Estimating marginal cohort working life expectancies from sequential cross-sectional survey data

This article applies recently developed health expectancy methodologies to estimate the average duration of future work life in different states of work ability. Data on working capacity obtained from sequential cross-sectional samples of the cohort population were available from Finnish surveys conducted among active municipal employees. We used these data to estimate cohort marginal probabilities and expected occupancy times in the work ability states. One finding is that the proportion of workers with excellent or good work ability decreased monotonically with advancing age for both genders, but men were prone to have worse work ability and a shorter work career than women. Transition from poor to good or excellent work ability state was estimated to increase working life expectancy of a 45-year-old person by four years for both genders. This study indicates that the work ability of aging Finnish workers deteriorates prematurely, leading to serious socio-economic consequences. Thus it is important to examine the development of work ability already at an early age when it is still possible to intervene in the process

Reaction Textures and Metamorphic Evolution of Sapphirine-bearing Granulites from the Gruf Complex, Italian Central Alps

Mineral chemistries and textures are described from a suite of sapphirine-bearing granulites from the Gruf Complex of the Italian Central Alps. The granulites contain combinations of garnet, orthopyroxene, sapphirine, sillimanite, cordierite, biotite, quartz, spinel, corundum, staurolite, plagioclase, K-feldspar, ilmenite and rutile, in assemblages with low (usually negative) variance. They are outstanding in that they preserve a textural and chemical record of a protracted metamorphic evolution. Reaction textures are common and include: (i) pseudomorphs (e.g. of sillimanite after kyanite); (ii) relatively coarse-grained monomineralic reaction rims (e.g. of cordierite between sapphirine and quartz); (iii) fine-grained symplectitic coronas (e.g. of orthopyroxene + sapphirine round garnet); (iv) inclusions, in garnet cores, of minerals (e.g. staurolite) not found elsewhere in the rocks. Detailed microprobe study has revealed large chemical variations within each phase. Different textural types of each phase have different compositions, and strong zoning is preserved in garnet (Mg/(Mg + Fe) from 0.30 to 0.61) and coarse sapphirine. Inclusion populations in garnet correlate with host composition. The textural and chemical features are interpreted in terms of successive equilibrium assemblages and reactions. Metamorphic conditions operative at each stage in the evolution are calculated using published geothermometers and geobarometers as well as thermodynamically calibrated MAS and FASH equilibria. The results are used to construct a P—T-time path for the sapphirine-granulites, which can be summarized as follows: (i) Increasing T at high P (>7 kb). Partial melting. (ii) A maximum T of ∼830 °C attained at ∼10 kb. (iii) Almost isothermal decompression, reaching 750 °C at ∼5 kb, under conditions of low μH2O. (iv) Further cooling, and decompression. Localized hydration. Rocks exposed. The P—T-time path is interpreted as the product of a single metamorphic cycle (the tertiary ‘Lepontine' event) and is extrapolated to the Gruf Complex as a whole. When combined with published geochronological data, the results indicate an average uplift rate in excess of 2 mm/yr for the Gruf Complex between 38 and 30 Ma ago. An in situ partial melting origin for the sapphirine-granulites is favoured. Extraction of an iron-rich granitic liquid from a normal pelitic palaeosome could generate a refractory residue with the required Mg, Al-rich composition. The change in bulk solid composition during partial melting is thought to account for the extraordinarity strong zoning in the garnet

Germline EMSY sequence alterations in hereditary breast cancer and ovarian cancer families

