1,662 research outputs found
Retrieval Practice and Context Reinstatement
Retrieval practice is a powerful learning strategy, but the mechanism(s) behind it are not fully understood. One account of this testing effect (i.e., enhanced memory for information that was previously retrieved vs. restudied) is the episodic-context account (Karpicke et al., 2014). According to this theory, successful retrieval requires contextual reinstatement which updates the target memory representation to include features of the current test context along with features of the initial study context. The resulting composite trace provides varied features that are more likely to match those on the final test. However, the specific features necessary for reinstatement remain unclear. The current study was designed to clarify the nature of these features using a three-phase paradigm. In phase 1, participants studied targets paired with different cues (phonemic vs. semantic) and presented in one of two different lists. In phase 2, participants either: (a) restudied the words; (b) restudied and made cue discrimination judgments; (c) restudied and made list discrimination judgments; or (d) freely-recalled the words. In phase 3, a final recognition test assessed item and context memory (i.e., cue type and list number). Unconditionalized analyses of final test performance found no differences between learning conditions. However, when only looking at words successfully retrieved at practice and thus subjected to reinstatement, free recall practice generally outperformed all other conditions on item and context memory, aside from the Restudy + Cue Discrimination condition. These results suggest that semantic, rather than temporal, features may be most relevant to the learning benefits of retrieval practice
Centrifugal spinning and characterization of CO3O4 coated carbon fibers
Centrifugally spun polyacrylonitrile (PAN) microfibers surface-coated with Co3O4 nanoparticles (NPs) were prepared as precursors to produce coated Co3O4 carbon-composite fibers. The Co3O4/C composite fibers were obtained through a staged heating process during which the Co3O4PAN precursor fibers were stabilized over four hours at 200 °C, and subsequently the stabilized fibers were carbonized for six hours at 600 °C. The synthesis process presented in this work provides an effective strategy for the fabrication of surface coated-fiber materials, including composite fibers with good structure and morphology. The characterization of the Co3O4/C composite fibers was performed using SEM, EDS, XPS, XRD and BET. The SEM data indicated the fibers were micron-sized in diameter with a non-homogenous distribution of the Co3O4 NPs on both the Co3O4-PAN and the CO3O4-Carbon composite fibers. The EDS mapping of the cobalt showed it to be distributed throughout the samples on the surface, but areas of high concentrations of particles were observed. The powder XRD data showed a reduction of the Co(III)/Co(II) starting material into a combination of Co-metal and CoO. The XRD results were confirmed by the Co 2P XPS data, which showed a change from the pure Co3O4 NPs to a combination of Co(III), Co(II) and Co-metal. In addition, the binding of the Co3O4 nanoparticles to the PAN fibers before carbonization showed a change in the chemical environment, which included attachment through an N ligand on the fibers
Using Novel Carbon Monoxide Devices in Remote Smoking Cessation Treatment: A Utilization and Reliability Analysis
https://openworks.mdanderson.org/sumexp22/1119/thumbnail.jp
Examining the Rotation Period Distribution of the 40 Myr Tucana-Horologium Association with TESS
The Tucana-Horologium Association (Tuc-Hor) is a 40 Myr old moving group in
the southern sky. In this work, we measure the rotation periods of 313 Tuc-Hor
objects with TESS light curves derived from TESS full frame images and
membership lists driven by Gaia EDR3 kinematics and known youth indicators. We
recover a period for 81.4% of the sample and report 255 rotaion periods for
Tuc-Hor objects. From these objects we identify 11 candidate binaries based on
multiple periodic signals or outlier Gaia DR2 and EDR3 re-normalised unit
weight error (RUWE) values. We also identify three new complex rotators
(rapidly rotating M dwarf objects with intricate light curve morphology) within
our sample. Along with the six previously known complex rotators that belong to
Tuc-Hor, we compare their light curve morphology between TESS Cycle 1 and Cycle
3 and find they change substantially. Furthermore, we provide context for the
entire Tuc-Hor rotation sample by describing the rotation period distributions
alongside other youth indicators such as H{\alpha} and Li equivalent width, as
