Longitudinal association between informal unpaid caregiving and mental health amongst working age adults in high-income OECD countries: a systematic review

Background Informal unpaid caregivers provide most of the world's care needs, experiencing numerous health and wealth penalties as a result. As the COVID-19 pandemic has highlighted, informal care is highly gendered. Longitudinal evidence is needed to assess the causal effect of caregiving on mental health. This review addresses a gap by summarising and appraising the longitudinal evidence examining the association between unpaid caregiving and mental health among working age adults in high-income Organisation for Economic Co-operation and Development (OECD) countries and examining gender differences. Methods Six databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science, Econlit) from Jan 1, 2000 to April 1, 2022. Population-based, peer-reviewed quantitative studies using any observational design were included. Population of interest was working age adults. Exposure was any unpaid caregiving, and studies must have had a non-caregiving comparator for inclusion. Mental health outcomes (depression, anxiety, psychological distress/wellbeing) were measurable by validated self-report tools or professional diagnosis. Screening, data extraction and quality assessment (ROBINS-E) were conducted by two reviewers. The study was prospectively registered with PROSPERO (CRD42022312401). Findings Of the 4536 records screened; 13 eligible studies (133,426 participants) were included. Overall quality of evidence was moderate. Significant between-study heterogeneity precluded meta-analysis, so albatross and effect-direction plots complement the narrative synthesis. Results indicate a negative association between informal unpaid care and mental health in adults of working age. Importantly, all included studies were longitudinal in design. Where studies were stratified by gender, caregiving had a consistently negative impact on the mental health of women. Few studies examined men but revealed a negative effect where an association was found. Interpretation Our review highlights the need to mitigate the mental health risks of caregiving in working age adults. Whilst men need to be included in further scholarship, reducing the disproportionate caregiving load on women is a crucial requirement for policy development. Funding Melbourne School of Population and Global Health, Targeted Research Support Grant

Leading nucleon and inelasticity in hadron-nucleus interactions

We present in this paper a calculation of the average proton-nucleus ine- lasticity. Using an Iterative Leading Particle Model and the Glauber model, we relate the leading particle distribution in nucleon-nucleus interactions with the respective one in nucleon-proton collisions. To describe the leading particle distribution in nucleon-proton collisions, we use the Regge-Mueller formalism. To appear in Journal of Physics G.Comment: 11 pages, 2 figure

“Proteotranscriptomic analysis of advanced colorectal cancer patient derived organoids for drug sensitivity prediction”

BACKGROUND: Patient-derived organoids (PDOs) from advanced colorectal cancer (CRC) patients could be a key platform to predict drug response and discover new biomarkers. We aimed to integrate PDO drug response with multi-omics characterization beyond genomics. METHODS: We generated 29 PDO lines from 22 advanced CRC patients and provided a morphologic, genomic, and transcriptomic characterization. We performed drug sensitivity assays with a panel of both standard and non-standard agents in five long-term cultures, and integrated drug response with a baseline proteomic and transcriptomic characterization by SWATH-MS and RNA-seq analysis, respectively. RESULTS: PDOs were successfully generated from heavily pre-treated patients, including a paired model of advanced MSI high CRC deriving from pre- and post-chemotherapy liver metastasis. Our PDOs faithfully reproduced genomic and phenotypic features of original tissue. Drug panel testing identified differential response among PDOs, particularly to oxaliplatin and palbociclib. Proteotranscriptomic analyses revealed that oxaliplatin non-responder PDOs present enrichment of the t-RNA aminoacylation process and showed a shift towards oxidative phosphorylation pathway dependence, while an exceptional response to palbociclib was detected in a PDO with activation of MYC and enrichment of chaperonin T-complex protein Ring Complex (TRiC), involved in proteome integrity. Proteotranscriptomic data fusion confirmed these results within a highly integrated network of functional processes involved in differential response to drugs. CONCLUSIONS: Our strategy of integrating PDOs drug sensitivity with SWATH-mass spectrometry and RNA-seq allowed us to identify different baseline proteins and gene expression profiles with the potential to predict treatment response/resistance and to help in the development of effective and personalized cancer therapeutics

