The Sex and Race Specific Relationship between Anthropometry and Body Fat Composition Determined from Computed Tomography: Evidence from the Multi-Ethnic Study of Atherosclerosis.

BackgroundFew studies have investigated the relationship of anthropometric measurements with computed tomography (CT) body fat composition, and even fewer determined if these relationships differ by sex and race.MethodsCT scans from 1,851 participants in the population based Multi-Ethnic Study of Atherosclerosis were assessed for visceral and subcutaneous fat areas by semi-automated segmentation of body compartments. Regression models were used to investigate relationships for anthropometry with visceral and subcutaneous fat separately by sex and race/ethnicity.ResultsParticipants were 50% female, 41% Caucasian, 13% Asian, 21% African American, and 25% Hispanic. For visceral fat, the positive relationship with weight (p = 0.028), waist circumference (p<0.001), waist to hip ratio (p<0.001), and waist to height ratio (p = 0.05) differed by sex, with a steeper slope for men. That is, across the range of these anthropometric measures the rise in visceral fat is faster for men than for women. Additionally, there were differences by race/ethnicity in the relationship with height (p<0.001), weight (p<0.001), waist circumference (p<0.001), hip circumference (p = 0.006), and waist to hip ratio (p = 0.001) with the Hispanic group having shallower slopes. For subcutaneous fat, interaction by sex was found for all anthropometric indices at p<0.05, but not for race/ethnicity.ConclusionThe relationship between anthropometry and underlying adiposity differs by sex and race/ethnicity. When anthropometry is used as a proxy for visceral fat in research, sex-specific models should be used

The influence of persistent pathogens on circulating levels of inflammatory markers: A cross-sectional analysis from the Multi-Ethnic Study of Atherosclerosis

Background: Systemic inflammation is linked to cardiovascular risk, but the influence of persistent pathogens, which are conventionally dichotomously categorized, on circulating levels of inflammatory markers is not clear. Antibody levels of pathogens have not been examined in relation to inflammation. Methods. Using data from a subsample of the Multi-Ethnic Study of Atherosclerosis, we examined circulating levels of interleukin-6 (IL-6), C-reactive protein (CRP) and fibrinogen in relation to five common persistent pathogens: cytomegalovirus, herpes simplex virus-1, Hepatitis A virus, Helicobacter pylori and Chlamydia pneumoniae. We tested the hypothesis that the number of seropositive pathogens (based on conventional cut-off points) would not be as sensitive a marker of inflammation as immune response measured by antibody levels to pathogens. Results. High antibody response to multiple pathogens showed graded and significant associations with IL-6 (p < 0.001), CRP (p = 0.04) and fibrinogen (p = 0.001), whereas seropositive pathogen burden did not. In multiple linear regression models, high antibody response to multiple pathogens maintained a positive association only with IL-6 (4.4% per pathogen exhibiting high antibody response, 95% CI 0.0-8.9). Conclusions. High antibody response to pathogens was a more consistent marker of inflammatory outcomes compared to seropositivity alone and high antibody response to multiple pathogens was a stronger marker compared to any single pathogen

Who Drives Climate-relevant Policies in Brazil?

In this report, the central question of our research is who drives/obstructs climate-relevant policies in Brazil, paying special attention to renewable energy policies, climate policies and politics. We aim to identify the actors (in government, the private sector and civil society) who drive, or obstruct, efforts to reduce the carbon intensity of Brazil’s energy mix. The hypothesis here is that the actors who drive climate policies in Brazil are not specifically concerned with global climate change itself, but with economic, social or even political issues, such as energy security, job creation, competitiveness, promoting national industries, and gaining political power domestically or internationally. In that sense, climate change mitigation can be regarded as a co-benefit of other policies (energy policies included) that may have very different objectives. To answer the above-mentioned question, this research assesses renewable energy policies in Brazil, identifying key actors from government, business and civil society and their explicit, or implicit, motivations.UK Department for International Developmen

Is Green Recovery Enough? Analysing the Impacts of Post-COVID-19 Economic Packages

Emissions pathways after COVID-19 will be shaped by how governments’ economic responses translate into infrastructure expansion, energy use, investment planning and societal changes. As a response to the COVID-19 crisis, most governments worldwide launched recovery packages aiming to boost their economies, support employment and enhance their competitiveness. Climate action is pledged to be embedded in most of these packages, but with sharp differences across countries. This paper provides novel evidence on the energy system and greenhouse gas (GHG) emissions implications of post-COVID-19 recovery packages by assessing the gap between pledged recovery packages and the actual investment needs of the energy transition to reach the Paris Agreement goals. Using two well-established Integrated Assessment Models (IAMs) and analysing various scenarios combining recovery packages and climate policies, we conclude that currently planned recovery from COVID-19 is not enough to enhance societal responses to climate urgency and that it should be significantly upscaled and prolonged to ensure compatibility with the Paris Agreement goal

Better late than never, but never late is better: risk assessment of nuclear power construction projects

