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To investigate whether amnestic mild cognitive impairment (aMCI) identified with visual memory tests conveys an increased risk of Alzheimer’s disease (risk-AD) and if the risk-AD differs from that associated with aMCI based on verbal memory tests.
4,771 participants aged 70.76 (SD = 6.74, 45.4% females) from five community-based studies, each a member of the international COSMIC consortium and from a different country, were classified as having normal cognition (NC) or one of visual, verbal, or combined (visual and verbal) aMCI using international criteria and followed for an average of 2.48 years. Hazard ratios (HR) and individual patient data (IPD) meta-analysis analyzed the risk-AD with age, sex, education, single/multiple domain aMCI, and Mini-Mental State Examination (MMSE) scores as covariates.
All aMCI groups (n = 760) had a greater risk-AD than NC (n = 4,011; HR range = 3.66 – 9.25). The risk-AD was not different between visual (n = 208, 17 converters) and verbal aMCI (n = 449, 29 converters, HR = 1.70, 95%CI: 0.88, 3.27, p = 0.111). Combined aMCI (n = 103, 12 converters, HR = 2.34, 95%CI: 1.13, 4.84, p = 0.023) had a higher risk-AD than verbal aMCI. Age and MMSE scores were related to the risk-AD. The IPD meta-analyses replicated these results, though with slightly lower HR estimates (HR range = 3.68, 7.43) for aMCI vs. NC.
Although verbal aMCI was most common, a significant proportion of participants had visual-only or combined visual and verbal aMCI. Compared with verbal aMCI, the risk-AD was the same for visual aMCI and higher for combined aMCI. Our results highlight the importance of including both verbal and visual memory tests in neuropsychological assessments to more reliably identify aMCI.
To assess produce availability, quality and price in a large sample of food stores in low-income neighbourhoods in California.
Cross-sectional statewide survey.
Between 2011 and 2015, local health departments assessed store type, WIC (Supplemental Nutrition Program for Women, Infants, and Children)/SNAP (Supplemental Nutrition Assistance Program) participation, produce availability, quality and price of selected items in stores in low-income neighbourhoods. Secondary data provided reference chain supermarket produce prices matched by county and month. t Tests and ANOVA examined differences by store type; regression models examined factors associated with price.
Large grocery stores (n 231), small markets (n 621) and convenience stores (n 622) in 225 neighbourhoods.
Produce in most large groceries was rated high quality (97 % of fruits, 98 % of vegetables), but not in convenience stores (25 % fruits, 14 % vegetables). Small markets and convenience stores participating in WIC and/or SNAP had better produce availability, variety and quality than non-participating stores. Produce prices across store types were, on average, higher than reference prices from matched chain supermarkets (27 % higher in large groceries, 37 % higher in small markets, 102 % higher in convenience stores). Price was significantly inversely associated with produce variety, adjusting for quality, store type, and SNAP and WIC participation.
The study finds that fresh produce is more expensive in low-income neighbourhoods and that convenience stores offer more expensive, poorer-quality produce than other stores. Variety is associated with price and most limited in convenience stores, suggesting more work is needed to determine how convenience stores can provide low-income consumers with access to affordable, high-quality produce. WIC and SNAP can contribute to the solution.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
There is currently little literature pertaining to levothyroxine overdose apart from minor or accidental overdoses in the pediatric population. In particular, there is little information available on how to confidently differentiate levothyroxine overdose from endogenous causes of thyrotoxicosis when there is no history available at the time of assessment.
We report a levothyroxine (15,800 mcg) and citalopram (2,460 mg) overdose in a 55-year-old woman presenting with seizure and tachycardia in which the diagnosis was not initially suspected. Clinical data, including a long history of treated hypothyroidism and lack of a goiter; and biochemical findings, such as an incompletely suppressed thyroid-stimulating hormone (TSH) level, despite a markedly elevated free thyroxine level (FT4), a normal sex hormone-binding globulin level at baseline, and an undetectable thyroglobulin, supported the diagnosis of thyrotoxicosis due to a massive exogenous thyroid hormone overdose. Treatment was given to decrease free triiodothyronine (FT3) conversion and increase thyroid hormone clearance with dexamethasone and cholestyramine. The patient made a full recovery.
