Mortality After the Hospitalization of a Spouse

Background: The illness of a spouse can affect the health of a caregiving partner. We examined the association between the hospitalization of a spouse and a partner’s risk of death among elderly people. Methods: We studied 518,240 couples who were enrolled in Medicare in 1993. We used Cox regression analysis and fixed-effects (case–time–control) methods to assess hospitalizations and deaths during nine years of follow-up. Results: Overall, 383,480 husbands (74 percent) and 347,269 wives (67 percent) were hospitalized at least once, and 252,557 husbands (49 percent) and 156,004 wives (30 percent) died. Mortality after the hospitalization of a spouse varied according to the spouse’s diagnosis. Among men, 6.4 percent died within a year after a spouse’s hospitalization for colon cancer, 6.9 percent after a spouse’s hospitalization for stroke, 7.5 percent after a spouse’s hospitalization for psychiatric disease, and 8.6 percent after a spouse’s hospitalization for dementia. Among women, 3.0 percent died within a year after a spouse’s hospitalization for colon cancer, 3.7 percent after a spouse’s hospitalization for stroke, 5.7 percent after a spouse’s hospitalization for psychiatric disease, and 5.0 percent after a spouse’s hospitalization for dementia. After adjustment for measured covariates, the risk of death for men was not significantly higher after a spouse’s hospitalization for colon cancer (hazard ratio, 1.02; 95 percent confidence interval, 0.95 to 1.09) but was higher after hospitalization for stroke (hazard ratio, 1.06; 95 percent confidence interval, 1.03 to 1.09), congestive heart failure (hazard ratio, 1.12; 95 percent confidence interval, 1.07 to 1.16), hip fracture (hazard ratio, 1.15; 95 percent confidence interval, 1.11 to 1.18), psychiatric disease (hazard ratio, 1.19; 95 percent confidence interval, 1.12 to 1.26), or dementia (hazard ratio, 1.22; 95 percent confidence interval, 1.12 to 1.32). For women, the various risks of death after a spouse’s hospitalization were similar. Overall, for men, the risk of death associated with a spouse’s hospitalization was 22 percent of that associated with a spouse’s death (95 percent confidence interval, 17 to 27 percent); for women, the risk was 16 percent of that associated with death (95 percent confidence interval, 8 to 24 percent). Conclusions: Among elderly people hospitalization of a spouse is associated with an increased risk of death, and the effect of the illness of a spouse varies among diagnoses. Such interpersonal health effects have clinical and policy implications for the care of patients and their families.Sociolog

On-Chip Cavity Optomechanical Coupling

On-chip cavity optomechanics, in which strong co-localization of light and mechanical motion is engineered, relies on efficient coupling of light both into and out of the on-chip optical resonator. Here we detail our particular style of tapered and dimpled optical fibers, pioneered by the Painter group at Caltech, which are a versatile and reliable solution to efficient on-chip coupling. First, a brief overview of tapered, single mode fibers is presented, in which the single mode cutoff diameter is highlighted. The apparatus used to create a dimpled tapered fiber is then described, followed by a comprehensive account of the procedure by which a dimpled tapered fiber is produced and mounted in our system. The custom-built optical access vacuum chambers in which our on-chip optomechanical measurements are performed are then discussed. Finally, the process by which our optomechanical devices are fabricated and the method by which we explore their optical and mechanical properties is explained. It is our expectation that this manuscript will enable the novice to develop advanced optomechanical experiments.Comment: 31 pages, 9 figure

Microstructural characterisation of biocompatible sol-gel derived vanadium doped TiO2 on Ti substrates

Sol-gel derived pure titania is compared with vanadium and / or aluminium modified titania deposited by spin coating on pure titanium substrates annealed at 300C and 650C. Reflection high-energy electron diffraction indicated the presence of anatase from the surface layers of samples annealed at 300C with a transition to rutile with increasing annealing temperature and addition of vanadium. Cross-sectional transmission electron microscopy indicated a gradation of Ti-O phases through the layer with the dominant presence of rutile. Aluminium was found to inhibit grain growth while vanadium promoted crystallisation

