Is Tinnitus Treatable?

What Is Tinnitus?

Tinnitus is a condition where a person frequently experiences buzzing, hissing or ringing in the ears. It affects around 25 million people in America. There are several things that can trigger tinnitus, including noise-induced hearing loss, brain tumors, blood vessel damage or hormonal changes.

It is also important to note that tinnitus can be a side effect of certain medications. In fact, it is estimated there are over 200 medications that can cause tinnitus.

Is Tinnitus Treatable?

Many people are wondering, "Is Tinnitus Treatable?" The answer to question is yes. Even though there is no miracle cure for tinnitus, there are many ways that it can be treated. People who suffer from hearing loss may be able to alleviate their tinnitus symptoms by wearing a hearing aid. The better you hear, the less you will notice your tinnitus.

Counseling is another treatment option for tinnitus. Counselors can educate you about what is going inside of your brain if you have tinnitus. Your counselor can also talk about ways you can relax so that the noise is less noticeable.

Antidepressants may also be used to reduce tinnitus symptoms. There have been studies done to suggest that antidepressants are effective for reducing tinnitus symptoms. However, antidepressants can cause side effects, such as dry mouth, constipation and heart problems. Only a physician can determine whether antidepressants are right for you.

Notch Sound Therapy

Are you still wondering, "Is tinnitus treatable?" If so, then you may want to consider trying notch sound therapy. Notch sound therapy is a treatment that works by reducing the volume of your tinnitus. It also helps reduce the distress and pain this condition causes.

Notch sound therapy involves using white noise or music to remove sound energy. Experts believe that notch sound therapy works by reducing the activity of the auditory neurons. There are a few steps you will need to take in order to use notch sound therapy. You will need to use the AudioNotch tuner in order to find the frequency of your tinnitus.

After that, you will need to either use AudioNotch sounds or upload your own music. AudioNotch will then create a sound therapy just for you. You will need to listen to sound therapy for one hour per day. You will notice an improvement in your tinnitus within several days of treatment. However, notch sound therapy is intended to be used for several months.
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Long-term effects of very low-carbohydrate and high-carbohydrate weight-loss diets on psychological health in obese adults with type 2 diabetes: randomized controlled trial

Abstract

Background/Objective

Very low-carbohydrate, high-fat (LC) diets are used for type 2 diabetes (T2DM) management, but their effects on psychological health remain largely unknown. This study examined the long-term effects of an LC diet on psychological health.

Methods

One hundred and fifteen obese adults [age: 58.5 ± 7.1 years; body mass index: 34.6 ± 4.3 kg m⁻²; HbA_1c: 7.3 ± 1.1%] with T2DM were randomized to consume either an energy-restricted (~6 to 7 MJ), planned isocaloric LC or high-carbohydrate, low-fat (HC) diet, combined with a supervised exercise programme (3 days week⁻¹) for 1 year. Body weight, psychological mood state and well-being [Profile of Mood States (POMS), Beck Depression Inventory (BDI) and Spielberger State Anxiety Inventory (SAI)] and diabetes-specific emotional distress [Problem Areas in Diabetes (PAID) Questionnaire] and quality of life [QoL Diabetes-39 (D-39)] were assessed.

Results

Overall weight loss was 9.5 ± 0.5 kg (mean ± SE), with no difference between groups (P = 0.91 time × diet). Significant improvements occurred in BDI, POMS (total mood disturbance and the six subscales of anger-hostility, confusion-bewilderment, depression-dejection, fatigue-inertia, vigour-activity and tension-anxiety), PAID (total score) and the D-39 dimensions of diabetes control, anxiety and worry, sexual functioning and energy and mobility, P < 0.05 time. SAI and the D-39 dimension of social burden remained unchanged (P ≥ 0.08 time). Diet composition had no effect on the responses for the outcomes assessed (P ≥ 0.22 time × diet).

Conclusion

In obese adults with T2DM, both diets achieved substantial weight loss and comparable improvements in QoL, mood state and affect. These results suggest that either an LC or HC diet within a lifestyle modification programme that includes exercise training improves psychological well-being.

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Donor-site closure using absorbable dermal staple for deep inferior epigastric artery perforator flaps: its efficacy and cosmetic outcomes

Surgeons tend to pay less attention to the donor site during breast reconstruction using deep inferior epigastric artery perforator flaps because attention is focused on microanastomosis and breast shaping. Th...

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PET-CT Surveillance versus Neck Dissection in Advanced Head and Neck Cancer

Chemoradiotherapy has become a mainstay of primary treatment in patients with squamous-cell carcinoma of the head and neck. However, there are wide variations in the management of advanced nodal disease (stage N2 or N3) in these patients because of the lack of prospective, randomized, controlled…

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Effect of low-dose spironolactone on resistant hypertension in type 2 diabetes mellitus: a randomized controlled trial in a sub-Saharan African population

Low-dose spironolactone has been proven to be effective for resistant hypertension in the general population, but this has yet to be confirmed in type 2 diabetic (T2DM) patients. We assessed the efficacy of a ...

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Pressed Paper-Based Dipstick for Detection of Foodborne Pathogens with Multistep Reactions

Analytical Chemistry

DOI: 10.1021/acs.analchem.5b04743

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A Potential Mechanism of Zhuang Jing Decoction Exerting Therapeutic Effects for Learning and Memory Deficits

Rejuvenation Research , Vol. 0, No. 0.


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A Potential Mechanism of Zhuang Jing Decoction Exerting Therapeutic Effects for Learning and Memory Deficits

Rejuvenation Research , Vol. 0, No. 0.


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Utilizing an Orally Dissolving Strip for Pharmacological and Toxicological Studies: A Simple and Humane Alternative to Oral Gavage for Animals

The following protocol describes a novel method for chronic oral drug administration using an orally dissolving strip (ODS) in lieu of the more commonly used oral gavage method. We demonstrate that preclinical, oral drug delivery using the ODS method represents a safe, convenient, and humane alternative to oral gavage.

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A Potential Mechanism of Zhuang Jing Decoction Exerting Therapeutic Effects for Learning and Memory Deficits

Rejuvenation Research , Vol. 0, No. 0.


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Assessing Specificity of Anticancer Drugs In Vitro

The goal of this protocol is to assess specificity of anticancer drugs in vitro using mixed cultures containing both tumor and non-tumor cells.

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A Magnetic Microbead Occlusion Model to Induce Ocular Hypertension-Dependent Glaucoma in Mice

Here, we present a protocol to induce ocular hypertension in the murine eye that results in the loss of retinal ganglion cells as observed in glaucoma. Magnetic microbeads are injected into the anterior chamber and attracted to the iridocorneal angle using a magnet to block the outflow of aqueous humour.

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The Effects of Sex on Cardiopulmonary Responses to Acute Normobaric Hypoxia

High Altitude Medicine & Biology , Vol. 0, No. 0.


