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2015, Vol.6  No.3

The lateral soft X-ray radiogram and the reconstructed micro-CT image after the mechanical testing. Marked radiolucency was recognized at the anterior part of the vertebra.

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  • Table of Content
      01 June 2015, Volume 6 Issue 3 Previous Issue    Next Issue
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    Original Article
    Plasma Epidermal Growth Factor Decreased in the Early Stage of Parkinson’s Disease
    Qian-Wen Jiang, Cheng Wang, Yi Zhou, Miao-Miao Hou, Xi Wang, Hui-Dong Tang, Yi-Wen Wu, Jian-Fang Ma, Sheng-Di Chen
    A&D. 2015, 6 (3): 168-173.   DOI: 10.14336/AD.2014.0925
    Abstract   HTML   PDF (340KB) ( 767 )

    Epidermal growth factor (EGF) is a neurotrophic factor that plays an important role in Parkinson’s disease (PD). We measured plasma EGF level in PD, essential tremor (ET) and normal controls toinvestigate whether it changes in PD and whether it is associated with motor and non-motor symptoms of PD. 100 patients with PD, 40 patients with ET as disease control and 76 healthy persons were enrolled in the present study. Motor and non-motor symptoms were assessed by different scales. Plasma EGF levels of three groups were measured by enzyme-linked immunosorbent assay kit. Spearman test and linear logistics regression model were used to test the correlation of EGF with motor and non-motor symptoms of PD. Plasma EGF level was significantly decreased in early PD patients compared with normal control, butnot in advanced PD patients. Interestingly, plasma EGF level was significantly increased in advanced PD and total PD patients compared with ET patients, but not in early PD patients. In addition, plasma EGF level was correlated with UPDRS-III scores in PD. Also plasma EGF level was correlated with UPDRS-III scores and NMS scores in early PD.Our results suggested that plasma EGF decreased in the early stage of PD and increased later on in the PD disease course. Also, plasma EGF level was increased significantly in PD compared with ET patients and correlated with motor and non-motor symptoms in early PD.

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    Effects of Hospital-Based Physical Therapy on Hospital Discharge Outcomes among Hospitalized Older Adults with Community-Acquired Pneumonia and DecliningPhysical Function
    Sun Jung Kim,Joo Hun Lee,Boram Han,Julia Lam,Elizabeth Bukowy,Avinash Rao,Jordan Vulcano,Anelia Andreeva,Heather Bertelson,Hyun Phil Shin,Ji Won Yoo
    A&D. 2015, 6 (3): 174-179.   DOI: 10.14336/AD.2014.0801
    Abstract   HTML   PDF (188KB) ( 773 )

    To examine whether hospital-based physical therapy is associated with functional changes and early hospital readmission among hospitalized older adults with community-acquired pneumonia and declining physical function. Study design was a retrospective observation study. Participants were community-dwelling older adults admitted to medicine floor for community-acquired pneumonia (n = 1,058). Their physical function using Katz activities of daily living (ADL) Index declined between hospital admission and 48 hours since hospital admission (Katz ADL Index 6→5). The intervention group was those receiving physical therapy for ≥ 0.5 hour/day. Outcomes were Katz ADL Index at hospital discharge and all-cause 30-day hospital readmission rate. The intervention and control groups did not differ in the Katz ADL Index at hospital discharge (p = 0.11). All-cause 30-day hospital readmission rate was lower in the intervention than in control groups (OR = 0.65, p = 0.02). Hospital-based physical therapy has the benefits toward reducing 30-day hospital readmission rate of acutely ill older adults with community-acquired pneumonia and declining physical function.

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    Analysis of Vertebral Bone Strength, Fracture Pattern, and Fracture Location: A Validation Study Using a Computed Tomography-Based Nonlinear Finite Element Analysis
    Kazuhiro Imai
    A&D. 2015, 6 (3): 180-187.   DOI: 10.14336/AD.2014.0621
    Abstract   HTML   PDF (390KB) ( 671 )

    Finite element analysis (FEA) is an advanced computer technique of structural stress analysis developed in engineering mechanics. Because the compressive behavior of vertebral bone shows nonlinear behavior, a nonlinear FEA should be utilized to analyze the clinical vertebral fracture. In this article, a computed tomography-based nonlinear FEA (CT/FEA) to analyze the vertebral bone strength, fracture pattern, and fracture location is introduced. The accuracy of the CT/FEA was validated by performing experimental mechanical testing with human cadaveric specimens. Vertebral bone strength and the minimum principal strain at the vertebral surface were accurately analyzed using the CT/FEA. The experimental fracture pattern and fracture location were also accurately simulated. Optimization of the element size was performed by assessing the accuracy of the CT/FEA, and the optimum element size was assumed to be 2 mm. It is expected that the CT/FEA will be valuable in analyzing vertebral fracture risk and assessing therapeutic effects on osteoporosis.

