Development and validation of a risk score predicting substantial weight gain over 5 years in middle-aged European men and women.

BACKGROUND Identifying individuals at high risk of excess weight gain may help targeting prevention efforts at those at risk of various metabolic diseases associated with weight gain. Our aim was to develop a risk score to identify these individuals and validate it in an external population. METHODS We used lifestyle and nutritional data from 53°758 individuals followed for a median of 5.4 years from six centers of the European Prospective Investigation into Cancer and Nutrition (EPIC) to develop a risk score to predict substantial weight gain (SWG) for the next 5 years (derivation sample). Assuming linear weight gain, SWG was defined as gaining ≥ 10% of baseline weight during follow-up. Proportional hazards models were used to identify significant predictors of SWG separately by EPIC center. Regression coefficients of predictors were pooled using random-effects meta-analysis. Pooled coefficients were used to assign weights to each predictor. The risk score was calculated as a linear combination of the predictors. External validity of the score was evaluated in nine other centers of the EPIC study (validation sample). RESULTS Our final model included age, sex, baseline weight, level of education, baseline smoking, sports activity, alcohol use, and intake of six food groups. The model's discriminatory ability measured by the area under a receiver operating characteristic curve was 0.64 (95% CI = 0.63-0.65) in the derivation sample and 0.57 (95% CI = 0.56-0.58) in the validation sample, with variation between centers. Positive and negative predictive values for the optimal cut-off value of ≥ 200 points were 9% and 96%, respectively. CONCLUSION The present risk score confidently excluded a large proportion of individuals from being at any appreciable risk to develop SWG within the next 5 years. Future studies, however, may attempt to further refine the positive prediction of the score.

A randomised double-blind clinical trial of two yellow fever vaccines prepared with substrains 17DD and 17D-213/77 in children nine-23 months old

This randomised, double-blind, multicentre study with children nine-23 months old evaluated the immunogenicity of yellow fever (YF) vaccines prepared with substrains 17DD and 17D-213/77. YF antibodies were tittered before and 30 or more days after vaccination. Seropositivity and seroconversion were analysed according to the maternal serological status and the collaborating centre. A total of 1,966 children were randomised in the municipalities of the states of Mato Grosso do Sul, Minas Gerais and São Paulo and blood samples were collected from 1,714 mothers. Seropositivity was observed in 78.6% of mothers and 8.9% of children before vaccination. After vaccination, seropositivity rates of 81.9% and 83.2%, seroconversion rates of 84.8% and 85.8% and rates of a four-fold increase over the pre-vaccination titre of 77.6% and 81.8% were observed in the 17D-213/77 and 17DD subgroups, respectively. There was no association with maternal immunity. Among children aged 12 months or older, the seroconversion rates of 69% were associated with concomitant vaccination against measles, mumps and rubella. The data were not conclusive regarding the interference of maternal immunity in the immune response to the YF vaccine, but they suggest interference from other vaccines. The failures in seroconversion after vaccination support the recommendation of a booster dose in children within 10 years of the first dose.

Were Spanish migrants attracted by industrial agglomerations?: an analysis for the interwar years in the light of the new economic geography

In this paper we examine whether access to markets had a significant influence onmigration choices of Spanish internal migrants in the inter-war years. We perform astructural contrast of a New Economic Geography model that focus on the forwardlinkage that links workers location choice with the geography of industrial production,one of the centripetal forces that drive agglomeration in the NEG models. The resultshighlight the presence of this forward linkage in the Spanish economy of the inter-warperiod. That is, we prove the existence of a direct relation between workers¿ localizationdecisions and the market potential of the host regions. In addition, the direct estimationof the values associated with key parameters in the NEG model allows us to simulatethe migratory flows derived from different scenarios of the relative size of regions andthe distances between them. We show that in Spain the power of attraction of theagglomerations grew as they increased in size, but the high elasticity estimated for themigration costs reduced the intensity of the migratory flows. This could help to explainthe apparently low intensity of internal migrations in Spain until its upsurge during the1920s. This also explains the geography of migrations in Spain during this period,which hardly affected the regions furthest from the large industrial agglomerations (i.e.,regions such as Andalusia, Estremadura and Castile-La Mancha) but had an intenseeffect on the provinces nearest to the principal centres of industrial development.

Ultrathin strut biodegradable polymer sirolimus-eluting stent versus durable polymer everolimus-eluting stent for percutaneous coronary revascularisation (BIOSCIENCE): a randomised, single-blind, non-inferiority trial.

