An Elastic Layers Pattern Approach with Dynamically Added Layers

Abstract Cloud environments often provide dynamic resource allocation techniques. These can be used to scale single components or even whole software systems according to their current workload. Fluctuating workloads can occur in different layers of the software architecture and need appropriate handling to meet performance requirements. Scaling workload-intensive components in combination with load-balancing can be used to deal with these issues. Therefore, we present a parallel layers approach, which extends an existing pattern regarding improved elasticity. Based on dynamically adding layers on top of bottleneck layers, we increase the flexibility and performance of related architectures. Furthermore, we describe a first design approach, implementation and an evaluation of the feasibility

Salt Appetite and its Effects on Cardiovascular Risk in Primary Aldosteronism

First described in 1955 by Jerome W. Conn, primary aldosteronism (PA) today is well established as a relevant cause of secondary hypertension and accounts for about 5–10 % of hypertensives. The importance of considering PA is based on its deleterious target organ damage far beyond the effect of elevated blood pressure and on PA being a potentially curable form of hypertension. Aside the established contributory role of high dietary salt intake to arterial hypertension and cardiovascular disease, high salt intake is mandatory for aldosterone-mediated deleterious effects on target-organ damage in patients with primary aldosteronism. Consequently, counselling patients on the need to reduce salt intake represents a major component in the treatment of PA to minimize cardiovascular damage. Unfortunately, in PA patients salt intake is high and far beyond the target values of 5 g per day, recommended by the World Health Organization. Insufficient patient motivation for lifestyle interventions can be further complicated by enhancing effects of aldosterone on salt appetite, via central and gustatory pathways. In this context, treatment for PA by adrenalectomy results in a spontaneous decrease in dietary salt intake and might therefore provide further reduction of cardiovascular risk in PA than specific medical treatment alone. Furthermore, there is evidence from clinical studies that even after sufficient treatment of PA dietary salt intake remains a relevant prognostic factor for cardiovascular risk. This review will focus on the synergistic benefits derived from both blockade of aldosterone-mediated effects and reduction in dietary salt intake on cardiovascular risk

Predigt über Johannis XIV, 19 : zum wohlverdienten Gedächtnisse weyland Herrn Johann Jakob Harder, ... bey dessen feyerlichen Leichen-Begängnisse den 15ten December 1775 vor einer sehr ansehnlichen und volkreichen Versamlung

Konvoluuthttp://tartu.ester.ee/record=b1417686~S1*es

Die 'neueste Kommunikationswissenschaft': Gegenstandsdynamik und Methodeninnovation in Kommunikationsforschung und Medienanalyse

Die Einleitung zu dem Band 'Neue Komplexitäten für Kommunikationsforschung und Medienanalyse: Analytische Zugänge und empirische Studien' soll einerseits dazu dienen, aktuelle kommunikationswissenschaftliche Forschung herausfordernde Entwicklungen der Technisierung, Digitalisierung und Datafizierung zu überblicken. Andererseits werden darauf antwortende oder mittelbar verknüpfte Trends in der Methodenentwicklung zusammengefasst. Somit spiegelt die Einleitung die Argumentationsstruktur der im Band versammelten Beiträge wider, die analytisch die Veränderungen in den empirischen Bezugsrahmen und Materialien der Kommunikationswissenschaft aufarbeiten

Awareness and use of home remedies in Italy's alps: a population-based cross-sectional telephone survey

Belief in complementary and alternative medicine practices is related to reduced preparedness for vaccination. This study aimed to assess home remedy awareness and use in South Tyrol, where vaccination rates in the coronavirus pandemic were lowest in Italy and differed between German- and Italian-speaking inhabitants.; A population-based survey was conducted in 2014 and analyzed using descriptive statistics, multiple logistic regression, and latent class analysis.; Of the representative sample of 504 survey respondents, 357 (70.8%) participants (43.0% male; primary language German, 76.5%) reported to use home remedies. Most commonly reported home remedies were teas (48.2%), plants (21.0%), and compresses (19.5%). Participants from rural regions were less likely (odds ratio 0.35, 95% confidence interval 0.19-0.67), while female (2.62, 1.69-4.10) and German-speaking participants (5.52, 2.91-9.88) were more likely to use home remedies. Latent classes of home remedies were "alcoholic home remedies" (21.4%) and "non-alcohol-containing home remedies" (78.6%). Compared to the "non-alcohol-containing home remedies" class, members of the "alcoholic home remedies" class were more likely to live in an urban region, to be male and German speakers.; In addition to residence and sex, language group membership associates with awareness and use of home remedies. Home remedies likely contribute to socio-cultural differences between the language groups in the Italian Alps. If the observed associations explain the lower vaccination rates in South Tyrol among German speakers requires further study

Lipoprotein insulin resistance score and branched-chain amino acids increase after adrenalectomy for unilateral aldosterone-producing adenoma: a preliminary study

Background and aims Primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA) is preferentially treated by unilateral adrenalectomy (ADX), but little is known about the changes in lipid and glucose metabolism that may occur after ADX. Methods We studied 19 non-diabetic patients who did not use lipid-lowering drugs with PA due to APA before and 6 months after unilateral ADX. Fasting plasma lipids, lipoprotein subfractions, branched-chain amino acids (BCAA), and GlycA, a pro-inflammatory glycoprotein biomarker, were measured by nuclear magnetic resonance (NMR) spectroscopy. The Lipoprotein Insulin Resistance (LP-IR) score, which is based on six lipoprotein variables, was calculated. Results In all patients, hyperaldosteronism was resolved after ADX. Body mass index and fasting plasma glucose were unchanged, but HbA1c increased (p = 0.002). Plasma triglycerides, large triglyceride-rich lipoprotein (TRL) cholesterol, and large TRL particles were increased (p < 0.01), resulting in an increase in TRL size (p = 0.027). High-density lipoprotein size was decreased (p = 0.015). LP-IR scores (p = 0.001) and total BCAA (p = 0.017) were increased, but GlycA remained unaltered. Conclusions Based on increases in LP-IR scores and BCAA, which each have been shown to predict new onset type 2 diabetes mellitus independent of conventional risk factors in the general population, this preliminary study suggests that diabetes risk is not improved but may even be increased after ADX for APA despite remission of PA