Moorelorentzen8352
Actionable knowledge not based on a narrow subset of threats and conditions can better guide policy, build societal resilience and ensure effective prevention in an uncertain world.
We propose a shift from a focus on the prediction of individual disease patterns to the identification and mitigation of broader fragilities in public health systems. Modeling capabilities should be used to perform "stress tests" on how interrelated fragilities respond when faced with a range of possible or plausible threats of different nature and intensity. This system should be able to reveal crosscutting solutions with the potential to address not only one threat, but multiple areas of vulnerability to future health risks. Actionable knowledge not based on a narrow subset of threats and conditions can better guide policy, build societal resilience and ensure effective prevention in an uncertain world.
High blood pressure (BP) after kidney transplantation decreases graft and patient survival. There is a causal relationship between high salt intake and increased BP in the general population, but the role of salt intake on post-transplant hypertension remains controversial. The aims of our study were to determine the pattern of salt intake in the first year post-transplantation and its influence on BP in our kidney transplant population.
We selected 270 deceased-donor kidney transplant recipients with graft survival longer than 1 year and at least 1 adequate 24-h urinary sodium excretion measurement at the first year visit in order to be included in the analysis.
Some 87.0% patients had a sodium excretion (mean 165±73 mmol/day) higher than recommended. Male and younger recipients with a high body mass index had a higher sodium excretion. Among other variables, sodium excretion was independently related to higher systolic (b 3.529 per 100 mmol/day, 95%CI 0.725-6.334, p=0.014) and diastolic (b 1.866 per 100 mmol/day, 95%CI 0.237-3.496, p=0.025) BP.
A high percentage of kidney transplant recipients have salt intake higher than recommended, contributing to increased BP. Measurement of 24-h urinary sodium excretion identifies non-compliant kidney transplant recipients who need intervention to improve BP control and graft outcome.
A high percentage of kidney transplant recipients have salt intake higher than recommended, contributing to increased BP. Measurement of 24-h urinary sodium excretion identifies non-compliant kidney transplant recipients who need intervention to improve BP control and graft outcome.
The purpose of this investigation was to identify modifiable risk factors for the development of first-onset chronic neck pain among an inception cohort of healthy individuals working in a high-risk occupation. Candidate risk factors identified from previous studies were categorized into psychosocial, physical, and neurophysiological domains, which were assessed concurrently in a baseline evaluation of 171 office workers within the first 3 months of hire. Participants completed monthly online surveys over the subsequent year to identify the presence of chronic interfering neck pain, defined as a Neck Disability Index score ≥5 points for 3 or more months. Data were analyzed using backward logistic regression to identify significant predictors within each domain, which were then entered into a multivariate regression model adjusted for age, sex, and body mass index. Development of chronic interfering neck pain was predicted by depressed mood (odds ratio [OR] = 3.36, 95% confidence interval [CI] = 1.10-10.31, by allowing clinicians to screen for individuals at risk of developing chronic neck pain.
It is established that omeprazole increases (R)+ warfarin levels with around 10%. Whether (es)omeprazole also increase the plasma levels of acenocoumarol or phenprocoumon is still uncertain. We analyzed whether addition of (es)omeprazole to acenocoumarol or phenprocoumon increases the international normalized ratio (INR) levels and the risk of overanticoagulation.
We analyzed all hospital admissions in four teaching hospitals. Patients who used coumarins and pantoprazole or (es)omeprazole simultaneously for at least four consecutive days were included in the study. We analyzed the highest INR level and whether patients had an INR level above six. We compared patients using omeprazole or esomeprazole with patients using pantoprazole, because for pantoprazole, no interaction has been reported.
We analyzed 5747 admissions with 4540 patients using one of the drug combinations. For acenocoumarol (4578 admissions), no significant differences were found between users of esomeprazole, omeprazole, and pantoprazo.
Cancers of female breast, upper aero-digestive tract (UADT) (oral cavity, pharynx, larynx, oesophagus) and colorectum are causally related to alcohol consumption. Although alcohol consumption is likely to vary during life, the few studies that have explicitly measured lifetime consumption or intake over time have not been summarised. We therefore conducted a systematic review and meta-analysis.
Studies were identified by searching the Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and Scopus databases through January 2015 using broad search criteria. Studies reporting relative risks (RR) for quantitatively defined categories of alcohol consumption over time for breast, UADT or colorectal cancer were eligible. A two-stage random-effects meta-analysis was used to estimate a dose-response relationship between alcohol intake and each cancer site. RRs were also calculated for the highest relative to the lowest intake category.
Sixteen articles for breast, 16 for UADT and 7 for colorectal cancer met the eligibility criteria. We observed a weak non-linear dose-response relationship for breast cancer and positive linear dose-response relationships for UADT and colorectal cancer. The pooled RRs were 1.28 (95% confidence interval, CI 1.07, 1.52) for breast, 2.83 (95% CI 1.73, 4.62) for UADT, 4.84 (95% CI 2.51, 9.32) for oral cavity and pharynx, 2.25 (95% CI 1.49, 3.42) for larynx, 6.71 (95% CI 4.21, 10.70) for oesophageal and 1.49 (95% CI 1.27, 1.74) for colorectal cancer.
Our findings confirm dose-dependent associations between long-term alcohol intake and breast, UADT and colorectal cancer.
