bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Pneumococcal Conjugate Vaccines Against Community-acquired Alveolar Pneumonia Attributable to Vaccine-serotype Streptococcus pneumoniae Among Children
Authors: Lewnard Joseph A , Givon-Lavi Noga , Dagan Ron
Published: December 2020

Introduction

Streptococcus pneumoniae is a leading cause of pneumonia among children. However, owing to diagnostic limitations, the protection conferred by pneumococcal conjugate vaccines (PCVs) against pediatric pneumonia attributable to vaccine-serotype pneumococci remains unknown.

Methods

We analyzed data on vaccination and nasopharyngeal pneumococcal detection among children <5 years old with community-acquired alveolar pneumonia (CAAP; “cases”) and those without respiratory symptoms (“controls”), who were enrolled in population-based prospective surveillance studies in southern Israel between 2009 and 2018. We measured PCV-conferred protection against carriage of vaccine-serotype pneumococci via the relative risk of detecting these serotypes among vaccinated versus unvaccinated controls. We measured protection against progression of vaccine serotypes from carriage to CAAP via the relative association of vaccine-serotype detection in the nasopharynx with CAAP case status, among vaccinated and unvaccinated children. We measured PCV-conferred protection against CAAP attributable to vaccine-serotype pneumococci via the joint reduction in risks of carriage and disease progression.

Results

Our analyses included 1032 CAAP cases and 7743 controls. At ages 12–35 months, a PCV13 schedule containing 2 primary doses and 1 booster dose provided 87.2% (95% confidence interval: 8.1–100.0%) protection against CAAP attributable to PCV13-serotype pneumococci, and 92.3% (–0.9%, 100.0%) protection against CAAP attributable to PCV7-serotype pneumococci. Protection against PCV13-serotype and PCV7-serotype CAAP was 67.0% (–424.3%, 100.0%) and 67.7% (–1962.9%, 100.0%), respectively, at ages 36–59 months. At ages 4–11 months, 2 PCV13 doses provided 98.9% (–309.8%, 100.0%) and 91.4% (–191.4%, 100.0%) against PCV13-serotype and PCV7-serotype CAAP.

Conclusions

Among children, PCV-conferred protection against CAAP attributable to vaccine-targeted pneumococcal serotypes resembles protection against vaccine-serotype invasive pneumococcal disease.
A case report of an aorto-pulmonary-venacaval fistula after penetrating cardiac injury
Authors: Koen Johannes Gerhardus , Wagenaar Riegardt , Janson Jacques T.
Published: December 2020

Background

Penetrating cardiac injury (PCI) is an accepted burden in high violent crime areas. Traumatic intracardiac fistulae are however not that commonly detected on initial presentation, with most of these injuries being detected post-operatively or at routine follow-up. The literature is devoid of general principles around the pre-operative planning and intra-operative management in these cases, and thus warrant documented case reports by clinical units experienced in the management of these challenging clinical scenarios.

Case summary

We describe a case report of a 29-year-old male patient presenting to our Cardiothoracic Unit with an aorto-pulmonary-venacaval fistula after a traumatic PCI. We describe the clinical presentation, diagnostic challenges, and institutional experience in the operative management of this case.

Discussion

The patient was treated successfully with repair via sternotomy and femoral cardiopulmonary bypass with no neurological, pulmonary, or cardiac sequelae at early follow-up. The importance of selective pre-operative imaging in PCI, appropriate pre-operative surgical planning, and surgical experience in the management of these injuries is highlighted in this case presentation.
Combination therapy with pulmonary arterial hypertension targeted drugs and immunosuppression can be a useful strategy for sarcoidosis-associated pulmonary hypertension: a case report
Authors: Sumimoto Keiko , Taniguchi Yu , Emoto Noriaki , Hirata Ken-Ichi
Published: December 2020

Background

Pulmonary hypertension (PH) is one of the significant complications of sarcoidosis. In the clinical classification of PH proposed in the recent world symposium of PH 2018, sarcoidosis-associated PH is classified in Group 5. The mechanisms of sarcoidosis-associated PH are very heterogeneous. There is no evidence of effective treatment for this condition.

Case summary

We report a case of a 46-year-old female who developed severe pulmonary hypertension due to sarcoidosis. Her haemodynamics, exercise capacity, and functional class remarkably improved after the treatment with pulmonary arterial hypertension (PAH) targeted drugs including macitentan and tadalafil and secondary immunosuppressive therapy with corticosteroids.

