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Simultaneous performance of motor and cognitive tasks may compete for common brain network resources in aging or patients with some neurological diseases, suggesting the occurrence of a cognitive-motor interference. While this phenomenon has been well described for multiple sclerosis (MS) patients, it never has been tested on asymptomatic subject with magnetic resonance imaging (MRI) findings suggestive of demyelinating disease (i.e., radiologically isolated syndrome: RIS). In this pilot study, 10 RIS subjects and 10 sex/age-matched healthy controls were tested by means of static posturography under eyes opened (single-task trial) and while performing two different cognitive tasks (semantic modified word list generation for first dual-task trial and phonemic semantic modified word list generation for second dual-task trial), to estimate the dual-task cost (DTC) of standing balance. In our sample, under cognitive interference (without any substantial differences between semantic and phonemic modified word list generation), the RIS group showed significance differences in CoP (center of pressure) total sway area, ellipse eccentricity, CoP sway path length, CoP median sway velocity along the AP (anteroposterior) axis and along the ML (mediolateral) axis, reflecting a higher negative DTC respect to healthy subjects (which have simply shown a statistical trend, failing to reach a significance, in some trials). The phenomenon of cognitive-motor interference might be unmasked by a dual-task posturography in RIS subjects, too. We hypothesize that this approach could be useful to early reveal the presence of a demyelinating disease and to reach a MS diagnosis in subjects otherwise classified as RIS. [ABSTRACT FROM AUTHOR]

Background: Understanding the factors that contribute to diagnostic errors is critical if we are to correct or prevent them. Some scholars influenced by the default interventionist dual‐process theory of cognition (dual‐process theory) emphasise a narrow focus on individual clinician's faulty reasoning as a significant contributor. In this paper, we examine the validity of claims that dual process theory is a key to error reduction. Methods: We examined the relationship between a clinical experience (staff and resident physicians) and viewing time on accuracy for categorising chest X‐rays (CXRs) and electrocardiograms (ECGs). In two studies, participants categorised images as normal or abnormal, presented at viewing times of 175, 250, 500 and 1000 ms, to encourage System 1 processing. Study 2 extended viewing times to 1, 5, 10 and 20 s to allow time for System 2 processing and a diagnosis. Descriptives and repeated measures analysis of variance were used to analyse the proportion of true and false positive rates (TP and FP) as well as correct diagnoses. Results: In Study 1, physicians were able to detect abnormal CXRs (0.78) and ECGs (0.67) with relatively high accuracy. The effect of experience was found for ECGs only, as staff physicians (0.71, 95% CI = 0.66–0.75) had higher ECG TP than resident physicians (0.63, 95% CI = 0.58–0.68) in Study 1, and staff had lower ECG FP (0.10, 95% CI = 0.03–0.18) than resident physicians (0.27, 95% CI = 0.20–0.33) in Study 2. In other comparisons, experience was equivocal for ECG FPs and CXR TPs and FPs. In Study 2, overall diagnostic accuracy was similar for both ECGs and CXRs, (0.74). There were small interactions between experience and time for TP in ECGs and FP in CXRs, which are discussed further in the discussion and offer insights into the relationship between processing and experience. Conclusion: Overall, our findings raise concerns about the practical application of models that link processing type to diagnostic error, or to specific diagnostic error reduction strategies. Recommendations to employ self‐directed strategies to slow down, take a diagnostic time out, or reflect, are reported as not being reliable means for reducing diagnostic error; in fact, these strategies may increase error. [ABSTRACT FROM AUTHOR]

Building effective communication and interdepartmental partnerships are essential components of strengthening services, policies, and procedures to meet the individual information needs of students, faculty, and the college community. Despite major advancements in library services for users with disabilities, there are ongoing challenges, which need to be addressed. It is essential to develop inclusion and accessibility frameworks that serve mutual departmental interests to share and document lessons learned along the way. This article explores the evolving shared leadership between an Architecture Librarian/Liaison to the AccessAbility Center; and the Director of Student Disability Services at the City College of New York to examine strategic methods of managing, enhancing, and integrating, universal inclusivity and diversity in library services. The Librarian Liaison must take an active role in matters of accessibility policies and practices to meet user needs with cultural sensitivity. Merging the individual experiences, both authors deliver tangible solutions in creating more accessible services and environments, including an assessment checklist to demonstrate whether the Libraries have barriers and/or accessible spaces. The collaborative observations and strategic methods may be applicable to similar academic institutions that are considering transformative outreach initiatives to aid underserved populations such as library users with various disabilities. [ABSTRACT FROM AUTHOR]

Objective: To compare healthcare utilisation outcomes among older hospitalised patients with and without cognitive impairment, and to compare the costs associated with these outcomes.Methods: Retrospective cohort study of administrative data from a large teaching hospital in Melbourne, Australia from 1 July 2006 to 30 June 2012. People with cognitive impairment were defined as having dementia or delirium coded during the admission. Outcome measures included length of stay, unplanned readmissions within 28 days and costs associated with these outcomes. Regression analysis was used to compare differences between those with and without cognitive impairment.Results: There were 93 300 hospital admissions included in the analysis. 6459 (6.9%) involved cognitively impaired patients. The adjusted median length of stay was significantly higher for the cognitively impaired group compared with the non-cognitively impaired group (7.4 days 6.7-10.0 vs 6.6 days, interquartile range 5.7-8.3; p < 0.001). There were no differences in odds of 28-day readmission. When only those discharged back to their usual residence were included in the analysis, the risk of 28-day readmission was significantly higher for those with cognitive impairment compared with those without. The cost of admissions involving patients with cognitive impairment was 51% higher than the cost of those without cognitive impairment.Conclusions: Hospitalised people with cognitive impairment experience significantly greater length of stay and when discharged to their usual residence are more likely to be readmitted to hospital within 28 days compared with those without cognitive impairment. The costs associated with hospital episodes and 28-day readmissions are significantly higher for those with cognitive impairment. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Disordered eating (DE) behaviors are associated with obesity and eating disorders. This study describes practices and attitudes of nursing students toward patients exhibiting DE and how personal DE behaviors affect practices and attitudes. Most respondents had a mental health rotation (74.7 percent) and DE education (68 percent); however, only 34.7 percent felt prepared to screen for DE, and only 44 percent were taught to screen. Those scoring high for DE behaviors (n = 7) indicated greater rates of feeling prepared to screen. This knowledge can help nurse educators design curricula to increase the preparation of nurses to address DE behaviors. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: After nerve injury, excessive calcium impedes nerve regeneration. We previously showed that calcitonin improved nerve regeneration in crush injury. We aimed to validate the direct effect of calcitonin on transected and repaired nerve. Methods: Two rat groups ( n = 8) underwent sciatic nerve transection followed by direct repair. In the calcitonin group, a calcitonin-filled mini-osmotic pump was implanted subcutaneously, with a catheter parallel to the repaired nerve. The control group underwent repair only, without a pump. Evaluation and comparison between the groups included: (1) compound muscle action potential recording of the extensor digitorum longus (EDL) muscle; (2) tetanic muscle force test of EDL; (3) nerve calcium concentration; and (4) nerve fiber count and calcified spot count. Results: The calcitonin pump group showed superior recovery. Conclusions: Calcitonin affects injured and repaired peripheral nerve directly. The calcitonin-filled mini-osmotic pump improved nerve functional recovery by accelerating calcium absorption from the repaired nerve. This finding has potential clinical applications. Muscle Nerve 51: 229-234, 2015 [ABSTRACT FROM AUTHOR]

