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There are few economic evaluations of adjunctive psychosocial therapies for bipolar disorder.
Aims
Estimate the cost–utility of in-person psychosocial therapies for adults with bipolar disorder added to treatment as usual (TAU), from an Australian Government perspective.
Method
We developed an economic model, estimating costs in 2021 Australian dollars (A$) and outcomes using quality-adjusted life-years (QALYs) gained and disability-adjusted life-years (DALYs) averted. The model compared psychoeducation, brief psychoeducation, carer psychoeducation, cognitive–behavioural therapy (CBT) and family therapy when added to TAU (i.e. pharmacotherapy) over a year for adults (18–65 years) with bipolar disorder. The relative risk of relapse was sourced from two network meta-analyses and applied to the depressive phase in the base case. Probabilistic sensitivity analysis and one-way sensitivity analyses were conducted, assessing robustness of results.
Results
Carer psychoeducation was preferred in the base case when the willingness-to-pay (WTP) threshold is below A$1000 per QALY gained and A$1500 per DALY averted. Brief psychoeducation was preferred when WTP is between A$1000 and A$300 000 per QALY gained and A$1500 and A$450 000 per DALY averted. Family therapy was only preferred at WTP thresholds above A$300 000 per QALY gained or A$450 000 per DALY averted. In sensitivity analyses, brief psychoeducation was the preferred therapy. Psychoeducation and CBT were dominated (more costly and less effective) in base-case and sensitivity analyses.
Conclusions
Carer and brief psychoeducation were found to be the most cost-effective psychosocial therapies, supporting use as adjunctive treatments for adults with bipolar disorder and their families in Australia.
Previous studies have reported comorbidities of autoimmune thyroid disorders (AITD), including Hashimoto’s disease (HT) and Graves’ disease (GD), and celiac disease (CeD), as well as the possible beneficial effects of a gluten-free diet (GFD) on AITD. Nonetheless, it remains uncertain whether there is a genetic causal relationship between AITD and CeD, while the beneficial effects on a GFD are controversial. This study aim to explore the causal relationship between CeD and AITD, particularly with HT, and to determine whether a GFD is beneficial for AITD. We performed a two-sample Mendelian Randomization (MR) analysis on data from the largest meta-analysis summary statistics of AITD, CeD and GFD. Genetic instrumental variables were established by pinpointing single nucleotide polymorphisms (SNPs) that relate to corresponding factors. In assessing sensitivity and heterogeneity, we conducted examinations of MR Egger, weighted median, simple mode, weighted mode, and MR Egger intercept tests. HT was found to play a pathogenic role in increasing the risk of CeD (ORIVW = 1.544 [95%CI 1.153-2.068], p = 0.00355), and our Mendelian randomization study does not support genetic liability related to CeD with GD (Graves’ disease) and GFD with AITD. This study supports the positive correlation between HT risk and CeD risk, while GFD has no protective effect on AITD and may exert its effect through other mechanisms. These findings provide valuable insights into potential targets for disease intervention and treatment at the genetic level.
The diverse implant landscape, the rising and disparate costs of implants in public healthcare institutions (PHIs), and the limited application of health technology assessment (HTA) impede fair and sustainable implant subsidies in Singapore. This study described the Agency for Care Effectiveness (ACE) Implant Subsidy List (ISL) methodology and the key enablers for supporting government subsidy of clinically effective and cost-effective implants in Singapore.
Methods
A multi-tiered implant grouping scheme on the ISL was established by adapting overseas implant classifications, consulting clinicians, and conducting HTA evaluations, with subsidy extensions at the product group tier. Implants within a product group share similar biomechanical actions and patient outcomes and are subject to the same clinical criteria and pricing requirement. Implants on the ISL must be approved by the regulatory authority. Patients who meet the clinical criteria for ISL implants are eligible for subsidy. ACE conducted value-based pricing (VBP) and partnered with the public healthcare supply chain agency to harmonize PHI implant prices. The ISL is updated three times per year.
Results
Implants listed on the ISL were deemed clinically and cost effective. Underpinned by HTA principles, the implant grouping scheme promoted parsimonious classification, while allowing the creation of new product groups for implants offering superior benefits for patients. Reasonable prices set for the product groups aided affordability and cost sustainability. The ISL clinical criteria and standardized implant identifiers encouraged the appropriate use of subsidized implants and facilitated implementation. By ISL implementation in December 2023, ACE assessed 42,165 implants and listed 22,689 ISL implants spanning 143 product groups. Industry can apply for ISL listing three times per year, which keeps the ISL updated and relevant.
