To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Levamisole is an increasingly common cutting agent used with cocaine. Both cocaine and levamisole can have local and systemic effects on patients.
A retrospective case series was conducted of patients with a cocaine-induced midline destructive lesion or levamisole-induced vasculitis, who presented to a Dundee hospital or the practice of a single surgeon in Paisley, from April 2016 to April 2019. A literature review on the topic was also carried out.
Nine patients from the two centres were identified. One patient appeared to have levamisole-induced vasculitis, with raised proteinase 3, perinuclear antineutrophil cytoplasmic antibodies positivity and arthralgia which improved on systemic steroids. The other eight patients had features of a cocaine-induced midline destructive lesion.
As the use of cocaine increases, ENT surgeons will see more of the complications associated with it. This paper highlights some of the diagnostic issues and proposes a management strategy as a guide to this complex patient group. Often, multidisciplinary management is needed.
This paper reports an integration of dual band microstrip antenna with thin film amorphous silicon solar cell which creates a wearable system to harvest microwave energy. The multiple layers in the encapsulation of the thin film solar cell are used as a substrate for microstrip antenna. The rectifier and matching circuit are designed on cotton jeans material and the whole system is mechanically supported by the foam of 5 mm thick. The performance of the antenna is studied for the mechanical bending condition. The device has maintained good power conversion efficiency. The efficiency of the voltage doubler is tested by varying radio frequency power levels from −30 to10 dBm. The voltage doubler conversion efficiency at 1.85 and 2.45 GHz are 58 and 43%, respectively, for a load of 7.5 kΩ for an input power level of −5 dBm.
Nanoemulsion formulation of vitamin D3 have been shown to have better bioavailability than the coarse emulsion preparation in vitro and in vivo animal studies. In the absence of randomised trial in humans, comparing the efficacy of nanotechnology-based miscellised vitamin D3 over conventional vitamin D3, we undertook this study. A total of 180 healthy adults were randomised to receive either micellised (DePura, group A) or conventional vitamin D3 (Calcirol, group B) at a monthly dose of 60 000 IU (1500μg) for 6 months. The outcome parameters were serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), Ca, phosphate, alkaline phosphatase and urinary Ca:creatinine ratio. A total of eighty-nine subjects in group A and seventy-seven in group B completed the trial. Subjects in both the groups had a significant increase in their serum 25(OH)D levels following supplementation (group A: 21·5 (sd 10·9) to 76·7 (sd 18·8) nmol/l (P<0·001); group B: 22·8 (sd 10·4) to 57·8 (sd 16·0) nmol/l (P<0·001)). Participants in micellised group had an additional increase of 20·2 (95 % CI 14·0, 26·4) nmol/l in serum 25(OH)D levels (P<0·001). The difference between the groups was 17·5 (95 % CI 11·8, 23·1) nmol/l, which remained statistically significant (P<0·001) even after adjustment for age and sex. Significant decline in mean serum PTH was observed in both the groups. No hypercalcaemia or hypercalciuria was noted. Although supplementation with both the preparations resulted in a significant rise in serum 25(OH)D levels, micellised vitamin D3 appeared to be more efficacious in achieving higher levels of serum 25(OH)D.
A novel series of nanocrystalline AlCuCrFeMnWx (x = 0, 0.05, 0.1, 0.5) high-entropy alloys (HEAs) were synthesized by mechanical alloying followed by spark plasma sintering. The phase evolution of the current HEAs was studied using X-ray diffraction (XRD), transmission electron microscopy, and selected area electron diffraction. The XRD of the AlCuCrFeMn sintered HEA shows evolution of ordered B2 phase (AlFe type), sigma phase (Cr rich), and FeMn phase. AlCuCrFeMnWx (x = 0.05, 0.1, 0.5 mol) shows formation of ordered B2 phases, sigma phases, FeMn phases, and BCC phases. Micro-hardness of the AlCuCrFeMnWx samples was measured by Vickers microindentation and the maximum value observed is 780 ± 12 HV. As the tungsten content increases, the fracture strength under compression increases from 1010 to 1510 MPa. Thermodynamic parameters of present alloys confirm the crystalline phase formation, and finally structure–property relationship was proposed by conventional strengthening mechanisms.