Dementia is a common condition of the elderly characterised by multiple cognitive deficits resulting in a decline from previous level of function. In the older person, multiple pathologies contribute, including changes commonly seen in Alzheimer disease, dementia with Lewy bodies in addition to vascular changes. Comorbid factors, such as depression, delirium and polypharmacy can contribute to cognitive decline. Novel biomarkers and neuroimaging techniques may assist in the near future to improve accuracy of diagnosis. To date, pharmacological therapies have been largely unsuccessful and provide symptomatic relief only. The timely diagnosis of dementia can facilitate important discussions regarding personal and financial planning and introduce education and supports to the person with dementia and their carers. The person with dementia commonly experiences behavioural and psychological symptoms of dementia that may cause much distress, including to families and carers. Clinical guidelines indicate non-pharmacological approaches as first line measures, including attention to pain, nutrition and the environment. Dementia is recognised as a National Health Priority in Australia, and efforts to target risk factors as preventative measures to delay onset of dementia require further urgent consideration. [ABSTRACT FROM AUTHOR]

Four new genera ( Apomorphyto gen.n. from Costa Rica, Bixinia gen.n. from Australia, Rhinodonia gen.n. from New Caledonia, Rhinopeza gen.n. from Papua New Guinea) and nine new species ( Apomorphyto inbio sp.n., Bixinia collessi sp.n., B. solitaria sp.n., B. spei sp.n., B. variabilis sp.n., B. winkleri sp.n., Rhinodonia antiqua sp.n., R. flavicera sp.n., Rhinopeza gracilis sp.n.) of Rhinophoridae ( Diptera: Calyptratae, Oestroidea) are described. All new species were included in a morphology-based phylogenetic analysis to provide arguments for the justification and monophyly (when nonmonotypic) of the new genera and for including these in the Rhinophoridae. The New Caledonian Rhinodonia is a candidate sister taxon to all other rhinophorids, and the Australasian 'axiniine' species emerge inside a clade of all Neotropical taxa thus suggesting migration from South America across Antarctica into Australia. This published work has been registered in ZooBank, . [ABSTRACT FROM AUTHOR]

Objective: to undertake a systematic literature review of risk factors for abuse in community-dwelling elders, as a first step towards exploring the clinical utility of a risk factor framework.Search strategy and selection criteria: a search was undertaken using the MEDLINE, CINAHL, EMBASE and PsycINFO databases for articles published in English up to March 2011, to identify original studies with statistically significant risk factors for abuse in community-dwelling elders. Studies concerning self-neglect and persons aged under 55 were excluded.Results: forty-nine studies met the inclusion criteria, with 13 risk factors being reproducible across a range of settings in high-quality studies. These concerned the elder person (cognitive impairment, behavioural problems, psychiatric illness or psychological problems, functional dependency, poor physical health or frailty, low income or wealth, trauma or past abuse and ethnicity), perpetrator (caregiver burden or stress, and psychiatric illness or psychological problems), relationship (family disharmony, poor or conflictual relationships) and environment (low social support and living with others except for financial abuse).Conclusions: current evidence supports the multifactorial aetiology of elder abuse involving risk factors within the elder person, perpetrator, relationship and environment. [ABSTRACT FROM PUBLISHER]

Aims: To report on the prevalence of falls, urinary incontinence, pain and associated factors in remote living Indigenous Australians over the age of 45 years. Methods: A cross-sectional, semi-purposeful sample of 363 indigenous men and women aged over 45 years living in six remote communities and one town in Kimberley, Australia. Participants were assessed for self- or informant-reported rates of falls, urinary incontinence and pain. Results: The prevalence of self- or informant-reported falls was 31% (95% CI 25.3, 36.7), pain 55% (95% CI 47.4, 62.6) and urinary incontinence 9% (95% CI 5.9, 12.1%). Associations with falls after adjustment for age, sex and education included alcohol use (OR 2.4, 95% CI 1.4, 4.2), stroke (OR 2.4, 95% CI 1.1, 5.0), epilepsy (OR 3.5, 95% CI 1.1, 11.6), head injury (OR 2.1, 95% CI 1.3, 3.3) and poor hearing (OR 2.5, 95% CI 1.4, 4.1); for urinary incontinence epilepsy (OR 6.0, 95% CI 1.7, 21.2) and stroke (OR 16.7, 95% CI 6.0, 46.3); and for pain, poor hearing (OR 1.9, 95% CI 1.0, 3.3) and female sex (OR 1.8, 95% CI 1.2, 2.7). Conclusions: Falls, urinary incontinence and pain are common and reported for the first time in older indigenous people living in remote regions. The presence of these syndromes in ages over 45 may be due to accumulation of health insults during the life course. [ABSTRACT FROM AUTHOR]