Conclusions
The ISL adopts a fit-for-purpose methodology to standardize implant classifications, enable scalable application of HTA, drive appropriate use of subsidized implants, and bring cost sustainability to the government subsidy of implants in Singapore. A strategic partnership with the public healthcare supply chain agency to concurrently establish national procurement contracts reduced disparate implant prices in PHIs and provided greater leverage for better implant prices.
This study is dedicated to achieving efficient active noise control in a supersonic underexpanded planar jet, utilizing control parameters informed by resolvent analysis. The baseline supersonic underexpanded jet exhibits complex wave structures and substantial high-amplitude noise radiations. To perform the active control, unsteady blowing and suction are applied along the nozzle inner wall close to the exit. Employing both standard and acoustic resolvent analyses, a suitable frequency and spanwise wavenumber range for the blowing and suction is identified. Within this range, the control forcing can be significantly amplified in the near field, effectively altering the original sound-producing energetic structure while minimizing far-field amplification to prevent excessive noise. A series of large-eddy simulations are further conducted to validate the control efficiency, demonstrating an over 10 dB reduction in upstream-propagated screech noise. It is identified that the present unsteady control proves more effective than steady control at the same momentum coefficient. The controlled jet flow indicates that the shock structures become more stable, and the stronger the streamwise amplification of the forcing, the more likely it is to modify the mean flow characteristics, which is beneficial for reducing far-field noise radiation. Spectral proper orthogonal decomposition analysis of the controlled flow confirms that the control redistributes energy to higher forcing frequencies and suppresses large-scale antisymmetric and symmetric modes related to screech and its harmonics. The findings of this study highlight the potential of resolvent-guided control techniques in reducing noise in supersonic underexpanded jets and provide a detailed understanding of the inherent mechanisms for effective noise reduction through active control strategies.
This study aimed to understand the potassium voltage-gated channel KQT-like subfamily, member 1 gene polymorphism in a rural elderly population in a county in Guangxi and to explore the possible relationship between its gene polymorphism and blood sugar. The 6 SNP loci of blood DNA samples from 4355 individuals were typed using the imLDRTM Multiple SNP Typing Kit from Shanghai Tianhao Biotechnology Co. The data combining epidemiological information (baseline questionnaire and physical examination results) and genotyping results were statistically analyzed using GMDR0.9 software and SPSS22.0 software. A total of 4355 elderly people aged 60 years and above were surveyed in this survey, and the total abnormal rate of glucose metabolism was 16·11 % (699/4355). Among them, male:female ratio was 1:1·48; the age group of 60–69 years old accounted for the highest proportion, with 2337 people, accounting for 53·66 % (2337/4355). The results of multivariate analysis showed that usually not doing farm work (OR 1·26; 95 % CI 1·06, 1·50), TAG ≥ 1·70 mmol/l (OR 1·19; 95 % CI 1·11, 1·27), hyperuricaemia (OR 1·034; 95 % CI 1·01, 1·66) and BMI ≥ 24 kg/m2 (OR 1·06; 95 % CI 1·03, 1·09) may be risk factors for abnormal glucose metabolism. Among all participants, rs151290 locus AA genotype, A allele carriers (AA+AC) were 0.70 times more likely (0.54 to 0.91) and 0.82 times more likely (0.70 to 0.97) to develop abnormal glucose metabolism than CC genotype carriers, respectively. Carriers of the T allele at the rs2237892 locus (CT+TT) were 0.85 times more likely to have abnormal glucose metabolism than carriers of the CC genotype (0.72 to 0.99); rs2237897 locus CT gene. The possibility of abnormal glucose metabolism in the carriers of CC genotype, TT genotype and T allele (CT + TT) is 0·79 times (0·67–0·94), 0·74 times (0·55–0·99) and 0·78 times (0·66, 0·92). The results of multifactor dimensionality reduction showed that the optimal interaction model was a three-factor model consisting of farm work, TAG and rs2237897. The best model dendrogram found that the interaction between TAG and rs2237897 had the strongest effect on fasting blood glucose in the elderly in rural areas, and they were mutually antagonistic. Environment–gene interaction is an important factor affecting abnormal glucose metabolism in the elderly of a county in Hechi City, Guangxi.