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New Topic Page: Chikungunya

Visit the new MedlinePlus Health Topic page on Chikungunya.

Chikungunya is a virus that spread by the same kinds of mosquitoes that spread dengue and Zika virus. Rarely, it can spread from mother to newborn around the time of birth...

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Assessment of occupational exposure to pesticides in a pooled analysis of agricultural cohorts within the AGRICOH consortium

Background

This paper describes methods developed to assess occupational exposure to pesticide active ingredients and chemical groups, harmonised across cohort studies included in the first AGRICOH pooling project, focused on the risk of lymph-haematological malignancies.

Methods

Three prospective agricultural cohort studies were included: US Agricultural Health Study (AHS), French Agriculture and Cancer Study (AGRICAN) and Cancer in the Norwegian Agricultural Population (CNAP). Self-reported pesticide use was collected in AHS. Crop-exposure matrices (CEMs) were developed for AGRICAN and CNAP. We explored the potential impact of these differences in exposure assessment by comparing a CEM approach estimating exposure in AHS with self-reported pesticide use.

Results

In AHS, 99% of participants were considered exposed to pesticides, 68% in AGRICAN and 63% in CNAP. For all cohorts combined (n=316 270), prevalence of exposure ranged from 19% to 59% for 14 chemical groups examined, and from 13% to 46% for 33 active ingredients. Exposures were highly correlated within AGRICAN and CNAP where CEMs were applied; they were less correlated in AHS. Poor agreement was found between self-reported pesticide use and assigned exposure in AHS using a CEM approach resembling the assessment for AGRICAN ( –0.00 to 0.33) and CNAP ( –0.01 to 0.14).

Conclusions

We developed country-specific CEMs to assign occupational exposure to pesticides in cohorts lacking self-reported data on the use of specific pesticides. The different exposure assessment methods applied may overestimate or underestimate actual exposure prevalence, and additional work is needed to better estimate how far the exposure estimates deviate from reality.

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Black Currant (Ribes nigrum L.) Extract Induces Apoptosis of MKN-45 and TE-1 Cells Through MAPK- and PI3K/Akt-Mediated Mitochondrial Pathways

Journal of Medicinal Food , Vol. 0, No. 0.


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Preparation of a Chicken scFv to Analyze Gentamicin Residue in Animal Derived Food Products

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b00426

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Gene-based aggregate SNP associations between candidate AD genes and cognitive decline

Abstract

Single nucleotide polymorphisms (SNPs) in and near ABCA7, BIN1, CASS4, CD2AP, CD33, CELF1, CLU, complement receptor 1 (CR1), EPHA1, EXOC3L2, FERMT2, HLA cluster (DRB5-DQA), INPP5D, MEF2C, MS4A cluster (MS4A3-MS4A6E), NME8, PICALM, PTK2B, SLC24A4, SORL1, and ZCWPW1 have been associated with Alzheimer's disease (AD) in large meta-analyses. We aimed to determine whether established AD-associated genes are associated with longitudinal cognitive decline by examining aggregate variation across these gene regions. In two single-sex cohorts of older, community-dwelling adults, we examined the association between SNPs in previously implicated gene regions and cognitive decline (age-adjusted person-specific cognitive slopes) using a Sequence Kernel Association Test (SKAT). In regions which showed aggregate significance, we examined the univariate association between individual SNPs in the region and cognitive decline. Only two of the original AD-associated SNPs were significantly associated with cognitive decline in our cohorts. We identified significant aggregate-level associations between cognitive decline and the gene regions BIN1, CD33, CELF1, CR1, HLA cluster, and MEF2C in the all-female cohort and significant associations with ABCA7, HLA cluster, MS4A6E, PICALM, PTK2B, SLC24A4, and SORL1 in the all-male cohort. We also identified a block of eight correlated SNPs in CD33 and several blocks of correlated SNPs in CELF1 that were significantly associated with cognitive decline in univariate analysis in the all-female cohort.

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Darier disease: candy-cane nails and hyperkeratotic papules

Case

A 43-year-old woman presented to our clinic with nail changes and a pruritic malodourous rash on the neck and trunk that began 27 years earlier. Her mother had similar cutaneous and nail findings. Physical examination of her fingernails revealed alternating red and white longitudinal bands, with V-shaped notches at the distal nail edges (figure 1). Clinical evaluation of the skin showed numerous hyperkeratotic papules and plaques on her neck, chest, submammary region and abdomen (figure 2). After treatment with compounded triamcinolone, Silvadene ointment and oral glycopyrrolate, her rash and symptoms were ameliorated. Genetic testing of the patient and her two children (ages 5 and 8) revealed mutations in the ATP2A2 gene, but to date, her children do not have any cutaneous findings.

Discussion

Darier disease, also known as follicular dyskeratosis and Darier–White disease, is an autosomal dominant inherited condition which was first described independently by Drs Darier...

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Anaemia secondary to erythropoietin resistance: important predictor of adverse outcomes in chronic obstructive pulmonary disease

Purpose

Anaemia is increasingly being linked to chronic obstructive pulmonary disease (COPD) as comorbidity with erythropoietin resistance secondary to chronic inflammation is hypothesised to have some role. This study purported to evaluate the occurrence of anaemia in COPD and its association with inflammatory markers, erythropoietin levels, severity and exacerbations of COPD.

Methods

Two hundred patients with COPD (90% men, mean age 62.4±8.33 years) were enrolled and subjected to detailed clinical and laboratory evaluation, including complete blood count, erythropoietin levels, C-reactive protein (CRP), pulmonary function test, blood gas analysis and chest X-ray. Severity of COPD was defined on the basis of forced expiratory volume in 1 s according to GOLD guidelines.

Results

Anaemia was diagnosed in 14% of patients (n=28, predominantly normocytic normochromic type (92.8%)) and polycythmia in 5% of patients (n=10). The prevalence of anaemia increased with increasing severity of COPD (stage 2: 8%, stage 3: 14.4% and stage 4: 17.2%; p=0.46). Serum erythropoietin was significantly higher in more advanced COPD, with mean levels being 30.2±6.5, 31.78±8.09 and 39.33±7.68 mIU/mL in stage 2, 3 and 4 respectively. Moreover erythropoietin levels inversely correlated with mean haemoglobin levels(r=–0.25), indicating erythropoietin resistance. CRP reactivity increased with increasing stage of disease in patients with anaemia (p=0.026). On follow-up, significant inverse correlation was observed between haemoglobin and COPD exacerbations (p<0.001).

Conclusions

Anaemia is a significant comorbidity of COPD with a negative prognostic impact on lung health. It can be ascribed to a state of systemic inflammation resulting in blunting of erythropoietin response with increasing severity of disease, leading to greater morbidity and hospitalisation.

