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Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity.
Methods
We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year.
Results
The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854).
Conclusions
The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.
Basic Self disturbances (BSD), including changes of the 'pre-reflexive' sense of self and the loss first-person perspective, are characteristic of the schizophrenic spectrum disorders and highly prevalent in subjects at 'ultra high risk' for psychosis (UHR). The current literature indicates that cortical midline structures (CMS) may be implicated in the neurobiological substrates of the 'basic self' in healthy controls.
Objectives
Neuroanatomical investigation of BSD in a UHR sample
Aims
To test the hypotheses :(i) UHR subjects have higher 'Examination of Anomalous Self Experience, EASE' scores as compared to controls, (ii) UHR subjects have neuroanatomical alterations as compared to controls in CMS, (iii) within UHR subjects, EASE scores are directly related to structural CMS alterations.
Methods
32 HR subjects (27 antipsychotics-naïve) and 17 healthy controls (HC) were assessed with the 57-items semi-structured EASE interview. Voxel-Based Morphometry (VBM) was conducted in the same subjects, with a-priori Region of Interests (ROIs) defined in the CMS (anterior/posterior cingulate and medial-prefrontal cortex).
Results
Despite high variability in the HR group, the overall EASE score was higher (t-test >0.01, Cohen's d =2.91) in HR (mean=30.15, SD=16.46) as compared to HC group (mean=1.79, SD=2.83). UHR subjects had gray matter reduction in CMS as compared to HC (p>0.05 FWE-corrected). Across the whole sample, lower gray matter volume in the anterior cingulate was correlated with higher EASE scores (p>0.05).
Conclusions
This study provides preliminary evidence that gray matter reductions in the CMS are correlated with BSD in UHR people.
The extent of diagenesis in Lower Jurassic shoreline sandstones of the Beatrice oilfield was controlled primarily by their detrital clay content. Sandstones rich in detrital clay had low depositional permeabilities; these show preservation of detrital feldspars to the present day and have no extensive diagenetic quartz overgrowths. Sandstones poor in detrital clay had high permeabilities and show large quartz overgrowths as part of a normal sub-arkosic diagenetic sequence. Such quartz occurs preferentially below, but not above, impermeable mudstones. These low- and high-permeability features suggest that pore-fluid flow was important during diagenesis. Fluid inclusions trapped in diagenetic quartz overgrowths formed between 68° and 94°C. This silica was probably supplied in solution from the temperature-driven illitization of smectitic clays surrounding these sandstones deeper in the basin. Fluid volumes from clay dewatering, from mechanical compaction, or from influx of overlying seawater were too small to transport diagenetic silica volumes. Silica-rich fluids were probably transported up-dip by convective cells within the sandstones and authigenic quartz precipitated as these fluids cooled. This episode of quartz diagenesis could have been completed within 1·6 × 106 yr if fluid velocities were 3·1 m/yr. Similar convective fluid flows could have transported the fluids responsible for secondary porosity development and the hydrocarbons expelled from mudstones later in the basin burial history.
Electric Santeria: Racial and Sexual Assemblages of Transnational Religion. By Aisha M. Beliso-De Jesús. New York: Columbia University Press, 2015. Pp. ix + 271. $30.00 paperback. ISBN: 9780231173179.
Embracing Protestantism: Black Identities in the Atlantic World. By John W. Catron. Gainesville: University Press of Florida, 2016. Pp. ix + 299. $74.95 hardcover. ISBN: 9780813061634.
Black Saint of the Americas: The Life and Afterlife of Martín de Porres. By Celia Cussen. New York: Cambridge University Press, 2014. Pp. xi + 285. $90.00 hardcover. ISBN: 9781107034372.
Afro-Cuban Religious Arts: Popular Expressions of Cultural Inheritance in Espiritismo and Santería. By Kristine Juncker. Gainesville: University Press of Florida, 2014. Pp. xi + 169. $74.95 hardcover. ISBN: 9780813049700.
The Black Christ of Esquipulas: Religion and Identity in Guatemala. By Douglass Sullivan-González. Lincoln: University of Nebraska Press, 2016. Pp. viii + 199. $55.00 hardcover. ISBN: 9780803268432.
