bluuebunny/crossref_metadata_2025 huggingface dataset:
Macrophage-derived MMP-8 determines smooth muscle cell differentiation from adventitia stem/progenitor cells and promotes neointima hyperplasia
Authors: Yang Feng , Chen Qishan , Yang Mei , Maguire Eithne Margaret , Yu Xiaotian , He Shiping , Xiao Rui , Wang Claire S , An Weiwei , Wu Wei , Zhou Yijiang , Xiao Qingzhong , Zhang Li
Published: February 2019

Aims

Emerging evidence has suggested that adventitia stem/progenitor cells (AdSPCs) migrate into the intima of arteries in response to injury, where they differentiate towards smooth muscle cells (SMCs) and participate in neointimal hyperplasia. We have previously identified matrix metalloproteinase-8 (MMP8) as a key player in atherogenesis. In this study, we aimed to investigate the functional roles of macrophage-derived MMP8 in AdSPC differentiation and injury-induced arterial remodelling.

Methods and results

We first observed an important role for MMP8 in SMC differentiation from embryonic stem cells, but this effect was not seen in AdSPCs. Instead, through macrophages/AdSPCs co-culture and macrophage conditional culture medium studies, we have demonstrated that the MMP8 protein secreted from macrophages promotes SMC differentiation from AdSPCs. Mechanistically, we showed that macrophage-derived MMP8 promotes SMC differentiation from AdSPCs through modulating transforming growth factor-β activity and a disintegrin and metalloproteinase domain-containing protein 10 (ADAM10)/Notch1 signalling. We further demonstrated that the binding site for CBF1, Suppressor of Hairless, and Lag-1 (CSL) within SMC gene promoters is responsible for Notch1 mediated SMC differentiation. Finally, we demonstrated that macrophage-derived MMP8 increased injury-induced neointimal SMC hyperplasia by activating ADAM10/Notch1 signalling.

Conclusions

We have identified macrophage-derived MMP8 as a regulator in SMC differentiation from AdSPCs and neointimal SMC hyperplasia in response to injury. Our data provide new insights into the roles of MMP8 in AdSPC differentiation and the pathogenesis of neointima formation in the context of angiographic restenosis, and therefore may aid in the development of novel therapeutic agents for the prevention of this disease.
Identification of invasive and radionuclide imaging markers of coronary plaque vulnerability using radiomic analysis of coronary computed tomography angiography
Authors: Kolossváry Márton , Park Jonghanne , Bang Ji-In , Zhang Jinlong , Lee Joo Myung , Paeng Jin Chul , Merkely Béla , Narula Jagat , Kubo Takashi , Akasaka Takashi , Koo Bon-Kwon , Maurovich-Horvat Pál
Published: February 2019

Aims

Identification of invasive and radionuclide imaging markers of coronary plaque vulnerability by a single, widely available non-invasive technique may provide the opportunity to identify vulnerable plaques and vulnerable patients in broad populations. Our aim was to assess whether radiomic analysis outperforms conventional assessment of coronary computed tomography angiography (CTA) images to identify invasive and radionuclide imaging markers of plaque vulnerability.

Methods and results

We prospectively included patients who underwent coronary CTA, sodium-fluoride positron emission tomography (NaF18-PET), intravascular ultrasound (IVUS), and optical coherence tomography (OCT). We assessed seven conventional plaque features and calculated 935 radiomic parameters from CTA images. In total, 44 plaques of 25 patients were analysed. The best radiomic parameters significantly outperformed the best conventional CT parameters to identify attenuated plaque by IVUS [fractal box counting dimension of high attenuation voxels vs. non-calcified plaque volume, area under the curve (AUC): 0.72, confidence interval (CI): 0.65–0.78 vs. 0.59, CI: 0.57–0.62; P < 0.001], thin-cap fibroatheroma by OCT (fractal box counting dimension of high attenuation voxels vs. presence of low attenuation voxels, AUC: 0.80, CI: 0.72–0.88 vs. 0.66, CI: 0.58–0.73; P < 0.001), and NaF18-positivity (surface of high attenuation voxels vs. presence of two high-risk features, AUC: 0.87, CI: 0.82–0.91 vs. 0.65, CI: 0.64–0.66; P < 0.001).

Conclusion

Coronary CTA radiomics identified invasive and radionuclide imaging markers of plaque vulnerability with good to excellent diagnostic accuracy, significantly outperforming conventional quantitative and qualitative high-risk plaque features. Coronary CTA radiomics may provide a more accurate tool to identify vulnerable plaques compared with conventional methods. Further larger population studies are warranted.
Significant regional variation in use of implantable cardioverter-defibrillators in Denmark
Authors: Pedersen Susanne Bendesgaard , Farkas Dóra Körmendiné , Hjortshøj Søren Pihlkjær , Bøtker Hans Erik , Johansen Jens Brock , Philbert Berit Thornvig , Haarbo Jens , Thomsen Reimar Wernich , Nielsen Jens Cosedis
Published: February 2019

Aims

Implantable cardioverter-defibrillator (ICD) treatment prevents sudden cardiac death in high-risk patients. This study examined geographical variation in ICD implantation rates in Denmark and potential causes of variation.

