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This paper reports the first T2K measurement of the transverse kinematic imbalance in the single-$\pi^+$ production channel of neutrino interactions. We measure the differential cross sections in the muon-neutrino charged-current interaction on hydrocarbon with a single $\pi^+$ and at least one proton in the final state, at the ND280 off-axis near detector of the T2K experiment. The extracted cross sections are compared to the predictions from different neutrino-nucleus interaction event generators. Overall, the results show a preference for models which have a more realistic treatment of nuclear medium effects including the initial nuclear state and final-state interactions.

OBJECTIVE: This study aimed to examine within-race interactions of multiple dimensions of self-reported discrimination with depressive symptoms in relation to carotid intimal-medial thickness (IMT), a subclinical marker of atherosclerosis prospectively implicated in stroke incidence, in middle-aged to older African American and white adults. METHODS: Participants were a socioeconomically diverse group of 1941 African Americans (56.5%) and whites from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (30–64 years old, 47% men, 45.2% with household income

The Conners' Continuous Performance Test-Second Edition (CCPT-2) is a widely used measure of attention and impulsivity, however, only a minimal amount is known about its reliability. To clarify the psychometric properties of the CCPT-2, we assessed its performance stability and related it to criterion measures. A total of 91 undergraduate students completed the CCPT-2, the State-Trait Personality Inventory (STPI), and reported on sleep during two sessions approximately one week apart. They completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) at session one and the Stroop Color and Word Test at session two. Findings indicated that the CCPT-2 had strong internal consistency, adequate test-retest reliability for commission errors and response time, poor test-retest reliability for omission errors, and practice effects for omission and commission errors. The CCPT-2 was largely unrelated to the BRIEF-A, Stroop Color and Word Test, and the STPI. More sleep was related to a quicker response time and more commission errors on the CCPT-2, and the BRIEF-A's Behavior Regulation Index was positively related to commission errors. Relative to the omission error component of the CCPT-2, commission errors and response time may be useful and stable measures of sustained attention and impulsivity.

The Stroop Color and Word Test is a test of processing speed, response inhibition, and executive functioning (EF). This project examined whether extending the Stroop Color-Word trial beyond the standard time limit could more accurately assess performance on EF measures. Cognitively healthy older individuals (n=198) enrolled in a study of cardiovascular health completed the Stroop as part of a neuropsychological battery. Two scores were computed for the Color-Word trial: the number of items completed within the first 45 seconds (traditional Color-Word score) and the speed of page completion beyond the first 45 seconds (Stroop-Extended score). Criterion measures included the Trail-Making Test Part B (TMT-B), Digit Span Backward, Symbol Digit Modalities Test, Short Category Test, and measures of verbal fluency. Results from hierarchical linear regression analyses indicated that the extended Stroop score accounted for small but statistically significant variance in TMT-B (additional 2.6%) and Digit Span Backwards (additional 2.6%) beyond the standard Color-Word score. These findings suggest that extending the Stroop Color-Word trial beyond the first 45 seconds provides a limited increase in predictive power within a healthy sample with restricted range of performance. The extended Stroop requires additional examination in heterogeneous samples, including clinical populations, to determine its predictive utility.

Hypertension confers increased risk for cognitive decline, dementia, and cerebrovascular disease. These associations have been attributed, in part, to cerebral hypoperfusion. Here we posit that relations of higher blood pressure to lower levels of cerebral perfusion may be potentiated by a prior head injury. Participants were 87 community-dwelling older adults -69% men, 90% white, mean age= 66.9 years, 27.6% with a history of mild traumatic brain injury (mTBI) defined as a loss of consciousness

OBJECTIVE Although both high and low levels of total and low-density lipoprotein (LDL) cholesterol have been associated with poor neuropsychological function, little research has examined nonlinear effects. We examined quadratic relations of cholesterol to performance on a comprehensive neuropsychological battery. METHOD Participants were 190 older adults (53% men, ages 54-83) free of major medical, neurologic, and psychiatric disease. Measures of fasting plasma total and high-density lipoprotein (HDL) cholesterol were assayed, and LDL cholesterol was calculated. Participants completed neuropsychological measures of attention, executive function, memory, visuospatial judgment, and manual speed and dexterity. Multiple regression analyses examined cholesterol levels as quadratic predictors of each measure of cognitive performance, with age (dichotomized as

