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Journal ArticleDOI
TL;DR: In this article, a Delphi survey was conducted among an international panel of experts on early and late fetal growth restriction (FGR) to determine, by expert consensus, a definition for early FGR through Delphi procedure.
Abstract: Objective To determine, by expert consensus, a definition for early and late fetal growth restriction (FGR) through a Delphi procedure. Method A Delphi survey was conducted among an international panel of experts on FGR. Panel members were provided with 18 literature-based parameters for defining FGR and were asked to rate the importance of these parameters for the diagnosis of both early and late FGR on a 5-point Likert scale. Parameters were described as solitary parameters (parameters that are sufficient to diagnose FGR, even if all other parameters are normal) and contributory parameters (parameters that require other abnormal parameter(s) to be present for the diagnosis of FGR). Consensus was sought to determine the cut-off values for accepted parameters. Results A total of 106 experts were approached, of whom 56 agreed to participate and entered the first round, and 45 (80%) completed all four rounds. For early FGR ( 95th centile in either the UA or uterine artery) were agreed upon. For late FGR (≥ 32 weeks), two solitary parameters (AC or EFW two quartiles on growth charts and cerebroplacental ratio 95th centile) were defined. Conclusion Consensus-based definitions for early and late FGR, as well as cut-off values for parameters involved, were agreed upon by a panel of experts. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

770 citations


Journal ArticleDOI
TL;DR: It is shown that charge carrier mobility within perovskite QD films is dictated by the chemical conditions at the QD-QD junctions, and the AX treatments presented here double the film mobility, enabling increased photocurrent, and lead to a record certified QD solar cell efficiency of 13.43%.
Abstract: We developed lead halide perovskite quantum dot (QD) films with tuned surface chemistry based on A-site cation halide salt (AX) treatments. QD perovskites offer colloidal synthesis and processing using industrially friendly solvents, which decouples grain growth from film deposition, and at present produce larger open-circuit voltages (VOC’s) than thin-film perovskites. CsPbI3 QDs, with a tunable bandgap between 1.75 and 2.13 eV, are an ideal top cell candidate for all-perovskite multijunction solar cells because of their demonstrated small VOC deficit. We show that charge carrier mobility within perovskite QD films is dictated by the chemical conditions at the QD-QD junctions. The AX treatments provide a method for tuning the coupling between perovskite QDs, which is exploited for improved charge transport for fabricating high-quality QD films and devices. The AX treatments presented here double the film mobility, enabling increased photocurrent, and lead to a record certified QD solar cell efficiency of 13.43%.

770 citations


Journal ArticleDOI
TL;DR: In this paper, five pre-trained convolutional neural network-based models were proposed for the detection of coronavirus pneumonia-infected patient using chest X-ray radiographs.
Abstract: The 2019 novel coronavirus disease (COVID-19), with a starting point in China, has spread rapidly among people living in other countries and is approaching approximately 101,917,147 cases worldwide according to the statistics of World Health Organization. There are a limited number of COVID-19 test kits available in hospitals due to the increasing cases daily. Therefore, it is necessary to implement an automatic detection system as a quick alternative diagnosis option to prevent COVID-19 spreading among people. In this study, five pre-trained convolutional neural network-based models (ResNet50, ResNet101, ResNet152, InceptionV3 and Inception-ResNetV2) have been proposed for the detection of coronavirus pneumonia-infected patient using chest X-ray radiographs. We have implemented three different binary classifications with four classes (COVID-19, normal (healthy), viral pneumonia and bacterial pneumonia) by using five-fold cross-validation. Considering the performance results obtained, it has been seen that the pre-trained ResNet50 model provides the highest classification performance (96.1% accuracy for Dataset-1, 99.5% accuracy for Dataset-2 and 99.7% accuracy for Dataset-3) among other four used models.

769 citations


Journal ArticleDOI
TL;DR: This review focuses on how tumour and tumour-associated stromal cells deposit, biochemically and biophysically modify, and degrade tumours' extracellular matrix (ECM).
Abstract: Tissues are dynamically shaped by bidirectional communication between resident cells and the extracellular matrix (ECM) through cell-matrix interactions and ECM remodelling. Tumours leverage ECM remodelling to create a microenvironment that promotes tumourigenesis and metastasis. In this review, we focus on how tumour and tumour-associated stromal cells deposit, biochemically and biophysically modify, and degrade tumour-associated ECM. These tumour-driven changes support tumour growth, increase migration of tumour cells, and remodel the ECM in distant organs to allow for metastatic progression. A better understanding of the underlying mechanisms of tumourigenic ECM remodelling is crucial for developing therapeutic treatments for patients.

