Riviste scientifiche

[Articles] Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials

The Lancet - Ve, 05/10/2018 - 00:30
In this individual-patient data meta-analysis of statin-treated patients, elevated baseline and on-statin lipoprotein(a) showed an independent approximately linear relation with cardiovascular disease risk. This study provides a rationale for testing the lipoprotein(a) lowering hypothesis in cardiovascular disease outcomes trials.

Correction: Comparison of artemether-lumefantrine and chloroquine with and without primaquine for the treatment of <i>Plasmodium vivax</i> infection in Ethiopia: A randomized controlled trial

PLoS Medicine - Gi, 04/10/2018 - 23:00

by Tesfay Abreha, Jimee Hwang, Kamala Thriemer, Yehualashet Tadesse, Samuel Girma, Zenebe Melaku, Ashenafi Assef, Moges Kassa, Mark D. Chatfield, Keren Z. Landman, Stella M. Chenet, Naomi W. Lucchi, Venkatachalam Udhayakumar, Zhiyong Zhou, Ya Ping Shi, S. Patrick Kachur, Daddi Jima, Amha Kebede, Hiwot Solomon, Addis Mekasha, Bereket Hailegiorgis Alemayehu, Joseph L. Malone, Gunewardena Dissanayake, Hiwot Teka, Sarah Auburn, Lorenz von Seidlein, Ric N. Price

Association between ambient air pollution and daily hospital admissions for ischemic stroke: A nationwide time-series analysis

PLoS Medicine - Gi, 04/10/2018 - 23:00

by Yaohua Tian, Hui Liu, Zuolin Zhao, Xiao Xiang, Man Li, Juan Juan, Jing Song, Yaying Cao, Xiaowen Wang, Libo Chen, Chen Wei, Yonghua Hu, Pei Gao

Background

Evidence of the short-term effects of ambient air pollution on the risk of ischemic stroke in low- and middle-income countries is limited and inconsistent. We aimed to examine the associations between air pollution and daily hospital admissions for ischemic stroke in China.

Methods and findings

We identified hospital admissions for ischemic stroke in 2014–2016 from the national database covering up to 0.28 billion people who received Urban Employee Basic Medical Insurance (UEBMI) in China. We examined the associations between air pollution and daily ischemic stroke admission using a two-stage method. Poisson time-series regression models were firstly fitted to estimate the effects of air pollution in each city. Random-effects meta-analyses were then conducted to combine the estimates. Meta-regression models were applied to explore potential effect modifiers. More than 2 million hospital admissions for ischemic stroke were identified in 172 cities in China. In single-pollutant models, increases of 10 μg/m3 in particulate matter with aerodynamic diameter <2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) and 1 mg/m3 in carbon monoxide (CO) concentrations were associated with 0.34% (95% confidence interval [CI], 0.20%–0.48%), 1.37% (1.05%–1.70%), 1.82% (1.45%–2.19%), 0.01% (−0.14%–0.16%), and 3.24% (2.05%–4.43%) increases in hospital admissions for ischemic stroke on the same day, respectively. SO2 and NO2 associations remained significant in two-pollutant models, but not PM2.5 and CO associations. The effect estimates were greater in cities with lower air pollutant levels and higher air temperatures, as well as in elderly subgroups. The main limitation of the present study was the unavailability of data on individual exposure to ambient air pollution.

Conclusions

As the first national study in China to systematically examine the associations between short-term exposure to ambient air pollution and ischemic stroke, our findings indicate that transient increase in air pollution levels may increase the risk of ischemic stroke, which may have significant public health implications for the reduction of ischemic stroke burden in China.

