Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water

Background While previous research has suggested that there is an association between fluoride ingestion and the incidence of hypothyroidism, few population level studies have been undertaken. In England, approximately 10% of the population live in areas with community fluoridation schemes and hypothyroidism prevalence can be assessed from general practice data. This observational study examines the association between levels of fluoride in water supplies with practice level hypothyroidism prevalence. Methods We used a cross-sectional study design using secondary data to develop binary logistic regression models of predictive factors for hypothyroidism prevalence at practice level using 2012 data on fluoride levels in drinking water, 2012/2013 Quality and Outcomes Framework (QOF) diagnosed hypothyroidism prevalence data, 2013 General Practitioner registered patient numbers and 2012 practice level Index of Multiple Deprivation scores. Findings We found that higher levels of fluoride in drinking water provide a useful contribution for predicting prevalence of hypothyroidism. We found that practices located in the West Midlands (a wholly fluoridated area) are nearly twice as likely to report high hypothyroidism prevalence in comparison to Greater Manchester (non-fluoridated area). Interpretation In many areas of the world, hypothyroidism is a major health concern and in addition to other factors—such as iodine deficiency—fluoride exposure should be considered as a contributing factor. The findings of the study raise particular concerns about the validity of community fluoridation as a safe public health measure

Advanced Thermal Control & Systems Design Enable Long Duration, Continuous Lunar Surface Operation of Robotic Science Landers and Payloads

No abstract availabl

Resolution requirements for numerical simulations of transition

The resolution requirements for direct numerical simulations of transition to turbulence are investigated. A reliable resolution criterion is determined from the results of several detailed simulations of channel and boundary-layer transition

A randomised trial of early palliative care for maternal stress in infants prenatally diagnosed with single-ventricle heart disease

AbstractChildren with single-ventricle disease experience high mortality and complex care. In other life-limiting childhood illnesses, paediatric palliative care may mitigate maternal stress. We hypothesised that early palliative care in the single-ventricle population may have the same benefit for mothers. In this pilot randomised trial of early palliative care, mothers of infants with prenatal single-ventricle diagnoses completed surveys measuring depression, anxiety, coping, and quality of life at a prenatal visit and neonatal discharge. Infants were randomised to receive early palliative care – structured evaluation, psychosocial/spiritual, and communication support before surgery – or standard care. Among 56 eligible mothers, 40 enrolled and completed baseline surveys; 38 neonates were randomised, 18 early palliative care and 20 standard care; and 34 postnatal surveys were completed. Baseline Beck Depression Inventory-II and State-Trait Anxiety Index scores exceeded normal pregnant sample scores (mean 13.76±8.46 versus 7.0±5.0 and 46.34±12.59 versus 29.8±6.35, respectively; p=0.0001); there were no significant differences between study groups. The early palliative care group had a decrease in prenatal to postnatal State-Trait Anxiety Index scores (−7.6 versus 0.3 in standard care, p=0.02), higher postnatal Brief Cope Inventory positive reframing scores (p=0.03), and a positive change in PedsQL Family Impact Module communication and family relationships scores (effect size 0.46 and 0.41, respectively). In conclusion, these data show that mothers of infants with single-ventricle disease experience significant depression and anxiety prenatally. Early palliative care resulted in decreased maternal anxiety, improved maternal positive reframing, and improved communication and family relationships.</jats:p

Dysfunctional stem and progenitor cells impair fracture healing with age

Successful fracture healing requires the simultaneous regeneration of both the bone and vasculature; mesenchymal stem cells (MSCs) are directed to replace the bone tissue, while endothelial progenitor cells (EPCs) form the new vasculature that supplies blood to the fracture site. In the elderly, the healing process is slowed, partly due to decreased regenerative function of these stem and progenitor cells. MSCs from older individuals are impaired with regard to cell number, proliferative capacity, ability to migrate, and osteochondrogenic differentiation potential. The proliferation, migration and function of EPCs are also compromised with advanced age. Although the reasons for cellular dysfunction with age are complex and multidimensional, reduced expression of growth factors, accumulation of oxidative damage from reactive oxygen species, and altered signaling of the Sirtuin-1 pathway are contributing factors to aging at the cellular level of both MSCs and EPCs. Because of these geriatric-specific issues, effective treatment for fracture repair may require new therapeutic techniques to restore cellular function. Some suggested directions for potential treatments include cellular therapies, pharmacological agents, treatments targeting age-related molecular mechanisms, and physical therapeutics. Advanced age is the primary risk factor for a fracture, due to the low bone mass and inferior bone quality associated with aging; a better understanding of the dysfunctional behavior of the aging cell will provide a foundation for new treatments to decrease healing time and reduce the development of complications during the extended recovery from fracture healing in the elderly

