Timed Up-and-Go Dual-Task Testing in the Assessment of Cognitive Function: A Mixed Methods Observational Study for Development of the UDDGait Protocol.

New methods to screen for and identify early-stage dementia disorders are highly sought after. The purpose of this pilot study is to develop a study protocol for a dual-task test aimed at aiding the early detection of dementia disorders. We used the Timed Up-and-Go (TUG) test, which is a mobility task involving starting in a sitting position, standing up, walking three meters to cross a line on the floor, turning around, walking back and sitting down again. We combined TUG with the verbal task of naming different animals. Pilot study participants were 43 individuals with and without established dementia diagnoses who attended a clinic for memory assessment. Video-recorded test performances were systematically analysed. Deviant test performances concerning the interplay between test administration and participants' responses to the assessment instructions were revealed and led to refinements being made to the final study protocol. Exploration of the dual-task test outcome measures in a sub-sample of 22 persons, ten with and twelve without dementia, indicated that step-length and number of named animals after the turning point of the dual-task test might constitute appropriate measures for examining this kind of sample. We concluded that the refined study protocol is feasible for testing individuals undergoing initial memory assessments and healthy controls. Follow-up studies with larger samples are being carried out and will bring new knowledge to this area of research. It may also provide an opportunity for further studies exploring possibilities for broad clinical implementation.

How effective is good domestic kitchen hygiene at reducing diarrhoeal disease in developed countries? A systematic review and reanalysis of the UK IID study.

BACKGROUND: To assess whether domestic kitchen hygiene is an important contributor to the development of diarrhoea in the developed world. METHODS: Electronic searches were carried out in October 2006 in EMBASE, MEDLINE, Web of Knowledge, Cochrane central register of clinical trials and CINAHL. All publications, irrespective of study design, assessing food hygiene practices with an outcome measure of diarrhoea were included in the review. All included studies underwent data extraction and the data was subsequently analysed. The analysis was conducted by qualitative synthesis of the results. Given the substantial heterogeneity in study design and outcome measures meta-analysis was not done. In addition the existing dataset of the UK IID study was reanalysed to investigate possible associations between self-reported diarrhoea and variables indicative of poor domestic kitchen hygiene RESULTS: Some 14 studies were finally included in subsequent analyses. Of the 14 studies included in this systematic review, 11 were case-control studies, 2 cross-sectional surveys, and 1 RCT. Very few studies identified any significant association with good environmental kitchen hygiene. Although some of the variables in the reanalysis of the UK IID study were statistically significant no obvious trend was seen. CONCLUSION: The balance of the available evidence does not support the hypothesis that poor domestic kitchen hygiene practices are important risk factors for diarrhoeal disease in developed countries.

Measurement of iron and zinc isotopes in human whole blood: preliminary application to the study of HFE genotypes.

Multi-collector inductively coupled plasma--sector field mass spectrometry was applied to the measurement of Fe and Zn isotopes in human whole blood samples. For the Fe present in the blood of healthy adults, enrichment of the lighter isotopes relative to a standard material was observed, in agreement with earlier studies. The level of fractionation was found to be lower in hemochromatosis patients exhibiting homozygous (C282Y/C282Y) mutation of the HFE gene. On the one hand, this reinforces the hypothesis that Fe fractionation in blood decreases with enhanced dietary absorption. On the other hand, this contradicts predictions made on the basis of determinations of Fe fractionation in blood samples collected from subjects characterized by milder HFE mutations. In healthy subjects, the Zn in blood is depleted in lighter isotopes, consistent with the limited number of prior observations. As for Fe, the Zn isotopic composition exhibited a tendency toward lower levels of fractionation in the blood of subjects with hereditary hemochromatosis with homozygous mutation (C282Y/C282Y) of the HFE gene. The results therefore suggest that both Fe and Zn isotopic signatures in whole blood, at least to some extent, reflect polymorphisms in the HFE gene.

Determination of low-abundance elements at ultra-trace levels in urine and serum by inductively coupled plasma-sector field mass spectrometry.

A procedure is described for the determination of Y, Zr, Nb, Ru, Rh, Pd, Ag, Sb, Te, Hf, Ta, W, Re, Os, Ir, Pt, Au, Tl, Bi, and U in human urine and serum at concentrations relevant to the occupationally unexposed population. Sample preparation was limited to tenfold dilution with 2% HCl. A combination of a sample-introduction system designed to provide enhanced sensitivity and the use of water and acids of high-purity has resulted in limits of quantification (LOQ) in the sub-nanogram per liter range for 13 analytes. Instrumental background caused by release of analytes (Y, Zr, Ag, Sb, Au, Tl, Bi, U) from different parts of the sample-introduction system was found to be the major limitation in obtaining even better LOQ. Nevertheless, detection capabilities of the proposed procedure were adequate for all elements except Ru, Pd, and Rh. Despite of the use of high-resolution mode for these analytes some unresolved spectral interferences might still be present. For 13 elements an external accuracy assessment was accomplished by participation in proficiency testing and inter-comparison programs. Results obtained for pooled urine and serum were compared with concentrations reported for occupationally unexposed populations in recent publications.

Isotopic variations of Zn in biological materials.

Variations in the isotopic composition of Zn present in various biological materials were determined using high-resolution multicollector inductively coupled plasma mass spectrometry (MC-ICPMS), following digestion and purification by anion exchange chromatography. To correct for differences in instrumental mass discrimination effects between samples and standards, Cu was employed as an elemental spike. Complementary analyses of Zn separates by sector field ICPMS instruments revealed that the concentrations of the majority of potentially interfering elements were reduced to negligible levels. Residual spectral interferences resulting from (35)Cl(16)O(2)(+), (40)Ar(14)N(2)(+), and (40)Ar(14)N(16)O(+) could be instrumentally resolved from the (67)Zn, (68)Zn, and (70)Zn ion beams, respectively, during measurement by MC-ICPMS. The only other observed interference in the Cu and Zn mass range that could not be effectively eliminated by high-resolution multicollection resulted from (35)Cl(2)(+), necessitating modification of the sample preparation procedure to allow accurate (70)Zn detection. Complete duplication of the entire analytical procedure for human whole blood and hair, as well as bovine liver and muscle, provided an external reproducibility of 0.05-0.12 per thousand (2sigma) for measured delta(66/64)Zn, delta(67/64)Zn, and delta(68/64)Zn values, demonstrating the utility of the method for the precise isotopic analysis of Zn in biological materials. Relative to the selected Zn isotopic standard, delta(66/64)Zn values for biological samples varied from -0.60 per thousand in human hair to +0.56 per thousand in human whole blood, identifying the former material as the isotopically lightest Zn source found in nature to date.

Isotopic fractionation during diffusion of transition metal ions in solution.

Isotope ratios and elemental concentrations were measured in aqueous solutions sampled at varying distances from sources of Fe or Zn ions. The measurements reveal fractionation of isotopes resulting from pure diffusion in solution. Our data demonstrate that diffusion alone can cause changes in (56)Fe/(54)Fe and (66)Zn/(64)Zn isotope ratios in excess of -0.3 per thousand. These findings thus confirm previous suspicions that transport processes contribute to observed variations in isotopic compositions. Diffusion must therefore be considered when attempting to make inferences from isotope measurements on samples originating from aqueous systems where concentration gradients may develop.