Aged care health professionals in Australia are increasingly referred patients whose standard of cleanliness and self-care has deteriorated to levels resulting in public health concern. This paper describes three illustrative case studies of people referred to an Australian Aged Care Assessment Service who present with 'Diogenes Syndrome'. The diversity and complexity of these cases reflect variable underlying diagnoses. Symptoms of self-neglect, hoarding and domestic squalor and combinations thereof may provide a more useful classification system of the older person who presents in such circumstances than the frequently used term Diogenes syndrome. Practical guidelines are required for appropriate assessment and management of these conditions. [ABSTRACT FROM AUTHOR]

Ageism among health professionals is increasingly recognized, but few studies investigated hospital doctors' attitudes towards older people. The aims of this study were to investigate hospital doctors' attitudes towards older people and to determine whether factors, which were identified in studies on other health professionals, influence hospital doctors' attitudes. Hospital doctors who worked in General Medicine or Aged Care units in two tertiary public hospitals in metropolitan Victoria, Australia, in 2008 were surveyed with Fraboni's Scale of Ageism (FSA), a validated instrument used to investigate attitudes towards older people. Demographic data from participants were collected. Of the 235 questionnaires distributed, 122 were returned (overall response rate 51.9%). Response rate was highest among consultants (80.4%), followed by registrars (64.1%) and lowest among interns and residents (35.2%). The mean FSA score attained by the respondents was 61.5 (SD 11.0), representing a point between a neutral and a positive disposition. Doctors' characteristics that were associated with more positive attitudes towards older people included age of 30 years or older ( P < 0.001), female gender ( P= 0.003), more senior in position ( P < 0.001), postgraduate years of 10 or more ( P < 0.001), previous working experience in Aged Care ( P < 0.001), interest in Aged Care ( P < 0.001) and more frequent social contacts with healthy older people ( P < 0.001). Hospital doctors of different demographic features and background characteristics display different attitudes towards older people. These findings can be used to inform future development of undergraduate and postgraduate medical curricula and form a basis for future studies on the effectiveness of these interventions in improving doctors' attitudes. [ABSTRACT FROM AUTHOR]

Abstract: In retinal bipolar neurons, synaptic ribbons mark the presence of exocytotic active zones in the synaptic terminal. It is unknown, however, where compensatory vesicle retrieval is localized in this cell type and by what mechanism(s) excess membrane is recaptured. To determine whether endocytosis is localized or diffuse in mouse bipolar neurons, we imaged FM4-64 to track vesicles in cells whose synaptic ribbons were tagged with a fluorescent peptide. In synaptic terminals, vesicle retrieval occurred at discrete sites that were spatially consistent over multiple stimuli, indicative of endocytotic “hot spots.” Retrieval sites were spatially correlated with fluorescently labeled synaptic ribbons. Electron microscopy (EM) analysis of bipolar cell terminals after photoconversion of internalized FM dye revealed that almost all of the dye was contained within vesicles ∼30 nm in diameter. Clathrin-coated vesicles were observed budding from the plasma membrane and within the cytosol, and application of dynasore, a dynamin inhibitor, arrested membrane retrieval just after the budding stage. We conclude that synaptic vesicles in the fine branches of mouse bipolar axon terminals are retrieved locally near active zones, at least in part via a clathrin-mediated pathway. [Copyright &y& Elsevier]

Synaptic ribbons are organelles that tether vesicles at the presynaptic active zones of sensory neurons in the visual, auditory, and vestibular systems. These neurons generate sustained, graded electrical signals in response to sensory stimuli, and fidelity of transmission therefore requires their synapses to release neurotransmitter continuously at high rates. It has long been thought that the ribbons at the active zones of sensory synapses accomplish this task by enhancing the size and accessibility of the readily releasable pool of synaptic vesicles, which may represent the vesicles attached to the ribbon. Recent evidence suggests that synaptic ribbons immobilize vesicles in the resting cell and coordinate the transient, synchronous release of vesicles in response to stimulation, but it is not yet clear how the ribbon can efficiently mobilize and coordinate multiple vesicles for release. However, detailed anatomical, electrophysiological, and optical studies have begun to reveal the mechanics of release at ribbon synapses, and this multidisciplinary approach promises to reconcile structure, function, and mechanism at these important sensory synapses. [ABSTRACT FROM AUTHOR]

Ribbon synapses release neurotransmitter continuously at high rates, and the ribbons tether a large pool of synaptic vesicles. To determine whether the tethered vesicles are actually released, we tracked vesicles labeled with styryl dye in mouse retinal bipolar cell terminals whose ribbons had been labeled with a fluorescent peptide. We photobleached vesicles in regions with ribbons and without them and then followed recovery of fluorescence as bleached regions were repopulated by labeled vesicles. In the resting terminal, fluorescence recovered by ~50% in non-ribbon regions but by only ~20% at ribbons. Thus, at rest, vesicles associated with ribbons cannot exchange freely with cytoplasmic vesicles. Depolarization stimulated vesicle turnover at ribbons as bleached, immobile vesicles were released by exocytosis and were then replaced by fluorescent vesicles from the cytoplasm, producing an additional increase in fluorescence specifically at the ribbon location. We conclude that vesicles immobilized at synaptic ribbons participate in the readily releasable pool that is tapped rapidly during depolarization. [ABSTRACT FROM AUTHOR]

Unlike conventional synaptic terminals that release neurotransmitter episodically in response to action potentials, neurons of the visual, auditory and vestibular systems encode sensory information in graded signals that are transmitted at their synapses by modulating the rate of continuous release. The synaptic ribbon, a specialized structure found at the active zones of these neurons, is necessary to sustain the high rates of exocytosis required for continuous release. To maintain the fidelity of synaptic transmission, exocytosis must be balanced by high-capacity endocytosis, to retrieve excess membrane inserted during vesicle fusion. Capacitance measurements following vesicle release in ribbon-type neurons indicate two kinetically distinct phases of compensatory endocytosis, whose relative contributions vary with stimulus intensity. The two phases can be independently regulated and may reflect different underlying mechanisms operating on separate pools of recycling vesicles. Electron microscopy shows diversity among ribbon-type synapses in the relative importance of clathrin-mediated endocytosis versus bulk membrane retrieval as mechanisms of compensatory endocytosis. Ribbon synapses, like conventional synapses, make use of multiple endocytosis pathways to replenish synaptic vesicle pools, depending on the physiological needs of the particular cell type. [ABSTRACT FROM AUTHOR]

