Percentile Increase Research Articles

Normal limits for oscillometric bronchodilator responses and relationships with clinical factors.

IntroductionWe aimed to determine normal thresholds for positive bronchodilator responses for oscillometry in an Australian general population sample aged ≥40 years, to guide clinical interpretation. We also examined relationships between bronchodilator responses and respiratory symptoms, asthma diagnosis, smoking and baseline lung function.MethodsSubjects recruited from Sydney, Melbourne and Busselton, Australia, underwent measurements of spirometry, resistance (Rrs6) and reactance (Xrs6) at 6 Hz, before and after inhalation of salbutamol 200 μg. Respiratory symptoms and/or medication use, asthma diagnosis, and smoking were recorded. Threshold bronchodilator responses were defined as the fifth percentile of decrease in Rrs6 and 95th percentile increase in Xrs6 in a healthy subgroup.ResultsOf 1318 participants, 1145 (570 female) were analysed. The lower threshold for ΔRrs6 was −1.38 cmH2O·s·L−1 (−30.0% or −1.42 Z-scores) and upper threshold for ΔXrs6 was 0.57 cmH2O·s·L−1 (1.36 Z-scores). Respiratory symptoms and/or medication use, asthma diagnosis, and smoking all predicted bronchodilator response, as did baseline oscillometry and spirometry. When categorised into clinically relevant groups according to those predictors, ΔXrs6 was more sensitive than spirometry in smokers without current asthma or chronic obstructive pulmonary disease (COPD), ∼20% having a positive response. Using absolute or Z-score change provided similar prevalences of responsiveness, except in COPD, in which responsiveness measured by absolute change was twice that for Z-score.DiscussionThis study describes normative thresholds for bronchodilator responses in oscillometry parameters, including intra-breath parameters, as determined by absolute, relative and Z-score changes. Positive bronchodilator response by oscillometry correlated with clinical factors and baseline function, which may inform the clinical interpretation of oscillometry.

Association between disparities in intergenerational economic mobility and cause-specific mortality among Black and White persons in the United States

BackgroundEvidence about the association between structural racism and mortality in the United States is limited. We examined the association between ongoing structural racism, measured as inequalities in adulthood income between White and Black children with similar parental household income (economic mobility gap) in a recent birth cohort, and Black-White disparities in death rates (mortality gap) overall and for major causes. MethodsSex-, race/ethnicity-, and county-specific data were used to examine sex-specific associations between economic mobility and mortality gaps for all causes combined, heart diseases, cerebrovascular diseases, chronic obstructive pulmonary disease (COPD), injury/violence, all malignant cancers, and 14 cancer types. Economic mobility data for 1978–1983 birth cohorts and death rates during 2011–2018 were obtained from the Opportunity Atlas and National Center for Health Statistics, respectively. Data from 471 counties were included in analyses of all-cause mortality at ages 30−39 years during 2011–2018 (corresponding to partially overlapping 1978–1983 birth cohorts); and from 1,572 and 1,248 counties in analyses of all-cause and cause-specific mortality in all ages combined, respectively. ResultsIn ages 30−39 years, a one percentile increase in the economic mobility gap was associated with a 6.8 % (95 % confidence interval 1.8 %–11.8 %) increase in the Black-White mortality gap among males and a 13.5 % (8.9 %–18.1 %) increase among females, based on data from 471 counties. In all ages combined, the corresponding percentages based on data from 1,572 counties were 10.2 % (7.2 %–13.2 %) among males and 14.8 % (11.4 %–18.2 %) among females, equivalent to an increase of 18.4 and 14.0 deaths per 100,000 in the mortality gap, respectively. Similarly, strong associations between economic mobility gap and mortality gap in all ages were found for major causes of death, notably for potentially preventable conditions, including COPD, injury/violence, and cancers of the lung, liver, and cervix. ConclusionsEconomic mobility gap conditional on parental income in a recent birth cohort as a marker of ongoing structural racism is strongly associated with Black-White disparities in all-cause mortality and mortality from several causes.

