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Background: Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients.
Methods: The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors.
Results: The mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0% of them were male and 1.9% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95% CI: 1.10-1.24), lipid metabolism (1.07; 1.00-1.14), stroke incl. TIA (1.68; 1.57-1.80), Parkinson's disease (PD) (1.89; 1.64-2.19), intracranial injury (1.30; 1.00-1.70), coronary heart disease (1.06; 1.00-1.13), mild cognitive impairment (MCI) (2.12; 1.82-2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50-2.57). The use of statins (OR: 0.94; 0.90-0.99), proton-pump inhibitors (PPI) (0.93; 0.90-0.97), and antihypertensive drugs (0.96, 0.94-0.99) were associated with a decreased risk of developing dementia.
Conclusions: Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.
Widespread flooding in June 2013 caused damage costs of €6 to 8 billion in Germany, and awoke many memories of the floods in August 2002, which resulted in total damage of €11.6 billion and hence was the most expensive natural hazard event in Germany up to now. The event of 2002 does, however, also mark a reorientation toward an integrated flood risk management system in Germany. Therefore, the flood of 2013 offered the opportunity to review how the measures that politics, administration, and civil society have implemented since 2002 helped to cope with the flood and what still needs to be done to achieve effective and more integrated flood risk management. The review highlights considerable improvements on many levels, in particular (1) an increased consideration of flood hazards in spatial planning and urban development, (2) comprehensive property-level mitigation and preparedness measures, (3) more effective flood warnings and improved coordination of disaster response, and (4) a more targeted maintenance of flood defense systems. In 2013, this led to more effective flood management and to a reduction of damage. Nevertheless, important aspects remain unclear and need to be clarified. This particularly holds for balanced and coordinated strategies for reducing and overcoming the impacts of flooding in large catchments, cross-border and interdisciplinary cooperation, the role of the general public in the different phases of flood risk management, as well as a transparent risk transfer system. Recurring flood events reveal that flood risk management is a continuous task. Hence, risk drivers, such as climate change, land-use changes, economic developments, or demographic change and the resultant risks must be investigated at regular intervals, and risk reduction strategies and processes must be reassessed as well as adapted and implemented in a dialogue with all stakeholders.
It has been proposed that in online sentence comprehension the dependency between a reflexive pronoun such as himself/herself and its antecedent is resolved using exclusively syntactic constraints. Under this strictly syntactic search account, Principle A of the binding theory which requires that the antecedent c-command the reflexive within the same clause that the reflexive occurs in constrains the parser's search for an antecedent. The parser thus ignores candidate antecedents that might match agreement features of the reflexive (e.g., gender) but are ineligible as potential antecedents because they are in structurally illicit positions. An alternative possibility accords no special status to structural constraints: in addition to using Principle A, the parser also uses non-structural cues such as gender to access the antecedent. According to cue -based retrieval theories of memory (e.g., Lewis and Vasishth, 2005), the use of non-structural cues should result in increased retrieval times and occasional errors when candidates partially match the cues, even if the candidates are in structurally illicit positions. In this paper, we first show how the retrieval processes that underlie the reflexive binding are naturally realized in the Lewis and Vasishth (2005) model. We present the predictions of the model under the assumption that both structural and non-structural cues are used during retrieval, and provide a critical analysis of previous empirical studies that failed to find evidence for the use of non-structural cues, suggesting that these failures may be Type II errors. We use this analysis and the results of further modeling to motivate a new empirical design that we use in an eye tracking study. The results of this study confirm the key predictions of the model concerning the use of non-structural cues, and are inconsistent with the strictly syntactic search account. These results present a challenge for theories advocating the infallibility of the human parser in the case of reflexive resolution, and provide support for the inclusion of agreement features such as gender in the set of retrieval cues.
The onset of modern central Asian atmospheric circulation is traditionally linked to the interplay of surface uplift of the Mongolian and Tibetan-Himalayan orogens, retreat of the Paratethys sea from central Asia and Cenozoic global cooling. Although the role of these players has not yet been unravelled, the vast dust deposits of central China support the presence of arid conditions and modern atmospheric pathways for the last 25 million years (Myr). Here, we present provenance data from older (42-33 Myr) dust deposits, at a time when the Tibetan Plateau was less developed, the Paratethys sea still present in central Asia and atmospheric pCO(2) much higher. Our results show that dust sources and near-surface atmospheric circulation have changed little since at least 42 Myr. Our findings indicate that the locus of central Asian high pressures and concurrent aridity is a resilient feature only modulated by mountain building, global cooling and sea retreat.
