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Objectives: Tinnitus is the perception of sound in the absence of an external source and is experienced by up to 15% of the general population. There are many causes of tinnitus, but no cure is currently available. It has significant comorbidities with clinical anxiety, depression, and insomnia, and degrades quality of life in 1–2% of society at large. Currently, psychological interventions are the best way forward in assisting tinnitus habituation, but treatment availability and suitable experience to deliver such interventions are limited. Methods: One hundred five individuals with chronic tinnitus took part in this study. An 8-week programme of guided online meditations focused on mindfulness was compared with a waiting list control group. Intervention outcomes were assessed by changes to tinnitus distress (Tinnitus Functional Index), tinnitus cognitions (Tinnitus Cognitions Questionnaire), and mindful awareness (Mindful Attention Awareness Scale). Results: As hypothesised, the online intervention saw clinically meaningful reductions in tinnitus distress for 30% of our sample (16 participants). Furthermore, the intervention saw significant increases in mindful awareness and significant reductions in negative thoughts about tinnitus, when compared with waiting list controls. There were no significant changes in positive thoughts about tinnitus. Twenty-one participants failed to complete the study and were considered "no change" as per intention-to-treat (ITT) paradigms. Conclusions: In the absence of accessible psychological interventions, online mindfulness programmes including body scans are recommended for individuals with tinnitus as an effective and low-cost self-help tool. Reductions in negative thoughts around tinnitus are considered key to living alongside the condition (i.e. tinnitus habituation). Suggestions are made for improving future adherence rates, including recommendations for investigation in conjunction with other interventions. [ABSTRACT FROM AUTHOR]

The impacts of species invasions can subside over time as ecosystems 'adapt' and invaders decline or increase over time as additional species invade. The character and timescales of invasion impacts provide important insights into ecosystem dynamics and management. Yet long-term studies of invasion impacts remain rare and often confound invasive species impacts with coincident environmental change. One way to address this challenge is to ask: what ecological changes over time since invasion are recapitulated in ecosystems that span a range of conditions, are located in different regions, and were invaded in different decades? We synthesize many-decade time series across seven ecosystems to resolve shared changes in seven key ecosystem features following invasion by zebra mussels and subsequent invasion by quagga mussels. These two congeners are among the most widespread invasive species that re-engineer and increasingly co-invade freshwater ecosystems. Seven polymictic shallow lakes with long-term data sets reveal remarkably similar trends, with the strongest ecosystem impacts occurring within 5–10 years of zebra mussel invasion. Surprisingly, plankton communities then exhibited a partial, significant recovery. This recovery was absent, and impacts of initial invasion amplified, in four lakes where quagga mussels outcompeted zebra mussels and more completely depleted phytoplankton. Thus, we show that the ecosystem impacts of invasive species can subside over time but amplify with serial introductions of competing, even closely similar, taxa. [ABSTRACT FROM AUTHOR]

Purpose of Review: To review the impact of contemporary treatment strategies on salvage outcomes in patients with recurrent human papilloma virus-positive oropharyngeal squamous cell carcinoma (HPV + OPSCC). Recent Findings: Secondary to HPV, changes in disease biology have impacted primary treatments and subsequent approaches to patients with recurrence. With treatment strategies more inclusive of upfront surgery, the characteristics of patients with recurrence HPV + OPSCC have been further redefined. Less invasive endoscopic surgical approaches such as transoral robotic surgery (TORS), and the continued refinement of conformal radiotherapy techniques, have improved treatment options for patients with recurrent HPV + OPSCC. Systemic treatment options have continued to expand including potentially effective immune-based therapies. Effective surveillance with systemic and oral biomarkers offers hope of earlier detection of recurrence. Summary: Management of patients with recurrent OPSCC remains difficult. Modest improvements in salvage treatment have been observed within the HPV + OPSCC cohort largely reflecting disease biology and improved treatment techniques. [ABSTRACT FROM AUTHOR]

This study explores the relationship between religious service attendance, social ties, and health among former NFL players, a population with relatively high levels of religious attendance who endure physically demanding occupations. Research shows that frequent religious service attenders tend to have better health, partly because of social connections formed through religious involvement. We analyzed a sample of 1029 former NFL players. Consistent with previous research, bivariate and multivariate OLS regression models show that frequent religious attenders have statistically significantly better self-rated health. However, this relationship is moderated by social ties. Respondents who scored lower on the social ties index exhibited a stronger significant relationship between frequent religious attendance and health; those scoring higher on the social ties index exhibited no relationship between frequent attendance and health. Future research should examine how benefits of religious attendance vary depending upon strength of social relationships. [ABSTRACT FROM AUTHOR]

We analyze the relationship between evolutionary theory and classification of higher taxa in the work of three ichthyologists: Albert C.L.G. Günther (1830–1914), Edward Drinker Cope (1840–1897), and Theodore Gill (1837–1914). The progress of ichthyology in the early years following the Origin has received little attention from historians, and offers an opportunity to further evaluate the extent to which evolutionary theorizing influenced published views on systematic methodology. These three ichthyologists held radically different theoretical views. The apparent commensurability of claims about relationships among groups of fishes belies differences in what the relationships actually were supposed to be. As well, interpreting classification as genealogical did not lead to agreement about taxonomic methodology; instead, applying evolutionary theory raised new axes of disagreement. [ABSTRACT FROM AUTHOR]

