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Hepatitis B vaccination is recommended for men who have sex with men (MSM) in many countries, but information on vaccine coverage is scarce. We studied hepatitis B vaccination programmes and coverage among MSM in Europe to guide prevention. From a large (N = 174 209) pan-European MSM survey (EMIS-2010), we used data on self-reported hepatitis B vaccination, age, education, settlement size and disclosure of the same-sex sexual orientation (‘outness’). We excluded participants with a history of hepatitis B. In multilevel (participants, countries) logistic regression models, we calculated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). We analysed data of 163 987 MSM in 38 European countries: 38.3% were ‘out’ to all or almost all, 56.4% reported vaccination against hepatitis B and 65.5% lived in countries with free recommended hepatitis B vaccination for MSM. In the final model the odds for being vaccinated increased with outness (‘out to all or almost all’: aOR 1.76, 95% CI 1.70–1.83 vs. ‘out to no one’) and with living in countries, where hepatitis B vaccination was recommended and free-of-charge for MSM (aOR 2.21, 95% CI 1.47–3.32 vs. ‘no or unclear recommendation’). To increase hepatitis B vaccination coverage among MSM, implementation of MSM-specific recommendations and improvement of the societal climate for MSM is needed.
Positive symptoms are a useful predictor of aggression in schizophrenia. Although a similar pattern of abnormal brain structures related to both positive symptoms and aggression has been reported, this observation has not yet been confirmed in a single sample.
To study the association between positive symptoms and aggression in schizophrenia on a neurobiological level, a prospective meta-analytic approach was employed to analyze harmonized structural neuroimaging data from 10 research centers worldwide. We analyzed brain MRI scans from 902 individuals with a primary diagnosis of schizophrenia and 952 healthy controls.
The result identified a widespread cortical thickness reduction in schizophrenia compared to their controls. Two separate meta-regression analyses revealed that a common pattern of reduced cortical gray matter thickness within the left lateral temporal lobe and right midcingulate cortex was significantly associated with both positive symptoms and aggression.
These findings suggested that positive symptoms such as formal thought disorder and auditory misperception, combined with cognitive impairments reflecting difficulties in deploying an adaptive control toward perceived threats, could escalate the likelihood of aggression in schizophrenia.
This note proposes a practical way for modelling and projecting health insurance expenditures over short time horizons, based on observed historical data. The present study is motivated by a similar age structure generally observed for health insurance claim frequencies and yearly aggregate losses on the one hand and mortality on the other hand. As an application, the approach is illustrated for German historical inpatient costs provided by the Federal Financial Supervisory Authority. In particular, similarities and differences to mortality modelling are addressed.
Previous studies have suggested that prenatal maternal folate deficiency is associated with reduced prenatal brain growth and psychological problems in offspring. However, little is known about the longer-term impact. The aims of this study were to investigate whether prenatal maternal folate insufficiency, high total homocysteine levels and low vitamin B12 levels are associated with altered brain morphology, cognitive and/or psychological problems in school-aged children. This study was embedded in Generation R, a prospective population-based cohort study. The study sample consisted of 256 Dutch children aged between 6 and 8 years from whom structural brain scans were collected using MRI. The mothers of sixty-two children had insufficient (<8 nmol/l) plasma folate concentrations in early pregnancy. Cognitive development was assessed by the Snijders-Oomen Niet-verbale intelligentietest – Revisie and the NEPSY-II-NL. Psychological problems were assessed at age 6 years using the parent report of the Child Behavior Checklist. Low prenatal folate levels were associated with a smaller total brain volume (B –33·34; 95 % CI –66·7, 0·02; P=050) and predicted poorer performance on the language (B –0·28; 95 % CI –0·52, –0·04; P=0·020) and visuo-spatial domains (B –0·27; 95 % CI –0·50, –0·04; P=0·021). High homocysteine levels (>9·1 µmol/l) predicted poorer performance on the language (B –0·31; 95 % CI –0·56, –0·06; P=0·014) and visuo-spatial domains (B –0·36; 95 % CI –0·60, –0·11; P=0·004). No associations with psychological problems were found. Our findings suggest that folate insufficiency in early pregnancy has a long-lasting, global effect on brain development and is, together with homocysteine levels, associated with poorer cognitive performance.
The Himalaya has some of the largest glacier concentrations outside the polar regions. Despite this, long-term measurements detecting the impact of global warming and changing precipitation patterns on glaciers are rare. The Nanga Parbat massif in northern Pakistan is an exception. The cartographer and glaciologist R. Finsterwalder investigated glacier dynamics of this mountain massif in the 1930s, and several other studies document changes since then. The aim of this study is to detect and analyse the changes of Raikot Glacier over the past seven decades. We use a multitemporal and multiscale approach, based on repeat terrestrial images, additional historical data and remotely sensed imagery (Corona, ASTER, Landsat, QuickBird). The multitemporal approach covers the period 1934–2007. While the analyses show a total glacier retreat of ~200 m in 73 years, this general trend was interrupted by a significant glacier advance between the 1950s and 1980s. Although down-wasting processes can be inferred from an increase in debris-covered area, a general trend of reduced glacier thickness does not appear significant over the whole observation period.
Population synthesis is a powerful tool to study stellar populations where the analysis of the stellar content of a composite system is based on the results of breaking down into components (of a given base) the spectrum of the observed system. Such process constitutes an inverse problem which can have a multitude of possible or “acceptable” solutions. This degenerative character of the synthesis rises mainly from observable errors and from the base of components itself with respect to its internal consistency and its (in)capacity to fully embrace all the free parameters involved.
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