Levothyroxine overdose can result in subtle symptoms and signs clinically, even when in massive quantities. This can make diagnosis challenging. Biochemical features, such as the pattern of thyroid hormone elevation and thyroglobulin levels, help differentiate exogenous thyroid hormone overdose from endogenous causes of thyrotoxicosis.
This article considers points of connection and coherence between and among the Rome I Regulation, the Rome II Regulation, and Regulation 1215, and relevant predecessor instruments. The degree of consistency in aim, design and detail of conflict of laws rules is examined, vertically (between/among consecutive instruments) and horizontally (across cognate instruments). Symbiosis between instruments is explored, as is the interrelationship between choice of court and choice of law. Disadvantaged parties, and the cohesiveness of their treatment under the Regulations, receive particular attention.
This article reviews the principles of magnetic field-directed self-assembly (MFDSA) of magnetic nanoparticles (MNPs), along with recent studies that advance the fundamental understanding and potential capabilities of MNP MFDSA. This technology could eventually find application in manufacturing novel materials and components for biomedicine, energy, optics, functional composites, and microfluidics. In MFDSA, an externally applied field drives the assembly of MNPs. Uniform fields can create complex chains of MNPs, while inhomogeneous fields (such as those created by permanent magnets) apply attractive forces to MNPs that pull them toward the region of strongest field strength. Thus, MNPs can be self-organized as well as directed into user-designed patterns by controlling the external field arrangement. Because of its biocompatibility, nanoscale resolution, and low cost, MFDSA is a highly versatile technique that could enable high volume nanomanufacturing of MNPs into complex, finished materials.
Criteria for mild cognitive impairment (MCI) consider impairment in instrumental activities of daily living (IADL) as exclusionary, but cross-sectional studies suggest that some high-level functional deficits are present in MCI. This longitudinal study examines informant-rated IADL in MCI, compared with cognitively normal (CN) older individuals, and explores whether functional abilities, particularly those with high cognitive demand, are predictors of MCI and dementia over a 2-year period in individuals who were CN at baseline.
A sample of 602 non-demented community dwelling individuals (375 CN and 227 with MCI) aged 70–90 years underwent baseline and 24-month assessments that included cognitive and medical assessments and an interview with a knowledgeable informant on functional abilities with the Bayer Activities of Daily Living Scale.
Significantly more deficits in informant-reported IADL with high cognitive demand were present in MCI compared with CN individuals at baseline and 2-year follow-up. Functional ability in CN individuals at baseline, particularly in activities with high cognitive demand, predicted MCI and dementia at follow-up. Difficulties with highly cognitively demanding activities specifically predicted amnestic MCI but not non-amnestic MCI whereas those with low cognitive demand did not predict MCI or dementia. Age, depressive symptoms, cardiovascular risk factors and the sex of the informant did not contribute to the prediction.
IADL are affected in individuals with MCI, and IADL with a high cognitive demand show impairment predating the diagnosis of MCI. Subtle cognitive impairment is therefore likely to be a major hidden burden in society.
Selective serotonin reuptake inhibitors take several weeks to achieve their full antidepressant effects. Post-synaptic 5-HT2A receptor activation is thought to be involved in this delayed therapeutic effect. Pipamperone acts as a highly selective 5-HT2A/D4 antagonist when administered in low doses. The purpose of this study was to compare citalopram 40 mg once daily plus pipamperone 5 mg twice daily (PipCit) versus citalopram plus placebo twice daily for magnitude and onset of therapeutic effect.
An 8-week, randomized, double-blind study in patients with major depressive disorder was carried out.
