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The aim of this study was to compare the data of conductance and capacitance measurements of facial skin hydration and to evaluate and discuss the advantages and disadvantages of the different approaches.We measured skin capacitance (Corneometer® CM 825) and skin conductance (Skicon-200EX®) on 30 pre-defined facial sites of 125 Chinese women, resulting in 3750 readings per device. The data were analysed and compared, and continuous colour maps were generated on a 3D avatar for capacitance, conductance, relative difference (Δ%) and correlation (R-value) by interpolating between the individual readings and converting the values to colours. This visualization allows a better interpretation of the results.The complexity of facial skin hydration is revealed by this approach. The similarities and discrepancies in the facial hydration maps are clearly apparent. Due to the superiority of the Skicon in measuring high hydration levels, differences in skin hydration were evident on the forehead compared with the Corneometer maps, which may be related to the more superficial measurement of the Skicon within the stratum corneum. Conversely, a greater understanding of the complexity of facial skin hydration in the nasolabial fold was obvious when using the Corneometer. The best congruence between the instruments was found at two specific but separated facial areas, one around the inner eye region and the other one on a line between the nasolabial sulcus and the oblique, lateral jaw. Interestingly, the data were not normally distributed for both instruments and they had opposite skews. All facial clusters were statistically different from each other (p 0.001), except the cheek and jaw for the Skicon. Larger than expected percentage coefficients of variance were found for the Corneometer on some facial sites that might be explainable by differences in stratum corneum physiology and biochemistry. Corneometer values of 48 AU and Skicon values of 132 μS were taken as the cutoff for normally hydrated facial skin.Both devices have their advantages and disadvantages suggesting that bio-instrumental measurement of skin hydration is actually more complicated than commonly thought and that the different facial zones and the use of multiple instrumentation have not been adequately considered.L’objectif de cette étude était de comparer des données issues de mesures d’hydratation de la peau du visage par conductance et capacité électrique, et d’évaluer et discuter les avantages et désavantages de ces différentes approches.La capacité électrique de la peau (Corneometer® CM 825) et saconductance (Skicon-200EX®) ont été mesurées en 30 points pré-définis du visage de 125 femmes chinoises, menant ainsi à 3750 mesures par appareil. Les données ont été analysées et comparées, puis transposées visuellement sur avatar 3D via la création de cartographies continues de couleur par conversion de chaque valeur en une coordonnée de couleur et interpolation colorielle entre les différents points. Des cartographies de capacité électrique, de conductance ainsi que celle de la différence relative (Δ%) et de corrélation (R-value) ont été générées, ces visualisations permettant de mieux interpréter les résultats.Cette étude a mis en lumière la complexité de l’hydratation de la peau du visage. Les similarités et différences entre les cartographies d’hydratation faciale apparaissent clairement. Du fait de la supériorité du Skicon pour la mesure de hauts taux d’hydratation, des différences sont clairement visualisées entre les cartographies d’hydratation des deux appareils au niveau du front, et pourraient être dues à une mesure plus superficielle au sein du stratum corneum avec le Skicon. A l’inverse, l’utilisation du Corneometer permet une bien meilleure compréhension de la complexité de l’hydratation de la peau au niveau du sillon nasogénien. Les appareils montrent les résultats les plus similaires au niveau de deux zones spécifiques et séparées du visage, une au niveau du coin interne de l’œil et l’autre sur une ligne séparant le sillon nasolabial et l’oblique latéral de la machoire. Il est intéressant de noter que les distributions des données ne suivent pas une loi normale, pour aucun des deux appareils, et présentent des biais de distribution opposés. Tous les résultats obtenus au niveau des clusters faciaux étudiés montrent des différences statistiquement significatives entre eux (p⟨0.001), à l’exception de la joue et de la mâchoire, avec le Skicon. Des pourcentages de coefficients de variation plus élevés qu’attendus ont été obtenus avec le Corneometer en certaines zones du visage, qui pourraient être expliqués par des différences physiologiques et biochimiques du stratum corneum. Des valeurs de 48 UA avec le Corneometer et de 132 μS avec le Skicon ont été retenues comme valeurs seuil d’une peau du visage normalement hydratée.Les deux appareils montrent des avantages et désavantages, suggérant que la mesure bio-instrumentale de l’hydratation cutanée du visage est en réalité plus compliquée que communément admise et qu’une approche multiinstrumentale n’a pas été suffisamment considérée à ce jour pour appréhender les différentes zones du visages.

