To determine if bisphosphonates are associated with reduced risk of acute myocardial infarction (AMI).
A cohort of 14,256 veterans 65 years or older with femoral or vertebral fractures was selected ...from national administrative databases operated by the US Department of Veterans Affairs and was derived from encounters at Veterans Affairs facilities between October 1, 1998, and September 30, 2006. The time to first AMI was assessed in relationship to bisphosphonate exposure as determined by records from the Pharmacy Benefits Management Database. Time to event analysis was performed using multivariate Cox proportional hazards regression. An adjusted survival analysis curve and a Kaplan-Meier survival curve were analyzed.
After controlling for atherosclerotic cardiovascular disease risk factors and medications, bisphosphonate use was associated with an increased risk of incident AMI (hazard ratio, 1.38; 95% CI, 1.08-1.77; P=.01). The timing of AMI correlated closely with the timing of bisphosphonate therapy initiation.
Our observations in this study conflict with our hypothesis that bisphosphonates have antiatherogenic effects. These findings may alter the risk-benefit ratio of bisphosphonate use for treatment of osteoporosis, especially in elderly men. However, further analysis and confirmation of these findings by prospective clinical trials is required.
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•New high resolution spectra of ethynyl radical in the 1.65 μm region.•Improved parameters for the lowest few levels of the radical are obtained.•The spectra will potentially be ...useful for monitoring CCH in chemical systems
Frequency-modulated diode laser transient absorption spectra of the ethynyl radical have been recorded at wavelengths close to 1.66 μm. The observed spectrum includes strong, regular, line patterns. The two main bands observed originate in the ground X̃2Σ+ state and its first excited bending vibrational level of 2Π symmetry. The upper states, of 2Σ+ symmetry at 6055.6 cm−1 and 2Π symmetry at 6413.5 cm−1, respectively, had not previously been observed and the data were analyzed in terms of an effective Hamiltonian representing their rotational and fine structure levels to derive parameters which can be used to calculate rotational levels up to J = 37/2 for the 2Π level and J = 29/2 for the 2Σ one. Additionally, a weaker series of lines have been assigned to absorption from the second excited bending, (0 2 0), level of 2Σ symmetry, to a previously observed state of 2Π symmetry near 6819 cm−1. These strong absorption bands at convenient near-IR laser wavelengths will be useful for monitoring CCH radicals in chemical systems.
A lung cancer case-control study was conducted in a Slovenian asbestos-cement factory for which unusually good records of asbestos exposures were available. The cohort consisted of all 6714 workers ...employed at the Salonit Anhovo factory after 31 December 1946 who worked there for at least one day between 1964 and 1994. Fifty-eight histologically confirmed cases of primary lung cancer and 290 controls were selected from the cohort. Working life exposure histories to amphibole and chrysotile forms of asbestos were estimated separately. Airborne asbestos concentrations were low. For example, the arithmetic mean exposure to all forms of asbestos in the highest exposure period (1947–1971) was 1.2 f/cm3. Chrysotile asbestos made up about 90% of this exposure (mean 1.1 f/cm3), whereas amphibole accounted for 10% (0.1 f/cm3). Comparing those above and below the 90 percentile of cumulative exposure, the odds ratios for all asbestos, chrysotile and amphibole were 1.5, 1.6 and 2.0, respectively, but confidence intervals were wide. There are only a few asbestos-lung cancer studies with high-quality exposure data and exposures in this low range. Though imprecise, the findings are important to the ongoing debate about asbestos risks.
In 2022, a new sea lock at IJmuiden is expected to open, permitting an increase in marine traffic of larger ships from the sea to the port. In the interest of facilitating operations, we evaluate the ...impact of the current first-come, first-served (FCFS) admittance policy in the context of berth allocation for a wet bulk terminal in the port. Four model types are constructed: optimal FCFS; no FCFS with fixed arrival times; 48-h arrival time relaxation; and complete arrival time relaxation. Comparison of the model types is done by means of a rolling time window: of each day within the time frame, a schedule was created for the following 2 weeks, after which the objective value was calculated. When comparing the average of all objective values, it was found that the optimal FCFS model already shows an improvement compared to the historical situation. Between the FCFS and the no FCFS model, there are no considerable differences, because the vessels are constrained to be scheduled on/after their arrival time at the port. When relaxation is allowed, a considerable efficiency gain is possible, especially if larger ships arrive at the port.
•Patient-Reported Measures (PRMs) implemented in adult, inpatient psychiatric setting.•PRMs help track symptom severity and suicidality with treatment, and may identify treatment effect ...modifiers.•Deploying PRMs as part of routine care is feasible in a well-resourced inpatient psychiatric setting.
