We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Telomere length is a biomarker of ageing(1). A shorter telomere length is associated with an increased risk of age-related diseases and mortality. Oxidative stress and inflammation are predominant mechanisms leading to telomere shortening(2). Diets and food groups high in antioxidant and anti-inflammatory properties are shown to be protective against telomere shortening(3). The nut and seed food group is rich in nutrients such as unsaturated fats, vitamins, and minerals, and contains antioxidants and anti-inflammatory phytochemicals. Evidence is emerging on the beneficial effects of nuts and seeds in the prevention and management of age-related chronic conditions. This review aims to evaluate the role of nut and seed intake on telomere length in humans using the evidence from observational and interventional studies. Four databases, including Medline, CINAHL, Embase and Web of Science, were systematically searched from inception to 12 March 2024 for observational and interventional studies assessing the intake of nut or seed or applied nut or seed interventions and measured telomere length as an outcome in adult human participants (age ≥ 18 years). The quality assessment of the included studies was performed using the Academy of Nutrition and Dietetics Evidence Analysis Library® November 2022: Quality Criteria Checklist. Nine observational and four interventional studies were included. A positive association between nut and seed intake and telomere length was reported in three of the nine observational studies. None of the interventional studies reported a significant positive effect of nuts on telomere length. Three of the observational and interventional studies were classified as high quality, and the remaining studies were of neutral quality. Meta-analysis was not warranted due to the high heterogeneity in the telomere length measurements across the studies. The findings are inconsistent across these studies, and the evidence is insufficient to establish a beneficial role of nut and seed intake on telomere length. Larger epidemiological studies and adequately powered long-term randomised controlled trials are needed to establish the positive role of nut and seed on telomere length. However, nut and seed should continue to be recommended as a part of a healthy diet, given their proven benefits against age-related conditions.
This study explored patient involvement in healthcare decision-making in the Asia Pacific region (APAC) by identifying roles and factors influencing differences between healthcare systems. Proposed recommendations to enhance patient engagement were made.
Methods
This systematic literature review was conducted using studies from Australia, China, Japan, Malaysia, New Zealand, the Philippines, South Korea, Singapore, Taiwan, and Thailand. Studies were included if they provided data on patient involvement in health technology assessment (HTA) and/or funding decisions for medicines. Extracted data were scored according to eleven parameters adapted from the National Health Council (NHC) rubric, which assessed the level of patient involvement in healthcare system decision-making.
Results
We identified 159 records between 2018 and 2022, including methodology guidelines from Government websites. Most mentioned parameters were patient partnership, patient-reported outcome, and mechanism to incorporate patient input. Limited information was available on diversity and patient-centered data sources. Tools for collecting patient experience included quality-of-life questionnaires, focus groups, interviews, and surveys, with feedback options like structured templates, videos, and public sessions.
Beyond input in assessment process, involvement of patients in decision-making phase has evolved within HTA bodies over time with considerable variation. Few APAC healthcare systems involve patients in the appraisal process as members of the recommendation or decision-making committee.
Conclusions
The findings indicate that while patient involvement in pharmaceutical reimbursement decisions exists, improvements are needed. Effective integration of patient input requires transparency, education, and resource planning. This study establishes a baseline to track progress and assess the long-term impact of patient involvement.
This paper reports an expansion of the English as a second language (L2) component of the Multilingual Eye Movement Corpus (MECO L2), an international database of eye movements during text reading. While the previous Wave 1 of the MECO project (Kuperman et al., 2023) contained English as a L2 reading data from readers with 12 different first language (L1) backgrounds, the newly collected dataset adds eye-tracking data on English text reading from 13 distinct L1 backgrounds (N = 660) as well as participants’ scores on component skills of English proficiency and information about their demographics and language background and use. The paper reports reliability estimates, descriptive statistics, and correlational analyses as means to validate the expansion dataset. Consistent with prior literature and the MECO Wave 1, trends in the MECO Wave 2 data include a weak correlation between reading comprehension and oculomotor measures of reading fluency and a greater L1-L2 contrast in reading fluency than reading comprehension. Jointly with Wave 1, the MECO project includes English reading data from more than 1,200 readers representing a diversity of native writing systems (logographic, abjad, abugida, and alphabetic) and 19 distinct L1 backgrounds. We provide multiple pointers to new venues of how L2 reading researchers can mine this rich publicly available dataset.
