bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship of smoking and coffee and alcohol consumption with seroconversion to Helicobacter pylori: A longitudinal study in hospital workers
Authors: GIKAS ARISTOFANIS , TRIANTAFILLIDIS JOHN K , APOSTOLIDIS NIKOLAOS , MALLAS ELIAS , PEROS GEORGE , ANDROULAKIS GEORGE
Published: December 2004

Background and Aim:  There are few data concerning the relationship between Helicobacter pylori seroconversion, and smoking habits and coffee and alcohol consumption. The aim of the present study was to investigate the relationship between smoking habits, coffee and alcohol consumption, and H. pylori seroconversion.

Methods:  The data used were derived from a sample of 238 subjects (hospital employees) who were initially (on 1994) seronegative to H. pylori. These subjects were tested again 5 years later (1999). Information concerning smoking habits and coffee and alcohol consumption was collected by the use of a special questionnaire, which was completed by the same cohort of subjects in two different periods (1994 and 1999). Logistic regression was used to assess the relationship between H. pylori seroconversion and the aforementioned lifestyle factors.

Results:  Neither smoking nor coffee consumption was significantly related to H. pylori seroconversion. Adjusted odds ratio for alcohol drinkers as compared with non‐/occasional drinkers was 0.59 (95% confidence interval [CI]: 0.31–1.16, P = 0.13). However, the odds ratio was significantly lower (0.26, 95%CI: 0.07–0.95, P = 0.042) in subjects who reported moderate alcohol consumption at first (1994) examination, as compared with non‐/occasional drinkers. Small and heavy drinking were not associated with H. pylori seroconversion.

Conclusions:  There is no significant relation between H. pylori seroconversion and smoking and coffee consumption. The present findings suggest that moderate alcohol consumption might be inversely associated with H. pylori seroconversion.

© 2004 Blackwell Publishing Asia Pty Ltd
Acute Budd–Chiari syndrome with liver failure: The experience of a policy of initial interventional radiological treatment using transjugular intrahepatic portosystemic shunt
Authors: KAVANAGH PAUL M , ROBERTS JAQUELINE , GIBNEY ROBIN , MALONE DERMOT , HEGARTY JOHN , MCCORMICK P AIDEN
Published: December 2004

Background and Aims:  The optimal management of acute Budd–Chiari syndrome (BCS) with liver failure is controversial. Options include anticoagulation, portal systemic shunting or liver transplantation. In recent years, transjugular intrahepatic portosystemic shunts (TIPS) have been tried in place of shunt surgery. We report our experience with a policy of initial interventional radiological treatment (TIPS) in this patient group.

Methods:  A consecutive, non‐selected series of five patients with acute BCS with liver failure presenting to our liver unit over a 36‐month period from October 2000 were treated with a policy of initial attempt at transjugular shunt.

Results:  Stents were successfully inserted in four patients. In one patient the hepatic vein remnant could not be cannulated. One of the four stented patients had a hepatic venous web. Rapid recurrent portal and hepatic vein thrombosis occurred in one patient despite anticoagulation and trans‐shunt thrombectomy. This patient and the patient with failed stenting underwent successful liver transplantation. One successfully stented patient died unexpectedly at home 2 weeks after TIPS insertion. Four of five patients are alive (80%) at a mean follow‐up time of 30 months.

Conclusion:  Initial TIPS, with liver transplantation for treatment failures, may be a reasonable, cost‐effective and surgery‐sparing treatment for acute Budd–Chiari presenting with liver failure.
Motilin in human milk and its elevated plasma concentration in lactating women
Authors: LIU JINSONG , QIAO XIAN , QIAN WEI , HOU XIAOHUA , HAYES JAMES , CHEN JDZ
Published: December 2004

Background and Aims:  The aims of this study were to investigate whether: (i) lactating women had an elevated plasma level of motilin; (ii) there was a correlation between the plasma motilin level and the motilin level in breast milk in lactating women; and (iii) there was a difference in motilin levels between the colostrum and mature human milk in a controlled postprandial state.

Methods:  Twenty control women and 18 lactating women were enrolled in this study. All samples were drawn in a controlled postprandial state. The concentration of motilin was measured using radioimmunoassay.

Results:  The plasma motilin level in lactating women was 434 ± 180 pmol/L on the fifth day after delivery and 450 ± 204 pmol/L on the 42nd day after delivery (P > 0.05). Both of these values were significantly higher than those in the control women (231 ± 48 pmol/L, P < 0.05). The motilin level in human milk in the controlled postprandial state was 161 ± 56 pmol/L on the fifth day and 154 ± 60 pmol/L on the 42nd day after parturition (P = 0.7). Although there was motilin in the breast milk and an elevated plasma level of motilin in the lactating women, there was no correlation in motilin level between the blood and the breast milk.

Conclusions:  Motilin is elevated in the blood of lactating women and human milk contains motilin. These elevated levels of motilin sustain for a period of at least 6 weeks. Further studies are necessary to assess whether motilin is involved in the development of gastrointestinal motility in the early stage of life in infancy.

© 2004 Blackwell Publishing Asia Pty Ltd
Development of gastric adenocarcinoma in Mongolian gerbils after long‐term infection with Helicobacter pylori
Authors: ZHENG QING , CHEN XIAO YU , SHI YAO , XIAO SHU DONG
Published: December 2004

Background and Aim:  The experimental evidence that long‐term colonization of Helicobacter pylori results in the development of gastric cancer in Mongolian gerbils has been reported only by two Japanese groups to date. This study aimed to investigate the carcinogenicity of H. pylori infection in a Mongolian gerbil model.