Background: Human milk is the sole source of folate in exclusively breastfed infants. We investigated whether human milk folate or maternal plasma folate are associated with infants’ folate status and postnatal growth in the first 4 months of life. Methods: Exclusively breastfed infants (n = 120) were recruited at age < 1 month (baseline). Blood samples were available at baseline and at the age of 4 months. Plasma and breastmilk samples were available from the mothers at 8 weeks postpartum. The concentrations of (6S)-5-methyltetrahydrofolate (5-MTHF) and different folate status markers were measured in samples of the infants and their mothers. The z-scores of weight, height, and head circumference of the infants were measured five times between baseline and 4 months. Results: Women with 5-MTHF concentrations in breastmilk 39.9 nmol/L (mean (SD) plasma 5-MTHF = 23.3 (16.5) vs. 16.6 (11.9) nmol/L; p = 0.015). At the age of 4 months, infants of women who were higher suppliers of 5-MTHF in breastmilk had higher plasma folate than those of low-supplier women (39.2 (16.1) vs. 37.4 (22.4) nmol/L; adjusted p = 0.049). The concentrations of breastmilk 5-MTHF and maternal plasma folate were not associated with infants’ longitudinal anthropometric measurements between baseline and 4 months. Conclusions: Higher 5-MTHF in breastmilk was associated with higher folate status in the infants and the depletion of folate in maternal circulation. No associations were seen between maternal or breastmilk folate and infants’ anthropometrics. Adaptive mechanisms might counteract the effect of low milk folate on infant development.

Accuracy in assessing age from facial cues is important in social perception given reports of strong negative correlations between perceived age and assessments of health and attractiveness. In a multi-ethnic and multi-centre study, we previously documented similar patterns of female facial age assessments across ethnicities, influenced by gender and ethnicity of assessors.Here we extend these findings by examining differences between estimated age from digital portraits and chronological age (Δ age) for 180 women from three age groups (20-34, 35-49, 50-66 years) and five ethnicities (36 images of each ethnicity, assessed for age on a continuous scale by 120 female and male raters of each ethnicity).Across ethnicities, Δ age was smallest in French assessors and largest in South African assessors. Numerically, French women were judged oldest and Chinese women youngest relative to chronological age. In younger women, Δ age was larger than in middle-aged and older women. This effect was particularly evident when considering the interaction of women's age with assessor gender and ethnicity, independently and together, on Δ age.Collectively, our findings suggest that accuracy in assessments of female age from digital portraits depends on the chronological age and ethnicity of the photographed women and the ethnicity and gender of the assessor. We discuss the findings concerning ethnic variation in skin pigmentation and visible signs of ageing and comment on implications for cosmetic science.La capacité à évaluer l’âge d’un visage avec exactitude en fonction de ses caractéristiques est important dans sa perception sociale. En effet, des corrélations négatives fortes ont été rapportées entre l’âge perçu d’un visage d’une part, et sa santé et attractivité d’autre part. Dans le cadre d’une étude multi-ethnique et multicentrique, nous avons déjà documenté, dans une démarche similaire, comment la perception de l’âge de visages féminins entre différentes populations, est influencée par le genre et l’origine des évaluateurs.Ici nous approfondissons ces premiers résultats par l’étude des différences entre l’âge estimé sur portraits numériques de 180 femmes issues de 3 groupes d’âges (20-34, 35-49, 50-66 ans) et de 5 populations d’origine différente (36 images de chaque population) et leur âge réel (Δ âge), et ce par 120 évaluatrices et évaluateurs de chaque population évaluant l’âge des visages en utilisant une échelle continue.Au sein des différentes populations d’évaluateurs, le Δ âge le plus faible a été trouvé chez les évaluateurs français et le plus élevé chez les évaluateurs sud-africains. Sur portraits numériques, les femmes françaises ont été perçues comme étant les plus âgées et les femmes chinoises les plus jeunes, par rapport à leur âge réel. Chez les femmes les plus jeunes, le Δ âge a été plus élevé que chez les femmes d’âge moyen et les plus âgées. Ceci a particulièrement été le cas lorsque l’on considère les interactions entre l’âge des femmes évaluées, et le genre et l’origine des évaluateurs, de façon indépendante ou liée, avec le Δ âge.Aux travers des différentes analyses, nos résultats suggèrent que l’exactitude avec laquelle l’âge des femmes est évalué sur images numériques de leur visage, dépend de l’âge réel et de l’origine de ces femmes photographiées, ainsi que de l’origine est du genre de l’évaluateur. Nous discutons ces résultats en regard des variations de pigmentation cutanée et de signes visibles de l’âge entre les différentes populations et commentons les implications possibles pour les sciences cosmétiques.

