A metabolomics perspective on 2 years of high-intensity training in horses

The plasma metabolomic profile of elite harness horses subjected to different training programmes was explored. All horses had the same training programme from 1.5 until 2 years of age and then high-intensity training was introduced, with horses divided into high and low training groups. Morning blood samples were collected at 1.5, 2, 2.5 and 3.5 years of age. The plasma was analysed using targeted absolute quantitative analysis and a combination of tandem mass spectrometry, flow-injection analysis and liquid chromatography. Differences between the two training groups were observed at 2 years of age, when 161 metabolites and sums and ratios were lower (e.g. ceramide and several triglycerides) and 51 were higher (e.g. aconitic acid, anserine, sum of PUFA cholesteryl esters and solely ketogenic AAs) in High compared with low horses. The metabolites aconitic acid, anserine, leucine, HArg synthesis and sum of solely ketogenic AAs increased over time, while beta alanine synthesis, ceramides and indole decreased. Therefore high-intensity training promoted adaptations linked to aerobic energy production and amino acid metabolism, and potentially also affected pH-buffering and vascular and insulin responses.

Mechanical loading intensities affect the release of extracellular vesicles from mouse bone marrow-derived hematopoietic progenitor cells and change their osteoclast-modulating effect

Low-intensity loading maintains or increases bone mass, whereas lack of mechanical loading and high-intensity loading decreases bone mass, possibly via the release of extracellular vesicles by mechanosensitive bone cells. How different loading intensities alter the biological effect of these vesicles is not fully understood. Dynamic fluid shear stress at low intensity (0.7 ± 0.3 Pa, 5 Hz) or high intensity (2.9 ± 0.2 Pa, 1 Hz) was used on mouse hematopoietic progenitor cells for 2 min in the presence or absence of chemical compounds that inhibit release or biogenesis of extracellular vesicles. We used a Receptor activator of nuclear factor kappa-Β ligand-induced osteoclastogenesis assay to evaluate the biological effect of different fractions of extracellular vesicles obtained through centrifugation of medium from hematopoietic stem cells. Osteoclast formation was reduced by microvesicles (10 000× g) obtained after low-intensity loading and induced by exosomes (100 000× g) obtained after high-intensity loading. These osteoclast-modulating effects could be diminished or eliminated by depletion of extracellular vesicles from the conditioned medium, inhibition of general extracellular vesicle release, inhibition of microvesicle biogenesis (low intensity), inhibition of ESCRT-independent exosome biogenesis (high intensity), as well as by inhibition of dynamin-dependent vesicle uptake in osteoclast progenitor cells. Taken together, the intensity of mechanical loading affects the release of extracellular vesicles and change their osteoclast-modulating effect.

Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder: CIAO-II study

BACKGROUND

Research has shown that 20-30% of prisoners meet the diagnostic criteria for attention-deficit hyperactivity disorder (ADHD). Methylphenidate reduces ADHD symptoms, but effects in prisoners are uncertain because of comorbid mental health and substance use disorders.

AIMS

To estimate the efficacy of an osmotic-release oral system methylphenidate (OROS-methylphenidate) in reducing ADHD symptoms in young adult prisoners with ADHD.

METHOD

We conducted an 8-week parallel-arm, double-blind, randomised placebo-controlled trial of OROS-methylphenidate versus placebo in male prisoners (aged 16-25 years) meeting the DSM-5 criteria for ADHD. Primary outcome was ADHD symptoms at 8 weeks, using the investigator-rated Connors Adult ADHD Rating Scale (CAARS-O). Thirteen secondary outcomes were measured, including emotional dysregulation, mind wandering, violent attitudes, mental health symptoms, and prison officer and educational staff ratings of behaviour and aggression.

RESULTS

In the OROS-methylphenidate arm, mean CAARS-O score at 8 weeks was estimated to be reduced by 0.57 points relative to the placebo arm (95% CI -2.41 to 3.56), and non-significant. The responder rate, defined as a 20% reduction in CAARS-O score, was 48.3% for the OROS-methylphenidate arm and 47.9% for the placebo arm. No statistically significant trial arm differences were detected for any of the secondary outcomes. Mean final titrated dose was 53.8 mg in the OROS-methylphenidate arm.

CONCLUSIONS

ADHD symptoms did not respond to OROS-methylphenidate in young adult prisoners. The findings do not support routine treatment with OROS-methylphenidate in this population. Further research is needed to evaluate effects of higher average dosing and adherence to treatment, multi-modal treatments and preventative interventions in the community.

Underwater noise emissions from ships during 2014-2020

This paper reports trends in the input of underwater noise source energy emission from global shipping, based on bottom-up modeling of individual ships. In terms of energy, we predict the doubling of global shipping noise emissions every 11.5 years, on average, but there are large regional differences. Shipping noise emissions increase rapidly in Arctic areas and the Norwegian Sea. The largest contributors are the containerships, dry bulk and liquid tanker vessels which emit 75% of the underwater shipping noise source energy. The COVID-19 pandemic changed vessel traffic patterns and our modeling indicates a reduction of -6% in global shipping noise source energy in the 63 Hz ⅓ octave band. This reduction was largest in the Greenland Sea, the Coastal Waters of Southeast Alaska and British Columbia as well as the Gulf of California, temporarily disrupting the increasing pre-pandemic noise emission trend. However, in some sea areas, such as the Indian Ocean, Yellow Sea and Eastern China Sea the emitted noise source energy was only slightly reduced. In global scale, COVID-19 pandemic reduced the underwater shipping noise emissions close to 2017 levels, but it is expected that the increasing trend of underwater noise emissions will continue when the global economy recovers.

An operational urban air quality model ENFUSER, based on dispersion modelling and data assimilation

An operational urban air quality modelling system ENFUSER is presented with an evaluation against measured data. ENFUSER combines several dispersion modelling approaches, uses data assimilation, and continuously extracts information from online, global open-access sources. The modelling area is described with a combination of geographic datasets. These GIS datasets are globally available with open access, and therefore the model can be applied worldwide. Urban scale dispersion is addressed with a combination of Gaussian puff and Gaussian plume modelling, and long-range transport of pollutants is accounted for via a separate regional model. The presented data assimilation method, which supports the use of AQ sensors and incorporates a longer-term learning mechanism, adjusts emission factors and the regional background values on an hourly basis. The model can be used with reasonable accuracy also in urban areas, for which detailed emissions inventories would not be available, due to the data assimilation capabilities.

Improved fracture risk prediction by adding VFA-identified vertebral fracture data to BMD by DXA and clinical risk factors used in FRAX

Vertebral fracture (VF) is a strong predictor of subsequent fracture. In this study of older women, VF, identified by dual-energy X-ray absorptiometry (DXA) vertebral fracture assessment (VFA), were associated with an increased risk of incident fractures and had a substantial impact on fracture probability, supporting the utility of VFA in clinical practice.