769 citations


Journal ArticleDOI
TL;DR: In this paper, a connection between the distance conjecture and a refined version of the de Sitter conjecture in any parametrically controlled regime of string theory by using Bousso's covariant entropy bound was made.

769 citations


Journal ArticleDOI
TL;DR: Research suggesting that repeated media exposure to community crisis can lead to increased anxiety, heightened stress responses, and misplaced health-protective and help-seeking behaviors that can overburden health care facilities and tax available resources is reviewed.
Abstract: The 2019 novel coronavirus (COVID-2019) has led to a serious outbreak of often severe respiratory disease, which originated in China and has quickly become a global pandemic, with far-reaching consequences that are unprecedented in the modern era. As public health officials seek to contain the virus and mitigate the deleterious effects on worldwide population health, a related threat has emerged: global media exposure to the crisis. We review research suggesting that repeated media exposure to community crisis can lead to increased anxiety, heightened stress responses that can lead to downstream effects on health, and misplaced health-protective and help-seeking behaviors that can overburden health care facilities and tax available resources. We draw from work on previous public health crises (i.e., Ebola and H1N1 outbreaks) and other collective trauma (e.g., terrorist attacks) where media coverage of events had unintended consequences for those at relatively low risk for direct exposure, leading to potentially severe public health repercussions. We conclude with recommendations for individuals, researchers, and public health officials with respect to receiving and providing effective communications during a public health crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

769 citations


Journal ArticleDOI
TL;DR: Ibrutinib was highly active, associated with durable responses, and safe in pretreated patients with Waldenström's macroglobulinemia, and the effect of MYD88 and CXCR4 mutations on outcomes was investigated.
Abstract: BackgroundMYD88L265P and CXCR4WHIM mutations are highly prevalent in Waldenstrom’s macroglobulinemia. MYD88L265P triggers tumor-cell growth through Bruton’s tyrosine kinase, a target of ibrutinib. CXCR4WHIM mutations confer in vitro resistance to ibrutinib. MethodsWe performed a prospective study of ibrutinib in 63 symptomatic patients with Waldenstrom’s macroglobulinemia who had received at least one previous treatment, and we investigated the effect of MYD88 and CXCR4 mutations on outcomes. Ibrutinib at a daily dose of 420 mg was administered orally until disease progression or the development of unacceptable toxic effects. ResultsAfter the patients received ibrutinib, median serum IgM levels decreased from 3520 mg per deciliter to 880 mg per deciliter, median hemoglobin levels increased from 10.5 g per deciliter to 13.8 g per deciliter, and bone marrow involvement decreased from 60% to 25% (P<0.01 for all comparisons). The median time to at least a minor response was 4 weeks. The overall response rate ...

769 citations


Journal ArticleDOI
TL;DR: Nonalcoholic steatohepatitis is a major cause of cirrhosis and liver cancer and is associated with visceral adiposity and the metabolic syndrome and is nearly as common as type 2 diabetes.
Abstract: Nonalcoholic steatohepatitis is a major cause of cirrhosis and liver cancer. It is associated with visceral adiposity and the metabolic syndrome and is nearly as common as type 2 diabetes. Metabolic stress, inflammation, and fibrosis are the primary pathogenic mechanisms.

769 citations


Journal ArticleDOI
TL;DR: HIF-dependent ALKBH5 expression mediates enrichment of BCSCs in the hypoxic tumor microenvironment and induces N6-methyladenosine (m6A) demethylation and stabilization of NANOG mRNA, thereby promoting the breast cancer stem cell (BCSC) phenotype.
Abstract: N(6)-methyladenosine (m(6)A) modification of mRNA plays a role in regulating embryonic stem cell pluripotency. However, the physiological signals that determine the balance between methylation and demethylation have not been described, nor have studies addressed the role of m(6)A in cancer stem cells. We report that exposure of breast cancer cells to hypoxia stimulated hypoxia-inducible factor (HIF)-1α- and HIF-2α-dependent expression of AlkB homolog 5 (ALKBH5), an m(6)A demethylase, which demethylated NANOG mRNA, which encodes a pluripotency factor, at an m(6)A residue in the 3'-UTR. Increased NANOG mRNA and protein expression, and the breast cancer stem cell (BCSC) phenotype, were induced by hypoxia in an HIF- and ALKBH5-dependent manner. Insertion of the NANOG 3'-UTR into a luciferase reporter gene led to regulation of luciferase activity by O2, HIFs, and ALKBH5, which was lost upon mutation of the methylated residue. ALKBH5 overexpression decreased NANOG mRNA methylation, increased NANOG levels, and increased the percentage of BCSCs, phenocopying the effect of hypoxia. Knockdown of ALKBH5 expression in MDA-MB-231 human breast cancer cells significantly reduced their capacity for tumor initiation as a result of reduced numbers of BCSCs. Thus, HIF-dependent ALKBH5 expression mediates enrichment of BCSCs in the hypoxic tumor microenvironment.

