185 research outputs found

    Sleep, 24-Hour Activity Rhythms, and Subsequent Amyloid-β Pathology

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    IMPORTANCE Sleep disturbances are common among older adults and have been associated with the development of Alzheimer disease (AD), such as amyloid-β (Aβ) pathology. For effective AD prevention, it is essential to pinpoint the specific disturbances in sleep and the underlying 24-hour activity rhythms that confer the highest risk of Aβ deposition. OBJECTIVE To determine the associations of 24-hour activity rhythms and sleep with Aβ deposition in adults without dementia, to evaluate whether disrupted 24-hour activity and sleep may precede Aβ deposition, and to assess the role of the apolipoprotein E ε4 (APOE4) genotype. DESIGN, SETTING, AND PARTICIPANTS This was an observational cohort study using data from the Rotterdam Study. Of 639 participants without dementia who underwent Aβ positron emission tomography (PET) from September 2018 to November 2021, 319 were included in the current study. Exclusion criteria were no APOE genotyping and no valid actigraphy data at the baseline visits from 2004 to 2006 or from 2012 to 2014. The mean (SD) follow-up was 7.8 (2.4) years. Data were analyzed from March 2023 to April 2024. EXPOSURES Actigraphy (7 days and nights, objective sleep, and 24-hour activity rhythms), sleep diaries (self-reported sleep), Aβ42/40, phosphorylated tau (p-tau) 181 and p-tau 217 plasma assays, 18F-florbetaben PET (mean standard uptake value ratio [SUVR] in a large cortical region of interest), and APOE4 genotype. MAIN OUTCOMES AND MEASURES Association of objective and self-reported sleep and 24-hour activity rhythms at baseline with brain Aβ PET burden at follow-up. RESULTS The mean (range) age in the study population was 61.5 (48-80) years at baseline and 69.2 (60-88) years at follow-up; 150 (47%) were women. Higher intradaily variability at baseline, an indicator of fragmented 24-hour activity rhythms, was associated with higher Aβ PET burden at follow-up (β, 0.15; bootstrapped 95% CI, 0.04 to 0.26; bootstrapped P = .02, false discovery rate [FDR] P = .048). APOE genotype modified this association, which was stronger in APOE4 carriers (β, 0.38; bootstrapped 95% CI, 0.05 to 0.64; bootstrapped P = .03) compared to noncarriers (β, 0.07; bootstrapped 95% CI, −0.04 to 0.18; bootstrapped P = .19). The findings remained largely similar after excluding participants with AD pathology at baseline, suggesting that a fragmented 24-hour activity rhythm may have preceded Aβ deposition. No other objective or self-reported measure of sleep was associated with Aβ. CONCLUSIONS AND RELEVANCE Among community-dwelling adults included in this study, higher fragmentation of the 24-hour activity rhythms was associated with greater subsequent Aβ burden, especially in APOE4 carriers. These results suggest that rest-activity fragmentation could represent a modifiable risk factor for AD.</p

    COMPETITION AMONG HOSPITALS AND ITS MEASUREMENT: THEORY AND A CASE STUDY

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    Our paper provides several insights on the characteristics of the concept of “Poles d’Excellence Rurale” (PER) through bilateral comparisons with that of Competitive Pole (CP) and cluster. The concept of PER is a French government’ initiative designed for the development of rural areas similar to that of the Competitive Pole. We emphasize important particularities of these concepts by analyzing some of their similarities and major differences.Pole d’Excellence Rurale, Competitive Pole, cluster, rural development

    Feiras livres como alternativa de comercialização de produtos da agrofloresta.

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    Com a busca por alternativas comerciais socialmente justas como maneira de otimizar a comercialização de produtos provenientes de agricultura familiar, destaca se a venda direta através de feiras, livres, que permite acesso direto ao consumidor sem necessidade de intermediadores. O Grupo de Produtores Agroflorestais Gralha Azul, de Morretes-PR, iniciou plantios de agroflorestas agroecológicas em 2009, sendo formado, atualmente, por 12 famílias de agricultores. Há um ano, o Gralha Azul iniciou sua participação na Matinfeira, feira semanal de produtos da agricultura familiar em Matinhos, PR. Com o objetivo de caracterização dos produtos, produtores e do processo de comercialização, foram acompanhados e sistematizados em planilha a comercialização destes produtos em 22 feiras semanais, entre maio e dezembro de 2012. Onze produtores participaram da Matinfeira, comercializando entre 13 e 29 variedades de alimentos, e proporcionando uma renda que variou de R101,00aR 101,00 a R 386,50, por semana. Mensalmente, as feiras permitiram uma receita bruta de R$ 141,17 por produtor familiar agroflorestal. Apesar desse baixo valor, há que se considerar que o mesmo reflete os primeiros seis meses de atuação do Grupo no processo de comercialização na feira (Matinfeira). A venda direta através desta feira livre mostra potencial como alternativa comercial socialmente justa para os produtores em transição agroecológica do Grupo Gralha Azul

