Showing papers by "Bielefeld University published in 2017"

Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Abstract: Summary Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services. Funding Bill & Melinda Gates Foundation.

Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015

Abstract: Importance Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. Objective To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. Design A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. Main Outcomes and Measures Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. Results Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). Loss of disability-adjusted life-years (DALYs) associated with SBP of at least 110 to 115 mm Hg increased from 148 million (95% UI, 134-162 million) to 211 million (95% UI, 193-231 million), and for SBP of 140 mm Hg or higher, the loss increased from 95.9 million (95% UI, 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [95% UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95% UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the global DALYs related to SBP of at least 110 to 115 mm Hg. Conclusions and Relevance In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher.

No saturation in the accumulation of alien species worldwide.

Abstract: Although research on human-mediated exchanges of species has substantially intensified during the last centuries, we know surprisingly little about temporal dynamics of alien species accumulations across regions and taxa. Using a novel database of 45,813 first records of 16,926 established alien species, we show that the annual rate of first records worldwide has increased during the last 200 years, with 37% of all first records reported most recently (1970-2014). Inter-continental and inter-taxonomic variation can be largely attributed to the diaspora of European settlers in the nineteenth century and to the acceleration in trade in the twentieth century. For all taxonomic groups, the increase in numbers of alien species does not show any sign of saturation and most taxa even show increases in the rate of first records over time. This highlights that past efforts to mitigate invasions have not been effective enough to keep up with increasing globalization.

The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level : results from the Global Burden of Disease Study 2015

Abstract: Importance Liver cancer is among the leading causes of cancer deaths globally. The most common causes for liver cancer include hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and alcohol use. Objective To report results of the Global Burden of Disease (GBD) 2015 study on primary liver cancer incidence, mortality, and disability-adjusted life-years (DALYs) for 195 countries or territories from 1990 to 2015, and present global, regional, and national estimates on the burden of liver cancer attributable to HBV, HCV, alcohol, and an “other” group that encompasses residual causes. Design, Settings, and Participants Mortality was estimated using vital registration and cancer registry data in an ensemble modeling approach. Single-cause mortality estimates were adjusted for all-cause mortality. Incidence was derived from mortality estimates and the mortality-to-incidence ratio. Through a systematic literature review, data on the proportions of liver cancer due to HBV, HCV, alcohol, and other causes were identified. Years of life lost were calculated by multiplying each death by a standard life expectancy. Prevalence was estimated using mortality-to-incidence ratio as surrogate for survival. Total prevalence was divided into 4 sequelae that were multiplied by disability weights to derive years lived with disability (YLDs). DALYs were the sum of years of life lost and YLDs. Main Outcomes and Measures Liver cancer mortality, incidence, YLDs, years of life lost, DALYs by etiology, age, sex, country, and year. Results There were 854 000 incident cases of liver cancer and 810 000 deaths globally in 2015, contributing to 20 578 000 DALYs. Cases of incident liver cancer increased by 75% between 1990 and 2015, of which 47% can be explained by changing population age structures, 35% by population growth, and −8% to changing age-specific incidence rates. The male-to-female ratio for age-standardized liver cancer mortality was 2.8. Globally, HBV accounted for 265 000 liver cancer deaths (33%), alcohol for 245 000 (30%), HCV for 167 000 (21%), and other causes for 133 000 (16%) deaths, with substantial variation between countries in the underlying etiologies. Conclusions and Relevance Liver cancer is among the leading causes of cancer deaths in many countries. Causes of liver cancer differ widely among populations. Our results show that most cases of liver cancer can be prevented through vaccination, antiviral treatment, safe blood transfusion and injection practices, as well as interventions to reduce excessive alcohol use. In line with the Sustainable Development Goals, the identification and elimination of risk factors for liver cancer will be required to achieve a sustained reduction in liver cancer burden. The GBD study can be used to guide these prevention efforts.

rptR: repeatability estimation and variance decomposition by generalized linear mixed-effects models