The enormous species richness of flowering plants is at least partly due to floral diversification driven by interactions between plants and their animal pollinators [1, 2]. Specific pollinator attraction relies on visual and olfactory floral cues [3-5]; floral scent can not only attract pollinators but also attract or repel herbivorous insects [6-8]. However, despite its central role for plant-animal interactions, the genetic control of floral scent production and its evolutionary modification remain incompletely understood [9-13]. Benzenoids are an important class of floral scent compounds that are generated from phenylalanine via several enzymatic pathways [14-17]. Here we address the genetic basis of the loss of floral scent associated with the transition from outbreeding to selfing in the genus Capsella. While the outbreeding C. grandiflora emits benzaldehyde as a major constituent of its floral scent, this has been lost in the selfing C. rubella. We identify the Capsella CNL1 gene encoding cinnamate: CoA ligase as responsible for this variation. Population genetic analysis indicates that CNL1 has been inactivated twice independently in C. rubella via different novel mutations to its coding sequence. Together with a recent study in Petunia [18], this identifies cinnamate: CoA ligase as an evolutionary hotspot for mutations causing the loss of benzenoid scent compounds in association with a shift in the reproductive strategy of Capsella from pollination by insects to self-fertilization.
Background:
Exercising at intensities where fat oxidation rates are high has been shown to induce metabolic benefits in recreational and health-oriented sportsmen. The exercise intensity (Fat peak ) eliciting peak fat oxidation rates is therefore of particular interest when aiming to prescribe exercise for the purpose of fat oxidation and related metabolic effects. Although running and walking are feasible and popular among the target population, no reliable protocols are available to assess Fat peak as well as its actual velocity (V PFO ) during treadmill ergometry. Our purpose was therefore, to assess the reliability and day-to-day variability of V PFO and Fat peak during treadmill ergometry running.
Methods:
Sixteen recreational athletes (f = 7, m = 9; 25 ± 3 y; 1.76 ± 0.09 m; 68.3 ± 13.7 kg; 23.1 ± 2.9 kg/m 2 ) performed 2 different running protocols on 3 different days with standardized nutrition the day before testing. At day 1, peak oxygen uptake (VO 2peak ) and the velocities at the aerobic threshold (V LT ) and respiratory exchange ratio (RER) of 1.00 (V RER ) were assessed. At days 2 and 3, subjects ran an identical submaximal incremental test (Fat-peak test) composed of a 10 min warm-up (70 % V LT ) followed by 5 stages of 6 min with equal increments (stage 1 = V LT , stage 5 = V RER ). Breath-by-breath gas exchange data was measured continuously and used to determine fat oxidation rates. A third order polynomial function was used to identify V PFO and subsequently Fat peak . The reproducibility and variability of variables was verified with an int raclass correlation coef ficient (ICC), Pearson ’ s correlation coefficient, coefficient of variation (CV) an d the mean differences (bias) ± 95 % limits of agreement (LoA).
Results:
ICC, Pearson ’ s correlation and CV for V PFO and Fat peak were 0.98, 0.97, 5.0 %; and 0.90, 0.81, 7.0 %, respectively. Bias ± 95 % LoA was − 0.3 ± 0.9 km/h for V PFO and − 2±8%ofVO 2peak for Fat peak.
Conclusion:
In summary, relative and absolute reliability indicators for V PFO and Fat peak were found to be excellent. The observed LoA may now serve as a basis for future training prescriptions, although fat oxidation rates at prolonged exercise bouts at this intensity still need to be investigated.