BACKGROUND: Refinements in stent design affecting strut thickness, surface polymer, and drug release have improved clinical outcomes of drug-eluting stents. We aimed to compare the safety and efficacy of a novel, ultrathin strut cobalt-chromium stent releasing sirolimus from a biodegradable polymer with a thin strut durable polymer everolimus-eluting stent. METHODS: We did a randomised, single-blind, non-inferiority trial with minimum exclusion criteria at nine hospitals in Switzerland. We randomly assigned (1:1) patients aged 18 years or older with chronic stable coronary artery disease or acute coronary syndromes undergoing percutaneous coronary intervention to treatment with biodegradable polymer sirolimus-eluting stents or durable polymer everolimus-eluting stents. Randomisation was via a central web-based system and stratified by centre and presence of ST segment elevation myocardial infarction. Patients and outcome assessors were masked to treatment allocation, but treating physicians were not. The primary endpoint, target lesion failure, was a composite of cardiac death, target vessel myocardial infarction, and clinically-indicated target lesion revascularisation at 12 months. A margin of 3·5% was defined for non-inferiority of the biodegradable polymer sirolimus-eluting stent compared with the durable polymer everolimus-eluting stent. Analysis was by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT01443104. FINDINGS: Between Feb 24, 2012, and May 22, 2013, we randomly assigned 2119 patients with 3139 lesions to treatment with sirolimus-eluting stents (1063 patients, 1594 lesions) or everolimus-eluting stents (1056 patients, 1545 lesions). 407 (19%) patients presented with ST-segment elevation myocardial infarction. Target lesion failure with biodegradable polymer sirolimus-eluting stents (69 cases; 6·5%) was non-inferior to durable polymer everolimus-eluting stents (70 cases; 6·6%) at 12 months (absolute risk difference -0·14%, upper limit of one-sided 95% CI 1·97%, p for non-inferiority <0·0004). No significant differences were noted in rates of definite stent thrombosis (9 [0·9%] vs 4 [0·4%], rate ratio [RR] 2·26, 95% CI 0·70-7·33, p=0·16). In pre-specified stratified analyses of the primary endpoint, biodegradable polymer sirolimus-eluting stents were associated with improved outcome compared with durable polymer everolimus-eluting stents in the subgroup of patients with ST-segment elevation myocardial infarction (7 [3·3%] vs 17 [8·7%], RR 0·38, 95% CI 0·16-0·91, p=0·024, p for interaction=0·014). INTERPRETATION: In a patient population with minimum exclusion criteria and high adherence to dual antiplatelet therapy, biodegradable polymer sirolimus-eluting stents were non-inferior to durable polymer everolimus-eluting stents for the combined safety and efficacy outcome target lesion failure at 12 months. The noted benefit in the subgroup of patients with ST-segment elevation myocardial infarction needs further study. FUNDING: Clinical Trials Unit, University of Bern, and Biotronik, Bülach, Switzerland.

Were Spanish migrants attracted by industrial agglomerations?: an analysis for the interwar years in the light of the new economic geography

In this paper we examine whether access to markets had a significant influence onmigration choices of Spanish internal migrants in the inter-war years. We perform astructural contrast of a New Economic Geography model that focus on the forwardlinkage that links workers location choice with the geography of industrial production,one of the centripetal forces that drive agglomeration in the NEG models. The resultshighlight the presence of this forward linkage in the Spanish economy of the inter-warperiod. That is, we prove the existence of a direct relation between workers¿ localizationdecisions and the market potential of the host regions. In addition, the direct estimationof the values associated with key parameters in the NEG model allows us to simulatethe migratory flows derived from different scenarios of the relative size of regions andthe distances between them. We show that in Spain the power of attraction of theagglomerations grew as they increased in size, but the high elasticity estimated for themigration costs reduced the intensity of the migratory flows. This could help to explainthe apparently low intensity of internal migrations in Spain until its upsurge during the1920s. This also explains the geography of migrations in Spain during this period,which hardly affected the regions furthest from the large industrial agglomerations (i.e.,regions such as Andalusia, Estremadura and Castile-La Mancha) but had an intenseeffect on the provinces nearest to the principal centres of industrial development.

Years of valor,1969.

This book was written by Edith Wasson McElroy and published by the Iowa Civil War Centennial Commission. It follows the Meigs, a fictitious family from the late 1680's in England to 1865 in Iowa. The Meigs personify the way of life, in a typical Iowa home during this period. Their experiences are those of many early Iowa pioneers and brings to life and into reality, early Iowa life and the Civil War in its climax.