We examined the efficacy of cognitive and behavioral interventions for improving symptoms of depression and anxiety in adults with neurological disorders. A pre-registered systematic search of Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, Embase, and Neurobite was performed from inception to May 2024. Randomized controlled trials (RCTs) which examined the efficacy of cognitive and behavioral interventions in treating depression and/or anxiety among adults with neurological disorders were included. Estimates were pooled using a random-effects meta-analysis. Subgroup analyses and meta-regression were performed on categorical and continuous moderators, respectively. Main outcomes were pre- and post-intervention depression and anxiety symptom scores, as reported using standardized measures. Fifty-four RCTs involving 5372 participants with 11 neurological disorders (including multiple sclerosis, epilepsy, stroke) were included. The overall effect of interventions yielded significant improvements in both depression (57 arms, Hedges' g = 0.45, 95% confidence interval [CI] 0.35–0.54) and anxiety symptoms (29 arms, g = 0.38, 95% CI 0.29–0.48), compared to controls. Efficacy was greater in studies which employed a minimum baseline symptom severity inclusion criterion for both outcomes, and greater in trials using inactive controls for depression only. There was also evidence of differential efficacy of interventions across the neurological disorder types and the outcome measure used. Risk of bias, intervention delivery mode, intervention tailoring for neurological disorders, sample size, and study year did not moderate effects. Cognitive and behavioral interventions yield small-to-moderate improvements in symptoms of both depression and anxiety in adults with a range of neurological disorders.
Depression is an independent risk factor for cardiovascular disease (CVD), but it is unknown if successful depression treatment reduces CVD risk.
Methods
Using eIMPACT trial data, we examined the effect of modernized collaborative care for depression on indicators of CVD risk. A total of 216 primary care patients with depression and elevated CVD risk were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed over 12 months. Incident CVD events were tracked over four years using a statewide health information exchange.
Results
The intervention group exhibited greater improvement in depressive symptoms (p < 0.01) and sleep quality (p < 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (p = 0.36), low-density lipoprotein cholesterol (p = 0.38), high-density lipoprotein cholesterol (p = 0.79), triglycerides (p = 0.76), CVD prevention medication adherence (p = 0.64), or sedentary behavior (p = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (p = 0.02). The likelihood of an incident CVD event did not differ between the intervention (13/107, 12.1%) and usual care (9/109, 8.3%) groups (p = 0.39).
Conclusions
Successful depression treatment alone is not sufficient to lower the heightened CVD risk of people with depression. Alternative approaches are needed.
A novel excretory–secretory (ES) protein of Trichinella pseudospiralis was produced. A cDNA library was constructed from mRNA of muscle larvae at 30 days post infection (p.i.) and immunoscreened with the antibody against ES products. A clone, designated Tp22-3, contained a cDNA transcript of 815 bp in length with a single open reading frame which encoded 244-amino acids (28407 Da in the estimated molecular mass). A database search revealed that no sequences had a homology to this predicted protein. The recombinant protein was produced in an Escherichia coli expression system. Stage specific expression of this protein was suggested from the following experiments. An antibody against the recombinant protein could stain proteins migrating at about 28 kDa (which is the expected size from the sequence) on Western blotting of crude extracts or ES products from 30 days p.i. muscle larvae, but failed to stain any proteins in crude extracts from newborn larvae or 15 days p.i. muscle larvae. The antibody reacted to the stichocytes of larvae at 30 days p.i., but did not react to 15 days p.i. muscle larvae. The production of an mRNA transcript for Tp22-3 gene was restricted largely to the 30 days p.i. muscle larvae and adult worms.
Recombinant protein was produced from the cDNA library of Trichinella pseudospiralis, which seemed to form part of the excretory–secretory (ES) products. The library was constructed from cDNA of muscle larvae at 1 month post-infection, and immunoscreened with antibody against T. pseudospiralis ES products. A clone, designated Tp21-3, contained a cDNA transcript of 657 bp in length with a single open reading frame, which encoded 172 amino acids (19617 Da in the estimated molecular mass). The predicted amino acid sequence of clone Tp21-3 had a similarity of 76% to that of clone ORF 17.20 (GenBank under accession number U88239) from T. spiralis. The recombinant fusion proteins encoded by clone Tp21-3 were produced in an Escherichia coli expression system and affinity purified. On Western blotting analysis, Tp21-3 recombinant proteins migrated at 40 kDa and reacted to antibody against T. pseudospiralis ES products and T. pseudospiralis-infected sera. Sera were developed against Tp 21-3 recombinant proteins, which reacted to a single band migrating at 21 kDa in crude worm extract and ES products from T. pseudospiralis on Western blotting analysis, and reacted with stichocytes of T. pseudospiralis on immunohistochemical staining.
