45 research outputs found

    Repositioning of the global epicentre of non-optimal cholesterol

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    High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

    The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study

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    Abstract Background Low socioeconomic status (SES) is persistently associated with poor health and suboptimal use of healthcare services, and more unplanned healthcare use. Suboptimal use of emergency and acute healthcare services may increase health inequalities, due to late diagnosis or lack of continuity of care. Given that health literacy has been associated with healthcare utilisation and with education attainment, we sought to explore whether health literacy is related to the use of out-of-hours (OOH) Primary Care Services (PCSs). Additionally, we aimed to study whether and to what extent health literacy accounts for some of the association between education and OOH PSC use. Methods A survey including measures of education attainment, health literacy (assessed by means of the Dutch version of the nine-dimension Health Literacy Questionnaire) and use of PCS was conducted among a sample of adults diagnosed with (any) somatic chronic condition in the Netherlands (response 76.3%, n = 1811). We conducted linear and logistic regression analyses to examine associations between education level and PCS use in the past year. We performed mediation analyses to assess whether the association between education and PCS use was (partly) explained by different aspects of health literacy. We adjusted the models for patient characteristics such as age and morbidity. Results Higher education attainment was associated with higher scores on the health literacy aspects Appraisal of health information, and Navigating the healthcare system. Additionally, appraisal and navigating the healthcare system partially accounted for educational differences in PCS use. Finally, higher appraisal of health information scores were associated with higher PCS utilisation. Conclusion Several aspects of health literacy were demonstrated to relate to PCS use, and partly accounted for educational differences herein. Accordingly, developing health literacy within individuals or communities may help to reduce inappropriate PCS use among people with low education

    Pyrolyse rapide de biomasses et de leurs constituants. Application à l'établissement de lois prévisionnelles

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    La pyrolyse rapide de différents types de celluloses, lignines, xylanes ainsi que de mélanges synthétiques obtenus à partir de ces composés modèles et aussi de deux biomasses réelles (bois de bouleau et paille de blé), est étudiée dans un four à image. Les vitesses de perte de masse pour les composés modèles étudiés sont très différentes, de manière générale la plus grande vitesse de perte de masse est observée pour la cellulose, suivie du xylane et de la lignine. La lignine se distingue par un temps de début de réaction plus petit que celui observé pour le xylane et la cellulose. Pour un temps donné, le rendement en charbon est plus grand pour la lignine que pour le xylane. La formation de charbon à partir de la cellulose est marginale. La cellulose microgranulaire produit en majorité des vapeurs et très peu de gaz. La cellulose extraite du bois de bouleau montre un comportement intermédiaire entre le comportement de la cellulose microgranulaire et les lignines. Le xylane se distingue par une vitesse de formation de gaz supérieure à celles des vapeurs. Les mélanges synthétiques à partir des trois composés modèles montrent un comportement intermédiaire. Le bois de bouleau est plus réactif que la paille de blé et son comportement peut être comparé à celui de la cellulose extraite du bois de bouleau en ce qui concerne les vitesses de perte de masse et de formation de vapeurs. Une corrélation simple se basant sur l addition pondérée des vitesses de formation des produits est établie et les résultats obtenus sont comparés aux résultats expérimentaux. Il s avère que les inorganiques jouent un rôle important lors de la pyrolyse : le comportement de la paille de blé, une biomasse riche en inorganiques, ne peut pas être décrit par de telles corrélations. Des écarts moins significatifs entre les valeurs obtenues par les corrélations théoriques et celles provenant des résultats expérimentaux sont observés pour les mélanges synthétiques et le bois de bouleau. En conclusion, l hypothèse d une corrélation simple, appelée loi prévisionnelle, ne semble pas être justifiée sur les vitesses de formation de produits. Un modèle est alors développé qui permet de décrire le comportement pyrolytique à l aide de courbes non linéaires pour la perte de masse et la production des produits. A l exception de la paille de blé, de nouvelles lois prévisionnelles additives peuvent alors être déterminées de manière très satisfaisante au regard de la précision des mesures expérimentalesThe fast pyrolysis of different types of celluloses, lignins, xylanes as well as different mixtures of these basic compounds and two real biomasses (birch wood and wheat straw) has been studied in an image furnace. The mass loss rates of each of the studied model compounds are very different, but usually higher for cellulose than xylane and higher for xylane than lignins. Lignins begin to react before xylane and cellulose. For a given pyrolysis time, lignins produce more char than xylane. Char formation from cellulose remains insignificant, close to zero. Microgranular cellulose gives mainly rise to vapours and very little gas is formed. Cellulose extracted from birch wood shows an intermediate behaviour between microgranular cellulose and lignins. Production rates of gases are higher than those of vapours for xylan. Regarding the mixtures of these three compounds, an intermediate behaviour can be observed. Birch wood is more reactive than wheat straw. Its pyrolytic behaviour is similar with that of cellulose extracted from birch wood with regard to concerning mass loss rates and vapours formation. A simple additive correlation relying on mass loss rates and products formations rates is elaborated and the results compared to the experimental values. It appears that inorganics play an important role in biomass pyrolysis : the pyrolytic behaviour of wheat straw, a biomass which is rich in inorganics, cannot be described by simple additive correlations. Less significant gaps between expected rates obtained by the correlations and the observed rates obtained by the experiments are found for synthetic mixtures and birch wood. In conclusion, the hypothesis of linear correlations cannot be supported for representing the products formations rates. A complete mathematical model is then developed revealing a non-linear behaviour of the variations of mass losses and products formations. Except for wheat straw, new additive correlations are then determined. The agreement with the experimental results is very satisfying with regard to the measurements accuraciesNANCY-INPL-Bib. électronique (545479901) / SudocSudocFranceF