Seed dormancy allows weedy rice (Oryza sp.) to persist in rice production systems. Weedy and wild relatives of rice (Oryza sativa L.) exhibit different levels of dormancy, which allows them to escape weed management tactics, increasing the potential for flowering synchronization, and therefore gene flow, between weedy Oryza sp. and cultivated rice. In this study, we determined the genetic diversity and divergence of representative dormant and nondormant weedy Oryza sp. groups from Arkansas. Twenty-five simple sequence repeat markers closely associated with seed dormancy were used. Four populations were included: dormant blackhull, dormant strawhull, nondormant blackhull, and nondormant strawhull. The overall gene diversity was 0.355, indicating considerable genetic variation among populations in these dormancy-related loci. Gene diversity among blackhull populations (0.398) was higher than among strawhull populations (0.245). Higher genetic diversity was also observed within and among dormant populations than in nondormant populations. Cluster analysis of 16 accessions, based on Nei’s genetic distance, showed four clusters. Clusters I, III, and IV consisted of only blackhull accessions, whereas Cluster II comprised only strawhull accessions. These four clusters did not separate cleanly into dormant and nondormant populations, indicating that not all markers were tightly linked to dormancy. The strawhull groups were most distant from blackhull weedy Oryza sp. groups. These data indicate complex genetic control of the dormancy trait, as dormant individuals exhibited higher genetic diversity than nondormant individuals. Seed-dormancy trait contributes to population structure of weedy Oryza sp., but this influence is less than that of hull color. Markers unique to the dormant populations are good candidates for follow-up studies on the control of seed dormancy in weedy Oryza sp.
Development of solid polymer electrolytes has potential applications for battery technology. Membranes should be environment friendly and also have high conductivity. We use chitosan, cellulose and graphene in this research. In this work, 1% (w/v) of chitosan powder and 1.5% (w/v) of acetic acid were dissolved in double distilled water. The solution was heated to 60°C under constant stirring until the chitosan powder was completely dissolved and a semi-transparent thick chitosan solution was obtained. To this chitosan solution, appropriate amounts of graphene (grade H5-XG Sciences) was added to have 5, 10, 20 and 30% graphene (weight with respect to chitosan). The solution was sonicated for dispersing graphene and then 100ml of it was poured on plastic dishes with and without cellulose fabric in it. The films were dried by slow evaporation technique. The sample thickness varied from 200 to 300µm. SEM images showed that chitosan film formed on cellulose and had grid like structures. Chitosan deposited more on the fibres of the cellulose. This is attributed to the rectangle shaped micro pores of cellulose fabric. From the cross section of the films, it was observed that graphene arranged in stacks along the plane of the cellulose fabric and the fabric became darker as graphene concentration increased. The dielectric properties such as dielectric constant, impedance, conductivity and dissipation factor were measured from 102 - 106 Hz. The conductivity of the sample increased as the frequency increased. The conductivity of the samples at room temperature increased with increase in graphene concentrations. The conductivity varied from 10-8 to 10-5 S/Cm as the graphene concentration increases from 0 to 30%. Hence conductivity increases significantly as graphene concentration increases. From the dissipation factor for the films, the relaxation process could be observed in the frequency ranging from 102 to 105 Hz. It is observed that as frequency increases, the relaxation tend to shift towards higher frequency indicating that graphene affects the relaxation of the polymer nanocomposite. At high frequency (106Hz) dissipation factor for cellulose fabric, chitosan in cellulose, chitosan with 5% graphene in cellulose, chitosan with 10% graphene in cellulose, chitosan with 20% graphene in cellulose, chitosan with 30% graphene in cellulose are 0.14, 0.19, 0.4, 0.8 and 1.38 respectively. This shows that dissipation factor increases as the graphene concentration increases. This implies that graphene improves heat dissipation in these films. The dielectric constant was observed to be maximum for chitosan with 30% graphene in cellulose indicating that the graphene may assemble into percolation networks at higher concentrations of graphene (20 and 30%).
This special issue focuses on the difficulties of negotiating the Transatlantic Trade and Investment Partnership (TTIP), with contributions by scholars from different perspectives. This introductory article briefly examines the trend to mega-FTAs of which TTIP is a leading example. It then reviews the contributions to this special issue, drawing on an analytical approach that reflects extant work on transnational and transgovernmental relations. This approach, we contend, helps to understand the stark mismatch between the desire of some parties to negotiate binding trade rules on behind-the-border regulatory policies in certain key sectors of national economies and the progress made in TTIP talks. We then highlight the significance of some key actors in a case study of failed E.U. attempts to include financial sector reforms and associated regulatory processes in TTIP.
