The findings of the present study support previous reports which infer that acute exercise or a physically active lifestyle may possess anti-inflammatory properties. Also this study, along with previous work from our laboratory, suggests that TLR4 may play a role in regulating the link between inflammatory cytokine production and a physically active lifestyle.

OBJECTIVES-To determine the cognitive and functional consequences of dual use of cholinesterase inhibitors (ChIs) and the bladder anticholinergics oxybutynin or tolterodine. DESIGN-Prospective cohort study.SETTING-Nursing homes (NHs) in the state of Indiana.PARTICIPANTS-Three thousand five hundred thirty-six Medicaid-eligible NH residents aged 65 and older taking a ChI between January 1, 2003, and December 31, 2004. Residents were excluded if they were taking an anticholinergic other than oxybutynin or tolterodine. MEASUREMENTS-IndianaMedicaid claims data were merged with data from the Minimum Data Set (MDS). Repeated-measures analyses were performed to assess the effects of dual therapy on change in cognitive function measured using the MDS Cognition Scale (MDS-COGS; scored 0-10) and change in activity of daily living (ADL) function using the seven ADL items in the MDS (scored 0-28). Potential covariates included age, sex, race, number of medications, and Charlson Comorbidity Index score.RESULTS-Three hundred seventy-six (10.6%) residents were prescribed oxybutynin or tolterodine concomitantly with a ChI. In residents in the top quartile of ADL function, ADL function declined an average of 1.08 points per quarter when not taking bladder anticholinergics (ChI alone), compared with 1.62 points per quarter when taking dual therapy, a 50% greater rate in Address correspondence to Kaycee M. Sink, MD, MAS, Assistant Professor of Medicine, Sticht Center on Aging, Wake Forest University, Medical Center Blvd, Winston-Salem, NC 27157. kmsink@wfubmc.edu. This research was presented in part at the 2006 Annual Meeting of the American Geriatrics Society. Conflict of Interest:The editor in chief has reviewed the conflict of interest checklist provided by the author and has determined that none of the authors have any financial or any other kind of personal conflicts with this manuscript.Author Contribution: All authors contributed to the study concept and design, analysis and interpretation of the data, and preparation of the manuscript. Drs. Sands and Thomas acquired the data. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript quarterly decline in ADL function (P =.01). There was no excess decline attributable to dual therapy in MDS-COGS scores or in ADL function for residents who started out with lower functioning.CONCLUSION-In higher-functioning NH residents, dual use of ChIs and bladder anticholinergics may result in greater rates of functional decline than use of ChIs alone. The MDS-COGS may not be sensitive enough to detect differences in cognition due to dual use. Keywordsdementia; incontinence; pharmacotherapy; anticholinergics; cholinesterase inhibitorsOlder adults, particularly those in nursing homes (NHs), are likely to have multiple medical conditions requiring complex medical management that can lead to therapeutic dilemmas. For example, two of the most common medical conditions in NH residents are dementia and urinary incontinence (UI), and they often coexist. 1,2 Ch...

We develop a new estimator of the inverse covariance matrix for high-dimensional multivariate normal data using the horseshoe prior. The proposed graphical horseshoe estimator has attractive properties compared to other popular estimators, such as the graphical lasso and the graphical smoothly clipped absolute deviation. The most prominent benefit is that when the true inverse covariance matrix is sparse, the graphical horseshoe provides estimates with small information divergence from the sampling model. The posterior mean under the graphical horseshoe prior can also be almost unbiased under certain conditions. In addition to these theoretical results, we also provide a full Gibbs sampler for implementing our estimator. MATLAB code is available for download from github at http://github.com/liyf1988/GHS. The graphical horseshoe estimator compares favorably to existing techniques in simulations and in a human gene network data analysis.

Unmet ADL need is prognostic of ED admissions, especially for falls and injuries. Future research is needed to determine whether resolution of unmet ADL need reduces ED utilization.

The results document changes in skeletal muscle transcript levels induced by short-term inadequate protein intakes in older humans that might precede adverse metabolic, functional, and structural events, including muscle wasting.

Demographic matrix models are standard tools for analyzing the dynamics of age‐ or stage‐structured populations. Here, we present a method for estimating the average vital rates that parameterize a demographic matrix using a series of measurements of population size and structure (an “inverse problem” of demographic analysis). We join a deterministic, density‐independent demographic matrix model with a stochastic observation model to write a likelihood function for the matrix parameters given the data. Adopting a Bayesian perspective, we combine this likelihood function with prior distributions for the model parameters to produce a joint posterior distribution for the parameters. We use a numerical technique (Markov chain Monte Carlo) to estimate and analyze the posterior distribution, and from this we calculate posterior distributions for functions of the demographic matrix, such as the population multiplication rate, stable stage distribution, and matrix sensitivities. Although measurements of population size and structure rarely contain enough information to estimate all the parameters in a matrix precisely, our analysis sheds light on the information that the data do contain about the vital rates by quantifying the precision of the parameter estimates and the correlations among them. Moreover, we show that matrix functions such as the population multiplication rate and matrix sensitivities can still be estimated precisely despite sizable uncertainty in the estimates of individual parameters, permitting biologically meaningful inference. We illustrate our approach for three populations of pea aphids (Acyrthosiphon pisum).

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