We report on the differences in ceramide composition and levels of omega-O-acylceramide processing enzymes of sun-exposed and sun-protected facialstratum corneum (SC) among Albino African, Black African and Caucasian women living in South Africa.Tape strippings were taken from the sun-exposed cheek and the sunprotected postauricular site (PA). In two subsets proteomic (n = 18) and lipidomic (n = 24) analysis were performed using mass-spectrometry-based shotgun platforms.No significant differences in total ceramide levels or ceramide subtypes were found between the Black African and Caucasian women in either the cheek or PA samples. Compared to the other two groups the levels of total ceramide as well as selected omega-O-acylceramide species were increased in Albino Africans. On the cheek, ceramide (CER) EOS, EOH along with CER AS were increased relative to the Caucasian women, while CER EOP and EOdS were elevated relative to the Black African women. Moreover, on the PA site CER EOP and EOdS were elevated compared with the Black African women and CER EOdS in Caucasians. Decreasesin masslevels of 12R-LOX and eLOX3 were observed on cheeks compared with the PA sites in all ethnic groups. On the PA sites 12R-LOX was particularly lower in the Albino Africans compared with the Black African and Caucasian women. On the cheeks mass levels of SDR9C7 was also lower in the Albino Africans.The mass levels of the ceramides were similar between Black African and Caucasian women. However, elevated total ceramides and excessively elevated selected omega-O-acylceramides were apparent in the Albino African women. The findings in the Albino African women were unexpected as these participants suffer from impaired skin barrier function. However, the elevated levels omega-O-acylceramides can contribute to barrier insufficiency by directly impacting SC lipid phase behaviour and/or secondly elevated omegaO-acylceramide levels may indicate a reduced attachment of ceramides to the corneocyte lipid envelope and reduced corneocyte maturation that can also impair the barrier. Indeed, differences in the mass levels of omega-O-acylceramide processing enzymes were observed for 12R-LOX and SDR9C7 for the Albino Africans. This indicates a corneocyte lipid scaffold disorder in this population.Nous décrivons les différences de composition en céramides et de niveaux des enzymes du métabolisme des oméga-O-acylcéramides du stratum corneum facial (SC) photo-exposé et photo-protégé chez des femmes Albinos Africaines, Noires Africaines et Caucasiennes vivant en Afrique du Sud. MÉTHODES: Les prélèvements ont été effectués sur la joue photo-exposée et sur le site post-auriculaire (PA) photo-protégé à l’aide de disques adhésifs. Dans deux sous-groupes, des analyses protéomiques (n = 18) et lipidomiques (n = 24) ont été réalisées à l'aide de plateformes de spectrométrie de masse non-ciblées. RÉSULTATS: Aucune différence significative de quantité globale de céramides ou dans les différentes classes de céramides n'a été observée entre les femmes Noires Africaines et les femmes Caucasiennes, quels que soient les échantillons (Joue ou de PA). Comparativement aux deux autres groupes, les quantités de céramides totales, ainsi que certaines espèces d’oméga-O-acylcéramides, étaient plus élevés chez les femmes Albinos Africaines. Sur la joue, les céramides (CER) EOS, EOH et CER AS étaient plus élevés que chez les femmes Caucasiennes, tandis que les CER EOP et EOdS étaient plus élevés que chez les femmes Noires Africaines. De plus, sur le site PA, les CER EOP et EOdS étaient plus élevés que chez les femmes Noires Africaines et les CER EOdS chez les Caucasiennes. Des diminutions des niveaux d’enzymes 12R-LOX et eLOX3 ont été observées sur les joues par rapport aux sites PA dans tous les groupes ethniques. Sur les sites PA, le niveau de 12RLOX était notablement plus faible chez les femmes Albinos Africaines comparativement aux femmes Noires Africaines et Caucasiennes. Sur les joues, le niveau de SDR9C7 était également plus faible chez les Albinos Africaines.La masse des céramides totaux était similaire entre les femmes Noires Africaines et Caucasiennes. Cependant, des niveaux élevés de céramides totaux et excessivement élevés des oméga-O-acylcéramides sélectionnés, ont été observés chez les femmes Albinos Africaines. Les résultats obtenus chez les femmes Albinos Africaines étaient surprenants car ces participantes souffrent d’une altération de la fonction de la barrière cutanée. Néanmoins, les niveaux élevés d’oméga-O-acylcéramides peuvent en premier lieu contribuer à l’insuffisance de la barrière en ayant un impact direct sur le comportement de la phase lipidique du SC et/ou, deuxièmement, peuvent indiquer une fixation réduite des céramides à l’enveloppe lipidique des cornéocytes et une maturation réduite des cornéocytes pouvant aussi altérer la barrière. En outre, des différences dans les niveaux d’expression des enzymes de transformation de l’oméga-O-acylcéramide ont été observées pour 12R-LOX et SDR9C7 chez les femmes Albinos Africaines. Ceci indique une désorganisation de l’échafaudage lipidique des cornéocytes dans cette population.