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An 8-channel RF coil array for carotid artery MR imaging in humans at 3 T

Purpose:

Carotid artery diseases due to plaque buildup at the carotid bifurcation are a leading cause of stroke. Accurate plaque quantification and characterization of plaque composition and morphology by magnetic resonance imaging(MRI) is essential to identifying high-risk patients. Difficulties in detecting plaque, which is physically small, and the unique physiological structure of the carotid artery make use of a radio frequency (RF) coil array with high resolution, large longitudinal coverage, and deep penetration ideal for clinical examinations. The goal of this project was to design and fabricate a sensitive RF coil array with sufficient imaging coverage and signal-to-noise ratio(SNR) for carotid arteryimaging at 3 T.

Methods:

Based on clinical requirements and the anatomical structure of the human carotid artery, an 8-channel carotid coil array was designed and fabricated for 3 T MRI of the carotid artery in humans. The performance of the proposed 8-channel carotid coil array was validated through bench tests and MR imaging experiments on a 3 T whole body MRI scanner. Its performance was also compared experimentally to the performance of a commercial 4-channel phased array carotid coil designed by Machnet BV (Machnet BV coil, Roden, Netherlands).

Results:

The 8-channel carotid coil array performed significantly better in imaging the carotid artery than the commercial 4-channel Machnet BV coil in terms of the SNR, coverage, and penetration depth. In parallel imaging, the proposed 8-channel carotid coil array demonstrated a much lower maximum value and average value of the geometry factor in the region of interest. Carotid arteryimages acquired in vivo using the proposed 8-channel carotid arterycoil and the commercial 4-channel Machnet BV coil were also compared, demonstrating the former's potential for clinical diagnosis.

Conclusions:

Based on the analyses of phantom and in vivoimaging studies, the proposed 8-channel carotid coil array has the potential for use in clinical diagnosis, performing better in terms of SNR,imaging coverage, and penetration depth than the commercial 4-channel carotid arterycoil array at 3 T. In future studies, the proposed 8-channel carotid coil array can also serve as an important part of a large-scale multichannel coil array for imaging the whole carotid artery system, including the extracranial and intracranial arteries.

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Urinary bladder segmentation in CT urography using deep-learning convolutional neural network and level sets

Purpose:

The authors are developing a computerized system for bladder segmentation in CT urography (CTU) as a critical component for computer-aided detection of bladder cancer.

Methods:

A deep-learning convolutional neural network (DL-CNN) was trained to distinguish between the inside and the outside of the bladder using 160 000 regions of interest (ROI) from CTU images. The trained DL-CNN was used to estimate the likelihood of an ROI being inside the bladder for ROIs centered at each voxel in a CTU case, resulting in a likelihood map. Thresholding and hole-filling were applied to the map to generate the initial contour for the bladder, which was then refined by 3D and 2D level sets. The segmentation performance was evaluated using 173 cases: 81 cases in the training set (42 lesions, 21 wall thickenings, and 18 normal bladders) and 92 cases in the test set (43 lesions, 36 wall thickenings, and 13 normal bladders). The computerized segmentation accuracy using the DL likelihood map was compared to that using a likelihood map generated by Haar features and a random forest classifier, and that using our previous conjoint level set analysis and segmentation system (CLASS) without using a likelihood map. All methods were evaluated relative to the 3D hand-segmented reference contours.

Results:

With DL-CNN-based likelihood map and level sets, the average volume intersection ratio, average percent volume error, average absolute volume error, average minimum distance, and the Jaccard index for the test set were 81.9% ± 12.1%, 10.2% ± 16.2%, 14.0% ± 13.0%, 3.6 ± 2.0 mm, and 76.2% ± 11.8%, respectively. With the Haar-feature-based likelihood map and level sets, the corresponding values were 74.3% ± 12.7%, 13.0% ± 22.3%, 20.5% ± 15.7%, 5.7 ± 2.6 mm, and 66.7% ± 12.6%, respectively. With our previous CLASS with local contour refinement (LCR) method, the corresponding values were 78.0% ± 14.7%, 16.5% ± 16.8%, 18.2% ± 15.0%, 3.8 ± 2.3 mm, and 73.9% ± 13.5%, respectively.

Conclusions:

The authors demonstrated that the DL-CNN can overcome the strong boundary between two regions that have large difference in gray levels and provides a seamless mask to guide level set segmentation, which has been a problem for many gradient-based segmentation methods. Compared to our previous CLASS with LCR method, which required two user inputs to initialize the segmentation, DL-CNN with level sets achieved better segmentation performance while using a single user input. Compared to the Haar-feature-based likelihood map, the DL-CNN-based likelihood map could guide the level sets to achieve better segmentation. The results demonstrate the feasibility of our new approach of using DL-CNN in combination with level sets for segmentation of the bladder.

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Broad-spectrum antimicrobial photocatalysis mediated by titanium dioxide and UVA is potentiated by addition of bromide ion via formation of hypobromite

Publication date: Available online 23 March 2016
Source:Free Radical Biology and Medicine
Author(s): Ximing Wu, Ying-Ying Huang, Yu Kushida, Brijesh Bhayana, Michael R Hamblin
Antimicrobial photocatalysis involves the UVA excitation of titanium dioxide (TiO2) nanoparticles (particularly the anatase form) to produce reactive oxygen species (ROS) that kill microbial cells. For the first time we report that the addition of sodium bromide to photoactivated TiO2 (P25) potentiates the killing of Gram-positive, Gram-negative bacteria and fungi by up to three logs. The potentiation increased with increasing bromide concentration in the range of 0–10mM. The mechanism of potentiation is probably due to generation of both short and long-lived oxidized bromine species including hypobromite as shown by the following observations. There is some antimicrobial activity remaining in solution after switching off the light, that lasts for 30min but not 2hours, and oxidizes 3,3',5,5'-tetramethylbenzidine. N-acetyl tyrosine ethyl ester was brominated in a light dose-dependent manner, however no bromine or tribromide ion could be detected by spectrophotometry or LC-MS. The mechanism appears to have elements in common with the antimicrobial system (myeloperoxidase + hydrogen peroxide + bromide).

