Riviste scientifiche

A series of jokes that work best out of order

New Scientist - Mer, 13/01/2021 - 19:00
Reading magazines back to front, plus where do all the teaspoons go and whether pyjamas affect productivity, in Feedback’s weird weekly round-up

Second Spring review: A brave film about agency and cognitive decline

New Scientist - Mer, 13/01/2021 - 19:00
In Second Spring, an archaeologist who has developed a lesser-known form of dementia that alters her personality, unmasks her new life – to the dismay of friends and family

You can boost a vaccine’s effect with good moods and good friends

New Scientist - Mer, 13/01/2021 - 19:00
A positive outlook, even just on the day of receiving a vaccine, as well as strong social ties and a happy relationship can help increase antibodies made in response to a shot

Chemical that makes chilli peppers spicy boosts solar panel cells

New Scientist - Mer, 13/01/2021 - 17:29
Solar cells treated with capsaicin, the compound that makes chilli peppers taste spicy, are more efficient at converting solar energy

Multimorbidity combinations, costs of hospital care and potentially preventable emergency admissions in England: A cohort study

PLoS Medicine - Mer, 13/01/2021 - 15:00

by Jonathan Stokes, Bruce Guthrie, Stewart W. Mercer, Nigel Rice, Matt Sutton

Background

Patients with multimorbidities have the greatest healthcare needs and generate the highest expenditure in the health system. There is an increasing focus on identifying specific disease combinations for addressing poor outcomes. Existing research has identified a small number of prevalent “clusters” in the general population, but the limited number examined might oversimplify the problem and these may not be the ones associated with important outcomes. Combinations with the highest (potentially preventable) secondary care costs may reveal priority targets for intervention or prevention. We aimed to examine the potential of defining multimorbidity clusters for impacting secondary care costs.

Methods and findings

We used national, Hospital Episode Statistics, data from all hospital admissions in England from 2017/2018 (cohort of over 8 million patients) and defined multimorbidity based on ICD-10 codes for 28 chronic conditions (we backfilled conditions from 2009/2010 to address potential undercoding). We identified the combinations of multimorbidity which contributed to the highest total current and previous 5-year costs of secondary care and costs of potentially preventable emergency hospital admissions in aggregate and per patient. We examined the distribution of costs across unique disease combinations to test the potential of the cluster approach for targeting interventions at high costs. We then estimated the overlap between the unique combinations to test potential of the cluster approach for targeting prevention of accumulated disease. We examined variability in the ranks and distributions across age (over/under 65) and deprivation (area level, deciles) subgroups and sensitivity to considering a smaller number of diseases.There were 8,440,133 unique patients in our sample, over 4 million (53.1%) were female, and over 3 million (37.7%) were aged over 65 years. No clear “high cost” combinations of multimorbidity emerged as possible targets for intervention. Over 2 million (31.6%) patients had 63,124 unique combinations of multimorbidity, each contributing a small fraction (maximum 3.2%) to current-year or 5-year secondary care costs. Highest total cost combinations tended to have fewer conditions (dyads/triads, most including hypertension) affecting a relatively large population. This contrasted with the combinations that generated the highest cost for individual patients, which were complex sets of many (6+) conditions affecting fewer persons. However, all combinations containing chronic kidney disease and hypertension, or diabetes and hypertension, made up a significant proportion of total secondary care costs, and all combinations containing chronic heart failure, chronic kidney disease, and hypertension had the highest proportion of preventable emergency admission costs, which might offer priority targets for prevention of disease accumulation. The results varied little between age and deprivation subgroups and sensitivity analyses.Key limitations include availability of data only from hospitals and reliance on hospital coding of health conditions.

Conclusions

Our findings indicate that there are no clear multimorbidity combinations for a cluster-targeted intervention approach to reduce secondary care costs. The role of risk-stratification and focus on individual high-cost patients with interventions is particularly questionable for this aim. However, if aetiology is favourable for preventing further disease, the cluster approach might be useful for targeting disease prevention efforts with potential for cost-savings in secondary care.

Plasma proteins associated with cardiovascular death in patients with chronic coronary heart disease: A retrospective study

PLoS Medicine - Mer, 13/01/2021 - 15:00

by Lars Wallentin, Niclas Eriksson, Maciej Olszowka, Tanja B. Grammer, Emil Hagström, Claes Held, Marcus E. Kleber, Wolfgang Koenig, Winfried März, Ralph A. H. Stewart, Harvey D. White, Mikael Åberg, Agneta Siegbahn

Background

Circulating biomarkers are associated with the development of coronary heart disease (CHD) and its complications by reflecting pathophysiological pathways and/or organ dysfunction. We explored the associations between 157 cardiovascular (CV) and inflammatory biomarkers and CV death using proximity extension assays (PEA) in patients with chronic CHD.

