Observed coupling between air mass history, secondary growth of nucleation mode particles and aerosol pollution levels in Beijing.

Atmospheric aerosols have significant effects on the climate and on human health. New particle formation (NPF) is globally an important source of aerosols but its relevance especially towards aerosol mass loadings in highly polluted regions is still controversial. In addition, uncertainties remain regarding the processes leading to severe pollution episodes, concerning e.g. the role of atmospheric transport. In this study, we utilize air mass history analysis in combination with different fields related to the intensity of anthropogenic emissions in order to calculate air mass exposure to anthropogenic emissions (AME) prior to their arrival at Beijing, China. The AME is used as a semi-quantitative metric for describing the effect of air mass history on the potential for aerosol formation. We show that NPF events occur in clean air masses, described by low AME. However, increasing AME seems to be required for substantial growth of nucleation mode (diameter < 30 nm) particles, originating either from NPF or direct emissions, into larger mass-relevant sizes. This finding assists in establishing and understanding the connection between small nucleation mode particles, secondary aerosol formation and the development of pollution episodes. We further use the AME, in combination with basic meteorological variables, for developing a simple and easy-to-apply regression model to predict aerosol volume and mass concentrations. Since the model directly only accounts for changes in meteorological conditions, it can also be used to estimate the influence of emission changes on pollution levels. We apply the developed model to briefly investigate the effects of the COVID-19 lockdown on PM2.5 concentrations in Beijing. While no clear influence directly attributable to the lockdown measures is found, the results are in line with other studies utilizing more widely applied approaches.

High level of fecal calprotectin at age 2 months as a marker of intestinal inflammation predicts atopic dermatitis and asthma by age 6.

BACKGROUND: Gut microbiota and intestinal inflammation regulate the development of immune-mediated diseases, such as allergies. Fecal calprotectin is a biomarker of intestinal inflammation. OBJECTIVE: We evaluated the association of early-age fecal calprotectin levels to the later development of allergic diseases in children from farming and non-farming environments and further studied the effect of gut microbiota on the fecal calprotectin levels. METHODS: Fecal calprotectin was measured from 758 infants participating in the PASTURE study at the age of 2 months using the ELISA method. Serum-specific IgE levels were measured at 6 years of age. Data of environmental factors, doctor-diagnosed atopic dermatitis (AD) and asthma were collected by questionnaire. Multivariate logistic regression models were used for analysis. The composition of fecal microbiota was analysed in a subgroup of 120 infants with 16S rRNA pyrosequencing. The effect of Escherichia coli lipopolysaccharide (LPS) on in vitro monocyte IL-10 secretion was studied by flow cytometry. RESULTS: The infants with high fecal calprotectin levels at 2 months, that is above the 90th percentile, had an increased risk of developing AD and asthma/asthmatic bronchitis by the age of 6 years (aOR 2.02 (1.06-3.85) and 2.41 (1.25-4.64), respectively). High fecal calprotectin levels correlated negatively with fecal Escherichia. LPS from E. coli stimulated production of IL-10 in monocytes. CONCLUSION AND CLINICAL RELEVANCE: High degree intestinal inflammation at 2 months of age, detected as high fecal calprotectin, predicted asthma and AD by the age of 6 years and was linked to low abundance of fecal Escherichia. Impaired IL-10 activation due to the lack of colonization with E. coli could explain the intestinal inflammation associated high fecal calprotectin and later risk of asthma and AD. Our results have implications for the design of probiotic treatments and suggest that early intestinal colonization has long-term health effects.

Case-control study of factors associated with arthritis detected at slaughter in pigs from 49 farms.

Data were collected on the housing, management and disease factors in the weaning and finishing units of 49 integrated pig herds, 24 of them with a high incidence of arthritis at slaughter (case herds) and 25 with a low incidence (control herds). A median of 5.2 per cent (range 3.7 to 12.4 per cent) of the slaughtered pigs in the case herds had arthritis at meat inspection, compared with 2.2 per cent (range 0.3 to 2.8 per cent) in the control herds. In the farrowing units, high clinical sign scores for the lactating sows and piglets less than one week old and a low age at castration were associated with the case herds. In the weaning units, the herds with open partitions between the pens were 5.6 times more likely to be a case herd than the herds with solid walls. A higher age at weaning and moving the piglets at weaning from the farrowing pen instead of the sows decreased the likelihood of being a case herd. In the finishing units, a higher score for clinical signs, using a proper hospital pen, disinfecting the pens between the groups and using a feeding plan increased the likelihood of being a case herd. In total, 145 condemned joints, a median of four (up to six per herd), were collected at the slaughterhouse. In the case herds, 71 of 76 joints (93.4 per cent) had lesions related to osteochondrosis and in the control herds 66 of 69 joints (95.6 per cent) had such lesions. Only two of 11 joints from the case herds and one of 12 joints from the control herds that were examined bacteriologically were positive for Stapylococcus aureus and/or Streptococcus species.

Sertraline-induced panic attacks.

