An analytical strategy for challenging members of the microplastic family: Particles from anti-corrosion coatings

Potentially hazardous particles from paints and functional coatings are an overlooked fraction of microplastic (MP) pollution since their accurate identification and quantification in environmental samples remains difficult. We have applied the most relevant techniques from the field of microplastic analysis for their suitability to chemically characterize anti-corrosion coatings containing a variety of polymer binders (LDIR, Raman and FTIR spectroscopy, Py-GC/MS) and inorganic additives (ICP-MS/MS). We present the basis of a possible toolbox to study the release and fate of coating particles in the (marine) environment. Our results indicate that, due to material properties, spectroscopic methods alone appear to be unsuitable for quantification of coating/paint particles and underestimate their environmental abundance. ICP-MS/MS and an optimized Py-GC/MS approach in combination with multivariate statistics enables a straightforward comparison of the multi-elemental and organic additive fingerprints of paint particles. The approach can improve the identification of unknown particles in environmental samples by an assignment to different typically used coating types. In future, this approach may facilitate allocation of emission sources of different environmental paint/coating particles. Indeed, future work will be required to tackle various remaining analytical challenges, such as optimized particle extraction/separation of environmental coating particles.

Somatic, positive and negative domains of the Center for Epidemiological Studies Depression (CES-D) scale: a meta-analysis of genome-wide association studies

BACKGROUND

Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains.

METHOD

We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons).

RESULTS

One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (p discovery = 3.82 × 10-8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (p discovery+replication = 1.10 × 10-6) with evidence of heterogeneity.

CONCLUSIONS

Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.

Does it always have to hurt? Premedications for adults and children for use with intravenous therapy

Determining the need for premedication or anesthetic agent use in starting intravenous therapy should be considered a necessary step toward a successful i.v. procedure. This article discusses the types of premedications currently available for adults and children. Discussion of each anesthetic agent, its usage and limitations, and other pertinent information is given. Antianxiety agents are briefly discussed as an adjunct to anesthetics. Relaxation techniques of distraction and biofeedback to aid in the reduction of pain also can provide some degree of success for i.v. procedures. Not all i.v. procedures require premedications or anesthetic agents. Making the correct decision regarding which medication or antianxiety method best suits the patient and the situation can improve the overall success of and satisfaction with i.v. procedures.

Age-specific incidence rates of Alzheimer's disease: the Baltimore Longitudinal Study of Aging

OBJECTIVE

To estimate age-specific incidence rates of AD in the Baltimore Longitudinal Study of Aging (BLSA).

BACKGROUND

The BLSA is a volunteer cohort of normal subjects followed longitudinally with biennial evaluations at the Gerontology Research Center of the National Institute on Aging.

METHODS

Subjects are 1236 participants (802 men, 434 women) in the BLSA with longitudinal follow-up between January 1985 and May 1998. The average length of follow-up was 7.5 years, with participants evaluated every 2 years by physical, neurologic, and neuropsychological examinations. Using Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., revised and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, the authors diagnosed dementia and AD.

RESULTS

The authors diagnosed 155 cases of dementia, of which 114 (74%) were AD. Incidence rates of AD increased with age from an estimated 0.08% per year (95% CI 0.00 to 0.43) in the 60 to 65 age group to an estimated 6.48% per year (95% CI 5.01 to 8.38) in the 85+ age group for men and women combined. The doubling time of incidence rates was estimated to be approximately 4.4 years and the median time of conversion from mild cognitive impairment to diagnosis of AD was estimated to be 4.4 years. There was a trend for women to have higher incidence rates than men and for fewer years of education to be associated with higher incidence rates; however, these effects were not significant.

CONCLUSION

Incidence rates for AD in the BLSA are consistent with published rates in other studies. The longitudinally followed subjects of the BLSA offer a unique opportunity to prospectively investigate the antecedents of AD.

