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Aims:
Although risk scores to predict type 2 diabetes exist, cost-effectiveness of risk thresholds to target prevention interventions are unknown. We applied cost-effectiveness analysis to identify optimal thresholds of predicted risk to target a low-cost community-based intervention in the USA.
Methods:
We used a validated Markov-based type 2 diabetes simulation model to evaluate the lifetime cost-effectiveness of alternative thresholds of diabetes risk. Population characteristics for the model were obtained from NHANES 2001-2004 and incidence rates and performance of two noninvasive diabetes risk scores (German diabetes risk score, GDRS, and ARIC 2009 score) were determined in the ARIC and Cardiovascular Health Study (CHS). Incremental cost-effectiveness ratios (ICERs) were calculated for increasing risk score thresholds. Two scenarios were assumed: 1-stage (risk score only) and 2-stage (risk score plus fasting plasma glucose (FPG) test (threshold 100 mg/dl) in the high-risk group).
Results:
In ARIC and CHS combined, the area under the receiver operating characteristic curve for the GDRS and the ARIC 2009 score were 0.691 (0.677-0.704) and 0.720 (0.707-0.732), respectively. The optimal threshold of predicted diabetes risk (ICER < $50,000/QALY gained in case of intervention in those above the threshold) was 7% for the GDRS and 9% for the ARIC 2009 score. In the 2-stage scenario, ICERs for all cutoffs >= 5% were below $50,000/QALY gained.
Conclusions:
Intervening in those with >= 7% diabetes risk based on the GDRS or >= 9% on the ARIC 2009 score would be cost-effective. A risk score threshold >= 5% together with elevated FPG would also allow targeting interventions cost-effectively.
Due to their ability to capture attention, emotional stimuli tend to benefit from enhanced perceptual processing, which can be helpful when such stimuli are task-relevant but hindering when they are task-irrelevant. Altered emotion-attention interactions have been associated with symptoms of affective disturbances, and emerging research focuses on improving emotion-attention interactions to prevent or treat affective disorders. In line with the Human Affectome Project's emphasis on linguistic components, we also analyzed the language used to describe attention-related aspects of emotion, and highlighted terms related to domains such as conscious awareness, motivational effects of attention, social attention, and emotion regulation. These terms were discussed within a broader review of available evidence regarding the neural correlates of (1) Emotion-Attention Interactions in Perception, (2) Emotion-Attention Interactions in Learning and Memory, (3) Individual Differences in Emotion-Attention Interactions, and (4) Training and Interventions to Optimize Emotion-Attention Interactions. This comprehensive approach enabled an integrative overview of the current knowledge regarding the mechanisms of emotion-attention interactions at multiple levels of analysis, and identification of emerging directions for future investigations.
Do stereotypes strike twice?
(2019)
Stereotypes influence teachers' perception of and behaviour towards students, thus shaping students' learning opportunities. The present study investigated how 315 Australian pre-service teachers' stereotypes about giftedness and gender are related to their perception of students' intellectual ability, adjustment, and social-emotional ability, using an experimental vignette approach and controlling for social desirability in pre-service teachers' responses. Repeated-measures ANOVA showed that pre-service teachers associated giftedness with higher intellectual ability, but with less adjustment compared to average-ability students. Furthermore, pre-service teachers perceived male students as less socially and emotionally competent and less adjusted than female students. Additionally, pre-service teachers seemed to perceive female average-ability students' adjustment as most favourable compared to male average-ability students and gifted students. Findings point to discrepancies between actual characteristics of gifted female and male students and stereotypes in teachers' beliefs. Consequences of stereotyping and implications for teacher education are discussed.
This study addresses the question of whether and how growing up with more than one language shapes a child's language impairment. Our focus is on Specific Language Impairment (SLI) in bilingual (Turkish-German) children. We specifically investigated a range of phenomena related to the so-called CP (Complementizer Phrase) in German, the hierarchically highest layer of syntactic clause structure, which has been argued to be particularly affected in children with SLI. Spontaneous speech data were examined from bilingual children with SLI in comparison to two comparison groups: (i) typically-developing bilingual children, (ii) monolingual children with SLI. We found that despite persistent difficulty with subject-verb agreement, the two groups of children with SLI did not show any impairment of the CP-domain. We conclude that while subject-verb agreement is a suitable linguistic marker of SLI in German-speaking children, for both monolingual and bilingual ones, 'vulnerability of the CP-domain' is not.