769 citations


Journal ArticleDOI
TL;DR: Clinical and experimental data suggest dysbiosis may play a pivotal role in the pathogenesis of IBD, and the therapeutic options for manipulating the altered gut microbiota, such as probiotics and fecal microbiota transplantation are reviewed.
Abstract: Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is a chronic and relapsing inflammatory disorder of the intestine. Although its incidence is increasing globally, the precise etiology remains unclear and a cure for IBD has yet to be discovered. The most accepted hypothesis of IBD pathogenesis is that complex interactions between genetics, environmental factors, and the host immune system lead to aberrant immune responses and chronic intestinal inflammation. The human gut harbors a complex and abundant aggregation of microbes, collectively referred to as the gut microbiota. The gut microbiota has physiological functions associated with nutrition, the immune system, and defense of the host. Recent advances in next-generation sequencing technology have identified alteration of the composition and function of the gut microbiota, which is referred to as dysbiosis, in IBD. Clinical and experimental data suggest dysbiosis may play a pivotal role in the pathogenesis of IBD. This review is focused on the physiological function of the gut microbiota and the association between the gut microbiota and pathogenesis in IBD. In addition, we review the therapeutic options for manipulating the altered gut microbiota, such as probiotics and fecal microbiota transplantation.

769 citations


Proceedings Article
19 Jun 2016
TL;DR: A generalized large-margin softmax (L-Softmax) loss which explicitly encourages intra-class compactness and inter-class separability between learned features and which not only can adjust the desired margin but also can avoid overfitting is proposed.
Abstract: Cross-entropy loss together with softmax is arguably one of the most common used supervision components in convolutional neural networks (CNNs). Despite its simplicity, popularity and excellent performance, the component does not explicitly encourage discriminative learning of features. In this paper, we propose a generalized large-margin softmax (L-Softmax) loss which explicitly encourages intra-class compactness and inter-class separability between learned features. Moreover, L-Softmax not only can adjust the desired margin but also can avoid overfitting. We also show that the L-Softmax loss can be optimized by typical stochastic gradient descent. Extensive experiments on four benchmark datasets demonstrate that the deeply-learned features with L-softmax loss become more discriminative, hence significantly boosting the performance on a variety of visual classification and verification tasks.

Journal ArticleDOI
TL;DR: In this paper, the stochastic average gradient (SAG) method is used to optimize the sum of a finite number of smooth convex functions, which achieves a faster convergence rate than black-box SG methods.
Abstract: We analyze the stochastic average gradient (SAG) method for optimizing the sum of a finite number of smooth convex functions. Like stochastic gradient (SG) methods, the SAG method's iteration cost is independent of the number of terms in the sum. However, by incorporating a memory of previous gradient values the SAG method achieves a faster convergence rate than black-box SG methods. The convergence rate is improved from $$O(1/\sqrt{k})$$O(1/k) to O(1 / k) in general, and when the sum is strongly-convex the convergence rate is improved from the sub-linear O(1 / k) to a linear convergence rate of the form $$O(\rho ^k)$$O(?k) for $$\rho < 1$$?<1. Further, in many cases the convergence rate of the new method is also faster than black-box deterministic gradient methods, in terms of the number of gradient evaluations. This extends our earlier work Le Roux et al. (Adv Neural Inf Process Syst, 2012), which only lead to a faster rate for well-conditioned strongly-convex problems. Numerical experiments indicate that the new algorithm often dramatically outperforms existing SG and deterministic gradient methods, and that the performance may be further improved through the use of non-uniform sampling strategies.

