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Presents a study that investigated the response characteristics of an oscillatory vane for flow-speed measurements. Background on vane dynamics; Determination of the effective force coefficient; Effect of fin shape on the behavior of an oscillatory vane.

Symptomatic spondylolysis is a stress reaction caused by microtrauma during physical exercise, an imaging diagnostic subgroup of Adolescent Low Back Pain (ALBP), found in adolescent athletes. Early diagnosis increases the possibility of healing. Thus, it is important to divide ALBP into subgroups. The aim of this study was to evaluate clinical tests that can distinguish symptomatic spondylolysis from other forms of ALBP in order to facilitate early referral for diagnostic imaging. The investigation subjects were a prospective case series with a control group, 25 subjects with ALBP and 13 subjects that had no history of LB. The 2 groups were examined using the same clinical protocol. MRI of the whole lumbar spine was performed in both the case and control groups and CT investigations of the L4 and L5 vertebrae were performed in the case group. Significant differences between the 2 groups were found in 8 of our clinical tests. No clinical test, alone or in combination, could distinguish between spondylolysis and other forms of ALBP. As 88 % of the subjects in the case group had MRI findings and almost 50 % had spondylolysis, MRI should be performed at an early age in young athletes with ALBP. [ABSTRACT FROM AUTHOR]

BACKGROUND: The number of hip fractures has doubled in the last 30-40 years in many countries. Age-adjusted incidence has been reported to be decreasing in Europe and North America, but is there a decreasing trend in all age groups? PATIENTS AND METHODS: This population-based study included all hip-fracture patients over 50 years of age (a total of 2,919 individuals, 31% of whom were men) admitted to Umeå University Hospital, Sweden, from 1993 through 2005. RESULTS: The incidence of hip fracture declined between the periods 1993-1996 and 2001-2005: from 706 to 625 hip fractures per 10(5) women and from 390 to 317 hip fractures per 10(5) men. However, there was a 114% increase in the number of fractures in women aged 90 or older (12 and 25 hip fractures/year, respectively, in the two time periods). For the period 2001-05, women > or = 90 years of age accounted for almost the same numbers of hip fractures as women aged 75-79 (27 fractures/year). The rate increased during this period, from 2,700 per 10(5) women to 3,900 per 10(5) women > 90 years. In men there were declining trends for both relative and absolute numbers. INTERPRETATION: Although age-adjusted incidence declined in the population > 50 years of age, absolute fracture rate and incidence increased in the very old. Women over 90 now have the same absolute number of hip fractures every year as women aged 75-79 years. There was a right-shift in hip fracture distribution towards the oldest old, probably due to an increased number of octo/nonagenarians, a new population of particularly frail old people that hardly existed earlier. Better health among septuagenarians may also have delayed the age at which fractures occurred. This changing pattern will strain orthopedic and geriatric resources even more. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To estimate the interval cancer incidence, its determinants and the episode sensitivity in the Norrbotten Mammography Screening Programme (NMSP). SETTING: Since 1989, women aged 40-74 years (n = 55,000) have been invited to biennial screening by the NMSP, Norrbotten county, Sweden. METHODS: Data on 1047 invasive breast cancers from six screening rounds of the NMSP (1989-2002) were collected. We estimated the invasive interval cancer rates, rate ratios and the episode sensitivity using the detection and incidence methods. A linear Poisson-model was used to analyse association between interval cancer incidence and sensitivity. RESULTS: 768 screen-detected and 279 interval cancer cases were identified. The rate ratio of interval cancer decreased with age. The 50-59 year age group showed the highest rate ratio (RR = 0.52, 95% CI 0.41-0.65) and the 70-74 year age group the lowest (RR = 0.23, 95% CI 0.15-0.36). The rate ratios for the early (0-12 months) and late (13-24 months) interval cancers were similar (RR = 0.18, 95% CI 0.15-0.22 and 0.20, 95% CI 0.17-0.24). There was a significantly lower interval cancer incidence in the prevalence round as compared with the incidence rounds. According to the detection method the episode sensitivity increased with age from 57% in the age group 40-49 years to 84% in the age group 70-74 years. The corresponding figures for the incidence method were 50% and 77%, respectively. CONCLUSION: Our study showed an interval cancer incidence of 38% and the episode sensitivity of 62-73%, depending on the method of calculation. Our results are of clinically acceptable level and concert with the reference values of the European guidelines. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To study the effectiveness of service screening with mammography in Northern Sweden. SETTING: Two counties which invited women aged 40-74 years to service screening with mammography were compared with two counties where service screening started 5-7 years later. There were 109,000 and 77,000 women in the study and control counties, respectively. METHODS: Cohorts in the study group were defined to include only breast cancer cases diagnosed after their first invitation to screening. Two outcome measures for breast cancer mortality were used; excess mortality and underlying cause of death (UCD). Detection mode was used to estimate the efficacy of screening for those women who actually attended screening. The cohorts were followed for 11 years. RESULTS: The relative rate (RR) of breast cancer death as excess mortality and UCD for women aged 40-74 years invited to screening, compared with women not yet invited, was 0.70 (95% confidence interval [CI] 0.56-0.87) and 0.74 (95% CI 0.62-0.88), respectively. The largest effect was seen in women aged 40-49 years (RR = 0.64 and RR = 0.62 for excess mortality and UCD, respectively). RR in age 40-74 years for women actually screened was 0.65 (95% CI 0.51-0.84) and 0.70 (95% CI 0.57-0.86) for excess mortality and UCD, respectively. The number of women needed to screen to save one life was 912 after 11 years of follow-up. CONCLUSIONS: This study confirms previous findings in the earlier follow-up and indicates a long-term reduction of breast cancer mortality by 26-30%. The efficacy among those who actually attended screening was about 5% larger. [ABSTRACT FROM AUTHOR]

