Screening for Alzheimer`s Disease Among Illiterate Elderly: Accuracy Analysis for Multiple Instruments

One of the challenges in screening for dementia in developing countries is related to performance differences due to educational and cultural factors. This study evaluated the accuracy of single screening tests as well as combined protocols including the Mini-Mental State Examination (MMSE), Verbal Fluency animal category (VF), Clock Drawing test (CDT), and Pfeffer Functional Activities Questionnaire (PFAQ) to discriminate illiterate elderly with and without Alzheimer`s disease (AD) in a clinical sample. Cross-sectional study with 66 illiterate outpatients diagnosed with mild and moderate AD and 40 illiterate normal controls. Diagnosis of AD was based on NINCDS-ADRDA. All patients were submitted to a diagnostic protocol including a clinical interview based on the CAMDEX sections. ROC curves area analyses were carried out to compare sensitivity and specificity for the cognitive tests to differentiate the two groups (each test separately and in two by two combinations). Scores for all cognitive (MMSE, CDT, VF) and functional assessments (PFAQ) were significantly different between the two groups (p < 0.001). The best screening instruments for this sample of illiterate elderly were the MMSE and the PFAQ. The cut-off scores for the MMSE, VF, CDT, and PFAQ were 17.5, 7.5, 2.5, and 11.5, respectively. The most sensitive combination came from the MMSE and PFAQ (94.1%), and the best specificity was observed with the combination of the MMSE and CDT (89%). Illiterate patients can be successfully screened for AD using well-known screening instruments, especially in combined protocols.

Cost-effectiveness analysis of routine rotavirus vaccination in Brazil

Objective. The objective of this study was to conduct a cost-effectiveness analysis of a universal rotavirus vaccination program among children : 5 years of age in Brazil. Methods. Considering a hypothetical annual cohort of approximately 3 300 000 newborns followed over 5 years, a decision-tree model was constructed to examine the possible clinical and economic effects of rotavirus infection with and without routine vaccination of children. Probabilities and unit costs were derived from published research and national administrative data. The impact of different estimates for key parameters was studied using sensitivity analysis. The analysis was conducted from both healthcare system and societal perspectives. Results. The vaccination program was estimated to prevent approximately 1735 351 (54%) of the 3 210 361 cases of rotavirus gastroenteritis and 703 (75%) of 933 rotavirus-associated deaths during the 5-year period. At a vaccine price of 18.6 Brazilian reais (R$) per dose, this program would cost R$121 673 966 and would save R$38 536 514 in direct costs to the public healthcare system and R$71 778 377 in direct and indirect costs to society. The program was estimated to cost R$1 028 and R$1 713 per life-years saved (LYS)from the societal and healthcare system perspectives, respectively. Conclusions. Universal rotavirus vaccination was a cost-effective strategy for both perspectives. However, these findings are highly sensitive to diarrhea incidence rate, proportion of severe cases, vaccine coverage, and vaccine price.

Further psychometric study of the Beck Anxiety Inventory including factorial analysis and social anxiety disorder screening

Objective. To analyze the psychometric properties of the Brazilian Portuguese version of the Beck Anxiety Inventory (BAI) in terms of its internal consistency, scores distribution, concurrent and discriminant validity, and factorial analysis in a sample of university students and social anxiety disorder (SAD) cases and non-cases. Methods. A sample of Brazilian university students from the general population (N = 2314) and a sample of university students identified as cases (N = 88) and non-cases (N = 90) of SAD were assessed, using as a parameter the Structured Clinical Interview for the DSM-IV. The different instruments were completed individually in the presence of an experienced rater. Results. The BAI showed adequate internal consistency (0.88-0.92) and discriminant validity, with 0.74 sensitivity and 0.71 specificity for a cut-off score of 10. The factorial analysis suggested a three-factor solution to be the most adequate. Conclusions. The version of the BAI studied is quite adequate to be used in the context of Brazilian university students, identifying the presence of anxiety indicators. However, its usefulness to screen for SAD seems limited.

Cost-effectiveness analysis of universal childhood vaccination against varicella in Brazil

This study conducts a cost-effectiveness analysis of a childhood universal varicella vaccination program in Brazil. An age and time-dependent dynamic model was developed to estimate the incidence of varicella for 30 years. Assuming a single-dose schedule; vaccine efficacy of 85% and coverage of 80%, the program could prevent 74,422,058 cases and 2905 deaths. It would cost R$ 3,178,396,110 and save R$ 660,076,410 to the society and R$ 365,602,305 to the healthcare system. The program is cost-effective (R$ 14,749 and R$ 16,582 per life-year saved under the societal and the healthcare system`s perspective, respectively). The program`s cost-effectiveness is highly sensitive to the vaccine price and number of doses. (C) 2008 Elsevier Ltd. All rights reserved.

