Objectives
To assess coronary artery calcification (CAC) on non-contrast non-ECG-gated CT thorax (NC-NECG-CTT) and to evaluate its correlation with short-term risk of cardiovascular disease (CVD) ...events and death.
Methods
Single-institution retrospective study including all patients 40–70 years old who underwent NC-NECG-CTT over a period of 6 months. Individuals with known CVD were excluded. The presence of CAC was assessed and quantified by the Agatston score (CACS). CAC severity was defined as mild (< 100), moderate (100–400), or severe (> 400). CVD events (including CVD death, myocardial infarction, revascularisation procedures, ischaemic stroke, acute peripheral atherosclerotic ischaemia), and all-cause mortality over a median of 3.5 years were recorded. Cox proportional-hazards regression modelling was performed including CACS, age, gender and CVD risk factors (smoking, hypertension, diabetes mellitus, dyslipidaemia, and family history of CVD).
Results
Of the total 717 eligible cases, 325 (45%) had CAC. In patients without CAC, there was only one CVD event, compared to 26 CVD events including 5 deaths in patients with CAC. The presence and severity of CAC correlated with CVD events (
p
< 0.001). A CACS > 100 was significantly associated with both CVD events, hazard ratio (HR) 5.74, 95% confidence interval: 2.19–15.02;
p
< 0.001, and all-cause mortality, HR 1.7, 95% CI: 1.08–2.66;
p
= 0.02. Ever-smokers with CAC had a significantly higher risk for all-cause mortality compared to never-smokers (
p
= 0.03), but smoking status was not an independent predictor for CVD events in any subgroup category of CAC severity.
Conclusions
The presence and severity of CAC assessed on NC-NECG-CTT correlates with short-term cardiovascular events and death.
Key Points
• Patients aged 40–70 years old without known CVD but with CAC on NC-NECG-CTT have a higher risk of CVD events compared to those without CAC.
• CAC (Agatston) score above 100 confers a 5.7-fold increase in the risk of short-term CVD events in these patients.
• The presence and severity of CAC on NC-NECG-CTT may have prognostic and therapeutic implications.
The development of medical countermeasures against the hematopoietic subsyndrome of the acute radiation syndrome requires well characterized and validated animal models. The model must define the ...radiation dose- and time-dependent relationships for mortality and major signs of morbidity to include other organ damage that may contribute to morbidity and mortality. Herein, the authors define these parameters for a nonhuman primate exposed to total body radiation and administered medical management. A blinded, randomized study (n = 48 rhesus macaques) determined the lethal dose-response relationship using bilateral 6 MV linear accelerator photon radiation to doses in the range of 7.20 to 8.90 Gy at 0.80 Gy min(-1). Following irradiation, animals were monitored for complete bloodcounts, body weight, temperature, diarrhea, and hydration status for 60 d. Animals were administered medical management consisting of intravenous fluids, prophylactic antibiotics, blood transfusions, anti-diarrheals, analgesics, and nutrition. The primary endpoint was survival at 60 d post-irradiation; secondary endpoints included hematopoietic-related parameters, number of transfusions, incidence of documented infection, febrile neutropenia, severity of diarrhea, mean survival time of decedents, and tissue histology. The study defined an LD30/60 of 7.06 Gy, LD50/60 of 7.52 Gy, and an LD70/60 of 7.99 Gy with a relatively steep slope of 1.13 probits per linear dose. This study establishes a rhesus macaque model of the hematopoietic acute radiation syndrome and shows the marked effect of medical management on increased survival and overall mean survival time for decedents. Furthermore, following a nuclear terrorist event, medical management may be the only treatment administered at its optimal schedule.