Objectives To report, at two and 4 years post-trial, on the potential legacy of a 3-year randomized controlled clinical trial (RCT) of the Caries Management System (CMS) at private general dental practices. The CMS was designed to reduce caries risk and need for restorative care. Methods Nineteen dental practices located in city, urban, and rural locations in both fluoridated and nonfluoridated communities participated in the RCT. Eight practices were lost to follow-up post-trial; however, baseline mean DMFT balance between CMS and control practices was maintained. At the control practices, caries management following usual practice continued to be delivered. The patient outcome measure was the cumulative increment in the DMFT index score, and the practice outcome measures included the practice-mean and practice-median increments of patient DMFT index scores. In covariable analysis (patient-level unit of analysis), as the patients were clustered by practices, mean DMFT increments were determined through multilevel modeling analysis. Practice-mean DMFT increments (practice-level unit of analysis) and practice-median DMFT increments (also practice level) were determined through general linear modeling analysis of covariance. In addition, a multiple variable logistic regression analysis of caries risk status was conducted. Results The overall 4-year post-trial result (years 4–7) for CMS patients was a DMFT increment of 2.44 compared with 3.39 for control patients (P < 0.01), a difference equivalent to 28%. From the clinical trial baseline to the end of the post-trial follow-up period, the CMS and control increments were 6.13 and 8.66, respectively, a difference of 29% (P < 0.0001). Over the post-trial period, the CMS and control practice-mean DMFT increments were 2.16 and 3.10 (P = 0.055) and the respective increments from baseline to year 7 were 4.38 and 6.55 (P = 0.029), difference of 33%. The practice-median DMFT increments during the 4-year post-trial period for CMS and control practices were 1.25 and 2.36 (P = 0.039), and the respective increments during the period from baseline to year 7 were 2.87 and 5.36 (P < 0.01), difference of 47%. Minimally elevated odds of being high risk were associated with baseline DMFT (OR = 1.17). Patients attending the CMS practices had lower odds of being high risk than those attending control practices (OR = 0.23, 95% CI = 0.06, 0.88). Conclusion In practices where adherence to the CMS protocols was maintained during the 4-year post-trial follow-up period, patients continued to benefit from a reduced risk of caries and, therefore, experienced lower needs for restorative treatment.

Background The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs. Methods A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables. Results Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were – one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel. Conclusion Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time. Electronic supplementary material The online version of this article (10.1186/s12909-018-1176-4) contains supplementary material, which is available to authorized users.

Aim The aim of the present study was to determine whether the adjustment of the fluoride concentration to 1 ppm in the drinking water supplied to the Blue Mountains, New South Wales, Australia in 1993 was associated with fluorosis incidence. Methods In 2003, children attending schools in the Blue Mountains and a control region (fluoridated in 1967) that had been randomly selected at baseline in 1992 were examined for dental fluorosis (maxillary central incisors only) using Dean's index. A fluoride history for each child was obtained by questionnaire. Associations between fluorosis and 58 potential explanatory variables were explored. Results The response rate was 63%. A total of 1138 children aged from 7 to 11 years with erupted permanent central incisors were examined for dental fluorosis. Fluorosis prevalence was the same in both regions. The Community Index of Dental Fluorosis values were slightly different, but were both above 0.6, indicative of public health concern. Conclusions For the group as a whole, we concluded that: (a) fluorosis prevalence (0.39) in both regions was similar; and (b) the higher-than-expected prevalence and severity of fluorosis was due mainly to two factors: (a) the higher-than-optimal fluoride level in drinking water; and (b) swallowing of fluoride toothpaste in early childhood.

BACKGROUND/STUDY CONTEXT: Although many of the Mini-Mental State Examination's (MMSE) limitations are well accepted among geriatricians, neuropsychologists, and other interested clinicians and researchers, its continued use in psychometrically unsound ways suggests that additional investigation and dissemination of information are sorely needed. The authors aimed to describe the reliability and validity of the MMSE as a measure of cognitive function among healthy older adults.The authors examined MMSE performance in 124 stroke- and dementia-free, community-dwelling older adults (65% male; mean age = 66.5 years). All participants were administered an extensive neuropsychological battery composed of measures of attention, executive function, memory, and visuospatial function. A subset of 99 participants also underwent magnetic resonance imaging (MRI). MMSE test-retest reliability was examined among 65 participants who underwent repeat MMSE testing over an average interval of 83.2 days.Spearman test-retest correlation for total MMSE scores was r S = .35 (p = .004), for Serial Sevens was r S = .40 (p = .001), and for Word Recall was r S = -.01 (p = .96). Total MMSE performance correlated significantly with a minority of neuropsychological tests and MRI-derived indices of white matter disease and brain atrophy. A subset of 17% of participants demonstrated inappropriate intrusion of MMSE Pentagon Copy during another test of visuospatial recall.Overall, MMSE scores exhibited ceiling effects, poor test-retest reliability, limited sensitivity to subtle brain abnormalities, and a high rate of intrusion elsewhere in the neuropsychological battery. Individual MMSE items demonstrated poor construct validity. These qualities illustrate the serious limitations of the MMSE in detecting individual differences in cognitive function among healthy older adults.

