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Unintended pregnancy and sexually transmitted infections (STIs) pose a huge public health problem in the United States. Efforts towards reducing unintended pregnancies have previously focused on women, but the role of men in family planning and preventing unwanted pregnancy is becoming clearer. The primary objective of the study was to fully examine the utilization of family planning services by men in the US, and to determine whether factors such as race, health insurance type and number of sexual partners influenced their utilization and receipt of family planning services and STI-related health services. Data were from the 2006–2010 National Survey on Family Growth (NSFG) study conducted in the US. The study sample comprised 7686 men aged 14–44 who ever had sex with women, and who had had at least one sexual partner in the 12 months before the survey. The receipt of family planning and STI-related health services by this group of men was estimated. The results showed that non-Hispanic Black men were more likely to receive family planning and STI-related services than Hispanic and non-Hispanic White males. Given that non-Hispanic Black men are disproportionately affected by STIs and are a high-risk group, the finding that this group received more family planning and STI services is a positive step towards reducing the disproportionately high prevalence of STIs in men in this under-privileged population.
Objective: To determine whether volumetric measures of the hippocampus, entorhinal cortex, and other cortical measures can differentiate between cognitively normal individuals and subjects with mild cognitive impairment (MCI). Method: Magnetic resonance imaging (MRI) data from 46 cognitively normal subjects and 50 subjects with MCI as part of the Boston University Alzheimer’s Disease Center research registry and the Alzheimer’s Disease Neuroimaging Initiative were used in this cross-sectional study. Cortical, subcortical, and hippocampal subfield volumes were generated from each subject’s MRI data using FreeSurfer v6.0. Nominal logistic regression models containing these variables were used to identify subjects as control or MCI. Results: A model containing regions of interest (superior temporal cortex, caudal anterior cingulate, pars opercularis, subiculum, precentral cortex, caudal middle frontal cortex, rostral middle frontal cortex, pars orbitalis, middle temporal cortex, insula, banks of the superior temporal sulcus, parasubiculum, paracentral lobule) fit the data best (R2 = .7310, whole model test chi-square = 97.16, p < .0001). Conclusions: MRI data correctly classified most subjects using measures of selected medial temporal lobe structures in combination with those from other cortical areas, yielding an overall classification accuracy of 93.75%. These findings support the notion that, while volumes of medial temporal lobe regions differ between cognitively normal and MCI subjects, differences that can be used to distinguish between these two populations are present elsewhere in the brain.
Acute respiratory infection (ARI) is a major cause of mortality among children under the age of five in developing countries. This paper examines Demographic and Health Survey (DHS) data on maternal recall of episodes of ARI in the contrasting settings of Bangladesh and Nigeria, where about 11.1% and 3.3% of under-5 children, respectively, are reported to have symptoms of ARI. The surveys found that about 25.6% of married Bangladeshi women and 15.4% of married Nigerian women reported experiencing spousal violence in the past year. To test the proposition that women’s experience of intimate partner violence (IPV) is associated with adversity in their children, the study examined the relationship between spousal violence in the past year and childhood ARI in the past 2 weeks among children under the age of five in Bangladesh and Nigeria. Data were taken from a nationally representative sample of mothers aged 15–49 years obtained from the 2007 Bangladesh DHS and 2008 Nigeria DHS. Random-effects multiple logistic regression models were estimated to assess the association of maternal exposure to IPV with the incidence of ARI in the past 2 weeks among under-5 children after controlling for the potentially confounding effects of maternal social and demographic characteristics. Results from Nigeria suggest that the odds of ARI incidence among children of mothers who were IPV victims were almost two times higher than among their counterparts whose mothers had not experienced IPV (OR = 1.78; 95% CI: 1.45–2.19; p <0.001). Similarly, the odds for the children of Bangladeshi IPV victims were elevated one and half times (OR = 1.61; 95% CI: 1.21–2.14; p <0.001). The findings suggest that under-5 children suffer indirect health consequences of gender-based violence.
Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.
The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.
The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.
Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.
