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Minor depression is diagnosed when a patient suffers from two to four depressive symptoms for at least two weeks. Though minor depression is a widespread phenomenon, its pathophysiology has hardly been studied. To get a first insight into the pathophysiological mechanisms underlying this disorder we assessed serum levels of biomarkers for plasticity, glial and neuronal function: brain-derived neurotrophic factor (BDNF), S100B and neuron specific enolase (NSE). Twenty-seven subjects with minor depressive episode and 82 healthy subjects over 60 years of age were selected from the database of the Leipzig population-based study of civilization diseases (LIFE). Serum levels of BDNF, S100B and NSE were compared between groups, and correlated with age, body-mass index, and degree of white matter hyperintensities (score on Fazekas scale). S100B was significantly increased in males with minor depression in comparison to healthy males, whereas other biomarkers did not differ between groups (P = 0.10–0.66). NSE correlated with Fazekas score in patients with minor depression (rs = 0.436, P = 0.048) and in the whole sample (rs = 0.252, P = 0.019). S100B correlated with body mass index (rs = 0.246, P = 0.031) and with age in healthy subjects (rs = 0.345, P = 0.002). Increased S100B in males with minor depression, without alterations in BDNF and NSE, supports the glial hypothesis of depression. Correlation between white matter hyperintensities and NSE underscores the vascular hypothesis of late life depression.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To investigate the association between parity and the risk of incident dementia in women.
We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)).
Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02–1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1–4 parities (HR = 1.30, 95% CI = 1.02–1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02–1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00–2.55), but the risk of AD was not significantly associated with parity.
Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.
During the 2014-2015 Ebola outbreak in West Africa, the lack of infection prevention and control (IPC) measures in health care facilities amplified human-to-human transmission and contributed to the magnitude of this humanitarian disaster.
In the summer of 2014, the Geneva University Hospitals (HUG; Geneva, Switzerland) conducted an IPC assessment and developed a project based on the local needs and their expertise with the support of the Swiss Agency for Development and Cooperation and the Humanitarian Aid Unit (SDC/HA; Bern, Switzerland). The project consisted of building local capacity in the production of alcohol-based hand-rub solution (ABHRS) based on the World Health Organization (WHO; Geneva, Switzerland) formula in non-Ebola health facilities at the peak of the outbreak in Liberia (Fall 2014) and during recovery in Guinea (September 2015) to promote safer care. Twenty-one pharmacists in Liberia and 22 in Guinea were trained and one years’ worth of laboratory equipment, chemical products, containers for personal use, and bioethanol were delivered to 10 hospitals per country with more than 8,000 100 ml bottles of solution produced at the end of the project.
Hand hygiene using hand-rub solution is a critical component of safer care, especially in health care settings lacking runnable water. Throughout the Ebola outbreak, it was a timely moment to promote hand-rub solution and to reinforce IPC measures in non-Ebola health facilities. During the project implementation, a substantial challenge was the unavailability of bioethanol in Liberia and Guinea. In the long run, sustainability of the production can become an issue as it depends heavily on the local government’s financial and political commitment, the capacity to create an on-going demand for hand-rub solution in health facilities, the local purchase and replacement of the materials and chemical products, as well as the availability of continuous local partners’ support.
The project demonstrated that it was feasible to build local capacity in ABHRS production during an emergency and in limited-resource settings when materials and training are provided. Future programs in similar contexts should identify and address the factors of sustainability during the implementation phase and provide regular, long-term technical support.
Jacquerioz BauschFA, HellerO, BengalyL, Matthey-KhouityB, BonnabryP, TouréY, KervillainGJ, BahEI, ChappuisF, HagonO. Building Local Capacity in Hand-Rub Solution Production during the 2014-2016 Ebola Outbreak Disaster: The Case of Liberia and Guinea.. Prehosp Disaster Med. 2018;33(6):660–667.
High-fidelity simulation (HFS) is a relatively new teaching modality, which is gaining widespread acceptance in medical education. To date, dozens of studies have proven the usefulness of HFS in improving student, resident, and attending physician performance, with similar results in the allied health fields. Although many studies have analyzed the utility of simulation, few have investigated why it works. A recent study illustrated that permissive failure, leading to simulated mortality, is one HFS method that can improve long-term performance. Critics maintain, however, that the use of simulated death is troubling and excessive. Given the controversy regarding simulated death, we consider the data about the educational value and the emotional harms associated with them, expecting that evidence could be useful in resolving the question. The goal of this narrative review is to explore the argument against simulated mortality and provide educators with an imperative as to why it can be safely utilized.