The study population comprised 165 patients (citalopram and placebo, n=82; PipCit, n=83) with a mean baseline Montgomery–Asberg Depression Rating Scale (MADRS) score of 32.6 (s.d.=5.5). In the first 4 weeks, more citalopram and placebo than PipCit patients discontinued treatment (18% v. 4%, respectively, p=0.003). PipCit patients had significantly greater improvement in MADRS score at week 1 [observed cases (OC), p=0.021; last observation carried forward (LOCF), p=0.007] and week 4 (LOCF, p=0.025) but not at week 8 compared with citalopram and placebo patients. Significant differences in MADRS scores favoured PipCit in reduced sleep, reduced appetite, concentration difficulties and pessimistic thoughts. Mean Clinical Global Impression–Improvement scores were significantly improved after 1 week of PipCit compared with citalopram and placebo (OC and LOCF, p=0.002).
Although the MADRS score from baseline to 8 weeks did not differ between groups, PipCit provided superior antidepressant effects and fewer discontinuations compared with citalopram and placebo during the first 4 weeks of treatment, especially in the first week.
If he be a man engaged in any important inquiry, he must have a method, and he will be under a strong and constant temptation to make a metaphysics out of his method, that is, to suppose the universe ultimately of such a sort that his method must be appropriate and successful.
E. A. Burtt, The Metaphysical Foundations of Modern Science (1925)
In this nascent age of “neurolaw”, “neuromarketing”, “neuropolicy”, “neuroethics”, “neurophilosophy”, “neuroeconomics”, and even “neurotheology”, it becomes necessary to disentangle the science from the scientism. There is a host of cultural entrepreneurs currently grasping at various forms of authority through appropriations of neuroscience, presented to us in the corresponding dialects of neurotalk. Such talk is often accompanied by a picture of a brain scan, that fast-acting solvent of critical faculties.
Elsewhere in this issue, O. Carter Snead offers a critique of the use of brain scans in the courtroom in which he alludes to, but ultimately brackets, questions about the scientific rigor of such use. For the sake of argument, he proceeds on the assumption that neuroimaging is competent to do what it is often claimed to do, namely, provide a picture of human cognition.
But there are some basic conceptual problems hovering about the interpretation of brain scans as pictures of mentation. In parsing these problems, it becomes apparent that the current “neuro” enthusiasm should be understood in the larger context of scientism, a pervasive cultural tendency with its own logic.
The excitation characteristics of the current-driven ion acoustic instability are studied, using a linearized kinetic model for a weakly ionized, unmagnetized plasma. Convective instability is predicted for typical low-pressure positive column conditions. The calculated spatial growth rates show a variation with frequency, which is similar to that of the amplitude variation with frequency of the self-excited instability measured in our positive column experiments in helium and argon. The comparison between theory and experiment indicates that ion Landau damping is significant for typical experimental conditions.
Anorexia nervosa (AN) is associated with behavioral traits that predate the onset of AN and persist after recovery. We identified patterns of behavioral traits in AN trios (proband plus two biological parents).
A total of 433 complete trios were collected in the Price Foundation Genetic Study of AN using standardized instruments for eating disorder (ED) symptoms, anxiety, perfectionism, and temperament. We used latent profile analysis and ANOVA to identify and validate patterns of behavioral traits.
We distinguished three classes with medium to large effect sizes by mothers' and probands' drive for thinness, body dissatisfaction, perfectionism, neuroticism, trait anxiety, and harm avoidance. Fathers did not differ significantly across classes. Classes were distinguished by degree of symptomatology rather than qualitative differences. Class 1 (~33%) comprised low symptom probands and mothers with scores in the healthy range. Class 2 (~43%) included probands with marked elevations in drive for thinness, body dissatisfaction, neuroticism, trait anxiety, and harm avoidance and mothers with mild anxious/perfectionistic traits. Class 3 (~24%) included probands and mothers with elevations on ED and anxious/perfectionistic traits. Mother–daughter symptom severity was related in classes 1 and 3 only. Trio profiles did not differ significantly by proband clinical status or subtype.