The forkhead (Fox) gene family comprises a diverse group of ‘winged-helix’ transcription factors that play important roles in development, metabolism, cancer and aging. Recently, several forkhead genes have been demonstrated to play critical roles in lymphocyte development and effector function, including Foxp3 in the development of regulatory T cells, Foxj1 and Foxo3a in the regulation of CD4+ T cell tolerance, and Foxn1 in thymic development. Roles for other forkhead genes have also been proposed, including Foxp1 in macrophage differentiation, Foxq1 in natural killer cell effector function and Foxd2 in T cell activation. Thus, forkhead genes promise insight into the mechanisms of immunoregulation in several immune cell lineages, and their dysregulation likely contributes to the pathogenesis of several immunological disorders, suggesting that their study will lead to the development of novel therapeutic agents. [ABSTRACT FROM AUTHOR]

In an attempt to learn more about the cytochrome P450 (CYP) system of mussels, we used protein databases and alignment software to extract highly conserved CYP sequences. From these alignments synthetic peptides were produced and used for rabbit immunisation, which yielded polyclonal antibodies against the CYP families 2 and 4. The antibodies were evaluated with Western Blot and ELISA assays, using digestive gland microsomal samples from the mussel Mytilus edulis. Western Blots revealed immunoreactions for both antibodies. The anti-CYP2 sequence rendered one major immunopositive protein of ≈49 kDa size, and weak signals for proteins of ≈41 and 56 kDa size. The anti-CYP4 sequence rendered two major bands of ≈56 and 59 kDa size, and also a weak immunoreaction with a protein of ≈43 kDa size. ELISA rendered only weak signals even with a 1:50 dilution of IgG-purified serum. A 10-day exposure to Aroclor 1254 did not appear to affect any of the immunopositive proteins, while total PCBs in soft bodies increased from 14–40 ng/g DW in controls to 373–638 ng/g DW in exposed mussels. [Copyright &y& Elsevier]

Wet wheat distillers' grain (WWDG), a residue from ethanol fermentation, was examined from a microbiological perspective. After storage, WWDG was characterized by a high content of lactobacilli, nondetectable levels of other bacteria, occasional occurrence of yeasts, and a pH of about 3.6 and contained a mixture of lactic acid, acetic acid, and ethanol. The composition of lactobacilli in WWDG was simple, including primarily the species Lactobacillus amyiolyticus, Lactobacillus panis, and Lactobacillus pontis, as determined by 16S rRNA gene sequencing. Since the use of WWDG as pig feed has indicated a health-promoting function, some relevant characteristics of three strains of each of these species were examined together with basal physiological parameters, such as carbohydrate utilization and growth temperature. Seven of the strains were isolated from WWDG, and two strains from pig feces were included for comparison. It was clear that all three species could grow at temperatures of 45 to 50°C, with L. amylolyticus being able to grow at temperatures as high as 54°C. This finding could be the explanation for the simple microflora of WWDG, where a low pH together with a high temperature during storage would select for these organisms. Some strains of L. panis and L. pontis showed prolonged survival at pH 2.5 in synthetic stomach juice and good growth in the presence of porcine bile salt. In addition, members of all three species were able to bind to immobilized mucus material in vitro. Especially the isolates from pig feces but, interestingly, some isolates from WWDG as well possessed properties that might be of importance for colonization of the gastrointestinal tracts of pigs. [ABSTRACT FROM AUTHOR]

Retirement is an occupational transition and is therefore important in the field of occupational therapy. This study examined how work and retirement were viewed by a group of Swedish people aged 63 years, living in a Stockholm suburb, who were about to retire. A questionnaire was sent to them, focussing on their present occupational pattern, the most important characteristics of their present work, their attitudes to retirement and their attitudes to paid and voluntary work after retirement. The results point in the direction of both generalization and diversity. At the age of 63 years, work was the most important area in life for 39% of the participants. Present work is experienced in various ways, with financial, social and intrinsic factors as the most important characteristics. A positive attitude to their own retirement was held by 78%. A positive attitude to some sort of paid or voluntary work after retirement was held by 73%. About three-quarters of the respondents had needs other than financial as their most important reason for working after retirement. Occupational therapy implications related to the role of work in fulfilling basic human needs are discussed. Opportunities for people to engage in some kind of work after retirement would combine individual satisfaction with social utility, thus having value for the individual as well as for society. [ABSTRACT FROM AUTHOR]

Experiments with an oscillatory vane in a wind tunnel reveal that the vane’s oscillation frequency is directly proportional to the square root of the dynamic pressure of the flow. The linear relationship is observed for flow speeds up to the speed of sound in air, argon, and helium. The vane’s oscillations are a measure of mass flow, or if used on an aircraft, of indicated air speed. In constant density media the oscillation frequency is directly proportional to flow speed, and a simple count of the oscillations is a measure of distance traveled. At given ambient temperature and pressure, the vane’s frequency is the same at the speed of sound for all gases, irrespective of their molecular weight. [ABSTRACT FROM AUTHOR]

BACKGROUND In 2021, the American College of Medical Genetics and Genomics (ACMG) recomdemended reporting actionable genotypes in 73 genes associated with diseases for which preventive or therapeutic measures are available. Evaluations of the association of actionable genotypes in these genes with li fe span are currently lacking. METHODS We assessed the prevalence of coding and splice variants in genes on the ACMG Secondary Findings, version 3.0 (ACMG SF v3.0), list in the genomes of 57,933 Icelanders. We assigned pathogenicity to all reviewed variants using reported eviHeldence in the ClinVar database, the frequency of variants, and their associations with disease to create a manually curated set of actionable genotypes (variants). We assessed the relationship between these genotypes and life span and further examined the specific causes of death among carriers. RESULTS Through manual curation of 4405 sequence variants in the ACMG SF v3.0 genes, we identified 235 actionable genotypes in 53 genes. Of the 57,933 participants, 2306 (4.090) carried at least one actionable genotype. We found shorter median survival among persons carrying actionable genotypes than among tioncarriers. Specifically, we found that carrying an actionable genotype in a cancer gene was associated with survival that was 3 years shorter than that among noncarriers, with causes of death among carriers attributed primarily to cancer-related conditions. Furthermore, we found evidence of association between carrying an actionable genotype in certain genes in the cardiovascular disease group and a reduced life span. CONCLUSIONS On the basis of the ACMG SF v3.0 guidelines, we found thatt approximately 1 in 25 Icelanders carried an actionable genotype and that carrying such a genotype was associated with a reduced life span. (Funded by deCODE Genetics-Amgen. [ABSTRACT FROM AUTHOR]