Methods and results

We obtained numbers of ICD implantations in the 5 Danish regions and 98 municipalities during 2007–13 from the Danish Pacemaker and ICD Registry. Standardized implantation rates (SIRs) were computed as ICD implantations per 1 000 000 person-years, and age- and gender-standardized to the Danish population. We examined associations of the municipal SIR with mean age and Charlson Comorbidity Index score of ICD recipients, percentage of implantations with primary prophylactic indication, and distance from patient residency to ICD implanting centre. Based on 7192 ICD implantations, the nationwide SIR was 186 [95% confidence interval (CI) 182–190], ranging from 170 (95% CI 158–183) in the North Denmark Region to 206 (95% CI 195–218) in the Region of Zealand. Municipalities with higher patient comorbidity scores, higher percentages of implantations with primary prophylactic indication, and shorter distances to ICD implanting centres, had higher SIRs [differences between SIRs of municipalities in highest and lowest quartiles 22 (95% CI 10–34), 45 (95% CI 33–58), and 35 (95% CI 24–47), respectively]. Regional differences in SIRs decreased over time and had become insignificant during 2011–13.

Conclusion

Implantable cardioverter-defibrillator implantation rates in Denmark varied significantly between regions but variation decreased during 2007–13. Geographical variation was associated with differences in patient comorbidity score, variation in use of primary prophylactic ICD treatment, and distance to ICD implanting centre.
A meta-analysis of the performance of small tissue versus mechanical aortic valve prostheses
Authors: Moscarelli Marco , Fattouch Khalil , Speziale Giuseppe , Nasso Giuseppe , Santarpino Giuseppe , Gaudino Mario , Athanasiou Thanos
Published: February 2019

OBJECTIVES

Small aortic prosthetic valves have been associated with suboptimal performance due to patient–prosthesis mismatch (PPM). This meta-analysis compared the outcomes of patients with a small root who received tissue versus mechanical aortic valves.

METHODS

A systematic literature review identified 7 candidate studies; of these, 5 met the meta-analysis criteria. We analysed outcomes for a total of 680 patients (227 tissue valves and 453 mechanical valves) using random effects modelling. Each study was assessed for heterogeneity and quality. The primary end point was mortality at follow-up. Secondary end points included intraoperative and postoperative outcomes, the rate of PPM and left ventricle mass regression and major cardiac and prosthesis-related adverse events at follow-up.

RESULTS

There was no between-group difference in mortality at follow-up [incidence rate ratio 1, 95% confidence interval (CI) 0.50–2.01; P = 0.99]. The tissue group had a higher rate of PPM (odds ratio 17.19, 95% CI 8.6–25.78; P = 0.002) and significantly less reduction in ventricular mass (weighted mean difference 40.79, 95% CI 4.62–76.96; P = 0.02). There were no significant differences in the incidence of structural valve disease at follow-up compared to that in the mechanical valve group. There was also no between-group difference in aggregated adverse events at follow-up (P = 0.68).

CONCLUSIONS

Tissue and mechanical valves were associated with similar mortality rates; however, patients receiving tissue valves had a higher rate of PPM and significantly less left ventricle mass regression. These findings indicate that patients receiving small tissue valves may require closer clinical surveillance than those receiving mechanical valves.
Board games for teaching English prosody to advanced EFL learners
Authors: Łodzikowski Kacper , Jekiel Mateusz
Published: February 2019

This exploratory study fills the gap in research on using print board games to teach English prosody to advanced EFL learners at university level. We developed three in-class print-and-play board games that accompanied three prosody-related topics in a course in English phonetics and phonology at a Polish university. For those topics, compared to topics without any board games, learners reported higher in-class engagement and obtained higher post-class quiz scores. At the end of the course, learners rated board games as equally or more useful than some of the other teaching aids. Although traditional printed worksheets were still rated as the most useful teaching aid, learners expressed their preference for using extra classroom time for playing board games instead of completing extra worksheet exercises. We hope these promising results will encourage teachers to experiment with implementing these and other board games in their advanced curricula.
Reasons for hospitalization and risk of mortality in patients with atrial fibrillation treated with dabigatran or warfarin in the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial
Authors: Alak Aiman , Hohnloser Stefan H , Fräßdorf Mandy , Reilly Paul , Ezekowitz Michael , Healey Jeff S , Brueckmann Martina , Yusuf Salim , Connolly Stuart J
Published: February 2019

Aims

Hospitalizations are common among patients with atrial fibrillation. This article aimed to analyse the causes and consequences of hospitalizations occurring during the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial.

Methods and results

The RE-LY database was used to evaluate predictors of hospitalization using multivariate regression modelling. The relationship between hospitalization and subsequent major adverse cardiac events was evaluated in a time dependent Cox proportional-hazard modelling. Of the 18 113 patients in RE-LY, 7200 (39.8%) were hospitalized at least once during a mean follow-up of 2 years. First hospitalization rates were 2312 (39.5%) for dabigatran etexilate (DE) 110, 2430 (41.6%) for DE 150, and 42.6% (N = 2458) for warfarin. Hospitalization was associated with post-discharge death [absolute event rate 9.1% vs. 2.2%; adjusted hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.2–4.0, P < 0.0001], vascular death (adjusted HR 2.9, 95% CI 2.5–3.3, P < 0.0001), and sudden cardiac death (adjusted HR 2.3; 95% CI 1.8–2.9, P < 0.0001). Cardiovascular hospitalization was also associated with an increased risk of post-discharge death (adjusted HR 2.8, 95% CI 2.5–3.2, P < 0.0001), vascular death (adjusted HR 2.8, 95% CI 2.4–3.2, P < 0.0001), and sudden cardiac death (adjusted HR 2.1, 95% CI 1.6–2.7, P < 0.0001) compared with patients not hospitalized for any cardiovascular reason.

