Serum 25-hydroxyvitamin D level and kidney function decline in a Swiss general adult population.

Molecular evidence suggests that levels of vitamin D are associated with kidney function loss. Still, population-based studies are limited and few have considered the potential confounding effect of baseline kidney function. This study evaluated the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline, and incidence of CKD and albuminuria. Baseline (2003-2006) and 5.5-year follow-up data from a Swiss adult general population were used to evaluate the association of serum 25-hydroxyvitamin D with change in eGFR, rapid eGFR decline (annual loss >3 ml/min per 1.73 m(2)), and incidence of CKD and albuminuria. Serum 25-hydroxyvitamin D was measured at baseline using liquid chromatography-tandem mass spectrometry. eGFR and albuminuria were collected at baseline and follow-up. Multivariate linear and logistic regression models were used considering potential confounding factors. Among the 4280 people included in the analysis, the mean±SD annual eGFR change was -0.57±1.78 ml/min per 1.73 m(2), and 287 (6.7%) participants presented rapid eGFR decline. Before adjustment for baseline eGFR, baseline 25-hydroxyvitamin D level was associated with both mean annual eGFR change and risk of rapid eGFR decline, independently of baseline albuminuria. Once adjusted for baseline eGFR, associations were no longer significant. For every 10 ng/ml higher baseline 25-hydroxyvitamin D, the adjusted mean annual eGFR change was -0.005 ml/min per 1.73 m(2) (95% confidence interval, -0.063 to 0.053; P=0.87) and the risk of rapid eGFR decline was null (odds ratio, 0.93; 95% confidence interval, 0.79 to 1.08; P=0.33). Baseline 25-hydroxyvitamin D level was not associated with incidence of CKD or albuminuria. The association of 25-hydroxyvitamin D with eGFR decline is confounded by baseline eGFR. Sufficient 25-hydroxyvitamin D levels do not seem to protect from eGFR decline independently from baseline eGFR.

Stability of a Seabird Population in the Presence of an Introduced Predator

We hypothesized that although large populations may appear able to withstand predation and disturbance, added stochasticity in population growth rate (λ) increases the risk of dramatic population declines. Approximately half of the Aleutian Islands' population of Least Auklets (Aethia pusilla) breed at one large colony at Kiska Island in the presence of introduced Norway rats (Rattus norvegicus) whose population erupts periodically. We evaluated two management plans, do nothing or eradicate rats, for this colony, and performed stochastic elasticity analysis to focus future research and management. Our results indicated that Least Auklets breeding at Kiska Island had the lowest absolute value of growth rate and more variable λ's (neither statistically significant) during 2001-2010, when compared with rat-free colonies at Buldir and Kasatochi islands. We found variability in the annual proportional change in population size among islands with Kiska Island having the fastest rate of decline, 78% over 20 years. Under the assumption that the eradication of rats would result in vital rates similar to those observed at rat-free Buldir and Kasatochi islands, we found the projected population decline decreased from 78% to 24% over 20 years. Overall, eradicating rats at Kiska Island is not likely to increase Least Auklet vital rates, but will decrease the amount of variation in λ, resulting in a significantly slower rate of population decline. We recommend the eradication of rats from Kiska Island to decrease the probability of dramatic population declines and ensure the future persistence of this important colony.

Influence of dietary protein intake and glycemic index on the association between TCF7L2 HapA and weight gain