Methods:  Thirty‐six Mongolian gerbils (inner Mongolian origin) were divided into two groups (male to female ratio, 1:1) and orally inoculated with a standard H. pylori strain (ATCC43504) or H. pylori161 (isolated from a Chinese patient with gastric adenocarcinoma), respectively, once a week for 5 weeks. Another 10 control gerbils were given phosphate‐buffered saline. The animals were killed 8, 20, 28 and 84 weeks after inoculation for bacterial and histological examination.

Results:  Seven inoculated gerbils died at the week 42. Overall, H. pylori colonization was detected in 24 (83%) of the 29 available inoculated gerbils. The gastric lesions were aggravated gradually over time. At week 84, moderate to severe gastritis, characterized by diffuse infiltration of mononuclear cells and formation of multiple lymphoid follicles in mucosa and submucosa, and even the lymphoepithelial lesions, were observed. Epithelial hyperplasia were dominant in almost all gerbils. Four (24%) of the 17 animals had hyperplastic polyps. Intestinal metaplasia were rarely seen (in three gerbils). Well‐differentiated gastric adenocarcinomas developed in three (18%) of the 17 gerbils after 84 weeks. Of the three gerbils, one female gerbil was infected with H. pylori161 and the others (one male and one female) were infected with ATCC43504.

Conclusions:  The present study reconfirms that H. pylori infection alone can induce gastric adenocarcinoma in Mongolian gerbils and suggests that different species of gerbil and both standard and clinically isolated H. pylori strains can be used for investigating the carcinogenesis of H. pylori. This is the first report of the development of gastric cancer in female gerbils, which highlights the importance of using both sexes to investigate the pathogenesis of H. pylori and whether host susceptibility is influenced by sex.
Improvement of the Likelihood Ratio Test Statistic in ARMA Models
Authors: Lagos Bernardo M. , Morettin Pedro A.
Published: December 2004

In this paper, we develop a Bartlett correction for the likelihood ratio statistic used to test hypotheses about parameters of a Gaussian stationary and invertible model belonging to the ARMA (autoregressive moving average) family. Alternative hypotheses with and without disturbance parameters are considered. The correction formulae are written in matrix form with the advantage of being easily implemented with the aid of some symbolic or numerical matrix language. Some simulation results are also presented.
LITURGICALLY TRAINED MEMORY: A READING OF SUMMA THEOLOGIAE III.83
Authors: CANDLER PETER M.
Published: December 2004

Drawing on Ciceronian rhetorical tropes, Thomas Aquinas treats the rite of the Eucharist in terms of the classical ars memoriae. The Eucharist, for Aquinas, is the schooling in desire whereby we are trained to order the associations of our memory to their proper objects in terms of their relations to God. He thus conceives of the liturgy of the Mass as rhetoric proper, which truly teaches, moves and delights. Since memory is the condition of all thought, as both Thomas and Augustine claim, the Eucharist is the “site” of all theological production, and therefore the liturgy is the art of memory of which all other similar arts are derivative.
Cryptic trysts, genomic mergers, and plant speciation
Authors: Cronn Richard , Wendel Jonathan F.
Published: December 2004

It has long been recognized that interspecific hybridization is common in plants, enhancing processes of diversification and speciation. With the widespread utilization of molecular tools, interspecific hybridization – as revealed through incongruence among two or more phylogenetic data sets – is now inferred to be even more prevalent than indicated by morphological and cytogenetic evidence. UsingGossypiumas an example, we show how multiple molecular markers have implicated a high frequency of historical hybridization between lineages whose modern descendants are strongly isolated by geography and intrinsic genetic barriers. For example, transoceanic dispersal of propagules from Africa to the New World led to the creation of a novel allotetraploid lineage, as well as the introgression of African repetitive elements into a Mexican diploid species. By mechanisms that remain obscure, fully one‐quarter of modernGossypiumspecies appear to have experienced historical interspecific cytoplasmic and possibly nuclear introgression. These remarkable observations of interspecific genetic exchange emerge from a genus for which such contact would appear improbable, implying that historical hybridization is a more creative force than suspected in angiosperm evolution.
Intramolecular, compound‐specific, and bulk carbon isotope patterns in C3 and C4 plants: a review and synthesis
Authors: A. Hobbie Erik , Werner Roland A.
Published: December 2004

Studies using carbon isotope differences between C3 and C4 photosynthesis to calculate terrestrial productivity or soil carbon turnover assume that intramolecular isotopic patterns and isotopic shifts between specific plant components are similar in C3 and C4 plants. To test these assumptions, we calculated isotopic differences in studies measuring components from C3 or C4 photosynthesis. Relative to source sugars in fermentation, C3‐derived ethanol had less 13C and C3‐derived CO2 had more 13C than C4‐derived ethanol and CO2. Both results agreed with intramolecular isotopic signatures in C3 and C4 glucose. Isotopic shifts between plant compounds (e.g. lignin and cellulose) or tissues (e.g. leaves and roots) also differed in C3 and C4 plants. Woody C3 plants allocated more carbon to 13C‐depleted compounds such as lignin or lipids than herbaceous C3 or C4 plants. This allocation influenced 13C patterns among compounds and tissues. Photorespiration and isotopic fractionation at metabolic branch points, coupled to different allocation patterns during metabolism for C3 vs C4 plants, probably influence position‐specific and compound‐specific isotopic differences. Differing 13C content of mobile and immobile compounds (e.g. sugars vs lignin) may then create isotopic differences among plant pools and along transport pathways. We conclude that a few basic mechanisms can explain intramolecular, compound‐specific and bulk isotopic differences between C3 and C4 plants. Understanding these mechanisms will improve our ability to link bulk and compound‐specific isotopic patterns to metabolic pathways in C3 and C4 plants.