PURPOSE

Clinical and occult VF can be identified using VFA with dual-energy X-ray absorptiometry (DXA). The aim of this study was to investigate to what extent VFA-identified VF improve fracture risk prediction, independently of bone mineral density (BMD) and clinical risk factors used in FRAX.

METHODS

A total of 2852 women, 75-80 years old, from the prospective population-based study SUPERB cohort, were included in this study. At baseline, BMD was measured by DXA, VF diagnosed by VFA, and questionnaires used to collect data on risk factors for fractures. Incident fractures were captured by X-ray records or by diagnosis codes. An extension of Poisson regression was used to estimate the association between VFA-identified VF and the risk of fracture and the 5- and 10-year probability of major osteoporotic fracture (MOF) was calculated from the hazard functions for fracture and death.

RESULTS

During a median follow-up of 5.15 years (IQR 4.3-5.9 years), the number of women who died or suffered a MOF, clinical VF, or hip fracture was 229, 422, 160, and 124, respectively. A VFA-identified VF was associated with an increased risk of incident MOF (hazard ratio [HR] = 1.78; 95% confidence interval [CI] 1.46-2.18), clinical VF (HR = 2.88; 95% [CI] 2.11-3.93), and hip fracture (HR = 1.67; 95% [CI] 1.15-2.42), adjusted for age, height, and weight. For women at age 75 years, a VFA-identified VF was associated with 1.2-1.4-fold greater 10-year MOF probability compared with not taking VFA into account, depending on BMD.

CONCLUSION

Identifying an occult VF using VFA has a substantial impact on fracture probability, indicating that VFA is an efficient method to improve fracture prediction in older women.

POS0603 CARDIOVASCULAR RISK FACTORS BEFORE ONSET OF RHEUMATOID ARTHRITIS ARE ASSOCIATED WITH CARDIOVASCULAR EVENTS AFTER DISEASE ONSET – A CASE CONTROL STUDY

Background

Increased comorbidity and mortality in rheumatoid arthritis (RA) patients are highly due to cardiovascular disease (CVD). The etiology of this increased morbidity and mortality in patients with RA compared with the general population is not fully understood. We have previously shown that individuals who subsequently develop RA have increased frequencies of several risk factors for CVD, such as elevated BMI, elevated Apoliprotein (Apo) B/ApoA1 ratio, and cigarette smoking compared with matched controls, already before symptom onset of RA.

Objectives

We aimed to assess the impact of CV risk factors, already present before onset of symptoms of RA, for future CV events (CVE) in comparison with matched controls.

Methods

A case-control study including 521 individuals before symptoms of RA and 1,566 matched controls identified in the Health Surveys of the Medical Biobank of Northern Sweden was performed. Information regarding the presence of the selected risk factors for CVD was based on surveys with data collected in the Västerbotten Intervention Programme (VIP) and the Northern Sweden Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA). Selected CVD risk factors were: hypertension, elevated Apolipoprotein B/A1 ratio, elevated body mass index, diabetes, and smoking. Information on comorbidities (coded according to the International Statistical Classification of Diseases and Related Health Problems ninth or tenth revision (ICD-9 and/or -10)) was requested from the Swedish National Patient Register and the Cause of Death Register. Statistics were performed using SPSS version 26.0 (IBM Corp., NY, USA), Cox proportional hazard regression was used and presented with calculated hazard ratios (HRs) and 95% confidence intervals (CI). Adjustments were performed for risk factors developed after RA onset.

Results

Pre-RA individuals had a higher risk for CVE after RA onset compared with matched controls (HR (95% CI)= 1.70 (1.31-2.21)) which remained after adjustment for various risk factors for CVD, (HR (95% CI)= 1.69 (1.24-2.30)). Also, treatment with biological disease modifying anti rheumatic drugs (bDMARDs) were associated with CVE (HR (95% CI)=2.06 (1.05-4.03), adjusted for CV risk factors). Most of the risk factors present prior to RA were associated with CVE after diagnosis, The significant association of risk factors present before RA onset for a CVE after onset remained after adjustments for risk factors that developed after RA onset. A combination of risk factors resulted in a higher risk in RA compared with controls (OR (95% CI); two risk factors 3.30 (1.16-9.36), vs. 1.21 (0.62-2.37), and three-four risk factors, 7.32 (2.71-19.74), vs. 4.16 (2.27-7.67).

Conclusion

Known risk factors for CVD present in individuals prior to onset of RA were associated with future CVE and even after adjustments for the risk factors, patients with RA had a higher risk for CVE compared with controls. In addition, risk factors present before RA was associated with future CVE even after adjustment for risk factors developed after RA onset. These findings further enlighten the importance of early assessment of risk for CVD in RA.

References

Disclosure of Interests

None declared

Reduced high-intensity training distance in growing horses had no effect on IGF-1 concentrations, but training onset interrupted time-dependent IGF-1 decline

This study investigated plasma insulin like growth factor (IGF)-1 concentrations in 16 young Standardbred horses introduced to systematic high-intensity training at two different levels of intensity. Growth and locomotion asymmetry and correlations between these and plasma IGF-1 concentrations were also examined. From September as 1-year olds to March as 2-year olds (Period 1), all horses were subjected to the same submaximal training program. In March (start of Period 2), the horses were divided into two groups (n=8) and one group was introduced to regular high-intensity training. The other group was introduced to a program where the high-intensity exercise distances were reduced by 30%. These two training programs were maintained for the remaining 21 months of the study (Periods 2, 3, and 4). There was no effect of training group on plasma IGF-1 concentrations. A continuous decline in IGF-1 levels was observed throughout the study (P<0.0001), with one notable interruption in Period 2 when the IGF-1 concentration remained at the level seen at the start of Period 1. Growth rate of body length was equally high in Periods 1 and 2 (P>0.05). Front and hind limb asymmetry was elevated in Period 2 compared with Period 1. There were positive correlations between IGF-1 concentrations and changes in body condition score, and a negative correlation between IGF-1 concentration and weight. These results indicate that introduction to high-intensity training induces IGF-1 release in horses, but that a 30% difference in the distances used in high-intensity training does not affect IGF-1 levels. The temporary interruption in decline in IGF-1 release with the onset of high-intensity training may influence growth pattern and locomotion asymmetry, but further studies are needed to assess causality.