Graphical abstract

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Mitochondrial permeabilization without caspase activation mediates the increase of basal apoptosis in cells lacking Nrf2

Publication date: Available online 22 March 2016
Source:Free Radical Biology and Medicine
Author(s): Julia Ariza, José A. González-Reyes, Laura Jódar, Alberto Díaz-Ruiz, Rafael de Cabo, José Manuel Villalba
Nuclear factor E2-related factor-2 (Nrf2) is a cap'n'collar/basic leucine zipper (b-ZIP) transcription factor which acts as sensor of oxidative and electrophilic stress. Low levels of Nrf2 predispose cells to chemical carcinogenesis but a dark side of Nrf2 function also exists because its unrestrained activation may allow the survival of potentially dangerous damaged cells. Since Nrf2 inhibition may be of therapeutic interest in cancer, and a decrease of Nrf2 activity may be related with degenerative changes associated with aging, it is important to investigate how the lack of Nrf2 function activates molecular mechanisms mediating cell death. Murine Embryonic Fibroblasts (MEFs) bearing a Nrf2 deletion (Nrf2KO) displayed diminished cellular growth rate and shortened lifespan compared with wild-type MEFs. Basal rates of DNA fragmentation and histone H2A.X phosphorylation were higher in Nrf2KO MEFs, although steady-state levels of reactive oxygen species were not significantly increased. Enhanced rates of apoptotic DNA fragmentation were confirmed in liver and lung tissues from Nrf2KO mice. Apoptosis in Nrf2KO MEFs was associated with a decrease of Bcl-2 but not Bax levels, and with the release of the mitochondrial pro-apoptotic factors cytochrome c and AIF. Procaspase-9 and Apaf-1 were also increased in Nrf2KO MEFs but caspase-3 was not activated. Inhibition of XIAP increased death in Nrf2KO but not in wild-type MEFs. Mitochondrial ultrastructure was also altered in Nrf2KO MEFs. Our results support that Nrf2 deletion produces mitochondrial dysfunction associated with mitochondrial permeabilization, increasing basal apoptosis through a caspase-independent and AIF-dependent pathway.

Graphical abstract

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Vitamin E metabolite 13’-carboxychromanols inhibit pro-inflammatory enzymes, induce apoptosis and autophagy in human cancer cells by modulating sphingolipids and suppress colon tumor development in mice

Publication date: Available online 23 March 2016
Source:Free Radical Biology and Medicine
Author(s): Yumi Jang, Na-Young Park, Agnetha Linn Rostgaard-Hansen, Jianjie Huang, Qing Jiang
Vitamin E forms are substantially metabolized to various carboxychromanols including 13'-carboxychromanols (13'-COOHs) that are found at high levels in feces. However, there is limited knowledge about functions of these metabolites. Here we studied δT-13'-COOH and δTE-13'-COOH, which are metabolites of δ-tocopherol and δ-tocotrienol, respectively. δTE-13'-COOH is also a natural constituent of a traditional medicine Garcinia Kola. Both 13'-COOHs are much stronger than tocopherols in inhibition of pro-inflammatory and cancer promoting cyclooxygenase-2 (COX-2) and 5-lipoxygnease (5-LOX), and in induction of apoptosis and autophagy in colon cancer cells. The anti-cancer effects by 13'-COOHs appeared to be partially independent of inhibition of COX-2/5-LOX. Using liquid chromatography tandem mass spectrometry, we found that 13'-COOHs increased intracellular dihydrosphingosin and dihydroceramides after short-time incubation in HCT-116 cells, and enhanced ceramides while decreased sphingomyelins during prolonged treatment. Modulation of sphingolipids by 13'-COOHs was observed prior to or coinciding with biochemical manifestation of cell death. Pharmaceutically blocking the increase of these sphingolipids partially counteracted 13'-COOH-induced cell death. Further, 13'-COOH inhibited dihydroceramide desaturase without affecting the protein expression. In agreement with these mechanistic findings, δTE-13'-COOH significantly suppressed the growth and multiplicity of colon tumor in mice. Our study demonstrates that 13'-COOHs have anti-inflammatory and anticancer activities, may contribute to in vivo anticancer effect of vitamin E forms and are promising novel cancer prevention agents.

Graphical abstract

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Cytoplasmic localization of Nrf2 promotes colorectal cancer with more aggressive tumors via upregulation of PSMD4

Publication date: Available online 23 March 2016
Source:Free Radical Biology and Medicine
Author(s): Po-Lin Lin, Jinghua Tsai Chang, De-Wei Wu, Chi-Chou Huang, Huei Lee
Differences in subcellular localization of Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) have been associated with poor outcomes in human cancers. However, the prognostic value of subcellular localization of Nrf2 in colorectal cancer and the underlying mechanism in tumor invasion remain unknown. We enrolled tumors from colorectal patients to evaluate Nrf2, NQO1, and HO-1 expression by immunohistochemistry. NQO1 and HO-1 positive tumors showed nearly complete expression of Nrf2 in the nucleus and/or showed partial expression in the nucleus/cytoplasm (nNrf2); however, tumors negative for NQO1 and HO-1 showed almost complete expression of Nrf2 in the cytoplasm and/or partial expression in the nucleus/cytoplasm (cNrf2). Kaplan-Meier and Cox regression analysis indicated poorer overall survival in patients with cNrf2 tumors than with nNrf2 tumors. Cell models provided evidence that cNrf2, rather than nNrf2, was responsible for cell invasion and soft agar growth triggered by activation of the NF-κB/AKT/β-catenin cascade. Mechanistically, cNrf2 persistently increased PSMD4 expression by the HIF1α/β-catenin axis, whereas PSMD4 reciprocally enhanced Nrf2 nuclear export by increasing CRM1 expression through p53 degradation. The mechanistic action of the cell model was further confirmed with a nude mouse animal model in which xenograft tumors induced by cNrf2 were nearly completely suppressed by the proteasomal inhibitor carfilzomib or the β-catenin inhibitor XAV939. We therefore suggest that PSMD4 or β-catenin might be potential targets for suppressing tumor aggressiveness, and consequently, improving outcomes in patients whose tumors express cNrf2.

Graphical abstract

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Urinary 8-oxo-7,8-dihydro-2’-deoxyguanosine analysis by an improved ELISA: an inter-laboratory comparison study

Publication date: Available online 22 March 2016
Source:Free Radical Biology and Medicine
Author(s): Pavel Rossner, Hilmi Orhan, Gudrun Koppen, Kazuo Sakai, Regina M. Santella, Antonin Ambroz, Andrea Rossnerova, Radim J. Sram, Miroslav Ciganek, Jiri Neca, Ege Arzuk, Neliye Mutlu, Marcus S. Cooke
ELISA is commonly used for the detection of urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), a marker of whole body oxidative stress. However, the method has been criticized for high inter-laboratory variability and poor agreement with chromatographic techniques. We performed an inter-laboratory comparison of 8-oxodG assessed in 30 urine samples and a urine spiked with four different concentrations of 8-oxodG by ELISA using standardized experimental conditions, including: sample pre-treatment with solid-phase extraction (SPE), performing analysis using a commercial kit from a single manufacturer and strict temperature control during the assay. We further compared the ELISA results with high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) and performed tentative identification of compounds that may contribute to the discrepancy between both methods. For all but one participating laboratory (Data 1) we observed consistent ELISA results lying mostly within 1SD of the mean 8-oxodG concentration. Mean 8-oxodG levels assessed by ELISA correlated with the data obtained by HPLC-MS/MS (R=0.679, p<0.001). The correlation improved when Data 1 were excluded from the analysis (R=0.749, p<0.001). We identified three outlying urine samples; one with an ELISA 8-oxodG concentration lower, and two with 8-oxodG levels higher, than those measured by HPLC-MS/MS. Omitting these samples further improved inter-methodology agreement (R=0.869, p<0.001). In the outliers with high 8-oxodG estimates various aromatic and heterocyclic compounds were tentatively identified using gas chromatography-mass spectrometry (GC–MS). Application of authentic standards revealed the presence of saccharides, including d-glucose and d-galactose as putative interfering substances. In summary, assay standardization improved ELISA inter-laboratory agreement, although some variability is still observed. There are still compounds contributing to overestimation of 8-oxodG by ELISA, but only in some urine samples. Thus, despite significant improvement, ELISA still should not be considered a robust alternative to chromatographic techniques.