Were Spanish migrants attracted by industrial agglomerations?: an analysis for the interwar years in the light of the new economic geography

In this paper we examine whether access to markets had a significant influence onmigration choices of Spanish internal migrants in the inter-war years. We perform astructural contrast of a New Economic Geography model that focus on the forwardlinkage that links workers location choice with the geography of industrial production,one of the centripetal forces that drive agglomeration in the NEG models. The resultshighlight the presence of this forward linkage in the Spanish economy of the inter-warperiod. That is, we prove the existence of a direct relation between workers¿ localizationdecisions and the market potential of the host regions. In addition, the direct estimationof the values associated with key parameters in the NEG model allows us to simulatethe migratory flows derived from different scenarios of the relative size of regions andthe distances between them. We show that in Spain the power of attraction of theagglomerations grew as they increased in size, but the high elasticity estimated for themigration costs reduced the intensity of the migratory flows. This could help to explainthe apparently low intensity of internal migrations in Spain until its upsurge during the1920s. This also explains the geography of migrations in Spain during this period,which hardly affected the regions furthest from the large industrial agglomerations (i.e.,regions such as Andalusia, Estremadura and Castile-La Mancha) but had an intenseeffect on the provinces nearest to the principal centres of industrial development.

Trigeminal neuralgia related to megadolichobasilar artery compression: a prospective series of twenty-nine patients treated with gamma knife surgery, with more than one year of follow-up.

BACKGROUND: Trigeminal neuralgia (TN) secondary to megadolichobasilar artery (MBA) compression is considerably difficult to manage surgically. OBJECTIVE: This study aims to evaluate the safety/efficacy of Gamma Knife surgery (GKS) in this special group of patients. METHODS: Between July 1992 and November 2010, 29 patients with >1 year of follow-up presenting with MBA compression were treated with GKS at Timone University Hospital. Radiosurgery was performed using a Gamma Knife (model B, C or Perfexion). A single 4-mm isocenter was positioned in the cisternal portion of the trigeminal nerve at a median distance of 9.1 mm (range: 6-18.2 mm) from the emergence. RESULTS: The median follow-up period was 46.1 months (range: 12.9-157.9 months). Initially, all patients (100%) were pain free; the average time to complete pain relief was 13.5 days (range: 0-240 days). Their actuarial probability of remaining pain free without medication at 0.5, 1 and 2 years was 93.1, 79.3 and 75.7%, respectively, and remained stable until 13 years after treatment. The actuarial probability of hypoesthesia onset at 6 months was 4.3%; at 1 year it reached 13% and remained stable until 13 years after treatment. CONCLUSIONS: GKS proved to be reasonably safe and effective on a long-term basis as a first- and/or second-line surgical treatment for TN due to MBA compression.

A Study of Fine Sand from Nine Mile Island at Dubuque, MLR-88-08, 1988

The specifications for concrete sand in Iowa have been used for many years with very good results. In several locations of the state, it is becoming more difficult to produce concrete sand consistently at a reasonable cost. Both ASTM and AASHTO have specifications for concrete sands that allow a finer, poorer graded sand than the Iowa specification. The ASTM and AASHTO specifications are based on the use of trial mix testing prior to construction. Iowa does not currently use the trial mix procedure.

Gone with the Wind and the Southern Way of Life: the Civil War as described in Margaret Mitchell’s Novel

This essay examines the American Civil War of 1861 – 1865, which is also known as the bloodiest war that the United States has ever experienced. The pretext for the war was the abolition of slavery in the South, and after many battles the Southern states lost: as a consequence, they experienced major changes in their economic and social life. This interesting piece from American history can be traced out throughout the characters’ lives in the novel Gone with the Wind which has been thoroughly analyzed in order to draw nearer and to comprehend the changes in the Southern way of life before and after the war. The author, Margaret Mitchell, was born in Atlanta, Georgia, and grew up with the stories about the war. As a result, Gone with the Wind studies not only its causes, but also the years after its end – a period which is not generally a subject of history and receives little attention – and the effects that such reversals have on former planters and slaves. From the position of contemporaneity, the reader can see that such changes in a society do not end with the laying down of an act, or in this case the end of the war, but they continue during many years; thus, the modern world can draw conclusions and lessons for events that are happening at the moment.

Twenty years of research into Chlamydia-like organisms: a revolution in our understanding of the biology and pathogenicity of members of the phylum Chlamydiae.