A sensitive vorticity gauge using rotated porphyroblasts, and its application to rocks adjacent to the Alpine Fault, New Zealand

Variable aspect ratio porphyroblasts deformed in non-coaxial flow. and internally containing rotated relicts of an external foliation, can be used to characterise plane strain flow regimes. The distribution obtained by plotting the orientation of the long axis of such grains, classified by aspect ratio, against the orientation of the internal foliation is potentially a sensitive gauge of both the bulk shear strain (as previously suggested) and kinematic vorticity number. We illustrate the method using rotated biotite porphyroblasts in the Alpine Schist: a sequence of mid-crustal rocks that have been ramped to the surface along the Alpine Fault. a major transpressional plate boundary. Results indicate that, at distances greater than or equal to similar to1 km from the fault, the rocks have undergone a combination of irrotational fattening and dextral-oblique, normal-sense shear, with a bulk shear strain of similar to0.6 and kinematic vorticity number of similar to0.2. The vorticity analysis is compatible with estimates of strongly oblate bulk strain of similar to 75% maximum shortening. Dextral-reverse transpressional flow characterises higher strain S-tectonite mylonite within similar to1 km of the Alpine Fault. These relationships provide insight into the kinematics of flow and distribution of strain in the hangingwall of the Alpine Fault and place constraints on numerical mechanical models for the exhumation of these mid-crustal rocks. (C) 2001 Elsevier Science Ltd. All rights reserved.

Introducing ethnomethodological analysis to the field of music education

In recent years qualitative research methods have been adopted within in the field of music education and have received widespread acceptance. However, the theoretical framework provided by ethnomethodology (Garfinkel, 1974, in R. Turner, Ethnomethodology , Penguin, Middlesex, UK) and the tools of conversational analysis (Sacks, 1992, Lectures on Conversation , edited by Gail Jefferson, Blackwell, Oxford, UK) have, to this point, been overlooked by researchers in the field of music education. In this paper I argue that the application of ethnomethodological and conversation analytical approaches in the field of research in music education can provide fresh insights into the work of music teachers and how this work is accomplished in institutional settings. Here I demonstrate how a conversation analytical perspective drawing on an ethnomethodological framework might be used to investigate transcripts of audio-recorded interview talk. This type of analysis can illuminate aspects of members' roles in relation to, and perceptions about music education in school settings that might be overlooked in other types of analysis. A conversation analytical approach to the examination of talk-in-interaction explicates in fine-grained detail how members orient to matters at hand in the context of research settings, as well as revealing features of the cultural world of music teaching. Further application of the approach to research problems in other school settings, I argue, will inform the field of music education in ways yet to be realised.

Host selection and utilisation of Sonchus oleraceus (Asteraceae) by Helicoverpa armigera (Lepidoptera : Noctuidae): A genetic analysis

The cotton bollworm (Helicoverpa armigera) prefers the common sowthistle (Sonchus oleraceus L.) to cotton (Gossypium hirsutum L.), sorghum (Sorghum bicolor L.) and maize (Zea mays L.) for oviposition in the field in Australia. Using the common sowthistle and cotton as host plants, we carried out this study to evaluate genetic variation in both oviposition preference and larval growth and genetic correlation between maternal preference and larval performance. There was a significant genetic component of phenotypic variation in both characters, and the heritability of oviposition preference was estimated as 0.602. Helicoverpa armigera larvae survived slightly better and grew significantly faster on common sowthistle than on cotton, but genetic correlation between maternal preference and larval growth performance was not detectable. Instead, larval growth performance on the two hosts changed with families, which renders the interaction between family and host plant significant. As a result, the genetic correlation between mean values of larval growth across the two host species was not different from zero. These results are discussed in the context of the relationship between H. armigera and the common sowthistle and the polyphagous behaviour of this insect in general.

A critical note on UNDP's gender inequality indices

This paper analyses the different indices applied for the measurement of human development as constructed by the United Nations Development Program. Of special interest is the Gender Development Index (GDI), introduced in the 1995 Human Development Report and the Gender Empowerment Measure (GEM). In light of the mate bias in the Indian socioeconomic context, the application of the GDI and GEM acquires special significance. A critical appraisal of their theoretical base and their application has been undertaken in this paper. The conclusion is that GDI and GEM. although praise-worthy achievements on the part of the UNDP, do not adequately reflect or measure male/female disparity in the Indian context. Both indices suffer from the weakness of employing a pre-assigned value of the Gender Sensitive Equity Indicator. They also exhibit several other shortcomings, outlined here. GDI is a poor indicator of the relative deprivation of females as shown by our analysis of the relationship between the GDI and the female/male ratio for 16 Indian core states.

