Lung function and respiratory symptoms in a 1-year randomized smoking cessation trial of varenicline in COPD patients

SummaryThere are few data concerning changes in lung function and respiratory symptoms in smokers with chronic obstructive pulmonary disease (COPD) weeks to months after quitting smoking. We examined serial changes in spirometry and Clinical COPD Questionnaire (CCQ) scores (measuring respiratory symptoms and health-related quality of life) in COPD participants by smoking status during a smoking cessation trial.In this randomized, double-blind trial, smokers with mild-to-moderate COPD were treated with varenicline 1 mg b.i.d. or placebo for 12 weeks and followed to Week 52. Primary endpoints of abstinence were previously reported. Secondary endpoints were mean changes from baseline in post-bronchodilator forced expired volume in 1 s (FEV1) and CCQ scores.Change from baseline in post-bronchodilator FEV1 was significantly improved in continuous abstainers (121.8 mL) vs. continuous smokers (37.9 mL) at Week 12 (P = 0.0069), but not at Weeks 24 or 52. Mean change from baseline at Week 12 in CCQ Total Score was significantly better in continuous abstainers (−1.04) vs. continuous smokers (−0.53; P < 0.0001): this improvement was sustained at Weeks 24 and 52.In a 1-year cessation trial of smokers with COPD, continuous abstinence compared with continuous smoking significantly improved post-bronchodilator FEV1 at Week 12 (although the difference narrowed subsequently) and CCQ Total Scores at Week 12, with sustained improvement thereafter.(Trial registry: http://www.clinicaltrials.gov; trial identifier: NCT00285012

Ambient particulate matter, ozone, and neurologic symptoms in U.S. Gulf states adults

Research on neurologic effects of air pollution has focused on neurodevelopment or later-life neurodegeneration; other effects throughout adulthood have received less attention. We examined air pollution levels and neurologic symptoms among 21,467 adults in US Gulf Coast states. We assigned exposure using Environmental Protection Agency estimates of daily ambient particulate matter 2.5 (PM2.5) and ozone. Gulf Long-term Follow-up Study participants reported neurologic symptoms at enrollment (2011-2013). We estimated cross-sectional associations between each air pollutant and prevalence of "any" neurologic, central nervous system (CNS), or peripheral nervous system (PNS) symptoms. Ambient PM2.5was consistently associated with prevalence of neurologic symptoms. The highest quartile of 30-day PM2.5was associated with any neurologic symptom (prevalence ratio [PR] = 1.16; 95% confidence interval [CI] = 1.09, 1.23) and there were increasing monotonic relationships between 30-day PM2.5and each symptom category (P-trend ≤ 0.01). Associations with PM2.5were slightly stronger among nonsmokers and during colder seasons. The highest quartile of 7-day ozone was associated with increased prevalence of PNS symptoms (PR = 1.09; 95% CI = 1.00, 1.19; P-trend = 0.03), but not with other outcomes. Ozone concentrations above regulatory levels were suggestively associated with neurologic symptoms (PR = 1.06; 95% CI = 0.99, 1.14). Mutual adjustment in co-pollutant models suggests that PM2.5is more relevant than ozone in relation to prevalence of neurologic symptoms

Mental health indicators and lung function following a large oil spill

To the Editor: Natural and anthropogenic disaster-related experiences can exacerbate background stressors, which may lead to negative mental health outcomes. However, few studies have assessed mental health indicators related to measured lung function in the aftermath of a disaster. In 2010 the Deepwater Horizon disaster resulted in the largest maritime oil spill in US history and negatively affected proximal communities, which experienced increased distress and post-traumatic stress disorder(PTSD)-like symptoms attributed to the disaster. We investigated the relationship between mental health indicators and lung function following this disaster

A Generating Function for all Semi-Magic Squares and the Volume of the Birkhoff Polytope

