 - 7 drugs 3 steroidal 7 drugs 4 anti 5 - 4 anti 7 drugs 6 inflammatory 7 drugs 7 drugs 9 nsaids 7 drugs 11 are 8 ( 9 nsaids 9 nsaids 10 ) 11 are 15 group 12 a 15 group 13 chemically 14 heterogeneous 14 heterogeneous 15 group 15 group 16 of 15 group 18 that 15 group 19 provide 16 of 17 compounds 18 that 19 provide 19 provide 24 benefits 19 provide 25 in 20 unmistakable 21 and 21 and 22 significant 21 and 24 benefits 23 health 24 benefits 25 in 27 treatment 26 the 27 treatment 27 treatment 28 of 28 of 30 and 29 pain 30 and 30 and 31 inflammation they include traditional nsaids ( tnsaids ) , [which] act by inhibiting both cyclooxygenase ( cox [ )(- 1 and [cox] - 2 and selective cox - 2 inhibitors ( coxibs ) . 0 ###LEFT-WALL### 1 they 0 ###LEFT-WALL### 8 , 0 ###LEFT-WALL### 33 . 1 they 8 , 2 include 4 nsaids 2 include 8 , 3 traditional 4 nsaids 4 nsaids 6 tnsaids 5 ( 6 tnsaids 6 tnsaids 7 ) 8 , 10 act 8 , 11 by 8 , 14 cyclooxygenase 11 by 12 inhibiting 12 inhibiting 13 both 14 cyclooxygenase 24 and 15 ( 24 and 16 cox 20 and 16 cox 24 and 18 )(- 19 1 19 1 20 and 20 and 23 2 22 - 23 2 24 and 26 cox 24 and 29 inhibitors 24 and 32 ) 25 selective 26 cox 27 - 29 inhibitors 28 2 29 inhibitors 29 inhibitors 31 coxibs 29 inhibitors 32 ) 30 ( 31 coxibs 31 coxibs 32 ) the development [of] biomarkers [predictive] [of] the impact of nsaids on cox [-] 1 and cox - 2 activities [in] [vitro] , ex vivo [and] in vivo [has] [been] [essential] to read out the clinical consequences of selective and [non] [-] selective inhibition of cox isozymes in human beings . 0 ###LEFT-WALL### 2 development 0 ###LEFT-WALL### 4 biomarkers 1 the 2 development 2 development 4 biomarkers 4 biomarkers 8 impact 4 biomarkers 11 on 7 the 8 impact 8 impact 9 of 9 of 10 nsaids 11 on 19 activities 12 cox 14 1 12 cox 15 and 15 and 16 cox 15 and 17 - 15 and 19 activities 18 2 19 activities 19 activities 31 to 22 , 31 to 23 ex 24 vivo 24 vivo 31 to 26 in 27 vivo 27 vivo 31 to 31 to 32 read 32 read 33 out 33 out 36 consequences 34 the 36 consequences 35 clinical 36 consequences 36 consequences 37 of 37 of 39 and 38 selective 39 and 39 and 43 inhibition 39 and 50 . 42 selective 43 inhibition 43 inhibition 44 of 44 of 46 isozymes 45 cox 46 isozymes 46 isozymes 47 in 47 in 49 beings 48 human 49 beings the analgesic and anti - inflammatory effects of nsaids are cox - 2 - dependent effects , unrelated to cox - 2 selectivity . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 10 are 0 ###LEFT-WALL### 24 . 1 the 2 analgesic 2 analgesic 3 and 3 and 7 effects 3 and 8 of 3 and 10 are 4 anti 5 - 4 anti 7 effects 6 inflammatory 7 effects 8 of 9 nsaids 10 are 23 selectivity 11 cox 14 - 11 cox 18 unrelated 11 cox 23 selectivity 12 - 14 - 13 2 14 - 14 - 16 effects 14 - 17 , 15 dependent 16 effects 17 , 18 unrelated 18 unrelated 19 to 18 unrelated 21 - 19 to 20 cox 22 2 23 selectivity the intensity and duration of these effects are influenced by dose [and] half - life of the nsaid . 0 ###LEFT-WALL### 3 and 0 ###LEFT-WALL### 11 dose 0 ###LEFT-WALL### 14 - 0 ###LEFT-WALL### 19 . 1 the 2 intensity 2 intensity 3 and 3 and 4 duration 3 and 5 of 3 and 7 effects 3 and 10 by 3 and 11 dose 5 of 6 these 7 effects 8 are 8 are 9 influenced 9 influenced 10 by 11 dose 13 half 14 - 15 life 15 life 16 of 16 of 18 nsaid 17 the 18 nsaid however , the inhibition of cox - 1 in cells of the gastrointestinal ( gi ) system and cox - 2 in vascular cells translates into increased risk of serious gi adverse events and atherothrombosis and hypertension , respectively . 0 ###LEFT-WALL### 4 inhibition 0 ###LEFT-WALL### 25 translates 1 however 2 , 1 however 4 inhibition 3 the 4 inhibition 4 inhibition 5 of 4 inhibition 25 translates 5 of 10 cells 6 cox 10 cells 7 - 8 1 8 1 9 in 9 in 10 cells 10 cells 11 of 11 of 18 and 12 the 17 system 13 gastrointestinal 15 gi 13 gastrointestinal 17 system 14 ( 15 gi 15 gi 16 ) 17 system 18 and 18 and 24 cells 19 cox 24 cells 20 - 21 2 21 2 22 in 22 in 24 cells 23 vascular 24 cells 25 translates 26 into 25 translates 36 and 25 translates 39 respectively 26 into 28 risk 27 increased 28 risk 28 risk 29 of 29 of 31 gi 30 serious 31 gi 32 adverse 33 events 33 events 34 and 34 and 35 atherothrombosis 34 and 36 and 36 and 37 hypertension 38 , 39 respectively 39 respectively 40 . the cox - 2 selectivity of nsaids can predict , at least [in] part , the gi [toxicity] . 0 ###LEFT-WALL### 2 cox 0 ###LEFT-WALL### 3 - 0 ###LEFT-WALL### 19 . 1 the 2 cox 3 - 4 2 3 - 10 , 4 2 5 selectivity 4 2 9 predict 5 selectivity 6 of 5 selectivity 8 can 6 of 7 nsaids 8 can 9 predict 10 , 14 part 10 , 15 , 11 at 12 least 12 least 14 part 15 , 17 gi 16 the 17 gi in contrast , the cv effects are largely cox - 2 - dependent effects , unrelated to cox - 2 selectivity [but] [are] dose dependent . 0 ###LEFT-WALL### 6 effects 0 ###LEFT-WALL### 7 are 0 ###LEFT-WALL### 19 - 1 in 2 contrast 1 in 3 , 1 in 6 effects 4 the 6 effects 5 cv 6 effects 6 effects 7 are 7 are 8 largely 7 are 9 cox 9 cox 12 - 10 - 12 - 11 2 12 - 12 - 14 effects 12 - 19 - 13 dependent 14 effects 14 effects 16 unrelated 15 , 16 unrelated 16 unrelated 17 to 16 unrelated 19 - 17 to 18 cox 19 - 25 dependent 19 - 26 . 20 2 24 dose 21 selectivity 24 dose 24 dose 25 dependent the reduction in the dose is recommended and presumably will limit the number of patients exposed to a cv or a gi hazard by nsaids and coxibs . 0 ###LEFT-WALL### 2 reduction 0 ###LEFT-WALL### 6 is 0 ###LEFT-WALL### 28 . 1 the 2 reduction 2 reduction 3 in 2 reduction 6 is 3 in 5 dose 4 the 5 dose 6 is 8 and 7 recommended 8 and 8 and 10 will 8 and 17 to 9 presumably 10 will 10 will 11 limit 11 limit 15 patients 12 the 13 number 13 number 14 of 13 number 15 patients 14 of 15 patients 15 patients 16 exposed 17 to 20 or 18 a 19 cv 19 cv 20 or 20 or 23 hazard 20 or 24 by 21 a 23 hazard 22 gi 23 hazard 24 by 26 and 25 nsaids 26 and 26 and 27 coxibs it will not , however , eliminate the risk on an individual level because there is [a] marked variability [in] [how] different people react to these drugs , based on their genetic background . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 18 marked 0 ###LEFT-WALL### 34 . 1 it 2 will 2 will 3 not 2 will 7 eliminate 4 , 5 however 5 however 6 , 5 however 7 eliminate 7 eliminate 9 risk 8 the 9 risk 9 risk 10 on 9 risk 13 level 9 risk 18 marked 10 on 12 individual 11 an 12 individual 13 level 14 because 13 level 16 is 13 level 18 marked 14 because 15 there 15 there 16 is 18 marked 19 variability 18 marked 30 on 19 variability 23 people 19 variability 29 based 22 different 23 people 23 people 28 , 24 react 25 to 24 react 28 , 25 to 27 drugs 26 these 27 drugs 28 , 29 based 30 on 33 background 31 their 33 background 32 genetic 33 background the challenge of the next future will be to develop biomarkers useful to identify the individuals who react abnormally to cox inhibition . 0 ###LEFT-WALL### 2 challenge 0 ###LEFT-WALL### 8 be 0 ###LEFT-WALL### 23 . 1 the 2 challenge 2 challenge 3 of 2 challenge 7 will 3 of 6 future 4 the 5 next 4 the 6 future 7 will 8 be 8 be 9 to 8 be 12 useful 9 to 10 develop 10 develop 11 biomarkers 12 useful 13 to 12 useful 14 identify 13 to 14 identify 14 identify 16 individuals 15 the 16 individuals 16 individuals 17 who 16 individuals 18 react 17 who 18 react 18 react 19 abnormally 18 react 20 to 20 to 22 inhibition 21 cox 22 inhibition background : aging plays a profound role in the ability of the kidney to function . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 aging 2 : 4 plays 2 : 16 . 3 aging 4 plays 4 plays 7 role 4 plays 8 in 5 a 6 profound 5 a 7 role 6 profound 7 role 8 in 10 ability 9 the 10 ability 10 ability 11 of 10 ability 14 to 10 ability 15 function 11 of 13 kidney 12 the 13 kidney 14 to 15 function aging which varies among individuals , has been associated with the matrix metalloproteinase ( mmp ) 7 and 20 genes . 0 ###LEFT-WALL### 1 aging 0 ###LEFT-WALL### 9 associated 0 ###LEFT-WALL### 21 . 1 aging 2 which 1 aging 6 , 1 aging 9 associated 2 which 6 , 3 varies 4 among 3 varies 6 , 4 among 5 individuals 6 , 7 has 7 has 8 been 9 associated 10 with 10 with 13 metalloproteinase 10 with 20 genes 11 the 13 metalloproteinase 12 matrix 13 metalloproteinase 13 metalloproteinase 15 mmp 14 ( 15 mmp 15 mmp 16 ) 17 7 18 and 18 and 19 20 18 and 20 genes this study was conducted to analyze correlations between polymorphisms of mmp genes [ rs880197 in mmp7 ( a>t ) and rs1711437 in mmp20 ( g>a ) ] and transplant outcomes in 235 recipients . 0 ###LEFT-WALL### 2 study 0 ###LEFT-WALL### 4 conducted 0 ###LEFT-WALL### 34 . 1 this 2 study 2 study 3 was 3 was 4 conducted 4 conducted 5 to 5 to 6 analyze 6 analyze 28 and 6 analyze 31 in 7 correlations 8 between 7 correlations 10 of 7 correlations 28 and 8 between 9 polymorphisms 10 of 12 genes 11 mmp 12 genes 12 genes 20 and 13 [ 20 and 14 rs880197 15 in 14 rs880197 20 and 15 in 16 mmp7 16 mmp7 18 a>t 17 ( 18 a>t 18 a>t 19 ) 20 and 21 rs1711437 20 and 27 ] 21 rs1711437 22 in 22 in 23 mmp20 23 mmp20 25 g>a 24 ( 25 g>a 25 g>a 26 ) 28 and 30 outcomes 29 transplant 30 outcomes 31 in 33 recipients 32 235 33 recipients methods : transplant outcomes were evaluated according to the sum of the [a] alleles in the recipients and the donors . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 21 . 2 : 4 outcomes 2 : 6 evaluated 3 transplant 4 outcomes 4 outcomes 5 were 5 were 6 evaluated 6 evaluated 8 to 6 evaluated 15 in 7 according 8 to 8 to 10 sum 9 the 10 sum 10 sum 11 of 11 of 14 alleles 12 the 14 alleles 15 in 18 and 16 the 17 recipients 17 recipients 18 and 18 and 20 donors 19 the 20 donors the group with a high number of [a] alleles ( ≥3 ) was compared with the group with a low number ( < 3 ) . 0 ###LEFT-WALL### 2 group 0 ###LEFT-WALL### 14 compared 0 ###LEFT-WALL### 26 . 1 the 2 group 2 group 3 with 2 group 7 of 2 group 13 was 3 with 6 number 4 a 5 high 4 a 6 number 5 high 6 number 7 of 9 alleles 9 alleles 11 ≥3 10 ( 11 ≥3 11 ≥3 12 ) 13 was 14 compared 14 compared 15 with 14 compared 18 with 15 with 17 group 16 the 17 group 18 with 21 number 19 a 20 low 19 a 21 number 20 low 21 number 21 number 24 3 22 ( 24 3 23 < 24 3 24 3 25 ) results : the group with a high number of mmp7 a alleles showed a [lower] risk [of] chronic tubulointerstitial lesion than the group with a low number ( p = [.] 009 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 34 . 2 : 4 group 2 : 13 showed 3 the 4 group 4 group 5 with 4 group 13 showed 5 with 8 number 6 a 8 number 7 high 8 number 8 number 9 of 9 of 12 alleles 10 mmp7 11 a 10 mmp7 12 alleles 13 showed 20 lesion 13 showed 21 than 13 showed 24 with 14 a 20 lesion 16 risk 20 lesion 18 chronic 20 lesion 19 tubulointerstitial 20 lesion 21 than 23 group 22 the 23 group 24 with 27 number 25 a 27 number 26 low 27 number 27 number 30 = 28 ( 30 = 29 p 30 = 30 = 32 009 30 = 33 ) the group with a high number of mmp20 a alleles had showed better long - term kidney function [at] 10 years after transplantation than the group with a low number ( p = [.] 