To examine interactive relations of blood pressure (BP) and age to MRI indices of subclinical cerebrovascular disease in middle-aged to older adults.One hundred and thirteen stroke-free and dementia-free, community-dwelling adults (ages 54-81 years; 65% men; 91% white) engaged in (1) clinical assessment of resting SBP and DBP; (2) MRI rated for periventricular white matter hyperintensities (WMH) and deep WMH silent brain infarction (SBI) and brain atrophy (i.e. ventricular enlargement and sulcal widening ). Principal components analysis of the MRI ratings yielded a two-component solution--(1) periventricular and deep WMH SBI; and (2) ventricular enlargement, sulcal widening.Relations of SBP, DBP and pulse pressure (PP) (and their interactions with age) to each MRI component were examined in multiple regression analyses adjusted for age, sex, fasting plasma glucose and cholesterol, and antihypertensives. For component 1, results indicated significant interactions of SBP and PP with age (P0.05); higher levels of SBP and PP were associated with greater white matter disease and brain infarction at younger ages (≤ 68 years). Significant interactions of SBP and DBP with age were also noted for component 2 (P0.05); higher levels of BP were associated with greater brain atrophy at younger ages (≤ 63 years).: Higher BP and PP are associated with greater subclinical cerebrovascular disease most prominently in the 'young old'. Appropriate management of hypertension and arterial stiffening may be critical to the preservation of brain structure with ageing.

Objectives: Long-term follow-up of the Caries Management System (CMS) protocol demonstrated that regular monitoring and noninvasive management of dental caries is effective in reducing the number of caries-related events over a 7-year period. This analysis complements the authors’ original economic evaluation of the CMS by re-evaluating the per-protocol cost-effectiveness of the CMS approach.Methods: An individual patient-simulation Markov model was developed previously, based on 3-year randomized-controlled trial (RCT) data, to simulate the incidence and progression of dental caries, and resultant interventions, and to evaluate the lifetime cost-effectiveness of the CMS versus standard dental care from the Australian private dental practitioner perspective (in which the baseline age distribution was similar to that of the Australian population). The 4-year posttrial follow-up data are used to re-evaluate the long-term cost-effectiveness of the CMS in a more real-life setting.Results: The reduction in caries risk was maintained among those practices within which the CMS protocols were adhered to. The per-protocol model appears to be reasonably accurate at predicting the risk of restorative events in the posttrial follow-up period. The per-protocol lifetime cost per restorative event avoided is AUD1,980 (USD1,409; 1 AUD = 0.71 USD).Conclusions: The current analysis confirms that the CMS approach is both effective, when the protocols are adhered to appropriately, and cost-effective compared with standard care in the Australian private practice setting.

Relatively little is known about differences in English-administered, clinical neuropsychological test performance between native versus non-native English speakers, with prior literature yielding mixed findings. The purpose of this study was to examine the performance of native and non-native English speakers with similar age and educational backgrounds on a variety of cognitive tests. Participants were 153 university students (115 native and 38 non-native English speakers) who completed a neuropsychological battery during two testing sessions. Multiple regression analyses examined relations of native language to cognitive performance after adjustment for age, education, sex, and depressive symptomatology. Results showed that native English speakers outperformed non-native English speakers on several language-mediated tasks-Letter and Category Fluency and the Cognitive Estimation Test-as well as Trails A (p's < .05). The two groups performed similarly on tests of executive functions, perceptuo-motor speed, verbal memory, and visuospatial abilities. These results suggest that non-native English language may have a negative influence predominantly on language-dependent tasks.

Although there is now a large evidence-based dentistry literature, previous investigators have shown that dentists often consider research evidence irrelevant to their practice. To understand why this is the case, we conducted a qualitative study. Objective: Our aim was to identify how dentists define evidence and how they adopt it in practice. Methods: A qualitative study using grounded theory methodology was conducted. Ten dentists working in eight dental practices were interviewed about their experience and work processes while adopting evidence-based preventive care. Analysis involved transcript coding, detailed memo writing, and data interpretation. Results: Findings revealed that dentists’ direct observations – referred to as clinical evidence – provided the most tangible and trusted evidence in practice and during discussions with colleagues. Dentists described a detailed process used to gather, compare and implement clinical evidence. This process began when they were exposed to novelty in daily practice and proceeded through self-driven testing, producing clinical or tangible evidence that clinicians could use in practice. Conclusion: Based on these findings, we propose an alternative to the linear form of knowledge transfer commonly represented in the literature.

In contrast to the predictions of the Standard Model of particle physics, experimental data now indicate that neutrinos are massive and undergo flavor oscillations. Indeed, observations of atmospheric neutrinos have confirmed that the disappearance of high-energy muon-like events is well described by the conversion of ν μ into ν τ . Though the primary atmospheric neutrino flux at these energies is composed almost exclusively of ν e and ν μ , this transition implies that it is also possible to observe ν τ -induced events. Recent results from the Super-Kamiokande ν μ disappearance analysis as well the search for the subsequent appearance of ν τ events in the data are presented.

Administration of caffeine or caffeinated coffee in laboratory and ambulatory settings results in small to moderate acute increases in blood pressure (BP). However, habitual coffee intake has not been linked conclusively to long-term increases in basal BP, and findings are inconsistent by sex. This study examined longitudinal relations of habitual coffee use to resting BP and pulse pressure.In a sample of 2,442 participants from the Baltimore Longitudinal Study of Aging (BLSA), coffee consumption was used to predict resting systolic and diastolic BP and pulse pressure using longitudinal mixed-effects regression models adjusted for age, education, antihypertensive, and antihyperlipidemic use, smoking, and body mass index (BMI). Analyses were stratified by sex (865 women and 1,577 men), and age and BMI were examined as possible effect modifiers.In men, we identified a significant three-way interaction among coffee intake (nonlinear), baseline age, and length of follow-up for systolic BP (SBP) and pulse pressure. A significant interaction of coffee intake and BMI (nonlinear) was also noted for SBP in men. There were no significant relations of coffee intake to BP or pulse pressure in women.Greater coffee intake in men was associated with steeper age-related increases in SBP and pulse pressure, particularly beyond 70 years of age and in overweight to obese men.

