Validation of the Finnish version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and evaluation of the applicability of the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) and the Fatigue Scale for Motor and Cognitive Functions (FSMC)

Objectives Cognitive impairment is frequent in multiple sclerosis (MS) as approximately half of the patients manifest some degree of cognitive impairment. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) has been designed for brief cognitive evaluation. The purpose of the study was to validate the BICAMS along with the Finnish versions of one self-rating questionnaire each for cognition and fatigue. Methods A total of 65 MS patients and 45 healthy controls (HC) were assessed with the BICAMS, the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), and the Fatigue Scale for Motor and Cognitive Functions (FSMC) twice, approximately within nine days. Results MS patients scored markedly lower than the HCs on each of the three tests of the BICAMS. Of the patients, 60% scored at least 1.5 SD below the mean of the HCs on at least one test; 49% on the SDMT, 26% on the CVLT-II, and 28% on the BVMT-R. Correlation coefficients for the repeated measurement were between 0.75 and 0.89 for the three tests in the whole study sample. MS patients reported more cognitive symptoms and more fatigue than the HCs. Cronbach's alpha was 0.94 for the MSNQ and 0.98 for the FSMC. Correlation coefficient for the repeated measurement was 0.91 for the MSNQ and between 0.92 and 0.94 for the FSMC scores for the whole study sample. Conclusions The present study supports the validity of the Finnish version of the BICAMS. The SDMT was the most sensitive of the three BICAMS tests and showed cognitive impairment in half of the patients. The Finnish versions of the MSNQ and the FSMC proved useful tools in approaching concerns related to cognition and fatigue.Peer reviewe

High-Rate Solid-Liquid Separation Coupled With Nitrogen and Phosphorous Treatment of Swine Manure: Effect on Ammonia Emission

A new treatment system was developed to meet multiple environmental performance standards including to substantially reduce ammonia emissions. It was tested full-scale for 2-years in a 5,145-head finishing swine farm with two anaerobic lagoons. The system combined high-rate solid-liquid separation with nitrogen and phosphorus removal processes. Both vertical radial plum mapping (VRPM) and floating static chamber techniques were used to measure NH3 emission fluxes from anaerobic storage lagoons and the total farm-level NH3 emission rates. The VRPM used an open-path tunable diode laser absorption spectroscopy (TDL) and the flux chamber used a photoacoustic gas analyzer to accurately measure NH3 concentration. After the treatment system started, one of the two lagoons became inactive without receiving anymore flushed manure. The ammonia emission flux from the other lagoon with the treated effluent decreased from 43.9 to 6.8 kg-N ha−1 d−1 1.5 years after implementation of the new treatment system. The NH3 emission flux from the inactive lagoon also decreased similarly because the already stored old manure of the lagoon prior to inactivation was diluted with rainfalls and lost some NH3 via volatilization. The total farm-level NH3 emission rates decreased from 1.72 g s−1 to below detection level of the VRPM technique. Using the minimum detection level of the TDL with R2 > 90% (i.e., 8.1 8.1 μL L−1-m), the total farm-level NH3 emission rates in the second year were less than 0.04–0.15 g s−1. These results suggested that the impact of the new treatment system on NH3 emission reduction was equivalent to closing conventional swine lagoons while actively growing 5,145 pigs with minimal ammonia emissions from the farm

Bestimmung der Bindung von Trijodthyronin an Serumproteine mittels Dextran-Gel-Filtration

