Anxiety disorders are the most prevalent mental disorders in developed countries. Obesity is hypothesized to be a risk factor for anxiety disorders but evidence supporting an association between ...these two conditions is not clear. The objectives of this paper were to systematically review the literature for a link between obesity and anxiety disorders in the general population, and to present a pooled estimate of association. We performed a systematic search for epidemiological articles reporting on obesity (explanatory variable) and anxiety disorders (outcome variable) in seven bibliographical databases. Two independent reviewers abstracted the data and assessed study quality. We found 16 studies (2 prospective and 14 cross-sectional) that met the selection criteria. Measures of effect from prospective data were mixed but cross-sectional evidence suggested a positive association between obesity and anxiety. The pooled odds ratio from cross-sectional studies was 1.4 (confidence interval: 1.2–1.6). Subgroup analyses revealed a positive association in men and women. Overall, a moderate level of evidence exists for a positive association between obesity and anxiety disorders. Questions remain regarding the role of obesity severity and subtypes of anxiety disorders. The causal relationship from obesity to anxiety disorders could not be inferred from current data; future etiologic studies are recommended.
Aim
Previous research has indicated an association between diabetes and anxiety. However, no synthesis has determined the direction of this association. The aim of this study was to determine the ...longitudinal relationship between anxiety and diabetes.
Methods
We searched seven databases for studies examining the longitudinal relationship between anxiety and diabetes. Two independent reviewers screened studies from a population aged 16 or older that examined either anxiety as a risk factor for incident diabetes or diabetes as a risk factor for incident anxiety. Studies that met eligibility criteria were put forward for data extraction and meta‐analysis.
Results
In total 14 studies (n = 1 760 800) that examined anxiety as a risk factor for incident diabetes and two (n = 88 109) that examined diabetes as a risk factor for incident anxiety were eligible for inclusion in the review. Only studies examining anxiety as a risk factor for incident diabetes were put forward for the meta‐analysis. The least adjusted (unadjusted or adjusted for age only) estimate indicated a significant association between baseline anxiety with incident diabetes (odds ratio 1.47, 1.23–1.75). Furthermore, most‐adjusted analyses indicated a significant association between baseline anxiety and incident diabetes. Included studies that examined diabetes to incident anxiety found no association.
Conclusions
There was an association between baseline anxiety and incident diabetes. The results also indicate the need for more research to examine the direction of association from diabetes to incident anxiety. This work adds to the growing body of evidence that poor mental health increases the risk of developing diabetes.
What's new?
This is the first synthesis to determine the direction of association between anxiety and diabetes.
The results indicate that anxiety is a risk factor for incident diabetes.
The results also indicate that there is a need for further research into diabetes as a risk factor for incident anxiety.
SUMMARY Histological and histochemical methods are important tools in the evaluation of joint tissue samples for degenerative joint diseases, both in humans and in animal models. In this respect, ...standardized, simple, and reliable techniques are mandatory. This chapter describes five basic staining procedures appropriate for macroscopic (Indian ink) and histologic (HE/hematoxylin - eosin) visualization and scoring of cartilage proteoglycan and collagen content (toluidine blue/safranin O and picrosirius red/Goldner's trichrome).
We assessed clinical outcomes of patients undergoing open hernia repair using STRATAFIX™ Symmetric, a barbed triclosan-coated suture (TCS; Ethicon), versus conventional polydioxanone suture (PDS) for ...abdominal wall closure.
This single-center retrospective cohort study identified patients undergoing hernia repair. The site used PDS from 2013 to 2016 and switched exclusively to barbed TCS in 2017. Outcomes were assessed at 30, 60, and 90 days. Multivariate regression analyses and Cox proportional hazards models were used.