Conclusion

Hospitalizations are associated an increased risk of with death and cardiovascular death in patients with atrial fibrillation.
Status quo bias and health behavior: findings from a cross-sectional study
Authors: Karl Florian M , Holle Rolf , Schwettmann Lars , Peters Annette , Laxy Michael
Published: February 2019

Background

Status quo bias (SQB) has often been referred to as an important tool for improving public health. However, very few studies were able to link SQB with health behavior.

Methods

Analysis were based on data from the population-based KORA S4 study (1999–2001, n = 2309). We operationalized SQB through two questions. The first asked whether participants switched their health insurance for financial benefits since this was enabled in 1996. Those who did were assigned a ‘very low SQB’ (n = 213). Participants who did not switch were asked a second hypothetical question regarding switching costs. We assigned ‘low SQB’ to those who indicated low switching costs (n = 1035), ‘high SQB’ to those who indicated high switching costs (n = 588), and ‘very high SQB’ to those who indicated infinite switching costs (n = 473). We tested the association between SQB and physical activity, diet, smoking, alcohol consumption, the sum of health behaviors, and body mass index (BMI) using logistic, Poisson and ordinary least square regression models, respectively. Models were adjusted for age, sex, education, income, satisfaction with current health insurance and morbidity.

Results

SQB was associated with a higher rate of physical inactivity [OR = 1.22, 95% CI (1.11; 1.35)], a higher sum of unhealthy lifestyle factors [IRR = 1.05, 95% CI (1.01; 1.10)] and a higher BMI [β = 0.30, 95% CI (0.08; 0.51)].

Conclusion

A high SQB was associated with unfavorable health behavior and higher BMI. Targeting SQB might be a promising strategy for promoting healthy behavior.
The influence of patient case mix on public health area statistics for cancer stage at diagnosis: a cross-sectional study
Authors: Barclay Matthew E , Abel Gary A , Elliss-Brookes Lucy , Greenberg David C , Lyratzopoulos Georgios
Published: February 2019

Background

Summary statistics comparing the stage at diagnosis of geographically defined populations of cancer patients are increasingly used in public reporting to monitor geographical inequalities but may be confounded by patient case mix. We explore the impact of case-mix adjustment on a publicly reported measure of early stage at diagnosis in England.

Methods

We analyzed data used for publicly reported statistics about the stage of patients diagnosed with 1 of 11 solid tumours in 2015 in England, including information on cancer site (bladder, breast, colon, rectum, kidney, lung, melanoma, non-Hodgkin lymphoma, ovarian, prostate, endometrial), age, gender, income deprivation and population-based commissioning organization. We investigated how cancer site and other patient characteristics influence organizational comparisons and attainment of early-stage targets (≥60% of all cases diagnosed in TNM stages I–II).

Results

Adjusting for patient case mix reduced between-organization variance by more than 50%, resulting in appreciable discordance in organizational ranks (Kendall’s tau = 0.53), with 18% (37/207) of organizations being reclassified as meeting/failing the early-stage target due to case mix.

Conclusion

Summary statistics on stage of cancer diagnosis for geographical populations currently used as public health surveillance tools to monitor organizational inequalities need to account for patient sociodemographic characteristics and cancer site case mix.
Trends in disease mortality before and during the Great Recession in individuals employed in Spain in 2001
Authors: Regidor Enrique , Ronda Elena , Tapia Granados José A , Viciana-Fernández Francisco J , de la Fuente Luis , Barrio Gregorio
Published: February 2019

Background

Previous studies on economic recessions and mortality due to cancer and other chronic diseases have yielded inconsistent findings. We investigated the trend in all-disease mortality and mortality due to several specific diseases before and during the Great Recession of 2008 in individuals who were employed in 2001, at the beginning of follow-up.

Methods

We follow in a nationwide longitudinal study over 15 million subjects who had a job in Spain in 2001. The analysed outcomes were mortality at ages 25–64 years due to all diseases, cancer and other chronic diseases. We calculated annual mortality rates from 2003 to 2011, and the annual percentage change (APC) in mortality rates during 2003–07 and 2008–11, as well as the effect size, measured by the APC difference between the two periods.

Results

All-disease mortality increased from 2003 to 2007 in both men and women; then, between 2008 and 2011, all-disease mortality decreased in men and reached a plateau in women. In men, the APC in the all-disease mortality rate was 1.6 in 2003–07 and −1.4 in 2008–11 [effect size −3.0, 95% confidence interval (CI) −3.7 to −2.2]; in women it was 2.5 and −0.3 (effect size −2.8, 95% CI −4.2 to −1.3), respectively. Cancer mortality and mortality due to other chronic diseases revealed similar trends.

Conclusions

In the group of individuals with a job in 2001 the Great Recession reversed or stabilized the upward trend in all-disease mortality.
Exposure to second-hand smoke in the context of tobacco policy changes in Estonia, 1996–2016
Authors: Reile Rainer , Pärna Kersti
Published: February 2019

Background

Exposure to second-hand smoke (SHS) is a preventable cause of disease and disability that can effectively be tackled by tobacco legislation. The aim of the study was to analyse the trends of SHS exposure and its sociodemographic patterning during 1996–2016 in the context of tobacco policy changes in Estonia.