A prospective study of estrogen replacement therapy and the risk of developing Alzheimer's disease: the Baltimore Longitudinal Study of Aging

Previous reports have suggested that estrogen replacement therapy (ERT) in women may exert a protective effect on their risk of developing Alzheimer's disease (AD). We investigated this relationship in the Baltimore Longitudinal Study of Aging (BLSA), a prospective multidisciplinary study of normal aging conducted by the National Institute on Aging. The sample consisted of 472 post- or perimenopausal women followed for up to 16 years in the BLSA. We documented ERT prospectively at each BLSA visit, and we categorized women who had used oral or transdermal estrogens at anytime as ERT users. We used Cox proportional hazards models with time-dependent covariates to estimate the relative risk of developing AD after ERT as compared with women who had not used estrogen replacement. Approximately 45% of the women in the cohort had used ERT, and we diagnosed 34 incident cases of AD (NINCDS/ADRDA criteria) during follow-up, including nine estrogen users. After adjusting for education, the relative risk for AD in ERT users as compared with nonusers was 0.46 (95% CI, 0.209-0.997), indicating a reduced risk of AD for women who had reported the use of estrogen. Our data did not show an effect for duration of ERT usage. Our finding offers additional support for a protective influence of estrogen in AD. Randomized clinical trials are necessary to confirm this association, which could have significant public health impact.

Association of radiographic features of osteoarthritis of the knee with knee pain: data from the Baltimore Longitudinal Study of Aging

OBJECTIVE

To examine the association between self-reported knee pain and radiographic features of osteoarthritis (OA) of the knee.

METHODS

A sample of participants in the Baltimore Longitudinal Study of Aging (452 Caucasian males and 223 Caucasian females) completed questionnaires and underwent a standing radiograph of both knees at the same biennial visit between 1984 and 1989. Radiographs were interpreted using both the Kellgren-Lawrence and individual features scales. Odds ratios were calculated for the association of radiographic features with knee pain after adjustment for age, sex, and body mass index.

RESULTS

Overall, 156 (23%) persons reported ever having knee pain, and 104 (15%) reported current knee pain (within the previous year). Both ever knee pain and current knee pain were significantly associated with the presence of definite knee OA (Kellgren-Lawrence grade > or = 2) and with the presence of all individual features. There was a direct relationship between all measures of severity of radiographic OA and knee pain.

CONCLUSION

These data demonstrate that radiographic features of knee OA are significantly associated with knee pain. The data also support the continued use of the Kellgren-Lawrence grading scale for defining knee OA in population studies.

Ethical dilemmas in intravenous nursing: a problem-solving model

There is no single task that nurses do more often than make decisions, yet many clinicians feel inadequately prepared to address and resolve ethical issues. The Intravenous Nurses Society Code of Ethics provides practice guidelines for intravenous nursing specialists who need to make these often difficult decisions. The availability of an ethical decision-making model can assist the IV nurse in providing ethical quality care, regardless of the clinical setting in which care is delivered.

Response stability and reliability in longitudinal health evaluations

Two approaches were used to study the stability over time and intravisit reliability of health questions and clinical medical examination items in the Baltimore Longitudinal Study of Aging (BLSA). The stability of responses was determined by evaluating the medical history and physical examination completed at each visit to identify items that once answered in a positive manner, should continue to be answered positively over time. Stability for each question and subject was calculated by the number of positive responses following the first positive response divided by the total number of visits following the first positive response. For 35 questions answered by the subject, the stability was 58% by a simple average or 64% when weighted for the percentage of subjects who had a positive response to the question; for 10 physician-asked questions, the corresponding figures were 29% or 36%. Eighteen items from the physical examination had a stability of 34% or 37%. Intravisit reliability was estimated by comparing responses from the general health questionnaire to responses on the Cornell Medical Index completed at the same visit. Subject-completed questions had substantial agreement (Kappa = 0.74, for questions worded the same), while physician-asked questions had moderate agreement (Kappa = 0.44).

Existence of irritable bowel syndrome supported by factor analysis of symptoms in two community samples

To determine whether bowel symptoms covary in a pattern consistent with the existence of irritable bowel as a distinct syndrome, bowel symptom questionnaires from 2 independent samples were factor analyzed. Samples consisted of 351 18-40-yr-old women who visited Planned Parenthood clinics for contraception and 149 18-89-yr-old women recruited through church women's societies. Factor analysis of 23 bowel symptoms identified 4 factors (clusters of symptoms that were correlated with each other) in both samples. The factor accounting for the most variance in both samples included relief of pain with defecation, looser stools with pain onset, more frequent stools with pain, and gastrointestinal reactions to eating. This irritable bowel factor was not correlated with an objective measure of lactose intolerance. An independent constipation factor was found in both samples to include self-reported constipation, straining with bowel movements, feeling of incomplete evacuation, and rectal bleeding. Thus factor analysis of bowel symptoms supports the existence of a specific irritable bowel syndrome and suggests symptoms that may be used to diagnose this syndrome.