026 ) . 0 ###LEFT-WALL### 2 group 0 ###LEFT-WALL### 12 showed 0 ###LEFT-WALL### 37 . 1 the 2 group 2 group 3 with 2 group 7 of 2 group 10 alleles 2 group 11 had 2 group 12 showed 3 with 6 number 4 a 5 high 4 a 6 number 5 high 6 number 7 of 8 mmp20 8 mmp20 9 a 10 alleles 11 had 12 showed 18 function 12 showed 21 years 12 showed 22 after 12 showed 24 than 13 better 16 term 14 long 15 - 14 long 16 term 16 term 18 function 17 kidney 18 function 18 function 20 10 22 after 23 transplantation 24 than 26 group 24 than 30 number 25 the 26 group 26 group 27 with 26 group 30 number 27 with 29 low 28 a 29 low 30 number 33 = 31 ( 33 = 32 p 33 = 33 = 35 026 33 = 36 ) furthermore , the group with a high number of mmp20 a alleles showed a trend toward better graft survival compared with the group with a low number , especially among recipients followed for >1 [year] ( p = [.] 022 ) . 0 ###LEFT-WALL### 4 group 0 ###LEFT-WALL### 13 showed 0 ###LEFT-WALL### 42 . 1 furthermore 2 , 1 furthermore 4 group 3 the 4 group 4 group 5 with 4 group 13 showed 5 with 8 number 6 a 8 number 7 high 8 number 8 number 9 of 9 of 12 alleles 10 mmp20 11 a 10 mmp20 12 alleles 13 showed 15 trend 13 showed 24 with 14 a 15 trend 15 trend 16 toward 16 toward 19 survival 17 better 18 graft 18 graft 19 survival 19 survival 20 compared 20 compared 21 with 21 with 23 group 22 the 23 group 24 with 27 number 25 a 26 low 25 a 27 number 26 low 27 number 27 number 30 among 28 , 29 especially 28 , 30 among 30 among 31 recipients 30 among 41 ) 31 recipients 32 followed 31 recipients 33 for 33 for 34 >1 34 >1 38 = 36 ( 38 = 37 p 38 = 38 = 40 022 38 = 41 ) conclusions : polymorphisms of mmp7 and mmp20 genes may be surrogate markers to predict long - term outcomes after kidney transplantation . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 22 . 1 conclusions 2 : 2 : 3 polymorphisms 2 : 13 to 3 polymorphisms 4 of 4 of 6 and 5 mmp7 6 and 6 and 7 mmp20 6 and 8 genes 6 and 10 be 8 genes 9 may 9 may 10 be 10 be 12 markers 11 surrogate 12 markers 13 to 14 predict 14 predict 18 outcomes 14 predict 19 after 15 long 16 - 15 long 17 term 17 term 18 outcomes 19 after 21 transplantation 20 kidney 21 transplantation purpose : critical illness results in derangements of all components of the immune response . 0 ###LEFT-WALL### 1 purpose 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 15 . 1 purpose 2 : 2 : 5 results 3 critical 4 illness 4 illness 5 results 5 results 6 in 5 results 8 of 6 in 7 derangements 8 of 10 components 9 all 10 components 10 components 11 of 11 of 14 response 12 the 14 response 13 immune 14 response nonetheless , most of the efforts evaluating immune status in critically ill patients have been done in the field of sepsis . 0 ###LEFT-WALL### 3 most 0 ###LEFT-WALL### 15 been 0 ###LEFT-WALL### 22 . 1 nonetheless 2 , 1 nonetheless 3 most 3 most 4 of 3 most 14 have 4 of 6 efforts 5 the 6 efforts 6 efforts 7 evaluating 7 evaluating 9 status 7 evaluating 10 in 8 immune 9 status 10 in 13 patients 11 critically 12 ill 12 ill 13 patients 14 have 15 been 15 been 16 done 16 done 17 in 17 in 19 field 18 the 19 field 19 field 20 of 20 of 21 sepsis here we have evaluated the immunity status at intensive care [unit] ( icu ) [admission] in a cohort of nonseptic critically ill patients and its influence on their outcome . 0 ###LEFT-WALL### 2 we 0 ###LEFT-WALL### 4 evaluated 0 ###LEFT-WALL### 30 . 1 here 2 we 2 we 3 have 3 have 4 evaluated 4 evaluated 7 status 4 evaluated 8 at 4 evaluated 16 in 5 the 7 status 6 immunity 7 status 8 at 10 care 9 intensive 10 care 10 care 13 icu 12 ( 13 icu 13 icu 14 ) 16 in 18 cohort 17 a 18 cohort 18 cohort 19 of 19 of 24 and 20 nonseptic 23 patients 21 critically 22 ill 22 ill 23 patients 23 patients 24 and 24 and 26 influence 24 and 27 on 25 its 26 influence 27 on 29 outcome 28 their 29 outcome patients with infection , sepsis , immunodeficiency , or concomitant immunosuppressive therapy were excluded . 0 ###LEFT-WALL### 9 or 0 ###LEFT-WALL### 14 excluded 0 ###LEFT-WALL### 15 . 1 patients 2 with 1 patients 4 , 2 with 3 infection 4 , 5 sepsis 4 , 6 , 6 , 7 immunodeficiency 6 , 9 or 8 , 9 or 9 or 12 therapy 9 or 13 were 10 concomitant 12 therapy 11 immunosuppressive 12 therapy 13 were 14 excluded results : levels of igm , cd3 [(] [+] [ )(t cells , cd4 ( [+] [ )( cells , cd8 ( [+] [ )(t [cells] , and [b] lymphocytes correlated inversely with age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 6 , 0 ###LEFT-WALL### 35 . 1 results 2 : 2 : 3 levels 3 levels 4 of 4 of 5 igm 6 , 28 and 6 , 31 correlated 7 cd3 11 )(t 7 cd3 12 cells 12 cells 13 , 13 , 14 cd4 13 , 28 and 14 cd4 19 cells 15 ( 19 cells 19 cells 21 cd8 19 cells 27 , 20 , 21 cd8 21 cd8 25 )(t 21 cd8 27 , 22 ( 25 )(t 25 )(t 27 , 28 and 30 lymphocytes 28 and 31 correlated 31 correlated 32 inversely 31 correlated 33 with 33 with 34 age in turn , levels of cd3 ( [+] [ )( cells , cd4 ( [+] [ )(t [cells] , cd8 ( [+] [ )(t [cells] , and c3 factor of the complement system correlated inversely with acute physiology and chronic health evaluation ii score . 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 44 score 0 ###LEFT-WALL### 45 . 1 in 2 turn 2 turn 3 , 2 turn 27 and 4 levels 5 of 4 levels 27 and 5 of 6 cd3 6 cd3 11 cells 6 cd3 13 cd4 6 cd3 20 cd8 7 ( 11 cells 11 cells 12 , 12 , 13 cd4 13 cd4 17 )(t 13 cd4 19 , 14 ( 17 )(t 17 )(t 19 , 19 , 20 cd8 20 cd8 24 )(t 20 cd8 26 , 21 ( 24 )(t 24 )(t 26 , 27 and 29 factor 27 and 30 of 27 and 44 score 28 c3 29 factor 30 of 39 and 31 the 33 system 32 complement 33 system 33 system 34 correlated 33 system 39 and 34 correlated 35 inversely 34 correlated 36 with 36 with 38 physiology 37 acute 38 physiology 39 and 42 evaluation 40 chronic 41 health 41 health 42 evaluation 42 evaluation 43 ii multivariate cox regression analysis censored at 28 days evidenced that levels of igm played a protective role , whereas levels of nk cells behaved as a risk factor for mortality . 0 ###LEFT-WALL### 4 analysis 0 ###LEFT-WALL### 5 censored 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 31 . 1 multivariate 4 analysis 2 cox 4 analysis 3 regression 4 analysis 4 analysis 5 censored 5 censored 6 at 5 censored 8 days 6 at 7 28 8 days 9 evidenced 8 days 10 that 10 that 11 levels 10 that 14 played 11 levels 12 of 11 levels 14 played 12 of 13 igm 14 played 17 role 15 a 16 protective 15 a 17 role 16 protective 17 role 18 , 23 cells 18 , 24 behaved 19 whereas 20 levels 19 whereas 23 cells 20 levels 21 of 21 of 22 nk 23 cells 24 behaved 24 behaved 25 as 25 as 28 factor 26 a 28 factor 27 risk 28 factor 28 factor 29 for 29 for 30 mortality kaplan - meier curves showed a cutoff of 58 mg/dl for igm and 140 cells/mm ( 3 ) for nk cells . 0 ###LEFT-WALL### 4 curves 0 ###LEFT-WALL### 5 showed 0 ###LEFT-WALL### 22 . 1 kaplan 2 - 1 kaplan 4 curves 3 meier 4 curves 4 curves 5 showed 5 showed 7 cutoff 5 showed 21 cells 6 a 7 cutoff 7 cutoff 8 of 7 cutoff 19 for 8 of 10 mg/dl 9 58 10 mg/dl 10 mg/dl 11 for 11 for 13 and 12 igm 13 and 13 and 15 cells/mm 13 and 17 3 14 140 15 cells/mm 16 ( 17 3 17 3 18 ) 19 for 20 nk conclusions : in [conclusion] , our results demonstrate that igm plays a protective role in critically ill patients with no sepsis , whereas nk cell counts seem to play a deleterious one . 0 ###LEFT-WALL### 1 conclusions 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 33 . 2 : 3 in 2 : 5 , 2 : 22 , 5 , 7 results 5 , 8 demonstrate 6 our 7 results 7 results 8 demonstrate 8 demonstrate 9 that 9 that 10 igm 9 that 11 plays 10 igm 11 plays 11 plays 14 role 11 plays 19 with 12 a 13 protective 12 a 14 role 13 protective 14 role 14 role 15 in 15 in 18 patients 16 critically 17 ill 17 ill 18 patients 19 with 21 sepsis 20 no 21 sepsis 22 , 26 counts 22 , 27 seem 23 whereas 24 nk 23 whereas 26 counts 25 cell 26 counts 26 counts 27 seem 27 seem 28 to 27 seem 29 play 28 to 29 play 29 play 32 one 30 a 32 one 31 deleterious 32 one aging and severity at admission [affect] levels of key factors of the immune system in the blood of these patients . 0 ###LEFT-WALL### 2 and 0 ###LEFT-WALL### 21 . 1 aging 2 and 2 and 3 severity 2 and 4 at 4 at 7 levels 5 admission 7 levels 7 levels 8 of 8 of 10 factors 9 key 10 factors 10 factors 11 of 11 of 14 system 12 the 14 system 13 immune 14 system 14 system 15 in 15 in 17 blood 16 the 17 blood 17 blood 18 of 18 of 20 patients 19 these 20 patients an analytical method was developed for simultaneous determination of ultratrace level plutonium ( pu ) and neptunium ( np ) using iron hydroxide coprecipitation in combination [with] automated sequential injection extraction chromatography separation and accelerator mass spectrometry ( ams ) measurement . 0 ###LEFT-WALL### 3 method 0 ###LEFT-WALL### 5 developed 0 ###LEFT-WALL### 42 . 1 an 3 method 2 analytical 3 method 3 method 4 was 4 was 5 developed 5 developed 6 for 5 developed 21 using 5 developed 25 in 6 for 16 and 7 simultaneous 8 determination 8 determination 9 of 8 determination 16 and 9 of 12 plutonium 10 ultratrace 12 plutonium 11 level 12 plutonium 12 plutonium 14 pu 13 ( 14 pu 14 pu 15 ) 16 and 17 neptunium 16 and 19 np 18 ( 19 np 19 np 20 ) 21 using 24 coprecipitation 22 iron 23 hydroxide 23 hydroxide 24 coprecipitation 25 in 34 and 26 combination 28 automated 28 automated 33 separation 29 sequential 30 injection 30 injection 33 separation 31 extraction 33 separation 32 chromatography 33 separation 33 separation 34 and 34 and 41 measurement 35 accelerator 36 mass 36 mass 41 measurement 37 spectrometry 39 ams 37 spectrometry 40 ) 37 spectrometry 41 measurement 38 ( 39 ams 39 ams 40 ) several experimental parameters affecting the analytical performance were investigated and compared including sample preboiling operation , aging time , amount of coprecipitating reagent [,] reagent [for] ph adjustment , sedimentation time , and organic matter decomposition approach . 0 ###LEFT-WALL### 3 parameters 0 ###LEFT-WALL### 10 and 0 ###LEFT-WALL### 19 , 0 ###LEFT-WALL### 38 . 1 several 3 parameters 2 experimental 3 parameters 3 parameters 4 affecting 3 parameters 8 were 4 affecting 7 performance 5 the 7 performance 6 analytical 7 performance 8 were 10 and 9 investigated 10 and 10 and 11 compared 10 and 15 operation 12 including 13 sample 13 sample 15 operation 14 preboiling 15 operation 15 operation 17 aging 16 , 17 aging 17 aging 18 time 17 aging 19 , 19 , 33 and 19 , 37 approach 20 amount 21 of 20 amount 29 , 21 of 22 coprecipitating 22 coprecipitating 28 adjustment 23 reagent 25 reagent 25 reagent 28 adjustment 27 ph 28 adjustment 29 , 31 time 29 , 33 and 30 sedimentation 31 time 32 , 33 and 33 and 36 decomposition 33 and 37 approach 34 organic 35 matter 35 matter 36 decomposition the overall analytical results show that preboiling and aging are important for obtaining high chemical yields for both pu and np , which is possibly related to the aggregation and adsorption behavior of organic substances contained in urine . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 show 0 ###LEFT-WALL### 26 related 1 the 4 results 2 overall 4 results 3 analytical 4 results 4 results 5 show 5 show 6 that 6 that 8 and 6 that 10 are 7 preboiling 8 and 8 and 9 aging 8 and 10 are 10 are 11 important 11 important 12 for 11 important 17 for 12 for 13 obtaining 13 obtaining 14 high 13 obtaining 16 yields 15 chemical 16 yields 17 for 18 both 19 pu 20 and 20 and 21 np 20 and 22 , 20 and 23 which 20 and 24 is 20 and 26 related 23 which 24 is 25 possibly 26 related 26 related 27 to 26 related 39 . 27 to 30 and 28 the 29 aggregation 29 aggregation 30 and 30 and 32 behavior 30 and 33 of 30 and 37 in 31 adsorption 32 behavior 33 of 35 substances 34 organic 35 substances 35 substances 36 contained 37 in 38 urine although the optimal condition for np and pu simultaneous determination requires 5 - day aging time , an immediate coprecipitation without preboiling and aging could also provide fairly satisfactory chemical yields for both np and pu ( 50 - 60 % ) with high sample throughput ( 4 h/sample ) . 0 ###LEFT-WALL### 10 determination 0 ###LEFT-WALL### 11 requires 0 ###LEFT-WALL### 13 - 0 ###LEFT-WALL### 51 . 1 although 4 condition 1 although 10 determination 2 the 4 condition 3 optimal 4 condition 5 for 7 and 5 for 10 determination 6 np 7 and 7 and 8 pu 9 simultaneous 10 determination 10 determination 11 requires 11 requires 12 5 13 - 14 day 14 day 15 aging 14 day 23 and 14 day 27 provide 16 time 17 , 17 , 20 coprecipitation 17 , 23 and 18 an 20 coprecipitation 19 immediate 20 coprecipitation 20 coprecipitation 21 without 21 without 22 preboiling 23 and 24 aging 23 and 25 could 25 could 27 provide 26 also 27 provide 27 provide 31 yields 28 fairly 29 satisfactory 29 satisfactory 31 yields 30 chemical 31 yields 31 yields 32 for 31 yields 43 with 32 for 35 and 33 both 35 and 34 np 35 and 35 and 36 pu 35 and 39 - 37 ( 39 - 38 50 39 - 39 - 41 % 39 - 42 ) 40 60 41 % 43 with 46 throughput 44 high 46 throughput 45 sample 46 throughput 46 throughput 49 h/sample 47 ( 49 h/sample 48 4 49 h/sample 49 h/sample 50 ) within the developed method , [(] 242 )pu was exploited as chemical yield [tracer] for both pu and np isotopes . 0 ###LEFT-WALL### 8 )pu 0 ###LEFT-WALL### 10 exploited 0 ###LEFT-WALL### 21 . 1 within 4 method 1 within 5 , 1 within 8 )pu 2 the 4 method 3 developed 4 method 7 242 8 )pu 8 )pu 9 was 9 was 10 exploited 10 exploited 11 as 11 as 13 yield 12 chemical 13 yield 13 yield 15 for 15 for 20 isotopes 16 both 20 isotopes 17 pu 18 and 18 and 19 np 19 np 20 isotopes [(] 242 )pu was also used as a spike in the ams measurement for quantification of [(] 239 )pu and [(] 237 )np concentrations . 0 ###LEFT-WALL### 3 )pu 0 ###LEFT-WALL### 6 used 0 ###LEFT-WALL### 25 . 2 242 3 )pu 3 )pu 4 was 4 was 5 also 4 was 6 used 6 used 7 as 7 as 9 spike 8 a 9 spike 9 spike 10 in 9 spike 14 for 9 spike 16 of 10 in 13 measurement 11 the 13 measurement 12 ams 13 measurement 14 for 15 quantification 16 of 20 and 18 239 19 )pu 19 )pu 20 and 20 and 24 concentrations 22 237 24 concentrations 23 )np 24 concentrations the results show that , under the optimal experimental condition , the chemical yields of [(] 237 )np and [(] 242 )pu are nearly identical , indicating the high feasibility of [(] 242 )pu as a nonisotopic tracer [for] ( 237 )np determination in real urine samples . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 11 , 1 the 2 results 2 results 3 show 3 show 4 that 3 show 6 under 5 , 6 under 6 under 10 condition 6 under 11 , 7 the 10 condition 8 optimal 10 condition 9 experimental 10 condition 11 , 14 yields 12 the 14 yields 13 chemical 14 yields 14 yields 15 of 14 yields 23 are 15 of 19 and 17 237 18 )np 18 )np 19 and 19 and 22 )pu 21 242 22 )pu 23 are 24 nearly 23 are 25 identical 25 identical 27 indicating 26 , 27 indicating 27 indicating 30 feasibility 27 indicating 35 as 28 the 30 feasibility 29 high 30 feasibility 30 feasibility 31 of 31 of 34 )pu 33 242 34 )pu 35 as 38 tracer 36 a 38 tracer 37 nonisotopic 38 tracer 38 tracer 41 237 40 ( 41 237 41 237 43 determination 41 237 47 samples 41 237 48 . 42 )np 43 determination 43 determination 44 in 43 determination 47 samples 44 in 46 urine 45 real 46 urine the analytical method was validated by analysis of a number of urine samples spiked with different levels of [(] 237 )np and [(] 239 )pu . 0 ###LEFT-WALL### 3 method 0 ###LEFT-WALL### 5 validated 0 ###LEFT-WALL### 26 . 1 the 3 method 2 analytical 3 method 3 method 4 was 4 was 5 validated 5 validated 6 by 5 validated 15 with 6 by 7 analysis 7 analysis 8 of 8 of 10 number 9 a 10 number 10 number 11 of 11 of 13 samples 12 urine 13 samples 13 samples 14 spiked 15 with 17 levels 16 different 17 levels 17 levels 18 of 18 of 22 and 20 237 21 )np 21 )np 22 and 22 and 25 )pu 24 239 25 )pu the measured values of [(] 237 )np and [(] 239 )pu by ams exhibit good agreement [(] r ( 2 [ )(≥ 0.955 ) with the spiked ones confirming the reliability of the proposed method . 0 ###LEFT-WALL### 3 values 0 ###LEFT-WALL### 14 exhibit 0 ###LEFT-WALL### 36 . 1 the 3 values 2 measured 3 values 3 values 4 of 3 values 14 exhibit 4 of 8 and 6 237 7 )np 7 )np 8 and 8 and 11 )pu 8 and 12 by 10 239 11 )pu 12 by 13 ams 14 exhibit 16 agreement 14 exhibit 25 with 15 good 16 agreement 16 agreement 18 r 16 agreement 22 )(≥ 19 ( 22 )(≥ 20 2 22 )(≥ 22 )(≥ 23 0.955 22 )(≥ 24 ) 25 with 28 ones 25 with 29 confirming 26 the 28 ones 27 spiked 28 ones 29 confirming 31 reliability 30 the 31 reliability 31 reliability 32 of 32 of 35 method 33 the 35 method 34 proposed 35 method objective : the aim of the present study was to determine whether serum urate ( sua ) concentration is positively associated with subclinical atherosclerosis , [independent] of body mass index [(] bmi ) , amongst generally healthy adults . 0 ###LEFT-WALL### 1 objective 0 ###LEFT-WALL### 2 : 1 objective 2 : 2 : 4 aim 2 : 10 to 3 the 4 aim 4 aim 5 of 5 of 7 present 6 the 7 present 7 present 8 study 7 present 9 was 8 study 9 was 10 to 11 determine 11 determine 12 whether 11 determine 35 amongst 12 whether 13 serum 12 whether 21 associated 13 serum 18 concentration 13 serum 19 is 13 serum 21 associated 14 urate 16 sua 14 urate 18 concentration 15 ( 16 sua 16 sua 17 ) 18 concentration 19 is 20 positively 21 associated 21 associated 22 with 22 with 24 atherosclerosis 23 subclinical 24 atherosclerosis 24 atherosclerosis 27 of 25 , 27 of 27 of 32 bmi 27 of 33 ) 28 body 32 bmi 29 mass 32 bmi 30 index 32 bmi 34 , 35 amongst 35 amongst 38 adults 35 amongst 39 . 36 generally 37 healthy 37 healthy 38 adults design and setting : the cardia study followed 5115 black and white individuals aged 18 - 30 years in 1985 - 1986 ( [year] 0 ) . 0 ###LEFT-WALL### 3 setting 0 ###LEFT-WALL### 4 : 0 ###LEFT-WALL### 27 . 1 design 2 and 2 and 3 setting 3 setting 4 : 4 : 18 years 4 : 19 in 5 the 18 years 6 cardia 7 study 7 study 8 followed 8 followed 13 individuals 9 5115 13 individuals 10 black 11 and 11 and 12 white 11 and 13 individuals 13 individuals 14 aged 14 aged 16 - 15 18 16 - 16 - 17 30 17 30 18 years 19 in 20 1985 20 1985 22 1986 21 - 22 1986 22 1986 25 0 22 1986 26 ) 23 ( 25 0 25 0 26 ) subclinical atherosclerosis comprised coronary artery calcified plaque ( cac ; years 15 , 20 and 25 ) , and maximum common carotid intima - media thickness ( imt ; [year] 20 [ )( sua ( years 0 , 10 , 15 and 20 ) was modelled as gender - specific quartiles that were pooled . 0 ###LEFT-WALL### 2 atherosclerosis 0 ###LEFT-WALL### 3 comprised 0 ###LEFT-WALL### 10 ; 0 ###LEFT-WALL### 46 modelled 1 subclinical 2 atherosclerosis 2 atherosclerosis 3 comprised 3 comprised 7 plaque 4 coronary 5 artery 5 artery 7 plaque 6 calcified 7 plaque 7 plaque 9 cac 8 ( 9 cac 9 cac 10 ; 10 ; 19 and 10 ; 29 ; 11 years 12 15 11 years 15 and 11 years 19 and 13 , 15 and 14 20 15 and 15 and 16 25 15 and 17 ) 18 , 19 and 19 and 26 thickness 19 and 28 imt 20 maximum 26 thickness 21 common 25 media 22 carotid 25 media 23 intima 24 - 23 intima 25 media 25 media 26 thickness 27 ( 28 imt 28 imt 29 ; 29 ; 31 20 29 ; 33 )( 31 20 33 )( 33 )( 34 sua 34 sua 36 years 34 sua 42 and 34 sua 45 was 35 ( 36 years 36 years 37 0 36 years 39 10 36 years 40 , 38 , 39 10 39 10 40 , 40 , 42 and 41 15 42 and 42 and 43 20 42 and 44 ) 45 was 46 modelled 46 modelled 47 as 47 as 48 gender 48 gender 51 quartiles 49 - 51 quartiles 50 specific 51 quartiles 51 quartiles 52 that 51 quartiles 53 were 51 quartiles 55 . 52 that 53 were 53 were 54 pooled discrete - time hazard regressions and generalized linear regressions were used for analyses . 0 ###LEFT-WALL### 6 and 0 ###LEFT-WALL### 11 used 0 ###LEFT-WALL### 14 . 1 discrete 2 - 1 discrete 5 regressions 3 time 5 regressions 4 hazard 5 regressions 5 regressions 6 and 6 and 9 regressions 6 and 10 were 7 generalized 9 regressions 8 linear 9 regressions 10 were 11 used 11 used 12 for 12 for 13 analyses results : mean sua concentration was lower in women than in men and increased with age . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 3 mean 0 ###LEFT-WALL### 17 . 1 results 2 : 2 : 3 mean 3 mean 5 concentration 3 mean 13 and 4 sua 5 concentration 5 concentration 13 and 6 was 7 lower 6 was 13 and 7 lower 8 in 7 lower 10 than 8 in 9 women 10 than 11 in 11 in 12 men 13 and 14 increased 14 increased 15 with 15 with 16 age adjusting for demographic and lifestyle factors , the highest versus [lowest] quartile of sua at [year] 0 was associated with a 44 % [[] 95 % confidence interval [(] ci [ )(20 % , 73 % ] [greater] risk of cac progression from years 15 to 25 ( ptrend [<] 0.001 ) , which was attenuated by adjustment for bmi at [year] 0 ( ptrend [=] 0.45 [ )( 1 adjusting 2 for 1 adjusting 6 factors 1 adjusting 7 , 1 adjusting 9 highest 2 for 4 and 3 demographic 4 and 4 and 5 lifestyle 8 the 9 highest 9 highest 10 versus 9 highest 13 of 9 highest 18 was 10 versus 12 quartile 13 of 14 sua 14 sua 15 at 15 at 17 0 18 was 19 associated 19 associated 20 with 20 with 28 interval 20 with 30 ci 21 a 28 interval 22 44 23 % 23 % 28 interval 25 95 28 interval 26 % 28 interval 27 confidence 28 interval 30 ci 33 % 30 ci 39 risk 30 ci 40 of 32 )(20 33 % 33 % 36 % 33 % 39 risk 34 , 36 % 35 73 36 % 36 % 37 ] 40 of 42 progression 41 cac 42 progression 42 progression 43 from 42 progression 49 ptrend 42 progression 54 which 43 from 44 years 44 years 46 to 45 15 46 to 46 to 47 25 48 ( 49 ptrend 49 ptrend 51 0.001 49 ptrend 52 ) 53 , 54 which 54 which 55 was 55 was 56 attenuated 56 attenuated 57 by 56 attenuated 59 for 56 attenuated 61 at 57 by 58 adjustment 59 for 60 bmi 61 at 63 0 63 0 65 ptrend 64 ( 65 ptrend 65 ptrend 67 0.45 65 ptrend 69 )( a stronger association [was] found [between] sua at year 15 and cac progression at [year] 20 or 25 ( hazard ratio 2.07 , 95 % ci 1.66 , 2.58 for the highest versus [lowest] sua quartile ptrend < [0.001] [ )(, which was attenuated , but remained significant with additional adjustment for bmi at [year] 15 ( ptrend [=] 0.01 [ )( 0 ###LEFT-WALL### 3 association 0 ###LEFT-WALL### 5 found 1 a 3 association 2 stronger 3 association 3 association 5 found 5 found 7 sua 5 found 13 progression 5 found 17 or 7 sua 8 at 8 at 12 cac 9 year 12 cac 10 15 11 and 11 and 12 cac 13 progression 14 at 14 at 16 20 17 or 18 25 17 or 29 2.58 18 25 21 ratio 18 25 26 ci 19 ( 21 ratio 20 hazard 21 ratio 21 ratio 22 2.07 21 ratio 23 , 23 , 26 ci 24 95 26 ci 25 % 26 ci 26 ci 27 1.66 26 ci 28 , 29 2.58 30 for 29 2.58 33 versus 30 for 32 highest 31 the 32 highest 33 versus 36 quartile 35 sua 36 quartile 36 quartile 37 ptrend 36 quartile 38 < 36 quartile 42 which 37 ptrend 38 < 41 )(, 42 which 42 which 46 but 43 was 44 attenuated 43 was 46 but 45 , 46 but 46 but 47 remained 47 remained 48 significant 48 significant 49 with 49 with 51 adjustment 49 with 52 for 50 additional 51 adjustment 52 for 53 bmi 53 bmi 54 at 53 bmi 58 ptrend 54 at 56 15 57 ( 58 ptrend 58 ptrend 60 0.01 58 ptrend 62 )( a greater increment in sua concentration from [year] 0 to [year] 15 , independent [of] change in bmi , was related to a higher risk of cac progression ( ptrend [<] 0.001 ) . 