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Neuropsychological tests are important instruments to determine a cognitive profile, giving insight into the etiology of dementia; however, these tests cannot readily be used in culturally diverse, low-educated populations, due to their dependence upon (Western) culture, education, and literacy. In this review we aim to give an overview of studies investigating domain-specific cognitive tests used to assess dementia in non-Western, low-educated populations. The second aim was to examine the quality of these studies and of the adaptations for culturally, linguistically, and educationally diverse populations.
A systematic review was performed using six databases, without restrictions on the year or language of publication.
Forty-four studies were included, stemming mainly from Brazil, Hong Kong, Korea, and considering Hispanics/Latinos residing in the USA. Most studies focused on Alzheimer’s disease (n = 17) or unspecified dementia (n = 16). Memory (n = 18) was studied most often, using 14 different tests. The traditional Western tests in the domains of attention (n = 8) and construction (n = 15), were unsuitable for low-educated patients. There was little variety in instruments measuring executive functioning (two tests, n = 13), and language (n = 12, of which 10 were naming tests). Many studies did not report a thorough adaptation procedure (n = 39) or blinding procedures (n = 29).
Various formats of memory tests seem suitable for low-educated, non-Western populations. Promising tasks in other cognitive domains are the Stick Design Test, Five Digit Test, and verbal fluency test. Further research is needed regarding cross-cultural instruments measuring executive functioning and language in low-educated people.
Integrated Modular Avionics enables applications of different criticality levels to share the same hardware platform with an established temporal and spatial isolation. On-chip communication systems for such platforms must support different bandwidth and latency requirements of applications while preserving time predictability. In this paper, our concern is a time-predictable on-chip network architecture for targeting applications in mixed-criticality aerospace systems. The proposed architecture introduces a mixed, priority-based and time-division-multiplexed arbitration scheme to accommodate different bandwidth and latency in the same network while preserving worst-case time predictability for end-to-end communication without packet loss. Furthermore, as isolation of erroneous transmission by a faulty application is a key aspect of contingency management, the communication system should support isolation mechanisms to prevent interference. For this reason, a sampling port and isolated sampling buffer-based approach is proposed with a transmission authorisation control mechanism, guaranteeing spatial and temporal isolation between communicating systems.
The COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) project is a large international collaborative effort to analyze individual-level phenotype data from twins in multiple cohorts from different environments. The main objective is to study factors that modify genetic and environmental variation of height, body mass index (BMI, kg/m2) and size at birth, and additionally to address other research questions such as long-term consequences of birth size. The project started in 2013 and is open to all twin projects in the world having height and weight measures on twins with information on zygosity. Thus far, 54 twin projects from 24 countries have provided individual-level data. The CODATwins database includes 489,981 twin individuals (228,635 complete twin pairs). Since many twin cohorts have collected longitudinal data, there is a total of 1,049,785 height and weight observations. For many cohorts, we also have information on birth weight and length, own smoking behavior and own or parental education. We found that the heritability estimates of height and BMI systematically changed from infancy to old age. Remarkably, only minor differences in the heritability estimates were found across cultural–geographic regions, measurement time and birth cohort for height and BMI. In addition to genetic epidemiological studies, we looked at associations of height and BMI with education, birth weight and smoking status. Within-family analyses examined differences within same-sex and opposite-sex dizygotic twins in birth size and later development. The CODATwins project demonstrates the feasibility and value of international collaboration to address gene-by-exposure interactions that require large sample sizes and address the effects of different exposures across time, geographical regions and socioeconomic status.
To assess the prevalence of prediabetes and metabolic abnormalities among overweight or obese clozapine- or olanzapine-treated schizophrenia patients, and to identify characteristics of the schizophrenia group with prediabetes.
