DEVELOPMENT AND PREDICTIVE UTILITY OF A COMPREHENSIVE GERIATRIC ASSESSMENT FOR OLDER ADULTS WITH CHRONIC KIDNEY DISEASE

Background: Older adults with chronic kidney disease (CKD) are at high risk of developing geriatric conditions in multiple domains, resulting in adverse health outcomes. A comprehensive geriatric assessment (CGA) tailored to the CKD population would yield a more targeted approach to assessment and care. The aims of this study were to 1) identify domains of a CKD-specific CGA (CKD-CGA), 2) characterize patterns of these domains in older adults with CKD, and 3) test the predictive utility of the CKD-CGA on adverse health outcomes. Methods: We used data from 868 participants enrolled in the Chronic Renal Insufficiency Cohort who were 55 years or older and not on dialysis (median age=67). Constituents of the CKD-CGA were selected a priori. Latent class analysis was conducted to inform the development of the CKD-CGA and to identify patterns of geriatric conditions in the participants. We examined the predictive utility of the CKD-CGA on mortality (Cox regression), dialysis initiation (Cox regression), and hospitalization (logistic regression), adjusting for age, sex, race, eGFR, smoking status, and BMI. Model discrimination was assessed with C-statistics. Results: The CKD-CGA included 16 domains: cardiovascular disease, diabetes, five frailty phenotype components, depression, cognition, five kidney disease quality of life components, health literacy, and medication use. A two-class model fit the data best, with 34.9% and 65.1% in the high and low burden of geriatric conditions class, respectively. Compared to participants in the low burden of geriatric conditions class, those in the high burden of geriatric conditions class were at higher risk of mortality (aHR=2.10; 95% CI: 1.55, 2.85), dialysis initiation (aHR=1.74; 95% CI: 1.13, 2.68), and hospitalization (aOR=1.98; 95% CI: 1.37, 2.84). Model discrimination was the strongest for dialysis initiation (C-statistics=0.86), and moderate for mortality and hospitalization (C-statistics= 0.70 and 0.66, respectively). Conclusions: We derived a CKD-CGA for older adults using psychometric methods and identified a class of participants with a high burden of geriatric conditions who were at risk of adverse health outcomes. The CKD-CGA has the potential to be used in nephrology practice for assessing and managing geriatric conditions in older adults with CKD

Small scale analysis of population structure in the woody cornelian cherry Cornus mas L. (Cornaceae) by AFLP accentuates the need for a population based conservation strategy

We investigated population differentiation among and within three populations (two natural, one artificial) of the cornelian cherry (Cornus mas L., Cornaceae) to examine the extent of gene flow from planted cornelian cherries commonly used in planting vegetations of public parks or streets into natural stands. Additionall we assessed if natural populations show any intrapopulational and/or interpopulational differentiation pointing towards restricted gene flow with possible necessity for a population based conservation strategy rather than a taxon based strategy. Results clearly indicated within and between population structure a radius of isolation by distance for pollen and seed dispersal of about 5.0 km. Interestingly genetic distance did not support coherence of the two natural populations but mirrored the historical origin of the innertown population from diverse natural sources reflecting the traditional use and selection of edible varieties from nature. The Nem value of 1.25 implicates the prevention of population differentation. However the low level of genetic diversity and distance at all might mislead the interpretation and the degree of distance reflects more ancient similarities than actual geneflow. Given this observable isolation by distance, conservation biology of Cornus mas requires a population based strategy rather than a broad taxon based strategy

Teacher Classroom Management Practices in an Inclusive Virtual Setting

The main purpose of this study is to explore the special education teacher’s classroom management strategies engagement in an inclusive virtual setting among the selected teachers in Region VII and one City in Region VIII during remote learning. Five respondents from two regions of Visayas were chosen using convenience and purposive sampling techniques. The researchers of this study used Descriptive Qualitative research design following Colaizzi’s method in thematic analysis. An online interview questionnaire was distributed to the respondents through Google forms and thematic analysis was used to analyze the data. The results indicated that teacher classroom management strategies undeniably played a vital role to maximize students’ engagement in an inclusive virtual classroom. On this basis, it is recommended that teacher classroom management practices should also investigate the variables that limit students\u27 willingness to participate, as well as the importance of the entire class population in students’ engagement. And since our study solely identifies best practices and strategies to maximize student engagement, further study is needed to emphasize assessing teachers’ ICT skills, the parental factors, and appropriate assessment methods to give a greater understanding of the nature of why student engagement is declining in this new mode of learning

Gain switching of an external cavity grating-coupled surface emitting laser with wide tunability

The gain-switched, single frequency operation of an external cavity grating-coupled surface emitting laser with a wavelength tuning range of 100 nm was presented. The light in the grating section was coupled out of the laser at a specific angle to the surface of the device. Analysis showed that within the driving current range, lasing in the device only occurred when the external cavity was properly aligned

Critical Susceptibility Exponent Measured from Fe/W(110) Bilayers

The critical phase transition in ferromagnetic ultrathin Fe/W(110) films has been studied using the magnetic ac susceptibility. A statistically objective, unconstrained fitting of the susceptibility is used to extract values for the critical exponent (gamma), the critical temperature Tc, the critical amplitude (chi_o) and the range of temperature that exhibits power-law behaviour. A fitting algorithm was used to simultaneously minimize the statistical variance of a power law fit to individual experimental measurements of chi(T). This avoids systematic errors and generates objective fitting results. An ensemble of 25 measurements on many different films are analyzed. Those which permit an extended fitting range in reduced temperature lower than approximately .00475 give an average value gamma=1.76+-0.01. Bilayer films give a weighted average value of gamma = 1.75+-0.02. These results are in agreement with the -dimensional Ising exponent gamma= 7/4. Measurements that do not exhibit power-law scaling as close to Tc (especially films of thickness 1.75ML) show a value of gamma higher than the Ising value. Several possibilities are considered to account for this behaviour.Comment: -Submitted to Phys. Rev. B -Revtex4 Format -6 postscript figure