Human urine is by far the largest contributor of nutrients to household wastewater. Source separation of urine can significantly decreasethe nutrient load on the recipients. By recycling the urine to agriculture as a fertiliser, with very low levels of heavy metals, the nutrients are made into resources instead of becoming pollutants. The amounts and concentrations of nutrients and heavy metals in urine solution from a source. separating sewage system were measured. The concentrations of nutrients were high. The ratio of nitrogen to phosphorus was close to the expected value, indicating that the system did not have any large nitrogen loss. The heavy metal concentrations in the urine were low, much lower than that in most chemical fertilisers. Per inhabitant and day, 1.34 litres of urine solution were collected. Of this, 0.34 litres was flush water. The low flush water volume was dueto the double flush mechanism of the toilets, which saved 48% of theflush water compared with conventional water closets. Per inhabitantand day, 4.9 g of nitrogen and 0.42 g of phosphorus were collected, which was 86 and 81% respectively of the expected amount. The contamination level of faecal material in the source separated urine was low. [ABSTRACT FROM AUTHOR]

Airborne flux measurements of isoprene were performed over the Californian oak belts surrounding the Central Valley. The authors demonstrate for the first time 1) the feasibility of airborne eddy covariance measurements of reactive biogenic volatile organic compounds; 2) the effect of chemistry on the vertical transport of reactive species, such as isoprene; and 3) the applicability of wavelet analysis to estimate regional fluxes of biogenic volatile organic compounds. These flux measurements demonstrate that instrumentation operating at slower response times (e.g., 1-5 s) can still be used to determine eddy covariance fluxes in the mixed layer above land, where typical length scales of 0.5-3 km were observed. Flux divergence of isoprene measured in the planetary boundary layer (PBL) is indicative of OH densities in the range of 4-7 × 106 molecules per cubic centimeter and allows extrapolation of airborne fluxes to the surface with Damköhler numbers (ratio between the mixing time scale and the chemical time scale) in the range of 0.3-0.9. Most of the isoprene is oxidized in the PBL with entrainment fluxes of about 10% compared to the corresponding surface fluxes. Entrainment velocities of 1-10 cm s−1 were measured. The authors present implications for parameterizing PBL schemes of reactive species in regional and global models. [ABSTRACT FROM AUTHOR]

Objective Analysing trends in population breast cancer mortality statistics appears a simple method of estimating the effectiveness of mammographic screening programmes. We reviewed such studies of population-based screening in Europe to assess their value. Methods A literature review identified 17 papers, of which 12 provided quantitative estimates of the impact of screening. Due to differences in comparisons and outcome measures, no pooled estimate of effectiveness was calculated. Results Comparisons included breast cancer mortality before and after the introduction of screening, trends in early and late starting areas and trends in age groups affected and unaffected by screening. Studies that calculated the percentage annual change after the start of screening found reductions of 1-9% per year (1%, 2.3-2.8% and 9% for those with adequate follow-up). Of studies that compared mortality in time periods before and after introduction of screening, three single country studies all had adequate follow-up and estimated mortality reductions ranging from 28% to 36%. Limitations of studies of population mortality rates include the inability to exclude deaths in women with breast cancer diagnosed before invitation to screening, diluting any observable impact of screening, and the gradual implementation of screening in a country or region. Conclusions Although analysing population breast cancer mortality rates over time can be a first step in examining changes following the introduction of screening, this method is of limited value for assessment of screening impact. Other methods and individual data are necessary to properly quantify the effect. [ABSTRACT FROM AUTHOR]

Aerosol samples were collected and cloud condensation nuclei (CCN) concentrations at five supersaturations were measured along and off the central California coast within the cloud-topped, marine boundary layer from aircraft flights during August 2007. Receptor modelling has been applied to estimate the natural versus anthropogenic source contribution of cloud condensation nuclei in this region, a region of climatically important marine stratocumulus. The results suggest that anthropogenic CCN accounted for about 50% of the CCN active at 0.3% supersaturation in this region during the measurement period. [ABSTRACT FROM AUTHOR]

Background: Because of current cost restrictions, we studied the effect of a shorter hospital stay on function, pain and quality of life (QOL) after total hip replacement (THR).Patients and methods: 50 patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team, and a control group (CG) of 23 patients receiving 'conventional' rehabilitation often augmented by a stay at a rehabilitation center.Results: Mean hospital stay was shorter for the SG than for the CG (6.4 days and 10 days, respectively; p < 0.001). During the 6-month study period, there were 9 non-fatal complications in the SG and 12 in the CG (p = 0.3). The difference in Oxford Hip Score between the groups was not statistically significant before the operation, but was better for the SG at 2 months (p = 0.03) and this difference remained more or less constant throughout the study. The overall score from the Nottingham Health Profile indicated a better QOL in the SG.Interpretation: Our preoperative education program, followed by postoperative home-based rehabilitation, appears to be safer and more effective in improving function and QOL after THR than conventional treatment. [ABSTRACT FROM AUTHOR]

Deals with a study which investigated the influence of dioxide concentration in the compost gas on the course of decomposition. Methods; Results; Discussion.

