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The aim of this study was to compare the accuracy of Demirjian's four dental development methods for forensic age assessment in a South Australian population. The sample comprised orthopantomograms (OPGs) of 408 sub-adult individuals (211 male; 197 female) with an age range of 4.9-14.5 years. The OPGs were obtained from various dental schools and clinics in urban Adelaide. The following Demirjian methods were evaluated: the original 7-tooth technique; the revised 7-tooth system; the 4-tooth method; and the alternate 4-tooth approach. The left mandibular teeth in each OPG were assessed and rated according to the eight stages (A-H) defined and illustrated in Demirjian et al.(5) Differences between chronological and estimated ages were calculated for males and females separately; 95% confidence intervals of mean age differences were calculated and ANOVA used to assess the significance of mean differences. When comparing all four methods there were significant differences overall (and in individual age groups) between mean chronological and estimated age in both sexes. In addition, each method consistently overestimated chronological age. We also demonstrate that the accuracy of the dental age methods evaluated varies in different subsets of an Australian population, a finding that parallels previous research in other global populations. Based on our analyses we conclude that population-specific standards based on dental maturity curves, as opposed to estimated ages, would provide more accurate and statistically robust age estimations. [ABSTRACT FROM AUTHOR]

Abstract: A variant of the h-index, named the stochastic h-index, is proposed. This new index is obtained by adding to the h-index the probability, under a specific stochastic model, that the h-index will increase by one or more within a given time interval. The stochastic h-index thus extends the h-index to the real line and has a direct interpretation as the distance to the next higher index value. We show how the stochastic h-index can be evaluated and compare it with other variants of the h-index which purportedly indicate the distance to a higher h-index. [Copyright &y& Elsevier]

Background: Residual neuromuscular block is associated with an increased risk of postoperative pulmonary complications in retrospective studies. The aim of our study was to investigate prospectively the incidence of postoperative pulmonary complications after reversal with either sugammadex (SUG) or neostigmine (NEO) in high-risk older patients.Methods: We randomly allocated 180 older patients with significant morbidity (ASA physical status 3) ≥75 yr old to reversal of rocuronium with either SUG or NEO. Adverse events in the recovery room and pulmonary complications (defined by a 5-point [0-4; 0=best to 4=worst] outcome score) on postoperative Days 1, 3, and 7 were compared between groups.Results: Data from 168 patients aged 80 (4) yr were analysed; SUG vs NEO resulted in a reduced probability (0.052 vs 0.122) of increased pulmonary outcome score (impaired outcome) on postoperative Day 7, but not on Days 1 and 3. More patients in the NEO group were diagnosed with radiographically confirmed pneumonia (9.6% vs 2.4%; P=0.046). The NEO group showed a non-significant trend towards longer hospital length of stay across all individual centres (combined 9 vs 7.5 days), with a significant difference in Malaysia (6 vs 4 days; P=0.011).Conclusions: Reversal of rocuronium neuromuscular block with SUG resulted in a small, but possibly clinically relevant improvement in pulmonary outcome in a select cohort of high-risk older patients.Clinical Trial Registration: ACTRN12614000108617. [ABSTRACT FROM AUTHOR]

Neocortical Aβ-amyloid deposition, one of the hallmark pathologic features of Alzheimer's disease (AD), begins decades prior to the presence of clinical symptoms. As clinical trials move to secondary and even primary prevention, understanding the rates of neocortical Aβ-amyloid deposition and the age at which Aβ-amyloid deposition becomes abnormal is crucial for optimizing the timing of these trials. As APOE -ε4 carriage is thought to modulate the age of clinical onset, it is also important to understand the impact of APOE -ε4 carriage on the age at which the neocortical Aβ-amyloid deposition becomes abnormal. Here, we show that, for 455 participants with over 3 years of follow-up, abnormal levels of neocortical Aβ-amyloid were reached on average at age 72 (66.5–77.1). The APOE -ε4 carriers reached abnormal levels earlier at age 63 (59.6–70.3); however, noncarriers reached the threshold later at age 78 (76.1–84.4). No differences in the rates of deposition were observed between APOE -ε4 carriers and noncarriers after abnormal Aβ-amyloid levels had been reached. These results suggest that primary and secondary prevention trials, looking to recruit at the earliest stages of disease, should target APOE -ε4 carriers between the ages of 60 and 66 and noncarriers between the ages of 76 and 84. • APOE -ε4 carriers reached abnormal levels of Aβ ~15 years earlier than noncarriers. • APOE -ε4 carriers and noncarriers had no differences in Aβ deposition rates beyond the threshold. • Primary and secondary prevention trials should target APOE -ε4 carriers aged between 60 and 66. • Primary and secondary prevention trials should target APOE -ε4 non-carriers aged between 76 and 84. [ABSTRACT FROM AUTHOR]