OBJECTIVES/SPECIFIC AIMS: To assess the effect of cannabis on impaired judgment and health outcomes among heart failure patients in the emergency room. METHODS/STUDY POPULATION: Patients with heart failure presenting to the emergency room. Cannabis with confounders such as income level, insurance type, tobacco use, and age. Discharged against medical advice to assess impaired judgment. Hospitalization rates, length of stay, and death rate to assess health outcomes. Multivariate logistic regression to access the odds of each of these outcomes from cannabis RESULTS/ANTICIPATED RESULTS: Cannabis is associated with impaired outcome (increase in discharge against medical advice). Cannabis have poorer health outcome in terms of more hospitalizations from the emergency department. Cannabis also have better health outcome in terms of shorter length of stay and death rate among cannabis users Versus nonusers. DISCUSSION/SIGNIFICANCE OF IMPACT: This is crucial to inform health care providers to ensure better counseling of cannabis users. This result should also be considered to interpret other publications that shows better outcomes in patients taking cannabis. Cannabis users might only seem to have a better outcome because they tend to discharge against medical advice and thereby die outside the hospital, etc.
Geomagnetic data gathering by micro-rovers is gaining momentum both for future planetary exploration missions and for terrestrial applications in extreme environments. This paper presents research into the integration of a planetary micro-rover with a potassium total-field magnetometer. The 40 kg Kapvik micro-rover is an ideal platform due to an aluminium construction and a rocker-bogie mobility system, which provides good manoeuvrability and terrainability. A light-weight GSMP 35U (uninhabited aerial vehicle) magnetometer, comprised of a 0.65 kg sensor and 0.63 kg electronics module, was mounted to the chassis via a custom 1.21 m composite boom. The boom dimensions were optimized to be an effective compromise between noise mitigation and mechanical practicality. An analysis using the fourth difference method was performed estimating the magnetic noise envelope at ±0.03 nT at 10 Hz sampling frequency from the integrated systems during robotic operations. A robotic magnetic survey captured the total magnetic intensity along three parallel 40 m long lines and a perpendicular 15 m long tie line over the course of 3.75 h. The total magnetic intensity data were corrected for diurnal variations, levelled by linear interpolation of tie-line intersection points, corrected for a regional gradient, and then interpolated using Delaunay triangulation to lead a residual magnetic intensity map. This map exhibited an anomalous linear feature corresponding to a magnetic dipole 650 nT in amplitude. This feature coincides with a storm sewer buried approximately 2 m in the subsurface. This work provides benchmark methodologies and data to guide future integration of magnetometers on board planetary micro-rovers.
Central type benzodiazepine receptors were studied in 9 patients with Friedreich's ataxia and 12 healthy subjects using positron emission tomography (PET) and [11C]Ro 15-1788, a specific antagonist of the central type benzodiazepine receptors, as radioligand. A standard PET procedure was used in 5 patients and 8 controls to obtain brain kinetics of the total binding of the radioligand. The remaining subjects were intravenously injected with a saturating dose of unlabeled Ro 15-1788, 30 minutes after the tracer injection, to determine the nondisplaceable binding of [11C]Ro 15-1788. A semi-quantitative method was used to quantify the [11C]Ro 15-1788 data. None of the quantification indices in the cerebellar hemispheres, or in the other brain areas investigated, was significantly modified in patients with Friedreich's ataxia. These findings suggest that brain benzodiazepine receptors are unaffected in Friedreich's ataxia.
Recent studies suggest that sand can serve as a vehicle for exposure of humans to pathogens at beach sites, resulting in increased health risks. Sampling for microorganisms in sand should therefore be considered for inclusion in regulatory programmes aimed at protecting recreational beach users from infectious disease. Here, we review the literature on pathogen levels in beach sand, and their potential for affecting human health. In an effort to provide specific recommendations for sand sampling programmes, we outline published guidelines for beach monitoring programmes, which are currently focused exclusively on measuring microbial levels in water. We also provide background on spatial distribution and temporal characteristics of microbes in sand, as these factors influence sampling programmes. First steps toward establishing a sand sampling programme include identifying appropriate beach sites and use of initial sanitary assessments to refine site selection. A tiered approach is recommended for monitoring. This approach would include the analysis of samples from many sites for faecal indicator organisms and other conventional analytes, while testing for specific pathogens and unconventional indicators is reserved for high-risk sites. Given the diversity of microbes found in sand, studies are urgently needed to identify the most significant aetiological agent of disease and to relate microbial measurements in sand to human health risk.