Background: BRCA1 and BRCA2 mutations explain approximately one-fifth of the inherited susceptibility in high-risk Finnish hereditary breast and ovarian cancer (HBOC) families. EMSY is located in the breast cancer-associated chromosomal region 11q13. The EMSY gene encodes a BRCA2-interacting protein that has been implicated in DNA damage repair and genomic instability. We analysed the role of germline EMSY variation in breast/ovarian cancer predisposition. The present study describes the first EMSY screening in patients with high familial risk for this disease.Methods: Index individuals from 71 high-risk, BRCA1/2-negative HBOC families were screened for germline EMSY sequence alterations in protein coding regions and exon-intron boundaries using Sanger sequencing and TaqMan assays. The identified variants were further screened in 36 Finnish HBOC patients and 904 controls. Moreover, one novel intronic deletion was screened in a cohort of 404 breast cancer patients unselected for family history. Haplotype block structure and the association of haplotypes with breast/ovarian cancer were analysed using Haploview. The functionality of the identified variants was predicted using Haploreg, RegulomeDB, Human Splicing Finder, and Pathogenic-or-Not-Pipeline 2.Results: Altogether, 12 germline EMSY variants were observed. Two alterations were located in the coding region, five alterations were intronic, and five alterations were located in the 3'untranslated region (UTR). Variant frequencies did not significantly differ between cases and controls. The novel variant, c.2709 + 122delT, was detected in 1 out of 107 (0.9%) breast cancer patients, and the carrier showed a bilateral form of the disease. The deletion was absent in 897 controls (OR = 25.28; P = 0.1) and in 404 breast cancer patients unselected for family history. No haplotype was identified to increase the risk of breast/ovarian cancer. Functional analyses suggested that variants, particularly in the 3'UTR, were located within regulatory elements. The novel deletion was predicted to affect splicing regulatory elements.Conclusions: These results suggest that the identified EMSY variants are likely neutral at the population level. However, these variants may contribute to breast/ovarian cancer risk in single families. Additional analyses are warranted for rare novel intronic deletions and the 3'UTR variants predicted to have functional roles

Indoor green wall affects health-associated commensal skin microbiota and enhances immune regulation : A randomized trial among urban office workers

Urbanization reduces microbiological abundance and diversity, which has been associated with immune mediated diseases. Urban greening may be used as a prophylactic method to restore microbiological diversity in cities and among urbanites. This study evaluated the impact of air-circulating green walls on bacterial abundance and diversity on human skin, and on immune responses determined by blood cytokine measurements. Human subjects working in offices in two Finnish cities (Lahti and Tampere) participated in a two-week intervention, where green walls were installed in the rooms of the experimental group. Control group worked without green walls. Skin and blood samples were collected before (Day0), during (Day14) and two weeks after (Day28) the intervention. The relative abundance of genus Lactobacillus and the Shannon diversity of phylum Proteobacteria and class Gammaproteobacteria increased in the experimental group. Proteobacterial diversity was connected to the lower proinflammatory cytokine IL-17A level among participants in Lahti. In addition, the change in TGF-beta 1 levels was opposite between the experimental and control group. As skin Lactobacillus and the diversity of Proteobacteria and Gammaproteobacteria are considered advantageous for skin health, air-circulating green walls may induce beneficial changes in a human microbiome. The immunomodulatory potential of air-circulating green walls deserves further research attention.Peer reviewe

Effect of certolizumab pegol over 96 weeks of treatment on inflammation of the spine and sacroiliac joints, as measured by MRI, and the association between clinical and MRI outcomes in patients with axial spondyloarthritis.