Contents

Summary
371

I.
Introduction
372

II.
Methods and terminology
373

III.
Results
373

IV.
Discussion
376

V.
Conclusions
382

Acknowledgements
382

References
382
Direct referral of posterior capsular opacification by optometrists
Authors: Menon G. Jayakrishna , Faridi Usama A. , Gray Roger H.
Published: December 2004

Purpose:  To study referrals of posterior capsular opacification (PCO) for laser capsulotomy by optometrists and compare direct referral with that via the general practitioner (GP).

Methods:  A prospective analysis of optometrist referrals with regard to diagnostic accuracy, appropriateness of referral, quality of letters and patient waiting times.

Results:  Of 222 referrals, 156 were direct and 66 via the GP. Forty‐five (20.3%) letters were of good quality, 141 (63.5%) were average and 36 (16.2%) were poor. Waiting times for direct referrals ranged from 2 to 30 weeks (mean 8.3 weeks, S.D. 4.1); that for referrals via the GP ranged from 4 to 25 weeks (mean 10.3 weeks, S.D. 3.6). Directly referred patients thus waited 2 weeks shorter than patients referred via GPs (95% confidence interval 0.7–3.1, p = 0.002). Diagnostic concurrence was 99% (211/213 patients). The rate of laser capsulotomy was 98.2% (215/219); 103 (46.4%) letters utilised a referral form (GOS18); 146 (65.8%) discussed subjective visual problems and five (2.3%) incorporated patient consent for provision of feedback to the referring optometrist.

Conclusion:  Direct optometrist referral is effective, accurate and reduces patient waiting time and GP workload. Referral letters should be typed or printed to optimise legibility. Patient consent for feedback should be obtained by the referring optometrist.
Peripheral light focusing as a potential mechanism for phakic dysphotopsia and lens phototoxicity
Authors: Kwok L. Stephen , Daszynski Damian C. , Kuznetsov Valerian A. , Pham Therese , Ho Arthur , Coroneo Minas T.
Published: December 2004

Our aim was to examine secondary image formation in the anterior segment caused by peripheral light focusing (PLF) in the human cornea, and in particular the crystalline lens. Non‐sequential ray‐tracing (OptiCAD) was applied to an anatomically based human eye model, which incorporates a gradient index crystalline lens. For analysis of the limbal effect, we varied the incident angle from 100 to 122°, while for the crystalline lens effect, the incident angle was varied from 60 to 90°. The corneal shapes studied included central radii from 7.4 to 8.2 mm with a range of shape factors. In each case, we computed the peak and average intensities, and the area of exposure at the limbus or lens periphery. The computation was repeated with a previous model eye for comparison. For the limbal effect, a peak intensity gain of ×22.5 was found at an incident angle of 104° which compares well with previous results. The average intensity gain at this angle was ×7.5 over an area of 0.23 mm2. Steeper corneal curvature produced a greater PLF effect. For the crystalline lens effect, maximum UVA (365 nm) intensity gain peaked at ×8.6 at 84° with average intensity gain of ×2.3. The area of UVA exposure peaked at 4.7 mm2 at 70°. A relatively wide range (30°) of incident angles produced peak PLF gains of ×3 or more in the lens. Significant focusing of light is directed to the nasal limbus, and to a lesser extent to the crystalline lens over a broad range of incident angles. PLF in the nasal cornea is reduced by an order of magnitude when a UV‐blocking soft contact lens is used. The concentration levels and intraocular sites of PLF action on UV and visible light suggest a new mechanism of phakic dysphotopsia and lens phototoxicity.
The Relationship Between a Dementia Diagnosis, Chronic Illness, Medicare Expenditures, and Hospital Use
Authors: Bynum Julie P. W. , Rabins Peter V. , Weller Wendy , Niefeld Marlene , Anderson Gerard F. , Wu Albert W.
Published: December 2004

Objectives: To determine whether dementia increases medical expenditures, the probability of hospitalization, and potentially preventable hospitalization, controlling for variables including age and comorbidity.

Design: Cross‐sectional analysis of 1 year of claims data comparing usage by patients with claims for dementia with usage by those without dementia.

Setting: A nationally representative 5% random sample of Medicare beneficiaries in 1999.

Participants: Medicare beneficiaries aged 65 and older with fee‐for‐service Medicare Parts A and B coverage for 1999 (N=1,238,895; dementia patients n=103,512).

Measurements: Per capita expenditures, rate of all‐cause hospitalization, rate of preventable hospitalization as defined using ambulatory‐care sensitive condition (ACSC) admissions, and dementia identified using International Classification of Diseases, 9th Edition, codes 290, 294, and 331.

Results: Prevalence of dementia was 8.3%. In a model of expenditures in those who survived the year adjusting for age, sex, race, and comorbidity, dementia was associated with an incremental cost of $6,927, or 3.3 times greater total expenditures than in nondementia patients (P<.001), with higher expenditures for each specific type of Medicare service. Hospitalization accounted for 54% of adjusted costs. The adjusted odds of hospitalization associated with dementia were 3.68 (95% confidence interval (CI)=3.62–3.73) and adjusted odds of ACSC hospitalization were 2.40 (95% CI=2.35–2.46). In those who died, the associations were positive but of smaller magnitude.

