ObjectivesTo quantitatively assess time-series studies of daily nitrogen dioxide (NO2) and mortality and hospital admissions which also controlled for particulate matter (PM) to determine whether or ...to what extent the NO2 associations are independent of PM.DesignA systematic review and meta-analysis.MethodsTime-series studies—published in peer-reviewed journals worldwide, up to May 2011—that reported both single-pollutant and two-pollutant model estimates for NO2 and PM were ascertained from bibliographic databases (PubMed, EMBASE and Web of Science) and reviews. Random-effects summary estimates were calculated globally and stratified by different geographical regions, and effect modification was investigated.Outcome measuresMortality and hospital admissions for various cardiovascular or respiratory diseases in different age groups in the general population.Results60 eligible studies were identified, and meta-analysis was conducted on 23 outcomes. Two-pollutant model study estimates generally showed that the NO2 associations were independent of PM mass. For all-cause mortality, a 10 µg/m3 increase in 24-hour NO2 was associated with a 0.78% (95% CI 0.47% to 1.09%) increase in the risk of death, which reduced to 0.60% (0.33% to 0.87%) after control for PM. Heterogeneity between geographical region-specific estimates was removed by control for PM (I2 from 66.9% to 0%). Estimates of PM and daily mortality assembled from the same studies were greatly attenuated after control for NO2: from 0.51% (0.29% to 0.74%) to 0.18% (−0.11% to 0.47%) per 10 µg/m3 PM10 and 0.74% (0.34% to 1.14%) to 0.54% (−0.25% to 1.34%) for PM2.5.ConclusionsThe association between short-term exposure to NO2 and adverse health outcomes is largely independent of PM mass. Further studies should attempt to investigate whether this is a generic PM effect or whether it is modified by the source and physicochemical characteristics of PM. This finding strengthens the argument for NO2 having a causal role in health effects.
ABSTRACT
In this paper, we present high-resolution spectroscopic transit observations from ESPRESSO of the super-Neptune WASP-166 b. In addition to spectroscopic ESPRESSO data, we analyse photometric ...data from TESS of six WASP-166 b transits along with simultaneous NGTS observations of the ESPRESSO runs. These observations were used to fit for the planetary parameters as well as assessing the level of stellar activity (e.g. spot crossings, flares) present during the ESPRESSO observations. We utilize the reloaded Rossiter McLaughlin (RRM) technique to spatially resolve the stellar surface, characterizing the centre-to-limb convection-induced variations, and to refine the star–planet obliquity. We find WASP-166 b has a projected obliquity of $\lambda = -15.52^{+2.85}_{-2.76}\, ^{\circ }$ and vsin (i) = 4.97 ± 0.09 km s−1 which is consistent with the literature. We were able to characterize centre-to-limb convective variations as a result of granulation on the surface of the star on the order of a few km s−1 for the first time. We modelled the centre-to-limb convective variations using a linear, quadratic, and cubic model with the cubic being preferred. In addition, by modelling the differential rotation and centre-to-limb convective variations simultaneously, we were able to retrieve a potential antisolar differential rotational shear (α ∼ −0.5) and stellar inclination (i* either 42.03$^{+9.13}_{-9.60}\, ^{\circ }$ or 133.64$^{+8.42}_{-7.98}\, ^{\circ }$ if the star is pointing towards or away from us). Finally, we investigate how the shape of the cross-correlation functions change as a function of limb angle and compare our results to magnetohydrodynamic simulations.
As part of the World Health Organization (WHO) Global Burden of Disease Comparative Risk Assessment, the burden of disease attributable to urban ambient air pollution was estimated in terms of deaths ...and disability-adjusted life years (DALYs). Air pollution is associated with a broad spectrum of acute and chronic health effects, the nature of which may vary with the pollutant constituents. Particulate air pollution is consistently and independently related to the most serious effects, including lung cancer and other cardiopulmonary mortality. The analyses on which this report is based estimate that ambient air pollution, in terms of fine particulate air pollution (PM
2.5
), causes about 3% of mortality from cardiopulmonary disease, about 5% of mortality from cancer of the trachea, bronchus, and lung, and about 1% of mortality from acute respiratory infections in children under 5 yr, worldwide. This amounts to about 0.8 million (1.2%) premature deaths and 6.4 million (0.5%) years of life lost (YLL). This burden occurs predominantly in developing countries; 65% in Asia alone. These estimates consider only the impact of air pollution on mortality (i.e., years of life lost) and not morbidity (i.e., years lived with disability), due to limitations in the epidemiologic database. If air pollution multiplies both incidence and mortality to the same extent (i.e., the same relative risk), then the DALYs for cardiopulmonary disease increase by 20% worldwide.
Background: Risk factors for post‐thrombotic syndrome (PTS) remain poorly understood.
Objectives: In this multinational multicenter study, we evaluated whether subtherapeutic warfarin ...anticoagulation was associated with the development of PTS.
