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Environmental risk factors for dementia are poorly understood. Aluminium and fluorine in drinking water have been linked with dementia but uncertainties remain about this relationship.
In the largest longitudinal study in this context, we set out to explore the individual effect of aluminium and fluoride in drinking water on dementia risk and, as fluorine can increase absorption of aluminium, we also examine any synergistic influence on dementia.
We used Cox models to investigate the association between mean aluminium and fluoride levels in drinking water at their residential location (collected 2005–2012 by the Drinking Water Quality Regulator for Scotland) with dementia in members of the Scottish Mental Survey 1932 cohort who were alive in 2005.
A total of 1972 out of 6990 individuals developed dementia by the linkage date in 2012. Dementia risk was raised with increasing mean aluminium levels in women (hazard ratio per s.d. increase 1.09, 95% CI 1.03–1.15, P < 0.001) and men (1.12, 95% CI 1.03–1.21, P = 0.004). A dose-response pattern of association was observed between mean fluoride levels and dementia in women (1.34, 95% CI 1.28–1.41, P < 0.001) and men (1.30, 95% CI 1.22–1.39, P < 0.001), with dementia risk more than doubled in the highest quartile compared with the lowest. There was no statistical interaction between aluminium and fluoride levels in relation with dementia.
Higher levels of aluminium and fluoride were related to dementia risk in a population of men and women who consumed relatively low drinking-water levels of both.
Conventional selected area diffraction patterns as obtained in the TEM present difficulties for identification of materials such as asbestifonn minerals, although diffraction data is considered to be one of the preferred methods for making this identification. The preferred orientation of the fibers in each field of measurement, and the spotty patterns that are obtained, do not readily lend themselves to measurement of the integrated intensity values for each dspacing, and even the d-spacings may be hard to determine precisely because the true center location for the broken rings requires estimation. To overcome these problems, we have implemented an automatic method for diffraction pattern measurement. It automatically locates the center of patterns with high precision, measures the radius of each ring of spots in the pattern, and integrates the density of spots in that ring.
X-ray diffraction to determine the phases present in complex specimens generally proceeds by acquiring a pattern of D-spacings and intensities from the sample, which is then compared to patterns from a series of known or standard phases. The process of searching through large data bases to identify matches is too time consuming for manual methods, and so computerised search/match programs have come into use. The magnitude of the general problem, in which perhaps 40,000 known patterns (corresponding to the present size of the JCPDS powder diffraction file) are involved, places it in the realm of large nainframe computers, which are often accessible on a time-share basis by many laboratories or researchers using XRD. On the other hand, in many practical applications, the search need only be carried out over a limited range of compounds which are expected or may possibly be present based on the known history of the material, or on its independently determined composition. In this case, the data base becomes much smaller, and can be accommodated In micro- and minicomputers. The system we report here utilizes a 64K-byte 8 -bit microcomputer (Apple 11+) with dual floppy disk drives. One 5-1/4 inch disk can hold the pattern information for fifty compounds, and can be searched for possible matches in a few minutes. The same computer can control the scanning diffractometer to acquire the pattern data, and can act as an intelligent terminal to larger time-share machines when it is necessary to access the large data bases.
In the preceding volume in this series, we described a stepping motor automation package for XRD data acquisition, based on the Apple microcomputer with an interface card that produces the stepping motor pulses and counts X-ray pulses from the normal X-ray detector and amplifier. We are presently using the system to automate a General Electric XRD-5 diffractometer mechanism, by replacing the original synchronous motor with the stepping motor, and installing 10:1 reduction gear instead of the chain drive to drive the double worm gears. This gives 2500 steps of the motor per degree two theta. Motor pulses are counted by a small machine language routine which also handles accelerating the mechanism when slewing over long angular ranges.
Caring for patients with personality disorder is one of the biggest challenges in psychiatric work. We investigated whether mentalisation-based treatment skills (MBT-S) teaching improves clinicians' understanding of mentalising and attitudes towards personality disorder. Self-report questionnaires (Knowledge and Application of MBT (KAMQ) and Attitudes to Personality Disorder (APDQ)) were completed at baseline and after a 2-day MBT-S workshop.
Ninety-two healthcare professionals completed questionnaires before and after training. The mean within-participant increase in scores from baseline to end-of-programme was 11.6 points (95% CI 10.0–13.3) for the KAMQ and 4.0 points (1.8–6.2) for the APDQ.
MBT-S is a short intervention that is effective in improving clinicians' knowledge of personality disorder and mentalisation. That attitudes to personality disorder improved overall is encouraging in relation to the possibility of deeper learning in staff and, ultimately, improved care for patients with personality disorder.
People with dementia are extremely vulnerable in hospital and unscheduled
admissions should be avoided if possible.
To identify any predictors of general hospital admission in people with
dementia in a well-characterised national prospective cohort study.
A cohort of 730 persons with dementia was drawn from the Scottish
Dementia Research Interest Register (47.8% female; mean age 76.3 years,
s.d. = 8.2, range 50–94), with a mean follow-up period of 1.2 years.