OBJECTIVE: To report MRI outcomes and explore the relationship between clinical remission and MRI inflammation in patients with axial spondyloarthritis (axSpA) from the RAPID-axSpA trial, including radiographic (r-)axSpA and non-radiographic (nr-)axSpA. METHODS: RAPID-axSpA (NCT01087762) was double-blind and placebo-controlled to week 24, dose-blind to week 48 and open-label to week 204. Patients were randomised to certolizumab pegol (CZP) or placebo. Placebo patients entering dose-blind were rerandomised to CZP. MRIs performed at baseline, weeks 12, 48 and 96 were scored by 2 reviewers independently: Spondyloarthritis Research Consortium of Canada (SPARCC) for sacroiliac (SI) joints; Berlin modification of the Ankylosing Spondylitis spine MRI scoring system for disease activity (Berlin) for spine. Inflammation thresholds: SPARCC≥2; Berlin>2. Remission thresholds: SPARCC<2 (SI joints); Berlin≤2 (spine); Ankylosing Spondylitis Disease Activity Score (ASDAS) inactive disease (<1.3, clinical). RESULTS: Across 163 patients in the MRI set (109 CZP; 54 placebo), week 12 mean changes from baseline in MRI scores were greater for CZP versus placebo: SPARCC: -4.8 (SD 8.6) vs -1.6 (7.8; p<0.001); Berlin: -2.9 (4.2) vs 0.2 (4.8; p<0.001). Improvements were maintained to week 96. Week 12 MRI remission was achieved by 52.6% of patients with baseline MRI inflammation in SI joints, 62.0% in the spine and 37.9% of patients with both. MRI remission rates were sustained to week 96, with similar trends in r-axSpA and nr-axSpA. At week 96, 57.5% vs 65.9% of patients achieving versus not achieving clinical remission had MRI remission. CONCLUSIONS: CZP reduced inflammation in the spine and SI joints in patients with r-axSpA and nr-axSpA, with improvements maintained over 96 weeks. Substantial proportions of patients achieved MRI remission. Concordance between clinical remission and current definitions of absence of MRI inflammation was limited. TRIAL REGISTRATION NUMBER: NCT01087762; Post-results

P2P Media Streaming with HTML5 and WebRTC

Abstract-Video-on-demand (VoD) services, such as YouTube, generate most of the Internet traffic today, and the popularity of video services is growing. Service and CDN providers have to invest more and more in distribution networks, which creates pressure to innovate novel approaches. Peer-to-peer (P2P) streaming is a viable alternative that is scalable and can meet the increasing demand. The emerging HTML5 standard introduces APIs that give web browsers an ability to communicate directly with each other in real time. New standards also enable a setup, where browsers can act as P2P nodes. This paper reviews whether the new HTML5 and WebRTC standards are a fit for P2P video streaming, evaluates the performance challenges and proposes solutions. Preliminary analysis indicates that HTML5 can be applied to VoD, but there are concerns

Early Disease Activity or Clinical Response as Predictors of Long-Term Outcomes With Certolizumab Pegol in Axial Spondyloarthritis or Psoriatic Arthritis

Pathophysiology and treatment of rheumatic disease

The impact of the environment on health by country: a meta-synthesis

<p>Abstract</p> <p>Background</p> <p>Health gains that environmental interventions could achieve are main questions when choosing environmental health action to prevent disease. The World Health Organization has recently released profiles of environmental burden of disease for 192 countries.</p> <p>Methods</p> <p>These country profiles provide an estimate of the health impacts from the three major risk factors 'unsafe water, sanitation & hygiene', 'indoor air pollution from solid fuel use' and 'outdoor air pollution'. The profiles also provide an estimate of preventable health impacts by the environment as a whole. While the estimates for the three risk factors are based on country exposures, the estimates of health gains for total environmental improvements are based on a review of the literature supplemented by expert opinion and combined with country health statistics.</p> <p>Results</p> <p>Between 13% and 37% of the countries' disease burden could be prevented by environmental improvements, resulting globally in about 13 million deaths per year. It is estimated that about four million of these could be prevented by improving water, sanitation and hygiene, and indoor and outdoor air alone. The number of environmental DALYs per 1000 capita per year ranges between 14 and 316 according to the country. An analysis by disease group points to main preventions opportunities for each country.</p> <p>Conclusion</p> <p>Notwithstanding the uncertainties in their calculation, these estimates provide an overview of opportunities for prevention through healthier environments. The estimates show that for similar national incomes, the environmental burden of disease can typically vary by a factor five. This analysis also shows that safer water, sanitation and hygiene, and safer fuels for cooking could significantly reduce child mortality, namely by more than 25% in 20 of the lowest income countries.</p

A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial

Background: Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers. Methods/Design: A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period. Discussion: This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability