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Recent reports show alarmingly high rates of suicide in middle-aged men, yet there are few long-term prospective studies that focus on suicidal behaviour in men in this age group.
To prospectively explore associations of potential risk factors at age 18 with suicide and self-harm in middle-aged men.
A population-based Swedish longitudinal cohort study of male conscripts with no history of self-harm at enlistment in 1968–1989 (n = 987 583). Conscription examinations included measures of cognitive performance, stress resilience, psychiatric diagnoses, body mass index (BMI), cardiovascular fitness and muscle strength. Suicides and self-harm at age 45–65 years were identified in the National Hospital Register and Swedish Cause of Death Register. Risks were calculated using Cox proportional hazards models.
Low stress resilience (cause-specific hazard ratio CHR = 2.31, 95% CI 1.95–2.74), low cognitive ability (CHR = 2.01, 95% CI 1.71–2.37) as well as psychiatric disorders and low cardiovascular fitness in late adolescence were associated with increased risk for suicide in middle-aged men. Similar risk estimates were obtained for self-harm. In addition, high and low BMI as well as low muscle strength were associated with increased risk of self-harm. Associations also remained significant after exclusion of men with self-harm before age 45.
This prospective study provides life-course perspective support that psychological and physical characteristics in late adolescence may have long-lasting consequences for suicidal behaviour in middle-aged men, a very large population at heightened risk of suicide.
Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterise the association between plasma concentrations of thirty-five polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein (hsCRP). A cross-sectional data analysis was performed based on 315 participants in the European Prospective Investigation into Cancer and Nutrition cohort with available measurements of plasma polyphenols and hsCRP. In logistic regression analysis, the OR and 95 % CI of elevated serum hsCRP (>3 mg/l) were calculated within quartiles and per standard deviation higher level of plasma polyphenol concentrations. In a multivariable-adjusted model, the sum of plasma concentrations of all polyphenols measured (per standard deviation) was associated with 29 (95 % CI 50, 1) % lower odds of elevated hsCRP. In the class of flavonoids, daidzein was inversely associated with elevated hsCRP (OR 0·66, 95 % CI 0·46, 0·96). Among phenolic acids, statistically significant associations were observed for 3,5-dihydroxyphenylpropionic acid (OR 0·58, 95 % CI 0·39, 0·86), 3,4-dihydroxyphenylpropionic acid (OR 0·63, 95 % CI 0·46, 0·87), ferulic acid (OR 0·65, 95 % CI 0·44, 0·96) and caffeic acid (OR 0·69, 95 % CI 0·51, 0·93). The odds of elevated hsCRP were significantly reduced for hydroxytyrosol (OR 0·67, 95 % CI 0·48, 0·93). The present study showed that polyphenol biomarkers are associated with lower odds of elevated hsCRP. Whether diet rich in bioactive polyphenol compounds could be an effective strategy to prevent or modulate deleterious health effects of inflammation should be addressed by further well-powered longitudinal studies.
The mainstay of management of epistaxis refractory to first aid and cautery is intranasal packing. This review aimed to identify evidence surrounding nasal pack use.
A systematic review of the literature was performed using standardised methodology.
Twenty-seven eligible articles were identified relating to non-dissolvable packs and nine to dissolvable packs. Nasal packing appears to be more effective when applied by trained professionals. For non-dissolvable packs, the re-bleed rates for Rapid Rhino and Merocel were similar, but were higher with bismuth iodoform paraffin paste packing. Rapid Rhino packs were the most tolerated non-dissolvable packs. Evidence indicates that 96 per cent of re-bleeding occurs within the first 4 hours after nasal pack removal. Limited evidence suggests that dissolvable packs are effective and well tolerated by patients. There was a lack of evidence relating to: the duration of pack use, the economic effects of pack choice and the appropriate care setting for non-dissolvable packs.
Rapid Rhino packs are the best tolerated, with efficacy equivalent to nasal tampons. FloSeal is easy to use, causes less discomfort and may be superior to Merocel in anterior epistaxis cases. There is no strong evidence to support prophylactic antibiotic use.
