Association of Prenatal Famine Exposure With Inflammatory Markers and Its Impact on Adulthood Liver Function Across Consecutive Generations

Although there has been increasing recognition that famine exposure in the fetal stage damages liver function in adulthood, this deteriorated effect could be extended to the next generation remains vague. This study aimed to explore whether famine exposure was associated with liver function in the two consecutive generations, and its association with the mediation role of inflammatory markers. We analyzed the data of 2,681 participants from Suihua rural area, Heilongjiang Province, China. According to the date of birth, the participants were classified as fetal exposed and nonexposed. The F2 subjects were classified as having no parents exposed to famine, maternal famine exposure, paternal famine exposure, or parental famine exposure. In the mixed-effect models, prenatal exposure to famine was associated with the elevation of Δ aspartate aminotransferase (ΔAST) (β: 0.22, 95% CI: 0.01, 0.43) and Δ alanine aminotransferase (ΔALT) (β: 0.42, 95% CI: 0.19, 0.66) levels in F1 adults. The mediation analysis showed that the inflammatory markers including serum C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α) might mediate the famine-liver function association. This longitudinal data were consistent with the hypothesis that the inflammatory markers explained part of the influence of prenatal famine exposure on liver function injury, and the natal mechanism was needed to be elucidated in the future study.

Intraoperative vs. Postoperative Side-Effects-Thresholds During Pallidal and Thalamic DBS

Background: It is currently unknown whether results from intraoperative test stimulation of two types of Deep Brain Stimulation (DBS), either during awake pallidal (GPi) or thalamic (Vim), are comparable to the results generated by chronic stimulation through the definitive lead.Objective: To determine whether side-effects-thresholds from intraoperative test stimulation are indicative of postoperative stimulation findings.Methods: Records of consecutive patients who received GPi or Vim were analyzed. Thresholds for the induction of either capsular or non-capsular side-effects were compared at matched depths and at group-level.Results: Records of fifty-two patients were analyzed (20 GPis, 75 Vims). The induction of side-effects was not significantly different between intraoperative and postoperative assessments at matched depths, although a large variability was observed (capsular: GPi DBS: p = 0.79; Vim DBS: p = 0.68); non-capsular: GPi DBS: p = 0.20; and Vim DBS: p = 0.35). Linear mixed-effect models revealed no differences between intraoperative and postoperative assessments, although the Vim had significantly lower thresholds (capsular side-effects p = 0.01, non-capsular side-effects p < 0.01). Unpaired survival analyses demonstrated lower intraoperative than postoperative thresholds for capsular side-effects in patients under GPi DBS (p = 0.01), while higher intraoperative thresholds for non-capsular side-effects in patients under Vim DBS (p = 0.01).Conclusion: There were no significant differences between intraoperative and postoperative assessments of GPi and Vim DBS, although thresholds cannot be directly extrapolated at an individual level due to high variability.

Origins of Varying Understandings of Democracy

This chapter uses mixed-effect models to examine the origins of varying conceptions of democracy. Due to data limitations, we are only able to account for some key individual demographic, cognitive, and psychological features as we explore the impact of surrounding economic, political, and cultural contexts. Overall, our findings demonstrate the salience of surrounding economic, political, and cultural contexts in shaping popular conceptions of democracy. Short-term fluctuations (like economic growth vs. recession), mid-term changes (like democratic practices gauged by Freedom House ratings and economic development measured by per capita GDP), and long-term evolutions (like the history of personal dictatorships and Confucian political traditions) all play important roles in this regard.

Health-related quality of life of individuals sharing a household with persons with dementia

Introduction Previous research has found a negative effect of dementia on the health-related quality of life (HrQoL) of persons with dementia (PWD) and their primary informal caregivers. However, the impact of dementia on HrQoL of other individuals sharing a household with PWD has not been investigated to date. The current study therefore aimed to determine differences in the HrQoL between those sharing a household with PWD and those not living with PWD. In addition, factors related to the HrQoL of those sharing a household with PWD were evaluated. Methods The analyses were based on data from the German Socio-Economic Panel, using the SF-12 to measure HrQoL. Mixed-effects models were calculated to compare the HrQoL of those sharing a household with PWD and persons not living with PWD, as well as to determine factors related to the HrQoL of those sharing a household with PWD. Bootstrapping was used where residuals were not normally distributed. Results Mixed-effect models showed a significantly lower HrQoL among those sharing a household with PWD, compared to those not living with PWD. Number of diseases, number of persons in the household, marital status and educational level were significantly related to HrQoL among those sharing a household with PWD. Discussion The HrQoL of those sharing a household with PWD was reduced compared to persons not living with PWD. Further, those living with PWD in small households, or those with multi-morbidities had a lower HrQoL. Further research focusing on HrQoL in the social environment of PWD is needed.

