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Situating Information History:The History and Historiography of Information and Its Practices
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Fatigue in people with primary biliary cholangitis:a position paper from the European Reference Network for Rare Liver Diseases
No full textGiven the unmet need of fatigue in primary biliary cholangitis (PBC), the PBC working group of the European Reference Network for Rare Liver Diseases assessed and summarised the current evidence relating to fatigue in PBC to provide guidance for clinical practice and identify knowledge gaps to shape the future research agenda. Six key questions regarding PBC-related fatigue were summarised through systematic review and meta-analyses. Fatigue is highly prevalent in PBC and substantially affects health-related quality of life. Several measurement tools are available but future research should emphasise longitudinal designs to track symptoms with easy-to-apply and accurate tools. The pathophysiology of fatigue in PBC remains largely unknown and involves a complex interplay of various factors. Pilot studies suggest the effectiveness of non-pharmacological treatments, which warrant further investigation. Pending the results of clinical trials, no pharmacological treatment can be recommended for PBC-related fatigue. Finally, we introduce a practical, three-step ASK-MEASURE-TREAT algorithm that can be applied in all patients with PBC.</p
Occupational exposure to respirable crystalline quartz and the risk of incident acute myocardial infarction
No full textWe aimed to investigate the association between occupational exposure to respirable crystalline quartz (RCQ) and acute myocardial infarction (AMI) in a Danish register-based cohort (DOC*X Dust, n = 903,415). Through 1976–2017, information on occupation was linked to quantitative exposure estimates of RCQ, obtained from the job-exposure matrix of SYN-JEM. The follow-up period (1996–2018) counted 19,357,326 person-years, where 35,511 first-time AMIs occurred, according to register-based hospital contacts. Incidence rate ratios (IRRs) for AMI based on cumulative, recent, and maximum exposure were computed using Poisson regression adjusted for socio-economic factors, comorbidities, air pollution, and other occupational exposures such as noise, physically demanding work, exposure to diesel exhaust, and job strain. For cumulative exposure, the IRR for AMI in the unadjusted model was highest in the two lowest exposed quartiles (IRR for Q1 = 1.19 (95%CI: 1.13–1.25), IRR for Q2 = 1.12 (95%CI: 1.06, 1.17)). However, in the fully adjusted model, these associations were no longer significant and even inverse for exposed above 25th percentile. The lowest IRR was observed in the highest RCQ exposure quartile (IRR = 0.87, (95%CI: 0.83–0.92)). In general, the RCQ exposure levels in the DOC*X Dust cohort were presumed to be lower than in countries that – contrary to Denmark – have an active mining industry. In conclusion, no increased risk of AMI due to RCQ exposure was observed, but cautious interpretation is warranted because of potential bias from the healthy worker survivor effect.We aimed to investigate the association between occupational exposure to respirable crystalline quartz (RCQ) and acute myocardial infarction (AMI) in a Danish register-based cohort (DOC*X Dust, n = 903,415). Through 1976–2017, information on occupation was linked to quantitative exposure estimates of RCQ, obtained from the job-exposure matrix of SYN-JEM. The follow-up period (1996–2018) counted 19,357,326 person-years, where 35,511 first-time AMIs occurred, according to register-based hospital contacts. Incidence rate ratios (IRRs) for AMI based on cumulative, recent, and maximum exposure were computed using Poisson regression adjusted for socio-economic factors, comorbidities, air pollution, and other occupational exposures such as noise, physically demanding work, exposure to diesel exhaust, and job strain. For cumulative exposure, the IRR for AMI in the unadjusted model was highest in the two lowest exposed quartiles (IRR for Q1 = 1.19 (95%CI: 1.13–1.25), IRR for Q2 = 1.12 (95%CI: 1.06, 1.17)). However, in the fully adjusted model, these associations were no longer significant and even inverse for exposed above 25th percentile. The lowest IRR was observed in the highest RCQ exposure quartile (IRR = 0.87, (95%CI: 0.83–0.92)). In general, the RCQ exposure levels in the DOC*X Dust cohort were presumed to be lower than in countries that–contrary to Denmark–have an active mining industry. In conclusion, no increased risk of AMI due to RCQ exposure was observed, but cautious interpretation is warranted because of potential bias from the healthy worker survivor effect.</p
Atrial cardiomyopathy:markers and outcomes
No full textBackground and Aims Atrial cardiomyopathy (AtCM) is increasingly recognized as an important substrate for atrial fibrillation (AF). This study aimed to examine potential markers and risk factors of AtCM, and associations with incident AF, heart failure (HF), and stroke. Methods Individuals from the UK Biobank with cardiac magnetic resonance imaging and electrocardiographic information were included. Atrial cardiomyopathy markers included left atrial dilation, left atrial mechanical dysfunction, P-wave prolongation, and abnormal P-wave terminal force. Risk factors for AtCM were assessed using logistic regressions. Incident AF, HF, and stroke according to AtCM markers were assessed in multivariable Cox-regression and cumulative incidence models. AF risk according to AtCM markers, clinical and genetic risk factors was evaluated by integrating the HARMS(2)-AF score and a polygenic risk score for AF. We used net reclassification improvement (NRI) to evaluate reclassification of risk when considering AtCM markers. Results Among 26 467 individuals, 4145 (15.7%) had >= 1 marker and 619 (2.3%) had >= 2 markers of AtCM. Age, coronary artery disease, and hypertension were consistently associated with AtCM. Having one AtCM marker conferred a hazard ratio (HR) for AF of 1.88 [95% confidence interval (CI): 1.54-2.31; P < .001], with higher rates observed in individuals with >= 2 markers (HR: 4.59; 95% CI: 3.52-5.99; P < .001). Addition of AtCM markers was associated with an NRI of 13.7% (95% CI: 9.2%-18.3%). Integration of clinical and genetic risk factors indicated an additive effect on AF rates. Having >= 2 markers associated with HF (HR: 3.08, 95% CI: 2.03-4.66, P < .001), and stroke (HR: 3.07, 95% CI: 1.78-5.28, P < .001). Conclusions One in seven individuals had at least one marker of AtCM. Atrial cardiomyopathy markers were associated with AF, HF, and stroke, supporting AtCM as a common substrate for all three outcomes