Background The effect of photodamage on facial stratum corneum (SC) is still poorly understood. Objective To describe the SC proteome from tape strippings of Caucasian SC from photoexposed cheek and photoprotected post auricular (PA) site a global analysis of photodamage on the skin will be developed leading to a better understanding of keratinocyte signalling pathways and identification of new molecular targets for the treatment of photoaged skin. Methods Female Caucasian subjects had 9 consecutive tape strippings taken from their cheeks and PA site. Proteins were extracted and the trypsin digested peptides were analyzed by nanochromatography coupled to a high-resolution mass spectrometer. Data dependent acquisition allowed protein identification that was processed by Paragon algorithm of Protein Pilot software. Results Changes in the levels of epidermal differentiation proteins were apparent indicating poor epidermal differentiation and SC maturation (keratins, cornified envelope (CE) proteins) on photoexposed cheeks. Differences in protease-antiprotease balance were observed for corneodesmolysis (favouring desquamation) and filaggrinolysis (favouring reduced filaggrin processing). 12R-LOX, a CE maturation enzyme, was reduced in photodamaged skin but not transglutaminases. Changes in signal keratinocyte transduction pathway markers were demonstrated especially by reduced levels of downstream signalling markers such as calreticulin (unfolded protein response; UPR) and increased level of stratifin (target of rapamycin; mTOR). Evidence for impaired proteostasis was apparent by reduced levels of a key proteasomal subunit (subunit beta type-6). Finally, key antioxidant proteins were upregulated except catalase. Conclusion Clear examples of poor keratinocyte differentiation and associated metabolic and signalling pathways together with reduced SC maturation were identified in photodamaged facial SC. Corneocyte immaturity was evident with changes in CE proteins. Particularly, the reduction in 12R-LOX is a novel finding in photodamaged skin and supports the lack of SC maturation. Moreover, filaggrinolysis was reduced, whereas corneodesmolysis was enhanced. From our results, we propose that there is a poor crosstalk between the keratinocyte endoplasmic reticulum UPR, proteasome network and autophagy machinery that possibly leads to impaired keratinocyte proteostasis. Superimposed on these aberrations is an apparent enhanced mTOR pathway that also contributes to reduced SC formation and maturation. Our results clearly indicate a corneocyte scaffold disorder in photodamaged cheek SC. This article is protected by copyright. All rights reserved.

