Dr. Rodney P Guttmann

Most individuals living with Alzheimer's disease and related dementias (ADRD) experience one or more neuropsychiatric symptoms, such as agitation which negatively impacts their quality of life. Adapted dance integrates recorded music and movement that is appropriate for people with cognitive limitations. Adapted dance may be an enjoyable activity for persons living with ADRD and may provide psychological and physical benefits.
The purpose of this pilot study was to assess the feasibility of an adapted dance intervention with persons with ADRD and the impacts of 12 weeks of adapted dancing on agitation, balance, gait, lower extremity strength, and caregiver burden.
This study used an experimental design with repeated measures. Participants with ADRD were randomly assigned to a usual care or adapted line dance group that met 60 min twice a week. At pre-test, 4-, 8-, and 12 weeks of intervention, measures were collected for agitation, balance, gait, lower extremity strength, and caregiver burden.
The sample consisted of 4 males and 12 females (n = 16) with ADRD whose age ranged from 69-97 years. Twelve weeks of adapted line dance was found acceptable by ADRD participants. Participants attended ≥90% of dance sessions and did not experience loss of balance or fall. ADRD participants danced an average of 70 min per week. Both groups had improvements in agitation from baseline to 12 weeks.
Twelve weeks of adapted dance was shown to be feasible and enjoyable for persons living with ADRD. Clinicians should consider adapted dance as part of an exercise prescription.

IntroductionMetabolic disorder promotes premature senescence and poses more severe cardiac dysfunction in females than males. Although endurance exercise (EXE) has been known to confer cardioprotection against metabolic diseases, whether EXE-induced cardioprotection is associated with mitigating senescence in females remains unknown. Thus, the aim of the present study was to examine metabolic disorder-induced cardiac anomalies (cellular senescence, metabolic signaling, and autophagy) using a mouse model of obese/type 2 diabetes induced by a high-fat/high-fructose (HFD/HF) diet.MethodsFemale C57BL/6 mice (10 wk old) were assigned to three groups (n = 11/group): normal diet group (CON), HFD/HF group, and HFD/HF diet + endurance exercise (HFD/HF + EXE) group. Upon confirmation of hyperglycemia and overweight after 12 wk of HFD/HF diet, mice assigned to HFD/HF + EXE group started treadmill running exercise (60 min center dot d(-1), 5 d center dot wk(-1) for 12 wk), with HFD/HF diet continued.ResultsEXE ameliorated HFD/HF-induced body weight gain and hyperglycemia, improved insulin signaling and glucose transporter 4 (GLUT4) levels, and counteracted cardiac disruption. EXE reversed HFD/HF-induced myocyte premature senescence (e.g., prevention of p53, p21, p16, and lipofuscin accumulation), resulting in suppression of a senescence-associated secretory phenotype such as inflammation (tumor necrosis factor alpha and interleukin-1 beta) and oxidative stress (protein carbonylation). Moreover, EXE restored HFD/HF-induced autophagy flux deficiency, evidenced by increased LC3-II concomitant with p62 reduction and restoration of lysosome function-related proteins (LAMP2, CATHEPSIN L, TFEB, and SIRT1). More importantly, EXE retrieved HFD/HF-induced apoptosis arrest (e.g., increased cleaved CASPASE3, PARP, and TUNEL-positive cells).ConclusionsOur study demonstrated that EXE-induced antisenescence phenotypes, autophagy restoration, and promotion of propitiatory cell removal by apoptosis play a crucial role in cardiac protection against metabolic distress-induced cardiac disruption.