Background: Worry is a common feature across many anxiety disorders. It is important to understand how and when worry presents from childhood to adolescence to prevent long-term negative outcomes. However, most of the existing studies that examine the relationship between worry and anxiety disorders utilize adult samples. Aims: The present study aimed to assess the level of worry in children and adolescents and how relationships between worry and symptoms of separation anxiety disorder (SAD) and social anxiety disorder (Soc) may present differently at different ages. Method: 127 children (age 8–12 years) and adolescents (age 13–18 years), diagnosed with any anxiety disorder, presenting at a child anxiety out-patient clinic, completed measures of worry, anxiety and depression. Results: Worry scores did not differ by age group. Soc symptoms were significantly correlated with worry in both age groups; however, SAD symptoms were only significantly correlated with worry in younger participants. After the inclusion of covariates, SAD symptoms but not Soc symptoms remained significant in the regression model with younger children, and Soc symptoms remained significant in the regression model with older children. Conclusions: The finding that worry was comparable in both groups lends support for worry as a stable construct associated with anxiety disorders throughout late childhood and early adolescence.
Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) study, we aimed to present the rates and clinical correlates of suicidal thoughts/acts in patients recruited from a total of 40 centres in 10 Asian countries/areas: China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand.
Data from 1122 patients with depressive disorders in the REAP-AD study were used. The ICD-10 was employed to diagnose depressive episodes and recurrent depressive disorder. The presence or absence of suicidal thoughts/acts and profile of other depressive symptoms was established using the National Institute for Health and Clinical Excellence guidelines for depression. Country/area differences in rates of suicidal thoughts/acts were evaluated with the χ2 test. In addition, depressive symptom profiles, other clinical characteristics, and patterns of psychotropic drug prescription in depressed patients with and without suicidal thoughts/acts were compared using analysis of covariance for continuous variables and logistic regression analysis for discrete variables to adjust the effects of covariates.
The rates of suicidal thoughts/acts in 10 countries/areas varied from 12.8% in Japan to 36.3% in China. Patients with suicidal thoughts/acts presented more persistent sadness (adjusted odds ratio [aOR]=2.64, p<0.001), loss of interest (aOR=2.33, p<0.001), fatigue (aOR=1.58, p<0.001), insomnia (aOR=1.74, p<0.001), poor concentration (aOR=1.88, p<0.001), low self-confidence (aOR=1.78, p<0.001), poor appetite (aOR=2.27, p<0.001), guilt/self-blame (aOR=3.03, p<0.001), and use of mood stabilisers (aOR=1.79, p<0.001) than those without suicidal thoughts/acts.
Suicidal thoughts/acts can indicate greater severity of depression, and are associated with a poorer response to antidepressants and increased burden of illness. Hence, suicidal thoughts/acts can provide a clinical index reflecting the clinical status of depressive disorders in Asians.
Soft X-ray background data from the ROSATPSPC have been fitted by a model including emission from the local bubble, embedded hot gas within the disk, hot gas in the Galactic halo and extra-galactic emission, together with local and disk absorption. In all directions a halo component at 106.2 K (0.2 keV) is required for an acceptable fit. The halo emission measure shows spatial variability and the global trend suggests a disk-like planar rather than more extended spherical distribution. New values for the emission measure within the local bubble are derived.
The escalating tendency of elderly population aged 65 and over, which grown up to 9% since 2001 in Taiwan, remarks the important issue of mental health among ageing population. Depression in the elderly is frequently undetected or inadequately treated. This study aimed to investigate the pharmacotherapy of elderly patients with depression by comparing the patterns of prescribing psychotropic drugs (psychotropics) of psychiatrists and non-psychiatrists.
A random sampling of 5% of inpatients from the National Health Insurance (NHI) database in Taiwan from 2001 to 2003 was selected. In all, 1058 (0.9%) inpatients aged 65 and older with a diagnosis of any depressive disorder were included. The psychotropic prescribing pattern and the dosages used were analysed and compared. Physician specialties were based on the record of NHI database. Non-psychiatrists were defined by physicians other than psychiatry.
A total of 88% of elderly depressed inpatients had two or more comorbid physical illnesses. The most commonly prescribed psychotropics were: antidepressants (71.4%), anxiolytics (62.6%) and hypnotics (51.4%). Psychiatrists had a higher rate of prescribing psychotropics, except anxiolytics, than non-psychiatrists. Although selective serotonin reuptake inhibitors were commonly prescribed, non-psychiatrists preferred the use of tricyclic antidepressants and moclobemide. Trazodone was the most preferred antidepressant, but was generally used in low dosages.
