Comparing the Frequency, Overlap, Stability, and Predictive Utility of Preclinical Dementia Constructs

Numerous constructs have been proposed to describe the transitional state between normal aging and dementia, but no one set of criteria is consistently referred to as the prodrome to dementia. Although there are many studies of the rates of these constructs, results are hampered by methodological differences. Research examining the overlap and stability of these constructs over time is also lacking, and predictive utility for later dementia remains inconclusive. Moreover, it is unknown whether one construct is superior in predicting later dementia or Alzheimer's disease. The current study addressed these issues using longitudinal clinical and neuropsychological data from a subsample (N=661) of participants in an epidemiological study of aging and dementia, the Cache County Memory Study (CCMS). Results confirmed wide variability in rates of preclinical dementia constructs. Constructs that included measures of functional impairment were the most stable, whereas constructs relying on memory impairment were generally unstable. Using bivariate logistic regression, four of the seven constructs were associated with later dementia, and these constructs either measured multiple cognitive domains or functional impairment. The 'Mild Ambiguous' construct, which includes memory or functional impairment, was statistically superior in predicting later dementia. Although four of the seven constructs were also significant predictors of later AD, no one construct was superior

From Frugality To Exuberance: Architecture And The City In Israel 1923-1977

ABSTRACT This dissertation argues for the emergence of a new materiality in Israeli architecture in the 1950s, 60s and 70s. It examines these decades in an extended historical time frame beginning with the British Mandate for Palestine. Materiality refers to local Israeli socioeconomic and geopolitical conditions. It also reflects the literal use, handling and finishing of materials in architecture. During this period first and second stages are described. The first was shaped by objective circumstances in which architecture operated in response to scarcity and demonstrated a realist attitude, one also embedded in the concept of asceticism. It was manifest in restrained formal gestures, abstention from material extravagance, the use of local materials, and an appeal to rational building procedures. The second stage emerging in the 60s had a different syntax. The analytical, skeletal frame constructions of the 50s turned synthetic, monolithic, and earth-bound. Compositions turned sculptural and exuberant. An appeal to the architect’s expressive ingenuity became a recognized design objective. The issue of banality versus extraordinariness in design surfaced at this point. My analysis of materiality is based on the following disciplinary themes: typology, public space, craft, and topography. These were dimensions of a broader search for a situated architecture undertaken by Israeli architects since the 1930s in which they sought to localize the importation of modern architecture from Europe. Typology offered an opportunity to synthesize modern building practices with vernacular models. It revealed the reciprocal interchange between cultures. Architects and planners perceived public space as a means to consolidate new communities, and represent the collective ethos of the new nation. Public space regained its value as a structural constituent in built fabrics. Building craft and use of local materials made architecture place-specific, of-its-time. Topographical awareness, and the mutual inscription between building and setting represented an ongoing desire to overcome the lack of an unmediated connection between the immigrants and their old/new territorial home. These disciplinary themes address a variety of scales from detail, building, neighborhood, city, and region. They demonstrate how Israeli architects adjusted the modernist appeal to abstraction and universalism with a perceptive recognition of their concrete reality

O contador empreendedor : ações iniciais, desafios, riscos e possibilidades

Orientador : Luiz Rogério FariasMonografia (especialização) - Universidade Federal do Paraná, Setor de Ciências Sociais Aplicadas, Curso de Especialização em ControladoriaInclui referênciasResumo: O trabalho a seguir tem como objetivo demonstrar a percepção do Contador como empreendedor, bem como verificar os quesitos observados no momento da migração para o campo do empreendedorismo, permitindo identificar o perfil necessário e as expectativas possíveis. O contexto atual permite prognósticos favoráveis ao movimento contábil empreendedor, tendo em vista recentes mudanças na Legislação do país, tais quais favoreceram a saída da informalidade para microempreendedores, ampliando então o nicho de atuação para escritórios de contabilidade. Concomitante ao estímulo de regularização aos profissionais, até então, informais, está o aumento de conjuntos residenciais e condomínios, os quais necessitam de serviços contábeis para seu pleno funcionamento; deste modo, entende-se que o mercado para o contador que deseja lograr-se autônomo e possuir o seu próprio negócio encontra-se receptivo. Com base nos preceitos, ora informados, faz-se necessária à pesquisa com profissionais já atuantes no ramo de escritórios contábeis, no intuito de obter informações concisas e que permitam ao profissional recém-graduado, auferir meios para avaliar mais esta possibilidade de carreira profissiona

The contribution of a negative colorectal screening test result to symptom appraisal and help-seeking behaviour among patients subsequently diagnosed with an interval colorectal cancer

Background: Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer. Methods: Twenty-six semi-structured face-to-face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result. Results: Participants reported they were reassured by a negative gFOBt, interpreting their result as an "all clear". Therefore, most did not suspect cancer as a possible cause of symptoms and many did not recall their screening result during symptom appraisal. Among those who did consider cancer, and did think about their screening test result, reassurance from a negative gFOBt led some to "downplay" the seriousness of their symptoms with some interviewees explicitly stating that their negative test result contributed to a delayed decision to seek help. Conclusion: Screening participants need to be informed of the limitations of screening and the ongoing risk of developing colorectal cancer even when in receipt of a negative result: the importance of minimizing delay in seeking medical advice for colorectal symptoms should be emphasized

Ovarian steroid cell tumor with biallelic adenomatous polyposis coli inactivation in a patient with familial adenomatous polyposis

