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We examined whether either psychotic features (e.g., delusions and hallucinations) or EEG abnormalities are associated with more rapid progression of Alzheimer's disease (AD). AD patients with psychosis have exhibited more EEG abnormalities than those without psychosis, and both abnormal EEG and psychosis have been noted to be predictors of functional and cognitive decline in AD. Ninety-five probable AD patients participating in a longitudinal study of dementia had an EEG and a semistructured psychiatric interview at baseline. Using EEG spectral analysis, we classified records as normal/abnormal based on the parasagittal mean frequency. Patients with abnormal EEGs were more functionally (e.g., Blessed Rating Scale for activities of daily living) and cognitively (e.g., Mini-Mental State) impaired than patients with normal EEG. AD patients with psychosis were only more functionally impaired than patients without psychosis. A two-factor analysis showed no interaction between abnormal EEG and psychosis. In addition, using a Cox proportional hazard model adjusted for age and education, the presence of an abnormal EEG or psychotic symptom at study entry was associated with higher risk of reaching severe cognitive and functional impairment during follow-up. Neither abnormal EEG nor the presence of psychosis predicted death. These results indicate that both abnormal EEG and psychosis are independent predictors of disease progression but not of physical survival.  相似文献   
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Automotive under-the-hood electronics often have to withstand temperatures up to 175 °C in combination with harsh environment conditions. This paper gives an overview about the reliability potential of epoxy based encapsulants for automotive applications. Therefore the resistance of epoxy molding compound against typical automotive fluids at temperature of use is analyzed. Six epoxy molding compounds available on the market, showing high temperature automotive potential have been carefully selected to undergo a media resistance testing. For this purpose a dedicated mold tool has been designed and manufactured to prepare these encapsulants for material testing. Thermo-mechanical, mechanical and thermal properties had been determined in initial state directly after molding and after storage in aggressive fluids typical for automotive applications as e.g. gas oil, automatic transmission fluid (ATF), brake fluid or accumulator acid at the respective temperature of use.  相似文献   
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This paper sets out to share BT's leadership and experience by determining the identity management opportunities and issues, then document the lessons learnt in previous deployments and recommend strategies for all types and sizes of organisation. Today's ICT environment has created a mixed approach to access management across sectors. Browser-based any time, anywhere, anyone access, coupled with the business need to access more systems and services across a changing infrastructure of distributed platforms and networked services, has changed the administrative landscape. Enterprises are being forced to add administrative support staff or invest in technology-driven process change. At the same time, users are undergoing significant change, creating new expectations in service quality. Moreover, regulatory bodies are demanding confirmation that processes granting access are controlled and documented. In this world of increasing demands, complexity and expectation, the service management tools, techniques and options available to improve user access management are as varied and numerous as the issues faced by management in their deployment. Identity management is widely heralded as an opportunity to improve the end user experience, reduce costs, improve security and deliver regulatory compliance — but is often misunderstood. Projects regularly fail to achieve the expected benefits. These failures are the result of expectations being inappropriately set, deployment of solutions turning out to be more complex or taking longer than expected, and/or products selected before required functionality has been determined. For the larger more mature organisations, or those organisations that are the amalgamation of mergers and acquisitions, the dilemma is where to start and what approach to take.  相似文献   
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OBJECTIVE: The purpose of our study was to test the hypothesis that surfactant dosing through a proximal sideport adapter on an endotracheal tube leads to more dosing-associated hypoxemia compared with a method of dosing that uses a double-lumen endotracheal tube. STUDY DESIGN: Using adequate sample size to compare significant changes in O2 saturation (power > 0.8, alpha < 0.05) we enrolled 36 infants with respiratory distress syndrome in this randomized trial. A 10% change in O2 saturation was considered clinically significant. Nineteen infants received 38 doses of surfactant through the sideport adapter. Seventeen infants received 31 doses of surfactant through the nonventilation lumen of a double-lumen endotracheal tube. Two main outcome measures were assessed: time-averaged O2 saturation values 30 minutes after dosing and the largest absolute fall in O2 saturation for each patient. RESULTS AND CONCLUSIONS: Time-averaged O2 saturation measures were higher in the proximal sideport group (p = 0.02), but the magnitude of difference was probably not clinically significant. No significant difference was detected between groups when we compared largest absolute drop in O2 saturation. Secondary analyses found no effect of birth weight or dose number (second vs third dose) on either outcome measure.  相似文献   
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Factor V Leiden mutation was initially detected in thrombophilic patients and relatives by PCR RFLP (Restriction Fragment Length Polymorphism) according to Bertina (1). This technique presents some drawbacks and the current trend is to simplify the diagnosis. We describe a technique of Allele Specific Amplification (ASA) which is optimized in terms of reliability: an additional mismatch in antepenultimate position enables to obtain the same specificity as PCR RFLP. Furthermore, coamplification of internal control warrants an optimal sensitivity. All the PCR have been simplified: the DNA extraction improvement allows to analyse the genotype with only a few microliters of whole blood whatever the anticoagulant and the procedure of preservation (freezing, dried blood spots, storage at +4 degrees C for several days). This technique saves time. Moreover, full automation of the ASA technique may be shortened thanks to the lack of extraction and the positive/negative reading of the PCR signal.  相似文献   
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