Are we there yet? Intergenerational mobility and economic assimilation of second-generation immigrants in Estonia

ABSTRACT This study investigates the role of intergenerational mobility in explaining the native-immigrant income gap in Estonia. A rich registry dataset on yearly earnings and different background characteristics for the period of 2007–2017 is used. We find that an increase of 1 percentile in parent income rank is associated with on average 0.2 percentile increase in child income rank for both natives and second-generation immigrants. Results from a detailed Blinder-Oaxaca decomposition indicate that up to 21% of the gap between income ranks of second-generation immigrants and natives is related to differences in parental background. Once we control for education, family, residence and industry related choices, differences in the parental income rank account for around 8% of the overall gap. The results indicate that although the intergenerational income mobility is relatively high in Estonia both for natives and children of foreign-born, the native-immigrant earnings gap has not decreased for the second generation.

Cessation of smoke exposure improves pediatric CF outcomes: Longitudinal analysis of CF Foundation Patient Registry data

BackgroundTobacco smoke exposure is a major risk factor for the health of children and adolescents with CF. In this study, we assess whether cessation of smoke exposure is associated with improved outcomes in this population. MethodsWe used annualized and encounter-based data from the U.S. CF Foundation Patient Registry (2006-2018) on all individuals born 1998-2010. The analytical sample included those who ever reported second-hand smoke exposure (daily or weekly), ever lived with a smoker, or ever reported smoking themselves. We used non-linear mixed models for pulmonary exacerbations and linear mixed models for ppFEV1 and BMI as a function of ceased exposure. ResultsThe sample included 3,633 individuals contributing 19,629 person-years. Cessation of smoke exposure reduced the odds of a pulmonary exacerbation in 12 months by 17% (OR 0.83, p < 0.001) in the first year of cessation, with an additional 6% decrease (OR 0.94, p = 0.003) for each additional year of cessation. Cessation was associated with improvements in ppFEV1 and BMI: 0.7% ppFEV1 increase (p < 0.001) in the first year of cessation and 0.4% increase (p = 0.001) for each additional year of cessation; 1% increase in BMI percentile (p < 0.001) in the first year of cessation plus 0.4% increase (p = 0.009) for each additional year. Three years of cessation reduce the predicted probability of a pulmonary exacerbation in 12 months by 8% and improve ppFEV1 and BMI by 2%. ConclusionEliminating smoke exposure may reduce pulmonary exacerbations and improve respiratory and nutritional outcomes in children and adolescents with CF. Both smoking cessation and exposure prevention should be prioritized in pediatric CF care.

Temporal trends in the association of social vulnerability and race/ethnicity with county-level COVID-19 incidence and outcomes in the USA: an ecological analysis

BackgroundThe COVID-19 pandemic adversely affected the socially vulnerable and minority communities in the USA initially, but the temporal trends during the year-long pandemic remain unknown.ObjectiveWe examined the temporal association of...

Factors Influencing Lung Function in Patients with Cystic Fibrosis in Western Romania.

PurposeThe aim of this cross-sectional study was to identify the major factors influencing pulmonary function in CF patients from western side of Romania.Patients and MethodsThe study enrolled 51 patients with CF between the ages of 6 and 27.8 years who were monitored at regular visits to the National Cystic Fibrosis Centre and Pius Branzeu County Hospital in Timisoara, Romania, over a period of 2 years. The relationships between lung function, as measured by forced expiratory volume in 1 s (FEV1), with patient age, sex, body mass index (BMI), pancreatic insufficiency (PI), microbial infection, CF-related diabetes (CFRD), CF-associated liver disease (CFLD), and physical activity <30 min/day, were evaluated by multivariate regression analysis.ResultsThe results showed that FEV1 was 0.32% higher for each increase in percentile of BMI (95% confidence interval: 0.034–0.619). In addition, mean FEV1 was 1.52% lower with every year rise of age. PI and female sex increased the risk of impaired lung function (FEV1 <60%). The factors most closely correlated with pulmonary function in pediatric CF patients were current age (negative) and BMI (positive).ConclusionThe findings of this study, in combination with what is known from other studies in CF, suggest that a better nutritional status and infection prophylaxis should be part of a comprehensive clinical management strategy for pediatric CF in Romania.

