Severity of influenza A 2009 (H1N1) pneumonia is underestimated by routine prediction rules. Results from a prospective, population-based study.

Characteristics of patients with community-acquired pneumonia (CAP) due to pandemic influenza A 2009 (H1N1) have been inadequately compared to CAP caused by other respiratory pathogens. The performance of prediction rules for CAP during an epidemic with a new infectious agent are unknown. Prospective, population-based study from November 2008-November 2009, in centers representing 70% of hospital beds in Iceland. Patients admitted with CAP underwent evaluation and etiologic testing, including polymerase chain reaction (PCR) for influenza. Data on influenza-like illness in the community and overall hospital admissions were collected. Clinical and laboratory data, including pneumonia severity index (PSI) and CURB-65 of patients with CAP due to H1N1 were compared to those caused by other agents. Of 338 consecutive and eligible patients 313 (93%) were enrolled. During the pandemic peak, influenza A 2009 (H1N1) patients constituted 38% of admissions due to CAP. These patients were younger, more dyspnoeic and more frequently reported hemoptysis. They had significantly lower severity scores than other patients with CAP (1.23 vs. 1.61, P= .02 for CURB-65, 2.05 vs. 2.87 for PSI, P<.001) and were more likely to require intensive care admission (41% vs. 5%, P<.001) and receive mechanical ventilation (14% vs. 2%, P= .01). Bacterial co-infection was detected in 23% of influenza A 2009 (H1N1) patients with CAP. Clinical characteristics of CAP caused by influenza A 2009 (H1N1) differ markedly from CAP caused by other etiologic agents. Commonly used CAP prediction rules often failed to predict admissions to intensive care or need for assisted ventilation in CAP caused by the influenza A 2009 (H1N1) virus, underscoring the importance of clinical acumen under these circumstances.Icelandic Center for Research, Rannis 100436021 Landspitali University Hospital Science Fun

Support for involvement of the AHI1 locus in schizophrenia

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldRecently, markers in the Abelson Helper Integration Site 1 (AHI1) region were shown to be associated with schizophrenia in a family sample of Israeli-Arabs. Here, we report a study evaluating the relevance of the AHI1 region to schizophrenia in an Icelandic sample. Seven markers shown to confer risk in the previous report were typed in 608 patients diagnosed with broad schizophrenia and 1,504 controls. Odds ratios for the overtransmitted alleles in the Israeli-Arab families ranged from 1.15 to 1.29 in the Icelandic sample. After Bonferroni correction for the seven markers tested, two markers were significantly associated with schizophrenia. Thus, our results are in general agreement with the previous report, with the strongest association signal observed in a region upstream of the AHI1 gene

Spectrum of Perforin Gene Mutations in Familial Hemophagocytic Lymphohistiocytosis

Familial hemophagocytic lymphohistiocytosis (FHL) is an autosomal recessive disease of early childhood characterized by nonmalignant accumulation and multivisceral infiltration of activated T lymphocytes and histiocytes (macrophages). Cytotoxic T and natural killer (NK) cell activity is markedly reduced or absent in these patients, and mutations in a lytic granule constituent, perforin, were recently identified in a number of FHL individuals. Here, we report a comprehensive survey of 34 additional patients with FHL for mutations in the coding region of the perforin gene and the relative frequency of perforin mutations in FHL. Perforin mutations were identified in 7 of the 34 families investigated. Six children were homozygous for the mutations, and one patient was a compound heterozygote. Four novel mutations were detected: one nonsense, two missense, and one deletion of one amino acid. In four families, a previously reported mutation at codon 374, causing a premature stop codon, was identified, and, therefore, this is the most common perforin mutation identified so far in FHL patients. We found perforin mutations in 20% of all FHL patients investigated (7/34), with a somewhat higher prevalence, ∼30% (6/20), in children whose parents originated from Turkey. No other correlation between the type of mutation and the phenotype of the patients was evident from the present study. Our combined results from mutational analysis of 34 families and linkage analysis of a subset of consanguineous families indicate that perforin mutations account for 20%–40% of the FHL cases and the FHL 1 locus on chromosome 9 for ∼10%, whereas the major part of the FHL cases are caused by mutations in not-yet-identified genes

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Energy efficient supply chain of an aluminium product in Sweden – What can be done in-house and between the companies?