Discussion

This case emphasizes the importance of considering the underlying mechanisms of sarcoidosis-associated PH in order to choose appropriate treatment.
On the Benefit of Reinventing the Wheel: The Notion of a Single Internationally Wrongful Act
Authors: Gasbarri Lorenzo
Published: December 2020

This article is a critical reaction to the 2020 EJIL Foreword titled ‘Guiding Principles on Shared Responsibility in International Law’. It focuses on Principle 3, concerning a ‘single internationally wrongful act’, and it is divided into its constitutive elements: the meaning of same conduct (Section 2), the attribution to multiple persons (Section 3), the breach of obligations (Section 4) and the indivisible injury (Section 5). The main criticism is that the Guiding Principles make things more complex than they already are. The established principles of international responsibility provide simpler and more effective answers. This is particularly the case for Principle 3, which concerns multiple responsibilities arising from the same conduct. There are two main elements through which the Guiding Principles on Shared Responsibility seek to provide guidance in the case of a plurality of internationally responsible persons. First, they employ the comprehensive notion of an internationally wrongful act, while ARSIWA and ARIO distinguish between the two elements of attribution of conduct and the breach of an obligation. Second, the Guiding Principles consider the injury to be a constitutive element included in the definition of shared responsibility, while ARSIWA and ARIO only employ it in the context of reparation and countermeasures. There are no actual benefits coming from these attempts of clarification.
Atrial fibrillation burden: an update—the need for a CHA2DS2-VASc-AFBurden score
Authors: Tiver Kathryn D , Quah Jing , Lahiri Anandaroop , Ganesan Anand N , McGavigan Andrew D
Published: December 2020

Atrial fibrillation (AF) is an established independent risk factor for stroke. Current guidelines regard AF as binary; either present or absent, with the decision for anti-coagulation driven by clinical variables alone. However, there are increasing data to support a biological gradient of AF burden and stroke risk, both in clinical and non-clinical AF phenotypes. As such, this raises the concept of combining AF burden assessment with a clinical risk score to refine and individualize the assessment of stroke risk in AF—the CHA2DS2VASc-AFBurden score. We review the published data supporting a biological gradient to try and construct a putative schema of risk attributable to AF burden.
An Innovating Tool to Enhance the Oral Health of Older Adults With or Without Dementia Through the 4Ms Model
Authors: Tabrizi Maryam , Melchor Margo
Published: December 2020

Oral health of the elderly is the most neglected area of healthcare by many providers across healthcare disciplines. Often due to lack of Medicare funding and affordability of the elderly that leads to a constant high cost of non-traumatic dental related emergency department visits. By 2030, the number of adults in the USA will increase to 74 million. Over 22 million (30%) of older Americans will need specialized geriatric care. Simultaneously, in 2025, a national shortage of medical geriatricians will be close to 27,000 full time positions. This shortage has a greater impact on oral health often due to limited access, affordability and shortage of trained dentists to manage patients with special needs, particularly those with cognitive declines. There is an urgent need for an innovation for workforce enhancement nationwide. Innovation that can create a network of age-friendly dental clinics could be based on the 4Ms model-Mentation, Mobility, Medication, and Matters most. Project ECHO is a telementoring guided practice model that revolutionizes health education and increases workforce to provide best-practice specialty care by reducing health disparities. By utilization of the Project ECHO among community dentists, this makes transformation richly effective. Training oral health providers for utilizing the project ECHO model is a logical response for the shortage and to increase oral health access. Project ECHO trains general dentists & dental hygienists to provide specialty care services. Meaning the elderly can obtain the care they need in the right place, at the right time, with better treatment outcomes and reduces costs.
Social Engagement and Episodic Memory in Non-Hispanic Black and White Older Adults
Authors: Hamlin Abbey , Kraal A Zarina , Zahodne Laura
Published: December 2020

Social engagement may confer cognitive benefits in older adulthood, but studies have typically been restricted to largely non-Hispanic White (NHW) samples. Levels of social engagement vary across race such that NHW report larger social networks, more frequent participation in social activities, and greater social support than non-Hispanic Blacks (NHB). Associations between social engagement and cognition may also vary by race, but research is sparse. The current cross-sectional study examined associations between different aspects of social engagement and episodic memory performance, as well as interactions between social engagement and race among NHB and NHW participants in the Michigan Cognitive Aging Project (N = 247; 48.4% NHB; age = 64.19 ± 2.92). Social engagement (network size, activities, support) was self-reported. Episodic memory was a z-score composite of immediate, delayed, and recognition trials of a list-learning task. Separate hierarchical linear regression models quantified interactions between race and each of the three social engagement variables on episodic memory, controlling for sociodemographics, depressive symptoms, and health conditions. Results showed a main effect of more frequent social activity on better episodic memory, as well as an interaction between race and social support indicating a significant positive association in NHB but not NHW. These preliminary findings suggest that participating in social activities may be equally beneficial for episodic memory across NHB and NHW older adults and that social support may be particularly beneficial for NHB. Future research is needed to determine the potential applications of these results in reducing cognitive inequalities through the development of culturally-relevant interventions.
Efficacy of Life Review Therapy Intervention on Life Satisfaction Among Older Adults Living in Taiwan Nursing Homes
Authors: Yao Ching-Teng , Lin Chia-Ju
Published: December 2020