Cardiovascular fitness in late adolescence is associated with future risk of depression. Relationships with other mental disorders need elucidation. This study investigated whether fitness in late adolescence is associated with future risk of serious non-affective mental disorders. Further, we examined how having an affected brother might impact the relationship.
Prospective, population-based cohort study of 1 109 786 Swedish male conscripts with no history of mental illness, who underwent conscription examinations at age 18 between 1968 and 2005. Cardiovascular fitness was objectively measured at conscription using a bicycle ergometer test. During the follow-up (3–42 years), incident cases of serious non-affective mental disorders (schizophrenia and schizophrenia-like disorders, other psychotic disorders and neurotic, stress-related and somatoform disorders) were identified through the Swedish National Hospital Discharge Register. Cox proportional hazards models were used to assess the influence of cardiovascular fitness at conscription and risk of serious non-affective mental disorders later in life.
Low fitness was associated with increased risk for schizophrenia and schizophrenia-like disorders [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.29–1.61], other psychotic disorders (HR 1.41, 95% CI 1.27–1.56), and neurotic or stress-related and somatoform disorders (HR 1.45, 95% CI 1.37–1.54). Relationships persisted in models that included illness in brothers.
Lower fitness in late adolescent males is associated with increased risk of serious non-affective mental disorders in adulthood.
Following an unusually heavy rainfall in June 2009, a community-wide outbreak of Campylobacter gastroenteritis occurred in a small Danish town. The outbreak investigation consisted of (1) a cohort study using an e-questionnaire of disease determinants, (2) microbiological study of stool samples, (3) serological study of blood samples from cases and asymptomatic members of case households, and (4) environmental analyses of the water distribution system. The questionnaire study identified 163 cases (respondent attack rate 16%). Results showed a significant dose-response relationship between consumption of tap water and risk of gastroenteritis. Campylobacter jejuni belonging to two related flaA types were isolated from stool samples. Serum antibody levels against Campylobacter were significantly higher in cases than in asymptomatic persons. Water samples were positive for coliform bacteria, and the likely mode of contamination was found to be surface water leaking into the drinking-water system. This geographically constrained outbreak presented an ideal opportunity to study the serological response in persons involved in a Campylobacter outbreak. The serology indicated that asymptomatic persons from the same household may have been exposed, during the outbreak period, to Campylobacter at doses that did not elicit symptoms or alternatively had been exposed to Campylobacter at a time prior to the outbreak, resulting in residual immunity and thus absence of clinical signs.
Since the Last Glacial Maximum, ice has retreated through the fjords of the South Shetland Islands leaving a valuable record of submarine landforms behind. In this study, glacial landforms and sub-bottom characteristics have been mapped to investigate the late Holocene retreat behaviour of the Fourcade Glacier and to delineate past environmental processes in Potter Cove, King George Island. The comprehensive datasets include high-resolution swath bathymetry, shallow seismic profiling and one sediment core. Moraines, moraine incisions and glacial lineations were mapped on the sea floor in the inner part of the cove, whereas pockmarks, ice scour marks and channel structures were identified in the outer part. Sub-bottom characteristics have been assigned to different acoustic facies types indicating different depositional settings. The results reveal glacial recessions as well as stillstands and potential readvances during the late Holocene. Furthermore, the sediment record indicates that the Fourcade Glacier was situated inside the inner cove during the Little Ice Age (500–100 cal yr bp).
To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.
Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995–2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.
Twenty-seven centres across ten European countries.
Women (64 %) and men (36 %) aged 35–74 years (n 36 020).
Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38–43 % for women and 41–45 % for men within Mediterranean countries compared with 16–27 % for women and 20–26 % for men in central and northern European countries. Likewise, a south–north gradient was found for daily energy intake from snacks, with 13–20 % (women) and 10–17 % (men) in Mediterranean countries compared with 24–34 % (women) and 23–35 % (men) in central/northern Europe.
We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.
