Influence of lipid profile and statin administration on arterial stiffness in renal transplant recipients

Background: Hyperlipidemia is one of the major risk factors for developing a cardiovascular disease (CVD) and it is a frequent post-transplant complication, occurring in up to 60% of the renal transplant recipients (RTRs). Lipid lowering therapy with HMG-CoA reductase inhibitors (statins) is generally recommended and may reduce the overall cardiovascular risk. The aim of this study was to evaluate the lipid profile, statin administration and their relationship with arterial stiffness parameters in renal transplant recipients. Methods: Three hundred and forty-four stable RTRs (62.5% male) transplanted between 1994 and 2018 were randomly enrolled to the study. The following parameters of arterial stiffness was measured in each patient: carotid femoral pulse wave velocity (baPWV left and right, cfPWV) and pulse pressure (PP right and left). The study group was divided based on the use statins: 143 (41.6%) and 201 (58.4%). RTRs were qualified to the statin (+) and the statin (–) group, respectively. Results: In the statin (+) as compared to statin (–) group there were more patients with a CVD (32.9% vs. 14.9%) and diabetes (25.2% vs. 14.4%). In the whole study group, CVD was associated with a significant increase of both baPWV and cfPWV as well as PP (8.5 mmHg). There were significant differences in arterial stiffness parameters (baPWV, cfPWV, PP) between the statin (+) and the statin (–) group. Conclusions: Arterial stiffness was increased in RTRs with CVD and hyperlipidemia. The control of hyperlipidemia was poor in RTRs

Catastrophizing, rumination, and reappraisal prospectively predict adolescent PTSD symptom onset following a terrorist attack: Jenness et al.

Disruptions in emotion regulation are a transdiagnostic risk factor for psychopathology. However, scant research has examined whether emotion regulation strategies are related to the onset of posttraumatic stress disorder (PTSD) symptoms among youths exposed to trauma. We investigated whether pretrauma emotion regulation strategies prospectively predicted PTSD symptom onset after the 2013 Boston Marathon terrorist attack among adolescents and whether these associations were moderated by the degree of exposure to media coverage of the attack

Northern Eurasia Future Initiative (NEFI): facing the challenges and pathways of global change in the 21st century

During the past several decades, the Earth system has changed significantly, especially across Northern Eurasia. Changes in the socio-economic conditions of the larger countries in the region have also resulted in a variety of regional environmental changes that can have global consequences. The Northern Eurasia Future Initiative (NEFI) has been designed as an essential continuation of the Northern Eurasia Earth Science Partnership Initiative (NEESPI), which was launched in 2004. NEESPI sought to elucidate all aspects of ongoing environmental change, to inform societies and, thus, to better prepare societies for future developments. A key principle of NEFI is that these developments must now be secured through science-based strategies co-designed with regional decision makers to lead their societies to prosperity in the face of environmental and institutional challenges. NEESPI scientific research, data, and models have created a solid knowledge base to support the NEFI program. This paper presents the NEFI research vision consensus based on that knowledge. It provides the reader with samples of recent accomplishments in regional studies and formulates new NEFI science questions. To address these questions, nine research foci are identified and their selections are briefly justified. These foci include: warming of the Arctic; changing frequency, pattern, and intensity of extreme and inclement environmental conditions; retreat of the cryosphere; changes in terrestrial water cycles; changes in the biosphere; pressures on land-use; changes in infrastructure; societal actions in response to environmental change; and quantification of Northern Eurasia's role in the global Earth system. Powerful feedbacks between the Earth and human systems in Northern Eurasia (e.g., mega-fires, droughts, depletion of the cryosphere essential for water supply, retreat of sea ice) result from past and current human activities (e.g., large scale water withdrawals, land use and governance change) and potentially restrict or provide new opportunities for future human activities. Therefore, we propose that Integrated Assessment Models are needed as the final stage of global change assessment. The overarching goal of this NEFI modeling effort will enable evaluation of economic decisions in response to changing environmental conditions and justification of mitigation and adaptation efforts

Climigration? Population and climate change in Arctic Alaska

Residents of towns and villages in Arctic Alaska live on “the front line of climate change.” Some communities face immediate threats from erosion and flooding associated with thawing permafrost, increasing river flows, and reduced sea ice protection of shorelines. The term climigration, referring to migration caused by climate change, originally was coined for these places. Although initial applications emphasized the need for government relocation policies, it has elsewhere been applied more broadly to encompass unplanned migration as well. Some historical movements have been attributed to climate change, but closer study tends to find multiple causes, making it difficult to quantify the climate contribution. Clearer attribution might come from comparisons of migration rates among places that are similar in most respects, apart from known climatic impacts. We apply this approach using annual 1990–2014 time series on 43 Arctic Alaska towns and villages. Within-community time plots show no indication of enhanced out-migration from the most at-risk communities. More formally, there is no significant difference between net migration rates of at-risk and other places, testing several alternative classifications. Although climigration is not detectable to date, growing risks make either planned or unplanned movements unavoidable in the near future

Thromboembolism and bleeding in patients with atrial fibrillation and stage 4 chronic kidney disease: impact of biomarkers

Background: Chronic kidney disease (CKD) is considered a risk factor for thromboembolic and bleeding events in patients with atrial fibrillation (AF). Aims: We sought to assess predictors of clinical outcomes among AF patients with advanced CKD. Methods: In a prospective cohort study, we enrolled 180 AF patients with stage 4 CKD, defined as estimated glomerular filtration rate of 15–29 ml/min/1.73 m2, on vitamin K antagonists (n = 90), and non-vitamin K antagonists oral anticoagulants (n = 90). We assessed biomarkers, including growth differentiation factor-15, cystatin C, and high-sensitivity cardiac troponin T, and prothrombotic state parameters, including plasma fibrin clot permeability (Ks).Results: The median age of the patients was 71.0 (64.0–75.0) years (men 65.0%). The median estimated glomerular filtration rate was 24.0 (21.0–25.0) ml/min/1.73 m2 while the median CHA2DS2-VASc score was 3.0 (2.0–4.0). Age (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.02–1.20) and decreased Ks (HR, 0.55; 95% CI, 0.34–0.90) were associated with thromboembolic events (n = 18; 4.7% per year). Previous bleeding (HR, 3.21; 95% CI, 1.22–8.45), growth differentiation factor-15 (HR, 1.48; 95% CI, 1.29–1.69), cystatin C (HR, 9.24; 95% CI, 2.15–39.67), and high-sensitivity cardiac troponin T (HR, 1.30; 95% CI, 1.14–1.48) were independent predictors of major or clinically relevant non-major bleeding (n = 27; 7.1% per year). After adjustment for age and comorbidities, only cystatin C (HR, 3.95; 95% CI, 1.08–14.37) predicted mortality (n = 25; 6.5% per year).Conclusions: Novel biomarkers might be useful in risk stratification of thromboembolic and bleeding events in AF patients with stage 4 CKD receiving oral anticoagulants