Muscle Weakness in Older Americans: Examining the Measurement, Health Outcomes and Life Course Determinants

Muscle weakness, as measured by hand grip strength, has been shown to be an important indicator of future disability, chronic disease status and early mortality. While muscle weakness is considered an important prognostic indicator, how best to measure weakness, the long term health outcomes associated with muscle weakness across different sub-populations and the life course determinants remain poorly understood. Indeed, there is little agreement on how best to measure muscle weakness across different groups and how to screen for muscle weakness in order to prevent disability and premature mortality. We begin by first deriving cutpoints for muscle weakness in a nationally representative sample of older adults from the Health and Retirement Study. After using Classification and Regression Tree (CART) models to identify cutpoints, we found that fifty-five percent of men (max grip strength < 39kg) and 47% of women (< 22kg) were classified as weak. Higher cutpoints were identified for Black males (< 40kg) and females (< 31kg), and the prevalence of weakness (57% and 88%, respectively), was higher compared to Whites. As an extension to these results, we examine the validity of these cutpoints in a longitudinal setting to determine whether muscle weakness is associated with disability dynamics and premature mortality. We found that clinical muscle weakness, as identified by sex/race specific population-derived cutpoints from Aim 1, is strongly associated with the onset, progression and persistence of physical disability status. The odds of experiencing an onset of ADL disability were 54% higher among weak individuals compared those who were not weak at baseline. We also found that weak individuals had a steeper decline in their survival trajectory, compared to non-weak individuals. Specifically, weak individuals were over 50% more likely to die earlier than non-weak individuals. Lastly, the third aim of this dissertation seeks to quantify and understand whether experiencing stressful and traumatic events across the life course influences trajectories of grip strength in later life. We found that life course trauma and stress experienced during emerging/early adulthood was associated with both mean grip strength at age 50 and trajectories of grip strength over time. Among Black men, stress and trauma experienced during emerging/early adulthood was not only related to higher mean grip strength at age 50, but also associated with steeper declines as individuals aged over time compare to White men. Among Black women, traumatic events during emerging/early adulthood were associated with lower mean grip strength at age 50. Taken together, the results of this dissertation chart new territory in its overall goal to improve the measurement of muscle health across the diverse, older adult population and in identifying those most at risk for future disability and premature mortality. This dissertation also demonstrates the importance of investigating how life course social exposures drive differential vulnerability to muscle weakness among older adults. The results of this dissertation can be used to inform clinical practice in screening adults for muscle weakness while also seeking to shift the distribution of muscle weakness at the population level in order to intervene among those who are most vulnerable.PHDEpidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttps://deepblue.lib.umich.edu/bitstream/2027.42/145837/1/duchowny_1.pd

Interpretando as lexias "Adebdar" e "Adebdamentos" no antigo português aljamiado do século XV