After treatment and surgery, patient tumors can initially respond followed by a rapid relapse, or respond well and seemingly be cured, but then recur years or decades later. The state of surviving cancer cells during the long, undetected period is termed dormancy. By definition, the dormant tumor cells do not proliferate to create a mass that is detectable or symptomatic, but also never die. An intrinsic state and microenvironment that are inhospitable to the tumor would bias toward cell death and complete eradication, while conditions that favor the tumor would enable growth and relapse. In neither case would clinical dormancy be observed. Normal cells and tumor cells can enter a state of cellular senescence after stress such as that caused by cancer therapy. Senescence is characterized by a stable cell cycle arrest mediated by chromatin modifications that cause gene expression changes and a secretory phenotype involving many cytokines and chemokines. Senescent cell phenotypes have been shown to be both tumor promoting and tumor suppressive. The balance of these opposing forces presents an attractive model to explain tumor dormancy: phenotypes of stable arrest and immune suppression could promote survival, while reversible epigenetic programs combined with cytokines and growth factors that promote angiogenesis, survival, and proliferation could initiate the emergence from dormancy. In this review, we examine the phenotypes that have been characterized in different normal and cancer cells made senescent by various stresses and how these might explain the characteristics of tumor dormancy. [ABSTRACT FROM AUTHOR]

Preservation of cognitive function is an important outcome in oncology. Optimal patient management requires an understanding of cognitive effects of the disease and its treatment and an efficacious approach to assessment and management of cognitive dysfunction, including selection of treatments to minimize the risk of cognitive impairment. Awareness is increasing of the potentially detrimental effects of cancer-related cognitive dysfunction on functional independence and quality of life. Prostate cancer occurs most often in older men, who are more likely to develop cognitive dysfunction than younger individuals; this population may be particularly vulnerable to treatment-related cognitive disorders. Prompt identification of treatment-induced cognitive dysfunction is a crucial aspect of effective cancer management. We review the potential etiologies of cognitive decline in patients with prostate cancer, including the potential role of androgen receptor pathway inhibitors; commonly used tools for assessing cognitive function validated in metastatic castration-resistant prostate cancer and adopted in non-metastatic castration-resistant prostate cancer trials; and strategies for management of cognitive symptoms. Many methods are currently used to assess cognitive function. The prevalence and severity of cognitive dysfunction vary according to the instruments and criteria applied. Consensus on the definition of cognitive dysfunction and on the most appropriate approaches to quantify its extent and progression in patients treated for prostate cancer is lacking. Evidence-based guidance on the appropriate tools and time to assess cognitive function in patients with prostate cancer is required. Plain Language Summary: Men with prostate cancer are usually elderly and may have other health conditions. Old age, poor health, and some medications can all affect a person's ability to think clearly, make sound judgments, remember things, and learn new information. These mental difficulties can make it hard for people to do day-to-day tasks such as shopping or making a meal, looking after themselves, or taking medications correctly. People may also have problems with friendships and relationships. Therefore, before a man starts treatment for prostate cancer, he and his doctor must consider the likelihood that his mental ability might be affected by the treatment in order to choose the most suitable treatment option. Initially, the doctor can use short screening tests, such as asking the patient to remember and repeat numbers or words, draw objects, name things in a picture, or complete a survey. If these tests show that the patient might be having mental difficulties, he may be invited for additional tests with a specialist, called a neuropsychologist. A patient with, or at risk of, mental difficulties will be offered a care plan, which might include one or more of the following: selecting or switching treatments to avoid side effects; using memory aids; treatment for pain, difficulty sleeping, depression, or other problems that might affect mental function; sessions with a specialist to improve mental ability and develop techniques to adapt to worsening mental function; physical exercise; and getting help from others with household tasks, personal care, or taking medications. [ABSTRACT FROM AUTHOR]

Diaryl ethers undergo electrocatalytic hydrogenolysis (ECH) over skeletal Ni cathodes in a mild, aqueous process that achieves direct C-O cleavage without initial benzene ring saturation. Mechanistic studies find that aryl phenyl ethers with a single para or meta functional group (methyl, methoxy, or hydroxy) are selectively cleaved to the substituted benzene and phenol, in contrast to recently reported homogeneous catalytic cleavage processes. Ortho positioning of substituents reverses this C-O bond selectivity, except for the 2-phenoxyphenol case. Together with isotope labeling and co-solvent studies, these results point to two distinct cleavage mechanisms: (a) dual-ring coordination and C-H activation, leading to vicinal elimination to form phenol and a surface-bound aryne intermediate which is then hydrogenated and released as the arene; and (b) surface binding in keto form by the phenolic ring of the hydroxy-substituted substrates, followed by direct displacement of the departing phenol. Notably, acetone inhibits the well-known reduction of phenol to cyclohexanol, affording control of product ring saturation. A byproduct of this work is the discovery that the ECH treatment completely defluorinates substrates bearing aromatic C-F and C-CF3 groupings. Biomass conversion holds promise as a more sustainable source of platform chemicals, but limitations in the ways in which lignin can be broken down is a current bottleneck. Here the authors report an electrocatalytic hydrogenolysis over skeletal Ni that cleaves diaryl ethers, chemically resistant moieties in both renewable carbon sources and persistent organic pollutants. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the relationship between self-reported concerns about becoming addicted to a medication and health-related quality of life (HRQoL) in patients with osteoarthritis (OA). Methods: This real-world study used patient-level cross-sectional survey data collected from the US Adelphi Disease Specific Programme (DSP). The DSP for OA selected 153 physicians who collected de-identified data on their next nine adult patients with OA. Each patient completed a disease-relevant survey, which included the Likert-scale question, "I am concerned about becoming addicted to my medicine," (CAA) with responses ranging from "completely disagree" [1] to "completely agree" [5]. HRQoL was measured by the EQ-5D-5L index value and the EQ Visual Analogue Scale (VAS). A set of ordinary least squares regressions using HRQoL measures as outcomes and CAA as a continuous predictor were estimated. Standardized effect size (ES) was used to gauge the magnitude of effects. Results: A total of 866 patients with OA completed the survey (female, 61.2%; White, 77.7%; mean age, 64.2 years). Of the 775 patients who completed the CAA question, almost one-third responded that they "agree" (18%) or "completely agree" (11%), while 27% responded "completely disagree" and 20% "disagree." Regression analyses found that patients who have concerns about medication addiction have significantly different EQ-5D-5L index values and EQ VAS scores compared with patients who do not have this concern (p < 0.0001). Conclusion: Our findings suggest that concern about medication addiction in patients with OA may have an impact on patient HRQoL, with more concerned patients reporting poorer HRQoL outcomes. [ABSTRACT FROM AUTHOR]