Characterised by the extensive use of obsidian, a blade-based tool inventory and microblade technology, the late Upper Palaeolithic lithic assemblages of the Changbaishan Mountains are associated with the increasingly cold climatic conditions of Marine Isotope Stage 2, yet most remain poorly dated. Here, the authors present new radiocarbon dates associated with evolving blade and microblade toolkits at Helong Dadong, north-east China. At 27 300–24 100 BP, the lower cultural layers contain some of the earliest microblade technology in north-east Asia and highlight the importance of the Changbaishan Mountains in understanding changing hunter-gatherer lifeways in this region during MIS 2.
Major depressive disorder (MDD) has been increasingly understood as a disruption of brain connectome. Investigating grey matter structural networks with a large sample size can provide valuable insights into the structural basis of network-level neuropathological underpinnings of MDD.
Aims
Using a multisite MRI data-set including nearly 2000 individuals, this study aimed to identify robust topology and connectivity abnormalities of grey matter structural network linked to MDD and relevant clinical phenotypes.
Method
A total of 955 MDD patients and 1009 healthy controls were included from 23 sites. Individualised structural covariance networks (SCN) were established based on grey matter volume maps. Following data harmonisation, network topological metrics and focal connectivity were examined for group-level comparisons, individual-level classification performance and association with clinical ratings. Various validation strategies were applied to confirm the reliability of findings.
Results
Compared with healthy controls, MDD individuals exhibited increased global efficiency, abnormal regional centralities (i.e. thalamus, precentral gyrus, middle cingulate cortex and default mode network) and altered circuit connectivity (i.e. ventral attention network and frontoparietal network). First-episode drug-naive and recurrent patients exhibited different patterns of deficits in network topology and connectivity. In addition, the individual-level classification of topological metrics outperforms that of structural connectivity. The thalamus-insula connectivity was positively associated with the severity of depressive symptoms.
Conclusions
Based on this high-powered data-set, we identified reliable patterns of impaired topology and connectivity of individualised SCN in MDD and relevant subtypes, which adds to the current understanding of neuropathology of MDD and might guide future development of diagnostic and therapeutic markers.
Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear.
Aims
This review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use.
Method
Literature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist.
Results
Eleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost–benefit studies reported cost-savings. One cost-effectiveness and two cost–utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds.
Conclusions
There are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics (‘the Network System to Prevent Doctor-Shopping for Narcotics’) show promising cost-effectiveness and warrant consideration.
Pyrophyllite is an important layered phyllosilicate material that is used in many fields due to its beneficial physicochemical and mechanical properties. Due to the presence of multiple defects in pyrophyllite, an in-depth investigation was conducted using density functional theory to explore the effects of Na(I), K(I), Mg(II), Ca(II) and Fe(II) doping on the atomic structure, electronic properties and mechanical characteristics of pyrophyllite. The results demonstrated that, among the studied defects, K(I) doping had the most pronounced effects on the lattice constants and bonding lengths of pyrophyllite, while the least significant effects were observed in the case of Fe(II) doping. Moreover, the partial and total densities of states and band structures of the five kinds of doped pyrophyllite also changed significantly due to the redistribution of electrons. Finally, the elastic constants of the doped pyrophyllite were lower than that of the undoped pyrophyllite. Doping with Na(I), K(I), Mg(II), Ca(II) and Fe(II) reduced the deformation resistance, stiffness and elastic wave velocity but increased the degree of anisotropy in pyrophyllite. The observed effects on the mechanical properties of pyrophyllite followed the order: Mg(II) > Fe(II) > Ca(II) >K(I) > Na(I).
Alcohol use is a leading risk factor for death and disability worldwide.
Aims
We conducted a systematic review on the cost-effectiveness evidence for interventions to prevent alcohol use across the lifespan.
Method
Electronic databases (EMBASE, Medline, PsycINFO, CINAHL and EconLit) were searched for full economic evaluations and return-on-investment studies of alcohol prevention interventions published up to May 2021. The methods and results of included studies were evaluated with narrative synthesis, and study quality was assessed by the Drummond ten-point checklist.
Results
A total of 69 studies met the inclusion criteria for a full economic evaluation or return-on-investment study. Most studies targeted adults or a combination of age groups, seven studies comprised children/adolescents and one involved older adults. Half of the studies found that alcohol prevention interventions are cost-saving (i.e. more effective and less costly than the comparator). This was especially true for universal prevention interventions designed to restrict exposure to alcohol through taxation or advertising bans; and selective/indicated prevention interventions, which involve screening with or without brief intervention for at-risk adults. School-based interventions combined with parent/carer interventions were cost-effective in preventing alcohol use among those aged under 18 years. No interventions were cost-effective for preventing alcohol use in older adults.
