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Evidence suggests that somatic rather than cognitive depressive symptoms are risk factors for recurrent cardiac events in at-risk patients. However, this has never been explored using a time-dependent approach in a narrow time-frame, allowing a cardiac event-free time-window.
The analysis was performed on 595 participants [70.6% male, median age 72 (27–98)] drawn from the UPBEAT-UK heart disease patient cohort with 6-monthly follow-ups over 3 years. Depressive symptomatology was measured using the Patient Health Questionnaire-9 (PHQ-9) (four somatic, five cognitive items). New cardiac events (NCEs) including cardiac-related mortality were identified by expert examination of patient records. Analyses were performed using Cox proportional hazard models with delayed entry, with time-dependent depressive dimensions and covariates measured 12–18 months (median: 14.1, IQR: 3.5) prior to the event, with a 12-month cardiac event-free gap.
There were 95 NCEs during the follow-up [median time-to-event from baseline: 22.3 months (IQR: 13.4)]. Both the somatic (HR 1.12, 95% CI 1.05–1.20, p = 0.001) and cognitive dimensions (HR 1.11, 95% CI 1.03–1.18, p = 0.004) were time-dependent risk factors for an NCE in the multi-adjusted models. Specific symptoms (poor appetite/overeating for the somatic dimension, hopelessness and feeling like a failure for the cognitive dimension) were also significantly associated.
This is the first study of the association between depressive symptom dimensions and NCEs in at-risk patients using a time-to-event standardised approach. Both dimensions considered apart were independent predictors of an NCE, along with specific items, suggesting regular assessments and tailored interventions targeting specific depressive symptoms may help to prevent NCEs in at-risk populations.
The present study investigated the effects of nutritional programming through parental feeding on offspring performance and expression of selected genes related to stress resistance in a marine teleost. Gilthead seabream broodstock were fed diets containing various fish oil (FO)/vegetable oil ratios to determine their effects on offspring performance along embryogenesis, larval development and juvenile on-growing periods. Increased substitution of dietary FO by linseed oil (LO) up to 80 % LO significantly reduced the total number of eggs produced by kg per female per spawn. Moreover, at 30 d after hatching, parental feeding with increasing LO up to 80 % led to up-regulation of the fatty acyl desaturase 2 gene (fads2) that was correlated with the increase in conversion rates of related PUFA. Besides, cyclo-oxygenase 2 (cox2) and TNF-α (tnf-α) gene expression was also up-regulated by the increase in LO in broodstock diets up to 60 or 80 %, respectively. When 4-month-old offspring were challenged with diets having different levels of FO, the lowest growth was found in juveniles from broodstock fed 100 % FO. An increase in LO levels in the broodstock diet up to 60LO raised LC-PUFA levels in the juveniles, regardless of the juvenile’s diet. The results showed that it is possible to nutritionally programme gilthead seabream offspring through the modification of the fatty acid profiles of parental diets to improve the growth performance of juveniles fed low FO diets, inducing long-term changes in PUFA metabolism with up-regulation of fads2 expression. The present study provided the first pieces of evidence of the up-regulation of immune system-related genes in the offspring of parents fed increased FO replacement by LO.
There is little information describing the trajectories of depression and anxiety symptomatology in the context of coronary heart disease (CHD), and their comparison according to sociodemographic and disability measures, cardiac risk factors, and health care costs.
Using a primary care cohort of 803 patients with a diagnosis of CHD, a latent class growth curve model was developed to study the distinct trajectories of depression and anxiety symptoms (using the hospital anxiety and depression scale) over a 3-year period comprised of 7 distinct follow-up points. Multinomial regression analysis was then conducted to study the association between latent classes, baseline risk factors, and total health care costs across time.