Reproductive health outcomes are indicators of larger social processes and researchers have long documented inequalities in these outcomes among Blacks and Whites in the United States. However, we do not fully understand the underlying mechanisms responsible for these inequalities. We believe that this is partially due to the treatment of the Black population as a monolith, which masks underlying variation in health risks and outcomes. By examining the variation that exists beneath the average, we can begin to develop a better understanding of the potential sources of health inequalities between Blacks and other racialized populations. We provide an application of this perspective through a geographic examination of reproductive health outcomes within the Black population. Using national birth records data from 2013 to 2016, we examine differences in low birth weight, preterm birth, gestational hypertension, and gestational diabetes by nativity (i.e., US- or foreign-born), region of origin (e.g., Sub-Saharan Africa, the Caribbean), and current US division of residence (e.g., Middle Atlantic, South Atlantic) within the Black population. While foreign-born Blacks are at a lower risk for low birth weight, preterm birth, and gestational hypertension, they are at an elevated risk for gestational diabetes compared to US-born Blacks. Moreover, we find substantial variation in this general pattern across region of origin and division of residence in the US. These findings demonstrate the potential role of migration, context, and selectivity in the health of foreign-born Blacks and demonstrate that national averages mask geographic variation, limiting our understanding of the contributions of these and other social processes to the health of racialized groups in the US. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate, from the patient's perspective, the burden of pain associated with hip/knee osteoarthritis (OA) in the USA and selected European Union (EU) countries. Methods: Data were drawn from the 2017 global Adelphi OA Disease Specific Programme™ (DSP). Patients with hip/knee OA were stratified based on pain intensity and the presence/absence of current opioid use. Outcomes included Western Ontario and McMaster Universities Osteoarthritis Index scores, functional limitations, unmet treatment needs, Charlson Comorbidity Index, relevant comorbid conditions, the 5-dimension 5-level EuroQol, and the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem. Bivariate testing compared outcomes using patients with no/mild pain without opioid use as the reference group. Results: The study population comprised 2170 patients (US: n = 623 [28.7%]; EU: n = 1547 [71.3%]) with knee (54.9%), hip (24.6%), or knee/hip (20.5%) OA. Mean (SD) age was 66.4 (11.2) years. Patients had no/mild pain without opioid use (39.6%), no/mild pain with opioid use (10.2%), moderate/severe pain without opioid use (30.6%), and moderate/severe pain with opioid use (19.7%). Compared with the reference group, patients with moderate/severe pain reported significantly (p < 0.05) higher functional limitations, greater use of ≥ 3 treatments and treatment dissatisfaction, reduced quality of life, and impaired work productivity and activity. The burden was highest with moderate/severe pain with opioid use. Results were generally similar in the US and EU cohorts. Conclusions: The results from this multinational cross-sectional study indicate that the impact of OA pain is multidimensional, worsened by increasing pain intensity, and may not be adequately addressed by current treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Migraine has a severe impact on health-related quality of life (HRQoL) affecting physical, emotional, and social aspects of daily living of an individual. Preventive treatment has been demonstrated to improve HRQoL by reducing the frequency of migraine headache days. Methods: The study used data from 2017 Adelphi Migraine Disease Specific Program, which is a cross-sectional survey of physicians and their consulting patients with migraine in the United States (US) and five European countries (EU [Germany, France, UK, Italy and Spain]). Objectives were to evaluate patient-reported outcome (PRO) measures in the following two subgroups and by region (US and EU): (i) patients who are eligible for migraine preventive treatment (≥4 migraine headache days/month), and (ii) patients who are non-eligible for preventive treatment (< 4 migraine headache days/month). Patient-reported outcome measures that were assessed included the following: Migraine-Specific Quality-of-Life Questionnaire Version 2.1, Migraine Disability Assessment Scale (MIDAS), European Quality of Life-5 Dimensions-5 Levels version, and Work Productivity and Activity Impairment. Results: In total, 5462 patients (US = 1373; EU = 4089) were included in the study (preventive eligible: US = 584; EU = 1942; preventive non-eligible: US = 789; EU = 2147). In the US and EU, preventive eligible patients were significantly more likely to have worse disability as measured by MIDAS than non-eligible patients; preventive eligible patients also had significantly greater functional impairment, worse health utility, and overall greater work impairment (p < 0.0001). Among patients who were preventive eligible, a larger proportion of patients in the US reported that migraine forced them to reduce the number of hours worked as compared with the EU population (29.0% vs 24.7%). Conclusion: Patients who were preventive eligible (≥4 migraine headache days/month) demonstrated greater burden of disease across multiple PRO measures; trends were similar across the US and the five EU countries. [ABSTRACT FROM AUTHOR]

This study examines racial/ethnic differences in perceived need for mental health treatment, barriers to treatment receipt, and reasons for dropout. Data are from the Collaborative Psychiatric Epidemiology Studies, a pooled dataset from three U.S. nationally-representative adult samples. Among respondents with a 12-month psychiatric disorder who received no treatment (N = 1417), Asians and Latinos reported lower perceived need than Blacks and Whites, and Latinos reported the fewest attitudinal barriers. Among those with a 12-month disorder who dropped out of treatment, Asians and Latinos gave more reasons for dropping out. Significant interactions of race/ethnicity with other characteristics identified subpopulations with high unmet need. [ABSTRACT FROM AUTHOR]