Conclusion: In a nationally representative sample, higher Medicare expenditures associated with a diagnosis of dementia are in large part due to increased hospitalization. Further study is needed into the factors associated with high rates of hospitalization in dementia patients including aspects of ambulatory management that may be improved. J Am Geriatr Soc 52:187–194, 2004.
Low Well‐Being Is an Independent Predictor for Stroke in Elderly Patients with Diabetes Mellitus
Authors: Araki Atsushi , Murotani Yukari , Kamimiya Fumi , Ito Hideki
Published: December 2004

Objectives: To examine whether psychological factors are risk factors for the development of stroke in elderly diabetic patients.

Design: Prospective cohort study.

Setting: Outpatient clinic.

Participants: Three hundred seventy‐six diabetic outpatients free of stroke; mean age 75.

Methods:

Well‐being and diabetes‐specific burden were assessed at baseline using the Philadelphia Geriatric Center morale scale and the Elderly Diabetes Burden Scale (EDBS), respectively. Symptomatic stroke was defined as a focal neurological deficit with rapid onset that persists for more than 24 hours, supported by brain computed tomography or magnetic resonance imaging.

Results: During the 3‐year follow‐up period, 25 symptomatic strokes (24 ischemic strokes and 1 cerebral hemorrhage) occurred. Low scores on the morale scale (≤7) were significant predictors for stroke after adjustment for age; sex; body mass index; hemoglobin A1c level; systolic blood pressure; serum levels of total cholesterol, triglycerides, and high‐density lipoprotein cholesterol; smoking; and previous ischemic heart disease (IHD) (hazard ratio (HR)=3.0, 95% confidence interval (CI)=1.2–7.3, P=.017). The relationship between low morale scores and future stroke remained significant after adjusting for socioeconomic factors and microalbuminuria. Increased symptom burden and social burden, but not dietary restrictions, worry about diabetes mellitus (DM), treatment satisfaction, and burden by tablets or insulin of EDBS, were also significant predictors for stroke after adjustment for age, sex, duration of DM, previous IHD, and microalbuminuria (HR=2.6, 95% CI=1.1–6.5, P=.039).

Conclusion: Low well‐being and symptom burden were predictors of stroke in elderly patients with diabetes mellitus (DM), although the causal relationship remains unknown.
Muscle Strength After Resistance Training Is Inversely Correlated with Baseline Levels of Soluble Tumor Necrosis Factor Receptors in the Oldest Old
Authors: Bruunsgaard Helle , Bjerregaard Eva , Schroll Marianne , Pedersen Bente Klarlund
Published: December 2004

Objectives:  To test the hypothesis that physical exercise induces an antiinflammatory response that is associated with reduced chronic activation of the tumor necrosis factor (TNF)‐alpha system in frail elders and that the increase in muscle strength after resistance training is limited by systemic low‐grade inflammation.

Design:  A 12‐week controlled resistance‐training study.

Setting:  Nursing homes in Copenhagen, Denmark.

Participants:  Twenty‐one frail nursing home residents aged 86 to 95 completed the study.

Intervention:  Ten participants were randomized to a program of resistance training of knee extensors and flexors three times a week for 12 weeks; the remaining 11 participants served as a control group who joined social activities supervised by an occupation therapist.

Measurements:  Muscle strength, plasma levels of TNF‐α, soluble TNF receptor (sTNFR)‐1, and interleukin (IL)‐6 were measured before and at the end of the intervention period.

Results:  The training program improved muscle strength but did not affect plasma levels of TNF‐α and sTNFR‐I or IL‐6. However, plasma levels of sTNFR‐I at baseline were inversely correlated with the increase in muscle strength.

Conclusion:  Low‐grade activation of the TNF system could limit the increase in muscle strength after resistance training in the oldest old. Furthermore, data suggest that theantiinflammatory response induced by 12 weeks of resistance training is not sufficient to reduce chronic activation of the TNF system, but the small sample size limited this interpretation.
Subcortical Vascular Lesions Predict Functional Recovery After Rehabilitation in Patients with L‐Dopa Refractory Parkinsonism
Authors: Guerini Fabio , Frisoni Giovanni B. , Bellwald Catherine , Psy Roberta Rossi , Bellelli Giuseppe , Trabucchi Marco
Published: December 2004

Objectives: To identify predictors of functional recovery after an intensive rehabilitation training in patients with gait disturbances and refractory parkinsonism.

Design: Observational study.

Setting: A hospital geriatric rehabilitation department (“Ancelle della Carità” hospital of Cremona).

Participants: Thirty‐eight subjects (mean age±standard deviation of 78.9±6.5; 66% women) with gait disturbances and L‐dopa refractory parkinsonism consecutively admitted to a rehabilitation unit within 6 months were recruited. Exclusion criteria were obvious musculoskeletal disorders (severe leg arthritis, hemiparesis, recent stroke), recent surgery, delirium, physical impairment from other identifiable causes, and missing computed tomography (CT) scan. All subjects received an intensive standardized rehabilitative program including conventional physical therapy and specific gait training.