Ion channels are transmembrane proteins that play ubiquitous roles in cellular homeostasis and activation. In addition to their recognized role in the regulation of ionic permeability and thus ...membrane potential, some channel proteins possess intrinsic kinase activity, directly interact with integrins or are permeable to molecules up to ≈1000 Da. The small size and anuclear nature of the platelet has often hindered progress in understanding the role of specific ion channels in hemostasis, thrombosis and other platelet‐dependent events. However, with the aid of transgenic mice and ‘surrogate’ patch clamp recordings from primary megakaryocytes, important unique contributions to platelet function have been identified for several classes of ion channel. Examples include ATP‐gated P2X1 channels, Orai1 store‐operated Ca2+ channels, voltage‐gated Kv1.3 channels, AMPA and kainate glutamate receptors and connexin gap junction channels. Furthermore, evidence exists that some ion channels, such as NMDA glutamate receptors, contribute to megakaryocyte development. This review examines the evidence for expression of a range of ion channels in the platelet and its progenitor cell, and highlights the distinct roles that these proteins may play in health and disease.
Research on autism and ADHD continues to increase, as does the research on well-being and mental health. There is a growing need to understand what factors impact mental health and well-being, and ...the question arises as to what factors impact mental health and well-being in autism and ADHD. The existing literature focuses on two different aspects when it comes to the well-being and mental health of autism in students. One aspect focuses on mental health and well-being in diagnosed neurodivergent individuals, and the other aspect focuses on associations between autistic and ADHD traits and mental health and well-being. In order to understand the impact on mental health in autism, an online survey using the Qualtrics platform was given to a sample of 430 university students. The survey used the well-being process questionnaire, the autism spectrum quotient, the ADHD self-report scale, and the strengths and difficulties questionnaire. The results showed significant correlations between anxiety, depression, and autistic and ADHD traits (all correlations > 0.2). These variables were also correlated with the well-being and SDQ outcomes and well-being predictors (all correlations > 0.2). The regression analyses showed significant associations between well-being outcomes and predictor variables and anxiety and depression, whereas the effects of autistic and ADHD traits were restricted to the SDQ outcomes (hyperactivity, conduct, and peer problems). Regression analyses were also conducted to determine whether a variable formed by combining autistic traits, ADHD, anxiety, and depression scores was a significant predictor of well-being and SDQ outcomes. The combined variable was associated with all outcome variables except the prosocial variable. This study provides the basis for further research for understanding the interaction between well-being, mental health, autism, and ADHD.
In response to the five commentaries on our paper ‘Comparative approaches to
gentrification: lessons from the rural’, we open up more ‘windows’ on rural
gentrification and its urban counterpart. ...First, we highlight the issues of
metrocentricity and urbanormativity within gentrification studies, highlighting
their employment by our commentators. Second, we consider the issue of
displacement and its operation within rural space, as well as gentrification as
a coping strategy for neoliberal existence and connections to more-than-human
natures. Finally, we consider questions of scale, highlighting the need to avoid
naturalistic conceptions of scale and arguing that attention could be paid to
the role of material practices, symbolizations and lived experiences in
producing scaled geographies of rural and urban gentrification.
The United States spends considerably more money on health care than the United Kingdom, but whether that translates to better health outcomes is unknown.
To assess the relative heath status of older ...individuals in England and the United States, especially how their health status varies by important indicators of socioeconomic position.
We analyzed representative samples of residents aged 55 to 64 years from both countries using 2002 data from the US Health and Retirement Survey (n = 4386) and the English Longitudinal Study of Aging (n = 3681), which were designed to have directly comparable measures of health, income, and education. This analysis is supplemented by samples of those aged 40 to 70 years from the 1999-2002 waves of National Health and Nutrition Examination Survey (n = 2097) and the 2003 wave of the Health Survey for England (n = 5526). These surveys contain extensive and comparable biological disease markers on respondents, which are used to determine whether differential propensities to report illness can explain these health differences. To ensure that health differences are not solely due to health issues in the black or Latino populations in the United States, the analysis is limited to non-Hispanic whites in both countries.
Self-reported prevalence rates of several chronic diseases related to diabetes and heart disease, adjusted for age and health behavior risk factors, were compared between the 2 countries and across education and income classes within each country.