    A simple sleep EEG marker in childhood predicts brain myelin 3.5 years later

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    Epidemiological research reveals that insufficient sleep in children has negative cognitive and emotional consequences; however, the physiological underpinnings of these observations remain understudied. We tested the hypothesis that the topographical distribution of deep sleep slow wave activity during the childhood predicts brain white matter microstructure (myelin) 3.5 y later. Healthy children underwent sleep high-density EEG at baseline (n = 13; ages 2.4–8.0 y) and follow-up (n = 14; ages 5.5–12.2 y). At follow-up, myelin (myelin water fraction) and cortical morphology were also quantified. Our investigation revealed 3 main findings. (1) The Frontal/Occipital (F/O)-ratio at baseline strongly predicted whole brain myelin at follow-up. (2) At follow-up, the F/O-ratio was only minimally (negatively) linked to brain myelin. (3) Cortical morphology was not related to the F/O-ratio, neither at baseline nor at follow-up. Our results support the hypothesis that during child development EEG markers during sleep longitudinally predict brain myelin content. Data extend previous findings reporting a link between EEG markers of sleep need and cortical morphology, by supporting the hypothesis that sleep is a necessary component to underlying processes of brain, and specifically myelin, maturation. In line with the overarching theory that sleep contributes to neurodevelopmental processes, it remains to be investigated whether chronic sleep loss negatively affects white matter myelin microstructure growth during sensitive periods of development

    N-Cadherin Interacts with Axin and LRP5 To Negatively Regulate Wnt/β-Catenin Signaling, Osteoblast Function, and Bone Formation▿