Integrative immune transcriptomic classification improves patient selection for precision immunotherapy in advanced gastro-oesophageal adenocarcinoma

BACKGROUND: Advanced gastro-oesophageal cancer (GEA) treatment has been improved by the introduction of immune checkpoint inhibitors (CPIs), yet identifying predictive biomarkers remains a priority, particularly in patients with a combined positive score (CPS) < 5, where the benefit is less clear. Our study assesses certain immune microenvironment features related to sensitivity or resistance to CPIs with the aim of implementing a personalised approach across CPS < 5 GEA. DESIGN: Through integrative transcriptomic and clinicopathological analyses, we studied in both a retrospective and a prospective cohort, the immune tumour microenvironment features. We analysed the cell types composing the immune infiltrate highlighting their functional activity. RESULTS: This integrative study allowed the identification of four different groups across our patients. Among them, we identified a cluster whose tumours expressed the most gene signatures related to immunomodulatory pathways and immunotherapy response. These tumours presented an enriched immune infiltrate showing high immune function activity that could potentially achieve the best benefit from CPIs. Finally, our findings were proven in an external CPI-exposed population, where the use of our transcriptomic results combined with CPS helped better identify those patients who could benefit from immunotherapy than using CPS alone (p = 0.043). CONCLUSIONS: This transcriptomic classification could improve precision immunotherapy for GEA

<i>Gaia</i> Data Release 1. Summary of the astrometric, photometric, and survey properties

Context. At about 1000 days after the launch of Gaia we present the first Gaia data release, Gaia DR1, consisting of astrometry and photometry for over 1 billion sources brighter than magnitude 20.7. Aims. A summary of Gaia DR1 is presented along with illustrations of the scientific quality of the data, followed by a discussion of the limitations due to the preliminary nature of this release. Methods. The raw data collected by Gaia during the first 14 months of the mission have been processed by the Gaia Data Processing and Analysis Consortium (DPAC) and turned into an astrometric and photometric catalogue. Results. Gaia DR1 consists of three components: a primary astrometric data set which contains the positions, parallaxes, and mean proper motions for about 2 million of the brightest stars in common with the HIPPARCOS and Tycho-2 catalogues – a realisation of the Tycho-Gaia Astrometric Solution (TGAS) – and a secondary astrometric data set containing the positions for an additional 1.1 billion sources. The second component is the photometric data set, consisting of mean G-band magnitudes for all sources. The G-band light curves and the characteristics of ∼3000 Cepheid and RR-Lyrae stars, observed at high cadence around the south ecliptic pole, form the third component. For the primary astrometric data set the typical uncertainty is about 0.3 mas for the positions and parallaxes, and about 1 mas yr−1 for the proper motions. A systematic component of ∼0.3 mas should be added to the parallax uncertainties. For the subset of ∼94 000 HIPPARCOS stars in the primary data set, the proper motions are much more precise at about 0.06 mas yr−1. For the secondary astrometric data set, the typical uncertainty of the positions is ∼10 mas. The median uncertainties on the mean G-band magnitudes range from the mmag level to ∼0.03 mag over the magnitude range 5 to 20.7. Conclusions. Gaia DR1 is an important milestone ahead of the next Gaia data release, which will feature five-parameter astrometry for all sources. Extensive validation shows that Gaia DR1 represents a major advance in the mapping of the heavens and the availability of basic stellar data that underpin observational astrophysics. Nevertheless, the very preliminary nature of this first Gaia data release does lead to a number of important limitations to the data quality which should be carefully considered before drawing conclusions from the data

Patients' perspectives on self-testing of oral anticoagulation therapy: Content analysis of patients' internet blogs

