Prevalence of systemic immunoreactivity to Aggregatibacter actinomycetemcomitans leukotoxin in relation to the incidence of myocardial infarction

<p>Abstract</p> <p>Background</p> <p>Chronic infections and associated inflammatory markers are suggested risk factors for cardiovascular disease (CVD). The proinflammatory cytokine, interleukin (IL)-1β, is suggested to play a role in the regulation of local inflammatory responses in both CVD and periodontitis. The leukotoxin from the periodontal pathogen <it>Aggregatibacter actinomycetemcomitans </it>has recently been shown to cause abundant secretion of IL-1β from macrophages. The aim of the present study was to compare the prevalence of systemic immunoreactivity to <it>A. actinomycetemcomitans </it>leukotoxin in myocardial infarction (MI) cases (n = 532) and matched controls (n = 1,000) in a population-based case and referents study in northern Sweden.</p> <p>Methods</p> <p>Capacity to neutralize <it>A. actinomycetemcomitans </it>leukotoxin was analyzed in a bioassay with leukocytes, purified leukotoxin, and plasma. Plasma samples that inhibited lactate-dehydrogenase release from leukotoxin-lysed cells by ≥50% were classified as positive.</p> <p>Results</p> <p>Neutralizing capacity against <it>A. actinomycetemcomitans </it>leukotoxin was detected in 53.3% of the plasma samples. The ability to neutralize leukotoxin was correlated to increasing age in men (n = 1,082) but not in women (n = 450). There was no correlation between presence of systemic leukotoxin-neutralization capacity and the incidence of MI, except for women (n = 146). Women with a low neutralizing capacity had a significantly higher incidence of MI than those who had a high neutralizing capacity.</p> <p>Conclusion</p> <p>Systemic immunoreactivity against <it>A. actinomycetemcomitans </it>leukotoxin was found at a high prevalence in the analyzed population of adults from northern Sweden. The results from the present study do not support the hypothesis that systemic leukotoxin-neutralizing capacity can decrease the risk for MI.</p

Identifying rail asset maintenance processes: a human-centric and sensemaking approach

Efficient asset maintenance is key for delivering services such as transport. Current rail maintenance processes have been mostly reactive with a recent shift towards exploring proactive modes. The introduction of new ubiquitous technologies and advanced data analytics facilitates the embedding of a ‘predict-and-prevent’ approach to managing assets. Successful, user-centred integration of such technology is still, however, a sparsely understood area. This study reports results from a set of interviews, based on Critical Decision Method, with rail asset maintenance and management experts regarding current procedural aspects of asset management and maintenance. We analyse and present the results from a human-centric sensemaking timeline perspective. We found that within a complex sociotechnical environment such as rail transport, asset maintenance processes apply not just at local levels, but also to broader, strategic levels that involve different stakeholders and necessitate different levels of expertise. This is a particularly interesting aspect within maintenance that has not been discussed as of yet within a process-based and timeline-based models of asset maintenance. We argue that it is important to consider asset maintenance activities within both micro (local) and macro (broader) levels to ensure reliability and stability in transport services. We also propose that the traditionally distinct notions of individual, collaborative and artefact-based sensemaking are in fact all in evidence in this sensemaking context, and argue that a more holistic view of sensemaking is therefore appropriate by placing these results within an amended Recogntion Primed Decsion making model