•Spatial clusters of suicides are identified.•Space-time clusters of suicides are identified.•Poisson regression tests and identifies covariates associated with suicides.•Bivariate spatial clusters of deaths by suicide and by opioids are identified.
The present study investigates the spatiotemporal variations in suicide mortality and tests associations between several covariates and suicides for the years 20002019 in the contiguous USA. The epidemiological disease surveillance software was used to identify spatiotemporal variations in suicide mortality rates and to test for significant spatial and space-time clusters with elevated relative suicide risk.
The analysis was done with age-adjusted suicide mortality counts data from the Centers for Disease Control (CDC) with International Classification of Diseases (ICD)-10 codes. Specifically, data with codes ICD-10 codes X60-X84.9 and Y87.0, plus ICD-10 113 codes from the CDC, was used. Fourteen significant spatial clusters and five significant space-time clusters of suicide in the contiguous USA were found, including nine significant bivariate spatial clusters of suicide deaths and opioid deaths.
Based on these data, there exist significant and non-random suicide mortality clusters after adjusting for multiple covariates or risk factors. The covariates studied provide evidence to develop a better understanding of possible associations in geographical areas where the suicide mortality rates are higher than expected. In addition, there is a significant association between several of the studied risk factors and suicide mortality. While most suicide clusters are also opioid clusters, there exist some clusters with high opioid deaths that are not suicide clusters.
These results have the potential to provide a scientific framework that is based on surveillance, allowing health agencies to intervene and reduce elevated rates of suicides in selected counties in the U.S. The study is limited due to the resolution of the data at the county level, and some covariate data was unavailable for the entire period of the study.
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The calcium-binding protein apoaequorin has been studied for its possible indication to improve human cognition and memory. Faculty at Quincy Bioscience developed Prevagen with this in mind, claiming its apoaequorin-formulated supplement may decrease age-related memory loss. A summary of the pathway orally administrated apoaequorin would take in order to penetrate the central nervous system (CNS), with particular focus on digestive elements and blood-brain barrier (BBB) permeability is presented. A discussion of the ethicality of the research and marketing practices of Quincy Bioscience in the commercial sale of Prevagen is given as well.

Objective: Investigate geographical variations in brain/central nervous system (CNS) cancer incidence and mortality, and test associations between covariates and brain/CNS cancer for the years 2000–2014 in the contiguous USA.
Methods: The disease surveillance software (SaTScanTM) was used to measure observable geographical variation in brain/CNS cancer incidence and mortality rates and identify and test spatial and space-time clusters with elevated relative risk. The analysis was done with age-adjusted brain/CNS cancer mortality and incidence counts data, including ICD codes C710–C719, C379, C740–C749, and C750–C759. The cancer data were then adjusted for covariates or risk factors, such as obesity, smoking, poverty, race, arsenic, air pollution, land pollution, water pollution, gender, health insurance, diabetes, glyphosate, superfund site density, and proximity to nuclear power plants.
Results: Several significant spatial clusters of brain/CNS cancer exist for incidence in the Northeast and the Northwest, while spatial mortality clusters cover additional parts of the US. There also exist several significant space-time clusters for incidence and mortality.
Conclusions: There exist significant and non-random brain/CNS cancer incidence and mortality clusters after adjusting for multiple covariates or risk factors. The thirteen covariates studied can assist in a better understanding of possible associations in geographical areas where the incidence or mortality rates are higher than expected. There is a significant association between several of the studied risk factors and the incidence rates of brain/CNS cancers, and the mortality rates. These results have the potential to provide a scientific framework
that is based on surveillance, allowing health agencies to intervene to try to reduce the elevated rates of brain/CNS cancer in some parts of the contiguous US.

This study’s main goal was to develop a comprehensive Quality of Life (QoL) Index based on 31 demographic variables for the 3108 counties in the contiguous USA. Counties were ranked worst in QoL to best, and spatial cluster analysis is used to identify counties with significant low/high QoL clusters. GIS-based mapping was used to create informative heat maps with significant clusters shown. The rate of African Americans, diversity in a race within counties, and upward mobility were studied in a regression analysis in which QoL was predicted from these three covariates. The QoL Index was adjusted for the covariates, and a new spatial heat map with clusters is obtained. It was concluded that as the rate of African Americans increases in a county, the QoL decreases, while the QoL increases when diversity or upward mobility increases.

