Accumulation of non-traditional risk factors for coronary heart disease is associated with incident coronary heart disease hospitalization and death

Assessing multiple traditional risk factors improves prediction for late-life diseases, including coronary heart disease (CHD). It appears that non-traditional risk factors can also predict risk. The objective was to investigate contributions of non-traditional risk factors to coronary heart disease risk using a deficit accumulation approach.Community-dwelling adults with no known history of CHD (n = 2195, mean age 46.9±18.7 years, 51.8% women) participated in the 1995 Nova Scotia Health Survey. Three risk factor indices were constructed to quantify the proportion of deficits present in individuals: 1) a 17-item Non-Traditional Risk Factor Index (e.g. sinusitis, arthritis); 2) a 9-item Traditional Risk Factor Index (e.g. hypertension, diabetes); and 3) a frailty index (25 items combined from the other two index measures). Ten-year risks of CHD events (defined as CHD-related hospitalization and CHD-related mortality) were evaluated.The Non-Traditional Risk Factor Index, made up of health deficits unrelated to CHD, was independently associated with incident CHD events over 10 years after controlling for age, sex, and the Traditional Risk Factor Index [adjusted {adj.} Hazard Ratio {HR} = 1.31; Confidence Interval {CI} 1.14-1.51]. When all health deficits, both those related and unrelated to CHD, were included in a frailty index the corresponding adjusted hazard ratio was 1.61; CI 1.40-1.85.Both traditional and non-traditional risk factor indices are independently associated with incident CHD events. CHD risk assessment may benefit from consideration of general health information as well as from traditional risk factors.Lindsay M. K. Wallace, Olga Theou, Susan A. Kirkland, Michael R. H. Rockwood, Karina W. Davidson, Daichi Shimbo, Kenneth Rockwoo

A standard procedure for creating a frailty index

<p>Abstract</p> <p>Background</p> <p>Frailty can be measured in relation to the accumulation of deficits using a frailty index. A frailty index can be developed from most ageing databases. Our objective is to systematically describe a standard procedure for constructing a frailty index.</p> <p>Methods</p> <p>This is a secondary analysis of the Yale Precipitating Events Project cohort study, based in New Haven CT. Non-disabled people aged 70 years or older (n = 754) were enrolled and re-contacted every 18 months. The database includes variables on function, cognition, co-morbidity, health attitudes and practices and physical performance measures. Data came from the baseline cohort and those available at the first 18-month follow-up assessment.</p> <p>Results</p> <p>Procedures for selecting health variables as candidate deficits were applied to yield 40 deficits. Recoding procedures were applied for categorical, ordinal and interval variables such that they could be mapped to the interval 0–1, where 0 = absence of a deficit, and 1= full expression of the deficit. These individual deficit scores were combined in an index, where 0= no deficit present, and 1= all 40 deficits present. The values of the index were well fit by a gamma distribution. Between the baseline and follow-up cohorts, the age-related slope of deficit accumulation increased from 0.020 (95% confidence interval, 0.014–0.026) to 0.026 (0.020–0.032). The 99% limit to deficit accumulation was 0.6 in the baseline cohort and 0.7 in the follow-up cohort. Multivariate Cox analysis showed the frailty index, age and sex to be significant predictors of mortality.</p> <p>Conclusion</p> <p>A systematic process for creating a frailty index, which relates deficit accumulation to the individual risk of death, showed reproducible properties in the Yale Precipitating Events Project cohort study. This method of quantifying frailty can aid our understanding of frailty-related health characteristics in older adults.</p

Validation of Predicted Breeding Values for Slash Pine (Pinus elliottii var. elliottii) Using Field Trials Planted in Large Block Plots

