Dietary approach to stop hypertension (DASH) diet and associated socioeconomic inequalities in the United Kingdom

The dietary approach to stop hypertension (DASH) diet is an effective measure in the prevention and treatment of CVD. We evaluated recent trends in socioeconomic differences in the DASH score in the UK population, using education, occupation and income as proxies of socioeconomic position (SEP). We analyzed data on 6416 subjects aged 18 and older collected in the National Diet and Nutrition Survey (NDNS 2008-2016). The DASH score was calculated using sex-specific quintiles of DASH items. Multiple linear regression and quantile regression models were used to evaluate the trend in DASH score according to SEP. The mean DASH score was 24 (standard deviation: 5). The estimated mean differences between people with no qualification and those having the highest level of education was -3.61 points (95% CI: -4.00; -3.22). The mean difference between subjects engaged in routine occupations and those engaged in high managerial and professional occupations was -3.41 points (95% CI: -3.89; -2.93) and for those in the first fifth and last fifth of the household income distribution was -2.71 points (95% CI: -3.15; -2.28). DASH score improved over time and no significant differences in the trend were observed across SEP. The widest socioeconomic differences emerged for consumption of fruit, vegetables, wholegrains, nuts, seeds and legumes. Despite an overall increase in the DASH score, a persisting SEP gap was observed. This is an important limiting factor in reducing the high socioeconomic inequality in CVD observed in the UK

Estimation of Fatigue Limit of a A356-T6 Automotive Wheel in Presence of Defects

The automotive wheel is a critical safety component in the vehicle and, for such a reason, it has also to meet strict requirements about technological properties. This component is produced by low pressure die casting technique and the casting defects related to the process have to be properly considered having a high effect in decreasing both static and dynamic resistance of the component. Effectively, casting defects like porosities influence the fatigue crack initiation and strongly affect the fatigue life too. One of the most common problem in the real component is the mismatch between the experimental data and literature. In fact, many scientific researches were carried out on small samples produced in a controlled condition and therefore it is difficult to direct transfer the laboratory results to a real cast component with a well-defined shape and different thicknesses. In the present study, an aluminum alloy A356-T6 wheel was analyzed in order to correlate the fatigue performance taking in to account the casting defects. The fatigue limit of the component was studied by rotating bending fatigue tests executed on the whole wheels. Microfractographic analyses on the broken wheels were carried out on the fracture surfaces using a Scanning Electron Microscope in order to identify the crack initiation zone: it was recognized that the crack always started from shrinkage porosities. The statistical population of these defects was therefore investigated on samples taken from the wheel in crack nucleation positions of the spoke and the maximum expected defect size on the component was estimated by the statistics of extreme values. The experimental fatigue limit was finally compared with the theoretical value predicted with the Murakami’s method

A meta-analysis of alcohol drinking and cancer risk

To evaluate the strength of the evidence provided by the epidemiological literature on the association between alcohol consumption and the risk of 18 neoplasms, we performed a search of the epidemiological literature from 1966 to 2000 using several bibliographic databases. Meta-regression models were fitted considering linear and non-linear effects of alcohol intake. The effects of characteristics of the studies, of selected covariates (tobacco) and of the gender of individuals included in the studies, were also investigated as putative sources of heterogeneity of the estimates. A total of 235 studies including over 117 000 cases were considered. Strong trends in risk were observed for cancers of the oral cavity and pharynx, oesophagus and larynx. Less strong direct relations were observed for cancers of the stomach, colon and rectum, liver, breast and ovary. For all these diseases, significant increased risks were found also for ethanol intake of 25 g per day. No significant nor consistent relation was observed for cancers of the pancreas, lung, prostate or bladder. Allowance for tobacco appreciably modified the relations with laryngeal, lung and bladder cancers, but not those with oral, oesophageal or colorectal cancers. This meta-analysis showed no evidence of a threshold effect for most alcohol-related neoplasms. The inference is limited by absence of distinction between lifelong abstainers and former drinkers in several studies, and the possible selective inclusion of relevant sites only in cohort studies. © 2001 Cancer Research Campaign http://www.bjcancer.co

Bladder cancer mortality of workers exposed to aromatic amines: analysis of models of carcinogenesis.

