Cigarette smoking and risk of severe infectious respiratory diseases in UK adults: 12-year follow-up of UK biobank

Background: The relevance of tobacco smoking for infectious respiratory diseases (IRD) is uncertain. We investigated the associations of cigarette smoking with severe IRD resulting in hospitalization or death in UK adults. Methods: We conducted a prospective study of cigarette smoking and risk of severe IRD in UK Biobank. The outcomes included pneumonia, other acute lower respiratory tract infections (OA-LRTI) and influenza. Multivariable Cox regression analyses were used to estimate hazard ratios (HRs) of severe IRD associated with smoking habits after adjusting for confounding factors. Results: Among 341 352 participants with no prior history of major chronic diseases, there were 12 384 incident cases with pneumonia, 7054 with OA-LRTI and 795 with influenza during a 12-year follow-up. Compared with non-smokers, current smoking was associated with ⁓2-fold higher rates of severe IRD (HR 2.40 [2.27–2.53] for pneumonia, 1.99 [1.84–2.14] for OA-LRTI and 1.82 [95% confidence interval: 1.47–2.24] for influenza). Incidence of all severe IRDs were positively associated with amount of cigarettes smoked. The HRs for each IRD (except influenza) also declined with increasing duration since quitting. Conclusions: Current cigarette smoking was positively associated with higher rates of IRD and the findings extend indications for tobacco control measures and vaccination of current smokers for prevention of severe IRD

Effects of Within-Person Variability in Spot Urinary Sodium Measurements on Associations With Blood Pressure and Cardiovascular Disease.

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A quasi-annual record of time-transgressive esker formation: implications for ice sheet reconstruction and subglacial hydrology

We identify and map chains of esker beads (series of aligned mounds) up to 15 m high and on average ~ 65 m wide across central Nunavut, Canada from the high-resolution (2 m) ArcticDEM. Based on the close one-to-one association with regularly spaced, sharp crested ridges interpreted as De Geer moraines, we interpret the esker beads to be quasi-annual ice-marginal deposits formed time-transgressively at the mouth of subglacial conduits during deglaciation. Esker beads therefore preserve a high-resolution record of ice-margin retreat and subglacial hydrology. The well-organised beaded esker network implies that subglacial channelised drainage was relatively fixed in space and through time. Downstream esker bead spacing constrains the typical pace of deglaciation in central Nunavut between 7.2 and 6 ka 14C BP to 165–370 m yr−1, although with short periods of more rapid retreat (> 400 m yr−1). Under our time-transgressive interpretation, the lateral spacing of the observed eskers provides a true measure of subglacial conduit spacing for testing mathematical models of subglacial hydrology. Esker beads also record the volume of sediment deposited in each melt season, thus providing a minimum bound on annual sediment fluxes, which is in the range of 103–104 m3 yr−1 in each 6–10 km wide subglacial conduit catchment. We suggest the prevalence of esker beads across this predominantly marine terminating sector of the former Laurentide Ice Sheet is a result of sediment fluxes that were unable to backfill conduits at a rate faster than ice-margin retreat. Esker ridges, conversely, are hypothesised to form when sediment backfilling of the subglacial conduit outpaced retreat resulting in headward esker growth close to but behind the margin. The implication, in accordance with recent modelling results, is that eskers in general record a composite signature of ice-marginal drainage rather than a temporal snapshot of ice-sheet wide subglacial drainage

Control of rotorcraft retreating blade stall using air-jet vortex generators

A series of low-speed wind tunnel tests were carried out on an oscillating airfoil fitted with two rows of air-jet vortex generators (AJVGs). The airfoil used had an RAE 9645 section and the two spanwise arrays of AJVGs were located at x/c=0.12 and 0.62. The devices and their distribution were chosen to assess their ability to modify/control dynamic stall; the goal being to enhance the aerodynamic performance of helicopter rotors on the retreating blade side of the disc. The model was pitched about the quarter chord with a reduced frequency (k) of 0.1 in a sinusoidal motion defined by a=15o+10sin_ t. The measured data indicate that, for continuous blowing from the front row of AJVGs with a momentum blowing coefficient (C μ) greater than 0.008, modifications to the stalling process are encouraging. In particular, the pitching moment behavior exhibits delayed stall and there is a marked reduction in the normal force hysteresis