Locomotion asymmetry in young Standardbred trotters in training and links to future racing career

This study evaluated whether front and hind limb symmetry patterns observed from 1.5 through 3 years of age in Standardbred trotters in training affect racing activity at older age. The hypothesis tested was that asymmetries observed during this period are linked to reduced number of lifetime races and low earnings. Sixteen Standardbreds were subjected to a controlled training and dietary programme from the age of 1.5 years until December as 3-year-olds (P1) and then continued their career with other trainers. On 17 occasions during P1, locomotion asymmetry (vector sum) in front and hind limbs during trot in hand was recorded with a sensor-based system. By 10 years of age, data on lifetime number of races and earnings of the horses were obtained from the Swedish Trotting Association. Horses were divided in groups based on the number of lifetime races performed, i.e. more or less than the median of the cohort born the same year. Mean asymmetry levels did not differ between horses performing more or less lifetime races than the cohort median. However, horses that showed the poorest lifetime race activity showed elevated hind limb asymmetry in August at the age of 3 years, compared to horses with more races (group <median: 9±6 mm vs group >median: 6±2 mm (P=0.02)). There were no correlations between individual mean and peak asymmetries and lifetime earnings. It is concluded that locomotion symmetry observed during trot in hand at the age of 1.5-year-olds to December as 3-year-olds was not a simple and straight-forward predictor of future racing career. However, hind limb asymmetries of around 10 mm in the late season as 3-year-olds could be a warning of impaired future performance.

Complement activation prior to symptom onset in myeloperoxidase ANCA-associated vasculitis but not proteinase 3 ANCA associated vasculitis - A Swedish biobank study

OBJECTIVE

Increased soluble levels of complement effectors have been demonstrated in active anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), but the timing of complement activation in the autoimmune inflammation remains elusive. This study investigated whether the complement system is activated before onset of symptoms in AAV.

METHOD

The Swedish National Patient Register and Cause of Death register were linked to registers of five biobanks to identify individuals sampled before AAV symptom onset. Diagnosis of AAV and time-point for symptom onset were confirmed by reviewing medical records. We identified 64 presymptomatic individuals with serum samples > 1 month < 10 years from AAV symptom onset and 122 matched controls. Complement factors (C2, C5) and activation markers (C5a, C4b) were measured using Luminex technology.

RESULTS

Presymptomatic individuals had higher levels of C5 up to 6.5 years before symptom onset, compared with controls [median (IQR) 80.7 (131.9) vs 46.6 (63.4) µg/mL, p = 0.05]. Levels of C5a increased significantly during the pre-dating time (p = 0.033) until symptom onset. The complement levels were significantly higher in presymptomatic myeloperoxidase (MPO)-ANCA⁺ individuals versus MPO-ANCA^- and proteinase-3-ANCA⁺ individuals. C5 was significantly increased in cases with renal involvement at diagnosis versus controls (p = 0.022), whereas levels of both C5 and C5a were significantly increased in presymptomatic individuals diagnosed with microscopic polyangiitis after onset compared with controls (C5: p = 0.027; C5a: p = 0.027).

CONCLUSION

Activation of the complement system is an early event in the pathogenesis of AAV and is mainly associated with MPO-ANCA⁺ AAV and with microscopic polyangiitis.

One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD

In women of ages 75-80 years, a low one leg standing time (OLST) was associated with an increased risk of incident fractures, independently of bone mineral density and clinical risk factors. OLST contributed substantially to fracture probability, indicating that the test should be considered when evaluating fracture risk in older women.

INTRODUCTION

Physical function and risk of falls are important risk factors for fracture. A few previous studies have suggested that a one leg standing time (OLST) less than 10 s predicts fracture risk, but the impact of OLST, in addition to known clinical risk factors, for fracture probability is unknown. The aim of this study was to determine the independent contribution of OLST to fracture probability in older women.

METHODS

The Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures (SUPERB) is a prospective population-based study of 3028 women 75-80 years old, recruited from the greater Gothenburg area in Sweden. At baseline, information on risk factors was collected using questionnaires, bone mineral density was measured with dual-energy X-ray absorptiometry (DXA), and OLST was performed.

RESULTS

During a median follow-up of 3.6 years (IQR 1.5 years), X-ray-verified incident fractures were identified using health records. OLST was available in 2405 women. OLST less than 10 s was associated with an increased risk for incident hip fracture (Hazard Ratio (HR) 3.02, 95% Confidence Interval (CI) [1.49-6.10]), major osteoporotic fracture (HR 95% CI 1.76 [1.34-1.46]), and nonvertebral fracture (HR 95% CI 1.61 [1.26-2.05]) in Cox regression analyses adjusted for age, height, and weight. Depending on BMD, the 4-year fracture probability increased by a factor of 1.3 to 1.5 in a 75-year-old woman with a low OLST (<10 s).

CONCLUSION

A low OLST has a substantial impact on fracture probability and should be considered when evaluating fracture risk in older women.

Modelling spatial dispersion of contaminants from shipping lanes in the Baltic Sea

Major sources of pollution from shipping to marine environments are antifouling paint residues and discharges of bilge, black, grey and ballast water and scrubber discharge water. The dispersion of copper, zinc, naphthalene, pyrene, and dibromochloromethane have been studied using the Ship Traffic Emission Assessment Model, the General Estuarine Transport Model, and the Eulerian tracer transport model in the Baltic Sea in 2012. Annual loads of the contaminants ranged from 10^-2 tons for pyrene to 100 s of tons for copper. The dispersion of the contaminants is determined by the surface kinetic energy and vertical stratification at the location of the discharge. The elevated concentration of the contaminants at the surface persists for about two-days and the contaminants are dispersed over the spatial scale of 10-60 km. The Danish Sounds, the southwestern Baltic Sea and the Gulf of Finland are under the heaviest pressure of shipborne contaminants in the Baltic Sea.

Shipping Remains a Globally Significant Source of Anthropogenic PN Emissions Even after 2020 Sulfur Regulation

Shipping is the main source of anthropogenic particle emissions in large areas of the globe, influencing climate, air quality, and human health in open seas and coast lines. Here, we determined, by laboratory and on-board measurements of ship engine exhaust, fuel-specific particle number (PN) emissions for different fuels and desulfurization applied in shipping. The emission factors were compared to ship exhaust plume observations and, furthermore, exploited in the assessment of global PN emissions from shipping, utilizing the STEAM ship emission model. The results indicate that most particles in the fresh ship engine exhaust are in ultrafine particle size range. Shipping PN emissions are localized, especially close to coastal lines, but significant emissions also exist on open seas and oceans. The global annual PN produced by marine shipping was 1.2 × 10²⁸ (±0.34 × 10²⁸) particles in 2016, thus being of the same magnitude with total anthropogenic PN emissions in continental areas. The reduction potential of PN from shipping strongly depends on the adopted technology mix, and except wide adoption of natural gas or scrubbers, no significant decrease in global PN is expected if heavy fuel oil is mainly replaced by low sulfur residual fuels. The results imply that shipping remains as a significant source of anthropogenic PN emissions that should be considered in future climate and health impact models.

The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density

The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. In older women, TUG time predicts the risk of major osteoporotic fracture and hip fracture independently of clinical risk factors and bone mineral density, and has a substantial impact on fracture probabilities.

INTRODUCTION

The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. A slow TUG has been associated with an increased fracture risk, but it is unclear whether the association is independent of clinical risk factors and bone mineral density (BMD). The aim of this study was to investigate if TUG time was associated with fracture risk independently of clinical risk factors and BMD and to determine its impact on fracture probabilities in older women.