Globally, our knowledge on lake fisheries is still limited despite their importance to food security and livelihoods. Here we show that fish catches can respond either positively or negatively to climate and land-use changes, by analyzing time-series data (1970–2014) for 31 lakes across five continents. We find that effects of a climate or land-use driver (e.g., air temperature) on lake environment could be relatively consistent in directions, but consequential changes in a lake-environmental factor (e.g., water temperature) could result in either increases or decreases in fish catch in a given lake. A subsequent correlation analysis indicates that reductions in fish catch was less likely to occur in response to potential climate and land-use changes if a lake is located in a region with greater access to clean water. This finding suggests that adequate investments for water-quality protection and water-use efficiency can provide additional benefits to lake fisheries and food security. Lake fisheries are vulnerable to environmental changes. Here, Kao et al. develop a Bayesian networks model to analyze time-series data from 31 major fisheries lake across five continents, showing that fish catches can respond either positively or negatively to climate and land-use changes. [ABSTRACT FROM AUTHOR]

Unlike many current navigation approaches for micro air vehicles, the relative navigation (RN) framework presented in this paper ensures that the filter state remains observable in GPS-denied environments by working with respect to a local reference frame. By subtly restructuring the problem, RN ensures that the filter uncertainty remains bounded, consistent, and normally-distributed, and insulates flight-critical estimation and control processes from large global updates. This paper thoroughly outlines the RN framework and demonstrates its practicality with several long flight tests in unknown GPS-denied and GPS-degraded environments. The relative front end is shown to produce low-drift estimates and smooth, stable control while leveraging off-the-shelf algorithms. The system runs in real time with onboard processing, fuses a variety of vision sensors, and works indoors and outdoors without requiring special tuning for particular sensors or environments. RN is shown to produce globally-consistent, metric, and localized maps by incorporating loop closures and intermittent GPS measurements. [ABSTRACT FROM AUTHOR]

Background: Migraine is a chronic, disabling neurological disease characterized by moderate-to-severe headache pain with other symptoms, including nausea, vomiting, and photophobia. Triptans, while generally effective, are insufficiently efficacious in 30–40% of patients and poorly tolerated by or contraindicated in others. We assessed the impact of insufficient response to triptans on health-related quality of life (HRQoL) and work productivity in patients currently receiving any prescribed triptan formulation as their only acute migraine medication. Methods: Data were from the 2017 Adelphi Migraine Disease Specific Programme, a cross-sectional survey of primary care physicians, neurologists, and headache specialists and their consulting patients with migraine in the USA, France, Germany, Italy, Spain, and UK. Triptan insufficient responders (TIRs) achieved freedom from headache pain within 2 h of acute treatment in ≤3/5 migraine attacks; triptan responders (TRs) achieved pain freedom within 2 h in ≥4/5 attacks. Multivariable general linear model examined differences between TIRs and TRs in HRQoL and work productivity. Logistic regression identified factors associated with insufficient response to triptans. Results: The study included 1413 triptan-treated patients (TIRs: n = 483, 34.2%; TRs: n = 930, 65.8%). TIRs were more likely to be female (76% vs. 70% for TIRs vs TRs, respectively; p = 0.011), older (mean age 42.6 vs. 40.5 years; p = 0.003), and had more headache days/month (7.0 vs. 4.4; p < 0.001). TIRs had significantly more disability, with higher Migraine Disability Scores (MIDAS; 13.2 vs. 7.7; p < 0.001), lower Migraine-specific Quality of Life scores, indicating greater impact (Role Function Restrictive: 62.4 vs. 74.5; Role Function Preventive: 70.0 vs. 82.2; Emotional Function: 67.7 vs. 82.1; all p < 0.001), and lower EQ5D utility scores (0.84 vs. 0.91; p = 0.001). Work productivity and activity were impaired (absenteeism, 8.6% vs. 5.1% for TIRs vs. TRs; presenteeism, 34.3% vs. 21.0%; work impairment, 37.1% vs. 23.3%; overall activity impairment, 39.8% vs. 25.3%; all p < 0.05). Conclusion: HRQoL and work productivity were significantly impacted in TIRs versus TRs in this real-world analysis of patients with migraine acutely treated with triptans, highlighting the need for more effective treatments for patients with an insufficient triptan response. Further research is needed to establish causal relationships between insufficient response and these outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To develop algorithms mapping the Kidney Disease Quality of Life 36-Item Short Form Survey (KDQOL-36) onto the 3-level EQ-5D questionnaire (EQ-5D-3L) and the 5-level EQ-5D questionnaire (EQ-5D-5L) for patients with end-stage renal disease requiring dialysis.Methods: We used data from a cross-sectional study in Europe (France, n = 299; Germany, n = 413; Italy, n = 278; Spain, n = 225) to map onto EQ-5D-3L and data from a cross-sectional study in Singapore (n = 163) to map onto EQ-5D-5L. Direct mapping using linear regression, mixture beta regression and adjusted limited dependent variable mixture models (ALDVMMs) and response mapping using seemingly unrelated ordered probit models were performed. The KDQOL-36 subscale scores, i.e., physical component summary (PCS), mental component summary (MCS), three disease-specific subscales or their average, i.e., kidney disease component summary (KDCS), and age and sex were included as the explanatory variables. Predictive performance was assessed by mean absolute error (MAE) and root mean square error (RMSE) using 10-fold cross-validation.Results: Mixture models outperformed linear regression and response mapping. When mapping to EQ-5D-3L, the ALDVMM model was the best-performing one for France, Germany and Spain while beta regression was best for Italy. When mapping to EQ-5D-5L, the ALDVMM model also demonstrated the best predictive performance. Generally, models using KDQOL-36 subscale scores showed better fit than using the KDCS.Conclusions: This study adds to the growing literature suggesting the better performance of the mixture models in modelling EQ-5D and produces algorithms to map the KDQOL-36 onto EQ-5D-3L (for France, Germany, Italy, and Spain) and EQ-5D-5L (for Singapore). [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether the metabolic tumor volume (MTV) of head and neck primary tumors may be a significant prognostic factor for feeding tube (FT) use and FT dependence. Seventy-nine patients with evaluable primary tumors, pre-therapy FDG-PET scans, treated with definitive intensity-modulated radiotherapy (IMRT) (± concurrent chemotherapy) for head and neck mucosal cancers were included. MTV was quantified and recorded for the primary lesion using a minimum standardized uptake value (SUV) threshold of 2.0. Patients were recommended prophylactic FT and followed up by a dietician for at least eight weeks of post-radiotherapy. Associations between MTV, dose to swallowing organs at risk, FT use, and FT dependence were analyzed. MTV was positively correlated with gross tumor volume (GTV) (r = 0.7357; p < 0.0001). MTVs larger than 17 cc were associated with higher rates of FT use (87.8% vs. 69.5%, p = 0.0067) and FT dependence at six weeks (76.7% vs. 41.7%, p = 0.0024) and six months (25.0% vs. 8.7%, p = 0.0088). Increasing MTV was associated with increasing mean dose to the oral cavity (p = < 0.0001), tongue base (p = 0.0009), and superior (SPCM) (p = 0.0001) and middle pharyngeal constrictor muscles (MPCM) (p = 0.0005). Increasing MTV was associated with increasing maximum dose to oral cavity (p = 0.0028), tongue base (p = 0.0056), SPCM (p = 0.0037), and MPCM (p = 0.0085). Pre-treatment MTV is a reproducible parameter that can be generated at or prior to a pre-treatment Multidisciplinary Tumor Board and may expedite decisions regarding placement of prophylactic FTs. Prospective evaluation in larger series is required to determine whether MTV is a more useful prognostic variable for FT use than clinical T-classification. [ABSTRACT FROM AUTHOR]