Familial adenomatous polyposis (FAP) is an autosomal dominant cancer predisposition syndrome that accounts for approximately 0.5–1% of all colorectal cancer cases. It is caused by germline mutations in the gene encoding the adenomatous polyposis coli ( APC ) tumor suppressor. Somatic APC inactivation due to mutation or loss of heterozygosity (LOH) promotes the development of adenomatous polyps by stabilizing the transcriptional coactivator β‐catenin. Although colorectal cancer is by far the most common malignancy seen in FAP patients, the widespread use of prophylactic colectomy in these patients has increased the clinical importance of extracolonic tumors that are part of the neoplastic spectrum in FAP. Many of these tumors exhibit LOH or somatic APC mutation, strongly supporting a causative role of APC inactivation in their pathogenesis. Here we describe a 47‐year‐old female FAP patient with clinical manifestations of virilization who was found to have an ovarian steroid cell tumor, a rare neoplasm not known to be associated with FAP. Immunohistochemical analysis of the ovarian tumor demonstrated strong nuclear β‐catenin staining consistent with somatic APC inactivation, and molecular analysis confirmed biallelic APC inactivation in the tumor. Our findings provide the first evidence that ovarian steroid cell tumors may be an extracolonic manifestation of FAP and implicate β‐catenin activation as an oncogenic mechanism in ovarian steroid cell tumorigenesis. © 2011 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90384/1/20953_ftp.pd

Acute WNT signalling activation perturbs differentiation within the adult stomach and rapidly leads to tumour formation

A role for WNT signalling in gastric carcinogenesis has been suggested due to two major observations. First, patients with germline mutations in adenomatous polyposis coli (APC) are susceptible to stomach polyps and second, in gastric cancer, WNT activation confers a poor prognosis. However, the functional significance of deregulated WNT signalling in gastric homoeostasis and cancer is still unclear. In this study we have addressed this by investigating the immediate effects of WNT signalling activation within the stomach epithelium. We have specifically activated the WNT signalling pathway within the mouse adult gastric epithelium via deletion of either glycogen synthase kinase 3 (GSK3) or APC or via expression of a constitutively active β-catenin protein. WNT pathway deregulation dramatically affects stomach homoeostasis at very short latencies. In the corpus, there is rapid loss of parietal cells with fundic gland polyp (FGP) formation and adenomatous change, which are similar to those observed in familial adenomatous polyposis. In the antrum, adenomas occur from 4 days post-WNT activation. Taken together, these data show a pivotal role for WNT signalling in gastric homoeostasis, FGP formation and adenomagenesis. Loss of the parietal cell population and corresponding FGP formation, an early event in gastric carcinogenesis, as well as antral adenoma formation are immediate effects of nuclear β-catenin translocation and WNT target gene expression. Furthermore, our inducible murine model will permit a better understanding of the molecular changes required to drive tumourigenesis in the stomach

Atributos agronômicos de cultivares de arroz de terras altas na região sul do Amazonas

A pouca disponibilidade de cultivares de arroz de terras altas recomendadas para o Amazonas, é um entrave para o desenvolvimento agrícola desse estado. Sendo assim, o objetivo deste trabalho foi avaliar cultivares de arroz de terras altas na região sul do Amazonas. O experimento foi instalado no município de Humaitá, AM. A área experimental constituiu-se de 8 cultivares de arroz de terras altas, sendo elas: AN Cambará, BRS Sertaneja, BRSMG Curinga, BRS Tropical, BRS Monarca, BRS Pepita, BRSGO Serra Dourada e BRS Esmeralda. O delineamento experimental foi em blocos casualizados com quatro repetições. Foram avaliadas as variáveis produtividade de grãos, floração média, estatura da planta, acamamento, rendimento industrial, número de grãos por panícula, número de panículas por m2, percentual de grãos cheios e peso de mil grãos, além da incidência de brusone nas folhas e grãos. Os dados foram submetidos à análise de variância e as médias comparadas pelo teste de Skott-Knott a 5 % de probabilidade. As cultivares BRSGO Serra Dourada, BRS Pepita, AN Cambará e BRS Sertaneja se destacaram positivamente em relação aos componentes de produção, sendo de grande interesse para a região. Contudo, avaliações específicas de manejo devem ser realizadas para se ter maior precisão quanto a seleção da melhor cultivar para a região

Attributes of pedoindicator soils in areas cultivated with typical crops in the Western Amazon, Brazil

The crop systems adopted in the Amazônia region have been studied several times in terms of the variability and to indicate the soil attributes more sensitive to the different crops. Thus, the objective of this work was to apply multivariate techniques in order to identify the chemical attributes most sensitive to environmental changes in different crop systems in Western Amazonia, Brazil. The research was conducted in five rural properties located in the Humaitá city region, Western Amazonia, Brazil. There were selected four environments with natural characteristics (Native Forest - NF) and five cropping systems (Grazing, Cassava, Açaí, Agroforestry and Reforestation). In the selected areas, soil samples were collected at depths layers of 0.0-0.05 m; 0.05-0.1 m and 0.1-0.2 m and the following chemical analyzes were performed: pH in water, Ca2+, Mg2+, K +, Resin-P, phosphorus bio-available particulate (Pbp), OC, Al3+, H++Al3+ and from these results SB, T, t, m% and V% were calculated. Multivariate statistical techniques were used to verify similarities between the crop systems in the attempt to relate the crops grown and the chemical attributes. The multivariate analysis was essential in the crop systems distinction, as well as to describe the relationship with the chemical properties. The results demonstrate and reinforce the existing variability between crop systems, with emphasis on the variation in crop systems, compared to natural environments