Mosaic Group Research Articles

Health Profiles of Mosaic Versus Non-mosaic FMR1 Premutation Carrier Mothers of Children With Fragile X Syndrome

The FMR1 premutation is of increasing interest to the FXS community, as questions about a primary premutation phenotype warrant research attention. 100 FMR1 premutation carrier mothers (mean age = 58; 67–138 CGG repeats) of adults with fragile X syndrome were studied with respect to their physical and mental health, motor, and neurocognitive characteristics. We explored the correlates of CGG repeat mosaicism in women with expanded alleles. Mothers provided buccal swabs from which DNA was extracted and the FMR1 CGG genotyping was performed (Amplidex Kit, Asuragen). Mothers were categorized into three groups: Group 1: premutation non-mosaic (n = 45); Group 2: premutation mosaic (n = 41), and Group 3: premutation/full mutation mosaic (n = 14). Group 2 mothers had at least two populations of cells with different allele sizes in the premutation range besides their major expanded allele. Group 3 mothers had a very small population of cells in the full mutation range (>200 CGGs) in addition to one or multiple populations of cells with different allele sizes in the premutation range. Machine learning (random forest) was used to identify symptoms and conditions that correctly classified mothers with respect to mosaicism; follow-up comparisons were made to characterize the three groups. In categorizing mosaicism, the random forest yielded significantly better classification than random classification, with overall area under the receiver operating characteristic curve (AUROC) of 0.737. Among the most important symptoms and conditions that contributed to the classification were anxiety, menopause symptoms, executive functioning limitations, and difficulty walking several blocks, with the women who had full mutation mosaicism (Group 3) unexpectedly having better health. Although only 14 premutation carrier mothers in the present sample also had a small population of full mutation cells, their profile of comparatively better health, mental health, and executive functioning was unexpected. This preliminary finding should prompt additional research on larger numbers of participants with more extensive phenotyping to confirm the clinical correlates of low-level full mutation mosaicism in premutation carriers and to probe possible mechanisms.

Randomized trial of the Carpentier-Edwards supra-annular prosthesis versus the Medtronic Mosaic aortic prosthesis: 10-year results.

We performed a prospective randomized study comparing the clinical performance of the Carpentier-Edwards supra-annular valve (CE-SAV) (Edwards Lifesciences, Irvine, CA, USA) and the newer Mosaic (Medtronic Corporation, Minneapolis, MN, USA) porcine bioprostheses in the aortic position over a 10-year period. Between January 2001 and March 2005, 394 patients undergoing bioprosthetic aortic valve replacement were randomized to receive either the CE-SAV (n = 191) or the Mosaic (n = 203) prosthesis. The preoperative demographics, EuroSCORE and intraoperative characteristics concerning cardiopulmonary bypass of the 2 groups were comparable. All patients were followed annually for 10 years. There were 77 (40.3%) deaths in the CE-SAV group and 93 (45.8%) deaths in the Mosaic group. The 10-year survival rate in the 2 groups was 59.7% and 54.2%, respectively (P = 0.27). There were no statistically significant differences between the 2 groups in terms of structural valve deterioration (P = 0.08), endocarditis (P = 0.95), thromboembolism (P = 0.06) and major bleeds (P = 0.09). However, the incidence of paravalvular leaks and valve-related reoperations were higher in the Mosaic group, with 5 leaks and 6 reoperations when compared to none in the CE-SAV group, (P = 0.02) and (P = 0.01) respectively. At 10 years after implantation, freedom from reoperation was greater in the CE-SAV group with no incidences of paravalvular leaks. There were no other statistically significant differences between CE-SAV and Mosaic aortic prostheses. clinicaltrial.gov ID 1301 (NCT03346044).

