Associations between interarm differences in blood pressure and cardiovascular disease outcomes: protocol for an individual patient data meta-analysis and development of a prognostic algorithm.

Introduction: Individual cohort studies in various populations and study-level meta-analyses have shown interarm differences (IAD) in blood pressure to be associated with increased cardiovascular and all-cause mortality. However, key questions remain, such as follows: (1) What is the additional contribution of IAD to prognostic risk estimation for cardiovascular and all-cause mortality? (2) What is the minimum cut-off value for IAD that defines elevated risk? (3) Is there a prognostic value of IAD and do different methods of IAD measurement impact on the prognostic value of IAD? We aim to address these questions by conducting an individual patient data (IPD) meta-analysis.

Methods And Analysis: This study will identify prospective cohort studies that measured blood pressure in both arms during recruitment, and invite authors to contribute IPD datasets to this collaboration.

Chemical and Physical Exposures in the Emerging US Green-Collar Workforce.

Objective: "Green collar" workers serve in occupations that directly improve environmental quality and sustainability. This study estimates and compares the prevalence of select physical and chemical exposures among green versus non-green U.S.

Green Collar Workers: An Emerging Workforce in the Environmental Sector.

Objective: We describe the socio-demographic, occupational, and health characteristics of "green collar" workers, a vital and emerging workforce in energy-efficiency and sustainability.

Methods: We linked data from the 2004 to 2012 National Health Interview Surveys (NHIS) and US Occupational Information Network (O*NET). Descriptive and logistic regression analyses were conducted using green collar worker status as the outcome (n = 143,346).

Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI.

Background: Coronary revascularization guided by fractional flow reserve (FFR) is associated with better patient outcomes after the procedure than revascularization guided by angiography alone. It is unknown whether the instantaneous wave-free ratio (iFR), an alternative measure that does not require the administration of adenosine, will offer benefits similar to those of FFR.

Methods: We randomly assigned 2492 patients with coronary artery disease, in a 1:1 ratio, to undergo either iFR-guided or FFR-guided coronary revascularization.

Management of thyroid eye disease in the United Kingdom: A multi-centre thyroid eye disease audit.

This article aims to provide baseline data and highlight any major deficiencies in the current level of care provided for adult patients with thyroid eye disease (TED). We undertook a prospective, nonrandomized cross-sectional multicenter observational study. During a 3-month period June-August 2014, consecutive adult patients with TED who presented to nominated specialist eye clinics in the United Kingdom, completed a standardized questionnaire.

Hepatitis E virus: Emerging from the shadows in developed countries.

Following the discovery of HEV in the 1980s, it became apparent that HEV is endemic in a number of developing countries in Asia, Africa and Mexico. In these geographical settings HEV is spread oral faecally by HEV genotypes (gt) 1 and 2, which are obligate human pathogens. Infection occurs oro-faecally, often as a result in the breakdown of fragile sanitary infrastructure allowing drinking water supplies to become contaminated with human sewage.

Mud-Bath Therapy in Addition to Usual Care in Bilateral Knee Osteoarthritis: An Economic Evaluation Alongside a Randomized Controlled Trial.

Objective: To perform a cost-effectiveness analysis of mud-bath therapy (MBT) in addition to usual treatment compared to usual treatment alone in patients with bilateral knee osteoarthritis (OA).

Methods: An economic evaluation alongside a randomized controlled trial was conducted. Patients were randomly assigned to receive either a 2-week cycle of MBT in addition to their usual treatment or to continue routine care alone.

Association between renin and atherosclerotic burden in subjects with and without type 2 diabetes.

Background: Activation of the renin-angiotensin-aldosterone-system (RAAS) has been proposed to contribute to development of vascular complications in type 2 diabetes (T2D). The aim of the present study was to determine if plasma renin levels are associated with the severity of vascular changes in subjects with and without T2D.

Methods: Renin was analyzed by the Proximity Extension Assay in subjects with (n = 985) and without (n = 515) T2D participating in the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study and in 205 carotid endarterectomy patients.

A systematic review of the compression regimes used in randomised clinical trials following endovenous ablation.

Objectives There is insufficient evidence to inform guidelines on the optimal compression strategy following ablation for varicose veins. This study aimed to identify the practice of key opinion leaders performing randomised clinical trials involving endovenous ablation. Method A systematic review of MEDLINE/EMBASE/CENTRAL was performed identifying the compression strategies used in randomised clinical trials where at least one comparator arm underwent endovenous ablation.

Thyroid research: stepping forward.

It is eight years since Thyroid Research was launched with an aim to enhance opportunities for scientists and clinicians, working in the rapidly advancing field of thyroidology, to publish their research (Thyroid Res 1(1):1, 2008). Right from the outset, Thyroid Research aspired to become a prominent journal in thyroidology with high quality publications. Over the years, the journal has not only survived in the increasingly competitive field of open-access academic journal publication, it has also been making a steady progress towards achieving this ambitious goal.

Fifty years of longitudinal continuity in general practice: a retrospective observational study.

Background: Continuity of care has been defined as relational continuity between patient and doctor and longitudinal continuity describing the duration of the relationship. Measurement of longitudinal continuity alone is associated with outcomes including patient satisfaction, medical costs, hospital admissions and mortality.