Background: The concept that the neurotoxicity of amyloid β protein could partly result from vascular effects that may be detected in peripheral microcirculation is new. Methods: We compared peripheral endothelial vascular responses of patients with early clinically confirmed Alzheimer's disease (AD) to that of people with normal cognition and those with other forms of dementia. Acetylcholine (ACh) was iontophoresed into the skin and the resultant vasodilator response was measured using laser Doppler flowmetery. Results: The ratio of ACh response to saline (ratio E/S) was determined. Mean ± SEM of ratios E/S were 8.8 ± 0.9 for controls (n=168), 1.4 ± 0.1 for AD patients (n=80) and 3.1 ± 0.5 for other dementia (n=84). Using the optimal cut-off point of E/S ratio of 1.9, an 80% diagnostic sensitivity and specificity for AD have been observed. When the control sample was filtered for those with cardiovascular diseases and with MMSE < 28, this improved the specificity to 90% (n=119). Furthermore, 15 subjects were randomly drawn from a longitudinal healthy ageing study. Five of those subjects met the criteria for mild cognitive impairment (MCI) after eight years of follow up using a battery of cognitive tests. When tested for their E/S ratio in a blind fashion, the skin test successfully identified those subjects. Conclusions: The results support our hypothesis that endothelial alterations can be detected early in the course of the disease. We suggest that this simple skin test could potentially be applied as diagnostic adjunct in patients with mild cognitive symptoms or those with early clinical evidence of AD. [ABSTRACT FROM AUTHOR]

Although it is recognized that many factors interact to cause extinctions, it is difficult to consider multiple factors when investigating species declines. I conducted a post hoc exploration of the major hypotheses for the decline of the Allegheny, woodrat (Neotoma magister), incorporated the historical environmental changes that accompanied and preceded the decline, and considered how these events may have affected the species. What emerges is a complicated picture involving multiple, relatively minor stressors, all attributable to human activities. The temporal pattern of the decline is most coherent when considered from a historical perspective. Among the factors that are likely to have affected Allegheny woodrats are two exotic tree pathogens, a native parasite, the proliferation of human-adapted competitors, and habitat fragmentation. In addition, changes in competitive and predatory regimes appear to have influenced the timing of the collapse. Although the historic record cannot give definitive answers, raking a synthetic, historical-ecological approach can enhance understanding of species declines. [ABSTRACT FROM AUTHOR]

Distinguishing the mechanisms responsible for the relationship between biodiversity and ecosystem services requires knowledge of (1) the functional roles played by individual species and (2) the sequence with which species are added to or lost from communities in nature (i.e., "community assembly" and "community disassembly," respectively). Rarely, if ever, are both these issues understood with certainty in any given ecosystem. We used an empirically based simulation model to assess the degree to which the sequence of species loss from vertebrate communities influences risk of human exposure to Lyme disease, as measured by the proportion of ticks infected with the etiological agent. Dramatic differences in the shapes of the curves relating vertebrate biodiversity to disease risk (which we consider an ecosystem service) were observed. Randomized sequences of species loss resulted in a decrease in disease risk with reduced biodiversity, a result that is contradicted by both empirical observations and model results from non-randomized sequences of species loss (i.e., specific "disassembly rules"). All potentially realistic disassembly rules resulted in increases in disease risk with decreasing biodiversity, although shapes of the curves varied considerably. Our results highlight the importance of both species identity and the order by which species are lost, in understanding the mechanisms by which biodiversity affects ecosystem functioning. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To report 9 years' experience of an Australian memory clinic using the -Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four instruments used in distinguishing patients with and without dementia. METHODS: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10). RESULTS: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were 'normal'. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = - 0.57 to 0.93). CONCLUSION: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: To report 9 years’ experience of an Australian memory clinic using the ­Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four ­instruments used in distinguishing patients with and without dementia. Methods: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10). Results: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were ‘normal’. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item ­mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = - 0.57 to 0.93). Conclusion: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders. [ABSTRACT FROM AUTHOR]

Disease threats to endangered species are most commonly caused by exotic microparasites accidentally introduced into naïve populations by humans. The case of raccoon roundworm ( Baylisascaris procyonis ) and the Allegheny woodrat ( Neotoma magister ) is an exception to this general rule and, as such, may be useful in the identification of other macroparasite disease threats in the future. B. procyonis is an intestinal nematode of raccoons ( Procyon lotor ) that is highly pathogenic in intermediate hosts. It is hypothesized to have caused or contributed to the extirpation of the Allegheny woodrat from the northern parts of its range. I tested this hypothesis by reintroducing Allegheny woodrats into four historically occupied sites with varying natural levels of environmental contamination with B. procyonis eggs. Populations were monitored via radiotelemetry and trapping for 22 months. Woodrat populations in less contaminated release sites survived significantly longer than populations in highly contaminated sites, and there was a strong negative correlation between the number of raccoon latrines and woodrat population persistence. This case demonstrates several points relevant to the conservation of small populations: trophically transmitted parasites ( in which prey species serve as intermediate hosts to the parasites of their predators ) can be significant sources of mortality in intermediate host populations; native parasites should not be ignored as potential disease threats; and parasites of human-adapted wild animals are likely to threaten rare and endangered species. This case also illustrates a previously unrecognized route through which host density can be decoupled from disease dynamics and provides evidence of apparent competition in nature. [ABSTRACT FROM AUTHOR]

