Project description:BackgroundThe family history of gastric cancer holds important implications for cancer surveillance and prevention, yet existing evidence predominantly comes from case-control studies. We aimed to investigate the association between family history of gastric cancer and gastric cancer risk overall and by various subtypes in Asians in a prospective study.MethodsWe included 12 prospective cohorts with 550,508 participants in the Asia Cohort Consortium. Cox proportional hazard regression was used to estimate study-specific adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between family history of gastric cancer and gastric cancer incidence and mortality, then pooled using random-effects meta-analyses. Stratified analyses were performed for the anatomical subsites and histological subtypes.ResultsDuring the mean follow-up of 15.6 years, 2258 incident gastric cancers and 5194 gastric cancer deaths occurred. The risk of incident gastric cancer was higher in individuals with a family history of gastric cancer (HR 1.44, 95% CI 1.32-1.58), similarly in males (1.44, 1.31-1.59) and females (1.45, 1.23-1.70). Family history of gastric cancer was associated with both cardia (HR 1.26, 95% CI 1.00-1.60) and non-cardia subsites (1.49, 1.35-1.65), and with intestinal- (1.48, 1.30-1.70) and diffuse-type (1.59, 1.35-1.87) gastric cancer incidence. Positive associations were also found for gastric cancer mortality (HR 1.30, 95% CI 1.19-1.41).ConclusionsIn this largest prospective study to date on family history and gastric cancer, a familial background of gastric cancer increased the risk of gastric cancer in the Asian population. Targeted education, screening, and intervention in these high-risk groups may reduce the burden of gastric cancer.
Project description:Background and aimPost-ERCP pancreatitis (PEP) is the most common complication following endoscopic retrograde cholangiopancreatography (ERCP). It is still controversial whether the presence of a trainee would increase the risk of PEP. Additionally, the effects of demographic factors and comorbidities on the risk and severity of PEP are not fully understood. Our aim was to evaluate these factors using national database.MethodsNationwide Inpatient Sample 2000-2014 was used to identify adult patients admitted with biliary obstruction without acute pancreatitis and had an inpatient ERCP. PEP was defined as having a subsequent diagnosis of acute pancreatitis. The presence of major organs failure marked moderate-severe PEP. Demographic information, hospital characteristics, and ERCP intervention types were collected.ResultsWe included 654 394 patients. Overall PEP rate was 5.4%. The PEP rate was lower in teaching (4.8%) compared with nonteaching (6.2%, P < 0.001) hospitals. The highest PEP rate was observed among patients undergoing Sphincter of Oddi Manometry (15.1%, odds ratio [OR] = 2.5, P < 0.001) as compared to diagnostic cholangiography (4.4%). Asians and Hispanics had higher rate of PEP (10% and 7.9%, respectively) compared with Caucasians and African Americans (4.9% and 5%, respectively, P < 0.001). Multivariate analysis showed that after controlling for the ERCP intervention types, Asians and Hispanics continued to have higher odds of PEP (OR = 1.3, P < 0.001). Seventeen percent of patients were classified as moderate-severe PEP. Older patients (OR = 3.2, P < 0.001), males (OR = 1.4, P < 0.001), and high comorbidities (1.3, P < 0.001) were major predictors of moderate-severe PEP.ConclusionNo evidence of higher PEP rates in teaching hospitals. Asians and Hispanics had higher PEP rates. Although ERCP intervention type is the major PEP predictor, its severity is dependent on patient characteristics.