Mosaic analysis for personal water consumption in residential buildings in Hong Kong

This paper investigates the daily per capita residential water use based on the demographic and socio-economic factors described by Mosaic Hong Kong and provides insights into future water supply planning. A survey was conducted to collect information on household water use behaviours and water consumption patterns. The survey results indicate that considerable consumption differences (in the range of 115.6 to 167.7 litres per person per day) exist among the Mosaic Groups, and the average daily per capita residential water consumption is estimated to be 139.6 litres per person per day. The results also reveal that the daily per capita water consumption is inversely proportional to household size in the range of 2 to 6. Moreover, consumption differences among housing types and districts are reported.

Inter‐group variability in seed dispersal by white‐handed gibbons in mosaic forest

AbstractSeed dispersers, like white‐handed gibbons (Hylobates lar), can display wide inter‐group variability in response to distribution and abundance of resources in their habitat. In different home ranges, they can modify their movement patterns along with the shape and scale of seed shadow produced. However, the effect of inter‐group variability on the destination of dispersed seeds is still poorly explained. In this study, we evaluate how seed dispersal patterns of this arboreal territorial frugivore varies between two neighboring groups, one inhabiting high quality evergreen forest and one inhabiting low quality mosaic forest. We predicted a difference in seed dispersal distance between the two groups (longer in the poor quality forest). We hypothesized that this difference would be explained by differences in home range size, daily path length, and ranging tortuosity. After 6 months of data collection, the evergreen group had a smaller home range (12.4 ha) than the mosaic group (20.9 ha), significantly longer daily path lengths (1507 m vs. 1114 m respectively) and greater tortuosity (39.1 vs. 16.1 respectively). Using gut passage times and displacement rates, we estimated the median seed dispersal distance as 163 m for the evergreen group (high quality forest) and of 116 m for the mosaic group (low quality forest). This contradiction with our initial prediction can be explained in term of social context, resource distribution, and habitat quality. Our results indicate that gibbons are dispersers of seeds between habitats and that dispersal distances provided by gibbons are influenced by a range of factors, including habitat and social context.

Transfer of embryos with segmental mosaicism is associated with a significant reduction in live birth rate compared to euploid controls

Segmental mosaicism is a complex issue with minimal to no data on established thresholds for labeling an embryo euploid versus aneuploid, or on pregnancy outcomes on the transfer of embryos with segmental mosaicism. We aim to evaluate the impact of segmental mosaicism on pregnancy and live birth rates (LBR) from the transfer of embryos previously designated as euploid. Retrospective cohort analysis. All PGS-screened frozen single embryo transfers from January 2015 - December 2015 from a high-volume fertility center were included. Transferred embryos were all designated euploid by high-density oligonucleotide array comparative genomic hybridization (aCGH) PGS by the reporting laboratory. Embryos with segmental mosaicism, designated as euploid, were classified by the reporting laboratory based on the size, location, and percentage of mosaicism of the duplication or deletion. The detailed aCGH results from all transferred euploid embryos were subsequently unmasked to determine the impact of segmental mosaicism on pregnancy outcomes. Chi-square analyses were used to detect differences between euploid versus segmental mosaic embryos. Logistic regression was performed to control for age and day of blastocyst biopsy. A total of 327 women underwent 377 frozen single euploid embryo transfers. After unmasking PGS results, 357 embryos were euploid with no mosaicism and 20 embryos had segmental mosaicism. Average patient age was similar between groups. LBR was significantly lower in the segmental mosaic group (30.0% vs 53.8%, p= 0.04). The odds of a live birth after transfer of embryos with segmental mosaicism was reduced by 66% compared to euploid embryos, controlled for age and day of biopsy (0.34 [95% CI, 0.13- 0.92]) (Table 1). Spontaneous miscarriage, defined as a failed pregnancy following a positive pregnancy test, was significantly higher in the segmental mosaic group compared to euploid controls (40.0% vs. 18.2%, p= 0.04). Blastocysts with segmental mosaicism result in significantly decreased LBR and higher SAB rates compared to euploid controls. These results support reporting all segmental mosaicism, regardless of degree, to optimize embryo selection and LBR.Tabled 1Transfer outcomes of embryos with segmental mosaicism compared to euploid controlsEuploid Embryos N=357Segmental Mosaicism Detected N=20Adjusted Odds Ratio (95% CI)Live Birth N (%)192 (53.8%)6 (30.0%)0.34 (0.13-0.92)Spontaneous Miscarriage N (%)65 (18.2%)8 (40.0%)3.02 (1.18-7.76) Open table in a new tab