Advances in surface EMG signal simulation with analytical and numerical descriptions of the volume conductor

Surface electromyographic (EMG) signal modeling is important for signal interpretation, testing of processing algorithms, detection system design, and didactic purposes. Various surface EMG signal models have been proposed in the literature. In this study we focus on 1) the proposal of a method for modeling surface EMG signals by either analytical or numerical descriptions of the volume conductor for space-invariant systems, and 2) the development of advanced models of the volume conductor by numerical approaches, accurately describing not only the volume conductor geometry, as mainly done in the past, but also the conductivity tensor of the muscle tissue. For volume conductors that are space-invariant in the direction of source propagation, the surface potentials generated by any source can be computed by one-dimensional convolutions, once the volume conductor transfer function is derived (analytically or numerically). Conversely, more complex volume conductors require a complete numerical approach. In a numerical approach, the conductivity tensor of the muscle tissue should be matched with the fiber orientation. In some cases (e.g., multi-pinnate muscles) accurate description of the conductivity tensor may be very complex. A method for relating the conductivity tensor of the muscle tissue, to be used in a numerical approach, to the curve describing the muscle fibers is presented and applied to representatively investigate a bi-pinnate muscle with rectilinear and curvilinear fibers. The study thus propose an approach for surface EMG signal simulation in space invariant systems as well as new models of the volume conductor using numerical methods

Change Management in a Dynamic Information Technology Environment: Inquiries Into the Adkar Model for Change Management Results

Change in our lives is an ongoing, complex, and difficult process that cannot be avoided, and in order for any organization comprised of people to be successful, change must be managed. There are many documented instances of organizations failing in their change efforts, and it is not always the technology that causes change failures, but it is the people aspect towards change that is neglected. This paper focuses on the ADKAR model which is a sequential and cumulative goal-oriented change management model with targeted results and consists of the elements Awareness, Desire, Knowledge, Ability, and Reinforcement, and how the model can be used to manage change individually and organizationally, and thereby increase the possibilities for desired change success

Measurement of the Inclusive Charm Cross Section at 4.03 GeV and 4.14 GeV

The cross section for charmed meson production at $\sqrt{s} = 4.03$ and 4.14 GeV has been measured with the Beijing Spectrometer. The measurement was made using 22.3 $pb^{-1}$ of $e^+e^-$ data collected at 4.03 GeV and 1.5 $pb^{-1}$ of $e^+e^-$ data collected at 4.14 GeV. Inclusive observed cross sections for the production of charged and neutral D mesons and momentum spectra are presented. Observed cross sections were radiatively corrected to obtain tree level cross sections. Measurements of the total hadronic cross section are obtained from the charmed meson cross section and an extrapolation of results from below the charm threshold.Comment: 11 pages, 13 figures. The top level tex file is paper.tex. It builds the paper from other tex files in this .tar and the .eps file

Long-Baseline Neutrino Facility (LBNF) and Deep Underground Neutrino Experiment (DUNE) Conceptual Design Report Volume 2: The Physics Program for DUNE at LBNF

The Physics Program for the Deep Underground Neutrino Experiment (DUNE) at the Fermilab Long-Baseline Neutrino Facility (LBNF) is described

First Measurement of the Branching Fraction of the Decay psi(2S) --> tau tau

The branching fraction of the psi(2S) decay into tau pair has been measured for the first time using the BES detector at the Beijing Electron-Positron Collider. The result is $B_{\tau\tau}=(2.71\pm 0.43 \pm 0.55) \times 10^{-3}$, where the first error is statistical and the second is systematic. This value, along with those for the branching fractions into e+e- and mu+mu of this resonance, satisfy well the relation predicted by the sequential lepton hypothesis. Combining all these values with the leptonic width of the resonance the total width of the psi(2S) is determined to be $(252 \pm 37)$ keV.Comment: 9 pages, 2 figure