METHODS

A standardized questionnaire was used to assess information regarding clinical risk factors in the large population-based SUPERB study of 3028 older women (75-80 years). At baseline, the TUG test was performed and BMD measured with DXA. The association between TUG time and the risk of hip fracture and major osteoporotic fracture (MOF) was examined using an extension of Poisson regression.

RESULTS

Fracture incidence increased steeply with increasing TUG time up to 12 s and subsequently started to level off. A slow TUG time was therefore defined as TUG > 12 s, a cutoff level then used in Cox models to study the association between slow TUG and fracture risk. A slow TUG time was associated with an increased risk of fracture (MOF 2.39 [1.80-3.18] and hip fracture 2.96 [1.62-5.40]). These associations were slightly attenuated but remained significant after adjustment for clinical risk factors and femoral neck BMD. Depending on BMD, the 4-year fracture probability of MOF increased by a factor of 1.5-1.9 in a 75-year-old woman with slow TUG (> 12 s).

CONCLUSION

The TUG time predicts the risk of MOF and hip fracture independently of clinical risk factors and BMD and has a substantial impact on fracture probabilities, indicating that inclusion of the TUG test in patient evaluation should be considered in order to improve fracture prediction in older women.

Association between inflammasome-related polymorphisms and psoriatic arthritis

Objective: Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease associated with psoriasis. Underlying genetic factors are considered important for disease expression and prognosis of PsA. Interleukin-1β-regulating protein complexes called inflammasomes are associated with several inflammatory diseases, e.g. rheumatoid arthritis and psoriasis. The aim was to determine whether inflammasome-related genetic variation is associated with PsA susceptibility or different disease phenotypes.Method: DNA from 724 patients with PsA and 587 population-based controls from northern Sweden was analysed for single-nucleotide polymorphisms in NLRP3-Q750K (rs35829419), NLRP3 (rs10733113), CARD8-C10X (rs2043211), NLRP1 (rs8079034), and NLRP1 (rs878329).Results: Significant associations were found with the genotype AA (vs AT+TT) of rs2043211 for PsA patients compared with controls [odds ratio (OR), 95% confidence interval (CI) 1.32 (1.05-1.65), p = 0.016]; and between the C-allele of rs878329 and axial involvement of PsA [OR (95% CI) 1.37 (1.02-1.84), p = 0.035], the T-allele of rs8079034 with prescription of conventional synthetic disease-modifying anti-rheumatic drugs [OR (95% CI) 1.76 (1.23-2.53), p = 0.0020], the G-allele of rs10733113 and patients with a skin disease with early onset [OR (95% CI) 1.58 (1.13-2.21), p = 0.007], and the C-allele of rs35829419 and a destructive/deforming disease [OR (95% CI) 1.63 (1.04-2.55), p = 0.030].Conclusions: This study is the first to show an association with a genetic polymorphism in an inflammasome-related gene, CARD8-C10X (rs2043211), in patients with PsA. Associations between different phenotypes of PsA and different polymorphisms of the inflammasome genes were also found. Our results indicate the involvement of inflammasome genes in the pathogenesis and disease expression of PsA.

Atrial fibrillation risk factor burden and disease onset across age decades

Background

Although a number of risk factors have been associated with the progression of atrial fibrillation (AF), there is limited knowledge of their relevance for AF in relation to age.

Purpose

We examined whether the association between modifiable risk factors and AF differed between age decades.

Methods

Data were derived from five European cohorts from Denmark, Finland, Italy, Sweden, and Norway. In total, 66 951 individuals (49.1% men) aged ≥40 years (mean baseline age 53.5 years) and without prevalent AF were followed for incident AF, with the follow-up truncated at 10 years. Data on risk factors (body mass index [BMI], hypertension [systolic blood pressure ≥140 mmHg and/or use of antihypertensive medication], diabetes mellitus, myocardial infarction [MI] event before baseline examinations, daily smoking, and alcohol consumption) were available from the baseline examinations. Stratification into age decades was based on age at baseline examination. Furthermore, the participants were followed for events of stroke or mortality after AF diagnosis. Mortality, stroke, and AF outcomes were derived from national registers and hospital discharge registers. All analyses were adjusted for AF risk factors.

Results

The incidence of AF increased from 0.9 per 1000 person-years at the age of 40 to &lt;50, to 17.7 at the age of ≥70 years. Multivariable-adjusted Cox models showed that BMI, hypertension, alcohol consumption, and history of MI were associated with increased risk of AF across age decades (p&lt;0.05). Of these, the risk of AF associated with BMI and an MI event before baseline examinations differed across age decades. For each 5 units increase in BMI, risk of AF increased with 40% (95% confidence interval 17–68%) at the age of 40 to &lt;50, falling to 17% (6–29%) at the age of ≥70 years (p=0.08 for difference between age decades 40 to &lt;50 and ≥70). Participants with a history of MI showed decreased risk of AF with ageing, from a hazard ratio (HR) of 5.53 (2.85–10.73) in the 40 to &lt;50 age group to a HR of 1.41 (1.11–1.79) at the age of ≥70 (p&lt;0.001). Daily smoking and prevalent diabetes mellitus were in general not associated with AF. The multivariable-adjusted associations between new-onset AF and the succeeding risk of stroke and mortality increased with age, showing a 1.6 to 2.6-fold increase in risk of death at ages ≥60 years and two-fold increased risk of stroke in participants aged ≥70 years (p≤0.001).

Conclusion

The relative importance of modifiable risk factors on incident AF do not vary across age decades, with a few exceptions; BMI and a history of MI were stronger risk factors for AF at younger ages. Thus, preventive measures should target risk factors rigorously, in particular obesity. New-onset AF was associated with increased risk of stroke and mortality only at older ages, emphasizing the importance of adequate patient management in the older and oldest old.

Funding Acknowledgement

Type of funding source: None

SAT0590 ORAL MICROBIOTA IDENTIFIES PATIENTS WITH EARLY RHEUMATOID ARTHRITIS

Background:

Several studies have suggested a link between the two chronic inflammatory diseases, rheumatoid arthritis (RA) and periodontitis (PD) [1]. The diseases share similar environmental and genetic risks factors,e.g.,smoking [2] and the HLA-DRB1 alleles [3]. Several serum markers used in the diagnosis of RA have also been found to be elevated in PD,e.g.,anti-citrullinated proteins antibodies (ACPA) and rheumatoid factor (RF) [4]. The connection between PD and RA has been suggested to be explained by several periodontal pathogens,e.g., Aggregatibacter actinomycetemcomitansandPorphyromonas gingivalis, which have been suggested to induce the production of autoantibodies [5, 6].

Objectives:

To investigate the composition of the concerted saliva microbiota and its role in the development of RA, with the aim of improving the diagnostic tools.