In the age- and gender-adjusted multivariable model (n =
681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per
s.d. disadvantage 1.21, 95% CI 1.08–1.36) was identified as an
independent predictor of admission to hospital.
Neuropsychiatric symptoms in dementia, measured using the
Neuropsychiatric Inventory, predict non-psychiatric hospital admission of
people with dementia. Further studies are merited to test whether
interventions to reduce such symptoms might reduce unscheduled admissions
to acute hospitals.
That risk factors measured in middle age may not fully explain future
dementia risk implicates exposures acting earlier in life. Height may
capture early-life illness, adversity, nutrition and psychosocial
To investigate the little-explored association between height and
Individual participant meta-analysis using 18 prospective general
population cohort studies with identical methodologies (1994–2008;
n = 181 800).
Mean follow-up of 9.8 years gave rise to 426 and 667 dementia deaths in
men and women respectively. The mean heights were 174.4cm (s.d. = 7.3)
for men and 161.0cm (s.d. = 6.8) for women. In analyses taking into
account multiple covariates, increasing height was related to lower rates
of death from dementia in a dose–response pattern
(P⩽0.01 for trend). There was evidence of a differential
effect by gender (P = 0.016 for interaction). Thus, the
association observed in men (hazard ratio per s.d. decrease in height
1.24, 95% CI 1.11–1.39) was markedly stronger than that apparent in women
(HR = 1.13, 95% CI 1.03–1.24).
Early-life circumstances, indexed by adult height, may influence later
Life-course socioeconomic factors may have a role in dementia aetiology but there is a current paucity of studies. Meta-analyses of individual participant data would considerably strengthen this evidence base.
To examine the association between socioeconomic status in early life and adulthood with later dementia death.
Individual participant meta-analysis of 11 prospective cohort studies (1994–2004, n = 86508).
Leaving full-time education at an earlier age was associated with an increased risk of dementia death in women (fully adjusted hazard ratio (HR) for age ⩽14 v. age ⩾16: HR = 1.76, 95% Cl 1.23–2.53) but not men. Occupational social class was not statistically significantly associated with dementia death in men or women.
Lower educational attainment in women was associated with an increased risk of dementia-related death independently of common risk behaviours and comorbidities.
Despite intense public awareness campaigns, many patients with ST-elevation myocardial infarction (STEMI) do not utilize Emergency Medical Services (EMS) transportation to the Emergency Department (ED). Predictors for mode of transport by EMS versus private vehicle in patients with an acute STEMI were investigated.
It was hypothesized that patient characteristics, specifically older age, male sex, and a history of a prior cardiac intervention, would be associated with a higher likelihood of EMS utilization.
A retrospective, observational cohort study was performed for all STEMI patients treated from April 1, 2007 through June 30, 2010 at an urban, academic ED with 24-hour cardiac catheterization available. Multivariable analyses with predetermined predictors (age, sex, prior cardiac intervention, weekend/evening arrival) were performed to investigate associations with mode of transport. Door-to-balloon (D2B) times were calculated.
Of the 209 STEMI patients, 11 were excluded, leaving 198 for analysis. Median age was 60 years (IQR: 53-70), 138 (70%) arrived by private vehicle, and 60 (30%) by EMS. The primary analysis did not identify significant predictors for EMS, but a post-hoc model found that private insurance (OR 0.18; 95% CI, 0.07-0.45) was associated with fewer EMS transports. Although not statistically significant due to the great variability in time of arrival for STEMI patients transported by private vehicle, EMS transports had shorter D2B times. During business hours and weekend/evenings, EMS had D2B times of 50 (IQR: 42-61) and 58 minutes (IQR: 47-63), respectively, while private vehicle transports had median D2B times of 62 (IQR: 50-74) and 78 minutes (IQR: 66-106).
No associations between mode of transport and patient age, sex, weekend/evening presentation and history of a prior cardiac intervention were identified. Privately insured patients were less likely to use EMS when experiencing a STEMI. More effective ways are needed to educate the public on the importance of EMS activation when one is concerned for acute coronary syndrome.
Scherer TM, Russ S, Jenkins CA, Jones ID, Slovis CM, Cunningham BL, Barrett TW. Predictors of ambulance transport in patients with ST-elevation myocardial infarction. Prehosp Disaster Med. 2012;27(3):1-5.
The spatial distribution of different physiological groups of bacteria (nitrifying bacteria, nitrate respiring bacteria, clostridia, phototrophic bacteria, sulphate reducing bacteria and methanogens) has been determined in the surface sediments of Kingoodie Bay in the Tay Estuary. The overall distribution of the different microbial populations is largely dependent upon the presence or absence of O2, i.e. populations of obligate aerobes were greater at the surface where O2 was present, but with increasing depth and hence anoxia were successively displaced by populations of facultative and then strictly anaerobic bacteria. Thus, maximum rates of nitrification, an oxygen dependent process, were recorded in the 0–10 mm depth horizon (098 μg of N per g dry weight of sediment per day) while nitrate respiration rates were maximal in the 10–20 mm horizon (2.92 μg N per g dry weight of sediment per day). Dissimilatory sulphate reduction at 20–30 mm depth (102.1 n mol SO42 reduced g dry weight sediment -1.d -1). Methanogenesis was similarly recorded at all depths investigated but higher rates were recorded at 40–50 mm depth (22.64 n mol CH4 produced g dry weight sediment -1.d -1). These data are discussed in relation to the physico-chemical factors which arc generated in these estuarine sediments and which not only govern the spatial organisation of individual microbial populations but also modulate their metabolic activities.