Measurements of selected dicarboxylic acid concentrations in cloud water from marine stratocumulus off of the central California coast are reported. The concentrations are consistent with previously reported concentrations in marine aerosols and suggest at least a partial anthropogenic origin. The concentrations were not sufficient to impact cloud drop activation and thus provide no support for an effect on cloud albedo, though such an effect cannot be ruled out in other circumstances. [Copyright &y& Elsevier]

Objective: To describe the prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in a large population-based study of elderly Icelanders, with particular reference to weight-related factors and the metabolic syndrome. Method: The study population comprised 5321 participants aged 68–96 years (2276 males, mean ± sd age 76 ± 5 , and 3045 females, age 77 ± 6) from the AGES-Reykjavik Study. DISH diagnosis was based on computed tomography (CT) scans, and interpreted strictly by the Resnick criteria and additional suggestions for CT interpretation by Oudkerk et al. Radiology readings were taken by a radiology resident and sample readings by two experienced radiologists. Results: A diagnosis of DISH was made in 13.7% of males and 2.8% of females. There was no association with age, but a strong association was seen with the metabolic syndrome [odds ratio (OR) 2.12, 95% confidence interval (CI) 1.69–2.64, p = 3.9 × 10−11]. Among the components of the metabolic syndrome, the association with DISH was significant for the insulin resistance criterion (OR 1.66, 95% CI 1.32–2.01, p < 0.001) and the body mass index (BMI) criterion (OR 2.16, 95% CI 1.70–2.74, p < 0.001). Other weight-related variables (midlife BMI, weight, and abdominal circumference) showed similar associations. Conclusions: This study, which to our knowledge is the largest published study on the prevalence of DISH, shows an association with the metabolic syndrome, particularly with the insulin resistance and BMI criteria. This is analogous with previous reports linking DISH with metabolic causes. In this age category, we did not observe any increase in prevalence with age. [ABSTRACT FROM AUTHOR]

Anti-neutrophil cytoplasm antibody (ANCA) has been shown to be no marker of systemic lupus erythematosus (SLE) including lupus nephritis or of progressive systemic sclerosis (PSS). Antibodies against myeloperoxidase (anti-MPO) and elastase. two granulocyte lysosomal enzymes, were found in patients with SLE but not in those with PSS. except or one patient who had anti-MPO. Anti-MPO was present in 21% of patients with SLE, and at low concentrations in about 80% of these cases. Anti-elastase was found in four patients with SLE. In another group ot six patients with a SLE-like syndrome induced by anti-hypertensive treatment with the anti-hypertensive hydralazine. anti-MPO antibodies occurred in all six, and anti-elastase antibodies in five, Monitored during a 2-year follow- up period, anti-MPO antibodies were found to persist, whereas anti-elastase antibodies were rapidly eliminated, after withdrawal of the drug. [ABSTRACT FROM AUTHOR]

There is interest in estimating and attributing temporal changes in incidence of breast cancer in relation to the initiation of screening programmes, in particular to estimation of overdiagnosis of breast cancer as a result of screening. In this paper, we show how screening introduces complexities of analysis and interpretation of incidence data. For example, lead time brings forward time- and age-related increases in incidence. In addition, risk factors such as hormone replacement therapy use have been changing contemporaneously with the introduction of screening. Although we do not indicate exactly how such complexities should be corrected for, we use some simple informal adjustments to show how they may account for a substantial proportion of increased incidence, which might otherwise erroneously have been attributed to overdiagnosis. We illustrate this using an example of analysis of breast cancer incidence data from Sweden. [ABSTRACT FROM AUTHOR]

During the Marine Aerosol Cloud and Wildfire Study (MACAWS) in June and July of 2018, aerosol composition and cloud condensation nuclei (CCN) properties were measured over the N.E. Pacific to characterize the influence of aerosol hygroscopicity on predictions of ambient CCN and stratocumulus cloud droplet number concentrations (CDNC). Three vertical regions were characterized, corresponding to the marine boundary layer (MBL), an above‐cloud organic aerosol layer (AC‐OAL), and the free troposphere (FT) above the AC‐OAL. The aerosol hygroscopicity parameter (κ) was calculated from CCN measurements (κCCN) and bulk aerosol mass spectrometer (AMS) measurements (κAMS). Within the MBL, measured hygroscopicities varied between values typical of both continental environments (~0.2) and remote marine locations (~0.7). For most flights, CCN closure was achieved within 20% in the MBL. For five of the seven flights, assuming a constant aerosol size distribution produced similar or better CCN closure than assuming a constant "marine" hygroscopicity (κ = 0.72). An aerosol‐cloud parcel model was used to characterize the sensitivity of predicted stratocumulus CDNC to aerosol hygroscopicity, size distribution properties, and updraft velocity. Average CDNC sensitivity to accumulation mode aerosol hygroscopicity is 39% as large as the sensitivity to the geometric median diameter in this environment. Simulations suggest CDNC sensitivity to hygroscopicity is largest in marine stratocumulus with low updraft velocities (<0.2 m s−1), where accumulation mode particles are most relevant to CDNC, and in marine stratocumulus or cumulus with large updraft velocities (>0.6 m s−1), where hygroscopic properties of the Aitken mode dominate hygroscopicity sensitivity. Key Points: Aerosol hygroscopicity exhibited substantial temporal variability in the MBLErrors in predicted MBL CCN concentrations produced by assuming a constant aerosol size distribution or hygroscopicity are discussedSensitivity of simulated CDNC to hygroscopicity is maximized in marine clouds with either very weak or relatively strong updraft velocities [ABSTRACT FROM AUTHOR]