In low-accumulation regions, the reliability of delta O-18-derived temperature signals from ice cores within the Holocene is unclear, primarily due to the small climate changes relative to the intrinsic noise of the isotopic signal. In order to learn about the representativity of single ice cores and to optimise future ice-core-based climate reconstructions, we studied the stable-water isotope composition of firn at Kohnen Station, Dronning Maud Land, Antarctica. Analysing delta O-18 in two 50m long snow trenches allowed us to create an unprecedented, two-dimensional image characterising the isotopic variations from the centimetre to the 100-metre scale. Our results show seasonal layering of the isotopic composition but also high horizontal isotopic variability caused by local stratigraphic noise. Based on the horizontal and vertical structure of the isotopic variations, we derive a statistical noise model which successfully explains the trench data. The model further allows one to determine an upper bound for the reliability of climate reconstructions conducted in our study region at seasonal to annual resolution, depending on the number and the spacing of the cores taken.
Referential Choice
(2016)
We report a study of referential choice in discourse production, understood as the choice between various types of referential devices, such as pronouns and full noun phrases. Our goal is to predict referential choice, and to explore to what extent such prediction is possible. Our approach to referential choice includes a cognitively informed theoretical component, corpus analysis, machine learning methods and experimentation with human participants. Machine learning algorithms make use of 25 factors, including referent’s properties (such as animacy and protagonism), the distance between a referential expression and its antecedent, the antecedent’s syntactic role, and so on. Having found the predictions of our algorithm to coincide with the original almost 90% of the time, we hypothesized that fully accurate prediction is not possible because, in many situations, more than one referential option is available. This hypothesis was supported by an experimental study, in which participants answered questions about either the original text in the corpus, or about a text modified in accordance with the algorithm’s prediction. Proportions of correct answers to these questions, as well as participants’ rating of the questions’ difficulty, suggested that divergences between the algorithm’s prediction and the original referential device in the corpus occur overwhelmingly in situations where the referential choice is not categorical.
An egalitarian approach to the fair representation of voters specifies three main institutional requirements: proportional representation, legislative majority rule and a parliamentary system of government. This approach faces two challenges: the under-determination of the resulting democratic process and the idea of a trade-off between equal voter representation and government accountability. Linking conceptual with comparative analysis, the article argues that we can distinguish three ideal-typical varieties of the egalitarian vision of democracy, based on the stages at which majorities are formed. These varieties do not put different relative normative weight onto equality and accountability, but have different conceptions of both values and their reconciliation. The view that accountability is necessarily linked to clarity of responsibility', widespread in the comparative literature, is questioned - as is the idea of a general trade-off between representation and accountability. Depending on the vision of democracy, the two values need not be in conflict.
The excitation of localized surface plasmons in noble metal nanoparticles (NPs) results in different nanoscale effects such as electric field enhancement, the generation of hot electrons and a temperature increase close to the NP surface. These effects are typically exploited in diverse fields such as surface-enhanced Raman scattering (SERS), NP catalysis and photothermal therapy (PTT). Halogenated nucleobases are applied as radiosensitizers in conventional radiation cancer therapy due to their high reactivity towards secondary electrons. Here, we use SERS to study the transformation of 8-bromoadenine (8BrA) into adenine on the surface of Au and AgNPs upon irradiation with a low-power continuous wave laser at 532, 633 and 785 nm, respectively. The dissociation of 8BrA is ascribed to a hot-electron transfer reaction and the underlying kinetics are carefully explored. The reaction proceeds within seconds or even milliseconds. Similar dissociation reactions might also occur with other electrophilic molecules, which must be considered in the interpretation of respective SERS spectra. Furthermore, we suggest that hot-electron transfer induced dissociation of radiosensitizers such as 8BrA can be applied in the future in PTT to enhance the damage of tumor tissue upon irradiation.
