24 research outputs found

    Hydrodynamic scaling limit of continuum solid-on-solid model

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    A fourth-order nonlinear evolution equation is derived from a microscopic model for surface diffusion, namely, the continuum solid-on-solid model. We use the method developed by Varadhan for the computation of hydrodynamic scaling limit of nongradient models. What distinguishes our model from other models discussed so far is the presence of two conservation laws for the dynamics in a nonperiodic box and the complex dynamics that is not nearest-neighbor. Along the way, a few steps has to be adapted to our new context. As a byproduct of our main result we also derive the hydrodynamic scaling limit of a perturbation of continuum solid-on-solid model, a model that incorporates both surface diffusion and surface electromigration

    Heart failure in young adults is associated with high mortality: a contemporary population-level analysis

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    Background: Data on young patients with heart failure (HF) are sparse. We examined the characteristics, healthcare utilization and survival of younger versus older patients with HF. Methods: Analysis of linked administrative databases in Alberta, Canada. 34,548 patients with first hospitalization for HF as principal diagnosis were identified from 2002 to 2014. Patients were stratified into four age groups: 20-44, 45-54, 55-64, and ≥65 years. Results: Of the 34548 patients, 496 (1.4%), 1319 (3.8%), 3359 (9.7%) and 29374 (85%) patients were aged 20-44, 45-54, 55-64 and ≥65 years, respectively. Incidence of HF hospitalization decreased over time among patients ≥65 years, and increased among men aged 20 – 64 years. In the year following the index HF hospitalization, younger compared to older patients were less likely to present to the emergency department (ED) (e.g. 67.2% of those aged 20-44 years vs. 74.8% of those aged ≥65 years) or be hospitalized: for any reason (48.5% vs. 61.2%), cardiovascular causes (28.6% vs. 34.4%), or HF (14.8% vs. 23.6%). Mortality rates were lower in younger patients aged 20-44 years, but still substantial: 3.9%, 12.4%, and 27.7% at 30 days, 1 year, and 5 years respectively. Conclusions: Although young patients, especially those <45 years of age, accounted for a small proportion of the total population, adverse events were frequent, with half of the younger patients being readmitted, two thirds presenting to an ED, and over 10% dying within a year

    The natural history of inflammatory bowel disease and primary sclerosing cholangitis after liver transplantation – a single-centre experience

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    OBJECTIVE: To describe the natural history of primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) after liver transplant, the predictors of PSC and IBD recurrence, and the interaction of these disease processes

    Associations between social determinants of health and weight status in preschool children: a population-based study

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    IntroductionSocial determinants of health (SDH) may influence children’s weight status. Our objective was to examine relationships between SDH and preschoolers’ weight status. MethodsThis retrospective cohort study included 169 465 children (aged 4–6 years) with anthropometric measurements taken at immunization visits from 2009 to 2017 in Edmonton and Calgary, Canada. Children were categorized by weight status based on WHO criteria. Maternal data were linked to child data. The Pampalon Material and Social Deprivation Indexes were used to assess deprivation. We used multinomial logistic regression to generate relative risk ratios (RRRs) to examine associations between ethnicity, maternal immigrant status, neighbourhood-level household income, urban/ rural residence and material and social deprivation with child weight status. ResultsChildren of Chinese ethnicity were less likely than those in the General Population to have overweight (RRR = 0.64, 95% CI: 0.61–0.69) and obesity (RRR = 0.51, 0.42–0.62). Children of South Asian ethnicity were more likely than those in the General Population to have underweight (RRR = 4.14, 3.54–4.84) and more likely to have obesity (RRR = 1.39, 1.22–1.60). Children with maternal immigrant status were less likely than those without maternal immigrant status to have underweight (RRR = 0.72, 0.63–0.82) and obesity (RRR = 0.71, 0.66–0.77). Children were less likely to have overweight (RRR = 0.95, 0.94–0.95) and obesity (RRR = 0.88, 0.86–0.90) for every CAD 10 000 increase in income. Relative to the least deprived quintile, children in the most materially deprived quintile were more likely to have underweight (RRR = 1.36, 1.13–1.62), overweight (RRR = 1.52, 1.46–1.58) and obesity (RRR = 2.83, 2.54–3.15). Relative to the least deprived quintile, children in the most socially deprived quintile were more likely to have overweight (RRR = 1.21, 1.17–1.26) and obesity (RRR = 1.40, 1.26–1.56). All results are significant to p $lt; 0.001. ConclusionOur findings suggest the need for interventions and policies to address SDH in preschoolers to optimize their weight and health

    Associations entre les déterminants sociaux de la santé et le statut pondéral des enfants d’âge préscolaire : une étude de population

