Up-to-date on mortality in COPD - report from the OLIN COPD study

<p>Abstract</p> <p>Background</p> <p>The poor recognition and related underdiagnosis of COPD contributes to an underestimation of mortality in subjects with COPD. Data derived from population studies can advance our understanding of the true burden of COPD. The objective of this report was to evaluate the impact of COPD on mortality and its predictors in a cohort of subjects with and without COPD recruited during the twenty first century.</p> <p>Methods</p> <p>All subjects with COPD (n = 993) defined according to the GOLD spirometric criteria, FEV₁/FVC < 0.70, and gender- and age-matched subjects without airway obstruction, non-COPD (n = 993), were identified in a clinical follow-up survey of the Obstructive Lung Disease in Northern Sweden (OLIN) Studies cohorts in 2002-2004. Mortality was observed until the end of year 2007. Baseline data from examination at recruitment were used in the risk factor analyses; age, smoking status, lung function (FEV₁% predicted) and reported heart disease.</p> <p>Results</p> <p>The mortality was significantly higher among subjects with COPD, 10.9%, compared to subjects without COPD, 5.8% (p < 0.001). Mortality was associated with higher age, being a current smoker, male gender, and COPD. Replacing COPD with FEV₁% predicted in the multivariate model resulted in the decreasing level of FEV₁being a significant risk factor for death, while heart disease was not a significant risk factor for death in any of the models.</p> <p>Conclusions</p> <p>In this cohort COPD and decreased FEV₁were significant risk factors for death when adjusted for age, gender, smoking habits and reported heart disease.</p

COPD diagnosis related to different guidelines and spirometry techniques

The aim was to compare the diagnosis of COPD among smokers according to different international guidelines and to compare the outcome when using slow (SVC) and forced vital capacity (FVC)

Anthropogenic heat flux: advisable spatial resolutions when input data are scarce

Anthropogenic heat flux (QF) may be significant in cities, especially under low solar irradiance and at night. It is of interest to many practitioners including meteorologists, city planners and climatologists. QF estimates at fine temporal and spatial resolution can be derived from models that use varying amounts of empirical data. This study compares simple and detailed models in a European megacity (London) at 500 m spatial resolution. The simple model (LQF) uses spatially resolved population data and national energy statistics. The detailed model (GQF) additionally uses local energy, road network and workday population data. The Fractions Skill Score (FSS) and bias are used to rate the skill with which the simple model reproduces the spatial patterns and magnitudes of QF, and its sub-components, from the detailed model. LQF skill was consistently good across 90% of the city, away from the centre and major roads. The remaining 10% contained elevated emissions and B hot spots ^ representing 30 – 40% of the total city-wide energy. This structure was lost because it requires workday population, spatially resolved building energy consumption and/or road network data. Daily total building and traffic energy consumption estimates from national data were within ± 40% of local values. Progressively coarser spatial resolutions to 5 km improved skill for total Q F , but important features (hot spots, transport network) were lost at all resolutions when residential population controlled spatial variations. The results demonstrate that simple QF models should be applied with conservative spatial resolution in cities that, like London, exhibit time-varying energy use patterns

A lightweight sensing platform for monitoring sleep quality and posture: a simulated validation study

