1,873 research outputs found
Public participation in development â the idea of a development 'jury' servic
Delivering sustainable development requires consideration of social, economic
and environmental factors. Many players are involved but in all cases at some
point society (the general public) need to have a say. To facilitate this, we
need something which we donât have at present, i.e. a fair, representative,
effective, efficient and affordable system to allow public participation in
decision maki
Thromboprophylaxis in atrial fibrillation and association with cognitive decline: systematic review
Objective:Atrial Fibrillation (AF) is associated with dementia. If AF-related cognitive decline is driven by cerebral embolic events, thromboprophylaxis may impact on this. This systematic review assessed the association between cognitive impairment and AF thromboprophylaxis.
Methods:Two independent reviewers searched CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science Core Collection, and Cochrane Library from inception until 12th November 2014. Eligible studies compared AF thromboprophylaxis to control with an outcome measure of cognition or dementia. Where data allowed, meta-analyses describing between-group differences in cognitive test scores or rates of incident dementia were performed.
Results:Nineteen studies were eligible. For two prospective studies (one RCT) comparing anticoagulation against antiplatelet therapy, change in Mini-Mental State Examination score from baseline to last follow-up (maximal duration:5.9 years) suggested a difference favouring anticoagulation (mean difference:0.90, 95% CI:0.29 to 1.51), in keeping with a trend seen in the single RCT (mean difference MMSE:0.80. 95% CI:-0.07 to 1.67). Pooled odds ratios suggested no association with incident dementia, comparing anticoagulant to antiplatelet therapy (two studies, OR:1.23, 95% CI:0.80 to 1.91) or no treatment (three studies, OR:0.89, 95%CI:0.47 to 1.69).
Conclusions:Our analyses show no definitive evidence of cognitive benefit or harm from anticoagulation. We demonstrated a potential benefit of anticoagulation in comparison to antiplatelet over time. Larger-scale studies with longer follow-up are needed to determine the true cognitive impact of AF thromboprophylaxis
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Adapting the International System of Units to the twenty-first century
We review the proposal of the International Committee for Weights and Measures
(Comité International des Poids et Mesures, CIPM), currently being considered by
the General Conference on Weights and Measures (Conférences Générales des Poids et
Mesures, CGPM), to revise the International System of Units (Le SystĂšme International
dâUnitĂšs, SI). The proposal includes new definitions for four of the seven base units of
the SI, and a new form of words to present the definitions of all the units. The objective
of the proposed changes is to adopt definitions referenced to constants of nature, taken
in the widest sense, so that the definitions may be based on what are believed to be
true invariants. In particular, whereas in the current SI the kilogram, ampere, kelvin and
mole are linked to exact numerical values of the mass of the international prototype of the
kilogram, the magnetic constant (permeability of vacuum), the triple-point temperature
of water and the molar mass of carbon-12, respectively, in the new SI these units are linked
to exact numerical values of the Planck constant, the elementary charge, the Boltzmann
constant and the Avogadro constant, respectively. The new wording used expresses the
definitions in a simple and unambiguous manner without the need for the distinction
between base and derived units. The importance of relations among the fundamental
constants to the definitions, and the importance of establishing a mise en pratique for
the realization of each definition, are also discussed
The Economic Recession: Early Impacts on Health Care Safety Net Providers
Examines how the recession and state and local budget cuts affected safety-net clinics' capacity to meet demand in five communities, the extent to which federal stimulus funds mitigated the impact, strategies for sustainability, and implications
Driving human motor cortical oscillations leads to behaviorally relevant changes in local GABAA inhibition: a tACS-TMS study