Life review therapy, used as part of a comprehensive therapy plan for increasing the quality of life of the elderly, helps them to resolve their past conflicts, and accept their present conditions. This study tested the effectiveness of a structured life review therapy protocol on the life satisfaction of institutionalized older adults. A quasi-experimental design was adopted in this study. Fifty older adults aged 65 or above were recruited from nursing homes in southern Taiwan through convenience sampling. The participants in the intervention group carried out life review therapy for eight weeks in addition to their daily activities. The participants in the comparison group maintained their daily activities. Both groups were evaluated using a life-satisfaction scale including two aspects of life worries and situations in weeks 1 and 8. Data were collected at baseline (T1), immediately post-intervention (T2). Generalized estimating equations were used to examine the effect of the intervention on the outcomes. The overall life satisfaction increased significantly over time for the intervention group compared to the comparison group from week 1 to week 8. The life review therapy programs showed promising effects in improving the life satisfaction of older adults living in nursing homes.
The Impact of COVID-19 on Informal Caregivers’ Health Behaviors
Authors: Greaney Mary , Kunicki Zachary , Drohan Megan , Cohen Steven
Published: December 2020

The population of older adults aged 65+ in the US is projected to increase from 15% to 21% in the next 30 years. Aging in place provides cost-savings and familiarity to the older adult, but often requires informal caregivers. Informal caregivers, individuals who provide unpaid care of assistance to family members and friends may have been uniquely impacted by the COVID-19 pandemic and shelter-at-home orders. Research is needed to examine how the pandemic impacted caregivers’ caregiving responsibilities and health behaviors (e.g., physical activity, sedentary time, fruit and vegetable intake, snacking, etc.) as this information will be invaluable to determine if health promotion interventions are needed for informal caregivers. Self-reported data were gathered from informal caregivers providing care to someone aged 50+ (n=835) through Amazon’s Mechanical Turk. Respondents reported their current and pre-pandemic health behaviors and demographics. Chi-square tests were used to examine bivariate associations between pandemic time (pre vs. post) and each examined behavior. The analysis identified some positive health behavior changes due to the pandemic: caregivers felt since the pandemic they ate more fruits and vegetables (p < .001), walked more, exercised more (p < .001), increased amounts of sleep (p < .001), and higher sleep quality (p < .001). However, respondents also had more screen time (p < .001) and sedentary time (p < .001). Future planned analyses will focus on examining whether these changes were consistent across all sociodemographic subgroups of caregivers and whether they persist after the pandemic recedes.
Anti-Aging Effects of Hydrophobic and Hydrophilic Components From Immature Pear Fruits Extract
Authors: Ogita Akira , Murata Wakae , Yamauchi Ken , Sakai Akiko , Yamaguchi Yoshihiro , Tanaka Toshio , Fujita Ken-ichi
Published: December 2020

Cellular senescence, the decline of cellular function due to aging, causes gradual loss of physiological functions and induces some chronic diseases, which negatively affect the quality of human life. Intervention in the cellular senescence process may reduce these incidences and delay the progression of age-related diseases, thereby contributing to the longevity of human lifespan. The budding yeast, Saccharomyces cerevisiae, is a model system that can provide significant insights into the genetics and molecular biology of senescence and is a suitable cellular model for research on mammalian cells. In the 2019 GSA meeting, we had revealed that the prolongation of yeast cell lifespan was induced by the addition of immature pear fruits extracts (iPE). In this study, we have focused on investigating the anti-senescence effects of hydrophilic (WiPE) and hydrophobic (OiPE) components of iPE on yeast cells and their genes and their possible application in extending human lifespan. The anti-aging effects of iPE were investigated using a chronological lifespan assay on S. cerevisiae cells. The chronological lifespan of the yeast was significantly extended in those treated with both WiPE and OiPE at 1% (v/v). The expression of sirtuin-related genes, which regulate cellular senescence, was examined by RT-PCR. Interestingly, gene expression was found to be significantly increased only in WiPE treated cells. The results suggested that the different polarity components from iPE exhibited anti-aging effects on the cells via different mechanisms. Research on the identification of useful components in iPE and the possibility of application to mammalian cells is ongoing.
Content Analysis of Church Leaders’ Perceptions and Attitudes Toward Dementia
Authors: Foster Kimberly , Epps Fayron
Published: December 2020

Individuals with dementia face many challenges, including the reactions others have to their diagnoses and associated symptoms. Those affected by dementia often seek support from their faith communities and find many of their faith leaders are unable to respond to their needs due to a lack of awareness. In an effort to transform the perception of dementia within the faith community, dementia educational workshops for church leaders were held at three African American churches in Metropolitan Atlanta. As part of the dementia workshop education, an exercise was used to assess attendees’ perceptions and attitudes toward dementia pre and post workshop. One hundred and eight participants took part in this exercise. At the beginning and end of the workshop, participants were asked to write a word or short phrase that came to mind when they thought of dementia. Qualitative content analysis was conducted and 15 codes were extracted and categorized into 3 groups: positive (e.g., supportive); negative (e.g., horrified); and neutral (e.g., information-seeking). Before the workshop, participant responses trended towards negative responses (e.g., fear, loss, damn). After the workshop, participants expressed in writing more neutral and positive phrases and words (e.g., support, hopefulness, caring). The findings indicate that with training, church leaders can change their perceptions and attitudes toward dementia to a more accepting and positive stance. Ultimately, continued education in the faith communities may allow for families affected by dementia to feel comfortable seeking help from their church, a very important resource in their community.
Sex Differences in Energetic Cost of Walking and Later-Life Function and Physical Activity Patterns
Authors: Peterson Matthew , Byrd Kira , Frohle Andrew
Published: December 2020