Project description:BackgroundThe frequency of cardiac rhythm abnormalities and their risk factors in community-dwelling adults are not well characterized.MethodsWe determined the frequency of rhythm abnormalities in the UK Biobank, a national prospective cohort. We tested associations between risk factors and incident rhythm abnormalities using multivariable proportional hazards regression.ResultsOf 502 627 adults (median age, 58 years [interquartile range, 13]; 54.4% women), 2.35% had a baseline rhythm abnormality. The prevalence increased with age with 4.84% of individuals aged 65 to 73 years affected. During 3 368 332 person-years of follow-up, 15 906 new rhythm abnormalities were detected (4.72 per 1000 person-years; 95% confidence interval [CI]: 4.65-4.80). Atrial fibrillation (3.11 per 1000 person-years; 95% CI: 3.05-3.17), bradyarrhythmias (0.89 per 1000 person-years; 95% CI: 0.86-0.92), and conduction system diseases (1.06 per 1000 person-years; 95% CI: 1.02-1.09) were more common than supraventricular (0.51 per 1000 person-years; 95% CI: 0.48-0.53) and ventricular arrhythmias (0.57 per 1000 person-years; 95% CI: 0.55-0.60). Older age (hazard ratio [HR]: 2.35 per 10-year increase; 95% CI: 2.29-2.41; P<0.01), male sex (HR: 1.83; 95% CI: 1.76-1.89; P<0.01), hypertension (HR: 1.49; 95% CI: 1.44-1.54; P<0.01), chronic kidney disease (HR: 1.95; 95% CI: 1.67-2.27; P<0.01), and heart failure (HR: 1.99; 95% CI: 1.76-2.26; P<0.01) were associated with new rhythm abnormalities.ConclusionsThe frequency of rhythm abnormalities in middle-aged to older community-dwelling adults is substantial. Atrial fibrillation, bradyarrhythmias, and conduction system diseases account for most rhythm conditions.
Project description:Optical resonators are essential for fundamental science, applications in sensing and metrology, particle cooling, and quantum information processing. Cavities can significantly enhance interactions between light and matter. For many applications they perform this task best if the mode confinement is tight and the photon lifetime is long. Free access to the mode center is important in the design to admit atoms, molecules, nanoparticles, or solids into the light field. Here, we demonstrate how to machine microcavity arrays of extremely high quality in pristine silicon. Etched to an almost perfect parabolic shape with a surface roughness on the level of 2 Å and coated to a finesse exceeding F = 500,000, these new devices can have lengths below 17 µm, confining the photons to 5 µm waists in a mode volume of 88λ3. Extending the cavity length to 150 µm, on the order of the radius of curvature, in a symmetric mirror configuration yields a waist smaller than 7 µm, with photon lifetimes exceeding 64 ns. Parallelized cleanroom fabrication delivers an entire microcavity array in a single process. Photolithographic precision furthermore yields alignment structures that result in mechanically robust, pre-aligned, symmetric microcavity arrays, representing a light-matter interface with unprecedented performance.
Project description:Chronic low-grade inflammation is linked to a multitude of chronic diseases. We report the largest genome-wide association study (GWAS) on C-reactive protein (CRP), a marker of systemic inflammation, in UK Biobank participants (N = 427,367, European descent) and the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium (total N = 575,531 European descent). We identify 266 independent loci, of which 211 are not previously reported. Gene-set analysis highlighted 42 gene sets associated with CRP levels (p ≤ 3.2 ×10-6) and tissue expression analysis indicated a strong association of CRP related genes with liver and whole blood gene expression. Phenome-wide association study identified 27 clinical outcomes associated with genetically determined CRP and subsequent Mendelian randomisation analyses supported a causal association with schizophrenia, chronic airway obstruction and prostate cancer. Our findings identified genetic loci and functional properties of chronic low-grade inflammation and provided evidence for causal associations with a range of diseases.
Project description:Few hydrogen adsorbents balance high usable volumetric and gravimetric capacities. Although metal-organic frameworks (MOFs) have recently demonstrated progress in closing this gap, the large number of MOFs has hindered the identification of optimal materials. Here, a systematic assessment of published databases of real and hypothetical MOFs is presented. Nearly 500,000 compounds were screened computationally, and the most promising were assessed experimentally. Three MOFs with capacities surpassing that of IRMOF-20, the record-holder for balanced hydrogen capacity, are demonstrated: SNU-70, UMCM-9, and PCN-610/NU-100. Analysis of trends reveals the existence of a volumetric ceiling at ∼40 g H2 L-1. Surpassing this ceiling is proposed as a new capacity target for hydrogen adsorbents. Counter to earlier studies of total hydrogen uptake in MOFs, usable capacities in the highest-capacity materials are negatively correlated with density and volumetric surface area. Instead, capacity is maximized by increasing gravimetric surface area and porosity. This suggests that property/performance trends for total capacities may not translate to usable capacities.