Social vulnerability and clinical trial access for older adults with myeloma in North Carolina.

e18540 Background: Multiple myeloma (MM) is a disease of aging, associated with one of the greatest black-white disparities in incidence and mortality among all US cancer types. Clinical trials provide the critical evidence-base to inform clinical management in all cancers, including MM. However, clinical trial participants are often younger (age &lt; 65 years) and white, limiting the generalizability of published data to real-world MM care. Although geographical and financial barriers to clinical trial participation are well recognized, less is known about the association of county-level social vulnerability with MM trial availability. We examined county-level variation in the number of registered myeloma trials per 10,000 North Carolina (NC) residents age ≥ 65 years as a function of social vulnerability and the presence of a National Cancer Institute Comprehensive Cancer Center (CCC). Methods: We conducted a cross-sectional study using data from ClinicalTrials.gov to identify all registered interventional myeloma trials involving adults age ≥ 65 years with sites in NC. Records were downloaded on January 24th, 2021. This strategy yielded 456 non-unique NC sites for 223 trials. We obtained county locations for all trial sites by matching city, zip code, or institution name. We obtained NC population data for residents age ≥ 65 years (in 2019) from the American Community Survey. The four themes (socioeconomic status, household composition, ethnic and racial minority status/language, housing/transportation) within the Centers for Disease Control Social Vulnerability Index (CDC SVI) (composite score: 0-1, with a higher number indicating more vulnerability) were used to characterize county-level social vulnerability. We performed negative binomial regression and tabulations using R, version 3.6.1. A p-value &lt; 0.05 was considered statistically significant. Results: Across 100 counties in NC, trial site counts by county per 10,000 residents age ≥ 65 years ranged from 0 to 23.2 (mean: 1.5, median: 0; IQR, 0-0.7). Controlling for the 4 SVI themes, counties with CCCs (Durham, Forsyth, Orange) had 77% more trials than those without CCCs [Incidence Rate Ratio (IRR): 7.74; p = 0.05]. We observed a 3.3% reduction in trial counts with each percentile increase in socioeconomic vulnerability (IRR: 0.97; p = 0.008). Counties with higher representation by racial and ethnic minorities had similar trial site counts to counties with lower minority populations (IRR: 1.01; p = 0.08). Sub-group analyses of early-stage studies (phase 1/2 and phase 2; n = 268) and late-stage studies (phase 2/3 and phase 3; n = 168) were similar. Conclusions: Our preliminary results suggest county-level socioeconomic status is associated with the distribution of MM clinical trial sites across NC. Further work is planned to explore whether additional variances in trial distribution could be explained by site- and study-specific characteristics.

Slowing of fetal growth and elevated maternal serum sFLT1:PlGF are associated with early term spontaneous labor

BackgroundThe physiological control of human parturition at term is unknown.ObjectiveThis study aimed to test the hypothesis that slowing of fetal growth or elevated maternal serum levels of markers of placental hypoxia in late gestation will be associated with earlier term labor.Study DesignWe observed 2208 women having first births and performed serial blinded ultrasonography and immunoassay of soluble fms-like tyrosine kinase-1 and placenta growth factor. We estimated the probability of spontaneous delivery from 37 weeks of gestational age concerning (1) fetal growth between 20 and 36 weeks of gestational age and (2) the maternal serum soluble fms-like tyrosine kinase-1–to–placenta growth factor ratio measured at approximately 36 weeks of gestational age. Data were analyzed using logistic regression and Cox regression.ResultsFetal size at 36 weeks of gestational age was not independently associated with the timing of delivery at term. However, there was an inverse relationship between fetal growth between 20 weeks of gestational age and 36 weeks of gestational age and the probability of spontaneous labor at 37 to 38 weeks’ gestation (hazard ratio [95% confidence interval] for a 50 percentile increase in abdominal circumference growth velocity, 0.60 [0.47–0.78]; P=.0001). This association was weaker at 39 to 40 weeks’ gestation (0.83 [0.74–0.93]; P=.0013), and there was no association at ≥41 weeks’ gestation. Very similar associations were observed for estimated fetal weight growth velocity. There was a positive relationship between soluble fms-like tyrosine kinase-1–to–placenta growth factor ratio and the probability of spontaneous labor at 37 to 38 weeks’ gestation (hazard ratio [95% confidence interval] for a 50 percentile increase in soluble fms-like tyrosine kinase-1–to–placenta growth factor ratio, 3.05 [2.32–4.02]; P<.0001). This association was weaker at 39 to 40 weeks’ gestation (1.46 [1.30–1.63]; P<.0001), and there was no association at ≥41 weeks’ gestation. Adjustment for maternal characteristics was without material effect on any of these associations.ConclusionSlowing of fetal growth and biomarkers of placental insufficiency were associated with an increased probability of early onset of spontaneous term labor. We speculated that progressive placental insufficiency may be a physiological phenomenon that occurs with advancing gestational age near and at term and promotes the initiation of labor.