We discuss how the geometrical irregularities of small crystallites, quantum dots or wires may play an essential role in the density of electronic states near the band gap in semiconductors. Assuming a possible irregular structure for porous silicon we show that the irregularity has a strong effect on the value of the band gap and of the density of states in the near band gap region. The effect of the irregularity is essentially to enhance the quantum confinement effect and to screen the fundamental wave-function from the surface.
Interfacial properties of Nicalon™-reinforced brittle matrix composites were determined from single-fiber load-controlled push-in tests using a Mechanical Properties Microprobe (Nanoindenter) and single-fiber displacement-controlled push-out tests using the Interfacial Test System (ITS). A comparison between the results from these two tests is presented along with a discussion of data analysis techniques.
A comparative study of pregate cleaning solution chemistries has been
conducted, for 30Å furnace oxides, to investigate the feasibility of
continuing to use current cleaning technologies in this thickness range. The
experiment focused on correlating changes of device properties with changes
in chemistry. Several options were investigated for growing or etching the
surface passivation oxide. Chemistries studied included standard SC1 (with
Megasonic)/SC2, final HF, as well as room temperature single bath HF based
chemistries (HF only, HF+H2O2, HF+HCl,
HF+H2O2+HCl, SPM+HF). These chemistries were
evaluated in terms of oxidation rate, metallic contamination from solutions,
capacitance-voltage (CV) characteristics, and gate oxide integrity. Data
suggest that furnace oxides can be reliably grown using conventional
cleaning technology. HF-based mixtures might be justified for even more
aggressive gate oxide thicknesses.
The business meeting of Division X in the IAU 2009GA took place in three sessions during the day of August 6, 2009. The meeting, being well attended, started with the approval for the meeting agenda. Then the triennium reports were made in the first session by the president of Division X, Ren-Dong Nan, and by the chairs of three working groups: “Historic Radio Astronomy WG” by Wayne Orchiston, “Astrophysically Important Lines WG” by Masatoshi Ohishi, and “Global VLBI WG” by Tasso Tzioumis (proxy chair appointed by Steven Tingay). Afterwards, a dozen reports from observatories and worldwide significant projects have been presented in the second session. Business meeting of “Interference Mitigation WG” was located in the third session.
Four percent gelatine is an alkaline compound due to NH2 groups, whereas 6% hydroxyethyl starch 130/0.4 (HES130) has acidic features. We investigated whether these solutions lead to differences in acid–base balance in pigs during acidaemia and correction of pH.
Anaesthetized pigs were randomized to HES130 or gelatine infusion (n = 5 per group). Animals received acid infusion (0.4 M solution of lactic acid and HCl diluted in normal saline) and low tidal volume ventilation (6–7 mL kg−1, PaCO2 of 80–85 mmHg, pH 7.19–7.24). Measurements were made before and after induction of acidaemia, before and after correction of pH with haemofiltration (continuous venovenous haemofiltration) and tris-hydroxymethylaminomethane infusion. We measured parameters describing acid–base balance according to Stewart’s approach, ketone body formation, oxygen delivery, haemodynamics, diuresis and urinary pH.
Acid–base balance did not differ significantly between the groups. In HES130-treated pigs, the haemodilution-based drop of haemoglobin (1.4 ± 1.0 g dL−1, median ± SD) was paralleled by an increase in the cardiac output (0.5 ± 0.4 L min−1). Lacking increases in cardiac output, gelatine-treated pigs demonstrated a reduction in oxygen delivery (149.4 ± 106.0 mL min−1). Tris-hydroxymethylaminomethane volumes required for pH titration to desired values were significantly higher in the gelatine group (0.7 ± 0.1 mL kg−1 h−1 vs. HES130: 0.5 ± 0.2 mL kg−1 h−1).
The buffer capacity of gelatine did not lead to favourable differences in acid–base balance in comparison to HES130.
There have been important advances in radio astronomy in the last three years. New discoveries both at the galactic and extragalactic scale have been reported over this period and we highlight here several of them. The outstanding results of the Wilkinson Microwave Anisotropy Probe satellite, allowing an accurate determination of the main cosmological constants, are certainly among the most important. At the international level, the consolidation of the Atacama Large Millimeter Array project, with participation of the USA, Europe, and Japan and an estimated cost of around one billion US dollars, takes the construction of radio telescopes to a new level of complexity and potential. We also include the Progress Report of the Working Group on Historic Radio Astronomy, that includes a description of the duties and activities of this recently created working group.