Hearing impairment in older adults is independently associated in longitudinal studies with accelerated cognitive decline and incident dementia, and in cross-sectional studies, with reduced volumes ...in the auditory cortex. Whether peripheral hearing impairment is associated with accelerated rates of brain atrophy is unclear. We analyzed brain volume measurements from magnetic resonance brain scans of individuals with normal hearing versus hearing impairment (speech-frequency pure tone average>25dB) followed in the neuroimaging substudy of the Baltimore Longitudinal Study of Aging for a mean of 6.4years after the baseline scan (n=126, age 56–86years). Brain volume measurements were performed with semi-automated region-of-interest (ROI) algorithms, and brain volume trajectories were analyzed with mixed-effect regression models adjusted for demographic and cardiovascular factors. We found that individuals with hearing impairment (n=51) compared to those with normal hearing (n=75) had accelerated volume declines in whole brain and regional volumes in the right temporal lobe (superior, middle, and inferior temporal gyri, parahippocampus, p<.05). These results were robust to adjustment for multiple confounders and were consistent with voxel-based analyses, which also implicated right greater than left temporal regions. These findings demonstrate that peripheral hearing impairment is independently associated with accelerated brain atrophy in whole brain and regional volumes concentrated in the right temporal lobe. Further studies investigating the mechanistic basis of the observed associations are needed.
Abstract
Objective:
To conduct a literature review and knowledge synthesis of medical support in cave rescue and confined space medicine (CSM), thereby, extrapolating the knowledge gained from cave ...rescue and CSM to consequence management in Urban Underground Space (UUS) development.
Methodology:
A review of current medical literature was conducted.
Data sources:
Search engines utilized include PubMed, Medline, Cochrane Library, Science Direct and Google Scholar.
Results and Recommendations:
The synthesized knowledge based on available literature was extrapolated to application during consequence management in UUS development.
Conclusion:
As underground urbanization progresses to create sustainable habitats for the world’s increasing population, city planners need to consider the need for consequence management in UUS. The knowledge and experience gleaned a posteriori from cave rescue and CSM should be utilised to optimize the planning of emergency response in an urban underground environment.
In this Letter, we illustrate how polarized neutron scattering can be used to isolate the spin-spin correlations of modes forming flat bands in a frustrated magnetic system hosting a classical spin ...liquid phase. In particular, we explain why the nearest-neighbor spin ice model, whose interaction matrix has two flat bands, produces a dispersionless (i.e., "flat") response in the non-spin-flip (NSF) polarized neutron scattering channel and demonstrate that NSF scattering is a highly sensitive probe of correlations induced by weak perturbations that lift the flat band degeneracy. We use this to explain the experimentally measured dispersive (i.e., nonflat) NSF channel of the dipolar spin ice compound Ho_{2}Ti_{2}O_{7}.
Diabet. Med. 28, 1082–1087 (2011)
Aims To compare maternal and neonatal outcomes in women with gestational diabetes treated with diet, metformin and/or insulin in routine clinical practice in a ...single centre.
Methods We analysed prospectively collected data from the National Women’s Health database for all women with gestational diabetes who delivered between January 2007 and December 2009. Since June 2007, women requiring medication have been given a choice of either metformin or insulin treatment, except women with a fetal abdominal circumference less than the 10th percentile, who were not offered metformin.
Results There were 1269 women with gestational diabetes; treatment was diet in 371, insulin in 399 and metformin in 465 (249 metformin alone, 216 metformin and insulin). Women treated with metformin and/or insulin had significantly higher BMIs compared with those in the diet group (P < 0.001) and had a higher fasting glucose at diagnosis (p < 0.001). Women treated with insulin had higher rates of Caesarean delivery (45.6% insulin, 37% metformin, 34% diet, P = 0.02) than women treated with metformin or diet. They also had higher rates of preterm births (19.2% insulin, 12.5% metformin, 12.1% diet, P = 0.005), customized large‐for‐gestational‐age infants (18.5% insulin, 12.5% metformin, 12.4% diet, P = 0.02), neonatal admissions (18.7% insulin, 12.7% metformin, 14.0% diet, P = 0.04) and neonatal intravenous dextrose use (11.1% insulin, 5.1% metformin, 7.4% diet, P = 0.004). Neonatal outcomes were similar between diet‐ and metformin‐treated women.
Conclusions In routine practice, use of metformin in gestational diabetes was associated with fewer adverse outcomes compared with insulin, but baseline differences between treatment groups may have contributed to this.
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•ARC reactor designed to have 500MW fusion power at 3.3m major radius.•Compact, simplified design allowed by high magnetic fields and jointed magnets.•ARC has innovative plasma ...physics solutions such as inboardside RF launch.•High temperature superconductors allow high magnetic fields and jointed magnets.•Liquid immersion blanket and jointed magnets greatly simplify tokamak reactor design.