Background The prevalence of self-reported shoulder pain in the UK has been estimated at 16%. This has been linked with significant sleep disturbance. It is possible that this relationship is bidirectional, with both symptoms capable of causing the other. Within the field of sleep monitoring, there is a requirement for a mobile and unobtrusive device capable of monitoring sleep posture and quality. This study investigates the feasibility of a wearable sleep system (WSS) in accurately detecting sleeping posture and physical activity. Methods Sixteen healthy subjects were recruited and fitted with three wearable inertial sensors on the trunk and forearms. Ten participants were entered into a ‘Posture’ protocol; assuming a series of common sleeping postures in a simulated bedroom. Five participants completed an ‘Activity’ protocol, in which a triphasic simulated sleep was performed including awake, sleep and REM phases. A combined sleep posture and activity protocol was then conducted as a ‘Proof of Concept’ model. Data were used to train a posture detection algorithm, and added to activity to predict sleep phase. Classification accuracy of the WSS was measured during the simulations. Results The WSS was found to have an overall accuracy of 99.5% in detection of four major postures, and 92.5% in the detection of eight minor postures. Prediction of sleep phase using activity measurements was accurate in 97.3% of the simulations. The ability of the system to accurately detect both posture and activity enabled the design of a conceptual layout for a user-friendly tablet application. Conclusions The study presents a pervasive wearable sensor platform, which can accurately detect both sleeping posture and activity in non-specialised environments. The extent and accuracy of sleep metrics available advances the current state-of-the-art technology. This has potential diagnostic implications in musculoskeletal pathology and with the addition of alerts may provide therapeutic value in a range of areas including the prevention of pressure sores

Evidence that dorsally mounted satellite transmitters affect migration chronology of Northern Pintails

We compared migration movements and chronology between Northern Pintails (Anas acuta) marked with dorsally mounted satellite transmitters and pintails marked only with tarsus rings. During weekly intervals of spring and autumn migration between their wintering area in Japan and nesting areas in Russia, the mean distance that ringed pintails had migrated was up to 1000 km farther than the mean distance radiomarked pintails migrated. Radiomarked pintails were detected at spring migration sites on average 9.9 days (90 % CI 8.0, 11.8) later than ringed pintails that were recovered within 50 km. Although ringed and radiomarked pintails departed from Japan on similar dates, the disparity in detection of radiomarked versus ringed pintails at shared sites increased 7.7 days (90 % CI 5.2, 10.2) for each 1000 km increase in distance from Japan. Thus, pintails marked with satellite transmitters arrived at nesting areas that were 2500 km from Japan on average 19 days later than ringed birds. Radiomarked pintails were detected at autumn migration stopovers on average 13.1 days (90 % CI 9.8, 16.4) later than ringed birds that were recovered within 50 km. We hypothesize that dorsal attachment of 12?20 g satellite transmitters to Northern Pintails increased the energetic cost of flight, which resulted in more rapid depletion of energetic reserves and shortened the distance pintails could fly without refueling. Radiomarked pintails may have used more stopovers or spent longer periods at stopovers. causing their migration schedule to diverge from ringed pintails. We urge further evaluation of the effects of dorsally mounted transmitters on migration chronology of waterfowl

The Probable Cell of Origin of NF1- and PDGF-Driven Glioblastomas

Primary glioblastomas are subdivided into several molecular subtypes. There is an ongoing debate over the cell of origin for these tumor types where some suggest a progenitor while others argue for a stem cell origin. Even within the same molecular subgroup, and using lineage tracing in mouse models, different groups have reached different conclusions. We addressed this problem from a combined mathematical modeling and experimental standpoint. We designed a novel mathematical framework to identify the most likely cells of origin of two glioma subtypes. Our mathematical model of the unperturbed in vivo system predicts that if a genetic event contributing to tumor initiation imparts symmetric self-renewing cell division (such as PDGF overexpression), then the cell of origin is a transit amplifier. Otherwise, the initiating mutations arise in stem cells. The mathematical framework was validated with the RCAS/tv-a system of somatic gene transfer in mice. We demonstrated that PDGF-induced gliomas can be derived from GFAP-expressing cells of the subventricular zone or the cortex (reactive astrocytes), thus validating the predictions of our mathematical model. This interdisciplinary approach allowed us to determine the likelihood that individual cell types serve as the cells of origin of gliomas in an unperturbed system

Countries with Higher Levels of Gender Equality Show Larger National Sex Differences in Mathematics Anxiety and Relatively Lower Parental Mathematics Valuation for Girls.

