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We examined the association of generational status and age at immigration with later life cognitive outcomes in a diverse sample of Latinos and Asian Americans.
Baseline data were obtained from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, and a prospective cohort is initiated in 2017.
Older adults in Northern California.
Our cohort consisted of Asians (n = 411) and Latinos (n = 340) who were on average 76 years old (SD = 6.8).
We used multivariable linear regression models to estimate associations between generational status and age at immigration (collapsed into one five-level variable) with measures of verbal episodic memory, semantic memory, and executive function, adjusting for age, gender, race and ethnicity, and own- and parental education.
Generational status and age at immigration were associated with cognitive outcomes in a graded manner. Compared to third-generation or higher immigrants, first-generation immigration in adulthood was associated with lower semantic memory (β = −0.96; 95% CI: −1.12, −0.81) than immigration in adolescence (β = −0.68; 95% CI: −0.96, −0.41) or childhood (β = −0.28; 95% CI: −0.49, −0.06). Moreover, immigration in adulthood was associated with lower executive function (β = −0.63; 95% CI: −0.78, −0.48) than immigration in adolescence (β = −0.49; 95% CI: −0.75, −0.23). Similarly, compared to third-generation individuals, first-generation immigrants had lower executive functioning scores.
Our study supports the notion that sociocontextual influences in early life impact later life cognitive scores. Longitudinal studies are needed to further clarify how immigration characteristics affect cognitive decline.
The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.
Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.
The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.
The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
We present a sediment-mixing process model of till genesis based on data from surface tills of the Saginaw lobe terrain in lower Michigan. Our research uses a spatial approach to understanding glacial landsystems and till genesis. We sampled calcareous till at 336 upland sites and at 17 sites in lacustrine sediment of the Saginaw Lake plain. The loamy tills have bimodal grain-size curves, with a fine-texture mode near the silt–clay boundary and a sand mode. Spatial grouping analysis suggests that tills can be divided into six groups, each with different textures and clay mineral compositions that vary systematically down-ice. The similarity among groups with respect to the silt–clay mode and clay mineralogy argues for a common origin for the fines—illite-rich lacustrine sediment of the Saginaw Lake plain. Fine-textured sediments were probably entrained, transported, and deposited down-ice as till, which also becomes sandier and enriched in kaolinite, reflecting increasing mixing with shallow sandstone bedrock with distance from the lacustrine clay source. Clayey tills on the flanks of the Saginaw terrain may reflect proglacial ponding against nearby uplands. A process model of progressive down-ice mixing of preexisting fine lake sediments with crushed/abraded sandstone bedrock helps to better explain till textures compared with a purely crushing/abrasion process model.
The elimination of unwanted catch in mixed species fisheries is technically challenging given the complexity of fish behaviour within nets. Most approaches to date have employed technologies that modify the nets themselves or use physical sorting grids within the gear. There is currently increasing interest in the use of artificial light to either deter fish from entering the net, or to enhance their escapement from within the net. Here, we evaluated the differences in catch retained in a standard otter trawl, relative to the same gear fitted with a square mesh panel, or a square mesh panel fitted with LEDs. We found that the selectivity of the gear differed depending on water depth. When using a square mesh panel in shallow depths of 29–40 m the unwanted bycatch of whiting and haddock was reduced by 86% and 58% respectively. In deep, darker water (45–95 m), no change in catch was observed in the square-mesh panel treatment, however when LEDs were added to the square-mesh panel, haddock and flatfish catches were reduced by 47% and 25% respectively. These findings demonstrate the potential to improve the performance of bycatch reduction devices through the addition of light devices to enhance selectivity. The results also highlight species-specific and site-specific differences in the performance of bycatch reduction devices, and hence a more adaptive approach to reduce bycatch is probably required to maximize performance.
The Everyday Cognition (ECog) scales measure cognitively based across domains of everyday abilities that are affected early in the course of neurodegenerative disorders such as Alzheimer’s disease. However, the degree to which the ECog may be differentially influenced by ethnic/racial background is unknown. This study evaluates measurement invariance of the ECog across non-Hispanic White (NHW), Black, and Hispanic individuals.