0 ###LEFT-WALL### 3 increment 0 ###LEFT-WALL### 21 related 0 ###LEFT-WALL### 34 . 1 a 3 increment 2 greater 3 increment 3 increment 4 in 3 increment 20 was 4 in 6 concentration 5 sua 6 concentration 6 concentration 10 to 6 concentration 16 change 7 from 10 to 9 0 10 to 10 to 12 15 13 , 16 change 14 independent 16 change 16 change 17 in 16 change 19 , 17 in 18 bmi 20 was 21 related 21 related 22 to 22 to 25 risk 23 a 25 risk 24 higher 25 risk 25 risk 26 of 25 risk 30 ptrend 26 of 28 progression 27 cac 28 progression 29 ( 30 ptrend 30 ptrend 32 0.001 30 ptrend 33 ) similar associations were found between sua and imt , but only in men . 0 ###LEFT-WALL### 2 associations 0 ###LEFT-WALL### 4 found 0 ###LEFT-WALL### 14 . 1 similar 2 associations 2 associations 3 were 3 were 4 found 4 found 10 but 5 between 7 and 5 between 10 but 6 sua 7 and 7 and 8 imt 9 , 10 but 10 but 11 only 10 but 12 in 12 in 13 men conclusion : sua may be an early biomarker for subclinical atherosclerosis in young adults ; starting in early middle age , sua predicts subclinical atherosclerosis independently of bmi . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 3 sua 2 : 5 be 2 : 15 ; 2 : 29 . 3 sua 4 may 4 may 5 be 5 be 8 biomarker 6 an 8 biomarker 7 early 8 biomarker 8 biomarker 9 for 9 for 11 atherosclerosis 10 subclinical 11 atherosclerosis 11 atherosclerosis 12 in 12 in 14 adults 13 young 14 adults 15 ; 22 sua 15 ; 23 predicts 16 starting 17 in 16 starting 20 age 16 starting 21 , 16 starting 22 sua 18 early 20 age 19 middle 20 age 22 sua 23 predicts 23 predicts 25 atherosclerosis 23 predicts 26 independently 24 subclinical 25 atherosclerosis 26 independently 27 of 27 of 28 bmi treatment of gynecological cancer has significant impact on a woman 's quality of life because it commonly includes removal of the uterus and ovaries , both being the core of a woman 's femininity , whilst irradiation and chemotherapy , be they as primary therapy or when indicated as postoperative adjuvant therapy , will lead to ablation of [ovarian] function if the ovaries had not been removed . 0 ###LEFT-WALL### 1 treatment 0 ###LEFT-WALL### 5 has 0 ###LEFT-WALL### 35 , 1 treatment 2 of 1 treatment 5 has 2 of 4 cancer 3 gynecological 4 cancer 5 has 7 impact 6 significant 7 impact 7 impact 8 on 7 impact 13 of 7 impact 15 because 7 impact 18 includes 8 on 12 quality 9 a 10 woman 10 woman 11 's 11 's 12 quality 13 of 14 life 15 because 16 it 16 it 18 includes 17 commonly 18 includes 18 includes 23 and 19 removal 20 of 19 removal 23 and 20 of 22 uterus 21 the 22 uterus 23 and 24 ovaries 23 and 26 both 25 , 26 both 26 both 27 being 26 both 35 , 27 being 29 core 28 the 29 core 29 core 30 of 30 of 34 femininity 31 a 32 woman 32 woman 33 's 33 's 34 femininity 35 , 42 they 35 , 60 function 36 whilst 38 and 36 whilst 41 be 36 whilst 42 they 37 irradiation 38 and 38 and 39 chemotherapy 38 and 40 , 38 and 41 be 42 they 46 or 42 they 58 of 42 they 60 function 43 as 44 primary 44 primary 45 therapy 45 therapy 46 or 46 or 47 when 46 or 53 , 48 indicated 52 therapy 48 indicated 53 , 49 as 50 postoperative 50 postoperative 52 therapy 51 adjuvant 52 therapy 53 , 54 will 53 , 56 to 54 will 55 lead 56 to 57 ablation 57 ablation 58 of 60 function 61 if 61 if 63 ovaries 61 if 67 removed 62 the 63 ovaries 63 ovaries 64 had 64 had 65 not 64 had 66 been 66 been 67 removed 67 removed 68 . about 25 % of gynecological cancers will occur in pre - and perimenopausal women , a large percentage of [whom] will become menopausal as a result of their treatment . 0 ###LEFT-WALL### 3 % 0 ###LEFT-WALL### 8 occur 1 about 2 25 2 25 3 % 3 % 4 of 3 % 7 will 4 of 6 cancers 5 gynecological 6 cancers 7 will 8 occur 8 occur 9 in 9 in 12 and 10 pre 12 and 11 - 12 and 12 and 14 women 12 and 18 percentage 13 perimenopausal 14 women 15 , 18 percentage 16 a 17 large 16 a 18 percentage 17 large 18 percentage 18 percentage 19 of 18 percentage 23 menopausal 18 percentage 30 . 19 of 21 will 21 will 22 become 23 menopausal 24 as 24 as 26 result 25 a 26 result 26 result 27 of 27 of 29 treatment 28 their 29 treatment there are also the gynecological cancer survivors who are not rendered menopausal as a result of the treatment strategy but who will become menopausal because of natural aging . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 20 but 0 ###LEFT-WALL### 29 . 1 there 2 are 2 are 3 also 2 are 7 survivors 4 the 7 survivors 5 gynecological 7 survivors 6 cancer 7 survivors 7 survivors 8 who 7 survivors 9 are 8 who 9 are 9 are 10 not 9 are 11 rendered 11 rendered 12 menopausal 12 menopausal 13 as 13 as 15 result 14 a 15 result 15 result 16 of 16 of 19 strategy 17 the 19 strategy 18 treatment 19 strategy 20 but 21 who 20 but 23 become 21 who 22 will 22 will 23 become 23 become 24 menopausal 24 menopausal 26 of 25 because 26 of 26 of 28 aging 27 natural 28 aging concern among the medical attendants of these women is whether use of estrogen therapy or estrogen and progestogens for their menopausal symptoms will reactivate tumor deposits and therefore increase the rate of recurrence [and] , as a result , decrease overall survival among these women . 0 ###LEFT-WALL### 1 concern 0 ###LEFT-WALL### 9 is 0 ###LEFT-WALL### 46 . 1 concern 2 among 1 concern 6 of 1 concern 9 is 2 among 5 attendants 3 the 5 attendants 4 medical 5 attendants 6 of 8 women 7 these 8 women 9 is 10 whether 10 whether 17 and 10 whether 27 and 11 use 12 of 11 use 17 and 12 of 15 or 13 estrogen 14 therapy 14 therapy 15 or 15 or 16 estrogen 17 and 18 progestogens 17 and 19 for 17 and 23 will 19 for 22 symptoms 20 their 22 symptoms 21 menopausal 22 symptoms 23 will 27 and 24 reactivate 26 deposits 24 reactivate 27 and 25 tumor 26 deposits 27 and 29 increase 27 and 42 survival 28 therefore 29 increase 29 increase 31 rate 30 the 31 rate 31 rate 32 of 32 of 33 recurrence 33 recurrence 36 as 35 , 36 as 36 as 38 result 36 as 39 , 37 a 38 result 40 decrease 41 overall 41 overall 42 survival 42 survival 43 among 43 among 45 women 44 these 45 women yet the data that are available do not support this concern . 0 ###LEFT-WALL### 1 yet 0 ###LEFT-WALL### 9 support 0 ###LEFT-WALL### 12 . 1 yet 3 data 2 the 3 data 3 data 4 that 3 data 5 are 3 data 7 do 4 that 5 are 5 are 6 available 7 do 8 not 7 do 9 support 9 support 11 concern 10 this 11 concern there are eight retrospective studies and only one randomized study that have analyzed [outcome] in endometrial cancer survivors who used hormone therapy after their surgery , whilst , among ovarian cancer survivors , there are four retrospective studies and one randomized study . 0 ###LEFT-WALL### 1 there 0 ###LEFT-WALL### 2 are 0 ###LEFT-WALL### 43 . 1 there 2 are 2 are 6 and 3 eight 6 and 4 retrospective 5 studies 5 studies 6 and 6 and 10 study 6 and 11 that 6 and 12 have 7 only 8 one 8 one 10 study 9 randomized 10 study 11 that 12 have 12 have 13 analyzed 13 analyzed 39 and 13 analyzed 42 study 15 in 18 survivors 15 in 39 and 16 endometrial 18 survivors 17 cancer 18 survivors 18 survivors 19 who 18 survivors 20 used 19 who 20 used 20 used 22 therapy 21 hormone 22 therapy 23 after 25 surgery 23 after 26 , 23 after 39 and 24 their 25 surgery 27 whilst 34 there 27 whilst 35 are 27 whilst 39 and 28 , 29 among 29 among 32 survivors 29 among 33 , 29 among 34 there 30 ovarian 32 survivors 31 cancer 32 survivors 34 there 35 are 35 are 36 four 37 retrospective 38 studies 38 studies 39 and 39 and 40 one 39 and 41 randomized 39 and 42 study the studies do suffer from small numbers and , [although] the studies pertaining to endometrial cancer analyze [mostly] women with early - stage disease , a number of the studies in both the endometrial and ovarian cancer survivors do have [a] [sizeable] follow - up . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 4 suffer 0 ###LEFT-WALL### 8 and 1 the 2 studies 2 studies 3 do 3 do 4 suffer 4 suffer 5 from 5 from 7 numbers 6 small 7 numbers 8 and 9 , 8 and 12 studies 11 the 12 studies 12 studies 13 pertaining 12 studies 14 to 12 studies 17 analyze 14 to 16 cancer 15 endometrial 16 cancer 17 analyze 19 women 17 analyze 20 with 20 with 24 disease 21 early 22 - 21 early 23 stage 23 stage 24 disease 24 disease 35 and 25 , 35 and 26 a 27 number 27 number 28 of 27 number 35 and 28 of 30 studies 29 the 30 studies 30 studies 31 in 31 in 32 both 32 both 33 the 32 both 34 endometrial 33 the 34 endometrial 35 and 37 cancer 35 and 38 survivors 35 and 40 have 35 and 46 . 36 ovarian 37 cancer 38 survivors 39 do 39 do 40 have 40 have 43 follow 43 follow 45 up 44 - 45 up 45 up 46 . these studies seem to support that estrogen therapy after the treatment for gynecological cancer does not impact negatively on outcome [in] endometrial and ovarian cancer survivors and that estrogen therapy can be considered as a plausible therapeutic option in survivors who are debilitated by their menopausal symptoms . 0 ###LEFT-WALL### 2 studies 0 ###LEFT-WALL### 27 and 0 ###LEFT-WALL### 48 . 1 these 2 studies 2 studies 3 seem 3 seem 4 to 3 seem 5 support 4 to 5 support 5 support 8 therapy 5 support 9 after 6 that 7 estrogen 7 estrogen 8 therapy 9 after 11 treatment 9 after 17 impact 10 the 11 treatment 11 treatment 12 for 11 treatment 15 does 12 for 14 cancer 13 gynecological 14 cancer 15 does 16 not 15 does 17 impact 17 impact 18 negatively 17 impact 19 on 17 impact 26 survivors 19 on 25 cancer 20 outcome 25 cancer 22 endometrial 23 and 23 and 24 ovarian 23 and 25 cancer 27 and 30 therapy 27 and 33 considered 28 that 30 therapy 29 estrogen 30 therapy 30 therapy 31 can 31 can 32 be 32 be 33 considered 33 considered 34 as 33 considered 39 in 34 as 38 option 35 a 38 option 36 plausible 38 option 37 therapeutic 38 option 39 in 40 survivors 40 survivors 41 who 40 survivors 42 are 41 who 42 are 42 are 43 debilitated 43 debilitated 44 by 44 by 47 symptoms 45 their 47 symptoms 46 menopausal 47 symptoms it is prudent not to offer estrogen therapy to survivors of endometrial stromal sarcoma and women with granulosa cell tumors of the ovaries . 