Journal ArticleDOI
TL;DR: Hidradenitis suppurativa/acne inversa is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep‐seated, inflamed lesions in the apocrine gland‐bearing areas of the body.
Abstract: Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillae, inguinal and anogenital regions. A mean disease incidence of 6.0 per 100,000 person-years and an average prevalence of 1% has been reported in Europe. HS has the highest impact on patients' quality of life among all assessed dermatological diseases. HS is associated with a variety of concomitant and secondary diseases, such as obesity, metabolic syndrome, inflammatory bowel disease, e.g. Crohn's disease, spondyloarthropathy, follicular occlusion syndrome and other hyperergic diseases. The central pathogenic event in HS is believed to be the occlusion of the upper part of the hair follicle leading to a perifollicular lympho-histiocytic inflammation. A highly significant association between the prevalence of HS and current smoking (Odds ratio 12.55) and overweight (Odds ratio 1.1 for each body mass index unit) has been documented. The European S1 HS guideline suggests that the disease should be treated based on its individual subjective impact and objective severity. Locally recurring lesions can be treated by classical surgery or LASER techniques, whereas medical treatment either as monotherapy or in combination with radical surgery is more appropriate for widely spread lesions. Medical therapy may include antibiotics (clindamycin plus rifampicine, tetracyclines), acitretin and biologics (adalimumab, infliximab). A Hurley severity grade-relevant treatment of HS is recommended by the expert group following a treatment algorithm. Adjuvant measurements, such as pain management, treatment of superinfections, weight loss and tobacco abstinence have to be considered.

Journal ArticleDOI
TL;DR: This updated Arabidopsis genome annotation with a substantially increased resolution of gene models will not only further the understanding of the biological processes of this plant model but also of other species.
Abstract: Summary The flowering plant Arabidopsis thaliana is a dicot model organism for research in many aspects of plant biology. A comprehensive annotation of its genome paves the way for understanding the functions and activities of all types of transcripts, including mRNA, the various classes of non-coding RNA, and small RNA. The TAIR10 annotation update had a profound impact on Arabidopsis research but was released more than 5 years ago. Maintaining the accuracy of the annotation continues to be a prerequisite for future progress. Using an integrative annotation pipeline, we assembled tissue-specific RNA-Seq libraries from 113 datasets and constructed 48 359 transcript models of protein-coding genes in eleven tissues. In addition, we annotated various classes of non-coding RNA including microRNA, long intergenic RNA, small nucleolar RNA, natural antisense transcript, small nuclear RNA, and small RNA using published datasets and in-house analytic results. Altogether, we identified 635 novel protein-coding genes, 508 novel transcribed regions, 5178 non-coding RNAs, and 35 846 small RNA loci that were formerly unannotated. Analysis of the splicing events and RNA-Seq based expression profiles revealed the landscapes of gene structures, untranslated regions, and splicing activities to be more intricate than previously appreciated. Furthermore, we present 692 uniformly expressed housekeeping genes, 43% of whose human orthologs are also housekeeping genes. This updated Arabidopsis genome annotation with a substantially increased resolution of gene models will not only further our understanding of the biological processes of this plant model but also of other species.

Journal ArticleDOI
TL;DR: This review begins by reviewing protocols of quantum key distribution based on discrete variable systems, and considers aspects of device independence, satellite challenges, and high rate protocols based on continuous variable systems.
Abstract: Quantum cryptography is arguably the fastest growing area in quantum information science. Novel theoretical protocols are designed on a regular basis, security proofs are constantly improving, and experiments are gradually moving from proof-of-principle lab demonstrations to in-field implementations and technological prototypes. In this paper, we provide both a general introduction and a state-of-the-art description of the recent advances in the field, both theoretical and experimental. We start by reviewing protocols of quantum key distribution based on discrete variable systems. Next we consider aspects of device independence, satellite challenges, and protocols based on continuous-variable systems. We will then discuss the ultimate limits of point-to-point private communications and how quantum repeaters and networks may overcome these restrictions. Finally, we will discuss some aspects of quantum cryptography beyond standard quantum key distribution, including quantum random number generators and quantum digital signatures.

Journal ArticleDOI
TL;DR: Evidence supports a causal association of sleep apnea with the incidence and morbidity of hypertension, coronary heart disease, arrhythmia, heart failure, and stroke, and research that has addressed the effect ofSleep apnea treatment on cardiovascular disease and clinical endpoints is reviewed.

Journal ArticleDOI
TL;DR: The Banff ABMR criteria are updated and paves the way for the Banff scheme to be part of an integrative approach for defining surrogate endpoints in next‐generation clinical trials.