Methods

Nationally representative data from biennial health surveys in 1996–2016 (n = 14 629) were used to present prevalence ratios for SHS exposure among non-smokers in Estonia. Joinpoint regression and multivariable logistic regression were used to study the sociodemographic and socio-economic differences in SHS exposure and its changes during the period.

Results

Exposure to SHS among non-smoking men and women has declined 3.6 and 5 times, respectively, during 1996–2016. While the rate of change was constant among men throughout the period, the decline in SHS exposure among women became significantly faster after 2006 compared with the previous period. However, 15.6% [95% confidence interval (CI) 13.1–18.3%] of men and 8.8% (95% CI 7.1–10.6%) of women were still exposed to SHS in 2016 with higher odds found for younger age groups, non-Estonians and those with lower education and income.

Conclusions

The consistently declining prevalence of SHS exposure among non-smoking population can be at least partially attributed to implementation of tobacco legislations in 2000s. However, the existing sociodemographic and socio-economic differences in SHS exposure require further attention as those in more vulnerable positions are also more exposed to SHS-related health harms.
Parent hazardous drinking and their children’s alcohol use in early and mid-adolescence: prospective cohort study
Authors: Sharmin Sonia , Kypri Kypros , Wadolowski Monika , Bruno Raimondo , Khanam Masuma , Aiken Alexandra , Hutchinson Delyse , Najman Jackob M , Slade Tim , McBride Nyanda , Attia John , Palazzi Kerrin , Oldmeadow Christopher , Mattick Richard P
Published: February 2019

Background

Why adolescents’ drinking is associated with their parents’ drinking remains unclear. We examined associations in a prospective cohort study, adjusting for socio-demographic characteristics and family factors.

Methods

We recruited 1927 children from grade 7 classes (mean age 13 years), and one of their parents, in three Australian states, contacted participants annually from 2010 to 2014, and analysed data from assessments at ages 13, 14, 15 and 16 years. We used the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) subscale to identify hazardous drinking in parents (score ≥5) and children (score ≥3) and constructed mixed-effect logistic regression models, accounting for clustering within school and adjusting for likely confounders. We evaluated the sensitivity of estimates by imputing missing values assuming the data were missing at random vs. missing not at random.

Results

Parent hazardous drinking predicted mid-adolescent hazardous drinking, e.g. 15 years olds whose parents [adjusted odds ratio (aOR) 2.00; 95% confidence interval 1.51–2.64] or parents’ partners (aOR 1.94; 1.48–2.55) were hazardous drinkers had higher odds of being hazardous drinkers at age 16. The magnitude of univariate associations changed little after adjusting for covariates, and sensitivity analyses confirmed the robustness of the association, across a wide range of assumptions about the missing data.

Conclusions

The associations between parents’ and their adolescent children’s hazardous drinking are unlikely to be due to confounding by socio-demographic and family factors. Parents should be encouraged, and supported by public policy, to reduce their own alcohol consumption in order to reduce their children’s risk of becoming hazardous drinkers.
Metabolic role of cGMP in S. cerevisiae: the murine phosphodiesterase-5 activity affects yeast cell proliferation by altering the cAMP/cGMP equilibrium
Authors: Cardarelli Silvia , Giorgi Mauro , Poiana Giancarlo , Biagioni Stefano , Saliola Michele
Published: February 2019

In higher eukaryotes, cAMP and cGMP are signal molecules of major transduction pathways while phosphodiesterases (PDE) are a superfamily of cAMP/cGMP hydrolysing enzymes, modulatory components of these routes. Saccharomyces cerevisiae harbours two genes for PDE: Pde2 is a high affinity cAMP-hydrolysing enzyme, while Pde1 can hydrolyse both cAMP and cGMP. To gain insight into the metabolic role of cGMP in the physiology of yeast, the murine Pde5a1 gene encoding a specific cGMP-hydrolysing enzyme, was expressed in S. cerevisiae pdeΔ strains. pde1Δ and pde2Δ PDE5A1-transformed strain displayed opposite growth-curve profiles; while PDE5A1 recovered the growth delay of pde1Δ, PDE5A1 reversed the growth profile of pde2Δ to that of the untransformed pde1Δ. Growth test analysis and the use of Adh2 and Adh1 as respiro-fermentative glycolytic flux markers confirmed that PDE5A1 altered the metabolism by acting on Pde1-Pde2/cyclic nucleotides content and also on the TORC1 nutrient-sensing cascade. cGMP is required during the log-phase of cell proliferation to adjust/modulate cAMP levels inside well-defined ranges. A model is presented proposing the role of cGMP in the cAMP/PKA pathway. The expression of the PDE5A1 cassette in other mutant strains might constitute the starting tool to define cGMP metabolic role in yeast nutrient signaling.
Trends in Risk of Limitations in Instrumental Activities of Daily Living Over Age in Older Persons With and Without Multiple Chronic Conditions
Authors: Mueller-Schotte Sigrid , Zuithoff Nicolaas P A , Van der Schouw Yvonne T , Schuurmans Marieke J , Bleijenberg Nienke
Published: February 2019

Background

To investigate trends over age by comorbidity status for the risk of limitations in individual activities of daily living for community-living older persons.

