It is not yet resolved how lifestyle factors and intermediate phenotypes interrelate with metabolic pathways. We aimed to investigate the associations between diet, physical activity, ...cardiorespiratory fitness and obesity with serum metabolite networks in a population-based study.
The present study included 2380 participants of a randomly drawn subcohort of the European Prospective Investigation into Cancer and Nutrition-Potsdam. Targeted metabolomics was used to measure 127 serum metabolites. Additional data were available including anthropometric measurements, dietary assessment including intake of whole-grain bread, coffee and cake and cookies by food frequency questionnaire, and objectively measured physical activity energy expenditure and cardiorespiratory fitness in a subsample of 100 participants. In a data-driven approach, Gaussian graphical modeling was used to draw metabolite networks and depict relevant associations between exposures and serum metabolites. In addition, the relationship of different exposure metabolite networks was estimated.
In the serum metabolite network, the different metabolite classes could be separated. There was a big group of phospholipids and acylcarnitines, a group of amino acids and C6-sugar. Amino acids were particularly positively associated with cardiorespiratory fitness and physical activity. C6-sugar and acylcarnitines were positively associated with obesity and inversely with intake of whole-grain bread. Phospholipids showed opposite associations with obesity and coffee intake. Metabolite networks of coffee intake and obesity were strongly inversely correlated (body mass index (BMI): r = -0.57 and waist circumference: r = -0.59). A strong positive correlation was observed between metabolite networks of BMI and waist circumference (r = 0.99), as well as the metabolite networks of cake and cookie intake with cardiorespiratory fitness and intake of whole-grain bread (r = 0.52 and r = 0.50; respectively).
Lifestyle factors and phenotypes seem to interrelate in various metabolic pathways. A possible protective effect of coffee could be mediated via counterbalance of pathways of obesity involving hepatic phospholipids. Experimental studies should validate the biological mechanisms.
Imbalances in tryptophan metabolism have been linked to cancer-related immune escape and implicated in several cancers, including lung cancer.
We conducted a nested case-control study within the ...European Prospective Investigation into Cancer and Nutrition (EPIC) that included 893 incident lung cancer cases and 1,748 matched controls. Circulating levels of tryptophan and six of its metabolites were measured and evaluated in relation to lung cancer risk.
Tryptophan (Ptrend = 2 × 10(-5)) and the kynurenine/tryptophan ratio (KTR; Ptrend = 4 × 10(-5)) were associated with lung cancer risk overall after adjusting for established risk factors. The ORs comparing the fifth and first quintiles (OR5th vs. 1st) were 0.52 95% confidence interval (CI), 0.37-0.74 for tryptophan and 1.74 (95% CI, 1.24-2.45) for KTR. After adjusting for plasma methionine (available from previous work, which was strongly correlated with tryptophan), the associations of tryptophan (adjusted Ptrend = 0.13) and KTR (Ptrend = 0.009) were substantially attenuated. KTR was positively associated with squamous cell carcinoma, the OR5th vs. 1st being 2.83 (95% CI, 1.62-4.94, Ptrend = 3 × 10(-5)) that was only marginally affected by adjusting for methionine.
This study indicates that biomarkers of tryptophan metabolism are associated with subsequent lung cancer risk. Although this result would seem consistent with the immune system having a role in lung cancer development, the overall associations were dependent on methionine, and further studies are warranted to further elucidate the importance of these metabolites in lung cancer etiology.
This is the first prospective study investigating the tryptophan pathway in relation to lung cancer risk.
As an indoor environment, public transport is subject to special conditions with many passengers in a comparatively small space. Therefore, both an efficient control of the climatic parameters and a ...good air exchange are necessary to avoid transmission and spread of respiratory diseases. However, in such a dynamic system it is practically impossible to determine pathogenic substances with the necessary temporal and spatial resolution, but easy-to-measure parameters allow the air quality to be assessed in a passenger compartment. Carbon dioxide has already proven to be a useful indicator, especially in environments with a high occupancy of people. Airborne particulate matter can also be an important aspect for assessing the air quality in an indoor space. Consequently, the time courses of temperature, relative humidity, carbon dioxide and particulate matter (PM
) were tracked and evaluated in local public transport buses, trams and trains in the Brunswick/Hanover region. In all measurements, the climatic conditions were comfortable for the passengers. Carbon dioxide was strongly correlated with occupancy and has proven to be the most informative parameter. The PM
concentration, however, often correlated with the dynamics of people when getting on and off, but not with the occupancy. Sensors, equipped with integrated GPS, were installed in the passenger cabins and were found to be useful for recording location-related effects such as stops. The results of this study show that the online recording of simple parameters is a valuable tool for assessing air quality as a function of time, location and number of people. When the occupancy is high, a low carbon dioxide level indicates good ventilation, which automatically reduces the risk of infection. It is therefore recommended to take more advantage of low-cost sensors as a control for air conditioning systems in passenger cabins and for evaluations of the dynamics in public transport.