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    Wnt signaling plays an important role in the regulation of bone formation and bone mass. The mechanisms that regulate canonical Wnt signaling in osteoblasts are not fully understood. We show here a novel mechanism by which the adhesion molecule N-cadherin interacts with the Wnt coreceptor LRP5 and regulates canonical Wnt/β-catenin signaling in osteoblasts. We demonstrate that N-cadherin, besides associating with β-catenin at the membrane, forms a molecular complex with axin and LRP5 involving the LRP5 cytoplasmic tail domain. N-cadherin overexpression in osteoblasts increases N-cadherin-LRP5 interaction, causing increased β-catenin degradation and altered TCF/LEF transcription in response to Wnt3a. This mechanism results in decreased osteoblast gene expression and osteogenesis in basal conditions and in response to Wnt3a. Consistent with a functional mechanism, silencing N-cadherin expression in control cells increases TCF/LEF transcription and enhances the response to Wnt3a. Using N-cadherin transgenic mice, we show that increased N-cadherin-LRP5 interaction resulting from targeted overexpression of N-cadherin in osteoblasts causes increased β-catenin ubiquitination and results in cell-autonomous defective osteoblast function, reduced bone formation, and delayed bone mass acquisition. These data indicate that a previously unrecognized N-cadherin-axin-LRP5 interaction negatively regulates Wnt/β-catenin signaling and is critical in the regulation of osteoblast function, bone formation, and bone mass

    In situ measurements of snow surface roughness using a laser profiler

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    International audienceThe snow surface roughness at centimetre and millimetre scales is an important parameter related to wind transport, snowdrifts, snowfall, snowmelt and snow grain size. Knowledge of the snow surface roughness is also of high interest for analyzing the signal from radar sensors such as SAR, altimeters and scatterometers. Unfortunately, this parameter has seldom been measured over snow surfaces. The techniques used to measure the roughness of other surfaces, such as agricultural or sand soils, are difficult to implement in polar regions because of the harsh climatic conditions. In this paper we develop a device based on a laser profiler coupled with a GPS receiver on board a snowmobile. This instrumentation was tested successfully in midre Lovénbreen, Svalbard, in April 2006. It allowed us to generate profiles of 3 km sections of the snow-covered glacier surface. Because of the motion of the snowmobile, the roughness signal is mixed with the snowmobile signal. We use a distance/frequency analysis (the empirical mode decomposition) to filter the signal. This method allows us to recover the snow surface structures of wavelengths between 4 and 50 cm with amplitudes of >1 mm. Finally, the roughness parameters of snow surfaces are retrieved. The snow surface roughness is found to be dependent on the scales of the observations. The retrieved RMS of the height distribution is found to vary between 0.5 and 9.2 mm, and the correlation length is found to be between 0.6 and 46 cm. This range of measurements is particularly well adapted to the analysis of GHz radar response on snow surfaces

    How important is consent in maternal serum screening for Down syndrome in France? Information and consent evaluation in maternal serum screening for Down syndrome: a French study.

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    OBJECTIVES: To evaluate the level of information and informed consent for maternal serum screening (MSS) for Down syndrome (DS) in the second trimester of pregnancy and analyse the exercise of autonomy towards the test by the women concerned. METHODS: We studied the population of pregnant women attending obstetric consultations in two French hospitals over a 3-month period. The women were assigned to three groups according to MSS results for DS: women at high risk of having a child with DS (group 1), women at low risk (group 2) and women who did not undergo the test (group 3). A questionnaire was completed before the medical consultation, to assess the quality of consent before amniocentesis for the group at high risk and before the second-trimester ultrasound scan for the other two groups. RESULTS: We analysed 305 questionnaires for 89, 137 and 79 women belonging to groups 1, 2 and 3 respectively. In total, 123 women (40.3% [IC 95%, 35-46%]) were considered to be well informed; 33 (10%, [IC 95%, 8-12%]) had a high level of knowledge, but made choices not consistent with their stated attitude, and 149 (49.7% [IC 95%, 45-56%]) were considered uninformed. Logistic regression analysis showed that maternal consent depended on three independent components: The score attributed to the doctor for information about MSS (t = 4.216, p < 0.001).Whether the patient belonged to group 1 (t = -2.631, p < 0.009).Educational level (< high-school diploma, high-school diploma or at least two years of higher education after high school) (t = 2.324, p < 0.02). The rate of consent increased with educational level and was highest for the women in group 1 and for those whose doctor had a high information score. CONCLUSIONS: Our findings clearly show that women are provided with insufficient information concerning MSS screening for DS in the second trimester of pregnancy for real and valid consent to be obtained. Copyright (c) 2007 John Wiley & Sons, Ltd
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