Sertraline is a selective serotonin reuptake inhibitor that is approved by the U.S. Food and Drug Administration for the treatment of major depression, obsessive-compulsive disorder (in adults and children), and panic disorder. Although numerous studies have found sertraline to be very effective in the treatment of anxiety, there have been few case reports of panic attacks actually being induced by treatment with sertraline. In this article, we present the cases of two patients without any personal or family history of anxiety disorders who developed panic attacks shortly after the initiation of sertraline therapy. We will also review the literature in regard to the development of anxiety symptoms during treatment with the newer antidepressants and discuss the neurochemical basis of these antidepressant-induced panic attacks.

The leukointegrin alpha d/beta 2 (alpha d/CD18): specific changes in surface expression in patients on hemodialysis.

Alpha d/CD18 is a newly discovered leukocyte adhesion molecule with sequence homology to CD11a, b and c of the beta 2 integrin family. Little is known about alpha d expression in vivo, particularly how it compares with the other beta 2 integrins. Previous studies have demonstrated that beta 2 integrin expression, particularly CD11b, is upregulated in vivo during hemodialysis (HD) with complement activating membranes. These changes may contribute to the immunologic abnormalities seen in HD patients. Given the well described changes of beta 2 integrins in these patients, we hypothesized that alpha d expression could also be altered by HD. Using flow cytometry with two specific antibodies to alpha d, alpha d expression in healthy adults (n = 16) was compared on macrophages (MO) > polymorphonuclear cells (PMNs) > lymphocytes (LY). Phorbol ester treatment of leukocytes in vitro significantly increased expression on MO and PMN, but not LY. Chronic HD patients at baseline (n = 15) had elevated (P < 0.05) alpha d mean channel fluorescence (MCF) on MOs, PMNs and LYs compared to normals. PMN alpha d MCF increased at 15 min into HD, but then returned to baseline levels at 180 min. Alpha d MCF for LYs decreased at 180 min, while MOs levels were unchanged. Alpha d expression is increased in chronic renal failure and further regulated by hemodialysis, but with unique characteristics compared to the other beta 2 integrins. Alpha d may be important in abnormal cell-cell contacts in renal failure.

Determinants and significance of declining blood pressure in old age. A prospective birth cohort study.

AIMS: To investigate the changes in blood pressure and their causes in an elderly population. METHODS: Orthostatic blood pressure measurements were performed in randomly in four birth cohorts (years 65-, 75-, 80- and 85, n=773) at 5-year intervals. RESULTS: Both systolic and diastolic blood pressures decreased in both genders and all age groups. The falls in blood pressure related closely to initial blood pressure values and to the thickness of the left ventricular posterior wall of the heart. The changes in supine (r=0.118, P=0.007) and standing systolic blood pressure (r=0.123, P=0.005), as well as supine (r=0.148, P<0.001) and standing diastolic blood pressure (r=0.186, P<0.001) correlated with changes in body weight. Changes in supine diastolic blood pressure also related to changes in serum cholesterol (r=0.207, P=0.002) and triglycerides (r=0.160, P=0.016). Changes in supine and standing systolic and standing diastolic blood pressures also related to changes in dehydroepiandrosterone sulphate (r=0.161, P<0.05; r=0.205, P<0.01; r=0.140, P<0.05, respectively). Changes in blood pressure also correlated with self-estimated poor health after 5 years (r for supine systolic blood pressure= -0.133, P<0.001, for standing systolic blood pressure= -0.135, P<0.001, for supine diastolic blood pressure= -0.111, P<0.002). PATIENTS: who were institutionalized during the follow-up or who had severely impaired performance capacity after 5 years, displayed the most marked decline in blood pressure. Declining systolic blood pressure was also related to impaired survival prognosis. According to the logistic regression analyses the baseline blood pressure, antihypertensive drugs and changes in dehydroepiandrosterone sulphate and cholesterol explained over 30% of the changes in blood pressure. In the logistic models, declining blood pressure was associated with baseline blood pressure, antihypertensive treatment, poor health after 5 years, and decreasing cholesterol and triglycerides. CONCLUSION: Decline in blood pressure in old age is associated with deteriorating health and is only partly explained by the use of antihypertensive drugs.

Blood pressure and mortality in an older population. A 5-year follow-up of the Helsinki Ageing Study.

OBJECTIVE: Hypertension is an established risk factor of cardiovascular diseases, and in clinical studies its treatment has reduced cardiovascular complications in subjects up to 80 years of age. In the older age groups, prognostic data on blood pressure is sparse. We evaluated the prognostic significance of different blood pressure levels and the history of elevated blood pressure in an older population. DESIGN: In the Helsinki Ageing Study random individuals 75, 80, and 85 years of age (n = 521) were evaluated at baseline using postal questionnaires, structured interviews, clinical examinations, laboratory investigations, and blood pressure measurements (supine, seated, standing). Date of death during a 5-year follow-up was verified using computerized registers, and thus the follow-up was 100% complete. The data were analysed using life-table analyses and Cox proportional hazards models. RESULTS: At 5 years, 240 subjects (40%) had died, 50% of them of cardiovascular disease. In crude analyses, an inverse relationship between both systolic and diastolic blood pressure and mortality was observed in all groups combined (P < 0.01), and separately in the 80 and 85-year-old groups. However, a J-shaped link between diastolic blood pressure and mortality was found in the 75-year-old group. After controlling for age, gender and the presence of clinically significant diseases (in 72% of subjects) baseline blood pressure was associated with favourable 5-year survival. The risk ratios of systolic (per 10 mmHg) and diastolic blood pressure (per 5 mmHg) were 0.90 (95% CI 0.85-0.96) and 0.92 (95% CI 0.86-0.99), respectively. Neither isolated systolic hypertension nor a history of hypertension treatment were associated with 5-year survival. CONCLUSION: At the population level, among subjects aged 75 years and over, favourable 5-year survival is indicated by a high, but not a low, blood pressure.