A key finding is the importance of mother and daughter traits in the identification of temperament and personality patterns in families affected by AN. Mother–daughter pairs with severe ED and anxious/perfectionistic traits may represent a more homogeneous and familial variant of AN that could be of value in genetic studies.
A vitrification technology utilizing a lanthanide borosilicate (LaBS) glass is a viable option for dispositioning excess weapons-useable plutonium that is not suitable for processing into mixed oxide (MOX) fuel. A significant effort to develop a glass formulation and vitrification process to immobilize plutonium was completed in the mid-1990s. The LaBS glass formulation was found to be capable of immobilizing in excess of 10 wt % Pu and to be tolerant of a range of impurities. A more detailed study is now needed to quantify the ability of the glass to accommodate the anticipated impurities associated with the Pu feeds now slated for disposition.
The database of Pu feeds was reviewed to identify impurity species and concentration ranges for these impurities. Based on this review, a statistically designed test matrix of glass compositions was developed to evaluate the ability of the LaBS glass to accommodate the impurities. Sixty surrogate LaBS glass compositions were prepared in accordance with the statistically designed test matrix. The heterogeneity (e.g. degree of crystallinity) and durability (as measured by the Product Consistency Test – Method A (PCT–A)) of the glasses were used to assess the effects of impurities on glass quality.
Customer requirements and vision in aerospace dictate that the next generation of civil transport aircraft should have a strong emphasis on increased safety, reduced environmental impact and reduced cost without sacrificing performance. In this context, the School of Mechanical and Aerospace Engineering at the Queen’s University of Belfast and Bombardier have, in recent years, been conducting research into some of the key aerodynamic technologies for the next generation of aircraft engine nacelles. Investigations have been performed into anti-icing technology, efficient thrust reversal, engine fire zone safety, life cycle cost and integration of the foregoing with other considerations in engine and aircraft design. A unique correlation for heat transfer in an anti-icing system has been developed. The effect of normal vibration on heat transfer in such systems has been found to be negligible. It has been shown that carefully designed natural blockage thrust reversers without a cascade can reduce aircraft weight with only a small sacrifice in the reversed thrust. A good understanding of the pressure relief doors and techniques to improve the performance of such doors have been developed. Trade off studies between aerodynamics, manufacturing and assembly of engine nacelles have shown the potential for a significant reduction in life cycle cost.
The Keck Interferometer Nuller (KIN) is one of the major scientific and technical precursors to the Terrestrial Planet Finder Interferometer (TPF-I) mission. KIN's primary objective is to measure the level of exo-zodiacal mid-infrared emission around nearby main sequence stars, which requires deep broad-band nulling of astronomical sources of a few Janskys at 10 microns. A number of new capabilitites are needed in order to reach that goal with the Keck telescopes: mid-infrared coherent recombination, interferometric operation in “split pupil” mode, N-band optical path stabilization using K-band fringe tracking and internal metrology, and eventually, active atmospheric dispersion correction. We report here on the progress made implementing these new functionalities, and discuss the initial levels of extinction achieved on the sky.
Background. Little is known about the extent to which negative life events predict depressive symptoms in ethnically diverse groups or whether this relationship is proximal or enduring.
Method. The relationship between negative life events in adolescence and depressive symptoms in young adulthood was studied in a sample of over 1300 black and white female adolescents. Five domains of life events were assessed at age 16 years and depressive symptoms were measured at age 18 and again at age 21 years. Questions of interest included whether the association continued over time and whether there were specific domains of life events that predicted symptoms better than others.
Results. The total number of negative life events at time 1 predicted depressive symptoms at both time 2 and time 3. Interpersonal loss events and other adversities, however, predicted depressive symptoms only at time 2, whereas at time 3, only interpersonal trauma was a significant predictor. No ethnic differences were found, indicating that the relationship between life events and depressive symptoms appears to be similar for black and white adolescent girls.