Abstract: Summary Intra-class correlations (ICC) and repeatabilities (R) are fundamental statistics for quantifying the reproducibility of measurements and for understanding the structure of biological variation. Linear mixed effects models offer a versatile framework for estimating ICC and R. However, while point estimation and significance testing by likelihood ratio tests is straightforward, the quantification of uncertainty is not as easily achieved. A further complication arises when the analysis is conducted on data with non-Gaussian distributions because the separation of the mean and the variance is less clear-cut for non-Gaussian than for Gaussian models. Nonetheless, there are solutions to approximate repeatability for the most widely used families of generalized linear mixed models (GLMMs). Here, we introduce the R package rptR for the estimation of ICC and R for Gaussian, binomial and Poisson-distributed data. Uncertainty in estimators is quantified by parametric bootstrapping and significance testing is implemented by likelihood ratio tests and through permutation of residuals. The package allows control for fixed effects and thus the estimation of adjusted repeatabilities (that remove fixed effect variance from the estimate) and enhanced agreement repeatabilities (that add fixed effect variance to the denominator). Furthermore, repeatability can be estimated from random-slope models. The package features convenient summary and plotting functions. Besides repeatabilities, the package also allows the quantification of coefficients of determination R2 as well as of raw variance components. We present an example analysis to demonstrate the core features and discuss some of the limitations of rptR.

Critical Assessment of Metagenome Interpretation - A benchmark of metagenomics software

Abstract: Methods for assembly, taxonomic profiling and binning are key to interpreting metagenome data, but a lack of consensus about benchmarking complicates performance assessment. The Critical Assessment of Metagenome Interpretation (CAMI) challenge has engaged the global developer community to benchmark their programs on highly complex and realistic data sets, generated from ∼700 newly sequenced microorganisms and ∼600 novel viruses and plasmids and representing common experimental setups. Assembly and genome binning programs performed well for species represented by individual genomes but were substantially affected by the presence of related strains. Taxonomic profiling and binning programs were proficient at high taxonomic ranks, with a notable performance decrease below family level. Parameter settings markedly affected performance, underscoring their importance for program reproducibility. The CAMI results highlight current challenges but also provide a roadmap for software selection to answer specific research questions.

The LOFAR Two-metre Sky Survey. I. Survey description and preliminary data release

Abstract: The LOFAR Two-metre Sky Survey (LoTSS) is a deep 120-168 MHz imaging survey that will eventually cover the entire northern sky. Each of the 3170 pointings will be observed for 8 h, which, at most declinations, is sufficient to produce ~5? resolution images with a sensitivity of ~100 ?Jy/beam and accomplish the main scientific aims of the survey, which are to explore the formation and evolution of massive black holes, galaxies, clusters of galaxies and large-scale structure. Owing to the compact core and long baselines of LOFAR, the images provide excellent sensitivity to both highly extended and compact emission. For legacy value, the data are archived at high spectral and time resolution to facilitate subarcsecond imaging and spectral line studies. In this paper we provide an overview of the LoTSS. We outline the survey strategy, the observational status, the current calibration techniques, a preliminary data release, and the anticipated scientific impact. The preliminary images that we have released were created using a fully automated but direction-independent calibration strategy and are significantly more sensitive than those produced by any existing large-Area low-frequency survey. In excess of 44 000 sources are detected in the images that have a resolution of 25?, typical noise levels of less than 0.5 mJy/beam, and cover an area of over 350 square degrees in the region of the HETDEX Spring Field (right ascension 10h45m00s to 15h30m00s and declination 45°00?00? to 57°00?00?).

