Mikromuovien valokatalyyttinen hajotus titaanidioksidilla

Tiivistelmä. Mikromuovit ovat maailmanlaajuinen ongelma: niitä havaitaan merissä, jätevesissä ja esimerkiksi maaperissä. Tämän vuoksi onkin tärkeää kehittää menetelmiä mikromuovien poistamiseen ja hajottamiseen jätevesistä. Lupaava menetelmä tähän on valokatalyysi, jossa käytetään TiO₂:a valokatalyyttinä. TiO₂:lla on sopiva valenssi- ja johtuvuusvyön sijainnit, se pysyy stabiilina pitkään, minkä lisäksi se on myrkytön katalyytti. Ominaisuuksiensa vuoksi TiO₂:a käytetään monissa sovelluksissa, joissa hyödynnetään sen valokatalyyttistä aktiivisuutta. TiO₂:n polymorfeilla, anataasilla ja rutiililla on esimerkiksi valokatalyysissä tapahtuvassa elektroni-aukkoparien rekombinaatiossa on eroja. Anataasin eroavat ominaisuudet selittävät, miksi sillä on parempi valokatalyyttinen aktiivisuus kuin rutiililla. Mikromuovit voidaan luokitella esimerkiksi niiden polymeerityypin tai muodon mukaan. Tutkimuksia mikromuovien esiintymisestä vesiympäristöstä on tehty, ja esimerkiksi tässä tutkielmassa tarkastelluissa tutkimuksissa sedimentti- ja vesinäytteistä löydettyjen mikromuovien yleisimmät polymeerityypit olivat PP, PE ja PS. Tarkastellut tutkimukset osoittivat, että mikromuovien valokatalyyttinen hajotus TiO₂:lla on kannattava menetelmä kehittää eteenpäin esimerkiksi modifioimalla TiO₂:a

Modifiable predictors of ventricular ectopy in the community

Background Premature ventricular contractions (PVCs) predict heart failure and death. Data regarding modifiable risk factors for PVCs are scarce. Methods and Results We studied 1424 Cardiovascular Health Study participants randomly assigned to 24-hour Holter monitoring. Demographics, comorbidities, habits, and echocardiographic measurements were examined as predictors of PVC frequency and, among 845 participants, change in PVC frequency 5 years later. Participants exhibited a median of 0.6 (interquartile range, 0.1-7.1) PVCs per hour. Of the more directly modifiable characteristics and after multivariable adjustment, every SD increase in systolic blood pressure was associated with 9% more PVCs (95% confidence interval [CI], 2%-17%; P=0.01), regularly performing no or low-intensity exercise compared with more physical activity was associated with ≈15% more PVCs (95% CI, 3-25%; P=0.02), and those with a history of smoking exhibited an average of 18% more PVCs (95% CI, 3-36%; P=0.02) than did never smokers. After 5 years, PVC frequency increased from a median of 0.5 (IQR, 0.1-4.7) to 1.2 (IQR, 0.1-13.8) per hour ( P<0.0001). Directly modifiable predictors of 5-year increase in PVCs, described as the odds per each quintile increase in PVCs, included increased diastolic blood pressure (odds ratio per SD increase, 1.16; 95% CI, 1.02-1.31; P=0.02) and a history of smoking (OR, 1.31; 95% CI, 1.02-1.68; P=0.04). Conclusions Enhancing physical activity, smoking cessation, and aggressive control of blood pressure may represent fruitful strategies to mitigate PVC frequency and PVC-associated adverse outcomes

Sekulaarisen kraniaalisen ja postkraniaalisen variaation tarkastelu keskiaikaisen ruotsalaisen sekä mesoliittisen ja myöhäispaleoliittisen kauden eurooppalaisten aineistojen valossa