Propõe-se uma interpretação dos termos adebdamentos e adebdar, encontrados em um guia astrológico em português arcaico aljamiado da primeira metade do século XV, intitulado De magia, sob a cota Ms. Laud Or. 282, na Bodleian Library, Oxford, Inglaterra. Apesar de não haver dúvidas quanto à língua do códice, há indícios de que se trata de uma tradução do catalão ou do espanhol para o português, o que poderia explicar uma ocorrência tão expressiva dos termos citados, tão pouco presentes em outros textos em português da mesma época. O verbo adebdar é um dos lexemas mais frequentes do manuscrito, ocorrendo sob as formas adebdan, adebdaron, adebda, adebdan, adebdaron, adeßdan, adeßda, adeßdaran, adevida. Em geral transitivo direto, algumas vezes seguido pela preposição sobre, descreve a ação ou domínio dos planetas ou signos do zodíaco sobre pessoas, ações e objetos. O substantivo adebdamento ocorre, por sua vez, sempre no plural, sob as formas adebdamentos, adebidamentos, adeßdamentos, adevidamentos. Lança-se a hipótese de que adebdar teria relação com o adeudar do espanhol, que pode significar contrair uma dívida, tornar alguém devedor de uma dívida ou favor e assinalar relações de parentesco, origem comum ou afinidade, entre outros. Os significados dos termos no De magia, entretanto, parecem ter sofrido mudanças, justificando-se, assim, uma descrição detalhada, a partir do levantamento exaustivo das ocorrências e de uma análise gramatical. O estudo pode trazer esclarecimentos para os estudos dos manuscritos judaicos, para a Lexicografia e a Lexicologia e para a história do léxico do português e do judeu-português. Interpreting Adebdar and Adebdamentos from the 15th century aljamiado old Portuguese- Abstract: It is proposed an interpretation of adebdamentos and adebdar, terms found in an astrological guide in aljamiado Old Portuguese, from the first half of the 15th century. The manuscript is entitled De magia (Ms. Laud Or. 282, Bodleian Library). Although there is no doubt as to the language of the codex, there are indications that it is a translation from Catalan or Spanish into Portuguese, which could explain such an expressive occurrence of adebdar and adebdamento, so unusual in other texts in Portuguese from the same time. The verb adebdar is one of the most frequent lexemes of the manuscript, used in many forms: adebdaron, adebda, adebdan, adebdaron, adeßdan, adeßda, adeßdaran, adevida. Sometimes followed by the preposition sobre, adebdar describes the action of planets and zodiac signs on people, events and objects. The noun adebdamento is, in turn, under the forms adebdamentos, adebidamentos, adeßdamentos and adevidamentos. The hypothesis that guides this work is that adebdar would be related with Spanish adeudar, which can mean contracting a debt, making someone liable for a debt or favor and show kinship, common origin or affinity, among others. The meanings of the terms in De magia, however, seem to have been changed, justifying thus a detailed description and a grammatical analysis of the two words. This work may shed light to the study of Jewish manuscripts, for lexicography and lexicology and the history of the lexicon of Portuguese and Judeo-Portuguese.

De Magia (Ms. Laud Or. 282, Bodleian Library): graphemic representation and transcription

 Este trabalho analisa a escrita do códice De magia (Ms. Laud Oriental 282, BodleianLibrary), guia astrológico aljamiado em língua portuguesa e caracteres hebraicos, datado doséculo 15. Além de feita a classificação da escrita, analisa-se a representação grafemática domanuscrito – grafemas simples, em nexo, dígrafos e trígrafos, sinais diacríticos, de valor numérico,de pontuação, de correção e anulação – e propõe-se um sistema de transcrição coerente edetalhado dos grafemas hebraicos em latinos.Analysis of the writing in the codex De magia (Ms. Laud Oriental 282, Bodleian Library), an astrological guide written in the Portuguese language as aljamia, with Hebrew characters, and dated to the 15th Century. As well as a classification of the writing, this study analyses the manuscript’s graphemic representation – simple graphemes, in nexus, digraphs and trigraphs, diacritics, number values, punctuation, corrections and cancellation marks – and proposes a coherent and detailed transcription system of Hebrew into Latin graphemes

Study on the titles given to Catholic clergyman in Minas Gerais in the 18th century

O principal objetivo deste trabalho é apresentar os resultados de um estudo sobre os itens lexicais utilizados para se fazer referência ao religioso ordenado católico, isto é, capelão, clérigo, cura, padre, pároco, sacerdote e vigário, no português setecentista das Minas Gerais, Brasil. Como base de pesquisa, utilizaram-se três tipos de obras lexicográficas: duas obras coetâneas ao corpus (BLUTEAU, 1728; SILVA, 1813); dois dicionários etimológicos (BUENO, 1974; CUNHA, 1986), e uma obra contemporânea (HOUAISS, 2009)

SABRE Hyperpolarization with up to 200 bar Parahydrogen in Standard and Quickly Removable Solvents

Parahydrogen (p-H2)-based techniques are known to drastically enhance NMR signals but are usually limited by p-H2 supply. This work reports p-H2-based SABRE hyperpolarization at p-H2 pressures of hundreds of bar, far beyond the typical ten bar currently reported in the literature. A recently designed high-pressure setup was utilized to compress p-H2 gas up to 200 bar. The measurements were conducted using a sapphire high-pressure NMR tube and a 43 MHz benchtop NMR spectrometer. In standard methanol solutions, it could be shown that the signal intensities increased with pressure until they eventually reached a plateau. A polarization of about 2%, equal to a molar polarization of 1.2 mmol L−1, could be achieved for the sample with the highest substrate concentration. While the signal plateaued, the H2 solubility increased linearly with pressure from 1 to 200 bar, indicating that p-H2 availability is not the limiting factor in signal enhancement beyond a certain pressure, depending on sample composition. Furthermore, the possibility of using liquefied ethane and compressed CO2 as removable solvents for hyperpolarization was demonstrated. The use of high pressures together with quickly removable organic/non-organic solvents represents an important breakthrough in the field of hyperpolarization, advancing SABRE as a promising tool for materials science, biophysics, and molecular imaging

Caracterização paleográfica do punho principal do Lybro de Magyka (Ms. 5-2-32, Biblioteca Colombina, Sevilha)

Este trabajo presenta un análisis paleográfico del texto copiado por la mano principal en el Lybro de magyka, una guía astrológica en español adquirida por Hernando Colón en 1527, en Sevilla. Conforme la Biblioteca Colombina, el texto está en gótica cursiva cortesana con la g humanística. Nuestro objetivo es presentar una descripción minuciosa de la escritura del documento y verificar esa información. Los resultados indican que de hecho el manuscrito manifiesta el multigrafismo mencionado por la Biblioteca. De este modo se ofrecen más informaciones acerca de la historia del manuscrito, cuya descripción es una etapa imprescindible para la introducción del texto en el corpus de las investigaciones acerca de la lengua española y de las lenguas románicas en general.This paper presents a paleographic analysis of the text copied by the main hand in the Lybro de magyka, an astrological guide in Spanish acquired by Hernando Colón in 1527, in Seville. According to the Colombina Library, the text is written in Gothic cursive with the humanistic g. Our objective is to present a detailed description of the writing of the document and to verify that information. The results indicate that in fact the manuscript presents a multigraphism mentioned by the Library. This provides more information about the history of the manuscript, which description is an essential stage for the introduction of the text in the corpus of research on the Spanish and Romance languages.Este artigo apresenta uma análise paleográfica do texto copiado pelo punho principal no Lybro de magyka, guia astrológico em espanhol adquirido por Hernando Colón em 1527, em Sevilha. Conforme a Biblioteca Colombina, o texto está escrito em gótica cursiva cortesã com g humanístico. Nosso objetivo é apresentar uma descrição detalhada da redação do documento e verificar tal informação. Os resultados indicam que de fato o manuscrito apresenta o multigrafismo mencionado pela Biblioteca. Dessa forma, são fornecidas mais informações sobre a história do manuscrito, cuja descrição é uma etapa essencial para a introdução do texto ao corpus de pesquisa da língua espanhola e das línguas românicas em geral

