Arrhythmia and other modifiable risk factors in incident dementia and MCI among elderly individuals with low educational levels in Taiwan

IntroductionThere is increasing evidence that arrhythmia is a risk factor for dementia; however, it appears that arrhythmia affects the cognitive function of individuals differentially across age groups, races, and educational levels. Demographic differences including educational level have also been found to moderate the effects of modifiable risk factors for cognitive decline.MethodsThis study recruited 1,361 individuals including a group of cognitively unimpaired (CU) individuals, a group of patients with mild cognitive impairment (MCI), and a group of patients with dementia with low education levels. The participants were evaluated in terms of modifiable risk factors for dementia, including arrhythmia and neuropsychiatric symptoms.ResultsCox proportional hazard regression models revealed that among older MCI patients (>75 years), those with arrhythmia faced an elevated risk of dementia. Among younger MCI patients, those taking anti-hypertensive drugs faced a relatively low risk of dementia. Among younger MCI patients, male sex and higher educational level were associated with an elevated risk of dementia. Among CU individuals, those with coronary heart disease and taking anti-lipid compounds faced an elevated risk of MCI and those with symptoms of depression faced an elevated risk of dementia.DiscussionThe risk and protective factors mentioned above could potentially be used as markers in predicting the onset of dementia in clinical settings, especially for individuals with low educational levels

Tropical Cyclones Disrupt the Relationship between Tree Height and Species Diversity: Comment

In a recent report on the patterns of tree species richness in eastern and western North America, Marks et al. (2016) claimed to have identified an operational indicator of environmental harshness (maximum tree height) and concluded that environmental stressors that limit tree height also act as ecological filters on species richness. Marks et al. (2017) attributed the positive association between species richness and maximum tree height to both the direct effects of environmental harshness on species richness and the indirect effects of environmental harshness on species richness as mediated by maximum tree height. This finding overlooked the fact that many environmental stressors such as cyclonic disturbance affect tree height and tree species diversity in different directions. In a study of elevational patterns in Taiwan, Chi et al. (2015) reported sharply contrasting relationships between tree species diversity and canopy tree height in sites that were subject to tropical cyclone disturbance vs. those that were not. In the mountains of southeastern China beyond the reach of tropical cyclones, both tree species richness and canopy tree height decreased with increasing elevation (Zheng et al. 2004, Chi et al. 2015), supporting the harshness hypothesis (Marks et al. 2016, 2017). In contrast, in Taiwan, where tropical cyclones occur annually, tree species richness decreased but maximum tree height increased with increasing elevation, the opposite of the predictions of the harshness hypothesis (Fig. 1). We attributed the contrasting elevational patterns and associations between tree diversity and canopy tree height in Taiwan to topographic mediation of tropical cyclone disturbance. The shorter tree stature in lower elevations was attributed to more severe tropical cyclone damage (Chi et al. 2015). Although tropical cyclones limit tree height, tree mortality is very low, possibly a result of both evolutional and ecological responses of these forest ecosystems through the long-term interaction between cyclones and the forest ecosystems (Lin et al. 2011). As an example, multiple category three tropical cyclones on the Saffir-Simpson scale (Simpson and Riehl 1981) caused \u3c2% tree mortality in low-elevation evergreen broadleaf forest in northeastern Taiwan in 1994, a record year of tropical cyclone frequency and intensity (Lin et al. 2011). However, taller trees were selectively killed and defoliation was severe, both of which contributed to the low stature of the forest even though the mean annual temperature (18°C) and precipitation (3800) mm are high (Lin et al. 2011). Cyclone disturbance limits vertical development of trees but does not lead to their elimination. Thus, more tropical cyclone disturbance at lower elevations overrides climatic controls on elevational patterns of tree height but does not change the elevational pattern of tree species richness. We suggest that there is an important difference between actual maximum tree height and potential maximum tree height in the presence of disturbance (e.g., tropical cyclone)

Brain computerized tomography reading in suspected acute ischemic stroke patients: what are essentials for medical students?

Background Few systematic methods prioritize the image education in medical students (MS). We hope to develop a checklist of brain computerized tomography (CT) reading in patients with suspected acute ischemic stroke (AIS) for MS and primary care (PC) physicians. Methods Our pilot group generated the items indicating specific structures or signs for the checklist of brain CT reading in suspected AIS patients for MS and PC physicians. These items were used in a modified web-based Delphi process using the online software “SurveyMonkey”. In total 15 panelists including neurologists, neurosurgeons, neuroradiologists, and emergency department physicians participated in the modified Delphi process. Each panelist was encouraged to express feedback, agreement or disagreement on the inclusion of each item using a 9-point Likert scale. Items with median scores of 7–9 were included in our final checklist. Results Fifty-two items were initially provided for the first round of the Delphi process. Of these, 35 achieved general agreement of being an essential item for the MS and PC physicians. The other 17 of the 52 items in this round and another two added items suggested by the panelists were further rated in the next round. Finally, 38 items were included in the essential checklist items of brain CT reading in suspected AIS patients for MS and PC physicians. Conclusions We established a reference regarding the essential items of brain CT reading in suspected AIS patients. We hope this helps to minimize malpractice and a delayed diagnosis, and to improve competency-based medical education for MS and PC physicians