The Turner syndrome life course project: Karyotype‐phenotype analyses across the lifespan

Turner syndrome (TS) is associated with a variety of morbidities affecting nearly every body system, some of which increase in prevalence in adult life. The severity of clinical features in TS is roughly in parallel with the magnitude of the deficit of X-chromosome material. The aim of this study was to extend the established karyotype-phenotype relationships using data from a large adult cohort. Karyotypes were available in 656 women with TS. 611 of whom could be classified into five major groups within the cohort: 45,X; 45,X mosaicism (45,X/46,XX); isochromosome X (isochromosome Xq); mosaicism 45,X/46,XY and ringX. Continuous variables such as blood pressure and biochemical markers from clinic data were binarised allocating those in the upper quartile to represent at-risk individuals. With the exception of bone mineral density T-score for which the lower quartile was allocated as at risk. For comorbidities, initiation of formal treatment was recorded. 45,X/46,XX had considerably lower frequency of comorbidities compared to 45,X. The isochromosome group experienced similar outcomes to 45,X. Novel associations were found between the XY mosaic karyotype group and a decreased prevalence of thyroid disease and severe hearing loss. A previously unreported increased incidence of metabolic syndrome was noted within the ring chromosome subgroup. Karyotype may play an important factor against stratifying risk of comorbidity in TS and should be taken into consideration when managing adults with TS. Further investigations of the isochromosome (Xq) and ring groups are necessary to further clarify their associations with comorbidities.

HER2 amplification and gene signal distribution in gastroesophageal cancer.

e15600 Background: HER2 serves as an important therapeutic target in gastroesophageal cancer. Differences in HER2 gene signal distribution patterns can be observed at the tissue level, but how it influences the HER2 amplification status has not been studied so far. Here, we investigated the link between HER2 amplification and the different types of gene signal distribution. Methods: Tumor samples from 140 patients with gastroesophageal adenocarcinoma where analyzed using the HER2 IQFISH pharmDx™ assay. Specimens covered non-amplified and amplified cases with a preselected high proportion of HER2 amplified cases. Based on the HER2/CEN-17 ratio, specimens were categorized into amplified or non-amplified. The signal distribution patterns were divided into homogeneous, heterogeneous focal or heterogeneous mosaic. The study was conducted based on anonymized specimens with limited access to clinicopathological data. Results: Among the 140 analyzed specimens 83 had a heterogeneous HER2 signal distribution, with 62 being focal and 21 of the mosaic type. The remaining 57 specimens had a homogeneous signal distribution. HER2 amplification was observed in 63 of the 140 specimens, and nearly all (93.7%) were found among specimens with a heterogeneous focal signal distribution (p < 0.0001). The mean HER2/CEN-17 ratio for the focal heterogeneous group was 8.75 (CI95%: 6.87 – 10.63), compared to 1.53 (CI95%: 1.45 – 1.61) and 1.70 (CI95%: 1.22 – 2.18) for the heterogeneous mosaic and homogeneous groups, respectively, (p < 0.0001). Conclusions: A clear relationship between HER2 amplification and the focal heterogeneous signal distribution was demonstrated in tumor specimens from patients with gastroesophageal cancer. Furthermore, we raise the hypothesis that the signal distribution patterns observed with FISH might be related to different subpopulations of HER2 positive tumor cells.

Consumer segmentation and time interval between types of hospital admission: a clinical linkage database study.