Anisotropic susceptibility of ferromagnetic ultrathin Co films on vicinal Cu

We measure the magnetic susceptibility of ultrathin Co films with an in-plane uniaxial magnetic anisotropy grown on a vicinal Cu substrate. Above the Curie temperature the influence of the magnetic anisotropy can be investigated by means of the parallel and transverse susceptibilities along the easy and hard axes. By comparison with a theoretical analysis of the susceptibilities we determine the isotropic exchange interaction and the magnetic anisotropy. These calculations are performed in the framework of a Heisenberg model by means of a many-body Green's function method, since collective magnetic excitations are very important in two-dimensional magnets.Comment: 7 pages, 3 figure

The heavy top quark in the two Higgs doublet model

Constraints on the two Higgs doublet model are presented, assuming a top mass of 174 $\pm$ 17 GeV. We concentrate primarily on the ``type II'' model, where up--type quarks receive their mass from one Higgs doublet, and down--type quarks receive their mass from the second doublet. High energy constraints derived from the $W$ mass, the full width of the $Z$ and the $b \bar b$ partial width of the $Z$ are combined with low energy constraints from $\Gamma(b\to s \gamma)$, $\Gamma(b \to c \tau \bar\nu_\tau)$ and $B^0$-$\bar B^0$ mixing to determine the experimentally favored configurations of the model. This combination of observables rules out small charged Higgs masses and small values of $\tan\beta$, and provides some information about the neutral Higgs masses and the mixing angle $\alpha$. In particular, constraints derived from the $\rho$ parameter rule out configurations where the charged Higgs is much heavier or much lighter than the neutral Higgses. We discuss a scenario where $\Gamma(Z\to b \bar b)$ is enhanced relative to the standard model result, which unfortunately is on the verge of being ruled out by the combination of $\Gamma(b\to s \gamma)$ and $\rho$ parameter constraints. Implications for various extensions of the standard model are briefly discussed.Comment: 26 page

On the interpretation of spin-polarized electron energy loss spectra

We study the origin of the structure in the spin-polarized electron energy loss spectroscopy (SPEELS) spectra of ferromagnetic crystals. Our study is based on a 3d tight-binding Fe model, with constant onsite Coulomb repulsion U between electrons of opposite spin. We find it is not the total density of Stoner states as a function of energy loss which determines the response of the system in the Stoner region, as usually thought, but the densities of Stoner states for only a few interband transitions. Which transitions are important depends ultimately on how strongly umklapp processes couple the corresponding bands. This allows us to show, in particular, that the Stoner peak in SPEELS spectra does not necessarily indicate the value of the exchange splitting energy. Thus, the common assumption that this peak allows us to estimate the magnetic moment through its correlation with exchange splitting should be reconsidered, both in bulk and surface studies. Furthermore, we are able to show that the above mechanism is one of the main causes for the typical broadness of experimental spectra. Finally, our model predicts that optical spin waves should be excited in SPEELS experiments.Comment: 11 pages, 7 eps figures, REVTeX fil

Seminal plasma proteins and their relationship with percentage of morphologically normal sperm in 2-year-old Brahman (Bos indicus) bulls

The objective was to determine the relationship between seminal plasma proteins and sperm morphology in Bos indicus bulls of the Brahman breed. Fifty-six 24-month-old Australian Brahman bulls were electroejaculated and samples were examined to determine the percentage of morphologically normal sperm (PNS24) and the seminal plasma protein composition was identified and quantified by 2-D gel electrophoresis. The total integrated optical density of 152 seminal plasma protein spots (SPPs) across all gels was determined using the PDQuest software version 8.0 (Bio Rad, USA). Using a single regression mixed model with the density of individual spots as a covariate for PNS24, 17 SPPs were significantly associated with PNS24 (

Edgetic perturbation models of human inherited disorders

Cellular functions are mediated through complex systems of macromolecules and metabolites linked through biochemical and physical interactions, represented in interactome models as ‘nodes' and ‘edges', respectively. Better understanding of genotype-to-phenotype relationships in human disease will require modeling of how disease-causing mutations affect systems or interactome properties. Here we investigate how perturbations of interactome networks may differ between complete loss of gene products (‘node removal') and interaction-specific or edge-specific (‘edgetic') alterations. Global computational analyses of ∼50 000 known causative mutations in human Mendelian disorders revealed clear separations of mutations probably corresponding to those of node removal versus edgetic perturbations. Experimental characterization of mutant alleles in various disorders identified diverse edgetic interaction profiles of mutant proteins, which correlated with distinct structural properties of disease proteins and disease mechanisms. Edgetic perturbations seem to confer distinct functional consequences from node removal because a large fraction of cases in which a single gene is linked to multiple disorders can be modeled by distinguishing edgetic network perturbations. Edgetic network perturbation models might improve both the understanding of dissemination of disease alleles in human populations and the development of molecular therapeutic strategies