Balance and Gait: Associations With Cognitive Impairment and Dementia in Individuals With Down Syndrome.

BACKGROUND: Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS. METHODS: We evaluated 66 individuals with DS (≥20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities. RESULTS: The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia ( P <0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score ( P <0.05). CONCLUSION: A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility.

Classification of Tea Aromas Using Multi-Nanoparticle Based Chemiresistor Arrays.

Nanoparticle based chemical sensor arrays with four types of organo-functionalized gold nanoparticles (AuNPs) were introduced to classify 35 different teas, including black teas, green teas, and herbal teas. Integrated sensor arrays were made using microfabrication methods including photolithography and lift-off processing. Different types of nanoparticle solutions were drop-cast on separate active regions of each sensor chip. Sensor responses, expressed as the ratio of resistance change to baseline resistance (ΔR/R0), were used as input data to discriminate different aromas by statistical analysis using multivariate techniques and machine learning algorithms. With five-fold cross validation, linear discriminant analysis (LDA) gave 99% accuracy for classification of all 35 teas, and 98% and 100% accuracy for separate datasets of herbal teas, and black and green teas, respectively. We find that classification accuracy improves significantly by using multiple types of nanoparticles compared to single type nanoparticle arrays. The results suggest a promising approach to monitor the freshness and quality of tea products.

Graphene Oxide Thin Films with Drug Delivery Function.

Graphene oxide has been used in different fields of nanomedicine as a manager of drug delivery due to its inherent physical and chemical properties that allow its use in thin films with biomedical applications. Several studies demonstrated its efficacy in the control of the amount and the timely delivery of drugs when it is incorporated in multilayer films. It has been demonstrated that oxide graphene layers are able to work as drug delivery or just to delay consecutive drug dosage, allowing the operation of time-controlled systems. This review presents the latest research developments of biomedical applications using graphene oxide as the main component of a drug delivery system, with focus on the production and characterization of films, in vitro and in vivo assays, main applications of graphene oxide biomedical devices, and its biocompatibility properties.

Graphene Biosensors-A Molecular Approach.

Graphene is the material elected to study molecules and monolayers at the molecular scale due to its chemical stability and electrical properties. The invention of scanning tunneling microscopy has deepened our knowledge on molecular systems through imaging at an atomic resolution, and new possibilities have been investigated at this scale. Interest on studies on biomolecules has been demonstrated due to the possibility of mimicking biological systems, providing several applications in nanomedicine: drug delivery systems, biosensors, nanostructured scaffolds, and biodevices. A breakthrough came with the synthesis of molecular systems by stepwise methods with control at the atomic/molecular level. This article presents a review on self-assembled monolayers of biomolecules on top of graphite with applications in biodevices. Special attention is given to porphyrin systems adsorbed on top of graphite that are able to anchor other biomolecules.

A pilot randomized controlled trial of the Occupational Goal Intervention method for the improvement of executive functioning in patients with treatment-resistant schizophrenia.

Schizophrenia is a chronic disabling mental disorder that involves impairments in several cognitive domains, especially in executive functions (EF), as well as impairments in functional performance. This is particularly true in patients with Treatment-Resistant Schizophrenia (TRS). The aim of this study was to test the efficacy of the Occupational Goal Intervention (OGI) method for the improvement of EF in patients with TRS. In this randomized, controlled, single-blind pilot study, 25 TRS patients were randomly assigned to attend 30 sessions of either OGI or craft activities (control) over a 15-week period and evaluated by the Behavioural Assessment of the Dysexecutive Syndrome (BADS) as the primary outcome and the Direct Assessment of Functional Status (DAFS-BR) as well as the Independent Living Skills Survey (ILSS-BR) as secondary outcomes, all adapted for the Brazilian population. The Positive and Negative Syndrome Scale (PANSS) was used for monitoring symptom severity. Results showed significant statistical differences, favoring the OGI group in terms of improvement on the BADS, both in subtests (Action Program and Key Search) and the total score. Improvements in EFs were observed by families in various dimensions as measured by different subtests of the ILSS-BR inventory. The OGI group showed no significant results in secondary outcomes (DAFS-BR) except in terms of improvement of communication skills. Although preliminary, our results indicate that the OGI method is efficacious and effective for patients with TRS.