The effect of coal particle size on colorimetric analysis of roadway dust

Colorimetric analysis of roadway dust is currently a method for monitoring the incombustible content of mine roadways within Australian underground coal mines. To test the accuracy of this method, and to eliminate errors of judgement introduced by human operators in the analysis procedure, a number of samples were tested using scanning software to determine absolute greyscale values. High variability and unpredictability of results was noted during this testing, indicating that colorimetric testing is sensitive to parameters within the mine that are not currently reproduced in the preparation of reference samples. This was linked to the dependence of colour on particle surface area, and hence also to the size distribution of coal particles within the mine environment. (C) 2001 Elsevier Science Ltd. All rights reserved.

Preprocessing and time-frequency analysis of newborn EEG seizures

Neurological disease or dysfunction in newborn infants is often first manifested by seizures. Prolonged seizures can result in impaired neurodevelopment or even death. In adults, the clinical signs of seizures are well defined and easily recognized. In newborns, however, the clinical signs are subtle and may be absent or easily missed without constant close observation. This article describes the use of adaptive signal processing techniques for removing artifacts from newborn electroencephalogram (EEG) signals. Three adaptive algorithms have been designed in the context of EEG signals. This preprocessing is necessary before attempting a fine time-frequency analysis of EEG rhythmical activities, such as electrical seizures, corrupted by high amplitude signals. After an overview of newborn EEG signals, the authors describe the data acquisition set-up. They then introduce the basic physiological concepts related to normal and abnormal newborn EEGs and discuss the three adaptive algorithms for artifact removal. They also present time-frequency representations (TFRs) of seizure signals and discuss the estimation and modeling of the instantaneous frequency related to the main ridge of the TFR.

Cloning and functional analysis of the Sry-related HMG box gene, Sox18

The Sox gene family (Sry like HMG box gene) is characterised by a conserved DNA sequence encoding a domain of approximately 80 amino acids which is responsible for sequence specific DNA binding. We initially published the identification and partial cDNA sequence of murine Sox18, a new member of this gene family, isolated from a cardiac cDNA library. This sequence allowed us to classify Sox18 into the F sub-group of Sox proteins, along with Sox7 and Sox17. Recently, we demonstrated that mutations in the Sox18 activation domain underlie cardiovascular and hair follicle defects in the mouse mutation, ragged (Ra) (Pennisi et al., 2000. Mutations in Sox18 underlie cardiovascular and hair follicle defecs in ragged mice. Nat. Genet. 24, 434-437). Ra homozygotes lack vibrissae and coat hairs, have generalised oedema and an accumulation of chyle in the peritoneum. Here we have investigated the genomic sequences encoding Sox18. Screening of a mouse genomic phage library identified four overlapping clones, we sequenced a 3.25 kb XbaI fragment that defined the entire coding region and approximately 1.5 kb of 5' flanking sequences. This identified (i) an additional 91 amino acids upstream of the previously designated methionine start codon in the original cDNA, and (ii);ln intron encoded within the HMG box/DNA binding domain in exactly the same position as that found in the Sox5, -13 and -17 genes. The Sox18 gene encodes a protein of 468 aa. We present evidence that suggests HAF-2, the human HMG-box activating factor-2 protein, is the orthologue of murine Sox18. HAF-2 has been implicated in the regulation of the Human IgH enhancer in a B cell context. Random mutagenesis coupled with GAL4 hybrid analysis in the activation domain between amino acids 252 and 346, of Sox18, implicated the phosphorylation motif, SARS, and the region between amino acid residues 313 and 346 as critical components of Sox18 mediated transactivation. Finally, we examined the expression of Sox18 in multiple adult mouse tissues using RT-PCR. Low-moderate expression was observed in spleen, stomach, kidney, intestine, skeletal muscle and heart. Very abundant expression was detected in lung tissue. (C) 2001 Elsevier Science B.V. All rights reserved.

Adaptive multiscale principal components analysis for online monitoring of wastewater treatment

Fault detection and isolation (FDI) are important steps in the monitoring and supervision of industrial processes. Biological wastewater treatment (WWT) plants are difficult to model, and hence to monitor, because of the complexity of the biological reactions and because plant influent and disturbances are highly variable and/or unmeasured. Multivariate statistical models have been developed for a wide variety of situations over the past few decades, proving successful in many applications. In this paper we develop a new monitoring algorithm based on Principal Components Analysis (PCA). It can be seen equivalently as making Multiscale PCA (MSPCA) adaptive, or as a multiscale decomposition of adaptive PCA. Adaptive Multiscale PCA (AdMSPCA) exploits the changing multivariate relationships between variables at different time-scales. Adaptation of scale PCA models over time permits them to follow the evolution of the process, inputs or disturbances. Performance of AdMSPCA and adaptive PCA on a real WWT data set is compared and contrasted. The most significant difference observed was the ability of AdMSPCA to adapt to a much wider range of changes. This was mainly due to the flexibility afforded by allowing each scale model to adapt whenever it did not signal an abnormal event at that scale. Relative detection speeds were examined only summarily, but seemed to depend on the characteristics of the faults/disturbances. The results of the algorithms were similar for sudden changes, but AdMSPCA appeared more sensitive to slower changes.