Patient-reported measures are an important tool in personalizing care and monitoring clinical outcomes. This work presents results from the routine collection of self-report measures from individuals (n = 753) admitted to depression and anxiety inpatient units at McLean Hospital. 93.7% participated in the Clinical Measurement Initiative (CMI) between September 2020 and February 2022 on the most established unit. The average time between admission and discharge measures was 12.6 days and an attrition rate of 10.4% was observed on this unit. Missingness of discharge assessments was unrelated to symptom severity or comorbidities. We discuss the feasibility of deploying patient-reported measures as part of routine care in an inpatient psychiatric setting. Systematic evaluation of potential treatment modifiers (e.g., personality disorder, trauma history, and substance misuse) may be valuable in better serving those impacted by psychiatric illness.
Abstract Objective This study evaluates whether depression is a risk factor for incident myocardial infarction (MI) in Department of Veterans Affairs (VA) patients with rheumatoid arthritis (RA) ...between 30 and 79 years of age. Methods We used a retrospective cohort study of 15,634 patients with RA. Diagnoses and sociodemographic data were obtained from VA administrative and pharmacy databases between fiscal years 1999 and 2006. Entry into the cohort required 2 years of patient time with no evidence of cardiovascular disease. Cox proportional hazard models with time-dependent covariates were computed to determine whether RA patients with depression as compared to RA patients without depression were at increased risk for MI during the maximum 6-year follow-up period. Results Unadjusted analyses indicated depressed RA patients were 1.4 times more likely than nondepressed RA patients to have an MI during follow-up. These results remained significant (HR=1.4; 95% CI: 1.1–1.8) in the adjusted Cox proportional hazards model which included the effects of sociodemographics and known physical risks (e.g., diabetes) for MI. Conclusions Depressed RA patients, without a history of cardiovascular disease, are 40% more likely to have a heart attack as compared to those without depression. These data demonstrate a rapid (within 6 years) transition to MI following onset of depression in RA patients. Increased monitoring of depression and heart disease status in this patient population may be warranted which in turn may result in longer duration of life.
ObjectivesStudies have shown greater health risks associated with blue-collar manufacturing employment for women than men. It remains challenging, however, to distinguish gendered job status ...(affected by family composition and other personal characteristics) from sex-linked biological differences influencing physiological response to workplace physical hazards.MethodsWe examined the effects of hourly (blue-collar) status on incident hypertension among men and women, using health claims data for 14 618 white- and blue-collar aluminium manufacturing employees in eight US states. To explore gender differences in job status, we developed sex-stratified propensity score models identifying key socioeconomic predictors of hourly status for men and women. To examine the effects of hourly employment on hypertension risk, after adjusting for gender differences in job status, we applied time-weighted logistic regression models, stratified by propensity score, with additional adjustment for socioeconomic confounders.ResultsFamily structure (partnership, parity) influenced job status for both sexes; single mothers were more likely to hold hourly jobs (OR 2.02; 95% CI 1.37 to 2.97) and partnered men with children less likely (OR 0.68; 95% CI 0.56 to 0.83). Education, age at hire and race influenced job status for both sexes. The effect of hourly status on hypertension was significant only among women predicted to be hourly (OR 1.78; 95% CI 1.34 to 2.35).ConclusionsOur results indicate significant risks of hypertension associated with hourly status for women, possibly exacerbated by sociodemographic factors predicting hourly status (eg, single parenthood, low education). Greater attention to gender differences in job status, and finer exploration of sex-linked biological differences influencing responsivity to workplace exposures, is warranted.
This publication is derived from the proceedings of the Third Canadian Conference on Research in the Rheumatic Diseases, sponsored jointly by the Canadian Rheumatism Association (the professional ...organization) and The Canadian Arthritis and Rheumatism Society (the voluntary association).
Frequency-modulated diode laser transient absorption spectra of the ethynyl radical have been recorded at wavelengths close to 1.66 μm. The observed spectrum includes strong, regular, line patterns. ...The two main bands observed originate in the ground $\tilde{χ}$2Σ+ state and its first excited bending vibrational level of 2$Π$ symmetry. The upper states, of 2Σ+ symmetry at 6055.6 cm-1 and 2$Π$ symmetry at 6413.5 cm-1, respectively, had not previously been observed and the data were analyzed in terms of an effective Hamiltonian representing their rotational and fine structure levels to derive parameters which can be used to calculate rotational levels up to J = 37/2 for the 2$Π$ level and J = 29/2 for the 2Σ one. Additionally, a weaker series of lines have been assigned to absorption from the second excited bending, (0 2 0), level of 2Σ symmetry, to a previously observed state of 2$Π$ symmetry near 6819 cm-1. These strong absorption bands at convenient near-IR laser wavelengths will be useful for monitoring CCH radicals in chemical systems.
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