Ocular and oral lesions caused by Tacinga inamoena in sheep and goats in Northeast Brazil

ABSTRACT: Two outbreaks of traumatic injuries in goats and sheep associated with grazing and ingestion of the cactus Tacinga inamoena have recently been reported in the state of Paraíba, Brazil. In the first of these, which was detected in 2019 during a preliminary inspection of a herd of 70 animals, it was found that 15 showed certain ocular complications, and these animals were subjected to general physical and ophthalmic examinations. The clinical findings included excessive lacrimation, blepharitis, photophobia, corneal opacity, hyphema, corneal neovascularization, corneal ulcers, and adherence of gloquids to the bulbar conjunctiva and cornea. Large amounts of T. inamoena were found to be present in several areas in which these animals had been grazed and had been observed consuming the fruits of this plant. In the second outbreak during the following year, two sheep from a total of 100 animals were identified as having oral lesions associated with grazing in areas within which T. inamoena was growing. One of these animals was referred to a veterinary hospital, and on physical examination was found to show apathy, anorexia, a body score of 1.5, and the presence of gloquids within the fur. With respect to the oral cavity, halitosis, severe sialorrhea, extensive hemorrhagic ulcers, and painful tenderness on palpation were detected. Given the unfavorable prognosis, the sheep was subsequently euthanized. At necropsy, multifocal to coalescent plaques were detected on the upper and lower lips, oral mucosa, tongue, and hard and soft palates. These were generally elevated and firm and characterized by an irregular, ulcerated surface, sometimes crusty, with a yellow to light brown center and erythematous edges. The findings of this study highlight that the consumption of T. inamoena can cause serious oral and ophthalmic lesions in small ruminants in the northeastern semi-arid regions of Brazil, and can potentially contribute to substantial large economic losses. This problem tends to be exacerbated by the invasive behavior of T. Inamoena, particularly in areas in the process of environmental degradation.

RESUMO: Relatam-se dois surtos de lesões traumáticas associadas ao pastejo e ingestão da Tacinga inamoena por caprinos e ovinos no estado da Paraíba, Brasil. No primeiro surto observou-se durante uma inspeção preliminar do rebanho que 15 dos 70 animais apresentavam alterações oculares, os animais foram submetidos ao exame físico geral e ao exame oftálmico. Lacrimejamento excessivo, blefarite, fotofobia, opacidade de córnea, hifema, neovascularização corneana, úlceras de córnea e gloquídeos aderidos à conjuntiva bulbar e córnea foram os achados clínicos identificados. A planta estava presente em diversas áreas e em grande quantidade nas áreas de pastejo, onde os animais eram vistos ingerindo seus frutos. No segundo surto, dois ovinos de um total de 100 animais, foram identificados com lesões orais associadas ao pastejo em áreas da planta. Um deles foi encaminhado ao Hospital Veterinário. No exame físico, o animal apresentou apatia, anorexia, escore corporal 1,5, pelos opacos, eriçados e no pelame era possível identificar gloquídeos. Na cavidade oral observou-se halitose, sialorreia intensa, extensas úlceras hemorrágicas e sensibilidade dolorosa à palpação. Devido ao prognóstico desfavorável o animal foi eutanasiado. Na necropsia, placas multifocais a coalescentes, elevadas, firmes e com superfície irregular, ulcerada, por vezes crostosas, com centro amarelo a marrom-claro e bordos eritematosos, estavam presentes nos lábios superiores, inferiores, mucosa oral, língua, palatos duro e mole. T. inamoena causa sérias lesões orais e oftálmicas em pequenos ruminantes no semiárido nordestino e prejuízos econômicos de grandes dimensões, que podem ser agravados pelo comportamento invasor da T. inamoena em áreas com indícios de degradação ambiental.

Ocular and oral lesions caused by Tacinga inamoena in sheep and goats in Northeast Brazil / Lesões oculares e orais causadas por Tacinga inamoena em ovinos e caprinos no Nordeste brasileiro

Two outbreaks of traumatic injuries in goats and sheep associated with grazing and ingestion of the cactus Tacinga inamoena have recently been reported in the state of Paraíba, Brazil. In the first of these, which was detected in 2019 during a preliminary inspection of a herd of 70 animals, it was found that 15 showed certain ocular complications, and these animals were subjected to general physical and ophthalmic examinations. The clinical findings included excessive lacrimation, blepharitis, photophobia, corneal opacity, hyphema, corneal neovascularization, corneal ulcers, and adherence of gloquids to the bulbar conjunctiva and cornea. Large amounts of T. inamoena were found to be present in several areas in which these animals had been grazed and had been observed consuming the fruits of this plant. In the second outbreak during the following year, two sheep from a total of 100 animals were identified as having oral lesions associated with grazing in areas within which T. inamoena was growing. One of these animals was referred to a veterinary hospital, and on physical examination was found to show apathy, anorexia, a body score of 1.5, and the presence of gloquids within the fur. With respect to the oral cavity, halitosis, severe sialorrhea, extensive hemorrhagic ulcers, and painful tenderness on palpation were detected. Given the unfavorable prognosis, the sheep was subsequently euthanized. At necropsy, multifocal to coalescent plaques were detected on the upper and lower lips, oral mucosa, tongue, and hard and soft palates. These were generally elevated and firm and characterized by an irregular, ulcerated surface, sometimes crusty, with a yellow to light brown center and erythematous edges. The findings of this study highlight that the consumption of T. inamoena can cause serious oral and ophthalmic lesions in small ruminants in the northeastern semi-arid regions of Brazil, and can potentially contribute to substantial large economic losses. This problem tends to be exacerbated by the invasive behavior of T. Inamoena, particularly in areas in the process of environmental degradation.(AU)

