Population assessment of future trajectories in coronary heart disease mortality.

Background: Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends. Methods and findings: The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25–74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: 1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. 2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040. Conclusions: The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future

On the Need for Phenomenological Theory of P-Vortices or Does Spaghetti Confinement Pattern Admit Condensed-Matter Analogies?

Usually the intuition from condensed-matter physics is used to provide ideas for possible confinement mechanisms in gauge theories. Today, with a clear but puzzling ``spaghetti'' confinement pattern, arising after a decade of lattice computer experiments, which implies formation of a fluctuating net of peculiar magnetic vortices rather than condensation of the homogeneously distributed magnetic monopoles, the time is coming to reverse the logic and search for similar patterns in condensed matter systems. The main thing to look for in a condensed matter setup is the simultaneous existence of narrow tubes ($P$-vortices or 1-branes) of direction-changing electric field and broader tubes (Abrikosov lines) of magnetic field, a pattern dual to the one, presumably underlying confinement in gluodynamics. As a possible place for this search we suggest systems with coexisting charge-density waves and superconductivity.Comment: 20 pages, 7 figures; to be published in ZhET

Modelling Future Coronary Heart Disease Mortality to 2030 in the British Isles.

OBJECTIVE: Despite rapid declines over the last two decades, coronary heart disease (CHD) mortality rates in the British Isles are still amongst the highest in Europe. This study uses a modelling approach to compare the potential impact of future risk factor scenarios relating to smoking and physical activity levels, dietary salt and saturated fat intakes on future CHD mortality in three countries: Northern Ireland (NI), Republic of Ireland (RoI) and Scotland. METHODS: CHD mortality models previously developed and validated in each country were extended to predict potential reductions in CHD mortality from 2010 (baseline year) to 2030. Risk factor trends data from recent surveys at baseline were used to model alternative future risk factor scenarios: Absolute decreases in (i) smoking prevalence and (ii) physical inactivity rates of up to 15% by 2030; relative decreases in (iii) dietary salt intake of up to 30% by 2030 and (iv) dietary saturated fat of up to 6% by 2030. Probabilistic sensitivity analyses were then conducted. RESULTS: Projected populations in 2030 were 1.3, 3.4 and 3.9 million in NI, RoI and Scotland respectively (adults aged 25-84). In 2030: assuming recent declining mortality trends continue: 15% absolute reductions in smoking could decrease CHD deaths by 5.8-7.2%. 15% absolute reductions in physical inactivity levels could decrease CHD deaths by 3.1-3.6%. Relative reductions in salt intake of 30% could decrease CHD deaths by 5.2-5.6% and a 6% reduction in saturated fat intake might decrease CHD deaths by some 7.8-9.0%. These projections remained stable under a wide range of sensitivity analyses. CONCLUSIONS: Feasible reductions in four cardiovascular risk factors (already achieved elsewhere) could substantially reduce future coronary deaths. More aggressive polices are therefore needed in the British Isles to control tobacco, promote healthy food and increase physical activity

Systematic conservation planning for Antarctic research stations

The small ice-free areas of Antarctica are essential locations for both biodiversity and scientific research but are subject to considerable and expanding human impacts, resulting primarily from station-based research and support activities, and local tourism. Awareness by operators of the need to conserve natural values in and around station and visitor site footprints exists, but the cumulative nature of impacts often results in reactive rather than proactive management. With human activity spread across many isolated pockets of ice-free ground, the pathway to the greatest reduction of human impacts within this natural reserve is through better management of these areas, which are impacted the most. Using a case study of Australia's Casey Station, we found significant natural values persist within the immediate proximity (<10 m) of long-term station infrastructure, but encroachment by physical disturbance results in ongoing pressures. Active planning to better conserve such values would provide a direct opportunity to enhance protection of Antarctica's environment. Here we introduce an approach to systematic conservation planning, tailored to Antarctic research stations, to help managers improve the conservation of values surrounding their activity locations. Use of this approach provides a potential mechanism to balance the need for scientific access to the continent with international obligations to protect its environment. It may also facilitate the development of subordinate conservation tools, including management plans and natural capital accounting. By proactively minimising and containing their station footprints, national programs can also independently demonstrate their commitment to protecting Antarctica's environment

Predictors of Response to Steroid Therapy for Eosinophilic Esophagitis and Treatment of Steroid-Refractory Patients

Eosinophilic esophagitis (EoE) is commonly treated with swallowed (topical) corticosteroids (tCS). However, few factors have been described that predict outcomes of steroid therapy. We aimed to identify factors associated with non-response to tCS and report outcomes of second-line treatment for patients with steroid-refractory EoE

Conserving Conflict? Transfrontier Conservation, Development Discourses and Local Conflict Between South Africa and Lesotho

This paper describes and analyses how discourses of conservation and development as well as migrant labour practices can be understood as transnational dynamics that both cement and complicate transnational relations. It also looks into how these dynamics articulate with, shape and are being shaped by ‘the local’. Focusing on the north-eastern boundary of Lesotho in the area of the ‘Maloti-Drakensberg transfrontier conservation and development project’, we show how conflictual situations put the ethnographic spotlight on the ways in which ‘local people’ in Lesotho deal with dual forces of localisation and transnationalisation. We argue that they accommodate, even appropriate, these dual pressures by adopting an increasingly flexible stance in terms of identity, alliances, livelihood options and discourses

