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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.
Potatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ’s), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11·4 (95 % CI 0·3, 16·9) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1·44; 95 % CI 0·93, 2·22, Pfor trend 0·030) when comparing the highest v. the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2·00; 95 % CI 1·07, 3·72, Pfor trend 0·020), but not for males (HR 1·01; 95 % CI 0·56, 1·84, Pfor trend 0·34). In addition, we explored the associations by spline regression, and the absence of dose–response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.
Patent foramen ovale (PFO) is an open hole between the right and left upper chambers of the heart. It may increase the risk of stroke, so closure of the hole is considered a secondary prevention in patients who have experienced cryptogenic stroke. Recent evidence has been published on the effectiveness of PFO closure, including a publicly funded prospective study on the effectiveness of PFO closure for preventing recurrent stroke or transient ischemic attack in selected Korean patients who have experienced cryptogenic stroke. The objective of this study was to examine the cost-effectiveness of PFO closure using this recent evidence.
Available clinical data from the aforementioned Korean prospective study and other recent multicenter trials funded by public bodies were used. The cost data were obtained from the current Korean National Health Insurance fee schedule. Utility data were extracted from local research on stroke patients. A cost-effectiveness analysis, based on a 20-year Markov model, was conducted using these data to compare PFO closure plus antiplatelet therapy with oral anticoagulants alone.
The initial analysis showed that PFO plus antiplatelet therapy costs KRW 7.13 million (USD 6,547) more than oral anticoagulants alone but has a higher utility of 1.3 quality-adjusted life-years (QALYs) per patient, which corresponds to an incremental cost-effectiveness ratio (ICER) of KRW 5.6 million (USD 5,142) per QALY. The implicit Korean ICER threshold is KRW 25 million (USD 22,955) for non-cancer drugs, so it seems that PFO plus antiplatelet therapy is cost effective in the Korean setting.
Since this study used some transition probabilities from foreign sources, the results may not be completely transferable to the Korean setting. However, this is the best available evidence so far in Korea for the economic evaluation of the PFO closure procedure. Therefore, use of PFO closure in carefully selected patients with a history of cryptogenic stroke may benefit the public payer in Korea.
In this report we describe an 82-year female with a longstanding anxiety disorder who developed severe psychogenic dysphagia, leading to hospitalization due to failure to thrive. We describe for the first time the use of electroconvulsive therapy (ECT) to successfully manage a patient with pharmacological treatment resistant psychogenic dysphagia.
Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.
The Korean VLBI Network (KVN) is a unique millimeter VLBI system which is consisted of three 21 m telescopes with relatively short baselines. We present the preliminary results of simultaneous monitoring observations of the 22.2 GHz H2O and 43.1/42.8/86.2/129.3 GHz SiO masers based on the KVN Key Science Project (KSP). We obtained the astrometrically registered maps of the H2O and SiO masers toward nine evolved stars using the source frequency phase referencing method (SFPR). The SFPR maps of the H2O and SiO masers enabled us to investigate the spatial structure and kinematics from the SiO to H2O maser regions including the development of an outward motion from the ring-like or elliptical structures of SiO masers to the asymmetric structures of the 22.2 GHz H2O maser features. In particular, the 86.2/129.3 GHz SiO (v=1, J=2–1 and J=3–2) masers were clearly imaged toward several objects for the first time. The SiO v=1, J=3–2 maser shows different distributions compared to those of the SiO v=1, 2, J=1–0 and v=1, J=2–1 masers implying a different physical condition.
Following two decades of armed conflict in Liberia, over 95% of health care facilities were partially or completely destroyed. Although the Liberian health system has undergone significant rehabilitation, one particular weakness is the lack of organized systems for referral and prehospital care. Acute care referral systems are a critical component of effective health care delivery and have led to improved quality of care and patient outcomes.
This study aimed to characterize the referral and transfer systems in the largest county of Liberia.
A cross-sectional, health referral survey of a representative sample of health facilities in Montserrado County, Liberia was performed. A systematic random sample of all primary health care (PHC) clinics, fraction proportional to district population size, and all secondary and tertiary health facilities were included in the study sample. Collected data included baseline information about the health facility, patient flow, and qualitative and quantitative data regarding referral practices.
A total of 62 health facilities—41 PHC clinics, 11 health centers (HCs), and 10 referral hospitals (RHs)—were surveyed during the 6-week study period. In sum, three percent of patients were referred to a higher-level of care. Communication between health facilities was largely unsystematic, with lack of specific protocols (n=3; 5.0%) and standardized documentation (n=26; 44.0%) for referral. While most health facilities reported walking as the primary means by which patients presented to initial health facilities (n=50; 81.0%), private vehicles, including commercial taxis (n=37; 60.0%), were the primary transport mechanism for referral of patients between health facilities.