Journal ArticleDOI
TL;DR: In this article, the authors show that the discrepancy between the von Neumann entropy as calculated by Hawking and the requirements of unitarity is fixed by including new saddles in the gravitational path integral.
Abstract: The information paradox can be realized in anti-de Sitter spacetime joined to a Minkowski region. In this setting, we show that the large discrepancy between the von Neumann entropy as calculated by Hawking and the requirements of unitarity is fixed by including new saddles in the gravitational path integral. These saddles arise in the replica method as complexified wormholes connecting different copies of the black hole. As the replica number n → 1, the presence of these wormholes leads to the island rule for the computation of the fine-grained gravitational entropy. We discuss these replica wormholes explicitly in two-dimensional Jackiw-Teitelboim gravity coupled to matter.

Journal ArticleDOI
TL;DR: Overall outcomes in newly diagnosed epilepsy have not improved and most patients who attain control do so with the first or second AED, although the probability of achieving seizure freedom diminishes substantially with each subsequent AED regimen tried.
Abstract: Importance A study published in 2000 showed that more than one-third of adults with epilepsy have inadequate control of seizures with antiepileptic drugs (AEDs). This study evaluates overall treatment outcomes in light of the introduction of more than 1 dozen new AEDs in the past 2 decades. Objective To assess long-term treatment outcome in patients with newly diagnosed and treated epilepsy. Design, Setting, and Participants This longitudinal observational cohort study was conducted at the Epilepsy Unit of the Western Infirmary in Glasgow, Scotland. A total of 1795 individuals who were newly treated for epilepsy with AEDs between July 1, 1982, and October 31, 2012, were included in this analysis. All patients were followed up for a minimum of 2 years (until October 31, 2014) or until death, whichever came sooner. Data analysis was completed between March 2015 and May 2016. Exposures Treatment with antiepileptic drugs for patients newly diagnosed with epilepsy. Main Outcomes and Measures Seizure control was assessed at the end of the study period. Probability of achieving 1-year seizure freedom was estimated for each AED regimen prescribed. Multivariable models assessed the associations between risk factors and AED treatment outcome after adjustments were made for demographic and clinical characteristics. Results Of the 1795 included patients, 964 (53.7%) were male; the median age was 33 years (range, 9-93 years). At the end of the study period, 1144 patients (63.7%) had been seizure free for the previous year or longer. Among those achieving 1-year seizure freedom, 993 (86.8%) were taking monotherapy and 1028 (89.9%) had achieved seizure control with the first or second AED regimens. Of the total patient pool, 906 (50.5%) remained seizure free for 1 year or longer with the initial AED. If this AED failed, the second and third regimens provided an additional 11.6% and 4.4% likelihoods of seizure freedom, respectively. Only 2.12% of patients attained optimal seizure control with subsequent AEDs. Epilepsy that was not successfully controlled with the first AED had 1.73 times greater odds of not responding to treatment for each subsequent medication regimen (odds ratio, 1.73; 95% CI, 1.56-1.91;P Conclusions and Relevance Despite the availability of many new AEDs with differing mechanisms of action, overall outcomes in newly diagnosed epilepsy have not improved. Most patients who attain control do so with the first or second AED. The probability of achieving seizure freedom diminishes substantially with each subsequent AED regimen tried. More than one-third of patients experience epilepsy that remains uncontrolled.

Journal ArticleDOI
TL;DR: In this article, the authors present 39 candidate gravitational wave events from compact binary coalescences detected by Advanced LIGO and Advanced Virgo in the first half of the third observing run (O3a) between 1 April 2019 15:00 UTC and 1 October 2019 15.00.
Abstract: We report on gravitational wave discoveries from compact binary coalescences detected by Advanced LIGO and Advanced Virgo in the first half of the third observing run (O3a) between 1 April 2019 15:00 UTC and 1 October 2019 15:00. By imposing a false-alarm-rate threshold of two per year in each of the four search pipelines that constitute our search, we present 39 candidate gravitational wave events. At this threshold, we expect a contamination fraction of less than 10%. Of these, 26 candidate events were reported previously in near real-time through GCN Notices and Circulars; 13 are reported here for the first time. The catalog contains events whose sources are black hole binary mergers up to a redshift of ~0.8, as well as events whose components could not be unambiguously identified as black holes or neutron stars. For the latter group, we are unable to determine the nature based on estimates of the component masses and spins from gravitational wave data alone. The range of candidate events which are unambiguously identified as binary black holes (both objects $\geq 3~M_\odot$) is increased compared to GWTC-1, with total masses from $\sim 14~M_\odot$ for GW190924_021846 to $\sim 150~M_\odot$ for GW190521. For the first time, this catalog includes binary systems with significantly asymmetric mass ratios, which had not been observed in data taken before April 2019. We also find that 11 of the 39 events detected since April 2019 have positive effective inspiral spins under our default prior (at 90% credibility), while none exhibit negative effective inspiral spin. Given the increased sensitivity of Advanced LIGO and Advanced Virgo, the detection of 39 candidate events in ~26 weeks of data (~1.5 per week) is consistent with GWTC-1.