Improvements in colorectal cancer (CRC) detection and treatment have led to greater numbers of CRC survivors, for whom there is limited evidence on which to provide dietary guidelines to improve survival outcomes. Higher intake of red and processed meat and lower intake of fibre are associated with greater risk of developing CRC, but there is limited evidence regarding associations with survival after CRC diagnosis. Among 3789 CRC cases in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, pre-diagnostic consumption of red meat, processed meat, poultry and dietary fibre was examined in relation to CRC-specific mortality (n 1008) and all-cause mortality (n 1262) using multivariable Cox regression models, adjusted for CRC risk factors. Pre-diagnostic red meat, processed meat or fibre intakes (defined as quartiles and continuous grams per day) were not associated with CRC-specific or all-cause mortality among CRC survivors; however, a marginal trend across quartiles of processed meat in relation to CRC mortality was detected (P 0·053). Pre-diagnostic poultry intake was inversely associated with all-cause mortality among women (hazard ratio (HR)/20 g/d 0·92; 95 % CI 0·84, 1·00), but not among men (HR 1·00; 95 % CI 0·91, 1·09) (Pfor heterogeneity=0·10). Pre-diagnostic intake of red meat or fibre is not associated with CRC survival in the EPIC cohort. There is suggestive evidence of an association between poultry intake and all-cause mortality among female CRC survivors and between processed meat intake and CRC-specific mortality; however, further research using post-diagnostic dietary data is required to confirm this relationship.
This paper reports on the experimental testing of oxygen-enriched porous fuel injection in a scramjet engine. Fuel was injected via inlet mounted, oxide-based ceramic matrix composite (CMC) injectors on both flow path surfaces that covered a total of 9.2 % of the intake surface area. All experiments were performed at an enthalpy of
, flight Mach number 9.2–9.6 and an equivalence ratio of
. At this condition, the engine was shown to be on the verge of achieving appreciable combustion. Oxygen was then added to the fuel prior to injection such that two distinct enrichment levels were achieved. Combustion was found to increase, by as much as 40 % in terms of combustion-induced pressure rise, over the fuel-only case with increasing oxygen enrichment. Further, the onset of combustion was found to move upstream with increasing levels of oxygen enrichment. Thrust, both uninstalled and specific, and specific impulse were found to be improved with oxygen enrichment. Enhanced fuel–air mixing due to the pre-mixing of oxygen with the fuel together with the porous fuel injection are believed to be the main contributors to the observed enhanced performance of the tested engine.
The reliability of InAlGaN multiple quantum well LEDs emitting around 308 nm has been investigated. The UV-B LEDs were stressed at constant current and current density, while the heat sink temperature was varied between 15°C and 80°C. The results reveal two different modes of the decrease of the optical power during aging. First, a fast reduction of the optical power within the first 100 h (mode 1) can be observed, followed by a slower degradation for operation times >100 h (mode 2). Mode 1 can be described as an initial degradation activation process which saturates after a certain time, whereas the second degradation mode can be described by a square-root time dependence of the optical power, suggesting a diffusion process to be involved. Both degradation modes are accompanied by changes of the I-V characteristic, particularly the reverse-bias leakage current and the drive voltage. Furthermore, the degradation behavior is strongly influenced by the temperature. Both, the maximum reduction of the optical power and the increase of the leakage current become stronger at higher temperatures.
Whole-grain intake has been reported to be associated with a lower risk of several lifestyle-related diseases such as type 2 diabetes, CVD and some types of cancers. As measurement errors in self-reported whole-grain intake assessments can be substantial, dietary biomarkers are relevant to be used as complementary tools for dietary intake assessment. Alkylresorcinols (AR) are phenolic lipids found almost exclusively in whole-grain wheat and rye products among the commonly consumed foods and are considered as valid biomarkers of the intake of these products. In the present study, we analysed the plasma concentrations of five AR homologues in 2845 participants from ten European countries from a nested case–control study in the European Prospective Investigation into Cancer and Nutrition. High concentrations of plasma total AR were found in participants from Scandinavia and Central Europe and lower concentrations in those from the Mediterranean countries. The geometric mean plasma total AR concentrations were between 35 and 41 nmol/l in samples drawn from fasting participants in the Central European and Scandinavian countries and below 23 nmol/l in those of participants from the Mediterranean countries. The whole-grain source (wheat or rye) could be determined using the ratio of two of the homologues. The main source was wheat in Greece, Italy, the Netherlands and the UK, whereas rye was also consumed in considerable amounts in Germany, Denmark and Sweden. The present study demonstrates a considerable variation in the plasma concentrations of total AR and concentrations of AR homologues across ten European countries, reflecting both quantitative and qualitative differences in the intake of whole-grain wheat and rye.