Project description:Background: The association between smoking and blood pressure (BP) has been explored extensively, yet the results remain inconclusive. Using real-world evidence of a large Chinese population, we examine the effect of smoking on BP levels. Methods: We utilize half a million adults from the China Kadoorie Biobank (CKB) study with baseline sampling collected between 2004 and 2008. Multivariable linear regression analyses are used to estimate linear regression coefficients of smoking for systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results: 459,815 participants (180,236 males and 279,579 females) are included in the analysis. Regular smoking is significantly associated with lower SBP (-0.57 mm Hg, p < 0.001) and DBP (-0.35 mm Hg, p < 0.001) when compared with non-smoking in men. Additionally, SBP and DBP decrease significantly among all groups of different smoking status in women (p < 0.001). Additionally, pack-years show negative associations with SBP and DBP in both men and women. Further analysis shows the interaction of smoking and alcohol consumption is associated with an increase of SBP and DBP (men: 2.38 mm Hg and 0.89 mm Hg; women: 5.21 mm Hg and 2.62 mm Hg) among co-regular smokers and regular drinkers when compared with regular smokers who are not exposed to alcohol consumption. Conclusions: A negative association between smoking and BP is observed. However, the interaction between smoking and alcohol consumption is associated with BP increase. The findings suggest the importance of considering smoking and alcohol consumption in BP control in addition to antihypertensive treatment in clinical and public health practice.
Project description:BackgroundHypertension may be influenced by multiple factors, including social and individual determinants. Regional and individual economic disparity in China is closely associated with such factors that may give rise to diverse health outcomes. This study examines the relationship between regional economic development, household income, gender and hypertension prevalence in China.MethodsThis study utilized data from the China Kadoorie Biobank (CKB), a population-based study on half a million Chinese adults from 10 geographically distinct regions. Hypertension was identified by a measured systolic blood pressure/diastolic blood pressure ≥ 140/90 mmHg or receiving treatment. Regional economic development was inferred from GDP per capita at the time of the study. A logistic regression based method was used in calculating the prevalence of hypertension in different household income, regional economic development, and gender groups, adjusting for demographic, social-economic and lifestyle factors.ResultsThe prevalence of hypertension was the lowest in the medium GDP per capita areas in both male (31.62, 95% CI: 31.26-31.98%) and female (22.85, 95% CI: 22.50-23.19%) as compared to that in the low GDP per capita regions (male: 32.75, 95% CI 32.41-33.08%; female: 32.12, 95% CI: 31.78-32.47%) and high GDP per capita areas (male: 39.74, 95% CI: 39.33-40.16%; female: 35.19, 95% CI: 34.74-35.65%). There was an inverse relationship between hypertension and household income in the low and high GDP areas and an U-shaped association in the medium GDP per capita areas. Higher hypertension prevalence was observed in males across all GDP per capita areas. The negative correlation between hypertension and household income (across all GDP per captia areas) was stronger in females than in males.ConclusionsThe present study underlined the important influence of regional economic development, household income and gender on hypertension. Interventions for hypertension prevention and management should take into consideration the influence of sex difference and socioeconomic disparities at both micro- and macro- levels, in addition to a person-centered approach.
Project description:Anthropogenic factors have significantly influenced the frequency, duration, and intensity of meteorological drought in many regions of the globe, and the increased frequency of wildfires is among the most visible consequences of human-induced climate change. Despite the fire role in determining biodiversity outcomes in different ecosystems, wildfires can cause negative impacts on wildlife. We conducted ground surveys along line transects to estimate the first-order impact of the 2020 wildfires on vertebrates in the Pantanal wetland, Brazil. We adopted the distance sampling technique to estimate the densities and the number of dead vertebrates in the 39,030 square kilometers affected by fire. Our estimates indicate that at least 16.952 million vertebrates were killed immediately by the fires in the Pantanal, demonstrating the impact of such an event in wet savanna ecosystems. The Pantanal case also reminds us that the cumulative impact of widespread burning would be catastrophic, as fire recurrence may lead to the impoverishment of ecosystems and the disruption of their functioning. To overcome this unsustainable scenario, it is necessary to establish proper biomass fuel management to avoid cumulative impacts caused by fire over biodiversity and ecosystem services.