MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: A systematic review and meta-analysis

© 2019 The Author(s). Background: Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls. Methods: We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments. Results: 55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p \u3c 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p \u3c 0.001). Conclusions: T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation

Exercise interventions for preventing dementia or delaying cognitive decline in people with mild cognitive impairment

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of exercise interventions for preventing dementia in people with mild cognitive impairment. We refer to Forbes 2015b and Forbes 2015c for the review protocols on exercise interventions for maintaining cognitive function in cognitively healthy people in mid and late life

Exercise interventions for maintaining cognitive function in cognitively healthy people in mid life

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects ofexercise interventions on cognitive function in cognitively healthy people in mid life. We refer to Forbes 2015b for the review protocol on Exercise interventions for maintaining cognitive function in cognitively healthy people in late life and to Forbes 2015c for the review protocol on Exercise interventions for prevention of dementia in people with mild cognitive impairment

Mining geriatric assessment data for in-patient fall prediction models and high-risk subgroups

<p>Abstract</p> <p>Background</p> <p>Hospital in-patient falls constitute a prominent problem in terms of costs and consequences. Geriatric institutions are most often affected, and common screening tools cannot predict in-patient falls consistently. Our objectives are to derive comprehensible fall risk classification models from a large data set of geriatric in-patients' assessment data and to evaluate their predictive performance (aim#1), and to identify high-risk subgroups from the data (aim#2).</p> <p>Methods</p> <p>A data set of n = 5,176 single in-patient episodes covering 1.5 years of admissions to a geriatric hospital were extracted from the hospital's data base and matched with fall incident reports (n = 493). A classification tree model was induced using the C4.5 algorithm as well as a logistic regression model, and their predictive performance was evaluated. Furthermore, high-risk subgroups were identified from extracted classification rules with a support of more than 100 instances.</p> <p>Results</p> <p>The classification tree model showed an overall classification accuracy of 66%, with a sensitivity of 55.4%, a specificity of 67.1%, positive and negative predictive values of 15% resp. 93.5%. Five high-risk groups were identified, defined by high age, low Barthel index, cognitive impairment, multi-medication and co-morbidity.</p> <p>Conclusions</p> <p>Our results show that a little more than half of the fallers may be identified correctly by our model, but the positive predictive value is too low to be applicable. Non-fallers, on the other hand, may be sorted out with the model quite well. The high-risk subgroups and the risk factors identified (age, low ADL score, cognitive impairment, institutionalization, polypharmacy and co-morbidity) reflect domain knowledge and may be used to screen certain subgroups of patients with a high risk of falling. Classification models derived from a large data set using data mining methods can compete with current dedicated fall risk screening tools, yet lack diagnostic precision. High-risk subgroups may be identified automatically from existing geriatric assessment data, especially when combined with domain knowledge in a hybrid classification model. Further work is necessary to validate our approach in a controlled prospective setting.</p

A Study of Time-Dependent CP-Violating Asymmetries and Flavor Oscillations in Neutral B Decays at the Upsilon(4S)

We present a measurement of time-dependent CP-violating asymmetries in neutral B meson decays collected with the BABAR detector at the PEP-II asymmetric-energy B Factory at the Stanford Linear Accelerator Center. The data sample consists of 29.7 ${\rm fb}^{-1}$ recorded at the $\Upsilon(4S)$ resonance and 3.9 ${\rm fb}^{-1}$ off-resonance. One of the neutral B mesons, which are produced in pairs at the $\Upsilon(4S)$, is fully reconstructed in the CP decay modes $J/\psi K^0_S$, $\psi(2S) K^0_S$, $\chi_{c1} K^0_S$, $J/\psi K^{*0}$ ($K^{*0}\to K^0_S\pi^0$) and $J/\psi K^0_L$, or in flavor-eigenstate modes involving $D^{(*)}\pi/\rho/a_1$ and $J/\psi K^{*0}$ ($K^{*0}\to K^+\pi^-$). The flavor of the other neutral B meson is tagged at the time of its decay, mainly with the charge of identified leptons and kaons. The proper time elapsed between the decays is determined by measuring the distance between the decay vertices. A maximum-likelihood fit to this flavor eigenstate sample finds $\Delta m_d = 0.516\pm 0.016 {\rm (stat)} \pm 0.010 {\rm (syst)} {\rm ps}^{-1}$. The value of the asymmetry amplitude $\sin2\beta$ is determined from a simultaneous maximum-likelihood fit to the time-difference distribution of the flavor-eigenstate sample and about 642 tagged $B^0$ decays in the CP-eigenstate modes. We find $\sin2\beta=0.59\pm 0.14 {\rm (stat)} \pm 0.05 {\rm (syst)}$, demonstrating that CP violation exists in the neutral B meson system. (abridged)Comment: 58 pages, 35 figures, submitted to Physical Review

Potentially inappropriate medication in older participants of the Berlin Aging Study II (BASE-II) - Sex differences and associations with morbidity and medication use

