Hospitalised patients with suspected 2009 H1N1 Influenza A in a hospital in Norway, July - December 2009

<p>Abstract</p> <p>Background</p> <p>The main objective of this study was to describe the patients who were hospitalised at Oslo University Hospital Aker during the first wave of pandemic Influenza A (H1N1) in Norway.</p> <p>Methods</p> <p>Clinical data on all patients hospitalised with influenza-like illness from July to the end of November 2009 were collected prospectively. Patients with confirmed H1N1 Influenza A were compared to patients with negative H1N1 tests.</p> <p>Results</p> <p>182 patients were hospitalised with suspected H1N1 Influenza A and 64 (35%) tested positive. Seventeen patients with positive tests (27%) were admitted to an intensive care unit and four patients died (6%). The H1N1 positive patients were younger, consisted of a higher proportion of non-ethnic Norwegians, had a higher heart rate on admission, and fewer had pre-existing hypertension, compared to the H1N1 negative patients. However, hypertension was the only medical condition that was significantly associated with a more serious outcome defined as ICU admission or death, with a univariate odds ratio of the composite endpoint in H1N1 positive and negative patients of 6.1 (95% CI 1.3-29.3) and 3.2 (95% CI 1.2-8.7), respectively. Chest radiography revealed pneumonia in 24/59 H1N1 positive patients. 63 of 64 H1N1 positive patients received oseltamivir.</p> <p>Conclusions</p> <p>The extra burden of hospitalisations was relatively small and we managed to admit all the patients with suspected H1N1 influenza without opening new pandemic isolation wards. The morbidity and mortality were similar to reports from comparable countries. Established hypertension was associated with more severe morbidity and patients with hypertension should be considered candidates for vaccination programs in future pandemics.</p

Photoacclimation in Dunaliella tertiolecta reveals a unique NPQ pattern upon exposure to irradiance

Highly time-resolved photoacclimation patterns of the chlorophyte microalga Dunaliella tertiolecta during exposure to an off–on–off (block) light pattern of saturating photon flux, and to a regime of consecutive increasing light intensities are presented. Non-photochemical quenching (NPQ) mechanisms unexpectedly responded with an initial decrease during dark–light transitions. NPQ values started to rise after light exposure of approximately 4 min. State-transitions, measured as a change of PSII:PSI fluorescence emission at 77 K, did not contribute to early NPQ oscillations. Addition of the uncoupler CCCP, however, caused a rapid increase in fluorescence and showed the significance of qE for NPQ. Partitioning of the quantum efficiencies showed that constitutive NPQ was (a) higher than qE-driven NPQ and (b) responded to light treatment within seconds, suggesting an active role of constitutive NPQ in variable energy dissipation, although it is thought to contribute statically to NPQ. The PSII connectivity parameter p correlated well with F′, Fm′ and NPQ during the early phase of the dark–light transients in sub-saturating light, suggesting a plastic energy distribution pattern within energetically connected PSII centres. In consecutive increasing photon flux experiments, correlations were weaker during the second light increment. Changes in connectivity can present an early photoresponse that are reflected in fluorescence signals and NPQ and might be responsive to the short-term acclimation state, and/or to the actinic photon flux

Spatial heterogeneity in Bayesian disease mapping

© 2018, The Author(s). Disease mapping applications generally assume homogeneous regression effects and use random intercepts to account for residual spatial dependence. However, there may be local variation in the association between disease and area risk factors. We consider implications for model fit, estimated regression coefficients, and substantive inferences of allowing spatial variability in impacts of area risk factors. An application to suicide in 6791 English small areas shows that average regression coefficients and substantive inferences (e.g. about relative risk) may be considerably affected by allowing spatially varying predictor effects, while fit is improved

Factors associated with acute depressive symptoms in patients with comorbid depression attending cardiac rehabilitation

