Long-term exposure to ultrafine particles and natural and cause-specific mortality

BACKGROUND: Health implications of long-term exposure to ubiquitously present ultrafine particles (UFP) are uncertain. The aim of this study was to investigate the associations between long-term UFP exposure and natural and cause-specific mortality (including cardiovascular disease (CVD), respiratory disease, and lung cancer) in the Netherlands. METHODS: A Dutch national cohort of 10.8 million adults aged >/= 30 years was followed from 2013 until 2019. Annual average UFP concentrations were estimated at the home address at baseline, using land-use regression models based on a nationwide mobile monitoring campaign performed at the midpoint of the follow-up period. Cox proportional hazard models were applied, adjusting for individual and area-level socio-economic status covariates. Two-pollutant models with the major regulated pollutants nitrogen dioxide (NO(2)) and fine particles (PM(2)(.)(5) and PM(10)), and the health relevant combustion aerosol pollutant (elemental carbon (EC)) were assessed based on dispersion modelling. RESULTS: A total of 945,615 natural deaths occurred during 71,008,209 person-years of follow-up. The correlation of UFP concentration with other pollutants ranged from moderate (0.59 (PM(2)(.)(5))) to high (0.81 (NO(2))). We found a significant association between annual average UFP exposure and natural mortality [HR 1.012 (95 % CI 1.010-1.015), per interquartile range (IQR) (2723 particles/cm(3)) increment]. Associations were stronger for respiratory disease mortality [HR 1.022 (1.013-1.032)] and lung cancer mortality [HR 1.038 (1.028-1.048)] and weaker for CVD mortality [HR 1.005 (1.000-1.011)]. The associations of UFP with natural and lung cancer mortality attenuated but remained significant in all two-pollutant models, whereas the associations with CVD and respiratory mortality attenuated to the null. CONCLUSION: Long-term UFP exposure was associated with natural and lung cancer mortality among adults independently from other regulated air pollutants

Air pollution exposure estimation using dispersion modelling and continuous monitoring data in a prospective birth cohort study in the Netherlands

Previous studies suggest that pregnant women and children are particularly vulnerable to the adverse effects of air pollution. A prospective cohort study in pregnant women and their children enables identification of the specific effects and critical periods. This paper describes the design of air pollution exposure assessment for participants of the Generation R Study, a population-based prospective cohort study from early pregnancy onwards in 9778 women in the Netherlands. Individual exposures to PM10 and NO2 levels at the home address were estimated for mothers and children, using a combination of advanced dispersion modelling and continuous monitoring data, taking into account the spatial and temporal variation in air pollution concentrations. Full residential history was considered. We observed substantial spatial and temporal variation in air pollution exposure levels. The Generation R Study provides unique possibilities to examine effects of short- and long-term air pollution exposure on various maternal and childhood outcomes and to identify potential critical windows of exposure

DOMINO, doxycycline 40 mg vs. minocycline 100 mg in the treatment of rosacea: a randomized, single-blinded, noninferiority trial, comparing efficacy and safety

Background There is a lack of evidence for minocycline in the treatment of rosacea. Objectives To compare the efficacy and safety of doxycycline 40 mg vs. minocycline 100 mg in papulopustular rosacea. Methods In this randomized, single-centre, 1 : 1 allocation, assessor-blinded, noninferiority trial, patients with mild-to-severe papulopustular rosacea were randomly allocated to either oral doxycycline 40 mg or minocycline 100 mg for a 16-week period with 12 weeks of follow-up. Our primary outcomes were the change in lesion count and change in patient's health-related quality of life (using RosaQoL). Intention-to-treat and per protocol analyses were performed. Results Of the 80 patients randomized (40 minocycline, 40 doxycycline), 71 were treated for 16 weeks. Sixty-eight patients completed the study. At week 16, the median change in lesion count was comparable in both groups: doxycycline vs. minocycline, respectively 13 vs. 14 fewer lesions. The RosaQoL scores were decreased for both doxycycline and minocycline, respectively by 0.62 and 0.86. Secondary outcomes were comparable except for Investigator's Global Assessment success, which was seen significantly more often in the minocycline group than in the doxycycline group (60% vs. 18%, P <0.001). At week 28, outcomes were comparable, except for RosaQoL scores and PaGA, which were significantly different in favour of minocycline (P = 0.005 and P = 0.043, respectively), and fewer relapses were recorded in the minocycline group than in the doxycycline group (7% and 48%, respectively; P <0.001). No serious adverse reactions were reported. Conclusions Minocycline 100 mg is noninferior to doxycycline 40 mg in efficacy over a 16-week treatment period. At follow-up, RosaQoL and PaGA were statistically significantly more improved in the minocycline group than in the doxycycline group, and minocycline 100 mg gives longer remission. In this study there was no significant difference in safety between these treatments; however, based on previous literature minocycline has a lower risk-to-benefit ratio than doxycycline. Minocycline 100 mg may be a good alternative treatment for those patients who, for any reason, are unable or unwilling to take doxycycline 40 m

Car seat design to improve rear-impact protection

This study presents car seat concepts which are designed to mitigate whiplash injuries through coordinated motion of seat components for a wide range of crash severities. In order to evaluate the effectiveness of the proposed car seat concepts, computational multibody models of a generic car seat and a biofidelic 50th-percentile male human model for rear impact are developed. A number of car seat concepts are shown to reduce the risk of whiplash injuries by utilizing head restraint support and energy-absorbing features, which remain reusable after impact