4,088 research outputs found

    Multimorbidity and co-morbidity in atrial fibrillation and effects on survival: findings from UK Biobank cohort

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    Aims: To examine the number and type of co-morbid long-term health conditions (LTCs) and their associations with all-cause mortality in an atrial fibrillation (AF) population. Methods and results: Community cohort participants (UK Biobank n = 502 637) aged 37–73 years were recruited between 2006 and 2010. Self-reported LTCs (n = 42) identified in people with AF at baseline. All-cause mortality was available for a median follow-up of 7 years (interquartile range 76–93 months). Hazard ratios (HRs) examined associations between number and type of co-morbid LTC and all-cause mortality, adjusting for age, sex, socio-economic status, smoking, and anticoagulation status. Three thousand six hundred fifty-one participants (0.7% of the study population) reported AF; mean age was 61.9 years. The all-cause mortality rate was 6.7% (248 participants) at 7 years. Atrial fibrillation participants with ≥4 co-morbidities had a six-fold higher risk of mortality compared to participants without any LTC. Co-morbid heart failure was associated with higher risk of mortality [HR 2.96, 95% confidence interval (CI) 1.83–4.80], whereas the presence of co-morbid stroke did not have a significant association. Among non-cardiometabolic conditions, presence of chronic obstructive pulmonary disease (HR 3.31, 95% CI 2.14–5.11) and osteoporosis (HR 3.13, 95% CI 1.63–6.01) was associated with a higher risk of mortality. Conclusion: Survival in middle-aged to older individuals with self-reported AF is strongly correlated with level of multimorbidity. This group should be targeted for interventions to optimize their management, which in turn may potentially reduce the impact of their co-morbidities on survival. Future AF clinical guidelines need to place greater emphasis on the issue of co-morbidity

    3-Fluoro­salicylaldoxime at 6.5 GPa

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    3-Fluoro­salicylaldoxime, C7H6FNO2, unlike many salicylaldoxime derivatives, forms a crystal structure containing hydrogen-bonded chains rather than centrosymmetric hydrogen-bonded ring motifs. Each chain inter­acts with two chains above and two chains below via π–π stacking contacts [shortest centroid–centroid distance = 3.295 (1) Å]. This structure at 6.5 GPa represents the final point in a single-crystal compression study

    Salicylaldehyde hydrazones: buttressing of outer sphere hydrogen-bonding and copper-extraction properties

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    Salicylaldehyde hydrazones are weaker copper extractants than their oxime derivatives, which are used in hydrometallurgical processes to recover ~20 % of the world’s copper. Their strength, based on the extraction equilibrium constant Ke, can be increased by nearly three orders of magnitude by incorporating electron-withdrawing or hydrogen-bond acceptor groups (X) ortho to the phenolic OH group of the salicylaldehyde unit. Density functional theory calculations suggest that the effects of the 3-X substituents arise from a combination of their influence on the acidity of the phenol in the pH-dependent equilibrium, Cu2+ + 2Lorg ⇌ [Cu(L–H)2]org + 2H+, and on their ability to ‘buttress’ interligand hydrogen bonding by interacting with the hydrazone N–H donor group. X-ray crystal structure determination and computed structures indicate that in both the solid state and the gas phase, coordinated hydrazone groups are less planar than coordinated oximes and this has an adverse effect on intramolecular hydrogen-bond formation to the neighbouring phenolate oxygen atoms

    Medical school gift restriction policies and physician prescribing of newly marketed psychotropic medications: difference-in-differences analysis

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    Objective: To examine the effect of attending a medical school with an active policy on restricting gifts from representatives of pharmaceutical and device industries on subsequent prescribing behavior. Design: Difference-in-differences approach. Setting: 14 US medical schools with an active gift restriction policy in place by 2004. Participants: Prescribing patterns in 2008 and 2009 of physicians attending one of the schools compared with physicians graduating from the same schools before the implementation of the policy, as well as a set of contemporary matched controls. Main outcome measure: Probability that a physician would prescribe a newly marketed medication over existing alternatives of three psychotropic classes: lisdexamfetamine among stimulants, paliperidone among antipsychotics, and desvenlafaxine among antidepressants. None of these medications represented radical breakthroughs in their respective classes. Results: For two of the three medications examined, attending a medical school with an active gift restriction policy was associated with reduced prescribing of the newly marketed drug. Physicians who attended a medical school with an active conflict of interest policy were less likely to prescribe lisdexamfetamine over older stimulants (adjusted odds ratio 0.44, 95% confidence interval 0.22 to 0.88; P=0.02) and paliperidone over older antipsychotics (0.25, 0.07 to 0.85; P=0.03). A significant effect was not observed for desvenlafaxine (1.54, 0.79 to 3.03; P=0.20). Among cohorts of students who had a longer exposure to the policy or were exposed to more stringent policies, prescribing rates were further reduced. Conclusion: Exposure to a gift restriction policy during medical school was associated with reduced prescribing of two out of three newly introduced psychotropic medications