Cardiovascular (CV) diseases and their risk factors negatively impact the brain and neurocognitive function prior to stroke, dementia, or mild cognitive impairment (MCI). Indeed, a progression of neurocognitive and neurobiological impairments may be associated with increasingly severe manifestations of CV risk and disease. In samples ranging from children to elderly, a broad spectrum of CV risk factors, and both subclinical and clinical CV diseases, have been related to decrements in cognitive function and cognitive decline across multiple domains of performance including executive functions, attention, learning and memory, perceptuo-motor speed, and others. In contrast to the MCI literature, the possibility of distinct subgroups has not been explored. Further, it remains unknown whether neurocognitive performance (or its pattern) per se can predict conversion to MCI and later dementia. We suggest that neurocognitive function may contribute to such prediction in concert with relevant radiological, genetic, biomedical, sociodemographic, and other data. To best do so, future research would benefit from inclusion of a breadth of neurocognitive tests that tap multiple domains of function and have historical sensitivity to vascular and neurodegenerative pathology, in addition to biological or radiological assessment of such pathology. Aggressive efforts at prevention and early intervention with CV risk may play a critical role in the prevention of MCI or dementia.

Objective To examine the relations of non-aspirin, nonsteroidal anti-inflammatory drug (NSAID) and aspirin use to age-related change in multiple domains of cognitive function among non-demented, community-dwelling individuals.

Objectives. The objectives of this study were to: (i) test the hypothesis that urbanization is a risk factor for dental caries in children aged 6 and 12 years in Kollam, Kerala; and (ii) identify other possible risk factors for dental caries. Methods. A cross-sectional study design was followed. The subjects were stratified by socio-demographic status into urban middle class, urban poor, and rural poor. Caries experience was measured by visual examination of teeth according to the World Health Organization criteria. Data on potential risk factors were collected using a close-ended, structured, and interviewer-administered questionnaire. Data modelling was conducted using logistic regression analyses. Results. Eight hundred seventy-six children were examined; 53% of 6-year-olds and 90% of 12-year-olds examined were caries free. The caries experience rates were 1.40 decayed, missing, or filled primary teeth and 0.15 Decayed, Missing, and Filled Teeth (DMFT) for the 6- and 12-year-olds, respectively. Urban children did not have a higher caries experience compared with rural children. The only risk factor associated with a significant difference in DMFT scores was the dental visiting pattern. Children who visited the dentist had a significantly higher mean DMFT score (P = 0.009). Conclusion. There was no evidence that urbanization is a risk factor for dental caries in Kerala. Dental caries experience was low, against any standard, in Kollam. Risk factors for caries were not identified.

A subset of neutrino-induced upward through-going muons in the Super-Kamiokande detector consists of high energy muons which lose energy through radiative processes such as bremsstrahlung, e^{+} e^{-} pair production and photonuclear interactions. These ``upward showering muons'' comprise an event sample whose mean parent neutrino energy is approximately 1 TeV. We show that the zenith angle distribution of upward showering muons is consistent with negligible distortion due to neutrino oscillations, as expected of such a high-energy neutrino sample. We present astronomical searches using these high energy events, such as those from WIMP annihilations in the Sun, Earth and Galactic Center, some suspected point sources, as well as searches for diffuse flux from the interstellar medium., Comment: Submitted for publication to Astroparticle Physics. Fig 12 has slightly higher resolution in the version submitted to the journal

Background and aims Examine age, sex, race, and socioeconomic status as modifiers of the association between carotid intimal medial thickness (IMT) and neurocognitive performance in a socioeconomically diverse, biracial, urban, adult population. Methods Participants were 1712 community-dwelling adults (45% men, 56% African-American, 38% below poverty threshold, aged 30–64 years) enrolled in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Participants underwent initial carotid ultrasonography followed by cognitive testing on up to two occasions over 4 years. Mixed-effects regression analyses were adjusted for demographic, behavioral, and biomedical covariates. Results Significant cross-sectional IMT × race × poverty interactions were identified for measures of delayed recall memory, auditory-verbal attention, and working memory. An IMT × race interaction also appeared for auditory-verbal learning. Higher IMT was generally associated with worse cognitive performance, but the disadvantage was most pronounced among those with higher socioeconomic status and white participants. No longitudinal associations were identified. Conclusions Carotid IMT-cognition associations differed as a function of race and socioeconomic status and were most compelling for measures of attention, executive function, and memory. These findings highlight the possibility that subclinical atherosclerosis may be differentially informative as a predictor of cognitive performance among varied demographic subgroups.