Health literacy in childhood and youth: a systematic review of definitions and models

Abstract: Children and young people constitute a core target group for health literacy research and practice: during childhood and youth, fundamental cognitive, physical and emotional development processes take place and health-related behaviours and skills develop. However, there is limited knowledge and academic consensus regarding the abilities and knowledge a child or young person should possess for making sound health decisions. The research presented in this review addresses this gap by providing an overview and synthesis of current understandings of health literacy in childhood and youth. Furthermore, the authors aim to understand to what extent available models capture the unique needs and characteristics of children and young people. Six databases were systematically searched with relevant search terms in English and German. Of the n = 1492 publications identified, N = 1021 entered the abstract screening and N = 340 full-texts were screened for eligibility. A total of 30 articles, which defined or conceptualized generic health literacy for a target population of 18 years or younger, were selected for a four-step inductive content analysis. The systematic review of the literature identified 12 definitions and 21 models that have been specifically developed for children and young people. In the literature, health literacy in children and young people is described as comprising variable sets of key dimensions, each appearing as a cluster of related abilities, skills, commitments, and knowledge that enable a person to approach health information competently and effectively and to derive at health-promoting decisions and actions. Identified definitions and models are very heterogeneous, depicting health literacy as multidimensional, complex construct. Moreover, health literacy is conceptualized as an action competence, with a strong focus on personal attributes, while also recognising its interrelatedness with social and contextual determinants. Life phase specificities are mainly considered from a cognitive and developmental perspective, leaving children’s and young people’s specific needs, vulnerabilities, and social structures poorly incorporated within most models. While a critical number of definitions and models were identified for youth or secondary school students, similar findings are lacking for children under the age of ten or within a primary school context.

QCD equation of state to O (μB6) from lattice QCD

Abstract: We calculated the QCD equation of state using Taylor expansions that include contributions from up to sixth order in the baryon strangeness and electric charge chemical potentials. Calculations have been performed with the Highly Improved Staggered Quark action in the temperature range T epsilon [135 MeV 330 MeV] using up to four different sets of lattice cutoffs corresponding to lattices of size N sigma 3x N tau with aspect ratio N sigma/N tau = 4 and N tau=6-16. The strange quark mass is tuned to its physical value and we use two strange to light quark mass ratios ms/ml = 20 and 27 which in the continuum limit correspond to a pion mass of about 160 and 140 MeV respectively. Sixth order results for Taylor expansion coefficients are used to estimate truncation errors of the fourth order expansion. We show that truncation errors are small for baryon chemical potentials less then twice the temperature (mu(B) 0.9.

Global distribution of particle phase state in atmospheric secondary organic aerosols

Abstract: Secondary organic aerosols (SOA) are a large source of uncertainty in our current understanding of climate change and air pollution. The phase state of SOA is important for quantifying their effects on climate and air quality, but its global distribution is poorly characterized. We developed a method to estimate glass transition temperatures based on the molar mass and molecular O:C ratio of SOA components, and we used the global chemistry climate model EMAC with the organic aerosol module ORACLE to predict the phase state of atmospheric SOA. For the planetary boundary layer, global simulations indicate that SOA are mostly liquid in tropical and polar air with high relative humidity, semi-solid in the mid-latitudes and solid over dry lands. We find that in the middle and upper troposphere SOA should be mostly in a glassy solid phase state. Thus, slow diffusion of water, oxidants and organic molecules could kinetically limit gas-particle interactions of SOA in the free and upper troposphere, promote ice nucleation and facilitate long-range transport of reactive and toxic organic pollutants embedded in SOA.

Strategic and practical guidelines for successful structured illumination microscopy

Abstract: Linear 2D- or 3D-structured illumination microscopy (SIM or3D-SIM, respectively) enables multicolor volumetric imaging of fixed and live specimens with subdiffraction resolution in all spatial dimensions. However, the reliance of SIM on algorithmic post-processing renders it particularly sensitive to artifacts that may reduce resolution, compromise data and its interpretations, and drain resources in terms of money and time spent. Here we present a protocol that allows users to generate high-quality SIM data while accounting and correcting for common artifacts. The protocol details preparation of calibration bead slides designed for SIM-based experiments, the acquisition of calibration data, the documentation of typically encountered SIM artifacts and corrective measures that should be taken to reduce them. It also includes a conceptual overview and checklist for experimental design and calibration decisions, and is applicable to any commercially available or custom platform. This protocol, plus accompanying guidelines, allows researchers from students to imaging professionals to create an optimal SIM imaging environment regardless of specimen type or structure of interest. The calibration sample preparation and system calibration protocol can be executed within 1-2 d.

