Validity of the geriatric depression scale and the collateral source version of the geriatric depression scale in nursing homes

Background Depression is a common psychiatric disorder in older people. The study aimed to examine the screening accuracy of the Geriatric Depression Scale (GDS) and the Collateral Source version of the Geriatric Depression Scale (CS-GDS) in the nursing home setting. Methods Eighty-eight residents from 14 nursing homes were assessed for depression using the GDS and the CS-GDS, and validated against clinician diagnosed depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID) for residents without dementia and the Provisional Diagnostic Criteria for Depression in Alzheimer Disease (PDCdAD) for those with dementia. The screening performances of five versions of the GDS (30-, 15-, 10-, 8-, and 4-item) and two versions of the CS-GDS (30- and 15-item) were analyzed using receiver operating characteristic (ROC) curves. Results Among residents without dementia, both the self-rated (AUC = 0.75–0.79) and proxy-rated (AUC = 0.67) GDS variations performed significantly better than chance in screening for depression. However, neither instrument adequately identified depression among residents with dementia (AUC between 0.57 and 0.70). Among the GDS variations, the 4- and 8-item scales had the highest AUC and the optimal cut-offs were >0 and >3, respectively. Conclusions The validity of the GDS in detecting depression requires a certain level of cognitive functioning. While the CS-GDS is designed to remedy this issue by using an informant, it did not have adequate validity in detecting depression among residents with dementia. Further research is needed on informant selection and other factors that can potentially influence the validity of proxy-based measures in the nursing home setting.

Anatomical landmarks for transnasal endoscopic skull base surgery.

Resection of midline skull base lesions involve approaches needing extensive neurovascular manipulation. Transnasal endoscopic approach (TEA) is minimally invasive and ideal for certain selected lesions of the anterior skull base. A thorough knowledge of endonasal endoscopic anatomy is essential to be well versed with its surgical applications and this is possible only by dedicated cadaveric dissections. The goal in this study was to understand endoscopic anatomy of the orbital apex, petrous apex and the pterygopalatine fossa. Six cadaveric heads (3 injected and 3 non injected) and 12 sides, were dissected using a TEA outlining systematically, the steps of surgical dissection and the landmarks encountered. Dissection done by the "2 nostril, 4 hands" technique, allows better transnasal instrumentation with two surgeons working in unison with each other. The main surgical landmarks for the orbital apex are the carotid artery protuberance in the lateral sphenoid wall, optic nerve canal, lateral optico-carotid recess, optic strut and the V2 nerve. Orbital apex includes structures passing through the superior and inferior orbital fissure and the optic nerve canal. Vidian nerve canal and the V2 are important landmarks for the petrous apex. Identification of the sphenopalatine artery, V2 and foramen rotundum are important during dissection of the pterygopalatine fossa. In conclusion, the major potential advantage of TEA to the skull base is that it provides a direct anatomical route to the lesion without traversing any major neurovascular structures, as against the open transcranial approaches which involve more neurovascular manipulation and brain retraction. Obviously, these approaches require close cooperation and collaboration between otorhinolaryngologists and neurosurgeons.

Genomic architecture of sickle cell disease clinical variation in children from West Africa : a case-control study design

Contexte : L’anémie falciforme ou drépanocytose est un problème de santé important, particulièrement pour les patients d’origine africaine. La variation phénotypique de l’anémie falciforme est problématique pour le suivi et le traitement des patients. L’architecture génomique responsable de cette variabilité est peu connue. Principe : Mieux saisir la contribution génétique de la variation clinique de cette maladie facilitera l’identification des patients à risque de développer des phénotypes sévères, ainsi que l’adaptation des soins. Objectifs : L’objectif général de cette thèse est de combler les lacunes relatives aux connaissances sur l’épidémiologie génomique de l’anémie falciforme à l’aide d’une cohorte issue au Bénin. Les objectifs spécifiques sont les suivants : 1) caractériser les profils d’expressions génomiques associés à la sévérité de l’anémie falciforme ; 2) identifier des biomarqueurs de la sévérité de l’anémie falciforme ; 3) identifier la régulation génétique des variations transcriptionelles ; 4) identifier des interactions statistiques entre le génotype et le niveau de sévérité associé à l’expression ; 5) identifier des cibles de médicaments pour améliorer l’état des patients atteints d’anémie falciforme. Méthode : Une étude cas-témoins de 250 patients et 61 frères et soeurs non-atteints a été menée au Centre de Prise en charge Médical Intégré du Nourrisson et de la Femme Enceinte atteints de Drépanocytose, au Bénin entre février et décembre 2010. Résultats : Notre analyse a montré que des profils d’expressions sont associés avec la sévérité de l’anémie falciforme. Ces profils sont enrichis de génes des voies biologiques qui contribuent à la progression de la maladie : l’activation plaquettaire, les lymphocytes B, le stress, l’inflammation et la prolifération cellulaire. Des biomarqueurs transcriptionnels ont permis de distinguer les patients ayant des niveaux de sévérité clinique différents. La régulation génétique de la variation de l’expression des gènes a été démontrée et des interactions ont été identifiées. Sur la base de ces résultats génétiques, des cibles de médicaments sont proposées. Conclusion: Ce travail de thèse permet de mieux comprendre l’impact de la génomique sur la sévérité de l’anémie falciforme et ouvre des perspectives de développement de traitements ciblés pour améliorer les soins offerts aux patients.