Methods and findings

The derivation cohort consisted of 605 cases with CV death and 2,788 randomly selected non-cases during 3–5 years follow-up included in the STabilization of Atherosclerotic plaque By Initiation of darapladIb TherapY (STABILITY) trial between 2008 and 2010. The replication cohort consisted of 245 cases and 1,042 non-cases during 12 years follow-up included in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study between 1997 and 2000. Biomarker levels were measured with conventional immunoassays and/or with the OLINK PEA panels CVD I and Inflammation. Associations with CV death were evaluated by Random Survival Forest (RF) and Cox regression analyses.Both cohorts had the same median age (65 years) and 20% smokers, while there were slight differences in male sex (82% and 76%), hypertension (70% and 78%), and diabetes (39% and 30%) in the respective STABILITY and LURIC cohorts. The analyses identified 18 biomarkers with confirmed independent association with CV death by Boruta analyses and statistical significance (all p < 0.0001) by Cox regression when adjusted for clinical characteristics in both cohorts. Most prognostic information was carried by N-terminal prohormone of brain natriuretic peptide (NTproBNP), hazard ratio (HR for 1 standard deviation [SD] increase of the log scale of the distribution of the biomarker in the replication cohort) 2.079 (95% confidence interval [CI] 1.799–2.402), and high-sensitivity troponin T (cTnT-hs) HR 1.715 (95% CI 1.491–1.973) carried most prognostic information. The other proteins with independent associations were growth differentiation factor 15 (GDF-15) HR 1.728 (95% CI 1.527–1.955), transmembrane immunoglobulin and mucin domain protein (TIM-1) HR 1.555 (95% CI 1.362–1.775), renin HR 1.501 (95% CI 1.305–1.727), osteoprotegerin (OPG) HR 1.488 (95% CI 1.297–1.708), soluble suppression of tumorigenesis 2 protein (sST2) HR 1.478 (95% CI 1.307–1.672), cystatin-C (Cys-C) HR 1.370 (95% CI 1.243–1.510), tumor necrosis factor-related apoptosis-inducing ligand receptor 2 (TRAIL-R2) HR 1.205 (95% CI 1.131–1.285), carbohydrate antigen 125 (CA-125) HR 1.347 (95% CI 1.226–1.479), brain natriuretic peptide (BNP) HR 1.399 (95% CI 1.255–1.561), interleukin 6 (IL-6) HR 1.478 (95% CI 1.316–1.659), hepatocyte growth factor (HGF) HR 1.259 (95% CI 1.134–1.396), spondin-1 HR 1.295 (95% CI 1.156–1.450), fibroblast growth factor 23 (FGF-23) HR 1.349 (95% CI 1.237–1.472), chitinase-3 like protein 1 (CHI3L1) HR 1.284 (95% CI 1.129–1.461), tumor necrosis factor receptor 1 (TNF-R1) HR 1.486 (95% CI 1.307–1.689), and adrenomedullin (AM) HR 1.750 (95% CI 1.490–2.056).The study is limited by the differences in design, size, and length of follow-up of the 2 studies and the lack of results from coronary angiograms and follow-up of nonfatal events.

Conclusions

Profiles of levels of multiple plasma proteins might be useful for the identification of different pathophysiological pathways associated with an increased risk of CV death in patients with chronic CHD.

Trial registration

ClinicalTrials.gov NCT00799903.

We’ve got intelligence all wrong – and that’s endangering our future

New Scientist - Mer, 13/01/2021 - 15:00
A narrow focus on IQ to determine success is depriving us of key decision-making smarts, as our faltering response to problems such as covid-19 and climate change shows

Superhuman sight may be possible with lens that makes UV light visible

New Scientist - Mer, 13/01/2021 - 14:06
A nanocrystal-coated lens can convert ultraviolet light into bright green, extending the range of people's vision

Artificial intelligence could train your dog how to sit

New Scientist - Mer, 13/01/2021 - 13:00
A prototype device can issue basic dog commands, use image recognition algorithms to check if they are carried out and provide a treat if they are

Is the UK right to delay the second dose of the covid-19 vaccines?

New Scientist - Mer, 13/01/2021 - 12:30
To vaccinate more people quickly, the UK is making people wait up to three months for a booster shot rather than the few weeks tested in trials. Here's what the evidence says about the situation

Houseflies have specialised wings that make them harder to swat

New Scientist - Mer, 13/01/2021 - 01:01
Some flies, including houseflies and blowflies, have specialised hindwings to help them take-off faster, making them trickier to catch

Lying makes us mimic the body language of the people we are talking to

New Scientist - Mer, 13/01/2021 - 01:01
When telling a lie, people may inadvertently imitate the body language of the person they are lying to – a finding that might eventually lead to a new lie detection test

Daily briefing: Pulsars hint at sea of gravitational waves

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/d41586-021-00084-1

Signs of ripples from supermassive black hole mergers in galaxies across the universe. Plus, the secret forces that squeeze and pull life into shape, and the questions around COVID vaccines and transmission.

Publisher Correction: Impacts of speciation and extinction measured by an evolutionary decay clock

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/s41586-020-03178-4

Publisher Correction: Impacts of speciation and extinction measured by an evolutionary decay clock

The mysterious extinction of the dire wolf

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/d41586-021-00072-5

DNA clues point to how dire wolves went extinct, a look at European science post-Brexit, and the lastest on RNA vaccines.

A pair of whirlpools delicately move an embryo — contact-free

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/d41586-021-00059-2

Vortex ‘tweezers’ can pick up and transport particles just 1 millimetre wide.

Traitorous COVID antibodies and fast-spreading variant

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/d41586-021-00017-y

The latest science news, in brief.

Giant nonlinear optical responses from photon-avalanching nanoparticles

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/s41586-020-03092-9

Room-temperature photon avalanching realized in single thulium-doped upconverting nanocrystals enables super-resolution imaging at near-infrared wavelengths of maximal biological transparency and provides a material platform potentially suitable for other optical technologies.

m<sup>6</sup>A RNA methylation regulates the fate of endogenous retroviruses

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/s41586-020-03135-1

A CRISPR screen in mouse embryonic stem cells shows that transcripts derived from endogenous retroviruses are destabilized by m6A RNA methylation.

A bright γ-ray flare interpreted as a giant magnetar flare in NGC 253

Nature - Mer, 13/01/2021 - 00:00

Nature, Published online: 13 January 2021; doi:10.1038/s41586-020-03076-9

The γ-ray burst GRB 200415A is probably a giant flare emitted from a magnetar in the nearby starburst galaxy NGC 253.