The accuracy of the Clock Drawing Test compared to that of standard screening tests for Alzheimer`s disease: results from a study of Brazilian elderly with heterogeneous educational backgrounds

Background: Although the Clock Drawing Test (CDT) is the second most used test in the world for the screening of dementia, there is still debate over its sensitivity specificity, application and interpretation in dementia diagnosis. This study has three main aims: to evaluate the sensitivity and specificity of the CDT in a sample composed of older adults with Alzheimer`s disease (AD) and normal controls; to compare CDT accuracy to the that of the Mini-mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG), and to test whether the association of the MMSE with the CDT leads to higher or comparable accuracy as that reported for the CAMCOG. Methods: Cross-sectional assessment was carried out for 121 AD and 99 elderly controls with heterogeneous educational levels from a geriatric outpatient clinic who completed the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). The CDT was evaluated according to the Shulman, Mendez and Sunderland scales. Results: The CDT showed high sensitivity and specificity. There were significant correlations between the CDT and the MMSE (0.700-0.730; p < 0.001) and between the CDT and the CAMCOG (0.753-0.779; p < 0.001). The combination of the CDT with the MMSE improved sensitivity and specificity (SE = 89.2-90%; SP = 71.7-79.8%). Subgroup analysis indicated that for elderly people with lower education, sensitivity and specificity were both adequate and high. Conclusions: The CDT is a robust screening test when compared with the MMSE or the CAMCOG, independent of the scale used for its interpretation. The combination with the MMSE improves its performance significantly, becoming equivalent to the CAMCOG.

Short Cognitive Performance Test: Diagnostic Accuracy and Education Bias in Older Brazilian Adults

The ""Short Cognitive Performance Test"" (Syndrom Kurztest, SKT) is a cognitive screening battery designed to detect memory and attention deficits. The aim of this study was to evaluate the diagnostic accuracy of the SKT as a screening tool for mild cognitive impairment (MCI) and dementia. A total of 46 patients with Alzheimer`s disease (AD), 82 with MCI, and 56 healthy controls were included in the study. Patients and controls were allocated into two groups according to educational level (< 8 years or > 8 years). ROC analyses suggested that the SKT adequately discriminates AD from non-demented subjects (MCI and controls), irrespective of the education group. The test had good sensitivity to discriminate MCI from unimpaired controls in the sub-sample of individuals with more than 8 years of schooling. Our findings suggest that the SKT is a good screening test for cognitive impairment and dementia. However, test results must be interpreted with caution when administered to less-educated individuals.

An alternative to the Pythagorean rule? Reevaluating Problem 1 of cuneiform tablet BM 34 568

The first problem of the Seleucid mathematical cuneiform tablet BM 34 568 calculates the diagonal of a rectangle from its sides without resorting to the Pythagorean rule. For this reason, it has been a source of discussion among specialists ever since its first publication. but so far no consensus in relation to its mathematical meaning has been attained. This paper presents two new interpretations of the scribe`s procedure. based on the assumption that he was able to reduce the problem to a standard Mesopotamian question about reciprocal numbers. These new interpretations are then linked to interpretations of the Old Babylonian tablet Plimpton 322 and to the presence of Pythagorean triples in the contexts of Old Babylonian and Hellenistic mathematics. (C) 2007 Elsevier Inc. All rights reserved.

