Cytomegalovirus infection and disease reduce 10-year cardiac allograft vasculopathy-free survival in heart transplant recipients.

BACKGROUND Cytomegalovirus (CMV) is associated with an increased risk of cardiac allograft vasculopathy (CAV), the major limiting factor for long-term survival after heart transplantation (HTx). The purpose of this study was to evaluate the impact of CMV infection during long-term follow-up after HTx. METHODS A retrospective, single-centre study analyzed 226 HTx recipients (mean age 45 ± 13 years, 78 % men) who underwent transplantation between January 1988 and December 2000. The incidence and risk factors for CMV infection during the first year after transplantation were studied. Risk factors for CAV were included in an analyses of CAV-free survival within 10 years post-transplant. The effect of CMV infection on the grade of CAV was analyzed. RESULTS Survival to 10 years post-transplant was higher in patients with no CMV infection (69 %) compared with patients with CMV disease (55 %; p = 0.018) or asymptomatic CMV infection (54 %; p = 0.053). CAV-free survival time was higher in patients with no CMV infection (6.7 years; 95 % CI, 6.0-7.4) compared with CMV disease (4.2 years; CI, 3.2-5.2; p < 0.001) or asymptomatic CMV infection (5.4 years; CI, 4.3-6.4; p = 0.013). In univariate analysis, recipient age, donor age, coronary artery disease (CAD), asymptomatic CMV infection and CMV disease were significantly associated with CAV-free survival. In multivariate regression analysis, CMV disease, asymptomatic CMV infection, CAD and donor age remained independent predictors of CAV-free survival at 10 years post-transplant. CONCLUSIONS CAV-free survival was significantly reduced in patients with CMV disease and asymptomatic CMV infection compared to patients without CMV infection. These findings highlight the importance of close monitoring of CMV viral load and appropriate therapeutic strategies for preventing asymptomatic CMV infection

Evaluation of energy and dietary intake estimates from a food frequency questionnaire using independent energy expenditure measurement and weighed food records

<p>Abstract</p> <p>Background</p> <p>We have developed a food frequency questionnaire (FFQ) for the assessment of habitual diet, with special focus on the intake of fruit, vegetables and other antioxidant-rich foods and beverages. The aim of the present study was to evaluate the relative validity of the intakes of energy, food and nutrients from the FFQ.</p> <p>Methods</p> <p>Energy intake was evaluated against independent measures of energy expenditure using the ActiReg^®system (motion detection), whereas 7-days weighed food records were used to study the relative validity of food and nutrient intake. The relationship between methods was investigated using correlation analyses and cross-classification of participants. The visual agreement between the methods was evaluated using Bland-Altman plots.</p> <p>Results</p> <p>We observed that the FFQ underestimated the energy intake by approximately 11% compared to the energy expenditure measured by the ActiReg^®. The correlation coefficient between energy intake and energy expenditure was 0.54 and 32% of the participants were defined as under-reporters. Compared to the weighed food records the percentages of energy from fat and added sugar from the FFQ were underestimated, whereas the percentage of energy from total carbohydrates and protein were slightly overestimated. The intake of foods rich in antioxidants did not vary significantly between the FFQ and weighed food records, with the exceptions of berries, coffee, tea and vegetables which were overestimated. Spearman's Rank Order Correlations between FFQ and weighed food records were 0.41 for berries, 0.58 for chocolate, 0.78 for coffee, 0.61 for fruit, 0.57 for fruit and berry juices, 0.40 for nuts, 0.74 for tea, 0.38 for vegetables and 0.70 for the intake of wine.</p> <p>Conclusions</p> <p>Our new FFQ provides a good estimate of the average energy intake and it obtains valid data on average intake of most antioxidant-rich foods and beverages. Our study also showed that the FFQs ability to rank participants according to intake of total antioxidants and most of the antioxidant-rich foods was good.</p

The role of natural science collections in the biomonitoring of environmental contaminants in apex predators in support of the EU's zero pollution ambition