0 ###LEFT-WALL### 1 it 0 ###LEFT-WALL### 6 offer 0 ###LEFT-WALL### 24 . 1 it 2 is 2 is 3 prudent 3 prudent 5 to 4 not 5 to 5 to 6 offer 6 offer 8 therapy 6 offer 17 with 7 estrogen 8 therapy 8 therapy 9 to 8 therapy 11 of 9 to 10 survivors 11 of 15 and 12 endometrial 14 sarcoma 13 stromal 14 sarcoma 14 sarcoma 15 and 15 and 16 women 17 with 20 tumors 18 granulosa 20 tumors 19 cell 20 tumors 20 tumors 21 of 21 of 23 ovaries 22 the 23 ovaries vulval , vaginal and cervical cancers are not considered hormone - dependent and therefore estrogen therapy can be given . 0 ###LEFT-WALL### 10 hormone 0 ###LEFT-WALL### 11 - 1 vulval 2 , 2 , 3 vaginal 2 , 4 and 4 and 5 cervical 4 and 6 cancers 4 and 9 considered 4 and 10 hormone 6 cancers 7 are 7 are 8 not 7 are 9 considered 11 - 16 therapy 11 - 19 given 11 - 20 . 12 dependent 13 and 13 and 14 therefore 13 and 15 estrogen 13 and 16 therapy 16 therapy 17 can 17 can 18 be 18 be 19 given management of the surgically unfit patient with symptomatic cholelithiasis can be fraught with difficulty . 0 ###LEFT-WALL### 1 management 0 ###LEFT-WALL### 11 be 0 ###LEFT-WALL### 15 . 1 management 2 of 1 management 10 can 2 of 6 patient 3 the 6 patient 4 surgically 5 unfit 5 unfit 6 patient 6 patient 7 with 7 with 9 cholelithiasis 8 symptomatic 9 cholelithiasis 10 can 11 be 11 be 12 fraught 12 fraught 13 with 13 with 14 difficulty we describe the case [of] [on] [such] gentleman in whom percutaneous transhepatic cholecystoscopy was used to completely fragment a large gallbladder calculus through the use of a nephroscope and swiss lithoclast master . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 describe 0 ###LEFT-WALL### 33 . 1 we 2 describe 2 describe 8 gentleman 3 the 8 gentleman 4 case 8 gentleman 8 gentleman 9 in 9 in 10 whom 9 in 13 cholecystoscopy 9 in 15 used 11 percutaneous 13 cholecystoscopy 12 transhepatic 13 cholecystoscopy 13 cholecystoscopy 14 was 14 was 15 used 15 used 16 to 15 used 18 fragment 16 to 18 fragment 17 completely 18 fragment 18 fragment 32 master 19 a 20 large 19 a 32 master 20 large 21 gallbladder 21 gallbladder 22 calculus 22 calculus 23 through 22 calculus 29 and 23 through 25 use 24 the 25 use 25 use 26 of 26 of 28 nephroscope 27 a 28 nephroscope 29 and 30 swiss 29 and 31 lithoclast the article is devoted community principles and stages of the psychoprevental and correctional approach for teenagers with beer . 0 ###LEFT-WALL### 2 article 0 ###LEFT-WALL### 3 is 0 ###LEFT-WALL### 19 . 1 the 2 article 2 article 3 is 3 is 7 and 4 devoted 5 community 5 community 6 principles 6 principles 7 and 7 and 8 stages 7 and 9 of 9 of 14 approach 10 the 14 approach 11 psychoprevental 12 and 12 and 13 correctional 12 and 14 approach 14 approach 15 for 14 approach 17 with 15 for 16 teenagers 17 with 18 beer the occurrence and structure of dyslipidemias , the result of the concentration of c - reactive protein in blood serum and some results of hormonal background [in] women with cardialgias in reproductive age , during peri - and postmenopause were studied . 0 ###LEFT-WALL### 38 and 0 ###LEFT-WALL### 40 were 0 ###LEFT-WALL### 42 . 1 the 2 occurrence 2 occurrence 3 and 3 and 4 structure 3 and 38 and 4 structure 5 of 5 of 6 dyslipidemias 6 dyslipidemias 9 result 6 dyslipidemias 21 and 7 , 9 result 8 the 9 result 9 result 10 of 9 result 15 - 10 of 12 concentration 11 the 12 concentration 12 concentration 13 of 13 of 14 c 15 - 21 and 16 reactive 17 protein 17 protein 18 in 17 protein 21 and 18 in 20 serum 19 blood 20 serum 21 and 23 results 21 and 24 of 21 and 37 - 22 some 23 results 24 of 28 women 25 hormonal 26 background 26 background 28 women 28 women 29 with 28 women 31 in 28 women 35 during 29 with 30 cardialgias 31 in 33 age 32 reproductive 33 age 34 , 35 during 35 during 36 peri 35 during 37 - 37 - 38 and 38 and 39 postmenopause 38 and 40 were 40 were 41 studied the features of proatherogenic disorders connected with dominating types of dyslipidemias , the degree of chronic inflammation [manifestation] and some results [of] hormonal background were established for people with certain reproductive status . 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 26 established 0 ###LEFT-WALL### 33 . 1 the 2 features 2 features 3 of 2 features 12 , 3 of 5 disorders 4 proatherogenic 5 disorders 5 disorders 6 connected 6 connected 7 with 7 with 8 dominating 8 dominating 10 of 9 types 10 of 10 of 11 dyslipidemias 12 , 17 inflammation 12 , 19 and 13 the 14 degree 14 degree 15 of 14 degree 17 inflammation 15 of 17 inflammation 16 chronic 17 inflammation 19 and 24 background 19 and 25 were 20 some 24 background 21 results 24 background 23 hormonal 24 background 25 were 26 established 26 established 27 for 26 established 29 with 27 for 28 people 29 with 32 status 30 certain 32 status 31 reproductive 32 status the claimed beneficial effects of the mediterranean diet include prevention of several age - related dysfunctions including neurodegenerative diseases and alzheimer - like pathology . 0 ###LEFT-WALL### 4 effects 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 25 . 1 the 4 effects 2 claimed 4 effects 3 beneficial 4 effects 4 effects 5 of 4 effects 20 and 5 of 8 diet 6 the 8 diet 7 mediterranean 8 diet 9 include 10 prevention 9 include 20 and 10 prevention 11 of 11 of 13 age 12 several 13 age 13 age 17 including 14 - 15 related 15 related 16 dysfunctions 15 related 17 including 17 including 19 diseases 18 neurodegenerative 19 diseases 20 and 23 like 21 alzheimer 22 - 21 alzheimer 23 like 23 like 24 pathology these effects have been related to the protection against cognitive [decline] associated with aging and disease by a number of polyphenols found in red wine and extra virgin olive oil . 0 ###LEFT-WALL### 2 effects 0 ###LEFT-WALL### 5 related 0 ###LEFT-WALL### 31 . 1 these 2 effects 2 effects 3 have 3 have 4 been 4 been 5 related 5 related 6 to 5 related 9 against 6 to 8 protection 7 the 8 protection 9 against 15 and 10 cognitive 12 associated 10 cognitive 13 with 10 cognitive 15 and 13 with 14 aging 15 and 16 disease 16 disease 17 by 17 by 26 and 18 a 19 number 19 number 20 of 19 number 23 in 19 number 26 and 20 of 21 polyphenols 21 polyphenols 22 found 23 in 25 wine 24 red 25 wine 26 and 30 oil 27 extra 29 olive 28 virgin 29 olive 29 olive 30 oil we report here that dietary supplementation of oleuropein aglycone strongly improves the cognitive performance of young/middle - aged tgcrnd8 mice , a model of amyloid - ß deposition , respect to age - matched littermates with [un] - supplemented diet . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 report 0 ###LEFT-WALL### 38 - 1 we 2 report 2 report 3 here 2 report 4 that 4 that 6 supplementation 4 that 11 improves 5 dietary 6 supplementation 6 supplementation 7 of 6 supplementation 11 improves 7 of 9 aglycone 8 oleuropein 9 aglycone 10 strongly 11 improves 11 improves 14 performance 12 the 14 performance 13 cognitive 14 performance 14 performance 15 of 15 of 27 ß 16 young/middle 20 mice 16 young/middle 26 - 16 young/middle 27 ß 17 - 20 mice 18 aged 20 mice 19 tgcrnd8 20 mice 20 mice 23 model 20 mice 26 - 21 , 23 model 22 a 23 model 23 model 24 of 23 model 26 - 24 of 25 amyloid 27 ß 28 deposition 27 ß 36 with 28 deposition 30 respect 28 deposition 34 matched 29 , 30 respect 30 respect 31 to 30 respect 33 - 31 to 32 age 34 matched 35 littermates 34 matched 36 with 38 - 40 diet 38 - 41 . 39 supplemented 40 diet immunofluorescence analysis of cerebral tissue in oleuropein aglycone - fed transgenic mice showed remarkably reduced ß - amyloid levels and plaque deposits , which appeared less compact and " fluffy " ; moreover , microglia migration to the plaques for phagocytosis and a remarkable reduction of the astrocyte reaction were evident . 0 ###LEFT-WALL### 20 and 0 ###LEFT-WALL### 23 , 0 ###LEFT-WALL### 52 . 1 immunofluorescence 2 analysis 2 analysis 3 of 2 analysis 20 and 3 of 5 tissue 4 cerebral 5 tissue 5 tissue 6 in 5 tissue 12 mice 5 tissue 19 levels 6 in 7 oleuropein 8 aglycone 9 - 8 aglycone 12 mice 10 fed 12 mice 11 transgenic 12 mice 12 mice 13 showed 13 showed 18 amyloid 13 showed 19 levels 14 remarkably 15 reduced 15 reduced 18 amyloid 16 ß 17 - 16 ß 18 amyloid 18 amyloid 19 levels 20 and 22 deposits 21 plaque 22 deposits 23 , 24 which 23 , 25 appeared 23 , 32 ; 24 which 25 appeared 25 appeared 26 less 25 appeared 28 and 27 compact 28 and 28 and 29 " 28 and 30 fluffy 30 fluffy 31 " 32 ; 42 and 32 ; 50 were 33 moreover 34 , 33 moreover 42 and 35 microglia 36 migration 36 migration 37 to 36 migration 42 and 37 to 39 plaques 38 the 39 plaques 39 plaques 40 for 40 for 41 phagocytosis 42 and 45 reduction 42 and 46 of 42 and 50 were 43 a 45 reduction 44 remarkable 45 reduction 46 of 49 reaction 47 the 49 reaction 48 astrocyte 49 reaction 50 were 51 evident finally , oleuropein aglycone - fed mice brain displayed an astonishingly intense autophagic reaction , as shown by the increase of autophagic markers expression [and] of lysosomal activity . 0 ###LEFT-WALL### 3 oleuropein 0 ###LEFT-WALL### 9 displayed 0 ###LEFT-WALL### 29 . 1 finally 2 , 1 finally 3 oleuropein 3 oleuropein 7 mice 3 oleuropein 8 brain 3 oleuropein 9 displayed 4 aglycone 5 - 4 aglycone 7 mice 6 fed 7 mice 7 mice 8 brain 9 displayed 14 reaction 9 displayed 18 by 10 an 14 reaction 11 astonishingly 12 intense 12 intense 14 reaction 13 autophagic 14 reaction 14 reaction 17 shown 15 , 17 shown 16 as 17 shown 18 by 20 increase 19 the 20 increase 20 increase 21 of 21 of 24 expression 22 autophagic 23 markers 23 markers 24 expression 24 expression 26 of 26 of 28 activity 27 lysosomal 28 activity data obtained with cultured cells confirmed the latter evidence , suggesting mtor regulation by oleuropein aglycone . 0 ###LEFT-WALL### 1 data 0 ###LEFT-WALL### 6 confirmed 1 data 2 obtained 1 data 6 confirmed 2 obtained 3 with 3 with 5 cells 4 cultured 5 cells 6 confirmed 9 evidence 6 confirmed 11 suggesting 7 the 9 evidence 8 latter 9 evidence 10 , 11 suggesting 11 suggesting 13 regulation 11 suggesting 14 by 11 suggesting 17 . 12 mtor 13 regulation 14 by 16 aglycone 15 oleuropein 16 aglycone our results support , and [provide] mechanistic insights [into] , the beneficial effects against alzheimer - associated neurodegeneration of a polyphenol enriched in the extra virgin olive oil , a major component of the mediterranean diet . 0 ###LEFT-WALL### 5 and 0 ###LEFT-WALL### 17 associated 1 our 3 support 2 results 3 support 3 support 5 and 4 , 5 and 5 and 8 insights 5 and 13 effects 5 and 17 associated 7 mechanistic 8 insights 10 , 13 effects 11 the 13 effects 12 beneficial 13 effects 13 effects 14 against 13 effects 16 - 14 against 15 alzheimer 17 associated 18 neurodegeneration 17 associated 23 in 18 neurodegeneration 19 of 19 of 21 polyphenol 20 a 21 polyphenol 21 polyphenol 22 enriched 23 in 28 oil 24 the 28 oil 25 extra 28 oil 26 virgin 28 oil 27 olive 28 oil 28 oil 32 component 29 , 32 component 30 a 31 major 30 a 32 component 31 major 32 component 32 component 33 of 32 component 37 . 