[Treatment of dementia patients in a geriatric day clinic : Improvement of behavioral abnormalities and distress of caring relatives]. / Therapie mit Demenzkranken in einer geriatrischen Tagesklinik : Verbesserung von Verhaltensauffälligkeiten und Belastungserleben der Angehörigen.

BACKGROUND AND OBJECTIVE: The aim of the study was to evaluate a specific treatment concept for patients suffering from dementia in a geriatric day clinic with respect to improvement of dementia-related behavioral abnormalities and effects on distress of the caring relatives. MATERIAL AND METHODS: Designed as a naturalistic study with a sample of 34 dementia patients (average age 83 years, 62% female, 82% mild dementia, 18% moderate dementia) surveyed at three time points, the dementia-related behavioral symptoms and the relatives' distress were measured using the neuropsychiatric inventory. A waiting time before treatment was implemented as a control condition. RESULTS: Compared with waiting time, a significant improvement of dementia-related behavioral abnormalities was found after treatment, especially in patients suffering from moderate dementia. The distress of caring relatives was clearly reduced. CONCLUSION: The interprofessional treatment of patients with dementia using a specific program in a geriatric day clinic leads to a clear improvement in behavioral symptoms and positively influences the distress of caring relatives.

Are self-adhesive resin cements suitable as core build-up materials? Analyses of maximum load capability, margin integrity, and physical properties.

OBJECTIVES: The aim of the present study was to test a self-adhesive resin cement used as core build-up material in comparison to two commercially available core build-up materials. MATERIALS AND METHODS: Forty human anterior teeth were endodontically treated and fiber post insertion (RelyX Fiber posts) and core build-ups were performed using two core build-up materials applied with an etch-and-rinse adhesive approach (Luxacore Dual-LC and Clearfil Core-CC) and an experimental self-adhesive resin cement (SAR) in two application modes (SAR Handmix and SAR Automix). Samples were subjected to thermo-mechanical loading. Margin integrity was determined using scanning electron microscopy (SEM), and maximum load capability (Fmax) was evaluated. Physical properties of the tested materials were also examined. RESULTS: Fmax was significantly affected by the core build-up material (p < 0.0005; one-way ANOVA). CC [481 (158) N] revealed significantly higher Fmax compared to LC [226 (80) N], SAR Hand [205 (115), and SAR Automix [197 (134) N] (p < 0.05; Tukey-B). The percentage of margin quality "continuous margin" in enamel after thermo-mechanical loading (TML) differed significantly among groups (p < 0.0005; Kruskal-Wallis); CC demonstrated a significantly higher percentage of margin quality "continuous margin" compared to the other groups. Physical properties were significantly affected by the different core materials (p < 0.0005; ANOVA); CC and LC demonstrated significantly higher flexural strength compared to both SAR groups as well as significantly higher water sorption of both SAR groups compared to CC and LC. CONCLUSION: Within the limitations of the present in vitro study, we conclude that the investigated experimental self-adhesive resin cement is not suitable as a core build-up material due to the lower maximum load capability, low margin quality, and the data of the mechanical properties. CLINICAL RELEVANCE: The investigated experimental self-adhesive resin cement cannot be recommended as a core build-up material.

Urolithiasis through the ages: data on more than 200,000 urinary stone analyses.

PURPOSE: The incidence and prevalence of urolithiasis are increasing but clinicians also have the impression that gender and age distributions of stone formers are changing. Moreover, regional differences in stone occurrence and composition have been observed. We analyzed such trends based on a large series of urinary stone analyses. MATERIALS AND METHODS: A total of 224,085 urinary stone analyses from 22 German centers were evaluated to determine the incidence of stone composition and identify age and gender distributions from 1977 to 2006. A subset of 58,682 stone analyses from 1993 to 2006 was available to identify regional differences in stone composition in Germany. RESULTS: Calcium containing calculi were most common in each gender. The overall male-to-female ratio of 2.4:1 increased from 1977 (1.86:1) to 2006 (2.7:1). The predominance of male calcium stone formers was even higher among elderly patients with a 3.13:1 ratio at ages 60 to 69. Since 1997, we observed a tendency toward an increasing incidence in middle-aged patients at ages 40 to 49 years. While the rate of infection stones constantly decreased, the incidence of uric acid calculi remained stable with an overall rate of 11.7% in males and 7.0% in females with a peak at higher ages. Cystine stones remained rare at 0.4% in males and 0.7% in females. In terms of regional analyses we noted great variation in stone composition in the 2 genders. Uric acid stones were more common in the eastern and southern regions but infection stones were mostly seen in eastern regions. CONCLUSIONS: In what is to our knowledge the largest series of stone analysis reported to date we identified an age and gender relationship of stone formation and composition. Regional variations are common and underline the influence of living habits, diet and standard of medical care on urinary stone formation.