Graphical abstract

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Luteolin inhibits viral-induced inflammatory response in RAW264.7 cells via suppression of STAT1/3 dependent NF-κB and activation of HO-1

Publication date: Available online 23 March 2016
Source:Free Radical Biology and Medicine
Author(s): Cheng-Wei Liu, Hui-Wen Lin, Deng-Jye Yang, Shih-Yin Chen, Jung-Kai Tseng, Tien-Jye Chang, Yuan-Yen Chang
Luteolin is a common dietary flavonoid present in Chinese herbal medicines that has been reported to have important anti-inflammatory properties. Previous studies have shown that luteolin is an anti-inflammatory and anti-oxidative agent.In this study, the anti-virus inflammatory capacity of luteolin and its molecular mechanisms of action were analyzed. The cytotoxic effects of luteolin were assessed in the presence or absence of pseudorabies virus (PRV) via LDH and MTT assays. The results showed that luteolin (< 10μM) had no toxic effects and there were tendencies toward higher cell survival.In PRV-infected RAW264.7 cells, luteolin potently inhibited the production of NO, iNOS, COX-2 and inflammatory cytokine production. Luteolin did not inhibit the phosphorylation of ERK 1/2, p38, and JNK 1/2 either. We found that PRV-induced NF-κB activation is regulated through inhibition of STAT1and STAT3 phosphorylation in response to luteolin. Additionally, luteolin caused the induction of HO-1 via upregulation of Nrf2, both of which are involved in the secretion of proinflammatory mediators. The blockade of HO-1 expression with SnPP, a HO-1 inhibitor, attenuated HO-1 induction by luteolin and thus mitigated its anti-inflammatory effects during PRV-infected RAW264.7 cells. Taken together, our data indicate that luteolin diminishes the proinflammatory mediators NO, inflammatory cytokines and the expression of their regulatory genes, iNOS and COX-2, in PRV-infected RAW264.7 cells by inhibiting STAT1/3 dependent NF-κB activation and inducing Nrf2⁻mediated HO-1 expression.



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Mitochondrial stress induces cellular senescence in an mTORC1-dependent manner

Publication date: Available online 23 March 2016
Source:Free Radical Biology and Medicine
Author(s): Timothy Nacarelli, Ashley Azar, Christian Sell
Although mitochondrial stress is a key determinant of cellular homeostasis, the intracellular mechanisms by which this stress is communicated to the nucleus and its impact on cell fate decisions are not well defined. In this study, we report that activation of mTORC1 signaling triggered by mitochondrial-generated reactive oxygen species (ROS) results in activation of the senescence program. We show that exposure of human fibroblasts to nucleoside analogs commonly used in antiretroviral therapies, and known to induce mitochondrial dysfunction, increases mitochondrial ROS and leads to a rise in intracellular ROS concomitant with activation of mTORC1. In this setting, it appears that mTORC1 activates senescence through HDM2 phosphorylation, facilitating a p53-mediated response. Inhibition of mTORC1 by rapamycin decreases HDM2 phosphorylation and blocks activation of the senescence program in human cells. In addition, decreasing mitochondrial ROS directly blocks mTORC1 signaling and prevents the onset of senescence. Consistent with these results, both total and mitochondrial-specific ROS increased in cells undergoing replicative senescence along with ribosomal p70 phosphorylation. The results reveal a novel link between mitochondrial dysfunction, mTORC1 signaling, and the senescence program.Summary: Mitochondrial ROS activates mTORC1/p70S6 kinase signaling to induce senescence

Graphical abstract

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Psychopathic traits affect the visual exploration of facial expressions

Publication date: Available online 22 March 2016
Source:Biological Psychology
Author(s): Sabrina Boll, Matthias Gamer
Deficits in emotional reactivity and recognition have been reported in psychopathy. Impaired attention to the eyes along with amygdala malfunctions may underlie these problems. Here, we investigated how different facets of psychopathy modulate the visual exploration of facial expressions by comparing personality traits in a sample of healthy young adults to eye-tracking data obtained in a face perception task. Fearless Dominance (the interpersonal-emotional facet of psychopathy) and Coldheartedness scores predicted reduced face exploration consistent with findings on lowered emotional reactivity in psychopathy. Moreover, participants high on the social deviance facet of psychopathy ('Self-Centered Impulsivity') showed a reduced bias to shift attention towards the eyes. Our data suggest that facets of psychopathy modulate face processing in healthy individuals and reveal possible attentional mechanisms which might be responsible for the severe impairments of social perception and behavior observed in psychopathy.



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Neural underpinnings of divergent production of rules in numerical analogical reasoning

Publication date: Available online 22 March 2016
Source:Biological Psychology
Author(s): Xiaofei Wu, Rex E. Jung, Hao Zhang
Creativity plays an important role in numerical problem solving. Although the neural underpinnings of creativity have been studied over decades, very little is known about neural mechanisms of the creative process that relates to numerical problem solving. In the present study, we employed a numerical analogical reasoning task with functional Magnetic Resonance Imaging (fMRI) to investigate the neural correlates of divergent production of rules in numerical analogical reasoning. Participants performed two tasks: a multiple solution analogical reasoning task and a single solution analogical reasoning task. Results revealed that divergent production of rules involves significant activations at Brodmann area (BA) 10 in the right middle frontal cortex, BA 40 in the left inferior parietal lobule, and BA 8 in the superior frontal cortex. The results suggest that right BA 10 and left BA 40 are involved in the generation of novel rules, and BA 8 is associated with the inhibition of initial rules in numerical analogical reasoning. The findings shed light on the neural mechanisms of creativity in numerical processing.



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JCM, Vol. 5, Pages 39: Osteopontin—A Master Regulator of Epithelial-Mesenchymal Transition

Osteopontin (OPN) plays an important functional role in both physiologic and pathologic states. OPN is implicated in the progression of fibrosis, cancer, and metastatic disease in several organ systems. The epithelial-mesenchymal transition (EMT), first described in embryology, is increasingly being recognized as a significant contributor to fibrotic phenotypes and tumor progression. Several well-established transcription factors regulate EMT and are conserved across tissue types and organ systems, including TWIST, zinc finger E-box-binding homeobox (ZEB), and SNAIL-family members. Recent literature points to an important relationship between OPN and EMT, implicating OPN as a key regulatory component of EMT programs. In this review, OPN's interplay with traditional EMT activators, both directly and indirectly, will be discussed. Also, OPN's ability to restructure the tissue and tumor microenvironment to indirectly modify EMT will be reviewed. Together, these diverse pathways demonstrate that OPN is able to modulate EMT and provide new targets for directing therapeutics.