Healthcare policies target unplanned hospital admissions and 30-day re-admission as key measures of efficiency, but do not focus on factors that influence trajectories of different types of admissions in the same patient over time. To investigate the influence of consumer segmentation and patient factors on the time intervals between different types of hospital admission. A cohort design was applied to an anonymised linkage database for adults aged 40 years and over (N = 58 857). Measures included Mosaic segmentation, multimorbidity defined on six chronic condition registers and hospital admissions over a 27-month time period. The shortest mean time intervals between two consecutive planned admissions were: 90 years and over (160 days (95% confidence interval (CI): 146-175)), Mosaic groups 'Twilight subsistence' (171 days (164-179)) or 'Welfare borderline' and 'Municipal dependency' (177 days (172-182)) compared to the reference Mosaic groups (186 days (180-193)), and multimorbidity count of four or more (137 days (130-145)). Mosaic group 'Twilight subsistence' (rate ratio (RR) 1.22 (95% CI: 1.08-1.36)) or 'Welfare borderline' and 'Municipal dependency' RR 1.20 (1.10-1.31) were significantly associated with higher rate to an unplanned admission following a planned event. However, associations between patient factors and unplanned admissions were diminished by adjustment for planned admissions. Specific consumer segmentation and patient factors were associated with shorter time intervals between different types of admissions. The findings support innovation in public health approaches to prevent by a focus on long-term trajectories of hospital admissions, which include planned activity.

Gene Signal Distribution and HER2 Amplification in Gastroesophageal Cancer

Background: HER2 serves as an important therapeutic target in gastroesophageal cancer. Differences in HER2 gene signal distribution patterns can be observed at the tissue level, but how it influences the HER2 amplification status has not been studied so far. Here, we investigated the link between HER2 amplification and the different types of gene signal distribution.Methods: Tumor samples from 140 patients with gastroesophageal adenocarcinoma where analyzed using the HER2 IQFISH pharmDx™ assay. Specimens covered non-amplified and amplified cases with a preselected high proportion of HER2 amplified cases. Based on the HER2/CEN-17 ratio, specimens were categorized into amplified or non-amplified. The signal distribution patterns were divided into homogeneous, heterogeneous focal or heterogeneous mosaic. The study was conducted based on anonymized specimens with limited access to clinicopathological data.Results: Among the 140 analyzed specimens 83 had a heterogeneous HER2 signal distribution, with 62 being focal and 21 of the mosaic type. The remaining 57 specimens had a homogeneous signal distribution. HER2 amplification was observed in 63 of the 140 specimens, and nearly all (93.7%) were found among specimens with a heterogeneous focal signal distribution (p<0.0001). The mean HER2/CEN-17 ratio for the focal heterogeneous group was 8.75 (CI95%: 6.87 - 10.63), compared to 1.53 (CI95%: 1.45 - 1.61) and 1.70 (CI95%: 1.22 - 2.18) for the heterogeneous mosaic and homogeneous groups, respectively, (p<0.0001).Conclusions: A clear relationship between HER2 amplification and the focal heterogeneous signal distribution was demonstrated in tumor specimens from patients with gastroesophageal cancer. Furthermore, we raise the hypothesis that the signal distribution patterns observed with FISH might be related to different subpopulations of HER2 positive tumor cells.

Differential hypersaline stress response in Zygosaccharomyces rouxii complex yeasts: a physiological and transcriptional study.

