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Background
Emerging epidemiological evidence suggests that statins may reduce the risk of community-acquired pneumonia (CAP) and its complications.Purpose
Performed a systematic review to address the role of statins in the prevention or treatment of CAP.Data Source
Ovid MEDLINE, Cochrane, EMBASE, ISI Web of Science, and Scopus from inception through December 2011 were searched for randomized clinical trials, cohort and case-control studies.Study Selection
Two authors independently reviewed studies that examined the role of statins in CAP.Data Extraction
Data about study characteristics, adjusted effect-estimates and quality characteristics was extracted.Data Synthesis
Eighteen studies corresponding to 21 effect-estimates (eight and 13 of which addressed the preventive and therapeutic roles of statins, respectively) were included. All studies were of good methodological quality. Random-effects meta-analyses of adjusted effect-estimates were used. Statins were associated with a lower risk of CAP, 0.84 (95% CI, 0.74–0.95), I2 = 90.5% and a lower short-term mortality in patients with CAP, 0.68 (95% CI, 0.59–0.78), I2 = 75.7%. Meta-regression did not identify sources of heterogeneity. A funnel plot suggested publication bias in the treatment group, which was adjusted by a novel regression method with a resultant effect-estimate of 0.85 (95% CI, 0.77–0.93). Sensitivity analyses using the rule-out approach showed that it is unlikely that the results were due to an unmeasured confounder.Conclusions
Our meta-analysis reveals a beneficial role of statins for the risk of development and mortality associated with CAP. However, the results constitute very low quality evidence as per the GRADE framework due to observational study design, heterogeneity and publication bias. 相似文献Fuel economy and emissions of heavy-duty trucks greatly vary based on vehicular/environmental conditions. Large-scale infrastructure construction projects require a large amount of material/equipment transportation. Single-parameter generic hauling models may not be the best option for an accurate estimation of hauling contribution in life cycle assessment (LCA) involving construction projects; therefore, more precise data and parameterized models are required to represent this contribution. This paper discusses key environmental/operational variables and their impact on transportation of materials and equipment; a variable-impact transportation (VIT) model accounting for these variables was developed to predict environmental impacts of hauling.
MethodsThe VIT model in the form of multi-nonlinear regression equations was developed based on simulations using the U.S. Environmental Protection Agency (EPA)’s Motor Vehicle Emission Simulator (MOVES) to compute all the impact categories in EPA’s TRACI 2.1 and energy consumption of transportation. Considering actual driving cycles of hauling trucks recorded during a pavement rehabilitation project, the corresponding environmental impacts were calculated, and sensitivity analyses were performed. In addition, an LCA case study based on historical pavement reconstruction projects in Illinois was conducted to analyze the contribution of transportation and variability of its impacts during the pavements’ life cycle.
Results and discussionThe importance of vehicle driving cycles was realized from simulation results. The case study results showed that considering driving cycles using the VIT model could increase the contribution of hauling in total life cycle Global Warming Potential (GWP) and total life cycle GWP itself by 2–4 and 3–5%, respectively. In addition to GWP, ranges of other hauling-related impact categories including Smog, Ozone Depletion, Acidification, and Primary Energy Demand from fuel were presented based on the case study. Ozone Depletion ranged from 9 to 45%, and Smog ranged from 11 to 48% of the total relevant life cycle impacts. The GWP contribution of hauling in pavement LCA ranged between 5 and 32%. The results indicate that the contribution of hauling transportation can be significant in pavement LCA.
ConclusionsFor large-scale roadway infrastructure construction projects that need a massive amount of material transportation, high fidelity models and data should be used especially for comparative LCAs that can be used as part of decision making between alternatives. The VIT model provides a simple analytical platform to include the critical vehicular/operational variables without any dependence on an external software; the model can also be incorporated in those studies where some of the transportation activity data are available.
相似文献Objective: To evaluate H19 RNA in urine cells as diagnostic tool for UC.
Materials and methods: RT-PCR analysis of urine samples from healthy volunteers and UC patients.
Results: H19 RNA was unequivocally detected in the urine of 90.5% of patients and 25.9% of controls. H19 copies were three orders of magnitude higher in patients. Receiver operating characteristic analysis showed an area under the curve of 0.933.
Conclusions: This pilot study shows that urinary cell H19 is a highly sensitive test for UC and pending verification could transform patient management. 相似文献