Despite initial intentions to better align transatlantic regulation and associated practices in the negotiation of the Transatlantic Trade and Investment Partnership (TTIP), this was not possible for rules concerning genetically modified organisms and data privacy. By 2016 both matters effectively fell off the TTIP negotiating agenda. This paper identifies the factors responsible, specifically the critical role played by independent regulatory agencies and associated bureaucratic politics, transnational coalitions of private sector organizations, and non-government organizations and contingency. These factors are not exclusive to the two salient regulations considered here, with the implication that the identification of cross-border spillovers is at best a necessary condition for the successful negotiation of binding trade rules on behind-the-border government policies.
A total of 326 pearl millet accessions selected for fodder traits from the world collection at ICRISAT genebank, India were evaluated in rainy, postrainy and summer seasons to identify promising sources for fodder yield. In rainy season, majority of accessions grew significantly tall, produced thick stems, long and broad leaves compared with postrainy and summer seasons. Total tillers per plant were significantly more in rainy and summer seasons than in postrainy season. Significant (P = 0.05) positive correlations were observed among all traits in all seasons except total tillers, which showed significant negative correlation with all other traits but for a few cases. Accessions of cluster 1 flowered early and produced more tillers per plant, while those of cluster 3 flowered late, grew tall, produced thick stems, more leaves per plant, which were long and broad. Promising sources identified include IP 11839 and IP 11840 for plant height and number of leaves per plant, IP 15710, IP 15735 and IP 15752 for stem thickness and leaf width, and IP 3628, IP 15285, IP 15288, IP 15302, IP 15342, IP 15351, IP 15290, IP 20347 and IP 20350 for total tillers per plant. Further testing of these sources of fodder traits at different locations will be very useful.
The world collection of pearl millet at ICRISAT genebank includes 19,696 landraces. Passport and characterization data of 2,929 accessions belonging to 89 named landraces originating in 15 countries of Africa was used to study the adoption pattern and genetic potential. Out of 89 named landraces under study, 71 were grown in one country, 11 in two countries, six in three countries and one in four countries. Latitude and prevailing climate at collection sites were found as the important determinants of cultivation pattern of landraces. A hierarchical cluster analysis using 12 agronomic traits resulted in five clusters. Cluster 1 for late flowering, short height in rainy season, high tillering and thin panicles; cluster 2 for early flowering; cluster 3 for stout panicles in both the seasons and larger seeds and cluster 5 for longer panicles in both seasons, were found as promising sources. IP 8957, IP 8958, IP 8964 of Iniadi landrace for short height, downy mildew and rust resistance and high seed iron and zinc contents; IP 17521 of Gnali (106.9 ppm) and IP 11523 of Idiyouwe (106.5 ppm) for high seed iron content; IP 17518 of Gnali (79.1 ppm) and IP 11535 of Iniadi (78.4 ppm) for high seed zinc content were the important sources. All accessions of Raa for high seed protein content (>15%) and those of Enele for drought tolerance, were found to be promising sources. Further evaluation of promising sources identified in this study is needed for enhanced utilization of germplasm in pearl millet improvement.
Nano-graphite oxide has been synthesized from graphite flakes using modified Hummer’s method. Fourier transform infrared (FT-IR) data, x-ray diffraction (XRD) and transmission electron microscopy (TEM) revealed functionalization of the synthesised nano-graphitic platelets with oxygenated bonds. Using thermal embedding technique for the fabrication of self-assembled films, electrodes of nano-graphite oxide have been fabricated for enzyme free detection of cholesterol electrochemically. The electrodes provided a linear response for the enzyme less detection in the range of 50mg/dl to 500mg/dl with a correlation coefﬁcient, R, of 0.99784 and sensitivity of 1.0587 µA/mg.
