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- Marini, S., et al.
(författare)
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Association of Apolipoprotein E With Intracerebral Hemorrhage Risk by Race/Ethnicity A Meta-analysis
- 2019
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Ingår i: Jama Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 76:4, s. 480-491
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Genetic studies of intracerebral hemorrhage (ICH) have focused mainly on white participants, but genetic risk may vary or could be concealed by differing nongenetic coexposures in nonwhite populations. Transethnic analysis of risk may clarify the role of genetics in ICH risk across populations. OBJECTIVE To evaluate associations between established differences in ICH risk by race/ethnicity and the variability in the risks of apolipoprotein E (APOE) epsilon 4 alleles, the most potent genetic risk factor for ICH. DESIGN, SETTING, AND PARTICIPANTS This case-control study of primary ICH meta-analyzed the association of APOE allele status on ICH risk, applying a 2-stage clustering approach based on race/ethnicity and stratified by a contributing study. A propensity score analysis was used to model the association of APOE with the burden of hypertension across race/ethnic groups. Primary ICH cases and controls were collected from 3 hospital- and population-based studies in the United States and 8 in European sites in the International Stroke Genetic Consortium. Participants were enrolled from January 1, 1999, to December 31, 2017. Participants with secondary causes of ICH were excluded from enrollment. Controls were regionally matched within each participating study. MAIN OUTCOMES AND MEASURES Clinical variables were systematically obtained from structured interviews within each site. APOE genotype was centrally determined for all studies. RESULTS In total, 13 124 participants (7153 [54.5%] male with a median [interquartile range] age of 66 [56-76] years) were included. In white participants, APOE epsilon 2 (odds ratio [OR], 1.49; 95% CI, 1.24-1.80; P < .001) and APOE epsilon 4 (OR, 1.51; 95% CI, 1.23-1.85; P < .001) were associated with lobar ICH risk; however, within self-identified Hispanic and black participants, no associations were found. After propensity score matching for hypertension burden, APOE epsilon 4 was associated with lobar ICH risk among Hispanic (OR, 1.14; 95% CI, 1.03-1.28; P = .01) but not in black (OR, 1.02; 95% CI, 0.98-1.07; P = .25) participants. APOE epsilon 2 and epsilon 4 did not show an association with nonlobar ICH risk in any race/ethnicity. CONCLUSIONS AND RELEVANCE APOE epsilon 4 and epsilon 2 alleles appear to affect lobar ICH risk variably by race/ethnicity, associations that are confirmed in white individuals but can be shown in Hispanic individuals only when the excess burden of hypertension is propensity score-matched; further studies are needed to explore the interactions between APOE alleles and environmental exposures that vary by race/ethnicity in representative populations at risk for ICH.
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| 2. |
- Mondejar, Maria E., et al.
(författare)
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Power generation from low heat sources
- 2014
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Ingår i: Advances in Energy Research and Development. - 9780989559010 ; , s. 49-82
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Bokkapitel (refereegranskat)abstract
- In this chapter a thorough review of the latest research findings on power generation from non-conventional low heat sources is presented. Main discoveries and results of research works ranging from source exploitation technologies to final power production are reported and discussed to offer an overview of their potential. Firstly the concept of low-grade source is presented and the main energy sources in this group (i.e. geothermal energy, solar thermal systems, industrial waste heat and ocean thermal energy) are introduced. Each of them is briefly described and the latest developments and improvements on the technologies for their exploitation are enumerated. Afterwards the state-of-the-art available power cycles for the conversion of low heat into electricity are reported. Only thermal power conversion technologies are presented due to their higher presence in commercial applications and their potential for small scale power generation. Among these technologies, last findings and results on organic Rankine cycles (ORC) and power cycles based on working fluid mixtures (e.g. Kalina cycle) are described. A special emphasis is placed on organic Rankine cycles (ORC) since over the last few years this technology has experienced a significant global growth, boosted by their viable performance and the inherited knowledge from the refrigeration industry. In addition, the suitability of less known technologies such as Stirling cycles and their current development status and perspectives are also commented. After this review it follows an examination of the implementation of these technologies in present power production systems. Discussion will be provided on which are the current barriers that the mentioned technologies are facing for their introduction or during their operation. On the other hand, practical restrictions concerning the availability of suitable technology, environmental requirements or economic viability are stated. Limitations regarding thermodynamic and technological aspects, as well as operational concerns will be considered of special interest. In the final section we deal with the future scenario for the integration of small-scale power generation. Potential solutions for overcoming technology development barriers are presented and directions of current research works on this topic are pointed out.
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