The chemical industry is the leading sector in the EU in terms of added value. However, contaminants pose a major threat and significant costs to the environment and human health. While EU legislation and international conventions aim to reduce this threat, regulators struggle to assess and manage chemical risks, given the vast number of substances involved and the lack of data on exposure and hazards. The European Green Deal sets a 'zero pollution ambition for a toxic free environment' by 2050 and the EU Chemicals Strategy calls for increased monitoring of chemicals in the environment. Monitoring of contaminants in biota can, inter alia: provide regulators with early warning of bioaccumulation problems with chemicals of emerging concern; trigger risk assessment of persistent, bioaccumulative and toxic substances; enable risk assessment of chemical mixtures in biota; enable risk assessment of mixtures; and enable assessment of the effectiveness of risk management measures and of chemicals regulations overall. A number of these purposes are to be addressed under the recently launched European Partnership for Risk Assessment of Chemicals (PARC). Apex predators are of particular value to biomonitoring. Securing sufficient data at European scale implies large-scale, long-term monitoring and a steady supply of large numbers of fresh apex predator tissue samples from across Europe. Natural science collections are very well-placed to supply these. Pan-European monitoring requires effective coordination among field organisations, collections and analytical laboratories for the flow of required specimens, processing and storage of specimens and tissue samples, contaminant analyses delivering pan-European data sets, and provision of specimen and population contextual data. Collections are well-placed to coordinate this. The COST Action European Raptor Biomonitoring Facility provides a well-developed model showing how this can work, integrating a European Raptor Biomonitoring Scheme, Specimen Bank and Sampling Programme. Simultaneously, the EU-funded LIFE APEX has demonstrated a range of regulatory applications using cutting-edge analytical techniques. PARC plans to make best use of such sampling and biomonitoring programmes. Collections are poised to play a critical role in supporting PARC objectives and thereby contribute to delivery of the EU's zero-pollution ambition.Non peer reviewe

Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to investigate the temporal relationship between autonomic changes and pain activation in migraine and tension-type headache induced by stress in a model relevant for everyday office-work.</p> <p>Methods</p> <p>We measured pain, blood pressure (BP), heart rate (HR) and skin blood flow (BF) during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free periods, 18 patients with tension-type headache (TTH) and 44 healthy controls. The stress lasted for one hour and was followed by 30 minutes of relaxation.</p> <p>Results</p> <p>Cardiovascular responses to cognitive stress in migraine did not differ from those in control subjects. In TTH patients HR was maintained during stress, whereas it decreased for migraineurs and controls. A trend towards a delayed systolic BP response during stress was also observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was associated with less vasoconstriction in TTH during recovery.</p> <p>Conclusion</p> <p>It is hypothesized that TTH patients have different stress adaptive mechanisms than controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control system inhibition.</p

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

An outline for a validation database for SAMGODS

En ny svensk nationell godstransportmodell, SAMGODS, har utvecklats i ett samarbete mellan svenska transportmyndigheter. Under senare tid, då detta system har börjat komma till användning i utredningar, har behovet av en valideringsdatabas vuxit sig allt starkare. Syftet med en sådan databas är att samla alla typer av data som kan användas för validering av modellen samt att underlätta själva valideringsprocessen, det vill säga jämförandet mellan utdata från SAMGODS och (oberoende) externa data. Detta notat presenterar en förstudie för, och ett första steg mot, skapandet av en valideringsdatabas för SAMGODS-systemet. Förstudien fokuserar på två delar; dels vilka datakällor som kan finnas tillgängliga för valideringen, dels hur man kan utforma verktyg som kan användas för att smidigt och enkelt genomföra den. Den senare delen är väsentlig eftersom där föreligger en lång rad praktiska svårigheter vid matchningen mellan SAMGODS-utdata och valideringsdata, vilka riskerar göra valideringsarbetet både tidskrävande och omständligt. Bland sådana svårigheter kan nämnas: den inhomogena strukturen på datatabellerna, de ofta olika avgränsningarna och aggregeringsnivåerna mellan modelldata och valideringsdata, de ibland även skilda tidsperioderna och skilda systemen för varugruppsindelningar samt att elasticiteter inte omedelbart erhålls från SAMGODS-utdata och som dessutom inte alltid är överförbara mellan olika länder/regioner. Ytterligare problem utgör hanteringen av konfidentiella data samt de stora datamängderna. I notatet läggs ett relativt detaljerat förslag fram över hur en valideringsdatabas för SAMGODS kan utformas. Designen av databasen är dock inte begränsad till SAMGODS utan är förhoppningsvis tillräckligt flexibel för att kunna tillämpas även på andra godsmodeller såsom regionala och lokala. En grundläggande idé är att använda ett enhetligt men flexibelt tabellformat för alla relevanta data.A new Swedish national goods transportation model, SAMGODS, has been developed through collaboration among Swedish transport authorities. As the model recently has begun to be applied to real world problems, the need for a validation database has increased. The purpose of such a database is to facilitate validations of the model. The current paper presents a pilot study to create a validation database for SAMGODS. The study focuses on two areas: available data sources that may provide validation data, and how to carry out the validation in practice. The latter is of particular importance since a large number of practical problems arise when matching SAMGODS output data with the validation data. Worth mentioning among the problems that arise are: the inhomogeneous structure of the data tables, the often differing aggregation levels between model output data and validation data, differing time periods, differing systems for commodity groups and elasticities not being immediately available from the SAMGODS data. Other complicating issues are handling of confidential data and the large quantities of data. In this report, a relatively detailed proposal for the design of a validation database is put forward. However, the proposed design is not limited to SAMGODS output data, but it is hoped to be sufficiently flexible to comprise also other goods transportation data from future regional or local models. One of the main ideas in designing the database has been to develop a uniform and flexible data table format in which all relevant data can be stored. This format greatly facilitates the matching between SAMGODS output data and the validation data. Other problems and associated possible solutions are thoroughly discussed