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An Advanced Orthotopic Ovarian Cancer Model in Mice for Therapeutic Trials

A nude mouse received subcutaneous injection of human ovarian cancer cells HO-8910PM to form a tumor, and then the tumor fragment was surgically transplanted to the ovary of a recipient mouse to establish an orthotopic cancer model. Tumors occurred in 100% of animals. A mouse displayed an ovarian mass, ascites, intraperitoneal spread, and lung metastasis at natural death. The mean survival time was days, with median survival time of 28.5 days. The findings indicated that the present mouse model can reflect the biological behavior of advanced human ovarian cancers. This in vivo model can be used to explore therapeutic means against chemoresistance and metastasis, and an effective treatment would prolong the survival time.

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Smith KE, Hill S and Bambra C (eds.). Health inequalities, critical perspectives.

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How have trends in lifespan variation changed since 1950? A comparative study of 17 Western European countries

Lifespan variation adds to life expectancy by measuring the inequality surrounding age of death that a population faces. Countries that tackle premature mortality generally have decreasing lifespan variation but this is the first study to compare and statistically assess when and to what extent trends in lifespan variation have changed across Western Europe. Lifespan variation was measured using e and joinpoint regression analysed the timing and rate of change. Trends have been mostly downward with the recent exception of men in Scotland, Northern Ireland, Ireland and Finland where trends have flattened or show slight increases. Future research aimed at identifying the ages and causes of death, driving trends in these countries, is key to preventing increasing inequalities.

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European Public Health News * EUPHA President's Column * EUPHA Office Column * Message from the WHO Regional Director for Europe * Message from Vytenis Andriukaitis, EU Commissioner for Health and Food Safety * 9th European Public Health Conference--'All for Health--Health for All

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Mapping health research capacity in 17 countries of the former Soviet Union and south-eastern Europe: an exploratory study

Background: Policies to improve health status, tackle disease and ensure equitable access to healthcare should be informed by evidence derived from high-quality research. However, health research capacity is unevenly distributed across countries, as revealed by mapping exercises that have been undertaken to provide a basis for concerted action to strengthen capacity. This study systematically describes capacity to undertake health research in the countries of the former Soviet Union and south-eastern Europe and identifies the elements required to create a national health research system. Methods: The mapping exercise comprised two elements: a survey of key informants in the respective countries and a bibliometric analysis of scientific publications in the field of public health. Results: Our results confirm that health research remains a low priority in some countries of the WHO European Region. In these countries, most of the literature was produced by researchers outside the country, often to inform international donors. Conclusions: This study provides important information for countries seeking to initiate action to strengthen their research capacity. There is a need for a comprehensive strategy with sustained investment in training and career development of researchers. There is also a need to create new funding systems to provide financial support to those undertaking policy-relevant research. International collaboration and investment in mechanisms to bridge the gap between research and policy are urgently required.

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Relationship of secondhand smoke exposure with sociodemographic factors and smoke-free legislation in the European Union

Background: To explore whether exposure to secondhand smoke (SHS) among non-smokers in the European Union (EU) showed any association with sociodemographic factors and/or the extent of national tobacco control policies. Methods: A secondary analysis was performed on data from 26 751 individuals ≥15 years old from 27 EU member states (EU MS), collected during the 2012 Special Eurobarometer survey (wave 77.1). Respondents were asked whether they had been exposed to SHS in eating or drinking establishments during the past 6 months, and/or in their workplace. Data on smoke-free policies were extracted from the European Tobacco Control Status Report and the European Tobacco Control Scale (TCS) in 2013. Results: In total, 29.0% of non-smoking participants reported being exposed to SHS in indoor areas. Males (vs. females) as well as individuals with difficulties to pay bills (vs. those with no difficulties), had significantly greater odds of being exposed to SHS in bars, restaurants and workplaces. For every unit increase of a country's score on the Smoke-free Component of the TCS (indicating greater adherence to smoke-free legislations) the odds ratio of reporting exposure to SHS was 0.82 in bars, 0.85 in restaurants and 0.94 in workplaces. Conclusions: Differences in exposure to SHS clearly exist between and within EU MS, despite the fact that they all have signed the Framework Convention on Tobacco Control, with the burden found to disproportionally affect younger people and individuals with financial difficulties. Moreover, enforcement of smoke-free legislation was inversely associated with SHS exposure, highlighting the importance of enforcing comprehensive smoking bans.

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Insights into the concept of vitality: associations with participation and societal costs

Background: In healthcare, the focus is currently shifting from someone's disabilities to someone's abilities, which is also evident from the increasing focus on vitality. Vitality (here defined as energy, motivation and resilience) is an often used concept, which also aims at someone's capabilities. However, little is known about vitality yet; in particular about its association with participation and societal costs. Methods: Within a cross-sectional design, information regarding vitality, participation and societal costs was collected among 8015 Dutch adults aged 20 years and over. Vitality was measured using the validated Dutch Vitality Questionnaire (Vita-16). Information on economic (i.e. want/able to work, work absenteeism, work performance), societal (i.e. voluntary work, informal care giving) and social participation (i.e. quantity and quality of social contacts) and societal costs (i.e. healthcare and work-related costs) was collected using an internet survey. Results: Significant associations were found between vitality and various economic (i.e. sustainable employability: want to work: β = 1.21, 95% CI: 0.99–1.43, able to work: β = 2.09, 95% CI: 1.79–2.38; work absenteeism: OR = 0.75, 95% CI: 0.71–0.79; work performance: β = 0.49, 95% CI: 0.46–0.52), societal (i.e. voluntary work, informal care) and social (i.e. quantity and quality of social contacts) participation measures, as well as between vitality and societal costs (i.e. healthcare costs: β = –213.73, 95% CI: -311.13 to -107.08), absenteeism costs: β = –338.57, 95% CI: -465.36 to -214.14 and presenteeism costs: β = –1293.31, 95% CI: -1492.69 to -1088.95). Conclusion: This study showed significant positive associations between vitality and economic, societal and social participation and negative associations between vitality and societal costs. This may stimulate research on interventions enhancing and maintaining vitality and thereby contributing to improved participation and reduced costs.

