Immunoradiometric assay of circulating C-reactive protein: age-related values in the adult general population

Background: Increased values of C-reactive protein (CRP), the classical acute phase protein, within the range below 5 mg/L, previously considered to be within the reference interval, are strongly associated with increased risk of atherothrombotic events, and are clinically significant in osteoarthritis and neonatal infection.<br/> Methods: A robust new polyclonal-monoclonal solid-phase IRMA for CRP was developed, with a range of 0.05- 10.0 mg/L.<br/> Results: Plasma CRP values in general adult populations from Augsburg, Germany (2291 males and 2203 females; ages, 25-74 years) and Glasgow, Scotland (604 males and 650 females; ages, 25-64 years) were very similar. The median CRP approximately doubled with age, from similar to 1 mg/L in the youngest decade to similar to 2 mg/L in the oldest, and tended to be higher in females. <br/>Conclusion: This extensive data set, the largest such study of CRP, provides valuable reference information for future clinical and epidemiological investigations

Between past, present and future – implications of socio-demographic changes in tourism.

This paper discusses the possibilities and limits of today’s tourism industry analyses regarding the predicted future travel behaviour on the basis of socio-demographic changes. Based on a written survey of German-speaking visitors of a destination in Switzerland, the results support the thesis of cohort-specific travel behaviour. The highlighted changes shall serve as a source for the development of a more diversified supply structure in tourism directed to the mature customer

Surge dynamics in the Nathorstbreen glacier system, Svalbard

Nathorstbreen glacier system (NGS) recently experienced the largest surge in Svalbard since 1936, and this was examined using spatial and temporal observations from DEM differencing, time series of surface velocities from satellite synthetic aperture radar (SAR) and other sources. The upper basins with maximum accumulation during quiescence corresponded to regions of initial lowering. Initial speed-up exceeded quiescent velocities by a factor of several tens. This suggests that polythermal glacier surges are initiated in the temperate area before mass is displaced downglacier. Subsequent downglacier mass displacement coincided with areas where glacier velocity increased by a factor of 100–200 times (stage 2). After more than 5 years, the joint NGS terminus advanced abruptly into the fjord during winter, increasing velocities even more. The advance was followed by up-glacier propagation of crevasses, indicating the middle and subsequently the upper part of the glaciers reacting to the mass displacement. NGS advanced ~15 km, while another ~3 km length was lost due to calving. Surface lowering of ~50 m was observed in some up-glacier areas, and in 5 years the total glacier area increased by 20%. Maximum measured flow rates were at least 25 m d⁻¹, 2500 times quiescent velocity, while average velocities were about 10 m d⁻¹. The surges of Zawadzkibreen cycle with ca. 70-year periods

Incidence of Neonatal Developmental Dysplasia of the Hip and Late Detection Rates Based on Screening Strategy A Systematic Review and Meta-analysis

IMPORTANCE Universal ultrasonographic screening for developmental dysplasia of the hip (DDH) has gained increasing popularity despite the lack of benefit in terms of reducing the rates of late-detected cases (age >= 12 weeks) in randomized clinical trials.OBJECTIVE To report the reported incidence of DDH in the English scientific literature and compare rates of late-detected cases in settings with different DDH screening strategies.DATA SOURCES PubMed, Scopus, and Web of Science databases were searched on November 25 and 27, 2021. No time filters were used in the search.STUDY SELECTION All observational studies reporting the incidence of early-detected or late-detected (age >= 12 weeks) DDH were included. Non-English reports were excluded if the abstract did not include enough information to be included for analysis.DATA EXTRACTION AND SYNTHESIS The number of newborns screened and the detection rates were extracted. Meta-analysis calculated the pooled incidence of DDH per 1000 newborns with 95% CIs using a random- or fixed-effects model. This study is reported according to the PRISMA and MOOSE guidelines.MAIN OUTCOMES AND MEASURES The main outcome measures were early detection, early treatment, late detection, and operative treatment incidences.RESULTS A total of 1899 studies were identified. 203 full texts were assessed, and 76 studies with 16 901079 infants were included in final analyses. The early detection rate was 8.4 (95% CI. 4.8-14.8) infants with DDH per 1000 newborns with clinical screening, 4.4(95% CI, 2.4-8.0) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 23.0 (95% CI, 15.7-33.4) infants with DDH per 1000 newborns with universal ultrasonographic screening. Rates for nonoperative treatment were 5.5 (95% CI, 2.1-14) treatments per 1000 newborns with clinical screening, 3.1(95% CI, 2.0-4.8) treatments per 1000 newborns with selective ultrasonographic screening, and 9.8 (95% CI, 6.7-14.4) treatments per 1000 newborns with universal ultrasonographic screening. The incidence of late-detected DDH was 0.5 (95% CI, 0.2-1.5) infants with DDH per 1000 newborns with clinical screening, 0.6 (95% CI. 0.3-1.3) infants with DDH per 1000 newborns with selective ultrasonographic screening, and 0.2 (95% CI, 0.0-0.8) infants with DDH per 1000 newborns with universal ultrasonographic screening. The corresponding incidences of operative treatment were 0.2 (95% CI, 0.0-0.9) operations per 1000 newborns with clinical screening, 0.5 (95% CI, 0.4-0.7) operations per 1000 newborns with selective ultrasonographic screening, and 0.4(95% CI, 0.2-0.7) operations per 1000 newborns with universal ultrasonographic screening.CONCLUSIONS AND RELEVANCE This meta-analysis found that early detection rates and nonoperative treatments were higher with universal screening. The late detection and operative treatment rates with universal screening were similar to those among selectively and clinically screened newborns. Based on these results, universal screening may cause initial overtreatment without reducing the rates of late detection and operative treatment.Peer reviewe

