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The Rotterdam Study is an ongoing prospective cohort study that started in 1990 in the city of Rotterdam, The Netherlands. The study aims to unravel etiology, preclinical course, natural history and potential targets for intervention for chronic diseases in mid-life and late-life. The study focuses on cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1700 research articles and reports. This article provides an update on the rationale and design of the study. It also presents a summary of the major findings from the preceding 3 years and outlines developments for the coming period.

Risk stratification is critical for the early identification of high-risk individuals and disease prevention. Here we explored the potential of nuclear magnetic resonance (NMR) spectroscopy-derived metabolomic profiles to inform on multidisease risk beyond conventional clinical predictors for the onset of 24 common conditions, including metabolic, vascular, respiratory, musculoskeletal and neurological diseases and cancers. Specifically, we trained a neural network to learn disease-specific metabolomic states from 168 circulating metabolic markers measured in 117,981 participants with ~1.4 million person-years of follow-up from the UK Biobank and validated the model in four independent cohorts. We found metabolomic states to be associated with incident event rates in all the investigated conditions, except breast cancer. For 10-year outcome prediction for 15 endpoints, with and without established metabolic contribution, a combination of age and sex and the metabolomic state equaled or outperformed established predictors. Moreover, metabolomic state added predictive information over comprehensive clinical variables for eight common diseases, including type 2 diabetes, dementia and heart failure. Decision curve analyses showed that predictive improvements translated into clinical utility for a wide range of potential decision thresholds. Taken together, our study demonstrates both the potential and limitations of NMR-derived metabolomic profiles as a multidisease assay to inform on the risk of many common diseases simultaneously. In a study involving more than 100,000 individuals in the UK Biobank, a neural network model trained on metabolomic data can predict disease risk for over 20 conditions and adds predictive information over clinical variables for eight common diseases.

For the treatment of wastewater and water resources, membrane technologies are rapidly developing. Also, water pollution by heavy metals, dyes, oil, medicinal, and salts leads to lower water quality and water shortages. In this research, thin-film nanocomposite nanofiltration (TFN) membranes were produced via the interfacial polymerization (IP) method between trimesoyl chloride (TMC) and m-phenylenediamine (MPD) monomers at the top surface of PES/(UF) membrane and modified by graphene oxide (GO) and aluminum fumarate (AlFu) metal-organic framework (MOF) nanostructures to remove heavy metal and (divalent and monovalent) salts. The FTIR, NMR, SEM, XRD, and zeta potential analyses investigated the modified thin-film nanocomposite membrane properties. Also, the hydrophilicity of the membrane was determined via contact angle analysis. Compared to the polyamide (PA) and PA/AlFu membranes, the as-synthesized TFN membrane contains 0.3 wt% GO had the highest water flux, 110.86 l/m2·h, rejection of Na2SO4 salt and Cr2+ about 98.94% and 97.5%, respectively. Generally, using nanostructures like GO and AlFu (MOF) opens a novel path to improve hydrophilicity, negative charge, water flux, and rejection of polyamide nanocomposite membrane.

Aims/hypothesis The aim of this work was to assess the association of advanced glycation end-products (AGEs), measured by skin autofluorescence (SAF), with prevalent heart failure, and with systolic and diastolic cardiac function, in a large population-based cohort study. Methods We assessed the cross-sectional association between SAF and prevalent heart failure among 2426 participants from the population-based Rotterdam Study, using logistic regression. Next, among individuals free of heart failure ( N =2362), we examined the link between SAF (on a continuous scale) and echocardiographic parameters of left ventricular (LV) systolic and diastolic function using linear regressions. Analyses were adjusted for traditional cardiovascular risk factors. Results Higher levels of SAF were associated with higher odds of prevalent heart failure (multivariable adjusted OR 2.90 [95% CI 1.80, 4.62] for one unit higher SAF value). Among individuals without heart failure, one unit increase in SAF was associated with 0.98% lower LV ejection fraction (mean difference [β] −0.98% [95% CI −1.45%, −0.50%]). The association was stronger among participants with diabetes (β −1.84% [95% CI −3.10%, −0.58%] and β −0.78% [95% CI −1.29%, −0.27%] among participants with and without diabetes, respectively). Associations of SAF with diastolic function parameters were not apparent, except in men with diabetes. Conclusions/interpretation AGE accumulation was independently associated with prevalent heart failure. Among individuals free of heart failure, AGEs were associated with cardiac function, in particular systolic function. This association was present in participants with and without diabetes and was more prominent in those with diabetes. Graphical abstract

