Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study

BACKGROUND: Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk. METHODS: In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108 173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium. FINDINGS: In phenotypic analyses (up to n=49 363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (β per 10% increase, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146 581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of -0·10 mm Hg in systolic blood pressure (-0·21 to -0·0001; p=0·0498) and a change of -0·08 mm Hg in diastolic blood pressure (-0·15 to -0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142 255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96-0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of -0·29 mm Hg in diastolic blood pressure (-0·52 to -0·07; p=0·01), a change of -0·37 mm Hg in systolic blood pressure (-0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87-0·97; p=0·002). INTERPRETATION: Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension. This finding warrants further investigation in an independent, similarly powered study.

A politics of the Dreamtime : destructive and regenerative rainbows in Alexis Wright's Carpentaria

A literary criticism of the book "Carpentaria," by Alexis Wright is presented. It discusses the representation of indigenous knowledge in the novel. It outlines the characters and explores the symbolic significance of these characters. It examines the themes of the novel, including the dreamtime mythology as an alternative form of scientific discourse. An overview of the story of the novel is also given.

The Road from Marja: Wounded in Afghanistan, Capt. Erik Quist '99, USMC, sees another side of combat

Marine Corps Capt. Erik Quist ’99 had fought in two wars. Now he fights again as he recovers from severe wounds suffered in Afghanistan.

A monetary mechanism for sharing capital: Diamond and Dybvig meet Kiyotaki and Wright

A model is presented in which banks accept deposits of fiat money and intermediate capital. Alt though theories about the coexistence of money and credit are inherently difficult, the model offers a simple explanation for the dual role of financial institutions: Banks are well monitored, and can credibly allow fiat-money withdraws to whom needs its, thus qualifying to become safe brokers of idle capital. The model shares some features with those of Diamond and Dybvig (1983) and Kiyotaki and Wright (1989).

A monetary mechanism for sharing capital: Diamond and Dybvig meet Kiyotaki and Wright

Historically, payment systems and capital intermediation interact. Friedman (1959), and many observers of bank instabilities, have ad- vocated separating depositary from credit institutions. His proposal meets today an ever-increasing provision of inside money, and a short- age of monetary models of bank intermediation. In this paper, we eval- uate the proposal from a new angle, with a model in which isolating a safe payments system from commercial intermediation undermines information complementarities in banking activities. Some features of the environment resemble the models in Diamond and Dybvig (1983), and Kiyotaki and Wright (1989).

Análise de barreiras e o modelo de ressonância funcional de acidentes de Erik Hollnagel

Partindo de apresentação da proposta de análise de acidentes baseada no modelo sistêmico e não linear de acidentes, dito de ressonância funcional, desenvolvido por Erik Hollnagel, este texto discute críticas às concepções deterministas de acidente e aos modelos lineares de representação desses eventos. Aspectos do modelo de ressonância funcional são usados como eixo definidor de proposta de agenda de discussões a ser desenvolvida pelos interessados no tema da análise de acidentes, destacando-se: a) a defesa do abandono da idéia de causas de acidentes e sua substituição pela de explicação desses eventos; b) apresentação dos conceitos de variabilidade de desempenhos e adaptações locais e a proposta de sua utilização como bases para a identificação de perfis ou aspectos típicos de acidentes. Por fim, discute-se a necessidade de incorporação dos conceitos apresentados no debate sobre novos caminhos para as práticas de análises e de prevenção de acidentes em nosso país.