Osteoarthritis is an increasingly important health problem for which the main treatment remains joint replacement. Therapy developments have been hampered by a lack of biomarkers that can reliably predict disease, while 2D radiographs interpreted by human observers are still the gold standard for clinical trial imaging assessment. We propose a 3D approach using computed tomography—a fast, readily available clinical technique—that can be applied in the assessment of osteoarthritis using a new quantitative 3D analysis technique called joint space mapping (JSM). We demonstrate the application of JSM at the hip in 263 healthy older adults from the AGES-Reykjavík cohort, examining relationships between 3D joint space width, 3D joint shape, and future joint replacement. Using JSM, statistical shape modelling, and statistical parametric mapping, we show an 18% improvement in prediction of joint replacement using 3D metrics combined with radiographic Kellgren & Lawrence grade (AUC 0.86) over the existing 2D FDA-approved gold standard of minimum 2D joint space width (AUC 0.73). We also show that assessment of joint asymmetry can reveal significant differences between individuals destined for joint replacement versus controls at regions of the joint that are not captured by radiographs. This technique is immediately implementable with standard imaging technologies. [ABSTRACT FROM AUTHOR]

Presents several doctorates on occupational therapy. 'Disease Impact and Quality of Life in Rheumatic Diseases,' by Birgitha Archenholtz; 'Hand Function in Rheumatoid Arthritis,' by Berit Dellhag; 'On the Structure and Contents of Occupational Therapy Paradigms,' by Anita Bjorklund.

Objectives: Large-scale observational cohorts may be used to study the effectiveness and rare side effects of biological disease-modifying anti-rheumatic drugs (bDMARDs) in ankylosing spondylitis (AS), but may be hampered by differences in baseline characteristics and disease activity across countries. We aimed to explore the research infrastructure in the five Nordic countries regarding bDMARD treatment in AS.Method: This observational cohort study was based on data from biological registries in Denmark (DANBIO), Sweden (SRQ/ARTIS), Finland (ROB-FIN), Norway (NOR-DMARD), and Iceland (ICEBIO). Data were collected for the years 2010-2016. Registry coverage, registry inventory (patient characteristics, disease activity measures), and national guidelines for bDMARD prescription in AS were described per country. Incident (first line) and prevalent bDMARD use per capita, country, and year were calculated. In AS patients who started first line bDMARDs during 2010-2016 (n = 4392), baseline characteristics and disease activity measures were retrieved.Results: Registry coverage of bDMARD-treated patients ranged from 60% to 95%. All registries included extensive prospectively collected data at patient level. Guidelines regarding choice of first line drug and prescription patterns varied across countries. During the period 2010-2016 prevalent bDMARD use increased (p < 0.001), whereas incident use tended to decrease (p for trend < 0.004), with large national variations (e.g. 2016 incidence: Iceland 10.7/100 000, Finland 1.7/100 000). Baseline characteristics were similar regarding C-reactive protein, but differed for other variables, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) (range 3.5-6.3) and Ankylosing Spondylitis Disease Activity Score (ASDAS) (2.7-3.8) (both p < 0.0001).Conclusion: Collaboration across the five Nordic biological registries regarding bDMARD use in AS is feasible but national differences in coverage, prescription patterns, and patient characteristics must be taken into account depending on the scientific question. [ABSTRACT FROM AUTHOR]

Background: Nursing procedures that are routinely performed in the intensive care unit (ICU) are assumed to have minimal side effects. However, these procedures may sometimes cause physiological changes that negatively affect the patient. We hypothesized that physiological changes associated with routine nursing procedures in the ICU are common.Methods: A clinical observational study of 16 critically ill patients in a nine-bed mixed university hospital ICU. All nursing procedures were observed, and physiological data were collected and subsequently analyzed. Minor physiological changes were defined as minimal changes in respiratory or circulatory variables, and major physiological changes were marked as hyper/hypotension, bradycardia/tachycardia, bradypnea/tachypnea, ventilatory distress, and peripheral blood oxygen desaturation.Results: In the 16 patients, 668 procedures generated 158 major and 692 minor physiological changes during 187 observational hours. The most common procedure was patient position change, which also generated the majority of the physiological changes. The most common major physiological changes were blood oxygen desaturation, ventilatory distress, and hypotension, and the most common minor changes were arterial pressure alteration, coughing, and increase in respiratory rate.Conclusion: In this pilot study, we examined physiological changes in connection with all regular routine nursing procedures in the ICU. We found that physiological changes were common and sometimes severe. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether complement activation, via the classical and alternative pathways, occurs following a cemented total hip replacement ( THR) surgery due to osteoarthritis. Blood samples were collected systematically from 12 patients - six male and six women, with a median age of 75 (range: 59-90 years) - preoperatively, 6 h post-operatively and on the first, second and third post-operative day. Total function of classical ( CH50) and alternative pathways ( AH50) was evaluated, along with the determination of serum concentrations of the complement proteins C3, C4, C3d, the soluble terminal complement complex ( sTCC) sC5b-9, as well as C-reactive protein ( CRP) and albumin. Measurements of CRP and albumin levels elucidated a marked inflammatory response following the operation. The CH50, AH50 and C3 and C4 levels were significantly lower 6 h after the surgery compared with the preoperative levels, but elevated above the preoperative levels during the following 3 days. The complement activation product C3d levels increased continually during the whole observation period, from 13.5 AU/ml (range: 8-19 AU/ml) preoperative to 20 AU/ml (range: 12-34 AU/ml) on the third post-operative day. Furthermore, we observed an increase in the sC5b-9 levels between the preoperative and the third post-operative day. These results demonstrate a significant activation of the complement system following cemented THR. Further studies are needed to elucidate the time frame and the pathogenic role of this observed complement activation. [ABSTRACT FROM AUTHOR]

A response by S. W. Duffy, E. Lynge and H. Jonsson to a letter to the editor about their article "Complexities in the Estimation of Overdiagnosis in Breast Cancer Screening," that was published in the previous issue is presented.

