2,973 research outputs found
The marginal utility of money: A modern Marshallian approach to consumer choice
We reformulate neoclassical consumer choice by focusing on lamda, the marginal utility of money. As the opportunity cost of current expenditure, lamda is approximated by the slope of the indirect utility function of the continuation. We argue that lamda can largely supplant the role of an arbitrary budget constraint in partial equilibrium analysis. The result is a better grounded, more flexible and more intuitive approach to consumer choice.budget constraint, separability, value for money
Prevalência de Síndrome Metabólica e Diabetes numa População de Alto Risco com Suspeita de Doença Coronária
Objectivos: A prevalência de Sindroma Metabólica (SM) e diabetes é variável consoante a definição utilizada, assim como com a região geográfica e o grupo étnico estudado. Não existem estudos em indivíduos portugueses com suspeita de doença arterial coronária.
Analisámos a prevalência de SM e diabetes nesta população específica de doentes, comparando também definições.
Métodos: Incluíram-se no estudo 300 indivíduos, com uma idade media de 64 ± 9 anos, 59% do género masculino, admitidos para
angiografia coronária electiva, tendo sido excluídos os doentes com doença cardíaca previamente conhecida. Avaliou-se a prevalência de SM e de diabetes.
Resultados: A prevalência ajustada de SM foi de 39,3% (critério NCEP-ATP III), 53,8% (critério IDF) e 48,4% (critério AHA/NHLBI). A prevalência ajustada de diabetes foi de 14,8% pela definição prévia da ADA e de 36.4% com a definição mais recente. A concordância global entre as definições de SM foi de 45,3%, sendo mais elevada entre as definições da AHA/NHLBI e da NCEP-ATP III (Kappa 0,821). A prevalência de SM está altamente dependente da idade em ambos os géneros, sendo mais prevalente no género feminino.
A prevalência de diabetes é também dependente da idade, sendo semelhante em ambos os géneros. O componente de SM mais
frequente é a hipertensão arterial, seguido pela obesidade abdominal, elevação da glicose, colesterol-HDL baixo e finalmente elevação dos triglicéridos. É também importante referir que 60% dos doentes estavam sob terapêutica hipolipemiante (56,6% com estatinas, 1,7% com fibratos e 1,7% com ambos). A diferença mais significativa entre géneros no que diz respeito aos componentes de SM é a
elevada prevalência de obesidade abdominal no género feminino.
Conclusões: Nesta população de alto risco, a prevalência de SM é elevada, sendo contudo a prevalência de diabetes semelhante à
registada em estudos epidemiológicos na população geral
Carotid Intima-Media Thickness and Carotid Plaques Improves Prediction of Obstructive Angiographic Coronary Artery Disease in Women
Does carotid intima-media thickness (cIMT), a surrogate marker of cardiovascular events, have predictive incremental value over established risk factors for stable coronary artery disease (CAD)? Prospective study of 300 patients, with suspected stable CAD, admitted for an elective coronary angiography and carotid ultrasound. The CAD patients had a higher cIMT, which showed a modest predictive accuracy for CAD (area under the receiver-operating characteristic curve 0.638, 95% confidence interval 0.576-0.701, P < .001). The cIMT was an independent predictor of CAD, together with age, gender, and diabetes. C-statistic for CAD prediction by traditional risk factors was not significantly different from a model that included cIMT, carotid plaque presence, or both. However, in women, it was significantly increased by the addition of cIMT or carotid plaque presence. Although cIMT cannot be used as a sole indicator of CAD, it should be considered in the panel of investigations that is requested, particularly in women who are candidates for coronary angiography
Poderá a Presença de Síndrome Metabólica Predizer a Presença de Doença Arterial?
INTRODUCTION: Metabolic syndrome (MS) is an independent predictor of acute cardiovascular events. However, few studies have addressed the relationship between MS and stable angiographic coronary artery disease (CAD), which has a different pathophysiological mechanism. We aimed to study the independent predictors for significant CAD, and to analyze the impact of MS (by the AHA/NHLBI definition) on CAD.
METHODS: We prospectively included 300 patients, mean age 64±9 years, 59% male, admitted for elective coronary angiography (suspected ischemic heart disease), excluding patients with known cardiac disease. All patients underwent assessment of demographic, anthropometric, and laboratory data and risk factors, and subsequently underwent coronary angiography.