The 5-class model yielded the best combination of statistical best-fit analysis and clinical correlation. These classes were as follows: “stable asymptomatic” (n = 558), “worsening” (n = 64), “improving” (n = 15), “chronic high” (n = 55), and “fluctuating symptomatology” (n = 111). The comparison group was the “stable asymptomatic” class. The symptomatic classes were younger and had higher proportion of women, and were also associated with non-white ethnicity, being a current smoker, and having chest pain. Other measures of disease severity, such as a history of myocardial infarction and comorbidities, were not associated with class membership. The highest mean total health care costs across the 3 years were the “chronic high” and “worsening” class, with the lowest being the “improving” and “stable low” classes. The total societal costs for patients in the “chronic high” and “worsening” class were significantly higher, as compared to the “stable low” class.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Nutrition during periconception and early development can modulate metabolic routes to prepare the offspring for adverse conditions through a process known as nutritional programming. In gilthead sea bream, replacement of fish oil (FO) with linseed oil (LO) in broodstock diets improves growth in the 4-month-old offspring challenged with low-FO and low-fishmeal (FM) diets for 1 month. The present study further investigated the effects of broodstock feeding on the same offspring when they were 16 months old and were challenged for a second time with the low-FM and low-FO diet for 2 months. The results showed that replacement of parental moderate-FO feeding with LO, combined with juvenile feeding at 4 months old with low-FM and low-FO diets, significantly (P<0·05) improved offspring growth and feed utilisation of low-FM/FO diets even when they were 16 months old: that is, when they were on the verge of their first reproductive season. Liver fatty acid composition was significantly affected by broodstock or reminder diets as well as by their interaction. Moreover, the reduction of long-chain PUFA and increase in α-linolenic acid and linoleic acid in broodstock diets lead to a significant down-regulation of hepatic lipoprotein lipase (P<0·001) and elongation of very long-chain fatty acids protein 6 (P<0·01). Besides, fatty acid desaturase 2 values were positively correlated to hepatic levels of 18 : 4n-3, 18 : 3n-6, 20 : 5n-3, 22 : 6n-3 and 22 : 5n-6. Thus, this study demonstrated the long-term nutritional programming of gilthead sea bream through broodstock feeding, the effect of feeding a ‘reminder’ diet during juvenile stages to improve utilisation of low-FM/FO diets and fish growth as well as the regulation of gene expression along the fish’s life-cycle.
The magnetic flux emergence can help understand the physical mechanism responsible for solar atmospheric phenomena. Emerging magnetic flux is frequently related to eruptive events, because when emerging they can reconnected with the ambient field and release magnetic energy. We will use a physic-based model to reconstruct the evolution of the solar emission based on the configuration of the photospheric magnetic field. The structure of the coronal magnetic field is estimated by employing force-free extrapolation NLFFF based on vector magnetic field products (SHARPS) observed by HMI instrument aboard SDO spacecraft from Sept. 29 (2013) to Oct. 07 (2013). The coronal plasma temperature and density are described and the emission is estimated using the CHIANTI atomic database 8.0. The performance of the our model is compared to the integrated emission from the AIA instrument aboard SDO spacecraft in the specific wavelengths 171Å and 304Å.
The density and temperature profiles in the solar corona are complex to describe, the observational diagnostics is not easy. Here we present a physics-based model to reconstruct the evolution of the electron density and temperature in the solar corona based on the configuration of the magnetic field imprinted on the solar surface. The structure of the coronal magnetic field is estimated from Potential Field Source Surface (PFSS) based on magnetic field from both observational synoptic charts and a magnetic flux transport model. We use an emission model based on the ionization equilibrium and coronal abundances from CHIANTI atomic database 8.0. The preliminary results are discussed in details.
Some key physical processes that impact the evolution of Earth's atmosphere on time-scale from days to millennia, such as the EUV emissions, are determined by the solar magnetic field. However, observations of the solar spectral irradiance are restricted to the last few solar cycles and are subject to large uncertainties. We present a physics-based model to reconstruct short-term solar spectral irradiance (SSI) variability. The coronal magnetic field is estimated to employ the Potential Field Source Surface extrapolation (PFSS) based on observational synoptic charts and magnetic flux transport model. The emission is estimated to employ the CHIANTI atomic database 8.0. The performance of the model is compared to the emission observed by TIMED/SORCE.
Most research on interventions to counter stigma and discrimination has
focused on short-term outcomes and has been conducted in high-income
To synthesise what is known globally about effective interventions to
reduce mental illness-based stigma and discrimination, in relation first
to effectiveness in the medium and long term (minimum 4 weeks), and
second to interventions in low- and middle-income countries (LMICs).
We searched six databases from 1980 to 2013 and conducted a
multi-language Google search for quantitative studies addressing the
research questions. Effect sizes were calculated from eligible studies
where possible, and narrative syntheses conducted. Subgroup analysis
compared interventions with and without social contact.
Eighty studies (n = 422 653) were included in the
review. For studies with medium or long-term follow-up (72, of which 21
had calculable effect sizes) median standardised mean differences were
0.54 for knowledge and −0.26 for stigmatising attitudes. Those containing
social contact (direct or indirect) were not more effective than those
without. The 11 LMIC studies were all from middle-income countries.