Kinematic analysis of lingual fatigue in myasthenia gravis

This study describes a preliminary examination of the viability and suitability of the physiologic technique electromagnetic articulography (EMA) in investigating lingual fatigue in myasthenia gravis (MG). A 52.9-year-old female diagnosed with MG at the age of 18 years, but who was in remission, participated in the study with a matched control subject. Changes in the duration, speed, and range of tongue-tip and tongue-back movements during repetition of /taka/ over two minutes were investigated. Results revealed that the MG subject did not exhibit significant changes in duration, maximum velocity, maximum acceleration, or the distance travelled by her tongue as measured by EMA over the task. The kinematic results were, in part, expected since the MG subject was in remission. The results, therefore, may not be representative of the majority of individuals with active MG. The examination of the current case did highlight, however, the potential advantages of EMA in providing detailed, objective information regarding lingual kinematics for future investigations of individuals with MG. It also showed that EMA may be sensitive in detecting subclinical kinematic features of fatigue in individuals who are in remission from MG. Finally, EMA led to the identification of possible physiologic factors underlying the CV transform effect, which was evident for the MG subject's syllable productions. In the past, the effect had been assumed to be a purely perceptual-based phenomenon.

New type of dual-channel PAM chlorophyll fluorometer for highly sensitive water toxicity biotests

A new type of dual-channel PAM chlorophyll fluorometer has been developed, which is specialised in the detection of extremely small differences in photosynthetic activity in algae or thylakoids suspensions. In conjunction with standardised algae cultures or isolated thylakoids, the new device provides an ultrasensitive biotest system for detection of toxic substances in water samples. In this report, major features of the new device are outlined and examples of its performance are presented using suspensions of Phaeodactylum tricornutum (diatoms) and of freeze-dried thylakoids of Lactuca sativa (salad). Investigated and reference samples are exposed to the same actinic intensity of pulse-modulated measuring light. The quantum yields are assessed by the saturation pulse method. Clock-triggered repetitive measurements of quantum yield typically display a standard deviation of 0.1%, corresponding to the inhibition induced by 0.02 mug diuron l(-1). Hence, for diuron or compounds with similar toxicity, the detection limit is well below the 0.1 mug l(-1) defined as the limit for the presence of a single toxic substance in water by the European Commission drinking water regulation. The amounts of water and biotest material required for analysis are very small, as a single assay involves two 1 ml samples, each containing ca. 0.5 mug chlorophyll. Both with Phaeodactylum and thylakoids the relationship between inhibition and diuron concentration is strictly linear up to 10% inhibition, with very similar slopes. Apparent inhibition depends on the actinic effect of the measuring light, showing optima at 6 and 4 mumol quanta m(-2) s(-1) with Phaeodactylum and thylakoids, respectively.

Large amplitude vibration of thermo-electro-mechanically stressed FGM laminated plates

This paper presents a large amplitude vibration analysis of pre-stressed functionally graded material (FGM) laminated plates that are composed of a shear deformable functionally graded layer and two surface-mounted piezoelectric actuator layers. Nonlinear governing equations of motion are derived within the context of Reddy's higher-order shear deformation plate theory to account for transverse shear strain and rotary inertia. Due to the bending and stretching coupling effect, a nonlinear static problem is solved first to determine the initial stress state and pre-vibration deformations of the plate that is subjected to uniform temperature change, in-plane forces and applied actuator voltage. By adding an incremental dynamic state to the pre-vibration state, the differential equations that govern the nonlinear vibration behavior of pre-stressed FGM laminated plates are derived. A semi-analytical method that is based on one-dimensional differential quadrature and Galerkin technique is proposed to predict the large amplitude vibration behavior of the laminated rectangular plates with two opposite clamped edges. Linear vibration frequencies and nonlinear normalized frequencies are presented in both tabular and graphical forms, showing that the normalized frequency of the FGM laminated plate is very sensitive to vibration amplitude, out-of-plane boundary support, temperature change, in-plane compression and the side-to-thickness ratio. The CSCF and CFCF plates even change the inherent hard-spring characteristic to soft-spring behavior at large vibration amplitudes. (C) 2003 Elsevier B.V. All rights reserved.