Methods: Patients with a first unprovoked deep venous thrombosis (DVT) received standard anticoagulation for 5–7 months and were then assessed for PTS. The time in the therapeutic range was calculated from the international normalized ratio (INR) data. An INR below 2, more than 20% of the time, was considered as subtherapeutic anticoagulation.
Results: Of the 349 patients enrolled, 97 (28%) developed PTS. The overall frequency of PTS in patients with subtherapeutic anticoagulation was 33.5%, compared with 21.6% in those with an INR below two for ≤ 20% of the time (P = 0.01). During the first 3 months of therapy, the odds ratio (OR) for developing PTS if a patient had subtherapeutic anticoagulation was 1.78 (95% confidence interval CI 1.10–2.87). After adjusting for confounding variables, the OR was 1.84 (95% CI 1.13–3.01). Corresponding ORs for the full period of anticoagulation were 1.83 (95% CI 1.14–3.00) crude and 1.88 (95% CI 1.15–3.07) adjusted.
Conclusion: Subtherapeutic warfarin anticoagulation after a first unprovoked DVT was significantly associated with the development of PTS.
What is the relationship between late follicular phase progesterone levels and clinic pregnancy and live birth rates in couples with unexplained infertility undergoing ovarian stimulation with IUI ...(OS-IUI)?
Late follicular progesterone levels between 1.0 and <1.5 ng/ml were associated with higher live birth and clinical pregnancy rates while the outcomes in groups with higher progesterone levels did not differ appreciably from the <1.0 ng/ml reference group.
Elevated late follicular progesterone levels have been associated with lower live birth rates after fresh embryo transfer following controlled ovarian stimulation and egg retrieval, but less is known about whether an association exists with outcomes in OS-IUI cycles. Existing studies are few and have been limited to ovarian stimulation with gonadotrophins, but the use of oral agents, such as clomiphene citrate and letrozole, is common with these treatments and has not been well studied.
The study was a prospective cohort analysis of the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) randomized controlled trial. Frozen serum was available for evaluation from 2121 cycles in 828 AMIGOS participants. The primary pregnancy outcome was live birth per cycle, and the secondary pregnancy outcome was clinical pregnancy rate per cycle.
Couples with unexplained infertility in the AMIGOS trial, for whom female serum from day of trigger with hCG was available in at least one cycle of treatment, were included. Stored frozen serum samples from day of hCG trigger during treatment with OS-IUI were evaluated for serum progesterone level. Progesterone level <1.0 ng/ml was the reference group for comparison with progesterone categorized in increments of 0.5 ng/ml up to ≥3.0 ng/ml. Unadjusted and adjusted risk ratios (RR) and 95% CI were estimated using cluster-weighted generalized estimating equations to estimate modified Poisson regression models with robust standard errors.
Compared to the reference group with 110/1363 live births (8.07%), live birth rates were significantly increased in cycles with progesterone 1.0 to <1.5 ng/ml (49/401 live births, 12.22%) in both the unadjusted (RR 1.56, 95% CI 1.14, 2.13) and treatment-adjusted models (RR 1.51, 95% CI 1.10, 2.06). Clinical pregnancy rates were also higher in this group (55/401 clinical pregnancies, 13.72%) compared to reference group with 130/1363 (9.54%) (unadjusted RR 1.46, 95% CI 1.10, 1.94 and adjusted RR 1.42, 95% CI 1.07, 1.89). In cycles with progesterone 1.5 ng/ml and above, there was no evidence of a difference in clinical pregnancy or live birth rates relative to the reference group. This pattern remained when stratified by ovarian stimulation treatment group but was only statistically significant in letrozole cycles.
The AMIGOS trial was not designed to answer this clinical question, and with small numbers in some progesterone categories our analyses were underpowered to detect differences between some groups. Inclusion of cycles with progesterone values above 3.0 ng/ml may have included those wherein ovulation had already occurred at the time the IUI was performed. These cycles would be expected to experience a lower success rate but pregnancy may have occurred with intercourse in the same cycle.
Compared to previous literature focusing primarily on OS-IUI cycles using gonadotrophins, these data include patients using oral agents and therefore may be generalizable to the wider population of infertility patients undergoing IUI treatments. Because live births were significantly higher when progesterone ranged from 1.0 to <1.5 ng/ml, further study is needed to clarify whether this progesterone range may truly represent a prognostic indicator in OS-IUI cycles.
Oklahoma Shared Clinical and Translational Resources (U54GM104938) National Institute of General Medical Sciences (NIGMS). AMIGOS was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U10 HD077680, U10 HD39005, U10 HD38992, U10 HD27049, U10 HD38998, U10 HD055942, HD055944, U10 HD055936, and U10HD055925. Research made possible by the funding by American Recovery and Reinvestment Act. Dr Burks has disclosed that she is a member of the Board of Directors of the Pacific Coast Reproductive Society. Dr Hansen has disclosed that he is the recipient of NIH grants unrelated to the present work, and contracts with Ferring International Pharmascience Center US and with May Health unrelated to the present work, as well as consulting fees with May Health also unrelated to the present work. Dr Diamond has disclosed that he is a stockholder and a member of the Board of Directors of Advanced Reproductive Care, Inc., and that he has a patent pending for the administration of progesterone to trigger ovulation. Dr Anderson, Dr Gavrizi, and Dr Peck do not have conflicts of interest to disclose.
