350 research outputs found
Is the incidence of dementia declining?
No full textAction on preventative health could lower the risk of dementia for future generations, argues this report.
Executive summary
The world-wide projections of the prevalence of dementia in the coming decades have been a source of great concern to health systems and societies around the world. The World Alzheimer Report 2010 estimated that there were 36 million people with dementia in 2010, with an expected doubling every 20 years to nearly 115 million in 2050. These sobering figures are based on assumptions that the age-adjusted prevalence of dementia would remain constant and the population would continue to age at the current rate.
The assumption that the incidence of dementia will remain stable is now being put into question. There is emerging evidence to suggest that the incidence of dementia in older individuals may be declining. It appears that this change may be recent and has possibly occurred only in the last one to two decades. It may also be restricted so far to high income countries, although data from low and middle income countries are lacking.
The reasons for this change are not understood, but education, more stimulating environments and better control of vascular risk factors may have contributed. The data are still preliminary and more studies are needed to establish the extent of this change and understand its causes. It should be noted that the decline is not large enough to offset the increase in prevalence of dementia due to the ageing of the population and therefore investment and efforts to develop better treatments and care for people with dementia need to continue.
The fact that dementia rates are malleable is an encouraging finding but the reduction cannot be taken for granted as gains in population health can easily be lost if societies do not remain vigilant and continually proactive. These preliminary findings provide a strong argument for large scale Government investment in dementia-prevention strategies, which should start from early life
Sachdev–Ye–Kitaev model as Liouville quantum mechanics
No full textAbstractWe show that the proper inclusion of soft reparameterization modes in the Sachdev–Ye–Kitaev model of N randomly interacting Majorana fermions reduces its long-time behavior to that of Liouville quantum mechanics. As a result, all zero temperature correlation functions decay with the universal exponent ∝τ−3/2 for times larger than the inverse single particle level spacing τ≫NlnN. In the particular case of the single particle Green function this behavior is manifestation of the zero-bias anomaly, or scaling in energy as ϵ1/2. We also present exact diagonalization study supporting our conclusions
Use of positive end-expiratory pressure titration and recruitment maneuvers in pediatric intensive care unit – A narrative review
No full textMechanical ventilation is a lifesaving support for patients suffering with acute respiratory distress syndrome. This modality is likely to cause ventilator-induced lung injury if not used judiciously and appropriately. Lung protective ventilation strategy is routinely practiced in adult and pediatric intensive care units. Positive end-expiratory pressure (PEEP) and recruitment maneuvers (RMs) are used in “Open Lung Ventilation” strategy and to keep the lung open. PEEP is applied to recruit collapsed alveoli to improve oxygenation, compliance, reduce tidal stress, and strain on the lungs and to promote homogenous lung ventilation. There is no agreement on methods to set “Best PEEP” for a particular patient. There are many approaches described in published literature to optimize PEEP. PEEP titration may be done with PEEP/FiO2 grid, targeted compliance, driving pressure, by using pressure-volume curve and stress index. Esophageal manometry and measurement of end-expiratory lung volume may be used if special equipment, machines, and expertise are available. No single method of PEEP titration has been shown to improve outcome. RM is characterised by sudden transient increase in transpulmonary pressure. Different RMs including high-frequency oscillator ventilation and prone position ventilation have been studied in adults and pediatric patients with very conflicting results and inconsistent survival benefits. Serious complications, hemodynamic instability, air leak syndrome, transient, or no improvements in oxygenation are reported. In this narrative review, we have discussed different methods of PEEP titration and RMs and available evidence for each especially in children
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Cognitive leisure activities, but not watching TV, for future brain benefits
No full textResponse of DNA molecules to external fields: Electric and hydrodynamic
No full textCasimir PhD Series: 2020-03ChemE/Product and Process Engineerin
Application of Policy Deployment and Daily Management in service sector
No full textBackground: Policy Deployment and Daily Management are two critical vehicles of Total Quality Management implementation in a company. Integration of these two vehicles has been discussed and adequately addressed in a few companies that have been practicing Total Quality Management for a long time. However, most companies often face challenges and difficulties in ensuring smooth and seamless transfer of Policy Deployment plans into Daily Management activities. Case description: The challenge is even bigger in service sector which embarked on the Total Quality Management journey barely 5-6 years ago. The service sector has traditionally used Balanced Scorecard which has relatively weaker emphasis on the means to achieve the targets. The authors of this report have found a customized and unique model whose success has been demonstrated through deployment in two customer-facing processes in a large life insurance company in India. The traditional approach used in manufacturing industry has been simplified and customized for the effective application in the service sector. Discussions & Evaluation: The traditional approach used in manufacturing industry has been simplified and customised for the effective application in the service sector. A survey was done to identify the issues and the approach was modified and implemented in couple of key customer-facing processes. Conclusion: The phenomenal results have led to a big 'pull' from other process owners to replicate this approach across all operational and support processes. Initial 'reluctant participants' of the process have now become the 'champions' and truly the 'change catalysts' for this approach. The process is now being replicated in several other processes across several Industrial sectors
Cerebrovascular complications in pediatric intensive care unit
No full textCerebrovascular complications are being frequently recognized in the
pediatric intensive care unit in the recent few years. The epidemiology
and risk factors for pediatric stroke are different from that of the
adults. The incidence of ischemic stroke is almost slightly more than
that of hemorrhagic stroke. The list of diagnostic causes is increasing
with the availability of newer imaging modalities and laboratory tests.
The diagnostic work up depends on the age of the child and the rapidity
of presentation. Magnetic resonance imaging, computerized tomography
and arteriography and venography are the mainstay of diagnosis and to
differentiate between ischemic and hemorrhagic events. Very
sophisticated molecular diagnostic tests are required in a very few
patients. There are very few pediatric studies on the management of
stroke. General supportive management is as important as the specific
treatment. Most of the treatment guidelines and suggestions are
extrapolated from the adult studies. Few guidelines are available for
the use of anticoagulants and thrombolytic agents in pediatric
patients. So, our objective was to review the available literature on
the childhood stroke and to provide an insight into the subject for the
pediatricians and critical care providers
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