Características físicas, químicas, celulares e microbiológicas do leite cru obtido em tanques de expansão individuais de fornecedores de um laticínio do nordeste do Estado de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Differential expression of a retrotransposable element, Rex6, in Colossoma macropomum fish from different Amazonian environments

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Andantino mit zẅolf Variationen : B-dur : für Clavier oder Fortepiano : componirt im December 1791 /

Publisher's no.: 507.

Variationen und Fuge über ein Thema von G. Ph. Telemann : für Pianoforte zu zwei Händen, Opus 134.

Mode of access: Internet.

Aus Italien : sinfonische Fantasie, G dur, für grosses Orchester, op. 16 /

Originally for orchestra; arr. for 2 pianos, 4 hands.

Variationen und Fuge über ein Thema von Händel, für das Pianoforte, Op. 24 /

Mode of access: Internet.

Klavier-werke /

Mode of access: Internet.

Minuetto /

Caption title.

Also sprach Zarathustra : Tondichtung, frei nach Friedr. Nietzsche, für grosses Orchester, Op. 30 /

Originally for orchestra; arr. for 2 pianos, 4 hands.

Polonaise (from the opera "Boris Godounof")

Publisher's plate no.: B.M.co.5521.

Results of the coupled atmosphere-land surface model ECHAM5-JSBACH in NetCDF format

In this study we present first results of a new model development, ECHAM5-JSBACH-wiso, where we have incorporated the stable water isotopes H218O and HDO as tracers in the hydrological cycle of the coupled atmosphere-land surface model ECHAM5-JSBACH. The ECHAM5-JSBACH-wiso model was run under present-day climate conditions at two different resolutions (T31L19, T63L31). A comparison between ECHAM5-JSBACH-wiso and ECHAM5-wiso shows that the coupling has a strong impact on the simulated temperature and soil wetness. Caused by these changes of temperature and the hydrological cycle, the d18O in precipitation also shows variations from -4 permil up to 4 permil. One of the strongest anomalies is shown over northeast Asia where, due to an increase of temperature, the d18O in precipitation increases as well. In order to analyze the sensitivity of the fractionation processes over land, we compare a set of simulations with various implementations of these processes over the land surface. The simulations allow us to distinguish between no fractionation, fractionation included in the evaporation flux (from bare soil) and also fractionation included in both evaporation and transpiration (from water transport through plants) fluxes. While the isotopic composition of the soil water may change for d18O by up to +8 permil:, the simulated d18O in precipitation shows only slight differences on the order of ±1 permil. The simulated isotopic composition of precipitation fits well with the available observations from the GNIP (Global Network of Isotopes in Precipitation) database.

Biologie de Penaeus duorarum notialis en Côte d'Ivoire. 4 - Rélations entre la répartition et les conditions du milieu. Étude des variations du sex-ratio

The analysis of the geographic and bathymetric distribution of Penaeus duorarum and, particularly P. d. notialis off Côte d'Ivoire and in its whole distribution area leads to the definition of the adult ecological requirements (temperature, salinity, grain size and sediment composition, organic matter) and the importance of the thermocline in the bathmetric distribution. The population structure study shows: (1) variations of size with depth, (2) variations of sex ratio, with size, depth and seasons.