Postmenopausal Women With Greater Paracardial Fat Have More Coronary Artery Calcification Than Premenopausal Women: The Study of Women's Health Across the Nation (SWAN) Cardiovascular Fat Ancillary Study.

BackgroundVolumes of paracardial adipose tissue (PAT) and epicardial adipose tissue (EAT) are greater after menopause. Interestingly, PAT but not EAT is associated with estradiol decline, suggesting a potential role of menopause in PAT accumulation. We assessed whether volumes of heart fat depot (EAT and PAT) were associated with coronary artery calcification (CAC) in women at midlife and whether these associations were modified by menopausal status and estradiol levels.Methods and resultsEAT and PAT volumes and CAC were measured using electron beam computed tomography scans. CAC was evaluated as (1) the presence of CAC (CAC Agatston score ≥10) and (2) the extent of any CAC (log CAC Agatston score >0). The study included 478 women aged 50.9 years (58% pre- or early perimenopausal, 10% late perimenopausal, and 32% postmenopausal). EAT was significantly associated with CAC measures, and these associations were not modified by menopausal status or estradiol. In contrast, associations between PAT and CAC measures were modified by menopausal status (interaction-P≤0.01). Independent of study covariates including other adiposity measures, each 1-SD unit increase in log PAT was associated with 102% higher risk of CAC presence (P=0.04) and an 80% increase in CAC extent (P=0.008) in postmenopausal women compared with pre- or early perimenopausal women. Additional adjustment for estradiol and hormone therapy attenuated these differences. Moreover, the association between PAT and CAC extent was stronger in women with lower estradiol levels (interaction P=0.004).ConclusionsThe findings suggest that PAT is a potential menopause-specific coronary artery disease risk marker, supporting the need to monitor and target this fat depot for intervention in women at midlife

Adolescent Reactions to Maternal Responsiveness and Internalizing Symptomatology: A Daily Diary Investigation

A daily diary methodology was employed to gather teens’ perceptions of maternal responsiveness to daily stressful events and teens’ reactions to maternal responsiveness in a diverse sample (792 entries from 104 teens; 81% African American, mean age 13.7 years). Additionally, parents and teens completed baseline reports of internalizing symptoms. Diary findings were congruent with prior studies employing self-report measures of global maternal responses to emotion (e.g., higher probability of Accepting reactions to supportive responses, higher probabilities of Attack, Avoid-Withdraw reactions to non-supportive responses). Elevated baseline internalizing symptoms were related to perception of elevated Punish and Magnify responses during the week, and more Avoidant (Avoid-Withdraw and Avoid-Protect) reactions to responsiveness. Results are discussed in the context of reciprocal emotion socialization processes

Community management does not equate to participation: fostering community participation in rural water supplies

Community management has remained the dominant paradigm for managing rural water supplies in sub-Saharan Africa. There is a widespread perception that community participation principles are inherently embedded in the community management model. In this paper, we analyze how an international nongovernmental organization engages rural communities in their rural water projects, and the ways in which community members are able to participate in the management and governance of their water supplies. Qualitative data were collected in 18 study communities – six each in Ghana, Kenya, and Zambia – through interviews, focus group discussions, and participatory mapping with community and water committee members. We argue that community management does not inherently lead to broader community participation, but rather that fostering community participation requires intentionality. We recommend implementers use collaborative planning processes and explicitly engage with intra-community diversity and inequalities in order to facilitate the opportunity for all community members to meaningfully participate in decision-making. Collaborative planning with diverse groups will also allow community members to realize their rights to transparency and accountability once community management structures are in place

Advanced localization of massive black hole coalescences with LISA

The coalescence of massive black holes is one of the primary sources of gravitational waves (GWs) for LISA. Measurements of the GWs can localize the source on the sky to an ellipse with a major axis of a few tens of arcminutes to a few degrees, depending on source redshift, and a minor axis which is 2--4 times smaller. The distance (and thus an approximate redshift) can be determined to better than a per cent for the closest sources we consider, although weak lensing degrades this performance. It will be of great interest to search this three-dimensional `pixel' for an electromagnetic counterpart to the GW event. The presence of a counterpart allows unique studies which combine electromagnetic and GW information, especially if the counterpart is found prior to final merger of the holes. To understand the feasibility of early counterpart detection, we calculate the evolution of the GW pixel with time. We find that the greatest improvement in pixel size occurs in the final day before merger, when spin precession effects are maximal. The source can be localized to within 10 square degrees as early as a month before merger at $z = 1$; for higher redshifts, this accuracy is only possible in the last few days.Comment: 11 pages, 4 figures, version published in Classical and Quantum Gravity (special issue for proceedings of 7th International LISA Symposium