Of 821 hernia repairs, 446 used barbed TCS and 375 used conventional PDS. Surgical site infections (SSIs) were significantly less frequent with barbed TCS (60 days, 5.9% vs. 11.4%; P = 0.0083; 90 days, 5.9% vs. 11.7%; P = 0.006) and this remained consistent after multivariate adjustment (60 days, OR 95% CI: 0.5 0.3-0.9; 90 days, 0.5 0.3-0.9). Among patients with SSI, deep SSIs were less frequent with barbed TCS (60 days, 9.1% vs. 35.7%; P = 0.022; 90 days, 9.1% vs. 34.9%; P = 0.0252). Barbed TCS significantly reduced the risk of perioperative complications (HR 95% CI: 0.50.3-0.8; P = 0.0058). Hospital length of stay was 2.5 days shorter with barbed TCS (mean 95% CI: 5.74.9-6.6 vs. 8.27.3-9.1 days; P < 0.0001). No differences in reoperation rate over time were observed by type of suture (HR95% CI:1.3 0.5-3.4; P = 0.4793).
This study showed that patients who underwent open hernia repair appeared to recover equally well regardless of the suture type. In addition, the use of barbed TCS was associated with significantly reduced risk of perioperative complications and hospital length of stay.
The aim of a massive reduction of CO2-emissions results in a move away from fossil fuels. In the hot strip production of steel, almost exclusively gas-fired furnaces are currently used due to the ...lower energy costs. On the contrary, it is imperative to convert existing fossil heated processes to CO2-free (green) technologies in the context of the energy-transition. Obvious alternatives are electrical heating or hydrogen combustion, both strongly dependent on the specific electricity generation mix that determines the CO2-emissions. In this case study, different process heat generation options for continuous reheating furnaces in steel hot rolling mills are discussed by a quantitative approach. A state-of-the-art reheating furnace fired with natural gas is used as reference case, while electrical heating, hydrogen-air heating and hydrogen-oxygen heating are the alternatives investigated. The energy balances, the primary energy consumption and the resulting CO2-emissions are compared for the three countries of France, Poland and Germany with regard to the country-specific electricity generation mix. Additionally, the possible development until 2050 is analysed. The results show the high impact of continuous reheating furnaces in steel hot rolling mills on the total CO2-emissions of downstream steel processing. Furthermore, the massive increase in electrical energy consumption of the whole steel production process is highlighted. Each investigated alternative shows a significant potential to save CO2-emissions, depending on the country specific electricity generation mix and the future expansion of renewable energy sources. An increase in H2-production efficiency will both lead to a lower primary energy consumption and lower CO2-emissions for reheating furnaces.
•Reheating furnaces have a high impact on CO2-emissions in downstream steel processing.•Primary energy consumption changes based on process heat generation alternative.•Alternative technologies show big potential to emit less CO2 than state-of-the-art.•Potential savings depend on technology and country-specific electricity generation mix.•CO2-emissions could be further reduced by increased H2-production efficiency.
Introduction
Adverse childhood experiences (ACEs) have been associated with numerous health consequences in adulthood including cognitive decline. However, the underlying mechanisms implicated remain ...unclear.
Objectives
In this study, depressive symptoms and systemic inflammation were investigated as potential independent mediators of the association between ACEs and cognitive decline.
Methods
Participants were adults aged 50+ from the English Longitudinal Study of Ageing (N = 3,029; 54.8% female). Measures included self-reported ACEs at wave 3 (2006-2007), C-reactive protein (CRP) and depressive symptoms at wave 4 (2008-2009), and cognitive function at waves 3 and 7 (2014-2015). Mediation analyses examined the direct associations between ACEs and cognitive function at wave 7 and the indirect associations via depressive symptoms and CRP at wave 4 and were conducted using ordinary least squares regression models with the SPSS PROCESS macro. In Step 1, models were adjusted for sociodemographic factors and baseline cognitive function. Models in Step 2 were additionally adjusted for obesity and health behaviours (n = 1,874).
Results
Cumulative ACEs exposure was shown to positively predict later-life depressive symptoms, which in turn predicted cognitive decline. ACEs were also shown to positively predict systemic inflammation as measured by CRP. However, CRP did not mediate the association between ACEs and cognitive decline.