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    IntroductionLes déterminants sociaux de la santé peuvent avoir une incidence sur le poids des enfants. Notre objectif était d’étudier les relations entre les déterminants sociaux de la santé et le poids des enfants d’âge préscolaire. MéthodologieCette étude de cohorte rétrospective portait sur 169 465 enfants (âgés de 4 à 6 ans) dont les mesures anthropométriques ont été prises lors de rendez-vous de vaccination de 2009 à 2017 à Edmonton et à Calgary (Canada). Les enfants ont été classés par statut pondéral sur la base des critères de l’Organisation mondiale de la santé (OMS). Les données sur les mères ont été jumelées aux données sur les enfants. Les indices de défavorisation matérielle et sociale de Pampalon ont été utilisés pour évaluer la défavorisation. Nous avons utilisé une régression logistique multinomiale pour générer des rapports de risque relatif (RRR) afin d’étudier les associations entre, d’une part, le groupe ethnique, le statut d’immigration de la mère, le revenu des ménages du quartier, la résidence en milieu urbain ou rural et la défavorisation matérielle et sociale et, d’autre part, le statut pondéral de l’enfant. RésultatsLes enfants d’origine chinoise risquaient moins que ceux de la population générale de faire de l’embonpoint (RRR = 0,64, IC à 95 % : 0,61 à 0,69) ou de l’obésité (RRR = 0,51, 0,42 à 0,62). Les enfants d’origine sud-asiatique risquaient plus que ceux de la population générale d’être en situation d’insuffisance pondérale (RRR = 4,14, 3,54 à 4,84) ou d’obésité (RRR = 1,39, 1,22 à 1,60). Les enfants de mère immigrante risquaient moins que les autres à être en situation d’insuffisance pondérale (RRR = 0,72, 0,63 à 0,82) ou d’obésité (RRR = 0,71, 0,66 à 0,77). La probabilité que les enfants fassent de l’embonpoint (RRR = 0,95, 0,94 à 0,95) ou de l’obésité (RRR = 0,88, 0,86 à 0,90) diminuait avec chaque passage à la tranche de revenu de 10 000 CAsupeˊrieure.Parrapportauquintilelemoinsdeˊfavoriseˊ,lesenfantsduquintileleplusdeˊfavoriseˊsurleplanmateˊrielrisquaientplusdepreˊsenteruneinsuffisancepondeˊrale(RRR=1,36,1,13aˋ1,62),unsurpoids(RRR=1,52,1,46aˋ1,58)oudel’obeˊsiteˊ(RRR=2,83,2,54aˋ3,15).Parrapportauquintilelemoinsdeˊfavoriseˊ,lesenfantsduquintileleplussocialementdeˊfavoriseˊrisquaientplusdepreˊsenterunsurpoids(RRR=1,21,1,17aˋ1,26)oudel’obeˊsiteˊ(RRR=1,40,1,26aˋ1,56).Touslesreˊsultatssontsignificatifsaˋp CA supérieure. Par rapport au quintile le moins défavorisé, les enfants du quintile le plus défavorisé sur le plan matériel risquaient plus de présenter une insuffisance pondérale (RRR = 1,36, 1,13 à 1,62), un surpoids (RRR = 1,52, 1,46 à 1,58) ou de l’obésité (RRR = 2,83, 2,54 à 3,15). Par rapport au quintile le moins défavorisé, les enfants du quintile le plus socialement défavorisé risquaient plus de présenter un surpoids (RRR = 1,21, 1,17 à 1,26) ou de l’obésité (RRR = 1,40, 1,26 à 1,56). Tous les résultats sont significatifs à p lt; 0,001. ConclusionNos constatations indiquent qu’il est nécessaire de mettre en place des interventions et des politiques qui tiennent compte des déterminants sociaux de la santé chez les enfants d’âge préscolaire afin d’optimiser leur poids et leur santé

    Quantification of lung water in heart failure using cardiovascular magnetic resonance imaging

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    Abstract Background Pulmonary edema is a cardinal feature of heart failure but no quantitative tests are available in clinical practice. The goals of this study were to develop a simple cardiovascular magnetic resonance (CMR) approach for lung water quantification, to correlate CMR derived lung water with intra-cardiac pressures and to determine its prognostic significance. Methods Lung water density (LWD, %) was measured using a widely available single-shot fast spin-echo acquisition in two study cohorts. Validation Cohort: LWD was compared to left ventricular end-diastolic pressure or pulmonary capillary wedge pressure in 19 patients with heart failure undergoing cardiac catheterization. Prospective Cohort: LWD was measured in 256 subjects, including 121 with heart failure, 82 at-risk for heart failure and 53 healthy controls. Clinical outcomes were evaluated up to 1 year. Results Within the validation cohort, CMR LWD correlated to invasively measured left-sided filling pressures (R = 0.8, p   20.8% (mean + 2 standard deviations of healthy controls) was an independent predictor of death, hospitalization or emergency department visit within 1 year, hazard ratio 2.4 (1.1–5.1, p = 0.03). Conclusions In patients with heart failure, increased CMR-derived lung water is associated with increased intra-cardiac filling pressures, and predicts 1 year outcomes. LWD could be incorporated in standard CMR scans
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