The extent to which the biodiversity and community composition of ecosystems affect their functions is an issue that grows ever more compelling as human impacts on ecosystems increase. We present evidence that supports a novel function of vertebrate biodiversity, the buffering of human risk of exposure to Lyme-disease-bearing ticks. We tested the Dilution Effect model, which predicts that high species diversity in the community of tick hosts reduces vector infection prevalence by diluting the effects of the most competent disease reservoir, the ubiquitous white-footed mouse (Peromyscus leucopus). As habitats are degraded by fragmentation or other anthropogenic forces, some members of the host community disappear. Thus, species-poor communities tend to have mice, but few other hosts, whereas species-rich communities have mice, plus many other potential hosts. We demonstrate that the most common nonmouse hosts are relatively poor reservoirs for the Lyme spirochete and should reduce the prevalence of the disease by feeding, but rarely infecting, ticks. By accounting for nearly every host species' contribution to the number of larval ticks fed and infected, we show that as new host species are added to a depauperate community, the nymphal infection prevalence, a key risk factor, declines. We identify important "dilution hosts" (e.g., squirrels), characterized by high tick burdens, low reservoir competence, and high population density, as well as 'rescue hosts" (e.g., shrews), which are capable of maintaining high disease risk when mouse density is low. Our study suggests that the preservation of vertebrate biodiversity and community composition can reduce the incidence of Lyme disease. [ABSTRACT FROM AUTHOR]

Provides information on a study which investigated the foraging behaviors of Allegheny woodrats with respect to raccoon latrines and compared them to the behaviors of white-footed mice, a species affected by Baylisascaris procyonis mortality. How the study was conducted; Description of the woodrats; Results; Discussion of the results.

Objectives The aim of this study was to compare demographic and clinical features of patients from Non-English Speaking Background (NESB) with those from English Speaking Background (ESB) who attended a memory clinic in Melbourne, Australia. Methods Data on 556 consecutive patients attending the memory clinic were analysed retrospectively. All patients were assessed by a geriatrician (Italian speaking) or psychogeriatrician with the aid of Cambridge Examination for Mental Disorders in the Elderly (CAMDEX) interview schedule. Patients were classified into the categories of dementia, functional psychiatric disorder (including depression), cognitive impairment other than dementia and normal, using ICD 10 criteria. Severity of dementia was determined using the Clinical Dementia Rating scale. Demographic information and use of community services were also documented. Results Of those seen, 148 (28.8%) were of NESB, the majority Italian (69, 12.4%). Patients of NESB were younger (p = 0.001), less educated (p = 0.001) and less likely to live alone (p = 0.009) compared to persons of ESB. Those of NESB were more likely present with a functional psychiatric disorder (particularly depression) or normal cognition (p = 0.001). Patients of NESB with dementia presented at a later stage of their disease as determined by CDR (p = 0.003). Those of NESB scored significantly lower (more impaired) on CAMCOG in all patients seen (including normal and psychiatric groups) (p = 0.02). Conclusions The clinical and demographic features of people of NESB referred to a memory clinic in Melbourne, Australia, differ from their ESB counterparts, with specific groups being under represented. This has implications for equity of assessment, service provision and utilisation for those of ethnically diverse backgrounds. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To determine the effects of attendance at a memory clinic on the psychosocial health of carers. Design Randomized control trial. Participants Fifty community dwelling subjects with mild to moderate dementia and their carers. Main outcome measures Carer burden, psychological morbidity and psychosocial health related quality of life at 6 and 12 months post intervention. Main results There was significant improvement in psychosocial health related quality of life of carers as measured by the psychosocial domain of the Functional Limitation Profile (FLP) at 6 months (p <0.01), including improvement in the subgroups of alertness behaviour (p <0.05) and social interaction (p <0.01), after adjustment for age of subject and baseline scores. The improvement in social interaction was maintained at 12 months (p <0.05). There was no significant difference in carer psychological morbidity (General Health Questionnaire), carer burden (Zarit family interview) or carer knowledge of dementia (Dementia Knowledge Test) at 6 or 12 months, between groups. Conclusions These results demonstrate improved psychosocial health related quality of life for carers of those with mild to moderate cognitive impairment attending a memory clinic. Further research in this area is indicated, comparing memory clinic intervention with alternative support. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective . To determine the positive predictive value of the Mini-Mental Status Examination (MMSE), the Abbreviated Mental Test (AMT) and the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) for dementia in different clinical settings. Design . Sensitivity and specificity of tests were compared against the criterion standard of clinical diagnosis made by a geriatrician or psychogeriatrician. Setting . Two groups of patients were studied, a referred group of outpatients to a memory clinic (MC) and a random selection of patients referred to an aged care assessment team (ACAT) Patients . Of 437 eligible MC patients, 299 were used in analyses of whom 216 subjects had dementia. Of 100 randomly selected ACAT patients, 78 agreed to be studied, and 32 subjects had dementia. Results . The correlation between the MMSE and AMT was 0.87 for the ACAT sample and 0.86 for the MC sample. The correlation between the MMSE and IQCODE was -0.65 for the ACAT sample and -0.56 for the MC sample. The correlation between the DMT and IQCODE was -0.62 for the ACAT sample and -0.54 for the MC sample. The AMT and MMSE had lower sensitivity and specificity in the MC sample compared with the ACAT sample. Using a sensitivity of 78% and a specificity of 88%, chosen on the basis of findings, the positive predictive value in clinical situations varied from 70% for patients over the age of 75 admitted to acute teaching hospitals to 84% for patients seen by ACATs, inpatient geriatric liaison patients or acute geriatric units. The positive predictive value for the general population aged 80–84 years was 45%. Conclusions . The use of these tests is appropriate for the clinical situations described above. Their use in an unselected elderly population is not recommended as the tests are likely to produce more false positives than true cases of dementia. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This project aimed to determine overall psychosocial health (measured using the psychosocial dimension of the Functional Limitations Profile) and factors which influence this in a group of carers of those with dementia and to compare their psychosocial health with that of older people attending general practitioners (GPs); arthritis support groups and a pain clinic (out-patients) and a group of community dwellers undergoing renal dialysis. The carer group showed a significant decrease in recreation and pastimes and social interactions compared to older GP attenders. The carers showed similar restrictions in social interactions and recreation to those with chronic arthritis, but the latter were more impaired in the domains of emotional behaviour and sleep and rest. The older people attending a pain clinic did not differ in the areas of alertness and social interactions compared to the carer group. The dialysis group demonstrated the greatest dysfunction overall. These results suggest that the psychosocial health of carers of those with dementia is impaired, the profile of which differs from those suffering with chronic diseases. Social and recreation activities appear most affected in the carers. Commensurate with studies exploring the health status of those suffering from diseases, the measurement of the psychosocial health status of carers should also be considered in the scope of assessment and intervention. [ABSTRACT FROM AUTHOR]

