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- Kaptoge, S., et al.
(författare)
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C-Reactive Protein, Fibrinogen, and Cardiovascular Disease Prediction
- 2012
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 367:14, s. 1310-1320
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Tidskriftsartikel (refereegranskat)abstract
- Background There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. Methods We analyzed data from 52 prospective studies that included 246,669 participants without a history of cardiovascular disease to investigate the value of adding CRP or fibrinogen levels to conventional risk factors for the prediction of cardiovascular risk. We calculated measures of discrimination and reclassification during follow-up and modeled the clinical implications of initiation of statin therapy after the assessment of CRP or fibrinogen. Results The addition of information on high-density lipoprotein cholesterol to a prognostic model for cardiovascular disease that included age, sex, smoking status, blood pressure, history of diabetes, and total cholesterol level increased the C-index, a measure of risk discrimination, by 0.0050. The further addition to this model of information on CRP or fibrinogen increased the C-index by 0.0039 and 0.0027, respectively (P < 0.001), and yielded a net reclassification improvement of 1.52% and 0.83%, respectively, for the predicted 10-year risk categories of "low" (< 10%), " intermediate" (10% to < 20%), and "high" (>= 20%) (P < 0.02 for both comparisons). We estimated that among 100,000 adults 40 years of age or older, 15,025 persons would initially be classified as being at intermediate risk for a cardiovascular event if conventional risk factors alone were used to calculate risk. Assuming that statin therapy would be initiated in accordance with Adult Treatment Panel III guidelines (i.e., for persons with a predicted risk of >= 20% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), additional targeted assessment of CRP or fibrinogen levels in the 13,199 remaining participants at intermediate risk could help prevent approximately 30 additional cardiovascular events over the course of 10 years. Conclusions In a study of people without known cardiovascular disease, we estimated that under current treatment guidelines, assessment of the CRP or fibrinogen level in people at intermediate risk for a cardiovascular event could help prevent one additional event over a period of 10 years for every 400 to 500 people screened. (Funded by the British Heart Foundation and others.)
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| 16. |
- Lammertsma, Emmy I., et al.
(författare)
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Sensitivity of wetland hydrology to external climate forcing in central Florida
- 2015
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Ingår i: Quaternary Research. - : Cambridge University Press (CUP). - 0033-5894 .- 1096-0287. ; 84:3, s. 287-300
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Tidskriftsartikel (refereegranskat)abstract
- Available proxy records from the Florida peninsula give a varying view on hydrological changes during the late Holocene. Here we evaluate the consistency and sensitivity of local wetland records in relation to hydrological changes over the past ~ 5 ka based on pollen and diatom proxies from peat cores in Highlands Hammock State Park, central Florida. Around 5 cal ka BP, a dynamic floodplain environment is present. Subsequently, a wetland forest establishes, followed by a change to persistent wet conditions between ~ 2.5 and 2.0 ka. Long hydroperiods remain despite gradual succession and basin infilling with maximum wet conditions between ~ 1.3 and 1.0 ka. The wet phase and subsequent strong drying over the last millennium, as indicated by shifts in both pollen and diatom assemblages, can be linked to the early Medieval Warm Period and Little Ice Age, respectively, driven by regionally higher sea-surface temperatures and a temporary northward migration of the Intertropical Convergence Zone. Changes during the 20th century are the result of constructions intended to protect the Highlands Hammock State Park from wildfires. The multiple cores and proxies allow distinguishing local and regional hydrological changes. The peat records reflect relatively subtle climatic changes that are not evident from regional pollen records from lakes.
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| 17. |
- Okur, Halil I., et al.
(författare)
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The Jones-Ray Effect Is Not Caused by Surface-Active Impurities
- 2018
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Ingår i: The Journal of Physical Chemistry Letters. - : American Chemical Society (ACS). - 1948-7185. ; 9:23, s. 6739-6743
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Tidskriftsartikel (refereegranskat)abstract
- Pure aqueous electrolyte solutions display a minimum in surface tension at concentrations of 2 +/- 1 mM. This effect has been a source of controversy since it was first reported by Jones and Ray in the 1930s. The Jones Ray effect has frequently been dismissed as an artifact linked to the presence of surface-active impurities. Herein we systematically consider the effect of surface-active impurities by purposely adding nanomolar concentrations of surfactants to dilute electrolyte solutions. Trace amounts of surfactant are indeed found to decrease the surface tension and influence the surface chemistry. However, surfactants can be removed by repeated aspiration and stirring cycles, which eventually deplete the surfactant from solution, creating a pristine surface. Upon following this cleaning procedure, a reduction in the surface tension by millimolar concentrations of salt is still observed. Consequently, we demonstrate that the Jones Ray effect is not caused by surface-active impurities.
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