1. Es wird eine Methode zur gleichzeitigen Bestimmung des sog. freien und des proteingebundenen Anteils von in vitro zugesetztem L-Trijodthyronin-131Jod im Serum mittels Dextran-Gel-Filtration angegeben. In der beschriebenen Form ist diese Technik für die routinemäßige Anwendung in der Klinik zur Bestimmung der Bindungs- und Transportverhältnisse von Trijodthyronin geeignet. 2. In sog. Verdrängungsversuchen wurde nichtmarkiertes Trijodthyronin dem Inkubationsgemisch von Serum und L-Trijodthyronin-131Jod zugesetzt. Die zugesetzten Trijodthyroninmengen erschöpfen die Gesamtbindungskapazität der Serumproteine in dem gewählten Konzentrationsbereich keineswegs. Im Gegensatz zum Verhalten der prozentualen Anteile des sog. freien und des proteingebundenen Trijodthyronins steigt die absolute Menge des proteingebundenen Trijodthyronins dabei steil an. Man findet eine Kurve, die nicht einer einfachen Sättigunskurve entspricht, sondern eine Resultante aus Sättigungskurven verschiedener Trijodthyronin-bindender Proteine und Verdrängungskurven kompetitiv gebundener Substanzen (z.B. Thyroxin) darstellt. 3. Dextran-Gel wirkt nicht als einfaches Molekülsieb für Trijodthyronin. Es greift vielmehr durch Adsorptionsvorgänge kompetitiv in die Serumproteinbindungsverhältnisse des Trijodthyronins ein. Die physiologische Bedeutung des sog. freien Anteils an Trijodthyronin wird diskutiert. 4. Die Methode zur Bestimmung des proteingebundenen Jods (PB127I) mittels alkalischer offener Veraschung (Barker) wurde technisch vereinfacht und bezüglich ihrer Reproduzierbarkeit untersucht. Die131Jodausbeute aus zugesetztem L-Thyroxin-131Jod lag bei diesem Verfahren bei ca. 80%

Klinische Bedeutung der Bestimmung der Bindung von Trijodthyronin an Serumproteine mittels Dextran-Gel-Filtration

Neben den bewährten älteren Verfahren zur Bestimmung des proteingebundenen127Jods und des Radiojodumsatzes hat sich die gleichzeitige Bestimmung des sog. freien und des proteingebundenen Anteils an in vitro mit Serum inkubiertem L-Trijodthyronin-131Jod mittels Dextran-Gel-Filtration klinisch zur Differentialdiagnose von Hyperthyreose und Euthyreose bewährt. Bei Ausnützung der Verdrängung von proteingebundenem L-Trijodthyronin-131Jod durch nichtmarkiertes Hormon und bei Variation der Dextran-Gel-Menge in der Säule bietet die Methode gute Differenzierungsmöglichkeiten auch für die Schilddrüsenfunktionszustände Euthyreose und Hypothyreose. Bei dem Verfahren wird der Patient nicht mit radioaktivem Jod belastet, ein für die Kinderklinik wichtiger Gesichtspunkt. Manche Störfaktoren, die den131Jodspeicherungstest und die Bestimmung des proteingebundenen Jods (PB127I) verfälschen, haben keinen Einfluß auf die mit der Dextran-Gel-Filtration untersuchten Proteinbindungsverhältnisse für L-Trijodthyronin-131Jod. So hat sich das Verfahren für die Untersuchung von Patienten mit operativ oder durch131Jodbehandlung verkleinerten Schilddrüsen, mit endokrinem Exophthalmus und in Fällen mit vorausgegangener Jodgabe, z. B. in Form von Kontrastmitteln, besonders bewährt. Mit der Bestimmung des sog. freien L-Trijodthyronin-131Jods wird ein physiologisch und pathogenetisch wichtiger Parameter der Schilddrüsenfunktion ermittelt. Die klinische Bedeutung der Bestimmung der Bindungs-und Transportverhältnisse für Trijodthyronin mittels Dextran-Gel-Filtration wird diskutiert.In addition to conventional methods of assay of protein bound iodine (PB127I) and of131iodine turnover in the thyroid, the simultaneous determination of socalled free and protein bound 1-triiodothyronine-131I, added in vitro to serum, using dextran gel filtration was found to be clinically helpful for diagnosis of euthyroidism and hyperthyroidism. Employing discharge effects of non-labelled triiodothyronine on protein bound 1-triiodothyronine-131I and varying the amount of dextran gel in the columns, the method provides reasonably good differentiation of euthyroid and hypothyroid states. No radioactive iodine is given to patients during this procedure, a fact of importance for pediatriciens. Some factors, that influence131iodine uptake or PB127I levels, do not disturb protein binding of 1-triiodothyronine-131I as determined by dextran gel filtration. The latter method was found to be especially useful for the examination of patients with surgically, or by therapy with131iodine dissected thyroid glands, with endocrine exophthalmos, and in cases of previous iodine administration (e.g. X-ray procedures). Determination of socalled free 1-triiodothyronine-131I provides information about a factor of physiological and pathogenetical significance, its clinical meaning is discussed