The Zygosaccharomyces rouxii complex comprises three distinct lineages of halotolerant yeasts relevant in food processing and spoilage, such as Z. sapae, Z. rouxii and a mosaic group of allodiploid strains. They manifest plastic genome architecture (variation in karyotype, ploidy level and Na(+)/H(+) antiporter-encoding gene copy number), and exhibit diverse tolerances to salt concentrations. Here, we investigated accumulation of compatible osmolytes and transcriptional regulation of Na(+)/H(+) antiporter-encoding ZrSOD genes during salt exposure in strains representative for the lineages, namely Z. sapae ABT301(T) (low salt tolerant), Z. rouxii CBS 732(T) (middle salt tolerant) and allodiploid strain ATCC 42981 (high salt tolerant). Growth curve modelling in 2 M NaCl-containing media supplemented with or without yeast extract as nitrogen source indicates that moderate salt tolerance of CBS 732(T) mainly depends on nitrogen availability rather than intrinsic inhibitory effects of salt. All the strains produce glycerol and not mannitol under salt stress and use two different glycerol balance strategies. ATCC 42981 produces comparatively more glycerol than Z. sapae and Z. rouxii under standard growth conditions and better retains it intracellularly under salt injuries. Conversely, Z. sapae and Z. rouxii enhance glycerol production under salt stress and intracellularly retain glycerol less efficiently than ATCC 42981. Expression analysis shows that, in diploid Z. sapae and allodiploid ATCC 42981, transcription of gene variants ZrSOD2-22/ZrSOD2 and ZrSOD22 is constitutive and salt unresponsive.

First Report of Sugarcane mosaic virus group IV Isolates from the Corn Production Fields in China

First Report of <i>Sugarcane mosaic virus</i> group IV Isolates from the Corn Production Fields in China

Cultural Mosaic Beliefs and Group Performance as Influenced by Attachment

The purpose of this study is to test how group differences in attachment style interact with the degree of cultural mosaic beliefs present in multicultural groups to dramatically alteridentification, trust and cooperation among group members (Brodt, Adair &amp; Lituchy, 2008). Firstly I hypothesize that priming attachment style among group’s members will lead to changes in their group experience, particularly their cultural mosaic beliefs. The three different attachment styles will have different effects on their cultural mosaic beliefs, measured using an existing scale (Chuapetcharasopon, Brodt, Adair, Lituchy, Neville, &amp; Lowe, 2011). Secondly I hypothesize that priming attachment style among group members will lead to differences in the number of overall ideas and the number of culture-related ideas generated in a group brainstorming task. Attachment styles can change group interaction, causing these differences in group performance. Thirdly I hypothesize that the effect of attachment style on the number of overall ideas and number of culture-related ideas will be moderated by mosaic beliefs. If attachment style does have an effect on performance, it will depend on the interaction of attachment style and the process of establishing mosaic beliefs within a group. The data is currently being collected. The outcomes of this study are valuable for research as they will help our understanding of the cultural mosaic construct as it relates to multicultural groups in the Canadian workplace. It will also help our understanding of multicultural workgroups and the role attachment style plays in a group setting.

The Relationship between Self-Verification and Cultural Mosaic Beliefs in Multicultural Groups

In previous research, the cultural mosaic model was found to describe multicultural group processes using three factors—cultural diversity, cultural expression and acceptance, and cultural utilization. The current study will test the role of cultural self-verification within multicultural work groups to demonstrate the cultural mosaic model. Given the observed relationship between the cultural mosaic model and team productivity, the study will prime cultural self-verification (or not) through discussion of group members’ cultural backgrounds to establish norms of openness of identity and acceptance of diversity within the group. I predict groups who are encouraged to openly discuss their cultural backgrounds will feel more comfortable utilizing their unique cultural knowledge and expressing innovative ideas which otherwise might not be shared. This will result in greater success during the problem-solving task and cause individuals to work more cohesively and be more inclined to present feasible and innovative solutions to the problem, and to be accepting of such solutions from other group members. It is also expected that participants in the self-verified condition will rate the experience of working in this multicultural group more positively than participants in the control condition who do not discuss their cultural backgrounds prior to the task. Should this pattern of findings occur, a research application is better understanding of the cultural mosaic construct, and a practical application would be for ways to engender cultural mosaic groups in organizations by encouraging discussion about team members’ ethnic and cultural backgrounds in order to achieve greater workplace productivity and a higher degree of job satisfaction.