Cytomegaloviral determinants of CD8+ T cell programming and RhCMV/SIV vaccine efficacy

Simian immunodeficiency virus (SIV) insert-expressing, 68–1 Rhesus Cytomegalovirus (RhCMV/SIV) vectors elicit major histocompatibility complex (MHC)-E- and -II-restricted, SIV-specific CD8(+) T cell responses, but the basis of these unconventional responses and their contribution to demonstrated vaccine efficacy against SIV challenge in the rhesus monkeys (RMs) has not been characterized. We show that these unconventional responses resulted from a chance genetic rearrangement in 68–1 RhCMV that abrogated the function of eight distinct immunomodulatory gene products encoded in two RhCMV genomic regions (Rh157.5/Rh157.4 and Rh158–161), revealing three patterns of unconventional response inhibition. Differential repair of these genes with either RhCMV-derived or orthologous human CMV (HCMV)-derived sequences (UL128/UL130; UL146/UL147) leads to either of two distinct CD8(+) T cell response types – MHC-Ia-restricted-only, or a mix of MHC-II- and MHC-Ia-restricted CD8(+) T cells. Response magnitude and functional differentiation are similar to RhCMV 68–1, but neither alternative response type mediated protection against SIV challenge. These findings implicate MHC-E-restricted CD8(+) T cell responses as mediators of anti-SIV efficacy and indicate that translation of RhCMV/SIV vector efficacy to humans will likely require deletion of all genes that inhibit these responses from the HCMV/HIV vector

Are sciences essential and humanities elective? Disentangling competing claims for humanities research public value

[EN] Recent policy discourse suggests that arts and humanities research is seen as being less useful to society than other disciplines, notably in science, technology, engineering and mathematics. The paper explores how this assumption s construction has been built and whether it is based upon an unfair prejudice: we argue for a prima facie case to answer in assuming that arts and humanities research s lower societal value. We identify a set of claims circulating in policy circles regarding science, technology, engineering and math- ematics research and arts and humanities research s differences. We find two groups: arts and humanities research is less useful than science, technology, engineering and mathematics, and arts and humanities research is merely differently useful. We argue that empirical analysis is necessary to disentangle which ones are true to assess whether policy-making is being based on rational and evidence-based claims. We argue that debates about public research value should recognise that humanities have different (but equally valid) kinds of societal value.This work was supported by the Spanish Ministry of Education, which funded the PhD research fellowship of Julia Olmos Peñuela through the F.P.U program [AP2007- 01850]. The research fellowship took place in the framework of the HERAVALUE project, Measuring the public value of arts and humanities research, financially supported by the HERA Joint Research Programme, cofunded by AHRC, AKA, DASTI, ETF, FNR, FWF, HAZU, IRCHSS, MHEST, NWO, RANNIS, RCN, VR and The European Community FP7 2007-2013, under the Socio-economic Sciences and Humanities programme. The authors would like to thank the editors and two anonymous referees for their invaluable comments. Any errors or omissions remain the authors’ responsibilitieOlmos-Peñuela, J.; Benneworth, P.; Castro-Martínez, E. (2015). Are sciences essential and humanities elective? Disentangling competing claims for humanities research public value. Arts and Humanities in Higher Education. 14(1):61-78. https://doi.org/10.1177/1474022214534081S617814

Changes in Dietary Fat Intake and Projections for Coronary Heart Disease Mortality in Sweden: A Simulation Study.

OBJECTIVE: In Sweden, previous favourable trends in blood cholesterol levels have recently levelled off or even increased in some age groups since 2003, potentially reflecting changing fashions and attitudes towards dietary saturated fatty acids (SFA). We aimed to examine the potential effect of different SFA intake on future coronary heart disease (CHD) mortality in 2025. METHODS: We compared the effect on future CHD mortality of two different scenarios for fat intake a) daily SFA intake decreasing to 10 energy percent (E%), and b) daily SFA intake rising to 20 E%. We assumed that there would be moderate improvements in smoking (5%), salt intake (1g/day) and physical inactivity (5% decrease) to continue recent, positive trends. RESULTS: In the baseline scenario which assumed that recent mortality declines continue, approximately 5,975 CHD deaths might occur in year 2025. Anticipated improvements in smoking, dietary salt intake and physical activity, would result in some 380 (-6.4%) fewer deaths (235 in men and 145 in women). In combination with a mean SFA daily intake of 10 E%, a total of 810 (-14%) fewer deaths would occur in 2025 (535 in men and 275 in women). If the overall consumption of SFA rose to 20 E%, the expected mortality decline would be wiped out and approximately 20 (0.3%) additional deaths might occur. CONCLUSION: CHD mortality may increase as a result of unfavourable trends in diets rich in saturated fats resulting in increases in blood cholesterol levels. These could cancel out the favourable trends in salt intake, smoking and physical activity