A cross-sectional study assessing the presence of prediabetes and metabolic abnormalities in schizophrenia clozapine- or olanzapine-treated patients with a body mass index (BMI) ≥27 kg/m2. Procedures were part of the screening process for a randomized, placebo-controlled trial evaluating liraglutide vs placebo for improving glucose tolerance. For comparison, an age-, sex-, and BMI-matched healthy control group without psychiatric illness and prediabetes was included. Prediabetes was defined as elevated fasting plasma glucose and/or impaired glucose tolerance and/or elevated glycated hemoglobin A1c.
Among 145 schizophrenia patients (age = 42.1 years; males = 59.3%) on clozapine or olanzapine (clozapine/olanzapine/both: 73.8%/24.1%/2.1%), prediabetes was present in 69.7% (101 out of 145). While schizophrenia patients with and without prediabetes did not differ regarding demographic, illness, or antipsychotic treatment variables, metabolic abnormalities (waist circumference: 116.7±13.7 vs 110.1±13.6 cm, P = 0.007; triglycerides: 2.3±1.4 vs 1.6±0.9 mmol/L, P = 0.0004) and metabolic syndrome (76.2% vs 40.9%, P<0.0001) were significantly more pronounced in schizophrenia patients with vs without prediabetes. The age-, sex-, and BMI-matched healthy controls had significantly better glucose tolerance compared to both groups of patients with schizophrenia. The healthy controls also had higher levels of high-density lipoprotein compared to patients with schizophrenia and prediabetes.
Prediabetes and metabolic abnormalities were highly prevalent among the clozapine- and olanzapine-treated patients with schizophrenia, putting these patients at great risk for later type 2 diabetes and cardiovascular disease. These results stress the importance of identifying and adequately treating prediabetes and metabolic abnormalities among clozapine- and olanzapine-treated patients with schizophrenia.
With increasing cultural diversity and growing elderly immigrant populations in Western European countries, the availability of brief cognitive screening instruments adequate for assessment of dementia in people from diverse backgrounds becomes increasingly important. The aim of the present study was to investigate diagnostic accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in a multicultural sample and to calculate normative data as a basis for demographic adjustment of RUDAS scores.
The study was a prospective international cross-sectional multi-center study. Receiver operating characteristic curve analysis was used to examine diagnostic accuracy. Regression analysis was used to assess the impact of demographic variables.
Data was collected from 341 cognitively intact participants and 80 people with dementia with a wide age- and educational range. Of the 421 included participants, 239 (57%) had immigrant background. The RUDAS had high diagnostic accuracy with an area under the curve (AUC) of 0.93. The optimal cut-off score was <25 (sensitivity 0.80, specificity 0.90). Regression analysis revealed that RUDAS scores were mainly affected by education and were unrelated to data collection site and immigrant status. Education-adjusted normative data was calculated as a basis for education adjustment of RUDAS scores. Applying education-adjusted RUDAS scores slightly but significantly improved diagnostic accuracy with an AUC of 0.95.
We found the RUDAS to have excellent diagnostic properties in our multicultural sample. However, we suggest that RUDAS scores should be adjusted for education to increase diagnostic accuracy and that the choice of cut-off score should be considered based on the clinical context and expected base rate of dementia.
The cold, wet climate of the Arctic has led to the extraordinary preservation of archaeological sites and materials that offer important contributions to the understanding of our common cultural and ecological history. This potential, however, is quickly disappearing due to climate-related variables, including the intensification of permafrost thaw and coastal erosion, which are damaging and destroying a wide range of cultural and environmental archives around the Arctic. In providing an overview of the most important effects of climate change in this region and on archaeological sites, the authors propose the next generation of research and response strategies, and suggest how to capitalise on existing successful connections among research communities and between researchers and the public.
The Holocene climatic optimum was a period 8–5 kyr ago when annual mean surface temperatures in Greenland were 2–3°C warmer than present-day values. However, this warming left little imprint on commonly used temperature proxies often used to derive the climate forcing for simulations of the past evolution of the Greenland ice sheet. In this study, we investigate the evolution of the Greenland ice sheet through the Holocene when forced by different proxy-derived temperature histories from ice core records, focusing on the effect of sustained higher surface temperatures during the early Holocene. We find that the ice sheet retreats to a minimum volume of ~0.15–1.2 m sea-level equivalent smaller than present in the early or mid-Holocene when forcing an ice-sheet model with temperature reconstructions that contain a climatic optimum, and that the ice sheet has continued to recover from this minimum up to present day. Reconstructions without a warm climatic optimum in the early Holocene result in smaller ice losses continuing throughout the last 10 kyr. For all the simulated ice-sheet histories, the ice sheet is approaching a steady state at the end of the 20th century.
