175 research outputs found
Differential risk of ST-Segment Elevation Myocardial Infarction in male and female smokers
Background
Smoking is a well-documented risk for acute ST-segment elevation myocardial infarction (STEMI). The differential effect between sexes has yet to be quantified.
Objectives
The purpose of this study was to differentiate the effect of smoking on increased risk of STEMI between sexes.
Methods
For this retrospective ecological cohort study, all patients at a U.K. tertiary cardiothoracic center who presented between 2009 and 2014 with acute STEMI were combined with population data to generate incidence rates of STEMI. Age-standardized incidence rate ratios (IRRs) using the Poisson distribution were calculated comparing STEMI rates between smokers and nonsmokers stratified by sex and 3 age groups (18 to 49, 50 to 64, and >65 years).
Results
A total of 3,343 patients presented over 5,639,328 person-years. Peak STEMI rate for current smokers was in the 70 to 79 years age range for women (235 per 100,000 patient-years) and 50 to 59 years (425 per 100,000 patient-years) in men. Smoking was associated with a significantly greater increase in STEMI rate for women than men (IRR: 6.62; 95% confidence interval [CI]: 5.98 to 7.31, vs. 4.40; 95% CI: 4.15 to 4.67). The greatest increased risk was in women age 18 to 49 (IRR: 13.22; 95% CI: 10.33 to 16.66, vs. 8.60; 95% CI: 7.70 to 9.59 in men). The greatest risk difference was in the age 50 to 64 years group, with IRR of 9.66 (95% CI: 8.30 to 11.18) in women and 4.47 (95% CI: 4.10 to 4.86) in men.
Conclusions
This study quantifies the differential effect of smoking between sexes, with women having a significantly increased risk of STEMI than men. This information encourages continued efforts to prevent smoking uptake and promote cessation
Formation of delta ferrite in 9 wt.% Cr steel investigated by in-situ X-ray diffraction using synchrotron radiation
In-situ X-ray diffraction (XRD) measurements using high energy synchrotron radiation were performed to monitor in real time the formation of delta ferrite in a martensitic 9 wt pct chromium steel under simulated weld thermal cycles. Volume fractions of martensite, austenite, and delta ferrite were measured as a function of temperature at a 10 K/s heating rate to 1573 K (1300 °C) and subsequent cooling. At the peak temperature, the delta ferrite concentration rose to 19 pct, of which 17 pct transformed back to austenite on subsequent cooling.Max Kade Foundation, Inc.Austrian Academy of SciencesUnited States. Dept. of Energy (Division of Materials Sciences and Engineering, Office of Science, and Office of Basic Energy Sciences
Encouraging Results of a Phase II Trial of Inhaled Fluticasone Propionate, Azithromycin, and Montelukast (FAM) May Maintain Lung Function in Bronchiolitis Obliterans Syndrome (BOS) after Hematopoietic Cell Transplantation
A Randomized Phase II Crossover Study of Imatinib or Rituximab for Cutaneous Sclerosis after Hematopoietic Cell Transplantation
Cutaneous sclerosis (CS) occurs in 20% of patients with chronic graft-versus-host disease (GVHD) and can compromise mobility and quality of life
Magnetic Reconnection in Extreme Astrophysical Environments
Magnetic reconnection is a basic plasma process of dramatic rearrangement of
magnetic topology, often leading to a violent release of magnetic energy. It is
important in magnetic fusion and in space and solar physics --- areas that have
so far provided the context for most of reconnection research. Importantly,
these environments consist just of electrons and ions and the dissipated energy
always stays with the plasma. In contrast, in this paper I introduce a new
direction of research, motivated by several important problems in high-energy
astrophysics --- reconnection in high energy density (HED) radiative plasmas,
where radiation pressure and radiative cooling become dominant factors in the
pressure and energy balance. I identify the key processes distinguishing HED
reconnection: special-relativistic effects; radiative effects (radiative
cooling, radiation pressure, and Compton resistivity); and, at the most extreme
end, QED effects, including pair creation. I then discuss the main
astrophysical applications --- situations with magnetar-strength fields
(exceeding the quantum critical field of about 4 x 10^13 G): giant SGR flares
and magnetically-powered central engines and jets of GRBs. Here, magnetic
energy density is so high that its dissipation heats the plasma to MeV
temperatures. Electron-positron pairs are then copiously produced, making the
reconnection layer highly collisional and dressing it in a thick pair coat that
traps radiation. The pressure is dominated by radiation and pairs. Yet,
