International meta-analysis of 684,660 men with vasectomies: a study utilising the International Population Data Linkage Network

Introduction Evidence on the effect of vasectomy and vasectomy reversal on risk of prostate cancer is conflicting, with the issue of detection bias a key criticism. In this study we examined the effect of vasectomy reversal on prostate cancer risk in a cohort of vasectomised men. Objectives and Approach A proof of concept study involving the International Population Data Linkage Network which pooled aggregated result data from participating centres in Australia, Canada and the United Kingdom. De-identified linked data extractions took place at each centre. Each participating centre locally conducted Cox proportional hazards regression analysis compared the risk of prostate cancer in those with/without vasectomy reversal in a cohort of vasectomised men. These results were then combined in a meta-analysis. Evidence of a protective effect of vasectomy reversal would suggest the harmful effect of vasectomy on prostate cancer risk, while nullifying detection bias. Results Data were received from Australia (the states of Western Australia and New South Wales), Canada (the province of Ontario), Wales and Scotland. In total, there were 9,754 men with vasectomy reversals, and 684,660 men with a vasectomy. The combined analysis showed no protective effect of vasectomy reversal on incidence of prostate cancer when compared to those who had vasectomy alone (HR, 95%CI: 0.92, 0.70-1.21). As such, the results align with previous studies which found little or no evidence of a link between vasectomy and prostate cancer. Conclusion/Implications The study, originally conceived at the first IPDLN meeting in London, found no obvious protective effect of vasectomy reversal on prostate cancer in vasectomised men. The project demonstrated the utility and feasibility of collaborative studies fostered through the IPDLN, despite methodological challenges faced when aggregating international data

Breath, urine, and blood measurements as biological exposure indices of short-term inhalation exposure to methanol

Due to their transient nature, short-term exposures can be difficult to detect and quantify using conventional monitoring techniques. Biological monitoring may be capable of registering such exposures and may also be used to estimate important toxicological parameters. This paper investigates relationships between methanol concentrations in the blood, urine, and breath of volunteers exposed to methanol vapor at 800 ppm for periods of 0.5, 1, 2, and 8 h. The results indicate factors that must be considered for interpretation of the results of biological monitoring. For methanol, concentrations are not proportional to the exposure duration due to metabolic and other elimination processes that occur concurrently with the exposure. First-order clearance models can be used with blood, breath, or urine concentrations to estimate exposures if the time that has elapsed since the exposure and the model parameters are known. The 0.5 to 2-h periods of exposure were used to estimate the half-life of methanol. Blood data gave a half-life of 1.44±0.33 h. Comparable but slightly more variable results were obtained using urine data corrected for voiding time (1.55±0.67 h) and breath data corrected for mucous membrane desorption (1.40±0.38 h). Methanol concentrations in blood lagged some 15–30 min behind the termination of exposure, and concentrations in urine were further delayed. Although breath sampling may be convenient, breath concentrations reflect end-expired or alveolar air only if subjects are in a methanol-free environment for 30 min or more after the exposure. At earlier times, breath concentrations included contributions from airway desorption or diffusion processes. As based on multicompartmental models, the desorption processes have half-lives ranging between 0.6 and 5 min. Preliminary estimates of the mucous membrane reservoir indicate contributions of under 10% for a 0.5-h exposure and smaller effects for longer periods of exposure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42238/1/420-71-5-325_80710325.pd

Controlled density-downramp injection in a beam-driven plasma wakefield accelerator

This paper describes the utilization of beam-driven plasma wakefield acceleration to implement a high-quality plasma cathode via density-downramp injection in a short injector stage at the FLASHForward facility at DESY. Electron beams with charge of up to 105 pC and energy spread of a few percent were accelerated by a tunable effective accelerating field of up to 2.7 GV/m. The plasma cathode was operated drift-free with very high injection efficiency. Sources of jitter, the emittance and divergence of the resulting beam were investigated and modeled, as were strategies for performance improvements that would further increase the wide-ranging applications for a plasma cathode with the demonstrated operational stabilityComment: 11 pages, 9 figure

A survey for variable young stars with small telescopes: II - mapping a protoplanetary disc with stable structures at 0.15 au

The HOYS citizen science project conducts long term, multifilter, high cadence monitoring of large YSO samples with a wide variety of professional and amateur telescopes. We present the analysis of the light curve of V1490 Cyg in the Pelican Nebula. We show that colour terms in the diverse photometric data can be calibrated out to achieve a median photometric accuracy of 0.02 mag in broadband filters, allowing detailed investigations into a variety of variability amplitudes over timescales from hours to several years. Using Gaia DR2 we estimate the distance to the Pelican Nebula to be 870 +70 −55 pc. V1490 Cyg is a quasi-periodic dipper with a period of 31.447 ± 0.011 d. The obscuring dust has homogeneous properties, and grains larger than those typical in the ISM. Larger variability on short timescales is observed in U and Rc−Hα, with U-amplitudes reaching 3 mag on timescales of hours, indicating the source is accreting. The Hα equivalent width and NIR/MIR colours place V1490 Cyg between CTTS/WTTS and transition disk objects. The material responsible for the dipping is located in a warped inner disk, about 0.15 AU from the star. This mass reservoir can be filled and emptied on time scales shorter than the period at a rate of up to 10−10 M�/yr, consistent with low levels of accretion in other T Tauri stars. Most likely the warp at this separation from the star is induced by a protoplanet in the inner accretion disk. However, we cannot fully rule out the possibility of an AA Tau-like warp, or occultations by the Hill sphere around a forming planet

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Property-liability insurance pricing models : an empirical evaluation

Includes bibliographical references (p. 44-46)

High resolution and rapid MRI

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