Conclusions. The results suggest that negative life events and some specific type of stressors increase the likelihood of the onset of depression symptoms in future years, for both black and white girls. Early preventive efforts should be directed at adolescents who experience loss due to death of a significant other, traumatic events, and psychosocial adversities to forestall the development of depressive symptoms.
Epibionts on both living and fossil decapod crustaceans may serve as valuable proxies for paleoecological factors such as behavior and environment. Prevalence of epibionts, as observed primarily on the carapaces of fossil brachyurous decapod crustaceans, appears to be less than observed on living crabs, based upon observations in the literature, and from the study of a limited preserved biological and fossil collection. Among these factors, the three most important are that many extant epibionts do not possess skeletal structures and, therefore, are unlikely to be preserved; the epicuticle upon which epibionts attach to living brachyurans is lightly calcified and tends to be lost readily as a result of taphonomic processes; and the most common mode of preservation of fossil brachyurans is in concretions which tend to break open and leave a layer of cuticle on the counterpart, thus obscuring the potential surface of attachment of epibionts. Other factors such as the life habits of the crab, whether burrowing, burying, or remaining above the substrate; lifestyle, whether benthic or pelagic; and duration of the intermolt phase of the organism also play important roles in potential prevalence of epibionts. Careful preparation of part and counterpart remains of brachyurans as well as reference to the occurrence of epibionts in systematic studies will enhance knowledge of the host and epibiont.
Forward-to-reverse bias step-recovery measurements were performed on In.07Ga.93N/GaN and Al.36Ga.64N/Al.46Ga.54N quantum-well (QW) light-emitting diodes grown on sapphire. With the QW sampling the minority-carrier hole density at a single position, distinctive two-phase optical decay curves were observed. Using diffusion equation solutions to self-consistently model both the electrical and optical responses, hole transport parameters τp = 758 ± 44 ns, Lp = 588 ± 45 nm, and μp = 0.18 ± 0.02 cm2/Vs were obtained for GaN. The mobility was thermally activated with an activation energy of 52 meV, suggesting trap-modulated transport. Optical measurements of sub-bandgap peaks exhibited slow responses approaching the bulk lifetime. For Al.46Ga.54N, a longer lifetime of τp = 3.0 μs was observed, and the diffusion length was shorter, Lp ≈ 280 nm. Mobility was an order of magnitude smaller than in GaN, μp ≈ 10−2 cm2/Vs, and was insensitive to temperature, suggesting hole transport through a network of defects.
Materials studies of high Al-content (> 30%) AlGaN epilayers and the performance of AlGaN-based LEDs with emission wavelengths shorter than 300 nm are reported. N-type AlGaN films with Al compositions greater than 30% reveal a reduction in conductivity with increasing Al composition. The reduction of threading dislocation density from the 1–5 × 1010 cm-2 range to the 6–9 × 109cm-2 range results in an improvement of electrical conductivity and Al0.90Ga0.10N films with n= 1.6e17 cm-3 and μ=20 cm2/Vs have been achieved. The design, fabrication and packaging of flip-chip bonded deep UV LEDs is described. Large area (1 mm × 1 mm) LED structures with interdigitated contacts demonstrate output powers of 2.25 mW at 297 nm and 1.3 mW at 276 nm when operated under DC current. 300 μm × 300 μm LEDs emitting at 295 nm and operated at 20 mA DC have demonstrated less than 50% drop in output power after more than 2400 hours of operation. Optimization of the electron block layer in 274 nm LED structures has enabled a significant reduction in deep level emission bands, and a peak quantum well to deep level ratio of 700:1 has been achieved for 300 μm × 300 μm LEDs operated at 100 mA DC. Shorter wavelength LED designs are described, and LEDs emitting at 260 nm, 254nm and 237 nm are reported.