RESULTS: In the study population, 23.0% were diabetic, 40.5% had MS (and no diabetes) and 36.7% had neither diagnosis. Significant CAD was present in 51.3% of patients. CAD patients were older and more frequently male and diabetic, with increased triglycerides and glucose and lower HDL cholesterol. Abdominal obesity was also less prevalent. MS was not associated with the presence of CAD (OR 0.94, 95% CI 0.59-1.48, p=0.778). Of the MS components, the most important predictors of CAD were increased glucose and triglycerides. Abdominal obesity was associated with a lower risk of CAD. In a multivariate logistic regression model for CAD, independent predictors of CAD were age, male gender, glucose and triglycerides. Body mass index had a protective effect.
CONCLUSIONS: Although MS is associated with cardiovascular events, the same was not found for stable angiographically proven CAD. Age, gender, diabetes and triglycerides are the most influential factors for CAD, with abdominal obesity as a protective factor
The Effect of Mood on Wishful Thinking and NFL Outcome Predictions
People make judgments and decisions on an everyday basis. From picking an NCAA Tournament bracket to judging the likelihood of rain, people often have a preference for one outcome over another. Wishful thinking is the idea that people’s desires exhibit a causal influence on their expectations—specifically, a desire for an outcome increases people’s optimism about that outcome. Past research has found wishful thinking (or “the desirability bias”) in a variety of contexts, including sports and political decisions. Separate research has shown that differing mood states can affect interpretation of information, judgments, and decisions. Because people rarely make decisions when in a neutral mood, our study investigated the influence of mood on wishful thinking. We hypothesized that putting participants into a happy mood would increase the amount of wishful thinking they exhibited relative to putting participants into a sad mood. To test this, we manipulated participants’ moods by having them watch either a happy or a sad video clip. Afterwards, they made predictions for each of the 16 games played in the first week of the 2014-15 NFL season. Overall, we found that people exhibited wishful thinking in that they were far more likely to predict their favorite team winning as compared to the other teams. However, mood did not appear to affect people’s predictions. In other words, both happy and sad participants exhibited similar levels of wishful thinking
Expression of Subclinical Atherosclerosis for Different Cardiovascular Risk Factors in Young Populations
INTRODUCTION: Carotid intima-media thickness (cIMT) is considered an early marker for atherosclerosis, but there are few studies on the expression of this marker in younger populations.
OBJECTIVES: To evaluate cIMT in younge patients (aged 30-50 years) and its expression according to cardiovascular risk factors.
METHODS: We analyzed individuals admitted for an invasive cardiac procedure. Normal cIMT was defined as 1.50 mm. Lipid profile, anthropometric parameters, fasting blood glucose and estimated GFR were also determined.
RESULTS: A total of 106 patients were included (59% male), with a mean age of 43 +/- 5 years, 36% with hypertension, 22% smokers, 32% with known hyperlipidemia, 16% with diabetes, 39% under statin therapy and 40% with metabolic syndrome (AHA/NHLBI definition). Mean cIMT was 0.69 +/- 0.26 mm, and was normal in 74% of the patients, thickened in 20% and with atherosclerotic plaques in 6%. cIMT correlated directly with age (r = 0.26, p = 0.007), log fasting glucose (r = 0.21, p = 0.04), and log triglycerides (r = 0.24, p = 0.017), and tended to correlate with the number of components of metabolic syndrome (r = 0.17, p = 0.08). However, on multivariate analysis, only age remained as an independent predictor (r = 0.29, p = 0.005). Diabetic patients had greater cIMT (0.81 +/- 0.22 vs. 0.67 +/- 0.26 mm, p = 0.039) and there was a trend for greater cIMT in those with metabolic syndrome (0.75 +/- 0.29 vs. 0.66 +/- 0.23 mm, p = 0.09). There were no differences for the other risk factors, A higher number of risk factors in a single patient showed a trend for increased cIMT (p = 0.083)
CONCLUSIONS: Age is the only independent determinant of cIMT in a young population. Diabetic patients have greater cIMT and a trend was seen in those with metabolic syndrome, possibly influenced by its relation with diabetes, one of the components of the metabolic syndrome
The Media, Public Perception, And Policy Decisions: An Analysis Of Two Racially Different Newsrooms’ Coverage Of BLM And DACA