Aerobic fitness is a strong predictor of functional independence with aging. Variability in aerobic fitness is due, in part, to the efficiency of the movement of body mass while ambulating [energetic cost of walking (ECoW)]. ECoW may serve as a low burden measure of fitness compared to volitional treadmill tests. We assessed the predictive ability of ECoW with later-life function and physical activity participation in healthy adults. N=75 (age = 54.7 +/- 9.2; 52% female) completed a treadmill test with indirect calorimetry, during which time a warm-up of 1.5 mph at 0% grade was uniform. ECoW was quantified as steady state volume of oxygen consumption (ml/kg/min) subtracted by the calculated metabolic cost of walking at given speed and grade (=7.5 ml/kg/min). Later-life (median=9 years follow-up) function was assessed using the SF-36 physical functioning subscale, and the Baecke questionnaire for physical activity. Mean EcoW was similar to calculated cost (difference = -0.14 ml/kg/min) but had large variation (SD = 2.7; range = -4.4 to +17 ml/kg/min). In females, higher ECoW was predictive of better later-life function (b=1.9; p=0.04) and higher physical activity levels (b=0.09; p=0.001). In males, lower ECoW was predictive of higher physical activity levels only (b=-0.04; p=0.01). All models controlled for % body fat, age, and comorbidities. Surprisingly, in females, higher ECoW was associated with better later-life health outcomes. We hypothesize that this phenomenon may be similar to the obesity paradox, in that relatively higher non-metabolic tissue in females may serve as a stimulus for muscle and functional preservation.
Association of Brain Natriuretic Peptide With Mortality in Exceptionally Long-Lived Families
Authors: Kuipers Allison , Boudreau Robert , Feitosa Mary , Galvin Angeline , Thygarajan Bharat , Zmuda Joseph
Published: December 2020

Natriuretic peptides are produced within the heart and released in response to increased chamber wall tension and heart failure (HF). N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) is a specific natriuretic peptide commonly assayed in persons at risk for HF. In these individuals, NT-proBNP is associated with future disease prognosis and mortality. However, its association with mortality among healthy older adults remains unknown. Therefore, we determined the association of NT-proBNP with all-cause mortality over a median follow-up of 10 years in 3253 individuals free from HF at baseline in the Long Life Family Study, a study of families recruited for exceptional longevity. We performed cox proportional hazards analysis (coxme in R) for time-to event (mortality), adjusted for field center, familial relatedness, age, sex, education, smoking, alcohol, physical activity, BMI, diabetes, hypertension, and cancer. In addition, we performed secondary analyses among individuals (N=2457) within the normal NT-proBNP limits at baseline (<125pg/ml aged <75 years; <450pg/ml aged ≥75 years). Overall, individuals were aged 32-110 years (median 67 years; 44% male), had mean NT-proBNP of 318.5 pg/ml (median 91.0 pg/ml) and 1066 individuals (33%) died over the follow-up period. After adjustment, each 1 SD greater baseline NT-proBNP was associated with a 1.30-times increased hazard of mortality (95% CI: 1.24-1.36; P<0.0001). Results were similar in individuals with normal baseline NT-proBNP (HR: 1.21; 95% CI: 1.11-1.32; P<0.0001). These results suggest that NT-proBNP is a strong and specific biomarker for mortality in older adults independent of current health status, even in those with clinically-defined normal NT-proBNP.
Using Quality Measurement to Support Healthy Aging: The Adult Immunization Status Composite Measure
Authors: Barbera Courtney
Published: December 2020

Vaccine-preventable diseases remain a significant public health threat, especially for older adults and those with compromised immunity. Efforts to drive vaccine uptake can include quality measures, which help providers, health care organizations, payers, and others to benchmark and track immunization activities. To help address low immunization rates in adults, the National Committee for Quality Assurance (NCQA) released the Adult Immunization Status (AIS) composite measure, which calculates a single rate for health plan performance on influenza, Td/Tdap, shingles, and pneumococcal immunizations. Discern Health and the American Medical Group Association (AMGA) performed a mixed-methods study using de-identified patient data from three healthcare organizations to analyze feasibility of the AIS measure in quality programs at the medical group-level. The team also team conducted qualitative interviews with the organizations to understand best practices for improving immunization rates in adults. The study showed that the AIS measure is feasible for use at the medical-group level. It also revealed that adults 50 years of age and older were less likely to receive all age-appropriate vaccinations than those younger than 50. These findings indicate that there is a significant gap in rates of immunizations among older adults and point to potential solutions that can be supported through use of the AIS measure.
Preserving the Activities of Daily Living Independence in Late Life
Authors: Tsai Pao-feng , Jakobs Thomas , Landes Reid
Published: December 2020