Conclusions
These findings suggest that ACEs are related to cognitive decline partly via depressive symptoms and corroborate prior research linking ACEs with adult systemic inflammation. Efforts towards screening for, preventing, and mitigating the effects of ACEs may therefore represent an important avenue for improving health outcomes in later life.
Disclosure
No significant relationships.
Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard second-line treatment for relapsed and refractory diffuse large B-cell lymphoma (DLBCL). However, the ...strategy is less clear in patients who require third-line treatment. Updated outcomes of 203 patients who could not proceed to scheduled ASCT in the Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) are herein reviewed. In the intent-to-treat analysis, overall response rate to third-line chemotherapy was 39%, with 27% CR or CR unconfirmed, and 12% PR. Among the 203 patients, 64 (31.5%) were eventually transplanted (ASCT 56, allogeneic SCT 8). Median overall survival (OS) of the entire population was 4.4 months. OS was significantly improved in patients with lower tertiary International Prognostic Index (IPI), patients responding to third-line treatment and patients transplanted with a 1-year OS of 41.6% compared with 16.3% for the not transplanted (P<0.0001). In multivariate analysis, IPI at relapse (hazard ratio (HR) 2.409) and transplantation (HR 0.375) independently predicted OS. Third-line salvage chemotherapy can lead to response followed by transplantation and long-term survival in DLBCL patients. However, improvement of salvage efficacy is an urgent need with new drugs.
Abstract
The substitution of natural gas with hydrogen is one way to eliminate direct CO
2
emissions. However, oxyfuel combustion of hydrogen or hydrogen enriched natural gas leads to different ...exhaust gas properties due to a changed composition compared to conventional combustion. In combustion simulation, the emissivity of a gas mixture is usually approximated using a Weighted Sum of Gray Gases (WSGG) model. Most of the existing WSGG models have been validated for natural gas combustion with air or oxyfuel and are therefore not applicable to hydrogen-oxyfuel combustion. CFD simulations showed, that none of the investigated WSGG models is able to predict the radiative heat transfer for all considered combustion scenarios with appropriate accuracy. In addition, in container glass manufacturing more than 95% of the heat flux to the glass surface is transferred by radiation because of the high process temperatures. Due to the changed gray gas emissivity, the high content of water vapor leads to a different emission spectrum of the exhaust gas. The influence of the changed emission spectrum on radiative heat transfer and the penetration depth of radiation in the glass melt is investigated using a simulation model of a pilot plant and non-gray modelling of the radiation transport. The CFD simulations show slightly enhanced radiative heat transfer to the glass and a slightly deeper penetration depth especially for wavelength below 2.2 μm for hydrogen-oxyfuel combustion.
Introduction
People with diabetes are vulnerable to diabetes-related distress and are more likely to experience depressive and anxiety symptoms than the general population. Diabetes distress, ...depressive, and anxiety symptoms also tend to commonly co-occur.
Objectives
This study aimed to apply network analysis to explore the associations between diabetes distress, depressive, and anxiety symptoms in a cohort of adults with type 2 diabetes.
Methods
Data were from the baseline (2011) assessment of the Evaluation of Diabetes Insulin Treatment (EDIT) study (
N
= 1,796; 49% female; mean age = 60,
SD
= 8) from Quebec, Canada. A first network using the 17 items of the diabetes distress scale (DDS-17) was estimated. A second network was estimated using the 17 items of the DDS-17, the 9 depressive items of the PHQ-9, and the 7 anxiety items of the GAD-7. Symptom centrality, network stability, and bridge symptoms were examined.
Results
Regimen-related and physician-related distress symptoms were amongst the most central (highly connected) in the diabetes distress network.
Worrying too much
(anxiety),
Not feeling motivated to keep up diabetes self-management
(diabetes distress), and
Feeling like a failure
(depression) were the most central symptoms in the combined network.
Feeling like a failure
(depression) was highly connected to diabetes distress symptoms, representing a potential bridge between diabetes distress and depression.
Conclusions
Identifying central and bridge symptoms may provide new insights into diabetes distress, depressive, and anxiety symptom maintenance and comorbidity in people with type 2 diabetes.
Disclosure
No significant relationships.
PDF
