...theory-based approaches have been used in particular to evaluate the effectiveness of health promotion and risk prevention interventions, 15, 16 and latterly have been adopted for the evaluation ...of complex community interventions in the UK, such as the English Health Action Zones. 17 Their value lies in assessing the effectiveness of the various components of existing interventions, and also in the design of future initiatives, by generating plausible programme theories and designing programmes to test them under real-life conditions. 14 Can these approaches help in the assessment of the various endeavours to tackle health inequalities? APPLYING THEORY-BASED APPROACHES TO HEALTH INEQUALITIES INTERVENTIONS Figure 1 illustrates schematically the logic-whether explicit or implicit-in the formulation of interventions in this field. ...the question is "what is causing the problem to be more severe with decreasing socioeconomic status?" In the case of poorer nutrition in poorer children, for example, it is not the cause of inadequate nutrition in children in general that is the focus of interest, but the causes of the gradient in nutritional status which result in an increasing problem as one goes further down the social scale.
Background There is increasing pressure to tackle the wider social determinants of health through the implementation of appropriate interventions. However, turning these demands for better evidence ...about interventions around the social determinants of health into action requires identifying what we already know and highlighting areas for further development. Methods Systematic review methodology was used to identify systematic reviews (from 2000 to 2007, developed countries only) that described the health effects of any intervention based on the wider social determinants of health: water and sanitation, agriculture and food, access to health and social care services, unemployment and welfare, working conditions, housing and living environment, education, and transport. Results Thirty systematic reviews were identified. Generally, the effects of interventions on health inequalities were unclear. However, there is suggestive systematic review evidence that certain categories of intervention may impact positively on inequalities or on the health of specific disadvantaged groups, particularly interventions in the fields of housing and the work environment. Conclusion Intervention studies that address inequalities in health are a priority area for future public health research.
Large prospective studies to establish the prevalence of non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH), are lacking. We prospectively assessed the prevalence and severity of ...NAFLD/NASH in a cohort of asymptomatic middle-aged Americans attending a colonoscopy class at a gastroenterology clinic.
Screening for NAFLD was performed using magnetic resonance (MR)-based LiverMultiScan® proton density fat fraction (LMS-PDFF). MR exams also included corrected T1 and elastography for liver stiffness measurement (LSM). FibroScan® was also used to measure LSM. Participants with predetermined abnormal imaging parameters were offered a liver biopsy. Biopsies were read in a blinded fashion with results based on the consensus by 2 expert pathologists. The prevalence of NAFLD was determined by PDFF ≥5% or by histological diagnosis of NAFLD (if biopsy data were available). The prevalence of NASH was defined by biopsy.
Of 835 participants, 664 met the inclusion and exclusion criteria. The mean age was 56 ± 6.4 years, 50% were male, the mean BMI was 30.48 ± 5.46 kg/m2, and 52% were obese. The prevalence of NAFLD was 38% (95% CI 34–41%) and the prevalence of NASH was 14% (95% CI 12–17%). While no patient had cirrhosis on biopsy, significant fibrosis (F ≥2) was present in 5.9% (95% CI 4–8%) and bridging fibrosis in 1.6% (95% CI 1-3%). In a multivariable analysis, factors associated with the presence of NASH were race, obesity, and diabetes.
Using state-of-the-art liver imaging modalities and reference biopsy, this study establishes an overall prevalence of NAFLD of 38% and NASH by biopsy of 14% in this cohort of asymptomatic middle-aged US adults.
There are no prospective studies to determine how common is nonalcoholic steatohepatitis (NASH), the severe form of non-alcoholic fatty liver disease (NAFLD). In a large number of asymptomatic middle-aged Americans, we used a combination of state-of-the-art liver imaging methods and liver biopsy to prospectively determine the prevalence of NAFLD and NASH. NAFLD was diagnosed in 38%, NASH in 14%, and significant liver fibrosis in 6% of asymptomatic middle-aged Americans.
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•In a prospective large cohort of middle-aged Americans living in Texas, the prevalence of NAFLD was estimated to be 38%.•Based on liver histology data, NASH was diagnosed in 14% of the entire cohort and 37% of those with NAFLD.•NASH was more common in Hispanics and those with obesity or type 2 diabetes.