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Tobacco use among prison staff in Germany: a cross-sectional study

Background: Studies on tobacco in the prison environment report high prevalence of use among detainees, but little data regarding staff are available. An observational study addressing tobacco control in German prisons was conducted in 2011. It involved multiple strands (quantitative and qualitative components) both among detainees and staff. This article presents quantitative results regarding staff. Methods: Cross-sectional study among prison employees in 16 different institutions in nine regions (Länder) in Germany. Tobacco use and second-hand smoke (SHS) exposure (primary outcomes) were assessed by a questionnaire designed specifically. Logistic regression models were used to assess the risk factors associated with each outcome. Results: Among 704 participants (60.6% male, mean age 43.9 years ± 9.33), 27.7% are smokers and 68% declared to be exposed to SHS. Independent factors associated with smoking were female gender [odds ratio (OR) 1.49, P = 0.026], an age below 45 years (OR 1.35, P = 0.08) and working in areas other than administration (OR P = 0.08). An age below 45 was associated with a higher degree of self-reported SHS exposure. The association between SHS and gender was different depending on occupational area with significantly more men exposed to SHS in administrative area and more women in health/social area (interaction between gender and occupational area, P = 0.02). Conclusion: Importance of SHS exposure among prison employees and confirm the need for a comprehensive tobacco control policy including support to smoking cessation and better enforcement of the smoke-free regulation, especially where staff contributes to SHS. Particular attention has to be given to female employees.

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Childrens hand hygiene behaviour and available facilities: an observational study in Dutch day care centres

Background: Children attending day care centres are at increased risk of infectious diseases, in particular gastrointestinal and respiratory infections. Hand hygiene of both caregivers and children is an effective prevention measure. This study examined hand hygiene behaviour of children attending day care centres, and describes hygiene facilities at day care centres. Methods: Data were collected at 115 Dutch day care centres, among 2318 children cared for by 231 caregivers (August to October 2010). Children's hand hygiene behaviour was observed and data on hand hygiene facilities of the day care centres collected by direct unobtrusive observation. National guidelines indicate hand hygiene is required before eating, after toilet use and after playing outside. Results: Among 1930 observed hand hygiene opportunities for children, overall adherence to hand hygiene guidelines was 31% (95% CI: 29–33%). Adherence after both toilet use and playing outside was 48%. Hands were less frequently washed before eating, where guideline adherence was 15%. In 38% of the playrooms there was no soap within reach of children and 17% had no towel facilities. In over 40% of the playrooms, appropriate hand hygiene facilities for children were lacking. Conclusion: Adequate hand washing facilities were available for children in only half of the participating day care centres in our study and children washed their hands in only 15–48% of the occasions defined by official guidelines. More attention is needed to hand hygiene of children attending day care centres in the prevention of infectious diseases.

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Access to care in the Baltic States: did crisis have an impact?

Background: In 2009, brief but deep economic crisis profoundly affected the three Baltic States: Estonia, Latvia and Lithuania. In response, all three countries adopted severe austerity measures with the shared goal of containing rising deficits, but employing different methods. Aims: In this article, we analyze the impact of the economic crisis and post-crisis austerity measures on health systems and access to medical services in the three countries. Methods: We use the EU-SILC data to analyze trends in unmet medical need in 2005–2012, and apply log-binomial regression to calculate the risk of unmet medical need in the pre- and post- crisis period. Results: Between 2009 and 2012 unmet need has increased significantly in Latvia (OR: 1.24, 95% confidence interval (CI): 1.15–1.34) and Estonia (OR: 1.98, 95% CI: 1.72–2.27), but not Lithuania (OR: 0.84. 95% CI: 0.69–1.04). The main drivers of increased unmet need were inability to afford care in Latvia and long waiting lists in Estonia. Conclusion: The impact of the crisis on access to care in the three countries varied, as did the austerity measures affecting their health systems. Estonia and Latvia experienced worsening access to care, largely exacerbating already existing barriers. The example of Lithuania suggests that deterioration in access is not inevitable, once health policies prioritise maintenance and availability of existing services, or if there is room for reducing existing inefficiencies. Moreover, better financial preparedness of health systems in Estonia and Lithuania achieved some protection of the population from increasing unmet need due to the rising cost of medical care.

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Educational differences in disability retirement among young employees in Helsinki, Finland

Background: Disability retirement (DR) among young employees is an increasing problem affecting work life and public health, given the potential major loss of working time. Little is known about educational differences in the risk of DR among young employees, despite the need for such knowledge in targeting preventive measures. We examined the association between education and DR due to any cause and to mental and non-mental causes among young employees. Methods: Personnel register data of the City of Helsinki from the years 2002–2013 for 25-to-34-year-old employees (n = 41225) were linked to register data from the Finnish Centre for Pensions on DR (n = 381), and from Statistics Finland on education. Education was categorised into four hierarchical groups. The mean follow-up time was 5.7 years. Cox regression analysis was used. Results: There were 381 DR events and of the events, over 70% were due to mental disorders and 72% were temporary. A consistent educational gradient was found. Those with a basic education were at the highest risk of DR due to any cause (HR 4.64, 95% CI 3.07, 7.02), and to mental (HR 4.79, 95% CI 2.89, 7.94) and non-mental causes (HR 4.32, 95% CI 2.10, 8.91). Conclusions: DR due to any cause, and to mental and non-mental causes, followed a clear educational gradient. Early intervention, treatment and rehabilitation with a view to maintaining work ability are needed among young employees, especially those with low education. Adapting working conditions to their health and work ability may also help to avoid premature exit from work.

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Age- and cause-specific contributions to income difference in life expectancy at birth: findings from nationally representative data on one million South Koreans

Background: Income is not frequently used to monitor health equity on a national level largely due to the lack of public data on income. Information on income allows policy makers to identify the economically disadvantaged population in a country directly. We examined differences in life expectancy (LE) at birth by income and quantified age- and cause-specific contributions to the LE differences using national health insurance data. Methods: Data from a nationally representative sample of 1 097 333 South Koreans (2% of the total population) collected between 2002 and 2010 (39 737 deaths) were used. National health insurance premiums were used to estimate income level. Age- and cause-specific contributions to differences in LE at birth by income were estimated using Arriaga's decomposition method. Results: LE at birth gradually increased with income in both genders. Interquintile income LE differences were 7.93 years in males and 3.82 years in females. Most of LE differentials were attributed to differences in mortality in middle-aged and older adults. Suicide and cerebrovascular accidents were the two leading causes of death contributing the most to income LE differences in both males and females. The top 10 causes of death accounted for over 50% of the total LE differences by income in both genders. Alcohol-related causes of death explained the majority of the gender differences in the income LE differentials. Conclusions: Income differentials in LE at birth according to national health insurance premiums and data linkage systems could provide a valuable opportunity for monitoring and prioritizing population health inequalities in South Korea.