Wind farms do affect climate – but they don’t cause global warming

New Scientist - Gi, 04/10/2018 - 17:00
A study has claimed that large-scale wind power in the US would cause significant warming, but this is misleading and could harm take-up of renewables

Faecal swaps could help stop heart transplants from being rejected

New Scientist - Gi, 04/10/2018 - 15:00
Giving mice a faecal transplant made them more tolerant of a subsequent heart transplant, hinting the gut may be key to avoiding organ rejection

Tree rings reveal plague hit medieval Europe’s construction industry

New Scientist - Gi, 04/10/2018 - 13:30
Dating timber used to build European houses between AD 1250 and 1699 reveals that building activity fell during the Black Death and the Thirty Years’ War

First known exomoon could be a baffling monster the size of Neptune

New Scientist - Me, 03/10/2018 - 20:00
Last year, New Scientist reported the possible discovery of the first ever exomoon. Now new evidence suggests that if it does exist, it is very strange

Row with Russia and SpaceX delays could leave NASA unable to reach ISS

New Scientist - Me, 03/10/2018 - 19:00
Talk of sabotage on the International Space Station has exposed cracks in the US-Russia space relationship that could see NASA unable to fly astronauts into orbit

[World Report] UN High-Level Meeting to end tuberculosis disappointing

The Lancet - Me, 03/10/2018 - 17:22
A high-level meeting in which a political declaration to end tuberculosis was agreed upon fell short of expectations, experts say. Sophie Cousins reports.

AI has reimagined nature and it’s both amazing and terrifying

New Scientist - Me, 03/10/2018 - 15:20
A pack of brown dogs look like majesties of nature, but they’ve actually been dreamt up by a DeepMind AI

T. rex evolved into a monster predator by dumbing down its brain

New Scientist - Me, 03/10/2018 - 14:35
The very first tyrannosaurs were relatively small dinosaurs – and the skull of one of them seems to have contained a brain with a more complex shape than that of the enormous T. rex

Chemistry Nobel Prize awarded for harnessing evolution to help humans

New Scientist - Me, 03/10/2018 - 12:03
The chemistry Nobel Prize goes to Frances Arnold, George Smith, and Gregory Winter for controlling evolution to create proteins that solve chemical problems.

Third lander arrives on asteroid Ryugu with only 16 hours to live

New Scientist - Me, 03/10/2018 - 11:20
Japan has just dropped off its third lander on the surface of the asteroid Ryugu. It has less than a day to complete its mission before its batteries run out

[Comment] Enlarging the loop: closed-loop insulin delivery for type 1 diabetes

The Lancet - Me, 03/10/2018 - 10:15
A growing number of clinical trials have shown that home use of hybrid closed-loop insulin delivery systems reduces time spent in hypoglycaemia and improves time in target ranges for those with type 1 diabetes.1–6 In September, 2016, the first commercially available hybrid closed-loop insulin delivery system for management of type 1 diabetes was approved by the US Food and Drug Administration for patients aged 15 years and older. Approval of this system was supported by a non-randomised trial in which the primary outcome was safety.

[Articles] Closed-loop insulin delivery in suboptimally controlled type 1 diabetes: a multicentre, 12-week randomised trial

The Lancet - Me, 03/10/2018 - 10:15
Hybrid closed-loop insulin delivery improves glucose control while reducing the risk of hypoglycaemia across a wide age range in patients with suboptimally controlled type 1 diabetes.

Gaia spacecraft prepares to weather an incoming meteoroid storm

New Scientist - Me, 03/10/2018 - 09:00
A spacecraft currently mapping the Milky Way could be pelted by space dust next week, so the European Space Agency is putting up its shields

Idly tapping your fingers can make you think time has slowed down

New Scientist - Me, 03/10/2018 - 01:01
Moving a body part in time to a rhythm alters your perception of time, causing it to either stretch or contract – providing new clues about which parts of the brain control our body clocks

In an unhealthy food system, what role should SNAP play?

PLoS Medicine - Ma, 02/10/2018 - 23:00

by Hilary Kessler Seligman, Sanjay Basu

In a Perspective, Hilary Seligman and Sanjay Basu discuss future scenarios of food assistance programs to improve population health in a changing political environment.