Genetic Map of Triticale Integrating Microsatellite, DArT and SNP Markers.

Triticale (×Triticosecale Wittm) is an economically important crop for fodder and biomass production. To facilitate the identification of markers for agronomically important traits and for genetic and genomic characteristics of this species, a new high-density genetic linkage map of triticale was constructed using doubled haploid (DH) population derived from a cross between cultivars ‘Hewo’ and ‘Magnat’. The map consists of 1615 bin markers, that represent 50 simple sequence repeat (SSR), 842 diversity array technology (DArT), and 16888 DArTseq markers mapped onto 20 linkage groups assigned to the A, B, and R genomes of triticale. No markers specific to chromosome 7R were found, instead mosaic linkage group composed of 1880 highly distorted markers (116 bins) from 10 wheat chromosomes was identified. The genetic map covers 4907 cM with a mean distance between two bins of 3.0 cM. Comparative analysis in respect to published maps of wheat, rye and triticale revealed possible deletions in chromosomes 4B, 5A, and 6A, as well as inversion in chromosome 7B. The number of bin markers in each chromosome varied from 24 in chromosome 3R to 147 in chromosome 6R. The length of individual chromosomes ranged between 50.7 cM for chromosome 2R and 386.2 cM for chromosome 7B. A total of 512 (31.7%) bin markers showed significant (P < 0.05) segregation distortion across all chromosomes. The number of 8 the segregation distorted regions (SDRs) were identified on 1A, 7A, 1B, 2B, 7B (2 SDRs), 5R and 6R chromosomes. The high-density genetic map of triticale will facilitate fine mapping of quantitative trait loci, the identification of candidate genes and map-based cloning.

The 100-genomes strains, an S. cerevisiae resource that illuminates its natural phenotypic and genotypic variation and emergence as an opportunistic pathogen.

Saccharomyces cerevisiae, a well-established model for species as diverse as humans and pathogenic fungi, is more recently a model for population and quantitative genetics. S. cerevisiae is found in multiple environments—one of which is the human body—as an opportunistic pathogen. To aid in the understanding of the S. cerevisiae population and quantitative genetics, as well as its emergence as an opportunistic pathogen, we sequenced, de novo assembled, and extensively manually edited and annotated the genomes of 93 S. cerevisiae strains from multiple geographic and environmental origins, including many clinical origin strains. These 93 S. cerevisiae strains, the genomes of which are near-reference quality, together with seven previously sequenced strains, constitute a novel genetic resource, the “100-genomes” strains. Our sequencing coverage, high-quality assemblies, and annotation provide unprecedented opportunities for detailed interrogation of complex genomic loci, examples of which we demonstrate. We found most phenotypic variation to be quantitative and identified population, genotype, and phenotype associations. Importantly, we identified clinical origin associations. For example, we found that an introgressed PDR5 was present exclusively in clinical origin mosaic group strains; that the mosaic group was significantly enriched for clinical origin strains; and that clinical origin strains were much more copper resistant, suggesting that copper resistance contributes to fitness in the human host. The 100-genomes strains are a novel, multipurpose resource to advance the study of S. cerevisiae population genetics, quantitative genetics, and the emergence of an opportunistic pathogen.

Roma Portekiz Mozaiklerindeki Bazı Geometrik Desenler ve Dekoratif Motifler: Doğu ve Batı Mozaikleriyle Karşılaştırmalı Bir Yaklaşım