radiation diffusion across the layer may be faster than the global Alfv\'en
transit time; then, radiative cooling governs the thermodynamics and
reconnection becomes a radiative transfer problem, greatly affected by the
ultra-strong magnetic field. This overall picture is very different from our
traditional picture of reconnection and thus represents a new frontier in
reconnection research.Comment: Accepted to Space Science Reviews (special issue on magnetic
reconnection). Article is based on an invited review talk at the
Yosemite-2010 Workshop on Magnetic Reconnection (Yosemite NP, CA, USA;
February 8-12, 2010). 30 pages, no figure
A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS
Patients with multimorbidity (defined as the co-occurrence of multiple chronic diseases) frequently experience fragmented care, which increases the risk of negative outcomes. A recently proposed Integrated Multimorbidity Care Model aims to overcome many issues related to fragmented care. In the context of Joint Action CHRODIS-PLUS, an implementation methodology was developed for the care model, which is being piloted in five sites. We aim to (1) explain the methodology used to implement the care model and (2) describe how the pilot sites have adapted and applied the proposed methodology. The model is being implemented in Spain (Andalusia and Aragon), Lithuania (Vilnius and Kaunas), and Italy (Rome). Local implementation working groups at each site adapted the model to local needs, goals, and resources using the same methodological steps: (1) Scope analysis; (2) situation analysis-"strengths, weaknesses, opportunities, threats" (SWOT) analysis; (3) development and improvement of implementation methodology; and (4) final development of an action plan. This common implementation strategy shows how care models can be adapted according to local and regional specificities. Analysis of the common key outcome indicators at the post-implementation phase will help to demonstrate the clinical effectiveness, as well as highlight any difficulties in adapting a common Integrated Multimorbidity Care Model in different countries and clinical settings
Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study
Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejection fractionâ<â55%) and explore the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2â7.0%] vs. population prevalence of 4.6% [95% C.I. 2.7â8.2], pâ=â0.99); 12/13 women had concurrent obstetric/medical risk factors for pre-eclampsia. The prevalence of preterm pre-eclampsia (<â37 weeks) and fetal growth restriction (FGR) was increased (1.8% vs. 0.7%, pâ=â0.03; 15.2% vs. 5.5%, pâ<â0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome. Antenatal Ă blockers (nâ=â116) were associated with lower birthweight Z score (adjusted difference ââ0.31 [95% C.I. ââ0.61 to ââ0.01], pâ=â0.04). To conclude, this study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with pre-existing cardiac dysfunction. Our results do not necessarily support a causal relationship between cardiac dysfunction and pre-eclampsia, especially given the populationâs background risk status. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant Ă blocker use
HistĂłria de vida de Laetacara aff. araguaiae Ottoni & Costa, 2009 (Perciformes, Cichlidae) em dois riachos no Noroeste do Estado de SĂŁo Paulo, Brasil
Genome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure
Heart failure (HF) is a leading cause of morbidity and mortality worldwide. A small proportion of HF cases are attributable to monogenic cardiomyopathies and existing genome-wide association studies (GWAS) have yielded only limited insights, leaving the observed heritability of HF largely unexplained. We report results from a GWAS meta-analysis of HF comprising 47,309 cases and 930,014 controls. Twelve independent variants at 11 genomic loci are associated with HF, all of which demonstrate one or more associations with coronary artery disease (CAD), atrial fibrillation, or reduced left ventricular function, suggesting shared genetic aetiology. Functional analysis of non-CAD-associated loci implicate genes involved in cardiac development (MYOZ1, SYNPO2L), protein homoeostasis (BAG3), and cellular senescence (CDKN1A). Mendelian randomisation analysis supports causal roles for several HF risk factors, and demonstrates CAD-independent effects for atrial fibrillation, body mass index, and hypertension. These findings extend our knowledge of the pathways underlying HF and may inform new therapeutic strategies
New insights into the genetic etiology of Alzheimer's disease and related dementias
Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE Δ4 allele
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