Stress and coping in older people with Alzheimer`s disease

To investigate stress intensity and coping style in older people with mild Alzheimer`s disease. The potential risk assessment of a stress event and the devising of coping strategies are dependent on cognitive function. Although older individuals with Alzheimer`s disease present significant cognitive impairment, little is known about how these individuals experience stress events and select coping strategies in stress situations. Survey. A convenient sample of 30 cognitively healthy older people and 30 individuals with mild Alzheimer`s disease were given an assessment battery of stress indicators (Symptom Stress List, Cornell Scale for Depression in Dementia, State-Trait Anxiety Inventory), coping style (Jalowiec Coping Scale) and cognitive performance (mini-mental state exam) were applied in both groups. Statistical analysis of the data employed the Mann-Whitney test to compare medians of stress indicators and coping style, Fischer`s exact test to compare proportions when expected frequencies were lower than five, and Spearman`s correlation coefficient to verify correlation between coping style and cognitive performance. Both groups suffered from the same stress intensity (p = 0.254). Regarding coping styles, although differences were not statistically significant (p = 0.124), emotion-oriented coping was predominant in the patients with Alzheimer`s disease. However, those individuals displaying better cognitive performance in the Alzheimer`s disease group had selected coping strategies focused on problem solving (p = 0.0074). Despite a tendency for older people with Alzheimer`s disease to select escape strategies and emotional control, rather than attempting to resolve or lesser the consequences arising from a problem, coping ultimately depends on cognitive performance of the individual. The findings of this study provide information and data to assist planning of appropriate support care for individuals with Alzheimer`s disease who experience stress situations, based on their cognitive performance.

Support vector machines for detecting age-related changes in running kinematics

Age-related changes in running kinematics have been reported in the literature using classical inferential statistics. However, this approach has been hampered by the increased number of biomechanical gait variables reported and subsequently the lack of differences presented in these studies. Data mining techniques have been applied in recent biomedical studies to solve this problem using a more general approach. In the present work, we re-analyzed lower extremity running kinematic data of 17 young and 17 elderly male runners using the Support Vector Machine (SVM) classification approach. In total, 31 kinematic variables were extracted to train the classification algorithm and test the generalized performance. The results revealed different accuracy rates across three different kernel methods adopted in the classifier, with the linear kernel performing the best. A subsequent forward feature selection algorithm demonstrated that with only six features, the linear kernel SVM achieved 100% classification performance rate, showing that these features provided powerful combined information to distinguish age groups. The results of the present work demonstrate potential in applying this approach to improve knowledge about the age-related differences in running gait biomechanics and encourages the use of the SVM in other clinical contexts. (C) 2010 Elsevier Ltd. All rights reserved.

Predicting MAOD using only a supramaximal exhaustive test

The objective of this study was to propose an alternative method (MAOD(ALT)) to estimate the maximal accumulated oxygen deficit (MAOD) using only one supramaximal exhaustive test. Nine participants performed the following tests: (a) a maximal incremental exercise test, (b) six submaximal constant workload tests, and (c) a supramaximal constant workload test. Traditional MAOD was determined by calculating the difference between predicted O(2) demand and accumulated O(2) uptake during the supramaximal test. MAOD(ALT) was established by summing the fast component of excess post-exercise oxygen consumption and the O(2) equivalent for energy provided by blood lactate accumulation, both of which were measured during the supramaximal test. There was no significant difference between MAOD (2.82 +/- 0.45 L) and MAOD(ALT) (2.77 +/- 0.37 L) (p = 0.60). The correlation between MAOD and MAOD(ALT) was also high (r = 0.78; p = 0.014). These data indicate that the MAOD(ALT) can be used to estimate the MAOD.

Aerobic profile of climbers during maximal arm test

This study compared measurements of upper body aerobic fitness in elite (EC; n = 7) and intermediate rock climbers (IC; n = 7), and a control group (C; n = 7). Subjects underwent an upper limb incremental test on hand cycle ergometer, with increments of 23 W.min(-1), until exhaustion. Ventilation (VE) data were smoothed to 10 s averages and plotted against time for the visual determination of the first (VT1) and second (VT2) ventilatory thresholds. Peak power output was not different among groups [EC = 130.9 (+/- 11.8) W; IC = 122.1 (+/- 28.4) W; C = 115.4 (+/- 15.1) W], but time to exhaustion was significantly higher in EC than IC and C. VO(2PEAK) was significantly higher in EC [36.8 (+/- 5.7) mL.kg(-1).min(-1)] and IC [35.5 (+/- 5.2) mL.kg(-1).min(-1)] than C [28.8 (+/- 5.0) mL.kg(-1).min(-1)], but there was no difference between EC and IC. VT1 was significantly higher in EC than C [EC = 69.0 (+/- 9.4) W; IC = 62.4 (+/- 13.0) W; C = 52.1 (+/- 11.8) W], but no significant difference was observed in VT2 [EC = 103.5 (+/- 18.8) W; IC = 92.0 (+/- 22.0) W; C = 85.6 (+/- 19.7) W]. These results show that elite indoor rock climbers elicit higher aerobic fitness profile than control subjects when measured with an upper body test.

