High spatial-density, cladding-pumped 6-mode 7-core fiber amplifier for C-band operation.

We present a C-band 6-mode 7-core fiber amplifier in an all-fiberized cladding-pumped configuration for space division multiplexed transmission supporting a record 42 spatial channels. With optimized fiber components (e.g. passively cooled pump laser diode, pump coupler, pump stripper), high power multimode pump light is coupled to the active fiber without any noticeable thermal degradation and an average gain of 18 dB and noise figure of 5.4 dB are obtained with an average differential modal gain of 3.4 dB.

Blood pressure as a risk factor for depression in elderly people: a prospective study.

A total of 1070 men and women aged 65 years and over living in the community in Liverpool were interviewed using the Geriatric Mental State. Diagnoses of depression at case and subcase level were made using the GMS-AGECAT package from an initial interview and at follow-up three years later. Data relating to blood pressure at year 0 was available on 748 subjects. Men not taking anti-hypertensives or antidepressants with diastolic blood pressure greater than 85 mmHg were significantly less likely to be subcases than men with low or normal diastolic pressure. People in this group were also significantly less likely to be cases 3 years later. There were no other significant findings. These results do not support an association between low blood pressure and coincidental or future subcase- or case-level depressive illness.

Prospective data on the prevalence of abnormal involuntary movements among elderly people living in the community.

Trained raters from the Liverpool Continuing Health in the Community study interviewed 1070 people over the age of 65 in 1982-1983 using the Geriatric Mental State (GMS) examination. Three years later the cohort was re-interviewed, this time by psychiatrists trained in the GMS, who used the GMS and the History and Aetiology Schedule (HAS). The cohort had fallen in size to 875, because of mortality; 701 were re-interviewed. The cohort was followed up again 6 years after the first interview by trained nurse raters using the GMS (A3) and the Mini-Mental State Examination. Cases of mental disorder identified by the computer diagnostic program AGECAT were re-interviewed by psychiatrists along with a number of controls using the GMS and the HAS on the remaining 450 individuals. Observational behavioural ratings from the GMS and summary sheets were analysed along with AGECAT diagnoses and data on medication gained at the 3 assessments. The community prevalence of tardive dyskinesia and other movement disorders in elderly people over a 6-year follow-up appears to be very low (the community prevalence of tardive dyskinesia being 0.22% and akathisia 1.57%), is usually associated with organic mental disorder (and consequently higher mortality) and is furthermore not usually associated with antipsychotic medication.

Expressed wish to die and mortality in older people: a community replication.

Three-year mortality of 1063 community residents aged 65 and over interviewed with the Geriatric Mental State Schedule was analysed to examine the influence of specific depression symptoms and physical illness in order to test theoretical predictions from models proposed by Macdonald and Dunn, and by Jorm and colleagues. Expressed wish to die was confirmed as a predictor of mortality, controlling for age, sex, and cognitive impairment. The suggestion that the effect of depressive symptoms on mortality might be a masked effect of physical illness was not confirmed. In general the more specific severe symptoms were better predictors of mortality.

Risk factors for depression in elderly people: a prospective study.

In 1982-1983 a random sample of 1486 people aged 65 years and above was generated from general practitioner lists; 1070 were interviewed in the community using the Geriatric Mental State and a Social History questionnaire. The cohort was followed up by interview 3 years later. At year 3 the diagnostic computer program AGECAT diagnosed 44 incident cases of depression. Information from the depressed group's initial and further interviews was compared with a control group (which excluded cases of affective or organic mental illness). Univariate analysis yielded three factors that were significantly associated with the development of depression 3 years later: a lack of satisfaction with life; feelings of loneliness; and smoking. Multivariate analysis confirmed their independent effects and revealed 2 further factors attaining significance: female gender and a trigger factor, bereavement of a close figure within 6 months of the third-year diagnosis. Some other factors traditionally associated with depression, such as poor housing, marital status and living alone, failed to attain significance as risk factors.

Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool.

A group of 1070 community-living persons aged 65 and over was assessed using the GMS-AGECAT package and other interviews at years 0 and 3. Year 3 interviewers were 'blind' to the findings at year 0, and the prevalence of organic disorders and depression was very similar in both years. According to the results at year 3, minimum and maximum prevalence figures for dementia at year 0 were 2.4% and 3.8% for moderate to severe and 0.4% and 2.4% for mild or early cases, with a best estimate of 3.5% and 0.8%, or 4.3% overall, divided into: senile, Alzheimer's type 3.3%; vascular 0.7%; and alcohol-related 0.3%. The overall incidence of dementia, clinically confirmed by six-year follow-up, was 9.2/1000 per year (Alzheimer type 6.3, vascular 1.9, alcohol related 1.0). Three years later, 72.0% of those with depressive psychosis and 62.3% of those with depressive neurosis were either dead or had some kind of psychiatric illness. Nearly 60% of milder depressive cases (7.2% of the total sample) had either died or developed a chronic mental illness. The outcome of depressive pseudodementias is equivocal so far. Findings at year 3 provide validation of AGECAT computer diagnosis against outcome; organic and depression diagnoses are seen to have important implications for prognosis.

The natural history of neurotic disorder in an elderly urban population. Findings from the Liverpool longitudinal study of continuing health in the community.

A random community sample of 1070 subjects aged 65 years and over was interviewed at home using the GMS-AGECAT package and followed up three years later. Neurotic symptoms were common, but symptoms sufficient to reach 'case' level were much less frequent. The overall prevalence of neurotic 'cases' was 2.4% in year 0 and 1.4% in year 3. The incidence was estimated as a minimum of 4.4 per 1000 per year over the age of 65. Women were more likely to be 'cases' than men but not 'subcases', and there was a general decline in prevalence with increasing age, particularly for 'subcases'. Anxiety was the commonest neurotic subtype. After three years, 'cases' were shown not to persist, but this did not reflect wellness. There was a tendency still to have some symptoms, but the predominant symptom appeared to change, suggesting a possible chronic neurotic disorder with changing presentation over time. Depressive symptoms were closely associated with this presentation, suggesting that depression may be an important and integral part of a general, changing neurotic disorder.

Geriatric Mental State-AGECAT: prevalence, incidence and long-term outcome of dementia and organic disorders in the Liverpool study of continuing health in the community.

The GMS-AGECAT package was used in the initial assessment and 3-year follow-up of a random sample of 1,070 elderly people living in the community. A prevalence of 4.3% is found for dementia after confirmation of diagnoses by outcome at year 3. The overall incidence of dementia was 9.2/1,000 per year after partial adjustments for outcome of year 6. Incidence per year for sub-types of dementia were AD 6.3/1,000, vascular 1.9/1,000, and alcohol-related 1.0/1,000.

Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool longitudinal community study.

A random community sample of subjects aged 65 and over was re-interviewed after three years by psychiatrists using the GMS and HAS. The relationship between drinking history and current psychiatric morbidity was examined. Men with a history of heavy drinking for five years or more at some time in their lives were found to have a greater than fivefold risk of suffering from a psychiatric disorder at the time of the interview. Among this group past alcohol consumption was significantly higher for those with a current psychiatric diagnosis compared with those who were well. This association between heavy alcohol consumption in earlier years and psychiatric morbidity in later life is not explained by current drinking habits.

Photosynthesis during winter in ryegrass/white clover mixtures in the field.

Measurements of canopy gas exchange of mixed communities of ryegrass (Lolium perenne L.) and white clover (Trifolium repens L.) in the field during winter showed that instantaneous rates of gross photosynthesis were usually little less than those of canopies of similar leaf area at similar irradiance in summer. Respiration rates per unit dry weight were on average 25% less than those of comparable swards in summer. The daily totals of net photosynthesis, however, were as little as a tenth of summer values, because of the short photoperiods and low average irradiance. Clover leaf area tended to be positioned lower in the canopy than grass leaf area, especially towards the end of winter, and clover had a lower rate of photosynthesis per unit leaf area in situ than grass.