This project aimed to determine overall psychosocial health (measured using the psychosocial dimension of the Functional Limitations Profile) and factors which influence this in a group of carers of those with dementia and to compare their psychosocial health with that of older people attending general practitioners (GPs); arthritis support groups and a pain clinic (out-patients) and a group of community dwellers undergoing renal dialysis. The carer group showed a significant decrease in recreation and pastimes and social interactions compared to older GP attenders. The carers showed similar restrictions in social interactions and recreation to those with chronic arthritis, but the latter were more impaired in the domains of emotional behaviour and sleep and rest. The older people attending a pain clinic did not differ in the areas of alertness and social interactions compared to the carer group. The dialysis group demonstrated the greatest dysfunction overall. These results suggest that the psychosocial health of carers of those with dementia is impaired, the profile of which differs from those suffering with chronic diseases. Social and recreation activities appear most affected in the carers. Commensurate with studies exploring the health status of those suffering from diseases, the measurement of the psychosocial health status of carers should also be considered in the scope of assessment and intervention. [ABSTRACT FROM AUTHOR]

An introduction to the article is presented wherein the editor discusses various reports published within the issue including barriers to teaching the importance of pleasure for wellbeing, discourse analysis of sexuality education curriculum and sexual experiences of adults with physical disabilities.

Background: Indigenous peoples globally continue to be underrepresented in biomarker, genomic, and biobanking research. The aim of this study was to identify core components of culturally safe and ethical biomarker and genomic research with Indigenous peoples in Australia, Aotearoa/New Zealand, Canada and the USA. Methods: A scoping review with a systematic search strategy was conducted utilising electronic databases MEDLINE, EMBASE, PsychINFO, CINAHL and Global Health. Key search terms included 'biomarkers' and 'genomics' research involving Indigenous peoples in relation to ethical and legal principles of respect, sovereignty, governance and existing policies. Original research studies published from the year 2000 to the 1st of August 2023 were reviewed in a systematic manner. Components of culturally safe and ethical research processes were identified and synthesised descriptively. The quality of included studies was assessed using an Aboriginal and Torres Strait Islander Quality Appraisal Tool through an Indigenous lens. Results: Seven interrelated research components were identified from seventeen studies as core processes to enhance the cultural safety of biomarker and genomic research. These included building relationships and community engagement, learning, research coordination, logistics, consent, samples and biospecimens, biobank structures and protections and policy. The importance of ensuring self-determination, ownership and decision-making power is emphasised in processes to establish and conduct biomarker and genomic research with Indigenous peoples. Conclusions: Components that contribute to the cultural safety of biomarker and genomic research processes identified in this scoping review were assembled into a theoretical framework to guide research practice. Further evaluation is required by Indigenous peoples and communities to appropriate and adapt this framework for local use to promote the cultural safety of research processes and minimise barriers to Indigenous peoples' participation in biomarker and genomic research. [ABSTRACT FROM AUTHOR]

Background: This review focuses on the prognostic role of resting-state functional magnetic resonance imaging (fMRI) in disorders of consciousness (DOCs). Several studies were conducted to determine the diagnostic accuracy in DOC patients to identify prognostic markers and to understand the neural correlates of consciousness. A correct diagnosis of consciousness in unresponsive or minimally responsive patients is important for prognostic and therapeutic management. Functional connectivity is considered as an important tool for the formulation of cerebral networks; it takes into account the primary sensorimotor, language, visual and central executive areas, where fMRI studies show damage in brain connectivity in the areas of frontoparietal networks in DOC patients. Methods: The integration of neuroimaging or neurophysiological methods could improve our knowledge of the neural correlates of clinical response after an acquired brain injury. The use of MRI is widely reported in the literature in different neurological diseases. In particular, fMRI is the most widely used brain-imaging technique to investigate the neural mechanisms underlying cognition and motor function. We carried out a detailed literature search following the relevant guidelines (PRISMA), where we collected data and results on patients with disorders of consciousness from the studies performed. Results: In this review, 12 studies were selected, which showed the importance of the prognostic role of fMRI for DOCs. Conclusions: Currently there are still few studies on this topic. Future studies using fMRI are to be considered an added value for the prognosis and management of DOCs. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to determine the proportion of older Aboriginal and Torres Strait Islander peoples participating in cultural events and activities and determine the demographic and sociocultural characteristics associated with participation. Methods The Australian Bureau of Statistics National Aboriginal and Torres Strait Islander Social Survey (2014–2015) was used to measure the prevalence of participation in cultural events and activities. Multivariate logistic regression models were used to measure associations. Sociocultural factors were selected by matching survey items to the 12 sociocultural factors described in the Good Spirit Good Life Framework, a culturally validated quality-of-life tool for older people. Results The majority (62.0%) of survey respondents 45 years and older participated in cultural events (e.g. ceremonies, funerals/sorry business, NAIDOC week activities, sports carnivals, festivals/carnivals) or were involved in organizations. Many (58.5%) also participated in activities (e.g. fishing, hunting, gathering wild plants/berries, arts/crafts, music/dance/theater, writing/telling of stories). In regression models including demographic and cultural variables, participation in cultural events was highest among people living remotely (odds ratio [OR] = 2.71), reporting recognition of homelands (OR = 2.39), identifying with a cultural group (OR = 3.56), and those reporting having a say in their communities (OR = 1.57), with similar odds seen for participation in activities. Participation was inversely proportional to increasing age, with a greater proportion of females participating in events and males in activities. Discussion The social lives of older Aboriginal and Torres Strait Islander people were characterized by widespread participation in cultural events and activities. These findings provide important insights into services as they support older people to live a good life. [ABSTRACT FROM AUTHOR]