Achromatium oxaliferum is a large sulfur bacterium easily recognized by large intracellular calcium carbonate bodies. Although these bodies often fill major parts of the cells' volume, their role and specific intracellular location are unclear. In this study, we used various microscopy and staining techniques to identify the cell compartment harboring the calcium carbonate bodies. We observed that Achromatium cells often lost their calcium carbonate bodies, either naturally or induced by treatments with diluted acids, ethanol, sodium bicarbonate and UV radiation which did not visibly affect the overall shape and motility of the cells (except for UV radiation). The water-soluble fluorescent dye fluorescein easily diffused into empty cavities remaining after calcium carbonate loss. Membranes (stained with Nile Red) formed a network stretching throughout the cell and surrounding empty or filled calcium carbonate cavities. The cytoplasm (stained with FITC and SYBR Green for nucleic acids) appeared highly condensed and showed spots of dissolved Ca2+ (stained with Fura-2). From our observations, we conclude that the calcium carbonate bodies are located in the periplasm, in extra-cytoplasmic pockets of the cytoplasmic membrane and are thus kept separate from the cell's cytoplasm. This periplasmic localization of the carbonate bodies might explain their dynamic formation and release upon environmental changes.
Lake sediments are increasingly explored as reliable paleoflood archives. In addition to established flood proxies including detrital layer thickness, chemical composition, and grain size, we explore stable oxygen and carbon isotope data as paleoflood proxies for lakes in catchments with carbonate bedrock geology. In a case study from Lake Mondsee (Austria), we integrate high-resolution sediment trapping at a proximal and a distal location and stable isotope analyses of varved lake sediments to investigate flood-triggered detrital sediment flux. First, we demonstrate a relation between runoff, detrital sediment flux, and isotope values in the sediment trap record covering the period 2011-2013 CE including 22 events with daily (hourly) peak runoff ranging from 10 (24) m(3) s(-1) to 79 (110) m(3) s(-1). The three- to ten-fold lower flood-triggered detrital sediment deposition in the distal trap is well reflected by attenuated peaks in the stable isotope values of trapped sediments. Next, we show that all nine flood-triggered detrital layers deposited in a sediment record from 1988 to 2013 have elevated isotope values compared with endogenic calcite. In addition, even two runoff events that did not cause the deposition of visible detrital layers are distinguished by higher isotope values. Empirical thresholds in the isotope data allow estimation of magnitudes of the majority of floods, although in some cases flood magnitudes are overestimated because local effects can result in too-high isotope values. Hence we present a proof of concept for stable isotopes as reliable tool for reconstructing flood frequency and, although with some limitations, even for flood magnitudes.
Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterise the association between plasma concentrations of thirty-five polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein (hsCRP). A cross-sectional data analysis was performed based on 315 participants in the European Prospective Investigation into Cancer and Nutrition cohort with available measurements of plasma polyphenols and hsCRP. In logistic regression analysis, the OR and 95 % CI of elevated serum hsCRP (>3 mg/l) were calculated within quartiles and per standard deviation higher level of plasma polyphenol concentrations. In a multivariable-adjusted model, the sum of plasma concentrations of all polyphenols measured (per standard deviation) was associated with 29 (95 % CI 50, 1) % lower odds of elevated hsCRP. In the class of flavonoids, daidzein was inversely associated with elevated hsCRP (OR 0 center dot 66, 95 % CI 0 center dot 46, 0 center dot 96). Among phenolic acids, statistically significant associations were observed for 3,5-dihydroxyphenylpropionic acid (OR 0 center dot 58, 95 % CI 0 center dot 39, 0 center dot 86), 3,4-dihydroxyphenylpropionic acid (OR 0 center dot 63, 95 % CI 0 center dot 46, 0 center dot 87), ferulic acid (OR 0 center dot 65, 95 % CI 0 center dot 44, 0 center dot 96) and caffeic acid (OR 0 center dot 69, 95 % CI 0 center dot 51, 0 center dot 93). The odds of elevated hsCRP were significantly reduced for hydroxytyrosol (OR 0 center dot 67, 95 % CI 0 center dot 48, 0 center dot 93). The present study showed that polyphenol biomarkers are associated with lower odds of elevated hsCRP. Whether diet rich in bioactive polyphenol compounds could be an effective strategy to prevent or modulate deleterious health effects of inflammation should be addressed by further well-powered longitudinal studies.