Production of phi mesons at mid-rapidity in sqrt(s_NN) = 200 GeV Au+Au collisions at RHIC

We present the first results of meson production in the K^+K^- decay channel from Au+Au collisions at sqrt(s_NN) = 200 GeV as measured at mid-rapidity by the PHENIX detector at RHIC. Precision resonance centroid and width values are extracted as a function of collision centrality. No significant variation from the PDG accepted values is observed. The transverse mass spectra are fitted with a linear exponential function for which the derived inverse slope parameter is seen to be constant as a function of centrality. These data are also fitted by a hydrodynamic model with the result that the freeze-out temperature and the expansion velocity values are consistent with the values previously derived from fitting single hadron inclusive data. As a function of transverse momentum the collisions scaled peripheral.to.central yield ratio RCP for the is comparable to that of pions rather than that of protons. This result lends support to theoretical models which distinguish between baryons and mesons instead of particle mass for explaining the anomalous proton yield.Comment: 326 authors, 24 pages text, 23 figures, 6 tables, RevTeX 4. To be submitted to Physical Review C as a regular article. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

J/psi production from proton-proton collisions at sqrt(s) = 200 GeV

J/psi production has been measured in proton-proton collisions at sqrt(s)= 200 GeV over a wide rapidity and transverse momentum range by the PHENIX experiment at RHIC. Distributions of the rapidity and transverse momentum, along with measurements of the mean transverse momentum and total production cross section are presented and compared to available theoretical calculations. The total J/psi cross section is 3.99 +/- 0.61(stat) +/- 0.58(sys) +/- 0.40(abs) micro barns. The mean transverse momentum is 1.80 +/- 0.23(stat) +/- 0.16(sys) GeV/c.Comment: 326 authors, 6 pages text, 4 figures, 1 table, RevTeX 4. To be submitted to PRL. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Measurement of Single Electron Event Anisotropy in Au+Au Collisions at sqrt(s_NN) = 200 GeV

The transverse momentum dependence of the azimuthal anisotropy parameter v_2, the second harmonic of the azimuthal distribution, for electrons at mid-rapidity (|eta| < 0.35) has been measured with the PHENIX detector in Au+Au collisions at sqrt(s_NN) = 200 GeV. The measurement was made with respect to the reaction plane defined at high rapidities (|eta| = 3.1 -- 3.9). From the result we have measured the v_2 of electrons from heavy flavor decay after subtraction of the v_2 of electrons from other sources such as photon conversions and Dalitz decay from light neutral mesons. We observe a non-zero single electron v_2 with a 90% confidence level in the intermediate p_T region.Comment: 330 authors, 11 pages text, RevTeX4, 9 figures, 1 tables. Submitted to Physical Review C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Systematic Studies of the Centrality and sqrt(s_NN) Dependence of dE_T/deta and dN_ch/deta in Heavy Ion Collisions at Mid-rapidity

The PHENIX experiment at RHIC has measured transverse energy and charged particle multiplicity at mid-rapidity in Au+Au collisions at sqrt(s_NN) = 19.6, 130 and 200 GeV as a function of centrality. The presented results are compared to measurements from other RHIC experiments, and experiments at lower energies. The sqrt(s_NN) dependence of dE_T/deta and dN_ch/deta per pair of participants is consistent with logarithmic scaling for the most central events. The centrality dependence of dE_T/deta and dN_ch/deta is similar at all measured incident energies. At RHIC energies the ratio of transverse energy per charged particle was found independent of centrality and growing slowly with sqrt(s_NN). A survey of comparisons between the data and available theoretical models is also presented.Comment: 327 authors, 25 pages text, 19 figures, 17 tables, RevTeX 4. To be submitted to Physical Review C as a regular article. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

Centrality Dependence of Charm Production from Single Electrons in Au+Au Collisions at sqrt(s_NN) = 200 GeV

The PHENIX experiment has measured mid-rapidity transverse momentum spectra (0.4 < p_T < 4.0 GeV/c) of single electrons as a function of centrality in Au+Au collisions at sqrt(s_NN) = 200 GeV. Contributions to the raw spectra from photon conversions and Dalitz decays of light neutral mesons are measured by introducing a thin (1.7% X_0) converter into the PHENIX acceptance and are statistically removed. The subtracted ``non-photonic'' electron spectra are primarily due to the semi-leptonic decays of hadrons containing heavy quarks (charm and bottom). For all centralities, charm production is found to scale with the nuclear overlap function, T_AA. For minimum-bias collisions the charm cross section per binary collision is N_cc^bar/T_AA = 622 +/- 57 (stat.) +/- 160 (sys.) microbarns.Comment: 326 authors, 4 pages text, 3 figures, 1 table, RevTeX 4. To be submitted to Physical Review Letters. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm

ICAR: endoscopic skull‐base surgery

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