Improving the Recording of Diagnoses in Primary Care with Team Incentives : A Controlled Longitudinal Follow-Up Study

Introduction. We studied whether primary care teams respond to financial group bonuses by improving the recording of diagnoses, whether this intervention leads to diagnoses reflecting the anticipated distribution of diseases, and how the recording of a significant chronic disease, diabetes, alters after the application of these bonuses. Methods. We performed an observational register-based retrospective quasi-experimental follow-up study with before-and-after setting and two control groups in primary healthcare of a Finnish town. We studied the rate of recorded diagnoses in visits to general practitioners with interrupted time series analysis. The distribution of these diagnoses was also recorded. Results. After group bonuses, the rate of recording diagnoses increased by 17.9% (95% CI: 13.6-22.3) but not in either of the controls (-2.0 to -0.3%). The increase in the rate of recorded diagnoses in the care teams varied between 14.9% (4.7-25.2) and 33.7% (26.6-41.3). The distribution of recorded diagnoses resembled the respective distribution of diagnoses in the former studies of diagnoses made in primary care. The rate of recorded diagnoses of diabetes did not increase just after the intervention. Conclusions. In primary care, the completeness of diagnosis recording can be, to varying degrees, influenced by group bonuses without guarantee that recording of clinically significant chronic diseases is improved.Peer reviewe

Length of Nutritional Transition Associates Negatively with Postnatal Growth in Very Low Birthweight Infants

Very low birthweight (VLBW

Length of Nutritional Transition Associates Negatively with Postnatal Growth in Very Low Birthweight Infants

Very low birthweight (VLBW

A triple-chamber parenteral nutrition solution was associated with improved protein intake in very low birthweight infants

Aim We evaluated the nutrient intakes of very low birthweight (VLBW) infants weighing less than 1500 g and tested the hypothesis that using a triple-chamber parenteral nutrition (PN) solution, containing lipids, glucose and amino acids, would improve protein intake. Methods This retrospective cohort study comprised 953 VLBW infants born in 2005-2013 at a gestational age of less than 32 + 0/7 weeks and admitted to the neonatal care unit at Helsinki Children's Hospital, Finland. The infants were divided into four groups according their birth year and PN regime. Nutrient intakes were obtained from computerised medication administration records. Results In 2012-2013, when a triple-chamber PN solution was used, infants were more likely to reach the target parenteral protein intake of 3.5 g/kg/d, and reach it 3-7 days earlier, compared with infants who received individual PN or standard two-in-one PN solutions in 2005-2011. In addition, infants in the triple-chamber group had the highest median energy intake (90 kcal/kg/d) during the first week. They also had higher median protein intakes in weeks one, two and three (3.1, 3.4 and 3.7 g/kg/d) than infants born in 2005-2011 (P <.05). Conclusion Using a triple-chamber PN solution was associated with improved protein intake, and the protein target was more likely to be achieved.Peer reviewe