Prediction of Childhood Obesity from Nationwide Health Records

To evaluate body mass index (BMI) acceleration patterns in children and to develop a prediction model targeted to identify children at high risk for obesity before the critical time window in which the largest increase in BMI percentile occurs. We analyzed electronic health records of children from Israel's largest healthcare provider from 2002 to 2018. Data included demographics, anthropometric measurements, medications, diagnoses, and laboratory tests of children and their families. Obesity was defined as BMI ≥95th percentile for age and sex. To identify the time window in which the largest annual increases in BMI z score occurs during early childhood, we first analyzed childhood BMI acceleration patterns among 417 915 adolescents. Next, we devised a model targeted to identify children at high risk before this time window, predicting obesity at 5-6years of age based on data from the first 2years of life of 132 262 children. Retrospective BMI analysis revealed that among adolescents with obesity, the greatest acceleration in BMI z score occurred between 2 and 4years of age. Our model, validated temporally and geographically, accurately predicted obesity at 5-6years old (area under the receiver operating characteristic curve of 0.803). Discrimination results on subpopulations demonstrated its robustness across the pediatric population. The model's most influential predictors included anthropometric measurements of the child and family. Other impactful predictors included ancestry and pregnancy glucose. Rapid rise in the prevalence of childhood obesity warrant the development of better prevention strategies. Our model may allow an accurate identification of children at high risk of obesity.

Implementation and evaluation of an adaptive online summer preparatory course for general chemistry: Whom does it benefit?

General chemistry courses are key gateways for many Science, Technology, Engineering, and Mathematics (STEM) majors. Here, we report on the implementation and evaluation of an adaptive, ALEKS-based online preparatory module (PM) for general chemistry. The module was made available in Summer 2018 at no cost to all students entering any section of general chemistry that fall. Of the 827 students who registered into the PM, 44% fully completed the module, 48% completed part of the module, and 8% did not complete any of the module. Considering students enrolled in first-term general chemistry, we find a marked increase in ACS final exam percentile for students who completed more than 50% of the module. This is suggested to reflect the self-selection of users who were highly motivated and/or likely to succeed in the course, a hypothesis supported by an analysis using an internal diagnostic metric, the predicted first-year quality point average (PQPA). To examine longer term impacts of the PM, we examined performance in subsequent chemistry courses, through second-semester organic, and found that students completing more than 50% of the module outperformed their counterparts across all courses, with the gap largest in first semester general chemistry and narrowing across subsequent courses. Finally, we surveyed students in summer 2020, two years after the PM offering. The survey indicated overall satisfaction with the PM. For students who did not complete the module, primary reasons given were difficulty (29% of respondents) and insufficient time (46%). As the module did not proportionally benefit the target group of underprepared or at-risk students, we suggest tweaks for future implementations.

Social Mobility in Germany

We characterize intergenerational social mobility in Germany using census data on the educational attainment of 526,000 children and their parents' earnings. Our measure of educational attainment is the A-Level degree, a requirement for access to university and the most important qualification in the German education system. On average, a 10 percentile increase in the parental income rank is associated with a 5.2 percentage point increase in the probability to obtain an A-Level. This parental income gradient has not changed for the birth cohorts from 1980 to 1996, despite a large-scale policy of expanding upper secondary education in Germany. At the regional level, there exists substantial variation in mobility estimates. Place effects, rather than sorting of households into different regions, seem to account for most of these geographical differences. Mobile regions are, among other aspects, characterized by high school quality and enhanced possibilities to obtain an A-Level degree in vocational schools.

