316 research outputs found
Mortality following a brain tumour diagnosis in patients with multiple sclerosis
Objectives: As brain tumours and their treatment may theoretically have a poorer prognosis in inflammatory central nervous system diseases such as multiple sclerosis (MS), all-cause mortality following a brain tumour diagnosis was compared between patients with and without MS. The potential role of age at tumour diagnosis was also examined. Setting: Hospital inpatients in Sweden with assessment of mortality in hospital or following discharge. Participants: Swedish national registers identified 20 543 patients with an MS diagnosis (1969-2005) and they were matched individually to produce a comparison cohort of 204 163 members of the general population without MS. Everyone with a primary brain tumour diagnosis was selected for this study: 111 with MS and 907 without MS. Primary and secondary outcome measures: 5-year mortality risk following brain tumour diagnosis and age at brain tumour diagnosis. Results: A non-statistically significant lower mortality risk among patients with MS (lower for those with tumours of high-grade and uncertain-grade malignancy and no notable difference for low-grade tumours) produced an unadjusted HR (and 95% CI) of 0.75 (0.56 to 1.02). After adjustment for age at diagnosis, grade of malignancy, sex, region of residence and socioeconomic index, the HR is 0.91 (0.67-1.24). The change in estimate was largely due to adjustment for age at brain tumour diagnosis, as patients with MS were on average 4.7 years younger at brain tumour diagnosis than those in the comparison cohort (p<0.001). Conclusions: Younger age at tumour diagnosis may contribute to mortality reduction in those with highgrade and uncertain-grade brain tumours. Survival following a brain tumour is not worse in patients with MS; even after age at brain tumour diagnosis and grade of malignancy are taken into account
Mechanisms to Evade the Phagocyte Respiratory Burst Arose by Convergent Evolution in Typhoidal Salmonella Serovars.
Typhoid fever caused by Salmonella enterica serovar (S.) Typhi differs in its clinical presentation from gastroenteritis caused by S. Typhimurium and other non-typhoidal Salmonella serovars. The different clinical presentations are attributed in part to the virulence-associated capsular polysaccharide (Vi antigen) of S. Typhi, which prevents phagocytes from triggering a respiratory burst by preventing antibody-mediated complement activation. Paradoxically, the Vi antigen is absent from S. Paratyphi A, which causes a disease that is indistinguishable from typhoid fever. Here, we show that evasion of the phagocyte respiratory burst by S. Paratyphi A required very long O antigen chains containing the O2 antigen to inhibit antibody binding. We conclude that the ability to avoid the phagocyte respiratory burst is a property distinguishing typhoidal from non-typhoidal Salmonella serovars that was acquired by S. Typhi and S. Paratyphi A independently through convergent evolution
Health inequalities in Japan between 1986 and 2007
Background: Despite concerns about widening social inequalities during the past 20 years of economic stagnation in Japan, evidence on health inequalities is sparse. Whether health inequalities are widening or narrowing, and what factors contribute to inequalities, remains unclear. Aim: To describe temporal trends in health inequalities between 1986 and 2007 and to investigate the contribution of material, behavioural, psychosocial and social relational factors to health inequalities in Japan. Methods: A series of eight triennial nationally representative sample surveys was analysed (n=398,303). Household income and a novel theory-driven social classification were used to calculate trends in relative and slope indices of inequality [RII and SII, respectively] in self-rated fair or poor [suboptimal] health. The contribution of mediating factors to the social gradient in suboptimal health was investigated in the 2001 sample. Results: In men, temporal trends in income RII narrowed over the period (RII declined 1.2% per year, p=0.008). Stable inequalities were observed in womenâs income SII. Menâs income SII and womenâs income RII showed marginally significant narrowing time trends. Inequalities by social class were constant in both genders. After imputation for missing household income, narrowing trends in income RII and SII were evident (annual declines: men 1.2%, women 1.1% for RII; both genders 0.1% for SII; all p<0.05, n=490,632). Overall, there were V-shaped time trends in age-standardised self-rated suboptimal health in both genders (quadratic term: men p<0.001, women p=0.005), with the lowest prevalence in early/mid 1990s. Mediating factors analysed altogether accounted for 20% in menâs and 44% in womenâs income inequalities in self-rated suboptimal health in 2001. Conclusions: Health inequalities according to household income showed narrowing trends, but persisted over the study period. The prevalence of suboptimal health increased since the early/mid 1990s. Changes in the distribution of mediating factors over the period might have influenced the time trends observed