We describe a novel deep learning neural network method and its application to impute assay pIC50 values. Unlike conventional machine learning approaches, this method is trained on sparse bioactivity ...data as input, typical of that found in public and commercial databases, enabling it to learn directly from correlations between activities measured in different assays. In two case studies on public domain data sets we show that the neural network method outperforms traditional quantitative structure–activity relationship (QSAR) models and other leading approaches. Furthermore, by focusing on only the most confident predictions the accuracy is increased to R 2 > 0.9 using our method, as compared to R 2 = 0.44 when reporting all predictions.
BackgroundIn England between 2010 and 2013, just over one million recipients of the main out-of-work disability benefit had their eligibility reassessed using a new functional checklist—the Work ...Capability Assessment. Doctors and disability rights organisations have raised concerns that this has had an adverse effect on the mental health of claimants, but there are no population level studies exploring the health effects of this or similar policies.MethodWe used multivariable regression to investigate whether variation in the trend in reassessments in each of 149 local authorities in England was associated with differences in local trends in suicides, self-reported mental health problems and antidepressant prescribing rates, while adjusting for baseline conditions and trends in other factors known to influence mental ill-health.ResultsEach additional 10 000 people reassessed in each area was associated with an additional 6 suicides (95% CI 2 to 9), 2700 cases of reported mental health problems (95% CI 548 to 4840), and the prescribing of an additional 7020 antidepressant items (95% CI 3930 to 10100). The reassessment process was associated with the greatest increases in these adverse mental health outcomes in the most deprived areas of the country, widening health inequalities.ConclusionsThe programme of reassessing people on disability benefits using the Work Capability Assessment was independently associated with an increase in suicides, self-reported mental health problems and antidepressant prescribing. This policy may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits.
•Calculations show single cellulose chains twist away from a flat ribbon conformation independent of degree of polymerization and water solvation.•The twisted structure has multiple periodicites, ...which suggests a possible method of propagation to the macroscopic scale.•Energy minimization of cellulose crystallites distorts the crystals into twisted rods. The degree of twist of the crystal is dependent on the cross-section of the crystal.•When solvated with water, the handedness of the twist of small crystals can reverse suggesting small crystals will spontaneously solubilize.•Simulated powder X-ray diffraction suggest small crystals lose crystallinity.
Molecular Mechanics, Hartree–Fock, and semi-empirical geometry optimizations were carried out on cellulose oligomers and crystallites with and without water solvation. The intramolecular bonding is visualized with the Delocalized Molecular Orbitals (DLMOs). Internal coordinates were relaxed and the structures were gradient optimized for cellulose oligomers composed of 4, 10, 12, 14, 19, and 65 glucose units. The cellulose conformation of minimum energy deviates from the flat ribbon conformation giving rise to half-twist repeating units of about 3–4nm and 60nm along the chain axis. An optimized cellulose chain which is ten glucose units long is 9.57kcal/mol more stable than the flat ribbon model. The DLMOs show the twisted model retains the same hydrogen bonding scheme as the flat model while minimizing steric interactions between H1 and H4′. In cellulose crystallites the twist, which can be left- or right-handed, calls into question the assumption of twofold symmetry in the current flat unit cell. Additionally the hydrogen bonded sheets reorient themselves, suggesting the crystallites are in fact crystalloids. The overall length of the crystal twist is dependent on the cross-section of the crystal. Powder X-ray diffraction patterns of the optimized crystallites were simulated.
The LHCb simulation application, Gauss, consists of two independent phases, the generation of the primary event and the tracking of particles produced in the experimental setup. For the LHCb ...experimental program it is particularly important to model B meson decays: the EvtGen code developed in CLEO and BABAR has been chosen and customized for non-coherent B production as occuring in pp collisions at the LHC. The initial proton-proton collision is provided by a different generator engine, currently PYTHIA 6 for massive production of signal and generic pp collisions events. Beam gas events, background events originating from proton halo, cosmics and calibration events for different detectors can be generated in addition to pp collisions. Different generator packages as available in the physics community or specifically developed in LHCb are used for the different purposes. Running conditions affecting the generated events such as the size of the luminous region, the number of collisions occuring in a bunch crossing and the number of spill-over events from neighbouring bunches are modeled via dedicated algorithms appropriately configured. The design of the generator phase of Gauss will be described: a modular structure with well defined interfaces specific to the various tasks, e.g. pp collisions, particle decays, selections, etc. has been chosen. Different implementations are available for the various tasks allowing selecting and combining them as most appropriate at run time as in the case of PYTHIA 6 for pp collisions or HIJING for beam gas. The advantages of such structure, allowing for example to adopt transparently new generators packages, will be discussed.