The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer. Within each country, there exists a pronounced negative socioeconomic status (SES) gradient with self-reported disease so that health disparities are largest at the bottom of the education or income variants of the SES hierarchy. This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking, which explain very little of these health differences. These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower. These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.
Based on self-reported illnesses and biological markers of disease, US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution.
Neutralizing antibody function provides a foundation for the efficacy of vaccines and therapies
. Here, using a robust in vitro Ebola virus (EBOV) pseudo-particle infection assay and a well-defined ...set of solid-phase assays, we describe a wide spectrum of antibody responses in a cohort of healthy survivors of the Sierra Leone EBOV outbreak of 2013-2016. Pseudo-particle virus-neutralizing antibodies correlated with total anti-EBOV reactivity and neutralizing antibodies against live EBOV. Variant EBOV glycoproteins (1995 and 2014 strains) were similarly neutralized. During longitudinal follow-up, antibody responses fluctuated in a 'decay-stimulation-decay' pattern that suggests de novo restimulation by EBOV antigens after recovery. A pharmacodynamic model of antibody reactivity identified a decay half-life of 77-100 days and a doubling time of 46-86 days in a high proportion of survivors. The highest antibody reactivity was observed around 200 days after an individual had recovered. The model suggests that EBOV antibody reactivity declines over 0.5-2 years after recovery. In a high proportion of healthy survivors, antibody responses undergo rapid restimulation. Vigilant follow-up of survivors and possible elective de novo antigenic stimulation by vaccine immunization should be considered in order to prevent EBOV viral recrudescence in recovering individuals and thereby to mitigate the potential risk of reseeding an outbreak.
To evaluate the association between furosemide exposure and risk of bronchopulmonary dysplasia (BPD).
This retrospective cohort study included infants (2004-2015) born at 23-29 weeks gestational age ...and 501-1249 g birth weight. We compared the demographic and clinical characteristics of infants exposed and not exposed to furosemide between postnatal day 7 and 36 weeks postmenstrual age. We examined the association between furosemide exposure and 2 outcomes: BPD and BPD or death. We performed multivariable probit regression models that included demographic and clinical variables in addition to 2 instrumental variables: furosemide exposure by discharge year, and furosemide exposure by site.
Of 37 693 included infants, 19 235 (51%) were exposed to furosemide; these infants were more premature and had higher respiratory support. Of 33 760 infants who survived to BPD evaluation, 15 954 (47%) had BPD. An increase in the proportion of furosemide exposure days by 10 percentage points was associated with a decrease in both the incidence of BPD (4.6 percentage points; P = .001), and BPD or death (3.7 percentage points; P = .01).
More days of furosemide exposure between postnatal day 7 and 36 weeks was associated with decreased risk of BPD and a combined outcome of BPD or death.
Background and Aims
Mouthfeel attributes of white wine contribute to its style and therefore to the context in which it is most appropriately consumed. The effect of polysaccharides on the mouthfeel ...of white wine and their interaction with pH, ethanol and phenolic substances was determined.
Methods and Results
White wine polysaccharides and polysaccharide fractions, defined by molecular mass and composition, were added to either white or model white wine of variable pH and concentration of alcohol and phenolic substances to assess their effect on white wine taste and mouthfeel. A higher concentration of polysaccharides reduced perceived palate hotness. The effect of polysaccharides on mouthfeel and taste was independent of the concentration of phenolic substances. A medium molecular mass polysaccharide fraction of 13–93 kDa, containing arabinogalactan protein and mannoprotein reduced palate hotness and increased viscosity at higher pH.
Conclusions
Polysaccharides had a relatively small effect on mouthfeel and taste compared with the effect of wine pH and ethanol. Medium molecular mass polysaccharides were mostly responsible for the difference in perceived hotness and viscosity.
Significance of the Study
Palate hotness is a negative characteristic in white table wines. Winemaking practices that increase the concentration of arabinogalactan protein and low molecular mass mannoprotein could assist in masking palate hotness in white wine. Management of pH and alcohol can also be used to significantly influence the taste and mouthfeel in white wine.
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