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The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort study of the Canadian Consortium on Neurodegeneration in Aging (CCNA) is a national initiative to catalyze research on dementia, set up to support the research agendas of CCNA teams. This cross-country longitudinal cohort of 2310 deeply phenotyped subjects with various forms of dementia and mild memory loss or concerns, along with cognitively intact elderly subjects, will test hypotheses generated by these teams.
The COMPASS-ND protocol, initial grant proposal for funding, fifth semi-annual CCNA Progress Report submitted to the Canadian Institutes of Health Research December 2017, and other documents supplemented by modifications made and lessons learned after implementation were used by the authors to create the description of the study provided here.
The CCNA COMPASS-ND cohort includes participants from across Canada with various cognitive conditions associated with or at risk of neurodegenerative diseases. They will undergo a wide range of experimental, clinical, imaging, and genetic investigation to specifically address the causes, diagnosis, treatment, and prevention of these conditions in the aging population. Data derived from clinical and cognitive assessments, biospecimens, brain imaging, genetics, and brain donations will be used to test hypotheses generated by CCNA research teams and other Canadian researchers. The study is the most comprehensive and ambitious Canadian study of dementia. Initial data posting occurred in 2018, with the full cohort to be accrued by 2020.
Availability of data from the COMPASS-ND study will provide a major stimulus for dementia research in Canada in the coming years.
Heterogeneity is observed in the patterns of cognition in Alzheimer’s disease (AD). Such heterogeneity might suggest the involvement of different etiological pathways or different host responses to pathology. A total of 627 subjects with mild/moderate AD underwent cognitive assessment with the Mini-Mental State Examination (MMSE) and the Dementia Rating Scale-2 (DRS-2). Latent class analysis (LCA) was performed on cognition subscale data to identify and characterize cognitive subgroups. Clinical, demographic, and genetic factors were explored for association with class membership. LCA suggested the existence of four subgroups; one group with mild and another with severe global impairment across the cognitive domains, one group with primary impairments in attention and construction, and another group with primary deficits in memory and orientation. Education, disease duration, age, Apolipoprotein E-ε4 (APOE ε4) status, gender, presence of grasp reflex, white matter changes, and early or prominent visuospatial impairment were all associated with class membership. Our results support the existence of heterogeneity in patterns of cognitive impairment in AD. Our observation of classes characterized by predominant deficits in attention/construction and memory respectively deserves further exploration as does the association between membership in the attention/construction class and APOE ε4 negative status. (JINS, 2010, 16, 233–243.)
Evidentialism is the thesis that a person is justified in believing a proposition iff the person's evidence on balance supports that proposition. In discussing epistemological issues associated with disagreements among epistemic peers, some philosophers have endorsed principles that seem to run contrary to evidentialism, specifying how one should revise one's beliefs in light of disagreement. In this paper, I examine the connection between evidentialism and these principles. I argue that the puzzles about disagreement provide no reason to abandon evidentialism and that there are no true general principles about justified responses to disagreement other than the general evidentialist principle. I then argue that the puzzles about disagreement are primarily puzzles about the evidential impact of higher-order evidence–evidence about the significance or existence of ordinary, or first-order, evidence. I conclude by arguing that such higher-order evidence can often have a profound effect on the justification of first-order beliefs.
Emergency medical services (EMS) responses to
mass gatherings have been described frequently,
but there are few reports describing the response
to a single-day gathering of large magnitude.
This report describes the EMS response to the
largest single-day, ticketed concert held in North
America: the 2003 “Toronto Rocks!” Rolling Stones
Medical care was provided by paramedics,
physicians, and nurses. Care sites included
ambulances, medically equipped, all-terrain
vehicles, bicycle paramedic units, first-aid
tents, and a 124-bed medical facility that
included a field hospital and a rehydration unit.
Records from the first-aid tents, ambulances,
paramedic teams, and rehydration unit were
obtained. Data abstracted included patient
demographics, chief complaint, time of incident,
treatment, and disposition.