Effect sizes were rarely calculable for behavioural outcomes or in LMIC
There is modest evidence for the effectiveness of anti-stigma
interventions beyond 4 weeks follow-up in terms of increasing knowledge
and reducing stigmatising attitudes. Evidence does not support the view
that social contact is the more effective type of intervention for
improving attitudes in the medium to long term. Methodologically strong
research is needed on which to base decisions on investment in
The response of vascular epiphyte communities following natural or human disturbance has been little studied. Over 5 y, we evaluated the post-stripping recolonization of vascular epiphytes in cloud forest. Vascular epiphytes were experimentally removed from branch and trunk plots (1 m in length) on five trees in two secondary cloud forest fragments in southern Mexico. Similarity between colonizer and established communities was compared in each fragment using a further five trees with no stripping. All seedlings were recorded yearly. Non-vascular epiphyte cover was estimated in each plot. The recolonization rate was very high; after 5 y, epiphyte density of the colonizer community (27.4 ± 6.8 individuals per segment) reached similar values to those of the established community (26.7 ± 3.3) in nearby trees. While similarity (composition and abundance) between the colonizer community and established community was high (81%), diversity accumulation curves indicated that the colonizer community presents a lower diversity of epiphytes (5.5 equivalent species) than the established community (11.4). Colonization of xerophytic bromeliads was high, while pteridophytes and orchids presented reduced recovery. The immediately surrounding source of propagules had a strong influence on recolonization. In both the colonizer and established communities, dominance rank was bromeliads > peperomias > pteridophytes. The results show that the recovery capacity of epiphytic vegetation in secondary forest is high, if propagule sources are close by. However, at 5 y after disturbance, it is unclear whether the colonizer community would present the same species composition as the established community or if it would give rise to a different community.
Stegophorus macronectes (Johnston & Mawson, 1942) is a gastrointestinal parasite found in Antarctic seabirds. The original description of the species, which was based only on females, is poor and fragmented with some unclear diagnostic characters. This study provides new morphometric and molecular data on this previously poorly described parasite. Nuclear rDNA sequences (18S, 5.8S, 28S and internal transcribed spacer (ITS) regions) were isolated from S. macronectes specimens collected from the chinstrap penguin Pygoscelis antarctica Forster on Deception Island, Antarctica. Using 18S rDNA sequences, phylogenetic analyses (maximum likelihood, maximum parsimony and Bayesian inference) of the order Spirurida were performed to determine the phylogenetic location of this species. Primer pairs of the ITS regions were designed for genus-level identification of specimens, regardless of their cycle, as an alternative to coprological methods. The utility of this molecular method for identification of morphologically altered specimens is also discussed.
Strontium titanate (SrTiO3) is a wide-band-gap semiconductor with a variety of novel properties. In this work, bulk single crystal SrTiO3 samples were heated to 1200°C, resulting in the creation of point defects. These thermally treated samples showed large persistent photoconductivity (PPC) at room temperature. Illumination with sub-gap light (>2.9 eV) caused an increase in free-electron concentration by over two orders of magnitude. After the light is turned off, the conductivity persists at room temperature, with essentially zero decay over several days. The results of electron paramagnetic resonance (EPR) measurements suggest that a point defect is responsible for PPC because the photo-induced response of one of the EPR signals is similar to that seen for the PPC. Due to a large barrier for recapture, the photo-excited electron remains in the conduction band, where it contributes to the conductivity.
The stability of green phosphorescent OLEDs with different structures was evaluated through constant-current stressing. Through the modifications of the ITO anode by different plasma treatments and the hole transport layer (HTL) by incorporating inorganic dopants, we proved that energy level misalignment at the ITO/HTL interface leads to localized joule heating, accelerating defect generation and luminescence decay. Pulsed current stressing was then employed to suppress the joule-heating effect so as to differentiate the thermal and nonthermal factors governing the device degradation. For OLEDs with a large energy barrier at the ITO/HTL interface, the effective lifetime was markedly increased under pulsed operation, whereas in OLEDs with an appropriate interfacial energy level alignment, pulsed stressing with 10% duty cycle only improved the effective half life by ∼15% as compared to continuous-wave stressing, indicating a minor role played by joule heating.
The physical mechanisms responsible for electrically-induced parametric degradation in GaN-based high electron mobility transistors are examined using a combination of experiments, device simulation, and first-principles defect analysis. A relatively simple formulation is developed under the assumption that the hot-electron scattering cross-section is independent of the electron energy. In this case, one can relate the change in defect concentration to the operational characteristics of a device, such as the spatial and energy distribution of electrons (electron temperature), electric field distribution, and electron energy loss to the lattice.