33 of 36 diet 34 the 36 diet 35 mediterranean 36 diet recent data from the manicaland hiv/std prevention project , a general - population open hiv cohort study , suggested that between 2004 and 2007 hiv prevalence amongst males aged 15 - 17 years in eastern zimbabwe increased from 1.20 % to 2.23 % , and in females remained unchanged at 2.23 % to 2.39 % , while prevalence continued to decline in the rest of the adult population . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 69 . 1 recent 2 data 2 data 3 from 2 data 18 , 3 from 13 population 4 the 13 population 5 manicaland 6 hiv/std 6 hiv/std 7 prevention 7 prevention 13 population 8 project 11 general 8 project 13 population 9 , 11 general 10 a 11 general 11 general 12 - 14 open 17 study 14 open 18 , 15 hiv 16 cohort 16 cohort 17 study 18 , 19 suggested 19 suggested 23 and 19 suggested 57 while 19 suggested 60 to 20 that 21 between 20 that 23 and 21 between 22 2004 23 and 26 prevalence 23 and 56 , 24 2007 26 prevalence 25 hiv 26 prevalence 26 prevalence 27 amongst 27 amongst 28 males 28 males 29 aged 29 aged 31 - 30 15 31 - 31 - 32 17 32 17 33 years 33 years 34 in 33 years 37 increased 34 in 36 zimbabwe 35 eastern 36 zimbabwe 37 increased 55 % 38 from 53 to 39 1.20 40 % 39 1.20 53 to 40 % 45 and 40 % 48 remained 41 to 43 % 41 to 45 and 42 2.23 43 % 44 , 45 and 45 and 46 in 46 in 47 females 48 remained 49 unchanged 49 unchanged 50 at 50 at 52 % 51 2.23 52 % 53 to 54 2.39 53 to 55 % 57 while 59 continued 58 prevalence 59 continued 60 to 61 decline 61 decline 62 in 62 in 68 population 63 the 64 rest 64 rest 65 of 64 rest 68 population 65 of 68 population 66 the 68 population 67 adult 68 population we assess whether the more likely source of the increase in adolescent hiv prevalence is recent sexual hiv acquisition , or the aging of long - term survivors of perinatal hiv acquisition that occurred during the early growth of the epidemic . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 assess 0 ###LEFT-WALL### 42 . 1 we 2 assess 2 assess 3 whether 3 whether 7 source 3 whether 15 is 4 the 7 source 5 more 6 likely 6 likely 7 source 7 source 8 of 7 source 15 is 8 of 10 increase 9 the 10 increase 10 increase 11 in 11 in 14 prevalence 12 adolescent 14 prevalence 13 hiv 14 prevalence 15 is 21 or 16 recent 19 acquisition 17 sexual 19 acquisition 18 hiv 19 acquisition 19 acquisition 21 or 20 , 21 or 21 or 23 aging 21 or 33 that 21 or 34 occurred 22 the 23 aging 23 aging 24 of 23 aging 29 of 24 of 28 survivors 25 long 26 - 25 long 28 survivors 27 term 28 survivors 29 of 32 acquisition 30 perinatal 32 acquisition 31 hiv 32 acquisition 33 that 34 occurred 34 occurred 35 during 35 during 38 growth 36 the 38 growth 37 early 38 growth 38 growth 39 of 39 of 41 epidemic 40 the 41 epidemic using data collected between august 2006 and november 2008 , we investigated associations between adolescent hiv and [(] [1] ) maternal orphanhood and maternal hiv status , ( 2 ) reported sexual behaviour , and [(] 3 [ )(reporting recurring sickness or chronic illness , suggesting infected adolescents might be in a late stage of hiv infection . 0 ###LEFT-WALL### 1 using 0 ###LEFT-WALL### 3 collected 0 ###LEFT-WALL### 10 , 1 using 2 data 1 using 3 collected 3 collected 4 between 3 collected 9 2008 4 between 7 and 5 august 6 2006 5 august 7 and 7 and 8 november 10 , 11 we 10 , 12 investigated 10 , 17 and 11 we 12 investigated 12 investigated 13 associations 13 associations 14 between 14 between 16 hiv 15 adolescent 16 hiv 17 and 20 ) 17 and 23 and 21 maternal 22 orphanhood 22 orphanhood 23 and 23 and 26 status 23 and 27 , 23 and 29 2 23 and 31 reported 24 maternal 26 status 25 hiv 26 status 28 ( 29 2 29 2 30 ) 31 reported 35 and 32 sexual 33 behaviour 33 behaviour 35 and 34 , 35 and 35 and 39 )(reporting 35 and 40 recurring 37 3 39 )(reporting 40 recurring 42 or 41 sickness 42 or 42 or 44 illness 42 or 46 suggesting 43 chronic 44 illness 45 , 46 suggesting 46 suggesting 48 adolescents 46 suggesting 50 be 46 suggesting 58 . 47 infected 48 adolescents 48 adolescents 49 might 49 might 50 be 50 be 51 in 51 in 54 stage 52 a 54 stage 53 late 54 stage 54 stage 55 of 55 of 57 infection 56 hiv 57 infection none of 22 hiv - infected adolescent males and only three [of] 23 hiv - infected females reported ever having had sex . 0 ###LEFT-WALL### 4 hiv 0 ###LEFT-WALL### 16 infected 0 ###LEFT-WALL### 23 . 1 none 2 of 1 none 4 hiv 2 of 4 hiv 3 22 4 hiv 4 hiv 9 and 4 hiv 16 infected 5 - 9 and 6 infected 8 males 7 adolescent 8 males 8 males 9 and 9 and 14 hiv 9 and 15 - 10 only 11 three 11 three 14 hiv 13 23 14 hiv 16 infected 17 females 17 females 18 reported 17 females 20 having 19 ever 20 having 20 having 21 had 21 had 22 sex hiv - infected adolescents were 60 % more likely to report illness than hiv - infected young adults . 0 ###LEFT-WALL### 4 adolescents 0 ###LEFT-WALL### 5 were 0 ###LEFT-WALL### 15 - 1 hiv 2 - 1 hiv 4 adolescents 3 infected 4 adolescents 4 adolescents 5 were 5 were 7 % 6 60 7 % 7 % 9 likely 8 more 9 likely 9 likely 10 to 9 likely 11 report 10 to 11 report 11 report 12 illness 11 report 13 than 13 than 14 hiv 15 - 18 adults 15 - 19 . 16 infected 18 adults 17 young 18 adults taken together , all three hypotheses suggest that recent increases in adolescent hiv prevalence in eastern zimbabwe are more [likely] attributable to long - term survival of mother - [to] - child transmission rather than increases in risky sexual behaviour . 0 ###LEFT-WALL### 6 hypotheses 0 ###LEFT-WALL### 7 suggest 0 ###LEFT-WALL### 41 . 1 taken 2 together 1 taken 3 , 1 taken 6 hypotheses 4 all 5 three 5 three 6 hypotheses 6 hypotheses 7 suggest 7 suggest 8 that 8 that 10 increases 8 that 18 are 9 recent 10 increases 10 increases 11 in 10 increases 18 are 11 in 14 prevalence 12 adolescent 14 prevalence 13 hiv 14 prevalence 14 prevalence 15 in 15 in 17 zimbabwe 16 eastern 17 zimbabwe 18 are 19 more 18 are 21 attributable 21 attributable 22 to 21 attributable 35 than 21 attributable 37 in 22 to 33 transmission 23 long 26 survival 23 long 31 - 23 long 32 child 24 - 26 survival 25 term 26 survival 26 survival 27 of 26 survival 29 - 27 of 28 mother 32 child 33 transmission 34 rather 35 than 35 than 36 increases 37 in 40 behaviour 38 risky 40 behaviour 39 sexual 40 behaviour hiv prevalence in adolescents and young adults cannot be used as a surrogate for recent hiv incidence , and health systems should prepare for increasing numbers of long - term infected adolescents . 0 ###LEFT-WALL### 17 incidence 0 ###LEFT-WALL### 19 and 0 ###LEFT-WALL### 33 . 1 hiv 17 incidence 2 prevalence 3 in 2 prevalence 5 and 3 in 4 adolescents 5 and 6 young 5 and 7 adults 5 and 9 be 5 and 10 used 5 and 14 for 5 and 17 incidence 7 adults 8 cannot 8 cannot 9 be 10 used 11 as 11 as 13 surrogate 12 a 13 surrogate 14 for 16 hiv 15 recent 16 hiv 18 , 19 and 19 and 21 systems 19 and 23 prepare 20 health 21 systems 21 systems 22 should 22 should 23 prepare 23 prepare 24 for 24 for 25 increasing 25 increasing 32 adolescents 26 numbers 27 of 26 numbers 32 adolescents 27 of 32 adolescents 28 long 29 - 28 long 32 adolescents 30 term 31 infected 31 infected 32 adolescents [with] the prevalence of obesity [,] artificial , [non] [-] nutritive sweeteners have been widely used as dietary supplements that [provide] sweet taste [without] excessive caloric load . 0 ###LEFT-WALL### 3 prevalence 0 ###LEFT-WALL### 19 supplements 0 ###LEFT-WALL### 28 . 2 the 3 prevalence 3 prevalence 4 of 3 prevalence 12 sweeteners 3 prevalence 14 been 3 prevalence 16 used 3 prevalence 19 supplements 4 of 5 obesity 7 artificial 8 , 7 artificial 12 sweeteners 11 nutritive 12 sweeteners 12 sweeteners 13 have 13 have 14 been 15 widely 16 used 16 used 17 as 17 as 18 dietary 19 supplements 27 load 20 that 27 load 22 sweet 23 taste 23 taste 27 load 25 excessive 27 load 26 caloric 27 load in order to better understand the overall actions of artificial sweeteners , especially when they are chronically used , we investigated the peripheral and central nervous system effects of protracted exposure to a widely used artificial sweetener , acesulfame k ( ack ) . 0 ###LEFT-WALL### 20 we 0 ###LEFT-WALL### 21 investigated 0 ###LEFT-WALL### 44 . 1 in 2 order 1 in 20 we 2 order 3 to 2 order 5 understand 3 to 5 understand 4 better 5 understand 5 understand 8 actions 5 understand 14 when 6 the 8 actions 7 overall 8 actions 8 actions 9 of 9 of 11 sweeteners 10 artificial 11 sweeteners 12 , 13 especially 12 , 14 when 14 when 15 they 14 when 16 are 14 when 19 , 15 they 16 are 16 are 18 used 17 chronically 18 used 20 we 21 investigated 21 investigated 28 effects 21 investigated 32 to 22 the 28 effects 23 peripheral 24 and 24 and 25 central 24 and 28 effects 26 nervous 27 system 27 system 28 effects 28 effects 29 of 29 of 31 exposure 30 protracted 31 exposure 32 to 37 sweetener 33 a 37 sweetener 34 widely 35 used 35 used 37 sweetener 36 artificial 37 sweetener 37 sweetener 39 acesulfame 38 , 39 acesulfame 39 acesulfame 40 k 39 acesulfame 42 ack 39 acesulfame 43 ) 41 ( 42 ack 42 ack 43 ) we found that extended ack exposure ( 40 weeks ) in normal c57bl/6j mice demonstrated a moderate and limited influence on metabolic homeostasis , including altering fasting insulin and leptin levels , pancreatic islet size and lipid levels , without affecting insulin sensitivity and bodyweight . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 20 influence 0 ###LEFT-WALL### 24 , 0 ###LEFT-WALL### 46 . 1 we 2 found 2 found 5 ack 2 found 6 exposure 2 found 11 in 3 that 5 ack 4 extended 5 ack 6 exposure 9 weeks 7 ( 9 weeks 8 40 9 weeks 9 weeks 10 ) 11 in 13 c57bl/6j 12 normal 13 c57bl/6j 13 c57bl/6j 14 mice 13 c57bl/6j 20 influence 14 mice 18 and 14 mice 20 influence 15 demonstrated 17 moderate 15 demonstrated 18 and 16 a 17 moderate 18 and 19 limited 20 influence 21 on 21 on 23 homeostasis 22 metabolic 23 homeostasis 24 , 44 and 25 including 26 altering 26 altering 28 insulin 27 fasting 28 insulin 28 insulin 29 and 29 and 38 levels 29 and 39 , 29 and 40 without 29 and 44 and 30 leptin 38 levels 31 levels 32 , 32 , 35 size 32 , 36 and 33 pancreatic 34 islet 34 islet 35 size 36 and 37 lipid 36 and 38 levels 40 without 41 affecting 41 affecting 43 sensitivity 42 insulin 43 sensitivity 44 and 45 bodyweight interestingly , impaired cognitive memory functions ( evaluated by morris water maze and novel objective preference tests ) were found in ack - treated c57bl/6j mice , while no differences in motor function [and] anxiety levels were detected . 