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.

Coordination dynamics and attentional costs of continuous and discontinuous bimanual circle drawing movements

It has been suggested that the temporal control of rhythmic unimianual movements is different between tasks requiring continuous (e.g., circle drawing) and discontinuous movements (e.g., finger tapping). Specifically, for continuous movements temporal regularities are ail emergent property, whereas for tasks that involve discontinuities timing is ail explicit part of the action goal. The present experiment further investigated the control of continuous and discontinuous movements by comparing the coordination dynamics and attentional demands of bimanual continuous circle drawing with bimanual intermittent circle drawing. The intermittent task required participants to insert a 400 ms pause between each cycle while circling. Using dual-task methodology, 15 right-handed participants performed the two circle drawing tasks, while vocally responding to randomly presented auditory probes. The circle drawing tasks were performed in symmetrical and asymmetrical coordination modes and at movement frequencies of 1 Hz and 1.7 Hz. Intermittent circle drawing exhibited superior spatial and temporal accuracy and stability than continuous circle drawing supporting the hypothesis that the two tasks have different underlying control processes. In terms of attentional cost, probe RT was significantly slower during the intermittent circle drawing task than the continuous circle drawing task across both coordination modes and movement frequencies. Of interest was the finding that in the intermittent circling task reaction time (RT) to probes presented during the pause between cycles did not differ from the RT to probes occurring during the circling movement. The differences in attentional demands between the intermittent and continuous circle drawing tasks may reflect the operation of explicit event timing and implicit emergent timing processes, respectively. (C) 2008 Elsevier B.V. All rights reserved.

Texture and mechanical properties evolution of a deep drawing medium carbon steel during cold rolling and subsequent recrystallization

Medium carbon steels are mostly used for simple applications; however, new applications have been developed for which good sheet metal formability is required. These types of steels have an inherent low formability. A medium-carbon hot-rolled SAE 1050 steel was selected for this study. It has been cold rolled with thickness reductions varying between 7 and 80%. The samples obtained were used to evaluate the strain hardening curve. For samples with a 50 and 80% thickness reduction, an annealing heat treatment was performed to achieve recrystallization. The material was characterized in the ""as-received"", cold rolled and annealed conditions using several methods: optical metallography, X-ray diffraction (texture), Vickers hardness, and tensile testing. For large thickness reductions, the SAE 1050 steel presented low elongation, less than 2%, and yield strength (YS) and tensile strength (TS) around 1400 MPa. Texture in the ""as-received"" condition showed strong components on the {001} plane, in the < 100 >, < 210 > and (110) directions. After cold rolling, the texture did not present any significant changes for small thickness reductions, however. It changed completely for large ones, where gamma, < 111 >//ND, alpha, < 110 > HRD, and gamma prime, < 223 >//ND, fibres were strengthened. After annealing, the microstructure of the SAE 1050 steel was characterized by recrystallized ferrite and globular cementite. There was little change in the alpha fibre for the 50% reduction, whereas for the 80% reduction, its intensity increased. Both gamma and gamma prime fibres vanished upon annealing for 50 and 80% reductions alike. (c) 2008 Elsevier B.V. All rights reserved.

Medium carbon steel deep drawing: A study on the evolution of mechanical properties, texture and simulations, from cold rolling to the end product

Medium carbon steels are mostly used for simple applications; nevertheless new applications have been developed for which good sheet formability is required. This class of steels has an inherent low formability. A medium carbon hot rolled SAE 1050 steel has been selected for this study. It has been cold rolled with reductions in the 7-80% range. Samples have been used to assess the cold work hardening curve. For samples with a 50 and 80% thickness reduction, an annealing heat treatment has been performed to obtain recrystallization. The material has been characterized in the ""as received"", cold rolled and annealed conditions, using several methods: optical microscopy, X-ray diffraction (texture), Vickers hardness and tensile testing. The 50% cold rolled and recrystallized material has been further studied in terms of sheet metal formability and texture evolution during the actual stamping of a steel toecap that has been used to validate the finite element simulations. (C) 2008 Elsevier B.V. All rights reserved.