Methods

A longitudinal population-based study was conducted in 9,319 community-living Dutch persons aged 60 years and older. Self-reported multiple chronic conditions (MCC) and nine instrumental activities of daily livings (IADLs) were assessed in 15 studies of the Dutch National Care for the Elderly Program (TOPICS-MDS). Risks of limitations in IADLs, odds ratios (per 5 years), and rate ratios (per 5 years) were calculated with mixed logistic and negative binomial regression models with age as the underlying timescale, stratified by number of MCC (no, 1–2, ≥ 3 MCC), and corrected for confounders.

Results

At inclusion, the number of IADL limitations was highest for the “≥3 MCC” group (2.00 interquartile range [1.00–4.00]) and equal for “no MCC” or “1–2 MCC” (1.00 interquartile range [0.00–2.00]). Trends of individual IADLs depicted a higher risk in IADL limitation with increasing age over 2 years of follow-up, except for handling finances for the “no MCC” group. The longitudinal age effect on IADL limitations varied subject to MCC, being strongest for the “no MCC” group for most IADLs; grooming and telephone use were almost unaltered by age and MCC.

Conclusion

We observed a decline in IADL functioning with increasing age over 2 years of follow-up in persons with and without MCC. The impact of MCC on IADL decline varied per IADL activity.
Feasibility Trial Evaluation of a Peer Volunteering Active Aging Intervention: ACE (Active, Connected, Engaged)
Authors: Stathi Afroditi , Withall Janet , Thompson Janice L , Davis Mark G , Gray Selena , De Koning Jolanthe , Parkhurst Graham , Lloyd Liz , Greaves Colin , Laventure Robert , Fox Kenneth R
Published: February 2019

Background

ACE (Active, Connected, Engaged) is a theory-informed, pragmatic intervention using peer volunteering support to promote active ageing in socially disengaged, inactive older adults. This study aimed to establish ACE’s feasibility and acceptability.

Methods

Fifty-four older adults were recruited as either peer volunteers (activators; n = 15) or participants (ACEs; n = 39). Participants were randomized to one-to-one support from an activator (ACEs-Intervention [ACEs-I]) or a waiting-list control group (ACEs-Control [ACEs-C]). Activators supported ACEs-I to get out more and engage with local activities. Objectively measured physical activity (PA), lower limb function, and number of out of house activities were assessed at baseline and post-intervention. A mixed-methods process evaluation assessed changes in confidence to get out and about, social support, autonomy, competence, and relatedness.

Results

Eighty-two percent of ACEs (mean age = 73.7 years [SD 7.3]) and all activators completed assessments at both baseline and post-intervention (6 months). ACEs-I reported more out of house activities (M [SD] = 6.34 [4.15]). ACEs-I increased physical function post-intervention (M [SD] = 9.8 [2.3]). ACEs-I reported improved well-being and vitality and increased confidence to get out and about, confidence in the face of specific barriers, knowledge of local initiatives, and perceived social support post-intervention. Activators, although sufficiently active at baseline, increased their PA further. ACE was well-accepted and easy to deliver.

Conclusions

ACE is an acceptable and feasible intervention for helping socially disengaged older people to get out and about more, improve their confidence, and engage more with their community.
Experiences of Living in the Community for Older Aboriginal Persons With Dementia Symptoms in Taiwan
Authors: Chen Mei-Chen , Huang Hsiu-Li , Chiu Yi-Chen , Yip Ping-Keung , Wu Suh-Mian , Hsu Wen-Chuin , Wang Woan-Shyuan , Huang Yueh-Fang , Shyu Yea-Ing L
Published: February 2019

Background and Objectives

Improving quality of life for community-dwelling older persons with dementia symptoms (PWDS) and family caregivers requires promoting dementia-friendly communities (DFC). However, little is known regarding older Taiwanese Aboriginal PWDS’ experiences of living in the community. We explored these experiences for older Atayal PWDS and their families in Taiwan.

Research Design and Methods

This grounded theory research used in-depth interviews to explore the perspectives of older PWDS (n = 4), their family members (n = 3), and key persons (n = 10) in an Atayal community in northern Taiwan. Data were analyzed using constant comparative analysis. Participants were interviewed between January and May 2015.

Results

Participants’ experiences were captured by the overarching concept of “low dementia awareness, high family-like ambience in the community.” Despite the low/absent community awareness of dementia, older Atayal PWDS functioned as freely in the community as at home due to a family-like supportive environment. Aboriginal PWDS and their families also faced environmental challenges, e.g., environmental constraints and barriers to transportation access.

Discussion and Implications

Our results suggest that this Aboriginal community and culture offer important DFC components, and these strengths could be further studied to enhance DFC models elsewhere. Despite these strengths in supporting PWDS, environmental challenges to transportation access still cause difficulties for PWDS and their families and need improvement. The Atayal community’s low dementia awareness suggests that services introduced must be culturally appropriate and nondisruptive to existing supportive helping systems. Our study can be a model for future studies to understand and identify PWDS’ needs in Indigenous communities.
Modelling decadal secular variation with only magnetic diffusion
Authors: Metman Maurits C , Livermore Philip W , Mound Jonathan E , Beggan Ciarán D
Published: February 2019

