Depressive symptoms are associated with analgesic use in people with Alzheimer's disease: Kuopio ALSOVA study.

Neuropsychiatric symptoms of Alzheimer's disease (AD) such as depression may be associated with pain, which according to the literature may be inadequately recognized and managed in this population. This study aimed to identify the factors associated with analgesic use in persons with AD; in particular, how AD severity, functional status, neuropsychiatric symptoms of AD, co-morbidities and somatic symptoms are associated with analgesic use. 236 community-dwelling persons with very mild or mild AD at baseline, and their caregivers, were interviewed over five years as part of the prospective ALSOVA study. Generalized Estimating Equations (GEEs) were used to estimate unadjusted and adjusted odds ratios (ORs) for the factors associated with analgesic use over a five year follow-up. The proportion of persons with AD using any analgesic was low (13.6%) at baseline and remained relatively constant during the follow-up (15.3% at Year 5). Over time, the most prevalent analgesic changed from non-steroidal anti-inflammatories (8.1% of persons with AD at Year 1) to acetaminophen (11.1% at Year 5). Depressive symptoms (measured by the Beck Depression Inventory, BDI) were independently associated with analgesic use, after effects of age, gender, education, AD severity, comorbidities and somatic symptoms were taken into account. For every one unit increase in BDI, the odds of analgesic use increased by 4% (OR = 1.04, 95% confidence interval CI = 1.02-1.07). Caregiver depressive symptoms were not statistically significantly associated with analgesic use of the person with AD. Depressive symptoms were significantly associated with analgesic use during the five year follow-up period. Possible explanations warranting investigation are that persons with AD may express depressive symptoms as painful somatic complaints, or untreated pain may cause depressive symptoms. Greater awareness of the association between depressive symptoms and analgesic use may lead to safer and more effective prescribing for these conditions

Variation of Absorption Angstrom Exponent in Aerosols From Different Emission Sources

The absorption Angstrom exponent (AAE) describes the spectral dependence of light absorption by aerosols. AAE is typically used to differentiate between different aerosol types for example., black carbon, brown carbon, and dust particles. In this study, the variation of AAE was investigated mainly in fresh aerosol emissions from different fuel and combustion types, including emissions from ships, buses, coal-fired power plants, and residential wood burning. The results were assembled to provide a compendium of AAE values from different emission sources. A dual-spot aethalometer (AE33) was used in all measurements to obtain the light absorption coefficients at seven wavelengths (370-950 nm). AAE(470/950) varied greatly between the different emission sources, ranging from -0.2 +/- 0.7 to 3.0 +/- 0.8. The correlation between the AAE(470/950) and AAE(370-950) results was good (R-2 = 0.95) and the mean bias error between these was 0.02. In the ship engine exhaust emissions, the highest AAE(470/950) values (up to 2.0 +/- 0.1) were observed when high sulfur content heavy fuel oil was used, whereas low sulfur content fuels had the lowest AAE(470/950) (0.9-1.1). In the diesel bus exhaust emissions, AAE(470/950) increased in the order of acceleration (0.8 +/- 0.1), deceleration (1.1 +/- 0.1), and steady driving (1.2 +/- 0.1). In the coal-fired power plant emissions, the variation of AAE(470/950) was substantial (from -0.1 +/- 2.1 to 0.9 +/- 1.6) due to the differences in the fuels and flue gas cleaning conditions. Fresh wood-burning derived aerosols had AAE(470/950) from 1.1 +/- 0.1 (modern masonry heater) to 1.4 +/- 0.1 (pellet boiler), lower than typically associated with wood burning, while the burn cycle phase affected AAE variation.Peer reviewe

Cut-off values to evaluate exercise-induced asthma in eucapnic voluntary hyperventilation test for children

Background and Aim The eucapnic voluntary hyperventilation (EVH) testing is a diagnostic tool for diagnostics of exercise-induced bronchoconstriction; while the testing has become more common among children, data on the test's feasibility among children remain limited. Our aim was to investigate EVH testing feasibility among children, diagnostic testing cut-off values, and which factors affect testing outcomes. Methods We recruited 134 patients aged 10-16 years with a history of exercise-induced dyspnoea and 100 healthy control children to undergo 6-min EVH testing. Testing feasibility was assessed by the children's ability to achieve >= 70% of the target minute ventilation of 30 times forced expiratory volume in 1 s (FEV1). Bronchoconstriction was assessed as a minimum of 8%, 10%, 12%, 15% or 20% fall in FEV1. Patient characteristics were correlated with EVH outcomes. Results Overall, 98% of the children reached >= 70%, 88% reached >= 80%, 79% reached >= 90% and 62% reached >= 100% of target ventilation in EVH testing; of children with a history of exercise-induced dyspnoea, the decline percentages were as follows: 24% (>= 8% fall), 17% (>= 10% fall), 10% (>= 12% fall), 6% (>= 15% fall) and 5% (>= 20% fall) in FEV1, compared to 11%, 4%, 3%, 1% and 0% among the healthy controls, respectively. Healthy controls and boys performed testing at higher ventilation rates (p < .05). Conclusion Eucapnic voluntary hyperventilation testing is feasible among children aged 10-16 years and has diagnostic value in evaluating exercise-induced dyspnoea among children. A minimum 10% fall in FEV1 is a good diagnostic cut-off value. Disease status appears to be important covariates

Contribution of brown carbon to light absorption in emissions of European residential biomass combustion appliances

Residential biomass combustion significantly contributes to light-absorbing carbonaceous aerosols in the atmosphere, impacting the earth's radiative balance at regional and global levels. This study investigates the contribution of brown carbon (BrC) to the total particulate light absorption in the wavelength range of 370–950 nm (BrC370–950) and the particulate absorption Ångström exponents (AAE470/950) in 15 different European residential combustion appliances using a variety of wood-based fuels. BrC370–950 was estimated to be from 1 % to 21 % for wood log stoves and 10 % for a fully automatized residential pellet boiler. Correlations between the ratio of organic to elemental carbon (OC / EC) and BrC370–950 indicated that a one-unit increase in OC / EC corresponded to approximately a 14 % increase in BrC370–950. Additionally, BrC370–950 was clearly influenced by the fuel moisture content and the combustion efficiency, while the effect of the combustion appliance type was less prominent. AAE470/950 of wood log combustion aerosols ranged from 1.06 to 1.61. By examining the correlation between AAE470/950 and OC / EC, an AAE470/950 close to unity was found for pure black carbon (BC) particles originating from residential wood combustion. This supports the common assumption used to differentiate light absorption caused by BC and BrC. Moreover, diesel aerosols exhibited an AAE470/950 of 1.02, with BrC contributing only 0.66 % to the total absorption, aligning with the assumption employed in source apportionment. These findings provide important data to assess the BrC from residential wood combustion with different emission characteristics and confirm that BrC can be a major contributor to particulate UV and near-UV light absorption for northern European wood stove emissions with relatively high OC / EC ratios.</p