1,224 research outputs found

    The Dynamics of Stress and Fatigue Across Menopause: Attractors, Coupling, and Resilience

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    Objective: The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience. Methods: Participants were drawn from the longitudinal Seattle Midlife Women\u27s Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. STRAW+10 criteria were used to stage women in either in late reproductive, early or late transition, or EPM stage. Change values were generated for fatigue and stress and analyzed with a multilevel structural equation model; slopes indicate how quickly a person returns to homeostasis after a perturbation. Coupling of stress and fatigue was modeled to evaluate resilience, the notion of maintaining stability during change. Results: Eligible women were on average 35 years old (SD = 4.71), well educated, employed, married or partnered, and white. Fit indices suggested the model depicts the relationships of stress and fatigue (χ2(9 df) = 7.638, P = 0.57, correction factor = 4.9244; root mean square error of approximation (RMSEA) 90% CI = 0.000 ≤ 0.000 ≤ 0.032; comparative fit index (CFI) = 1.00). A loss in model fit across stages suggests that the four stages differed in their dynamics (χ2Δ(12 df) = 21.181, P = .048). All stages showed fixed-point attractor dynamics: fatigue became less stable over time; stress generally became more stable over time. Coupling relationships of stress on fatigue show evidence for shifts in regulatory relationships with one another across the MT. Conclusions: Results are suggestive of general dysregulation via disruptions to coupling relationships of stress and fatigue across the MT. Findings support a holistic approach to understanding symptoms and supporting women during the MT

    Community production modulates coral reef pH and the sensitivity of ecosystem calcification to ocean acidification

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    Author Posting. © American Geophysical Union, 2017. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 122 (2017): 745–761, doi:10.1002/2016JC012326.Coral reefs are built of calcium carbonate (CaCO3) produced biogenically by a diversity of calcifying plants, animals, and microbes. As the ocean warms and acidifies, there is mounting concern that declining calcification rates could shift coral reef CaCO3 budgets from net accretion to net dissolution. We quantified net ecosystem calcification (NEC) and production (NEP) on Dongsha Atoll, northern South China Sea, over a 2 week period that included a transient bleaching event. Peak daytime pH on the wide, shallow reef flat during the nonbleaching period was ∼8.5, significantly elevated above that of the surrounding open ocean (∼8.0–8.1) as a consequence of daytime NEP (up to 112 mmol C m−2 h−1). Diurnal-averaged NEC was 390 ± 90 mmol CaCO3 m−2 d−1, higher than any other coral reef studied to date despite comparable calcifier cover (25%) and relatively high fleshy algal cover (19%). Coral bleaching linked to elevated temperatures significantly reduced daytime NEP by 29 mmol C m−2 h−1. pH on the reef flat declined by 0.2 units, causing a 40% reduction in NEC in the absence of pH changes in the surrounding open ocean. Our findings highlight the interactive relationship between carbonate chemistry of coral reef ecosystems and ecosystem production and calcification rates, which are in turn impacted by ocean warming. As open-ocean waters bathing coral reefs warm and acidify over the 21st century, the health and composition of reef benthic communities will play a major role in determining on-reef conditions that will in turn dictate the ecosystem response to climate change.NSF Grant Number: 12205292017-07-3

    Association Between Atopic Eczema and Cancer in England and Denmark.

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    Importance: Associations between atopic eczema and cancer are unclear, with competing theories that increased immune surveillance decreases cancer risk and that immune stimulation increases cancer risk. Establishing baseline cancer risk in people with atopic eczema is important before exploring the association between new biologic drugs for atopic eczema and cancer risk. Objective: To investigate whether atopic eczema is associated with cancer. Design, Setting, and Participants: Matched cohort studies were conducted from January 2, 1998, to March 31, 2016, in England and from January 1, 1982, to June 30, 2016, in Denmark. We conducted our analyses between July 2018 and July 2019. The setting was English primary care and nationwide Danish data. Participants with atopic eczema (adults only in England and any age in Denmark) were matched on age, sex, and calendar period (as well as primary care practice in England only) to those without atopic eczema. Exposure: Atopic eczema. Main Outcomes and Measures: Overall cancer risk and risk of specific cancers were compared in people with and without atopic eczema. Results: In England, matched cohorts included 471 970 individuals with atopic eczema (median [IQR] age, 41.1 [24.9-60.7] years; 276 510 [58.6%] female) and 2 239 775 individuals without atopic eczema (median [IQR] age, 39.8 [25.9-58.4] years; 1 301 074 [58.1%] female). In Denmark, matched cohorts included 44 945 individuals with atopic eczema (median [IQR] age, 13.7 [1.7-21.1] years; 22 826 [50.8%] female) and 445 673 individuals without atopic eczema (median [IQR] age, 13.5 [1.7-20.8] years; 226 323 [50.8%] female). Little evidence was found of associations between atopic eczema and overall cancer (adjusted hazard ratio [HR], 1.04; 99% CI, 1.02-1.06 in England and 1.05; 99% CI, 0.95-1.16 in Denmark) or for most specific cancers. However, noncutaneous lymphoma risk was increased in people with atopic eczema in England (adjusted HR, 1.19; 99% CI, 1.07-1.34 for non-Hodgkin lymphoma [NHL] and 1.48; 99% CI, 1.07-2.04 for Hodgkin lymphoma). Lymphoma risk was increased in people with greater eczema severity vs those without atopic eczema (NHL adjusted HR, 1.06; 99% CI, 0.90-1.25 for mild eczema; 1.24; 99% CI, 1.04-1.48 for moderate eczema; and 2.08; 99% CI, 1.42-3.04 for severe eczema). Danish point estimates also showed increased lymphoma risk in people with moderate to severe eczema compared with those without atopic eczema (minimally adjusted HR, 1.31; 99% CI, 0.76-2.26 for NHL and 1.35; 99% CI, 0.65-2.82 for Hodgkin lymphoma), but the 99% CIs were wide. Conclusions and Relevance: The findings from 2 large population-based studies performed in different settings do not support associations between atopic eczema and most cancers. However, an association was observed between atopic eczema and lymphoma, particularly NHL, that increased with eczema severity. This finding warrants further study as new immunomodulatory systemic therapeutics are brought to market that may alter cancer risk

    Infrared Dark Clouds in the Small Magellanic Cloud?