BACKGROUND There are few studies directly comparing the pharmacokinetics of 25-hydroxycholecalciferol [25(OH)D3] to cholecalciferol (D3). OBJECTIVES The primary objectives were to compare the effectiveness of D3 and 25(OH)D3 in raising 25-hydroxyvitamin D [25(OH)D] serum concentrations and achieving steady state. METHODS This was a randomized, double-blind, active comparator trial of 91 participants (53 females, 38 males), aged 63.3 ± 7.9 y. 25(OH)D3 (10, 15, and 20 µg) and D3 (20 µg) were dosed daily for 6 mo followed by 6 mo of washout. Frequent measurements of serum 25(OH)D were performed. Pharmacokinetic parameters were fitted for each individual and the treatment average was modeled with linear regression using the individual baseline level, sex, and gender as covariates. RESULTS Mean baseline 25(OH)D was similar in all groups (47.1-49.5 nmol/L). Increases in 25(OH)D to steady state were higher in the 25(OH)D3 groups than in the D3 group [least squares (LS) means (95% CI): 50.1 (43.3-58.0), 72.5 (64.3-81.7), 97.4 (86.6-109.6) nmol/L in 10, 15, and 20 µg/d and 38.7 (33.1-45.2) nmol/L in the D3 group; P = 0.0173, P < 0.0001, P < 0.0001]. The rate to reach steady state was similar in all groups, but the time to reach 25(OH)D concentrations of 75 nmol/L was faster in the higher-dosed 25(OH)D3 groups than in the D3 group (7 and 10 d compared with 40 d, P < 0.0001 and P < 0.0001 for 15 and 20 µg/d). The rate of elimination was 59-109% higher in the 25(OH)D3 groups than in the D3 group. The area under the curve (AUC)/µg dose demonstrated that 25(OH)D3 was 3 times as effective as D3 at raising 25(OH)D concentrations. CONCLUSIONS 25(OH)D3 is ∼3 times as effective as D3 at raising 25(OH)D concentrations. Once supplementation is discontinued, the elimination rate of 25(OH)D3 is faster than D3. This trial was registered at clinicaltrials.gov as NCT02333682.

International audience; Adding amylase to fortified blended foods can improve energy density, and increase child's energy and nutrient intake. The efficacy of this strategy is unknown for the World Food Programme's Super Cereal Plus (SC+) and Super Cereal (SC) blends. The primary goal of this study was to investigate the increased energy intake from amylase-containing SC+ and SC compared to control por-ridges in Burkinabe children. Secondly, energy intake from amylase-containing porridges compared to CERELAC ® , Vitazom, and eeZeeBAR™ was studied. Thirdly, caregivers' (n = 100) porridge acceptability was investigated. The design was a randomized double-blind controlled cross-over trial studying the effect of amylase addition to SC+ and SC flours on porridge energy and nutrient intake in healthy Burkinabe children aged 12-23 (n = 80) and 24-35 months (n = 40). Amylase added to porridges increased energy density from 0.68 to 1.16 kcal/g for SC+ and from 0.66 to 1.03 kcal/g for SC porridges. Among children aged 12-23 months, mean energy intake from all porridges with amylase (135-164 kcal/meal) was significantly higher compared to control SC+ por-ridges (84-98 kcal/meal; model-based average). Among children aged 24-35 months, mean energy intakes were also significantly higher from all porridges with amylase added (245-288 kcal/meal) compared to control SC porridges (175-183 kcal/meal). Acceptability of the porridges among care-givers was rated neutral to good, both for amylase-added and non-amylase-containing porridges. These findings suggest that, among 12-35-month-old, adding amylase to fortified blended foods significantly increased energy and consequently nutrient intake per meal by 67% for SC+ and 47% for SC. Moreover, amylase-containing porridges were well accepted by the caregivers.

We performed the largest randomized, placebo-controlled clinical trial to date (N = 112, 12-week intervention) to investigate the effects and safety of resveratrol supplementation on liver fat content and cardiometabolic risk parameters in overweight and obese and insulin-resistant subjects. At baseline the variability in liver fat content was very large, ranging from 0.09% to 37.55% (median, 7.12%; interquartile range, 3.85%-12.94%). Mean (SD) liver fat content was 9.22 (6.85) % in the placebo group and 9.91 (7.76) % in the resveratrol group. During the study liver fat content decreased in the placebo group (-0.7%) but not in the resveratrol group (-0.03%) (differences between groups: P = .018 for the intention-to-treat [ITT] population; N = 54, resveratrol, N = 54, placebo and P = .0077 for the per protocol [PP] population). No effects of resveratrol supplementation on cardiometabolic risk parameters were observed. Resveratrol supplementation was well tolerated and safe. In conclusion, these data suggest that resveratrol supplementation is safe and that it does not considerably impact liver fat content or cardiometabolic risk parameters in humans.