Electroweak bubble wall speed limit

Abstract: In extensions of the Standard Model with extra scalars, the electroweak phase transition can be very strong, and the bubble walls can be highly relativistic. We revisit our previous argument that electroweak bubble walls can "run away," that is, achieve extreme ultrarelativistic velocities γ ~ 1014. We show that, when particles cross the bubble wall, they can emit transition radiation. Wall-frame soft processes, though suppressed by a power of the coupling α, have a significance enhanced by the γ-factor of the wall, limiting wall velocities to γ ~ 1/α. Though the bubble walls can move at almost the speed of light, they carry an infinitesimal share of the plasma's energy.

Advanced Biofuels and Beyond: Chemistry Solutions for Propulsion and Production.

Abstract: Sustainably produced biofuels, especially when they are derived from lignocellulosic biomass, are being discussed intensively for future ground transportation. Traditionally, research activities focus on the synthesis process, while leaving their combustion properties to be evaluated by a different community. This Review adopts an integrative view of engine combustion and fuel synthesis, focusing on chemical aspects as the common denominator. It will be demonstrated that a fundamental understanding of the combustion process can be instrumental to derive design criteria for the molecular structure of fuel candidates, which can then be targets for the analysis of synthetic pathways and the development of catalytic production routes. With such an integrative approach to fuel design, it will be possible to improve systematically the entire system, spanning biomass feedstock, conversion process, fuel, engine, and pollutants with a view to improve the carbon footprint, increase efficiency, and reduce emissions.

Mapping the emotional face. How individual face parts contribute to successful emotion recognition.

Abstract: Which facial features allow human observers to successfully recognize expressions of emotion? While the eyes and mouth have been frequently shown to be of high importance, research on facial action units has made more precise predictions about the areas involved in displaying each emotion. The present research investigated on a fine-grained level, which physical features are most relied on when decoding facial expressions. In the experiment, individual faces expressing the basic emotions according to Ekman were hidden behind a mask of 48 tiles, which was sequentially uncovered. Participants were instructed to stop the sequence as soon as they recognized the facial expression and assign it the correct label. For each part of the face, its contribution to successful recognition was computed, allowing to visualize the importance of different face areas for each expression. Overall, observers were mostly relying on the eye and mouth regions when successfully recognizing an emotion. Furthermore, the difference in the importance of eyes and mouth allowed to group the expressions in a continuous space, ranging from sadness and fear (reliance on the eyes) to disgust and happiness (mouth). The face parts with highest diagnostic value for expression identification were typically located in areas corresponding to action units from the facial action coding system. A similarity analysis of the usefulness of different face parts for expression recognition demonstrated that faces cluster according to the emotion they express, rather than by low-level physical features. Also, expressions relying more on the eyes or mouth region were in close proximity in the constructed similarity space. These analyses help to better understand how human observers process expressions of emotion, by delineating the mapping from facial features to psychological representation.

The effect of avatar realism in immersive social virtual realities

Abstract: This paper investigates the effect of avatar realism on embodiment and social interactions in Virtual Reality (VR) We compared abstract avatar representations based on a wooden mannequin with high fidelity avatars generated from photogrammetry 3D scan methods Both avatar representations were alternately applied to participating users and to the virtual counterpart in dyadic social encounters to examine the impact of avatar realism on self-embodiment and social interaction quality Users were immersed in a virtual room via a head mounted display (HMD) Their full-body movements were tracked and mapped to respective movements of their avatars Embodiment was induced by presenting the users' avatars to themselves in a virtual mirror Afterwards they had to react to a non-verbal behavior of a virtual interaction partner they encountered in the virtual space Several measures were taken to analyze the effect of the appearance of the users' avatars as well as the effect of the appearance of the others' avatars on the users The realistic avatars were rated significantly more human-like when used as avatars for the others and evoked a stronger acceptance in terms of virtual body ownership (VBO) There also was some indication of a potential uncanny valley Additionally, there was an indication that the appearance of the others' avatars impacts the self-perception of the users