Cost-effectiveness of financial incentives and disincentives for improving food purchases and health through the US Supplemental Nutrition Assistance Program (SNAP): A microsimulation study

PLoS Medicine - Ma, 02/10/2018 - 23:00

by Dariush Mozaffarian, Junxiu Liu, Stephen Sy, Yue Huang, Colin Rehm, Yujin Lee, Parke Wilde, Shafika Abrahams-Gessel, Thiago de Souza Veiga Jardim, Tom Gaziano, Renata Micha

Background

The Supplemental Nutrition Assistance Program (SNAP) provides approximately US$70 billion annually to support food purchases by low-income households, supporting approximately 1 in 7 Americans. In the 2018 Farm Bill, potential SNAP revisions to improve diets and health could include financial incentives, disincentives, or restrictions for certain foods. However, the overall and comparative impacts on health outcomes and costs are not established. We aimed to estimate the health impact, program and healthcare costs, and cost-effectiveness of food incentives, disincentives, or restrictions in SNAP.

Methods and findings

We used a validated microsimulation model (CVD-PREDICT), populated with national data on adult SNAP participants from the National Health and Nutrition Examination Survey (NHANES) 2009–2014, policy effects from SNAP pilots and food pricing meta-analyses, diet–disease effects from meta-analyses, and policy, food, and healthcare costs from published literature to estimate the overall and comparative impacts of 3 dietary policy interventions: (1) a 30% incentive for fruits and vegetables (F&V), (2) a 30% F&V incentive with a restriction of sugar-sweetened beverages (SSBs), and (3) a broader incentive/disincentive program for multiple foods that also preserves choice (SNAP-plus), combining 30% incentives for F&V, nuts, whole grains, fish, and plant-based oils and 30% disincentives for SSBs, junk food, and processed meats. Among approximately 14.5 million adults on SNAP at baseline with mean age 52 years, our simulation estimates that the F&V incentive over 5 years would prevent 38,782 cardiovascular disease (CVD) events, gain 18,928 quality-adjusted life years (QALYs), and save $1.21 billion in healthcare costs. Adding SSB restriction increased gains to 93,933 CVD events prevented, 45,864 QALYs gained, and $4.33 billion saved. For SNAP-plus, corresponding gains were 116,875 CVD events prevented, 56,056 QALYs gained, and $5.28 billion saved. Over a lifetime, the F&V incentive would prevent approximately 303,900 CVD events, gain 649,000 QALYs, and save $6.77 billion in healthcare costs. Adding SSB restriction increased gains to approximately 797,900 CVD events prevented, 2.11 million QALYs gained, and $39.16 billion in healthcare costs saved. For SNAP-plus, corresponding gains were approximately 940,000 CVD events prevented, 2.47 million QALYs gained, and $41.93 billion saved. From a societal perspective (including programmatic costs but excluding food subsidy costs as an intra-societal transfer), all 3 scenarios were cost-saving. From a government affordability perspective (i.e., incorporating food subsidy costs, including for children and young adults for whom no health gains were modeled), the F&V incentive was of low cost-effectiveness at 5 years (incremental cost-effectiveness ratio: $548,053/QALY) but achieved cost-effectiveness ($66,525/QALY) over a lifetime. Adding SSB restriction, the intervention was cost-effective at 10 years ($68,857/QALY) and very cost-effective at 20 years ($26,435/QALY) and over a lifetime ($5,216/QALY). The combined incentive/disincentive program produced the largest health gains and reduced both healthcare and food costs, with net cost-savings of $10.16 billion at 5 years and $63.33 billion over a lifetime. Results were consistent in probabilistic sensitivity analyses: for example, from a societal perspective, 1,000 of 1,000 iterations (100%) were cost-saving for all 3 interventions. Due to the nature of simulation studies, the findings cannot prove the health and cost impacts of national SNAP interventions.

Conclusions

Leveraging healthier eating through SNAP could generate substantial health benefits and be cost-effective or cost-saving. A combined food incentive/disincentive program appears most effective and may be most attractive to policy-makers.

Distant dwarf planet called ‘The Goblin’ could point to Planet X

New Scientist - Ma, 02/10/2018 - 19:33
There is a 300-kilometre-wide ice world in the far reaches of the Solar System - and its orbit is consistent with the presence of the hypothetical Planet X
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