Growing evidence suggests that self-reported physical activity accounts for variability in cognitive function among older adults, and aerobic intervention may improve cognitive function in this population. However, much less is known about the longitudinal association between direct measures of cardiorespiratory fitness and cognitive function across the life span. The present study examined the prospective association between symptom-limited maximal oxygen consumption (VO2max) and longitudinal performance on a comprehensive neuropsychological battery.Up to 1,400 participants aged 19-94 years underwent initial VO2max assessment and completed subsequent tests of memory, attention, perceptuomotor speed, language, and executive function, in addition to cognitive screening measures, on up to six occasions (mean, M = 2; standard deviation, SD = 1) for up to 18 years (M = 7, SD = 3). Mixed-effects regression models were adjusted for demographic, biomedical, and behavioral confounders.Analyses revealed significant longitudinal associations between baseline VO2max and trajectory of performance on multiple measures of verbal and visual memory, as well as on a cognitive screening test (all ps.05). Individuals with lower VO2max demonstrated accelerated trajectories of cognitive decline over time.Baseline cardiorespiratory fitness is related to longitudinal neuropsychological performance, and memory appears to be a particularly vulnerable domain. Evidence that aerobic fitness is associated with accelerated cognitive decline emphasizes the possible importance of behavioral interventions to optimize cognitive aging over time.

We present the results of searches for nucleon decay via n→ν[over ¯]π0 and p→ν[over ¯]π+ using data from a combined 172.8 kt·yr exposure of Super-Kamiokande-I,-II, and-III. We set lower limits on the partial lifetime for each of these modes: τn→ν[over ¯]π01.1×10(33) years and τp→ν[over ¯]π+3.9×10(32) years at a 90% confidence level.

An acid Appalachian soil was amended with two flue gas desulfurization (FGD) by-products, one consisting of wallboard-quality gypsum (CaSO{sub 4}{center_dot}2H{sub 2}) and the other containing CaSO{sub 3}{center_dot}0.5H{sub 2}O as a major component. Soil columns treated with FGD by-products were leached with deionized H{sub 2}O under unsaturated conditions. Aluminum amounts leached increased 25-fold over the control when CaSO{sub 4}{center_dot}2H{sub 2}O FGD by-product was incorporated into the soil. Leachate pH decreased with FGD product treatment, but bulk soil pH increased, and exchangeable Al and total soil acidity decreased. Mean 4-d root lengths of sudangrass (Sorghum bicolor L. Moench) seedlings grown in the leached soils were as much as 440 and 310% the value of the control for CaSO{sub 3}{center_dot}0.5H{sub 2}O and CaSO{sub 4}{center_dot}2H{sub 2}O treatments, respectively. Mechanisms by which mitigation of Al toxicity occurs with addition of high-Ca FGD by-products to acid soils are discussed. 48 refs., 8 figs., 6 tabs.

CaSO3 is a by-product formed by several of the processes used for scrubbing SO2 from flue gas produced by coal-burning power generators. Using CaSO3 to improve the calcium status of acid soils would be a beneficial alternative to disposal in landfills. CaSO3 has biocidal properties and is used as a disinfectant and food and drink preservative. It is important to evaluate under what conditions application to soils would not harm plant growth. Laboratory experiments confirmed that two transformations of CaSO3 occurred in soil systems: (1) decomposition to produce SO2 gas, and (2) oxidation to calcium sulfate. Conversion to SO2 occurred in solution and soil at low pH, and acid soils treated with CaSO3 were initially toxic to seedling root growth. The degree of toxicity was time-dependent, with reduction in toxicity occurring as CaSO3 oxidized to calcium sulfate. Soil reaction also influenced toxicity, and at soil pH levels above 6, little seedling toxicity was evident.

Cardiovascular diseases are the leading cause of morbidity and mortality in the United States and most westernized nations [1]. Cardiovascular risk factors and diseases confer substantial increase in risk for ischemic and hemorrhagic stroke [2]. Yet, outside the context of clinical stroke, the brain is an under-recognized target organ of a spectrum of cardiovascular diseases. Although it has long been known that cardiovascular risk factors and diseases contribute to the development of vascular (previously known as multi-infarct) dementia, we now know that similar risk is conferred for Alzheimer’s disease (AD) [3]. Importantly, long before clinical manifestations of stroke or dementia are apparent, cardiovascular risk factors are also known to negatively impact the brain and neurocognitive function. Evidence suggests that cardiovascular risk factors elevate risk of concurrent cognitive dysfunction, as well as accelerated cognitive aging.

