Adverse Effects of Cholinesterase Inhibitors in Dementia, According to the Pharmacovigilance Databases of the United-States and Canada.

This survey analyzes two national pharmacovigilance databases in order to determine the major adverse reactions observed with the use of cholinesterase inhibitors in dementia. We conducted a statistical analysis of the Food and Drug Administration Adverse Event Reporting System (FAERS) and the Canada Vigilance Adverse Reaction Database (CVARD) concerning the side effects of cholinesterase inhibitors. The statistics calculated for each adverse event were the frequency and the reporting odds ratios (ROR). A total of 9877 and 2247 reports were extracted from the FAERS and CVARD databases, respectively. A disproportionately higher frequency of reports of death as an adverse event for rivastigmine, compared to the other acetylcholinesterase inhibiting drugs, was observed in both the FAERS (ROR = 3.42; CI95% = 2.94-3.98; P<0.0001) and CVARD (ROR = 3.67; CI95% = 1.92-7.00; P = 0.001) databases. While cholinesterase inhibitors remain to be an important therapeutic tool against Alzheimer's disease, the disproportionate prevalence of fatal outcomes with rivastigmine compared with alternatives should be taken into consideration

A simplified model for transport in aquifers

Chemicals that are dissolved in groundwater flow along with the slow-moving water as it makes its way through the complex pores of the aquifer; during this process they are dispersed in different directions. The rate of dispersion depends on the porous structure and the fluid speed. Many groundwater aquifers have a natural layered structure; here this is used to advantage by discretizing them into almost horizontal layers, where each may have different matrix properties such as thickness, permeability, dispersivity, porosity, etc. The mean dynamic pressure (or mean hydraulic head) may be assumed constant vertically at each horizontal point if it is not in the vicinity of a well or where there is very small vertical flow. In the vicinity of recharge or pumping wells, the mean dynamic pressures or hydraulic heads for each sub-layer of the aquifer may be allowed to have different values for each different sub-layer. Steady-state fluid flow is considered here, in both confined and phreatic (unconfined) aquifers for illustration

The hazards of genotype imputation in chromosomal regions under selection: A case study using the Lactase gene region

Although imputation of missing SNP results has been widely used in genetic studies, claims about the quality and usefulness of imputation have outnumbered the few studies that have questioned its limitations. But it is becoming clear that these limitations are real—for example, disease association signals can be missed in regions of LD breakdown. Here, as a case study, using the chromosomal region of the well-known lactase gene, LCT, we address the issue of imputation in the context of variants that have become frequent in a limited number of modern population groups only recently, due to selection. We study SNPs in a 500 bp region covering the enhancer of LCT, and compare imputed genotypes with directly genotyped data. We examine the haplotype pairs of all individuals with discrepant and missing genotypes. We highlight the nonrandom nature of the allelic errors and show that most incorrect imputations and missing data result from long haplotypes that are evolutionarily closely related to those carrying the derived alleles, while some relate to rare and recombinant haplotypes. We conclude that bias of incorrectly imputed and missing genotypes can decrease the accuracy of imputed results substantially

Ceramic Water Filters for the Removal of Bacterial, Chemical, and Viral Contaminants

International audienceIn this study, the combination of capture mechanisms in ceramic water filters (doped with hydroxyapatite and alumina) was considered for the removal of contaminants from drinking water. It was found that hydroxyapatite and alumina were conserved during the firing process of the ceramic water filters up to 950°C. The nanopores resulting from the conservation of the additives increased the specific surface area of the ceramic water filters from 3.7 to 21.0m2·g−1. On the other hand, the microscopic pores associated with the processing of the ceramic water filters (i.e., pressing and drying) and the combustion of the sawdust reduced the filtration time from 24 to 4 h. The efficiency of the resulting filters in removing bacterial, chemical, and viral contaminants from water was investigated using E. coli, fluoride, and MS2 as model contaminants. The contaminants were found to be captured from water by trapping in the pores, substitution in the hydroxyapatite, and adsorption on the surface of alumina. Hence, the ceramic water filters incorporating hydroxyapatite and alumina combined the different capture mechanisms. They had an efficiency of 99.998%, 99.970%, and 99.450% in the removal of bacterial, chemical, and viral contaminants, corresponding to log reduction values (LRVs) of 4.69, 3.47, and 2.26, respectively

Assessment of measured and perceived microclimates within a tropical urban forest