Journal ArticleDOI
21 Jul 2015-BMJ
TL;DR: Hitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity, and both artificially sweetened alcoholic beverages and fruit juice were unlikely to be healthy alternatives to sugarsweetened beverages for the prevention of type 1 diabetes.
Abstract: ObjeCtives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom. Design Systematic review and meta-analysis. Data sOurC es anD eligibility

Proceedings Article
06 Aug 2017
TL;DR: Constrained Policy Optimization (CPO) as discussed by the authors is the first general-purpose policy search algorithm for constrained reinforcement learning with guarantees for near-constraint satisfaction at each iteration.
Abstract: For many applications of reinforcement learning it can be more convenient to specify both a reward function and constraints, rather than trying to design behavior through the reward function. For example, systems that physically interact with or around humans should satisfy safety constraints. Recent advances in policy search algorithms (Mnih et al., 2016; Schulman et al., 2015; Lillicrap et al., 2016; Levine et al., 2016) have enabled new capabilities in high-dimensional control, but do not consider the constrained setting. We propose Constrained Policy Optimization (CPO), the first general-purpose policy search algorithm for constrained reinforcement learning with guarantees for near-constraint satisfaction at each iteration. Our method allows us to train neural network policies for high-dimensional control while making guarantees about policy behavior all throughout training. Our guarantees are based on a new theoretical result, which is of independent interest: we prove a bound relating the expected returns of two policies to an average divergence between them. We demonstrate the effectiveness of our approach on simulated robot locomotion tasks where the agent must satisfy constraints motivated by safety.

Journal ArticleDOI
TL;DR: In 2010, Alzheimer's Disease International presented estimates of the global cost of illness (COI) of dementia, and new studies have been conducted, and the number of people with dementia has increased.
Abstract: Introduction In 2010, Alzheimer's Disease International presented estimates of the global cost of illness (COI) of dementia. Since then, new studies have been conducted, and the number of people with dementia has increased. Here, we present an update of the global cost estimates. Methods This is a societal, prevalence-based global COI study. Results The worldwide costs of dementia were estimated at United States (US) $818 billion in 2015, an increase of 35% since 2010; 86% of the costs occur in high-income countries. Costs of informal care and the direct costs of social care still contribute similar proportions of total costs, whereas the costs in the medical sector are much lower. The threshold of US $1 trillion will be crossed by 2018. Discussion Worldwide costs of dementia are enormous and still inequitably distributed. The increase in costs arises from increases in numbers of people with dementia and in increases in per person costs.


Journal ArticleDOI
31 Jul 2015-Science
TL;DR: P pervasive and substantial “legacy effects” of reduced growth and incomplete recovery for 1 to 4 years after severe drought were found, most prevalent in dry ecosystems, among Pinaceae, and among species with low hydraulic safety margins.
Abstract: The impacts of climate extremes on terrestrial ecosystems are poorly understood but important for predicting carbon cycle feedbacks to climate change. Coupled climate-carbon cycle models typically assume that vegetation recovery from extreme drought is immediate and complete, which conflicts with the understanding of basic plant physiology. We examined the recovery of stem growth in trees after severe drought at 1338 forest sites across the globe, comprising 49,339 site-years, and compared the results with simulated recovery in climate-vegetation models. We found pervasive and substantial "legacy effects" of reduced growth and incomplete recovery for 1 to 4 years after severe drought. Legacy effects were most prevalent in dry ecosystems, among Pinaceae, and among species with low hydraulic safety margins. In contrast, limited or no legacy effects after drought were simulated by current climate-vegetation models. Our results highlight hysteresis in ecosystem-level carbon cycling and delayed recovery from climate extremes.

