Development of the CHARIOT Research Register for the Prevention of Alzheimer’s Dementia and Other Late Onset Neurodegenerative Diseases

Identifying cognitively healthy people at high risk of developing dementia is an ever-increasing focus. These individuals are essential for inclusion in observational studies into the natural history of the prodromal and early disease stages and for interventional studies aimed at prevention or disease modification. The success of this research is dependent on having access to a well characterised, representative and sufficiently large population of individuals. Access to such a population remains challenging as clinical research has, historically, focussed on patients with dementia referred to secondary and tertiary services. The primary care system in the United Kingdom allows access to a true prodromal population prior to symptoms emerging and specialist referral. We report the development and recruitment rates of the CHARIOT register, a primary care-based recruitment register for research into the prevention of dementia. The CHARIOT register was designed specifically to support recruitment into observational natural history studies of pre-symptomatic or prodromal dementia stages, and primary or secondary prevention pharmaceutical trials or other prevention strategies for dementia and other cognitive problems associated with ageing.Participants were recruited through searches of general practice lists across the west and central London regions. Invitations were posted to individuals aged between 60 and 85 years, without a diagnosis of dementia. Upon consent, a minimum data set of demographic and contact details was extracted from the patient's electronic health record.To date, 123 surgeries participated in the register, recruiting a total of 24,509 participants-a response rate of 22.3%. The age, gender and ethnicity profiles of participants closely match that of the overall eligible population. Higher response rates tended to be associated with larger practices (r = 0.34), practices with a larger older population (r = 0.27), less socioeconomically disadvantaged practices (r = 0.68), and practices with a higher proportion of White patients (r = 0.82).Response rates are comparable to other registers reported in the literature, and indicate good interest and support for a research register and for participation in research for the prevention of age-related neurodegenerative diseases and dementia. We consider that the simplicity of the approach means that this system is easily scalable and replicable across the UK and internationally

Laparoscopic Enteropexy for Prolapsing Stoma: A Case Series Describing a Novel Technique

BACKGROUND: Ileostomy prolapse has a cumulative risk of 11% and represents a significant complication with associated morbidity, which may result in multiple admissions and procedures requiring a general anesthetic. We have developed a laparoscopic technique for managing stoma prolapse-so-called laparoscopic enteropexy for prolapsing stoma (LEPS). METHODS: Retrospective analysis of a prospectively maintained departmental surgical logbook was performed alongside clinical case history review for patients undergoing LEPS. Primary outcome was defined as recurrent prolapse. Secondary outcomes were any postoperative complication or complication occurring at the time of stoma closure. RESULTS: A total of 15 LEPS procedures were performed on 14 patients with stoma prolapse-13 were patients with ileostomy and 1 with a loop colostomy. Median operative time was 75 minutes (range 50-95). Median postoperative stay was 1 day (1-4 days). There was one return to theater for a small bowel intussusception on the second postoperative day wherein taking down of the bowel and repeat LEPS were necessary. There was one recurrence of prolapse in a separate patient (1/14 [7%]). Three patients have since had their stoma closed without complication. CONCLUSION: We describe here the initial case series of our LEPS procedure for managing stoma prolapse. This is a reproducible and technically straightforward laparoscopic procedure with an excellent success rate in preventing further prolapse

Study of an advanced General Aviation Turbine Engine (GATE)

The best technology program for a small, economically viable gas turbine engine applicable to the general aviation helicopter and aircraft market for 1985-1990 was studied. Turboshaft and turboprop engines in the 112 to 746 kW (150 to 1000 hp) range and turbofan engines up to 6672 N (1500 lbf) thrust were considered. A good market for new turbine engines was predicted for 1988 providing aircraft are designed to capitalize on the advantages of the turbine engine. Parametric engine families were defined in terms of design and off-design performance, mass, and cost. These were evaluated in aircraft design missions selected to represent important market segments for fixed and rotary-wing applications. Payoff parameters influenced by engine cycle and configuration changes were aircraft gross mass, acquisition cost, total cost of ownership, and cash flow. Significant advantage over a current technology, small gas turbine engines was found especially in cost of ownership and fuel economy for airframes incorporating an air-cooled high-pressure ratio engine. A power class of 373 kW (500 hp) was recommended as the next frontier for technology advance where large improvements in fuel economy and engine mass appear possible through component research and development