Purpose: There has been no comprehensive examination of how race/ethnicity and nativity intersect in explaining differences in lifetime prevalence of mental disorders among Asian, Black, Latino, and White adults. This study aims to estimate racial/ethnic differences in lifetime risk of mental disorders and examine how group differences vary by nativity.Methods: Survival models were used to estimate racial/ethnic and nativity differences in lifetime risk of DSM-IV anxiety, mood, and substance use disorders in a nationally representative sample of over 20,000 respondents to four US surveys.Results: Asians had the lowest lifetime prevalence of mental disorders (23.5%), followed by Blacks (37.0%), Latinos (38.8%), and Whites (45.6%). Asians and Blacks had lower lifetime risk than Whites for all disorders even after adjusting for nativity; Latinos and Whites had similar risk after adjusting for nativity. Risk of disorder onset was lowest for foreign-born respondents in years before migration. There were significant race/ethnicity and nativity interactions for mood and substance use disorders. Odds of mood disorder onset were higher for Whites with at least one US-born parent. Odds of substance use disorder onset among Asians were higher for US-born respondents; for Latinos, they were higher for those with at least one US-born parent.Conclusions: Parental foreign-born nativity is associated with a low risk of mental disorders, but not uniformly across racial/ethnic groups or disorders. Exposure to the US context may be associated with greater mental disorder risk for Latinos and Whites particularly. Investigations of cultural processes, including among Whites, are needed to understand group differences. [ABSTRACT FROM AUTHOR]

Invasive zebra (ZM) and quagga (QM) mussels continue to spread within and across inland waters worldwide. Oneida Lake, NY, USA, is a large (207 km2), mesotrophic, polymictic lake surveyed annually for dreissenids across substrates since 1992. We estimated abundance and distribution of ZMs and QMs across substrates, calculated lakewide density and biomass, analyzed seasonal and annual differences in veliger density, and explored dynamics of species replacement. ZMs and QMs were detected in 1991 and 2005, respectively. ZM density peaked at almost 30,000 ind/m2 in 1992, declined to between 2600 and 7600 ind/m2 until 2008, and further declined to 370–560 ind/m2 in 2010–2013 concurrent with increasing QM abundance. ZM biomass remained stable from 1992 to 2008 (140–530 g shell-on dry wt/m2) but declined to < 10 g from 2010 to 2013. QMs increased from 38% of the total biomass in 2008 to ≥ 90% from 2010 to 2013 which was accompanied by a decrease in ZM lengths and increase in QM lengths. In shallow (< 9 m) waters, both mussels were more abundant on rock than sand and silt substrate. Only QMs were abundant in deep silt substrate. The shift from ZM to QM dominance increased total biomass, but not density, due to larger QMs. Veliger densities were higher in May and August–November after arrival of QMs; however, there was no correlation between number of veligers and new recruits in fall or adult mussel biomass. The replacement of ZM occurred over about 4 years even though published mechanisms for QM dominance are not operating in summer in Oneida Lake. [ABSTRACT FROM AUTHOR]