Secular variation (SV) of Earth’s internal magnetic field is the sum of two contributions, one resulting from core fluid flow and the other from magnetic diffusion. Based on the millenial diffusive timescale of global-scale structures, magnetic diffusion is widely perceived to be too weak to significantly contribute to decadal SV, and indeed is entirely neglected in the commonly adopted end-member of frozen-flux. Such an argument however lacks consideration of radially fine-scaled magnetic structures in the outermost part of the liquid core, whose diffusive timescale is much shorter. Here we consider the opposite end-member model to frozen flux, that of purely diffusive evolution associated with the total absence of fluid flow. Our work is based on a variational formulation, where we seek an optimized full-sphere initial magnetic field structure whose diffusive evolution best fits, over various time windows, a time-dependent magnetic field model. We present models that are regularized based on their magnetic energy, and consider how well they can fit the COV-OBS.x1 ensemble mean using a global error bound based on the standard deviation of the ensemble. With these regularized models, over time periods of up to 30 yr, it is possible to fit COV-OBS.x1 within one standard deviation at all times. For time windows up to 102 yr we show that our models can fit COV-OBS.x1 when adopting a time-averaged global uncertainty. Our modelling is sensitive only to magnetic structures in approximately the top 10 per cent of the liquid core, and show an increased surface area of reversed flux at depth. The diffusive models recover fundamental characteristics of field evolution including the historical westward drift, the recent acceleration of the North Magnetic Pole and reversed-flux emergence. Based on a global time-averaged residual, our diffusive models fit the evolution of the geomagnetic field comparably, and sometimes better than, frozen-flux models within short time windows.
Transhealth Information Project: A Peer-Led HIV Prevention Intervention to Promote HIV Protection for Individuals of Transgender Experience
Authors: Martinez Omar , Lopez Nikki , Woodard Tatyana , Rodriguez-Madera Sheilla , Icard Larry
Published: February 2019

Individuals of transgender experience (ITE) in the United States face an elevated risk of HIV infection. Several conditions have been attributed to the high HIV incidence and prevalence within this group, including experiences of discrimination, unemployment, incarceration, stigma, and elevated rates of sexual risk and substance use. In response to these needs, the Gay and Lesbian Latino AIDS Education Initiative and Prevention Point Philadelphia, two local community-based organizations in Philadelphia, developed the Transhealth Information Project (TIP). TIP is a peer-led six-session hybrid individual- and group-based intervention emphasizing leadership, social and structural interventions, and HIV risk reduction that incorporates other evidence-based practices for HIV prevention and care. Since 2003, TIP has served over 1,500 ITE and linked them to HIV prevention and care services. TIP has an established record of reaching ITE and linking them to HIV prevention services and HIV primary care. TIP’s utilization speaks to the need for interventions to respond to the complex, interacting syndemic factors that cumulatively determine HIV vulnerability among ITE.
A systematic review and standardized clinical validity assessment of male infertility genes
Authors: Oud Manon S , Volozonoka Ludmila , Smits Roos M , Vissers Lisenka E L M , Ramos Liliana , Veltman Joris A
Published: February 2019

STUDY QUESTION

Which genes are confidently linked to human monogenic male infertility?

SUMMARY ANSWER

Our systematic literature search and clinical validity assessment reveals that a total of 78 genes are currently confidently linked to 92 human male infertility phenotypes.

WHAT IS KNOWN ALREADY

The discovery of novel male infertility genes is rapidly accelerating with the availability of next-generating sequencing methods, but the quality of evidence for gene–disease relationships varies greatly. In order to improve genetic research, diagnostics and counseling, there is a need for an evidence-based overview of the currently known genes.

STUDY DESIGN, SIZE, DURATION

We performed a systematic literature search and evidence assessment for all publications in Pubmed until December 2018 covering genetic causes of male infertility and/or defective male genitourinary development.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Two independent reviewers conducted the literature search and included papers on the monogenic causes of human male infertility and excluded papers on genetic association or risk factors, karyotype anomalies and/or copy number variations affecting multiple genes. Next, the quality and the extent of all evidence supporting selected genes was weighed by a standardized scoring method and used to determine the clinical validity of each gene–disease relationship as expressed by the following six categories: no evidence, limited, moderate, strong, definitive or unable to classify.

MAIN RESULTS AND THE ROLE OF CHANCE

From a total of 23 526 records, we included 1337 publications about monogenic causes of male infertility leading to a list of 521 gene–disease relationships. The clinical validity of these gene–disease relationships varied widely and ranged from definitive (n = 38) to strong (n = 22), moderate (n = 32), limited (n = 93) or no evidence (n = 160). A total of 176 gene–disease relationships could not be classified because our scoring method was not suitable.

LARGE SCALE DATA

Not applicable.

LIMITATIONS, REASONS FOR CAUTION

Our literature search was limited to Pubmed.

WIDER IMPLICATIONS OF THE FINDINGS

The comprehensive overview will aid researchers and clinicians in the field to establish gene lists for diagnostic screening using validated gene–disease criteria and help to identify gaps in our knowledge of male infertility. For future studies, the authors discuss the relevant and important international guidelines regarding research related to gene discovery and provide specific recommendations for the field of male infertility.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by a VICI grant from The Netherlands Organization for Scientific Research (918-15-667 to J.A.V.), the Royal Society, and Wolfson Foundation (WM160091 to J.A.V.) as well as an investigator award in science from the Wellcome Trust (209451 to J.A.V.).