•The emissions of 24 specifically manufactured candle types were examined in a test chamber.•The emission profiles of the scented and unscented candles differed significantly.•Emission rates and ...indoor exposure scenarios were calculated from the measured data.•In most scenarios the calculated concentrations were significantly below established safe levels.•As expected, the NO2 produced from atmospheric nitrogen was of particular relevance.
It has been known for a long time that incomplete combustion processes produce by-products that are harmful to human health. Particularly high concentrations of such by-products can arise in indoor environments when operating open flames without venting. The emission behavior of many combustion sources, including candles, has already been examined in detail. However, to date there are no studies in which the chemical composition of the candles is known exactly or where the candles were specifically manufactured for comparative measurements. In this respect, the study presented here, which was designed in collaboration with candle manufacturers and fragrance houses, demonstrates new insights into the emissions of burning candles depending on their composition.
All investigations were carried out under controlled climatic conditions in an 8 m3 stainless steel chamber. Combinations of four different fuels (waxes) and five different fragrances in addition to one set of unscented control candles were examined. This resulted in 24 experiments, 20 with scented candles and four with unscented candles. The typical combustion gases carbon monoxide, carbon dioxide and NOx, organic compounds, such as formaldehyde, benzene, and polycyclic aromatic hydrocarbons, PM2.5 and ultrafine particles were monitored in the chamber air and the emission rates were determined. The data were statistically evaluated using parametric and non-parametric methods as well as hierarchical cluster analysis. Exposure scenarios typical for indoor environments were calculated from the emission rates and the results were compared with indoor guidance and reference values.
As expected, a multitude of gaseous and particulate emissions were detected. These were typical combustion products as well as evaporated constituents of the fragrance mixtures. In most cases, the calculated indoor concentrations were well below the respective guidance and reference values. The exceptions observed in some cases for nitrogen dioxide, acrolein and benzoapyrene are discussed critically.
Purpose
Real‐world evidence (RWE) is increasingly used for medical regulatory decisions, yet concerns persist regarding its reproducibility and hence validity. This study addresses reproducibility ...challenges associated with diversity across real‐world data sources (RWDS) repurposed for secondary use in pharmacoepidemiologic studies. Our aims were to identify, describe and characterize practices, recommendations and tools for collecting and reporting diversity across RWDSs, and explore how leveraging diversity could improve the quality of evidence.
Methods
In a preliminary phase, keywords for a literature search and selection tool were designed using a set of documents considered to be key by the coauthors. Next, a systematic search was conducted up to December 2021. The resulting documents were screened based on titles and s, then based on full texts using the selection tool. Selected documents were reviewed to extract information on topics related to collecting and reporting RWDS diversity. A content analysis of the topics identified explicit and latent themes.
Results
Across the 91 selected documents, 12 topics were identified: 9 dimensions used to describe RWDS (organization accessing the data source, data originator, prompt, inclusion of population, content, data dictionary, time span, healthcare system and culture, and data quality), tools to summarize such dimensions, challenges, and opportunities arising from diversity. Thirty‐six themes were identified within the dimensions. Opportunities arising from data diversity included multiple imputation and standardization.
Conclusions
The dimensions identified across a large number of publications lay the foundation for formal guidance on reporting diversity of data sources to facilitate interpretation and enhance replicability and validity of RWE.
Self-management of health refers to various actions and decisions that impact health outcomes. To improve health, independence, and quality of life (QoL) while reducing healthcare utilization and ...costs, patients' self-management abilities can be enhanced. However, disease-specific self-management interventions may not be applicable for older adults with multiple illnesses. Instead, focusing on prevalent geriatric syndromes, such as frailty, cognitive decline, pain, incontinence, or impaired mobility, may be more beneficial. To achieve this, a detailed understanding of the specific needs of the older population is crucial.
Patients who are 70 years old or older will be chosen from four geriatric hospitals, which include both inpatient and outpatient facilities. At baseline, each participant will undergo a comprehensive geriatric evaluation and answer various questionnaires that focus on their current self-management abilities, self-efficacy, anxiety, aging perception, and QoL. Moreover, extensive data on the presence and impact of geriatric syndromes will be gathered. Three and six months after the initial evaluation, follow-up assessments will be conducted to identify any changes in participants' health, independence in daily activities, geriatric syndromes, cognition and mood, QoL, and self-management.
