It is premature to test older drivers with the SIMARD-MD

Background

A new tool, the SIMARD-MD, has been proposed to help physicians identify cognitively impaired drivers who may be unfit to drive, but little empirical evidence is available to justify its use. We analyzed data from a cohort of older Canadian drivers who had undergone cognitive testing to: (1) correlate the SIMARD-MD with other tools that measure cognition (e.g., trail-making test), (2) identify how many drivers, using published cut-offs on the SIMARD-MD, would be recommended to lose their license, or be considered fit to drive, or be required to undergo further driving assessment, and (3) determine if the SIMARD-MD is biased by level of education as many cognitive tools are.

Methods

Cross-sectional data from 841 drivers aged 70 and over from seven Canadian sites who are enrolled in a 5-year cohort study were used for the analyses. Scores on the SIMARD-MD were correlated with scores on the other cognitive measures. The recommendations that would be made based on the SIMARD-MD scores were based on published cut-off values suggested by the authors of the tool. The impact of education status was examined using linear regression controlling for age.

Results

Correlations between the SIMARD-MD and other cognitive measures ranged from .15 to .86. Using published cut-off scores, 21 participants (2.5%) would have been recommended to relinquish their licenses, 428 (50.9%) would have been deemed fit to drive, and 392 (46.6%) would have been required to undergo further testing. We found a difference of 8.19 points (95% CI = 4.99, 11.40, p < .001) in favor of drivers with post-secondary education versus those without, representing over 11% of the mean score.

Discussion

The SIMARD-MD is unlikely to be valuable to clinicians because it lacks sufficient precision to provide clear recommendations about fitness-to-drive. Recommendations based solely on the SIMARD-MD may place many seniors at risk of losing their transportation mobility or incurring unnecessary stress and costs to prove they are safe to drive. Furthermore, the education bias may create an unwanted structural inequity. Hence, adoption of the SIMARD-MD as a tool to determine fitness-to-drive appears premature.     

Quick Analysis Methods for Random Balance,Screening Experiments

A short expository account of random balance ia given, in which some different types of sampling are distinguished. As a quick significance test of effectiveness of single factors, a simple analysis of variance method is recommended. For the sake of sensitivity, it is suggested that the number of levels of quantitative factors should preferably be less than five. The degree of unbalance of a random balance design is studied, largely through an example, and a desirable upper bound is suggested for the number of levels of any factor, namely one eighth of the total number of observations.     

Glycerolipids as Selective Thrombin Inhibitors from the Fungus Stereum Hirsutum

ABSTRACT

A dry extract of Stereum hirsutum exhibited a significant inhibitory activity on thrombin (34%). A bioassay oriented fractionation of the extract of Stereum hirsutum has led to the isolation of two active fractions. On the basis of spectroscopic data, chemical reactions, and GC-MS analysis, complex mixtures of diacylglycerophospholipids (DAGPs) and diacylglycerols (DGs) have been isolated and identified. Docking studies suggest that some isolated compounds could bind to the thrombin active site in a similar manner as previously reported phosphonate thrombin inhibitors.     

Polaron State Screening by Plasmons in a Spherical Nanocrystal

We establish that the screening due to plasmons reduces the effective electron-phonon coupling in the nanocrystal appreciably, and that the contribution of the self-action potential energy to the polaron ground state energy reduces with increasing plasmon density. We find that higher plasmon density leads to smaller Debye radius and greater screening of the electron-phonon interaction. We point out the existence of a threshold value of the Debye radius beyond which the electron-phonon interaction is redundant. The Debye screening radius provides a good estimate of the distance beyond which the electron-phonon interactions can be essentially ignored. The screened self-action potential energy is found to have a dominant effect on the polaron ground state energy. The Green function and the modified electron-phonon coupling amplitudes are principally expressed in terms of a function which we call the F-function, one of the arguments of which determines its zero.     