Our findings confirm dose-dependent associations between long-term alcohol intake and breast, UADT and colorectal cancer.The polymer-induced forces between colloidal particles in a semidilute or concentrated polymer solution are considered theoretically. This study is focussed on the case of partially adsorbing colloidal surfaces involving some attractive centers able to trap polymer segments. In the presence of free polymers the particles are covered by self-assembled fluffy layers whose structure is elucidated. It is shown that the free-polymer-induced interaction between the particles is repulsive at distances exceeding the polymer correlation length, and that this depletion repulsion can be strongly enhanced due to the presence of fluffy layers. This enhanced depletion stabilization mechanism (which works in tandem with a more short-range steric repulsion of fluffy layers) can serve on its own to stabilize colloidal dispersions. More generally, we identify three main polymer-induced interaction mechanisms depletion repulsion, depletion attraction, and steric repulsion. Their competition is analyzed both numerically and analytically based on an asymptotically rigorous mean-field theory. It is shown that colloid stabilization can be achieved by simply increasing the molecular weight of polymer additives, or by changing their concentration.Catheter-based intravascular imaging modalities are being developed to visualize pathologies in coronary arteries, such as high-risk vulnerable atherosclerotic plaques known as thin-cap fibroatheroma, to guide therapeutic strategy at preventing heart attacks. Mounting evidences have shown three distinctive histopathological features-the presence of a thin fibrous cap, a lipid-rich necrotic core, and numerous infiltrating macrophages-are key markers of increased vulnerability in atherosclerotic plaques. To visualize these changes, the majority of catheter-based imaging modalities used intravascular ultrasound (IVUS) as the technical foundation and integrated emerging intravascular imaging techniques to enhance the characterization of vulnerable plaques. However, no current imaging technology is the unequivocal "gold standard" for the diagnosis of vulnerable atherosclerotic plaques. Each intravascular imaging technology possesses its own unique features that yield valuable information although encumbered by inherent limitations not seen in other modalities. In this context, the aim of this review is to discuss current scientific innovations, technical challenges, and prospective strategies in the development of IVUS-based multi-modality intravascular imaging systems aimed at assessing atherosclerotic plaque vulnerability.
Sociodemographic factors may affect adherence to specific dietary patterns during pregnancy. The present study aimed to identify dietary patterns during pregnancy and associated factors among Brazilian pregnant women.
A cross-sectional analysis. Dietary intake was evaluated with a semi-quantitative FFQ during the first postpartum week; the time frame included the second and third gestational trimesters. Principal component analysis was used to identify dietary patterns during pregnancy. Sociodemographic data were obtained using a structured questionnaire. Multiple linear regressions were applied to test the associations between the sociodemographic factors and dietary patterns.
Mesquita, Rio de Janeiro, Brazil, 2011.
Postpartum women (n 327) who were 18-45 years of age and Mesquita residents.
Three different dietary patterns were identified 'healthy' (mainly comprising legumes, vegetables and fruits), 'mixed' (mainly comprising candy, butter and margarine, and snacks) and 'traditional' (mainly comprising beans and rice). check details Women with a higher monthly per capita family income (β=0·0006; 95% CI 0·0001, 0·001; P=0·011) and women of older age (β=0·021; 95% CI -0·001, 0·042; P=0·058) were more likely to adhere to the 'healthy' dietary pattern. Women with higher parity were less likely to adhere to the 'healthy' pattern (β=-0·097; 95% CI -0·184, -0·009; P=0·030) and were more likely to adhere to the 'traditional' pattern (β=0·098; 95% CI 0·021, 0·175; P=0·012). Although not statistically significant, older women were less likely to adhere to the 'mixed' (β=-0·017; 95% CI -0·037, 0·003; P=0·075) and 'traditional' (β=-0·018; 95% CI -0·037, 0·001; P=0·061) dietary patterns.
Monthly per capita family income, parity and maternal age were factors associated with adherence to a healthy diet during pregnancy.
Monthly per capita family income, parity and maternal age were factors associated with adherence to a healthy diet during pregnancy.In our previous study, we genetically analyzed bovine viral diarrhea viruses (BVDVs) isolated from 2000 to 2006 in Japan and reported that subgenotype 1b viruses were predominant. In the present study, 766 BVDVs isolated from 2006 to 2014 in Hokkaido, Japan, were genetically analyzed to understand recent epidemics. Phylogenetic analysis based on nucleotide sequences of the 5'-untranslated region of viral genome revealed that 766 isolates were classified as genotype 1 (BVDV-1; 544 isolates) and genotype 2 (BVDV-2; 222). BVDV-1 isolates were further divided into BVDV-1a (93), 1b (371) and 1c (80) subgenotypes, and all BVDV-2 isolates were grouped into BVDV-2a subgenotype (222). Further comparative analysis was performed with BVDV-1a, 1b and 2a viruses isolated from 2001 to 2014. Phylogenetic analysis based on nucleotide sequences of the viral glycoprotein E2 gene, a major target of neutralizing antibodies, revealed that BVDV-1a, 1b and 2a isolates were further classified into several clusters. Cross-neutralization tests showed that BVDV-1b isolates were antigenically different from BVDV-1a isolates, and almost BVDV-1a, 1b and 2a isolates were antigenically similar among each subgenotype and each E2 cluster.