Chlamydiae are obligate intracellular bacteria that share a unique but remarkably conserved biphasic developmental cycle that relies on a eukaryotic host cell for survival. Although the phylum was originally thought to only contain one family, the Chlamydiaceae, a total of nine families are now recognized. These so-called Chlamydia-like organisms (CLOs) are also referred to as 'environmental chlamydiae', as many were initially isolated from environmental sources. However, these organisms are also emerging pathogens, as many, such as Parachlamydia sp., Simkania sp. and Waddlia sp., have been associated with human disease, and others, such as Piscichlamydia sp. and Parilichlamydia sp., have been documented in association with diseases in animals. Their strict intracellular nature and the requirement for cell culture have been a confounding factor in characterizing the biology and pathogenicity of CLOs. Nevertheless, the genomes of seven CLO species have now been sequenced, providing new information on their potential ability to adapt to a wide range of hosts. As new isolation and diagnostic methods advance, we are able to further explore the richness of this phylum with further research likely to help define the true pathogenic potential of the CLOs while also providing insight into the origins of the 'traditional' chlamydiae.

Addenda a la biografia i l'obra del pintor Joan Arnau Moret (1603-1693)

The present article treats of the painter Joan Arnau Moret, catalan painter of the 17th century. Aspects treat each other as the order of the great picture preserved in the cathedral of Barcelona with the iconography The de live ry o f the ke ys of the city of Barcelona to the Immaculate, the biographical news it extracted of the process of canonization of santa Maria of Cervelló or the professional relation that Joan Arnau joined with the prince Joan Josep d’Àustria newly finished the Segadors war (The Reapers’ War). Of them the study also announces a work – the Saint Cathe rine o f Ale xandria of the chapel of Saint Catherine of the cathedral of Girona – proposes to attribute four paintings more – the paintings of the altarpiece of The Saints fo ur Martyrs of the cathedral of Girona – and thinks about the controversial paintings of the altarpiece of the Castle of Vilassar and of the monastery of Sant Joan of the Abadesses. Finally, by means of the stylistic reading of the new works, which the author considers of the best of his catalogue, one tries to demonstrate that thesources of your figurative culture and stylistic are in the painting of Madrid of the first decades of the 17th century

The association between obesity and back pain in nine countries: a cross-sectional study

BACKGROUND: The association between obesity and back pain has mainly been studied in high-income settings with inconclusive results, and data from older populations and developing countries are scarce. The aim of this study was to assess this association in nine countries in Asia, Africa, Europe, and Latin America among older adults using nationally-representative data. METHODS: Data on 42116 individuals ≥50 years who participated in the Collaborative Research on Ageing in Europe (COURAGE) study conducted in Finland, Poland, and Spain in 2011-2012, and the World Health Organization's Study on Global Ageing and Adult Health (SAGE) conducted in China, Ghana, India, Mexico, Russia, and South Africa in 2007-2010 were analysed. Information on measured height and weight available in the two datasets was used to calculate Body Mass Index (BMI). Self-reported back pain occurring in the past 30 days was the outcome. Multivariable logistic regression analysis was used to assess the association between BMI and back pain. RESULTS: The prevalence of back pain ranged from 21.5% (China) to 57.5% (Poland). In the multivariable analysis, compared to BMI 18.5-24.9 kg/m(2), significantly higher odds for back pain were observed for BMI ≥35 kg/m(2) in Finland (OR 3.33), Russia (OR 2.20), Poland (OR 2.03), Spain (OR 1.56), and South Africa (OR 1.48); BMI 30.0-34.0 kg/m(2) in Russia (OR 2.76), South Africa (OR 1.51), and Poland (OR 1.47); and BMI 25.0-29.9 kg/m(2) in Russia (OR 1.51) and Poland (OR 1.40). No significant associations were found in the other countries. CONCLUSIONS: The strength of the association between obesity and back pain may vary by country. Future studies are needed to determine the factors contributing to differences in the associations observed.