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    Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits
    Anupam Chandra,Sarah J Crane,Ericka E Tung,Gregory J Hanson,Frederick North,Stephen S Cha,Paul Y Takahashi
    A&D. 2015, 6 (3): 188-195.   DOI: 10.14336/AD.2014.0706
    Abstract   HTML   PDF (527KB) ( 662 )

    There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age, a self-report of worse health, history of 2 or more falls, weight loss, and depressed mood were significantly associated with hospitalization or ED visits within 1 year. A score equal to or greater than 2 had a sensitivity of 0.74 and specificity of 0.45. The calculated AUC was 0.60. The MAGE questionnaire, which was completed by patients at an outpatient visit to screen for common geriatric issues, could also be used to assess risk for ED visits and hospitalization within 1 year.

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    Information Theoretical Analysis of Aging as a Risk Factor for Heart Disease
    David Blokh, Ilia Stambler
    A&D. 2015, 6 (3): 196-207.   DOI: 10.14336/AD.2014.0623
    Abstract   HTML   PDF (230KB) ( 898 )

    We estimate the weight of various risk factors in heart disease, and the particular weight of age as a risk factor, individually and combined with other factors. To establish the weights we use the information theoretical measure of normalized mutual information that permits determining both individual and combined correlation of diagnostic parameters with the disease status. The present information theoretical methodology takes into account the non-linear correlations between the diagnostic parameters, as well as their non-linear changes with age. Thus it may be better suited to analyze complex biological aging systems than statistical measures that only estimate linear relations. We show that individual parameters, including age, often show little correlation with heart disease. Yet in combination, the correlation improves dramatically. For diagnostic parameters specific for heart disease the increase in the correlative capacity thanks to the combination of diagnostic parameters, is less pronounced than for the less specific parameters. Age shows the highest influence on the presence of disease among the non-specific parameters and the combination of age with other diagnostic parameters substantially improves the correlation with the disease status. Hence age is considered as a primary “metamarker” of aging-related heart disease, whose addition can improve diagnostic capabilities. In the future, this methodology may contribute to the development of a system of biomarkers for the assessment of biological/physiological age, its influence on disease status, and its modifications by therapeutic interventions.

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    Review Article
    Learning from Normal Aging:Preserved Emotional Functioning Facilitates Adaptation among Early Alzheimer’s Disease Patients
    Fan Zhang,YuanWan Ho,Helene H. Fung*
    A&D. 2015, 6 (3): 208-215.   DOI: 10.14336/AD.2014.0620
    Abstract   HTML   PDF (666KB) ( 845 )

    Alzheimer’s disease (AD) has been largely characterized by severe deterioration of cognitive functioning. Only recently has more attention been shifted to identifying the preserved capacity and functioning of AD patients. By reviewing the AD literature, we observe that despite the various cognitive impairment and deficits, early Alzheimer’s patients perform certain types of automatic emotion regulation and display a positivity effect in emotion recognition and emotional memory.Moreover, we argue that, like their healthy aged peers, the optimization of such preserved emotion-based capacities helps early AD patients increase positive emotions, which may counteract the negative effects of the disease, thus maintaining their socio-emotional functioning. Finally, we discuss the emotion-based capacities strategies that AD patients may use to facilitate their adjustment to a life with Alzheimer’s.

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    Mechanisms of Superoxide Signaling in Epigenetic Processes: Relation to Aging and Cancer
    Igor Afanas’ev
    A&D. 2015, 6 (3): 216-227.   DOI: 10.14336/AD.2014.0924
    Abstract   HTML   PDF (970KB) ( 971 )

    Superoxide is a precursor of many free radicals and reactive oxygen species (ROS) in biological systems. It has been shown that superoxide regulates major epigenetic processes of DNA methylation, histone methylation, and histone acetylation. We suggested that superoxide, being a radical anion and a strong nucleophile, could participate in DNA methylation and histone methylation and acetylation through mechanism of nucleophilic substitution and free radical abstraction. In nucleophilic reactions superoxide is able to neutralize positive charges of methyl donors S-adenosyl-L-methionine (SAM) and acetyl-coenzyme A (AcCoA) enhancing their nucleophilic capacity or to deprotonate cytosine. In the reversed free radical reactions of demethylation and deacetylation superoxide is formed catalytically by the (Tet) family of dioxygenates and converted into the iron form of hydroxyl radical with subsequent oxidation and final eradication of methyl substituents. Double role of superoxide in these epigenetic processes might be of importance for understanding of ROS effects under physiological and pathological conditions including cancer and aging.

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  Editors-in-Chief  
Kunlin Jin, M.D., Ph.D., Professor
Ashok K. Shetty, Ph.D., Professor
David A. Greenberg, M.D., Ph.D., Professor
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