Sistema de abreviaturas de documentos adamantinos setecentistas

Tem-se como objetivo principal a identificação, a classificação e a caracterização das abreviaturas do século XVIII de documentos da cidade de Diamantina, Minas Gerais, Brasil. As abreviaturas, representação de uma ou mais palavras por meio de apenas algumas de suas letras ou por um ou mais sinais, é um fenômeno bastante usual, presente em manuscritos de muitos séculos atrás. Os documentos analisados apresentam variadas abreviaturas, em grande quantidade, as quais, analisadas, poderão fornecer novas informações sobre a língua portuguesa. Além disso, compreender o sistema braquigráfico do século XVIII permite melhor entender a cultura escrita na qual os documentos do corpus - termos de devassa e estatutos de irmandades religiosas - estavam inseridos, favorecendo, também, os estudos históricos e sociais. Propõe-se, assim, a distribuição dos vários tipos de abreviaturas em um contínuo de legibilidade, com a intenção de verificar o grau de legibilidade de cada uma. Conclui-se que a abreviatura numérica é a que apresenta o maior grau de legibilidade, tendo tanto o copista quanto o leitor menor esforço para “desvendá-la”. Já a abreviatura por sinal especial é a que demanda maior conhecimento de regras específicas e, consequentemente, maior grau de letramento por parte do copista e do leitor

Processes and changes in Minas Gerais’ 18th century abbreviations: regularity and rupture

This study analyzed 18th century abbreviations from documents written in Arraial do Tijuco, today Diamantina, in Minas Gerais, Brazil. Brachygraphic resources used in religious brotherhoods’ commitments from different social strata were compared to test two hypotheses: (i) abbreviations reflect differences between strata and therefore (ii) they allow identifying the degree of literacy of writing subjects. The analysis undertaken do not attest the correctness of assumptions, but the generalizations reached indicate that abbreviations, as any other linguistic phenomenon, suffer systematic, organized and multiple change processes, a different result from those that the meagre literature on the subject provides.Este trabalho analisou abreviaturas de documentos setecentistas escritos no Arraial do Tijuco, hoje cidade de Diamantina-MG. Cotejaram- se recursos braquigráficos empregados em compromissos de irmandades religiosas de estratos sociais distintos para testar duas hipóteses: (i) as abreviaturas refletem diferenças diastráticas e, portanto, (ii) permitem identificar o grau de letramento do escrevente. As análises empreendidas não atestam a correção das hipóteses, mas as generalizações alcançadas sinalizam que as abreviaturas, como qualquer outro fenômeno linguístico, sofrem processos de mudança sistemáticos, organizados e múltiplos, diferentemente do que prevê a parca literatura sobre o tema

Clinical efficacy and safety of lamotrigine monotherapy in newly diagnosed pediatric patients with epilepsy

Purpose : To verify the efficacy and safety of lamotrigine (LTG) monotherapy in newly diagnosed children with epilepsy. Methods : We prospectively enrolled 148 children who had undergone LTG monotherapy at our institution between September 2002 and June 2009. Twenty-nine patients were excluded: 19 due to incomplete data and 10 were lost to follow up. The data of the remaining 119 patients was analyzed. Results : We enrolled 119 pediatric epilepsy patients (aged 2.8-19.3 years&#59; 66 males and 53 females) in this study. Out of 119 patients, 29 (25.2&#37;) had generalized epilepsy and 90 (74.8&#37;) had partial epilepsy. The responses of seizure reduction were as follows: Seizure freedom (no seizure attack for at least 6 months) in 87&#47;111 (78.4&#37;, n&#61;111) patients&#59; partial response (reduced seizure frequency compared to baseline) in 13 (11.7&#37;) patients&#59; and persistent seizure in 11 (9.9&#37;) patients. The seizure freedom rate was in 81.6&#37; in patients with partial seizure (75.9&#37; for complex partial seizure and 90.9&#37; for benign rolandic epilepsy) and 44.8&#37; in patients with generalized epilepsy (30.0&#37; for absence seizure, 35.7&#37; for juvenile myoclonic epilepsy patients, and 100.0&#37; for idiopathic generalized epilepsy patients). Adverse reactions were reported in 17 (14.3&#37;) patients, and 8 patients (6.7&#37;) discontinued LTG because of rash and tic. No patient experienced severe adverse reaction such as Stevens-Johnson syndrome. Conclusion : LTG showed excellent therapeutic response and had few significant adverse effects. Our findings report may contribute in promoting the use of LTG monotherapy in epileptic children