Age-Related Increases in Verbal Knowledge Are Not Associated With Word Finding Problems in the Cam-CAN Cohort: What You Know Won't Hurt You.

Objective: We tested the claim that age-related increases in knowledge interfere with word retrieval, leading to word finding failures. We did this by relating a measure of crystallized intelligence to tip-of-the-tongue (TOT) states and picture naming accuracy. Method: Participants were from a large (N = 708), cross-sectional (aged 18-88 years), population-based sample from the Cambridge Centre for Ageing and Neuroscience cohort (Cam-CAN; www.cam-can.com). They completed (a) the Spot-the-Word Test (STW), a measure of crystallized intelligence in which participants circled the real word in word/nonword pairs, (b) a TOT-inducing task, and (c) a picture naming task. Results: Age and STW independently predicted TOTs, with higher TOTs for older adults and for participants with lower STW scores. Tests of a moderator model examining interactions between STW and age indicated that STW was a significant negative predictor of TOTs in younger adults, but with increasing age, the effect size gradually approached zero. Results using picture naming accuracy replicated these findings. Discussion: These results do not support the hypothesis that lifelong knowledge acquisition leads to interference that causes an age-related increase in TOTs. Instead, crystallized intelligence supports successful word retrieval, although this relationship weakens across adulthood

National Athletic Trainers\u27 Association Position Statement: Evaluation, Management, and Outcomes of and Return-to-Play Criteria for Overhead Athletes With Superior Labral Anterior-Posterior Injuries

Objective: To present recommendations for the diagnosis, management, outcomes, and return to play of athletes with superior labral anterior-posterior (SLAP) injuries. Background: In overhead athletes, SLAP tears are common as either acute or chronic injuries. The clinical guidelines presented here were developed based on a systematic review of the current evidence and the consensus of the writing panel. Clinicians can use these guidelines to inform decision making regarding the diagnosis, acute and long-term conservative and surgical treatment, and expected outcomes of and return-to-play guidelines for athletes with SLAP injuries. Recommendations: Physical examination tests may aid diagnosis; 6 tests are recommended for confirming and 1 test is recommended for ruling out a SLAP lesion. Combinations of tests may be helpful to diagnose SLAP lesions. Clinical trials directly comparing outcomes between surgical and nonoperative management are absent; however, in cohort trials, the reports of function and return-to-sport outcomes are similar for each management approach. Nonoperative management that includes rehabilitation, nonsteroidal anti-inflammatory drugs, and corticosteroid injections is recommended as the first line of treatment. Rehabilitation should address deficits in shoulder internal rotation, total arc of motion, and horizontal-adduction motion, as well as periscapular and glenohumeral muscle strength, endurance, and neuromuscular control. Most researchers have examined the outcomes of surgical management and found high levels of satisfaction and return of shoulder function, but the ability to return to sport varied widely, with 20% to 94% of patients returning to their sport after surgical or nonoperative management. On average, 55% of athletes returned to full participation in prior sports, but overhead athletes had a lower average return of 45%. Additional work is needed to define the criteria for diagnosing and guiding clinical decision making to optimize outcomes and return to play

Acute respiratory effects on workers exposed to metalworking fluid aerosols in an automotive transmission plant