Wedge insole as treatment method for knee osteoarthritis compared with natural insole, a systematic review

Bakgrund: Många individer oftast äldre drabbas av gonartros, denna diagnos kan orsaka smärta och nedsatt funktion vilket i sin tur kan leda till begränsningar i det dagliga livet. Detta är en systematisk litteraturöversikt över studier som har undersökt laterala kil-inlägg som behandlingsmetod för att minska smärta och förbättra funktion hos patienter med medial gonartros. Syfte: Att studera om laterala kil-inlägg leder till reducerad smärta och främjad funktion jämfört med neutrala inlägg. Vidare utreds också om resultatet är baserat på olika undergrupper. Metod: En systematisk sökning i databaserna PubMed, MEDLINE, AMED, CINAHL och Cochrane Library utfördes för att hitta relevanta studier som sedan inkluderades utifrån förutbestämda kriterier. Data analyserades utifrån dessa artiklar för att besvara frågeställningen i detta arbete. Artiklarnas evidens och validitet/reliabilitet har bedömts. Resultat: Resultaten visar att laterala kilinlägg inte ger reducerad smärta och främjad funktion. Det finns heller inga samband kopplat till undergrupperna som studeras i denna systematiska översikt. Slussats: Det finns i denna rapport blandat med bevis för huruvida laterala kilinlägg reducerar smärta och främjar funktion. Även om ett antal studier påvisar positiva effekter är detta inte tillräckligt för att på ett statistiskt signifikant sätt säga att det hjälper. Det går inte att säga om behandlingen är mer lämpad för någon specifik undergrupp.Background: Many individuals often the elderly suffering of gonatros, this diagnosis can cause pain and impaired function which in turn can lead to limitations in daily living. This is a systematic review of studies that have investigated lateral wedged insoles as a treatment to reduce pain and improve function in patients with medial gonartros. Aim: To study whether lateral wedge insoles lead to reduced pain and improved function compared with neutral insoles. Furthermore, it is also investigated if the result is based on different sub-groups. Method: A systematic search in the databases PubMed, MEDLINE, AMED, CINAHL and Cochrane Library was performed to find relevant studies which then were included based of predetermined criteria. Data from these articles where analysed to answer our question in this paper. The articles were examined for risk of bias and validity/reliability. Results: The results show that lateral wedge insoles do not reduce pain and improve function. There are also no signs that a certain sub-group would be more suited for the treatment. Conclusion: There is in this paper a contradictory result of whether lateral wedge insoles reduce pain and improve function. Although several studies indicate positive effects it is not enough to prove in a statistically significant way that it helps. It is not possible to say whether the treatment is more suitable for any specific subgroup

Maritime traffic calling at Swedish ports 2007 to 2019 : changes in volume, structure and movement patterns