Predicted breeding values were validated using realized gains estimated from large-rectangular-plot field trials from the first generation breeding population of slash pine (Pinus elliottii var. elliottii Engelm.) in the Southeast. These 43 realized gain trials consisted of three types: 1) rust resistant and rust susceptible material growing in high rust hazard sites in the Best Management Practices study (5 trials), 2) material selected for growth by the Cooperative Forest Genetics Research Program at the University of Florida (19 trials), and 3) Improved and unimproved material established by the Plantation Management Research Cooperative at the University of Georgia (19 trials). All trials contained slash pine seedlots collected from unrogued or lightly rogued first generation seed orchards. Multiple regression analyses were conducted to validate predicted breeding values calculated for each seedlot considering pollen background. Observed realized gains for each seedlot were used as the dependent variable, while site variables (site index and rust hazard) along with the predicted breeding values were used as independent variables. BLP values predicted for rust resistance were reasonably accurate, and most of the known variation in rust incidence was accounted for by the predicted breeding values. Conversely, validation of BLP-predicted volume breeding values was difficult due to excessive noise in the data for individual tree volume and stand yield. The use of highly replicated medium-size rectangular plots is suggested to overcome this problem of imprecise field data from realized gain trials.Papers and abstracts from the 27th Southern Forest Tree Improvement Conference held at Oklahoma State University in Stillwater, Oklahoma on June 24-27, 2003

Slash and Loblolly Pine Productivity on Reclaimed Titanium Mined Lands in Northeast Florida

Titanium mining often occurs on forestlands that previously supported productive pine plantations. The productivity of reclaimed mined lands is uncertain, based on observations that tree height on reclaimed lands is less, perhaps due to compaction. This paper summarizes early results from field studies initiated in December 1999 on unmined and reclaimed mined lands near Green Cove Springs, Florida, using two slash (Pinus elliottii var. elliottii) and loblolly (Pinus taeda) pine progenies, three fertilizers (granulite, diammonium phosphate, and a 16-4-8 blend at 36lbs N/acre (40.3 kg N/ha)) each, one herbicide (glyphosate), one dry humate addition, one mycorrhizal inoculation, subsoiling, and various combinations thereof to determine silvicultural treatments that optimize pine productivity on reclaimed mined lands. Mined sites had significantly higher survival but shorter trees than the unmined lands. A combination of treatments, including pines genetically superior for growth and disease resistance, may afford the opportunity for sustaining pine productivity on titanium mined lands.Papers and abstracts from the 27th Southern Forest Tree Improvement Conference held at Oklahoma State University in Stillwater, Oklahoma on June 24-27, 2003

Four patients with a history of acute exacerbations of COPD: implementing the CHEST/Canadian Thoracic Society guidelines for preventing exacerbations

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Miniature Toroidal Radio Frequency Ion Trap Mass Analyzer

A miniature ion trap mass analyzer is reported. The described analyzer is a 1/5-scale version of a previously reported toroidal radio frequency (rf) ion trap mass analyzer. The toroidal ion trap operates with maximum rf trapping voltages about 1 kVp-p or less; however despite the reduced dimensions, it retains roughly the same ion trapping capacity as conventional 3D quadrupole ion traps. The curved geometry provides for a compact mass analyzer. Unit-mass resolved mass spectra for n-butylbenzene, xenon, and naphthalene are reported and preliminary sensitivity data are shown for naphthalene. The expected linear mass scale with rf amplitude scan is obtained when scanned using a conventional mass-selective instability scan mode combined with resonance ejection

The frailty index outperforms DNA methylation age and its derivatives as an indicator of biological age

The measurement of biological age as opposed to chronological age is important to allow the study of factors that are responsible for the heterogeneity in the decline in health and function ability among individuals during aging. Various measures of biological aging have been proposed. Frailty indices based on health deficits in diverse body systems have been well studied, and we have documented the use of a frailty index (FI(34)) composed of 34 health items, for measuring biological age. A different approach is based on leukocyte DNA methylation. It has been termed DNA methylation age, and derivatives of this metric called age acceleration difference and age acceleration residual have also been employed. Any useful measure of biological age must predict survival better than chronological age does. Meta-analyses indicate that age acceleration difference and age acceleration residual are significant predictors of mortality, qualifying them as indicators of biological age. In this article, we compared the measures based on DNA methylation with FI(34). Using a well-studied cohort, we assessed the efficiency of these measures side by side in predicting mortality. In the presence of chronological age as a covariate, FI(34) was a significant predictor of mortality, whereas none of the DNA methylation age-based metrics were. The outperformance of FI(34) over DNA methylation age measures was apparent when FI(34) and each of the DNA methylation age measures were used together as explanatory variables, along with chronological age: FI(34) remained significant but the DNA methylation measures did not. These results indicate that FI(34) is a robust predictor of biological age, while these DNA methylation measures are largely a statistical reflection of the passage of chronological time