The creation of the World Trade Organization (WTO) in 1995 was a landmark in the development of the liberal international economic order. Yet the global economic crisis of 2008 put the spotlight on the longstanding question whether WTO membership limited the policy choices of governments coping with distress. This Special Issue of Business and Politics uses the crisis as a “stress test” for evaluating the prominent thesis that multilateral trade rules presently impose sharp limits on national industrial policies. The evidence from a wide range of sectoral and national contexts suggests that the WTO's ability to constrain member governments’ use of industrial policy is highly exaggerated. As we argue in this introductory essay, and as the studies in this Issue show, assertions of the WTO's strength do not reflect the incomplete and contested nature of its accords and the imperatives of policymaking in an era when many governments simultaneously intervene in national economies.
The genebank at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT), Patancheru, India holds a collection of 542 accessions from the Caribbean and Central American (CCA) regions, of which 424 were evaluated for eight qualitative and 17 quantitative traits at ICRISAT farm. A hierarchical cluster analysis was performed using the scores of the first nine principal components that resulted in four clusters. The accessions of these four clusters exhibited the following good characteristics: cluster 1 had high pod-bearing length and high seed protein content; those of cluster 2 had high degree of branching, large number of pods per plant and high seed yield per plant; those of cluster 3 had long pods; and those of cluster 4 had larger seeds. In the whole collection of accessions, diversity was found to be maximum (H′ = 0.630+0.026) for plant height and minimum for tertiary branches per plant (H′ = 0.259+0.026). The highest correlation coefficient was observed between racemes per plant and pods per plant (r= 0.914) followed by between pods per plant and seed yield per plant (r= 0.744), and between shelling percentage and the harvest index (r= 0.703). In view of the poor representation of the world collection of pigeonpea (13,771 accessions) from the CCA regions, launching of collection missions in these countries has been suggested to fill gaps and increase the variability. Multi-location evaluation of the collections for agronomic traits at potential locations in the CCA regions and systematic evaluation for nutritional traits and resistance to biotic and abiotic stress could result in the identification of useful genotypes, particularly vegetable types, for use in breeding programmes to develop high-yielding cultivars as well as to release as varieties in these regions.
Mahseer are popularly regarded by anglers as the king of freshwater fishes, and are valued across the Himalayan and South-east Asian regions. In India, mahseer are important game fish. Mahseer populations and their habitats face a range of anthropogenic threats, however, including unregulated fishing and habitat fragmentation as a result of hydro-development projects. Catch-and-release angling for mahseer attracts both national and international anglers and could provide information about rivers while generating revenue for regional economies. In this context, we evaluated catch-and-release angling records from rivers that flow within two Indian reserves (the Ramganga and Jia Bharali Rivers in Corbett and Nameri Tiger Reserves, respectively). Golden mahseer Tor putitora in the Ramganga and golden and chocolate mahseer Neolissochilus hexagonolepis in the Jia Bharali were the most frequently caught fish species. Catch data suggested these game fish populations are probably not negatively affected by angling activities. Interviews with stakeholders highlighted support for catch-and-release angling, mainly because of its perceived economic benefits. The data obtained in this research could potentially assist with both fish conservation and the protection of associated aquatic ecosystems.
The International Crops Research Institute for the Semi-Arid Tropics conserves 335 accessions of Pennisetum glaucum subsp. monodii originated in 13 countries. In the present study, the collection was evaluated and assessed for diversity and geographical gaps. A wide variation was observed in the collection for total tillers per plant (16 to 609), productive tillers per plant (12 to 368), leaf length (21.3 to 58.8 cm) and leaf width (8.1 to 33.1 mm), indicating high fodder yield potential of the collection. The accessions of cluster 3 flowered late, grew tall with thick stems and long and broad leaves, and differed significantly from those of cluster 1 and cluster 2. The accessions of cluster 2 were found to be promising for tillering. The highly significant positive correlation (r= 0.944) between total and productive tillers per plant suggests that the selection for total tillers will result in selection for productive tillers. A total of 354 districts located in 86 provinces of eight countries in the primary centre of origin for pearl millet were identified as geographical gaps. The probability map generated using FloraMap in the present study matched quite closely to the origin of pearl millet, supporting the prediction of P.glaucum subsp. monodii occurrence in the primary centre of diversity for pearl millet. The high fodder yield potential of P.glaucum subsp. monodii germplasm and low intensity of collection in countries under study suggest the need for launching germplasm collection missions, exclusively for pearl millet wild relatives to fill taxonomic and geographical gaps in the collection.
Conventional medical therapies for ulcerative colitis (UC) are still limited due to the adverse side effects like dose-dependent diarrhoea and insufficient potency to keep in remission for long-term periods. So, new alternatives that provide more effective and safe therapies for ulcerative colitis are constantly being sought. In the present study, probiotic LaBb Dahi was selected for investigation of its therapeutic effect on DSS-induced colitis model in mice. LaBb Dahi was prepared by co-culturing Dahi culture of Lactococci along with selected strain of Lactobacillus acidophilus LaVK2 and Bifidobacterium bifidum BbVK3 in buffalo milk. Four groups of mice (12 each) were fed for 17 d with buffalo milk (normal control), buffalo milk plus DSS (Colitis control), Dahi plus DSS, and LaBb Dahi plus DSS, respectively, with basal diet. The disease activity scores, weight loss, organ weight, colon length, myeloperoxidase (MPO) and β-glucoronidase activity was assessed, and the histopathological picture of the colon of mice was studied. All colitis control mice evidenced significant increase in MPO, β-glucoronidase activity and showed high disease activity scores along with histological damage to colonic tissue. Feeding with LaBb Dahi offered significant reduction in MPO activity, β-glucoronidase activity and improved disease activity scores. We found significant decline in length of colon, organ weight and body weight in colitis induced controls which were improved significantly by feeding LaBb Dahi. The present study suggests that LaBb Dahi can be used as a potential nutraceutical intervention to combat UC related changes and may offer effective adjunctive treatment for management of UC.
Radioactive contamination can occur as a result of accidental or intentional release of radioactive materials (RM) into the environment. RM may deposit on clothing, skin, or hair. Decontamination of contaminated persons should be done as soon as possible to minimize the deleterious health effects of radiation. The goal of this study was to evaluate the decontamination efficiency (for residual contaminant) of the active components of “Shudhika,” an indigenously developed skin decontamination kit. The study kit is for external radioactive decontamination of intact skin.
Decontamination efficiency was evaluated on the skin surface of rabbit (n = 6) and human volunteers (n = 13). 99mTc sodium pertechnetate (200-250 μCi) was used as the radio-contaminant. Skin surface area (5 × 5 cm2) of thoracic abdominal region of the rabbit and the forearm and the palm of human volunteers were used for the study. Decontamination was performed by using cotton swabs soaked with chemical decontamination agents of the kit.
Decontamination efficiency (% of the contaminant removed) was calculated for each component of the study. Overall effectiveness of the kit was calculated to be 85% ± 5% in animal and 92% ± 3% in human skin surfaces. Running water and liquid soap with water was able to decontaminate volunteers' hand and animal skin up to 70% ± 5%. Chemical decontamination agents were applied only for trace residues (30% ± 5%). Efficiency of all the kit components was found up to be 20% ± 3% (animal) and 28% ± 2 (human), respectively. Residual contamination after final decontamination attempt for both the models was observed to be 12% ± 3% and 5% ± 2%. After 24 and 48 hours of the decontamination procedure, skin was found to be normal (no redness, erythema and edema were observed).
Decontaminants of the study kit were effective in removal of localized radioactive skin contamination when water is ineffective for further decontamination. By using the chemical decontaminants of the study kit, the use of water and radioactive waste generation could be reduced. Cross-contamination could also be avoided. During radiologic emergencies where water may be radioactively contaminated, the study kit could be used.
Rana S, Dutta M, Soni NL, Chopra MK, Kumar V, Goel R, Bhatnagar A, Sultana S, Sharma RK. Decontamination of human and rabbit skin experimentally contaminated with 99mTc radionuclide using the active components of “Shudika”—a skin decontamination kit. Prehosp Disaster Med. 2012;27(2):1-5.
This study evaluated the effects of probiotic Dahi administration in ageing mice on macrophage and lymphocyte functions. Probiotic Dahi were prepared by co-culturing in buffalo milk (3% fat) Dahi bacteria (Lactococcus lactis ssp. cremoris NCDC-86 and Lc. lactis ssp. lactis biovar diacetylactis NCDC-60) along with Lactobacillus acidophilus LaVK2 (La-Dahi) or combined Lb. acidophilus and Bifidobacterium bifidum BbVK3 (LaBb-Dahi). Four groups of 12 mo old mice were fed for four months, with the supplements (5 g/day) of buffalo milk (3% fat), Dahi, La-Dahi and LaBb-Dahi, respectively, in addition to basal diet, and a fifth group that received no supplements served as control. The immune functions of young mice (4 mo old) were also compared with those of ageing adult mice (16 mo old). The production of nitric oxide and cytokines IL-6 and TNF-α declined and that of immunosuppressive prostaglandin E2 (PGE2) increased by stimulated peritoneal and splenic macrophages in ageing mice, compared with their young counterparts. The proliferation of stimulated splenocytes diminished and the production of IL-2 decreased and that of IL-6 and TNF-α enhanced in ageing compared with young mice. Feeding ageing mice with La-Dahi or LaBb-Dahi improved peritoneal macrophage functions stimulating nitric oxide and IL-6 and diminishing PGE2 production. Feeding La-Dahi or LaBb-Dahi also improved lymphocyte functions stimulating their proliferation and production of IL-2 in ageing mice. To conclude, the probiotic La-Dahi and LaBb-Dahi are effective in reversing age related decline in immune functions in mice.
The commercialization of imazethapyr-resistant (Clearfield™, CL) rice in the southern United States has raised serious concerns about gene flow to red rice, producing imazethapyr-resistant red rice populations. Our objectives were to determine the impact of planting date, CL cultivars, and red rice biotypes on outcrossing rate; and to investigate the relative contribution of flowering time of CL rice and red rice biotypes, together with air temperature and relative humidity (RH), on outcrossing rate. Field experiments were conducted at Stuttgart, Rohwer, and Kibler, AR, from 2005 to 2007, at three or four planting times from mid-April to late May. ‘CL161’ (inbred cultivar) and ‘CLXL8’ (hybrid) rice were planted in nine-row plots, with red rice planted in the middle row. Twelve red rice biotypes were used. The flowering of red rice and CL rice, air temperature, and RH were recorded. Red rice seeds were collected at maturity. To estimate outcrossing rate, resistance to imazethapyr was evaluated in subsequent years and confirmed using rice microsatellite markers. CLXL8 rice flowered 2 to 4 d earlier than CL161 rice, and flowering was completed within 1 wk in all plantings. The flowering duration of most red rice biotypes ranged from 4 to 17 d. Flowering synchrony of red rice biotypes and CL rice ranged from 0 to 100% at different plantings. In general, CLXL8 had greater flowering overlap and higher outcrossing rate with red rice than did CL161 rice. The outcrossing rate of red rice biotypes ranged from 0 to 0.21% and 0 to 1.26% with CL161 and CLXL8 rice, respectively. The outcrossing rate differed within each planting date (P < 0.05). Outcrossing was generally lower in mid-May and late May than in mid-April and late April planting times. Flowering synchrony and outcrossing rate were not correlated (r2 < 0.01). Outcrossing with CL161 was primarily influenced by red rice biotype. A minimum air temperature of > 24 C in the evening also favors outcrossing with CL161. With CLXL8 rice, outcrossing was most affected by RH. When RH was < 54%, outcrossing was less (0.12%) than when RH was ≥ 54% (0.38%). With CLXL8 rice, a minimum RH of ≥ 54%, from mid-morning to noon, increased outcrossing with red rice. To fully understand the interaction effects of these factors on outcrossing with red rice, controlled experiments are needed.
Background: Many screening instruments for the diagnosis of dementia are not education and culture fair. In addition, despite good sensitivity and specificity, they result in unacceptable levels of false positives when used in the community. This study aimed to develop appropriate instruments for populations with low literacy and to consider strategies to reduce the false positive rates in low prevalence settings.
Methods: Activities of daily living, which are not influenced by education and culture, were used to develop a patient screen and an informant version to identify people with dementia. The instruments were validated in the hospital and in the community setting against the standards of DSM-IV and the education-adjusted 10/66 Dementia Research Group diagnosis of dementia.
Results: The instruments were administered to 90 patients attending a hospital and 101 subjects living in the community in Vellore, South India. The psychometric properties and inter-rater reliability of these screening instruments were good. While the sensitivity and specificity of the patient screen and the informant version were good their false positive rates were high in the community setting. However, the false positive rates reduced when these instruments were used in combination.
Conclusion: The patient screen and the informant version are short culture- and education-fair instruments. They reduce false positive rates, when used in combination in the community.