Determination of absolute size of fundus objects.

BACKGROUND: Creating multiple beam interference fringes on the retina using the "retina fringe projector" (RFP) provides us with a scale which can be used to determine the absolute size of objects at the fundus. METHODS: The procedure is tested on an model eye, the optical parameters of which are varied in order to simulate different refraction conditions. The RFP was used to determine the size of a known object at the model fundus; the result was then checked against the real value of the object. In a second series of measurements, the RFP fringes were included in fundus photos of 52 patients with varying levels of ametropia, taken at the University Eye Clinic in Jena using the FF450 fundus camera (manufacturer: Carl Zeiss Meditec AG) for diagnostic purposes. The distance between the fringes was determined using both the RFP and the Littmann method. RESULTS: The differences to the real value of the fundus size of a known object deviated on average by 1 to 2%, and always remained under 3% in the model eye. A very good correlation between RFP and Littmann methods results could be found in the clinical part of the study. The resulting deviations are below 2.5%. CONCLUSION: Integration of a RFP in a fundus camera permits measurement of absolute values of the retina, regardless of the type of observation or documentation. Knowing the real size of fundus objects holds a potential in many clinical classification scales of fundus objects such as drusen or vessels, or in optimizing photodynamic therapy spot size measurement.

Age effect on orthodontic tooth movement rate and the composition of gingival crevicular fluid : A literature review.

PURPOSE: To evaluate and form a comprehensive understanding of the effect of patient age on bone remodeling and consequently on the rate of orthodontic tooth movement (OTM). METHODS: A systematic search in PubMed and Embase from 1990 to December 2017 was performed and completed by a hand search. Prospective clinical trials which investigated the rate of OTM and/or studies assessing age-related changes in the composition of gingival crevicular fluid (GCF) in older compared to younger study groups were included. Study selection, data extraction and risk of bias were assessed by two authors. RESULTS: Eight studies fulfilled the inclusion criteria. Among them, four evaluated the rate of OTM and six investigated mediators in the GCF (prostaglandin E2, interleukin [IL]-1ß, IL­6, IL­1 receptor antagonist, receptor activator of nuclear factor kappa­Β ligand, osteoprotegerin, granulocyte-macrophage colony-stimulating factor, pentraxin 3). Patient age ranged between 16 and 43 years for older and <16 years for younger groups. In most of the studies, the younger patients showed faster OTM in the first phase of treatment and more pronounced cytokine levels. Older patients had a delayed reaction to orthodontic forces. CONCLUSION: The small number of included studies and large heterogeneity in study design give limited clinical evidence that the older patients are less responsive to orthodontic force in comparison to younger patients. The initial cellular response to orthodontic force is expected to be delayed in older patients. Control intervals during orthodontic treatment should be adjusted to the individual's treatment response.

Using Rasch Analysis to Examine the Item-Level Psychometrics of the Infant-Toddler Meaningful Auditory Integration Scales.

The Infant-Toddler Meaningful Auditory Integration Scales (IT-MAIS; Zimmerman-Phillips et al. 2001) is a popular assessment designed to measure listening skills in children with hearing loss aged 0-3 years. For this study we analyzed the item-level psychometric properties of the IT-MAIS via Rasch analysis to gain further understanding about its validity and reliability. We chose to analyze the psychometric properties of the IT-MAIS because very little information exists regarding its development and validation, although it is widely used to assess listening skills in children with SNHL ages 0 to 3 years pre- and post-CI. Our results indicated that the IT-MAIS items demonstrated less than ideal psychometric properties and the IT-MAIS item order did not reflect the order in which children are expected to develop functional listening skills. Our findings suggest that there is a pressing need for further discussion among researchers and clinicians about 1) how the IT-MAIS is used, and 2) what other valid and reliable outcome measures could be used alongside, or in place of, the IT-MAIS to determine CI candidacy, establish treatment goals, or track progress in listening development in very young children with hearing loss.

Exotic QTL improve grain quality in the tri-parental wheat population SW84.