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Educational inequality as a predictor of rising back pain prevalence in Austria--sex differences

Background: Back pain (BP) represents a widespread public health problem in Europe. The morbidity depends on several indicators, which must be investigated to discover risk groups. The examination of trends in socioeconomic developments should ensure a better understanding of the complex link between socioeconomic-status and BP. Therefore, the role of social inequalities for BP has been investigated among Austrian subpopulations over a 24-year period. Methods: Self-reported data from nationally representative health surveys (1983–2007) were analyzed and adjusted for self-report bias (N=121 486). Absolute changes (ACs) and aetiologic fractions (AF) were calculated to measure trends. To quantify the extent of social inequality, the relative index of inequality was computed based on educational levels. Results: The prevalence of BP nearly doubled between 1983 and 2007. When investigating educational groups, subjects with low educational level were most prevalent. Obese persons generally showed higher rates of BP than non-obese subjects. Continuously rising trends across the different educational groups were more evident in men. The AC was highest in obese men with high education (+32.9%). Education-related inequalities for BP were more evident in men than women. Conclusion: Educational level is an important social indicator for BP. A gradient for low to high educational level in the trends of BP prevalence was clearly identified and stable only among men. We presume that the association 'education' and 'physical workload leading to BP' is more relevant for men than for women. The implementation of effective approaches to BP, in combination with target group-specific interventions focusing on educational status, is recommended.

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Expectation of sickness absence duration: a review on statements and methods used in guidelines in Europe and North America

Background: Certifying physicians play a key role in the management of sickness absence and are often provided with guidelines. Some of these guidelines contain statements on expected sickness absence duration, according to diagnosis. We were interested in exploring the evidence base of these statements. Methods: We identified guidelines through a survey of EUMASS members and a literature search of the Internet and PubMed. We extracted the statements and methods from the guidelines. We compared: diagnoses that were addressed, expected durations and development processes followed. Next, we presented our findings to the developers, to afford them an opportunity to comment and/or correct any misinterpretations. Results: We identified 4 guidelines from social insurance institutions (France, Serbia, Spain and Sweden) and 4 guidelines from private organisations (1 Netherlands, 3 US). Guidelines addressed between 63 and some 63000 health conditions (ICD 10 codes). Health conditions overlapped among guidelines. Direct comparison is hampered by differences in coding (ICD 9 or 10) and level of aggregation (three or four digit, clustering of diseases and treatment situations). Expectations about duration are defined as minimum, maximum, and optimum or mean or median and percentile distribution, stratified to age and work requirements. In a sample of 5 diagnoses we found overlap in expected duration but also differences. Guidelines are developed differently, pragmatic expert consensus being used most, supplemented with data on sickness absence from different registers, other guidelines and non-systematic literature reviews. The effectiveness of these guidelines has not yet been formally evaluated. Conclusions: Expectations about duration of sickness absence by diagnosis are expressed in several guidelines. The expectations are difficult to compare, their evidence base is unclear and their effectiveness needs to be established.

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Ethnic variations in upper gastrointestinal hospitalizations and deaths: the Scottish Health and Ethnicity Linkage Study

Background: Upper gastrointestinal (GI) diseases are common, but there is a paucity of data describing variations by ethnic group and so a lack of understanding of potential health inequalities. We studied the incidence of specific upper GI hospitalization and death by ethnicity in Scotland. Methods: Using the Scottish Health and Ethnicity Linkage Study, linking NHS hospitalizations and mortality to the Scottish Census 2001, we explored ethnic differences in incidence (2001–10) of oesophagitis, peptic ulcer disease, gallstone disease and pancreatitis. Relative Risks (RRs) and 95% confidence intervals were calculated using Poisson regression, multiplied by 100, stratified by sex and adjusted for age, country of birth (COB) and socio-economic position. The White Scottish population (100) was the reference population. Results: Ethnic variations varied by outcome and sex, e.g. adjusted RRs (95% confidence intervals) for oesophagitis were comparatively higher in Bangladeshi women (209; 124–352) and lower in Chinese men (65; 51–84) and women (69; 55–88). For peptic ulcer disease, RRs were higher in Chinese men (171; 131–223). Pakistani women had higher RRs for gallstone disease (129; 112–148) and pancreatitis (147; 109–199). The risks of upper GI diseases were lower in Other White British and Other White [e.g. for peptic ulcer disease in men, respectively (74; 64–85) and (81; 69–94)]. Conclusion: Risks of common upper GI diseases were comparatively lower in most White ethnic groups in Scotland. In non-White groups, however, risk varied by disease and ethnic group. These results require consideration in health policy, service planning and future research.

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Workplace social capital and risk of long-term sickness absence. Are associations modified by occupational grade?

Background: Workplace social capital (WSC) is an emerging topic among both work environment professionals and researchers. We examined (i) whether high WSC protected against risk of long-term sickness absence (LTSA) in a random sample of the Danish workforce during a 1-year follow-up and (ii) whether the association of WSC with sickness absence was modified by occupational grade. Methods: We measured WSC by self-report in a cohort of 3075 employees and linked responses to a national register of sickness absence. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) of onset of LTSA (≥21 days), adjusted for covariates. We stratified analyses by occupational grade and examined if there was an interaction effect of WSC and occupational grade. Results: A one standard deviation higher WSC score predicted a reduced risk of sickness absence after adjustment for sociodemographic variables, prevalent health problems and health behaviours (HR = 0.85, 95% CI = 0.74–0.99). The HR was attenuated and lost statistical significance after further adjustment for occupational grade (HR = 0.90, 95% CI = 0.78–1.04). When stratified by occupational grade, high WSC predicted a decreased risk of sickness absence among higher grade workers (HR = 0.61, 95% CI = 0.44–0.84) but not among lower grade workers (HR = 0.98, 95% CI = 0.83–1.15). The interaction effect of WSC and occupational grade was statistically significant (HR = 0.97, 95% CI = 0.95–0.99). Conclusion: High WSC might reduce risk of LTSA. However, the protective effect appears to be limited to workers of higher occupational grade.

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Disentangling the relative importance of different socioeconomic resources for myocardial infarction incidence and survival: a longitudinal study of over 300 000 Finnish adults

Background: Lower socioeconomic position (SEP) is associated with an increased risk of myocardial infarction (MI) incidence and mortality, but the relative importance of different socioeconomic resources at different stages of the disease remains unclear. Methods: A nationally representative register-based sample of 40- to 60-year-old Finnish men and women in 1995 (n = 302 885) were followed up for MI incidence and mortality in 1996–2007. We compared the effects of education, occupation, income and wealth on first MI incidence, first-day and long-term fatality. Cox's proportional hazards regression and logistic regression models were estimated adjusting for SEP covariates simultaneously to assess independent effects. Results: Fully adjusted models showed greatest relative inequalities of MI incidence by wealth in both sexes, with an increased risk also associated with manual occupations. Education was a significant predictor of incidence in men. Low income was associated with a greater risk of death on the day of MI incidence [odds ratio (OR) = 1.40 in men and 1.95 in women when comparing lowest and highest income quintiles], and in men, with long-term fatality [hazard ratio (HR) = 1.74]. Wealth contributed to inequalities in first-day fatality in men and in long-term fatality in both sexes. Conclusion: The results show that different socioeconomic resources have diverse effects on the disease process and add new evidence on the significant association of wealth with heart disease onset and fatality. Targeting those with the least resources could improve survival in MI patients and help reduce social inequalities in coronary heart disease mortality.

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