Psychiatrists generally utilised higher dosages of newer antidepressants than non-psychiatrists. Differences in the prescribing pattern of psychotropics existed between physician specialties. Further investigations are warranted to determine how the selection and dosing of drugs influence the outcome of depression on the elderly.
Multiferroic magnetoelectric nanostructures with coupled magnetization and electric polarization across their interfaces have stimulated intense research activities over the past decade. Such interface-based magnetoelectric coupling can be exploited to significantly improve the performance of many devices such as memories, tunable radio-frequency/microwave devices, and magnetic sensors. In this article, we introduce a number of current or developing technologies and discuss their limitations. We describe how the use of magnetoelectric nanostructures can overcome these limitations to optimize device performance. We also present challenges that need to be addressed in pursuing practical applications of magnetoelectric devices.
Following a discussion of two recent papers by Schmidt (1973, 1975), we conclude that for the large amplitude, longer period Cepheids (log P greater than about 1.1), the small colour excesses derived from the six-colour photometry (traditional method or Parsons method) are to be preferred to the large colour excesses derived from the γ-index photometry (Kraft's scale).
Folate and vitamin B12 are two vital regulators in the metabolic process of homocysteine, which is a risk factor of atherothrombotic events. Low folate intake or low plasma folate concentration is associated with increased stroke risk. Previous randomized controlled trials presented discordant findings in the effect of folic acid supplementation-based homocysteine lowering on stroke risk. The aim of the present review was to perform a meta-analysis of relevant randomized controlled trials to check the how different folate fortification status might affect the effects of folic acid supplementation in lowering homocysteine and reducing stroke risk.
Relevant randomized controlled trials were identified through formal literature search. Homocysteine reduction was compared in subgroups stratified by folate fortification status. Relative risks with 95 % confidence intervals were used as a measure to assess the association between folic acid supplementation and stroke risk.
The meta-analysis included fourteen randomized controlled trials,
A total of 39 420 patients.
Homocysteine reductions were 26·99 (sd 1·91) %, 18·38 (sd 3·82) % and 21·30 (sd 1·98) %, respectively, in the subgroups without folate fortification, with folate fortification and with partial folate fortification. Significant difference was observed between the subgroups with folate fortification and without folate fortification (P=0·05). The relative risk of stroke was 0·88 (95 % CI 0·77, 1·00, P=0·05) in the subgroup without folate fortification, 0·94 (95 % CI 0·58, 1·54, P=0·82) in the subgroup with folate fortification and 0·91 (95 % CI 0·82, 1·01, P=0·09) in the subgroup with partial folate fortification.
Folic acid supplementation might have a modest benefit on stroke prevention in regions without folate fortification.
There have been substantial improvements in measurement systems in order to meet
fluctuating market demands. This rapid change and development in measurement technology
has primarily been governed by demands of accuracy and precision from aerospace,
automotive and other manufacturing industries. Coordinate measuring machines (CMMs)
available with different technologies and configurations has efficiently been fulfilling
customer demands for more than a decade. Though, current CMMs can meet needs of rapid and
increased demands of customers to a greater extent but still there is lot of scope for
improvement and development in CMMs. The globalization of manufacturing has resulted in
development of variety of complex products and miniaturization of mechanical components.
The technology of micro/nano-scale 3D measurement is still a bottleneck for industries.
Therefore, precise and accurate system which is flexible enough to deal with complexities
of parts and micro & nano range products has to be investigated. In this paper,
comprehensive review concerning CMMs with capabilities to measure micro/nano features has
been presented. This work has also discussed different methods to estimate measurement
uncertainty, as well as performance evaluation of CMMs. Moreover, novel concepts such as
intelligent CMM, multi-sensor CMM, virtual CMM have been presented.