Background and Purpose— Although vascular risk factors have been implicated in the development of all-cause dementia and Alzheimer disease (AD), few studies have examined the association between subclinical atherosclerosis and prospective risk of dementia. Methods— Participants from the Baltimore Longitudinal Study of Aging (n=364; age, 60–95 years; median age, 73; 60% male; 82% white) underwent initial carotid atherosclerosis assessment and subsequently were assessed for dementia and AD annually for up to 14 years (median, 7.0). Cox proportional hazards models predicting all-cause dementia and AD were adjusted for age, sex, race, education, blood pressure, cholesterol, cardiovascular disease, diabetes mellitus, and smoking. Results— Sixty participants developed dementia, with 53 diagnosed as AD. Raw rates of future dementia and AD among individuals initially in the upper quintile of carotid intimal medial thickness or with bilateral carotid plaque were generally double the rates of individuals with intimal medial thickness in the lower quintiles or no plaque at baseline. Adjusted proportional hazards models revealed >2.5-fold increased risk of dementia and AD among individuals in the upper quintile of carotid intimal medial thickness, and approximately 2.0-fold increased risk of dementia among individuals with bilateral plaque. Conclusions— Multiple measures of carotid atherosclerosis are associated with prospective risk of dementia. Individuals in the upper quintile of carotid intimal medial thickness or bilateral carotid plaque were at greatest risk. These findings underscore the possibility that early intervention to reduce atherosclerosis may help delay or prevent onset of dementia and AD.

Background Associations among diagnosed unipolar depression, depressive symptoms, and cerebrovascular disease are well known. However, minimal research has investigated whether sex may modify such associations, despite known sex differences in depression and depressive symptoms. This study examined whether depressive symptoms were disproportionately related to subclinical cerebrovascular disease (SCD) in women versus men. Methods One hundred one older adults (58% men; mean age=67 years), free of major comorbidities, completed the Beck Depression Inventory and underwent magnetic resonance imaging (MRI). MRI scans were neuroradiologist rated for markers of SCD (periventricular and deep white matter hyperintensities, and number of silent infarcts) and brain atrophy (ventricular enlargement and sulcal widening). Two rank-sum outcome variables (SCD and brain atrophy) were then created. Results On average, depressive symptoms were relatively low in magnitude (mean = 3.8, standard deviation=3.6, range=0–17). Multiple regression analyses, adjusted for age, sex, education, systolic blood pressure, fasting glucose, maximal oxygen consumption, body mass index, average weekly alcohol consumption, and Mini-Mental State Examination performance revealed sex to be a significant effect modifier of depressive symptoms in the prediction of SCD. Sex-stratified regression analyses indicated depressive symptoms, and SCD was strongly related among women but not men. Depressive symptoms were not related to brain atrophy, regardless of inclusion of sex as an effect modifier. Conclusions Depressive symptoms, even in a subclinical range, are significantly associated with an MRI-derived index of SCD among women, but not men, in the present sample of relatively healthy older adults.

Neurocognition is a critically important dimension of our daily functioning that is impacted negatively by a host of non-neurological, systemic diseases. In the field of behavioral medicine, neurocognitive testing is used to examine the impact of such diseases and their risk factors on multiple domains of function including attention; learning and memory; executive functions; visuospatial; psychomotor; and perceptual abilities; and language. In that regard, a host of behavioral, biomedical, psychosocial, and psychophysiological risk factors and a broad spectrum of systemic medical diseases confer vulnerability to (or in some instances resilience against) cognitive difficulties, subclinical cerebrovascular disease, and ultimately dementia or stroke. Neurocognitive assessment can also be used to help facilitate an understanding of medical decision making, treatment outcomes, quality of life, and functional status. For example, the executive functions may have a particularly important role in health behaviors and their change, management of chronic disease and chronic pain, treatment adherence, and other medical decision making. Neuropsychological assessment is highly relevant to the study and practice of behavioral medicine.

Background: Obesity indices (i.e. BMI, waist-to-hip ratio) show differential relationships to other health outcomes, though their association to neurocognitive outcome is unclear. Methods: We examined whether central obesity would be more closely associated with cognitive function in 1,703 participants from the Baltimore Longitudinal Study of Aging. Results: Longitudinal mixed-effects regression models showed multiple obesity indices were associated with poorer performance in a variety of cognitive domains, including global screening measures, memory, and verbal fluency tasks. Obesity was associated with better performance on tests of attention and visuospatial ability. An obesity index by age interaction emerged in multiple domains, including memory and attention/executive function. Conclusion: Obesity indices showed similar associations to cognitive function, and further work is needed to clarify the physiological mechanisms that link obesity to poor neurocognitive outcome.

We have searched for proton decays via p--e;{+}pi;{0} and p--micro;{+}pi;{0} using data from a 91.7 kt.yr exposure of Super-Kamiokande-I and a 49.2 kt.yr exposure of Super-Kamiokande-II. No candidate events were observed with expected backgrounds induced by atmospheric neutrinos of 0.3 events for each decay mode. From these results, we set lower limits on the partial lifetime of 8.2 x 10;{33} and 6.6 x 10;{33} years at 90% confidence level for p--e;{+}pi;{0} and p--micro;{+}pi;{0} modes, respectively.