Hybrid pointer networks for traveling salesman problems optimization

In this work, we proposed a hybrid pointer network (HPN), an end-to-end deep reinforcement learning architecture is provided to tackle the travelling salesman problem (TSP). HPN builds upon graph pointer networks, an extension of pointer networks with an additional graph embedding layer. HPN combines the graph embedding layer with the transformer’s encoder to produce multiple embeddings for the feature context. We conducted extensive experimental work to compare HPN and Graph pointer network (GPN). For the sack of fairness, we used the same setting as proposed in GPN paper. The experimental results show that our network significantly outperforms the original graph pointer network for small and large-scale problems. For example, it reduced the cost for travelling salesman problems with 50 cities/nodes (TSP50) from 5.959 to 5.706 without utilizing 2opt. Moreover, we solved benchmark instances of variable sizes using HPN and GPN. The cost of the solutions and the testing times are compared using Linear mixed effect models. We found that our model yields statistically significant better solutions in terms of the total trip cost. We make our data, models, and code publicly available https://github.com/AhmedStohy/Hybrid-Pointer-Networks.

Energy and Fatigue Predict Gait Speed and Mood Decline: Results From the Health, Aging and Body Composition Study

Older adults may report high energy alongside tiredness or vice versa; little is known about whether discordant self-reported energy (SEL) and tiredness predict trajectories of mood, cognition, or gait speed. SEL (0-10 scale dichotomized at median) and tiredness (present/absent) were obtained in 2,613 older adults (aged 74.6± 2.87 years) and used to create four groups (energized/not tired, low energy/tired, energized/tired, low energy/not tired). Center for Epidemiologic Studies Depression Scale (CES-D) and gait speed were measured over 10 years; mixed effect models compared trajectories in these domains across each group with low energy/tired group as referent. Each group was significantly associated with CES-D and gait. Adjusting for demographics, the high SEL/not tired group showed the least decline in mood (ß = -0.17, p<0.01); the high SEL/tired group showed the least decline in rapid gait (ß = 0.008, p = 0.02). High SEL may indicate resilience for mood and gait speed decline.

Social Isolation and Accelerated Tooth Loss Among Chinese Older Adults

Social isolation and loneliness in older adults are major global public health concerns. Tooth loss is also a common problem in this population. This study examined the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss among Chinese older adults. We included 4,268 older adults age 65+ from three waves of the Chinese Longitudinal Healthy Longevity Survey (2011/2012, 2014, 2018). Linear mixed-effect models showed higher levels of social isolation were associated with fewer remaining teeth (β = -1.59, P < 0.05) and accelerated tooth loss (β=-0.10, P<0.05) controlled for socio-demographic, lifestyle, oral hygiene behavior, and health status. Loneliness was neither associated with the number of remaining teeth (β=0.64, P>0.05) nor with the rate of tooth loss (β=-0.09, P>0.05) before and after controlling for covariates. These findings expand our knowledge regarding the correlation between social connection and tooth loss in non-Western populations.

Stress events and Changes in Dysfunctional Attitudes and Automatic Thoughts Following Recovery from Depression in Inpatient Psychotherapy: Mediation Analyses with Longitudinal Data

Background Stressful event exposure, dysfunctional attitudes (DA), negative automatic thoughts (NAT), and declining positive automatic thoughts (PAT) have been associated with depressive relapse/recurrence. Few studies have investigated the course of these variables and their relevance for relapse/recurrence in remitted depression. Methods Following successful inpatient treatment, in 39 remitted depressive patients, stressful events, DA, NAT, PAT, and depressive relapse/recurrence were assessed five times during a 16-month follow-up. Data were analyzed with mixed effect models, and mediation effects were tested. Results Stressful events after discharge correlated with depressive relapse/recurrence. This association was mainly mediated by a stress-related decline of PAT within four months post discharge. Patients’ DA were relatively stable during the observation period and did not depend on stressful events, indicating DA as a risk trait for depressive relapse/recurrence. Mediation analyses revealed that independent of stress, DA were linked to depressive relapse/recurrence through more NAT. Conclusion Our findings suggest stressful events evoke relapse/recurrence in remitted depression through rapid deterioration of PAT after discharge from inpatient therapy. DA are expressed through NAT which additionally contribute to higher risk of depressive relapse/recurrence. Consequently, maintenance therapy requires techniques to promote the maintenance of PAT, and to effectively restructure DA and NAT.

