Liver Fibrosis-4 index indicates atrial fibrillation in acute ischemic stroke

BACKGROUND: Non-alcoholic fatty liver disease and particularly liver fibrosis is related to cardiovascular disease and may indicate an increased risk for atrial fibrillation (AF), but this association has not yet been systematically investigated in a cohort of ischemic stroke patients. METHODS: We analyzed data from a prospective single-center study enrolling all consecutive ischemic stroke patients admitted to our stroke unit over a one-year-period. All patients received a thorough etiological work-up. For evaluation of liver fibrosis, we determined the FIB-4 index, a well-established noninvasive liver fibrosis test. Laboratory results were analyzed from a uniform blood sample taken at stroke unit admission. RESULTS: Of 414 included patients (mean age 70.2 years, 57.7% male), FIB-4 indicated advanced liver fibrosis in 92 (22.2%). AF as the underlying stroke mechanism was present in 28.0% (large vessel disease: 25.6%, small vessel disease: 11.4%, cryptogenic: 29.2%). Patients with FIB-4 ≥2.67 had higher rates of AF (53.3% vs. 20.8%, p<0.001), this association remained significant after correction for established AF risk factors (Odds Ratio 2.53, 95% confidence interval 1.44-4.46, p=0.001). FIB-4 was further associated with worse functional outcome three months (p<0.001) and higher mortality four years post-stroke (p<0.02), but these relationships were no longer present after correction for age and initial stroke severity. Moreover, FIB-4 did not associate with long-term recurrent vascular events. CONCLUSIONS: Liver fibrosis assessed by the FIB-4 index is independently associated with AF in acute ischemic stroke patients. Further studies should evaluate whether adding the FIB-4 index to AF risk scores increases their precision

Synthesis of aircraft noise operations

This paper provides an overview of the aircraft noise synthesis techniques that were developed within the European FP7 project COSMA (Community Orientated Solutions to Minimize Aircraft Noise Annoyance). The main ambition of COSMA is to develop engineering criteria for aircraft design and operations in order to reduce the annoyance within airport communities due to aircraft exterior noise. As a basis for this activity, a powerful aircraft flyover noise synthesis tool was developed, allowing psychometric studies and the analysis of community noise annoyance in relation to aircraft design and flight procedures. The sound synthesis tool integrates dedicated interfaces for on-line interactive sound quality analysis and for simulating complex airport noise scenarios based on aircraft source and noise propagation models. The main tool features are described and an example case study is presented, illustrating the noise modeling and audio synthesis. Next to that, an overview is given of the different airport noise scenarios that were synthesized in the COSMA project, considering standard and optimized procedures, existing aircraft and target sounds, as well as first examples of design optimizations, innovative concepts and low noise technologies

Human response to simulated airport noise scenarios in home-like environments

his research is part of a FP7 project supported by the European Commission called 'Community oriented solutions to minimize aircraft noise annoyance' (COSMA). The present paper focuses on the development and the application of a methodology for the assessment of changes in airport noise exposure in home- like environments, particularly the design of sound scenarios and of experiments. Two airport noise changes are assessed and compared to a reference scenario: a halving of the number of aircraft, and an improvement in aircraft sound quality. For that purpose, sound perception, annoyance and activity dis- turbance as well as performances to cognitive tasks (Stroop and Word list Memory) are considered in the experiments involving 142 participants in 3 laboratories. Despite a similar LAeq, overall annoyance significantly decreases when reducing the number of aircraft, which reinforces the interest in a noise event index (NNE-NA) in addition to energetic noise indices for regulatory purposes. Results to a change in aircraft sound quality are largely inconclusive. Further work should address the human response to future airport noise scenarios based on new aircraft designs, including innovative concepts