31 research outputs found

    Serum 25-Hydroxyvitamin D and the Incidence of Acute Viral Respiratory Tract Infections in Healthy Adults

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    Declining serum concentrations of 25-hydroxyvitamin D seen in the fall and winter as distance increases from the equator may be a factor in the seasonal increased prevalence of influenza and other viral infections. This study was done to determine if serum 25-hydroxyvitamin D concentrations correlated with the incidence of acute viral respiratory tract infections.In this prospective cohort study serial monthly concentrations of 25-hydroxyvitamin D were measured over the fall and winter 2009-2010 in 198 healthy adults, blinded to the nature of the substance being measured. The participants were evaluated for the development of any acute respiratory tract infections by investigators blinded to the 25-hydroxyvitamin D concentrations. The incidence of infection in participants with different concentrations of vitamin D was determined. One hundred ninety-five (98.5%) of the enrolled participants completed the study. Light skin pigmentation, lean body mass, and supplementation with vitamin D were found to correlate with higher concentrations of 25-hydroxyvitamin D. Concentrations of 38 ng/ml or more were associated with a significant (p<0.0001) two-fold reduction in the risk of developing acute respiratory tract infections and with a marked reduction in the percentages of days ill.Maintenance of a 25-hydroxyvitamin D serum concentration of 38 ng/ml or higher should significantly reduce the incidence of acute viral respiratory tract infections and the burden of illness caused thereby, at least during the fall and winter in temperate zones. The findings of the present study provide direction for and call for future interventional studies examining the efficacy of vitamin D supplementation in reducing the incidence and severity of specific viral infections, including influenza, in the general population and in subpopulations with lower 25-hydroxyvitamin D concentrations, such as pregnant women, dark skinned individuals, and the obese

    Genome-wide meta-analysis of muscle weakness identifies 15 susceptibility loci in older men and women

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    Low muscle strength is an important heritable indicator of poor health linked to morbidity and mortality in older people. In a genome-wide association study meta-analysis of 256,523 Europeans aged 60 years and over from 22 cohorts we identify 15 loci associated with muscle weakness (European Working Group on Sarcopenia in Older People definition: n = 48,596 cases, 18.9% of total), including 12 loci not implicated in previous analyses of continuous measures of grip strength. Loci include genes reportedly involved in autoimmune disease (HLA-DQA1p = 4 × 10−17), arthritis (GDF5p = 4 × 10−13), cell cycle control and cancer protection, regulation of transcription, and others involved in the development and maintenance of the musculoskeletal system. Using Mendelian randomization we report possible overlapping causal pathways, including diabetes susceptibility, haematological parameters, and the immune system. We conclude that muscle weakness in older adults has distinct mechanisms from continuous strength, including several pathways considered to be hallmarks of ageing

    Common variants in Alzheimer's disease and risk stratification by polygenic risk scores.

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    Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease

    Key Performance Indicators: Measurement and performance assessment in health care.

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    Abstract: The raising of the standard levels of quality and efficiency related to the provision of services within the National Health System has once again highlighted the importance of building an ad hoc system for measuring and evaluating performance. This work aims to build a system of indicators for existing public health facilities that assess the quality and adequacy of the services offered in the field of primary care. The construction of performance indicators, especially in health services, is a very useful practice, not only to use a strategy for reviewing expenditure in the provision of specific services but mainly to rationalize the working methods of projection to results. The proposed model can be used for the efficient and profitable management of health departments and entire hospitals, also paying attention to the well-being of hospitalized patients. The results of this work demonstrate the importance of statistical techniques to obtain information from data of different nature and optimize their use. Through a multivariate analysis of the data (Principal Components Analysis), we built a series of indicators and we will be able to weight them in order to create a performance assessment model using KPI (Key Performance Indicator) able to provide the relevance of each indicator within the analysis carried out

    Customer Relationship Management: il caso di BPPB

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    Il presente lavoro si pone alla base dei meccanismi decisionali della Cusomer Relationship Management bancario per la fidelizzazione della clientela, che implicano un focus sulle caratteristiche della clientela medesima. L’accurata compilazione del questionario MIFID da parte del cliente è il primo passo verso la raccolta dati nel processo di profilazione della clientela. In questo studio sono presi in considerazione appunto i dati provenienti dai que–stionari MIFID compilati dalla clientela di un istituto bancario localmente molto importante. I dati sono stati dapprima analizzati tramite analisi statistiche descritti–ve e successivamente sono state avviate analisi con tecniche multivariate di esplo–razione dati. Nello specifico, utilizzando in modo esplorativo-confermativo la clu–ster analysis, innanzitutto si suddividono i clienti in gruppi con caratteristiche si–mili al loro interno e in un secondo momento se ne identificano le peculiarità
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