    Finite element approximation of sparse parabolic control problems

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    We study the finite element approximation of an optimal control problem governed by a semilinear partial differential equation and whose objective function includes a term promoting space sparsity of the solutions. We prove existence of solution in the absence of control bound constraints and provide the adequate second order sufficient conditions to obtain error estimates. Full discretization of the problem is carried out, and the sparsity properties of the discrete solutions, as well as error estimates, are obtained.The first two authors were partially supported by the Spanish Ministerio de Economía y Competitividad under project MTM2014-57531-P

    Computational prediction of pressure change in the vicinity of tidal stream turbines and the consequences for fish survival rate

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    The presence of Tidal Stream Turbines (TST) for tidal power production, leads to changes in the local physical environment that could affect fish. While other work has considered the implications with respect to conventional hydroelectric devices (i.e. hydroelectric dams), including studies such as physical impact with the rotors and pressure variation effects, this research considers the effects of sudden changes in pressure and turbulence on the hypothetical fish with respect to TSTs. Computational fluid dynamics (CFD) is used to investigate changes to the environment, and thus study the implications for fish. Two CFD methods are employed, an embedded Blade Element representation of the rotor in a RANS CFD model, and a blade resolved geometry using a moving reference frame. A new data interpretation approach is proposed as the primary source of environmental impact data; ‘rate of change of pressure’ with time along a streamtrace. This work also presents results for pressure, pressure gradients, shear rates and turbulence to draw conclusions about changes to the local physical environment. The assessment of the local impact is discussed in terms of the implications to individual fish passing a single or array of TST devices

    Improved approximation rates for a parabolic control problem with an objective promoting directional sparsity

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    We discretize a directionally sparse parabolic control problem governed by a linear equation by means of control approximations that are piecewise constant in time and continuous piecewise linear in space. By discretizing the objective functional with the help of appropriate numerical quadrature formulas, we are able to show that the discrete optimal solution exhibits a directional sparse pattern alike the one enjoyed by the continuous solution. Error estimates are obtained and a comparison with the cases of having piecewise approximations of the control or a semilinear state equation are discussed. Numerical experiments that illustrate the theoretical results are included.The first two authors were partially supported by the Spanish Ministerio de Economía y Competitividad under projects MTM2014-57531-P and MTM2017-83185-P

    J. Med. Genet.

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    Background: Primary microcephaly (MCPH) is a genetically heterogeneous disorder showing an autosomal recessive mode of inheritance. Affected individuals present with head circumferences more than three SDs below the age- and sex-matched population mean, associated with mild to severe mental retardation. Five genes (MCPH1, CDK5RAP2, ASPM, CENPJ, STIL) and two genomic loci, MCPH2 and MCPH4, have been identified so far. Methods and results: In this study, we investigated all seven MCPH loci in patients with primary microcephaly from 112 Consanguineous Iranian families. In addition to a thorough clinical characterisation, karyotype analyses were performed for all patients. For Homozygosity mapping, microsatellite markers were selected for each locus and used for genotyping. Our investigation enabled us to detect homozygosity at MCPH1 (Microcephalin) in eight families, at MCPH5 (ASPM) in thirtheen families. Three families showed homozygosity at MCPH2 and five at MCPH6 (CENPJ), and two families were linked to MCPH7 (STIL). The remaining 81 families were not linked to any of the seven known loci. Subsequent sequencing revealed eight, 10 and one novel mutations in Microcephalin, ASPM and CENPJ, respectively. In some families, additional features such as short stature, seizures or congenital hearing loss were observed in the microcephalic patient, which widens the spectrum of clinical manifestations of mutations in known microcephaly genes. Conclusion: Our results show that the molecular basis of microcephaly is heterogeneous; thus, the Iranian population may provide a unique source for the identification of further genes underlying this disorder

    The Noise Exposure Structured Interview (NESI): an instrument for the comprehensive estimation of lifetime noise exposure

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    Lifetime noise exposure is generally quantified by self report. The accuracy of retrospective self report is limited by respondent recall, but is also bound to be influenced by reporting procedures. Such procedures are of variable quality in current measures of lifetime noise exposure, and off-the-shelf instruments are not readily available. The Noise Exposure Structured Interview (NESI) represents an attempt to draw together some of the stronger elements of existing procedures and to provide solutions to their outstanding limitations. Reporting is not restricted to pre-specified exposure activities, and instead encompasses all activities that the respondent has experienced as noisy (defined based on sound level estimated from vocal effort). Changing exposure habits over time are reported by dividing the lifespan into discrete periods in which exposure habits were approximately stable, with life milestones used to aid recall. Exposure duration, sound level, and use of hearing protection are reported for each life period separately. Simple-to-follow methods are provided for the estimation of free-field sound level, the sound level emitted by personal listening devices, and the attenuation provided by hearing protective equipment. An energy-based means of combining the resulting data is supplied, along with a primarily energy-based method for incorporating firearm-noise exposure. Finally, the NESI acknowledges the need of some users to tailor the procedures; this flexibility is afforded and reasonable modifications are described. Competency needs of new users are addressed through detailed interview instructions (including troubleshooting tips) and a demonstration video. Limited evaluation data are available and future efforts at evaluation are proposed
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