In this study, I looked into the cycle between the media, the public, and policy decisions. The media influences the public’s perception, which then influences their support for policies. I studied how racial and ethnic diversity in newsrooms affects the coverage of blacks in rhetoric about the Black Lives Matter (BLM) movement and Hispanic/Latino immigrants in rhetoric about Deferred Action for Childhood Arrivals (DACA). I utilized an online survey with established social science scales to measure perceived racism. I employed this survey with the Tampa Bay Times (Times), a predominately White newsroom, and the Atlanta Journal-Constitution (AJC), a more ethnically and racially diverse newsroom. I also conducted a textual analysis on a sample of articles from each publication written nine months before Donald Trump was elected president to three months after his first State of the Union (SOTU) address. The purpose of the textual analysis was to identify any differences in word choice, frames, and other factors present in the journalists’ coverage of BLM and DACA. Using these methods, I found that the ethnicity of journalists does influence coverage of blacks and Hispanic/Latino immigrants, that journalists cover DACA more sympathetically and ethically than BLM, and that specialized reporting leads to better media representation of these two groups
Bullying Victimization As A Predictor Of Anabolic-Androgenic Steroid Abuse In A Nationally Representative Sample Of Adolescent Males
Due to their potential for negative physical, psychological, and social effects, both anabolic-androgenic steroid (AAS) misuse and bullying victimization are significant public health concerns confronting U.S. adolescent males. Previous research examining the link between bullying victimization and AAS abuse has been limited and most studies have had insufficient sample sizes to detect low base rate risks such as AAS abuse. The current study examined whether 1) bullying victimization on school property or 2) electronic bullying victimization were associated with increased risk of AAS misuse in adolescent males. Our study utilized a nationally representative sample drawn from the CDC's 2015 National Youth Risk Behavior Surveillance Survey (YRBS). Participants included 7,749 adolescent males in 9th-12th grade in U.S. public and private schools. Participants who reported victimization were found to be at higher risk of misusing steroids. This is the first study with a nationally representative sample large enough to establish a link between a history of having been bullied and misuse of AAS. These results suggest the need for the development and evaluation of interventions to prevent bullying and to prevent steroid abuse. Future research should further investigate the link between bullying or teasing victimization, specifically about physical appearance, and AAS abuse
Limiar do Índice Homeostasis Model Assessment (HOMA) para Resistência à Insulina numa População de Doentes Admitidos Electivamente numa Enfermaria Portuguesa de Cardiologia
INTRODUCTION: Insulin resistance is the pathophysiological key to explain metabolic syndrome. Although clearly useful, the Homeostasis Model Assessment index (an insulin resistance measurement) hasn't been systematically applied in clinical practice. One of the main reasons is the discrepancy in cut-off values reported in different populations. We sought to evaluate in a Portuguese population the ideal cut-off for Homeostasis Model Assessment index and assess its relationship with metabolic syndrome.
MATERIAL AND METHODS: We selected a cohort of individuals admitted electively in a Cardiology ward with a BMI < 25 Kg/m2 and no abnormalities in glucose metabolism (fasting plasma glucose < 100 mg/dL and no diabetes). The 90th percentile of the Homeostasis Model Assessment index distribution was used to obtain the ideal cut-off for insulin resistance. We also selected a validation cohort of 300 individuals (no exclusion criteria applied).
RESULTS: From 7 000 individuals, and after the exclusion criteria, there were left 1 784 individuals. The 90th percentile for Homeostasis Model Assessment index was 2.33. In the validation cohort, applying that cut-off, we have 49.3% of individuals with insulin resistance. However, only 69.9% of the metabolic syndrome patients had insulin resistance according to that cut-off. By ROC curve analysis, the ideal cut-off for metabolic syndrome is 2.41. Homeostasis Model Assessment index correlated with BMI (r = 0.371, p < 0.001) and is an independent predictor of the presence of metabolic syndrome (OR 19.4, 95% CI 6.6 - 57.2, p < 0.001).
DISCUSSION: Our study showed that in a Portuguese population of patients admitted electively in a Cardiology ward, 2.33 is the Homeostasis Model Assessment index cut-off for insulin resistance and 2.41 for metabolic syndrome.
CONCLUSION: Homeostasis Model Assessment index is directly correlated with BMI and is an independent predictor of metabolic syndrome
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Ultrafast laser welding of ceramics.
Welding of ceramics is a key missing component in modern manufacturing. Current methods cannot join ceramics in proximity to temperature-sensitive materials like polymers and electronic components. We introduce an ultrafast pulsed laser welding approach that relies on focusing light on interfaces to ensure an optical interaction volume in ceramics to stimulate nonlinear absorption processes, causing localized melting rather than ablation. The key is the interplay between linear and nonlinear optical properties and laser energy-material coupling. The welded ceramic assemblies hold high vacuum and have shear strengths comparable to metal-to-ceramic diffusion bonds. Laser welding can make ceramics integral components in devices for harsh environments as well as in optoelectronic and/or electronic packages needing visible-radio frequency transparency
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