Background Little is known about the associations of metabolic aberrations with malignant melanoma (MM) and nonmelanoma skin cancer (NMSC). Objectives To assess the associations between metabolic factors (both individually and combined) and the risk of skin cancer in the large prospective Metabolic Syndrome and Cancer Project (Me-Can). Methods During a mean follow-up of 12 years of the Me-Can cohort, 1728 (41% women) incident MM, 230 (23% women) fatal MM and 1145 (33% women) NMSC were identified. Most NMSC cases (76%) were squamous cell carcinoma (SCC) (873, 33% women). Hazard ratios (HRs) were estimated by Cox proportional hazards regression for quintiles and standardized z-scores (with a mean of 0 and SD of 1) of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and for a combined metabolic syndrome score. Risk estimates were corrected for random error in the measurements. Results Blood pressure per unit increase of z-score was associated with an increased risk of incident MM cases in men and women [HR 1·17, 95% confidence interval (CI) 1·04-1·31 and HR 1·18, 95% CI 1·03-1·36, respectively] and fatal MM cases among women (HR 2·39, 95% CI 1·58-3·64). In men, all quintiles for BMI above the reference were associated with a higher risk of incident MM. In women, SCC NMSC risk increased across quintiles for glucose levels ( P-trend 0·02) and there was a trend with triglyceride concentration ( P-trend 0·09). Conclusion These findings suggest that mechanisms linked to blood pressure may be involved in the pathogenesis of MM. SCC NMSC in women could be related to glucose and lipid metabolism. [ABSTRACT FROM AUTHOR]

The article presents a study on the airborne deployment and characterisation of a new counterflow virtual impactor (CVI) inlet. The study used aircraft probes, Twin Otter cloud service, and aerodynamic drag theory. Results show that a number of particles have been activated at supersaturations through continuous flow thermal gradient cloud condensation nuclei counter.

The article presents a study which uses a new counterflow virtual impactor (CVI) inlet in an effort to derive characterization and airborne deployment during the 2011 Eastern Pacific Emitted Aerosol Cloud Experiment (E-PEACE). The study suggests that the proposed CVI inlet is capable of dealing with several design issues including accessibility to probe interior and organic contamination. It also describes CVI design and presents results of field deployment.

Abstract: Altered activity in the axioscapular muscles is considered to be an important feature in patients with neck pain. The activity of the serratus anterior (SA) and trapezius muscles during arm elevation has not been investigated in these patients. The objectives of this study was to investigate whether there is a pattern of altered activity in the SA and trapezius in patients with insidious onset neck pain (IONP) (n =22) and whiplash associated disorders (WAD) (n =27). An asymptomatic group was selected for baseline measurements (n =23). Surface electromyography was used to measure the onset of muscle activation and duration of muscle activity of the SA as well as the upper, middle, and lower trapezius during unilateral arm elevation in the three subject groups. Both arms were tested. With no interaction, the main effect for the onset of muscle activation and duration of muscle activity for serratus anterior was statistically significant among the groups. Post hoc comparison revealed a significantly delayed onset of muscle activation and less duration of muscle activity in the IONP group, and in the WAD group compared to the asymptomatic group. There were no group main effects or interaction effects for upper, middle and lower trapezius. This finding may have implications for scapular stability in these patients because the altered activity in the SA may reflect inconsistent or poorly coordinated muscle activation that may reduce the quality of neuromuscular performance and induce an increased load on the cervical and the thoracic spine. [Copyright &y& Elsevier]

Background: Risk factors for rare gynecological cancers are largely unknown. Initial research has indicated that the metabolic syndrome (MetS) or individual components could play a role.Materials and methods: The Metabolic syndrome and Cancer project cohort includes 288 834 women. During an average follow-up of 11 years, 82 vulvar, 26 vaginal and 43 other rare gynecological cancers were identified. Hazard ratios (HRs) were estimated fitting Cox proportional hazards regression models for tertiles and standardized z-scores [with a mean of 0 and a standard deviation (SD) of 1] of body mass index (BMI), blood pressure, glucose, cholesterol, triglycerides and MetS. Risk estimates were corrected for random error in the measurement of metabolic factors.Results: The MetS was associated with increased risk of vulvar [HR 1.78, 95% confidence interval (CI) 1.30–2.41) and vaginal cancer (HR 1.87, 95% CI 1.07–3.25). Among separate MetS components, 1 SD increase in BMI was associated with overall risk (HR 1.43, 95% CI 1.23–1.66), vulvar (HR 1.36, 95% CI 1.11–1.69) and vaginal cancer (HR 1.79, 95% CI 1.30–2.46). Blood glucose and triglyceride concentrations were associated with increased risk of vulvar cancer (HR 1.98, 95% CI 1.10–3.58 and HR 2.09, 95% CI 1.39–3.15, respectively).Conclusion: The results from this first prospective study on rare gynecological cancers suggest that the MetS and its individual components may play a role in the development of these tumors. [ABSTRACT FROM AUTHOR]