安徽省SMV株系的鉴定及其抗源筛选

为明确安徽省大豆花叶病毒（soybean mosaic virus,SMV）株系的最新组成、分布及消长动态,以及筛选对流行株系的抗性种质,2009-2010年广泛采集安徽省各大豆主产区疑似SMV病样461份,采用生物学及血清学方法鉴定得到83个SMV分离物。用全国统一的10个鉴别寄主对这些分离物进行鉴定,共鉴定出14个SMV株系,如SC3~SC9、SC11、SC13~SC15、SC17、SC19和SC22,其中SC5、SC11、SC14、SC15、SC17、SC19和SC22是本研究在大豆主产区新发现的。进一步比较分析发现,SMV株系SC3和SC7仍为目前安徽省大豆产区的流行株系,分别占分离物总数的16.9%和25.3%;其次为新发现的强毒株系SC15,在安徽省也有较为广泛的分布,比率为12.1%。针对流行株系SC3和SC7的抗源筛选结果表明,来自参加安徽省区试的149份资源中有中作J8023、中黄45、L85-2308、中涡47号和濉科13等5份材料对SC3表现高抗,中黄45、宿03-4-1-4和鲁06-7等9份材料对SC7表现高抗;参加我国南方区试的95份种质资源中有13份对强毒株系SC15表现抗病,占鉴定品种的13.7%。本研究明确了安徽省大豆产区的流行株系及变化趋势,筛选出针对SMV流行株系的抗源,为培育抗病品种和抗病品种布局提供了依据。     

患者住院期间握力变化与分析

目的:研究患者在住院期间的握力变化及其影响因素。方法:选取926例于2012年6月1日—2012年12月31日期间在北京友谊医院住院的患者,分析其住院期间握力变化情况及其影响因素。结果:75%的患者住院期间握力降低。外科系统中,无论男性还是女性,中年组和老年组出院时的握力较入院时有所降低(P0.05),而青年组患者则无明显差异(P0.05)。内科系统中,所有女性患者出院握力均低于入院握力(P0.05);男性患者中,青年组和中年组出院时的握力低于入院时握力(P0.05),但65岁以上老年男性患者的握力在出院时虽较入院时有所降低,但差异无统计学意义(P0.05)。Logistic回归分析结果显示,住院患者的性别、年龄及其营养风险筛查分值(NRS2002)高低影响其入院及出院握力(P0.05),此外出院时的握力还与患者的疾病及其严重程度(所处科别、所患疾病及并发症、住院时长)有关(P0.05)。患者营养风险筛查得分的高低主要与性别、体重指数、经口的进食途径、入院握力等因素有关(P0.05)。结论:大部分患者住院期间握力降低,这与患者营养风险筛查得分的高低有关,而合理的营养支持途径是降低患者营养风险筛查得分的主要措施之一。     

Nachweis von Dioxinen und dioxinähnlichen Substanzen mit dem Micro-EROD-Bioassay: Untersuchungen von Milch und Rinderfett