Probing the Origins of the CIV and Fe Kalpha Baldwin Effect

We use UV/optical and X-ray observations of 272 radio-quiet Type 1 AGNs and quasars to investigate the CIV Baldwin Effect (BEff). The UV/optical spectra are drawn from the Hubble Space Telescope, International Ultraviolet Explorer and Sloan Digital Sky Survey archives. The X-ray spectra are from the Chandra and XMM-Newton archives. We apply correlation and partial-correlation analyses to the equivalent widths, continuum monochromatic luminosities, and alpha_ox, which characterizes the relative X-ray to UV brightness. The equivalent width of the CIV 1549 emission line is correlated with both alpha_ox and luminosity. We find that by regressing l_UV with EW(CIV) and alpha_ox, we can obtain tighter correlations than by regressing l_UV with only EW(CIV). Both correlation and regression analyses imply that l_UV is not the only factor controlling the changes of EW(CIV); alpha_ox (or, equivalently, the soft X-ray emission) plays a fundamental role in the formation and variation of CIV. Variability contributes at least 60% of the scatter of the EW(CIV)-l_UV relation and at least 75% of the scatter of the of the EW(CIV)-alpha_ox relation. In our sample, narrow Fe Kalpha 6.4 keV emission lines are detected in 50 objects. Although narrow Fe Kalpha exhibits a BEff similar to that of CIV, its equivalent width has almost no dependence on either alpha_ox or EW(CIV). This suggests that the majority of narrow Fe Kalpha emission is unlikely to be produced in the broad emission-line region. We do find suggestive correlations between the emission-line luminosities of CIV and Fe Kalpha, which could be potentially used to estimate the detectability of the Fe Kalpha line of quasars from rest-frame UV spectroscopic observations

The Nature of Optically Dull Active Galactic Nuclei in COSMOS

We present infrared, optical, and X-ray data of 48 X-ray bright, optically dull AGNs in the COSMOS field. These objects exhibit the X-ray luminosity of an active galactic nucleus (AGN) but lack broad and narrow emission lines in their optical spectrum. We show that despite the lack of optical emission lines, most of these optically dull AGNs are not well-described by a typical passive red galaxy spectrum: instead they exhibit weak but significant blue emission like an unobscured AGN. Photometric observations over several years additionally show significant variability in the blue emission of four optically dull AGNs. The nature of the blue and infrared emission suggest that the optically inactive appearance of these AGNs cannot be caused by obscuration intrinsic to the AGNs. Instead, up to ~70% of optically dull AGNs are diluted by their hosts, with bright or simply edge-on hosts lying preferentially within the spectroscopic aperture. The remaining ~30% of optically dull AGNs have anomalously high f_x/f_o ratios and are intrinsically weak, not obscured, in the optical. These optically dull AGNs are best described as a weakly accreting AGN with a truncated accretion disk from a radiatively inefficient accretion flow.Comment: 12 pages, 10 figures. Accepted for publication in the Ap

Mindfulness Training Supports Quality of Life and Advance Care Planning in Adults With Metastatic Cancer and Their Caregivers: Results of a Pilot Study

Background: Emotional distress often causes patients with cancer and their family caregivers (FCGs) to avoid end-of-life discussions and advance care planning (ACP), which may undermine quality of life (QoL). Most ACP interventions fail to address emotional barriers that impede timely ACP. Aim: We assessed feasibility, acceptability, and preliminary effects of a mindfulness-based intervention to facilitate ACP for adults with advanced-stage cancer and their FCGs. Design: A single-arm pilot was conducted to assess the impact of a 6-week group mindfulness intervention on ACP behaviors (patients only), QoL, family communication, avoidant coping, distress, and other outcomes from baseline (T1) to post-intervention (T2) and 1 month later (T3). Participants: Eligible patients had advanced-stage solid malignancies, limited ACP engagement, and an FCG willing to participate. Thirteen dyads (N = 26 participants) enrolled at an academic cancer center in the United States. Results: Of eligible patients, 59.1% enrolled. Attendance (70.8% across 6 sessions) and retention (84.6% for patients; 92.3% for FCGs) through T3 were acceptable. Over 90% of completers reported high intervention satisfaction. From T1 to T3, patient engagement more than doubled in each of 3 ACP behaviors assessed. Patients reported large significant decreases in distress at T2 and T3. Family caregivers reported large significant improvements in QoL and family communication at T2 and T3. Both patients and FCGs reported notable reductions in sleep disturbance and avoidant coping at T3. Conclusions: The mindfulness intervention was feasible and acceptable and supported improvements in ACP and associated outcomes for patients and FCGs. A randomized trial of mindfulness training for ACP is warranted