Tiivistelmä. Tutkimuksen tarkoituksena on tarkastella korreloiko kallon mittojen suhde reisiluun pituuden kanssa samalla tavalla keskiaikaisessa ja kivikautisessa aineistossa. Tutkimuksessa on käytetty aiempien tutkimusten keräämää mittausaineistoa. Aineisto koostuu 127 keskiaikaisesta ja 68 kivikautisesta yksilöstä. Kivikautinen aineisto koostuu useasta eri populaatioista peräisin olevista yksilöistä. Kivikautinen aineisto jaettiin tutkimusta varten Mesoliittiseen, Nuorempaan Myöhäispaleoliittiseen ja Myöhempään Myöhäispaleoliittiseen aikaan. Tutkimuksessa käytetyt mitat olivat reisiluun kokonaispituus (maximum length of femur), kallon maksimipituus (maximum skull length), kallon maksimileveys (maximum skull breadth), kallon korkeus (Basion-Bregma), poskikaarien välinen maksimileveys (Bizygomatic breadth) ja nenäontelon korkeus (Nasal height). Aineiston analyysissä hyödynnettiin SPSS tilastonkäsittelyohjelmaa ja Excel -tietokoneohjelmaa. Keskeiset tutkimusmenetelmät olivat regressioanalyysi, tilastollinen analyysi sekä aineiston tarkastelu sirontakarttojen ja laatikkojanakuvioiden avulla. Aineiston keskiarvoja verrattiin myös T-testin avulla. Aineistojen vertailtavuuden parantamiseksi mittausdata on muunnettu z-arvoiksi. Regressioanalyysin ja sirontakarttojen perusteella kasvojen mittojen havaittiin korreloivan reisiluun pituuden kanssa karkeasti samanlaisella tavalla kaikkien tarkasteltujen aikakausien kohdalla. Samankaltaisen korrelaation arvioitiin liittyvän muiden tutkimuksien havaitsemaan sekä ihmisten pituuden että kasvon mittojen vahvaan korrelaatioon lämpötilan kaltaisten ympäristöllisten tekijöiden kanssa. Aivokopan mittojen korrelaatiossa reisiluun pituuden kanssa havaittiin puolestaan eroavaisuuksia eri aikakausien kohdalla. Aiemmat tutkimukset ovat todenneet aivokopan luiden korreloivan vähemmän ympäristöllisten tekijöiden kanssa ja olevan enemmän geneettisten vaikutusten alainen. Tästä johtuen aivokopan mittojen erilaisten korrelaatioiden tulkittiin olevan populaatiospesifisiä. Laatikko-Janakuvioiden perusteella kivikautisen aineiston kallon mitat suhteessa reisiluun pituuteen olivat suurempia kuin keskiaikaisen aineiston kohdalla. Erityisesti näin oli verrattaessa keskiaikaista ja mesoliittista aineistoa toisiinsa. Naisten reisiluun pituuden todettiin vaihtelevan miehiä vähemmän aikakaudesta toiseen. Kivikautisesta aineistosta saatuja tuloksia ei voi pitää täysin luotettavina johtuen aineiston hajanaisuudesta. Kivikautisen aineiston eri aikakausien yksilömäärät jäivät usein pieniksi ja niistä saadut tutkimustulokset saattavat olla näennäisiä. Näin ollen mahdollinen tuleva jatkotutkimus on tutkimuksen toistaminen laajemmalla kivikautisella aineistolla, joka olisi selkeämmin peräisin tietystä populaatiosta. Tulevat tutkimukset voivat tarkastella myös muiden kehon pitkien luiden korrelaatiota kallon luiden mittojen kanssa

Healthcare costs and outcomes in adult patients with juvenile idiopathic arthritis : a population-based study

Objectives: Evidence of the economic burden and long-term outcomes of juvenile idiopathic arthritis (JIA) remains scarce. Our aim was to explore healthcare costs and long-term outcomes in adult patients with JIA. Method: We identified all adult patients (>= 18 years) with JIA who visited Jyvaskyla Central Hospital rheumatology unit between May 2007 and March 2016. We considered individual medians of time-dependent clinical variables. These data were linked to administrative data from the area from the fiscal year 2014, which include information on all public healthcare contacts. Healthcare utilization is presented as direct costs in euros (EUR). Factors affecting direct costs were assessed with a generalized linear model. Results: In 218 patients, median 28-joint Disease Activity Score with three variables (DAS28-3) was = 30 years, and median Health Assessment Questionnaire (HAQ) score was <0.5 in 85.7% and 45.4%, respectively. In the utilization data (four municipalities, 137 patients), the total annual health services-related direct costs were 432 257 EUR (mean = 3155 EUR/patient/year). Thirty-six patients (26.3%) used biological disease-modifying anti-rheumatic drugs (bDMARDs) in 2014 for a total of 355 months, and the annual cost of bDMARDs was estimated at 355 000 EUR. Those with active disease had mean costs 2.4-fold higher than those with low or no disease activity. A one-point increase in median raw HAQ incurred an average 228 EUR increase in annual costs (p = 0.03). Conclusion: Most adult patients with JIA seem to manage well with their arthritis, bearing in mind that there still is room for improvement in long-term outcomes.Peer reviewe

Psoriatic arthritis, axial spondyloarthritis and rheumatoid arthritis in Norway : nationwide prevalence and use of biologic agents