Turbulence and angular momentum transport in a global accretion disk simulation

The global development of magnetohydrodynamic turbulence in an accretion disk is studied within a simplified disk model that omits vertical stratification. Starting with a weak vertical seed field, a saturated state is obtained after a few tens of orbits in which the energy in the predominantly toroidal magnetic field is still subthermal. The efficiency of angular momentum transport, parameterized by the Shakura-Sunyaev alpha parameter, is of the order of 0.1. The dominant contribution to alpha comes from magnetic stresses, which are enhanced by the presence of weak net vertical fields. The power spectra of the magnetic fields are flat or decline only slowly towards the largest scales accessible in the calculation, suggesting that the viscosity arising from MHD turbulence may not be a locally determined quantity. I discuss how these results compare with observationally inferred values of alpha, and possible implications for models of jet formation.Comment: ApJ Letters, in press. The paper and additional visualizations are available at http://www.cita.utoronto.ca/~armitage/global_abs.htm

Shapes of Molecular Cloud Cores and the Filamentary Mode of Star Formation

Using recent dust continuum data, we generate the intrinsic ellipticity distribution of dense, starless molecular cloud cores. Under the hypothesis that the cores are all either oblate or prolate randomly-oriented spheroids, we show that a satisfactory fit to observations can be obtained with a gaussian prolate distribution having a mean intrinsic axis ratio of 0.54. Further, we show that correlations exist between the apparent axis ratio and both the peak intensity and total flux density of emission from the cores, the sign of which again favours the prolate hypothesis. The latter result shows that the mass of a given core depends on its intrinsic ellipticity. Monte Carlo simulations are performed to find the best-fit power law of this dependence. Finally, we show how these results are consistent with an evolutionary scenario leading from filamentary parent clouds to increasingly massive, condensed, and roughly spherical embedded cores.Comment: 16 pages, incl. 11 Postscript figures. Accepted by Ap

Single-machine scheduling with stepwise tardiness costs and release times

We study a scheduling problem that belongs to the yard operations component of the railroad planning problems, namely the hump sequencing problem. The scheduling problem is characterized as a single-machine problem with stepwise tardiness cost objectives. This is a new scheduling criterion which is also relevant in the context of traditional machine scheduling problems. We produce complexity results that characterize some cases of the problem as pseudo-polynomially solvable. For the difficult-to-solve cases of the problem, we develop mathematical programming formulations, and propose heuristic algorithms. We test the formulations and heuristic algorithms on randomly generated single-machine scheduling problems and real-life datasets for the hump sequencing problem. Our experiments show promising results for both sets of problems

Molecular and morphometric variation in European populations of the articulate brachiopod <i>Terebeatulina retusa</i>

Molecular and morphometric variation within and between population samples of the articulate brachiopod &lt;i&gt;Terebratulina&lt;/i&gt; spp., collected in 1985-1987 from a Norwegian fjord, sea lochs and costal sites in western Scotland, the southern English Channel (Brittany) and the western Mediterranean, were measured by the analysis of variation in the lengths of mitochondrial DNA (mtDNA) fragments produced by digestion with nine restriction endonucleases and by multivariate statistical analysis of six selected morphometric parameters. Nucleotide difference within each population sample was high. Nucleotide difference between population samples from the Scottish sites, both those that are tidally contiguous and those that appear to be geographically isolated, were not significantly different from zero. Nucleotide differences between the populations samples from Norway, Brittany, Scotland and the western Mediterranean were also very low. Morphometric analysis confirmed the absence of substantial differentiation