Assessing the impact of glioma location on prognosis remains elusive. We approached the problem using multivoxel proton magnetic resonance spectroscopic imaging (1H-MRSI) to define a tumor “metabolic epicenter”, and examined the relationship of metabolic epicenter location to survival and histopathological grade.
Methods:
We studied 54 consecutive patients with a supratentorial glioma (astrocytoma or oligodendroglioma, WHO grades II-IV). The metabolic epicenter in each tumor was defined as the 1H-MRSI voxel containing maximum intra-tumoral choline on preoperative imaging. Tumor location was considered the X-Y-Z coordinate position, in a standardized stereotactic space, of the metabolic epicenter. Correlation between epicenter location and survival or grade was assessed.
Results:
Metabolic epicenter location correlated significantly with patient survival for all tumors (r2 = 0.30, p = 0.0002) and astrocytomas alone (r2 = 0.32, p = 0.005). A predictive model based on both metabolic epicenter location and histopathological grade accounted for 70% of the variability in survival, substantially improving on histology alone to predict survival. Location also correlated significantly with grade (r2 = 0.25, p = 0.001): higher grade tumors had a metabolic epicenter closer to the midpoint of the brain.
Conclusions:
The concept of the metabolic epicenter eliminates several problems related to existing methods of classifying glioma location. The location of the metabolic epicenter is strongly correlated with overall survival and histopathological grade, suggesting that it reflects biological factors underlying glioma growth and malignant dedifferentiation. These findings may be clinically relevant to predicting patterns of local glioma recurrence, and in planning resective surgery or radiotherapy.
The mechanism of anthelmintic resistance against the widely used macrocyclic lactones (MLs) is still not fully understood. Pharyngeal, somatic body muscles and the ovijector have been proposed as putative sites of action as well as resistance. In the present study the effects of three avermectins and three milbemycins on adult parasitic nematodes were evaluated in vitro. The Muscle Transducer system was used to investigate the effects of MLs on muscle contraction in female Haemonchus contortus and effects on motility were measured in Ostertagia (Teladorsagia) circumcincta using the Micromotility Meter. Concentration-response curves for all substances in both systems shifted to the right in the resistant isolates. Resistance was present to ivermectin (IVM) and its components IVM B1a and IVM B1b, suggesting that both components are involved in the mode of action and resistance. No consistent patterns of potency and resistance of the substances were observed except that milbemycins generally showed lower resistance ratios (RRs) than IVM. IVM and IVM B1b were the most potent inhibitors of contraction and motility in both susceptible isolates and also showed the highest RR in both species. Low RRs for milbemycins recorded in vitro for highly resistant isolates in vivo suggest that other factors such as pharmacokinetics influence drug potency in vivo.
It is well documented that global warming is unequivocal. Dairy production systems are considered as important sources of greenhouse gas emissions; however, little is known about the sensitivity and vulnerability of these production systems themselves to climate warming. This review brings different aspects of dairy cow production in Central Europe into focus, with a holistic approach to emphasize potential future consequences and challenges arising from climate change. With the current understanding of the effects of climate change, it is expected that yield of forage per hectare will be influenced positively, whereas quality will mainly depend on water availability and soil characteristics. Thus, the botanical composition of future grassland should include species that are able to withstand the changing conditions (e.g. lucerne and bird's foot trefoil). Changes in nutrient concentration of forage plants, elevated heat loads and altered feeding patterns of animals may influence rumen physiology. Several promising nutritional strategies are available to lower potential negative impacts of climate change on dairy cow nutrition and performance. Adjustment of feeding and drinking regimes, diet composition and additive supplementation can contribute to the maintenance of adequate dairy cow nutrition and performance. Provision of adequate shade and cooling will reduce the direct effects of heat stress. As estimated genetic parameters are promising, heat stress tolerance as a functional trait may be included into breeding programmes. Indirect effects of global warming on the health and welfare of animals seem to be more complicated and thus are less predictable. As the epidemiology of certain gastrointestinal nematodes and liver fluke is favourably influenced by increased temperature and humidity, relations between climate change and disease dynamics should be followed closely. Under current conditions, climate change associated economic impacts are estimated to be neutral if some form of adaptation is integrated. Therefore, it is essential to establish and adopt mitigation strategies covering available tools from management, nutrition, health and plant and animal breeding to cope with the future consequences of climate change on dairy farming.