Purpose: Cancer and cancer therapy-related neurocognitive changes negatively affect quality of life, yet few studies have examined neurocognitive changes in patients with head and neck cancer. The purpose of this study was to evaluate neurocognitive performance in patients with head and neck cancer at baseline before starting treatment and 3 months after treatment completion to assess treatment-associated changes in performance.Methods: Patients with head and neck cancer who were to receive primary or adjuvant chemoradiation (N = 55) underwent neuropsychological testing before and 3 months posttreatment. Changes in neurocognitive performance were assessed using a practice effect adjusted Reliable Change Index.Results: At baseline, 38 % of patients exhibited global neurocognitive impairment. Posttreatment, 21.8 % demonstrated declines in neurocognitive performance in at least one domain. Declines in domain-specific performance ranged from 1.8 to 12.7 % with the greatest decline in language, specifically verb retrieval. Domain-specific improvements ranged from 0 to 7.3 %.Conclusions: Patients had a high prevalence of baseline neurocognitive impairment. While neurocognitive performance posttreatment remained unchanged in the majority, almost 13 % suffered declines in language. Small percentages of patients exhibited improvements in their performance. Long-term effects and risk factors for neurocognitive decline in this population should be studied on a larger scale. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive impairment induced by cancer therapy is common and can be long lasting after completion of therapy. Little is known on factors that influence recovery from the impairment. We evaluated the associations of dietary intake and supplement use with post-therapy cognitive recovery in a large cohort of breast cancer survivors.Methods: This study included 1047 breast cancer patients aged 20-75 who were recruited to the Shanghai Breast Cancer Survival Study between 2002 and 2006 at approximately 6.5 months post-cancer diagnosis. Two cognitive assessments covering immediate memory, delayed memory, verbal fluency, and attention, were conducted at 18 and 36 months post-diagnosis. We used food frequency questionnaire to collect information on their dietary intake and supplement use between 18 and 36 months post-diagnosis. Linear regression models were used to examine the associations of dietary intake and supplement use with mean cognitive scores at 36 months post-diagnosis and with differences in cognitive scores between 18 and 36 months post-diagnosis.Results: Higher vegetable, fruit and fish intake, supplementation with vitamin B and vitamin E, and tea drinking were associated with higher cognitive scores, while alcohol drinking was associated with lower cognitive scores at 36 months post-diagnosis. Vegetable intake was positively associated with improvement in verbal fluency, while tea drinking and fish oil supplementation were associated with greater improvements in delayed memory between 18 and 36 months post-diagnosis.Conclusions: Our results indicate that higher vegetable intake, tea drinking, and fish oil supplementation may help post-therapy cognitive recovery for cancer patients. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest older patients hospitalized for community-acquired pneumonia are at risk for new-onset cognitive impairment. The characteristics of long-term cognitive impairment after pneumonia, however, have not been elucidated.Objective: To characterize long-term cognitive impairment among adults of all ages hospitalized for community-acquired pneumonia.Design: Prospective cohort study.Participants: Adults without severe preexisting cognitive impairment who were hospitalized with community-acquired pneumonia.Main Measures: At enrollment, we estimated baseline cognitive function with the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). At 2- and 12-month follow-up, we assessed cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and tests of executive function, diagnosing cognitive impairment when results were ≥ 1.5 standard deviations below published age-adjusted means for the general population. We also identified subtypes of mild cognitive impairment using standard definitions.Key Results: We assessed 58 (73%) of 80 patients who survived to 2-month follow-up and 57 (77%) of 74 who survived to 12-month follow-up. The median [range] age of survivors tested was 57 [19-97] years. Only 8 (12%) had evidence of mild cognitive impairment at baseline according to the Short IQCODE, but 21 (38%) at 2 months and 17 (30%) at 12 months had mild cognitive impairment per the RBANS. Moderate-to-severe cognitive impairment was common among adults ≥ 65 years [4/13 (31%) and 5/13 (38%) at 2 and 12 months, respectively] but also affected many of those < 65 years [10/43 (23%) and 8/43 (19%) at 2 and 12 months, respectively]. Deficits were most often noted in visuospatial function, attention, and memory.Conclusions: A year after hospitalization for community-acquired pneumonia, moderate-to-severe impairment in multiple cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment. [ABSTRACT FROM AUTHOR]

Purpose: Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are associated with cognitive impairment and disability after discharge.Methods: We enrolled adults with respiratory failure and/or shock and measured plasma concentrations of BBB (S100B), neuronal (UCHL1, BDNF), and endothelial (E-selectin, PAI-1) injury markers within 72 h of ICU admission. At 3 and 12 months post-discharge, we assessed participants' global cognition, executive function, and activities of daily living (ADL). We used multivariable regression to determine whether biomarkers were associated with outcomes after adjusting for relevant demographic and acute illness covariates.Results: Our study included 419 survivors of critical illness with median age 59 years and APACHE II score 25. Higher S100B was associated with worse global cognition at 3 and 12 months (P = 0.008; P = 0.01). UCHL1 was nonlinearly associated with global cognition at 3 months (P = 0.02). Higher E-selectin was associated with worse global cognition (P = 0.006 at 3 months; P = 0.06 at 12 months). BDNF and PAI-1 were not associated with global cognition. No biomarkers were associated with executive function. Higher S100B (P = 0.05) and E-selectin (P = 0.02) were associated with increased disability in ADLs at 3 months.Conclusions: S100B, a marker of BBB and/or astrocyte injury, and E-selectin, an adhesion molecule and marker of endothelial injury, are associated with long-term cognitive impairment after critical illness, findings that may reflect mechanisms of critical illness brain injury. [ABSTRACT FROM AUTHOR]

The article discusses the cognitive function of patients who survive in an intensive care unit (ICU) admission. Topics mentioned include the prevalence of cognitive impairments in ICU survivors, risk factors for such impairment including patient characteristics and pre-existing cognitive impairment, and the trajectories of cognitive functioning after the illness.

Introduction: Patients with chronic kidney disease (CKD) have an increased risk of comorbid conditions, including cardiovascular disease (CVD). Anemia is prevalent in the CKD population and worsens as kidney function declines, resulting in a diminished quality of life and increased morbidity/mortality. The purpose of this secondary analysis was to determine the real-world prevalence of CVD among patients with non-dialysis-dependent CKD (NDD-CKD), with and without comorbid anemia, and to assess the impact of these conditions on quality of life (QoL) and work productivity.Methods: Data were drawn from the Adelphi CKD Disease-Specific Programme, conducted in France, Germany, Italy, Spain, and the UK (2012). Anonymized data were collected via patient record forms and patient-completed questionnaires. Patient data were stratified by anemic status and the presence of CVD comorbidity.Results: Data were collected by physicians for 1993 patients, of whom 867 completed a patient-completed questionnaire. A total of 61.4% of patients had anemia, and the prevalence of anemia increased with CKD stage. Patients with anemia had a higher mean number of cardiovascular comorbidities than non-anemic patients (1.27 vs 0.95, respectively; P < 0.001). The presence of cardiovascular conditions was associated with a significantly reduced QoL (EuroQol EQ-5D-3L visual analog scale: coefficient, -5.68 in anemic patients; P = 0.028) and work productivity and activity impairment (WPAI activity impairment: coefficient, +8.04 in anemic patients; P = 0.032), particularly among anemic patients.Conclusions: The presence of anemia in this cohort of NDD-CKD patients was high. The presence of concomitant cardiovascular conditions was more common in NDD-CKD patients with comorbid anemia, and was associated with reduced QoL and work productivity outcomes. [ABSTRACT FROM AUTHOR]