Aircraft measurements obtained during the 2003--04 Autonomous Ocean Sampling Network (AOSN-II) project were used to study the effect of small-scale variations of near-surface wind stress on coastal upwelling in the area of Monterey Bay. Using 5-km-long measurement segments at 35 m above the sea surface, wind stress and its curl were calculated with estimated accuracy of 0.02--0.03 N m−−2 and 0.1--0.2 N m−−2 per 100 kilometers, respectively. The spatial distribution of wind speed, wind stress, stress curl, and sea surface temperature were analyzed for four general wind conditions: northerly or southerly wind along the coastline, onshore flow, and offshore flow. Wind stress and speed maxima frequently were found to be noncollocated as bulk parameterizations imply owing to significant stability and nonhomogeneity effects at cold SST pools. The analyses revealed that complicated processes with different time scales (wind stress field variation, ocean response and upwelling, sea surface currents, and heating by solar radiation) affect the coastal sea surface temperature. It was found that the stress-curl-induced coastal upwelling only dominates in events during which positive curl extended systematically over a significant area (scales larger than 20 km). These events included cases with a northerly wind, which resulted in an expansion fan downstream from Point Añño Nuevo (wind speed peaks greater than about 8--10 m s−−1), and cases with an offshore/onshore flow, which are characterized by weak background upwelling due to Ekman transport. However, in general, observations show that cold pools of sea surface temperature in the central area of Monterey Bay were advected by ocean surface currents from strong upwelling regions. Aircraft vertical soundings taken in the bay area showed that dominant effects of the lee wave sheltering of coastal mountains resulted in weak atmospheric turbulence and affected the development of the atmospheric boundary layer. This effect causes low wind stress that limits upwelling, especially at the northern part of Monterey Bay. The sea surface temperature is generally warm in this part of the bay because of the shallow oceanic surface layer and solar heating of the upper ocean. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of mammography screening for women ages 40 to 49 years still is questioned, and few studies of the effectiveness of service screening for this age group have been conducted. Methods: Breast cancer mortality was compared between women who were invited to service screening at ages 40 to 49 years (study group) and women in the same age group who were not invited during 1986 to 2005 (control group). Together, these women comprise the Mammography Screening of Young Women (SCRY) cohort, which includes all Swedish counties. A prescreening period was defined to facilitate a comparison of mortality in the absence of screening. The outcome measure was refined mortality, ie, breast cancer death for women who were diagnosed during follow-up at ages 40 to 49 years. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated. Results: There was no significant difference in breast cancer mortality during the prescreening period. During the study period, there were 803 breast cancer deaths in the study group (7.3 million person-years) and 1238 breast cancer deaths in the control group (8.8 million person-years). The average follow-up was 16 years. The estimated RR for women who were invited to screening was 0.74 (95% CI, 0.66-0.83), and the RR for women who attended screening was 0.71 (95% CI, 0.62-0.80). Conclusions: In this comprehensive study, mammography screening for women ages 40 to 49 years was efficient for reducing breast cancer mortality. [ABSTRACT FROM AUTHOR]

OBJECTIVE: GDF5 and FRZB have been proposed as genetic loci conferring susceptibility to osteoarthritis (OA); however, the results of several studies investigating the association of OA with the rs143383 polymorphism of the GDF5 gene or the rs7775 and rs288326 polymorphisms of the FRZB gene have been conflicting or inconclusive. To examine these associations, we performed a large-scale meta-analysis of individual-level data. METHODS: Fourteen teams contributed data on polymorphisms and knee, hip, and hand OA. For rs143383, the total number of cases and controls, respectively, was 5,789 and 7,850 for hip OA, 5,085 and 8,135 for knee OA, and 4,040 and 4,792 for hand OA. For rs7775, the respective sample sizes were 4,352 and 10,843 for hip OA, 3,545 and 6,085 for knee OA, and 4,010 and 5,151 for hand OA, and for rs288326, they were 4,346 and 8,034 for hip OA, 3,595 and 6,106 for knee OA, and 3,982 and 5,152 for hand OA. For each individual study, sex-specific odds ratios (ORs) were calculated for each OA phenotype that had been investigated. The ORs for each phenotype were synthesized using both fixed-effects and random-effects models for allele-based effects, and also for haplotype effects for FRZB. RESULTS: A significant random-effects summary OR for knee OA was demonstrated for rs143383 (1.15 [95% confidence interval 1.09-1.22]) (P = 9.4 x 10(-7)), with no significant between-study heterogeneity. Estimates of effect sizes for hip and hand OA were similar, but a large between-study heterogeneity was observed, and statistical significance was borderline (for OA of the hip [P = 0.016]) or absent (for OA of the hand [P = 0.19]). Analyses for FRZB polymorphisms and haplotypes did not reveal any statistically significant signals, except for a borderline association of rs288326 with hip OA (P = 0.019). CONCLUSION: Evidence of an association between the GDF5 rs143383 polymorphism and OA is substantially strong, but the genetic effects are consistent across different populations only for knee OA. Findings of this collaborative analysis do not support the notion that FRZB rs7775 or rs288326 has any sizable genetic effect on OA phenotypes. [ABSTRACT FROM AUTHOR]

In a study of a 12-year population-based injury register, Umeå, Sweden, we analyzed the fracture mechanisms and fracture pattern in men and women 50 years and older. Low-energy trauma was responsible for the major and costliest part of the fracture panorama, but the pattern differs between age groups. Osteoporosis-related fracture is a major health problem: the number of hip fractures is expected to double to 2030. While osteoporosis is one of many risk factors, trauma is almost always involved. Therefore, we analyzed injury mechanisms in patients aged over 50. We registered injury mechanism, cause, diagnosis in all trauma patients at Umeå University hospital, Sweden. This population-based register (1993–2004) comprises a total of 113,668 injuries (29,189 fractures). Patients ≥50 years contributed to 13,279 fractures. Low-energy trauma (fall <1 m) caused 53% of all fractures ≥50 years and older. In those over 75 low-energy trauma caused >80%. The seasonal variation of fractures was maximally 25%. With increasing age, proximal fractures became more common, in both upper and lower extremities. Proximal locations predominate in older age groups. Low-energy trauma was responsible for the largest and costliest part of the fracture panorama. In fact, almost all fractures in middle-aged and old people were caused by low-energy mechanisms; thus, most fractures in these patients have a fragility component, and the contribution of osteoporosis-related fractures is more important than previously thought. A better understanding of injury mechanisms also in low-energy trauma is a prerequisite for preventive interventions. [ABSTRACT FROM AUTHOR]