Hospital-diagnosed infections before age 20 and risk of a subsequent multiple sclerosis diagnosis
The involvement of specific viral and bacterial infections as risk factors for multiple sclerosis has been studied extensively. However, whether this extends to infections in a broader sense is less clear and little is known about whether risk of a multiple sclerosis diagnosis is associated with other types and sites of infections, such as of the CNS. This study aims to assess if hospital-diagnosed infections by type and site before age 20âyears are associated with risk of a subsequent multiple sclerosis diagnosis and whether this association is explained entirely by infectious mononucleosis, pneumonia, and CNS infections. Individuals born in Sweden between 1970-1994 were identified using the Swedish Total Population Register (nâ=â2,422,969). Multiple sclerosis diagnoses from age 20âyears and hospital-diagnosed infections before age 20âyears were identified using the Swedish National Patient Register. Risk of a multiple sclerosis diagnosis associated with various infections in adolescence (11-19âyears) and earlier childhood (birth-10âyears) was estimated using Cox regression, with adjustment for sex, parental socioeconomic position, and infection type. None of the infections by age 10âyears were associated with risk of a multiple sclerosis diagnosis. Any infection in adolescence increased the risk of a multiple sclerosis diagnosis (hazard ratio 1.33, 95% confidence interval 1.21-1.46) and remained statistically significant after exclusion of infectious mononucleosis, pneumonia, and CNS infection (hazard ratio 1.17, 95% confidence interval 1.06-1.30). CNS infection in adolescence (excluding encephalomyelitis to avoid including acute disseminated encephalitis) increased the risk of a multiple sclerosis diagnosis (hazard ratio 1.85, 95% confidence interval 1.11-3.07). The increased risk of a multiple sclerosis diagnosis associated with viral infection in adolescence was largely explained by infectious mononucleosis. Bacterial infections in adolescence increased risk of a multiple sclerosis diagnosis, but the magnitude of risk reduced after excluding infectious mononucleosis, pneumonia and CNS infection (hazard ratio 1.31, 95% confidence interval 1.13-1.51). Respiratory infection in adolescence also increased risk of a multiple sclerosis diagnosis (hazard ratio 1.51, 95% confidence interval 1.30-1.75), but was not statistically significant after excluding infectious mononucleosis and pneumonia. These findings suggest that a variety of serious infections in adolescence, including novel evidence for CNS infections, are risk factors for a subsequent multiple sclerosis diagnosis, further demonstrating adolescence is a critical period of susceptibility to environmental exposures that raise the risk of a multiple sclerosis diagnosis. Importantly, this increased risk cannot be entirely explained by infectious mononucleosis, pneumonia, or CNS infections
Remarriage after divorce and depression risk
As marriage is associated with lower depression rates compared with being single in men, we aimed to examine if remarriage compared with remaining divorced is also associated with a reduced depression risk. Swedish register data were used to define a cohort of men who were born between 1952 and 1956, and underwent a compulsory military conscription assessment in adolescence. This study population comprised men who were divorced in 1985 (n=72,246). The risk of pharmaceutically treated depression from 2005 to 2009 was compared for those who remarried or remained divorced between 1986 and 2004. Cox proportional hazards analysis was used to estimate hazard ratios for the risk of depression identified by pharmaceutical treatment, with adjustment for a range of potential confounding factors including childhood and adulthood socioeconomic circumstances, cognitive, physical, psychological and medical characteristics at the conscription assessment. The results showed that, even though divorced men who remarried had markers of lower depression risk in earlier life such as higher cognitive and physical function, higher stress resilience and socioeconomic advantages than men who remained divorced, remarriage was associated with a statistically significant elevated risk of depression with an adjusted hazard ratio (and 95% confidence interval) of 1.27(1.03 1.55), compared with men who remained divorced. Remarriage following divorce is not associated with a reduced risk of depression identified by pharmaceutical treatment, compared with remaining divorced. Interpersonal or financial difficulties resulting from remarriage may outweigh the benefits of marriage in terms of depression risk
Trends in health and health inequality during the Japanese economic stagnation: Implications for a healthy planet