AbstractUrban greenery is a favoured approach applied towards reducing urban warmth and climate discomfort, but ascertaining its measured and perceived effectiveness in tropical climates is relatively understudied. To this end, we investigated microclimate differences within an urban park (the Singapore Botanic Gardens) to assess if variations in plot-scale land cover affect both objective (measured) and subjective (surveyed) microclimate data. Over two monsoonal seasons, we obtained data from four distinct sites—a tropical rainforest stand, a palm tree valley, a water-body feature, and the park visitors’ centre. Measured climate data (e.g. air temperature, vapour pressure, wind velocity and globe temperatures) were used to derive mean radiant temperature Tmrt and three thermal comfort indices (e.g. temperature-humidity index THI, physiological equivalent temperature PET, and wet-bulb globe temperature WBGT). Concurrent to these measurements, we also surveyed park users (n=1573) for perceived microclimate sensations and preferences in thermal, humidity, wind and sun exposure, as well as their overall assessment of climate comfort/discomfort. The results indicate significant differences in both measured and perceived microclimates over different sites and seasons, with (i) selected heat stress thresholds based on thermal comfort indices exceeded at several sites, and (ii) visitors perceived generally hot, humid and low-wind conditions throughout. Variations in respondent acclimatisation to tropical climates are observed between correlations of WBGT and some sensation votes, with apparently stronger correlations with more acclimated respondents. While humidity was voted as the most uncomfortable climate variable across all sites, a large majority of respondents felt comfortable climate conditions throughout. Present results confirm that vegetation canopy characteristics affecting wind and sun exposure appear to be important factors in outdoor thermal comfort. Lastly, we suggest that future tropical outdoor thermal comfort studies consider the critical aspects of site humidity and wind to discern comfort/discomfort levels

Models of pollutant transport in natural aquifers

We present an approach for modelling the transport of pollution within a groundwater aquifer. The model is based on vertical discretisation of the aquifer into a number of horizontal layers. The approach can be used in a variety of situations. In particular, aquifers with lenses and phreatic surfaces are discussed. The use of the model is illustrated with examples including a comparison with experimental field data and the use of a second transported substance for remediation of the pollution. References A. Ali (2015) Simplified modelling of pollutant transport in naturally-layered aquifers, PhD Thesis, Massey University, NZ. https://mro.massey.ac.nz/handle/10179/6782 A. Ali, R. McKibbin, W.L. Sweatman (2012) Fluid flow and solute transport in unevenly-stratified groundwater aquifers, AIP Conference Proceedings, 1453, 11–16. doi:10.1063/1.4711146 A. Ali, R. McKibbin, W.L. Sweatman (2012) Simplified modelling of pollutant transport in stratified groundwater aquifers, Proceedings of IEMSs 2012, 2739–2746. http://www.iemss.org/sites/iemss2012/proceedings/I1_0675_Ali_et_al.pdf A. Ali, R. McKibbin, W.L. Sweatman (2012) Tracer transport: Appearing or disappearing sub-layer in a groundwater aquifer, In: G. Mallinson, ed., Proceedings of the 23rd International Symposium on Transport Phenomena (ISTP), The University of Auckland, NZ. A. Ali, R. McKibbin, W.L. Sweatman (2014) A simplified model for transport in aquifers, Proceedings of ICPM5, ECI Symposium Series. http://dc.engconfintl.org/porous_media_V/56 A. Ali, W.L. Sweatman, R. McKibbin (2014) Pollutant transport and its alleviation in groundwater aquifers, Mathematics in Industry, 19, 53–58. doi:10.1007/978-3-319-05365-3_8 M.P. Anderson, J.A. Cherry (1979) Using models to simulate the movement of contaminants through groundwater flow systems, CRC Critical Reviews in Environmental Control, 9(2):97–156. doi:10.1080/10643387909381669, J. Bear (1972) Dynamics of fluid in porous media Dover, New York. ISBN 10 0486656756 J. Bear, Y. Bachmat (1991) Introduction to modeling of transport phenomena in porous media, Kluwer. ISBN 978-94-009-1926-6 J. Bear, A. Verruijt (1978) Modeling groundwater flow and pollution D. Reidel, Dordrecht, Holland. H.P.G. Darcy (1856) Les fontaines publiques de la ville de dijon, Technical report, Victor Dalmont, Paris. J. Dupuit (1863) Etudes theoriques et pratiques sur le mouvement des eaux dans les canaux decouverts et a travers les terrains permeables, Dunod, Paris, 2nd edition. D.L. Freyberg (1986) A natural gradient experiment on solute transport in a sand aquifer: 2. Spatial moments and the advection and dispersion of nonreactive tracers, Water Resources Research, 22, 2031–2046. doi:10.1029/WR022i013p02031 D.M. Mackay, D.L. Freyberg, P.V. Roberts, J.A. Cherry (1986) A natural gradient experiment on solute transport in a sand aquifer: 1. Approach and overview of plume movement, Water Resources Research, 22, 2017–2029. doi:10.1029/WR022i013p02017 R. McKibbin (2009) Groundwater pollutant transport: transforming layered models to dynamical systems, An. St. Univ. Ovidius Constanta, Ser. Mat., 17(3), 183–196. http://www.emis.ams.org/journals/ASUO/mathematics/pdf19/McKibbin.pdf R. McKibbin (2010) Some aspects of modelling pollution transport in groundwater aquifers, In: L.H. Weiranto, S. Pudjaprasetya, editors, Proceedings of CIAM 2010, 9–16, ITB, Indonesia