Classification of clouds, cirrus, snow, shadows and clear sky areas is a crucial step in the pre-processing of optical remote sensing images and is a valuable input for their atmospheric correction. The Multi-Spectral Imager on board the Sentinel-2's of the Copernicus program offers optimized bands for this task and delivers unprecedented amounts of data regarding spatial sampling, global coverage, spectral coverage, and repetition rate. Efficient algorithms are needed to process, or possibly reprocess, those big amounts of data. Techniques based on top-of-atmosphere reflectance spectra for single-pixels without exploitation of external data or spatial context offer the largest potential for parallel data processing and highly optimized processing throughput. Such algorithms can be seen as a baseline for possible trade-offs in processing performance when the application of more sophisticated methods is discussed. We present several ready-to-use classification algorithms which are all based on a publicly available database of manually classified Sentinel-2A images. These algorithms are based on commonly used and newly developed machine learning techniques which drastically reduce the amount of time needed to update the algorithms when new images are added to the database. Several ready-to-use decision trees are presented which allow to correctly label about 91% of the spectra within a validation dataset. While decision trees are simple to implement and easy to understand, they offer only limited classification skill. It improves to 98% when the presented algorithm based on the classical Bayesian method is applied. This method has only recently been used for this task and shows excellent performance concerning classification skill and processing performance. A comparison of the presented algorithms with other commonly used techniques such as random forests, stochastic gradient descent, or support vector machines is also given. Especially random forests and support vector machines show similar classification skill as the classical Bayesian method.
Can the statistical properties of single-electron transfer events be correctly predicted within a common equilibrium ensemble description? This fundamental in nanoworld question of ergodic behavior is scrutinized within a very basic semi-classical curve-crossing problem. It is shown that in the limit of non-adiabatic electron transfer (weak tunneling) well-described by the Marcus–Levich–Dogonadze(MLD) rate the answer is yes. However, in the limit of the so-called solvent-controlled adiabatic electron transfer, a profound breaking of ergodicity occurs. Namely, a common description based on the ensemble reduced density matrix with an initial equilibrium distribution of the reaction coordinate is not able to reproduce the statistics of single-trajectory events in this seemingly classical regime. For sufficiently large activation barriers, the ensemble survival probability in a state remains nearly exponential with the inverse rate given by the sum of the adiabatic curve crossing (Kramers) time and the inverse MLD rate. In contrast, near to the adiabatic regime, the single-electron survival probability is clearly non-exponential, even though it possesses an exponential tail which agrees well with the ensemble description. Initially, it is well described by a Mittag-Leffler distribution with a fractional rate. Paradoxically, the mean transfer time in this classical on the ensemble level regime is well described by the inverse of the nonadiabatic quantum tunneling rate on a single particle level. An analytical theory is developed which perfectly agrees with stochastic simulations and explains our findings.
In contrast to recent advances in projecting sea levels, estimations about the economic impact of sea level rise are vague. Nonetheless, they are of great importance for policy making with regard to adaptation and greenhouse-gas mitigation. Since the damage is mainly caused by extreme events, we propose a stochastic framework to estimate the monetary losses from coastal floods in a confined region. For this purpose, we follow a Peak-over-Threshold approach employing a Poisson point process and the Generalised Pareto Distribution. By considering the effect of sea level rise as well as potential adaptation scenarios on the involved parameters, we are able to study the development of the annual damage. An application to the city of Copenhagen shows that a doubling of losses can be expected from a mean sea level increase of only 11 cm. In general, we find that for varying parameters the expected losses can be well approximated by one of three analytical expressions depending on the extreme value parameters. These findings reveal the complex interplay of the involved parameters and allow conclusions of fundamental relevance. For instance, we show that the damage typically increases faster than the sea level rise itself. This in turn can be of great importance for the assessment of sea level rise impacts on the global scale. Our results are accompanied by an assessment of uncertainty, which reflects the stochastic nature of extreme events. While the absolute value of uncertainty about the flood damage increases with rising mean sea levels, we find that it decreases in relation to the expected damage.
Information about the strength of donor–acceptor interactions in push–pull alkenes is valuable, as this so-called “push–pull effect” influences their chemical reactivity and dynamic behaviour. In this paper, we discuss the applicability of NMR spectral data and barriers to rotation around the C[double bond, length as m-dash]C double bond to quantify the push–pull effect in biologically important 2-alkylidene-4-oxothiazolidines. While olefinic proton chemical shifts and differences in 13C NMR chemical shifts of the two carbons constituting the C[double bond, length as m-dash]C double bond fail to give the correct trend in the electron withdrawing ability of the substituents attached to the exocyclic carbon of the double bond, barriers to rotation prove to be a reliable quantity in providing information about the extent of donor–acceptor interactions in the push–pull systems studied. In particular all relevant kinetic data, that is the Arrhenius parameters (apparent activation energy Ea and frequency factor A) and activation parameters (ΔS‡, ΔH‡ and ΔG‡), were determined from the data of the experimentally studied configurational isomerization of (E)-9a. These results were compared to previously published related data for other two compounds, (Z)-1b and (2E,5Z)-7, showing that experimentally determined ΔG‡ values are a good indicator of the strength of push–pull character. Theoretical calculations of the rotational barriers of eight selected derivatives excellently correlate with the calculated C[double bond, length as m-dash]C bond lengths and corroborate the applicability of ΔG‡ for estimation of the strength of the push–pull effect in these and related systems.