Levels of Assistance (LoA) is an effective caregiving intervention for maintaining activity of daily living (ADL) independence. It is a structured, almost prescriptive, approach to encourage completing ADLs as independently as an elder’s capabilities permit. With appropriate prompts and assistance during dressing, elders can overcome disability, express retained competencies, and experience success. Simultaneously, caregivers learn to view their functions as maintaining the quality of life of able elders, and they receive reinforcement from elders who are more confident and happier. This study is a continuation of a previous project that created and tested a computer application training program for LoA in nursing homes. We refined the app to include grooming LoA and tested on 10 certified nursing assistant (CNA)/resident dyads at a local nursing home. The pilot results showed, although we did not see consistent improvement in CNA’s dressing LoA, we achieved 10% to 30% improvement in grooming LoA. This indicates that the dressing assistance training is able to transfer to grooming LoA. With only an average of one-hour app training, this improvement is cost effective as compared to training provided by care professionals. Future studies should consider incorporating a culture change strategy to improve CNAs’ intention for assisting elders. In addition, the training program should be offered in the initial hire to achieve maximum effect.
Qualitative Assessment of Resident Obesity in Nursing Homes by Medical Providers
Authors: Harris John , Handler Steven , Trinkoff Alison , Wolf David , Castle Nicholas
Published: December 2020

We present qualitative themes from an ongoing five-year AHRQ-funded project (R01HS026943) examining the various ways nursing homes provide care for residents with obesity to determine the most effective way to prevent adverse safety events for residents with obesity. Obesity is a common diagnosis among short- and long-stay residents, and in the past, nursing home administrators have reported concerns from admissions issues to negative resident outcomes. No studies have examined the medical provider’s perspective on health of residents with obesity. In this abstract, we present three emergent themes from semi-structured interviews of medical providers (n=6) (nursing home medical directors, staff physicians, nurse practitioners) across the U.S. First, residents with obesity often have several complex and challenging medical conditions that require more services and health monitoring than most residents. Significant medical issues include diabetes, hypertension, cardiovascular disease, arthritis, and sleep apnea. Second, medical providers observe that it is difficult to provide daily custodial and nursing care, but the actual medical harm from substandard care is hard to quantify. Third, medical providers would like to help residents with obesity to lose weight and live healthier lives. There is, however, not an easy way to facilitate weight loss, due to limited resident physical activity, concerns about unhealthy weight loss, and difficulty changing established dietary habits of residents. These findings are limited by sample size, though themes have been consistent within the current participants. Comparing and contrasting these themes with other stakeholder groups (residents, nurse aides, administrators) interviews in the future will strengthen these findings.
Differences in Cause-Specific Mortality Between Frail Men and Women in the United States
Authors: Lohman Matthew , Sonnega Amanda , Leggett Amanda , Resciniti Nicholas
Published: December 2020

While frailty is associated with risk of numerous adverse health outcomes including mortality, little is known about the most common specific causes of death among frail older adults or how these causes might differ by gender. This information may be important to understanding the frailty syndrome and to informing screening and treatment. We used linked data from the Health and Retirement Study (2004 – 2012) and the National Death Index (NDI). We analyzed data from HRS participants age 65 and older who completed a general health interview and physiological measures (n=10,490). Frailty was operationalized using the phenotype criteria – low weight, low energy expenditure, exhaustion, slow gait, and weakness. Causes of death were determined using International Classification of Diseases (v10) codes from death certificates. We used Cox proportional hazards to compare incidence of cause-specific mortality by frailty status and gender. The attributable risk of mortality due to frailty in the sample was 16.6% among women and 17.3% among men. Overall, frail older adults had greater risk of death from heart disease (hazard ratio (HR): 2.97; 95% CI: 2.18, 4.04), cancer (HR: 2.81; 95% CI: 2.01, 3.93), and dementia 2.86 (95% CI: 1.46, 5.58) but not cerebrovascular disease or accidents. Frail women were more approximately 29% more likely to die from heart disease than frail men. Findings suggest that frailty is a significant risk factor for mortality from several different causes, especially among women. Findings may help inform screening and treatment decisions for older adults at risk for frailty.
Assessing Alzheimer’s Disease Specific Barriers to Enrollment in an Observational Actigraphy Study
Authors: Losinski Genna , Laffer Alex , Hicks Hilary , Watts Amber
Published: December 2020

There are unique challenges to recruit and enroll individuals with Alzheimer’s disease (AD) into research studies, and typical barriers to participation include the need for study partner involvement, use of invasive procedures (e.g., lumbar punctures), and lack of awareness of ongoing research. Failure to enroll this population impacts generalizability and external validity of results. The current study sought to explore reasons for non-participation in individuals with AD enrolled in the University of Kansas Alzheimer’s Disease Center (ADC) Registry. Participants were approached at their annual registry visit and asked to participate in an observational sub-study that utilized wrist-worn actigraphy to measure physical activity and sleep over a one-week period. Of the thirty-six non-participation encounters that were recorded over a 2.5 year data collection period, 28% were never recruited due to appointment cancellation, rescheduling, or no-show. Of the remaining encounters, the three most common reasons for non-participation included: physical limitations of individuals with AD (15%), unknown (28%), and study partner concerns regarding use of technology in individuals with impaired cognition due to AD (25%). Multiple study partners were concerned that the individual with AD would lose the watch, remove the watch from the wrist, or become irritated while wearing it. Findings suggest that the use of technology such as actigraphy presents an additional barrier to enrollment that is unique to individuals with AD. Future studies should consider potential interventions to address study partner concerns regarding use of technology in individuals with AD.
Can Social Connections Improve Dementia Knowledge Among Homebound Community-Dwelling Older African Americans?
Authors: Dowling Maritza , Dodge Hiroko , Puente Antonio , Lunsford Beverly
Published: December 2020