The drinking water fluoride concentration in Hong Kong was reduced by about 0.2 ppm in June 1978. This study was undertaken to determine whether the prevailing level of dental fluorosis was affected by such a minor change. Cohorts of children (N = 1,062) aged seven to 12 years, who were born both before and after the fluoride reduction, were examined clinically using Dean's fluorosis index. Based on upper right central incisors, dental fluorosis prevalence decreased from 64 to 47 percent and the community fluorosis index decreased from 1.01 to 0.75 (P less than .01). Thus, dental fluorosis was reduced, although the reduction in water fluoride concentration was not sufficient to achieve the minimal fluorosis level that Dean associated with a fluoride concentration optimal for caries prevention. Variation in dental fluorosis has been reported previously to result from marked sudden changes, during tooth formative years, to drinking water fluoride concentration. This study confirms preliminary findings that variation in dental fluorosis arising from minor changes to the fluoride level in drinking water is also measurable.

A sociological study was conducted in 1987 on a sample of 490 Hong Kong Chinese civil servants for the purpose of investigating factors which influenced their utilization of a freely available Government dental service. The proportions of regular, irregular and non-users of the dental service were 69, 18, and 13% respectively. Regular users had a higher educational standard and income level than the other two user-types. Most of the regular users attended the dental clinics for a check-up. The irregular users did not regularly utilize the service mainly because it took a long time to obtain an appointment. Non-users referred to the long waiting time to obtain an appointment and to their perception of not having dental problems when asked to give their main reasons for not utilizing the dental service. The majority of the user-types considered that shortening the waiting time and employing more dentists would increase the utilization of the Government dental service.

The development of a Source Control Emergency Response Plan is one of the best ways in which an operator can ensure that the goals of their regional or project-specific Source Control emergency preparedness efforts will be met, if needed. Procedures for handling emergencies are absolutely essential to ensure the protection of life, property, and the environment. This Source Control Emergency Response Plan (SCERP) is based on decades of conventional and subsea well control experience to ensure that the planning efforts and to develop Source Control Emergency Response Planning (SCERP) through field deployment of the system in order to cap a subsea well. The aforementioned experience covers many years of source control, well control and intervention operations in conceivable operational settings and in a variety of geographic locations. The equipment and procedures specified in this SCERP address a “worst case” scenario involving a loss of well control, necessitating the immediate mobilization of intervention equipment and personnel. The primary objective of the SCERP is to establish a process for responding to and safely managing source-control emergencies using a standard, uniform approach. This process includes the following information:emergency contact information and resourcesresponse managementsource-control operational overview with strategic methodologiesorganizational staffing recommendationscheck list to guide groups and unit leaders andkey resource identification The SCERP is not intended to replace sound judgment. Modification of the mobilization plan and intervention strategy may be necessary, depending on circumstances. Subsea source-control events require common sense and professional judgment on the part of the person(s) in charge of operations, and no operation should be undertaken if it involves unreasonable risk to personnel. Additional, a Logistics Plan must be developed to support operations by identifying mobilization guidelines from the stored location for the capping stack and other support equipment necessary to secure the well. Disembarkation of the equipment clearly offering various options with estimated timelines for transporting the equipment by air, ground and sea should also be outlined to ensure equipment arrives timely and safely. Locating vessels and rigs meeting operational requirements will help ensure well incidents are managed and executed within incident-command and other expectations.

Purpose The purpose of this study was to determine an improved estimate of the critical period for susceptibility to fluorosis in human maxillary central incisors. Methods The fluorosis score, S, of the incisal (I), middle (M), and cervical (C) third divisions on the labial surface of right maxillary central incisors of subjects (a representative sample of 1,085 Hong Kong Chinese children aged 7 to 12 years surveyed in 1986) was determined according to the Chronological Fluorosis Assessment (CFA) Index. Subject data were grouped by month of birth relative to June 1978, when the designated concentration for waterborne fluoride in the community water supply was reduced from 1.0 to 0.7 mg/L. The analytical task was one of finding the correlation maximum in a system of 12 variates and adjustable parameters including the waterborne fluoride concentration, [F-], and the fluorosis score. Results The main findings were: (1) the peak correlation of S vs [F-] for the male incisal third centered at 17.5 months after birth; (2) and six months later for females; (3) the correlation of S with [F-] is maximized for S(M) following S(I) by two months, and S(C) following S(M) by a further two months for both males and females; and (4) the critical period for exposure to fluoride is of about four months' duration for each third. Conclusions The maxillary central incisor, as a whole, appears most at risk to fluorosis from dietary fluoride between age 15 and 24 months for males and between 21 and 30 months for females.

Sulfite and sulfate compounds are common in many coal combustion by-products (CCBP), some of which have potential as amendments to acid soils. This study was conducted to determine effects of high-sulfite (BP-#1) and high-sulfate (BP-#16 and BP-#22) coal flue gas desulfurisation by-products (FGD-BPs) and chemical grade CaSO3, CaSO4, and CaCO3 (lime) mixed with acid Porters soil (Umbric Dystrochrepts) on growth of maize (Zea mays L.) in a greenhouse. Shoot and root dry matter yields (DMY) increased or remained unchanged at low levels of BP-#1 (>1%) before decreases occurred. Shoot DMY increased and/or remained high when increasing levels of BP-#16 and BP-#22 (up to 75%) were added to soil. Root DMY decreased at low levels of BP-#16 (>5%), but increased at high levels ( 0.5–1.0%), and increased at higher levels (