Comparing some geometrical patterns and decorative motifs occurring in Roman mosaics from the West and the East, namely from Portugal and from Turkey, we aim to understand the reasons for the similarities and the divergences between them, attending also to the chronologies. In the first place we will focus on the “compass drawing” composition, its geographical expansion and some achievements of this schema on mosaics from the Western and Eastern Roman Provinces such as Dalmatia, Macedonia and Pontus. From Lusitania, we will focus particularly on mosaics proceeding from some villae located in the Portuguese territory comparing them with a mosaic proceeding from Pontus, attending their chronologies and their decoration. Secondly, we will do a first approach to the analysis of a mosaic, unpublished, and reported by Abraços 2005, proceeding from the Roman city of Bracara Augusta, nowadays Braga, in the NW of Portugal. On this interesting mosaic, we can see some decorative motifs that are quite common on the Eastern and North African realisations, though restricted to a group of Portuguese mosaics belonging to Conuentus Scalabitanus: from «Casa de Cantaber» at Conimbriga and from the Roman villae of Santiago da Guarda and of Rabaçal, both in the area of the Conimbriga ciuitas. The stylistic comparisons of Bracara Auguta’s mosaic and these of Portuguese and also eastern and western realisations point to an achievement from the 3rd/4th c. A.D. This chronology seems coincident with the urban improvement that Bracara Augusta benefited under its promotion to the capital of the Province Gallaecia

Efficacy of Stentless Aortic Bioprosthesis Implantation for Aortic Stenosis with Small Aortic Annulus.

In patients with small aortic annulus, sufficient size of stented aortic bioprosthesis cannot be implanted without additional procedures. In such cases, we use stentless aortic bioprosthesis to obtain sufficient effective orifice area. In this study, we investigated long-term impact of stentless aortic bioprosthesis on clinical outcomes, compared with stented aortic bioprosthesis. We retrospectively investigated 140 patients who underwent aortic valve replacement (AVR) with porcine bioprosthesis for severe aortic stenosis between 1999 and 2010. Patients who had moderate or more aortic regurgitation and who underwent concomitant mitral procedures were excluded. A total of 69 patients (49%) were implanted stentless bioprosthesis (Freestyle group; Medtronic Inc, Minneapolis, Minnesota, United States) and 71 patients (51%) were implanted stented bioprosthesis (Mosaic group; Medtronic Inc). Follow-up was complete in 97.9% patients. Median follow-up period was 4.2 years. Patients in Freestyle group had smaller body surface area, smaller aortic annulus diameter, smaller aortic valve area, larger mean pressure gradient, higher peak velocity across aortic valve, larger left ventricular mass index (LVMI), and lower left ventricular ejection fraction (LVEF). Mean size of implanted prosthesis was larger in Freestyle group. In-hospital mortality was 1.4% in Freestyle group and 2.8% in Mosaic group (p = 0.980). Five-year survival rate was not different between two groups (5-year survival rate was 87.5 ± 4.7% in Freestyle group and 84.1 ± 7.5% in Mosaic group; log rank, p = 0.619). Late New York Heart Association functional class was lower in Freestyle group. Late LVMI and LVEF became similar between two groups. Stentless aortic bioprosthesis is superior in left ventricular remodeling after AVR for aortic stenosis and is especially effective for small aortic annulus.

Late Survival After Aortic Valve Replacement With the Perimount Versus the Mosaic Bioprosthesis

The objective was to compare late survival after aortic valve replacement (AVR) with a Carpentier-Edwards Perimount (Edwards Lifesciences, Irvine, CA) versus a Mosaic bioprosthesis (Medtronic Inc, Minneapolis, MN). Secondary objectives were to compare early mortality, the rate of reoperation, and the effect of prosthesis-patient mismatch (PPM) on late survival. The design was a population-based cohort study including all patients who underwent AVR with a Perimount or Mosaic bioprosthesis at our institution between 2002 and 2010. Baseline, operative characteristics and clinical outcomes were collected from patient charts and national registers. The primary outcome was all-cause mortality. We analyzed the unadjusted and multivariable adjusted association between valve type and late survival. In total, 1,219 patients received the Perimount (n=864) or the Mosaic (n=355) bioprosthesis. During a mean follow-up of 4.2 and 6.9 years, there were 193 and 177 deaths in the Perimount and Mosaic groups, respectively. The unadjusted 1-, 5-, and 8-year survival was 93%, 78%, and 63%, respectively, in the Perimount group and 92%, 80%, and 57%, respectively, in the Mosaic group (p=0.971).There was no significant association between valve choice and all-cause mortality in the multivariable analysis (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.65-1.11). Freedom from aortic valve reoperation was similar between the groups. No significant association was found between severe PPM and late mortality. We found no significant difference in late survival after AVR with a Perimount bioprosthesis compared with a Mosaic bioprosthesis. Even though severe PPM was more common in the Mosaic group, it did not affect the late survival or the frequency of reoperation.