0 ###LEFT-WALL### 6 functions 0 ###LEFT-WALL### 20 found 1 interestingly 2 , 1 interestingly 6 functions 3 impaired 5 memory 4 cognitive 5 memory 5 memory 6 functions 6 functions 8 evaluated 6 functions 19 were 7 ( 8 evaluated 8 evaluated 9 by 8 evaluated 18 ) 9 by 13 and 10 morris 11 water 11 water 12 maze 12 maze 13 and 13 and 17 tests 14 novel 15 objective 15 objective 16 preference 16 preference 17 tests 19 were 20 found 20 found 21 in 20 found 28 while 21 in 22 ack 22 ack 26 mice 23 - 26 mice 24 treated 26 mice 25 c57bl/6j 26 mice 26 mice 27 , 28 while 30 differences 28 while 38 detected 29 no 30 differences 30 differences 31 in 30 differences 37 were 31 in 36 levels 32 motor 33 function 33 function 36 levels 35 anxiety 36 levels 37 were 38 detected 38 detected 39 . the generation of an ack [-] induced neurological phenotype was associated with metabolic dysregulation ( glycolysis inhibition and functional atp depletion ) and neurosynaptic abnormalities ( dysregulation of trkb - mediated bdnf and akt/erk [-] mediated cell growth/survival pathway ) in hippocampal neurons . 0 ###LEFT-WALL### 2 generation 0 ###LEFT-WALL### 11 associated 0 ###LEFT-WALL### 23 and 0 ###LEFT-WALL### 44 . 1 the 2 generation 2 generation 3 of 2 generation 10 was 3 of 9 phenotype 4 an 9 phenotype 5 ack 7 induced 7 induced 9 phenotype 8 neurological 9 phenotype 10 was 11 associated 11 associated 12 with 12 with 14 dysregulation 13 metabolic 14 dysregulation 14 dysregulation 18 and 15 ( 18 and 16 glycolysis 17 inhibition 17 inhibition 18 and 18 and 21 depletion 18 and 22 ) 19 functional 21 depletion 20 atp 21 depletion 23 and 25 abnormalities 23 and 31 mediated 24 neurosynaptic 25 abnormalities 25 abnormalities 27 dysregulation 25 abnormalities 31 mediated 26 ( 27 dysregulation 27 dysregulation 28 of 27 dysregulation 30 - 28 of 29 trkb 31 mediated 33 and 31 mediated 41 in 32 bdnf 33 and 33 and 39 pathway 33 and 40 ) 34 akt/erk 36 mediated 36 mediated 37 cell 37 cell 39 pathway 38 growth/survival 39 pathway 41 in 43 neurons 42 hippocampal 43 neurons our data suggest that chronic use of ack could affect cognitive functions , potentially [via] altering neuro - metabolic functions in male c57bl/6j mice . 0 ###LEFT-WALL### 2 data 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 18 - 0 ###LEFT-WALL### 25 . 1 our 2 data 2 data 3 suggest 3 suggest 4 that 4 that 6 use 4 that 10 affect 5 chronic 6 use 6 use 7 of 6 use 9 could 7 of 8 ack 9 could 10 affect 10 affect 12 functions 10 affect 16 altering 11 cognitive 12 functions 13 , 16 altering 14 potentially 16 altering 16 altering 17 neuro 16 altering 18 - 18 - 20 functions 19 metabolic 20 functions 20 functions 21 in 21 in 24 mice 22 male 24 mice 23 c57bl/6j 24 mice expecting motion in some particular direction biases sensitivity to that direction , which speeds detection of motion . 0 ###LEFT-WALL### 1 expecting 0 ###LEFT-WALL### 7 biases 0 ###LEFT-WALL### 12 , 0 ###LEFT-WALL### 18 . 1 expecting 2 motion 1 expecting 3 in 1 expecting 7 biases 3 in 6 direction 4 some 6 direction 5 particular 6 direction 7 biases 8 sensitivity 7 biases 9 to 9 to 11 direction 10 that 11 direction 12 , 13 which 12 , 14 speeds 13 which 14 speeds 14 speeds 15 detection 15 detection 16 of 16 of 17 motion however , the neural processes underlying this effect remain underexplored , especially in the context of normal aging . 0 ###LEFT-WALL### 5 processes 0 ###LEFT-WALL### 9 remain 1 however 2 , 1 however 5 processes 3 the 5 processes 4 neural 5 processes 5 processes 6 underlying 5 processes 9 remain 6 underlying 8 effect 7 this 8 effect 9 remain 10 underexplored 10 underexplored 13 in 11 , 12 especially 11 , 13 in 13 in 15 context 13 in 19 . 14 the 15 context 15 context 16 of 16 of 18 aging 17 normal 18 aging to address this , we examined younger and older adults ' performance in a motion detection task . 0 ###LEFT-WALL### 1 to 0 ###LEFT-WALL### 2 address 0 ###LEFT-WALL### 4 , 0 ###LEFT-WALL### 18 . 1 to 2 address 2 address 3 this 4 , 5 we 4 , 6 examined 5 we 6 examined 6 examined 12 performance 6 examined 13 in 7 younger 8 and 8 and 9 older 8 and 10 adults 10 adults 11 ' 11 ' 12 performance 13 in 17 task 14 a 15 motion 14 a 17 task 15 motion 17 task 16 detection 17 task [in] separate conditions , the probability was either 50 [%] or 100 % that a field of dots would move coherently in the direction a participant expected [(] either vertically or horizontally ) . 0 ###LEFT-WALL### 2 separate 0 ###LEFT-WALL### 34 . 2 separate 3 conditions 3 conditions 13 % 4 , 13 % 5 the 6 probability 6 probability 7 was 7 was 8 either 7 was 11 or 9 50 11 or 11 or 12 100 12 100 13 % 13 % 14 that 13 % 27 expected 13 % 33 ) 14 that 16 field 14 that 27 expected 15 a 16 field 16 field 17 of 16 field 19 would 17 of 18 dots 19 would 20 move 20 move 21 coherently 20 move 22 in 22 in 24 direction 23 the 24 direction 25 a 26 participant 26 participant 27 expected 27 expected 29 either 27 expected 31 or 30 vertically 31 or 31 or 32 horizontally expectation and aging effects were assessed via response times ( rt ) to detect motion and electroencephalography ( eeg ) . 0 ###LEFT-WALL### 16 and 0 ###LEFT-WALL### 21 . 1 expectation 2 and 2 and 3 aging 2 and 4 effects 2 and 14 detect 2 and 16 and 4 effects 5 were 5 were 6 assessed 6 assessed 7 via 6 assessed 13 to 7 via 9 times 8 response 9 times 9 times 11 rt 10 ( 11 rt 11 rt 12 ) 13 to 14 detect 14 detect 15 motion 16 and 17 electroencephalography 16 and 19 eeg 18 ( 19 eeg 19 eeg 20 ) in both age groups , rts were [fastest] when motion was similar to the expected direction of motion . 0 ###LEFT-WALL### 6 rts 0 ###LEFT-WALL### 7 were 0 ###LEFT-WALL### 19 . 1 in 4 groups 1 in 5 , 1 in 6 rts 2 both 4 groups 3 age 4 groups 6 rts 7 were 7 were 9 when 9 when 10 motion 9 when 11 was 10 motion 11 was 11 was 12 similar 12 similar 13 to 13 to 16 direction 14 the 16 direction 15 expected 16 direction 16 direction 17 of 17 of 18 motion rt tuning curves exhibited a characteristic u - shape such that detection time increased with an increasing deviation from the participant 's expected direction . 0 ###LEFT-WALL### 3 curves 0 ###LEFT-WALL### 8 - 0 ###LEFT-WALL### 25 . 1 rt 2 tuning 2 tuning 3 curves 3 curves 4 exhibited 4 exhibited 6 characteristic 5 a 6 characteristic 6 characteristic 7 u 7 u 8 - 8 - 9 shape 9 shape 11 that 9 shape 19 from 10 such 11 that 11 that 13 time 11 that 14 increased 12 detection 13 time 13 time 14 increased 14 increased 15 with 15 with 18 deviation 16 an 18 deviation 17 increasing 18 deviation 19 from 24 direction 20 the 21 participant 21 participant 22 's 22 's 24 direction 23 expected 24 direction strikingly , eeg results showed an analogous , hyperbolic curve for n1 amplitude , reflecting neural biasing . 0 ###LEFT-WALL### 4 results 0 ###LEFT-WALL### 5 showed 1 strikingly 2 , 1 strikingly 4 results 3 eeg 4 results 4 results 5 showed 5 showed 10 curve 5 showed 13 amplitude 6 an 7 analogous 6 an 10 curve 7 analogous 8 , 7 analogous 10 curve 9 hyperbolic 10 curve 10 curve 11 for 11 for 12 n1 13 amplitude 15 reflecting 14 , 15 reflecting 15 reflecting 17 biasing 15 reflecting 18 . 16 neural 17 biasing though the form of behavioral and eeg curves did not vary with age , older adults displayed a clear decline in the speed of detection and a corresponding reduction in eeg n1 amplitude when horizontal ( but not vertical [ )(motion was expected . 0 ###LEFT-WALL### 16 adults 0 ###LEFT-WALL### 17 displayed 0 ###LEFT-WALL### 44 . 1 though 3 form 1 though 11 vary 1 though 16 adults 2 the 3 form 3 form 4 of 3 form 9 did 4 of 6 and 5 behavioral 6 and 6 and 8 curves 7 eeg 8 curves 9 did 10 not 9 did 11 vary 12 with 13 age 12 with 14 , 12 with 16 adults 15 older 16 adults 16 adults 17 displayed 17 displayed 20 decline 17 displayed 30 in 17 displayed 34 when 18 a 20 decline 19 clear 20 decline 20 decline 21 in 20 decline 24 of 21 in 23 speed 22 the 23 speed 24 of 26 and 25 detection 26 and 26 and 29 reduction 27 a 29 reduction 28 corresponding 29 reduction 30 in 33 amplitude 31 eeg 33 amplitude 32 n1 33 amplitude 34 when 41 )(motion 34 when 43 expected 35 horizontal 37 but 36 ( 37 but 37 but 38 not 37 but 39 vertical 37 but 41 )(motion 38 not 39 vertical 41 )(motion 42 was 42 was 43 expected our results suggest that expectation - based detection ability varies with age [and] , for older adults , also with axis of motion . 0 ###LEFT-WALL### 2 results 0 ###LEFT-WALL### 3 suggest 0 ###LEFT-WALL### 24 . 1 our 2 results 2 results 3 suggest 3 suggest 5 expectation 3 suggest 19 also 3 suggest 20 with 4 that 5 expectation 5 expectation 8 detection 6 - 8 detection 7 based 8 detection 8 detection 9 ability 8 detection 10 varies 8 detection 18 , 9 ability 10 varies 10 varies 11 with 11 with 12 age 12 age 15 for 14 , 15 for 15 for 17 adults 15 for 18 , 16 older 17 adults 20 with 21 axis 21 axis 22 of 22 of 23 motion background : mild cognitive impairment encompasses the clinical [continuum] between physiologic age - related cognitive changes and dementia . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 5 impairment 2 : 6 encompasses 2 : 14 related 2 : 19 . 3 mild 5 impairment 4 cognitive 5 impairment 5 impairment 6 encompasses 6 encompasses 8 clinical 6 encompasses 10 between 7 the 8 clinical 10 between 12 age 11 physiologic 12 age 13 - 14 related 14 related 17 and 15 cognitive 16 changes 16 changes 17 and 17 and 18 dementia a variety of medications , including herbal preparations [(] in particular ginkgo biloba and panax ginseng ) , have been advocated as treatments for cognitive impairment in the elderly . 0 ###LEFT-WALL### 14 and 0 ###LEFT-WALL### 18 , 0 ###LEFT-WALL### 30 . 1 a 2 variety 2 variety 3 of 2 variety 5 , 3 of 4 medications 5 , 8 preparations 5 , 14 and 6 including 8 preparations 7 herbal 8 preparations 8 preparations 10 in 10 in 13 biloba 11 particular 13 biloba 12 ginkgo 13 biloba 14 and 16 ginseng 14 and 17 ) 15 panax 16 ginseng 18 , 19 have 19 have 20 been 20 been 21 advocated 21 advocated 22 as 21 advocated 27 in 22 as 23 treatments 23 treatments 24 for 24 for 26 impairment 25 cognitive 26 impairment 27 in 29 elderly 28 the 29 elderly in this study , we investigated the effect of an already marketed dietary supplement ( memo® ) combining 750 mg of lyophilized royal jelly with standardized extracts of g . biloba 120 mg and p ..y ginseng 150 mg on mini - mental state examination ( mmse ) scores in patients with mild cognitive impairment . 0 ###LEFT-WALL### 5 we 0 ###LEFT-WALL### 6 investigated 0 ###LEFT-WALL### 30 . 1 in 3 study 1 in 4 , 1 in 5 we 2 this 3 study 5 we 6 investigated 6 investigated 8 effect 6 investigated 25 with 7 the 8 effect 8 effect 9 of 8 effect 18 combining 8 effect 21 of 9 of 14 supplement 10 an 14 supplement 11 already 12 marketed 12 marketed 14 supplement 13 dietary 14 supplement 14 supplement 16 memo® 15 ( 16 memo® 16 memo® 17 ) 18 combining 20 mg 19 750 20 mg 21 of 24 jelly 22 lyophilized 24 jelly 23 royal 24 jelly 25 with 27 extracts 26 standardized 27 extracts 27 extracts 28 of 28 of 29 g 30 . 31 biloba 30 . 34 and 30 . 37 ginseng 31 biloba 33 mg 32 120 33 mg 34 and 35 p 34 and 36 ..y 35 p 36 ..y 36 ..y 37 ginseng 37 ginseng 39 mg 37 ginseng 40 on 38 150 39 mg 40 on 41 mini 41 mini 49 scores 42 - 49 scores 43 mental 44 state 44 state 45 examination 45 examination 47 mmse 46 ( 47 mmse 47 mmse 48 ) 47 mmse 49 scores 49 scores 50 in 49 scores 52 with 49 scores 56 . 