525 research outputs found

    Five-year follow-up of participants diagnosed with chronic airflow obstruction in a South African Burden of Obstructive Lung Disease (BOLD) survey

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    Background. A community-based prevalence survey performed in two suburbs in Cape Town, South Africa (SA), in 2005, using the international Burden of Obstructive Lung Disease (BOLD) method, confirmed a prevalence of chronic airflow obstruction (CAO) in 23.1% of adults aged >40 years.Objectives. To study the clinical course and prognosis over 5 years of patients with CAO identified in the 2005 survey.Methods. Patients with CAO in 2005 were invited to participate. Standard BOLD and modified questionnaires were completed. Spirometry was performed using spirometers of the same make as in 2005.Results. Of 196 eligible participants from BOLD 2005, 45 (23.0%) had died, 8 from respiratory causes, 10 from cardiovascular causes and 6 from other known causes, while in 21 cases the cause of death was not known. On multivariate analysis, only age and Global initiative for Obstructive Lung Disease (GOLD) stage 4 disease at baseline were significantly associated with death. Of the 151 survivors, 11 (5.6% of the original cohort) were unavailable and 33 (16.8%) declined or had medical exclusions. One hundred and seven survivors were enrolled in the follow-up study (54.6%, median age 63.1 years, 45.8% males). Post-bronchodilator spirometry performed in 106 participants failed to confirm CAO, defined as a forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio of <0.7, in 16 participants (15.1%), but CAO was present in 90. The median decline in FEV1 was 28.9 mL/year (interquartile range –54.8 - 0.0) and was similar between GOLD stages. The median total decline in FVC was 75 mL, and was significantly greater in GOLD stage 1 (–350 mL) than in stages 2 or 3 (–80 mL and +140 mL, respectively; p<0.01). Fifty-eight participants with CAO in 2005 (64.4%) remained in the same GOLD stage, while 21 (23.3%) deteriorated and 11 (12.2%) improved by ≥1 stage. Only one-third were receiving any treatment for chronic obstructive pulmonary disease (COPD).Conclusions. The prevalence, morbidity and mortality of CAO and COPD in SA are high and the level of appropriate treatment is very low, pointing to underdiagnosis and inadequate provision of and access to effective treatments and preventive strategies for this priority chronic non-communicable disease

    Carma CO observations of three extremely metal-poor, star-forming galaxies

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    We present sensitive CO (J = 1 0) emission line observations of the three metal-poor dwarf irregular galaxies Leo P (Z ∼ 3% Zo), Sextans A (Z ∼ 7.5% Zo), and Sextans B (Z ∼ 7.5% Zo), all obtained with the Combined Array for Millimeter-wave Astronomy interferometer. While no CO emission was detected, the proximity of the three systems allows us to place very stringent (4σ) upper limits on the CO luminosity (LCO) in these metal-poor galaxies. We find the CO luminosities to be LCO < 2900 K km s-1 pc2 for Leo P, LCO < 12,400 K km s-1 pc2 for Sextans A, and LCO < 9700 K km s-1 pc2 for Sextans B. Comparison of our results with recent observational estimates of the factor for converting between LCO and the mass of molecular hydrogen, as well as theoretical models, provides further evidence that either the CO-to-H2 conversion factor increases sharply as metallicity decreases, or that stars are forming in these three galaxies very efficiently, requiring little molecular hydroge

    Spin-gravity coupling and gravity-induced quantum phases

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    External gravitational fields induce phase factors in the wave functions of particles. The phases are exact to first order in the background gravitational field, are manifestly covariant and gauge invariant and provide a useful tool for the study of spin-gravity coupling and of the optics of particles in gravitational or inertial fields. We discuss the role that spin-gravity coupling plays in particular problems.Comment: 18 pages, 1 figur

    Hurricane Florence and suicide mortality in North Carolina: A controlled interrupted time-series analysis

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    Background Natural disasters are associated with increased mental health disorders and suicidal ideation; however, associations with suicide deaths are not well understood. We explored how Hurricane Florence, which made landfall in September 2018, may have impacted suicide deaths in North Carolina (NC). Methods We used publicly available NC death records data to estimate associations between Hurricane Florence and monthly suicide death rates using a controlled, interrupted time series analysis. Hurricane exposure was determined by using county-level support designations from the Federal Emergency Management Agency. We examined effect modification by sex, age group, and race/ethnicity. Results 8363 suicide deaths occurred between January 2014 and December 2019. The overall suicide death rate in NC between 2014 and 2019 was 15.53 per 100 000 person-years (95% CI 15.20 to 15.87). Post-Hurricane, there was a small, immediate increase in the suicide death rate among exposed counties (0.89/100 000 PY; 95% CI -2.69 to 4.48). Comparing exposed and unexposed counties, there was no sustained post-Hurricane Florence change in suicide death rate trends (0.02/100 000 PY per month; 95% CI -0.33 to 0.38). Relative to 2018, NC experienced a statewide decline in suicides in 2019. An immediate increase in suicide deaths in Hurricane-affected counties versus Hurricane-unaffected counties was observed among women, people under age 65 and non-Hispanic black individuals, but there was no sustained change in the months after Hurricane Florence. Conclusions Although results did not indicate a strong post-Hurricane Florence impact on suicide rates, subgroup analysis suggests differential impacts of Hurricane Florence on several groups, warranting future follow-up
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