Vasomotor symptoms (hot flushes and night sweats) and other symptoms, including depression, anxiety and panic attacks, are commonly experienced by menopausal women and have been associated with an unfavourable cardiovascular risk profile. To investigate whether presence of menopausal symptoms is associated with the development of cardiovascular disease (CVD). Five electronic databases (Medline, EMBASE and Web of Science) were search until February 17th, 2015 to identify relevant studies. Observational cohort studies or randomised intervention studies were eligible for inclusion if they followed participants prospectively (at least 1 year of follow-up), and reported relevant estimates on the association of any vasomotor symptoms, or other menopausal symptoms, with risk of CVD, coronary heart disease (CHD), or stroke in perimenopausal, menopausal, or postmenopausal women. Data were extracted by two independent reviewers using a pre-designed data collection form. Separate pooled relative risks (RRs) for age and non-established cardiovascular risk factors (e.g., education, ethnicity) adjusted data and for established cardiovascular risk factors and potential mediators-adjusted data (e.g., smoking, body mass index, and hypertension) were calculated. Out of 9,987 initially identified references, ten studies were selected, including 213,976 women with a total of 10,037 cardiovascular disease outcomes. The age and non-established cardiovascular risk factors adjusted RRs) [95% confidence intervals] for development of CHD, Stroke and CVD comparing women with and without any menopausal symptoms were 1.34 [1.13-1.58], 1.30 [0.99-1.70], 1.48 [1.21-1.80] respectively, and the corresponding RRs adjusted for cardiovascular risk factors and potential mediators were 1.18 [1.03-1.35], 1.08 [0.89-1.32], 1.29 [0.98-1.71]. However, these analyses were limited by potential unmeasured confounding and the small number of studies on this topic. Presence of vasomotor symptoms and other menopausal symptoms are generally associated with an increased risk of cardiovascular disease, which is mainly explained by cardiovascular risk factors.

Aims/hypothesis In this study, we aimed to examine the association between age at natural menopause and risk of type 2 diabetes, and to assess whether this association is independent of potential mediators. Methods We included 3639 postmenopausal women from the prospective, population-based Rotterdam Study. Age at natural menopause was self-reported retrospectively and was treated as a continuous variable and in categories (premature, <40 years; early, 40–44 years; normal, 45–55 years; and late menopause, >55 years [reference]). Type 2 diabetes events were diagnosed on the basis of medical records and glucose measurements from Rotterdam Study visits. HRs and 95% CIs were calculated using Cox proportional hazards models, adjusted for confounding factors; in another model, they were additionally adjusted for potential mediators, including obesity, C-reactive protein, glucose and insulin, as well as for levels of total oestradiol and androgens. Results During a median follow-up of 9.2 years, we identified 348 individuals with incident type 2 diabetes. After adjustment for confounders, HRs for type 2 diabetes were 3.7 (95% CI 1.8, 7.5), 2.4 (95% CI 1.3, 4.3) and 1.60 (95% CI 1.0, 2.8) for women with premature, early and normal menopause, respectively, relative to those with late menopause ( p trend  <0.001). The HR for type 2 diabetes per 1 year older at menopause was 0.96 (95% CI 0.94, 0.98). Further adjustment for BMI, glycaemic traits, metabolic risk factors, C-reactive protein, endogenous sex hormone levels or shared genetic factors did not affect this association. Conclusions/interpretation Early onset of natural menopause is an independent marker for type 2 diabetes in postmenopausal women.

Carotid intima-media thickness (cIMT) is related to the risk of cardiovascular events in the general population. An association between changes in cIMT and cardiovascular risk is frequently assumed but has rarely been reported. Our aim was to test this association. We identified general population studies that assessed cIMT at least twice and followed up participants for myocardial infarction, stroke, or death. The study teams collaborated in an individual participant data meta-analysis. Excluding individuals with previous myocardial infarction or stroke, we assessed the association between cIMT progression and the risk of cardiovascular events (myocardial infarction, stroke, vascular death, or a combination of these) for each study with Cox regression. The log hazard ratios (HRs) per SD difference were pooled by random effects meta-analysis. Of 21 eligible studies, 16 with 36 984 participants were included. During a mean follow-up of 7·0 years, 1519 myocardial infarctions, 1339 strokes, and 2028 combined endpoints (myocardial infarction, stroke, vascular death) occurred. Yearly cIMT progression was derived from two ultrasound visits 2–7 years (median 4 years) apart. For mean common carotid artery intima-media thickness progression, the overall HR of the combined endpoint was 0·97 (95% CI 0·94–1·00) when adjusted for age, sex, and mean common carotid artery intima-media thickness, and 0·98 (0·95–1·01) when also adjusted for vascular risk factors. Although we detected no associations with cIMT progression in sensitivity analyses, the mean cIMT of the two ultrasound scans was positively and robustly associated with cardiovascular risk (HR for the combined endpoint 1·16, 95% CI 1·10–1·22, adjusted for age, sex, mean common carotid artery intima-media thickness progression, and vascular risk factors). In three studies including 3439 participants who had four ultrasound scans, cIMT progression did not correlate between occassions (reproducibility correlations between r=−0·06 and r=−0·02). The association between cIMT progression assessed from two ultrasound scans and cardiovascular risk in the general population remains unproven. No conclusion can be derived for the use of cIMT progression as a surrogate in clinical trials. Deutsche Forschungsgemeinschaft.