The AGILE Mission

AGILE is an Italian Space Agency mission dedicated to observing the gamma-ray Universe. The AGILE's very innovative instrumentation for the first time combines a gamma-ray imager (sensitive in the energy range 30 MeV-50 GeV), a hard X-ray imager (sensitive in the range 18-60 keV), a calorimeter (sensitive in the range 350 keV-100 MeV), and an anticoincidence system. AGILE was successfully launched on 2007 April 23 from the Indian base of Sriharikota and was inserted in an equatorial orbit with very low particle background. Aims. AGILE provides crucial data for the study of active galactic nuclei, gamma-ray bursts, pulsars, unidentified gamma-ray sources, galactic compact objects, supernova remnants, TeV sources, and fundamental physics by microsecond timing. Methods. An optimal sky angular positioning (reaching 0.1 degrees in gamma- rays and 1-2 arcmin in hard X-rays) and very large fields of view (2.5 sr and 1 sr, respectively) are obtained by the use of Silicon detectors integrated in a very compact instrument. Results. AGILE surveyed the gamma- ray sky and detected many Galactic and extragalactic sources during the first months of observations. Particular emphasis is given to multifrequency observation programs of extragalactic and galactic objects. Conclusions. AGILE is a successful high-energy gamma-ray mission that reached its nominal scientific performance. The AGILE Cycle-1 pointing program started on 2007 December 1, and is open to the international community through a Guest Observer Program

Estimated height from knee-height in Caucasian elderly : implications on nutritional status by Mini Nutritional Assessment

Objectives: To investigate if the use of estimeted height (EH) by currently available prediction formulas might affect the screening and outcome prediction attitudes of both the Mini Nutritional Assessment (MNA) and its short-form version (MNA-SF). Design: A 6-month observational study. Setting: Two long-term cares of the province of Como. Participants: 266 resident elderly (102 men, 164 women; mean age\ub1SD: 80.4\ub18.6 years). Measurements: Subjects were studied by anthropometry (weight, standing height, knee-height, arm and calf circumferences, triceps skinfold) and biochemistry (albumin and prealbumin). Nutritional status was assessed using both MNA and MNA-SF. At 6 months, major outcome were: death, infections and bedsores. Results: In overall population, prediction formulas significantly underestimated real height. The bias by Italianspecific equation was higher than that by nationally-representative formulas for white Americans. The use of EHs produced significant differences in body mass index (BMI) but these did not affect nutritional status scoring by MNA and MNA-SF (r 650.99, p0.9). Moreover, similar degrees of correlation were found between nutritional parameters and both MNA and MNA-SF scores by BMI from SH and EHs. After 6 months, major complications occurred in twenty-eight patients (11.6%). The use EHs did not affect the distribution of events among MNA and MNA-SF nutritional classes. Conclusion: In Italian elderly, height prediction by nationally representative equations for white Americans should be preferred to that by ethnic-specifc formula. However, the use of both models does not seem to affect nutritional screening and outcome prediction by MNA and MNA-SF

Geriatric Nutritional Risk Index and overall-cause mortality prediction in institutionalised elderly : a 3-year survival analysis

Background & aims: A new tool, the Geriatric Nutritional Risk Index (GNRI), was recently proposed to predict short-term complications in elderly medical patients but no information is available when long-term follow-up periods are considered. Methods: A 3-year follow-up study in 245 institutionalised elderly (51 M:194 F; 83.7 \ub1 8.6 years). Nutritional risk was graded by GNRI (severe, 98). Main outcome was overall-cause death. Results: After the follow-up 99 (26 M:73 F) events occurred. Nutritional risk prevalence was 5.7%, 24.1%, 34.7% and 35.5% and mortality rates were 71.4%, 48.6% 33.7% and 34.3% with the GNRI 98, respectively. Kaplan-Meier curves were significantly associated to GNRI (p = 0.0068). GNRI 98. Similar results were confirmed by Cox regression (hazard ratio, HR = 2.76 [95%CI: 1.89-4.03], p = 0.0072). Finally, when "severe" and "moderate" risk were analysed as a single class (GNRI < 92) outcome associations were: OR = 2.17, [95%CI: 1.10-4.28] (p = 0.0245); HR = 1.76 [95%CI: 1.34-2.23] (p = 0.0315). Survival analysis showed higher mortality rates by GNRI < 92 (p = 0.0188). Conclusions: Present data support the use of the GNRI in the evaluation of long-term nutrition-related risk of death. We suggest a GNRI < 92 as clinical trigger for nutritional support in institutionalised elderly