Reduced lung function and cause-specific mortality: A population-based study of Norwegian men followed for 26 years

Background and aim Reduced lung function is associated with increased mortality, but it is unclear how different spirometric patterns are related to specific deaths. Aim of this study was to investigate these associations in a large general population cohort. Methods The study population consisted of 26,091 men aged 30–46 years from the Pneumoconiosis Survey of Western Norway conducted in 1988–1990 with follow-up on date and cause of death for 26 years. Cox proportional hazard models were used to estimate the association between baseline FEV1, FVC, obstructive (OSP) and restrictive spirometric pattern (RSP) (z-scores calculated according to GLI-2012 equations) and mortality (European 2012 shortlist classification (E−2012)), after adjustment for age, body mass index, smoking habits, and education. Results In total, 2462 (9%) subjects died. A predominant reduction of FEV1 (and OSP) were associated with respiratory non-cancer (E−8) (HR for one unit FEV1 z-score decrease 2.29 (95% CI 1.90, 2.77) and lung cancer mortality (E−2.1.8) (1.27(1.12, 1.44)). A similar reduction of FEV1 and FVC (and RSP) were associated with diabetes (E−4.1) (FEV1 2.21(1.67, 2.92), FVC 2.41(1.75, 3.32)), cerebrovascular (E−7.3) (1.52(1.21, 1.91), 1.54(1.19, 1.98)), ischemic heart disease (E−7.1) (1.22(1.10, 1.35), 1.21(1.08, 1.36)), neurological (E−6.3) (1.56(1.21, 2.01), 1.61(1.22, 2.13)), suicide (E−17.2) (1.37(1.13, 1.65), 1.29(1.04, 1.59)) and hematological cancer mortality (E−2.1.19–21) (1.29(1.05, 1.58), (1.26(1.00, 1.58)). No association was found between reduced lung function and mortality due to accidents, alcohol abuse, digestive and genitourinary cancer. Conclusions Spirometric obstruction was mainly related to pulmonary mortality. Spirometric restriction was mainly related to extra-pulmonary mortality.publishedVersio

Period and cohort effects: consequences on spirometric lung function in Norway during the 20th century

Background and aim Several factors can influence measured lung function over time. The aim of this study was to investigate period and cohort effects on spirometric measures in a large general population sample in Norway during the 20th century, using Global Lung Function Initiative (GLI-2012) equations as a reference. Methods 36 466 subjects (born 1894–1969) from four cross-sectional surveys conducted between 1965 and 1999 were included, with harmonised data on smoking habits, respiratory symptoms, lung diseases, education and spirometry. Changes in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) z-scores in healthy subjects across surveys were explored to investigate period effects. Linear mixed-effects models of FEV1 and FVC z-scores on birth cohort, with survey as random effect, were used to investigate cohort effects, both in subjects of the total population and in healthy ones. Results Relatively higher FEV1 and FVC z-scores in healthy subjects were found in the first survey (1965–1970) compared to the more recent ones (1988–1999), suggesting period effects. FEV1 and FVC z-scores increased significantly with birth cohort from 1894 to 1935, after adjustment for covariates. A more stable trend of FEV1 and FVC z-scores with birth cohort was evidenced for subjects born more recently (1945–1969). Conclusions An increase of lung function with year of birth was observed in Norwegian subjects during the first half of the 20th century. The impact of period effects on lung function decreased from 1965 to 1999.publishedVersio

Should perfusion scintigraphy be done to follow patients with acute PE? If so, when?

Aims: This investigation evaluated the changes of pulmonary perfusion at four different points of follow-up within 1 year in patients with pulmonary embolism (PE) and the factors predictive of complete or incomplete recovery of pulmonary perfusion. Materials and Methods: Patients with symptomatic PE underwent perfusion lung scintigraphy (PLS) and blood gas analysis within 48 hours from clinical presentation, after 1 week, and after 1, 6 and 12 months; echocardiogram was made at baseline and after 6 and 12 months. All PLS were examined by two expert nuclear medicine physicians with a scoring method that attributed a score of 0, 0.5 or 1 for extension (maximum 18) to the presence of perfusion defects (PD), both at baseline and on each follow-up scan. Results: Among 183 patients who completed 1-year-follow-up, median baseline PD score was 8.2; it decreased significantly at each follow-up time point until 6 months (p<0.001). Median baseline alveolar-arterial difference of oxygen partial pressure (PA-aO2) was 50.9 and decreased significantly up to 1 month (p<0.001); median pulmonary artery systolic pressure (PAsP) was 45.9 mmHg, then decreased significantly until 12 months (p<0.001). A correlation was found between PD and both PA-aO2 (p<0.05) and PAsP (p<0.05). We found a correlation between PD ≠ 0 and PAsP≥ 40 mmHg at 12 months (p<0.05); in 6 (3.3%) of these patients such correlation was still present after 24 months, suggesting they could develop chronic thromboembolic pulmonary hypertension. Low baseline PD (odds ratio, OR,0.80, p< 0.0001) and high 1-week-percent recovery (OR 1.04, p< 0.0001) were predictive factors of complete 6 months-recovery. Conclusions: Perfusion scintigraphy may be useful to follow patients with PE. The follow-up should consist of three steps: the baseline examination since it reflects the severity of PE; the scan at 1-week that indicates the early amount of reperfusion; and the scan at 6-months that demonstrates the maximum attainable recovery. Patients with incomplete recovery and persistence of pulmonary hypertension on the 24-month control should be further studied for possible development of chronic thromboembolic pulmonary hypertension. Running title: Usefulness of follow-up in pulmonary embolism

Should Perfusion Scintigraphy Be Performed to Follow Patients with Acute Pulmonary Embolism? If So, When?