A Survey for Diclofop-Methyl Resistance in Italian Ryegrass from Tennessee and How To Manage Resistance in Wheat

Italian ryegrass resistance to diclofop has been documented in several countries, including the United States. The purpose of this research was to screen selected putative resistant populations of Italian ryegrass for resistance to the acetyl-CoA carboxylase (ACCase)-inhibiting herbicides diclofop and pinoxaden and the acetolactate synthase (ALS)-inhibiting herbicides imazamox, pyroxsulam, and mesosulfuron in the greenhouse and to use field experiments to develop herbicide programs for Italian ryegrass control. Resistance to diclofop was confirmed in eight populations from Tennessee. These eight populations did not show cross-resistance to pinoxaden. One additional population (R1) from Union County, North Carolina, was found to be resistant to both diclofop and pinoxaden. The level of resistance to pinoxaden of the R1 population was 15 times that of the susceptible population. No resistance was confirmed to any of the ALS-inhibiting herbicides examined in this research. Field experiments demonstrated PRE Italian ryegrass control with chlorsulfuron (71 to 94%) and flufenacet + metribuzin (84 to 96%). Italian ryegrass control with pendimethalin applied PRE or delayed preemergence (DPRE) was variable (0 to 85%). POST control of Italian ryegrass was acceptable with pinoxaden, mesosulfuron, flufenacet + metribuzin, and chlorsulfuron + flucarbazone (> 80%). Application timing and herbicide treatment had no effect on wheat yield, except for diclofop and pendimethalin treatments, in which uncontrolled Italian ryegrass reduced wheat yield.

Spectrum of MMACHC mutations in Italian and Portuguese patients with combined methylmalonic aciduria and homocystinuria, cblC type

Methylmalonic aciduria (MMA) and homocystinuria, cblC type (MIM 277400) is the most frequent inborn error of vitamin B-12. The recent identification of the disease gene, MMACHC, has permitted preliminary genotype-phenotype correlations. We studied 24 Italian and 17 Portuguese patients with cblC defect to illustrate the spectrum of mutations in a southern European population and discuss the impact that mutation identification has on routine diagnostic procedures. Since the metabolic defect raises the serum levels of homocysteine, we also tested if variants in MTHFR-playing a key role in homocysteine remethylation pathway-could act as genetic modifier in cblC defect. We found that the c.271 dupA (accounting for 55% of the MMA CH alleles in our cohort) followed by c.394C > T (16%) and c.331C > T (9%) were the most frequent mutations. In our study we also identified a novel mutation (c.544T > C). On the other hand, the MTHFR genotype did not appear to influence age at onset, the clinical phenotype and outcome of patients with cblC defect. This study shows that mutation screening for the most common MMACH mutations occurring in early-onset forms (c.271dupA and c.331C > T) seems to have a high diagnostic yield in a southern European population with cblC defect. Although the identification of the gene defect per se does not predict completely time and severity of disease appearance, our data corroborate the importance of a molecular testing to offer accurate prenatal diagnosis to couples at high risk of having affected children. (C) 2007 Elsevier Inc. All rights reserved.

Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study

Background: Metabolic syndrome (MS) prevalence between different populations in obese adolescents is scanty to date. Objective: To compare the MS prevalence and related risk factors in Brazilian and Italian obese adolescents. Methods: A total of 509 adolescents (110 Brazilian, 399 Italian), aged 15-19 years. Anthropometric characteristics, triglycerides (TG), total, low-density lipoprotein (LDL)-, high-density lipoprotein (HDL)-cholesterol, fasting plasma glucose (FPG), insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and blood pressure were measured. Results: Age, body mass index (BMI) and BMI z-score were not significantly different between the two subgroups. BMI z-score, TG, FPG, HOMA-IR and systolic blood pressure (SBP) were significantly higher in boys than in girls both in Brazilian and Italian adolescents, while HDL-cholesterol levels were lower in boys than in girls. No significant differences were observed in BMI, LDL and total-cholesterol and DBP in two genders and groups. Insulin, FPG, HOMA-IR and TG were significantly higher, while LDL-cholesterol and SBP were significantly lower in Brazilian than in Italian subjects, both in males and females. HDL and total-cholesterol and diastolic blood pressure (DBP) were not significantly different between the two subgroups and genders. MS prevalence was higher in Brazilian than in Italian obese boys (34.8 vs. 23.6%, p < 0.001) and girls (15.6 vs. 12.5%, p < 0.01). The most frequently altered parameter was HOMA-IR both in subjects with MS (100% in Brazilian and 81.8% in Italian) and without MS (42.9% and 11.7%). Conclusion: Metabolic syndrome represents a worldwide emerging health problem in different ethnical populations, the alterations of the risk factors related to MS (different in their prevalence between different subgroups) being strictly linked to the degree of obesity.