The affordable, robust, compact (ARC) reactor is the product of a conceptual design study aimed at reducing the size, cost, and complexity of a combined fusion nuclear science facility (FNSF) and demonstration fusion Pilot power plant. ARC is a ∼200–250MWe tokamak reactor with a major radius of 3.3m, a minor radius of 1.1m, and an on-axis magnetic field of 9.2T. ARC has rare earth barium copper oxide (REBCO) superconducting toroidal field coils, which have joints to enable disassembly. This allows the vacuum vessel to be replaced quickly, mitigating first wall survivability concerns, and permits a single device to test many vacuum vessel designs and divertor materials. The design point has a plasma fusion gain of Qp≈13.6, yet is fully non-inductive, with a modest bootstrap fraction of only ∼63%. Thus ARC offers a high power gain with relatively large external control of the current profile. This highly attractive combination is enabled by the ∼23T peak field on coil achievable with newly available REBCO superconductor technology. External current drive is provided by two innovative inboard RF launchers using 25MW of lower hybrid and 13.6MW of ion cyclotron fast wave power. The resulting efficient current drive provides a robust, steady state core plasma far from disruptive limits. ARC uses an all-liquid blanket, consisting of low pressure, slowly flowing fluorine lithium beryllium (FLiBe) molten salt. The liquid blanket is low-risk technology and provides effective neutron moderation and shielding, excellent heat removal, and a tritium breeding ratio≥1.1. The large temperature range over which FLiBe is liquid permits an output blanket temperature of 900K, single phase fluid cooling, and a high efficiency helium Brayton cycle, which allows for net electricity generation when operating ARC as a Pilot power plant.
BACKGROUND: TB continues to impose a significant healthcare burden despite advancement in diagnostics and increased availability of effective antimicrobials. Recent years have seen a resurgence of ...the disease in association with increasing life expectancy and use of immunosuppressive
therapy. Mortality remains high in TB patients requiring admission to critical care units.METHODS: We conducted a retrospective study in two public hospitals to determine factors associated with mortality in patients with TB requiring critical care admission. All patients aged ≥21
years with a diagnosis of active TB involving any organ system at the time of a critical care admission were eligible. The primary outcome measure was 30-day mortality.RESULTS: Over the study period of 4 years, 148 patients were identified. Overall 30-day mortality was 36.5%. Based
on multivariate analysis, factors which independently correlated with 30-day mortality include higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score, acid-fast bacilli smear positivity, initiation of anti-TB treatment prior to critical care admission and need for renal
replacement therapy.CONCLUSION: TB in critically ill patients continues to be associated with significant mortality. The factors identified to be associated with poor survival outcomes in our study were largely related to greater disease burden and potential for suboptimal treatment.
Novel polymer grafted metal-organic framework (MOF) nanoparticles were synthesized. The formed core/shell nanoparticles exhibit outstanding water dispersity and pH sensitivity, and show their ...catalytic effect for the reduction reaction of 4-nitrophenol (NP) to 4-aminophenol (AP) when loaded with Pd(0) catalyst.
Scarf repairs to aircraft structures need to sustain design ultimate load in the presence of flaws due to manufacturing and impact by foreign objects, in order to demonstrate compliance with ...airworthiness regulations. This paper presents an investigation into the effect of disbonds on the load-carrying capacity of adhesively bonded scarf joints. Experiments were conducted on scarf joints containing disbonds of varying lengths. The results showed that the load-carrying capacity of scarf joints decreases with the size of the bondline flaw at a faster rate than the reduction in the effective bond area. Fractographic analysis showed that the fracture occurred in the composite matrix adjacent to the adhesive-composite interface, at a distance equal to a small fraction of ply thickness. Computational analyses using the virtual crack closure technique (VCCT) and the cohesive zone model (CZM) confirmed these experimental observations: model predictions using composite material properties were in better correlation with experimental results than those using adhesive properties. Furthermore, CZM is capable of predicting the effects of flaws of all sized being considered, while the VCCT model is only applicable to joints containing flaws greater than a certain size.
This article summarizes the current status of CT perfusion in oncologic imaging, including lesion characterization, staging, prediction of patient outcome or response to therapy, assessment of ...response to different therapies, and evaluation of tumor relapse. Technical limitations and drawbacks of CT perfusion are also discussed.
Tumor angiogenesis is essential for cancer growth and provides an attractive target for oncologic therapies. CT perfusion is an emerging imaging tool that provides both qualitative and quantitative information regarding tumor angiogenesis.
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