The nurse cell in the cyst of Trichinella spiralis comprises at least two kinds of cytoplasm, derived from muscle or satellite cells, as indicated by the pattern of staining using regular dye (haematoxylin and eosin, or toluidine blue), alkaline phosphatase (ALP) expression, acid phosphatase (ACP) expression and immunostaining with an anti-intermediate filament protein (desmin or keratin). Muscle cells undergo basophilic changes following a T. spiralis infection and transform to the nurse cells, accompanied by an increase in ACP activity and the disappearance of desmin. Satellite cells are activated, transformed and joined to the nurse cells but remain eosinophilic. The eosinophilic cytoplasm is accompanied by an increase in desmin and ALP expression but not an increase in ACP activity. Differences in the staining results for ALP or ACP suggest that the two kinds of cytoplasm have different functions. Trichinella pseudospiralis infection results in an increase of ACP activity at a later stage than T. spiralis. There is also a difference in the location pattern of ACP in the cyst of T. spiralis compared with T. pseudospiralis. In T. spiralis, ACP is diffused within the cell, but in T. pseudospiralis, ACP distribution is spotty corresponding to the location of the nucleus. Trichinella pseudospiralis infection is accompanied by a slight increase in ALP activity. Activated satellite cells following a T. pseudospiralis infection exhibit an increase in desmin expression. The present study therefore reveals that nurse cell cytoplasm differs between the two Trichinella species and between the two origins of cytoplasm in the cyst of T. spiralis.
A clone, designated as TsTM, was selected from the cDNA library of newborn larvae (NBL) of Trichinella spiralis through immunoscreening against infected sera. The clone contained a cDNA transcript of 855 bp in length with a single open reading frame, which encoded 285-amino acids (33 kDa in the estimated molecular weight). A sequence analysis revealed that the clone TsTM encoded the full-length of tropomyosin gene. The phylogenetic analysis of the tropomyosin gene was in good agreement with the classical taxonomical position of T. spiralis. The fusion proteins encoded by the clone TsTM were produced in an Escherichia coli expression system and affinity purified, and the antibody was raised against the protein for the following studies. The antibody against the fusion protein positively bound to the hypodermal muscle layer in immunolocalization analysis, and the 35 kDa band in crude extracts of muscle larvae but not in excretory and secretory (ES) products on Western blots. The antigenicity of the clone TsTM was recognized by host mice but exhibited little species specificity.
Heart rate variability (HRV) can be an indicator of the flexibility of the central and autonomic nervous systems. Heart rate variability biofeedback (HRV-BF) has been shown to validate the neuro-peripheral relationship and enhance the interaction between top-down and bottom-up processes. Few previous studies have focused on the treatment outcomes of HRV-BF in traumatic brain injury, and such studies have been mostly limited to pilot studies or case reports. The purpose of this study is to investigate the efficacy of HRV-BF for neuropsychological functioning in patients with mild traumatic brain injury (mTBI).
Participants and Methods:
Forty-one patients with mTBI were referred from the neurosurgery outpatient program and randomly assigned to a psychoeducation group or a HRV-BF intervention group. The psychoeducation group received standard medical care and one 60-minute psychoeducation session after brain injury. The HRV-BF group received standard medical care and one 60-minute session of the HRV-BF intervention weekly for 10 weeks. All participants received performance-based and self-reported neuropsychological measures of memory, executive function, mood, and information processing at week 1 of injury (pretest) and week 12 (posttest).
Results:
Participants in HRV-BF improved significantly after the intervention compared with the psychoeducation group on the Verbal Learning Test, Frontal Assessment Battery, Verbal Fluency Test, Paced Auditory Serial Addition Test, Trail Making Test, Dysexecutive Questionnaire, Depression Inventory, and Checklist of Post-concussion Symptoms.