The Search for Supernova-produced Radionuclides in Terrestrial Deep-sea Archives

An enhanced concentration of 60Fe was found in a deep ocean's crust in 2004 in a layer corresponding to an age of ~2 Myr. The confirmation of this signal in terrestrial archives as supernova-induced and detection of other supernova-produced radionuclides is of great interest. We have identified two suitable marine sediment cores from the South Australian Basin and estimated the intensity of a possible signal of the supernova-produced radionuclides 26Al, 53Mn, 60Fe and the pure r-process element 244Pu in these cores. A finding of these radionuclides in a sediment core might allow to improve the time resolution of the signal and thus to link the signal to a supernova event in the solar vicinity ~2 Myr ago. Furthermore, it gives an insight on nucleosynthesis scenarios in massive stars, the condensation into dust grains and transport mechanisms from the supernova shell into the solar system

Evidence for a broadly distributed Samoan-plume signature in the northern Lau and North Fiji Basins

Author Posting. © American Geophysical Union, 2014. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry, Geophysics, Geosystems 15 (2014): 986–1008, doi:10.1002/2013GC005061.Geochemical enrichment of lavas in the northern Lau Basin may reflect the influx of Samoan-plume mantle into the region. We report major and trace element abundances and He-Sr-Nd-Hf-Pb-isotopic measurements for 23 submarine volcanic glasses covering 10 locations in the northern Lau and North Fiji Basins, and for three samples from Wallis Island, which lies between Samoa and the Lau Basin. These data extend the western limit of geochemical observations in the Basins and improve the resolution of North-South variations in isotopic ratios. The Samoan hot spot track runs along the length of the northern trace of the Lau and North Fiji Basins. We find evidence for a Samoan-plume component in lavas as far West as South Pandora Ridge (SPR), North Fiji Basin. Isotopic signatures in SPR samples are similar to those found in Samoan Upolu shield lavas, but show a slight shift toward MORB-like compositions. We explain the origin of the enriched signatures by a model in which Samoan-plume material and ambient depleted mantle undergo decompression melting during upwelling after transiting from beneath the thick Pacific lithosphere to beneath the thin lithosphere in the northern Lau and North Fiji Basins. Other lavas found in the region with highly depleted isotopic signatures may represent isolated pockets of depleted mantle in the basins that evaded this enrichment process. We further find that mixing between the two components in our model, a variably degassed high-3He/4He Samoan component and depleted MORB, can explain the diversity among geochemical data from the northern Lau Basin.M.G.J. acknowledges support from NSF grants OCE-1061134, OCE-1153894, and EAR-1145202 and J.B.T. acknowledges support from the French Agence Nationale de la Recherche (grant ANR-10-BLANC-0603 M&Ms—Mantle Melting—Measurements, Models, Mechanisms).2014-10-1

Epidural Hematoma Following Cervical Spine Surgery.

STUDY DESIGN: A multicentered retrospective case series. OBJECTIVE: To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. METHODS: Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified. RESULTS: A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0.090%. Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0.76%. All patients initially presented with a neurologic deficit. Nine patients had complete resolution of the neurologic deficit after hematoma evacuation; however 2 of the 3 patients (66%) who had a delay in the diagnosis of the epidural hematoma had residual neurologic deficits compared to only 4 of the 12 patients (33%) who had no delay in the diagnosis or treatment (P = .53). Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation. CONCLUSION: This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery, and this study suggest that an epidural hematoma occurs in approximately 1 out of 1000 cervical spine surgeries. Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements

International meta-analysis of PTSD genome-wide association studies identifies sex- and ancestry-specific genetic risk loci.

The risk of posttraumatic stress disorder (PTSD) following trauma is heritable, but robust common variants have yet to be identified. In a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls we conduct a genome-wide association study of PTSD. We demonstrate SNP-based heritability estimates of 5-20%, varying by sex. Three genome-wide significant loci are identified, 2 in European and 1 in African-ancestry analyses. Analyses stratified by sex implicate 3 additional loci in men. Along with other novel genes and non-coding RNAs, a Parkinson's disease gene involved in dopamine regulation, PARK2, is associated with PTSD. Finally, we demonstrate that polygenic risk for PTSD is significantly predictive of re-experiencing symptoms in the Million Veteran Program dataset, although specific loci did not replicate. These results demonstrate the role of genetic variation in the biology of risk for PTSD and highlight the necessity of conducting sex-stratified analyses and expanding GWAS beyond European ancestry populations

Neutrino oscillations in structured matter

A layered material structure in a monochromatic neutrino beam produces interference effects that could be used for the measurement of features of the neutrino mass matrix. The phenomenon would be most useful at high energies.Comment: 18 pp of which two figure