50 in 51 patients 52 with 55 impairment 53 mild 55 impairment 54 cognitive 55 impairment methods : sixty - six subjects presenting with forgetfulness and satisfying the diagnostic and statistical manual of mental disorders , 4th edition , text revision ( dsm - iv - tr ) clinical criteria for mild cognitive impairment were randomly divided into an experimental group treated with one memo capsule before breakfast daily for 4 weeks and a control group [who] [took] placebo . 0 ###LEFT-WALL### 1 methods 0 ###LEFT-WALL### 2 : 0 ###LEFT-WALL### 64 . 2 : 6 subjects 2 : 20 , 3 sixty 4 - 4 - 5 six 4 - 6 subjects 6 subjects 7 presenting 7 presenting 8 with 7 presenting 14 and 8 with 10 and 9 forgetfulness 10 and 10 and 11 satisfying 12 the 14 and 13 diagnostic 14 and 14 and 19 disorders 14 and 20 , 15 statistical 16 manual 16 manual 17 of 16 manual 19 disorders 17 of 18 mental 20 , 22 edition 20 , 23 , 21 4th 22 edition 23 , 29 iv 23 , 30 - 24 text 25 revision 25 revision 27 dsm 26 ( 27 dsm 27 dsm 28 - 27 dsm 29 iv 30 - 34 criteria 30 - 41 divided 31 tr 32 ) 31 tr 34 criteria 33 clinical 34 criteria 34 criteria 35 for 34 criteria 39 were 35 for 38 impairment 36 mild 38 impairment 37 cognitive 38 impairment 39 were 41 divided 40 randomly 41 divided 41 divided 42 into 41 divided 47 with 42 into 45 group 43 an 45 group 44 experimental 45 group 45 group 46 treated 47 with 57 and 48 one 50 capsule 49 memo 50 capsule 50 capsule 51 before 50 capsule 57 and 51 before 52 breakfast 52 breakfast 53 daily 53 daily 54 for 54 for 56 weeks 55 4 56 weeks 57 and 63 placebo 58 a 59 control 58 a 63 placebo 59 control 60 group 60 group 63 placebo the mean change [in] mmse score from baseline and reported adverse effects were compared between the two groups . 0 ###LEFT-WALL### 5 mmse 0 ###LEFT-WALL### 9 and 0 ###LEFT-WALL### 19 . 1 the 5 mmse 2 mean 5 mmse 3 change 5 mmse 5 mmse 9 and 6 score 7 from 6 score 9 and 7 from 8 baseline 9 and 10 reported 10 reported 12 effects 10 reported 14 compared 11 adverse 12 effects 12 effects 13 were 13 were 14 compared 14 compared 15 between 15 between 18 groups 16 the 17 two 17 two 18 groups results : the mean change [in] mmse score in the group treated with memo for 4 weeks was significantly greater than in the control group [(] +2.07 versus +0.13 , respectively [ )(by the student 's [t] - test ( t = 6.485 , p < 0.0001 ) . 0 ###LEFT-WALL### 1 results 0 ###LEFT-WALL### 2 : 2 : 8 score 3 the 8 score 4 mean 5 change 5 change 8 score 7 mmse 8 score 8 score 9 in 8 score 18 was 9 in 11 group 10 the 11 group 11 group 12 treated 11 group 13 with 13 with 14 memo 14 memo 15 for 15 for 17 weeks 16 4 17 weeks 18 was 20 greater 19 significantly 20 greater 20 greater 21 than 21 than 22 in 22 in 27 +2.07 23 the 27 +2.07 24 control 27 +2.07 25 group 27 +2.07 27 +2.07 28 versus 28 versus 29 +0.13 29 +0.13 33 )(by 29 +0.13 39 test 30 , 31 respectively 30 , 33 )(by 33 )(by 36 's 33 )(by 38 - 34 the 35 student 35 student 36 's 38 - 39 test 39 test 42 = 39 test 49 . 40 ( 42 = 41 t 42 = 42 = 43 6.485 43 6.485 46 < 44 , 46 < 45 p 46 < 46 < 47 0.0001 46 < 48 ) this was also true after adjusting for age as a covariate and educational level as a factor nested within the treatment groups in a general linear model ( analysis of covariance , f = 9.675 [ corrected [model] ] , p < 0.0001 ) . 0 ###LEFT-WALL### 1 this 0 ###LEFT-WALL### 2 was 0 ###LEFT-WALL### 12 and 0 ###LEFT-WALL### 45 . 1 this 2 was 2 was 3 also 2 was 4 true 4 true 5 after 4 true 7 for 4 true 9 as 5 after 6 adjusting 7 for 8 age 9 as 11 covariate 10 a 11 covariate 12 and 14 level 12 and 18 nested 13 educational 14 level 14 level 15 as 14 level 18 nested 15 as 17 factor 16 a 17 factor 18 nested 19 within 18 nested 23 in 18 nested 42 < 19 within 22 groups 20 the 22 groups 21 treatment 22 groups 23 in 27 model 24 a 25 general 24 a 27 model 25 general 27 model 26 linear 27 model 27 model 29 analysis 28 ( 29 analysis 29 analysis 30 of 29 analysis 37 corrected 29 analysis 40 , 30 of 31 covariance 31 covariance 34 = 32 , 34 = 33 f 34 = 34 = 35 9.675 36 [ 37 corrected 37 corrected 39 ] 41 p 42 < 42 < 43 0.0001 42 < 44 ) conclusion : this combined triple formula may be beneficial in treating the cognitive decline that occurs during the aging process as well as in the early phases of pathologic cognitive impairment typical of insidious - onset vascular dementia and in the early stages of alzheimer 's disease . 0 ###LEFT-WALL### 1 conclusion 0 ###LEFT-WALL### 2 : 2 : 6 formula 2 : 8 be 2 : 48 . 3 this 6 formula 4 combined 6 formula 5 triple 6 formula 6 formula 7 may 7 may 8 be 8 be 9 beneficial 9 beneficial 10 in 9 beneficial 17 during 9 beneficial 21 as 9 beneficial 23 as 10 in 11 treating 11 treating 14 decline 12 the 14 decline 13 cognitive 14 decline 14 decline 15 that 14 decline 16 occurs 15 that 16 occurs 17 during 20 process 18 the 20 process 19 aging 20 process 21 as 22 well 23 as 39 and 24 in 27 phases 24 in 39 and 25 the 27 phases 26 early 27 phases 27 phases 28 of 28 of 31 impairment 29 pathologic 31 impairment 30 cognitive 31 impairment 31 impairment 32 typical 32 typical 33 of 33 of 38 dementia 34 insidious 35 - 34 insidious 36 onset 36 onset 38 dementia 37 vascular 38 dementia 39 and 40 in 40 in 43 stages 41 the 43 stages 42 early 43 stages 43 stages 44 of 44 of 47 disease 45 alzheimer 46 's 46 's 47 disease larger - sized studies with longer treatment durations are needed to confirm this . 0 ###LEFT-WALL### 4 studies 0 ###LEFT-WALL### 10 needed 0 ###LEFT-WALL### 14 . 1 larger 2 - 1 larger 4 studies 3 sized 4 studies 4 studies 5 with 4 studies 9 are 5 with 8 durations 6 longer 7 treatment 7 treatment 8 durations 9 are 10 needed 10 needed 11 to 11 to 12 confirm 12 confirm 13 this alteplase has traditionally been the only pharmacologic agent available [for] treating acute ischemic stroke worldwide , and is considered an effective and safe therapeutic drug for acute cerebral ischemia . 0 ###LEFT-WALL### 1 alteplase 0 ###LEFT-WALL### 17 and 0 ###LEFT-WALL### 30 . 1 alteplase 17 and 2 has 4 been 2 has 17 and 3 traditionally 4 been 4 been 14 stroke 4 been 15 worldwide 5 the 6 only 5 the 14 stroke 7 pharmacologic 8 agent 8 agent 14 stroke 9 available 14 stroke 11 treating 14 stroke 12 acute 14 stroke 13 ischemic 14 stroke 16 , 17 and 17 and 18 is 18 is 19 considered 19 considered 25 drug 20 an 25 drug 21 effective 22 and 22 and 23 safe 22 and 25 drug 24 therapeutic 25 drug 25 drug 26 for 26 for 29 ischemia 27 acute 29 ischemia 28 cerebral 29 ischemia however , the drug is usually indicated for use in patients aged < 81 years due to insufficient literature regarding the drug 's safety in older individuals . 0 ###LEFT-WALL### 4 drug 0 ###LEFT-WALL### 12 aged 0 ###LEFT-WALL### 28 . 1 however 2 , 1 however 4 drug 3 the 4 drug 4 drug 5 is 5 is 7 indicated 6 usually 7 indicated 7 indicated 8 for 8 for 9 use 9 use 10 in 9 use 12 aged 10 in 11 patients 12 aged 15 years 12 aged 17 to 13 < 14 81 14 81 15 years 16 due 17 to 17 to 19 literature 18 insufficient 19 literature 19 literature 20 regarding 20 regarding 24 safety 20 regarding 25 in 21 the 22 drug 22 drug 23 's 23 's 24 safety 25 in 27 individuals 26 older 27 individuals nevertheless , the elderly can benefit from alteplase after they experience an acute ischemic stroke . 0 ###LEFT-WALL### 4 elderly 0 ###LEFT-WALL### 6 benefit 0 ###LEFT-WALL### 16 . 1 nevertheless 2 , 1 nevertheless 4 elderly 3 the 4 elderly 4 elderly 5 can 5 can 6 benefit 6 benefit 7 from 6 benefit 9 after 7 from 8 alteplase 9 after 10 they 9 after 11 experience 10 they 11 experience 11 experience 15 stroke 12 an 13 acute 12 an 15 stroke 13 acute 15 stroke 14 ischemic 15 stroke age differences have been observed in the clinical presentation [of] acute ischemic stroke [;] [however] , the safety and efficacy of alteplase for patients [with] acute ischemic stroke do not [depend] on age or sex . 0 ###LEFT-WALL### 2 differences 0 ###LEFT-WALL### 5 observed 1 age 2 differences 2 differences 3 have 3 have 4 been 4 been 5 observed 5 observed 6 in 6 in 13 stroke 7 the 13 stroke 8 clinical 9 presentation 9 presentation 13 stroke 11 acute 13 stroke 12 ischemic 13 stroke 13 stroke 29 do 16 , 29 do 17 the 29 do 18 safety 19 and 19 and 20 efficacy 19 and 29 do 20 efficacy 21 of 21 of 22 alteplase 22 alteplase 23 for 23 for 24 patients 26 acute 28 stroke 27 ischemic 28 stroke 28 stroke 29 do 29 do 30 not 29 do 36 . 30 not 32 on 32 on 34 or 33 age 34 or 34 or 35 sex evidence of an increasing rate of intracerebral hemorrhage among the elderly [with] acute ischemic stroke , following alteplase treatment , has not been reported . 0 ###LEFT-WALL### 1 evidence 0 ###LEFT-WALL### 24 reported 0 ###LEFT-WALL### 25 . 1 evidence 2 of 1 evidence 21 has 2 of 5 rate 3 an 5 rate 4 increasing 5 rate 5 rate 6 of 6 of 8 hemorrhage 7 intracerebral 8 hemorrhage 8 hemorrhage 9 among 9 among 15 stroke 10 the 15 stroke 11 elderly 15 stroke 13 acute 15 stroke 14 ischemic 15 stroke 15 stroke 17 following 16 , 17 following 17 following 19 treatment 17 following 20 , 18 alteplase 19 treatment 21 has 22 not 21 has 23 been 23 been 24 reported severe intracranial hemorrhage is a known side effect of alteplase but is not associated with age in patients [with] acute ischemic [stroke] . 0 ###LEFT-WALL### 3 hemorrhage 0 ###LEFT-WALL### 14 associated 0 ###LEFT-WALL### 23 . 1 severe 3 hemorrhage 2 intracranial 3 hemorrhage 3 hemorrhage 11 but 4 is 8 effect 4 is 11 but 5 a 8 effect 6 known 7 side 7 side 8 effect 8 effect 9 of 9 of 10 alteplase 11 but 12 is 12 is 13 not 12 is 14 associated 14 associated 15 with 14 associated 21 ischemic 15 with 16 age 15 with 20 acute 16 age 17 in 17 in 18 patients alteplase can be used safely and effectively to treat elderly patients who suffer an acute ischemic stroke , including those over the age of 80 years . 0 ###LEFT-WALL### 1 alteplase 0 ###LEFT-WALL### 6 and 1 alteplase 2 can 2 can 6 and 3 be 4 used 3 be 6 and 4 used 5 safely 6 and 8 to 6 and 9 treat 7 effectively 8 to 8 to 9 treat 9 treat 11 patients 10 elderly 11 patients 11 patients 12 who 11 patients 13 suffer 12 who 13 suffer 13 suffer 17 stroke 14 an 15 acute 14 an 17 stroke 15 acute 17 stroke 16 ischemic 17 stroke 17 stroke 19 including 18 , 19 including 19 including 20 those 19 including 21 over 19 including 27 . 21 over 23 age 22 the 23 age 23 age 24 of 24 of 26 years 25 80 26 years background : exercise has been shown to be effective in cardiovascular endurance in the elderly . 0 ###LEFT-WALL### 1 background 0 ###LEFT-WALL### 2 : 2 : 3 exercise 2 : 6 shown 2 : 16 . 3 exercise 4 has 4 has 5 been 5 been 6 shown 6 shown 7 to 7 to 8 be 8 be 9 effective 9 effective 10 in 9 effective 13 in 10 in 12 endurance 11 cardiovascular 12 endurance 13 in 15 elderly 14 the 15 elderly we studied the effect of thai dancing on physical performance of thai [elderly] . 0 ###LEFT-WALL### 1 we 0 ###LEFT-WALL### 2 studied 0 ###LEFT-WALL### 14 . 1 we 2 studied 2 studied 4 effect 2 studied 8 on 3 the 4 effect 4 effect 5 of 5 of 6 thai 6 thai 7 dancing 8 on 10 performance 9 physical 10 performance 10 performance 11 of 11 of 12 thai