Survey on challenges of Question Answering in the Semantic Web

Abstract: Semantic Question Answering (SQA) removes two major access requirements to the Semantic Web: the mastery of a formal query language like SPARQL and knowledge of a specific vocabulary. Because of the complexity of natural language, SQA presents difficult challenges and many research opportunities. Instead of a shared effort, however, many essential components are redeveloped, which is an inefficient use of researcher’s time and resources. This survey analyzes 62 different SQA systems, which are systematically and manually selected using predefined inclusion and exclusion criteria, leading to 72 selected publications out of 1960 candidates. We identify common challenges, structure solutions, and provide recommendations for future systems. This work is based on publications from the end of 2010 to July 2015 and is also compared to older but similar surveys.

Empathy in Virtual Agents and Robots: A Survey

Abstract: This article surveys the area of computational empathy, analysing different ways by which artificial agents can simulate and trigger empathy in their interactions with humans. Empathic agents can be seen as agents that have the capacity to place themselves into the position of a user’s or another agent’s emotional situation and respond appropriately. We also survey artificial agents that, by their design and behaviour, can lead users to respond emotionally as if they were experiencing the agent’s situation. In the course of this survey, we present the research conducted to date on empathic agents in light of the principles and mechanisms of empathy found in humans. We end by discussing some of the main challenges that this exciting area will be facing in the future.

Personality traits below facets: The consensual validity, longitudinal stability, heritability, and utility of personality nuances.

Abstract: It has been argued that facets do not represent the bottom of the personality hierarchy-even more specific personality characteristics, nuances, could be useful for describing and understanding individuals and their differences. Combining 2 samples of German twins, we assessed the consensual validity (correlations across different observers), rank-order stability, and heritability of nuances. Personality nuances were operationalized as the 240 items of the Revised NEO Personality Inventory (NEO-PI-R). Their attributes were examined by analyzing item residuals, controlling for the variance of the facet the item had been assigned to and all other facets. Most nuances demonstrated significant (p < .0002) cross-method agreement and rank-order stability. A substantial proportion of them (48% in self-reports, 20% in informant ratings, and 50% in combined ratings) demonstrated a significant (p < .0002) component of additive genetic variance, whereas evidence for environmental influences shared by twins was modest. Applying a procedure to estimate stability and heritability of true scores of item residuals yielded estimates comparable with those of higher-order personality traits, with median estimates of rank-order stability and heritability being .77 and .52, respectively. Few nuances demonstrated robust associations with age and gender, but many showed incremental, conceptually meaningful, and replicable (across methods and/or samples) predictive validity for a range of interest domains and body mass index. We argue that these narrow personality characteristics constitute a valid level of the personality hierarchy. They may be especially useful for providing a deep and contextualized description of the individual, but also for the prediction of specific outcomes. (PsycINFO Database Record

Selecting the Number of States in Hidden Markov Models: Pragmatic Solutions Illustrated Using Animal Movement

Abstract: We discuss the notorious problem of order selection in hidden Markov models, that is of selecting an adequate number of states, highlighting typical pitfalls and practical challenges arising when analyzing real data. Extensive simulations are used to demonstrate the reasons that render order selection particularly challenging in practice despite the conceptual simplicity of the task. In particular, we demonstrate why well-established formal procedures for model selection, such as those based on standard information criteria, tend to favor models with numbers of states that are undesirably large in situations where states shall be meaningful entities. We also offer a pragmatic step-by-step approach together with comprehensive advice for how practitioners can implement order selection. Our proposed strategy is illustrated with a real-data case study on muskox movement. Supplementary materials accompanying this paper appear online.