Methods: In one UK general practice, records were searched for patients with continuous registration for 50 or more years.

Evolution of Quantitative Traits under a Migration-Selection Balance: When Does Skew Matter?

Quantitative-genetic models of differentiation under migration-selection balance often rely on the assumption of normally distributed genotypic and phenotypic values. When a population is subdivided into demes with selection toward different local optima, migration between demes may result in asymmetric, or skewed, local distributions. Using a simplified two-habitat model, we derive formulas without a priori assuming a Gaussian distribution of genotypic values, and we find expressions that naturally incorporate higher moments, such as skew.

The PsychENCODE project.

Recent research on disparate psychiatric disorders has implicated rare variants in genes involved in global gene regulation and chromatin modification, as well as many common variants located primarily in regulatory regions of the genome. Understanding precisely how these variants contribute to disease will require a deeper appreciation for the mechanisms of gene regulation in the developing and adult human brain. The PsychENCODE project aims to produce a public resource of multidimensional genomic data using tissue- and cell type–specific samples from approximately 1,000 phenotypically well-characterized, high-quality healthy and disease-affected human post-mortem brains, as well as functionally characterize disease-associated regulatory elements and variants in model systems.

Symptoms of Pancreatic Cancer in Primary Care: A Systematic Review.

Objectives: The aim of this study was to quantify the risk of pancreatic cancer in patients presenting in primary care with symptoms that may indicate pancreatic cancer.

Methods: We searched MEDLINE, PreMEDLINE, EMBASE, the Cochrane Library, Web of Science, and ISI Proceedings (1980 to August 2014) and PsychINFO (1980 to May 2013) for diagnostic studies of symptomatic adult patients in primary care. Study quality was assessed using QUADAS-II, and data were extracted to calculate the positive predictive values (PPVs) of symptoms, singly or in combination, for pancreatic cancer.

Recognition and Management of Individuals With Hyperglycemia Because of a Heterozygous Glucokinase Mutation.

Glucokinase-maturity-onset diabetes of the young (GCK-MODY), also known as MODY2, is caused by heterozygous inactivating mutations in the GCK gene. GCK gene mutations are present in ∼1 in 1,000 of the population, but most are not diagnosed. They are common causes of MODY (10-60%): persistent incidental childhood hyperglycemia (10-60%) and gestational diabetes mellitus (1-2%).

Cadmium, one of the villains behind the curtain: has exposure to cadmium helped to pull the strings of seropositive rheumatoid arthritis pathogenesis all along?

Exposure to cadmium links smoking, the most import antetiological factor in the development of seropositive RA, and many of the other known contemporary risk factors. Epidemiological studies investigating the link between smoking, occupations, social class, region of residency and RA should consider cadmium exposure as an important confounding factor. Studies to determine if cadmium can induce citrullination will be pivotal in determining if cadmium has indeed been the villain behind the curtain regarding the pathogenesis of seropositive RA.

Bronchiectasis is a Model for Chronic Bacterial Infection Inducing Autoimmunity in Rheumatoid Arthritis.

Objective: To examine the potential of chronic severe bacterial infection to generate rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs), by studying patients with bronchiectasis (BR) alone and BR patients with rheumatoid arthritis (BR/RA).

Methods: We studied 122 patients with BR alone, 50 patients with BR/RA, and 50 RA patients without lung disease, as well as 87 patients with asthma and 79 healthy subjects as controls. RF levels were measured using an automated analyzer, and cyclic citrullinated peptide 2 (CCP-2) was used to detect ACPAs.

Elevated Plasma Levels of MMP-12 Are Associated With Atherosclerotic Burden and Symptomatic Cardiovascular Disease in Subjects With Type 2 Diabetes.

Objective: Matrix metalloproteinases (MMPs) degrade extracellular matrix proteins and play important roles in development and tissue repair. They have also been shown to have both protective and pathogenic effects in atherosclerosis, and experimental studies have suggested that MMP-12 contributes to plaque growth and destabilization. The objective of this study was to investigate the associations between circulating MMPs, atherosclerosis burden, and incidence of cardiovascular disease with a particular focus on type 2 diabetes mellitus.

A simple technique to identify key recruitment issues in randomised controlled trials: Q-QAT - Quanti-Qualitative Appointment Timing.

Background: Recruitment to pragmatic randomised controlled trials (RCTs) is acknowledged to be difficult, and few interventions have proved to be effective. Previous qualitative research has consistently revealed that recruiters provide imbalanced information about RCT treatments. However, qualitative research can be time-consuming to apply.

Assessing Competence in Collaborative Case Conceptualization: Development and Preliminary Psychometric Properties of the Collaborative Case Conceptualization Rating Scale (CCC-RS).

Background: Case conceptualization is assumed to be an important element in cognitive-behavioural therapy (CBT) because it describes and explains clients' presentations in ways that inform intervention. However, we do not have a good measure of competence in CBT case conceptualization that can be used to guide training and elucidate mechanisms.

Aims: The current study addresses this gap by describing the development and preliminary psychometric properties of the Collaborative Case Conceptualization - Rating Scale (CCC-RS; Padesky et al.