More than 450,000 people attended the concert and
1,870 sought medical care (42/10,000 attendees).
No record was kept for the 665 attendees simply
requesting water, sunscreen, or bandages. Of the
remaining 1,205 patients, the average of the ages
was 28 ±11 years, and 61% were female.
Seven-hundred, ninety-five patients (66%) were
cared for at one of the first-aid tents.
Physicians at the tents assisted in patient
management and disposition when crowds restricted
ambulance movement. Common complaints included
headache (321 patients; 27%), heat-related
complaints (148; 12%), nausea or vomiting (91;
7.6%), musculoskeletal complaints (83; 6.9%), and
breathing problems (79; 6.6%). Peak activity
occurred between 14:00 and 19:00 hours, when 102
patients per hour sought medical attention.
Twenty-four patients (0.5/10,000) were transferred
to off-site hospitals.
This report on the EMS response, outcomes, and
role of the physicians at a large single-day mass
gathering may assist EMS planners at future
Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar I disorder.
To evaluate whether olanzapine plus either lithium or valproate reduces the rate of relapse, compared with lithium or valproate alone.
Patients achieving syndromic remission after 6 weeks'treatment with olanzapine plus either lithium (0.6–1.2 mmol/l) or valproate (50–125 μg/ml) received lithium or valproate plus either olanzapine 5–20 mg/day (combination therapy) or placebo (monotherapy), and were followed in a double-masked trial for 18 months.
The treatment difference in time to relapse into either mania or depression was not significant for syndromic relapse (median time to relapse: combination therapy 94 days, monotherapy40.5 days; P=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy42 days; P=0.023).
Patients taking olanzapine added to lithium or valproate experienced sustained symptomatic remission, but not syndromic remission, for longer than those receiving lithium or valproate monotherapy.
We have fabricated ordered arrays of gold nanocrystals on FIB-processed silicon substrates using electroless deposition. We have also fabricated ordered arrays of silver nanocrystals on silicon with diameters 40–60 nm separated by 180 nm center-to-center, using pulsed-laser deposition (PLD) to deposit silver on the substrate. The metal nanocrystal arrays are characterized using SEM as well as AFM and energy dispersive x-ray (EDX) analysis. AFM confirms particle sizes measured in SEM, and EDX analysis demonstrates that Ag preferentially clusters at sites that have been damaged by the ion beam. These results suggest that the FIB-PLD combination can be used to create ordered arrays of Ag nanocrystals with diameters of 10 nm or less.
A new procedure that generates the transient solution of the first moment of the state of a Markovian queueing network with state-dependent arrivals, services, and routeing is developed. The procedure involves defining a partial differential equation that relates an approximate multivariate cumulant generating function to the intensity functions of the network. The partial differential equation then yields a set of ordinary differential equations which are numerically solved to obtain the first moment.
This study proposes a model explaining the association between physical abuse of children
and children's social and affective status as one in which children's social
expectations and behavior, developed within the context of abusive parenting, mediate current
functioning in these two outcome domains. Subjects included one hundred 9 to 12-year-old
physically abused children recruited from consecutive entries onto the New York State Register
for Child Abuse for New York City and 100 case-matched classmate nonabused comparison
children. Sociometric assessments were carried out in classrooms, interviews were conducted
with the children and their parents, and teachers, parents, and classmates rated the
children's behavior. Path analysis was utilized to test the conceptually derived models.
Children's social expectations regarding peers, and two social behaviors—aggressive
behavior and prosocial behavior—were found to mediate between abuse and positive and
negative social status, as well as between abuse and positive and negative reciprocity. Social
expectations and withdrawn behavior mediated between abuse and positive social status, but only
where withdrawn behavior was a function of social expectations. Social expectations were
generally found to mediate between abuse and internalizing problems. Negative social status (peer
rejection) added to social expectations in producing internalizing problems. Identification of these
mediating pathways can serve to guide secondary preventive intervention efforts so that they best
address the problems abused children face in the absence of adequate parental and peer support as
the children enter adolescence.