Textual data are plagued by underreporting bias. For example, news sources often fail to report human rights violations. Cook et al. propose a multi-source estimator to gauge, and to account for, the underreporting of state repression events within human codings of news texts produced by the Agence France-Presse and Associated Press. We evaluate this estimator with Monte Carlo experiments, and then use it to compare the prevalence and seriousness of underreporting when comparable texts are machine coded and recorded in the World-Integrated Crisis Early Warning System dataset. We replicate Cook et al.’s investigation of human-coded state repression events with our machine-coded events, and validate both models against an external measure of human rights protections in Africa. We then use the Cook et al. estimator to gauge the seriousness and prevalence of underreporting in machine and human-coded event data on human rights violations in Colombia. We find in both applications that machine-coded data are as valid as human-coded data.
Studies of the association between pre-deployment cognitive ability and post-deployment post-traumatic stress disorder (PTSD) have shown mixed results.
To study the inflence of pre-deployment cognitive ability on PTSD symptoms 6–8 months post-deployment in a large population while controlling for pre-deployment education and deployment-related variables.
Study linking prospective pre-deployment conscription board data with post-deployment self-reported data in 9695 Danish Army personnel deployed to different war zones in 1997–2013. The association between pre-deployment cognitive ability and post-deployment PTSD was investigated using repeated-measure logistic regression models. Two models with cognitive ability score as the main exposure variable were created (model 1 and model 2). Model 1 was only adjusted for pre-deployment variables, while model 2 was adjusted for both pre-deployment and deployment-related variables.
When including only variables recorded pre-deployment (cognitive ability score and educational level) and gender (model 1), all variables predicted post-deployment PTSD. When deployment-related variables were added (model 2), this was no longer the case for cognitive ability score. However, when educational level was removed from the model adjusted for deployment-related variables, the association between cognitive ability and post-deployment PTSD became significant.
Pre-deployment lower cognitive ability did not predict post-deployment PTSD independently of educational level after adjustment for deployment-related variables.
The postpartum period is well-known risk period for the first onset of autoimmune thyroid disorders (AITDs) as well as first onset of psychiatric disorders. These two disorders are some of the most prevalent medical conditions postpartum, often misdiagnosed and disabling if left untreated. Our study was designed to explore the possible bidirectional association between AITDs and psychiatric disorders during the postpartum period.
A population-based cohort study through linkage of Danish national registers, which comprised 312 779 women who gave birth to their first child during 1997–2010. We conducted Poisson regression analysis to estimate the incidence rate ratio (IRR) of psychiatric disorders among women with first-onset AITDs, the IRR of AITDs among women with first-onset psychiatric disorders as well as the overlap between these disorders using a comorbidity index.
Women with first-onset AITDs postpartum were more likely to have first-onset psychiatric disorders than women who did not have postpartum AITDs (IRR = 1.88, 95% confidence interval (CI): 1.25–2.81). Women with first-onset postpartum psychiatric disorders had a higher risk of AITDs than women with no psychiatric disorders (IRR = 2.16, 95% CI: 1.45–3.20). The comorbidity index 2 years after delivery was 2.26 (95% CI: 1.61–2.90), indicating a comorbidity between first-onset AITDs and psychiatric disorders.
First-onset AITDs and psychiatric disorders co-occur in the postpartum period, which has relevance to further studies on the etiologies of these disorders and why childbirth in particular triggers the onset.
