Forecasting the 20-Year Incidence of Dementia by Socioeconomic Status, Race/Ethnicity, and Region Based on Mid-Life Risk Factors in a U.S. Nationally Representative Sample.

Background: Alzheimer's disease and related dementias (ADRD) incidence varies based on demographics, but mid-life risk factor contribution to this variability requires more research. Objective: The purpose of this study is to forecast the 20-year incidence of dementia in the U.S. overall and stratified by race/ethnicity, socioeconomic status (SES), and U.S. geographic region given prior mid-life risk factor prevalence and to examine the extent to which risk factor differences 20 years ago may explain current SES, race/ethnicity, or regional disparities in dementia incidence. Methods: We applied the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) prediction model to the 2006 wave of the Health and Retirement Study (HRS) in participants aged 45 to 64 to estimate the 20-year risk of incident ADRD. Results: The 20-year risk of dementia among middle-aged Americans was 3.3% (95% CI: 3.2%, 3.4%). Dementia incidence was forecast to be 1.51 (95% CI: 1.32, 1.71) and 1.27 (95% CI: 1.14, 1.44) times that in Hispanic and Non-Hispanic Black individuals respectively compared statistically to Non-Hispanic White individuals given mid-life risk factors. There was a progressive increase in dementia risk from the lowest versus highest SES quintile. For geographic region, dementia incidence was forecast to be 1.17 (95% CI: 1.06, 1.30) and 1.27 (95% CI: 1.14, 1.43) times that in Midwestern and Southern individuals respectively compared statistically to Western individuals. Conclusions: Some disparities in dementia incidence could be explained by differences in mid-life risk factors and may point toward policy interventions designed to lessen the ADRD disease burden through early prevention.

Non-penetrating deep sclerectomy with the sub flap (Ahmed's) suture: a 12-month comparative study.

PURPOSE: To assess the IOP-lowering effect of adding a mattress suture (Ahmed's suture) to non-penetrating deep sclerectomy (NPDS), in patients with open angle glaucoma over a 12-month follow-up period. METHODS: This is a randomized controlled study comparing 52 eyes with a sub-flap Ahmed's suture modified NPDS (group A) and 51 with a conventional NPDS (group B). Success of surgery was categorized as complete success if the IOP remained between 6 and 18 mmHg without medications and as qualified if topical medications were required. RESULTS: The post-operative IOP at the 1st week, 3rd, 6th, 9th & 12th months follow ups in group A were significantly lower (7.3 ± 2.1, 12.0 ± 2.3, 12.6 ± 2.7, 13.6 ± 3.4 & 13.8 ± 3.8 mmHg) than in B (9.2 ± 1.9, 14.0 ± 3.1, 14.8 ± 2.9, 15.4 ± 2.6 & 15.7 ± 2.7 mmHg) (p = 0.001, p = 0.001, p = 0.002, p = 0.027 & p = 0.029 respectively). The percentage of IOP reduction after 1 year was significantly higher in group A than in group B (49% vs. 36.5%). At the end of the 12-month follow-up, 81% of group A and 69% of group B were considered as complete success. Multivariate regression analysis showed lower 1st week post-operative IOP was associated with better outcome. CONCLUSION: In conclusion, the Ahmed's suture, a simple, novel and economic modification, maintains lower IOP levels and has a higher success rate over conventional DS, as it is 30% more effective in reducing the IOP.

Restrained Shrinkage of High-Performance Ready-Mix Concrete Reinforced with Low Volume Fraction of Hybrid Fibers.

Cracking due to restrained shrinkage is a recurring issue with concrete bridge decks, impacting durability and ultimately service life. Several scholars' research has proven that the incorporation of fibers in concrete mitigates restrained shrinkage cracking when utilizing high (0.5-3%) fiber volumes. This often presents a mixing and placement issue when used for ready-mixed concretes, which discourages their use in bridge decks. This study aims to optimize the incorporation of fibers for their benefits while producing concrete that is conducive to ready-mix, jobsite use. A series of tests were performed on a high-performance concrete (HPC) mix which incorporated blended, multiple fiber types (steel crimped, macro polypropylene, and micro polypropylene) while maintaining low total fiber (0.19-0.37%) volume. These "hybrid" fiber mixes were tested for multiple mechanical properties and durability aspects, with a focus on the AASHTO T334 ring test, to evaluate fiber efficiency under restrained conditions. Promising results indicate the use of a low-volume hybrid fiber addition, incorporating a macro and micro polypropylene fiber (0.35% by volume) blend, reduced the cracking area by 16.6% when compared to HPC incorporating a single fiber type, and 39% when compared to nonfibrous HPC control mixture.

Sub-flap Mattress Suture With Deep Sclerectomy: A Novel Step.

The study was a prospective interventional clinical trial enrolling 29 eyes from 20 patients with uncontrolled open-angle glaucoma to evaluate the effect of adding a novel simple economical step to nonpenetrating deep sclerectomy. We obtained an additional 12.5% reduction in the intraocular pressure compared with the standard surgery.