Objective To estimate the prevalence of psoriatic arthritis (PsA), axial spondyloarthritis (axSpA) and rheumatoid arthritis (RA) and the use of biologic agents in these diseases in Norway. Methods From the Norwegian Patient Registry (NPR), we identified as PsA, axSpA and RA patients >= 18 years those with >= 2 recorded episodes with diagnostic coding for index disease (L40.5, M07.0-M07.3 for PsA; M45, M46.0, M46.1, M46.8 and M46.9 for axSpA; M05-M06 for RA). We calculated the point prevalence of PsA, axSpA and RA as per the 1(st) of January 2017 in the Norwegian adult population (age >= 18). Dispensed disease-modifying antirheumatic drug (DMARD) prescriptions were obtained from the Norwegian Prescription Database and biologic DMARDs given in hospitals from the NPR. Results The point prevalence of PsA, axSpA, RA, and any of these diseases in total was 0.46%, 0.41%, 0.78%, and 1.56%, respectively. Among women, the prevalence of PsA, axSpA, and RA was 0.50%, 0.37%, and 1.10%, and among men 0.43%, 0.45%, and 0.46%, respectively. In 2017, 27.3% of RA patients, 25.7% of PsA patients and 35.1% of axSpA patients used biologic DMARDs. Treatment with biologics was more frequent in younger age groups in all three diseases, and became more infrequent especially after age >= 55 years. Conclusion In Norway, the combined prevalence of PsA, axSpA, and RA was over 1.5%. Reflecting the good overall access to highly effective but costly biologic treatments, more than a fourth of these patients used biologic agents, which corresponds to over 0.4% of Norwegian adult population.Peer reviewe

All-cause and cause-specific mortality in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis : a nationwide registry study

Objectives To explore mortality and causes of death among Norwegian patients with RA, PsA and axial spondyloarthritis (axSpA) compared with the general population by conducting a nationwide registry-based cohort study. Methods Patients with RA, PsA and axSpA were identified from the Norwegian Patient Registry based on ICD-10 codes between 2008 and 2017. Using age as the time variable, all-cause and cause-specific mortality were estimated between 2010 and 2017 with the Kaplan-Meier estimator and the cumulative incidence competing risk method, respectively. Sex-, education level-, health region- and age group-adjusted hazard ratios (HRs) for mortality were estimated using Cox regression models. Results We identified 36 095 RA, 18 700 PsA and 16 524 axSpA patients (70%, 53% and 45% women, respectively). RA and axSpA were associated with increased all-cause mortality (HR 1.45 [95% CI: 1.41, 1.48] and HR 1.38 [95% CI: 1.28, 1.38], respectively). Women but not men with PsA had a slightly increased mortality rate (HR 1.10 [95% CI: 1.00, 1.21] among women and 1.02 [95% CI: 0.93, 1.11] among men). For all patient groups as well as for the general population, the three leading causes of death were cardiovascular diseases, neoplasms and respiratory diseases. RA patients had increased mortality from all of these causes, while axSpA patients had increased mortality from cardiovascular and respiratory diseases. Conclusion Even in the era of modern treatments for IJDs, patients with RA and axSpA still have shortened life expectancy. Our findings warrant further attention to the prevention and management of comorbidities.Peer reviewe

Incidence, sociodemographic factors and treatment penetration of rheumatoid arthritis and psoriatic arthritis in Norway

ABSTR A C T Objectives: To evaluate nationwide incidence, sociodemographic associations and treatment penetration of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) in Norway. Methods: The study combined data from nationwide registries on the total Norwegian adult population (age > 18). From the Norwegian Patient Registry, incident RA and PsA cases during 2011-2015 were identified with records of first and second healthcare episodes listing RA/PsA diagnostic codes, and > 1 episode in an internal medicine or rheumatology unit with RA/PsA code during the two-year period after the first episode. Dispensed DMARD prescriptions were obtained from the Norwegian Prescription Database. Persons with dis-pensed DMARD prescriptions or biologic DMARDs given in hospitals > 12 months before the index date were excluded. Results: Incidence of RA/PsA in Norway was 42/26 per 100,000 person-years (55/28 among women and 28/23 among men). RA peak incidence was observed at ages 70-79 in both sexes, whereas the peak incidence of PsA occurred at ages 50-59. Age-and sex-standardized incidences of RA and PsA were lower among persons with higher education levels. Within a year from the index date, 82.4/57.4% of RA/PsA patients used synthetic DMARDs while 9.4/9.5% used biologic DMARDs. Conclusions: Register-based incidence estimates for RA and PsA in Norway are similar to other Nordic countries, but slightly higher than in previous Norwegian studies. Furthermore, we found that higher socioeconomic status was associated with lower incidence of both RA and PsA. Although conventional synthetic DMARDs were less often used in early PsA than RA, frequency of biologic DMARD prescriptions was comparable. (c) 2021 Elsevier Inc. All rights reserved.Peer reviewe

Electrocardiogram as a predictor of sudden cardiac death in middle-aged subjects without a known cardiac disease