BACKGROUND: Genetic polymorphisms of transcription factor 7-like 2 (TCF7L2) have been associated with type 2 diabetes and BMI. OBJECTIVE: The objective was to investigate whether TCF7L2 HapA is associated with weight development and whether such an association is modulated by protein intake or by the glycemic index (GI). DESIGN: The investigation was based on prospective data from 5 cohort studies nested within the European Prospective Investigation into Cancer and Nutrition. Weight change was followed up for a mean (±SD) of 6.8 ± 2.5 y. TCF7L2 rs7903146 and rs10885406 were successfully genotyped in 11,069 individuals and used to derive HapA. Multiple logistic and linear regression analysis was applied to test for the main effect of HapA and its interaction with dietary protein or GI. Analyses from the cohorts were combined by random-effects meta-analysis. RESULTS: HapA was associated neither with baseline BMI (0.03 ± 0.07 BMI units per allele; P = 0.6) nor with annual weight change (8.8 ± 11.7 g/y per allele; P = 0.5). However, a previously shown positive association between intake of protein, particularly of animal origin, and subsequent weight change in this population proved to be attenuated by TCF7L2 HapA (P-interaction = 0.01). We showed that weight gain becomes independent of protein intake with an increasing number of HapA alleles. Substitution of protein with either fat or carbohydrates showed the same effects. No interaction with GI was observed. CONCLUSION: TCF7L2 HapA attenuates the positive association between animal protein intake and long-term body weight change in middle-aged Europeans but does not interact with the GI of the diet.

Avaliações clínicas e metabólicas de cavalos da raça Árabe submetidos a exercício progressivo em esteira

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação espirométrica de cavalos da raça puro sangue árabe durante teste padrão de exercício progressivo em esteira

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Temporal Trends of Asthma Mortality Rates in Brazil from 1980 to 2010

Objective. Mortality from asthma has varied among countries during the last several decades. This study aimed to identify temporal trends of asthma mortality in Brazil from 1980 to 2010. Method. We analyzed 6840 deaths of patients aged 5-34 years that occurred in Brazil with the underlying cause of asthma. We applied a log-linear model using Poisson regression to verify peaks and trends. We also calculated the point estimation and 95% confidence interval (CI 95%) of the annual percent change (APC) of the mortality rates, and the average annual percent change (AAPC) for 2001-2010. Results. A decline was observed from 1980 to 1992 [APC = -3.4 (-5.0 to -1.8)], followed by a nonsignificant rise until 1996 [APC = 6.8 (-1.4 to 15.6)], and a new downward trend from 1997 to 2010 [APC = -2.7 (-3.9 to -1.6)]. The APCs varied according to age strata: 5-14 years from 1980 to 2010 [-0.3 (-1.1 to 0.5)]; 15-24 years from 1980 to 1991 [-2.1 (-5.0 to 0.9)], from 1992 to 1996 [6.8 (-6.7 to 22.2)], and from 1997 to 2010 [-3.9 (-5.7 to -2.0)]; 24-25 years from 1980 to 1992 [-2.5 (-4.6 to -0.3)], from 1993 to 1995 [12.0 (-21.1 to 59.1)], and from 1996-2010 [-1.7 (-3.0 to -0.4)]. AAPC from 2001 to 2010 was -1.7 (-3.0 to -0.4); the decline for this period was significant for patients over 15 years old, women, and those living in the Southeast region. Conclusion. Asthma mortality rates in Brazil have been declining since the late 1990s.

Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009

OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC = 12%), Paraiba (APC = 11.9%), and Piaui (APC = 10.9%). CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.

Greenland accumulation and its connection to the large-scale atmospheric circulation in ERA-Interim and paleoclimate simulations

Changes in Greenland accumulation and the stability in the relationship between accumulation variability and large-scale circulation are assessed by performing time-slice simulations for the present day, the preindustrial era, the early Holocene, and the Last Glacial Maximum (LGM) with a comprehensive climate model. The stability issue is an important prerequisite for reconstructions of Northern Hemisphere atmospheric circulation variability based on accumulation or precipitation proxy records from Greenland ice cores. The analysis reveals that the relationship between accumulation variability and large-scale circulation undergoes a significant seasonal cycle. As the contributions of the individual seasons to the annual signal change, annual mean accumulation variability is not necessarily related to the same atmospheric circulation patterns during the different climate states. Interestingly, within a season, local Greenland accumulation variability is indeed linked to a consistent circulation pattern, which is observed for all studied climate periods, even for the LGM. Hence, it would be possible to deduce a reliable reconstruction of seasonal atmospheric variability (e.g., for North Atlantic winters) if an accumulation or precipitation proxy were available that resolves single seasons. We further show that the simulated impacts of orbital forcing and changes in the ice sheet topography on Greenland accumulation exhibit strong spatial differences, emphasizing that accumulation records from different ice core sites regarding both interannual and long-term (centennial to millennial) variability cannot be expected to look alike since they include a distinct local signature. The only uniform signal to external forcing is the strong decrease in Greenland accumulation during glacial (LGM) conditions and an increase associated with the recent rise in greenhouse gas concentrations.