Is there more dementia, depression and neurosis in New York? A comparative study of the elderly in New York and London using the computer diagnosis AGECAT.

A computerised diagnosis, AGECAT, is applied to data from random community samples of the elderly in New York and London in order to examine the prevalence of mental illness in the two cities, especially the result reported from the same study, using a different diagnostic procedure, that the proportion of dementia was higher in New York. The greater proportion of dementia in New York is confirmed for all AGECAT's levels of diagnostic confidence, for both sexes and at all half-decades over 65 years. Provided that this difference is upheld and genetic differences can be discounted, these findings would seem to support a contributory environmental cause for dementia. Proportions of depression as a whole are similar in both cities. Syndrome case and sub-case levels of neurotic disorder are generally higher in London.

Range of mental illness among the elderly in the community. Prevalence in Liverpool using the GMS-AGECAT package.

A sample of 1070 elderly persons aged over 65 living in the Liverpool community was interviewed using the community version of the Geriatric Mental State (GMS) and the findings processed to provide a computerised diagnosis by AGECAT. Levels of organic disorder, probably dementia, reached 5.2%, intermediate between those of London and New York derived from previous studies. Levels for depressive illness overall were below those of other studies at 11.3% while levels for neurotic disorder were much the same at 2.4%. The rise in the prevalence of dementia with age was further confirmed. The GMS AGECAT Package provides a method for standardising both the collection of data and the diagnostic process for comparative epidemiological studies and other research.

Sexual differentiation of the human midtrimester brain.

It is firmly believed that sexual differentiation of the brain is linked with external genital differentiation in timing as an in utero event in the human. An extensive search for oestrogen, androgen and progestin receptors failed to show their presence despite adequate controls in cytosols from human fetal brain of gestational ages 14-20 weeks. It is possible that the receptors are present in levels so low that they are undetectable by present-day methods. Our results would indicate that hormonally influenced in utero brain sexual differentiation is most unlikely to occur as a mid-trimester event.

Successful cardiopulmonary bypass in diabetics with anaphylactoid reactions to protamine.

Two insulin dependent diabetics with previous anaphylactic like (anaphylactoid) reactions to protamine underwent successful cardiopulmonary bypass for coronary artery surgery. Platelet concentrates instead of protamine were used to neutralise their systemic heparinisation. In both cases the anaphylactoid reactions first became apparent after administration of protamine sulphate at the end of cardiac catheterisation. These cases show that adverse reactions to protamine need not be a contraindication to cardiopulmonary bypass and cardiac surgery and emphasise that this condition should be considered in all patients with a history of previous protamine exposure or one which may be associated with anaphylactoid reactions to protamine.

Oestrogen conjugation in mid trimester human fetal brain: a possible role in its sexual differentiation.

Mid-trimester human fetal brain cytosol incubated with [3H]-oestradiol gave a radioactive peak on 5% polyacrylamide gels, which migrated with the bromophenol blue marker (anodic peak) and which could be suppressed by the addition of 100 times molar excess of unlabelled ligand to the incubate. This anodic peak could only be destroyed by proteolytic enzymes if they were added at the beginning of the incubation, but not subsequently, indicating that it did not represent a protein-bound oestradiol. Competition studies show that the anodic peak can be suppressed with natural oestrogens and ethinyloestradiol, but not by the synthetic oestrogens, androgens and progestins tested. Butanol extraction of incubates, followed by t.l.c. in a number of systems, indicates that both oestrone and oestradiol are sulphated. The parent steroids could be liberated by hydrolysis of incubates with either 1N sulphuric acid or aryl sulphatase. This conjugation may effectively curtail the action in fetal tissues of high levels of oestrogens and hence play a role in brain sexual differentiation in the human.