For a vertical profile with three distinct layers (marine boundary, pollution, and dust layers), observed during the ACE-Asia campaign, we carried out a comparison between the modeled lidar ratio vertical profile and that obtained from co-located airborne NASA AATS-14 sunphotometer and shipborne Micro-Pulse Lidar (MPL) measurements. The vertically resolved lidar ratio was calculated from two size distribution vertical profiles—one obtained by inversion of sunphotometer-derived extinction spectra, and one measured in-situ—combined with the same refractive index model based on aerosol chemical composition. The aerosol model implies single scattering albedos of 0.78–0.81 and 0.93–0.96 at 0.523 μm (the wavelength of the lidar measurements), in the pollution and dust layers, respectively. The lidar ratios calculated from the two size distribution profiles agree closely in the dust layer; they are however, significantly lower than the lidar ratios derived from combined lidar and sunphotometer measurements. Uncertainties in aerosol size distributions and refractive index only partly explain these differences, suggesting that particle nonsphericity in this layer is an additional explanation. In the pollution layer, the two size distribution profiles yield lidar ratios that agree within the estimated uncertainties. The retrieved size distributions result in a lidar ratio which is in closer agreement with that derived from lidar/sunphotometer measurements in this layer, with still large differences at certain altitudes (the largest relative difference was 46%). We explain these differences by non-uniqueness of the result of the size distribution retrieval, by a lack of information on the mixing state of particles, and the vertical variability of the particle refractive index. [ABSTRACT FROM AUTHOR]

Measurements of both horizontal gradients and vertical profiles of aerosols, cloud droplets and thermodynamic parameters in the cloud topped marine boundary layer off of central California are presented. They suggest that, while aerosols can indeed modulate cloud albedo, other parameters such as sea surface temperature may similarly affect cloud albedo. Additionally, the impact of aerosols, through sedimentation and precipitation, on cloud optical depths and thus albedo is not always in accord with conventional expectations and can either enhance or decrease the albedo, depending on ambient conditions. Taken together, these results suggest that current estimates of indirect forcing by aerosols could be significantly in error. [ABSTRACT FROM AUTHOR]

In this article, aerosol size distributions retrieved from aerosol layer optical thickness spectra, derived from the 14-channel NASA Ames Airborne Tracking Sunphotometer (AATS-14) measurements during the ACE-Asia campaign, are presented. Focusing on distinct aerosol layers (with different particle characteristics) observed in four vertical profiles, we compare the results of two different retrieval methods: constrained linear inversion and a non-linear least squares method. While the former does not use any assumption about the analytical form of the size distribution, the latter was used to retrieve parameters of a bimodal lognormal size distribution. Furthermore, comparison of the retrieved size distributions with those measured in-situ, aboard the same aircraft on which the sunphotometer was flown, was carried out. Results of the two retrieval methods showed good agreement in the radius ranges from ∼0.1 μm to ∼1.2–2.0 μm, close to the range of retrievable size distributions from the AATS-14 measurements. In this radius interval, shapes of retrieved and measured size distributions were similar, in accord with close wavelength dependencies of the corresponding optical thicknesses. Additionally, the effect of a size-resolved refractive index on the retrieved size spectra was investigated in selected cases. Retrieval using a constant refractive index pertaining to particle sizes within the range of retrievable size distributions resulted in a size distribution very close to the one retrieved using a size-resolved refractive index. [ABSTRACT FROM AUTHOR]

Our objective was to investigate the initiation and course of pro- and anti-inflammatory cytokines in early inflammatory response and to elucidate the cytokine system in relation to the adrenal response caused by stress. Seven blood samples were collected, pre- and postoperatively (0–72 h) after total hip replacement (THR) due to osteoarthritis. The following cytokines were measured using Cytometric Bead Array: interleukin-1 β (IL-1 β), IL-6, tumour necrosis factor- α, IL-8, IL-12 and IL-10 (B&D). Thirteen patients took part in the study (67 ± 9 years). C-reactive protein increased from <6 to over 200 mg/l on the second post-op day. The concentration of IL-6 increased 10-fold just 3 h post-op (4–47 pg/ml) and reached its maximum value 6 h post-op (77 pg/ml; Wilcoxon test P < 0.01) Repeated measurements were also significant (Friedman P < 0.05). The concentration of IL-8 doubled the day of surgery but did not reach a significant level (Friedman test =0.069). None of the other cytokines showed any significant changes. The diurnal cortisol rhythm was interrupted after the surgery and there was a significant correlation between the cortisol secretion and IL-6 response. This study demonstrates an isolated elevation in IL-6 levels with only a minor elevation in IL-8 following THR. This pro-inflammatory response seemed to decline without activation of anti-inflammatory cytokines (IL-10), but cortisol seemed to play a complicated role in halting the acute inflammatory response. [ABSTRACT FROM AUTHOR]

Objective: To determine whether the recently described hand osteoarthritis (HOA)‐associated T 303 M mutation in the gene for matrilin‐3 (MATN3) is associated with specific radiological changes on hand radiographs. Method: Standard hand radiographs from 26 HOA patients carrying the T 303 M missense mutation in the MATN3 gene (T 303 M patients) were compared with those from 52 HOA controls matched for sex, age, and clinical disease severity. Two blinded readers scored the radiographs, using the Verbruggen–Veys anatomical scoring system for the interphalangeal and metacarpophalangeal joints and the OARSI atlas scoring system for the first carpometacarpal (CMC1) joints. A scoring system based on the latter was used for the scaphoid–trapezoid–trapezoideum (STT) joints. Results: No particular distinguishing features were found in the T 303 M patients and the prevalence of erosive and cystic changes was similar to the control group. As a group, however, the T 303 M patients had more severe thumb‐base affection, particularly in the STT joint. Thus, definite radiological OA in both CMC1 and STT joints and higher STT scores compared with CMC1 were significantly more common in patients carrying the T 303 M mutation. Radiological scores for joint‐space narrowing (CMC1 and STT) and osteophytes (STT) were also significantly higher in the T 303 M patients. Conclusion: Patients carrying the T 303 M mutation in the gene for matrilin‐3 express a form of HOA that is radiologically indistinguishable from idiopathic HOA in individual patients but they have more severe thumb‐base involvement, particularly in the STT joint. This is the first described genetic mutation that is associated with a common form of osteoarthritis. [ABSTRACT FROM AUTHOR]