Conclusions
Alcohol prevention interventions show promising evidence of cost-effectiveness. Further economic analyses are needed to facilitate policy-making in low- and middle-income countries, and among child, adolescent and older adult populations.
This paper presents systematic molecular dynamics modelling of Na-montmorillonite subjected to uniaxial compression and unidirectional shearing. An initial 3D model of a single-cell Na-montmorillonite structure is established using the Build Crystal module. The space group is C2/m, and COMPASS force fields are applied. Hydration analysis of Na-montmorillonite has been performed to validate the simulation procedures, where the number of absorbed water molecules varied with respect to the various lattice parameters. A series of uniaxial compression stress σzz and unidirectional shear stress τxy values are applied to the Na-montmorillonite structure. It is shown that the lattice parameter and hydration degree exhibit significant influence on the stress–strain relationship of Na-montmorillonite. The ultimate strain increases with increases in the lattice parameter but decreases in the number of water molecules. For saturated Na-montmorillonite, more water molecules result in a stiffer clay mineral under uniaxial compression and unidirectional shearing.
Extraction of reference signal is an indispensable step in the signal processing of polarization diversity passive radar (PDPR) based on a digital television signal. A conventional reference signal extraction method requires an additional reference antenna, which has a certain demand for space. Single dual-polarization antenna passive radar (SDPPR) systems do not require a reference antenna, and the radar station layout is flexible, which is suitable for a large-scale radar network. It is a main research direction of PDPR in future. However, its reference signal extraction needs to rely on the signal reconstruction method. When the signal to interference and noise ratio of the direct-path signal is relatively low, the signal reconstruction method will fail. In this paper, we propose a reference signal extraction method based on sub-carrier processing method, blind adaptive oblique projection technology, and extensive cancelation algorithm to solve the above problem. Experimental results show that the method proposed in this paper is a reasonable alternative after the failure of reference signal reconstruction, and it is an effective supplement to the reference signal extraction technology.
Neuroimaging- and machine-learning-based brain-age prediction of schizophrenia is well established. However, the diagnostic significance and the effect of early medication on first-episode schizophrenia remains unclear.
Aims
To explore whether predicted brain age can be used as a biomarker for schizophrenia diagnosis, and the relationship between clinical characteristics and brain-predicted age difference (PAD), and the effects of early medication on predicted brain age.
Method
The predicted model was built on 523 diffusion tensor imaging magnetic resonance imaging scans from healthy controls. First, the brain-PAD of 60 patients with first-episode schizophrenia, 60 healthy controls and 21 follow-up patients from the principal data-set and 40 pairs of individuals in the replication data-set were calculated. Next, the brain-PAD between groups were compared and the correlations between brain-PAD and clinical measurements were analysed.
Results
The patients showed a significant increase in brain-PAD compared with healthy controls. After early medication, the brain-PAD of patients decreased significantly compared with baseline (P < 0.001). The fractional anisotropy value of 31/33 white matter tract features, which related to the brain-PAD scores, had significantly statistical differences before and after measurements (P < 0.05, false discovery rate corrected). Correlation analysis showed that the age gap was negatively associated with the positive score on the Positive and Negative Syndrome Scale in the principal data-set (r = −0.326, P = 0.014).
Conclusions
The brain age of patients with first-episode schizophrenia may be older than their chronological age. Early medication holds promise for improving the patient's brain ageing. Neuroimaging-based brain-age prediction can provide novel insights into the understanding of schizophrenia.
The present work was performed to analyse the association of dietary patterns with glycaemic control (Hb A1c < 7 %) in a large group of Chinese adults aged between 45 and 59 years.
Design:
Habitual dietary intakes in the preceding 12 months were assessed by well-trained interviewers using a validated semi-quantitative FFQ. Factor analysis with principal component method was used to obtain the dietary patterns, and the associations between dietary patterns and glycaemic control were determined using multivariable logistic regression models. Poor glycaemic control was defined as HbA1c ≥ 7·0.
Setting:
Despite decades of research, data on the relationship between dietary patterns and glycaemic control (HbA1c < 7 %) in China are sparse.
Participants:
A total of 1739 participants aged 45–59 years from Hangzhou were included in the final analysis.