This study compares the provision and receipt of kin support for Jamaican immigrants in the US and Jamaican nationals residing in Jamaica. Two datasets are utilized for the study. US data is from the National Survey of American Life (NSAL) which contains the first national probability sample of Caribbean immigrants in the USA. Data for Jamaican nationals comes from the Family Connections across Generations and Nations, a dataset associated with the NSAL. Findings indicate that both Jamaican immigrants and Jamaican nationals provide and receive substantial support from family members. Age and parental and marital status impact the amount of support given and received. In particular, there is a significant interaction between parental status, age, and receiving support that is consistent for both Jamaican immigrants in the US and Jamaican nationals. Findings are discussed in relation to previous research in this field. [ABSTRACT FROM AUTHOR]

There is a void in empirical research that examines African American women's self-reported skin tone discrimination from out-groups (e.g., whites) and ingroups (blacks). We analyzed data of women from diverse socioeconomic backgrounds in the nationally representative National Survey of American Life (N = 1653). Lightskinned women reported less out-group colorism, and light-, medium-, and dark-skinned women with higher selfmastery perceived lower out-group colorism. Mediumskinned women perceived less in-group colorism, while dark-skinned women perceived more in-group and outgroup colorism than counterparts. Implications for intergroup and intragroup race relations as well as well-being are discussed. [ABSTRACT FROM AUTHOR]

Individual behavior drives population-level patterns, yet few studies have integrated how intraspecific niche partitioning influences energy pathways that support consumer production across multiple ecosystem states. We used stable isotope analyses to assess the individual foraging behavior of a dominant consumer, yellow perch ( Perca flavescens), in a single lake (Oneida Lake, NY) under both eutrophic (1960s) and mesotrophic (2000s) conditions and at different yellow perch densities. We then integrated this data with intensive population surveys to assess how variation in foraging behavior between individuals and lake trophic status interacts to drive energy pathways supporting consumer production. Stable isotope analyses highlight that individual yellow perch varied greatly in their reliance on benthic and pelagic energy pathways even within a given year. At the population-level, benthic reliance increased from 2 to 20% under eutrophic conditions to 30-70% under mesotrophic conditions. At low densities, individual fish primarily selected inshore habitats and were reliant on benthic carbon, increasing population-level reliance on benthic carbon. This pattern was present during both trophic states, but was more pronounced during mesotrophic conditions. Our results highlight that variation in foraging behavior between individuals can affect the integration of benthic and pelagic energy pathways at the population-level, and that this integration is dependent on ecosystem state and consumer population density. We propose that models that incorporate variation between individual consumers across multiple habitats can more accurately represent energy flows within ecosystems. [ABSTRACT FROM AUTHOR]

Research has accumulated to demonstrate that depressive symptoms are associated with heterosexual romantic involvement during adolescence, but relatively little work has linked this body of literature to the existing literature on associations between early pubertal timing and adolescent depressive symptoms. This study extends prior research by examining whether early menarche and heterosexual romantic involvement interact to predict depressive symptoms in a national sample of Black adolescent girls (N = 607; M age = 15 years; 32 % Caribbean Black and 68 % African American). We further examined whether the adverse effects of heterosexual romantic involvement and early menarche would be mediated by perceived social support from mothers, fathers, and peers. Path analysis results indicated that girls who report current involvement in a heterosexual romantic relationship also reported high levels of perceived peer support than girls with no romantic involvement. High levels of perceived peer support, in turn, predicted low levels of depressive symptoms. Romantically involved girls with an early menarche also reported significantly less depressive symptoms than girls not romantically involved with an early menarche. Neither perceived maternal support nor perceived paternal support mediated associations between heterosexual romantic involvement, menarche, and depressive symptoms. The findings suggest that individual and social factors can impede heterosexual romantic involvement effects on depressive symptoms in Black adolescent girls. [ABSTRACT FROM AUTHOR]

Cognitive decline is a common health problem among breast cancer patients and understanding trajectories of cognitive change following among breast cancer survivors is an important public health goal. We conducted a longitudinal study to investigate the cognitive function changes from 18 month to 3 years after breast cancer diagnosis among participants of the Shanghai Breast cancer survivor study, a population-based cohort study of breast cancer survivors. In our study, we completed cognitive function evaluation for 1,300 breast cancer survivors at the 18th month's survey and 1,059 at 36th month's survey, respectively, using a battery of cognitive function measurements. We found the scores in attention and executive function, immediate memory and delayed memory significantly improved from 18 to 36 months after breast cancer diagnosis. The improvements appeared in breast cancer survivors receiving treatments (i.e., surgery, radiotherapy, tamoxifen, or chemotherapy combined with or without tamoxifen), but not in those who received neither chemotherapy nor tamoxifen treatment. The results indicate that cognitive functions, particularly immediate verbal episodic memory, and delayed memory significantly improved among breast cancer survivors from 18 to 36 months after cancer diagnosis. In general, comorbidity was inversely associated with the improvements. [ABSTRACT FROM AUTHOR]