Learning to Read: Successful Program-Based Remediation Using the Surgical Council on Resident Education (SCORE) Curriculum

The Surgical Council on Resident Education (SCORE) curriculum is aligned with the American Board of Surgery (ABS) objectives. Our program adopted the SCORE curriculum in 2015 after poor ABS In-Training Examination (ABSITE) performance and lowest quartile ABS Certifying Exam (CE) and Qualifying Exam (QE) first-time pass rates. We examined the association of SCORE use with ABSITE performance and ABS board exam first-time pass rate. At a single institution, a retrospective review of surgery residents' SCORE metrics and ABSITE percentile was conducted for academic years 2015 to 2019. Metrics analyzed on the SCORE web portal were mean total minutes and total visits per resident for all residents using SCORE that year. First-time pass rates of the ABS QE and CE were examined from 2013 to 2019. Chi-square and linear regression analysis were performed, and a 95% level of confidence was assumed (alpha= 0.05). Yearly data from categorical general surgery residents showed a significant increase in total minutes, total visits, and ABSITE percentile. Combined first time pass rates for the ABS QE and CE significant increased from 70.8% in 2013 to 2015 to 93.9% in 2016 to 2019 (p= 0.018). Increased longitudinal use of the SCORE curriculum was associated with programmatic improvements in ABSITE performance and ABS board exam first-time pass rate.

Antihistamines Increase Body Mass Index Percentiles and Z-Scores in Hispanic Children.

The prevalence of childhood obesity has increased over the years in the United States and contributed to a rise in metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). Animal studies suggested the role of histamine blockade on mesenteric lymphatics tone, contributing to weight gain and hepatic steatosis. This study aimed to investigate an association between antihistamines (AH) use in children and obesity. A single-center retrospective cohort study on children with a diagnosis of NAFLD, followed in the gastroenterology clinic, was performed between January 2018 and April 2019. The demographics, medications, and body mass index (BMI) were assessed. Participants were divided into an AH group with documented use and comparison group, antihistamine naïve. Of the 32 participants in the study, 13 used AH, and 19 did not. Antihistamine users had a mean increase in BMI percentile per year of 1.17 compared to a decrease of 0.06 in comparison group (p = 0.0008). AH usage correlated with a mean increase in BMI z-score of 0.23 per year, as opposed to a decrease by 0.012 in comparison group (p = 0.0016). No difference was found in triglycerides (TG), glucose, and liver enzymes. AH use increases BMI percentiles and z-scores over time and is associated with obesity in children.

Follow-Up of Elevated Blood Lead Levels and Sources in a Cohort of Children in Benin.

Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011–2013) suggested that 58% of 1-year-old children had BLLs > 50 ug/L. We aimed to investigate the prevalence of elevated BLLs (>50 µg/L and >100 µg /L) among 425 of these children at 6 years of age in 2016–2018 and to compare BLLs between age 1 and 6 years, and study sources of lead at age 6 years. BLLs were analysed by inductively coupled plasma mass spectrometry. Multiple linear regression and quantile regressions were used to study potential sources of lead. The prevalence of BLLs > 50 µg/L in children was 59.5% (Geometric Mean (GM) 56.4 µg/L, 95% CI: 54.1–58.7) at 6 years of age compared to 54.8% (GM 56.5 µg/L, 95% CI: 53.4–59.6) at 1 year of age. The prevalence of children with BLLs > 100 µg/L decreased from 14.4% at 1 year of age to 8.2% at 6 years of age. After adjustment for all other covariates, consumption of peanuts more than once per month was significantly associated with a 22.0% (95% CI: 4.6, 42.5) increment in BLLs at age 6 years compared with no consumption. Consumption of bushmeat killed by lead bullets at age 6 years was associated with an increase in the higher percentiles of BLLs (P75) compared with the absence of this source. Other potential sources of lead associated with BLLs with marginal significance were consumption of rice, paternal occupational exposure, and the presence of activity with the potential use of lead. This prospective cohort confirms the persistently high prevalence of elevated BLLs in children residing in a rural region in the south of Benin, as well as the presence of multiple and continuous sources of lead. These results highlight the need for prevention programs to reduce and eliminate lead exposure in children.

Proximity to livestock farms and exposure to livestock-related particulate matter are associated with lower probability of medication dispensing for obstructive airway diseases.