Despite international advancements in gender equality across a variety of societal domains, the underrepresentation of girls and women in Science, Technology, Engineering, and Mathematics (STEM) related fields persists. In this study, we explored the possibility that the sex difference in mathematics anxiety contributes to this disparity. More specifically, we tested a number of predictions from the prominent gender stratification model, which is the leading psychological theory of cross-national patterns of sex differences in mathematics anxiety and performance. To this end, we analyzed data from 761,655 15-year old students across 68 nations who participated in the Programme for International Student Assessment (PISA). Most importantly and contra predictions, we showed that economically developed and more gender equal countries have a lower overall level of mathematics anxiety, and yet a larger national sex difference in mathematics anxiety relative to less developed countries. Further, although relatively more mothers work in STEM fields in more developed countries, these parents valued, on average, mathematical competence more in their sons than their daughters. The proportion of mothers working in STEM was unrelated to sex differences in mathematics anxiety or performance. We propose that the gender stratification model fails to account for these national patterns and that an alternative model is needed. In the discussion, we suggest how an interaction between socio-cultural values and sex-specific psychological traits can better explain these patterns. We also discuss implications for policies aiming to increase girls' STEM participation

Combining Free Text and Structured Electronic Medical Record Entries to Detect Acute Respiratory Infections

The electronic medical record (EMR) contains a rich source of information that could be harnessed for epidemic surveillance. We asked if structured EMR data could be coupled with computerized processing of free-text clinical entries to enhance detection of acute respiratory infections (ARI).A manual review of EMR records related to 15,377 outpatient visits uncovered 280 reference cases of ARI. We used logistic regression with backward elimination to determine which among candidate structured EMR parameters (diagnostic codes, vital signs and orders for tests, imaging and medications) contributed to the detection of those reference cases. We also developed a computerized free-text search to identify clinical notes documenting at least two non-negated ARI symptoms. We then used heuristics to build case-detection algorithms that best combined the retained structured EMR parameters with the results of the text analysis.An adjusted grouping of diagnostic codes identified reference ARI patients with a sensitivity of 79%, a specificity of 96% and a positive predictive value (PPV) of 32%. Of the 21 additional structured clinical parameters considered, two contributed significantly to ARI detection: new prescriptions for cough remedies and elevations in body temperature to at least 38°C. Together with the diagnostic codes, these parameters increased detection sensitivity to 87%, but specificity and PPV declined to 95% and 25%, respectively. Adding text analysis increased sensitivity to 99%, but PPV dropped further to 14%. Algorithms that required satisfying both a query of structured EMR parameters as well as text analysis disclosed PPVs of 52-68% and retained sensitivities of 69-73%.Structured EMR parameters and free-text analyses can be combined into algorithms that can detect ARI cases with new levels of sensitivity or precision. These results highlight potential paths by which repurposed EMR information could facilitate the discovery of epidemics before they cause mass casualties

Is There a Place for Dietary Fiber Supplements in Weight Management?

Inadequate dietary fiber intake is common in modern diets, especially in children. Epidemiological and experimental evidence point to a significant association between a lack of fiber intake and ischemic heart disease, stroke atherosclerosis, type 2 diabetes, overweight and obesity, insulin resistance, hypertension, dyslipidemia, as well as gastrointestinal disorders such as diverticulosis, irritable bowel disease, colon cancer, and cholelithiasis. The physiological effects of fiber relate to the physical properties of volume, viscosity, and water-holding capacity that the fiber imparts to food leading to important influences over the energy density of food. Beyond these physical properties, fiber directly impacts a complex array of microbiological, biochemical, and neurohormonal effects directly through modification of the kinetics of digestion and through its metabolism into constituents such as short chain fatty acids, which are both energy substrates and important enteroendocrine ligands. Of particular interest to clinicians is the important role dietary fiber plays in glucoregulation, appetite, and satiety. Supplementation of the diet with highly functional fibers may prove to play an important role in long-term obesity management