Despite the clear and compelling association between social connections and well-being, the underlying mechanisms that help stave off adverse health impacts are not well understood, particularly among older adults in disadvantaged groups. Social relationships in older age may be instrumental for exchanging and gaining knowledge that further influence health and help increase awareness about misconceptions and lifestyle behaviors known to delay or reduce cognitive decline. This study used cross-sectional survey data from 147(aged 58-90 years; 75% female) low-income African American homebound community dwellers to investigate heterogeneity in dementia literacy profiles and its association with social connectedness. Eleven items (false=0, true=1, don’t know=2) from a validated instrument were used to measure dementia literacy (DL). The Lubben’s social network scale was used for a social connectedness construct. We employed a 2-stage latent class modeling approach to examine heterogeneity in DL and estimate the regressions among the derived classes and the predictors (social connectedness, education level and age). A 3-class model produced a reasonable fit and classification (entropy=0.852) of “dementia literacy patterns” labeled as (high-literacy:37%), moderate-literacy:45.2%), low-literacy:17.8%)). Social connectedness was highly predictive of class membership. A high level of social relationships increased the probability of being in the “high-dementia-literacy” class compared to the “low-dementia-literacy” class (OR=2.189, p=0.016). For a unit increase in social connectedness, the odds of being in the “high-dementia-literacy” class compared to the “low-dementia-literacy” class increased by a factor of 2.2. Tailored and focused interventions to reduce social disconnectedness may also help increase dementia awareness and reduce barriers to early diagnosis.
Shear wave structure of southern Sweden from precise phase-velocity measurements of ambient-noise data
Authors: Sadeghisorkhani Hamzeh , Gudmundsson Ólafur , Li Ka Lok , Tryggvason Ari , Lund Björn , Högdahl Karin
Published: December 2020

Rayleigh-wave phase-velocity tomography of southern Sweden is presented using ambient seismic noise at 36 stations (630 station pairs) of the Swedish National Seismic Network. We analyse 1 yr (2012) of continuous recordings to get the first crustal image based on the ambient-noise method in the area. Time-domain cross-correlations of the vertical component between the stations are computed. Phase-velocity dispersion curves are measured in the frequency domain by matching zero crossings of the real spectra of cross-correlations to the zero crossings of the zeroth-order Bessel function of the first kind. We analyse the effect of uneven source distributions on the phase-velocity dispersion curves and correct for the estimated velocity bias before tomography. To estimate the azimuthal source distribution to determine the bias, we perform inversions of amplitudes of cross-correlation envelopes in a number of period ranges. Then, we invert the measured and bias-corrected dispersion curves for phase-velocity maps at periods between 3 and 30 s. In addition, we investigate the effects of phase-velocity bias corrections on the inverted tomographic maps. The difference between bias-corrected and -uncorrected phase-velocity maps is small (<1.2 per cent), but the correction significantly reduces the residual data variance at long periods where the bias is biggest. To obtain a shear velocity model, we invert for a 1-D velocity profile at each geographical node. The results show some correlation with surface geology, regional seismicity and gravity anomalies in the upper crust. Below the upper crust, the results agree well with results from other seismological methods.
Branched I antigen regulated cell susceptibility against natural killer cytotoxicity through its N-linked glycosylation and overall expression
Authors: Wu Yu-Xuan , Lu Hsu-Feng , Lin Yen-Hsi , Chuang Hui-Yu , Su Shih-Chi , Liao Yi-Jen , Twu Yuh-Ching
Published: December 2020

Cell surface glycosylation has been known as an important modification process that can be targeted and manipulated by malignant cells to escape from host immunosurveillance. We previously showed that the blood group branched I antigen on the leukemia cell surface can regulate the cell susceptibility against natural killer (NK) cell-mediated cytotoxicity through interfering target–NK interaction. In this work, we first identified N-linkage as the major glycosylation linkage type for branched I glycan formation on leukemia cells, and this linkage was responsible for cell sensitivity against therapeutic NK-92MI targeting. Secondly, by examining different leukemia cell surface death receptors, we showed death receptor Fas had highest expressions in both Raji and TF-1a cells. Mutations on two Fas extracellular N-linkage sites (118 and 136) for glycosylation impaired activation of Fas-mediated apoptosis during NK-92MI cytotoxicity. Last, we found that the surface I antigen expression levels enable leukemia cells to respond differently against NK-92MI targeting. In low I antigen expressing K-562 cell, reduction of I antigen presence greatly reduced leukemia cell susceptibility against NK-92MI targeting. But in other high I antigen expressing leukemia cells, similar reduction in I antigen expression did not affect cell susceptibility.
Scattered Representations of Complex Classical Lie Groups
Authors: Dong Chao-Ping , Wong Kayue Daniel
Published: December 2020