INTRODUCTION: Multimorbidity in advanced age and the need for drug treatment may lead to polypharmacy, while pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug events (ADEs). OBJECTIVE: The aim of this study was to determine the proportion of subjects using potentially inappropriate medication (PIM) in a cohort of older and predominantly healthy adults in relation to polypharmacy and morbidity. METHODS: Cross-sectional data were available from 1,382 study participants (median age 69 years, IQR 67-71, 51.3% females) of the Berlin Aging Study II (BASE-II). PIM was classified according to the EU(7)-PIM and German PRISCUS (representing a subset of the former) list. Polypharmacy was defined as the concomitant use of at least five drugs. A morbidity index (MI) largely based on the Charlson Index was applied to evaluate the morbidity burden. RESULTS: Overall, 24.1% of the participants were affected by polypharmacy. On average, men used 2 (IQR 1-4) and women 3 drugs (IQR 1-5). According to PRISCUS and EU(7)-PIM, 5.9% and 22.6% of participants received at least one PIM, while use was significantly more prevalent in females (25.5%) compared to males (19.6%) considering EU(7)-PIM (p = 0.01). In addition, morbidity in males receiving PIM according to EU(7)-PIM was higher (median MI 1, IQR 1-3) compared to males without PIM use (median MI 1, IQR 0-2, p<0.001). CONCLUSION: PIM use occurred more frequently in women than in men, while it was associated with higher morbidity in males. As expected, EU(7)-PIM identifies more subjects as PIM users than the PRISCUS list but further studies are needed to investigate the differential impact of both lists on ADEs and outcome. KEY POINTS: We found PIM use to be associated with a higher number of regular medications and with increased morbidity. Additionally, we detected a higher prevalence of PIM use in females compared to males, suggesting that women and people needing intensive drug treatment are patient groups, who are particularly affected by PIM use

Measurement of the Branching Fraction for B- --> D0 K*-

We present a measurement of the branching fraction for the decay B- --> D0 K*- using a sample of approximately 86 million BBbar pairs collected by the BaBar detector from e+e- collisions near the Y(4S) resonance. The D0 is detected through its decays to K- pi+, K- pi+ pi0 and K- pi+ pi- pi+, and the K*- through its decay to K0S pi-. We measure the branching fraction to be B.F.(B- --> D0 K*-)= (6.3 +/- 0.7(stat.) +/- 0.5(syst.)) x 10^{-4}.Comment: 7 pages, 1 postscript figure, submitted to Phys. Rev. D (Rapid Communications

Maltese teachers’ beliefs concerning the integration of children’s literature in mathematics teaching and learning

This exploratory mixed-methods study set out to explore Maltese primary school teachers’ perceived barriers to, and enablers for, the integration of children’s literature in mathematics teaching. Data were collected by means of an online questionnaire and semi-structured interviews, and analysed thematically using Ajzen’s Theory of Planned Behaviour. The responses given by the participants showed that integration of mathematics and stories was not a common practice. The perceived barriers were categorised as Resource Constraint, Time Constraint, Lack of Pedagogical Knowledge and Confidence, Doubts about Outcome Expectancy, and Inhibiting Social Norms while the three perceived enablers identified were Pedagogical Benefits, Love of Stories, and Enabling Social Norms. Given that the majority of the participating teachers acknowledged the potential benefits of the approach and expressed a wish for training, one key recommendation of the study is for teaching mathematics through stories to be explicitly included in pre-service and in-service professional development programmes

First observations of high-temperature submarine hydrothermal vents and massive anhydrite deposits off the north coast of Iceland

High-temperature (250°C) hydrothermal vents and massive anhydrite deposits have been found in a shallow water, sediment-filled graben near 66°36′N in the Tjornes Fracture Zone north of Iceland. The site is located about 30 km offshore, near the small island of Grimsey. The main vent field occurs at a depth of 400 m and consists of about 20 large-diameter (up to 10 m) mounds and 1–3 m chimneys and spires of anhydrite and talc. A north–south alignment of the mounds over a 1-km strike length of the valley floor suggests that their distribution is controlled by a buried fault. Widespread shimmering water and extensive white patches of anhydrite in the sediment between the mounds indicates that the entire 1-km2 area occupied by the vents is thermally active. A 2-man research submersible JAGO was used to map the area and to sample vent waters, gases, and chimneys. Actively boiling hydrothermal vents occur on most of the mounds, and extensive two-phase venting indicates that the field is underlain by a large boiling zone (200×300 m). The presence of boiling fluids in shallow aquifers beneath the deposits was confirmed by sediment coring. The highest-temperature pore fluids were encountered in talc- and anhydrite-rich sedimentary layers that occur up to 7 m below the mounds. Baked muds underlie the talc and anhydrite layers, and pyrite is common in stockwork-like fractures and veins in the hydrothermally altered sediments. However, massive sulfides (pyrite–marcasite crusts) were found in only one relict mound. Subseafloor boiling has likely affected the metal-carrying capacity of the hydrothermal fluids, and deposition of sulfides may be occurring at greater depth. Although the mounds and chimneys at Grimsey resemble other deposits at sedimented ridges (e.g. Middle Valley, Escanaba Trough, Guaymas Basin), the shallow water setting and extensive boiling of the hydrothermal fluids represent a distinctive new type of seafloor hydrothermal system