LOGIKA FUZZY UNTUK MENENTUKAN ASUPAN KALORI PADA TERAPI DIET TERHADAP PENDERITA OBESITAS

It takes time for a while to determine calory intake for diabetics. Computer technology has been growing rapidly, that can help human life even outside the field of computer science. One of the ways to fulfill those needs is by using fuzzy methode. Fuzzy methode has been applicated in many fields, especially in health. In diet theraphy, obesity can be prevented by restriction in food intake, called diet. Calory intake is determined manually by counting ideal weight combined with other weight. In this research, researcher use fuzzy logic to determine calory intake for patients with obesity when nutrition section still use counting ideal weight, basal needs and activity manually. Therefore, it is a need a methode that can determine calory intake in diet therapy for the sake of a new knowledge and more competitive like for Puskesmas Ambacang.Keywords : Fuzzy Logic, Mamdani Method, Calory Inta

Educational and social inequalities and cause-specific mortality in Mexico City: a prospective study

Background: Social inequalities in adult mortality have been reported across diverse populations, but there is no largescale prospective evidence from Mexico. We aimed to quantify social, including educational, inequalities in mortality among adults in Mexico City. Methods: The Mexico City Prospective Study recruited 150 000 adults aged 35 years and older from two districts of Mexico City between 1998 and 2004. Participants were followed up until Jan 1, 2021 for cause-specific mortality. Cox regression analysis yielded rate ratios (RRs) for death at ages 35–74 years associated with education and examined, in exploratory analyses, the mediating effects of lifestyle and related risk factors. Findings: Among 143 478 participants aged 35–74 years, there was a strong inverse association of education with premature death. Compared with participants with tertiary education, after adjustment for age and sex, those with no education had about twice the mortality rate (RR 1·84; 95% CI 1·71–1·98), equivalent to approximately 6 years lower life expectancy, with an RR of 1·78 (1·67–1·90) among participants with incomplete primary, 1·62 (1·53–1·72) with complete primary, and 1·34 (1·25–1·42) with secondary education. Education was most strongly associated with death from renal disease and acute diabetic crises (RR 3·65; 95% CI 3·05–4·38 for no education vs tertiary education) and from infectious diseases (2·67; 2·00–3·56), but there was an apparent higher rate of death from all specific causes studied with lower education, with the exception of cancer for which there was little association. Lifestyle factors (ie, smoking, alcohol drinking, and leisure time physical activity) and related physiological correlates (ie, adiposity, diabetes, and blood pressure) accounted for about four-fifths of the association of education with premature mortality. Interpretation: In this Mexican population there were marked educational inequalities in premature adult mortality, which appeared to largely be accounted for by lifestyle and related risk factors. Effective interventions to reduce these risk factors could reduce inequalities and have a major impact on premature mortality. Funding: Wellcome Trust, the Mexican Health Ministry, the National Council of Science and Technology for Mexico, Cancer Research UK, British Heart Foundation, and the UK Medical Research Council Population Health Research Unit

Associations of fruit intake with adiposity and cardiometabolic biomarkers in UK Biobank

Background: Fruit consumption has been associated with a lower cardiovascular disease (CVD) risk but the underlying mechanisms are unclear. We investigated the cross-sectional and prospective associations of fruit consumption with markers of adiposity, blood pressure, lipids, low-grade inflammation, glycaemia, and oxidative stress. Methods: The main analyses included 365 534 middle-aged adults from the UK Biobank at baseline, of whom 11 510, and 38 988 were included in the first and second follow-up respectively, free from CVD and cancer at baseline. Fruit consumption frequency at baseline was assessed using a questionnaire. We assessed the cross-sectional and prospective associations of fruit with adiposity (body mass index, waist circumference and %body fat), systolic and diastolic blood pressure, lipids (low-density and high-density lipoproteins, triglycerides and apolipoprotein B), glycaemia (haemoglobin A1c), low-grade inflammation (C-reactive protein) and oxidative stress (gamma-glutamyl-transferase) using linear regression models adjusted for socioeconomic and lifestyle factors. Analyses were repeated in a subset with two to five complete 24-h dietary assessments (n = 26 596) allowing for adjustment for total energy intake. Results: Fruit consumption at baseline generally showed weak inverse associations with adiposity and biomarkers at baseline. Most of these relationships did not persist through follow-up, except for inverse associations with diastolic blood pressure, C-reactive protein, gamma-glutamyl transferase and adiposity. However, for most mechanisms, mean levels varied by less than 0.1 standard deviations (SD) between high and low fruit consumption (> 3 vs < 1 servings/day) in further adjusted models (while the difference was < 0.2 SD for all of them). For example, waist circumference and diastolic blood pressure were 1 cm and 1 mmHg lower in high compared to low fruit intake at the first follow-up (95% confidence interval: -1.8, -0.1 and -1.8, -0.3, respectively). Analyses in the 24-h dietary assessment subset showed overall similar associations. Conclusions: We observed very small differences in adiposity and cardiometabolic biomarkers between those who reported high fruit consumption vs low, most of which did not persist over follow-up. Future studies on other mechanisms and detailed assessment of confounding might further elucidate the relevance of fruit to cardiovascular disease