Methods:

16S ribosomal RNA gene sequencing of saliva bacterial DNA isolated from a total of 61 early RA (eRA) patients and 59 healthy controls was made. The eRA (symptoms ≤ 12 months) was diagnosed at an Early Arthritis Clinic (fulfilling the 1987 ARA criteria) and matched with the controls for sex and age, except for two of the elderly cases. None of the individuals included in the study had taken antibiotics during the preceding 3 months. No one of the cases were treated with anti-rheumatic drugs except for corticosteroids in 16 cases the latest month.

Results:

All participants were classified into three hierarchical cluster groups based on their saliva microbiota and the distribution of eRA cases versus controls differed distinctly between the cluster groups. The microbiota from the eRA had higher species richness, differed in beta-diversity, and was enriched for species in the Fusobacterium and Porphyromonas genera, and for the Alloprevotella tannerae, Campylobacter gracilis, Capnocytophaga leadbetteri, Filifactor alocis, Fusobacterium nucleatum subsp. polymorphum, Neisseria elongate, Porphyromionas endodontalis and Prevotella pleuritidis species compared to controls. Combining two topped ranked species,A. tanneraeandCatonella morbisignificantly predicted eRA with an AUC score of 0.86 and a specificity and sensitivity of 0.80 and 0.85, respectively.

The predicted functions of the microbiota in eRA patients were dominated by fatty acid metabolism, ornithine metabolism, glucosylceramidase, sphingolipids, beta-lactamase resistance, biphenyl degradation and 17-beta-estradiol 17-dehydrogenase metabolism.

Conclusion:

In this study a difference in oral microbiota diversity between eRA patients and healthy controls could be shown. Some of the eRA-associated oral bacteria have previously been suggested to play an aetiological role in the development of RA, but others have not been recognized earlier, such as A. tannerae, F. alocis, F. nucleatum subsp. polymorphum, and P. endodontalis, and may therefore be useful in RA risk assessment.

References:

[1]Fuggle, N.R., et al.,Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis.Front Immunol, 2016. 7: p. 80.

[2]Heliovaara, M., et al.,Smoking and risk of rheumatoid arthritis.J Rheumatol, 1993. 20(11): p. 1830-5.

[3]Katz, J., et al.,Human leukocyte antigen (HLA) DR4. Positive association with rapidly progressing periodontitis.J Periodontol, 1987. 58(9): p. 607-10.

[4]Mikuls, T.R., et al.,Periodontitis and Porphyromonas gingivalis in patients with rheumatoid arthritis.Arthritis Rheumatol, 2014. 66(5): p. 1090-100.

[5]Konig, M.F., et al.,Aggregatibacter actinomycetemcomitans-induced hypercitrullination links periodontal infection to autoimmunity in rheumatoid arthritis.Sci Transl Med, 2016. 8(369): p. 369ra176.

[6]Rosenstein, E.D., et al.,Hypothesis: the humoral immune response to oral bacteria provides a stimulus for the development of rheumatoid arthritis.Inflammation, 2004. 28(6): p. 311-8.

Disclosure of Interests:

None declared

Environmental impacts of grey water discharge from ships in the Baltic Sea

Discharge of grey water from ships is today unregulated in most sea areas, including the Baltic Sea. Annually, an estimated 5.5 million m³ grey water is emitted to the Baltic Sea with largest contribution from RoPax (4.25 million m³) and cruise ships (0.65 million m³). In total 44 different contaminants in grey water was identified and sorted into the sub categories organic compounds (28) and metals (16). Zinc and copper had the highest average concentrations with yearly inputs of 2.8 tons (zinc) and 1.5 tons (copper). 159 tons of nitrogen and 26.4 tons of phosphorus were estimated to be discharged to the Baltic Sea annually. An environmental risk assessment of contaminants, performed at a shipping lane in the Baltic Sea, showed the risk for adverse effects from grey water to be low. Nitrogen and phosphorus input from grey water contributes to 0.25% of the exceedance of, for the Baltic Sea set, eutrophication target.

Irreversible TrxR1 inhibitors block STAT3 activity and induce cancer cell death

Because of its key role in cancer development and progression, STAT3 has become an attractive target for developing new cancer therapeutics. While several STAT3 inhibitors have progressed to advanced stages of development, their underlying biology and mechanisms of action are often more complex than would be expected from specific binding to STAT3. Here, we have identified and optimized a series of compounds that block STAT3-dependent luciferase expression with nanomolar potency. Unexpectedly, our lead compounds did not bind to cellular STAT3 but to another prominent anticancer drug target, TrxR1. We further identified that TrxR1 inhibition induced Prx2 and STAT3 oxidation, which subsequently blocked STAT3-dependent transcription. Moreover, previously identified inhibitors of STAT3 were also found to inhibit TrxR1, and likewise, established TrxR1 inhibitors block STAT3-dependent transcriptional activity. These results provide new insights into the complexities of STAT3 redox regulation while highlighting a novel mechanism to block aberrant STAT3 signaling in cancer cells.

Decreased physical health-related quality of life-a persisting state for older women with clinical vertebral fracture

In a population-based study of older Swedish women, we investigated if clinical vertebral fracture was associated with lower health-related quality of life (HRQoL) and determined whether the association remained over time. Clinical vertebral fracture was associated with lower HRQoL and the effect persisted for up to 18.9 years.

INTRODUCTION

Vertebral fractures are often associated with back pain and reduced physical function, which might result in isolation and depression. As a result, women with vertebral fractures often have lower health-related quality of life (HRQoL), but during what time frame the decrease lingers is unclear. Therefore, the aim of this study was to investigate if clinical vertebral fracture and hip fracture were associated with lower HRQoL and to determine whether the associations remained over time.

METHODS

Vertebral fracture assessments (VFA) were performed using dual-energy X-ray absorptiometry. Data regarding prior fractures, medications, medical history, and physical activity was collected using a questionnaire. Self-rated physical HRQoL was assessed using the 12-Item Short-Form Health Survey (SF-12). Women with clinical vertebral fractures were divided into tertiles according to time since fracture onset and their HRQoL was compared with non-fractured women.

RESULTS

In a population-based cross-sectional study of 3028 women aged 77.8 ± 1.63 (mean ± SD), a total of 130 (4.3%) women reported at least one clinical vertebral fracture. Women with a clinical vertebral fracture, divided into tertiles (T1-T3) depending on time since the fracture occurred, had lower HRQoL (T1: 36.3 ± 10.8; T2: 41.0 ± 9.94; and T3:41.6 ± 11.4) than women without fracture (46.2 ± 10.6; p < 0.001). Using linear regression analysis, clinical vertebral fracture was associated with reduced physical HRQoL for up to 18.9 years, independently of covariates (age, height, weight, smoking, prior stroke, mental HRQoL, grip strength, and lumbar spine BMD).