– A representative sample of Hong Kong children aged 6–8 yr was examined for dental caries, and data on possible explanatory variables for dmft were obtained from questionnaires. Variation in dmft was partially accounted for by the effect of some demographic variables and other variables having a socioeconomic base. Girls had a lower dmft index than boys, and being born in Hong Kong rather than elsewhere (that is, China) was also associated with a lower dmft index. Better dental status was strongly associated with increasing educational level of the mother, monthly household income, and with an increasingly positive perception of the questionnaire respondent's own dental status. Preschool dental visits and enrolment in the School Dental Care Service were associated with higher dmft indices. Altogether, 22.5% of the variance in dmft was explained. It was concluded that 1) demographic and socioeconomic factors significantly affect dmft variation in Hong Kong, 2) the mother's role in determining the dental status of her child is probably important, and 3) further elucidation of the variation in dmft will depend on the analysis of data pertaining to dietary and oral hygiene practices during the preschool years and to an analysis of tooth morphology, fluoride exposure, and microbiologic, salivary, and genetic factors.

The temporal relation between a declining fluorosis gradient and an abrupt downward shift in community drinking water fluoride concentration was evaluated through multiple correlation analysis to determine the critical time frame during which developing maxillary central incisors are most susceptible to fluoride challenge. Fluorosis data were scrutinized through a time-related series of epidemiologic "windows" or time frames of varying lengths. The placement of these time frames was in turn related to the presumed start of enamel mineralization (at birth), and ranged from zero to 60 months later. In this way, the susceptibility of developing enamel to changes in water fluoride concentration was localized. The greatest risk was associated with a four-month critical period commencing at 22 months following birth. The risk of fluorosis from exposures to a fluoride challenge acting during shorter periods was better localized than risk associated with longer exposures. We concluded (1) that human maxillary central incisors are most susceptible to fluorosis during a critical period of as little as four months' duration, commencing at 22 months of age; and (2) that for these incisors, fluoride exposure during the months prior to this period carries less risk than continued exposure for up to 36 months beyond this critical time.

The analgesic efficacy of single 500- and 1,000-mg doses of diflunisal (Dolobid), a new nonsteroidal anti-inflammatory analgesic, was compared in a double-blind study with that of acetaminophen, 600 mg, the combination of acetaminophen, 600 mg, with codeine phosphate, 60 mg, and placebo in 159 oral surgery outpatients. Using a self-rating record, patients rated their pain and its relief hourly for 12 hours after medication. Both doses of diflunisal were significantly more effective than acetaminophen alone and produced peak analgesia comparable to that of the acetaminophen-codeine combination. Diflunisal proved to have an unusually long duration of analgesic action. Acetaminophen and the combination were significantly superior to placebo through hours 2 and 5, respectively; both doses of diflunisal were significantly superior through the end of the 12-hour observation period. None of the active treatments produced more side effects than the placebo. ( JAMA 1982;248:2139-2142)

This article examines the relationship between fluoridation and socioeconomic status on caries experience, as measured by the dmf index, in 5-yr-old New Zealand children in the city of Dunedin (fluoridated in 1967) and in adjacent non-fluoride communities. The children were subdivided into six socioeconomic status groups (SES 1, professional and managerial-SES 6, unskilled workers), but then for simplicity they were combined to form three groups. A two-way analysis of variance demonstrated that interaction between fluoride history and socioeconomic status was not significant. In all three SES groups, dmf was higher in non-fluoride communities, but the difference was significant only in SES group (5&6) (P less than 0.01). Caries experience increased with decreasing socioeconomic status in both fluoride and non-fluoride communities, but this effect was only significant between SES groups (1&2) and (3&4) in the fluoridated community (P less than 0.05), and between SES groups (3&4) and (5&6) in non-fluoride communities (P less than 0.01). These results are compared with those of similar studies, and it is concluded that so far, the relationship between fluoridation and socioeconomic status on caries experience remains equivocal. A note of caution is sounded regarding the interpretation of such results, and the difficulties faced when comparing studies is discussed.

— Young mice treated with hydrocortisone (50 mg/kg) subcutaneously for 10 days showed a doubling of brain glucose. Brain phospho-creatine, glucose-6-phosphate, and ATP increased slightly. Brain glycogen and lactate were unchanged. Total energy reserve of the brain was 23 per cent higher than the control value. Liver glycogen was increased 47 per cent; liver and blood glucose levels were 11 per cent lower than in control animals. Since the animals showed no evidence of sedation, these findings suggest a facilitated transport of glucose from blood into the brain under the influence of hydrocortisone. Other possible explanations include an inhibition of the hexose monophosphate shunt and a proportionate decrease in both the oxidative and glycolytic pathways of the brain, but it was concluded that these explanations are less likely.

Either the McCaman-Robins fluorimetric method or the microbiologic inhibitionassay can be used effectively to identify phenylketonuric individuals. Physicians who routinely use either of these methods to screen and follow up all newborn infants can be quite confident that infants with phenylketonuria will be detected.