Trypanosomatids represent the causative agents of major diseases in humans, livestock and plants, with inevitable suffering and economic hardship as a result. They are also evolutionarily highly divergent organisms, and the many unique aspects of trypanosome biology provide opportunities in terms of identification of drug targets, the challenge of exploiting these putative targets and, at the same time, significant scope for exploration of novel and divergent cell biology. We can estimate from genome sequences that the degree of divergence of trypanosomes from animals and fungi is extreme, with perhaps one third to one half of predicted trypanosome proteins having no known function based on homology or recognizable protein domains/architecture. Two highly important aspects of trypanosome biology are the flagellar pocket and the nuclear envelope, where in silico analysis clearly suggests great potential divergence in the proteome. The flagellar pocket is the sole site of endo- and exocytosis in trypanosomes and plays important roles in immune evasion via variant surface glycoprotein (VSG) trafficking and providing a location for sequestration of various invariant receptors. The trypanosome nuclear envelope has been largely unexplored but, by analogy with higher eukaryotes, roles in the regulation of chromatin and most significantly, in controlling VSG gene expression are expected. Here we discuss recent successful proteomics-based approaches towards characterization of the nuclear envelope and the endocytic apparatus, the identification of conserved and novel trypanosomatid-specific features, and the implications of these findings.
Metallic and non-metallic nanoparticles (NPs), ranging in size from 1–200 nm, have unique functional properties that differ from their bulk materials and their component atoms or molecules. These unique properties have driven the demand for nano-sized materials and new methods to synthesize NPs, which are used in drug delivery systems, bio-imaging agents, catalysts, photonics, and optical devices. Inorganic NPs can be synthesized with a variety of methods that impart size, shape, and other structural properties. Cobalt-based NPs, for instance, display unique size and shape-dependent magnetic properties, while the band gap, UV blocking properties and stability of zinc oxide (ZnO) NPs enable new applications in products ranging from cosmetics to solar cell power.
This volume is an international compilation for biotechnologists of data on the location and use of filamentous fungi. The volume provides details of the location and scope of major culture collections around the world holding fungi; information on how to access their data, administration and safety, identification, culture and media recipes, preservation, patents, specialist services and international organization. The authors are international authorities who have combined with the resource centres to provide a source book for mycologists in industry, research establishments and universities.
Das, Kamp and Sluijter have proposed equations describing three-dimensional electron inertia Alfvén waves for which the characteristic length scales in directions parallel and perpendicular to the ambient magnetic field are of the same order. Planar, obliquely propagating soliton solutions of these equations are known to be linearly unstable. Numerical simulations reveal the nonlinear phase of the evolution of these solitons: a transition from flat to cylindrical solitons is observed, followed by breaking-up into three-dimensional localized cavities. The final stage corresponds to wave breaking; no final stable structure is achieved within the model.
Pepper (Capsicum sp.) is important in human diets in many parts of the world and a major source of several antioxidants, including carotenoids, ascorbic acid, tocopherols and phenolics. More information on genetic diversity within Capsicum for antioxidant (AO) content and antioxidant activity (AOA) could contribute to improved human health. We evaluated 46 Capsicum accessions from AVRDC—the World Vegetable Center Capsicum core collection for content of nine AO (five carotenoids, ascorbic acid, tocopherols α and γ, and total phenolics) and two AOA assays for 2 years in south Taiwan. Ample genetic diversity exists within C. annuum to increase AO content. Based on dry weight values, non-pungent C. annuum entries as a group were significantly greater than pungent entries for contents of β-cryptoxanthin (36%), ascorbic acid (65%), total phenolics (36%) and α-tocopherol (11%). Group means of the brown-fruited entries exceeded the means of red-fruited entries for capsanthin (34%), zeaxanthin (37%), lutein (36%), β-cryptoxanthin (71%), β-carotene (82%), ascorbic acid (19%) and α-tocopherol (40%). Red-fruited C. annuum entries ‘Verdano Poblano’ and ‘Guajillo Ancho’ from Mexico ranked among the entries highest for all carotenoids, ascorbic acid and α-tocopherol. The inhibition of lipid peroxidation (ILP) assay could be adopted for AOA characterization or selection because of high variation among entries and consistent entry performance over years. ILP was positively correlated with phenolics (r=0.72**) and ascorbic acid (r=0.58**) contents. Significant positive correlations were detected between most carotenoids as well as a significant positive correlation between ascorbic acid and total phenolics contents (r=0.78**).