This study aimed to describe the diurnal shedding dynamics of Escherichia coli O157 in cattle managed on pasture. The purpose was to identify the value of a single measurement for predicting the shedding status on subsequent days. Over a 14-day period, 24 beef cows with known E. coli O157 shedding status were sampled twice daily or daily (21 sampling points) and E. coli O157 was enumerated from faeces. No association between shedding status of individual animals within a 7-h period was identified (odds ratio 1·5, P = 0·08). Short-interval sampling demonstrated substantial diurnal volatility in shedding of E. coli O157 that is not evident in studies based on long-interval (>7 days) sampling. The findings contribute to and support previous findings on the question why it has been difficult to achieve progress in understanding the epidemiology of E. coli O157 infection in cattle.
This study aims to describe in detail the temporal dynamics of E. coli O157 shedding and risk factors for shedding in a grass-fed beef herd. During a 9-month period, 23 beef cows were sampled twice a week (58 sampling points) and E. coli O157 was enumerated from faecal samples. Isolates were screened by PCR for presence of rfbE, stx1 and stx2. The prevalence per sampling day ranged from 0% to 57%. This study demonstrates that many members of the herd were concurrently shedding E. coli O157. Occurrence of rainfall (P < 0·01), feeding silage (P < 0·01) and lactating (P < 0·01) were found to be predictors of shedding. Moving cattle to a new paddock had a negative effect on shedding. This approach, based on short-interval sampling, confirms the known variability of shedding within a herd and highlights that high shedding events are rare.
As physical activity may modify the effect of the apolipoprotein E (APOE) ε4 allele on the risk of dementia and Alzheimer's disease (AD) dementia, we tested for such a gene–environment interaction in a sample of general practice patients aged ⩾75 years.
Data were derived from follow-up waves I–IV of the longitudinal German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). The Kaplan–Meier survival method was used to estimate dementia- and AD-free survival times. Multivariable Cox regression was used to assess individual associations of APOE ε4 and physical activity with risk for dementia and AD, controlling for covariates. We tested for gene–environment interaction by calculating three indices of additive interaction.
Among the randomly selected sample of 6619 patients, 3327 (50.3%) individuals participated in the study at baseline and 2810 (42.5%) at follow-up I. Of the 2492 patients without dementia included at follow-up I, 278 developed dementia (184 AD) over the subsequent follow-up interval of 4.5 years. The presence of the APOE ε4 allele significantly increased and higher physical activity significantly decreased risk for dementia and AD. The co-presence of APOE ε4 with low physical activity was associated with higher risk for dementia and AD and shorter dementia- and AD-free survival time than the presence of APOE ε4 or low physical activity alone. Indices of interaction indicated no significant interaction between low physical activity and the APOE ε4 allele for general dementia risk, but a possible additive interaction for AD risk.
Physical activity even in late life may be effective in reducing conversion to dementia and AD or in delaying the onset of clinical manifestations. APOE ε4 carriers may particularly benefit from increasing physical activity with regard to their risk for AD.
Quantum dot gate (QDG) field-effect transistors (FET) have shown three-state transfer characteristics. Quantum dot channel (QDC) field-effect transistors (FET) have exhibited fourstate ID-VG characteristics. This project aims at studying the effect of incorporating cladded quantum dot layers in the gate region of QDC-FET. Four-state characteristics are explained by carrier transport in narrow energy mini-bands which are manifested in a quantum dot superlattice (QDSL) channel. QDSL is formed by an array of cladded quantum dots (such as SiOx-Si and GeOx-Ge). Multi-state FETs are needed in multi-valued logic (MVL) that can reduce the number of gates and transistors in digital circuits. The fabricated device showed the four-state characteristic (OFF, ‘I1’, ‘I2’, ON).
Whether late-onset depression is a risk factor for or a prodrome of dementia remains unclear. We investigated the impact of depressive symptoms and early- v. late-onset depression on subsequent dementia in a cohort of elderly general-practitioner patients (n = 2663, mean age = 81.2 years).
Risk for subsequent dementia was estimated over three follow-ups (each 18 months apart) depending on history of depression, particularly age of depression onset, and current depressive symptoms using proportional hazard models. We also examined the additive prediction of incident dementia by depression beyond cognitive impairment.
An increase of dementia risk for higher age cut-offs of late-onset depression was found. In analyses controlling for age, sex, education, and apolipoprotein E4 genotype, we found that very late-onset depression (aged ⩾70 years) and current depressive symptoms separately predicted all-cause dementia. Combined very late-onset depression with current depressive symptoms was specifically predictive for later Alzheimer's disease (AD; adjusted hazard ratio 5.48, 95% confidence interval 2.41–12.46, p < 0.001). This association was still significant after controlling for cognitive measures, but further analyses suggested that it was mediated by subjective memory impairment with worries.
Depression might be a prodrome of AD but not of dementia of other aetiology as very late-onset depression in combination with current depressive symptoms, possibly emerging as a consequence of subjectively perceived worrisome cognitive deterioration, was most predictive. As depression parameters and subjective memory impairment predicted AD independently of objective cognition, clinicians should take this into account.
Age-related changes in leptin and adiponectin levels remain controversial, being affected by inconsistent normalisation for adiposity and body fat distribution in the literature. In a cross-sectional study on 210 Caucasians (127 women, eighty-three men, 18–78 years, BMI 16·8–46·8 kg/m2), we investigated the effect of age on adipokine levels independent of fat mass (FM measured by densitometry), visceral and subcutaneous adipose tissue volumes (VAT and SAT assessed by whole-body MRI). Adiponectin levels increased with age in both sexes, whereas leptin levels decreased with age in women only. There was an age-related increase in VAT (as a percentage of total adipose tissue, VAT%TAT), associated with a decrease in SATlegs%TAT. Adiposity was the main predictor of leptin levels, with 75·1 % of the variance explained by %FM in women and 76·6 % in men. Independent of adiposity, age had a minor contribution to the variance in leptin levels (5·2 % in women only). The variance in adiponectin levels explained by age was 14·1 % in women and 5·1 % in men. In addition, independent and inverse contributions to the variance in adiponectin levels were found for truncal SAT (explaining additional 3·0 % in women and 9·1 % in men) and VAT%TAT (explaining additional 13·0 % in men). In conclusion, age-related changes in leptin and adiponectin levels are opposite to each other and partly independent of adiposity and body fat distribution. Normalisation for adiposity but not for body fat distribution is required for leptin. Adiponectin levels are adversely affected by subcutaneous and visceral trunk fat.
The accumulation of deleterious mutations in a finite diploid selfing population is investigated. It is shown that the conditions for accumulation are very similar to those for the accumulation of mutations in an asexual population by ‘Muller's ratchet’. The ratchet is likely to operate in both types of population if there is a large class of slightly deleterious mutations.
A paramecium generally bears on its surface but one immobilization antigen from among the many it may have the potentiality for expressing. By assaying soluble extracts of whole cells, it had been demonstrated previously that animals of the E serotype may possess the cross-reacting G antigen. Now the existence of these secondary antigens—immobilization antigens undetected by in vivo tests—has been extended to include unrelated antigens, e.g. G antigen in animals of C serotype.
The amount of these cryptic immobilization antigens varies from stock to stock; also within a stock cultures harvested at different times may have quite different quantities.
The secondary and primary G antigens appear to be indistinguishable by the criteria of antigenic specificities, immunoelectrophoretic mobilities sedimentation rates and ammonium sulfate solubilities. As to their distribution within the cell, both secondary and primary antigens are located primarily on or within the cilia.
This paper presents electrical transfer (Id-Vg) and output (Id-Vds) characteristics of a GeOx-cladded-Ge quantum dot (QD) gate Si MOSFET devices. In QD gate FETs, the manifestation of an intermediate state ‘i” makes it a 3-state device. The intermediate state originates due to compensation of increment in the gate voltage by a similar increase in the threshold voltage, which occurs via charge neutralization in the QD gate due to transfer of charge from the inversion layer to either first or second of the two QD layers.