Measurements: The outcome measure of the rehabilitation training was the gain between admission and discharge on the Unified Parkinson Disease Rating Scale (delta‐UPDRS). The following potential predictors were assessed using comprehensive geriatric assessment: physical health (Charlson Comorbidity Index, number of drugs), cognitive performance (Mini‐Mental State Examination (MMSE)), functional status (Tinetti scale), depressive symptoms (Geriatric Depression Scale), nutritional status (serum albumin and body mass index), and subcortical cerebrovascular load (four classes of increasing severity based on diffuse leukoariosis, patchy lesions of the white matter, and lacunas on CT scan). Multivariate logistic regression with fixed adjustment for age, cognitive performance, and UPDRS on admission and stepwise selection of variables were used to identify independent predictors.

Results: Patients were divided into two groups of equal size based on the delta‐UPDRS (high and low functional recovery: delta‐UPDRS >8 and ≤8, respectively). Of all variables, only subcortical cerebrovascular load predicted functional recovery at discharge (odds ratio adjusted for age, MMSE, and UPDRS on admission=2.3, 95% confidence interval=1.0–5.1). The adjusted proportion of patients with high functional recovery decreased with increasing subcortical cerebrovascular load: 83%, 61%, 44%, and 27% (adjusted P for trend=0.047).

Conclusion: Subcortical cerebrovascular load is a predicting factor of successful rehabilitation in patients with L‐dopa refractory parkinsonism.
Home Hospitalization Service for Acute Uncomplicated First Ischemic Stroke in Elderly Patients: A Randomized Trial
Authors: Ricauda Nicoletta Aimonino , Bo Mario , Molaschi Mario , Massaia Massimiliano , Salerno Dominga , Amati Dario , Tibaldi Vittoria , Fabris Fabrizio
Published: December 2004

Objectives: To evaluate whether home treatment of elderly patients with acute uncomplicated first ischemic stroke is associated with different mortality rates and clinical outcomes from those of patients treated on a general medical ward (GMW).

Design: Randomized, controlled, single‐blind trial.

Setting: S. Giovanni Battista Hospital of Turin.

Participants: One hundred twenty elderly patients admitted to the emergency department of the hospital with first acute ischemic stroke were randomized to home treatment from a geriatric home hospitalization service (GHHS) or to GMW treatment.

Measurement: Main outcome was cumulative survival at 6 months in the two groups. Residual functional impairment, neurological deficit, depression, morbidity, and admission to rehabilitation and long‐term care facilities were considered as secondary outcomes in survivors.

Results: One hundred twenty patients (mean age 82; 54 men and 66 women) were enrolled (60 in each study arm). The cumulative proportion of cases surviving at 6 months was 0.65 in the GHHS group and 0.60 in GMW group (log‐rank test P=.53). Functional and neurological parameters were significantly improved in both GHHS and GMW patients, without significant differences between the two groups. Depression score was significantly better in home‐treated patients (P<.001), who were more likely to remain at home at 6 months than hospital‐treated patients and had a lower rate of select medical complications.

Conclusion: Home‐treated elderly patients with ischemic stroke have better depressive scores and lower rates of admission to nursing homes. These results should prompt further studies to evaluate home hospitalization for elderly stroke patients.
Declining Executive Control in Normal Aging Predicts Change in Functional Status: The Freedom House Study
Authors: Royall Donald R. , Palmer Raymond , Chiodo Laura K. , Polk Marsha J.
Published: December 2004

Objectives: To assess the contribution of executive control function (ECF) to functional status.

Design: Three‐year longitudinal cohort study.

Setting: A comprehensive‐care retirement community.

Participants: Five hundred forty‐seven noninstitutionalized septuagenarians.

Measurements: The Mini‐Mental State Examination (MMSE) and Executive Interview (EXIT25). Functional status was assessed using instrumental activities of daily living (IADLs). Latent growth curves of MMSE, EXIT25, and IADL were modeled. The rate of change in IADLs (ΔIADL), adjusted for baseline IADLs and cognition, was regressed on the rate of change in each cognitive measure (adjusted for baseline cognition). Models were also adjusted for baseline age, level of care, and comorbid illnesses.

Results: Baseline test scores were within normal ranges, but mean EXIT25 scores reached the impaired range by the second follow‐up. There was significant variability around the baseline means and slopes for all variables. The rate of change in EXIT25 was strongly correlated with ΔIADL (r=−0.57, P<.001). This remained significant after adjusting for baseline EXIT25 scores, IADLs, age, comorbid disease, and level of care. The effect of the EXIT25 on ΔIADL was stronger than those of age, baseline IADLs, comorbid disease, or level of care. The rate of change in MMSE scores was not significantly associated with ΔIADL.

Conclusion: ECF is a significant and independent correlate of functional status in normal aging. Traditional dementia case finding is likely to underestimate cognition‐related disability. Neither a normal baseline MMSE score nor stable MMSE scores over time preclude functionally significant changes in ECF.
A Randomized, Controlled Trial of Doxycycline and Rifampin for Patients with Alzheimer's Disease
Authors: Loeb Mark B. , Molloy D. William , Smieja Marek , Standish Tim , Goldsmith Charles H. , Mahony Jim , Smith Stephanie , Borrie Michael , Decoteau Earl , Davidson Warren , Mcdougall Allan , Gnarpe Judy , O'donnell Martin , Chernesky Max
Published: December 2004

Objectives: To assess whether doxycycline and rifampin have a therapeutic role in patients with Alzheimer's disease (AD).

Design: Randomized, triple‐blind, controlled trial.

Setting: Three tertiary care and two community geriatric clinics in Canada.

Participants: One hundred one patients with probable AD and mild to moderate dementia.

Intervention: Oral daily doses of doxycycline 200 mg and rifampin 300 mg for 3 months.