As a continuation of [9], this paper studies scattered representations of $SO(2n+1, {{\mathbb{C}}})$, $Sp(2n, {{\mathbb{C}}})$, and $SO(2n, {{\mathbb{C}}})$. We describe the Zhelobenko parameters of these representations, count their cardinality, and determine their spin-lowest $K$-types. We also disprove a conjecture raised in 2015 asserting that the unitary dual can be obtained via parabolic induction from irreducible unitary representations with nonzero Dirac cohomology.
Pneumonia Following Symptomatic Influenza Infection Among Nicaraguan Children Before and After Introduction of the Pneumococcal Conjugate Vaccine
Authors: Kubale John , Balmaseda Angel , Sanchez Nery , Lopez Roger , Gresh Lionel , Ojeda Sergio , Harris Eva , Kuan Guillermina , Zelner Jon , Gordon Aubree
Published: December 2020

Influenza is associated with primary viral and secondary bacterial pneumonias; however, the dynamics of this relationship in populations with varied levels of pneumococcal vaccination remain unclear. We conducted nested matched case-control studies in 2 prospective cohorts of Nicaraguan children aged 2–14 years: 1 before pneumococcal conjugate vaccine introduction (2008–2010) and 1 following introduction and near universal adoption (2011–2018). The association between influenza and pneumonia was similar in both cohorts. Participants with influenza (across types/subtypes) had higher odds of developing pneumonia in the month following influenza infection. These findings underscore the importance of considering influenza in interventions to reduce global pneumonia burden.
The role of ATP in the differential ability of Sr2+ to trigger Ca2+ oscillations in mouse and human eggs
Authors: Storey Anna , Elgmati Khalil , Wang Yisu , Knaggs Paul , Swann Karl
Published: December 2020

At fertilization in mice and humans, the activation of the egg is caused by a series of repetitive Ca2+ oscillations which are initiated by phospholipase-C(zeta)ζ that generates inositol-1,4,5-trisphophate (InsP3). Ca2+ oscillations and egg activation can be triggered in mature mouse eggs by incubation in Sr2+ containing medium, but this does not appear to be effective in human eggs. Here, we have investigated the reason for this apparent difference using mouse eggs, and human eggs that failed to fertilize after IVF or ICSI. Mouse eggs incubated in Ca2+-free, Sr2+-containing medium immediately underwent Ca2+ oscillations but human eggs consistently failed to undergo Ca2+ oscillations in the same Sr2+ medium. We tested the InsP3-receptor (IP3R) sensitivity directly by photo-release of caged InsP3 and found that mouse eggs were about 10 times more sensitive to InsP3 than human eggs. There were no major differences in the Ca2+ store content between mouse and human eggs. However, we found that the ATP concentration was consistently higher in mouse compared to human eggs. When ATP levels were lowered in mouse eggs by incubation in pyruvate-free medium, Sr2+ failed to cause Ca2+ oscillations. When pyruvate was added back to these eggs, the ATP levels increased and Ca2+ oscillations were induced. This suggests that ATP modulates the ability of Sr2+ to stimulate IP3R-induced Ca2+ release in eggs. We suggest that human eggs may be unresponsive to Sr2+ medium because they have a lower level of cytosolic ATP.
Alignment, Classification, Clinical Evaluation, and Surgical Treatment for Adult Cervical Deformity: A Complete Guide
Authors: Scheer Justin K , Lau Darryl , Smith Justin S , Lee Sang-Hun , Safaee Michael M , Fury Marissa , Ames Christopher P
Published: December 2020

Adult cervical deformity management is complex and is a growing field with many recent advancements. The cervical spine functions to maintain the position of the head and plays a pivotal role in influencing subjacent global spinal alignment and pelvic tilt as compensatory changes occur to maintain horizontal gaze. There are various types of cervical deformity and a variety of surgical options available. The major advancements in the management of cervical deformity have only been around for a few years and continue to evolve. Therefore, the goal of this article is to provide a comprehensive review of cervical alignment parameters, deformity classification, clinical evaluation, and surgical treatment of adult cervical deformity. The information presented here may be used as a guide for proper preoperative evaluation and surgical treatment in the adult cervical deformity patient.
The Impact of Phosphorus on Plant Immunity
Authors: Chan Ching , Liao Ya-Yun , Chiou Tzyy-Jen
Published: December 2020