Individuals within populations often differ substantially in habitat use, the ecological consequences of which can be far reaching. Stable isotope analysis provides a convenient and often cost effective means of indirectly assessing the habitat use of individuals that can yield valuable insights into the spatiotemporal distribution of foraging specialisations within a population. Here we use the stable isotope ratios of southern sea lion (Otaria flavescens) pup vibrissae at the Falkland Islands, in the South Atlantic, as a proxy for adult female habitat use during gestation. A previous study found that adult females from one breeding colony (Big Shag Island) foraged in two discrete habitats, inshore (coastal) or offshore (outer Patagonian Shelf). However, as this species breeds at over 70 sites around the Falkland Islands, it is unclear if this pattern is representative of the Falkland Islands as a whole. In order to characterize habitat use, we therefore assayed carbon (delta C-13) and nitrogen (delta N-15) ratios from 65 southern sea lion pup vibrissae, sampled across 19 breeding colonies at the Falkland Islands. Model-based clustering of pup isotope ratios identified three distinct clusters, representing adult females that foraged inshore, offshore, and a cluster best described as intermediate. A significant difference was found in the use of inshore and offshore habitats between West and East Falkland and between the two colonies with the largest sample sizes, both of which are located in East Falkland. However, habitat use was unrelated to the proximity of breeding colonies to the Patagonian Shelf, a region associated with enhanced biological productivity. Our study thus points towards other factors, such as local oceanography and its influence on resource distribution, playing a prominent role in inshore and offshore habitat use.
The coil-to-globule transition of poly(N-isopropylacrylamide) (PNIPAM) microgel particles suspended in water has been investigated in situ as a function of heating and cooling rate with four optical process analytical technologies (PAT), sensitive to structural changes of the polymer. Photon Density Wave (PDW) spectroscopy, Focused Beam Reflectance Measurements (FBRM), turbidity measurements, and Particle Vision Microscope (PVM) measurements are found to be powerful tools for the monitoring of the temperature-dependent transition of such thermo-responsive polymers. These in-line technologies allow for monitoring of either the reduced scattering coefficient and the absorption coefficient, the chord length distribution, the reflected intensities, or the relative backscatter index via in-process imaging, respectively. Varying heating and cooling rates result in rate-dependent lower critical solution temperatures (LCST), with different impact of cooling and heating. Particularly, the data obtained by PDW spectroscopy can be used to estimate the thermodynamic transition temperature of PNIPAM for infinitesimal heating or cooling rates. In addition, an inverse hysteresis and a reversible building of micrometer-sized agglomerates are observed for the PNIPAM transition process.
In Turkey, there is a shortage of studies on the prevalence of sexual aggression among young adults. The present study examined sexual aggression victimization and perpetration since the age of 15 in a convenience sample of N = 1,376 college students (886 women) from four public universities in Ankara, Turkey. Prevalence rates for different coercive strategies, victim-perpetrator constellations, and sexual acts were measured with a Turkish version of the Sexual Aggression and Victimization Scale (SAV-S). Overall, 77.6% of women and 65.5% of men reported at least one instance of sexual aggression victimization, and 28.9% of men and 14.2% of women reported at least one instance of sexual aggression perpetration. Prevalence rates of sexual aggression victimization and perpetration were highest for current or former partners, followed by acquaintances/friends and strangers. Alcohol was involved in a substantial proportion of the reported incidents. The findings are the first to provide systematic evidence on sexual aggression perpetration and victimization among college students in Turkey, including both women and men.
Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far.
Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI.
Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95% confidence interval 1.07–2.79; P = 0.03) and heavy workloads (OR 2.18, 95% confidence interval 1.42–3.36; P < 0.01).
Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE.
Preface
(2016)