Brain metastases (BMs) are a major source of mortality and morbidity in patients with melanoma. This study assesses prognostic nodal factors in patients with nodal metastatic melanoma with respect to the development of BMs. The aim was to identify a high risk subset that may benefit from brain directed management. Prospective surgical and clinical trial databases identified patients who had had nodal dissections and were seen through the Princess Alexandra Hospital Melanoma clinic between August 1995 and June 2010. Patient data was collected and event data was updated from medical imaging and clinical records. The primary endpoint was the rate of development of BMs. 474 patients were identified as having nodal dissections. Two hundred and eighty-seven patients (61 %) were male with a median age of 52 (39-66). The most common nodal dissection site was axilla 190 (40 %), followed by groin 154 (32.5 %) and neck 130 (27.5 %). Adjuvant radiotherapy to the nodal basin was delivered to 134 patients (28 %). BMs occurred in 61 patients (12.9 %) with a median time of 13.87 months from dissection. No lymph node characteristics were significantly associated with the development of BMs including: nodal region ( p = 0.72), nodal size ( p = 0.08), number of involved nodes ( p = 0.36), presence of extra-capsular spread ( p = 0.47) and AJCC N stage. There was no significant association between primary ulceration ( p = 0.37) or location and development of BMs. It appears that for patients with resected stage III melanoma there is no histopathological lymph node feature associated with the development of BMs. This highlights the importance of identifying molecular markers in nodal melanoma which may predict for BMs to further direct site-specific therapy. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to investigate the intratumoral uptake of hollow gold nanospheres (HAuNS) after hepatic intra-arterial (IA) and intravenous (IV) injection in a liver tumor model. Materials and methods: Fifteen VX2 tumor-bearing rabbits were randomized into five groups ( n = 3 in each group) that received either IV Cu-labeled PEG-HAuNS (IV-PEG-HAuNS), IA Cu-labeled PEG-HAuNS (IA-PEG-HAuNS), IV cyclic peptide (RGD)-conjugated Cu-labeled PEG-HAuNS (IV-RGD-PEG-HAuNS), IA RGD-conjugated Cu-labeled PEG-HAuNS (IA-RGD-PEG-HAuNS), or IA Cu-labeled PEG-HAuNS with lipiodol (IA-PEG-HAuNS-lipiodol). The animals underwent PET/CT 1 h after injection, and uptake expressed as percentage of injected dose per gram of tissue (%ID/g) was measured in tumor and major organs. The animals were euthanized 24 h after injection, and tissues were evaluated for radioactivity. Results: At 1 h after injection, animals in the IA-PEG-HAuNS-lipiodol group showed significantly higher tumor uptake ( P < 0.001) and higher ratios of tumor-to-normal liver uptake ( P < 0.001) than those in all other groups. The biodistribution of radioactivity 24 h after injection showed that IA delivery of PEG-HAuNS with lipiodol resulted in the highest tumor uptake (0.33 %ID/g; P < 0.001) and tumor-to-normal liver ratio ( P < 0.001) among all delivery methods. At 24 h, the IA-RGD-PEG-HAuNS group showed higher tumor uptake than the IA-PEG-HAuNS group (0.20 vs. 0.099 %ID/g; P < 0.001). Conclusion: Adding iodized oil to IA-PEG-HAuNS maximizes nanoparticle delivery to hepatic tumors and therefore may be useful in targeted chemotherapy and photoablative therapy. PET/CT can be used to noninvasively monitor the biodistribution of radiolabeled HAuNS after IV or IA injection. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated co-morbidities, level of disability, service utilization and demographic correlates of panic disorder (PD) among African Americans, Caribbean blacks and non-Hispanic white Americans. Methods: Data are from the National Survey of American Life (NSAL) and the National Comorbidity Survey-Replication (NCS-R). Results: Non-Hispanic whites are the most likely to develop PD across the lifespan compared to the black subgroups. Caribbean blacks were found to experience higher levels of functional impairment. There were no gender differences found in prevalence of PD in Caribbean blacks, indicating that existing knowledge about who is at risk for developing PD (generally more prevalent in women) may not be true among this subpopulation. Furthermore, Caribbean blacks with PD were least likely to use mental health services compared to African Americans and non-Hispanic whites. Conclusion: This study demonstrates that PD may affect black ethnic subgroups differently, which has important implications for understanding the nature and etiology of the disorder. [ABSTRACT FROM AUTHOR]

Purpose: To assess the associations between a priori-selected markers of inflammation and coagulation and delirium during critical illness. Methods: In this prospective cohort study, we collected blood from mechanically ventilated medical intensive care unit (ICU) patients and measured nine plasma markers of inflammation and coagulation. We assessed patients daily for delirium using the Confusion Assessment Method for the ICU and used multivariable regression to analyze the associations between plasma markers and subsequent delirium, after adjusting for age, severity of illness, and sepsis. Results: Among the 138 patients studied, with median age of 66 years and median Acute Physiology and Chronic Health Evaluation (APACHE) II of 27, 107 (78 %) were delirious at some point during the study. Two markers of inflammation and one of coagulation were significantly associated with delirium. After adjusting for covariates, lower plasma concentrations of matrix metalloproteinase-9 (MMP-9) and protein C were associated with increased probability of delirium ( p = 0.04 and 0.01, respectively), and higher concentrations of soluble tumor necrosis factor receptor-1 (sTNFR1) were associated with increased probability of delirium ( p < 0.01). Concentrations of C-reactive protein ( p = 0.82), myeloperoxidase ( p = 0.11), neutrophil gelatinase-associated lipocalin ( p = 0.70), D-dimer ( p = 0.83), plasminogen activator inhibitor type 1 ( p = 0.98), and Von Willebrand factor antigen ( p = 0.65) were not associated with delirium. Conclusions: In this study, MMP-9, protein C, and sTNFR1 were independently associated with subsequent ICU delirium. These results suggest that specific aspects of inflammation and coagulation may play a role in the evolution of delirium during critical illness and that these markers should be examined in larger studies of ICU patients. [ABSTRACT FROM AUTHOR]