We present a multivariate generating function for all n x n nonnegative integral matrices with all row and column sums equal to a positive integer t, the so called semi-magic squares. As a consequence we obtain formulas for all coefficients of the Ehrhart polynomial of the polytope B_n of n x n doubly-stochastic matrices, also known as the Birkhoff polytope. In particular we derive formulas for the volumes of B_n and any of its faces.Comment: 24 pages, 1 figure. To appear in Journal of Algebraic Combinatoric

Neighborhood Deprivation, Obesity, and Diabetes in Residents of the US Gulf Coast

Socioeconomic status has been associated with cardiovascular disease risk factors. However, few studies have examined this relationship among populations in the US Gulf Coast region. We assessed neighborhood deprivation in relation to obesity and diabetes in 9,626 residents participating in the Gulf Long-Term Follow-Up Study (2011-present) who completed a home visit (2011-2013) with height, weight, waist, and hip measurements. Obesity was categorized as body mass index of at least 30, and diabetes was defined by doctor's diagnosis or prescription medication. Participant home addresses were linked to an established Area Deprivation Index and categorized into 4 levels (1 = least deprived). In adjusted, modified Poisson regression models, participants with greatest deprivation were more likely to have obesity compared with those with least deprivation (adjusted prevalence ratio (aPR) = 1.21, 95% confidence interval (CI): 1.08, 1.35), central obesity (aPR = 1.11, 95% CI: 1.04, 1.19), and diabetes (aPR = 1.49, 95% CI: 1.03, 2.14). Repeated analyses among a subgroup of participants (n = 3,016) whose hemoglobin A1C values were measured 3 years later indicated the association with diabetes (defined as diagnosis, medications, or hemoglobin A1C ≥ 6.5) was similar (aPR = 1.46, 95% CI: 1.14, 1.86). Results suggest neighborhood deprivation is associated with obesity and diabetes in a US region with high baseline prevalence

Being relevant: Practical guidance for early career researchers interested in solving conservation problems

AbstractIn a human-altered world where biodiversity is in decline and conservation problems abound, there is a dire need to ensure that the next generation of conservation scientists have the knowledge, skills, and training to address these problems. So called “early career researchers” (ECRs) in conservation science have many challenges before them and it is clear that the status quo must change to bridge the knowledge–action divide. Here we identify thirteen practical strategies that ECRs can employ to become more relevant. In this context, “relevance” refers to the ability to contribute to solving conservation problems through engagement with practitioners, policy makers, and stakeholders. Conservation and career strategies outlined in this article include the following: thinking ‘big picture’ during conservation projects; embracing various forms of knowledge; maintaining positive relationships with locals familiar with the conservation issue; accepting failure as a viable (and potentially valuable) outcome; daring to be creative; embracing citizen science; incorporating interdisciplinarity; promoting and practicing pro-environmental behaviours; understanding financial aspects of conservation; forming collaboration from the onset of a project; accepting the limits of technology; ongoing and effective networking; and finally, maintaining a positive outlook by focusing on and sharing conservation success stories. These strategies move beyond the generic and highlight the importance of continuing to have an open mind throughout the entire conservation process, from establishing one’s self as an asset to embracing collaboration and interdisciplinary work, and striving to push for professional and personal connections that strengthen personal career objectives

The Giant Inflaton

We investigate a new mechanism for realizing slow roll inflation in string theory, based on the dynamics of p anti-D3 branes in a class of mildly warped flux compactifications. Attracted to the bottom of a warped conifold throat, the anti-branes then cluster due to a novel mechanism wherein the background flux polarizes in an attempt to screen them. Once they are sufficiently close, the M units of flux cause the anti-branes to expand into a fuzzy NS5-brane, which for rather generic choices of p/M will unwrap around the geometry, decaying into D3-branes via a classical process. We find that the effective potential governing this evolution possesses several epochs that can potentially support slow-roll inflation, provided the process can be arranged to take place at a high enough energy scale, of about one or two orders of magnitude below the Planck energy; this scale, however, lies just outside the bounds of our approximations.Comment: 31 pages, 4 figures, LaTeX. v2: references added, typos fixe