Relatam-se dois surtos de lesões traumáticas associadas ao pastejo e ingestão da Tacinga inamoena por caprinos e ovinos no estado da Paraíba, Brasil. No primeiro surto observou-se durante uma inspeção preliminar do rebanho que 15 dos 70 animais apresentavam alterações oculares, os animais foram submetidos ao exame físico geral e ao exame oftálmico. Lacrimejamento excessivo, blefarite, fotofobia, opacidade de córnea, hifema, neovascularização corneana, úlceras de córnea e gloquídeos aderidos à conjuntiva bulbar e córnea foram os achados clínicos identificados. A planta estava presente em diversas áreas e em grande quantidade nas áreas de pastejo, onde os animais eram vistos ingerindo seus frutos. No segundo surto, dois ovinos de um total de 100 animais, foram identificados com lesões orais associadas ao pastejo em áreas da planta. Um deles foi encaminhado ao Hospital Veterinário. No exame físico, o animal apresentou apatia, anorexia, escore corporal 1,5, pelos opacos, eriçados e no pelame era possível identificar gloquídeos. Na cavidade oral observou-se halitose, sialorreia intensa, extensas úlceras hemorrágicas e sensibilidade dolorosa à palpação. Devido ao prognóstico desfavorável o animal foi eutanasiado. Na necropsia, placas multifocais a coalescentes, elevadas, firmes e com superfície irregular, ulcerada, por vezes crostosas, com centro amarelo a marrom-claro e bordos eritematosos, estavam presentes nos lábios superiores, inferiores, mucosa oral, língua, palatos duro e mole. T. inamoena causa sérias lesões orais e oftálmicas em pequenos ruminantes no semiárido nordestino e prejuízos econômicos de grandes dimensões, que podem ser agravados pelo comportamento invasor da T. inamoena em áreas com indícios de degradação ambiental.(AU)

Effects of a multidisciplinary cognitive rehabilitation program for patients with mild Alzheimer's disease.

OBJECTIVE: To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatry symptoms in patients with mild Alzheimer's disease. METHOD: The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention. INTERVENTION: Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings. MEASUREMENTS: The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments. RESULTS: Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life. CONCLUSION: This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield adjunct and clinically relevant benefits in dementia treatment.

Family context and duration of untreated psychosis (DUP): results from the Sao Paulo Study.

BACKGROUND: Duration of untreated psychosis (DUP) depends on several factors, including socio-demographic, socioeconomic, clinical and contextual circumstances, such as availability of mental health services. Living arrangements may also play a role, especially in low- and middle-income countries, where most people who develop psychosis live with their relatives. METHODS: Population-based study of first-episode psychosis in São Paulo, Brazil. Participants were aged 18-64 years, lived in a defined geographic area of the city and had a first contact in life with mental health services due to a psychotic episode. Duration of untreated psychosis was defined as the period between onset of first psychotic symptom and first contact with health service due to psychosis. The median DUP was used to classify participants into short and long DUP. Psychopathology, social adjustment and psychiatric diagnoses were made with standardized assessments. Type of service sought and living arrangements were examined. RESULTS: Two hundred participants were included (52% women, 61% non-affective psychoses). The median DUP was 4.1 weeks (inter-quartile range: 1.9-11.4), and was shorter for affective psychoses. Most participants had their first contact with psychiatric emergency services. Those who did not live with a relative (children older than 18 years, parents, partner) were more likely to present long DUP (OR: 2.63; 95%CI: 0.98-7.04); p=0.05). CONCLUSION: The DUP in São Paulo was shorter than expected. Living arrangements may play an important role in shortening the DUP in urban centres of low- and middle income countries that have a network of mental health services.

Effects of a multidisciplinar cognitive rehabilitation program for patients with mild Alzheimer's disease

OBJECTIVE: To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatry symptoms in patients with mild Alzheimer's disease. METHOD: The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention. INTERVENTION: Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing), physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings. MEASUREMENTS: The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments. RESULTS: Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life. CONCLUSION: This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield adjunct and clinically relevant benefits in dementia treatment.