Measurements: The primary outcome was a change in Standardized Alzheimer's Disease Assessment Scale cognitive subscale (SADAScog) at 6 months. Secondary outcomes were changes in the SADAScog at 12 months and tests of dysfunctional behavior, depression, and functional status.

Results: There was significantly less decline in the SADAScog score at 6 months in the antibiotic group than in the placebo group, (−2.75 points, 95% confidence interval (CI)=−5.28 to −0.22, P=.034). At 12 months, the difference between groups in the SADAScog was −4.31 points (95% CI=−9.17–0.56, P=.079). The antibiotic group showed significantly less dysfunctional behavior at 3 months. There was no significant difference in adverse events between groups (P=.34). There were no differences in Chlamydia pneumoniae detection using polymerase chain reaction or antibodies (immunoglobulin (Ig)G or IgA) between groups.

Conclusion: Therapy with doxycycline and rifampin may have a therapeutic role in patients with mild to moderate AD. The mechanism is unlikely to be due to their effect on C. pneumoniae. More research is needed to investigate these agents.
Aging Does not Affect Beta‐Agonist Responsiveness after Methacholine‐Induced Bronchoconstriction
Authors: Parker Annie Lin
Published: December 2004

Objectives: To assess the response to an inhaled beta‐agonist alone or in combination with an anticholinergic agent after methacholine‐induced bronchoconstriction in four age groups.

Design: Retrospective analysis.

Setting: Pulmonary function laboratory in a university‐affiliated hospital.

Participants: Seven hundred sixty‐four consecutive subjects with a 20% reduction or more in forced expiratory volume during the first second (FEV1) of exhalation from total lung capacity after inhaling 189 or fewer cumulative units of methacholine were included in the analysis.

Intervention: The first 382 subjects received three inhalations of metaproterenol (total of 1.95 mg), and the other 382 subjects received three inhalations of albuterol and ipratropium combination (total of 309 μg of albuterol and 54 μg of ipratropium) after methacholine‐induced bronchoconstriction.

Measurements: The response to bronchodilators was assessed as the postbronchodilator percentage change in FEV1 and the percentage of subjects recovering to 90% or better of baseline FEV1 after the use of bronchodilator.

Results: The percentage change in FEV1 postbronchodilator in the elderly was similar to that of the younger subjects. The percentage of subjects who recovered to 90% or better of their baseline FEV1 postbronchodilator was also similar in the elderly and younger age groups. Response to metaproterenol was similar to that of the albuterol/ipratropium combination in all age groups (all P>.05).

Conclusion: Aging does not affect bronchodilator response to beta‐agonist after methacholine‐induced bronchoconstriction. The responsiveness to beta‐agonist alone is similar to the responsiveness to the combination of beta‐agonist and anticholinergic agent in all age groups.
Impairments of Muscles and Nerves Associated with Peripheral Arterial Disease and Their Relationship with Lower Extremity Functioning: The InCHIANTI Study
Authors: Mcdermott Mary McGrae , Guralnik Jack M. , Albay Monique , Bandinelli Stefania , Miniati Benedetta , Ferrucci Luigi
Published: December 2004

Objectives: To define the relationships between lower extremity peripheral arterial disease (PAD), pathophysiological findings in lower extremity muscles and nerves, and lower extremity performance.

Design: Cross‐sectional.

Setting: Two communities in Italy.

Participants: Nine‐hundred seventy‐nine community‐dwelling men and women aged 60 and older (109 with PAD).

Measurements: Presence and degree of lower extremity arterial obstruction were determined using the ankle‐brachial index (ABI). Lower extremity muscle cross‐sectional area was measured using computed tomography. Peroneal nerve conduction velocity (NCV) and leg power were also determined. Measures of lower extremity functioning were fast walking speed over 4 meters, time required to walk 400 meters, and the summary performance score.

Results: Participants with PAD had significantly poorer performance on functional outcomes than participants without PAD. Adjusting for age and sex, presence of PAD was associated with reduced leg muscle power (83.69 vs 103.51 watts, P<.001), reduced muscle cross‐sectional area (61.5 vs 63.5 cm2, P=.14), and reduced NCV (43.0 vs 44.2 m/s, P=.003). Adjustment for leg power diminished the independent association between ABI and the functional outcomes measures.

Conclusion: In community‐dwelling individuals, PAD is associated with reduced NCV and reduced muscle power in the lower extremities. Muscle power may mediate the association between lower ABI levels and poorer functional performance.
Screening and Cognitive Impairment: Ethics of Forgoing Mammography in Older Women
Authors: Raik Barrie L. , Miller Franklin G. , Fins Joseph J.
Published: December 2004

Mammographic screening for breast cancer in cognitively impaired women poses significant ethical questions. Many woman with dementia should not be screened because of the greater harm than benefits and the difficulty in obtaining informed consent. This article reviews the current controversy about mammography and then suggests a risk/benefit analysis for this vulnerable population. Autonomy, decision‐making capacity, and the roles of surrogates and physicians are considered, as are ageism and the risk of undertreatment. The harm of overdiagnosis and subsequent overtreatment for women who are cognitively impaired, have comorbidity and a limited life span are outlined. In these cases, the burdens of mammography outweigh the benefits. For women with early cognitive impairment and longer life expectancies, the potential benefits may outweigh the harms. A decision‐making process by the patient, proxy, and practitioner that takes account of foreseeable risks and benefits, patient capacity and preferences, and the effect of this screening intervention on quality of life is outlined.
Thermally actuated probe array for parallel dip-pen nanolithography
Authors: Wang Xuefeng , Bullen David A. , Zou Jun , Liu Chang , Mirkin Chad A.
Published: December 2004