According to the Energy Efficiency Directive executed by the European Union, each member state is obliged to set a national target on energy efficiency. This requirement constitutes the basis for governments to formulate policy measures directed towards industrial companies. Such policy measures, along with the demand for cost-effective production to remain competitive on the market, motivates industrial companies to improve their energy efficiency. The aluminium industry is energy intensive and consumes substantial amounts of electricity and fossil fuels, resulting in both direct and indirect greenhouse gas emissions. This paper presents a study of the production of an aluminium product in Sweden in terms of implemented energy efficiency measures in the supply chain and potential areas for further improvement. Most previous studies have focused on energy efficiency measures in individual companies (value chains). However, this paper presents and analyses energy efficiency measures not only in each individual company but also in the entire supply chain of the product. The supply chain studied starts with secondary aluminium production followed by the production of a part of an automobile motor and ends with installing the motor detail in a car. Empirical data were gathered through a questionnaire and a focus group. The study shows the great potential for further energy efficiency improvements in the value chains of each individual company and in the whole supply chain. The work shown here is a part of a larger research project performed in close cooperation with the Swedish aluminium industry

Energy efficient supply chain of an aluminium product in Sweden – What can be done in-house and between the companies?

According to the Energy Efficiency Directive executed by the European Union, each member state is obliged to set a national target on energy efficiency. This requirement constitutes the basis for governments to formulate policy measures directed towards industrial companies. Such policy measures, along with the demand for cost-effective production to remain competitive on the market, motivates industrial companies to improve their energy efficiency. The aluminium industry is energy intensive and consumes substantial amounts of electricity and fossil fuels, resulting in both direct and indirect greenhouse gas emissions. This paper presents a study of the production of an aluminium product in Sweden in terms of implemented energy efficiency measures in the supply chain and potential areas for further improvement. Most previous studies have focused on energy efficiency measures in individual companies (value chains). However, this paper presents and analyses energy efficiency measures not only in each individual company but also in the entire supply chain of the product. The supply chain studied starts with secondary aluminium production followed by the production of a part of an automobile motor and ends with installing the motor detail in a car. Empirical data were gathered through a questionnaire and a focus group. The study shows the great potential for further energy efficiency improvements in the value chains of each individual company and in the whole supply chain. The work shown here is a part of a larger research project performed in close cooperation with the Swedish aluminium industry

Energy efficient supply chain of an aluminium product in Sweden – What can be done in-house and between the companies?

According to the Energy Efficiency Directive executed by the European Union, each member state is obliged to set a national target on energy efficiency. This requirement constitutes the basis for governments to formulate policy measures directed towards industrial companies. Such policy measures, along with the demand for cost-effective production to remain competitive on the market, motivates industrial companies to improve their energy efficiency. The aluminium industry is energy intensive and consumes substantial amounts of electricity and fossil fuels, resulting in both direct and indirect greenhouse gas emissions. This paper presents a study of the production of an aluminium product in Sweden in terms of implemented energy efficiency measures in the supply chain and potential areas for further improvement. Most previous studies have focused on energy efficiency measures in individual companies (value chains). However, this paper presents and analyses energy efficiency measures not only in each individual company but also in the entire supply chain of the product. The supply chain studied starts with secondary aluminium production followed by the production of a part of an automobile motor and ends with installing the motor detail in a car. Empirical data were gathered through a questionnaire and a focus group. The study shows the great potential for further energy efficiency improvements in the value chains of each individual company and in the whole supply chain. The work shown here is a part of a larger research project performed in close cooperation with the Swedish aluminium industry

Sinu culture artefacts, Museo del Oro, Bogota, Colombia, 1977, [24] [picture] /

Condition: Good.; Title devised by cataloguer based on inscription on reverse.; Part of Wolfgang Sievers photographic archive.; Sievers number: EK-4560-add71 (devised number).; Also available in an electronic version via the Internet at: http://nla.gov.au/nla.pic-vn4192462