Temporal trends in the systemic inflammatory response syndrome, sepsis, and medical coding of sepsis.

BACKGROUND Recent reports using administrative claims data suggest the incidence of community- and hospital-onset sepsis is increasing. Whether this reflects changing epidemiology, more effective diagnostic methods, or changes in physician documentation and medical coding practices is unclear. METHODS We performed a temporal-trend study from 2008 to 2012 using administrative claims data and patient-level clinical data of adult patients admitted to Barnes-Jewish Hospital in St. Louis, Missouri. Temporal-trend and annual percent change were estimated using regression models with autoregressive integrated moving average errors. RESULTS We analyzed 62,261 inpatient admissions during the 5-year study period. 'Any SIRS' (i.e., SIRS on a single calendar day during the hospitalization) and 'multi-day SIRS' (i.e., SIRS on 3 or more calendar days), which both use patient-level data, and medical coding for sepsis (i.e., ICD-9-CM discharge diagnosis codes 995.91, 995.92, or 785.52) were present in 35.3 %, 17.3 %, and 3.3 % of admissions, respectively. The incidence of admissions coded for sepsis increased 9.7 % (95 % CI: 6.1, 13.4) per year, while the patient data-defined events of 'any SIRS' decreased by 1.8 % (95 % CI: -3.2, -0.5) and 'multi-day SIRS' did not change significantly over the study period. Clinically-defined sepsis (defined as SIRS plus bacteremia) and severe sepsis (defined as SIRS plus hypotension and bacteremia) decreased at statistically significant rates of 5.7 % (95 % CI: -9.0, -2.4) and 8.6 % (95 % CI: -4.4, -12.6) annually. All-cause mortality, SIRS mortality, and SIRS and clinically-defined sepsis case fatality did not change significantly during the study period. Sepsis mortality, based on ICD-9-CM codes, however, increased by 8.8 % (95 % CI: 1.9, 16.2) annually. CONCLUSIONS The incidence of sepsis, defined by ICD-9-CM codes, and sepsis mortality increased steadily without a concomitant increase in SIRS or clinically-defined sepsis. Our results highlight the need to develop strategies to integrate clinical patient-level data with administrative data to draw more accurate conclusions about the epidemiology of sepsis.

Zur Höhenänderung von Ostalpengletschern im Zeitraum 1969-1979

Eight selected glaciers in the Eastern Alps with a total area of 52 qkm have been surveyed photogrammetrically in the years 1969 and 1979, to determine the annual height change of the glacier surface by the comparison of the two different surveys. In this period of ten years the glaciers show, except for the Hintereisferner, a positive annual height change. But it is less than the change in the past period from 1959 to 1969. The increase in elevation happens mainly in the lower regions of the glaciers, while the glacier-snow-fields don't show any remarkable height changes. So the glacier advance of the sixties seem to have already reached or crossed its maximum.

Static GPS measurements in the vicinity of EDML and an elevation model for Dronning Maud Land

The knowledge of ice sheet surface topography and the location of the ice divides are essential for ice dynamic modeling. An improved digital elevation model (DEM) of Dronning Maud Land (DML), Antarctica, is presented in this paper. It is based on ground-based kinematic GPS profiles, airborne radar altimetry, and data of the airborne radio-echo sounding system, as well as spaceborne laser altimetry from NASA's Ice, Cloud and land Elevation Satellite (ICESat). The accuracy of ICESat ice sheet altimetry data in the area of investigation is discussed. The location of the ice divides is derived from aspect calculation of the topography and is verified with several velocity data derived from repeated static GPS measurements.