Organisational determinants and consequences of diagnostic discrepancy in two large patient groups in the emergency departments: a national study of consecutive episodes between 2008 and 2016

Background Diagnostic discrepancy (DD) is a common phenomenon in healthcare, but little is known about its organisational determinants and consequences. Thus, the aim of the study was to evaluate this among selected emergency department (ED) patients. Method We conducted an observational study including all consecutive ED patients (hip fracture or erysipelas) in the Danish healthcare sector admitted between 2008 and 2016. DD was defined as a discrepancy between discharge and admission diagnoses. Episode and department statistics were retrieved from Danish registers. We conducted a survey among all 21 Danish EDs to gather information about organisational determinants. To estimate the results while adjusting for episode- and department-level heterogeneity, we used mixed effect models of ED organisational determinants and 30-day readmission, 30-day mortality and episode costs (2018-DKK) of DDs. Results DD was observed in 2308 (3.3%) of 69,928 hip fracture episodes and 3206 (8.5%) of 37,558 erysipelas episodes. The main organisational determinant of DD was senior physicians (nonspecific medical specialty) being employed at the ED (hip fracture: odds ratio (OR) 2.74, 95% confidence interval (CI) 2.15–3.51; erysipelas: OR 3.29, 95% CI 2.65–4.07). However, 24-h presence of senior physicians (nonspecific medical specialty) (hip fracture) and availability of external senior physicians (specific medical specialty) (both groups) were negatively associated with DD. DD was associated with increased 30-day readmission (hip fracture, mean 9.45% vs 13.76%, OR 1.46, 95% CI 1.28–1.66, p < 0.001) and episode costs (hip fracture, 61,681 DKK vs 109,860 DKK, log cost 0.58, 95% CI 0.53–0.63, p < 0.001; erysipelas, mean 20,818 DKK vs 56,329 DKK, log cost 0.97, 95% CI 0.92–1.02, p < 0.001) compared with episodes without DD. Conclusion DD was found to have a negative impact on two out of three study outcomes, and particular organisational characteristics seem to be associated with DD. Yet, the complexity of organisations and settings warrant further studies into these associations.

Annual Population Dynamics and Their Influencing Factors for an Endangered Submerged Macrophyte (Ottelia cordata)

Due to wetland loss, Ottelia cordata (O. cordata, Wallich) Dandy has been categorized as an endangered species on the List of Key Protected Wild Plants in China. Quantifying the relative importance of demographic (i.e., growth, survival, and reproduction) and habitat preference traits on the population dynamics (abundance) of O. cordata could guide how to develop the best recovery strategies of O. cordata, yet currently, there are no studies that investigate this. By monitoring monthly changes in O. cordata abundance and demographic traits (plant height, leaf area, flower sex ratio, and seed number) that were highly correlated with growth rate, photosynthetic rate, and water depth, we identified several relationships. Linear mixed-effect models and variance partition quantified the specific effects of four demographic traits and water depth on O. cordata abundance in three habitat types (paddyfield, stream, and spring). The linear mixed-effect models indicate that among the four demographic traits, height could be significantly positively correlated to abundance in all three habitat types. In contrast, other three traits (leaf area, sex ratio, and seed numbers) were non-significantly associated with abundance across each habitat. Height was determined by water depth, so water depth rather than photosynthetic rate and reproduction rate may promote the development and recovery of O. cordata populations. Variance partition results showed that water depth mediated the positive influence of growth rate on the abundance of O. cordata in the living habitats (paddyfield and spring). In contrast, water depth but not growth rate determined the abundance of O. cordata in the living habitat (stream). However, water depth had a significantly negative impact on the abundance of O. cordata in stream habitats, likely because all of the streams were shallow. Altogether, in the short term for avoiding the potential harm or even extinction of O. cordata, keeping appropriate water depth or transplanting O. cordata to spring should be an effective strategy because the water is not only deep enough but also clear in spring habitats. Additionally, water turbidity was shown to affect the density of O. cordata growth, wherein O. cordata was sparsely distributed when turbidity was high. Therefore, in the long run, to make the population gradually recovery, it will be necessary to restore the degraded wetland. This could be accomplished by reducing water pollution and removing sludge to reduce turbidity and increase hydrological connectivity.