The effects of various factors were evaluated on both relative risk (multiplicative model), and absolute excess risk (additive model) of bladder cancer among 664 workers of a dyestuff factory in Northern Italy. These workers were exposed to aromatic amines in fairly constant working conditions from 1922 to 1970, and were employed for at least one year. They were followed up till the end of 1981 for a total of 12,302 man-years at risk. Under both models, the risk was greater for workers directly involved in aromatic amine manufacture than for those with only intermittent exposure. There was no marked effect of age at first exposure on the absolute excess risk of bladder cancer, but the relative risk was strongly and negatively related to age at first exposure. Under the multistage theory of carcinogenesis, this pattern of risk indicates an early stage effect. Absolute excess risk increased sharply during exposure, and continued to rise, although less sharply, after exposure had ceased. Relative risk, however, decreased after cessation of exposure, indicating a possible late stage effect. Thus, the results derived from both additive and multiplicative models are not in contrast when interpreted in terms of the multistage theory of carcinogenesis, though they are not totally consistent with a single-stage effect, either early or late. Aromatic amines may act on a stage somewhere between the first and penultimate, or on more than one stage of the process of carcinogenesis. Alternatively, it is possible that imprecision in the job classification or other observational problems may obscure the trends, or produce fictitious trends in the effects of variables such as age at first exposure and time since last exposure. Finally, such a pattern of trends could emerge if there were only two stages and the first and penultimate stage were the same

Malignant ovarian tumours in childhood in Britain, 1962-78.

The files of the Childhood Cancer Research Group and of the Oxford Survey of Childhood Cancers were scrutinized for all the ovarian neoplasms registered in England, Scotland and Wales in children under age 15 years throughout the period 1962-78. Among 172 cases confirmed as malignant ovarian tumours, 145 (84%) were tumours of germ cell origin (54 dysgerminomas, 36 malignant teratomas, 26 endodermal sinus tumours, 4 embryonal carcinomas, 2 pure choriocarcinomas, 20 mixed germ cell neoplasms, 3 gonadoblastomas), 13 (8%) were epithelial carcinomas (3 serous or undifferentiated, 10 mucinous), 9 (5%) were sex-cord stromal tumours (3 granulosa cell, 3 Sertoli-Leydig, 3 unclassified) and 5 (3%) were other miscellaneous tumour types. Less than 10% of the neoplasms occurred at age less than 5 years, approximately 20% from 5-9, and greater than 70% from 10-14 years. Germ cell neoplasms of greater malignancy (immature teratomas, endodermal sinus tumours) occurred in a significantly higher proportion at younger age (less than 10 years) than dysgerminomas (P = 0.01). The overall incidence (approximately 1.7 cases per 10(6) per annum) did not show any noticeable trend over the 17-year period considered. The clustering of two confined cases and, possibly, a third case, of germ cell neoplasms in three generations of the same family pointed to a genetic component in the aetiology of some of these neoplasms. A large number of sex related and mental or neurological abnormalities was also reported in case children. The 10-year survival rates, determined by the life-table method were: epithelial carcinomas 73%, sex-cord stromal tumours 44%, dysgerminomas 73%, malignant teratomas 33%, endodermal sinus tumours 39%, embryonal carcinomas 25%, other germ cell neoplasms 30% and gonadoblastomas 100%. Apart from cell-type, factors associated with prognosis were clinical stage (in all types), size and degree of histological differentiation (in malignant teratomas, but only when stage was not allowed for). The adoption of efficacious polychemotherapy regimens completely changed the prognosis of germ cell tumours other than dysgerminomas (from 29% to greater than 85% disease-free survivors in the present series)