Participants included 1177 NHW, 243 Black, and 216 Hispanic older adults from the UC Davis Alzheimer’s Disease Center Cohort who had an ECog. Differential item functioning (DIF) for each ECog domain was evaluated separately for Black and Hispanic participants compared to NHW participants. An iterative multiple group confirmatory factor analysis approach for ordinal scores was used to identify items whose measurement properties differed across groups and to adjust scores for DIF. Adjusted scores were then evaluated to test whether they were more strongly associated with cognitive function (concurrent and longitudinal change in cognition) and brain volumes (measured by brain imaging).
Varying levels, patterns, and impacts of DIF were found across domains and groups. However, the impact of DIF was relatively small, and DIF effects on scores generally were less than one-half standard error of measurement. There were no meaningful differences in associations with cognition and brain injury between DIF adjusted and unadjusted scores.
Varying patterns of DIF were observed across the Black and Hispanic participants across select ECog domains. Overall, DIF effects were relatively small and did not change the relationship between the ECog and other indicators of disease.
The Everyday Compensation scale (EComp) is an informant-rated questionnaire designed to measure cognitively based compensatory strategies that support both everyday memory and executive function in the context of completing instrumental activities of daily living (IADLs). Although previous findings provided early support for the usefulness of the initial version of EComp, the current paper further describes the development, refinement, and validation of EComp as a new assessment tool of compensation for IADLs.
Confirmatory factor analysis (CFA) was used to examine its factor structure. Convergent and predictive validity was evaluated by examining the relationship between EComp and markers of disease, including diagnosis, cognitive change, and trajectories of functional abilities.
CFA supported a general compensation factor after accounting for variance attributable to IADL domain-specific engagement. The clinical groups differed in compensatory strategy use, with those with dementia using significantly fewer compensatory strategies as compared to individuals with normal cognition or mild cognitive impairment. Greater levels of compensation were related to better cognitive functions (memory and executive function) and functional abilities, as well as slower rates of cognitive and functional decline over time. Importantly, higher levels of compensation were associated with less functional difficulties and subsequently slower rate of functional decline independent of the level of cognitive impairment.
Engagement in compensatory strategies among older adults has important implications for prolonging functional independence, even in those with declining cognitive functioning. Results suggest that the revised EComp is likely to be useful in measuring cognitively based compensation in older adults.
To evaluate the long-term safety and tolerability of once-dailyvalbenazine in adults with tardive dyskinesia(TD).
Data were pooled from KINECT 3 (NCT02274558: 6-week double-blind placebo-controlled period, followed by a 42-week double-blind extension and 4-week drug-free washout) and KINECT 4 (NCT02405091: 48-week open-label treatment period and 4-week drug-free washout). KINECT 3/4 study completers could enroll in a subsequent rollover study (NCT02736955: up to 72weeks of open-label treatment or until valbenazine became commercial available); data from this study were described separately for this analysis. Valbenazine dose groups (40 and 80mg) were pooled for analysis. Safety assessments included treatment-emergent adverse events (TEAEs) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Psychiatric status was assessed in KINECT 3 and KINECT 4 using the following measures: Positive and Negative Syndrome Scale (PANSS) total score and Calgary Depression Scale for Schizophrenia (CDSS) in participants with schizophrenia/schizoaffective disorder; Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) in participants with a mood disorder.
Analyses included 304 KINECT 3/4 participants and 160 rollover participants. In KINECT 3/4, the summary of TEAEs was as follows: any TEAE (71.7%), serious TEAE (16.8%), and discontinuation due to TEAE (15.5%). TEAEs reported in ≥5% of all KINECT 3/4 participants were headache (8.9%), urinary tract infection (8.9%), somnolence (7.9%), fatigue (6.3%), dizziness (5.9%), and suicidal ideation (5.6%). The summary of TEAEs from the rollover study was as follows: any TEAE (53.1%), serious TEAE (10.0%), and discontinuation due to TEAE (5.6%). The most common TEAEs in the rollover study were back pain and urinary tract infection (4.4%, each); no TEAE was reported in ≥5% of participants. Minimal changes in psychiatric status were observed in KINECT 3/4, as indicated by mean score changes from baseline to Week 48 in participants with schizophrenia/schizoaffective disorder (PANSS total, –3.2; CDSS total, –0.5) or a mood disorder (MADRS total, 0.3; YMRS total, –1.0). Over one-third of study participants had a lifetime history of suicidal ideation or behavior (KINECT 3/4, 41%; rollover, 38%). Most participants had no C-SSRS suicidal ideation at study baseline; of these, >90% had no emergence of suicidal ideation at any time during the study (KINECT 3/4, 93% [276/296]; rollover, 98% [153/156]).