Background Specific bio-active dietary compounds modulate numerous metabolic processes in adipose tissue (AT), including pre-adipocyte proliferation and differentiation. AT dysfunction, rather than an increased fat mass per se, is strongly associated with the development of insulin resistance and is characterized by impaired adipogenesis, hypertrophic adipocytes, inflammation, and impairments in substrate metabolism. A better understanding of mechanisms underlying AT dysfunction may provide new strategies for the treatment of obesity-associated metabolic diseases. Here we evaluated the role of (all-E)-lycopene (Lyc), eicosapentaenoic acid (EPA) or trans-resveratrol (Res) and combinations thereof on human white adipocyte function. Methods In-vitro differentiating human pre-adipocytes were treated with EPA, Lyc and Res or their combinations for 14 days. The effects on intracellular lipid droplet (LD) accumulation, secreted anti- and pro-inflammatory cyto-/adipokines (e.g. adiponectin, IL-6, IL-8/CXCL-8 and MCP-1/CCL2) and on gene expression of markers of adipocyte differentiation and substrate metabolism (e.g. PPAR-gamma, C/EBP-alpha, GLUT-4, FAS, ATGL, HSL, and PLIN-1) were measured by fluorescent microscopy (Cellomics™), multi-parametric LiquiChip® technology and quantitative RT-PCR, respectively. Results Treatment of differentiating adipocytes for 14 days with the combination of Lyc/Res and EPA/Res resulted in significantly inhibited LD formation (~ -25 and -20%, respectively) compared to the effects of the single compounds. These morphological changes were accompanied by increased mRNA levels of the adipogenic marker PPAR-gamma and the lipase ATGL and by decreased expression levels of lipogenic markers (LPL, FAS, GLUT-4) and the LD-covering protein PLIN-1. In addition, a blunted adipocyte secretion of pro-inflammatory cytokines (IL-6 and MCP-1) and adiponectin was observed following treatment with these compounds. Conclusion The combination of the dietary bio-actives Lyc and EPA with Res might influence adipocyte function by affecting the balance between adipogenic, lipogenic and lipolytic gene expression, resulting in a reduced LD storage and a less inflammatory secretion profile. Taken together, our results indicate that combinations of dietary compounds may be beneficial for the prevention and treatment of metabolic disorders via effects on human white adipocyte function. Electronic supplementary material The online version of this article (doi:10.1186/s12986-016-0143-5) contains supplementary material, which is available to authorized users.

Prognostic models for time-to-event data play a prominent role in therapy assignment, risk stratification and inter-hospital quality assurance. The assessment of their prognostic value is vital not only for responsible resource allocation, but also for their widespread acceptance. The additional presence of competing risks to the event of interest requires proper handling not only on the model building side, but also during assessment. Research into methods for the evaluation of the prognostic potential of models accounting for competing risks is still needed, as most proposed methods measure either their discrimination or calibration, but do not examine both simultaneously. We adapt the prediction error proposal of Graf et al. (Statistics in Medicine 1999, 18, 2529–2545) and Gerds and Schumacher (Biometrical Journal 2006, 48, 1029–1040) to handle models with competing risks, i.e. more than one possible event type, and introduce a consistent estimator. A simulation study investigating the behaviour of the estimator in small sample size situations and for different levels of censoring together with a real data application follows.

Objective.To assess the representativeness of the data in the Krankenhaus Infektions Surveillance System (KISS), which is a nosocomial infections surveillance system for intensive care units (ICUs) in Germany.Design.Prospective and retrospective surveillance study.Setting.Medical-surgical ICUs in Germany.Methods.A sample of medical-surgical ICUs from all over Germany, stratified according to hospital size, was randomly selected. Surveillance personnel from the hospitals were trained in surveillance of nosocomial infections, and they subsequently conducted a 2-month surveillance in their ICUs. Data were compared with KISS data for medical-surgical ICUs.Results.During the period from 2004 through 2005, a total of 50 medical-surgical ICUs agreed to participate in our study: 21,832 patient-days were surveyed, and 262 cases of nosocomial infection were registered, 176 of which were cases of device-associated nosocomial infection (100 cases of lower respiratory tract infection, 47 cases of urinary tract infection, and 29 cases of bloodstream infection). The overall incidence density of all types of nosocomial infections was estimated to be 10.65 cases per 1,000 patient-days. Device utilization rates in the study ICUs and in the KISS medical-surgical ICUs were similar. The pooled mean device-associated infection rates were higher in the study ICUs than in the KISS medical-surgical ICUs (10.2 vs 5.1 cases of pneumonia; 2.0 vs 1.2 cases of bloodstream infection; and 2.7 vs 1.2 cases of urinary tract infection), but the pooled mean device-associated infection rates in the study ICUs were comparable to those of the KISS ICUs during their first year of participation in KISS. The incidence density for nosocomial infections in the study ICUs varied according hospital size, with ICUs in larger hospitals having a higher incidence density than those in smaller hospitals.Conclusions.KISS ICUs started with nosocomial infection rates comparable to those found in our study ICUs. Over the years of participation, however, a decrease in nosocomial infections is seen. Thus, rates of nosocomial infection from KISS should be used as benchmarks, but estimations for Germany that are based on KISS data may underestimate the real burden of nosocomial infections.