Acute effects and postactivation potentiation in the special judo fitness test

Miarka, B, Del Vecchio, FB, and Franchini, E. Acute effects and postactivation potentiation in the special judo fitness test. J Strength Cond Res 25(2): 427-431, 2011-The purpose of this study was to compare the acute short-term effects of (1) plyometric exercise, (2) combined strength and plyometric exercise (contrast), and (3) maximum strength performance in the Special Judo Fitness Test (SJFT). Eight male judo athletes (mean +/- SD, age, 19 +/- 1 years; body mass, 60.4 +/- 5 kg; height, 168.3 +/- 5.4 cm) took part in this study. Four different sessions were completed; each session had 1 type of intervention: (a) SJFT control, (b) plyometric exercises + SJFT, (c) maximum strength + SJFT, and (d) contrast + SJFT. The following variables were quantified: throws performed during series A, B, and C; total number of throws; heart rate immediately and 1 minute after the test; and test index. Significant differences were found in the number of throws during series A: the plyometric exercise (6.4 +/- 0.5 throws) was superior (p < 0.05) to the control condition (5.6 +/- 0.5 throws). Heart rate 1 minute after the SJFT was higher (p < 0.01) during the plyometric exercise (192 +/- 8 bpm) than during the contrast exercise (184 +/- 9 bpm). The contrast exercise (13.58 +/- 0.72) resulted in better index values than the control (14.67 +/- 1.30) and plyometric exercises (14.51 +/- 0.54). Thus, this study suggests that contrast and plyometric exercises performed before the SJFT can result in improvements in the test index and anaerobic power of judo athletes, respectively.

A special judo fitness test classificatory table

Background and Study Aim: Judo is very physiological demanding sport, but there are no many physical fitness specific tests. One of the most used specific judo tests is the Special Judo Fitness Test (SJFT) proposed by Sterkowicz ( 1995). Although this test has been used by many coaches in different countries no classificatory table was found to classify the judo athletes according to their results. Thus, the aim of this work was to present a classificatory table for this test. Material/Methods: For this purpose 141 judo athletes ( mean +/-standard deviation: 21.3+/-4.5years-old; 74.2+/-15.9 kg of body mass and 176.7+/-8.2 cm of height; judo ranking between 3(rd) kyu and 3(rd) dan) familiarized with the SJFT performed it once in order to provide data to establish a classificatory table. Results: After the analysis of data distribution a five scale table (20% for each classificatory category) was developed considering the variables used in the SJFT ( number of throws, heart rate after and 1 min after the test and index). Conclusions: The classificatory table can help coaches using the SJFT to classify their athletes` level and to monitor their physical fitness progress.

A Semi-Tethered Test for Power Assessment in Running

We analyzed the usefulness of a semi-tethered field running test (STR) and the relationships between indices of anaerobic power, anaerobic capacity and running performance in 9 trained male sprinters (22.2 +/- 2.9 yrs, 176 +/- 1 cm, 68.0 +/- 9.4 kg). STR involved an all out 120 m run attached to an apparatus that enabled power calculation from force and velocity measures. Subjects also carried out a cycloergometer Win-gate Anaerobic Test (WT), an all out 300 m run and had accessed their maximal accumulated oxygen deficit (MAOD) on a treadmill. Peak and mean powers attained in STR (1 720 +/- 221 and 1 391 +/- 201 W) were greater but significantly related (r=0.82; P<0.01) to those in the WT (808 +/- 130 and 603 +/- 87 W). In addition, power measures derived from the STR were stronger related to running performance compared to those from the WT (r=0.81-0.94 vs. 0.68-0.84; P<0.05). Relationships between MAOD and most power indices were only weak to moderate. These results support the usefulness of STR for specific power assessment in field running and suggest that anaerobic power and capacity are not related entities, irrespective of having been evaluated using similar or dissimilar exercise modes.