Valbenazine was well tolerated and no unexpected safety signals were found in adults who received >1 year of once-daily treatment. Psychiatric stability was maintained, and few participants experienced any emergence of suicidal ideation during the studies despite 35–40% having a lifetime history of suicidality. These results indicate that once-daily valbenazine may be an appropriate treatment for the long-term management of TD.
Funding Acknowledgements: Neurocrine Biosciences, Inc.
Summer 2000/01 ASTER and Landsat 7 scenes and semi-automated digitization were used to compile a glacier inventory for local glaciers of the Geikie Plateau region, central East Greenland. Of the 332 glaciers (41 591 km2), 120 are tidewater-terminating and drain 90% of the glacierized area. Differencing the 2000/01 tidewater margins from the 1980s GEUS map database ice polygons (113 glaciers) and from 2004/05 ASTER tidewater margins (78 glaciers) shows a cumulative tidewater terminus width decrease from 196 km to 183 km between the 1980s and 2000s, with a corresponding areal loss of ~31 km2 and an effective length change of –14.3 km. Between 2000/01 and 2004/05, areal loss was 26 km2. Average margin retreat rate increased two- to threefold, from 1.7–2.1km2 a–1 (1980s– 2000) to 3.9–5.7km2 a–1 (2000–05). Advances are negligible, apart from two surges, of which one was previously undetected. Coastal, ‘outer’ fjord-terminating, glaciers have two to three times larger areal and effective length retreat rates than ‘inner’ fjord-terminating glaciers. We investigate possible causes and hypothesize that, in addition to ocean temperature and sea ice, changes in sea fog may affect coastal-terminating more than inner fjord-terminating glaciers.
Annex III is intended to become a ‘living document’, which will be updated in the light of new information in order to serve as an input to the IPCC Fifth Assessment Report (AR5). Scientists that are interested in supporting this process are invited to contact the IPCC WG III Technical Support Unit (TSU) (using firstname.lastname@example.org) in order to get further information concerning the submission process. Comments and new data input will be considered for inclusion in Volume 3 of the IPCC AR5 according to the procedures of the IPCC review system.
This Annex contains recent cost and performance parameter information for currently commercially available renewable power generation technologies (Table A.III.1), heating technologies (Table A.III.2) and bio-fuel production processes (Table A.III.3). It summarizes information that determines the levelized cost of energy or energy carriers supplied by the respective technologies.
The input ranges are based on assessments of various studies by authors of the respective technology chapters (Chapters 2 through 7). If not stated otherwise, the data ranges provided here are worldwide aggregates. Data are generally for 2008, but can be as recent as 2009. They represent roughly the mid-80% of values found in the literature, hence, excluding outliers. The availability and quality of different sources of data varies significantly across individual technologies for a variety of reasons. Some expert judgment is therefore required to determine data ranges that are representative of particular classes of technologies and specific periods of time and valid globally.
A case-based book organized by the top 10 common complaints of patients presenting to emergency departments. This approach allows the reader to learn the pathophysiology of the major diseases, and analyze each case in a way that more closely approximates the clinical practice of medicine; not knowing which organ system is damaged or compromised before examining the patient. The cases are based on real patients and the diseases are either common in emergency practice, or are dangerous diagnoses not to be missed. The case descriptions include questions regarding the patient's presentation and basic information about the disease, illustrating key elements from the history, physical, and when necessary ancillary studies that help lead to a diagnosis. Each chapter ends with a flow diagram showing how diseases of different organ systems can present with similar initial complaints. This book is an ideal resource for medical students, residents and trainees in emergency medicine.