Background: Rates of dementia for Aboriginal and Torres Strait Islander peoples are three to five times greater compared to non-Indigenous Australians, with earlier age of onset. However, the risk and protective factors that drive these higher rates vary across existing cohort studies, with minimal findings on the role of vascular risk factors beyond stroke. Harmonisation of data across studies may offer greater insights through enhanced diversity and strengthened statistical capabilities. This study aims to combine three landmark cohort studies of Aboriginal and Torres Strait Islander participants to better understand the determinants of cognitive health and dementia. Methods/design: Three cohort studies - the Kimberley Healthy Adults Project (KHAP, N = 363), Koori Growing Old Well Study (KGOWS, N = 336) and Torres Strait Dementia Prevalence Study (TSDPS, N = 274) - share a similar research methodology with demographic, medical history, psychosocial factors, cognitive tests and consensus clinical diagnoses of cognitive impairment and dementia. Associations between risk and protective factors of interest and the presence of dementia and/or cognitive impairment diagnoses will be evaluated by univariable and multivariable logistic regression in a harmonised cross-sectional cohort of 898 participants. Factors associated with incident dementia and/or cognitive impairment will be assessed in a subset of KHAP (n = 189) and KGOWS participants (n = 165) who were available in longitudinal follow-up, after exclusion of those with baseline dementia or cognitive impairment. Analyses in relation to outcome measure of death or dementia will be conducted to account for the competing risk of death. Logistic regression will be used to evaluate the association between the individual components of the 16-component Kimberley Indigenous Cognitive Assessment (KICA) tool and the presence of dementia and cognitive impairment determined by independent consensus diagnoses. Multivariable binary logistic regression will be used to adjust for the effect of confounding variables. Results will be reported as odds ratios (OR) with 95% confidence intervals (95% CI). Discussion: Greater understanding of risk and protective factors of dementia and cognitive impairment relevant to Aboriginal and Torres Strait Islander peoples may improve approaches across the life course to delay cognitive decline and reduce dementia risk. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander people are ageing with high rates of comorbidity, yet little is known about suboptimal prescribing in this population. Aim: The prevalence of potentially suboptimal prescribing and associated risk factors were investigated among older patients attending primary care through Aboriginal Community Controlled Health Services (ACCHSs). Methods: Medical records of 420 systematically selected patients aged ≥50 years attending urban, rural and remote health services were audited. Polypharmacy (≥ 5 prescribed medications), potentially inappropriate medications (PIMs) as per Beers Criteria and anticholinergic burden (ACB) were estimated and associated risk factors were explored with logistic regression. Results: The prevalence of polypharmacy, PIMs and ACB score ≥3 was 43%, 18% and 12% respectively. In multivariable logistic regression analyses, polypharmacy was less likely in rural (odds ratio (OR) = 0.43, 95% confidence interval (CI) = 0.24–0.77) compared to urban patients, and more likely in those with heart disease (OR = 2.62, 95% CI = 1.62–4.25), atrial fibrillation (OR = 4.25, 95% CI = 1.08–16.81), hypertension (OR = 2.14, 95% CI = 1.34–3.44), diabetes (OR = 2.72, 95% CI = 1.69–4.39) or depression (OR = 1.91, 95% CI = 1.19–3.06). PIMs were more frequent in females (OR = 1.88, 95% CI = 1.03–3.42) and less frequent in rural (OR = 0.41, 95% CI = 0.19–0.85) and remote (OR = 0.58, 95% CI = 0.29–1.18) patients. Factors associated with PIMs were kidney disease (OR = 2.60, 95% CI = 1.37–4.92), urinary incontinence (OR = 3.00, 95% CI = 1.02–8.83), depression (OR = 2.67, 95% CI = 1.50–4.77), heavy alcohol use (OR = 2.83, 95% CI = 1.39–5.75) and subjective cognitive concerns (OR = 2.69, 95% CI = 1.31–5.52). High ACB was less common in rural (OR = 0.10, 95% CI = 0.03–0.34) and remote (OR = 0.51, 95% CI = 0.25–1.04) patients and more common in those with kidney disease (OR = 3.07, 95% CI = 1.50–6.30) or depression (OR = 3.32, 95% CI = 1.70–6.47). Conclusion: Associations between potentially suboptimal prescribing and depression or cognitive concerns highlight the importance of considering medication review and deprescribing for these patients. [ABSTRACT FROM AUTHOR]

Introduction: To better tailor prevention and care strategies, there is a need to identify modifiable factors associated with functional impairment in older Aboriginal people, and related service needs. Objective: To investigate the prevalence and associated factors for functional impairment in older Aboriginal people, and related service needs. Design: Cross‐sectional survey of 289 Aboriginal people aged ≥45 years living in the remote Kimberley region of Western Australia. Factors associated with functional impairment were explored with logistic regression. Findings: 41.2% (95% CI 35.6%–47.0%) of participants required assistance with at least one I/ADL, and 26.0% (95% CI 21.2%–31.3%) required assistance with two or more I/ADLs. A core activity limitation (required assistance with showering, dressing or cooking) was reported by 15.9% (95% CI 12.1%–20.6%). In multivariable logistic regression analyses, older age, diabetes, difficulty walking, head injury, higher depression score and worse cognition were associated with needing help with two or more I/ADLs, while older age, history of stroke, higher depression score and worse cognition were associated with the presence of a core activity limitation. The proportion of participants receiving support with I/ADLs ranged from 71.2% to 97.6%. Support was generally provided by family and friends rather than service providers. Discussion: The key modifiable factors associated with functional impairment in older Aboriginal people living in remote regions are diabetes, depression and cognitive impairment. Services required are transport and socio‐cultural activities, and ensuring support for family providing the majority of care. Conclusions: This study highlights the need for holistic prevention strategies and care for older Aboriginal people with functional limitations and their families. [ABSTRACT FROM AUTHOR]

The article discusses the application of restraints in the emergency department (ED) for the patients suffering from dementia to control their behavioral symptoms. It examines patients with behavioral and psychological symptoms of dementia (BPSD), a table representing the symptoms of BPSD, and effects of antipsychotic medication on patients.

In this issue of Neuron, Granseth et al. re-examine the mechanism of endocytosis at hippocampal synapses using a new optical reporter, sypHy. They conclude that only a single slow mode of endocytosis operates at this synapse and that retrieval after physiological stimuli is largely, if not solely, dominated by the clathrin-mediated pathway. These conclusions dispute previous assertions that “kiss-and-run” is a major mechanism of vesicle recycling at hippocampal synapses. [Copyright &y& Elsevier]

A response to a letter to the editor about the AVMA Membership Directory & Resource Manual is presented.

