Care for older adults with dementia: PACE day care or residential dementia care units?

BACKGROUND

Persons with dementia (PwD) are at greater risk for various adverse health outcomes, and the best care model remains to be determined. This study aimed to compare the physical and neurocognitive performance of PwD in the Program of All-inclusive Care for the Elderly (PACE) and residential dementia care units.

METHODS

This was a case-control study comparing outcomes between care recipients of PACE services (PC group) and residential dementia care (RC group). Demographic characteristics, underlying diseases, physical function, cognitive function, mood status, and behavioral and psychotic symptoms of dementia (BPSDs) were assessed every 3-6 months in both groups, while frailty status and Timed Up-and-Go Test (TUGT) performance were assessed every 6 months in the PC group only.

RESULTS

Overall, 96 participants (PC group: 25, RC group: 71; mean age: 86.4 ± 6.8 years) were enrolled with the median follow-up period of 43.6 weeks. Lower incidence of hospital admissions was noted in the PC group (0.52 ± 1.12 vs 1.38 ± 2.49 admissions/1,000 person-days, p=0.023), even though the PC group had higher multimorbidity and more severe BPSDs. During the study period, the PC group showed a significant improvement in body mass index, less physical dependence, better cognitive performance and reduced depressive mood. In addition, the PC group showed improvement in frailty, leisure hour activities, and TUGT results. However, participants in the PC group were more likely to experience BPSD deterioration (β coeff.: 0.193, 95% CI: 0.121- 0.265).

CONCLUSION

The PACE services significantly reduced unexpected hospital admissions of PwD, facilitated the maintenance of physical independence, and improved cognitive performance and mood status. Further randomized controlled studies are needed to determine the most appropriate care model for PwD.

Silica SBA-15 template assisted synthesis of ultrasmall and homogeneously sized copper nanoparticles

The synthesis of spherical copper nanoparticles with extremely narrow size distribution by electroless copper deposition on mesoporous silica support is described. The materials were characterized by nitrogen sorption, transmission electron microscopy, x-ray diffractometry and Fourier transform infrared spectroscopy. The copper nanoparticles have a cubic crystalline structure and an average particle size of 5.5 +/- 0.8 nm. The copper nanoparticles are stable, without detectable oxidation or further agglomeration under ambient conditions even after months. These results demonstrate that electroless copper reduction can be conducted and constrained within the mesoporous silica framework, which pave the way for engineered mesoreactors.

Capsaicin may induce breast cancer cell death through apoptosis-inducing factor involving mitochondrial dysfunction

The majority of breast cancer patients are resistant to chemotherapy or radiotherapy due to the down-regulation or lack of caspase-3 expression. Capsaicin was found to inhibit cancer cell growth in caspase-3-deficient human breast cancer cells. This study aimed to investigate the growth-inhibitive effect of capsaicin and its mechanisms in human breast cancer cell lines, MCF-7 and BT-20. The results showed that cell viability decreased in a dose-dependent manner in both the caspase-3-deficient and non-deficient cells through inducing cell apoptosis and arresting the cell cycle in the S phase. Capsaicin significantly decreased mitochondria membrane potential, induced the cleavage of PARP-1, and decreased procaspase-7 expression in both cells. Apoptosis-inducing factor (AIF) was distinctly released from mitochondria and translocated into the cytoplasm and nucleus in MCF-7 cells (52.9%), but not in BT-20 cells (2%) after treatment with 200 μM of capsaicin for 24 hours. Capsaicin inhibited breast cancer cell growth through inducing cell apoptosis and cell cycle arrest in the S phase. This apoptotic effect could be induced through the mitochondrial pathway, and PARP-1 subsequently cleaved by activation of caspase-7. The application of capsaicin in clinical therapy could be useful for breast cancer patients.

Identification of a Potyvirus Causing Latent Infection in Calla Lilies

A new potyvirus designated as Calla lily latent virus (CLLV) was isolated from apparently healthy calla lilies (Zantedeschia spp.) collected from nurseries in Taichung County, Taiwan. Different from most calla lily-infecting potyviruses, CLLV infects Chenopodium quinoa and develops local lesions on inoculated leaves (3). Typical potyvirus particles approximately 780 nm long were detected from CLLV-induced C. quinoa local lesions. CLLV was transmitted readily to and established in C. quinoa. Attempts to establish CLLV infection in calla lilies from extracts of C. quinoa lesions were not successful. The virus was transmitted from infected to healthy calla lilies with difficulty. A 1.3-kb cDNA product was amplified by reverse transcription-polymerase chain reaction (RT-PCR) from CLLV-infected calla lilies and C. quinoa using potyvirus degenerate primers (2). The PCR product was cloned and sequenced. It was found to consist of 1,339 nucleotides (nt) (GenBank Accession No. AF469171) corresponding to the genome organization of the 3'terminal region of potyviruses. The deduced amino acid sequence contains 362 residues encoding the 3'terminal region of the nuclear inclusion b gene (80 residues) and the complete coat protein (CP) gene (282 residues). A 253-nt noncoding region (NCR) was found at the 3'terminal region of the cDNA. By comparing with known sequences of potyviruses, CLLV was identified as a new species of Potyvirus based on the uniqueness in the CP gene and 3' NCR. Soybean mosaic virus and Watermelon mosaic virus 2 are the potyviruses most similar to CLLV, but they share only approximately 80% nucleotide identity with CLLV in the CP and NCR regions. Attempts to purify sufficient CLLV from C. quinoa for antiserum preparation were not successful. Alternatively, polyclonal antibodies were produced using E. coli-expressed CLLV CP (1). The antibodies were useful for detection of CLLV and its CP in calla lilies using enzyme-linked immunosorbent assay, sodium dodecyl sulfate-immunodiffusion, immuno-specific electron microscopy, and western blot. Field surveys showed that calla lily plants found positive for CLLV by serological methods always remained symptomless throughout the six-month growing season. Occasionally, CLLV was detected in symptomatic calla lilies, but these plants were consistently confirmed dually infected by other viruses (Dasheen mosaic virus and Konjak mosaic virus found most commonly). Infection of CLLV alone in calla lilies may not have a direct impact on the production and marketing of the crop. Synergism is not currently known when calla lilies are coinfected with other viruses. CLLV is spread by vegetative propagation through infected rhizomes or tubers. References: (1) C. C. Chen et al. Plant Dis. 87:901-905, 2003. (2) S. S. Pappu et al. Plant Dis. 82:1121-1125, 1998. (3) F. W. Zettler and R. D. Hartman. Pages 464-470 in: Virus and Virus-like Diseases of Bulb and Flower Crops. G. Loebenstein et al., eds. John Wiley and Sons Inc., UK, 1995.

Identification of Turnip mosaic virus Isolates Causing Yellow Stripe and Spot on Calla Lily

Two virus cultures, RC4 and YC5, were isolated in Taiwan from calla lily (Zantedeschia spp.) cv. Black magic displaying yellow spot and stripe on leaves. Both isolates were mechanically transmitted to various hybrids of Zantedeschia and induced systemic symptoms similar to those observed on diseased Black magic. In addition to Zantedeschia spp., the two virus isolates also infected several cruciferous species and induced mosaic symptoms. Electron microscopy revealed the presence of flexuous virus particles about 750 nm in length. The two isolates were propagated in and purified from mustard plants and were used as immunogens for production of antisera in rabbits. In enzyme-linked immunosorbent assay and sodium dodecyl sulfate-immunodiffusion tests, both antisera reacted strongly with their homologous antigens and with antigens of two Turnip mosaic virus (TuMV) isolates from radish (TuMV-R) and lisianthus (TuMV-L), but not with 21 other different potyviruses tested. In reciprocal tests, antisera against TuMV-R and TuMV-L also reacted strongly with RC4 and YC5 antigens, indicating that these two calla lily isolates are serologically indistinguishable from other known TuMV strains. Cloning and sequence analyses confirmed that both isolates shared 95 to 99% of deduced amino acid sequence identities in the coat protein genes with those of various known TuMV strains. This investigation represents the first record of the natural infection of TuMV in calla lily.

Pollution by PCDDS and PCDFS in sediment from freshwater fish culture ponds near incineration sites for metal reclamation in Wan-Li, Taiwan, Republic of China

Sediment samples from nine culture ponds for freshwater fish at and near waste incineration sites for metal reclamation in Wan-Li, southern Taiwan, Republic of China were analyzed for PCDDs and PCDFs by HRGC-HRMS. Four of nine samples were heavily polluted by PCDDs and PCDFs, indicating the latter to be dominant. The total TEQ concentrations of PCDDs and PCDFs in the four samples were in the range of 257 to 12200 pg/g dry weight. In addition, the levels corresponded to those of surface soil samples from the same waste combustion areas.