N/A.
Partial nephrectomy (PN) for small renal masses is common, but outcomes are not reported in a standard manner. Traditionally, parameters such as 90-day mortality, blood loss, transfusion rates, ...length of stay, nephrometry scoring and complications are published but their collective impact on warm ischemia time (WIT) and post-surgery GFR is rarely determined. Thus, our aim was to assess if “Trifecta” and “Pentafecta” outcomes could be used as useful surgical outcome markers. A prospective database of 252 Robotic-Assisted PN (RAPN) cases (2008–2019) was analysed. “Pentafecta” was defined as achievement of “Trifecta” (negative surgical margin, no postoperative complications and WIT of < 25 min) plus over 90% estimated GFR preservation and no CKD stage upgrading at 1 year. Binary logistic regression analysis was conducted to predict factors which may prevent achieving a Trifecta/Pentafecta. Median tumour size was 3 cm and mean WIT was 15 min. Positive surgical margins (PSM) occurred in 2 cases. Overall, the intra-operative complication rate was 7%. One recurrence conferred 5-year cancer-free survival of 97%. Trifecta outcome was achieved in 169 (67%) and Pentafecta in 141 (56%) of cases. At logistic regression analysis, intraoperative blood loss was the only factor to affect Trifecta achievement (
p
= 0.018). Advanced patient age negatively impacted Pentafecta achievement (
p
= 0.010). The Trifecta and Pentafecta outcomes are easily applicable to PN data, and offer an internationally comparable PN outcome, quality measure. We recommend applying this standardization to national data collection to improve the quality of reporting and ease of interpretation of surgeon/centres’ outcomes.
This article reports a comparative characterization of ultrafine MgAl2O4 spinel nanoparticles synthesized by polymeric precursor (Pechini) and coprecipitation methods. The nanoparticles were ...evaluated in terms of purity and surface cleanliness, size distribution, state of agglomeration, and sintering behavior. Powders synthesized by the Pechini technique were highly agglomerated and revealed a bimodal particle size distribution centered around 12 and 27 nm. Thermal analysis and infrared spectroscopy measurements indicated that carbon species remained on the surface of the powders only to be released when temperatures exceeded 1000°C. Isothermal sintering of such nanopowders at 1300°C showed a maximum relative density of only 54%. MgAl2O4 synthesized via coprecipitation created small nanoparticles, around 5–6 nm after calcination at 800°C, with significantly less agglomeration. Compared with the precursor‐derived powders, excellent sinterability of the coprecipitated powders was obtained under the same sintering conditions. Relative densities above 90% were obtained after only 10 min, which further increased to greater than 95% after 20 min with no sintering aids or dopants. The results highlight the importance of purity and processing control to exploit the beneficial high sinterability of nanoparticles.
Purpose
Black and Hispanic cancer patients experience many worse care quality and health outcomes than non-Hispanic White patients, yet less is known about disparities in caregiving responsibilities ...and burden among cancer caregivers.
Methods
We analyzed cross-sectional data from Cancer Care Outcomes Research and Surveillance consortium, a large multi-regional, population-based study of colorectal and lung cancer patients and their caregivers. Bivariate and multivariable regression models assessed differences by racial and ethnic groups in caregiving responsibilities and social/emotional, financial, and health burdens. Structural equation models estimated whether sociocultural resources (social support, caregiving preparedness, caregiver–patient communication) mediated racial and ethnic differences in caregiver burden.
Results
Compared with non-Hispanic White caregivers (
N
= 1,169), Black (
N
= 220) and Hispanic (
N
= 84) caregivers spent more time caregiving (18 vs. 26 vs. 26 h/week;
P
< 0.001), completed more tasks (6.8 vs. 7.6 vs. 8.7;
P
< 0.05), and reported greater financial burden (
P
= 0.02). Yet, compared to non-Hispanic Whites, Hispanic caregivers reported similar social/emotional and health burdens, while Black caregivers reported lower levels
(P
< 0.01)
.
In adjusted models, disparities in financial burden disappeared, and Hispanic caregivers had less health burden than non-Hispanic White caregivers (
P
= 0.01). Social support and/or caregiving preparedness partially mediated the Black–White gap for all three types of burdens.
Conclusions
Black and Hispanic cancer caregivers perform more caregiving and report greater financial burden than non-Hispanic White caregivers, but experience lower or equivalent social/emotional and health burdens. Racial differences in caregivers’ social support and caregiving preparedness levels partially explain Black–White burden differences. Research and policy should address Black and Hispanic caregivers’ increased financial burden.
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