Pentacene thin films were grown in ultra high vacuum on amorphous SiO2 and on a high dielectric constant material, crystalline BaTiO3. During pentacene deposition, substrates were held at three different temperatures (-650, 250 and 750 C). In general, three different morphologies were identified: a first closed interfacial layer, a thin film mode composed of faceted grains with single molecule step height, and a volume mode with features substantially higher than those of the thin film mode. Analysis was carried out by atomic force microscopy and in some cases by synchrotron X-ray diffraction.
We describe recent experiments in which we attempted the initial steps for fabricating twodimensional arrays of metal nanocrystals. We use a commercial pulsed-laser deposition system in concert with a focused ion beam to attempt control over both lateral and vertical dimensions at the nanometer length scale. In our experiments, regular arrays of holes typically 80 nm in diameter were drilled in Si substrates using the focused ion beam. Silver atoms were then deposited onto these substrates by pulsed laser evaporation from a metallic target in high vacuum. Under certain conditions of substrate temperature, laser pulse repetition rate, and fluence, small silver nanoclusters form preferentially around the structures previously etched in the silicon surfaces by the focused ion beam.
Visual perception is the process of inferring world structure from image structure. If the world structure we recover from our images “makes sense” as a plausible world event, then we have a “percept” and can often offer a concise linguistic description of what we see. For example, in the upper panel of Figure 3.1, if asked, “What do you see?”, a typical response might be a pillbox with a handle either erect (left) or flat (right). This concise and confident response suggests that we have identified a model type that fits the image observation with no residual ambiguities at the level of the description. In contrast, when asked to describe the two lower drawings in Figure 3.1, there is some hesitancy and uncertainty. Is the handle erect or not? Does it have a skewed or rectangular shape? The depiction leaves us somewhat uncertain, as if several options were possible, but none where all aspects of the interpretation collectively support each other. What then, leads us to the certainty in the upper set and to the ambiguity in the lower pair?
To be a bit more precise about our goal, let us assume that some Waltz-like algorithm has already identified the base of the pillbox and the wire-frame handle as separate 3D parts. Even with this decomposition, there remains an infinity of possible interpretations for any of these drawings.
The steady-state analysis of a quasi-birth-death process is possible by matrix geometric procedures in which the root to a quadratic matrix equation is found. A recent method that can be used for analyzing quasi-birth–death processes involves expanding the state space and using a linear matrix equation instead of the quadratic form. One of the difficulties of using the linear matrix equation approach regards the boundary conditions and obtaining the norming equation. In this paper, we present a method for calculating the boundary values and use the operator-machine interference problem as a vehicle to compare the two approaches for solving quasi-birth-death processes.
To evaluate the seroconversion rate of EMS personnel given the hepatitis B virus (HBV) recombinant deoxyribonucleic acid (DNA) vaccine series.
Retrospective review of paramedics and firefighters consecutively completing the HBV recombinant DNA vaccine program.
Urban, non-prof it, private, regional EMS Resource Hospital. The Chicago North EMS System is under contract with the Chicago Fire Department. This contract allows for the voluntary vaccination of EMS personnel with recombinant DNA-HBV vaccine and treatment and follow-up of paramedics and firefighters possibly exposed to HBV.
Initial 68 EMS personnel completing HBV recombinant DNA vaccine program (48 primary prophylaxis and 20 post-exposure prophylaxis).
HBV recombinant DNA vaccine series was administered voluntarily to Chicago EMS System paramedics and firefighters per manufacturers recommendations. Two weeks after completion of the vaccination series, blood samples for HBV antibody titres were drawn to determine reactivity and the need for further immunization.
Of the 68 vaccinated individuals, only two had negative titres (3%). These two individuals were given a fourth dose of vaccine with successful seroconversion.
Prehospital care personnel are known highrisk, health-care workers for acquiring HBV and should be vaccinated prophylactically. There is a high seroconversion rate (97%) utilizing HBV recombinant DNA vaccine. However, post-vaccination antibody titres must be performed to identify those rare individuals that do not seroconvert.