The spread of African swine fever virus (ASFV) threatens to reach further parts of Europe. In countries with a large swine production, an outbreak of ASF may result in devastating economic consequences for the swine industry. Simulation models can assist decision makers setting up contingency plans. This creates a need for estimation of parameters. This study presents a new analysis of a previously published study. A full likelihood framework is presented including the impact of model assumptions on the estimated transmission parameters. As animals were only tested every other day, an interpretation was introduced to cover the weighted infectiousness on unobserved days for the individual animals (WIU). Based on our model and the set of assumptions, the within- and between-pen transmission parameters were estimated to βw = 1·05 (95% CI 0·62–1·72), βb = 0·46 (95% CI 0·17–1·00), respectively, and the WIU = 1·00 (95% CI 0–1). Furthermore, we simulated the spread of ASFV within a pig house using a modified SEIR-model to establish the time from infection of one animal until ASFV is detected in the herd. Based on a chosen detection limit of 2·55% equivalent to 10 dead pigs out of 360, the disease would be detected 13–19 days after introduction.
Internal layers in polar ice sheets have been mapped in many areas using information from radio-echo sounding surveys. The layers contain imprints of past accumulation patterns and ice flow and can potentially provide estimates of past accumulation rates. In this study, average accumulation rates for the past 14.7 ka in north and central Greenland are recovered from the mapped depth of one pronounced isochrone using a simple ice flow model, accounting for both vertical and horizontal flow combined with formal inversion techniques. Using this method, upstream variations in the accumulation and flow are taken into account when inferring the accumulation rates from the deep layer. This resulted in larger spatial variations in the inferred accumulation rates compared to approaches using a one-dimensional ice flow model. The largest differences were found in areas of significant horizontal flow. The inferred accumulation rates agree with Holocene estimates from ice cores in the interior of the ice sheet. Across the central ice divide, the inferred accumulation pattern shows a pronounced gradient in accumulation rates, similar to the present-day pattern, suggesting that the large-scale pattern in the interior of central northern Greenland has been consistent throughout the past 14.7 ka.
Infield route planning is used to optimise field operations in order to decrease operational costs and environmental impacts. Route planners must be able to plan operations within real fields and account for real situations such as irregular shapes and obstacles. Therefore, a representative set of fields is required to robustly test the route planner. Instead of choosing randomly, which may result in a non-representative sample of the diversity of fields; a stratification strategy was used to separate the field dataset into strata. Proportional sampling from each stratum provided a representative sample of 217 fields, out of the original set of 603,218 from the Danish field database.
Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression.
We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol.
We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47–2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04–1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94–1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81–1.32).
Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.
Dietary long-chain n-3 PUFA (n-3 LCPUFA) in infancy may have long-term effects on lifestyle disease risk. The present follow-up study investigated whether maternal fish oil (FO) supplementation during lactation affected growth and blood pressure in adolescents and whether the effects differed between boys and girls. Mother–infant pairs (n 103) completed a randomised controlled trial with FO (1·5 g/d n-3 LCPUFA) or olive oil (OO) supplements during the first 4 months of lactation; forty-seven mother–infant pairs with high fish intake were followed-up for 4 months as the reference group. We also followed-up 100 children with assessment of growth, blood pressure, diet by FFQ and physical activity by 7-d accelerometry at 13·5 (sd 0·4) years of age. Dried whole-blood fatty acid composition was analysed in a subgroup (n 49). At 13 years of age, whole-blood n-3 LCPUFA, diet, physical activity and body composition did not differ between the three groups. The children from the FO group were 3·4 (95 % CI 0·2, 6·6) cm shorter (P=0·035) than those from the OO group, and tended to have less advanced puberty (P=0·068), which explained the difference in height. There was a sex-specific effect on diastolic blood pressure (Psex×group=0·020), which was driven by a 3·9 (95 % CI 0·2, 7·5) mmHg higher diastolic blood pressure in the FO compared with the OO group among boys only (P=0·041). Our results indicate that early n-3 LCPUFA intake may reduce height in early adolescence due to a delay in pubertal maturation and increase blood pressure specifically in boys, thereby tending to counteract existing sex differences.