well as near ultra-violet and X ray flux. We find that measuring rotation
periods with TESS to be a fast and effective means to confirm members in young
moving groups.Comment: 27 pages, 12 figure
Household and climate factors influence Aedes aegypti presence in the arid city of Huaquillas, Ecuador
Funding: This study was funded by NSF EEID DEB 1518681 to SJR, EAM, AMS. EAM was also supported by NIH R35GM133439, NSF DEB-2011147, the Terman Award, the Helman Faculty Fellowship, and the Stanford Center for Innovation in Global Health.Arboviruses transmitted by Aedes aegypti (e.g., dengue, chikungunya, Zika) are of major public health concern on the arid coastal border of Ecuador and Peru. This high transit border is a critical disease surveillance site due to human movement-associated risk of transmission. Local level studies are thus integral to capturing the dynamics and distribution of vector populations and social-ecological drivers of risk, to inform targeted public health interventions. Our study examines factors associated with household-level Ae. aegypti presence in Huaquillas, Ecuador, while accounting for spatial and temporal effects. From January to May of 2017, adult mosquitoes were collected from a cohort of households (n = 63) in clusters (n = 10), across the city of Huaquillas, using aspirator backpacks. Household surveys describing housing conditions, demographics, economics, travel, disease prevention, and city services were conducted by local enumerators. This study was conducted during the normal arbovirus transmission season (January-May), but during an exceptionally dry year. Household level Ae. aegypti presence peaked in February, and counts were highest in weeks with high temperatures and a week after increased rainfall. Univariate analyses with proportional odds logistic regression were used to explore household social-ecological variables and female Ae. aegypti presence. We found that homes were more likely to have Ae. aegypti when households had interruptions in piped water service. Ae. aegypti presence was less likely in households with septic systems. Based on our findings, infrastructure access and seasonal climate are important considerations for vector control in this city, and even in dry years, the arid environment of Huaquillas supports Ae. aegypti breeding habitat.Publisher PDFPeer reviewe
Kyphoplasty vs Vertebroplasty: A Systematic Review of Height Restoration in Osteoporotic Vertebral Compression Fractures
Background: Back pain is a leading cause of morbidity in older US adults, especially those with osteoporosis. Osteoporotic vertebral compression fractures (OVCF) commonly occur in people with osteoporosis. ~1/3 of OVCF are symptomatic with acute or chronic low back pain. Annual US cases of osteoporosis with OVCF are ~700,000/year. OVCF and osteoporosis cause high levels of morbidity, decreased functional independence, and chronic pain. Conservative treatment for OVCF is often insufficient for many patients. Insufficient vertebral height caused by OVCF can lead to spinal deformities, reduced pulmonary function, depression, reduced mobility, and lower quality of life. Surgical correction is a viable option for increasing vertebral height in patients with OVCF.
Kyphoplasty and vertebroplasty are vertebral augmentation therapies that can restore bone height for the alleviation of OVCF. Both procedures involve injection of a polymer cement into sites of fracture. Only kyphoplasty involves using an inflatable balloon to first make space for polymer injection. These minimally invasive procedures are recommended for patients who have OVCF but are refractory to conventional therapies. Also, patients with benign bone tumors or traumatic acute vertebral compression fractures with a local kyphotic angle greater than 15 degrees can benefit from these procedures. The aim of our systematic review was to identify the overall effectiveness of kyphoplasty and vertebroplasty. Height restoration after treatment was used as the key indicator of therapeutic success. Restoration of function and pain relief were also assessed.
Purpose: To critically investigate whether vertebral body height restoration correlates with pain relief after kyphoplasty and vertebroplasty. Primary Outcome: height restoration. Secondary Outcomes: pain relief, functionality, cement leakage, Cobb’s Angle, wedge angle restoration, kyphosis angle restoration, and Gardner’s angle. We assessed only randomized controlled trials (RCTs) to generate a more robust and clinically applicable. We also provide an update on the literature comparing kyphoplasty versus vertebroplasty for height restoration, pain relief, and function restoration. We searched 6 databases to ensure that the review was comprehensive.