Some functional equations related to the characterizations of information measures and their stability

The main purpose of this paper is to investigate the stability problem of some functional equations that appear in the characterization problem of information measures.Comment: 36 pages. arXiv admin note: text overlap with arXiv:1307.0657, arXiv:1307.0631, arXiv:1307.0664, arXiv:1307.065

Spirometry quality predictors in a large multistate prospective study

Background: The Gulf Long-Term Follow-up (GuLF) Study is a prospective cohort study of health effects associated with oil spill response and clean-up following the 2010 Deepwater Horizon Disaster (DWH). As part of the study, spirometry testing of lung function was carried out in home visits across multiple states. Few studies have described factors associated with spirometry test failure in field-based settings. Objective: Our objective was to identify what factors, if any, predict test failure among GuLF Study participants who completed spirometry testing in a non-traditional setting. Methods: Trained examiners administered spirometry (May 2011–May 2013) to 10,019 participants living in US Gulf States (LA, MS, TX, AL, FL) using an Easy-on ultrasonic spirometer. We applied American Thoracic Society/European Respiratory Society quality criteria to determine quality test failure and identified factors predictive of failure using both a Stepwise and a LASSO model. We calculated odds ratios and 95% confidence intervals (CIs) for associations of selected factors with test failure. Results: Among GuLF Study participants who conducted spirometry, self-reported African American/Black participants (OR: 1.39, 95% CI: 1.23,1.56); men (OR:1.61, 95% CI: 1.41,1.83); and those making less than $20,000 per year (OR: 1.45, 95% CI: 1.26,1.67) were more likely to fail quality testing, while those who were obese were less likely to fail (OR: 0.61, 95% CI: 0.42,0.89). Conclusion: Field-based studies involving spirometry should identify and account for participant factors that may influence test failure. Coaching that is tailored to those less likely to have experience with spirometry may help reduce test failure rates

Neighborhood disadvantage and immune-related illnesses among residents living in the US Gulf States

Purpose: Neighborhood disadvantage has been associated with increased risk for pneumonia and influenza-associated hospitalizations. Few studies, however, have investigated how neighborhood disadvantage may influence immune-related illnesses. The aim of this study was to examine the association between neighborhooddisadvantage and immune-related illnesses. Methods: We used data from the Gulf Long-term Follow-up (GuLF) Study (n = 32,608). Our analytic sample included home visit participants (n = 11,193) who had complete information on exposure and covariates (n = 10,543). Neighborhood disadvantage was assessed using the 2013 Area Deprivation Index (ADI), which assigns a ranking of 1 to 100 for lowest to highest disadvantage. We linked ADI to participants’ geocoded enrollment addresses at the census block group level. ADI was categorized into quartiles based on the national distribution with the first quartile as the referent. Immune-related illnesses self-reported at the home visit (May 2011–May 2013) included occurrence of shingles, pneumonia, cold sores, flu, and colds since the Deepwater Horizon oil spill (April 2010). Frequent colds and frequent flu were defined as ≥4 colds and ≥2 episodes of flu since the spill. An aggregated outcome, based on occurrence of any pneumonia, cold sores, flu, and ≥4 colds since the spill, was also examined. We assessed the association of each outcome with ADI using multivariable log-binomial regression adjusting for individual-level demographics, behavioral factors, kids at home, and season of interview completion. Results: We found elevated prevalence ratios (PR) and 95% confidence intervals (CI) for pneumonia associated with ADI in the third (PR: 2.04, 95% CI: 1.04, 4.02) and fourth (PR: 2.00; 95% CI: 1.00, 3.98) quartiles. PRs for frequent colds were also elevated for increasing ADI quartiles, but with confidence intervals including the null value. Conclusions: The observed associations of frequent colds and pneumonia with increasing neighborhood disadvantage may warrant further research on this topi