Dip-pen nanolithography (DPN) uses scanning probes to directly deposit chemical and biological materials on a solid substrate. It offers the advantages of nanometer resolution and flexibility in pattern generation. Conventional DPN uses a single probe and its throughput is limited due to the serial nature of the process. This article reports the development of a linear silicon probe array that enables parallel DPN writing with improved throughput. The probe array has ten probes with tips with 100nm radius of curvature. Each probe in the array is individually controllable by a bimorph thermal actuator on its cantilever. DPN writing tests with octadecanethiol (ODT) as ink on gold surface have been conducted on an atomic force microscope. Simultaneous generation of ten different ODT patterns has been achieved with an average linewidth of 40nm.
Influence of molecular weight of resist polymers on surface roughness and line-edge roughness
Authors: Yamaguchi T. , Yamazaki K. , Namatsu H.
Published: December 2004

The effect of molecular weight on the roughness of the dissolution front (surface roughness) and line-edge roughness (LER) was investigated in a chain-scission-type of positive-tone electron-beam resist. Surface roughness and LER were measured by directly observing the surface of flood-exposed resists after development and the sidewall of patterns, respectively, with an atomic force microscope. It was clarified that the molecular weight dependencies of surface roughness and LER are quite different. Surface roughness was found to increase with molecular weight. This is because the size of aggregates protruding from the surface as a result of the development process becomes larger as the molecular weight increases. In contrast, LER was found to be larger in a low-molecular-weight resist than in a high-molecular-weight resist. Moreover, the dependence of LER on the latent-image profile is different for low- and high-molecular-weight resists. For low-molecular-weight resist, LER is independent of the steepness of the latent image; whereas, for high-molecular-weight resist, it increases rapidly as the steepness decreases. These results can be explained by the relationship between the size of aggregates and the width of the transition zone between low- and high-dose regions of the latent-image profile. This strongly suggests that low-molecular-weight resists are not necessarily advantageous in reducing LER.
Electron-beam-based photomask repair
Authors: Edinger Klaus , Becht Hans , Bihr Johannes , Boegli Volker , Budach Michael , Hofmann Thorsten , Koops Hans W. P. , Kuschnerus Peter , Oster Jens , Spies Petra , Weyrauch Bernd
Published: December 2004

High-resolution electron-beam-assisted deposition and etching is an enabling technology for current and future generation photomask repair. NaWoTec in collaboration with Carl Zeiss NTS (formerly LEO Electron Microscopy) has developed a mask repair tool capable of processing a wide variety of mask types, such as quartz binary masks, phase shift masks, extreme ultraviolet masks, and e-beam projection stencil masks. Specifications currently meet the 65nm device node requirements, and tool performance is extendible to 45nm and below. The tool combines LEO’s ultra-high-resolution Supra scanning electron microscope platform with NaWoTec’s proprietary e-beam deposition and etching technology, gas delivery system, and mask repair software. In this article, we focus on tool performance results; that is, the reproducibility and accuracy of repair of clear and opaque programmed defects on Cr binary and MoSi phase shift masks. These masks have in the past been difficult to repair due to beam position instability caused by charging of the insulating quartz areas. We have found and implemented a solution to this charging problem and have demonstrated in spec repair of various defect types. The extendibility of e-beam-based repair technology to future lithography nodes, both in terms of the required resolution and the ability to repair next generation lithography mask types, will also be addressed.
Full-field exposure performance of electron projection lithography tool
Authors: Suzuki Kazuaki , Hirayanagi Noriyuki , Fujiwara Tomoharu , Yamada Atsushi , Ikeda Junji , Yahiro Takehisa , Kojima Shinichi , Udagawa Jin , Yamamoto Hajime , Katakura Norihiro , Suzuki Motoko , Aoyama Takashi , Takekoshi Hidekazu , Umemoto Takaaki , Shimizu Hiroyasu , Fukui Saori , Suzuki Shohei , Okino Teruaki , Ohkubo Yukiharu , Shimoda Toshimasa , Tanida Toru , Watanabe Yoichi , Kohama Yoshiaki , Ohmori Kaoru , Mori Futoshi , Takemoto Shigeru , Yoshioka Takeshi , Hirose Hiroshi , Morita Kenji , Hada Kazunari , Kawata Shintaro , Kakizaki Yukio , Miura Takaharu
Published: December 2004

Electron projection lithography (EPL) is a realistic technology for the 65nm node and below, as a complementary technology of optical lithography especially for contacts and gate layers because of its high resolution and large process margin. Nikon has developed an EPL exposure tool as an electron-beam (EB) stepper and the first generation EB stepper; NSR-EB1A is now almost completed as an R&D tool for the 65nm technology node. Using a ϕ200mm reticle, a 20mm×25mm exposure field is realized. Full-field exposure performance of NSR-EB1A is shown. A 70nm isolated line and 1:1 nested lines are simultaneously resolved, as are 50nm 1:2 nested lines. 60nm contact holes are resolved with a depth of focus over a 10μm range and dosage window over ±6%. Stitching accuracy is about 20nm (3σ) and the single machine overlay is about 30nm (mean + 3σ). These data mean sufficient performance for device manufacturing of the 65nm technology node. The concept of a large subfield is one candidate for resolution and throughput enhancement in EPL production tool. The Coulomb blur is directly measured by an aerial image sensor for a large subfield and small beam half-angle, and the data show good agreement with simulations. It is shown that throughput over 20 wafers per hour (ϕ300mm) is realistic and achievable in a production tool of a 45nm technology node.
Chemically enhanced physical vapor deposition of tantalum nitride-based films for ultra-large-scale integrated devices
Authors: Li Ning , Ruzic D. N. , Powell R. A.
Published: December 2004