The production of photovoltaic modules is increasing to reduce greenhouse gas emissions. However, this results in a significant amount of waste at the end of their lifespan. Therefore, recycling these solar panels is important for environmental and economic reasons. However, collecting and separating crystalline silicon, cadmium telluride, and copper–indium–gallium–selenide panels can be challenging, especially in underdeveloped countries. The innovation in this work is the development of a process to recycle all solar panel waste. The dissolution of all metals through the leaching process is studied as the main step of the flowchart. In the first step of leaching, 98% of silver can be recovered by 0.5 M nitric acid. Then, the second and third step involves the use of glycine for base metal dissolution, followed by the leaching of valuable metals with hydrochloric acid. The effect of parameters such as the initial pH, acid concentration, solid/liquid ratio, and hydrogen peroxide concentration is studied. The results show that up to 100% of Cu, Pb, Sn, Zn, Cd, In, Ga, and Se can be recovered under optimal conditions. The optimal conditions for the dissolution of Cu, Zn, and Cd were a glycine concentration of 0.5 M, a temperature of 25 °C, a solid/liquid ratio of 10 gr/L, and 1% of hydrogen peroxide. The optimized glycine concentration for the leaching of lead and tin was 1.5 M. Indium and gallium were recovered at 100% by the use of 5 M hydrochloric acid, S/L ratio = 10 gr/L, and T = 45 °C. Separation of selenium and tellurium occurred using 0.5 M HCl at a temperature of 60 °C. Additionally, for the first time, a general outlook for the recycling of various end-of-life solar panels is suggested.

To establish age- and sex-specific distribution of the infrarenal abdominal aortic diameters (IAD) among non-aneurysmal elderly population and to investigate the associations between traditional cardiovascular risk factors and IAD in men and women. We included 4032 participants (mean age 67.2 years; 60.4% women) from the population-based Rotterdam Study, free of cardiovascular disease, who underwent IAD ultrasound assessment between 2009–2014. Linear regression analysis was used to identify determinants of IAD. The medians (inter-quartile range) of absolute IAD and body surface area (BSA)-adjusted IAD were 17.0 (15.0–18.0) mm and 9.3 (8.5–10.2) mm for women and 19.0 (18.0–21.0) mm and 9.4 (8.6–10.3) mm for men, respectively. There was a non-linear relationship between age and IAD. IAD increased steeply with advancing age and up to 70 years. After around 75 years of age, the diameter values reached a plateau. Waist circumference and diastolic blood pressure were associated with larger diameters in both sexes. Body mass index [Effect estimate (95% CI): 0.04 (0.00 to 0.08)], systolic blood pressure [− 0.01(− 0.02 to 0.00)], current smoking [0.35 (0.06 to 0.65)], total cholesterol levels [− 0.21 (− 0.31 to − 0.11)], and lipid-lowering medication [− 0.43 (− 0.67 to − 0.19)] were significantly associated with IAD in women. Sex differences in IAD values diminished after taking BSA into account. The increase in diameters was attenuated after 70 years. Differences were observed in the associations of several cardiovascular risk factors with IAD among men and women.

BackgroundAtrial fibrillation (AF) is a common sustained cardiac arrhythmia with increasing prevalence and incidence worldwide. However, long-term trends in AF prevalence, incidence, associated risk factors, and the role of comorbidities, including sex-specific differences is limited.MethodsWe included 7750, 7675, and 7121 participants from the population-based Rotterdam Study across three epochs over 3 decades (epoch 1990s: 1989–1993; epoch 2000s: 1997–2001; and epoch 2010s: 2009–2014). We examined trends in incidence rates and estimated incidence rate ratios (IRRs) over time, both overall and stratified by sex. Cox regression were applied to evaluate associations between comorbidities and incident AF to derive HRs with 95% CIs. Population attributable fractions (PAFs) were calculated to quantify the contribution of key comorbidities to AF incidence.ResultsThe mean (SD) of age in three epochs was around 70 years (epoch 1990s: 70.3 (9.6), epoch 2000s: 70.0 (8.7) and epoch 2010s: 70.4 (9.8)). The follow-up for each participant was 5 years. The age and sex-adjusted AF incidence rates in three epochs were 36.1, 27.4 and 52.0 per 1000 person-years. The AF incidence rates were 31.4, 22.9 and 44.1 for women and 45.0, 34.7 and 65.6 for men, respectively. Hypertension was the most important contributor to incident AF in all three epochs (PAFs were epoch 1990s: 36.0% (95% CI 24.3% to 54.2%), epoch 2000s: 35.0% (95% CI 14.0% to 59.5%) and epoch 2010s: 42.7% (95% CI 22.6% to 61.0%)), especially in women (epoch 1990s: 46.6% (95% CI 24.0% to 68.3%), epoch 2000s: 38.60% (95% CI 11.9% to 68.9%) and epoch 2010s: 59.9% (95% CI 40.5% to 82.5%)).ConclusionThe increasing burden of AF over the last three decades for both women and men calls for improved sex-specific AF prevention and management strategies. Hypertension remains to be a principal contributor to the population burden of AF, in particular among women. Effective sex-specific management of hypertension is a promising target in AF prevention strategies.