This paper documents pervasive evidence of intra-industry reversals in monthly
returns. Unlike the conventional reversal strategy based on stock returns
relative to the market portfolio, we document intra-industry return reversals
that are larger in magnitude, consistently present over time, and prevalent
across subgroups of stocks, including large and liquid stocks. These return
reversals are driven by order imbalances and noninformational shocks. Consistent
with reversals representing compensation for supplying liquidity, intra-industry
reversals are stronger following aggregate market declines and volatile times,
reflecting binding capital constraints and limited risk-bearing capacity of
The conflict between India and Pakistan may be the most serious and imminent danger to the South Asian region and to humanity over the next 50 years. During this period, India and China will continue their rise as great powers and rivals, even if they do not become peers of the United States. This will ensure that Pakistan remains at the heart of regional and global politics for decades to come.
We examine the dynamics of the India–Pakistan nuclear relationship and how it may evolve, especially as it becomes increasingly part of a larger set of strategic relationships involving the United States and China. At the same time, Islamist politics in Pakistan, which may gather strength in coming decades, seeks to more directly confront India and the West. We look in particular at the risk of nuclear war and of nuclear terrorism. We consider also how India and Pakistan might respond to the renewed global effort to eliminate nuclear weapons.
There is another nuclear danger growing in South Asia. India and Pakistan have relied on nuclear energy for electricity production on a small scale for decades and have ambitious plans for expanding their respective programs. Other countries in the region have been seeking to start their own programs. This is part of a renewed worldwide interest in nuclear energy. But the March 2011 Fukushima nuclear disaster in Japan offers a stark reminder of the ever-present danger of nuclear accidents.
In insects, the enzyme trehalase plays a crucial role in energy metabolism, chitin synthesis and possibly during plant–insect interactions. We have characterized a soluble trehalase gene (Tre-1) from cDNA of Aphis glycines, a serious migratory pest of soybean. The full-length cDNA of Tre-1 in A. glycines (AyTre-1) was 2550 bp long with an open reading frame of 1770 bp that encoded for a 589 amino acid residues protein. Sequence assessment and phylogenetic analysis of the putative protein suggested that the selected cDNA belongs to soluble trehalase group. Quantitative PCR (qPCR) analysis in different tissues and developmental stages revealed peak mRNA levels of AyTre-1 in the gut (compared with other tissues assayed) and highest expression in the second instar compared with the other developmental stages assayed. Interestingly, a significantly increased expression of AyTre-1 (1.9-fold, P < 0.05) was observed in the alate morphs compared with that in apterate morphs. However, there was no significant difference in AyTre-1 expression in A. glycines-nymphs fed with resistant and susceptible plants. Expression patterns identified in this study provide a platform to investigate the role of AyTre-1 in physiological activities such as flight and feeding in A. glycines. The characterization of soluble trehalase gene may help to develop novel strategies to manage A. glycines using trehalase inhibitors and using RNA interference for knock-down of AyTre-1 expression.
To date, there are a strikingly growing number of patients who need various
orthopedic implants. However, traditional orthopedic implants face many
complications such as infection and implant loosening which may lead to
implant failures. Conventional metal implants such as titanium were chosen
for orthopedic applications mainly based on their excellent mechanical
properties and biological inertness. Since natural bone matrix is nanometer
in dimension, it is desirable to design a biologically inspired
nanostructured coating that can turn conventional inert titanium surfaces
into biomimetic active interfaces, thus enhance bone cell adhesion and
osseointegration. For this purpose, we designed a biomimetic nanostructured
coating based on nanocrystalline hydroxyapatites (nHA) and single wall
carbon nanotubes (SWCNTs). Specifically, nHA with good crystallinity and
biomimetic dimensions were prepared via a wet chemistry method and
hydrothermal treatment; and the SWCNTs were synthesized via an arc plasma
method with or without magnetic fields. TEM images showed that the
hydrothermally treated nHA possessed regular rod-like nanocrystals and
biomimetic nanostructure. In addition, the length of SWCNTs can be
significantly increased under external magnetic fields when compared to
nanotubes produced without magnetic fields. More importantly, our results
showed that the above nHA and SWCNTs nanomaterials can greatly promote
osteoblast (bone-forming cell) adhesion on titanium in
vitro, thus holding great promise to improve osseointegration
and lengthen the lifetime of current orthopedic implants.