Mosaic segmentation, COPD and CHF multimorbidity and hospital admission costs: a clinical linkage study

How multimorbidity and socio-economic factors influence healthcare costs is unknown. Geo-demographic profiling system, Mosaic, which adds to socio-economic factors, provides the potential for an investigation of the relationship with multimorbidity, and their influence on healthcare costs. Using chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) registers from 53 general practices for a population aged 40 years and over in Stoke-on-Trent, England (N = 10,113), were linked to hospital admissions data and Healthcare Resource Groups as a measure of hospital cost (2007-09). Eleven Mosaic groups were linked on the basis of individual patients' post codes. The COPD and CHF multimorbid group (n = 763) had the highest proportion with at least one hospital admission in the 3-year time period (n = 550, 72%), compared with the index COPD (56%) and CHF (66%) groups. Multimorbid patients had significantly higher mean costs for hospital admission (£4896) compared with the index COPD (£2769) or CHF (£3876). The associations between multimorbid groups and hospital admission costs compared with index groups varied by different Mosaic groups. CHF and COPD multimorbidity is associated with high costs, and average hospital admission costs vary by Mosaic segmentation. Multimorbidity and Mosaic provide an innovative basis for developing and targeting healthcare interventions in high-hospital-cost patients.

Socioeconomic variations in access to smoking cessation interventions in UK primary care: insights using the Mosaic classification in a large dataset of primary care records.

BackgroundSmoking prevalence is particularly high amongst more deprived social groups. This cross-sectional study uses the Mosaic classification to explore socioeconomic variations in the delivery and/or uptake of cessation interventions in UK primary care.MethodsData from 460,938 smokers registered in The Health Improvement Network between 2008 and 2010 were analysed. Logistic regression was used to calculate odds ratios for smokers having a record of receiving cessation advice or a prescription for a cessation medication during the study period by Townsend quintile and for each of the 11 Mosaic groups and 61 Mosaic types. Both of these measures are area-level indicators of deprivation. Profiles of Mosaic categories were used to suggest ways to target specific groups to increase the provision of cessation support.ResultsOdds ratios for smokers having a record of advice or a prescription increased with increasing Townsend deprivation quintile. Similarly, smokers in more deprived Mosaic groups and types were more likely to have a documented cessation intervention. The odds of smokers receiving cessation advice if they have uncertain employment and live in social housing in deprived areas were 35% higher than the odds for successful professionals living in desirable areas (odds ratio (OR) 1.35, 95% confidence interval (CI) 1.20-1.52; absolute risks 57.2% and 50.1% respectively), and those in low-income families living in estate-based social housing were 50% more likely to receive a prescription than these successful professionals (OR 1.50, 95% CI 1.31-1.73; absolute risks 19.5% and 13% respectively). Smokers who did not receive interventions were generally well educated, financially successful, married with no children, read broadsheet newspapers and had broadband internet access.ConclusionsWide socioeconomic variations exist in the delivery and/or uptake of smoking cessation interventions in UK primary care, though encouragingly the direction of this variation may help to reduce smoking prevalence-related socioeconomic inequalities in health. Groups with particularly low intervention rates may be best targeted through broadsheet media, the internet and perhaps workplace-based interventions in order to increase the delivery and uptake of effective quit support.