This study identified several weaknesses in acute care referral systems in Liberia, including lack of systematic care protocols for transfer, documentation, communication, and transport. However, several informal, well-functioning mechanisms for referral exist and could serve as the basis for a more robust system. Well-integrated acute care referral systems in low-income countries, like Liberia, may help to mitigate future public health crises by augmenting a country’s capacity for emergency preparedness.
KimJ, BarreixM, BabcockC, BillsCB. Acute Care Referral Systems in Liberia: Transfer and Referral Capabilities in a Low-Income Country. Prehosp Disaster Med. 2017;32(6):642–650.
Next-generation electronic devices are expected to demonstrate greater utility, efficiency and durability. Meanwhile, plastics such as polyethylene terephthalate (PET), polyethylene naphthalate (PEN) and variety of poly(para-xylylene) polymers enable transformational advantages to device shape, flexibility, weight, transparency and recyclability. Exhibiting a combination of outstanding mechanical, electrical, optical, and chemical properties of graphene with the plastic substrates could propose ideal material for the future flexible electronics. Chemical vapor deposition (CVD) allows cost-effective fabrication of a high-quality large-area graphene films, however, the critical issue is clean and noninvasive transfer of the films onto a desired substrate. The water-based delamination of CVD grown graphene on Cu can be considered as a “green” transfer process utilizing only hot deionized water. We investigated a method requiring only two essential steps: coating of 6-inch monolayer CVD graphene with transparent and flexible polymer, and Cu delamination in hot water. Proposed method is inexpensive, reproducible, environmentally friendly, waste-free and suitable for large-scale, high quality graphene. The transfer process demonstrated films with enhanced charge carrier mobility, high uniformity, free of mechanical defects, and sheet resistance as low as ∼50 Ω/sq with 96.5 % transparency at 550 nm wavelength.
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.
We report fully-printed top-gate-bottom-contact organic thin-film transistors
using substrates prepared from cellulose nanofibers and commercially available
printing inks to fabricate the devices. Gravure printing was used to coat the
substrate with a polymer resist to decrease the surface roughness and close the
surface. Transistor structures were fabricated using inkjet printing for
conductors and gravure printing for the dielectric and semiconducting layers.
The obtained transistor performance is compared to that of similar transistors
on plastic substrate.
How long has Spanish been spoken in the US and how many people speak it today? Is Spanish being passed down through generations? What role does Spanish play in US Latino identity? Analysing and synthesising data from a wide variety of sources, Escobar and Potowski explore these questions and more in this up-to-date textbook for students of Spanish language, linguistics, bilingualism, sociolinguistics, culture, and history.Over 150 exercises help students engage with the linguistic characteristics of Spanish, Spanish-dialect contact, bilingualism, and Spanish communities in the USExercises and examples refer students to external, online sources so they can experience Spanish through a range of mediaConcepts are clearly defined with detailed examples for readers who may not have a background in linguisticsMisconceptions about Spanish varieties and Latino communities are addressed, ensuring readers will emerge with a clear understanding of how Latino communities vary linguistically and socioculturally.
Existen varios tipos de programas educativos en los EE.UU. que emplean la lengua española. Algunos son para niños que todavía no saben el inglés, a quienes se les suele referir como “English Language Learners” (ELL) o aprendices del idioma inglés (AII). De estos, hay programas que tienen como única meta la preparación de los estudiantes para las aulas que imparten la instrucción totalmente en inglés. Otros buscan promover el mantenimiento y el desarrollo del español. También existen programas para estudiantes de todas las edades que quieren aprender el español como segunda lengua. En este capítulo, repasamos la historia y la trayectoria de la “educación bilingüe,” así como varios tipos de programa que enseñan el español a diferentes tipos de estudiantes en los EE.UU.
Aspectos históricos de la educación bilingüe en los EE.UU.
Bien se sabe que los EE.UU. es un país fundado y, posteriormente, poblado por numerosos grupos de inmigrantes provenientes de todas partes del mundo. Durante la época colonial, llegaban principalmente hablantes del inglés, de alemán, de francés, de español y de holandés. A partir del siglo xix y especialmente desde principios del siglo xx llegaron grandes olas de inmigrantes de todas partes de Europa.
Muchos de estos grupos establecieron sus propias escuelas.