State care in childhood and adult mortality: a systematic review and meta-analysis of prospective cohort studies

BACKGROUND: Removal from family of origin to state care can be a highly challenging childhood experience and is itself linked to an array of unfavourable outcomes in adult life. We aim to synthetise evidence on the risk of adult mortality in people with a history of state care in early life, and assess the association according to different contexts. METHODS: In this systematic review and meta-analysis, we focused on four health outcomes hypothesised to be associated with exposure to early state care: total mortality, cardiovascular disease, cancer, and suicide. We searched the electronic databases PubMed and Embase from inception to Jan 21, 2022, for studies fulfilling the following criteria: it was a prospective study in which the assessment of care was made up to 18 years of age; it included an unexposed comparator group; the focus of the study was temporary out-of-home care and not adoption; mortality surveillance was extended into adulthood; standard estimates of association (eg, relative risk, odds ratios, or hazard ratios) and variance (eg, CIs and SE) were provided; the study appeared in a peer-reviewed journal; and the study was published in English. An adapted Cochrane Risk of Bias Tool was used to assess study quality. We extracted estimates of association and variance from qualifying studies and augmented these findings with analyses of unpublished data from individual participants in two UK birth cohorts-ie, the 1958 and 1970 studies (total n=21 936). We computed hazard ratios with accompanying 95% CIs for care and each health outcome separately for each study, and then pooled the results using a random-effects meta-analysis. This review is registered at PROSPERO, CRD42021254665. FINDINGS: We identified 210 potentially eligible published articles, of which 14 met our inclusion criteria (two studies were unpublished). Of 3 223 580 individuals drawn from 13 studies, those who were exposed to care in childhood had twice the risk of total mortality in adulthood relative to those without a history of care in childhood (summary risk ratio 2·21 [95% CI 1·62-3·02]), with study-specific estimates varying between 1·04 and 5·77 (I2 =98%). Despite some attenuation, this association remained following adjustment for other measures of early-life adversity; extended into middle and older age; was stronger in higher-quality studies; and was of equal magnitude according to sex, geographical region, and birth year. There was some suggestion of sensitive periods of exposure to care, whereby individuals who entered state care for the first time in adolescence (2·47 [0·98-6·52]) had greater rates of mortality than those doing so early in the life course (1·75 [1·25-2·45]). In four studies including 534 890 people, children in care had more than three times the risk of completed suicide in adulthood relative to their unexposed peers (3·35 [2·41-4·68]), with study-specific estimates ranging between 2·42 and 5·85 (I2=72%). The magnitude of this association was weaker after adjustment for multiple covariates; in men than in women; and in lower-quality studies. INTERPRETATION: Our results for adult mortality suggest child protection systems, social policy, and health services following care graduation are insufficient to mitigate the adverse experiences that might have preceded placement into care and those that might accompany it. FUNDING: None

Applying Ultrashort Pulsed Direct Laser Interference Patterning for Functional Surfaces

Surface structures in the micro- and nanometre length scale exert a major influence on performance and functionality for many specialized applications in surface engineering. However, they are often limited to certain pattern scales and materials, depending on which processing technique is used. Likewise, the morphology of the topography is in complex relation to the utilized processing methodology. In this study, the generation of hierarchical surface structures in the micro- as well as the sub-micrometre scale was achieved on ceramic, polymer and metallic materials by utilizing Ultrashort Pulsed Direct Laser Interference Patterning (USP-DLIP). The morphologies of the generated patterns where examined in relation to the unique physical interaction of each material with ultrashort pulsed laser irradiation. In this context, the pattern formation on copper, CuZn37 brass and AISI 304 stainless steel was investigated in detail by means of a combination of experiment and simulation to understand the individual thermal interactions involved in USP-DLIP processing. Thereby, the pattern’s hierarchical topography could be tailored besides achieving higher process control in the production of patterns in the sub-µm range by USP-DLIP

Systemic inflammation and subsequent risk of amyotrophic lateral sclerosis: prospective cohort study

BACKGROUND: While systemic inflammation has been implicated in the etiology of selected neurodegenerative disorders, its role in the development of amyotrophic lateral sclerosis (ALS) is untested. Accordingly, we quantified the relationship of C-reactive protein (CRP), an acute-phase reactant and marker of systemic inflammation, with subsequent ALS occurrence. METHODS: We used data from UK Biobank, a prospective cohort study of 502,649 participants who were aged 37 to 73 years when examined at research centers between 2006 and 2010. Venous blood was collected at baseline in the full cohort and assayed for CRP, and repeat measurement was made 3-7 years later in a representative subgroup (N=14,514) enabling correction for regression dilution. ALS was ascertained via national hospitalization and mortality registries until 2021. We computed multivariable hazard ratios with accompanying 95% confidence intervals for log-transformed CRP expressed as standard deviation and tertiles. RESULTS: In an analytical sample of 400,884 initially ALS-free individuals (218,203 women), a mean follow-up of 12 years gave rise to 231 hospitalizations and 223 deaths ascribed to ALS. After adjustment for covariates which included health behaviors, comorbidity, and socio-economic status, a one standard deviation higher log-CRP was associated with elevated rates of both ALS mortality (hazard ratios; 95% confidence intervals: 1.32; 1.13, 1.53) and hospitalizations (1.20; 1.00, 1.39). There was evidence of dose-response effects across tertiles of CRP for both outcomes (p for trend ≤0.05). Correction for regression dilution led to a strengthening of the relationship with CRP for both mortality (1.62; 1.27, 2.08) and hospitalizations (1.37; 1.05, 1.76) ascribed to ALS. CONCLUSIONS: Higher levels of CRP, a blood-based biomarker widely captured in clinical practice, is associated with moderately increased future risk of amyotrophic lateral sclerosis