Prevalence and Correlates of Common Mental Disorders among Mothers of Young Children in Kilimanjaro Region of Tanzania.

Although poor maternal mental health is a major public health problem, with detrimental effects on the individual, her children and society, information on its correlates in low-income countries is sparse. This study investigates the prevalence of common mental disorders (CMD) among at-risk mothers, and explores its associations with sociodemographic factors. This population-based survey of mothers of children aged 0-36 months used the 14-item Shona Symptom Questionnaire (SSQ). Mothers whose response was "yes" to 8 or more items on the scale were defined as "at risk of CMD." Of the 1,922 mothers (15-48 years), 28.8% were at risk of CMD. Risk of CMD was associated with verbal abuse, physical abuse, a partner who did not help with the care of the child, being in a polygamous relationship, a partner with low levels of education, and a partner who smoked cigarettes. Cohabiting appeared to be protective. Taken together, our results indicate the significance of the quality of relations with one's partner in shaping maternal mental health. The high proportion of mothers who are at risk of CMD emphasizes the importance of developing evidence-based mental health programmes as part of the care package aimed at improving maternal well-being in Tanzania and other similar settings

Medication-related harm in older adults following hospital discharge: development and validation of a prediction tool

Objectives: To develop and validate a tool to predict the risk of an older adult experiencing medication-related harm (MRH) requiring healthcare use following hospital discharge. Design, setting, participants: Multicentre, prospective cohort study recruiting older adults (65 years) discharged from five UK teaching hospitals between 2013 and 2015. Primary outcome measure: Participants were followed up for 8 weeks in the community by senior pharmacists to identify MRH (adverse drug reactions, harm from non-adherence, harm from medication error). Three data sources provided MRH and healthcare use information; hospital readmissions, primary care use, participant telephone interview. Candidate variables for prognostic modelling were selected using two systematic reviews, the views of patients with MRH, and an expert panel of clinicians. Multivariable logistic regression with backward elimination, based on the Akaike Information Criterion, was used to develop the PRIME tool. The tool was internally validated. Results: 1116 out of 1280 recruited participants completed follow-up (87%). Uncertain MRH cases (‘possible’ and ‘probable’) were excluded, leaving a tool derivation cohort of 818. 119 (15%) participants experienced ‘definite’ MRH requiring healthcare use and 699 participants did not. Modelling resulted in a prediction tool with eight variables measured at hospital discharge; age, gender, antiplatelet drug, sodium level, antidiabetic drug, past adverse drug reaction, number of medicines, living alone. The tool’s discrimination C-statistic was 0.69 (0.66 after validation) and showed good calibration. Decision curve analysis demonstrated the potential value of the tool to guide clinical decision making compared with alternative approaches. Conclusions: The PRIME tool could be used to identify older patients at high risk of MRH requiring healthcare use following hospital discharge. Prior to clinical use we recommend the tool’s evaluation in other settings

10 A noninvasive approach for the early detection of diabetic retinopathy

This chapter introduces one of the most critical problems in ophthalmology, specifically the diagnosis and detection of diabetic retinopathy (DR). Developing a fast, accurate, and reliable method for the early detection of DR is of great clinical importance to prevent blindness in patients. For this reason, various methods for early detection of DR have been investigated and used such as a dilated eye examination, tonometry, fluorescein angiography, optical coherence tomography, and ultrawide-field retinal imaging. With the increased popularity of machine learning, researchers have formulated their own algorithms and methods to detect DR with various rates of success. This chapter overviews past and current diagnostic methods that have been developed for DR. In addition, this chapter addresses new methodologies being developed/researched and some challenges that researchers face in developing fast, accurate, and reliable diagnosis