Journal ArticleDOI
TL;DR: This paper performs simulation studies to investigate the magnitude of bias and Type 1 error rate inflation arising from sample overlap and considers both a continuous outcome and a case‐control setting with a binary outcome.
Abstract: Mendelian randomization analyses are often performed using summarized data. The causal estimate from a one-sample analysis (in which data are taken from a single data source) with weak instrumental variables is biased in the direction of the observational association between the risk factor and outcome, whereas the estimate from a two-sample analysis (in which data on the risk factor and outcome are taken from non-overlapping datasets) is less biased and any bias is in the direction of the null. When using genetic consortia that have partially overlapping sets of participants, the direction and extent of bias are uncertain. In this paper, we perform simulation studies to investigate the magnitude of bias and Type 1 error rate inflation arising from sample overlap. We consider both a continuous outcome and a case-control setting with a binary outcome. For a continuous outcome, bias due to sample overlap is a linear function of the proportion of overlap between the samples. So, in the case of a null causal effect, if the relative bias of the one-sample instrumental variable estimate is 10% (corresponding to an F parameter of 10), then the relative bias with 50% sample overlap is 5%, and with 30% sample overlap is 3%. In a case-control setting, if risk factor measurements are only included for the control participants, unbiased estimates are obtained even in a one-sample setting. However, if risk factor data on both control and case participants are used, then bias is similar with a binary outcome as with a continuous outcome. Consortia releasing publicly available data on the associations of genetic variants with continuous risk factors should provide estimates that exclude case participants from case-control samples.

Journal ArticleDOI
TL;DR: This research presents a novel and scalable approach to community-based management of thrombosis called “informed consent” that aims to provide real-time information about the safe and effective use of anticoagulation techniques.

Journal ArticleDOI
TL;DR: Investigation of the branching phenotype revealed that in branching cells nucleoid organization, divisome formation and peptidoglycan incorporation were disrupted, and Xac with minC deleted exhibited the classic Δmin phenotype observed in other bacteria deleted for min components.
Abstract: Xanthomonas citri (Xac) is the causal agent of citrus canker, a disease that affects citrus crops and causes economic impact worldwide. To further characterize cell division in this plant pathogen, we investigated the role of the protein MinC in cell division, chromosome segregation, and peptidoglycan incorporation by deleting the gene minC using allele exchange. Xac with minC deleted exhibited the classic Δmin phenotype observed in other bacteria deleted for min components: minicells and short filamentation. In addition we noticed the formation of branches, which is similar to what was previously described for Escherichia coli deleted for either min or for several low molecular weight penicillin-binding proteins (PBPs). The branching phenotype was medium dependent and probably linked to gluconeogenic growth. We complemented the minC gene by integrating gfp-minC into the amy locus. Xac complemented strains displayed a wild-type phenotype. In addition, GFP-MinC oscillated from pole to pole, similar to MinCD oscillations observed in E. coli and more recently in Synechococcus elongatus. Further investigation of the branching phenotype revealed that in branching cells nucleoid organization, divisome formation and peptidoglycan incorporation were disrupted.

Journal ArticleDOI
TL;DR: The pregnancy- related mortality ratio and the distribution of the main causes of pregnancy-related mortality have been relatively stable in recent years.

Journal ArticleDOI
17 Jul 2015-Science
TL;DR: The authors found that cholesterol crystals triggered neutrophils to release neutrophil extracellular traps (NETs), activating T helper 17 (TH17) cells that amplify immune cell recruitment in atherosclerotic plaques.
Abstract: Secretion of the cytokine interleukin-1β (IL-1β) by macrophages, a major driver of pathogenesis in atherosclerosis, requires two steps: Priming signals promote transcription of immature IL-1β, and then endogenous “danger” signals activate innate immune signaling complexes called inflammasomes to process IL-1β for secretion. Although cholesterol crystals are known to act as danger signals in atherosclerosis, what primes IL-1β transcription remains elusive. Using a murine model of atherosclerosis, we found that cholesterol crystals acted both as priming and danger signals for IL-1β production. Cholesterol crystals triggered neutrophils to release neutrophil extracellular traps (NETs). NETs primed macrophages for cytokine release, activating T helper 17 (TH17) cells that amplify immune cell recruitment in atherosclerotic plaques. Therefore, danger signals may drive sterile inflammation, such as that seen in atherosclerosis, through their interactions with neutrophils.