    Application of a photo-identification based assessment model to southern right whales in South African waters, now including data up to 2012

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    This paper extends the analyses of Brandão et al. (2012) which applied the three-mature-stages (receptive, calving and resting) model of Cooke et al. (2003) to photo-identification data available from 1979 to 2010 for southern right whales in South African waters, by taking two further years of data into account. The 2012 number of parous females is estimated to be 1 321, the total population (including males and calves) 5 062, and the annual population growth rate 6.6%. This reflects a small reduction to the 6.8% increase rate estimated previously; this is a result of slightly lesser numbers in recent years than estimated previously. Information from resightings of grey blazed calves as adults with calves allows estimation of first year survival rate of 0.850, compared to a subsequent annual rate of 0.988. This information also suggests that 7% (s.e. 6%) of grey blazed calves are not recognised as such when adults; this estimate is much less than that of 27% obtained previously by Brandão et al. (2012), and is more compatible with the relative proportions of grey blazed animals amongst calves and amongst calving adults which suggest a value of 10% (s.e. 8%)

    Interpersonal prosodic correlation in frontotemporal dementia.

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    Communication accommodation describes how individuals adjust their communicative style to that of their conversational partner. We predicted that interpersonal prosodic correlation related to pitch and timing would be decreased in behavioral variant frontotemporal dementia (bvFTD). We predicted that the interpersonal correlation in a timing measure and a pitch measure would be increased in right temporal FTD (rtFTD) due to sparing of the neural substrate for speech timing and pitch modulation but loss of social semantics. We found no significant effects in bvFTD, but conversations including rtFTD demonstrated higher interpersonal correlations in speech rate than healthy controls

    Application of a photo-identification based assessment model to southern right whales in South African waters, now including data up to 2012

    Get PDF
    This paper extends the analyses of Brandão et al. (2012) which applied the three-mature-stages (receptive, calving and resting) model of Cooke et al. (2003) to photo-identification data available from 1979 to 2010 for southern right whales in South African waters, by taking two further years of data into account. The 2012 number of parous females is estimated to be 1 321, the total population (including males and calves) 5 062, and the annual population growth rate 6.6%. This reflects a small reduction to the 6.8% increase rate estimated previously; this is a result of slightly lesser numbers in recent years than estimated previously. Information from resightings of grey blazed calves as adults with calves allows estimation of first year survival rate of 0.850, compared to a subsequent annual rate of 0.988. This information also suggests that 7% (s.e. 6%) of grey blazed calves are not recognised as such when adults; this estimate is much less than that of 27% obtained previously by Brandão et al. (2012), and is more compatible with the relative proportions of grey blazed animals amongst calves and amongst calving adults which suggest a value of 10% (s.e. 8%)

    Incorporating habitat distribution in wildlife disease models: conservation implications for the threat of squirrelpox on the Isle of Arran

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    Emerging infectious diseases are a substantial threat to native populations. The spread of disease through naive native populations will depend on both demographic and disease parameters, as well as on habitat suitability and connectivity. Using the potential spread of squirrelpox virus (SQPV) on the Isle of Arran as a case study, we develop mathematical models to examine the impact of an emerging disease on a population in a complex landscape of different habitat types. Furthermore, by considering a range of disease parameters, we infer more generally how complex landscapes interact with disease characteristics to determine the spread and persistence of disease. Specific findings indicate that a SQPV outbreak on Arran is likely to be short lived and localized to the point of introduction allowing recovery of red squirrels to pre-infection densities; this has important consequences for the conservation of red squirrels. More generally, we find that the extent of disease spread is dependent on the rare passage of infection through poor quality corridors connecting good quality habitats. Acute, highly transmissible infectious diseases are predicted to spread rapidly causing high mortality. Nonetheless, the disease typically fades out following local epidemics and is not supported in the long term. A chronic infectious disease is predicted to spread more slowly but can remain endemic in the population. This allows the disease to spread more extensively in the long term as it increases the chance of spread between poorly connected populations. Our results highlight how a detailed understanding of landscape connectivity is crucial when considering conservation strategies to protect native species from disease threats
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