Exposure to metalworking fluids has been linked to modest cross-shift reductions in FEV 1 and occupational asthma. To identify responsible agents, we measured personal exposures to thoracic particulate (TP), viable plus nonviable thoracic bacteria (BAC), and vapor phase nicotine (VPN) (as a surrogate for tobacco particulate) among 83 machinists exposed to soluble oils and 46 dry assemblers working in an automotive transmission machining plant using biocides infrequently. The participants completed interviews and performed pre- and postshift spirometry on Monday and Thursday of the same week in each of three rounds of data collection (June 1992, January 1993, June 1993). Generalized estimating equations were used to combine information across rounds in multiple regression models of cross-shift and cross-week changes in forced expiratory volume, I second (FEV 1 ) and forced vital capacity (FVC). Mean seniority was 19 years among machinists. Mean personal TP levels were 0.41 mg/m 3 in machinists and 0.13 mg/m 3 in assemblers. Six of the 83 machinists and none of the 46 assemblers experienced a greater than 19% cross-shift decrement in FEV 1 or FVC at least once (p = .07). In regression models using either TP or BAC, among subjects with lower baseline (Monday preshift) FEV 1 /FVC ratios, increasing exposure was significantly associated with increasing cross-shift decrements in FEV 1 and FVC in linear models, and with increased likelihood of a 10% or greater cross-shift decrement in FEV 1 or FVC in logistic models. Adjustment of TP for VPN did not affect models significantly. We conclude that clinically important cross-shift decrements in pulmonary function are associated with exposure to metalworking fluid aerosols within a high-seniority population. Am. J. Ind. Med. 31:510–524, 1997. © 1997 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34816/1/4_ftp.pd

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Exposure assessment for a study of acute respiratory effects of machining fluid aerosols.

Various components of machining fluids have been associated with acute airways dysfunction, but the nature and magnitude of these relationships are not completely understood. This work describes an exposure assessment for a study of machining fluid aerosols and acute changes in pulmonary function. The specific objectives were to: (1) obtain indices of personal exposure to machining fluid aerosols in an automotive transmission plant, either directly (by sampling) or indirectly (by estimation), (2) characterize sources of exposure misclassification and adjust for them, where possible, and (3) provide personal exposure data with which to explore the relationship between exposure and respiratory impairment. No prior studies have characterized personal exposures to machining fluid aerosols so extensively. Exposure data were obtained during three principal rounds of data collection over a fifteen month period in conjunction with spirometric testing of 131 subjects. Subjects worked in one of two machining departments, Case and Valve Body, or in a comparison department, Final Assembly. The primary exposure measures for this study were thoracic fraction particulate, thoracic fraction bacteria (viable and non-viable), and total endotoxin. In addition, we collected personal samples of vapor phase nicotine (VPN) to estimate and adjust for the proportion of ambient tobacco smoke in personal thoracic particulate measures. Mean personal air concentrations of thoracic particulate across all study rounds were 0.13 mg/m\sp3 in Final Assembly, 0.32 mg/m\sp3 in Valve Body, and 0.56 mg/m\sp3 in Case. Average personal exposures to thoracic fraction bacteria were 0.38 bacteria/cc in Final Assembly, 0.87 bacteria/cc in Valve Body, and 2.66 bacteria/cc in Case. Average personal endotoxin measurements (Round 3 only) were 16.4 endotoxin units (EU)/m\sp3 in Assembly, 34.7 Eu/m\sp3 in Valve Body, and 234 Eu/m\sp3 in Case. Sump fluid contained on the order of 10\sp8 bacteria/ml, and 10\sp4{-}10\sp5 EU/ml. Since direct quantification of bacterial exposures is costly and time-consuming, mathematical models were developed to estimate personal bacterial concentrations. Generalized estimating equations (GEE) were extremely useful for developing and validating predictive models with correlated (i.e., repeated measures) exposure data. The results demonstrate that it is possible to predict personal levels of airborne bacteria from other measures, including: (1) thoracic particulate concentration, (2) concentration of bacteria in sump fluid, (3) percentage of tramp oil and non-tramp oil in sump fluid, (4) area bacterial concentration, (5) group and individual average exposures, (6) area temperature/humidity, and (7) time and location variables. In exposure-response models, thoracic bacteria measures predicted declines in FEV\sb1 and FVC more consistently and significantly than thoracic particulate. These results strongly suggest that bacteria (or bacterial products) play a role in the causation of respiratory dysfunction. In addition, VPN was significantly associated with cross-shift pulmonary function decrements among non- and ex-smokers, indicating a detrimental effect of passive smoking. We conclude that statistical models proved an effective means of estimating personal bacterial exposures in a metalworking environment. Recommendations for future exposure monitoring, control strategies, and exposure assessment studies are presented.Ph.D.Health and Environmental SciencesOccupational safetyToxicologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/129931/2/9711914.pd