This study investigates the effect of different anticonsumption constructs on consumer wellbeing. The study assumes that people will only lower their level of consumption if doing so does not also lower personal wellbeing. More precisely, this research investigates how specific subtypes of sustainable anticonsumption (e.g., voluntary simplicity, collaborative consumption, and debt-free living) relate to different states of consumer's wellbeing (e.g., financial, psychosocial, and subjective wellbeing). This work also examines whether consumer empowerment can improve personal wellbeing and strengthen the anticonsumption wellbeing relationship. The results show that voluntarily foregoing consumption does not reduce wellbeing and consumer empowerment plays a significant role in supporting sustainable pathways to consumer wellbeing. This study reasons that empowerment improves consumer sovereignty, but may be detrimental for consumers heavily concerned about debt-free living. The present investigation concludes by proposing implications for public and consumer policymakers wishing to promote appropriate sustainable (anticonsumption) pathways to consumer wellbeing.
Experimental and kinetic modelling studies are presented to investigate the mechanism of 3,3 ',5,5 '-tetramethylbenzidine (TMB) oxidation by hydrogen peroxide (H2O2) catalyzed by peroxidase-like Pt nanoparticles immobilized in spherical polyelectrolyte brushes (SPB-Pt). Due to the high stability of SPB-Pt colloidal, this reaction can be monitored precisely in situ by UV/VIS spectroscopy. The time-dependent concentration of the blue-colored oxidation product of TMB expressed by different kinetic models was used to simulate the experimental data by a genetic fitting algorithm. After falsifying the models with abundant experimental data, it is found that both H2O2 and TMB adsorb on the surface of Pt nanoparticles to react, indicating that the reaction follows the Langmuir-Hinshelwood mechanism. A true rate constant k, characterizing the rate-determining step of the reaction and which is independent on the amount of catalysts used, is obtained for the first time. Furthermore, it is found that the product adsorbes strongly on the surface of nanoparticles, thus inhibiting the reaction. The entire analysis provides a new perspective to study the catalytic mechanism and evaluate the catalytic activity of the peroxidase-like nanoparticles.
Purpose
After therapy of cancer of the esophagus or the esophagogastric junction, patients often suffer from anxiety and depression. Some risk factors for elevated anxiety and depression are reported, but the influence of steatorrhea, the frequency of which has only recently been reported, has not yet been investigated.
Method
Using the Hospital Anxiety and Depression Scale (HADS), we analyzed the correlation of anxiety and depression with steatorrhea, appetite, and weight loss in 72 patients with cancer of the esophagus or of the esophagogastric junction, who were treated at our rehabilitation clinic between January 2011 and December 2014. In addition, effectiveness of psychological interviews was analyzed.
Results
We have evaluable anxiety questionnaires from 51 patients showing a median anxiety value of 5 (range 0-13). As for the depression, results from evaluable questionnaires of 54 patients also showed a median value of 5 (range 0-15). Increased anxiety and depression values (> 7) were observed in 25.4% and 37.0% of the patients respectively. Patients who were admitted with steatorrhea for rehabilitation showed a statistically higher anxiety value (median 6.3 vs. 4.7, p < 0.05), reduced appetite, and a weight loss above 15 kg depicting a correlation to anxiety and depression. Psychological conversations helped lowering the depression but had no influence on anxiety.
Conclusions
Impairments after cancer treatment, such as steatorrhea, appetite loss, and weight loss, should be interpreted as an alarm signal and should necessitate screening for increased anxiety and depression. Psychological therapy can help improving the extent of the depression.