Beta and gamma oscillations are the dominant oscillatory activity in the human motor cortex (M1). However, their physiological basis and precise functional significance remain poorly understood. Here, we used transcranial magnetic stimulation (TMS) to examine the physiological basis and behavioral relevance of driving beta and gamma oscillatory activity in the human M1 using transcranial alternating current stimulation (tACS). tACS was applied using a sham-controlled crossover design at individualized intensity for 20 min and TMS was performed at rest (before, during, and after tACS) and during movement preparation (before and after tACS). We demonstrated that driving gamma frequency oscillations using tACS led to a significant, duration-dependent decrease in local resting-state GABAA inhibition, as quantified by short interval intracortical inhibition. The magnitude of this effect was positively correlated with the magnitude of GABAA decrease during movement preparation, when gamma activity in motor circuitry is known to increase. In addition, gamma tACS-induced change in GABAA inhibition was closely related to performance in a motor learning task such that subjects who demonstrated a greater increase in GABAA inhibition also showed faster short-term learning. The findings presented here contribute to our understanding of the neurophysiological basis of motor rhythms and suggest that tACS may have similar physiological effects to endogenously driven local oscillatory activity. Moreover, the ability to modulate local interneuronal circuits by tACS in a behaviorally relevant manner provides a basis for tACS as a putative therapeutic intervention.SIGNIFICANCE STATEMENT Gamma oscillations have a vital role in motor control. Using a combined tACS-TMS approach, we demonstrate that driving gamma frequency oscillations modulates GABAA inhibition in the human motor cortex. Moreover, there is a clear relationship between the change in magnitude of GABAA inhibition induced by tACS and the magnitude of GABAA inhibition observed during task-related synchronization of oscillations in inhibitory interneuronal circuits, supporting the hypothesis that tACS engages endogenous oscillatory circuits. We also show that an individual's physiological response to tACS is closely related to their ability to learn a motor task. These findings contribute to our understanding of the neurophysiological basis of motor rhythms and their behavioral relevance and offer the possibility of developing tACS as a therapeutic tool
The impact of different rainfall products on landscape modelling simulations
Rainfall products can contain significantly different spatiotemporal estimates, depending on their underlying data and final constructed resolution. Commonly used products, such as rain gauges, rain gauge networks, and weather radar, differ in their information content regarding intensities, spatial variability, and natural climatic variability, therefore producing different estimates. Landscape evolution models (LEMs) simulate the geomorphic changes in landscapes, and current models can simulate timeframes from event level to millions of years and some use rainfall inputs to drive them. However, the impact of different rainfall products on LEM outputs has never been considered. This study uses the STREAP rainfall generator, calibrated using commonly used rainfall observation products, to produce longer rainfall records than the observations to drive the CAESARâLisflood LEM to examine how differences in rainfall products affect simulated landscapes. The results show that the simulation of changes to basin geomorphology is sensitive to the differences between rainfall products, with these differences expressed linearly in discharges but nonâlinearly in sediment yields. Furthermore, when applied over a 1500âyear period, large differences in the simulated long profiles were observed, with the simulations producing greater sediment yields showing erosion extending further downstream. This suggests that the choice of rainfall product to drive LEMs has a large impact on the final simulated landscapes. The combination of rainfall generator model and LEMs represents a potentially powerful method for assessing the impacts of rainfall product differences on landscapes and their shortâ and longâterm evolution
Home-Time Is a Feasible and Valid Stroke Outcome Measure in National Datasets
Background and Purposeâ
Home-time (HT) is a stroke outcome measure based on time spent at home after stroke. We hypothesized that HT assessment would be feasible and valid using national data.
Methodsâ
We linked the Scottish Stroke Care Audit to routine healthcare data and calculated 90-day HT for all strokes, 2005 to 2017. We described prognostic validity (Spearman rank correlation) of HT to baseline factors.
Resultsâ
We were able to calculate HT for 101â969 strokes (99.3% of total Scottish strokes). Mean HT was 46 days (95% CI, 45.8â46.2; range, 0â90). HT showed consistent correlation with our prespecified prognostic factors: age: Ï, â0.35 (95% CI, â0.35 to â0.36); National Institutes of Health Stroke Scale score, â0.54 (95% CI, â0.52 to â0.55); and 6 simple variables (ordinal), â0.61 (95% CI, â0.61 to â0.62).
Conclusionsâ
HT can be derived at scale using routine clinical data and appears to be a valid proxy measure of functional recovery. Other national databases could use HT as a time and cost efficient measure of medium and longer-term outcomes
Ubiquinones have surface-active properties suited to transport electrons and protons across membranes
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