<p>Abstract</p> <p>Background</p> <p>Patients on oral anticoagulant therapy (OAT) require regular testing of the prothrombin time (PT) and the international normalised ratio (INR) to monitor their blood coagulation level to avoid complications of either over or under coagulation. PT/INR can be tested by a healthcare professional or by the patient. The latter mode of the testing is known as patient self-testing or home testing. The objective of this study was to elicit patients' perspectives and experiences regarding PT/INR self-testing using portable coagulometer devices.</p> <p>Methods</p> <p>Internet blog text mining was used to collect 246 blog postings by 108 patients, mainly from the USA and the UK. The content of these qualitative data were analysed using XSight and NVivo software packages.</p> <p>Results</p> <p>The key themes in relation to self-testing of OAT identified were as follows: Patient benefits reported were time saved, personal control, choice, travel reduction, cheaper testing, and peace of mind. Equipment issues included high costs, reliability, quality, and learning how to use the device. PT/INR issues focused on the frequency of testing, INR fluctuations and individual target (therapeutic) INR level. Other themes noted were INR testing at laboratories, the interactions with healthcare professionals in managing and testing OAT and insurance companies' involvement in acquiring the self-testing equipment. Social issues included the pain and stress of taking and testing for OAT.</p> <p>Conclusions</p> <p>Patients' blogs on PT/INR testing provide insightful information that can help in understanding the nature of the experiences and perspectives of patients on self-testing of OAT. The themes identified in this paper highlight the substantial complexities involved in self-testing programmes in the healthcare system. Thus, the issues elicited in this study are very valuable for all stakeholders involved in developing effective self-testing strategies in healthcare that are gaining considerable current momentum particularly for patients with chronic illness.</p

Public Claims about Automatic External Defibrillators: An Online Consumer Opinions Study

Patients are no longer passive recipients of health care, and increasingly engage in health communications outside of the traditional patient and health care professional relationship. As a result, patient opinions and health related judgements are now being informed by a wide range of social, media, and online information sources. Government initiatives recognise self-delivery of health care as a valuable means of responding to the anticipated increased global demand for health resources. Automated External Defibrillators (AEDs), designed for the treatment of Sudden Cardiac Arrest (SCA), have recently become available for 'over the counter' purchase with no need for a prescription. This paper explores the claims and argumentation of lay persons and health care practitioners and professionals relating to these, and how these may impact on the acceptance, adoption and use of these devices within the home context. METHODS: We carry out a thematic content analysis of a novel form of Internet-based data: online consumer opinions of AED devices posted on Amazon.com, the world's largest online retailer. A total of 83 online consumer reviews of home AEDs are analysed. The analysis is both inductive, identifying themes that emerged from the data, exploring the parameters of public debate relating to these devices, and also driven by theory, centring around the parameters that may impact upon the acceptance, adoption and use of these devices within the home as indicated by the Technology Acceptance Model (TAM). RESULTS: Five high-level themes around which arguments for and against the adoption of home AEDs are identified and considered in the context of TAM. These include opinions relating to device usability, usefulness, cost, emotional implications of device ownership, and individual patient risk status. Emotional implications associated with AED acceptance, adoption and use emerged as a notable factor that is not currently reflected within the existing TAM. CONCLUSIONS: The value and credibility of the findings of this study are considered within the context of existing AED research, and related to technology acceptance theory, and current methods and practice. From a methodological perspective, this study demonstrates the potential value of online consumer reviews as a novel data source for exploring the parameters of public debate relating to emerging health care technologies

Euclid preparation. XXIX. Water ice in spacecraft part I:The physics of ice formation and contamination