Cardiovascular fitness influences many aspects of brain function. However, the relationship between cardiovascular fitness and suicidal behaviour is unknown. Therefore, we aimed to determine whether cardiovascular fitness at age 18 years is associated with future risk of suicide attempt/death.
We performed a population-based Swedish longitudinal cohort study of male conscripts with no previous or ongoing mental illness (n = 1 136 527). The conscription examination, which took place during 1968–2005, included the cycle ergonometric test and tests of cognitive performance. Future risk of suicide attempt/death over a 5- to 42-year follow-up period was calculated with Cox proportional hazards models controlling for several confounders including familial factors.
At least one suicide attempt was recorded for 12 563 men. Death by suicide without a prior attempt was recorded in 4814 additional individuals. In fully adjusted models low cardiovascular fitness was associated with increased risk for future attempt/death by suicide [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.64–1.94]. The HR changed only marginally after exclusion of persons who received in-patient care for depression (HR 1.76, 95% CI 1.61–1.94). Poor performance on both the cardiovascular fitness and cognitive tests was associated with a fivefold increased risk of suicide attempt or suicide death (HR 5.46, 95% CI 4.78–6.24).
Lower cardiovascular fitness at age 18 years was, after adjustment for a number of potential confounders, associated with an increased risk of attempt/death by suicide in adulthood. It remains to be clarified whether interventions designed to improve fitness in teens can influence the risk of suicidal behaviour later in life.
Studies suggest a role for cardiovascular fitness in the prevention of
To determine whether cardiovascular fitness at age 18 is associated with
future risk of serious affective illness.
Population-based Swedish cohort study of male conscripts
(n = 1 117 292) born in 1950–1987 with no history of
mental illness who were followed for 3–40 years. Data on cardiovascular
fitness at conscription were linked with national hospital registers to
calculate future risk of depression (requiring in-patient care) and
In fully adjusted models low cardiovascular fitness was associated with
increased risk for serious depression (hazard ratios (HR)=1.96, 95%, CI
1.71–2.23). No such association could be shown for bipolar disorder
(HR=1.11, 95% CI 0.84–1.47).
Lower cardiovascular fitness at age 18 was associated with increased risk
of serious depression in adulthood. These results strengthen the theory
of a cardiovascular contribution to the aetiology of depression.
Fish consumption is the major dietary source of EPA and DHA, which according to rodent experiments may reduce body fat mass and prevent obesity. Only a few human studies have investigated the association between fish consumption and body-weight gain. We investigated the association between fish consumption and subsequent change in body weight. Women and men (n 344 757) participating in the European Prospective Investigation into Cancer and Nutrition were followed for a median of 5·0 years. Linear and logistic regression were used to investigate the associations between fish consumption and subsequent change in body weight. Among women, the annual weight change was 5·70 (95 % CI 4·35, 7·06), 2·23 (95 % CI 0·16, 4·31) and 11·12 (95 % CI 8·17, 14·08) g/10 g higher total, lean and fatty fish consumption per d, respectively. The OR of becoming overweight in 5 years among women who were normal weight at enrolment was 1·02 (95 % CI 1·01, 1·02), 1·01 (95 % CI 1·00, 1·02) and 1·02 (95 % CI 1·01, 1·04) g/10 g higher total, lean and fatty consumption per d, respectively. Among men, fish consumption was not statistically significantly associated with weight change. Adjustment for potential over- or underestimation of fish consumption did not systematically change the observed associations, but the 95 % CI became wider. The results in subgroups from analyses stratified by age or BMI at enrolment were not systematically different. In conclusion, the present study suggests that fish consumption has no appreciable association with body-weight gain.