How stable is postural hypotension in the general aged population?

Although postural hypotension (PH) is a common clinical symptom in the elderly, nothing is known of its stability in the long run. To investigate this issue we carried out a prospective cohort study in a general aged population as a part of Helsinki (Finland) Aging Study. Random persons of three age cohorts (75-, 80- and 85-years, n = 274) were followed for 5 years. Blood pressure (BP) was measured at supine and standing positions both at entry and after 5 years. Both supine and standing BP levels decreased during 5-year follow-up but the prevalence of PH (decrease in systolic BP > 20 mmHg or that in diastolic BP > 10 mmHg) remained virtually unchanged (28% at entry - 26% after 5 years). There were, however, marked differences in the distributions of individuals in the different categories of PH and only 25.8% of subjects fulfilled the same criteria at 5 years. Only 9% of subjects had significant falls in SBP and DBP both at entry and after 5 years. These persons were characterized by no other clinical features than higher initial supine BP levels. In conclusion, this study shows the instable nature of PH during the 5-year follow-up in the general aged population and challenges the use of blood pressure changes as a sole diagnostic criteria of PH in epidemiological studies.

Postural hypotension and dizziness in a general aged population: a four-year follow-up of the Helsinki Aging Study.

OBJECTIVE: To evaluate the frequency, risk factors, and prognostic significances of postural hypotension (PH) and dizziness on postural testing (DPT). DESIGN: A prospective cohort study. SETTING: General community, The Helsinki (Finland) Aging Study. SUBJECTS: Persons of three age cohorts (75, 80, and 85 years, n = 569) were chosen randomly and followed for 4 years. MEASURES: Postal questionnaires, structured interview, extensive clinical and laboratory examinations, blood pressure (BP) changes in a postural test using different definitions for PH, history of dizziness, dizziness on testing postural blood pressure reactions (DPT), and date of death during a 4-year follow-up. RESULTS: The frequency of a fall in systolic blood pressure greater than 20 mm Hg or a fall in diastolic pressure greater than 10 mm Hg (PH-I) was 30.3%. Both criteria occurred simultaneously (PH-II) in 7.5%, and if dizziness on postural testing (DPT) was an additional symptom (PH-III), the prevalence was 2.6%. The overall prevalence of DPT was 19.7%. PH-I, PH-II, and DPT were also frequent among the healthy aged (26.6%, 6.6%, and 17.3%, respectively). The postural change in BP correlated inversely with the initial supine BP levels (systolic r = -.149, P < .001 and diastolic r = -.218, P < .001), but in persons with isolated systolic hypertension PH was rather less frequent (21.9% and 2.3%). DPT was more common in the subjects with heart failure (26.3%, P < .05), impaired exercise tolerance (NYHA III-IV) (33.7%, P < .05), and PH-II (37.2%, P < .05) compared with the healthy controls (17.3%). The 1-year mortality was higher in subjects with than without DPT (7.1% vs 4.8%, P < .05), but the difference was not significant after controlling for age and gender. PH-I, PH-II, and PH-III were not significantly related to 4-year mortality. CONCLUSIONS: In this study of older people in Helsinki, Finland, asymptomatic hypotensive postural BP reactions and DPT were found frequently among healthy older people, and they tended to be increased in people with some diseases. Neither PH nor DPT were of prognostic significance for mortality in this population.

Urinary incontinence as a predictor of death and institutionalization in a general aged population.

The prognostic significance of urinary incontinence (UI) was evaluated using the Helsinki (Finland) Aging Study Database, in which a random sample of persons of three age cohorts (75, 80 and 85 years, n=649) was followed for 5 years. The prevalence rates of UI in the three age groups were 10.5%, 20.4% and 28.6%, respectively. UI was also frequent in healthy aged subjects (15.6%), but most common in hospitalized patients (35.3%), in those with severe depression (51.8%), previous stroke (37.6%) or dementia (48.8%). UI had age- and gender-adjusted risk ratios (95% C.I.) for mortality of 1.75 (1.33-2.30) and for long-term institutional care of 2.37 (1.30-3.84). However, after controlling for the presence of dementia, the risk ratios were no longer significant. Thus, UI predicts both death and long-term institutionalization in the general aged population. However, this observation is mainly explained by the close association of UI with dementia.