This work seeks to evaluate overnight construction costs (OCC) and lead-time escalation of nuclear power construction projects from 1955 to 2016. To this end, a comprehensive database of commercial Light Water Reactors (LWR) was developed and a statistical analysis was conducted. Findings reveal a significant delay in lead-time, especially for the last generation reactors constructed from 2010s, with 3/4 of the sample showing significant construction delays. This results in an escalation of capital costs rather than in a decline. Average OCC of newer reactors is 60% higher than the ones implemented in the earlier stages of the nuclear era. This suggests a discontinuity of the learning curve for both OCC and lead-time, which threats the market and financial sustainability of current and future nuclear energy projects. Although this is a general trend, this discontinuity is country specific and, thus, induced by national policies and regulatory frameworks. Therefore, the role of nuclear technology as an alternative to cope with the need for a decarbonisation of the power sector must be better evaluated, taking into account the real cost impacts of nuclear technology implementation.- This work was funded by the Brazilian National Council for Scientific and Technological Development agency (CNPq) (166074/2015-2) and the Marie Curie International Research Staff Exchange Scheme Fellowship within the 7th European Union Framework Programme, under the project NETEP- European Brazilian Network on Energy Planning (PIRSES-GA-2013-612263). Authors would like to acknowledge Rafael Garaffa for his helpful advices about processing data with R statistical software and data analysis. Authors are also thankful to the comments of anonymous reviewers. Special thanks to the Grantham Institute and Imperial College London media office for assisting in publicising the findings of the paper

The relationship between attitudes, beliefs and physical activity in older adults with knee pain: secondary analysis of a randomised controlled trial

Objective To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). Methods We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross‐sectional and longitudinal associations between baseline Self‐Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self‐report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6‐month followup) were investigated using multiple linear and logistic regression. Results Cross‐sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. Conclusion Greater exercise self‐efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity

Pericardial Fat and Myocardial Perfusion in Asymptomatic Adults from the Multi-Ethnic Study of Atherosclerosis

BACKGROUND:Pericardial fat has adverse effects on the surrounding vasculature. Previous studies suggest that pericardial fat may contribute to myocardial ischemia in symptomatic individuals. However, it is unknown if pericardial fat has similar effects in asymptomatic individuals. METHODS:We determined the association between pericardial fat and myocardial blood flow (MBF) in 214 adults with no prior history of cardiovascular disease from the Minnesota field center of the Multi-Ethnic Study of Atherosclerosis (43% female, 56% Caucasian, 44% Hispanic). Pericardial fat volume was measured by computed tomography. MBF was measured by MRI at rest and during adenosine-induced hyperemia. Myocardial perfusion reserve (PR) was calculated as the ratio of hyperemic to resting MBF. RESULTS:Gender-stratified analyses revealed significant differences between men and women including less pericardial fat (71.9±31.3 vs. 105.2±57.5 cm(3), p<0.0001) and higher resting MBF (1.12±0.23 vs. 0.93±0.19 ml/min/g, p<0.0001), hyperemic MBF (3.49±0.76 vs. 2.65±0.72 ml/min/g, p<0.0001), and PR (3.19±0.78 vs. 2.93±0.89, p = 0.03) in women. Correlations between pericardial fat and clinical and hemodynamic variables were stronger in women. In women only (p = 0.01 for gender interaction) higher pericardial fat was associated with higher resting MBF (p = 0.008). However, this association was attenuated after accounting for body mass index or rate-pressure product. There were no significant associations between pericardial fat and hyperemic MBF or PR after multivariate adjustment in either gender. In logistic regression analyses there was also no association between impaired coronary vasoreactivity, defined as having a PR <2.5, and pericardial fat in men (OR, 1.18; 95% CI, 0.82-1.70) or women (OR, 1.11; 95% CI, 0.68-1.82). CONCLUSIONS:Our data fail to support an independent association between pericardial fat and myocardial perfusion in adults without symptomatic cardiovascular disease. Nevertheless, these findings highlight potentially important differences between asymptomatic and symptomatic individuals with respect to the underlying subclinical disease burden

Short and long-term prediction of clinical and subclinical atherosclerosis by traditional risk factor

http://deepblue.lib.umich.edu/bitstream/2027.42/55819/1/Nieto FJ, Short- and Long-Term Prediction of Clinical and Subclinical Atherosclerosis, 1999.pd

Predictors of local malaria outbreaks: an approach to the development of an early warning system in Colombia

Risk factor surveillance is a complementary tool of morbidity and mortality surveillance that improves the likelihood that public health interventions are implemented in a timely fashion. The aim of this study was to identify population predictors of malaria outbreaks in endemic municipalities of Colombia with the goal of developing an early warning system for malaria outbreaks. We conducted a multiple-group, exploratory, ecological study at the municipal level. Each of the 290 municipalities with endemic malaria that we studied was classified according to the presence or absence of outbreaks. The measurement of variables was based on historic registries and logistic regression was performed to analyse the data. Altitude above sea level [odds ratio (OR) 3.65, 95% confidence interval (CI) 1.34-9.98], variability in rainfall (OR 1.85, 95% CI 1.40-2.44) and the proportion of inhabitants over 45 years of age (OR 0.17, 95% CI 0.08-0.38) were factors associated with malaria outbreaks in Colombian municipalities. The results suggest that environmental and demographic factors could have a significant ability to predict malaria outbreaks on the municipal level in Colombia. To advance the development of an early warning system, it will be necessary to adjust and standardise the collection of required data and to evaluate the accuracy of the forecast models