Conclusions:
HRV-BF was found to be an efficacious and efficient intervention for improving neuropsychological functioning in patients with mTBI and a potential candidate for mTBI rehabilitation.
The importance of patient centricity in healthcare decision making has been recognized and advocated for decades. However, approaches for including the patient perspective are diverse, and progress varies among countries. Some reimbursement bodies acknowledge the importance of patient preferences in health technology assessment (HTA) and funding decision processes. However, patients’ perspectives are not yet systematically and transparently included in value assessment frameworks globally, and even less so in the Asia-Pacific (APAC) region. This systematic review aimed to investigate how patients’ perspectives are used to inform pricing and reimbursement decisions in the APAC region.
Methods
A systematic review is ongoing that utilized a search of 12 databases, including MEDLINE and Embase, to identify publications on the consideration of patient perspectives in health policy decision-making published to November 2022. Conference abstracts published in the last five years from ISPOR and Health Technology Assessment International (HTAi) were screened, along with gray literature and government websites from Australia, China, Japan, Malaysia, New Zealand, the Philippines, Singapore, South Korea, Taiwan, and Thailand. Publications were included if the impact of either one or more of the following on HTA decision-making was assessed: active participation of patients or patient advocacy groups; type, extent, and evolution of patient-reported outcomes; health-related quality of life or quality of life tools; and themes where the impact of patients’ perspectives on value assessment was the primary outcome. Countries were characterized into archetypes based on similarities or differences in the weight and value assigned to patient perspectives in decision-making.
Results
A total of 6,438 retrieved citations will undergo the systematic review process. Additionally, 758 conference abstracts from ISPOR, 1,312 from HTAi conferences and 73 records from gray literature will be screened.
The results of the systematic review will be consolidated into country archetypes, examples, and learnings. Gaps and opportunities will also be identified.
Conclusions
The research will provide recommendations to increase shared decision-making and support the development of decision-making frameworks that systematically incorporate patients’ perspectives in value assessment across APAC countries.
Knowledge graphs have become a common approach for knowledge representation. Yet, the application of graph methodology is elusive due to the sheer number and complexity of knowledge sources. In addition, semantic incompatibilities hinder efforts to harmonize and integrate across these diverse sources. As part of The Biomedical Translator Consortium, we have developed a knowledge graph–based question-answering system designed to augment human reasoning and accelerate translational scientific discovery: the Translator system. We have applied the Translator system to answer biomedical questions in the context of a broad array of diseases and syndromes, including Fanconi anemia, primary ciliary dyskinesia, multiple sclerosis, and others. A variety of collaborative approaches have been used to research and develop the Translator system. One recent approach involved the establishment of a monthly “Question-of-the-Month (QotM) Challenge” series. Herein, we describe the structure of the QotM Challenge; the six challenges that have been conducted to date on drug-induced liver injury, cannabidiol toxicity, coronavirus infection, diabetes, psoriatic arthritis, and ATP1A3-related phenotypes; the scientific insights that have been gleaned during the challenges; and the technical issues that were identified over the course of the challenges and that can now be addressed to foster further development of the prototype Translator system. We close with a discussion on Large Language Models such as ChatGPT and highlight differences between those models and the Translator system.
We aimed to investigate child mortality, perinatal morbidities and congenital anomalies born by women with substance misuse during or before pregnancy (DP or BP).
Methods
Taiwan Birth Registration from 2004 to 2014 linking Integrated Illicit Drug Databases used to include substance misuse participates. Children born by mothers convicted of substance misuse DP or BP were the substance-exposed cohort. Two substance-unexposed comparison cohorts were established: one comparison cohort selected newborns from the rest of the population on a ratio of 1:1 and exact matched by the child’s gender, child’s birth year, mother’s birth year and child’s first use of the health insurance card; another comparison cohort matched newborns from exposed and unexposed mothers by their propensity scores calculated from logistic regression.
Results
The exposure group included 1776 DP, 1776 BP and 3552 unexposed individuals in exact-matched cohorts. A fourfold increased risk of deaths in children born by mothers exposed to substance during pregnancy was found compared to unexposed group (hazard ratio [HR] = 4.54, 95% confidence interval (CI): 2.07–9.97]. Further multivariate Cox regression models with adjustments and propensity matching substantially attenuated HRs on mortality in the substance-exposed cohort (aHR = 1.62, 95% CI: 1.10–2.39). Raised risks of perinatal morbidities and congenital anomalies were also found.