Association of childhood psychomotor coordination with survival up to 6 decades later

Importance: Poorer performance on standard tests of motor coordination in children has emerging links with sedentary behavior, obesity, and functional capacity in later life. These observations are suggestive of an untested association of coordination with health outcomes, including mortality. Objective: To examine the association of performance on a series of psychomotor coordination tests in childhood with mortality up to 6 decades later. Design, Setting, and Participants: The British National Child Development Study (1958 Birth Cohort Study) is a prospective cohort study based on a nationally representative sample of births from England, Scotland, and Wales. A total of 17 415 individuals had their gross and fine motor psychomotor coordination assessed using 9 tests at ages 11 and 16 years. Data analysis for the present study was conducted from October 2016 to December 2019. Main Outcomes and Measures: All-cause mortality as ascertained from a vital status registry and survey records. Results: In this birth cohort study of 17 415 individuals who underwent a series of psychomotor coordination tests in childhood, follow up was conducted over several decades. Of the analytical sample of 12 678 individuals, 51% were male, and 72% came from a lower social group. Mortality surveillance between ages 12 and 58 years in an analytical sample of 17 062 men and women yielded 1072 deaths (766 661 person-years at risk). In survival analyses with adjustment for sex, higher scores on 7 of the 9 childhood coordination tests were associated with a lower risk of mortality in a stepwise manner. After controlling for early-life socioeconomic, health, cognitive, and developmental factors, lower mortality was statistically significantly associated with 3 tests: ball catching at age 11 years (0-8 vs 10 catches: hazard ratio [HR], 1.57; 95% CI, 1.19-2.07), match-picking at age 11 years (>50 vs 0-36 seconds: HR, 1.33; 95% CI, 1.09-1.63), and hopping at age 16 years (very unsteady vs very steady: HR, 1.28; 95% CI, 1.01-1.63). Conclusions and Relevance: The results of this cohort study suggest that childhood motor coordination is associated with lower mortality up to middle-age; these findings require replication

Transport, Magnetic and Vibrational Properties of Chemically Exfoliated Few Layer Graphene

We study the vibrational, magnetic and transport properties of Few Layer Graphene (FLG) using Raman and electron spin resonance spectroscopy and microwave conductivity measurements. FLG samples were produced using wet chemical exfoliation with different post-processing, namely ultrasound treatment, shear mixing, and magnetic stirring. Raman spectroscopy shows a low intensity D mode which attests a high sample quality. The G mode is present at $1580$ cm$^{-1}$ as expected for graphene. The 2D mode consists of 2 components with varying intensities among the different samples. This is assigned to the presence of single and few layer graphene in the samples. ESR spectroscopy shows a main line in all types of materials with a width of about $1$ mT and and a $g$-factor in the range of $2.005-2.010$. Paramagnetic defect centers with a uniaxial $g$-factor anisotropy are identified, which shows that these are related to the local sp$^2$ bonds of the material. All kinds of investigated FLGs have a temperature dependent resistance which is compatible with a small gap semiconductor. The difference in resistance is related to the different grain size of the samples

Moisture adsorption and desorption behavior of raw materials for the t-rtm process

The use of fiber reinforced plastics (FRPs) has significant potential to reduce the weight of components. As regards the sustainability of these components, thermoplastic matrices offer more potential for recycling than thermoset ones. A possible manufacturing process for the production of thermoplastic FRPs is thermoplastic resin transfer molding (T-RTM). In this very moisture-sensitive process, ε-caprolactam in addition to an activator and catalyst polymerizes anionically to polyamide 6 (aPA6). The anionic polymerization of aPA6 is slowed down or even completely blocked by the presence of water. This study analyses the sorption behavior of the matrix, fiber, binder and core materials for the production of anionic polyamide 6 composites, which are processed in the thermoplastic RTM process. Water vapor sorption measurements are used to determine the adsorption and desorption behavior of the materials. The maximum moisture loading of the materials provides information about the water adsorption capacity of the material. This knowledge is crucial for correct handling of the materials to achieve a fast process and good properties of the final product