Background: The literature suggests that comorbid depression, defined in this paper as a history of depression prior to a cardiovascular event, has an impact on later onset depression as well as constituting increased risk of mortality and adverse cardiac events. However, which factors are associated with depression, specifically in patients with comorbid depression, is unclear. Therefore, this paper investigates the factors associated with depression in patients with comorbid depression attending cardiac rehabilitation (CR). Methods: This observational study used routinely collected data from the British Heart Foundation National Audit of Cardiac Rehabilitation for the time period between April 2012 and March 2017. CR participants with comorbid depression were selected as the study population. An independent t-test and chi-square test were used to compare the association between acute depression symptoms and baseline characteristics in this population. Results: A total of 2715 CR patients with comorbid depression were analysed. Characteristics associated with acute depressive symptoms in patients with comorbid depression were found to be: young age (MD: 2.71, 95% CI 1.91, 3.50), increased number of comorbidities (MD: -0.50, 95% CI -0.66, -0.34), increased weight (MD: -1.94, 95% CI -3.35, -0.52), high BMI (MD: -1.94, 95% CI -3.35, -0.52), HADS anxiety (MD: -5.17, 95% CI -5.47, -4.87), comorbid anxiety (52.4%, p < 0.001), physical inactivity (150 minutes moderate physical activity a week and 75 minutes vigorous exercise a week; 27.5%, p < 0.001; 5.6%, p < 0.001 respectively), smoking (12.7%, p < 0.001), and being less likely to be partnered (63.6%, p < 0.001). Conclusion: The study demonstrated the association between a variety of clinical and socio-demographic factors and depression. The findings of the research indicated that, at CR baseline assessment, caution must be taken with patients with comorbid depression, specifically those with higher level depressive symptoms at the start of rehabilitation. Furthermore, their multi-comorbid condition must also be taken into account. Patients with higher depression symptoms and comorbid depression scored five points higher on the HADS anxiety scale in comparison to patients with lower level depression symptoms at the start of CR, which demonstrated that anxiety and depression are interrelated and present together

Cross-sectional and longitudinal associations between different exercise types and food cravings in free-living healthy young adults

Introduction: An increase in energy intake due to alterations in hedonic appetite sensations may, at least in part, contribute to lower-than-expected weight loss in exercise interventions. The aim of this study was to examine cross-sectional and longitudinal associations between habitual exercise participation and food cravings in free-living young adults. Methods: A total of 417 adults (49% male, 28 ± 4 years) reported frequency and duration of walking, aerobic exercise, resistance exercise and other exercise at baseline and every 3 months over a 12-month period. Food cravings were assessed via the Control of Eating Questionnaire at baseline and 12-month follow-up. Results: Cross-sectional analyses revealed more frequent cravings for chocolate and a greater difficulty to resist food cravings in women compared to men (p < 0.01). Only with resistance exercise significant sex by exercise interaction effects were observed with favorable responses in men but not in women. Significant main effects were shown for walking and aerobic exercise with exercisers reporting more frequent food cravings for chocolate and fruits and greater difficulty to resist eating compared to non-exercisers (p < 0.05). Longitudinal analyses revealed significant interaction effects for other exercise (p < 0.05) with favorable results in men but not women. Furthermore, significant main effects were observed for aerobic exercise, resistance exercise and total exercise with an increase in exercise being associated with a reduced difficulty to resist food cravings (p < 0.05). Discussion: The association between exercise participation and hedonic appetite sensations varies by exercise type and sex. Even though exercise was associated with more frequent and greater difficulty to food cravings in the cross-sectional analyses, which may be attributed to greater energy demands, longitudinal results indicate beneficial effects of increased exercise on appetite control, particularly in men

Long-term monitoring of nitrate transport to drainage from three agricultural clayey till fields

The application of nitrogen (N) fertilisers to crops grown on tile-drained fields is required to sustain most modern crop production, but it poses a risk to the aquatic environment since tile drains facilitate rapid transport pathways with no significant reduction in nitrate. To maintain the water quality of the aquatic environment and the provision of food from highly efficient agriculture in line with the EU's Water Framework Directive and Nitrates Directive, field-scale knowledge is essential for introducing water management actions on-field or off-field and producing an optimal differentiated N-regulation in future. This study strives to provide such knowledge by evaluating on 11 years of nitrate-N concentration measurements in drainage from three subsurface-drained clayey till fields (1.3–2.3 ha) representing approximately 71 % of the surface sediments in Denmark dominated by clay. The fields differ in their inherent hydrogeological field settings (e.g. soil-type, geology, climate, drainage and groundwater table) and the agricultural management of the fields (e.g. crop type, type of N fertilisers and agricultural practices). The evaluation revealed three types of clayey till fields characterised by: (i) low net precipitation, high concentration of nitrate-N, and short-term low intensity drainage at air temperatures often below 5 °C; (ii) medium net precipitation, medium concentration of nitrate-N, and short-term medium-intensity drainage at air temperatures often above 5 °C; and (iii) high net precipitation, low concentration of nitrate-N and long-term high intensity drainage at air temperatures above 5 °C. For each type, on-field water management actions, such as the selection of crop types and introduction of catch crops, appeared relevant, whereas off-field actions only seemed relevant for the latter two field types given the temperature-dependent reduction potential of nitrate off-field. This initial well-documented field-scale knowledge from fields that are representative of large areas in Denmark is a first step towards establishing a differentiated N-regulation for clayey till areas. Additionally, it provides a unique starting point by identifying important parameters for future mapping of catchment-scale variations in nitrate concentrations and fluxes