Det har länge funnits en outnyttjad potential i möjligheten att via positioneringsdata för fartyg kunna studera sjöfart mot svensk hamn ur ett bredare perspektiv, med beaktande av att sjöfartsnäringen agerar mot en större marknad än den svenska och planerar för godstransporter i hela Östersjöområdet. I detta projekt undersöks därför möjligheten att kunna utnyttja den information om fartygsrörelser som samlas in via det automatiska identifikationssystemet (AIS) och hur denna information kan komplettera den som finns tillgänglig via den officiella statistiken över sjötrafik mot svensk hamn.  Med hjälp av AIS går det att sammanställa hur enskilda fartyg rör sig i Östersjön, Kattegatt och östra delarna av Skagerack genom att varje fartyg lämnar en geografisk positionering ungefär var tionde sekund. För att kunna använda denna information krävs någon form av metod för att hantera den datamängd som genereras. I detta projekt har en metod utvecklats som översiktligt består av två steg. I ett första steg begränsas datamängden i AIS genom att endast datapunkter när fartyg passerar in till och ut från hamnar sparas. För varje passage in till respektive ut från hamn finns därmed ett datum och en tidpunkt. I ett andra steg sekvenseras anlöpen för varje givet fartyg i kronologisk ordning så att dess rörelsemönster mellan hamnarna i hela Östersjöområdet kan följas. Slutligen kan dessa datapunkter matchas mot den datuminformation som finns för fartygsanlöp i den officiella statistiken. Denna matchning gör att den databas som skapas kan tillföras information om lastad och lossad godsvikt vid anlöpen i de svenska hamnarna. Med hjälp av den databas som skapats har utvecklingen av den del av sjöfarten som arbetar mot svensk hamn studerats för perioden 2007 till 2018.Using ship positional data to study maritime traffic calling at Swedish ports from has long been an underutilized potential. In this project, the possibilities of using information from the automatic identification system (AIS) are investigated, including how this information can be used to complement the official statistics covering maritime traffic calling at Swedish ports.  Using AIS, it is possible to track and compile the movements of individual vessels in the Baltic Sea, Kattegatt and the eastern parts of Skagerack through the geographic positioning signals sent by ships approximately every ten seconds. In order to use this information, some sort of method is needed to handle the generated amounts of data. In this project, a method has been developed which can be briefly described as consisting of two steps. In the first step, the amount of AIS data is limited by filtering out the datapoints wherein ships pass in and out of ports. For every passage in and out of a port there is a corresponding date and time. In the second step, the port calls are sequenced chronologically so that a vessel’s pattern of movement through the Baltic Sea area can be tracked. Finally, these datapoints can be matched against the information regarding dates, which is available in the official statistics. This matching process allows the resulting database of voyages and port calls to be complemented with loaded and unloaded cargo volumes in Swedish ports. Using the created database, the development of maritime traffic calling at Swedish ports can be studied during the period 2007 to 2018

Maritime traffic calling at Swedish ports 2007 to 2019 : changes in volume, structure and movement patterns

Det har länge funnits en outnyttjad potential i möjligheten att via positioneringsdata för fartyg kunna studera sjöfart mot svensk hamn ur ett bredare perspektiv, med beaktande av att sjöfartsnäringen agerar mot en större marknad än den svenska och planerar för godstransporter i hela Östersjöområdet. I detta projekt undersöks därför möjligheten att kunna utnyttja den information om fartygsrörelser som samlas in via det automatiska identifikationssystemet (AIS) och hur denna information kan komplettera den som finns tillgänglig via den officiella statistiken över sjötrafik mot svensk hamn.  Med hjälp av AIS går det att sammanställa hur enskilda fartyg rör sig i Östersjön, Kattegatt och östra delarna av Skagerack genom att varje fartyg lämnar en geografisk positionering ungefär var tionde sekund. För att kunna använda denna information krävs någon form av metod för att hantera den datamängd som genereras. I detta projekt har en metod utvecklats som översiktligt består av två steg. I ett första steg begränsas datamängden i AIS genom att endast datapunkter när fartyg passerar in till och ut från hamnar sparas. För varje passage in till respektive ut från hamn finns därmed ett datum och en tidpunkt. I ett andra steg sekvenseras anlöpen för varje givet fartyg i kronologisk ordning så att dess rörelsemönster mellan hamnarna i hela Östersjöområdet kan följas. Slutligen kan dessa datapunkter matchas mot den datuminformation som finns för fartygsanlöp i den officiella statistiken. Denna matchning gör att den databas som skapas kan tillföras information om lastad och lossad godsvikt vid anlöpen i de svenska hamnarna. Med hjälp av den databas som skapats har utvecklingen av den del av sjöfarten som arbetar mot svensk hamn studerats för perioden 2007 till 2018.Using ship positional data to study maritime traffic calling at Swedish ports from has long been an underutilized potential. In this project, the possibilities of using information from the automatic identification system (AIS) are investigated, including how this information can be used to complement the official statistics covering maritime traffic calling at Swedish ports.  Using AIS, it is possible to track and compile the movements of individual vessels in the Baltic Sea, Kattegatt and the eastern parts of Skagerack through the geographic positioning signals sent by ships approximately every ten seconds. In order to use this information, some sort of method is needed to handle the generated amounts of data. In this project, a method has been developed which can be briefly described as consisting of two steps. In the first step, the amount of AIS data is limited by filtering out the datapoints wherein ships pass in and out of ports. For every passage in and out of a port there is a corresponding date and time. In the second step, the port calls are sequenced chronologically so that a vessel’s pattern of movement through the Baltic Sea area can be tracked. Finally, these datapoints can be matched against the information regarding dates, which is available in the official statistics. This matching process allows the resulting database of voyages and port calls to be complemented with loaded and unloaded cargo volumes in Swedish ports. Using the created database, the development of maritime traffic calling at Swedish ports can be studied during the period 2007 to 2018