CONCLUSIONS

Clinical vertebral fracture was associated with lower self-rated physical HRQoL, for up to 18.9 years after time of fracture.

Effect of ship emissions on O3 in the Yangtze River Delta region of China: Analysis of WRF-Chem modeling

The Yangtze River Delta (YRD) region locates on the eastern coast of China, and it has suffered severe O₃ pollutions due to high and mixed emissions of air pollutants. There are 3 different emission sectors for O₃ precursors in the region, including anthropogenic VOC_S and NO_X emissions, ship emissions (mainly NO_X), and biogenic emissions from a large forest (biogenic VOC_S). This unique emission mixture produces complicated chemical processes in studying the O₃ pollutions in the region. This study aims to identify the contribution of the ship emissions to O₃ pollutions, as well as the effect of mixing emissions on O₃ pollutions in YRD. To identify the individual emission effect, the WRF-Chem model is used in this study. The model generally performs well in simulating meteorological parameters and air pollutants against observations in YRD. Sensitive study suggests that the ship emissions have important effects on the O₃ concentrations over ocean and inland, with a maximum increase of 30-50 μg m^-3 occurred mainly in the ship track regions. However, the ship emissions have a very complicated effect on the in-land O₃ concentrations. In the north of Shanghai, the NO_X concentrations are high due to high anthropogenic emissions, and a further increase in NO_X emissions from ship results in depressing O₃ chemical production. In contrast, in the south of Shanghai, there are high biogenic VOC emissions (mainly isoprene) and low NOx concentrations. As a result, the O₃ concentrations are enhanced by 30-50 μg m^-3, due to the mixing between ship and forest emissions. This study suggests that ship emissions play important roles in controlling O₃ pollutions in YRD. Furthermore, the mixing emissions between ship, anthropogenic, and biogenic emissions in YRD produce a complicated O₃ chemical production and need to be carefully considered in controlling strategy of O₃ pollution in the region.

Shipborne nutrient dynamics and impact on the eutrophication in the Baltic Sea

The Baltic Sea is a severely eutrophicated sea-area where intense shipping as an additional nutrient source is a potential contributor to changes in the ecosystem. The impact of the two most important shipborne nutrients, nitrogen and phosphorus, on the overall nutrient-phytoplankton-oxygen dynamics in the Baltic Sea was determined by using the coupled physical and biogeochemical model system General Estuarine Transport Model-Ecological Regional Ocean Model (GETM-ERGOM) in a cascade with the Ship Traffic Emission Assessment Model (STEAM) and the Community Multiscale Air Quality (CMAQ) model. We compared two nutrient scenarios in the Baltic Sea: with (SHIP) and without nutrient input from ships (NOSHIP). The model uses the combined nutrient input from shipping-related waste streams and atmospheric depositions originating from the ship emission and calculates the effect of excess nutrients on the overall biogeochemical cycle, primary production, detritus formation and nutrient flows. The shipping contribution is about 0.3% of the total phosphorus and 1.25-3.3% of the total nitrogen input to the Baltic Sea, but their impact to the different biogeochemical variables is up to 10%. Excess nitrogen entering the N-limited system of the Baltic Sea slightly alters certain pathways: cyanobacteria growth is compromised due to extra nitrogen available for other functional groups while the biomass of diatoms and especially flagellates increases due to the excess of the limiting nutrient. In terms of the Baltic Sea ecosystem functioning, continuous input of ship-borne nitrogen is compensated by steady decrease of nitrogen fixation and increase of denitrification, which results in stationary level of total nitrogen content in the water. Ship-borne phosphorus input results in a decrease of phosphate content in the water and increase of phosphorus binding to sediments. Oxygen content in the water decreases, but reaches stationary state eventually.

Cleaner fuels for ships provide public health benefits with climate tradeoffs

We evaluate public health and climate impacts of low-sulphur fuels in global shipping. Using high-resolution emissions inventories, integrated atmospheric models, and health risk functions, we assess ship-related PM_2.5 pollution impacts in 2020 with and without the use of low-sulphur fuels. Cleaner marine fuels will reduce ship-related premature mortality and morbidity by 34 and 54%, respectively, representing a ~ 2.6% global reduction in PM_2.5 cardiovascular and lung cancer deaths and a ~3.6% global reduction in childhood asthma. Despite these reductions, low-sulphur marine fuels will still account for ~250k deaths and ~6.4 M childhood asthma cases annually, and more stringent standards beyond 2020 may provide additional health benefits. Lower sulphur fuels also reduce radiative cooling from ship aerosols by ~80%, equating to a ~3% increase in current estimates of total anthropogenic forcing. Therefore, stronger international shipping policies may need to achieve climate and health targets by jointly reducing greenhouse gases and air pollution.

Cleaner fuels for ships provide public health benefits with climate tradeoffs

We evaluate public health and climate impacts of low-sulphur fuels in global shipping. Using high-resolution emissions inventories, integrated atmospheric models, and health risk functions, we assess ship-related PM2.5 pollution impacts in 2020 with and without the use of low-sulphur fuels. Cleaner marine fuels will reduce ship-related premature mortality and morbidity by 34 and 54%, respectively, representing a ~ 2.6% global reduction in PM2.5 cardiovascular and lung cancer deaths and a ~3.6% global reduction in childhood asthma. Despite these reductions, low-sulphur marine fuels will still account for ~250k deaths and ~6.4 M childhood asthma cases annually, and more stringent standards beyond 2020 may provide additional health benefits. Lower sulphur fuels also reduce radiative cooling from ship aerosols by ~80%, equating to a ~3% increase in current estimates of total anthropogenic forcing. Therefore, stronger international shipping policies may need to achieve climate and health targets by jointly reducing greenhouse gases and air pollution.

Risk assessment of bilge water discharges in two Baltic shipping lanes

Environmental concentrations and effects of bilge water contaminants in two Baltic Sea areas were estimated from modelling of discharge rates and analytical data on bilge water from seven ships. Biodegradation of bilge water oil was accounted for and annual water concentrations were estimated to peak in late spring, which coincides with the beginning of a period with extensive biological activities in the sea. Concentrations on bilge water metals were calculated both as water concentrations and as the annual contribution of metals to sediments. The predicted bilge water concentrations of oil and metal in the marine environment were estimated to be 4 to 8 orders of magnitude lower than reported toxic concentrations. However, available toxicity data are based on short term exposure and there is to date limited information on toxic effects of the small but chronically elevated contaminant concentrations derived from bilge water discharge and other operational shipping activities.

Increased cortical porosity in women with hip fracture

BACKGROUND

Hip fractures cause increased mortality and disability and consume enormous healthcare resources. Only 46% of hip fracture patients have osteoporosis at the total hip according to dual-energy X-ray absorptiometry (DXA) measurement. Cortical porosity increases with ageing and is believed to be important for bone strength.

OBJECTIVE

To investigate whether older women with hip fracture have higher cortical porosity than controls, and if so whether this difference is independent of clinical risk factors and areal bone mineral density (aBMD).