Conclusions
Increased risks of child mortality, perinatal morbidities or congenital anomalies were found in women with substance use during pregnancy. From estimates before and after adjustments, our results showed that having outpatient visits or medical utilizations during pregnancy were associated with substantially attenuated HRs on mortality in the substance-exposed cohort. Therefore, the excess mortality risk might be partially explained by the lack of relevant antenatal clinical care. Our finding may suggest that the importance of early identification, specific abstinence program and access to appropriate antenatal care might be helpful in reducing newborn mortality. Adequate prevention policies may be formulated.
With the dangerous and troublesome nature of hollow defects inside building structures, hollowness inspection has always been a challenge in the field of construction quality assessment. Several methods have been proposed for inspecting hollowness inside concrete structures. These methods have shown great advantages compared to manual inspection but still lack autonomy and have several limitations. In this paper, we propose a range-point migration-based non-contact hollowness inspection system with sensor fusion of ultra-wide-band radar and laser-based depth camera to extract both outer surface and inner hollowness information accurately and efficiently. The simulation result evaluates the performance of the system based on the original range-point migration algorithm, and our proposed one and the result of our system show great competitiveness. Several simulation experiments of structures that are very common in reality are carried out to draw more convincing conclusions about the system. At the same time, a set of laboratory-made concrete components were used as experimental objects for the robotic system. Although still accompanied by some problems, these experiments demonstrate the availability of an automated hollow-core detection system.
Background: Although seizures are a well-recognized phenomena in patients with multiple sclerosis (MS) with many observational studies reporting its prevalence and incidence, the relative risk of seizures or epilepsy in adults with MS compared to those without is not well-described. Methods: We systematically searched MEDLINE and Embase, from their inception to January 1, 2022, using keywords and database-specific terms. We included observational studies that reported risk of seizures or epilepsy in adults with MS and that in a comparison group, consisting of people without MS or the general population. We used a random-effects meta-analysis to report a pooled adjusted risk ratio (RR) of seizures in adults with MS compared to the comparison group. Results: We screened 8,750 articles and included 17 studies, totaling over 192,850 adults with MS of which 6064 (3.1%) had seizures. Compared to a comparison group, the pooled adjusted RR of seizures in adults with MS was 2.86 (95% CI, 2.35-3.47, I2 = 95.8%). Conclusions: MS should be considered an independent risk factor for seizures or epilepsy. Further research should help identify patients with MS who are at risk of seizures, to improve screening and treatment and in turn reduce the burden of epilepsy in this population.
To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status.
Design:
An incident cohort study design.
Setting:
Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan.
Participants:
A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years.
Measurements:
Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms.
Results:
One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status.
Conclusions:
Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.
The FNDC5 gene encodes the fibronectin type III domain-containing protein 5 that is a membrane protein mainly expressed in skeletal muscle, and the FNDC5 rs3480 polymorphism may be associated with liver disease severity in non-alcoholic fatty liver disease (NAFLD). We investigated the influence of the FNDC5 rs3480 polymorphism on the relationship between sarcopenia and the histological severity of NAFLD. A total of 370 adult individuals with biopsy-proven NAFLD were studied. The association between the key exposure sarcopenia and the outcome liver histological severity was investigated by binary logistic regression. Stratified analyses were undertaken to examine the impact of FNDC5 rs3480 polymorphism on the association between sarcopenia and the severity of NAFLD histology. Patients with sarcopenia had more severe histological grades of steatosis and a higher prevalence of significant fibrosis and definite non-alcoholic steatohepatitis than those without sarcopenia. There was a significant association between sarcopenia and significant fibrosis (adjusted OR 2·79, 95 % CI 1·31, 5·95, P = 0·008), independent of established risk factors and potential confounders. Among patients with sarcopenia, significant fibrosis occurred more frequently in the rs3480 AA genotype carriers than in those carrying the FNDC5 rs3480 G genotype (43·8 v. 17·2 %, P = 0·031). In the association between sarcopenia and liver fibrosis, there was a significant interaction between the FNDC5 genotype and sarcopenia status (P value for interaction = 0·006). Sarcopenia is independently associated with significant liver fibrosis, and the FNDC5 rs3480 G variant influences the association between sarcopenia and liver fibrosis in patients with biopsy-proven NAFLD.
Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.