Rose hip powder (RHP) alleviates osteoarthritis (OA) due to its anti-inflammatory and cartilage-protective properties. Substances contained in RHP might contribute to its clinical efficacy. The activity of two RHP (i.e., RH-A, from the whole fruit, RH-B, from fruits without seeds) was investigated in human peripheral blood leukocytes (PBL) and primary chondrocytes (NHAC-kn). RH-A and RH-B diminished the secretion of chemokines and cytokines in LPS/IFN-γ-activated PBL, including CCL5/RANTES, CXCL10/IP-10, interleukin- (IL-) 6, and IL-12. Most effects were transcriptional, since gene expression levels were significantly influenced by RH-A and RH-B. In IL-1βtreated normal chondrocytes (NHAC-kn), both RH preparations reduced the expression of matrix metalloproteinase- (MMP-) 1, MMP-3, and MMP-13 and ADAMTS-4. These changes are associated with diminished inflammatory damage or cartilage erosion. Principal component analysis revealed that (1) RH-A and RH-B modified a large pattern of biomarkers, and (2) RH-B outperformed RH-A. Furthermore, RH-B contained more chondroprotective and anti-inflammatory constituents than RH-A. Thus, RHP contributed to restore cellular homeostasis in PBL and chondrocytes. RH preparations from fruits without seeds are thus expected to have an improved OA-preventive or OA-therapeutic profile, as subsequently shown in a related clinical trial.

BACKGROUND: Risk scores for prediction of coronary heart disease (CHD) in older adults are needed. OBJECTIVE: To develop a sex-specific CHD risk prediction model for older adults that accounts for competing risks for death. DESIGN: 2 observational cohort studies, using data from 4946 participants in the Cardiovascular Health Study (CHS) and 4303 participants in the Rotterdam Study (RS). SETTING: Community settings in the United States (CHS) and Rotterdam, the Netherlands (RS). PARTICIPANTS: Persons aged 65 years or older who were free of cardiovascular disease. MEASUREMENTS: A composite of nonfatal myocardial infarction and coronary death. RESULTS: During a median follow-up of 16.5 and 14.9 years, 1166 CHS and 698 RS participants had CHD events, respectively. Deaths from noncoronary causes largely exceeded the number of CHD events, complicating accurate CHD risk predictions. The prediction model had moderate ability to discriminate between events and nonevents (c-statistic, 0.63 in both U.S. and European men and 0.67 and 0.68 in U.S. and European women). The model was well-calibrated; predicted risks were in good agreement with observed risks. Compared with the Framingham point scores, the prediction model classified elderly U.S. persons into higher risk categories but elderly European persons into lower risk categories. Differences in classification accuracy were not consistent and depended on cohort and sex. Adding newer cardiovascular risk markers to the model did not substantially improve performance. LIMITATION: The model may be less applicable in nonwhite populations, and the comparison Framingham model was not designed for adults older than 79 years. CONCLUSION: A CHD risk prediction model that accounts for deaths from noncoronary causes among older adults provided well-calibrated risk estimates but was not substantially more accurate than Framingham point scores. Moreover, adding newer risk markers did not improve accuracy. These findings emphasize the difficulties of predicting CHD risk in elderly persons and the need to improve these predictions. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute; National Institute of Neurological Disorders and Stroke; The Netherlands Organisation for Scientific Research; and the Netherlands Organisation for Health Research and Development.

Prediction of future events using longitudinally collected patient measurements is increasingly popular as technical and methodological advances allow the construction of more and more complex prognostic models. We aim to give an overview of existing approaches to measure the prediction error of such dynamic predictions and link these to a measure proposed in a preceding paper (Schoop et al.), the conditional prediction error. We present theoretical results of the conditional prediction error, especially regarding the comparison of different prediction rules and its behavior in the presence of misspecification of the link between longitudinal covariates and survival time. A simulation study investigating the performance of its estimator in finite sample sizes rounds off this paper.