Background: Abnormal 12 lead electrocardiogram (ECG) findings and proposing its ability for enhanced risk prediction, majority of the studies have been carried out with elderly populations with prior cardiovascular diseases. This study aims to denote the association of sudden cardiac death (SCD) and various abnormal ECG morphologies using middle-aged population without a known cardiac disease. Methods: In total, 9511 middle-aged subjects (mean age 42 +/- 8.2 years, 52% males) without a known cardiac disease were included in this study. Risk for SCD was assessed after 10 and 30-years of follow-up. Results: Abnormal ECG was present in 16.3% (N = 1548) of subjects. The incidence of SCD was distinctly higher among those with any ECG abnormality in 10 and 30-year follow-ups (1.7/1000 years vs. 0.6/1000 years, P 100', left ventricular hypertrophy, and T-wave inversions were the most significant independent ECG risk markers for 10-year SCD prediction with up to 3-fold risk for SCD. Those with ECG abnormalities had a 1.3-fold risk (95% CI 1.07-1.57, P - 0.007) for SCD in 30-year follow-up, whereas QRST-angle > 100 degrees, LVH, ER 0.1 mV and 0.2 mV were the strongest individual predictors. Subjects with multiple ECG abnormalities had up to 6.6-fold risk for SCD (P <0.001). Conclusion: Several ECG abnormalities are associated with the occurrence of early and late SCD events in the middle-age subjects without known history of cardiac disease. (C) 2018 The Authors. Published by Elsevier B.V.Peer reviewe

Diabetes, glucose tolerance, and the risk of sudden cardiac death

Background: Diabetes predisposes to sudden cardiac death (SCD). However, it is uncertain whether greater proportion of cardiac deaths are sudden among diabetes patients than other subjects. It is also unclear whether the risk of SCD is pronounced already early in the course of the disease. The relationship of impaired glucose tolerance (IGT) and SCD is scarcely documented. Methods: A general population cohort of 10594 middle-aged subjects (mean age 44 years, 52.6 % male, follow-up duration 35-41 years) was divided into diabetes patients (n = 82), subjects with IGT (n = 3806, plasma glucose = 9.58 mmol/l in one-hour glucose tolerance test), and controls (n = 6706). Results: Diabetes patients had an increased risk of SCD after adjustment confounders (hazard ratio 2.62, 95 % confidence interval 1.46-4.70, p = 0.001) but risk for non-sudden cardiac death was similarly increased and the proportion of SCD of cardiac deaths was not increased. The SCD risk persisted after exclusion of subjects with baseline cardiac disease or non-fatal cardiac events during the follow-up. Subjects with IGT were at increased risk for SCD (univariate hazard ratio 1.51; 95 % confidence interval 1.31-1.74; p <0.001) and also for non-sudden cardiac deaths and non-fatal cardiac events but adjustments for other risk factors attenuated these effects. Conclusions: Diabetes was associated with increased risk of SCD but also the risk of non-sudden cardiac death was similarly increased. The proportion of cardiac deaths being sudden in subjects with diabetes was not increased. The higher SCD risk in diabetes patients was independent of known cardiac disease at baseline or occurrence of nonfatal cardiac event during the follow-up.Peer reviewe

GHQ increases among Scottish 15 year olds 1987–2006

BACKGROUND: Increases in a number of psychosocial disorders have been identified among Western youth in the second half of the Twentieth century. However findings are not consistent, trends are complex, and comparisons over time are hampered by methodological problems. METHODS: Data were drawn from three samples identical in respect of age (15 years), school year (final year of statutory schooling) and geographical location (the West of Scotland). Each sample was administered the 12-item General Health Questionnaire, a measure of self-report psychological distress, in 1987 (N = 505), 1999 (N = 2,196) and 2006 (N = 3,194). Analyses were conducted to examine changes in: GHQ 'caseness'; individual items; and factors, derived via confirmatory factor analysis representing (a) 'negative' and 'positive' items, and (b) 'anxiety and depression', 'loss of confidence or self-esteem' and 'anhedonia and social dysfunction'. RESULTS: Based on the standard (2/3) cut-off, 'caseness' rates in 1987, 1999 and 2006 were 12.7, 15.1 and 21.5% (males) and 18.8, 32.5 and 44.1% (females). Similar increases were observed with more stringent 'caseness' cut-offs. Examination of individual items showed some to have increased much more markedly over time than others. There were larger increases among females for all except two items and some evidence, among both genders, of steeper increases among 'negative' items compared with 'positive' ones. However, the differences in slope were very small compared with the overall increases in both types. CONCLUSIONS: Data from three samples identical in respect of age, school year and geographical location, show marked increases in GHQ-12 'caseness' among females between 1987 and 1999 and among both males and females between 1999 and 2006. Although slightly steeper increases in 'negative' items raise the possibility that endorsing such symptoms may have become more acceptable, these were small in comparison with increases in all dimensions of psychological distress. The next step is to identify causal explanations for the increases reported here