The introduction of Mormonism to Finnish society, 1840-1900

This study examines the place of The Church of Jesus Christ of Latter-day Saints (commonly known as the Mormon church) in the Russian Grand Duchy of Finland between the years 1840 and 1900. Attention is put on both the internal workings of the movement and the reactions of society. Theoretical insight is gained through the concepts of social construction and religious economies. Mormon image formation in Finland began by 1840 through newspaper reports on activities abroad and through essays on the faith’s history and doctrine. Mormons are mentioned almost 3,500 times in Finnish newspapers between 1840 and 1900, and at least twelve unique book titles sold in the country were explicitly devoted to discussing Mormonism. Most of the publicity was derived from foreign sources. Discourse analysis of this textual corpus shows a hegemonic discourse that combined themes such as fraud, deception, and theocracy in explaining the Mormon movement. Accompanied by plural marriage, these themes contributed to the construction of a strongly negative image of Mormonism already before the first missionaries arrived in 1875. In a society with a stringently regulated religious economy, this image contributed to a high level of resistance by civil authorities and Lutheran clergy. Twenty-five Mormon missionaries worked in Finland between 1875 and 1900, with a concentrated effort taking place between 1875 and 1889. At least 78 persons converted, mostly in the coastal areas among the Swedish-speaking minority population. Nine percent emigrated to Utah, 36% were excommunicated, others fell into oblivion, while still others clung to their new faith. The work was led from Sweden, with no stable church organization emerging among the isolated pockets of converts. Mormonism’s presence was thus characterized by private or small-group religiosity rather than a vibrant movement. The lack of religious community, conversation, and secondary socialization eventually caused the nineteenth-century manifestation of Finnish Mormonism to die out. Only one group of converts was perpetuated past World War II, after which large-scale proselytizing began.

Sotilaspolitiikka Kremlin Olympoksella. Venäjän sotilasreformin diskursiivinen rakentuminen venäläisessä sanomalehdistössä 2008–2012

Tutkimus käsittelee venäläisessä sanomalehdistössä esiintyvää keskustelua Venäjän sotilasreformista. Tutkimuksessa haluttiin selvittää, millaisia diskursseja keskustelussa käytetään sotilasreformin oikeuttamiseksi ja miten ne toimivat vallankäytön välineenä. Tutkimus on monitieteinen. Se antaa vastauksia kielitieteellisessä kehyksessä kielen ja diskurssin roolista päätöksenteossa, yhteiskuntatieteellisessä kehyksessä venäläisestä mediasta ja päätöksentekojärjestelmästä sekä sotatieteellisessä kehyksessä asevoimien kehityksestä ja sotilaspolitiikasta. Tutkimuksen primääriaineisto muodostuu 220 artikkelista, jotka kerättiin yhdeksästä venäläisestä sanomalehdestä vuosien 2008–2012 ajalta. Venäjän johtohenkilöt ja heitä tukevat sanomalehdet oikeuttivat sotilasreformia julkisessa keskustelussa ensisijaisesti viiden syyn avulla: uhkien lisääntymisellä, sodan kuvan muutoksella, asevoimien kalustollisella ja toiminnallisella jälkeenjääneisyydellä, henkilöstön osaamisen alhaisella tasolla ja tarpeella toiminnan järkeistykseen. Sotilasreformin päätöksiä oikeutettiin vetoamalla niiden huolelliseen suunnitteluun, henkilöstön asialliseen kohteluun ja taloudellisten asioiden vakauteen. Sanomalehdistössä esiintyi paljon toisistaan poikkeavia näkemyksiä kehitykseen tarvittavasta suunnasta. Suurin osa kritisoivista diskursseista keskittyi kritisoimaan reformin toteutusta, ei sen olemassaoloa. Kritiikki keskittyi tiedotuksen ja demokraattisen päätöksenteon puutteeseen sekä epäilyksiin reformin valmisteluprosessista. Venäjän asevoimia ja sotilaspolitiikkaa koskevaa uutisointia on ongelmallista tarkastella ilman diskurssikäytäntöjen huomiointia. Venäjän johdon ja sen legitimiteettiä vahvistavien sanomalehtien diskursiivisen vallankäytön tavoitteena on saada Venäjä näyttämään todellisuutta vahvemmalta ja yhtenäisemmältä. Vaikka venäläinen media ja siinä etenkin televisio ei ole vapaata, sanomalehdistö on verrattain hyvä tiedonlähde. Sen varsin monipuolinen omistajuus tutkimusaineiston rajauksen aikana mahdollisti erilaisten näkökulmien esillepääsyn. Analyyttisimmin sotilasreformista uutisoivat ne sanomalehdet, jotka eivät nähneet länsimaita Venäjän uhkana ja representoivat diskursseissaan liberalistisia arvoja kuten avoimuutta ja demokratiaa. Sanomalehdistön vaatimaton rooli venäläisessä mediakentässä heikentää kuitenkin sen vaikuttavuutta yleiseen mielipiteeseen. Sanomalehtien diskurssikäytäntöjen analysointi ideologioiden ja vallankäytön kautta voi tarjota mahdollisuuksia parantaa venäläisen valtionjohdon päätösten ennustettavuutta.