Long working hours and cardiovascular mortality: a census-based cohort study

Objectives Long working hours have been associated with cardiovascular disease (CVD) mortality. However, results are inconsistent and large cohort studies are needed to confirm these findings. Methods We conducted a census-based cohort study including 11,903,540 Italian workers aged 20-64 years, registered in the 2011 census, with a 5-year follow-up (2012-2016). We estimated cause-specific hazard ratios (cHRs) through Cox regression models to quantify the association between long working hours and CVD mortality. Results Over 5 years of follow-up, 17,206 individuals died from CVD (15,262 men and 1944 women). Men working 55 or more hours per week had a cHR of 0.95 (95% confidence interval, CI 0.89-1.02) for all CVDs, while women showed a cHR of 1.19 (95% CI 0.95-1.49). Professional women working more than 55 h per week had a cHR of 1.98 (95% CI 0.87-4.52). Conclusions This study does not support an association between long working hours and CVD mortality among active Italian men, while it suggests a possible excess risk among women, although based on limited number of events

Evaluation of cavitation erosion resistance of Al-Si casting alloys: effect of eutectic and intermetallic phases

In the present paper, the influence of eutectic and intermetallic phases on cavitation resistance of Al-Si alloys was studied. In fact, Al-Si alloys are commonly used for the production of components, such as cylinders, pistons, pumps, valves and combustion chambers, which in service may incur in cavitation phenomenon. Samples of AlSi3, AlSi9 and AlSi9CuFe were characterized from the microstructural point of view. Hardness measurements were also performed. Subsequently, cavitation tests were carried out according to ASTM G32 standard and the erosion mechanism was examined by scanning electron microscope. It was found the both eutectic and intermetallic phases enhance cavitation resistance, expressed in terms of mass loss. Particularly, intermetallic particles with complex morphologies provide a positive contribution, exceeding that of other microstructural features, as grain size. The effect of T6 heat treatment was also evaluated. It was confirmed that the precipitation of fine strengthening particles in the Al matrix successfully hinders the movement of dislocations, resulting in a longer incubation stage and a lower mass loss for heat-treated samples in comparison with as-cast ones. Finally, the relationship between cavitation resistance and material hardness was investigated

Reproductive factors and the risk of invasive and intraepithelial cervical neoplasia.

The relation between reproductive factors and cervical neoplasia was evaluated in a case-control study of 528 cases of invasive cancer compared with 456 control subjects in hospital for acute conditions unrelated to any of the established or suspected risk factors for cervical cancer, and of 335 cases of cervical intraepithelial neoplasia compared with 262 outpatient controls. The risk of invasive cervical cancer increased with number of livebirths, the estimated multivariate relative risk (RR) being 4.39 in women with five or more births compared with nulliparous women. There was also an inverse relation with age at first livebirth (RR = 0.42 for greater than or equal to 30 vs. less than 20 years) which, however, disappeared after inclusion of parity in multiple logistic regression analysis. Likewise, cases of invasive cervical cancer tended more frequently to report induced abortions. However, this association was not statistically significant after allowance for confounding factors, including parity. No relation emerged with number of spontaneous abortion and age at last pregnancy. When the interaction between parity and sexual habits was analysed, the relative risk increased in subsequent strata of parity with increasing number of sexual partners or decreasing age at first intercourse, thus suggesting an independent effect of sexual and reproductive factors, and hence multiplicative on the relative risk of invasive cervical cancer. No consistent association emerged between the risk of intraepithelial cervical neoplasm and parity, number of abortions and age at first or last birth

Risk factors for adenocarcinoma of the cervix: a case-control study.

To assess risk factors for cervical adenocarcinoma data were collected in a case-control study of 39 cases and 409 controls conducted in the greater Milan area. Questions were asked about personal characteristics and habits, gynaecologic and obstetric data, history of lifetime use of oral contraceptives and other female hormones, and general indicators of sexual habits (age at first intercourse and total number of sexual partners). The relative risk of cervical adenocarcinoma increased with number of births and abortions, early age at first birth and early age at first intercourse. These estimates did not materially change after adjustment for the potential reciprocal confounding effect. Further, there was a positive association with overweight, but an apparent association with lower education was not significant. No relationship emerged with oral contraceptive use. Thus, despite the similarities with the epidemiology of squamous cell cancer, reproductive patterns and other factors related to the risk of endometrial cancer (i.e., overweight) seem to play an important role in the risk of adenocarcinoma of cervix uteri