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Association between lipid-A-producing oral bacteria of different potency and fractional exhaled nitric oxide in a Norwegian population-based adult cohort

Abstract Background Lipid A is the primary immunostimulatory part of the lipopolysaccharide (LPS) molecule. The inflammatory response of LPS varies and depends upon the number of acyl chains and phosphate groups in lipid A which is specific for a bacterial species or strain. Traditional LPS quantification assays cannot distinguish between the acylation degree of lipid A molecules, and therefore little is known about how bacteria with different inflammation-inducing potencies affect fractional exhaled nitric oxide (FeNO). We aimed to explore the association between pro-inflammatory hexa- and less inflammatory penta-acylated LPS-producing oral bacteria and FeNO as a marker of airway inflammation. Methods We used data from a population-based adult cohort from Norway (n = 477), a study center of the RHINESSA multi-center generation study. We applied statistical methods on the bacterial community- (prediction with MiRKAT) and genus-level (differential abundance analysis with ANCOM-BC) to investigate the association between the oral microbiota composition and FeNO. Results We found the overall composition to be significantly associated with increasing FeNO levels independent of covariate adjustment, and abundances of 27 bacterial genera to differ in individuals with high FeNO vs. low FeNO levels. Hexa- and penta-acylated LPS producers made up 2.4% and 40.8% of the oral bacterial genera, respectively. The Bray–Curtis dissimilarity within hexa- and penta-acylated LPS-producing oral bacteria was associated with increasing FeNO levels independent of covariate adjustment. A few single penta-acylated LPS producers were more abundant in individuals with low FeNO vs. high FeNO, while hexa-acylated LPS producers were found not to be enriched. Conclusions In a population-based adult cohort, FeNO was observed to be associated with the overall oral bacterial community composition. The effect of hexa- and penta-acylated LPS-producing oral bacteria was overall significant when focusing on Bray–Curtis dissimilarity within each of the two communities and FeNO levels, but only penta-acylated LPS producers appeared to be reduced or absent in individuals with high FeNO. It is likely that the pro-inflammatory effect of hexa-acylated LPS producers is counteracted by the dominance of the more abundant penta-acylated LPS producers in this population-based adult cohort involving mainly healthy individuals

The Sabina Terahertz/Infrared Beamline at SPARC-Lab Facility

Following the EU Terahertz (THz) Road Map [1], high-intensity, ps-long, THz)/Infrared (IR) radiation is going to become a fundamental spectroscopy tool for probing and control quantum materials ranging from graphene [2], and Topological Insulators, to strongly correlated oxides [3-6] and novel superconductors [7, 8]. In the framework of the SABINA project a novel THz/IR beamline based on an APPLE-X undulator emission will be developed at the SPARC-Lab facility at LNF- INFN. Light will be propagated from the SPARC-Lab to a new user lab facility nearly 25 m far away from the SPARC laboratory. This beamline will cover a broad spectral region from 3 THz to 30 THz, showing ps- pulses and energy of hundreds of μJ with variable polarization from linear to circular. The corresponding electric fields up to 10 MV/cm, are able to induce non-linear phenomena in many quantum systems. The beamline, open to user experiments, will be equipped with a 5 T magnetic cryostat, and will be synchronized with a fs laser for THz/IR pump, VIS/UV probe experiment

Detectors and Cultural Heritage: The INFN-CHNet Experience

Detectors are a key feature of the contemporary scientific approach to cultural heritage (CH), both for diagnostics and conservation. INFN-CHNet is the network of the Italian National Institute of Nuclear Physics that develops and applies new instrumentation for the study of CH. This process results in both optimized traditional state-of-the-art and highly innovative detection setups for spectrometric techniques. Examples of the former are X-rays, gamma-rays, visible-light and particles spectrometers tailored for CH applications, with optimized performances, reliability, weight, transportability, cost, absorbed power, and complementarity with other techniques. Regarding the latter, examples are ARDESIA, the array of detectors at the DAΦNE-Light facility, the MAXRS detection setup at the Riken-RAL muon beamline and the imaging facilities at the LENA Laboratory. Paths for next-generation instruments have been suggested, as in the case of the X-ray Superconductive Detectors and X-ray Microcalorimeter Spectrometers, allowing astonishing improvement in energy resolution. Many issues in CH can now be addressed thanks to scientific techniques exploiting the existing detectors, while many others are still to be addressed and require the development of new approaches and detectors