Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females

Objectives The aim of this study was to identify sex-specific prevalence and strength of risk factors for the incidence of radiographic knee OA (incRKOA). Methods Our study population consisted of 10 958 Rotterdam Study participants free of knee OA in one or both knees at baseline. One thousand and sixty-four participants developed RKOA after a median follow-up time of 9.6 years. We estimated the association between each available risk factor and incRKOA using sex stratified multivariate regression models with generalized estimating equations. Subsequently, we statistically tested sex differences between risk estimates and calculated the population attributable fractions (PAFs) for modifiable risk factors. Results The prevalence of the investigated risk factors was, in general, higher in women compared with men, except that alcohol intake and smoking were higher in men and high BMI showed equal prevalence. We found significantly different risk estimates between men and women: high level of physical activity [relative risk (RR) 1.76 (95% CI: 1.29–2.40)] or a Kellgren and Lawrence score 1 at baseline [RR 5.48 (95% CI: 4.51–6.65)] was higher in men. Among borderline significantly different risk estimates was BMI ≥27, associated with higher risk for incRKOA in women [RR 2.00 (95% CI: 1.74–2.31)]. The PAF for higher BMI was 25.6% in women and 19.3% in men. Conclusion We found sex-specific differences in both presence and relative risk of several risk factors for incRKOA. Especially BMI, a modifiable risk factor, impacts women more strongly than men. These risk factors can be used in the development of personalized prevention strategies and in building sex-specific prediction tools to identify high risk profile patients

ICU at home, with the use of mobile IC unit services:intensive care goes that extra mile

In this report we describe a patient with a long ICU stay because of severe Guillain Barré syndrome. Treatment was patient-centred and Mobile ICU facilities were used to facilitate an ICU at home for one day. Early focus on individual needs and wishes and close communication with and within ICU treatment teams can help to improve the long-term consequences of ICU admission. Research on which interventions are effective and most cost-effective need to be performed

Influence of sensitization and allergen provocation procedures on the development of allergen-induced bronchial hyperreactivity in conscious, unrestrained guinea-pigs

The effects of different sensitization and allergen provocation regimens on the development of allergen-induced bronchial hyperreactivity (BHR) to histamine were investigated in conscious, unrestrained guinea-pigs. Similar early and late phase asthmatic reactions, BHR for inhaled histamine after the early (6 h) as well as after the late reaction (24 h), and airway inflammation were observed after a single allergen provocation in animals sensitized to produce mainly IgG or IgE antibodies, respectively. Repeating the allergen provocation in the IgE-sensitized animals after 7 days, using identical provocation conditions, resulted in a similar development of BHR to histamine inhalation. Repetition of the allergen provocation during 4 subsequent days resulted in a decreased development of BHR after each provocation, despite a significant increase in the allergen provocation dose necessary to obtain similar airway obstruction. The number of inflammatory cells in the bronchoalveolar lavage was not significantly changed after repeated provocation, when compared with a single allergen provocation. Finally, we investigated allergen-induced bronchial hyperreactivity by repetition of the sensitization procedure at day 7 and 14 (booster), followed by repeated allergen provocation twice a week for 5 weeks. Surprisingly, no BHR to histamine could be observed after either provocation, while the number of inflammatory cells in the bronchoalveolar lavage fluid after 5 weeks was enhanced compared with controls. These data indicate that both IgE and IgG sensitized guinea-pigs may develop bronchial hyperreactivity after a single allergen provocation. Repeated allergen exposure of IgE sensitized animals causes a gradual fading of the induced hyperreactivity despite the on-going presence of inflammatory cells in the airways, indicating a mechanism of reduced cellular activation

The role of charge-matching in nanoporous materials formation

Unravelling the molecular-level mechanisms that lead to the formation of mesoscale-ordered porous materials is a crucial step towards the goal of computational material design. For silica templated by alkylamine surfactants, a mechanism based on hydrogen-bond interactions between neutral amines and neutral silicates in solution has been widely accepted by the materials science community, despite the lack of conclusive evidence to support it. We demonstrate, through a combination of experimental measurements and multi-scale modelling, that the so-called “neutral templating route” does not represent a viable description of the synthesis mechanism of hexagonal mesoporous silica (HMS), the earliest example of amine-templated porous silica. Instead, the mesoscale structure of the material is defined by charge-matching of ionic interactions between amines and silicates. This has profound implications for the synthesis of a wide range of templated porous materials, and may shed new light on developing sustainable and economical routes to high value porous materials

Expanded Parameters in the Self-Organized Critical Forest Fire Model

The forest fire model has been used to test the theory of Self-Organized Criticality as a model of complexity. The goal is to search for scale invariance in randomly generated forest fires using a computer simulation. In a previous model by B. Drossel and F. Schwabl,1 power-law behavior was seen when the nearest neighbors to a tree on fire catch on fire, and it has been assumed that if further trees also catch fire, then it will still exhibit self-organized criticality, showing scale invariance. Testing this assumption aids to the exploration of the applicability of self-organized criticality because the model is the most useful when it applies to a large range of systems, as closely related to nature as possible. 1 B. Drossel and F. Schwabl, Phys. Rev. Lett. 69, 1629 (1992

Rectification of thermal fluctuations in ideal gases

We calculate the systematic average speed of the adiabatic piston and a thermal Brownian motor, introduced in [Van den Broeck, Kawai and Meurs, \emph{Microscopic analysis of a thermal Brownian motor}, to appear in Phys. Rev. Lett.], by an expansion of the Boltzmann equation and compare with the exact numerical solution.Comment: 18 page