A response from the author of the article "Dementia in Older People: An Update" in the 2014 issue is presented.

Two neonates with congenital heart disease, one and thirty-one days old respectively, suffered inadvertent arterial injury from cardiac catheterization. Both insults resulted in unrecognized avulsion of the external iliac artery from its origin. The patients quickly decompensated, with their right lower extremities becoming critically ischemic. In both cases, segments of reversed greater saphenous vein were used as interposition grafts from the common iliac artery to the common femoral artery. Reperfusion of the right foot was immediate for the one-day-old. She is now three years old and able to run, but is followed for a mild limb length discrepancy. The 31-day-old had restoration of flow to the right limb; however, the foot remained ischemic and eventually required transmetatarsal amputation. She is now 16 months old and able to crawl; she also is followed for limb length discrepancy. Without vein grafting, both infants would likely have lost their affected limbs, and possibly lost their lives. These cases advocate for microsurgical repair of arterial injuries in even the youngest patients, and promote the use of vein grafts when direct anastomosis is not feasible. [ABSTRACT FROM AUTHOR]

When handling large wounds, zone of injury is a key concept in reconstructive microsurgery, as it pertains to the selection of recipient vessels. Historically, surgeons have avoided placing microvascular anastomosis within widely traumatized, inflamed, or radiated fields. The harvest of vein grafts facilitates reconstruction in complex cases by extending arterial and/or venous pedicle length. To illustrate the utility and fidelity of these techniques, this paper reviews the indications and outcomes for vein grafting in ten consecutive patients at a single tertiary referral center hospital. The case series presented is unique in three aspects. First, there are two cases of successful coaptation of the flap artery to the side of the arterial limb of an arteriovenous loop. Second, there is a large proportion of cases where vein grafts were used to elongate the venous pedicle. In these 10 cases, the mean vein graft length was 37 cm. We observed zero flap failures and zero amputations. Although limited in sample size, these case data support the efficacy and reliability of long segment vein grafting in complex cases in referral centers. [ABSTRACT FROM AUTHOR]

The article discusses the use and the importance of acclimation certificates. An acclimation certificate is used to permit airlines to ship dogs and cats when the airline cannot guarantee compliance with animal welfare regulations particularly that of the minimum temperature allowed by the regulations. Federal laws require that dogs and cats must not be exposed to temperatures below 45 degrees Fahrenheit. It is in the best interest of the animals' well-being to issue an acclimation certificate.

Parkinson's disease is a neurodegenerative disorder characterized by different motor, vegetative, behavioral, and cognitive impairments, with worsening quality of life. Virtual reality devices have given promising results in neurorehabilitation as they can provide multisensory stimulation in a realistic environment. This study aims to test the efficacy of virtual reality training by using Computer Assisted Rehabilitation Environment in cognitive impairment in a sample of PD. 31 patients affected by PD were enrolled. All PD patients underwent 24 sessions of Computer Assisted Rehabilitation Environment training. The participants were assessed at baseline (T0) and after two months (T1). Our results suggested that Computer Assisted Rehabilitation Environment training may be effective in the cognitive and emotional domains, particularly by improving executive function, anxiety, and depressive symptoms. These changes have helped to improve self-efficacy and coping strategies. These results indicate greater cognitive and physical effort to overcome stressors. Our results show that Computer Assisted Rehabilitation Environment training was beneficial in improving cognitive functions. Longer duration training may be especially beneficial for patients with mild cognitive impairment. Our findings open the door to tailored personalized treatments based on the patient's motor and cognitive profiles. [ABSTRACT FROM AUTHOR]

Microvascular dysfunction predicts adverse cardiovascular events despite absence of large vessel disease. A shift in the mediator of flow‐mediated dilatation (FMD) from nitric oxide (NO) to mitochondrial‐derived hydrogen peroxide (H2O2) occurs in arterioles from patients with coronary artery disease (CAD). The underlying mechanisms governing this shift are not completely defined. Lipid phosphate phosphatase 3 (LPP3) is a transmembrane protein that dephosphorylates lysophosphatidic acid, a bioactive lipid, causing a receptor‐mediated increase in reactive oxygen species. A single nucleotide loss‐of‐function polymorphism in the gene coding for LPP3 (rs17114036) is associated with elevated risk for CAD, independent of traditional risk factors. LPP3 is suppressed by miR‐92a, which is elevated in the circulation of patients with CAD. Repression of LPP3 increases vascular inflammation and atherosclerosis in animal models. We investigated the role of LPP3 and miR‐92a as a mechanism for microvascular dysfunction in CAD. We hypothesized that modulation of LPP3 is critically involved in the disease‐associated shift in mediator of FMD. LPP3 protein expression was reduced in left ventricle tissue from CAD relative to non‐CAD patients (P = 0.004), with mRNA expression unchanged (P = 0.96). Reducing LPP3 expression (non‐CAD) caused a shift from NO to H2O2 (% maximal dilatation: Control 78.1 ± 11.4% vs. Peg‐Cat 30.0 ± 11.2%; P < 0.0001). miR‐92a is elevated in CAD arterioles (fold change: 1.9 ± 0.01 P = 0.04), while inhibition of miR‐92a restored NO‐mediated FMD (CAD), and enhancing miR‐92a expression (non‐CAD) elicited H2O2‐mediated dilatation (P < 0.0001). Our data suggests LPP3 is crucial in the disease‐associated switch in the mediator of FMD. Key points: Lipid phosphate phosphatase 3 (LPP3) expression is reduced in heart tissue patients with coronary artery disease (CAD).Loss of LPP3 in CAD is associated with an increase in the LPP3 inhibitor, miR‐92a.Inhibition of LPP3 in the microvasculature of healthy patients mimics the CAD flow‐mediated dilatation (FMD) phenotype.Inhibition of miR‐92a restores nitric oxide‐mediated FMD in the microvasculature of CAD patients. [ABSTRACT FROM AUTHOR]