Retention weighted recall improves discrimination of Alzheimer's disease.

Impaired recall for early items (primacy) and late items (recency) on word list recall tests are seen in Alzheimer's disease (AD). We compared conventional scoring on the Telephone Instrument for Cognitive Status (TICS) recall list with scorings based on retention-weighted recall (RWR: each item weighted by its serial position) in older adults participating in a community-based aging study. Subjects with mild AD (N=18) did not differ from those without dementia (N=231) with respect to recency (46% vs. 59%, p = 0.2), but had impaired primacy (2% vs. 39%, p < .001) on word recall on the TICS. RWR scoring improved the effect size (1.52 SD) compared to conventional scoring (1.08 SD). With a fixed sensitivity of 85%, specificity was lower using conventional scoring (56%) than RWR (76%) scoring. Our findings suggest that optimized RWR scoring of word list free recall can improve detection of mild AD compared to conventional scoring.     

Quality of life and exercise performance in patients in sinus rhythm versus persistent atrial fibrillation: a Veterans Affairs Cooperative Studies Program Substudy.

OBJECTIVES: The purpose of this study was to determine quality of life (QOL) and exercise performance (EP) in patients with persistent atrial fibrillation (AF) converted to sinus rhythm (SR) compared with those remaining in or reverting to AF. BACKGROUND: Restoration of SR in patients with AF improving QOL and EP remains controversial. METHODS: Patients with persistent AF were randomized double-blind to amiodarone, sotalol, or placebo. Those not achieving SR at day 28 were cardioverted and classified into SR or AF groups at 8 weeks (n = 624) and 1 year (n = 556). The QOL (SF-36), symptom checklist (SCL), specific activity scale (SAS), AF severity scale (AFSS), and EP were assessed. RESULTS: Favorable changes were seen in SR patients at 8 weeks in physical functioning (p < 0.001), physical role limitations (p = 0.03), general health (p = 0.002), and vitality (p < 0.001), and at 1 year in general health (p = 0.007) and social functioning (p = 0.02). Changes in the scores for SCL severity (p = 0.01), functional capacity (p = 0.003), and AFSS symptom burden (p < 0.001) at 8 weeks and in SCL severity (p < 0.01) and AF symptom burden (p < 0.001) at 1 year showed significant improvements in SR versus AF. Symptomatic patients were more likely to have improvement. The EP in SR versus AF was greater from baseline to 8 weeks (p = 0.01) and to 1 year (p = 0.02). The EP correlated with physical functioning and functional capacity except in the AF group at 1 year. CONCLUSIONS: In patients with persistent AF, restoration and maintenance of SR was associated with improvements in QOL measures and EP. There was a strong correlation between QOL measures and EP.     

Predictors of Partner Notification for C. trachomatis and N. gonorrhoeae: An Examination of Social Cognitive and Psychological Factors

Efforts to control chlamydial and gonococcal infections include notifying eligible sexual partners of possible infection, primarily by asking the diagnosed patient to notify their partners. This approach, known as patient referral, is widely used but poorly understood. The current study examined psychosocial and cognitive factors associated with patient referral among an urban, minority sample of 168 participants recently diagnosed with Chlamydia trachomatis or Neisseria gonorrhoeae. At a follow-up interview 1-month from diagnosis, participants were more likely to have notified all eligible partners if they had greater intention to notify at baseline (OR = 3.72; 95% CI = 1.34, 10.30) and if they had only one partner at baseline (OR = 4.08; 95% CI = 1.61, 10.31). There were also gender differences as well as differences based on type of partner (i.e., regular, casual, one-time). The implications of these findings for the design of programs to promote patient referral for sexually transmitted infections are discussed. Schwartz, Malka, Augenbraun, McCormack, and Wilson are with the State University of New York, Downstate Medical Center, Brooklyn, NY, USA; Rubin is with the New York City Department of Health, Bureau of STD Control, New York, NY, USA; Rubin, Hogben, and Liddon are with the Centers for Disease Control and Prevention, Atlanta, GA, USA; Schwartz is with the Department of Preventive Medicine and Community Health, SUNY Downstate Medical Center, Box 1240, 450 Clarkson Avenue, Brooklyn, NY 11203, USA.     

Radiopacity of dental materials using a digital X-ray system.

OBJECTIVES: Radiopacity is a desirable property for most intra-oral materials. There are established ISO and ANSI/ADA protocols for determining radiopacity using film-based radiography. However, these methods are not always followed by researchers. This study aims to adapt those procedures by using digital radiography, a simplified stepwedge, and examine the effects of target distance and exposure time choice. METHODS: One millimetre thick samples of three dental materials were prepared by placing the materials into a 1.00 mm thick washer sandwiched between two glass slides. The samples were digitally radiographed alongside a stepwedge of aluminum alloy 1100 with an X-ray unit at 70 kVp using five different target distance/exposure time combinations. For each combination, the grey scale values of various thicknesses of the stepwedge were converted into absorbencies and plotted against their thickness. These plots were then linearly regressed in order to correlate absorbance with a thickness of aluminum for each target distance/exposure time combination. The absorbencies of each sample were then converted into radiopacities using these correlations. RESULTS: The correlations between the absorbance of the stepwedge and its thickness were highly linear. This linearity allows the correlation to be accurately deduced from fewer data points than required by the ISO and ANSI/ADA protocols. Varying exposure time did not significantly affect the mean radiopacity measured at a target distance of 30 cm. Varying the target distance did not significantly affect the measured radiopacity as long as the samples were properly exposed. SIGNIFICANCE: A simplified, consistent digital method for determining radiopacity is presented.