We demonstrate that the anisotropic optical response of metal (cobalt) slanted columnar thin films (STF) at THz frequencies strongly depends on the dielectric properties of the dielectric ambient surrounding the slanted columnar thin films. An effective medium dielectric function approach is used to describe the combined optical response of metal slanted columnar thin film and dielectric ambient. Our observations indicate that metal (cobalt) slanted columnar thin films can be used as sensors which will enable detection and characterization of minute amounts of dielectrics at THz frequencies, such as for flow-based detection of liquid chemical constituents.
During RV Polarstern cruise ANT-XXIII/4 in 2006, a gravity core (PS 69/335-2) and a giant box core (PS 69/335-1) were retrieved from Maxwell Bay off King George Island (KGI). Comprehensive geochemical (bulk parameters, quantitative XRF, Inductively Coupled Plasma Mass Spectrometry) and radiometric dating analyses (14C, 210Pb) were performed on both cores. A comparison with geochemical data from local bedrock demonstrates a mostly detrital origin for the sediments, but also points to an overprint from changing bioproductivity in the overlying water column in addition to early diagenetic processes. Furthermore, ten tephra layers that were most probably derived from volcanic activity on Deception Island were identified. Variations in the vertical distribution of selected elements in Maxwell Bay sediments further indicate a shift in source rock provenance as a result of changing glacier extents during the past c. 1750 years that may be linked to the Little Ice Age and the Medieval Warm Period. Whereas no evidence for a significant increase in chemical weathering rates was found, 210Pb data revealed that mass accumulation rates in Maxwell Bay have almost tripled since the 1940s (0.66 g cm-2 yr-1 in ad 2006), which is probably linked to rapid glacier retreat in this region due to recent warming.
Nineteen specimens of the rare dragonfish Vomeridens infuscipinnis were evaluated for meristic counts, morphometric measurements, vomerine teeth and the supratemporal canal, anatomical and histological observations of bone, cartilage and lipid, diet, and reproductive status. Seven individuals were measured for buoyancy. All specimens had small vomerine teeth that varied in number. There was also variability in the arrangement of the supratemporal pores and canals. Vomeridens possess a body with little bone and considerable amounts of cartilage and lipid. A mean percentage buoyancy of 1.61% indicated that Vomeridens is nearly neutrally buoyant. Inferences from measurements of buoyancy and from morphological data suggest that Vomeridens lives in an epibenthic water column habitat at 400–900 m. Facilitated by its reduced body density, Vomeridens are likely to forage in the water column by hovering above the substrate. The stomach contents consisted of krill (Euphausia superba), some as large as 46–50 mm.The absolute and relative fecundity in seven female was 1576–2296 oocytes (mean 1889) and 21.3–28.9 oocytes g-1 body weight (mean 25.3), respectively. The reproductive effort in terms of egg diameter, GSI, and absolute and relative fecundity is similar to that for other bathydraconids.
Systematic microstructural and mechanical investigations of the Fe84.3Cr4.3Mo4.6V2.2C4.6 alloy cast under special manufacturing conditions in the as-cast state and after specific heat treatment are presented to point out that the special manufacturing of the alloy led to high compression strength (up to 4680 MPa) combined with large fracture strain (about 20%) already in the as-cast state. One select chemical composition of the alloy, which was mentioned previously [Kühn et al., Appl. Phys. Lett.90, 261901 (2007)] enhanced mechanical properties already in the as-cast state. Furthermore, that composition is comparable to commercial high-speed steel. By the special manufacturing used, a high purity of elements and a high cooling rate, which led to a microstructure similar to a composite-like material, composed of dendritic area (martensite, bainite, and ferrite) and interdendritic area (e.g., complex carbides). The presented article demonstrates an alloy that exhibits already in the as-cast state high fracture strength and large ductility. Furthermore, these outstanding mechanical properties remain unchanged after heating up to 873 K.