The aim of this study is to assess whether medication use for obstructive airway diseases is associated with environmental exposure to livestock farms. Previous studies in the Netherlands at a regional level suggested that asthma and chronic obstructive pulmonary disease (COPD) are less prevalent among persons living near livestock farms. A nationwide population-based cross-sectional study was conducted among 7,735,491 persons, with data on the dispensing of drugs for obstructive airway diseases in the Netherlands in 2016. Exposure was based on distances between home addresses and farms and on modelled atmospheric particulate matter (PM10) concentrations from livestock farms. Data were analysed for different regions by logistic regression analyses and adjusted for several individual-level variables, as well as modelled PM10 concentration of non-farm-related air pollution. Results for individual regions were subsequently pooled in meta-analyses. The probability of medication for asthma or COPD being dispensed to adults and children was lower with decreasing distance of their homes to livestock farms, particularly cattle and poultry farms. Increased concentrations of PM10 from cattle were associated with less dispensing of medications for asthma or COPD, as well (meta-analysis OR for 10th-90th percentile increase in concentration of PM10 from cattle farms, 95%CI: 0.92, 0.86-0.97 for adults). However, increased concentrations of PM10 from non-farm sources were positively associated (meta-analysis OR for 10th-90th percentile increase in PM10-concentration, 95%CI: 1.29, 1.09-1.52 for adults). The results show that the probability of dispensing medication for asthma or COPD is inversely associated with proximity to livestock farms and modelled exposure to livestock-related PM10 in multiple regions within the Netherlands. This finding implies a notable prevented risk: under the assumption of absence of livestock farms in the Netherlands, an estimated 2%-5% more persons (an increase in tens of thousands) in rural areas would receive asthma or COPD medication.

Exploring Water Consumption in Dhaka City Using Instrumental Variables Regression Approaches

This paper explores water consumption in Dhaka city for better understanding of its usage, and considers the implications of findings from distributive rationale. Using 459 household survey data collected by BRAC Institute of Governance and Development (BIGD), this study estimates income elasticities of water consumption after controlling the effects of other covariates including wealth-proxies, location, household size, water bill and spatial zones using the instrumental variable regression (IVREG) and instrumental variable quantile regression (IVQREG) approaches. The latter has an additive advantage over the former as the IVQREG provides a more accurate picture of the relationship of water consumption with the income throughout the entire water consumption distribution. Using the fixed pay variable as instrument, findings reveal the strong evidence that income is endogenous. The IVQREG results show that income elasticities are heterogeneous and vary significantly across the water quantiles, implying inequality in water consumption. It also provides strong systematic evidence as income elasticity of water consumption decreases with the increase in percentile. Significant spatial inequality in water consumption from IVREG approach disappears as we use IVQREG. This also strongly supports the systematic evidence obtained. Therefore, it is imperative to introduce different tariff structures among different water consumer groups for bringing equity in water consumption and revenue generation. However, Dhaka Water Supply & Sewerage Authority (DWASA) must ensure smart water meter before implementing such tariff structure as we face severe challenges while measuring residential water consumption.

Распространенность субклинического атеросклероза при ревматоидном артрите

Objective. To study the parameters of the morpho-functional state of the vascular wall in patients with rheumatoid arthritis (RA) with different levels of total cardiovascular risk (CVR). Materials and methods. 181 patients with active RA (mean age 40.4 [31.8; 49.6] years) were examined, and 2 groups were formed: 1) patients with the seronegative subtype (n=87); 2) those with the seropositive subtype (n=94). CVR was determined using the modified Systematic COronary Risk Evaluation (SCORE) scale; the intima-media complex thickness (IMCT) and the stiffness index (SI) of common carotid arteries (CCA) were assessed with specific methods. Results. Low CVR was determined in 86 (48%), moderate risk - in 47%, and high risk - in 5% patients with RA. 176 (97%) patients with RA had signs of subclinical atherosclerosis, with simultaneous IMCT increase above the 75th percentile and SI increase over 10 m/s in 21% patients. Mean IMCT values and SI in the 2nd group were higher than in the 1st group (р=0.018 and р=0.048, respectively). The lower risk was more commonly accompanied by the IMCT increase; as the CVR increased, the proportion of RA patients with SI over 10 m/s increased (р&lt;0.01). A correlation was detected between the age and SI (r=0.58, p=0.035), IMCT parameters (r=0.64, p=0.002). SI correlated with the body mass index (BMI) (r=0.64, p=0.04), and IMTC correlated with the С-reactive protein level (r=0.61, p&lt;0.01). Direct correlation was detected between SI, IMTC, and the Disease Activity Score 28 (DAS28) (r=0.51, p=0.02; r=0.45, p=0.008), RA duration (r=0.42, p=0.04; r=0.58, p=0.04), rheumatoid factor (RF) (r=0.68, p=0.04; r=0.49, р=0.04) and anti-citrullinated peptide antibody (ACPA) levels (r=0.62, p=0.018; r=0.45, р=0.003), respectively. Conclusion. It is feasible to perform an advanced examination for the diagnosis of subclinical atherosclerosis along with the routine evaluation of total CVR using the SCORE scale in patients with active RA.