Results:
Three dietary patterns were ascertained and labelled as traditional southern Chinese, Western and grains-vegetables patterns. After controlling of the possible confounders, participants in the highest quartile of Western pattern scores had greater OR for HbA1c ≥ 7·0 (OR = 1·05; (95 % CI 1·000, 1·095); P = 0·048) than did those in the lowest quartile. Compared with those in the lowest quartile of grains-vegetables pattern, participants in the highest quartile had lower OR for HbA1c ≥ 7·0 (OR = 0·82; (95 % CI 0·720, 0·949); P = 0·038). Besides, no significant relationship between the traditional southern Chinese pattern and HbA1c ≥ 7·0 was observed (P > 0·05).
Conclusions:
This study indicated that the Western pattern was associated with a higher risk, and the grains-vegetables pattern was associated with a lower risk for HbA1c ≥ 7·0. Future prospective studies are needed to confirm our findings.
The tectonic evolution of the Sibumasu Block during the Permian remains controversial, and Permian faunas and their paleobiogeographic affinities provide some insight into its paleogeographic and tectonic evolutionary histories. In this paper, a new brachiopod fauna dominated by Spinomartinia prolifica Waterhouse, 1981 is described from the uppermost part of the Taungnyo Group in the Zwekabin Range, eastern Myanmar. This brachiopod fauna includes 23 species and its age is well constrained as late Kungurian by the associated conodonts, i.e., Vjalovognathus nicolli Yuan et al., 2016 and Mesogondolella idahoensis (Youngquist, Hawley, and Miller, 1951), contrary to the late Sakmarian age given to the same brachiopod faunas previously reported from southern Thailand and Malaysia. Based on comprehensive comparisons of the Cisuralian brachiopod faunas and other data in different parts of the Sibumasu Block, we consider that they are better subdivided into two independent stratigraphic assemblages, i.e., the lower (earlier) Bandoproductus monticulus-Spirelytha petaliformis Assemblage of a Sakmarian to probably early Artinskian age, and the upper (younger) Spinomartinia prolifica-Retimarginifera alata Assemblage of a late Kungurian age. The former assemblage is a typical cold-water fauna, mainly composed of Gondwanan-type genera, e.g., Bandoproductus Jin and Sun, 1981, Spirelytha Fredericks, 1924, and Sulciplica Waterhouse, 1968. The latter assemblage is strongly characterized by an admixture of both Cathaysian and Gondwanan elements, as well as some genera restricted to the Cimmerian continents. Notably, the spatial distribution pattern of these two separate brachiopod assemblages varies distinctly. The Sakmarian cold-water brachiopod faunas have been found in association with glacial-marine diamictites throughout the Sibumasu Block including both the Irrawaddy and Sibuma blocks. In contrast, the Kungurian biogeographically mixed brachiopod faunas are only recorded in the Irrawaddy Block, unlike the Sibuma Block that contains a contemporaneous paleotropical Tethyan fusuline fauna. Thus, it appears likely that by the end of Cisuralian (early Permian), the Sibumasu Block comprised the Irrawaddy Block in the south with cool climatic conditions, and the Sibuma Block in the north with a temperate to warm-water environment, separated by the incipient Thai-Myanmar Mesotethys.
This study aimed to evaluate the performance of Cobas human papillomavirus (HPV) test in cervical cancer screening. A total of 3442 women aged ⩾20 years used Cobas HPV and hybrid capture 2 (HC2) tests were included in this study. Women with any positive result were examined by liquid-based cytology (LBC) test. Then subjects with abnormal LBC or positive Cobas HPV16/18 were further checked by colposcopy to observe the visible lesions to perform the pathological examination. Of these 3442 women, 328 cases were Cobas HPV positive, and the positive rate was 9.53% (95% confidence interval (CI) 8.50–10.53). The positive rate of HPV16, HPV18, and other 12 types of high-risk HPV were 1.54% (95% CI 1.12–1.95), 0.55% (95% CI 0.30–0.80), and 7.44% (95% CI 6.56–8.32), respectively. The coincidence rate of Cobas HPV test and HC2 test was 90% (95% CI 89.00–91.00; Kappa = 0.526) in the primary screening. Age had a non-linear relationship with Cobas HPV positive rate (χ2 = 4.240, P = 0.040) and HPV16/18 typing positive rate (χ2 = 6.610, P = 0.010). Compared with the LBC test, the Cobas HPV test had higher sensitivity when detecting patients with high cervical intraepithelial neoplasia (CIN2+ and CIN3+).