PROSPERO REGISTRATION NUMBER

None.
Bilateral internal thoracic artery versus single internal thoracic artery: a meta-analysis of propensity score-matched observational studies
Authors: Urso Stefano , Nogales Eliú , González Jesús María , Sadaba Rafael , Tena María Ángeles , Bellot Raquel , Ríos Luis , Portela Francisco
Published: February 2019

The lack of benefit in terms of mid-term survival and the increase in the risk of sternal wound complications published in a recent randomized controlled trial have raised concerns about the use of bilateral internal thoracic artery (BITA) in myocardial revascularization surgery. For this reason, we decided to explore the current evidence available on the subject by carrying out a meta-analysis of propensity score-matched studies comparing BITA versus single internal thoracic artery (SITA). PubMed, EMBASE and Google Scholar were searched for propensity score-matched studies comparing BITA versus SITA. The generic inverse variance method was used to compute the combined hazard ratio (HR) of long-term mortality. The DerSimonian and Laird method was used to compute the combined risk ratio of 30-day mortality, deep sternal wound infection and reoperation for bleeding. Forty-five BITA versus SITA matched populations were included. Meta-analysis showed a significant benefit in terms of long-term survival in favour of the BITA group [HR 0.78; 95% confidence interval (CI) 0.71–0.86]. These results were consistent with those obtained by a pooled analysis of the matched populations comprising patients with diabetes (HR 0.65; 95% CI 0.43–0.99). When compared with the use of SITA plus radial artery, BITA did not show any significant benefit in terms of long-term survival (HR 0.86; 95% CI 0.69–1.07). No differences between BITA and SITA groups were detected in terms of 30-day mortality or in terms of reoperation for bleeding. Compared with the SITA group, patients in the BITA group had a significantly higher risk of deep sternal wound infection (risk ratio 1.66; 95% CI 1.41–1.95) even when the pooled analysis was limited to matched populations in which BITA was harvested according to the skeletonization technique (risk ratio 1.37; 95% CI 1.04–1.79). The use of BITA provided a long-term survival benefit compared with the use of SITA at the expense of a higher risk of sternal deep wound infection. The long-term survival advantage of BITA is undetectable when compared with SITA plus radial artery.
Risk of acute respiratory infection from crop burning in India: estimating disease burden and economic welfare from satellite and national health survey data for 250 000 persons
Authors: Chakrabarti Suman , Khan Mohammed Tajuddin , Kishore Avinash , Roy Devesh , Scott Samuel P
Published: February 2019

Background

Respiratory infections are among the leading causes of death and disability globally. Respirable aerosol particles released by agricultural crop-residue burning (ACRB), practised by farmers in all global regions, are potentially harmful to human health. Our objective was to estimate the health and economic costs of ACRB in northern India.

Methods

The primary outcome was acute respiratory infection (ARI) from India’s fourth District Level Health Survey (DLHS-4). DLHS-4 data were merged with Moderate-Resolution Imaging Spectroradiometer satellite data on fire occurrence. Mutually adjusted generalized linear models were used to generate risk ratios for risk factors of ARI. Overall disease burden due to ACRB was estimated in terms of disability-adjusted life years.

Results

Seeking medical treatment for ARI in the previous 2 weeks was reported by 5050 (2%) of 252 539 persons. Living in a district with intense ACRB—the top quintile of fires per day—was associated with a 3-fold higher risk of ARI (mutually adjusted risk ratio 2.99, 95% confidence interval 2.77 to 3.23) after adjustment for socio-demographic and household factors. Children under 5 years of age were particularly susceptible (3.65, 3.06 to 4.34 in this subgroup). Additional ARI risk factors included motor-vehicle congestion (1.96, 1.72 to 2.23), open drainage (1.91, 1.73 to 2.11), cooking with biomass (1.73, 1.58 to 1.90) and living in urban areas (1.35, 1.26 to 1.44). Eliminating ACRB would avert 14.9 million disability-adjusted life years lost per year, valued at US$152.9 billion over 5 years.

Conclusions

Investments to stop crop burning and offer farmers alternative crop-residue disposal solutions are likely to improve population-level respiratory health and yield major economic returns.
Inflammation and hearing status in mid-childhood and mid-life: a population-based cross-sectional study
Authors: Wang Jing , Sung Valerie , Carew Peter , Liu Richard S , Burgner David , Wake Melissa
Published: February 2019

Background

Lifelong inflammation – known to be associated with many non-communicable diseases – has not been thoroughly investigated in hearing. We aimed to determine if glycoprotein A (GlycA), a novel biomarker of chronic inflammation, is associated with hearing acuity in mid-childhood and mid-life.

Methods

Population-based cross-sectional study within the Longitudinal Study of Australian Children with plasma GlycA and audiometry data (1169 children and 1316 parents). We calculated high Fletcher Index (mean threshold across 1, 2 and 4 kHz), defining hearing loss as threshold >15 decibel hearing level (dB HL) (better ear). Linear/logistic regression quantified associations of GlycA with hearing threshold/loss.

Results

Mean [standard deviation (SD)] high Fletcher Indices (dB HL) were 8.0 (5.7) for children and 13.1 (6.9) for adults, with 8.7% and 26.1% respectively showing hearing loss. 1-SD rise in GlycA (children 0.13 mmol/L, adults 0.17 mmol/L) predicted higher hearing thresholds for the lower individual frequencies [1 kHz: children β 0.8, 95% confidence interval (CI) 0.3–1.3; adults β 0.8, 95% CI 0.2–1.4]. This same pattern was evident for the high Fletcher Index (children β 0.7, 95% CI 0.3–1.1; adults β 0.8, 95% CI 0.3–1.4). This translated into 1-SD rise in GlycA predicting adult hearing loss [odds ratio (OR) 1.2, 95% CI 1.0–1.5] with similar but attenuated patterns in children.