Fault current test of a bifilar Bi-2212 bulk coil

A bifilar Bi-2212 bulk coil with parallel shunt resistor was tested under fault current condition using a 3 MVA single-phase transformer in a 220 V-60 Hz line achieving fault current peak of 8 kA. The fault current tests are performed from steady state peak current of 200 A by applying controlled short circuits up to 8 kA varying the time period from one to six cycles. The test results show the function of the shunt resistor providing homogeneous quench behavior of the HTS coil besides its intrinsic stabilizing role. The limiting current ratio achieves a factor 4.2 during 5 cycles without any degradation.

Test of a Modular Fault Current Limiter for 220 V Line Using YBCO Coated Conductor Tapes With Shunt Protection

A modular superconducting fault current limiter (SFCL) consisting of 16 elements was constructed and tested in a 220 V line for a fault current between 1 kA to 7.4 kA. The elements are made up of second generation (2G) YBCO-coated conductor tapes with stainless steel reinforcement. For each element four tapes were electrically connected in parallel with effective length of 0.4 m per element, totaling 16 elements connected in series. The evaluation of SFCL performance was carried out under DC and AC tests. The DC test was performed through pulsed current tests and its recovery characteristics under load current were analysed by changing the shunt resistor value. The AC test performed using a 3 MVA/220 V/60 Hz transformer has shown the current limiting ratio achieved a factor higher than 10 during fault of up to five cycles without conductor degradation. The measurement of the voltage for each element during the AC test showed that in this modular SFCL the quench is homogeneous and the transition occurs similarly in all the elements.

Concretes and mortars recycled with water treatment sludge and construction and demolition rubble

There are about 7500 water treatment plants in Brazil. The wastes these plants generate in their decantation tanks and filters are discharged directly into the same brooks and rivers that supply water for treatment. Another serious environmental problem is the unregulated disposal of construction and demolition rubble, which increases the expenditure of public resources by degrading the urban environment and contributing to aggravate flooding and the proliferation of vectors harmful to public health. In this study, an evaluation was made of the possibility of recycling water treatment sludge in construction and demolition waste recycling plants. The axial compressive strength and water absorption of concretes and mortars produced with the exclusive and joint addition of these two types of waste was also determined. The ecoefficiency of this recycling was evaluated by determining the concentration of aluminum in the leached extract resulting from the solubilization of the recycled products. The production of concretes and mortars with the joint addition of water treatment sludge and recycled concrete rubble aggregates proved to be a viable recycling alternative from the standpoint of axial compression strength, modulus of elasticity, water absorption and tensile strength by the Brazilian test method. (C) 2008 Elsevier Ltd. All rights reserved.

Influence of the Operational Constraints in the Active Transmission Losses Allocation via Lagrange Multipliers

This paper presents an approach for the active transmission losses allocation between the agents of the system. The approach uses the primal and dual variable information of the Optimal Power Flow in the losses allocation strategy. The allocation coefficients are determined via Lagrange multipliers. The paper emphasizes the necessity to consider the operational constraints and parameters of the systems in the problem solution. An example, for a 3-bus system is presented in details, as well as a comparative test with the main allocation methods. Case studies on the IEEE 14-bus systems are carried out to verify the influence of the constraints and parameters of the system in the losses allocation.

Power imbalance application region method for distributed synchronous generator anti-islanding protection design and evaluation

This paper presents a novel graphical approach to adjust and evaluate frequency-based relays employed in anti-islanding protection schemes of distributed synchronous generators, in order to meet the anti-islanding and abnormal frequency variation requirements, simultaneously. The proposed method defines a region in the power mismatch space, inside which the relay non-detection zone should be located, if the above-mentioned requirements must be met. Such region is called power imbalance application region. Results show that this method can help protection engineers to adjust frequency-based relays to improve the anti-islanding capability and to minimize false operation occurrences, keeping the abnormal frequency variation utility requirements satisfied. Moreover, the proposed method can be employed to coordinate different types of frequency-based relays, aiming at improving overall performance of the distributed generator frequency protection scheme. (C) 2011 Elsevier B.V. All rights reserved.