Methods: We performed a systematic review per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol. Level II randomized controlled trials assessing kyphoplasty and/or vertebroplasty were included. Study selection inclusion criteria: patients \u3e 18 years, in English, study of OVCF, active comparator vs placebo, outcome measure of height restoration, with pain relief and functionality as secondary outcomes. Of 4147 individual articles, 238 articles were screened, and 33 were analyzed. Of the 33 analyzed studies, 6 compared kyphoplasty to vertebroplasty.
Results:
Vertebral Height Restoration
7 studies of vertobroplasty
2 showed height loss
1 showed height restoration
2 showed absolute height gain
20 studies of kyphoplasty
None showed height loss
8 showed height restoration
8 showed absolute height gain
6 head-to-head comparisons
3 showed correlation of cement injection volume with improved height
5 favored kyphoplasty for height restoration
Alleviation of Pain:
Assessed by visual analogue scale (VAS)score
6 of 6 vertebroplasty studies showed reduced postop pain
6 of 18 kyphoplasty studies showed sustained reduced pain at 12 months
6 studies compared kyphoplasty & vertebroplasty and none saw a difference between the 2 for reducing postop pain
Restoration of Function
Assessed by Oswestry disability index (ODI)
3 studies showed improved ODI after vertebroplasty at 18 to 36 months postop
4 studies showed improved ODI at 12 months after kyphoplasty
3 studies compared kyphoplasty & vertebroplasty and all showed lower postop ODI
Conclusions: Both kyphoplasty and vertebroplasty are effective treatments for OVCF and are viable options for OVCF patients. Both treatments restored some vertebral body height, reduced kyphosis angle, improved Cobbs angle, and improved wedge angle. Both treatments showed similar benefits of pain reduction and improved functionality. It was unclear whether fracture type or age of fracture influence procedure outcomes. Kyphoplasty has the possibility of cement leakage, which can lead to negative outcomes. It was not possible to conclude whether one approach was superior.https://scholarlycommons.henryford.com/sarcd2021/1006/thumbnail.jp
MyD88-dependent expansion of an immature GR-1+CD11b+ population induces T cell suppression and Th2 polarization in sepsis
Polymicrobial sepsis alters the adaptive immune response and induces T cell suppression and Th2 immune polarization. We identify a GR-1+CD11b+ population whose numbers dramatically increase and remain elevated in the spleen, lymph nodes, and bone marrow during polymicrobial sepsis. Phenotypically, these cells are heterogeneous, immature, predominantly myeloid progenitors that express interleukin 10 and several other cytokines and chemokines. Splenic GR-1+ cells effectively suppress antigen-specific CD8+ T cell interferon (IFN) γ production but only modestly suppress antigen-specific and nonspecific CD4+ T cell proliferation. GR-1+ cell depletion in vivo prevents both the sepsis-induced augmentation of Th2 cell–dependent and depression of Th1 cell–dependent antibody production. Signaling through MyD88, but not Toll-like receptor 4, TIR domain–containing adaptor-inducing IFN-β, or the IFN-α/β receptor, is required for complete GR-1+CD11b+ expansion. GR-1+CD11b+ cells contribute to sepsis-induced T cell suppression and preferential Th2 polarization
Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017
Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk outcome pairs, and new data on risk exposure levels and risk outcome associations.
Methods: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
Findings: In 2017,34.1 million (95% uncertainty interval [UI] 33.3-35.0) deaths and 121 billion (144-1.28) DALYs were attributable to GBD risk factors. Globally, 61.0% (59.6-62.4) of deaths and 48.3% (46.3-50.2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10.4 million (9.39-11.5) deaths and 218 million (198-237) DALYs, followed by smoking (7.10 million [6.83-7.37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6.53 million [5.23-8.23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4.72 million [2.99-6.70] deaths and 148 million [98.6-202] DALYs), and short gestation for birthweight (1.43 million [1.36-1.51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4.9% (3.3-6.5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23.5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18.6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low.
Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator.Background Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator
- …