Global Cardiovascular and Renal Outcomes of Reduced GFR

Abstract: The burden of premature death and health loss from ESRD is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced GFR. We estimated the prevalence of reduced GFR categories 3, 4, and 5 (not on RRT) for 188 countries at six time points from 1990 to 2013. Relative risks of cardiovascular outcomes by three categories of reduced GFR were calculated by pooled random effects meta-analysis. Results are presented as deaths for outcomes of cardiovascular disease and ESRD and as disability-adjusted life years for outcomes of cardiovascular disease, GFR categories 3, 4, and 5, and ESRD. In 2013, reduced GFR was associated with 4% of deaths worldwide, or 2.2 million deaths (95% uncertainty interval [95% UI], 2.0 to 2.4 million). More than half of these attributable deaths were cardiovascular deaths (1.2 million; 95% UI, 1.1 to 1.4 million), whereas 0.96 million (95% UI, 0.81 to 1.0 million) were ESRD-related deaths. Compared with metabolic risk factors, reduced GFR ranked below high systolic BP, high body mass index, and high fasting plasma glucose, and similarly with high total cholesterol as a risk factor for disability-adjusted life years in both developed and developing world regions. In conclusion, by 2013, cardiovascular deaths attributed to reduced GFR outnumbered ESRD deaths throughout the world. Studies are needed to evaluate the benefit of early detection of CKD and treatment to decrease these deaths.

Peroxiredoxins and Redox Signaling in Plants.

Abstract: Significance: Peroxiredoxins (Prxs) are thiol peroxidases with multiple functions in the antioxidant defense and redox signaling network of the cell. Our progressing understanding assigns both local and global significance to plant Prxs, which are grouped in four Prx types. In plants they are localized to the cytosol, mitochondrion, plastid, and nucleus. Antioxidant defense is fundamentally connected to redox signaling, cellular communication, and acclimation. The thiol–disulfide network is central part of the stress sensing and processing response and integrates information input with redox regulation. Recent Advances: Prxs function both as redox sensory system within the network and redox-dependent interactors. The processes directly or indirectly targeted by Prxs include gene expression, post-transcriptional reactions, including translation, post-translational regulation, and switching or tuning of metabolic pathways, and other cell activities. The most advanced knowledge is available for the ...

Health Literacy in the German Population

Abstract: Background Persons with low health literacy have difficulty dealing with the health care system and understanding health-related information. Studies from multiple countries have shown that low health literacy negatively affects health, health-related and illness-related behavior, and the utilization of health care resources. The data available till now on health literacy in Germany have been sparse. The goal of this study is to acquire representative data on the health literacy of the German population. Methods In a cross-sectional study, we collected data from a representative group of 2000 persons over age 15 in Germany by means of computer-assisted personal interviews (CAPI) that were based on the long version of the questionnaire used in the European Health Literacy Survey (HLS-EU-Q47). Sociodemographic data were also collected. Results The respondents were a representative sample of the German population. 54.3% of them were found to have limited health literacy. Multiple logistic regression revealed associations of limited health literacy with advanced age (odds ratio [OR] 1.83, 95% confidence interval [CI] [1.36; 2.48]), an immigrant background (OR 1.87 [1.27; 2.75]), low self-assessed social status (OR 5.25 [3.57; 7.72]), and low functional literacy (OR 1.94 [1.49; 2.52]). Conclusion The low health literacy of many Germans can impair communication between doctors and patients and exacerbate existing problems in health policy. In the future, greater effort will have to be made to foster health literacy, make health-related information for patients easier to understand, and intensify research in the field of health literacy.

Comparing Conventional and Augmented Reality Instructions for Manual Assembly Tasks

Abstract: Augmented Reality (AR) gains increased attention as a means to provide assistance for different human activities. Hereby the suitability of AR does not only depend on the respective task, but also to a high degree on the respective device. In a standardized assembly task, we tested AR-based in-situ assistance against conventional pictorial instructions using a smartphone, Microsoft HoloLens and Epson Moverio BT-200 smart glasses as well as paper-based instructions. Participants solved the task fastest using the paper instructions, but made less errors with AR assistance on the Microsoft HoloLens smart glasses than with any other system. Methodically we propose operational definitions of time segments and other optimizations for standardized benchmarking of AR assembly instructions.