DEVELOPING THE TRI-PARENTAL EXOTIC WHEAT POPULATION SW84: Genetic diversity of cultivated wheat was markedly reduced, first, during domestication and, second, since the onset of modern elite breeding. There is an increasing demand for utilizing genetic resources to increase genetic diversity and, simultaneously, to improve agronomic performance of cultivated wheat. To locate favorable effects of exotic wheat alleles, we developed the tri-parental wheat population SW84. The population was derived from crossing the hexaploid spring wheat cultivars Triso and Devon with one synthetic exotic donor accession, Syn084L, followed by two rounds of backcrossing and three rounds of selfing. SW84 consists of 359 BC2F4 lines, split into two families, D84 (Devon*Syn084L) and T84 (Triso*Syn084L). STUDYING THE GENETIC CONTROL OF GRAIN QUALITY IN SW84: As a case study, grain quality of SW84 was studied in replicated field trials. Transgressive segregation was observed for all studied grain quality traits by evaluating SW84 for two years at two locations under low and high nitrogen supply. Subsequently, a genome-wide association study (GWAS) was carried out based on genomic data derived from a 90k Infinium iSELECT single nucleotide polymorphism (SNP) array. In total, GWAS yielded 37 marker-trait associations, summarized to 16 quantitative trait loci (QTL). These SNPs indicate genetic regulators of grain protein content, grain hardness, sedimentation value and sedimentation ratio. The majority of exotic QTL alleles (75%) exerted favorable effects, increasing grain protein content and sedimentation value in ten and two cases, respectively. For instance, two exotic QTL alleles were associated with a substantial increase of grain protein content and sedimentation value by 1.09% and 7.31 ml, respectively. This finding confirms the potential of exotic germplasm to improve grain quality in cultivated wheat. So far, the molecular nature of most of the detected QTL is unknown. However, two QTL correspond to known genes controlling grain quality: The major QTL on chromosome 6B, increasing grain protein content by 0.70%, on average, co-localizes with the NAM-B1 gene, known to control grain protein content as well as iron and zinc content. Likewise, the major QTL on chromosome 5D, reducing grain hardness by 8.98%, on average, co-localizes with the gene for puroindoline b (Pinb-D1) at the Ha locus. In total, 13 QTL were detected across families, whereas one and three QTL were exclusively detected in families D84 and T84, respectively. Likewise, ten QTL were detected across nitrogen treatments, whereas one and five QTL were exclusively detected under low and high N treatments, respectively. Our data indicate that most effects in SW84 act across families and N levels. Merging of data from two families or two N treatments may, thus, be considered in association studies to increase sample size and, as a result, QTL detection power. UTILIZING FAVORABLE EXOTIC QTL ALLELES IN WHEAT BREEDING: Our study serves as a model how favorable exotic QTL alleles can be located in exotic germplasm of wheat. In future, the localized favorable exotic QTL alleles will be utilized in wheat breeding programs to simultaneously improve grain quality and selectively expand genetic diversity of the elite wheat gene pool.

Membrane insertion of small proteins.

Proteins that are less than 10 kDa in size are easily purified under denaturing conditions and can often be refolded by removal of the denaturing agents. The purified small membrane proteins are competent for membrane insertion when the denaturing agent is diluted out and a membranous system like liposomes or proteoliposomes is added. This system allows the characterization of the membrane insertion process at the molecular level. The insertion of the protein into proteoliposomes can be followed by protease digestion and Western blot analysis. Only if the antigenic region of the protein has translocated into the lumen of the proteoliposome it is protected from the protease. When combining this approach with fluorophores that are placed within the membrane protein, membrane insertion can also be followed by fluorescence correlation spectroscopy.

Connexin family members target to lipid raft domains and interact with caveolin-1.

Lipid rafts are cholesterol-sphingolipid-rich microdomains that function as platforms for membrane trafficking and signal transduction. Caveolae are specialized lipid raft domains that contain the structural proteins known as the caveolins. Connexins are a family of transmembrane proteins that self-associate to form cell-cell connections known as gap junctions and that are linked to cytosolic proteins, forming a protein complex or Nexus. To determine the extent to which these intracellular compartments intersect, we have systematically evaluated whether connexins are associated with lipid rafts and caveolin-1. We show that connexin 43 (Cx43) colocalizes, cofractionates, and coimmunoprecipitates with caveolin-1. A mutational analysis of Cx43 reveals that the hypothesized PDZ- and presumptive SH2/SH3-binding domains within the Cx43 carboxyl terminus are not required for this targeting event or for its stable interaction with caveolin-1. Furthermore, Cx43 appears to interact with two distinct caveolin-1 domains, i.e., the caveolin-scaffolding domain (residues 82-101) and the C-terminal domain (135-178). We also show that other connexins (Cx32, Cx36, and Cx46) are targeted to lipid rafts, while Cx26 and Cx50 are specifically excluded from these membrane microdomains. Interestingly, recombinant coexpression of Cx26 with caveolin-1 recruits Cx26 to lipid rafts, where it colocalizes with caveolin-1. This trafficking event appears to be unique to Cx26, since the other connexins investigated in this study do not require caveolin-1 for targeting to lipid rafts. Our results provide the first evidence that connexins interact with caveolins and partition into lipid raft domains and indicate that these interactions are connexin specific.