Public perspectives on inequality and mental health: A peer research study

Introduction: Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense-making of inequality in their daily lives, with particular consideration of impacts on mental health. Methods: We conducted a peer research study. Participants had to live in one of two London Boroughs and have an interest in inequalities and mental health. Using social media, newsletters, local organisations and our peer researchers' contacts, we recruited 30 participants who took photos representing their experience of inequality and discussed them during semi-structured interviews. Data were analysed using reflexive thematic analysis. Results: Three themes were identified in this study: (1) inequalities are unjust, multilayered and intertwined with mental health. Accounts demonstrated a deep understanding of inequalities and their link to mental health outcomes, describing inequalities as ‘suffering’ and ‘not good for anyone’. Financial, housing, immigration and healthcare problems exacerbated poor mental health, with racism, gender-based violence and job loss also contributing factors for both poor mental health and experiences of inequality; (2) inequalities exclude and have far-reaching mental health consequences, impacting personal sense of belonging and perceived societal value and (3) moving forwards—addressing long-standing inequality and poor public mental health necessitated coping and resilience strategies that are often unacknowledged and undervalued by support systems. Conclusion: Lived experience expertise was central in this study, creating an innovative methodological approach. To improve public mental health, we must address the everyday, painful structural inequalities experienced by many as commonplace and unfair. New policies and strategies must be found that involve communities, redistributing resources and power, building on a collective knowledge base, to coproduce actions combatting inequalities and improving population mental health. Patient or Public Contribution: This study was peer-led, designed and carried out by researchers who had experiences of poor mental health. Six authors of the paper worked as peer researchers on this study

Blood pressure variability and cardiovascular risk in the PROspective study of pravastatin in the elderly at risk (PROSPER)

Variability in blood pressure predicts cardiovascular disease in young- and middle-aged subjects, but relevant data for older individuals are sparse. We analysed data from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) study of 5804 participants aged 70–82 years with a history of, or risk factors for cardiovascular disease. Visit-to-visit variability in blood pressure (standard deviation) was determined using a minimum of five measurements over 1 year; an inception cohort of 4819 subjects had subsequent in-trial 3 years follow-up; longer-term follow-up (mean 7.1 years) was available for 1808 subjects. Higher systolic blood pressure variability independently predicted long-term follow-up vascular and total mortality (hazard ratio per 5 mmHg increase in standard deviation of systolic blood pressure = 1.2, 95% confidence interval 1.1–1.4; hazard ratio 1.1, 95% confidence interval 1.1–1.2, respectively). Variability in diastolic blood pressure associated with increased risk for coronary events (hazard ratio 1.5, 95% confidence interval 1.2–1.8 for each 5 mmHg increase), heart failure hospitalisation (hazard ratio 1.4, 95% confidence interval 1.1–1.8) and vascular (hazard ratio 1.4, 95% confidence interval 1.1–1.7) and total mortality (hazard ratio 1.3, 95% confidence interval 1.1–1.5), all in long-term follow-up. Pulse pressure variability was associated with increased stroke risk (hazard ratio 1.2, 95% confidence interval 1.0–1.4 for each 5 mmHg increase), vascular mortality (hazard ratio 1.2, 95% confidence interval 1.0–1.3) and total mortality (hazard ratio 1.1, 95% confidence interval 1.0–1.2), all in long-term follow-up. All associations were independent of respective mean blood pressure levels, age, gender, in-trial treatment group (pravastatin or placebo) and prior vascular disease and cardiovascular disease risk factors. Our observations suggest variability in diastolic blood pressure is more strongly associated with vascular or total mortality than is systolic pressure variability in older high-risk subjects