Zusammenfassung. Es wurde untersucht, ob der Micro-EROD-Bioassay (EROD-Assay) für den Einsatz als amtliche Screening-Methode für Dioxine und dioxin?hnliche Stoffe in Lebensmitteln grunds?tzlich geeignet ist. Ein Ziel war das Verkürzen und Vereinfachen der Probenaufarbeitung im Vergleich zu den Anforderungen der instrumentellen Analytik. Alle Proben wurden zuvor instrumentell nach gesetzlichen Vorgaben auf PCDD/F untersucht. Die Ergebnisse des EROD-Assays und der instrumentellen Analytik wurden unter Berücksichtigung der Anforderungen der EG-Richtlinien an Screening-Verfahren für Dioxine und dioxin?hnliche Substanzen verglichen. Die vorliegende Publikation gibt einen überblick über die bisherigen Ergebnisse. Proben aus frischer, bereits verdorbener und gefriergetrockneter Milch sowie Rinderfett standen zur Verfügung. Die Rohfett-Aufarbeitung für den EROD-Assay wurde auf eine S?ulenchromatographie reduziert. Die Ergebnisse waren mit steigender Matrixqualit?t, verdorbene Milch < Rinderfett < Frischmilch, besser. In allen F?llen lag der mittlere Quotient der Ergebnisse von EROD-Assay und HRGC/HRMS um 1. Es zeigte sich eine Tendenz zu h?heren Werten im EROD-Assay bei niedriger Dioxinbelastung (<0,7 pg WHO-PCDD/F-TEQ/g Fett) und zu geringeren Werten bei Proben mit >5 pg WHO-PCDD/F-TEQ/g Fett. “Falsch” positive Ergebnisse k?nnen durch andere stabile CYP1A1-Induktoren, wie dioxin?hnliche PCBs, ausgel?st werden. Für eine bessere Erfassung hoher Belastungen sind andere Verdünnungsstufen zu w?hlen. In den vorliegenden Versuchen sollte der Bereich um den jeweiligen Ausl?sewert optimal erfasst werden. Die meisten Anforderungen der EG an zellbasierte Testsysteme im Rahmen des Nachweises von Dioxinen wurden bei allen Proben erfüllt. Der VK unabh?ngiger Extraktionen lag nur bei frischer Milch im Rahmen der gesetzlichen Vorgaben. Für über 90% der Proben, die aufgrund ihres Verderbs nicht mehr für eine HRGC/HRMS-Analyse geeignet waren, konnte aber über die Mittelwerte der Messungen eine korrekte Zuordnung zum jeweiligen Ausl?sewert getroffen werden. Durch den gleichzeitigen Einsatz einer Standardzulage und eines empirischen Faktors traten keine falsch negativen, jedoch eine erh?hte Anzahl “falsch” positiver Proben auf. Abh?ngig vom Messumfang k?nnten durch den Einsatz des EROD-Assays mehr Proben untersucht bzw. die Kosten für die Dioxin-Analytik gesenkt werden. Erste Ergebnisse mit frischer Milch er?ffnen die M?glichkeit eines 24-Stunden-Tests zur Identi- fizierung gering belasteter Proben. Im n?chsten Schritt sollen die Daten für frische Milch mit belasteten Proben konsolidiert werden. Weiter sind unverdorbene Matrices tierischer Herkunft (z.B. Leber, Muskel) und pflanzliche Proben unter den vorgestellten Bedingungen zu untersuchen. Eingegangen: 24. Mai 2006     

Diagnostic patterns in keratoconus

PurposeTo investigate the current patterns of diagnosis and referral in keratoconus.MethodsA retrospective chart review was performed of patients who had recently been diagnosed with keratoconus and attended dedicated clinics at Antwerp University Hospital, Belgium and Maria Middelares General Hospital, Ghent, Belgium between June 2013 and February 2018. Exclusion criteria included longstanding keratoconus diagnosis, reduced cognitive capabilities and prior surgical procedures (corneal crosslinking, penetrating keratoplasty or any type of refractive surgery).ResultsThree-hundred and ninety-nine patients (722 eyes) were included in this study. The mean age was 24.7 ± 6.5 years and the average maximal keratometry was 51 ± 5.2 D for the better eye and 58.4 ± 9.6 D for the worse eye. Upon diagnosis, 233 eyes (32.2 %) and 51 eyes (7.1 %) had a thinnest pachymetry <450 and <400 μm, respectively. At 6-month follow-up, 58 % of patients had been fitted with specialty contact lenses. During follow-up, 199 eyes (27.6 %) underwent corneal crosslinking. One patient underwent corneal graft surgery of his worse eye due to contact lens intolerance and insufficient visual acuity.ConclusionDespite advances in diagnostic tools, keratoconus is often diagnosed at a relatively late stage. Earlier detection of keratoconus would increase the overall clinical benefit of corneal crosslinking. Further research into screening strategies is required to develop cost-effective screening programs.     

Combined Plate Microbial Assay (CPMA): A 6-plate-method for simultaneous first and second level screening of antibacterial residues in meat

This paper proposes an improved high throughput microbial method for the simultaneous performance of first and second level screening for antibacterial residues in meat. It is based on growth inhibition of B. subtilis on agar medium pH 6, 7.2 and 8, of B. cereus on agar medium pH 5.9, of M. luteus on agar medium pH 8 and of E. coli on agar medium pH 7.2 (research or first level screening) and on the use of confirmatory solutions (Pase, Paba, MgSO₄) for the identification or second level screening. In kidney control samples, dialysis membranes were interposed between samples and the agar surface to both prevent the action of lysozyme and reduce false positive results. The proposed method detects β-lactams, sulfonamides, tetracyclines, aminoglycosides, macrolides and quinolones at MRL concentrations and reliably indicates the inhibitor family. Results are obtained in 18-24 h.