Geographical inequalities in drinking water in the Solomon Islands

Sustainable Development Goal 6.1 seeks to “by 2030, achieve universal and equitable access to safe and affordable drinking water”, which is challenging particularly in Small Island Developing States (SIDS) and Pacific Island Countries (PIC). We report drinking water sources and services in the Solomon Islands and examine geographical inequalities. Based on two quantitative baseline datasets of n = 1,598 rural and n = 1,068 urban households, we analyzed different drinking water variables (source type, collection time, amount, use, perceived quality, storage, treatment) and a composite index, drinking water service level. We stratified data by urban and rural areas and by province, mapped, and contextualized them. There are substantive rural–urban drinking water inequalities in the Solomon Islands. Overall, urban households are more likely to: use improved drinking water sources, need less time to collect water, collect more water, store their water more safely, treat water prior to consumption, perceive their water quality as better and have an at least basic drinking water service than rural households. There are also provincial and center-periphery inequalities in drinking water access, with more centrally located provinces using piped water supplies and more distant and remote provinces using rainwater and surface water as their primary source. There are also inter-national inequalities. Out of all PICs, the Solomon Islands have among the lowest access to basic drinking water services: 92% of urban and 55% of rural households. Of all SIDS, PICs are least serviced. This study shows that drinking water inequality is a critical issue, and highlights that all identified dimensions of inequality - rural–urban, provincial, center-periphery and inter-national - need to be explicitly recognized and addressed and included in pro-equity monitoring, policy and programming efforts by the Solomon Islands Government and stakeholders to reduce inequalities as per the Agenda 2030

Urban and rural sanitation in the Solomon Islands: How resilient are these to extreme weather events?

The Solomon Islands, like other small island developing states in the Pacific, face significant challenges from a changing climate, and from increasing extreme weather events, while also lagging behind the rest of the world in terms of drinking water, sanitation and hygiene (WaSH) services. In order to support planning for the implementation of national WaSH strategies and policies, this study contextualizes representative urban and rural baselines for Sustainable Development Goal (SDG) 6 (“by 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation”). We highlight specific threats to the current sanitation services under extreme weather events such as flooding and drought, both of which are commonly observed in the country, and provide suggestions for structural improvements to sanitation facilities to increase resiliency. As the first detailed nationally representative cross-sectional sanitation study in urban and rural areas in the Solomon Islands, the results of this paper inform national WaSH policy, strategic planning and programming by the Solomon Islands Government and stakeholders

Geographical inequalities in drinking water in the Solomon Islands

Sustainable Development Goal 6.1 seeks to “by 2030, achieve universal and equitable access to safe and affordable drinking water”, which is challenging particularly in Small Island Developing States (SIDS) and Pacific Island Countries (PIC). We report drinking water sources and services in the Solomon Islands and examine geographical inequalities. Based on two quantitative baseline datasets of n = 1,598 rural and n = 1,068 urban households, we analyzed different drinking water variables (source type, collection time, amount, use, perceived quality, storage, treatment) and a composite index, drinking water service level. We stratified data by urban and rural areas and by province, mapped, and contextualized them. There are substantive rural–urban drinking water inequalities in the Solomon Islands. Overall, urban households are more likely to: use improved drinking water sources, need less time to collect water, collect more water, store their water more safely, treat water prior to consumption, perceive their water quality as better and have an at least basic drinking water service than rural households. There are also provincial and center-periphery inequalities in drinking water access, with more centrally located provinces using piped water supplies and more distant and remote provinces using rainwater and surface water as their primary source. There are also inter-national inequalities. Out of all PICs, the Solomon Islands have among the lowest access to basic drinking water services: 92% of urban and 55% of rural households. Of all SIDS, PICs are least serviced. This study shows that drinking water inequality is a critical issue, and highlights that all identified dimensions of inequality - rural–urban, provincial, center-periphery and inter-national - need to be explicitly recognized and addressed and included in pro-equity monitoring, policy and programming efforts by the Solomon Islands Government and stakeholders to reduce inequalities as per the Agenda 2030