The present investigation aims to assess the factors that may facilitate or impede self-management in older adults afflicted with geriatric syndromes. Instead of concentrating on particular diseases, this study will analyze the association between self-management and geriatric syndromes. The information obtained will contribute to clinical expertise on the self-management habits of older adults and their effects on their well-being, autonomy, and overall QoL, as well as provide insights into geriatric syndromes. This valuable knowledge will be crucial for developing personalised programs to enhance self-management among older adults.
German Trial Register (Deutsches Register Klinischer Studien) DRKS00031016.
The SARS‐CoV‐2 pandemic, which suddenly appeared at the beginning of 2020, revealed our knowledge deficits in terms of ventilation and air pollution control. It took many weeks to realize that ...aerosols are the main route of transmission. The initial attempt to hold back these aerosols through textile masks seemed almost helpless, although there is sufficient knowledge about the retention capacity of fabric filters for aerosols. In the absence of a sufficient number of permanently installed heating, ventilation, and air conditioning systems, three main approaches are pursued: (a) increasing the air exchange rate by supplying fresh air, (b) using mobile air purifiers, and (c) disinfection by introducing active substances into the room air. This article discusses the feasibility of these different approaches critically. It also provides experimental results of air exchange measurements in a school classroom that is equipped with a built‐in fan for supplying fresh air. With such a fan and a window tilted at the appropriate distance, an air exchange rate of 5/h can be set at a low power level and without any significant noise pollution. Heat balance calculations show that no additional heat exchanger is necessary in a normal classroom with outside temperatures above 10°C. Furthermore, a commercial mobile air purifier is studied in a chamber and a test room setup in order to examine and evaluate the efficiency of such devices against viable viruses under controlled and realistic conditions. For this purpose, bacteriophages of the type MS2 are used. Both window ventilation and air purifiers were found to be suitable to reduce the concentration of phages in the room.
Display omitted
•Wood-burning fireplaces are potential sources of indoor air contaminants.•Especially the concentration of ultrafine particles increases during operation.•The effects of NOx, CO and ...CO2 were comparatively small.•In addition to the combustion process itself firelighters are a potential source for benzene.•In some case increased concentrations of benzoapyrene were measured.
The use of combustion heat sources like wood-burning fireplaces has regained popularity in the past years due to increasing energy costs. While the outdoor emissions from wood ovens are strictly regulated in Germany, the indoor release of combustion products is rarely considered. Seven wood burning fireplaces were tested in private homes between November 2012 and March 2013. The indoor air quality was monitored before, during and after operation. The following parameters were measured: ultra-fine particles (5.6–560nm), fine particles (0.3–20μm), PM2.5, NOx, CO, CO2, formaldehyde, acetaldehyde, volatile organic compounds (VOCs) and benzoapyrene (BaP). Most ovens were significant sources of particulate matter. In some cases, an increase of benzene and BaP concentrations was observed in the indoor air.
The results illustrate that wood-burning fireplaces are potential sources of indoor air contaminants, especially ultra-fine particles. Under the aspect of lowering indoor air exchange rates and increasing the use of fuels with a net zero-carbon footprint, indoor combustion sources are an important topic for the future. With regards to consumer safety, product development and inspection should consider indoor air quality in addition to the present fire protection requirements.
With demographic changes, prioritizing effective care for geriatric patients to maintain functionality, independence, and quality of life is crucial. Well-developed self-management or self-care ...abilities, which can be maintained and improved through interventions, are of the utmost importance. To implement these interventions tailored and effectively, a thorough assessment of the individual's self-management and self-care abilities is required.
This scoping review aimed to identify self-management and self-care instruments suitable for geriatric patients, their underlying theories and definitions of self-management and self-care, and their similarities and differences in item content.
A systematic search of the PubMed and CINAHL databases was conducted to identify retrievable full-text articles published in English in the medical and nursing fields since the 1970s, which were validated on a sample with an average age of at least 70 years, used generic rather than disease-specific items, and addressed the broad range of self-management and self-care abilities.
Of the 20 included articles, six instruments were identified that were based on different theories and offered varying definitions of self-management or self-care. Despite these differences, all emphasize empowered individuals taking an active role in their care. Most address actual behavior and abilities referring to lifestyle factors and (anticipated) adjustment behavior. However, crucial aspects, such as psychological factors, (instrumental) activities of daily living, and social environment are not fully addressed in these instruments, nor are the types of execution to which the items refer, such as wants, feelings, confidence, or attitudes.
To fully understand how geriatric patients implement daily self-management or self-care, a combination of instruments covering the important factors of self-management and self-care and addressing multiple types of item execution, such as behaviors, abilities, wants, or attitudes, is recommended. This review provides the first comprehensive overview of self-management and self-care instruments suitable for geriatric patients.
PDF