Phosphorus (P) is the second most essential macronutrient in terms of limiting plant growth. The genes involved in P acquisition, transport, storage, utilization and respective regulation have been extensively studied. In addition, significant attention has been given to the crosstalk between P and other environmental stresses. In this review, we summarize recent discoveries pertaining to the emerging function of P in plant immunity. The roles of external soil P availability, internal cellular P in plants, P starvation signaling machinery and phosphate transporters in biotic interactions are discussed. We also highlight the impact of several phytohormones on the signaling convergence between cellular P and immune responses. This information may serve as a foundation for dissecting the molecular interaction between nutrient responses and plant immunity.
BnaGVD: A Genomic Variation Database of Rapeseed (Brassica napus)
Authors: Yan Tao , Yao Yao , Wu Dezhi , Jiang Lixi
Published: December 2020

Rapeseed (Brassica napus L.) is a typical polyploid crop and one of the most important oilseed crops worldwide. With the rapid progress on high-throughput sequencing technologies and the reduction in sequencing cost, large-scale genomic data of a specific crop have become available. However, raw sequence data are mostly deposited in the sequence read archive of the National Center of Biotechnology Information and the European Nucleotide Archive, which is freely accessible to all researchers. Extensive tools for practical purposes should be developed to efficiently utilize these large raw data. Here, we report a web-based rapeseed genomic variation database (BnaGVD, http://rapeseed.biocloud.net/home) from which genomic variations, such as single-nucleotide polymorphisms (SNPs) and insertions/deletions (InDels) across a worldwide collection of rapeseed accessions, can be referred. The current release of the BnaGVD contains 34,591,899 high-quality SNPs and 12,281,923 high-quality InDels and provides search tools to retrieve genomic variations and gene annotations across 1,007 accessions of worldwide rapeseed germplasm. We implement a variety of built-in tools (e.g. BnaGWAS, BnaPCA and BnaStructure) to help users perform in-depth analyses. We recommend this web resource for accelerating studies on the functional genomics and the screening of molecular markers for rapeseed breeding.
Trend of the mortality of major liver diseases and its impact on life expectancy in China from 2006 to 2017
Authors: Zhu Jicun , Wang Peng , Ye Hua , Shi Jianxiang , Wang Xiao , Wang Keyan , Duan Fujiao , Yang Qian , Sun Guiying , Zhang Jianying
Published: December 2020

Background

Liver diseases are the serious cause of death in China. We aim to describe the trends and disparities of major liver disease mortality rates and the loss of life expectancy (LLE) in China.

Methods

Annual percentage change (APC) and average APC (AAPC) were calculated using the Joinpoint regression model. LLE was calculated using cause eliminated life table.

Results

From 2006 to 2017, the overall age-standardized mortality rate (ASMR) of liver cirrhosis lightly declined (AAPC: −2.97%), whereas the ASMR of viral hepatitis and liver cancer remained stable. Viral hepatitis (AAPC: −4.36%) and liver cirrhosis (AAPC: −4.35%) ASMRs both declined for females. The highest ASMRs of viral hepatitis and liver cirrhosis were in the west region, while that of liver cancer was in the middle region. The ASMRs of liver cirrhosis in the middle region and liver cancer in the east region significantly decreased. The means of LLE on viral hepatitis, liver cirrhosis and liver cancer were 0.05, 0.1 and 0.46 years, respectively.

Conclusions

The burden of liver diseases is still severe and there are disparities between genders and different regions in China. Accurate early diagnostic approaches for high-risk populations should be established to eliminate the burden of liver diseases.
Corruption
Authors: Fisman Ray , Golden Miriam A.
Published: December 2020

Corruption regularly makes front page headlines: public officials embezzling government monies, selling public offices, and trading bribes for favors to private companies generate public indignation and calls for reform. In Corruption: What Everyone Needs to Know®, renowned scholars Ray Fisman and Miriam A. Golden provide a deeper understanding of why corruption is so damaging politically, socially, and economically. Among the key questions examined are: is corruption the result of perverse economic incentives? Does it stem from differences in culture and tolerance for illicit acts of government officials? Why don't voters throw corrupt politicians out of office? Vivid examples from a wide range of countries and situations shed light on the causes of corruption, and how it can be combated.
Mental health problems among youth experiencing sex trafficking
Authors: Fazio Nicole , Lynch Jenna , Devlin Maura , Kameg Brayden
Published: December 2020

There are an estimated 4.8 million victims of sex trafficking (ST) globally, and 21% of these victims are children or adolescents. Victims of ST are at risk for mental health problems, and it is critical that primary care providers can accurately identify and treat them.
Post COVID-19 return to “new normal” in surgical care: joining the dots
Authors: Sandhu Harindra , Rai Ankit , Huda Farhanul , Ravi Bina , Basu Somprakas , Mammen Kim Jacob
Published: December 2020

The severe acute respiratory syndrome caused by novel coronavirus was declared an international public health emergency and has burdened the health care system since December 2019. With changing priorities and difficult delivery of health care, researchers are working hard on developing new ways of dealing with the changing scenarios without compromising patient care and safety. Focus on personal protection at hospitals and digital consultations have gained attention. Coronavirus disease 2019 has caused significant life style changes in diet, etiquettes, ways of learning and social media. Keeping this in mind, studies conducted from December 2019 till August 2020 were reviewed and an attempt has been made to define the new normal in surgical care and medical education.