Measurement of the CKM Angle γ Whitehead, M.
Journal of physics. Conference series,
11/2016, Letnik:
770, Številka:
1
Journal Article
Recenzirano
Odprti dostop
A summary of constraints on the CKM angle γ from recent LHCb analyses are discussed. The results of a combination of several LHCb measurements of γ are presented, giving where the single uncertainty ...is a combination of statistical and systematic sources. This represents the most precise measurement of the angle γ.
The massa intermedia is a normal midline transventricular thalamic connection. Massa intermedia aberrations are common in schizophrenia, Chiari II malformation, X-linked hydrocephalus, Cornelia de ...Lange syndrome, and diencephalic-mesencephalic junction dysplasia, among others. We have noticed that massa intermedia abnormalities often accompany other midline malformations. The massa intermedia has never been formally evaluated in a group of exclusively pediatric patients, to our knowledge. We sought to compare and contrast the prevalence, size, and location of the massa intermedia in pediatric patients with and without congenital midline brain abnormalities.
Successive 3T brain MR imaging examinations from pediatric patients with and without midline malformations were procured from the imaging data base at a pediatric hospital. Massa intermedia presence, size, morphology, and position were determined using 3D-TIWI with 1-mm isotropic resolution. The brain commissures, septum pellucidum, hypothalamus, hippocampus, vermis, and brain stem were evaluated to determine whether alterations were related to or predictive of massa intermedia abnormalities.
The massa intermedia was more frequently absent, dysmorphic, and/or displaced in patients with additional midline abnormalities than in those without. The massa intermedia was absent in 40% of patients with midline malformations versus 12% of patients with normal findings (
< .001). Massa intermedia absence, surface area, and morphology were predictable by various attributes and alterations of the commissures, hippocampus, hypothalamus, vermis, brain stem, and third ventricle.
Most pediatric patients have a thalamic massa intermedia centered in the anterior/superior third ventricle. Massa intermedia abnormalities are commonly associated with other midline malformations. Normal-variant massa intermedia absence is a diagnosis of exclusion.
Given the worldwide prevalence of NAFLD and NASH, there is a need to develop treatments to slow or reverse disease progression. GR-MD-02 (galactoarabino-rhamnogalaturonate) has been shown to reduce ...hepatic fibrosis in animal studies, and lower serum biomarkers of NASH fibrogenesis in humans. The primary aim of this study was to determine the difference between four-months of treatment with GR-MD-02 or placebo in liver inflammation and fibrosis as measured by iron-corrected T1 (cT1) mapping, a non-invasive magnetic resonance imaging (MRI) biomarker that correlates with the extent of hepatic fibro-inflammatory disease. The secondary aims were to determine change in liver stiffness as measured by magnetic resonance elastography (MRE) and shear-wave ultrasonic elastography (LSM), and to explore test-retest repeatability of the three biomarkers.
Thirty subjects (13 females, 46-71 years) with NASH and advanced fibrosis were recruited. Subjects were randomized to receive 8 mg.kg-1 GR-MD-02 (via IV infusion) or placebo, administered biweekly over a 16-week period. Therapeutic efficacy was examined using cT1, MRE, and LSM. Statistical analyses on group differences in the biomarkers were performed using robust ANCOVA models adjusting for baseline measurement and additional covariates.
There was no significant difference in cT1 (p = 0.16) between GR-MD-02 and placebo groups following a 16-week intervention. There was also no significant difference in liver stiffness, measured by MRE (p = 0.80) or LSM (p = 0.63), between groups. Examination of repeatability of the cT1, MRE and LSM revealed coefficient of variations of 3.1%, 11% and 40% respectively.
8 mg.kg-1 of GR-MD-02 had no significant effect on non-invasive biomarkers of liver inflammation or fibrosis over a 4-month period. Histological confirmation was not available in this study. The high reproducibility of the primary outcome measure suggests that cT1 could be utilized for monitoring longitudinal change in patients with NASH.
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