Bladder cancer is a significant health issue across the United States of America (USA). Evidence of unequal distribution of a disease or condition's incidence and mortality would suggest that important geographically-defined variables may play a role. In this study, a spatial cluster analysis of bladder cancer mortality identified significant hot spots in some parts of the USA. Regression analysis modelling estimated the effects of selected covariates or risk factors for bladder cancer mortality and also incidence. Spatial heat maps and cluster identification were done for mortality and incidence. The main result was the significant association between bladder cancer mortal-ity and arsenic intake from well water. A similar result was also obtained for cancer incidence and arsenic. Additionally, there are certain geographic areas that appear to have bladder cancer mortality rates beyond the simple association with the studied covariates. These geographic areas warrant further investigation to better under-stand why cancer mortality is unusually high in such geographic areas and to potentially identify additional local concerns or needs to further address bladder cancer mortality in those specific sites.

Vancomycin is a key antibiotic used in the treatment of multiple conditions including infections associated with cystic fibrosis and methicillin-resistant Staphylococcus aureus. The present study sought to develop a model based on empirical evidence of optimal vancomycin dose as judged by clinical observations that could accelerate the achievement of desired trough level in children with cystic fibrosis. Transformations of dose and trough were used to arrive at regression models with excellent fit for dose based on weight or age for a target trough. Results of this study indicate that the 2 proposed regression models are robust to changes in age or weight, suggesting that the daily dose on a per-kilogram basis is determined primarily by the desired trough level. The results show that to obtain a vancomycin trough level of 20 μg/mL, a dose of 80 mg/kg/day is needed. This analysis should improve the efficiency of vancomycin usage by reducing the number of titration steps, resulting in improved patient outcome and experience.

Importance: The results identified geographic clusters of high and low Alzheimer's disease (AD)-related mortality across the contiguous United States. These clusters identify specific geographic groupings of counties that allow researchers to narrow the focus to identify some of the biopsychosocial variables contributing to increased or decreased AD mortality.

Objectives: To determine the extent to which geographic clusters exist where AD mortality significantly differs from the national average. Such knowledge could further future research in a more focused study of variables that are contributing to these differences.

Design: Age adjusted AD mortality rates were analyzed with a spatial cluster analysis using the disease surveillance software SatScanTM.

Results: Three large clusters had elevated age-adjusted AD mortality of at least 60% above the national average. These clusters were in Washington State, Iowa, and North and South Dakota. Below average AD mortality was observed in several areas including New York City, and parts of Arizona, California, Arkansas and Texas. Conclusion and Relevance: This study demonstrates the use of disease surveillance methodology in identifying geographic patterns of unusually high or low AD mortality rates in the USA. Such results provide supporting evidence of appropriate locations to test interventions with the goal to reduce AD mortality.

Shared decision making places an emphasis on patient understanding and engagement. However, when it comes to treatment selection, research tends to focus on how doctors select pharmaceutical treatments. The current study is a qualitative assessment of how patients choose among three common treatments that have varying degrees of scientific support and side effects. We used qualitative data from 157 undergraduates (44 males, 113 females; mean age = 21.89 years) that was collected as part of a larger correlational study of depression and critical thinking skills. Qualitative analysis revealed three major themes: shared versus independent decision making, confidence in the research and the drug, and cost and availability. Some participants preferred to rely on informal networks such as consumer testimonials while others expressed a false sense of security for over-the-counter treatments because they believe the drugs are regulated. Many indicated that they avoid seeking mental health services because of the time and money needed. The results indicate several factors influence selection of common depression treatments. Young adults indicate that when reading prescription information, they most often rely on perceptions including ease of access, price, and beliefs about drug regulations. General guidelines for treatment descriptions were created based on the qualitative analysis.