The cost of recruitment and training of newcomers can be a burden for enterprises, causing adverse effects on human resources management. Although much research has addressed employee turnover, less attention has been paid to methods of improving the retention of new hires. This study is an empirical examination of the increase in predictive strength of antecedents of affective commitment for comparing newcomers’ workplace spirituality. The results of an employee survey completed by 237 newcomers with under two years of work experience indicate that socialization tactics have a direct impact on job embeddedness, which in turn has a direct effect on affective commitment. Workplace spirituality has a significant moderating effect on the relationship between socialization tactics and job embeddedness. Also, workplace spirituality has a significant moderating effect on the relationship between job embeddedness and affective commitment.
The association between dietary Fe intake and diabetes risk remains inconsistent. We aimed to explore the association between dietary Fe intake and type 2 diabetes mellitus (T2DM) risk in middle-aged and older adults in urban China. This study used data from the Guangzhou Nutrition and Health Study, an on-going community-based prospective cohort study. Participants were recruited from 2008 to 2013 in Guangzhou community. A total of 2696 participants aged 40–75 years without T2DM at baseline were included in data analyses, with a median of 5·6 (interquartile range 4·1–5·9) years of follow-up. T2DM was identified by self-reported diagnosis, fasting glucose ≥ 7·0 mmol/l or glycosylated Hb ≥ 6·5 %. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % CI. We ascertained 205 incident T2DM cases during 13 476 person-years. The adjusted HR for T2DM risk in the fourth quartile of haem Fe intake was 1·92 (95 % CI 1·07, 3·46; Ptrend = 0·010), compared with the first quartile intake. These significant associations were found in haem Fe intake from total meat (HR 2·74; 95 % CI 1·22, 6·15; Ptrend = 0·011) and haem Fe intake from red meat (HR 1·86; 95 % CI 1·01, 3·44; Ptrend = 0·034), but not haem Fe intake from processed meat, poultry or fish/shellfish. The association between dietary intake of total Fe or non-haem Fe with T2DM risk had no significance. Our findings suggested that higher dietary intake of haem Fe (especially from red meat), but not total Fe or non-haem Fe, was associated with greater T2DM risk in middle-aged and older adults.
Studies have indicated government transfers greatly alleviate poverty among older Americans. Yet recent social policy changes were suggested to increase older Americans’ fiscal insecurity. New evidence is needed to expand the evaluation of government transfers. Longitudinal Health and Retirement Study data from 2002 to 2014 were used. We computed individuals’ poverty status both when household income included and did not include government transfers. Results indicated the poverty rate dropped dramatically when household income included government transfers. The poverty alleviation effect was significantly greater among people who were female, older, members of a minority group, having fewer years of education, residing in the South, and living in a bigger household. Evidence from this study solidified the overall poverty alleviation effect of government transfers in old age. Differential effects among various demographic groups could be attributed to their initial status and divergent political beliefs about who should receive government transfers.
To investigate the cumulative effects of maternal supplementation with nucleotides in the form of uridine (UR) on fatty acid and amino acid constituents of neonatal piglets, fifty-two sows in late gestation were assigned randomly into the control (CON) group (fed a basal diet) or UR group (fed a basal diet with 150 g/t UR). Samples of neonates were collected during farrowing. Results showed that supplementing with UR in sows’ diet significantly decreased the birth mortality of pigs (P = 0·05), and increased serum total cholesterol, HDL and LDL of neonatal piglets (P < 0·05). Moreover, the amino acid profile of serum and liver of neonatal piglets was affected by the addition of UR in sows’ diets (P < 0·05). Furthermore, an up-regulation of mRNA expression of energy metabolism-related genes, including fatty acid elongase 5, fatty acid desaturase 1, hormone-sensitive lipase and cholesterol-7a-hydroxylase, was observed in the liver of neonates from the UR group. Additionally, a decrease in placental gene expression of excitatory amino acid transporters 2, excitatory amino acid transporter 3 and neutral AA transporter 1 in the UR group was concurrently observed (P < 0·05), and higher protein expression of phosphorylated protein kinase B, raptor, PPARα and PPARγ in placenta from the UR group was also observed (P < 0·05). Together, these results showed that maternal UR supplementation could regulate placental nutrient transport, largely in response to an alteration of mTORC1–PPAR signalling, thus regulating the nutrition metabolism of neonatal piglets and improving reproductive performance.