Chemical and isotopic analyses have been made of pigment samples from two separate rock art sites in Argentina. The purpose of the study has been to establish the feasibility of extracting carbonaceous material from the samples which will permit reliable radiocarbon dates for the time of painting. The two sites, Catamarca and Rio Negro, present quite different problems. Most of the paper is concerned with Catamarca, and here we have shown that the paint pigments contain very little or no organic binder; but they do contain calcium oxalate derived from local cacti, and calcium carbonate derived probably from local plant ash. We describe a method to purify carbon extracted from the calcium oxalate, and present the dates obtained on both components. We show that, though rare, natural deposits containing both calcium oxalate and calcite do occur, but that they are very distinct in both 13C and 14C compositions; and we argue that they are very unlikely to contaminate the pigments to such an extent that the 14C dates are altered. For the Rio Negro site we show that the ground for the paint pigments contains carbon derived from fires burnt inside the cave, and discuss how analytical methods provide information to develop a strategy for extracting material, from both ground and pigment, for more reliable dating.
We report the discovery of a large (15 kpc diameter) Hα+[NII] emission-line disk in the elliptical galaxy IC 1459, showing weak spiral structure. The line flux peaks strongly at the nucleus and is more concentrated than the stellar continuum. The major axis of the disk of ionized gas coincides with that of the stellar body of the galaxy. The mass of the ionized gas is estimated to be ~ 1 105 M⊙, less than 1% of the total mass of gas present in IC 1459. The total gas mass of 4 107 M⊙ has been estimated from the dust mass derived from a broad-band colour index image and the IRAS data. We speculate that the presence of dust and gas in IC 1459 is a signature of a merger event.
We use high-resolution Keck, VLT, or Hubble Space Telescope spectra of background quasars to examine the kinematic properties of the multiphase, metal-enriched circumgalactic medium in the outskirts of galaxies at 0.08 < zgal < 1.0, focusing on the low-ionization Mgii and high-ionization Ovi doublets. The absorption kinematics of low-ionization gas in the circumgalactic medium depend strongly on the star formation activity and the location about the host galaxy, where the largest velocity dispersions are associated with blue, face-on galaxies probed along the minor axis. Conversely, high-ionization gas kinematics are independent of galaxy star formation activity and orientation.
The layered agpaitic nepheline syenites (kakortokites) of the Ilímaussaq complex, South Greenland, host voluminous accumulations of eudialyte-group minerals (EGM). These complex Na-Ca-zirconosilicates contain economically attractive levels of Zr, Nb and rare-earth elements (REE), but have commonly undergone extensive autometasomatic/hydrothermal alteration to a variety of secondary mineral assemblages. Three EGM alteration assemblages are recognized, characterized by the secondary zirconosilicates catapleiite, zircon and gittinsite. Theoretical petrogenetic grid models are constructed to assess mineral stabilities in terms of component activities in the late-stage melts and fluids. Widespread alteration of EGM to catapleiite records an overall increase in water activity, and reflects interaction of EGM with late-magmatic Na-, Cl- and F-rich aqueous fluids at the final stages of kakortokite crystallization. Localized alteration of EGM and catapleiite to the rare Ca-Zr silicate gittinsite, previously unidentified at Ilímaussaq, requires an increase in CaO activity and suggests post-magmatic interaction with Ca-Sr bearing aqueous fluids. The pseudomorphic replacement of EGM in the kakortokites was not found to be associated with significant remobilization of the primary Zr, Nb and REE mineralization, regardless of the high concentrations of potential transporting ligands such as F and Cl. We infer that the immobile behaviour essentially reflects the neutral to basic character of the late-magmatic fluids, in which REE-F compounds are insoluble and remobilization of REE as Cl complexes is inhibited by precipitation of nacareniobsite-(Ce) and various Ca-REE silicates. A subsequent decrease in F– activity would furthermore restrict the mobility of Zr as hydroxyl-fluoride complexes, and promote precipitation of the secondary zirconosilicates within the confines of the replaced EGM domains.