Molecular contamination is a well-known problem in space flight. Water is the most common contaminant and alters numerous properties of a cryogenic optical system. Too much ice means that Euclid's calibration requirements and science goals cannot be met. Euclid must then be thermally decontaminated, a long and risky process. We need to understand how iced optics affect the data and when a decontamination is required. This is essential to build adequate calibration and survey plans, yet a comprehensive analysis in the context of an astrophysical space survey has not been done before. In this paper we look at other spacecraft with well-documented outgassing records, and we review the formation of thin ice films. A mix of amorphous and crystalline ices is expected for Euclid. Their surface topography depends on the competing energetic needs of the substrate-water and the water-water interfaces, and is hard to predict with current theories. We illustrate that with scanning-tunnelling and atomic-force microscope images. Industrial tools exist to estimate contamination, and we must understand their uncertainties. We find considerable knowledge errors on the diffusion and sublimation coefficients, limiting the accuracy of these tools. We developed a water transport model to compute contamination rates in Euclid, and find general agreement with industry estimates. Tests of the Euclid flight hardware in space simulators did not pick up contamination signals; our in-flight calibrations observations will be much more sensitive. We must understand the link between the amount of ice on the optics and its effect on Euclid's data. Little research is available about this link, possibly because other spacecraft can decontaminate easily, quenching the need for a deeper understanding. In our second paper we quantify the various effects of iced optics on spectrophotometric data

Gaia Data Release 2: The astrometric solution

Gaia Data Release 2 (Gaia DR2) contains results for 1693 million sources in the magnitude range 3 to 21 based on observations collected by the European Space Agency Gaia satellite during the first 22 months of its operational phase. We describe the input data, models, and processing used for the astrometric content of Gaia DR2, and the validation of these results performed within the astrometry task. Some 320 billion centroid positions from the pre-processed astrometric CCD observations were used to estimate the five astrometric parameters (positions, parallaxes, and proper motions) for 1332 million sources, and approximate positions at the reference epoch J2015.5 for an additional 361 million mostly faint sources. Special validation solutions were used to characterise the random and systematic errors in parallax and proper motion. For the sources with five-parameter astrometric solutions, the median uncertainty in parallax and position at the reference epoch J2015.5 is about 0.04 mas for bright (G<14 mag) sources, 0.1 mas at G=17 mag, and 0.7 mas at G=20 mag. In the proper motion components the corresponding uncertainties are 0.05, 0.2, and 1.2 mas/yr, respectively. The optical reference frame defined by Gaia DR2 is aligned with ICRS and is non-rotating with respect to the quasars to within 0.15 mas/yr. From the quasars and validation solutions we estimate that systematics in the parallaxes depending on position, magnitude, and colour are generally below 0.1 mas, but the parallaxes are on the whole too small by about 0.03 mas. Significant spatial correlations of up to 0.04 mas in parallax and 0.07 mas/yr in proper motion are seen on small (<1 deg) and intermediate (20 deg) angular scales. Important statistics and information for the users of the Gaia DR2 astrometry are given in the appendices.Includes STFC

On-orbit performance of the Gaia CCDs at L2

The European Space Agency's Gaia satellite was launched into orbit around L2 in December 2013 with a payload containing 106 large-format scientific CCDs. The primary goal of the mission is to repeatedly obtain high-precision astrometric and photometric measurements of one thousand million stars over the course of five years. The scientific value of the down-linked data, and the operation of the onboard autonomous detection chain, relies on the high performance of the detectors. As Gaia slowly rotates and scans the sky, the CCDs are continuously operated in a mode where the line clock rate and the satellite rotation spin-rate are in synchronisation. Nominal mission operations began in July 2014 and the first data release is being prepared for release at the end of Summer 2016. In this paper we present an overview of the focal plane, the detector system, and strategies for on-orbit performance monitoring of the system. This is followed by a presentation of the performance results based on analysis of data acquired during a two-year window beginning at payload switch-on. Results for parameters such as readout noise and electronic offset behaviour are presented and we pay particular attention to the effects of the L2 radiation environment on the devices. The radiation-induced degradation in the charge transfer efficiency (CTE) in the (parallel) scan direction is clearly diagnosed; however, an extrapolation shows that charge transfer inefficiency (CTI) effects at end of mission will be approximately an order of magnitude less than predicted pre-flight. It is shown that the CTI in the serial register (horizontal direction) is still dominated by the traps inherent to the manufacturing process and that the radiation-induced degradation so far is only a few per cent. Finally, we summarise some of the detector effects discovered on-orbit which are still being investigated.Comment: Published in A&A Gaia special featur