Introduction: Human health and wellbeing may depend on economic growth, the implication being that policymakers need to choose between population health and the health of ecosystems. Over two decades of low economic growth, Japan's life expectancy grew. Here we assess the temporal changes of subjective health and health inequality during the long-term low economic growth period. Methods: Eight triennial cross-sectional nationally representative surveys in Japan over the period of economic stagnation from 1992 to 2013 were used (n = 625,262). Health is defined positively as wellbeing, and negatively as poor health, based on self-rated health. We used Slope and Relative Indices of Inequality to model inequalities in self-rated health based on household income. Temporal changes in health and health inequalities over time were examined separately for children/adolescents, working-age adults, young-old and old-old. Results: At the end of the period of economic stagnation (2013), compared to the beginning (1992), the overall prevalence of wellbeing declined slightly in all age groups. However, poor health was stable or declined in the young-old and old-old, respectively, and increased only in working-age adults (Prevalence ratio: 1.14, 95% CI 1.08, 1.20, <0.001). Over time, inequality in wellbeing and poor self-rated health were observed in adults but less consistently for children, but the inequalities did not widen in any age group between the start and end of the stagnation period. Conclusions: Although this study was a case study of one country, Japan, and inference to other countries cannot be made with certainty, the findings provide evidence that low economic growth over two decades did not inevitably translate to unfavourable population health. Japanese health inequalities according to income were stable during the study period. Therefore, this study highlighted the possibility that for high-income countries, low economic growth may be compatible with good population health
Latent heat in the chiral phase transition
The chiral phase transition at finite temperature and density is discussed in
the framework of the QCD-like gauge field theory. The thermodynamical potential
is investigated using a variational approach. Latent heat generated in the
first-order phase transition is calculated. It is found that the latent heat is
enhanced near the tricritical point and is more than several hundred MeV per
quark.Comment: 6 pages, 3 figure
Correction: Appetite disinhibition rather than hunger explains genetic effects on adult BMI trajectory
Correction to: International Journal of Obesity
https://doi.org/10.1038/s41366-020-00735-9
The original version of this article unfortunately contained a mistake in the ESM. The original article has been corrected
Appetite disinhibition rather than hunger explains genetic effects on adult BMI trajectory
BACKGROUND/OBJECTIVES: The mediating role of eating behaviors in genetic susceptibility to weight gain during mid-adult life is not fully understood. This longitudinal study aims to help us understand contributions of genetic susceptibility and appetite to weight gain. SUBJECTS/METHODS: We followed the body-mass index (BMI) trajectories of 2464 adults from 45 to 65 years of age by measuring weight and height on four occasions at 5-year intervals. Genetic risk of obesity (gene risk score: GRS) was ascertained, comprising 92 BMI-associated single-nucleotide polymorphisms and split at a median (=high and low risk). At the baseline, the Eating Inventory was used to assess appetite-related traits of 'disinhibition', indicative of opportunistic eating or overeating and 'hunger' which is susceptibility to/ability to cope with the sensation of hunger. Roles of the GRS and two appetite-related scores for BMI trajectories were examined using a mixed model adjusted for the cohort effect and sex. RESULTS: Disinhibition was associated with higher BMI (ÎČâ=â2.96; 95% CI: 2.66-3.25âkg/m2), and accounted for 34% of the genetically-linked BMI difference at age 45. Hunger was also associated with higher BMI (ÎČâ=â1.20; 0.82-1.59âkg/m2) during mid-life and slightly steeper weight gain, but did not attenuate the effect of disinhibition. CONCLUSIONS: Appetite disinhibition is most likely to be a defining characteristic of genetic susceptibility to obesity. High levels of appetite disinhibition, rather than hunger, may underlie genetic vulnerability to obesogenic environments in two-thirds of the population of European ancestry
Preparation and CO2 adsorption of amine modified Mg-Al LDH via exfoliation route
In response to the recent focus on reducing carbon dioxide emission, the preparation and characterization of organically functionalized materials for use in carbon capture have received considerable attention. In this paper the synthesis of amine modified layered double hydroxides (LDHs) via an exfoliation and grafting synthetic route is reported. The materials were characterized by elemental analysis (EA), powder x-ray diffraction (PXRD), diffuse reflectance infrared Fourier transform spectrometer (DRIFTS) and thermogravimetric analysis (TGA). Adsorption of carbon dioxide on modified layered double hydroxides was investigated by TGA at 25â80 °C. 3-[2-(2-Aminoethylamino) ethylamino]propyl-trimethoxysilane modified MgAl LDH showed a maximum CO2 adsorption capacity of 1.76 mmol gâ1 at 80 °C. The influence of primary and secondary amines on carbon dioxide adsorption is discussed. The carbon dioxide adsorption isotherms presented were closely fitted to the Avrami kinetic model
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