We simulated the frequency of tuberculosis infection in healthcare workers in order to classify the risk of TB transmission for nine hospitals in Medellín, Colombia. We used a risk assessment approach to estimate the average number of infections in three risk groups of a cohort of 1082 workers exposed to potentially infectious patients over 10- and 20-day periods. The risk level of the hospitals was classified according to TB prevalence: two of the hospitals were ranked as being of very high priority, six as high priority and one as low priority. Consistent results were obtained when the simulation was validated in two hospitals by studying 408 healthcare workers using interferon gamma release assays and tuberculin skin testing. The latent infection prevalence using laboratory tests was 41% [95% confidence interval (CI) 34·3–47·7] and 44% (95% CI 36·4–51·0) in those hospitals, and in the simulation, it was 40·7% (95% CI 32·3–49·0) and 36% (95% CI 27·9–44·0), respectively. Simulation of risk may be useful as a tool to classify local and regional hospitals according to their risk of nosocomial TB transmission, and to facilitate the design of hospital infection control plans.
The Helioseismic and Magnetic Imager (HMI) on board the Solar Dynamics Observatory (SDO) provides continuous monitoring of the Sun's vector magnetic field through full-disk photospheric data with both high cadence and high spatial resolution. Here we investigate the evolution of AR 11249 from March 6 to March 7, 2012. We make use of HMI Stokes imaging, SDO/SHARPs, the HMI magnetic field line-of-sight (LOS) maps and the transverse components of the magnetic field as well as LOS velocity maps in order to detect regions with significant flux emergence and/or cancellation. In addition, we apply the Local Correlation Tracking (LCT) technique to the total and signed magnetic flux data and derive maps of horizontal velocity. From this analysis, we were able to pinpoint localized shear regions (and a shear channel) where penumbrae and pore formation areas, with strong linear polarization signals, are stretched and squeezed, showing also important downflows and upflows. We have also utilized Hinode/SP data and compared them to the HMI-SHARPs and the HMI-Stokes spectrograms. The aforementioned shear channel seems to correspond well with the X-class flare main channel of March 7 2012, as observed in AIA/SDO 171, 304 and 1600 Å.
Flux emergence phenomena are relevant at different temporal and spatial scales. We have studied a flux emergence region underneath a filament. This filament elevated itself smoothly, and the associated CME reached the Earth. In this study we investigate the size and the amount of flux in the emergence event. The flux emergence site appeared just beneath a filament. The emergence acquired a size of 24 Mm in half a day. The unsigned magnetic flux density from LOS-magnetograms was around 1 kG at its maximum. The transverse field as well as the filament eruption were also analysed.
We describe the preliminary design of a magnetograph and visible-light imager instrument to study the solar dynamo processes through observations of the solar surface magnetic field distribution. The instrument will provide measurements of the vector magnetic field and of the line-of-sight velocity in the solar photosphere. As the magnetic field anchored at the solar surface produces most of the structures and energetic events in the upper solar atmosphere and significantly influences the heliosphere, the development of this instrument plays an important role in reaching the scientific goals of The Atmospheric and Space Science Coordination (CEA) at the Brazilian National Institute for Space Research (INPE). In particular, the CEA's space weather program will benefit most from the development of this technology. We expect that this project will be the starting point to establish a strong research program on Solar Physics in Brazil. Our main aim is acquiring progressively the know-how to build state-of-the-art solar vector magnetograph and visible-light imagers for space-based platforms to contribute to the efforts of the solar-terrestrial physics community to address the main unanswered questions on how our nearby Star works.
Recently, the use of different types of natural fibers to produce paper and textiles from agave plants has been proposed. Agave atrovirens can be a good source of cellulose and lignin; nevertheless, the microstructural changes that happen during delignification have scarcely been studied. The aim of this work was to study the microstructural changes that occur during the delignification of agave fibers by means of microscopy techniques and image analysis. The fibers of A. atrovirens were obtained from leaves using convective drying, milling, and sieving. Fibers were processed using the Acetosolv pulping method at different concentrations of acetic acid; increasing acid concentration promoted higher levels of delignification, structural damage, and the breakdown of fiber clumps. Delignification followed by spectrometric analysis and microstructural studies were carried out by light, confocal laser scanning and scanning electron microscopy and showed that the delignification process follows three stages: initial, bulk, and residual. Microscopy techniques and image analysis were efficient tools for microstructural characterization during delignification of agave fibers, allowing quantitative evaluation of the process and the development of linear prediction models. The data obtained integrated numerical and microstructural information that could be valuable for the study of pulping of lignocellulosic materials.