Conclusions

GlycA is associated with poorer hearing by mid-childhood. This potentially reframes hearing loss as a life-course condition with inflammatory antecedents common to other non-communicable diseases. Replication and mechanistic studies could inform causal inference and early prevention efforts.
Postwar Kosovo: Global and Local Dimensions of Interethnic Reconciliation Processes
Authors: Ferati-Sachsenmaier Flora
Published: February 2019

Abstract∞

This article examines how Kosovo’s postwar struggle for statehood intersected with interethnic reconciliation processes from 1999 to 2008. It argues that, among other factors, it was the ensuing governance in postwar Kosovo that made it difficult, if not impossible, for any kind of meaningful interethnic reconciliation to take place. Drawing on primary sources and personal interviews, the article focuses on groups that can be called ‘reconciliation agents’ and that were among the main actors dealing with the legacy of the Kosovo war. They were typically multiethnic actors, both in terms of their staff members and their declared agendas, and they were exceptionally creative and courageous in their efforts to promote interethnic reconciliation. They were, however, not seen as postconflict forces by much of the population and were often perceived as agents continuing the conflict over the status of Kosovo by other means. The same was true for their international donors and other relevant international governmental actors that were supporting interethnic reconciliation activities.
Like Dust before the Wind, or, the Winds of Change? The Influence of International Criminal Tribunals on Narratives and Media Frames
Authors: Bachmann Klaus , Kemp Gerhard , Ristić Irena , Mihajlović Trbovc Jovana , Ljubojević Ana , Nędzi-Marek Aleksandra , Bayisenge Fortunee , Ahmet Mohammed Ali Mohammed , Krasniqi Vjollca
Published: February 2019

Abstract∞

When created, international criminal tribunals (ICTs) were not only expected to do justice but also to provide stabilization to postconflict regions, contribute to reconciliation and curb the potential denial of atrocities. Based on media content analysis, this article examines whether controversial ICT decisions triggered changes in narratives or frames about the conflicts which formed the background of the respective ICT decisions. There is no evidence for dramatic changes in the preexisting narratives about these conflicts, but we found some cases in which tribunal decisions caused changes in media frames and in elements of such frames, mostly by emphasizing outgroup victimhood and individual responsibility of ingroup perpetrators, as well as triggering effects of collective guilt externalization. Although frame changes were often observed in both democratic and nondemocratic countries, only in democratic countries with pluralist and competitive media systems could they be attributed to tribunal decisions.
Adaptive restart of accelerated gradient methods under local quadratic growth condition
Authors: Fercoq Olivier , Qu Zheng
Published: February 2019

By analyzing accelerated proximal gradient methods under a local quadratic growth condition, we show that restarting these algorithms at any frequency gives a globally linearly convergent algorithm. This result was previously known only for long enough frequencies. Then as the rate of convergence depends on the match between the frequency and the quadratic error bound, we design a scheme to automatically adapt the frequency of restart from the observed decrease of the norm of the gradient mapping. Our algorithm has a better theoretical bound than previously proposed methods for the adaptation to the quadratic error bound of the objective. We illustrate the efficiency of the algorithm on Lasso, regularized logistic regression and total variation denoising problems.
Prevention of opportunistic non-communicable diseases
Authors: Hegelund Maria H , Faurholt-Jepsen Daniel , Bygbjerg Ib C
Published: February 2019

As strategies targeting undernutrition and infections become increasingly successful in low- and middle-income countries (LMICs), a second challenge has appeared, namely premature onset of non-communicable diseases (NCDs). In LMICs, NCDs are often related to exposure to undernutrition and infections. As NCDs strike societies and individuals with impaired resistance or a deficient health (care) state, why not label such diseases ‘opportunistic’, in analogy with opportunistic infections attacking individuals with HIV? We propose the concept of opportunistic NCDs, hoping that fighting against infections, and for better maternal and child health, is becoming acknowledged as essential for the early prevention of NCDs.
Association between HIV knowledge and stigmatizing attitudes towards people living with HIV in Afghanistan: findings from the 2015 Afghanistan Demographic and Health Survey
Authors: Alemi Qais , Stempel Carl
Published: February 2019

Background

Afghanistan has witnessed a dramatic increase in HIV infections. Public health officials have responded with campaigns to educate the public about HIV prevention and transmission. We examine the association between HIV prevention and transmission knowledge and stigma towards people living with HIV (PLHIV) in Afghanistan.

Methods

We conducted a secondary analysis of cross-sectional data (n=11 930) from the 2015 Afghanistan Demographic and Health Survey. Hierarchical linear regression analysis was used to examine the effects of accurate HIV knowledge related to safer sex and local misconceptions about the virus’s transmission (e.g. mosquitos and witchcraft) on two stigma outcomes, namely, stigma towards public others with HIV (teachers and food vendors) and stigma towards close family members with HIV.

Results

Stigmatizing attitudes were highly prevalent and HIV knowledge varied widely. Multivariate analyses show that correct knowledge related to local misconceptions about HIV prevention and transmission is significantly associated with lower stigma towards public others (ΔR2adjusted=0.07); however, knowledge had little and contradictory influence in the model predicting stigma towards close family members with HIV (ΔR2adjusted=0.005).

Conclusions

These findings suggest that it would be worthwhile designing interventions that dispel local misconceptions about HIV. This may be helpful in reducing stigma towards PLHIV in public positions but not towards family members, which calls for alternative strategies for reducing HIV-related stigma.