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    We have applied the unsharp-masking technique to the 24 μ\mum image of the Small Magellanic Cloud (SMC), obtained with the Spitzer Space Telescope, to search for high-extinction regions. This technique has been used to locate very dense and cold interstellar clouds in the Galaxy, particularly infrared dark clouds (IRDCs). Fifty five candidate regions of high-extinction, namely high-contrast regions (HCRs), have been identified from the generated decremental contrast image of the SMC. Most HCRs are located in the southern bar region and mainly distributed in the outskirts of CO clouds, but most likely contain a significant amount of H2. HCRs have a peak-contrast at 24 μ\mum of 2 - 2.5 % and a size of 8 - 14 pc. This corresponds to the size of typical and large Galactic IRDCs, but Galactic IRDCs are 2 - 3 times darker at 24 μ\mum than our HCRs. To constrain the physical properties of the HCRs, we have performed NH3, N2H+, HNC, HCO+, and HCN observations toward one of the HCRs, HCR LIRS36-EAST, using the Australia Telescope Compact Array and the Mopra single-dish radio telescope. We did not detect any molecular line emission, however, our upper limits to the column densities of molecular species suggest that HCRs are most likely moderately dense with n ~ 10^{3} cm-3. This volume density is in agreement with predictions for the cool atomic phase in low metallicity environments. We suggest that HCRs may be tracing clouds at the transition from atomic to molecule-dominated medium, and could be a powerful way to study early stages of gas condensation in low metallicity galaxies. Alternatively, if made up of dense molecular clumps < 0.5 pc in size, HCRs could be counterparts of Galactic IRDCs, and/or regions with highly unusual abundance of very small dust grains.Comment: accepted for publication in the Astronomical Journa

    The Molecular and Spatial Epidemiology of Typhoid Fever in Rural Cambodia.

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    Typhoid fever, caused by the bacterium Salmonella Typhi, is an endemic cause of febrile disease in Cambodia. The aim of this study was to better understand the epidemiology of pediatric typhoid fever in Cambodia. We accessed routine blood culture data from Angkor Hospital for Children (AHC) in Siem Reap province between 2007 and 2014, and performed whole genome sequencing (WGS) on the isolated bacteria to characterize the S. Typhi population. The resulting phylogenetic information was combined with conventional epidemiological approaches to investigate the spatiotemporal distribution of S. Typhi and population-level risk factors for reported disease. During the study period, there were 262 cases of typhoid within a 100 km radius of AHC, with a median patient age of 8.2 years (IQR: 5.1-11.5 years). The majority of infections occurred during the rainy season, and commune incidences as high as 11.36/1,000 in children aged <15 years were observed over the study period. A population-based risk factor analysis found that access to water within households and increasing distance from Tonle Sap Lake were protective. Spatial mapping and WGS provided additional resolution for these findings, and confirmed that proximity to the lake was associated with discrete spatiotemporal disease clusters. We confirmed the dominance of MDR H58 S. Typhi in this population, and found substantial evidence of diversification (at least seven sublineages) within this single lineage. We conclude that there is a substantial burden of pediatric typhoid fever in rural communes in Cambodia. Our data provide a platform for additional population-based typhoid fever studies in this location, and suggest that this would be a suitable setting in which to introduce a school-based vaccination programme with Vi conjugate vaccines

    Inactivated Influenza Vaccine That Provides Rapid, Innate-Immune- System-Mediated Protection and Subsequent Long-Term Adaptive Immunity

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    The continual threat to global health posed by influenza has led to increased efforts to improve the effectiveness of influenza vaccines for use in epidemics and pandemics. We show in this study that formulation of a low dose of inactivated detergent-split influenza vaccine with a Toll-like receptor 2 (TLR2) agonist-based lipopeptide adjuvant (R4Pam2Cys) provides (i) immediate, antigen-independent immunity mediated by the innate immune system and (ii) significant enhancement of antigendependent immunity which exhibits an increased breadth of effector function. Intranasal administration of mice with vaccine formulated with R4Pam2Cys but not vaccine alone provides protection against both homologous and serologically distinct (heterologous) viral strains within a day of administration. Vaccination in the presence of R4Pam2Cys subsequently also induces high levels of systemic IgM, IgG1, and IgG2b antibodies and pulmonary IgA antibodies that inhibit hemagglutination (HA) and neuraminidase (NA) activities of homologous but not heterologous virus. Improved primary virus nucleoprotein (NP)-specific CD8! T cell responses are also induced by the use of R4Pam2Cys and are associated with robust recall responses to provide heterologous protection. These protective effects are demonstrated in wild-type and antibody-deficient animals but not in those depleted of CD8! T cells. Using a contact-dependent virus transmission model, we also found that heterologous virus transmission from vaccinated mice to naive mice is significantly reduced. These results demonstrate the potential of adding a TLR2 agonist to an existing seasonal influenza vaccine to improve its utility by inducing immediate short-term nonspecific antiviral protection and also antigen-specific responses to provide homologous and heterologous immunity
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