METHODS

From an ongoing population-based study, we identified 46 women with a prevalent X-ray-verified hip fracture and 361 control subjects without any fractures. aBMD was measured with DXA. High-resolution peripheral quantitative computed tomography was used to measure bone microstructure at the standard (ultradistal) site and at 14% (distal) of the tibial length.

RESULTS

Women with a previous hip fracture had lower aBMD at the femoral neck (-11.8%) and total hip (-14.6%) as well as higher cortical porosity at the ultradistal (32.1%) and distal (29.3%) tibia compared with controls. In multivariable logistic regression analysis, with adjustment for covariates (age, height, weight, smoking, calcium intake, physical activity, walk time, oral glucocorticoids, parental hip fracture, rheumatoid arthritis, previous fall, current bisphosphonate treatment and femoral neck aBMD), cortical porosity at the ultradistal [odds ratio per standard deviation increase (95% confidence interval) 2.61 (1.77-3.85)] and distal [1.57 (1.12-2.20)] sites was associated with prevalent hip fracture.

CONCLUSION

Cortical porosity was associated with prevalent hip fracture in older women independently of femoral neck aBMD and clinical risk factors.

Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program

OBJECTIVE

The aim of the study was to investigate the outcome of change in body weight associated with use of a structured preventive care process among persons with dementia assessed as at risk of malnutrition or malnourished. The preventive care process is a pedagogical model used in the Senior Alert (SA) quality register, where nutrition is one of the prioritized areas and includes four steps: assessment, analysis of underlying causes, actions performed and outcome.

DESIGN

An analysis of data from SA with a pre-post design was performed.

SETTING

The participants were living in ordinary housing or special housing in Sweden.

PARTICIPANTS

1912 persons, 65 years and older, registered in both SA and the dementia quality register Svedem were included.

INTERVENTION

A national preventive care program including individualized actions.

MEASUREMENTS

The Mini Nutritional Assessment-Short Form was used to assess nutritional status at baseline. Body weight was measured during baseline and follow-up (7-106 days after baseline).

RESULTS

74.3% persons were malnourished or at risk of malnutrition. Those at risk of malnutrition or malnourished who were registered in all four steps of the preventive care process, increased in body weight from baseline (Md 60.0 kg) to follow-up (Md 62.0 kg) (p=0.013). In those with incomplete registration no increase in body weight was found.

CONCLUSION

Using all steps in the structured preventive care process seems to improve nutritional status of persons with dementia assessed as at risk of malnutrition or malnourished. This study contributes to the development of evidence-based practice regarding malnutrition and persons with dementia.

Costs and benefits of low-sulphur fuel standard for Baltic Sea shipping

The maximum allowable fuel sulphur content for shipping in the Baltic Sea dropped from 1%S to 0.1%S in 1 January 2015. We provide a cost-benefit analysis of the sulphur reduction policy in the Baltic Sea Sulphur Emission Control Area (SECA). We calculated the abatement costs based on shipowners' optimal decision-making in choosing between low-sulphur fuel and a sulphur scrubber, and the benefits were modelled through a high-resolution impact pathway analysis, which took into account the formation and dispersion of the emissions, and considered the positive health impacts resulting from lowered ambient PM_2.5 concentrations. Our basic result indicates that for the Baltic Sea only, the latest sulphur regulation is not cost-effective. The expected annual cost is roughly €465 M and benefit 2200 saved Disability Adjusted Life-Years (DALYs) or monetized €105 M. Based on our sensitivity analysis, the benefits yet have a potential to exceed the costs. The analysis neither takes into account the acidifying impact of sulphur nor the impact North Sea shipping has on the cost-benefit ratio. Lastly, a similar approach is found highly recommendable to study the implications of the upcoming Tier III NO_x standard for shipping.

Combinations of nonlabeled, 125I-Labeled, and Anti-Idiotypic Antiplacental Alkaline Phosphatase Monoclonal Antibodies at Experimental Radioimmunotargeting

Purpose: Placental alkaline phosphatase (PLAP) is a membrane-bound oncofetal antigen that can be used for radioimmunotargeting. Preinjection of nonlabeled monoclonal anti-PLAP antibody (H7) and postinjection of monoclonal anti-idiotypic anti-PLAP antibody (αPH7) were used in order to improve the localization efficacy of 125I-labeled H7

Material and Methods: A human cervix adenocarcinoma cell line (HeLa Hep 2) was inoculated subcutaneously in 24 nude mice. Repeated quantitative radioimmunoscintigraphic recordings were performed on 27 occasions in each of the 24 mice during the observation period which lasted for nearly 3 months. the tumor and nontumor doses were calculated according to the Medical International Radiation Dose Committee formula on the basis of the scintigraphic data

Results: All tumors were clearly visualized as early as one day after injection of 125I-labeled H7. the remaining radioactivity was exclusively located in the tumors at days 30–81. as much as 12–16% of the injected dose/g accumulated in the tumors during the first 2 days after injection, and remained stable at this high level for approximately 10 days in all investigated groups. Radioactivity in the whole body was rapidly eliminated during the same time period. the highest tumor/nontumor dose ratio was obtained after a single injection of 125I-labeled H7

Conclusion: Neither a preinjection of nonlabeled H7 nor a postinjection of αPH7 nor a combination of both strategies resulted in improved tumor/nontumor dose ratios compared to a single injection of labeled H7. the monoclonal antibody H7 has a rapid and high uptake, combined with a prolonged retention time in the tumors. the kinetic properties of H7 are different from antibodies targeting intracellular tumor antigens

Distribution of Renal Scars and Intrarenal Reflux in Children with a Past History of Urinary Tract Infection

The distribution of renal scars in children with vesicoureteral reflux (VUR) and a past history of urinary tract infection was studied to see whether a correlation existed between renal scarring and intrarenal reflux. In 37 children with one or more scars in one or both kidneys, scarring was significantly more frequent in the polar areas than in the lateral area. In 7 children with intrarenal reflux (IRR), the distribution of IRR was almost identical with that of renal scarring. When children with marked VUR (grade IV-V) were analyzed separately, a uniform distribution of scars was found. It was concluded that fused papillae, which normally are most frequent in the polar area, are a prerequisite for the development of IRR/renal scars.

Bone material strength is associated with areal BMD but not with prevalent fractures in older women

Reference point indentation is a novel method to assess bone material strength index (BMSi) in vivo. We found that BMSi at the mid-tibia was weakly associated with spine and hip areal bone mineral density but not with prevalent fracture in a population-based cohort of 211 older women.

INTRODUCTION

Reference point indentation is a novel method to assess BMSi in vivo. Lower BMSi has been observed in patients with prior fracture than in controls, but no association between BMSi and areal bone mineral density (aBMD) has been found. Population-based association studies and prospective studies with BMSi and fractures are lacking. We hypothesized that BMSi would be associated with prevalent fractures in older Swedish women. The aim was to investigate the associations between BMSi, aBMD, and prevalent fracture in older women.