Overweight, obesity, and individual symptoms of depression : A multicohort study with replication in UK Biobank

Objectives: Obesity is associated with increased risk of depression, but the extent to which this association is symptom-specific is unknown. We examined the associations of overweight and obesity with individual depressive symptoms. Methods: We pooled data from 15 population-based cohorts comprising 57,532 individuals aged 18 to 100 years at study entry. Primary analyses were replicated in an independent cohort, the UK Biobank study (n = 122,341, age range 38 to 72). Height and weight were assessed at baseline and body mass index (BMI) was computed. Using validated self-report measures, 24 depressive symptoms were ascertained once in 16 cross-sectional, and twice in 7 prospective cohort studies (mean follow-up 3.2 years). Results: In the pooled analysis of the primary cohorts, 22,045 (38.3 %) participants were overweight (BMI between 25 and 29.9 kg/m(2)), 12,025 (20.9 %) class I obese (BMI between 30 and 34.9 kg/m(2)), 7,467 (13.0 %) class II-III obese (BMI >= 35 kg/m(2)); and 7,046 (12.3 %) were classified as depressed. After multivariable adjustment, obesity class I was cross-sectionally associated with 1.11-fold (95 % confidence interval 1.01-1.22), and obesity class II-III with 1.31-fold (1.16-1.49) higher odds of overall depression. In symptom-specific analyses, robust associations were apparent for 4 of the 24 depressive symptoms ('could not get going/lack of energy', 'little interest in doing things', 'feeling bad about yourself, and 'feeling depressed'), with confounder-adjusted odds ratios of having 3 or 4 of these symptoms being 1.32 (1.10-1.57) for individuals with obesity class I, and 1.70 (1.34-2.14) for those with obesity class II-III. Elevated C-reactive protein and 21 obesity-related diseases explained 23 %-31 % of these associations. Symptom-specific associations were confirmed in longitudinal analyses where obesity preceded symptom onset, were stronger in women compared with men, and were replicated in UK Biobank. Conclusions: Obesity is associated with a distinct set of depressive symptoms. These associations are partially explained by systemic inflammation and obesity-related morbidity. Awareness of this obesity-related symptom profile and its underlying biological correlates may inform better targeted treatments for comorbid obesity and depression.Peer reviewe

Interplay between microstructural evolution and tribo-chemistry during dry sliding of metals

Understanding the microstructural and tribo-chemical processes during tribological loading is of utmost importance to further improve the tribological behavior of metals. In this study, the friction, wear and tribo-chemical behavior of Ni with different initial microstructures (nanocrystalline, bi-modal, coarse-grained) is investigated under dry sliding conditions. In particular, the interplay be-tween frictional response, microstructural evolution and tribo-oxidation is considered. Friction tests are carried out using ball-on-disk experiments with alumina balls as counter-bodies, varying the load between 1 and 5 N. The microstructural evolution as well as the chemical reactions beneath the samples’ surface is investigated by means of cross-sections. The samples with finer microstructures show a faster run-in and lower maximum values of the coefficient of friction (COF) which can be attributed to higher oxidation kinetics and a higher hardness. It is observed that with increasing sliding cycles, a stable oxide layer is formed. Furthermore, initially coarse-grained samples show grain refinement, whereas initially finer microstructures undergo grain coarsening converging towards the same superficial grain size after 2,000 sliding cycles. Consequently, the experimental evidence supports that, irrespective of the initial microstructure, after a certain deformation almost identical steady-state COF values for all samples are achieved

Intracranial Penetration During Temporal Soft Tissue Filler Injection-Is It Possible?

BACKGROUND Treating temporal volume loss for aesthetic and reconstructive purposes can be achieved by superficial or deep injections of soft tissue fillers into the temples. The latter is performed with bone contact that can lead to intracranial penetration when the bone is accidentally penetrated. OBJECTIVE Based on a clinical case, the potential risk of accidental intracranial penetration was investigated. MATERIALS AND METHODS Twenty fresh-frozen hemi-faces (all Caucasian ethnicity, 10 women, 10 men, mean age 72.8 +/- 11.2 years) were investigated. Shape of pterion and bone-stability parameters of the temporal fossa were investigated. Bone stability was tested using uniaxial mechanical indentation (18-G, 1.25-mm diameter, 15-mm length blunt-tip device) until intracranial perforation occurred. RESULTS Variations in the shape of the pterion, bone thickness, and density correlates were detected, however, without statistical significant differences in side symmetry. Minimum force necessary to penetrate intracranially was 40.4 N. Maximum force generated by an 18-g, 70-mm length blunt-tip cannula was 32.1 +/- 4.2 N in 70 mm length and 75.3 +/- 10.2 N in 15 mm length. CONCLUSION Based on the results of this investigation, it can be concluded that there is a risk for intracranial penetration performing the deep temple injection technique with direct pressure on the bone