Physical vapor deposition (PVD) using ionized metal plasmas (ionized PVD or IPVD) is widely used to deposit conducting diffusion barriers and liners such as Ta and TaN for use in ultra-large-scale integrated (ULSI) interconnect stacks. Ionized PVD films exhibit the low resistivity, high density, and good adhesion to underlying dielectric desired for this application. On the other hand, extending PVD beyond the 45 nm technology node is problematic since IPVD may not provide sufficient step coverage to reliably coat features having high aspect ratio and sub-100 nm dimensions. Alternatively, chemical vapor deposition (CVD) and atomic layer deposition (ALD) can be used to deposit highly conformal metal films, but the electrical performance and interfacial quality may not equal that of PVD. To address future ULSI barrier∕liner deposition needs, a method providing PVD-like film quality and CVD-like step coverage would be highly attractive. We have recently reported a hybrid approach to film deposition, referred to as chemically enhanced physical vapor deposition (CEPVD), in which a chemical precursor is introduced at the substrate during IPVD to provide a CVD component to the overall deposition process. The isotropic precursor flux is intended to provide film deposition on surfaces that are not impacted by the directional ions, such as the lower sidewall of a narrow via or trench. Conversely, the kinetic energy delivered to the surface by the flux of ionized metal may serve to enhance the desorption of CVD byproducts, reduce incorporation of impurities, and increase film density. In order to investigate the potential of CEPVD to deposit barrier∕liner films, we have focused on the Ta-N material system since Ta∕TaN is widely used as a diffusion barrier in Cu damascene processing. IPVD TaN films were deposited by reactive sputtering of a Ta target in Ar∕N2 using a planar magnetron and internal rf coils to provide a secondary ionization plasma for the sputtered neutrals. CEPVD was carried out by introducing a Ta-containing, organometallic precursor [tert-butylimino tris(diethylamino) tantalum] in the vicinity of the substrate surface during IPVD. Film thickness and step coverage were determined by cross-sectional scanning electron microscopy (SEM). Film composition, chemical state, and crystal structure were characterized using Auger electron spectroscopy, x-ray photoelectron spectroscopy, and x-ray diffraction, respectively. Resistivity was measured by four-point probe. Cross-sectional SEM showed improved step coverage over IPVD TaN. CEPVD film properties were highly process dependent; however, unlike IPVD TaNx films that vary in stoichiometry but not purity, CEPVD “TaN” films contained relatively large amounts of carbon (∼30%–60%) and could best be described as TaCxNy. Resistivity as low as ∼370μΩcm was obtained for planar films of approximately 90 nm in thickness.
Mechanism of Cu oxidation in ashing process
Authors: Kojima Akihiro , Sakai Takayuki , Ohiwa Tokuhisa
Published: December 2004

Because Cu is easily oxidized and its oxidation reaction proceeds without stopping, the oxygen ashing process causes unacceptable oxidation of the Cu surface. We investigated the chemical state and morphology of the Cu surface after the oxygen ashing process using x-ray photoelectron spectroscopy∕Auger electron spectroscopy and scanning electron microscopy, and then considered the oxidation mechanism of the Cu surface under the oxygen downstream and the oxygen reactive ion etch (RIE) ashing processes in the substrate temperature range of 35 °C to 260 °C. The Cu surface treated by an oxygen RIE ashing process at temperatures below 150 °C was found to have chiefly CuO bonds, whereas the Cu surface treated by the oxygen downstream ashing process consisted mostly of Cu2O bonds. The oxidized Cu thickness after the oxygen downstream process was thicker than that formed by the oxygen RIE ashing process. The Cu surface treated with the oxygen RIE ashing process at under 150 °C is less prone to oxidization because the Cu surface with CuO formation has a smooth surface that suppresses further oxidation.
Characterization of extreme ultraviolet masks by extreme ultraviolet scatterometry
Authors: Perlich J. , Kamm F.-M. , Rau J. , Scholze F. , Ulm G.
Published: December 2004

The applicability of scatterometry for mask critical dimension (CD) metrology at extreme ultraviolet (EUV) wavelengths is investigated. Two different mask absorber stacks, a Cr∕SiO2 mask and a TaN∕Cr mask are patterned with periodic lines and spaces pattern and measured at EUV wavelengths in the range of λ=13.35–13.57nm. All measurements are performed by the Physikalisch-Technische-Bundesanstalt at the BESSY II storage ring. The intensity of the diffracted light is measured as a function of diffraction angle 2Θ∕2 in the range between −0.5° and 10°. The measured results are compared to simulations in the Fourier domain, using the difference method. For the Cr∕SiO2 mask, the comparison between measured and simulated results shows good agreement for nominally 800nm lines with 400nm spaces (mask level). No arbitrary scaling has to be applied for the simulated intensity of the diffraction signal. A best-fit CD value of 742nm at an absorber and buffer sidewall angle of 80° is obtained. This result is in excellent agreement with mechanical measurements using a surface nanoprofiler. Compared to a scanning electron microscope measurement, an offset of 16nm is observed. For the TaN∕Cr mask, this offset is found to be only 9nm, which can be attributed to the smaller stack thickness.