METHODS

Two hundred eleven women, mean age 78.3 ± 1.1 years, were included in this cross-sectional, population-based study. BMSi was assessed using the OsteoProbe device at the mid-tibia. Areal BMD of the hip, spine, and non-dominant radius was measured using dual-energy X-ray absorptiometry (DXA). Fracture history was retrieved using questionnaires, and vertebral fractures were identified using vertebral fracture assessment (VFA) by DXA.

RESULTS

One hundred ninety-eight previous fractures in 109 subjects were reported. A total of 106 women had a vertebral fracture, of which 58 women had moderate or severe fractures. An inverse correlation between BMSi and weight (r = -0.14, p = 0.04) was seen, and BMSi differed according to operator (ANOVA p < 0.01). Adjusting for weight and operator in a linear regression model, we found that BMSi was positively associated with aBMD of the total hip (β = 0.14, p = 0.04), non-dominant radius (β = 0.17, p = 0.02), and lumbar spine (L1-L4) (β = 0.14, p < 0.05). Using logistic regression, we could not find any association in crude or adjusted BMSi (for age, weight, height, walking speed, calcium intake, smoking, bisphosphonate and glucocorticoid use, and operator) with prevalent fractures.

CONCLUSION

We conclude that BMSi is associated with aBMD but not with prevalent fracture in a population-based cohort of 211 older women.

Comparison of (18)F activity measurements at the VNIIM, NPL and the ENEA-INMRI using the SIRTI of the BIPM

In 2014, the first three comparisons of activity measurements of (18)F were carried out at the VNIIM, NPL and the ENEA-INMRI using the BIPM's Transfer Instrument of the International Reference System. The transfer instrument and the NMIs primary measurement methods are briefly described. The degrees of equivalence with the key comparison reference value defined in the frame of the corresponding SIR comparison have been evaluated. World-wide consistency of activity measurements of (18)F is demonstrated.

The Swedish CArdioPulmonary BioImage Study: objectives and design

Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.

Radiation Dose to Patients from Radiopharmaceuticals: a Compendium of Current Information Related to Frequently Used Substances

This report provides a compendium of current information relating to radiation dose to patients, including biokinetic models, biokinetic data, dose coefficients for organ and tissue absorbed doses, and effective dose for major radiopharmaceuticals based on the radiation protection guidance given in Publication 60(ICRP, 1991). These data were mainly compiled from Publications 53, 80, and 106(ICRP, 1987, 1998, 2008), and related amendments and corrections. This report also includes new information for 82Rb-chloride, iodide (123I, 124I, 125I, and 131I) and 123I labeled 2ß-carbomethoxy 3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (FPCIT).The coefficients tabulated in this publication will be superseded in due course by values calculated using new International Commission on Radiation Units and Measurements/International Commission on Radiological Protection adult and paediatric reference phantoms and Publication 103 methodology (ICRP,2007). The data presented in this report are intended for diagnostic nuclear medicine and not for therapeutic applications.

Synthesis and biological evaluation of [¹¹C]AZ12504948; a novel tracer for imaging of glucokinase in pancreas and liver

INTRODUCTION

Glucokinase (GK) is potentially a target for imaging of islets of Langerhans. Here we report the radiosynthesis and preclinical evaluation of the GK activator, [(11)C]AZ12504948, for in vivo imaging of GK.

METHODS

[(11)C]AZ12504948 was synthesized by O-methylation of the precursor, AZ125555620, using carbon-11 methyl iodide ([(11)C]CH₃I). Preclinical evaluation was performed by autoradiography (ARG) of human tissues and PET/CT studies in pig and non-human primate.

RESULT

[(11)C]AZ12504948 was produced in reproducible good radiochemical yield in 28-30 min. Radiochemical purity of the formulated product was >98% for up to 2 h with specific radioactivities 855 ± 209 GBq/μmol (n=8). The preclinical evaluation showed some specificity for GK in liver, but not in pancreas.

CONCLUSION

[(11)C]AZ12504948 images GK in liver, but the low specificity impedes the visualization of GK in pancreas. Improved target specificity is required for further progress using PET probes based on this class of GK activators.

An internal radiation dosimetry computer program, IDAC 2.0, for estimation of patient doses from radiopharmaceuticals

The internal dosimetry computer program internal dose assessment by computer (IDAC) for calculations of absorbed doses to organs and tissues as well as effective doses to patients from examinations with radiopharmaceuticals has been developed. The new version, IDAC2.0, incorporates the International Commission on Radiation Protection (ICRP)/ICRU computational adult male and female voxel phantoms and decay data from the ICRP publication 107. Instead of only 25 source and target regions, calculation can now be made with 63 source regions to 73 target regions. The major advantage of having the new phantom is that the calculations of the effective doses can be made with the latest tissue weighting factors of ICRP publication 103. IDAC2.0 uses the ICRP human alimentary tract (HAT) model for orally administrated activity and for excretion through the gastrointestinal tract and effective doses have been recalculated for radiopharmaceuticals that are orally administered. The results of the program are consistent with published data using the same specific absorption fractions and also compared with published data from the same computational phantoms but with segmentation of organs leading to another set of specific absorption fractions. The effective dose is recalculated for all the 34 radiopharmaceuticals that are administered orally and has been published by the ICRP. Using the new HAT model, new tissue weighting factors and the new adult computational voxel phantoms lead to an average effective dose of half of its earlier estimated value. The reduction mainly depends on electron transport simulations to walled organs and the transition from the stylised phantom with unrealistic interorgan distances to more realistic voxel phantoms.

Word-level intelligibility after caudal zona incerta stimulation for Parkinson's disease

OBJECTIVES

To investigate the effect of caudal zona incerta-deep brain stimulation (cZi-DBS) on word-level speech intelligibility in patients with Parkinson's disease, under both an optimal listening condition and a simulated more naturalistic listening condition.

MATERIALS AND METHODS

Spoken single words were extracted from read samples collected from 10 bilaterally implanted patients with PD pre- and post-cZi-DBS. Intelligibility was assessed through a transcription task performed by 32 naive listeners under two listening conditions: (i) with low-amplitude conversational speech added as background and (ii) with no added background noise. The listeners' responses were scored in terms of agreement with the intended words.

RESULTS

Post-operatively, the total intelligibility score was significantly lower when cZi stimulation was switched on compared with off, for both listening conditions (with and without added background noise). Intelligibility was also significantly lower on stimulation compared with preoperative recordings, but only when assessed in the listening condition without background noise. The listening condition with added background noise resulted in significantly lower intelligibility scores compared with the no added noise condition for all stimulation conditions.

CONCLUSIONS

The results of this study indicate that cZi-DBS in patients with PD can be detrimental to word-level speech intelligibility.