Polygenic Contribution to Low-Density Lipoprotein Cholesterol Levels and Cardiovascular Risk in Monogenic Familial Hypercholesterolemia.

Familial hypercholesterolemia (FH) is a common autosomal codominant genetic disorder, which causes elevated levels of low-density lipoprotein cholesterol (LDL-C) and increased risk of premature atherosclerotic cardiovascular disease (ASCVD). Even among individuals with monogenic FH, there is substantial interindividual variability in LDL-C levels and risk of ASCVD. We assessed the influence of an LDL-C polygenic score on levels of LDL-C and risk of ASCVD for individuals with monogenic FH. We constructed a weighted LDL-C polygenic score, composed of 28 single-nucleotide variants, for individuals with monogenic FH from the British Columbia FH (n=262); Nutrition, Metabolism and Atherosclerosis Clinic (n=552); and UK Biobank cohorts (n=306). We assessed the association between LDL-C polygenic score with LDL-C levels and ASCVD risk using linear regression and Cox-proportional hazard models, respectively. ASCVD was defined as myocardial infarction, coronary or carotid revascularization, transient ischemic attack, or stroke. The results from individual cohorts were combined in fixed-effect meta-analyses. Levels of LDL-C were significantly associated with LDL-C polygenic score in the Nutrition, Metabolism and Atherosclerosis Clinic cohort, UK Biobank cohort, and in the meta-analysis (β [95% CI]=0.13 [0.072-0.19] per a 20% increase in LDL-C polygenic score percentile, P<0.0001). Additionally, an elevated LDL-C polygenic score (≥80th percentile) was associated with a trend towards increased ASCVD risk in all 3 cohorts individually. This association was statistically significant in the meta-analysis (hazard ratio [95% CI]=1.48 [1.02-2.14], P=0.04). Polygenic contributions to LDL-C explain some of the heterogeneity in clinical presentation and ASCVD risk for individuals with FH.

Hypertension Editors' Picks: Air Pollution.

Hypertension Editors' Picks: Air Pollution.

In vivo microdialysis: A novel sampling technique for drug analysis in live subjects

By using an in vivo microdialysis technique, extracellular dopamine (DA) and cocaine concentration in the medial prefrontal cortex (mPFC) after intravenous cocaine injection (1.5 mg/kg in group A and 3.0 mg/kg in group B) were evaluated in adult male Sprague-Dawley rats anesthetized with chloral hydrate (400 mg/kg, i.p., with 80 mg/kg/h supplements). Dialysate samples were collected at 20-min intervals for a 100-min period and were analyzed for DNA content by an HPLC/electrochemical detector, and for cocaine content by an HPLC/ultraviolet detector. After intravenous (i.v.) cocaine injection, both DA and cocaine concentrations in the dialysate reached maximum within 20 minutes, correlated nicely, and then rapidly declined. The maximal DA increase was 214.0 ± 20.3% for the high dose group and 118.7 ± 5.0% for the low dose group. The DA baseline concentration in dialysate was 0.390 ± 0.058 nM. The maximal cocaine concentration was 0.20 ± 0.08 μM, and 0.6 ± 0.08 μM respectively. By using an in vivo calibration method for microdialysis, the in vivo recovery of cocaine in the mPFC was obtained as 33 ± 5%. The actual extracellular cocaine concentration was therefore calculated to be 1.84 ± 0.64 μM in group A and 4.00 ± 0.94 μgM in group B. From the results, extracellular cocaine concentration was found to be highly correlated with a DA percentile increase over the 100 min period of time. After first-order linear regression, the correlation coefficient was 0.976. In summary, in vivo microdialysis is not only a sampling technique for determining the drug concentration at a specific area in live subjects, but is also useful simultaneously to observe the changes of endogenous compound. Therefore, microdialysis technique is a popular research tool with great potential in the immediate future and is a valuable new state of the art to be introduced into our research society.