The metabolic syndrome adds utility to the prediction of mortality over its components: The Vietnam Experience Study

Background\ud The metabolic syndrome increases mortality risk. However, as “non-affected” individuals may still have up to two risk factors, the utility of using three or more components to identify the syndrome, and its predictive advantage over individual components have yet to be determined.\ud \ud Methods\ud Participants, male Vietnam-era veterans (n = 4265) from the USA, were followed-up from 1985/1986 for 14.7 years (61,498 person-years), and all-cause and cardiovascular disease deaths collated. Cox's proportional-hazards regression was used to assess the effect of the metabolic syndrome and its components on mortality adjusting for a wide range of potential confounders.\ud \ud Results\ud At baseline, 752 participants (17.9%) were identified as having metabolic syndrome. There were 231 (5.5%) deaths from all-causes, with 60 from cardiovascular disease. After adjustment for a range of covariates, the metabolic syndrome increased the risk of all-cause, HR 2.03, 95%CI 1.52, 2.71, and cardiovascular disease mortality, HR 1.92, 95%CI 1.10, 3.36. Risk increased dose-dependently with increasing numbers of components. The increased risk from possessing only one or two components was not statistically significant. The adjusted risk for four or more components was greater than for only three components for both all-cause, HR 2.30, 95%CI 1.45, 3.66 vs. HR 1.70, 95%CI 1.11, 2.61, and cardiovascular disease mortality, HR 3.34, 95%CI 1.19, 9.37 vs. HR 2.81, 95%CI 1.07, 7.35. The syndrome was more informative than the individual components for all-cause mortality, but could not be assessed for cardiovascular disease mortality due to multicollinearity. Hyperglycaemia was the individual strongest parameter associated with mortality.\ud \u

Left ventricular geometric patterns and adaptations to hemodynamics are similar in elderly men and women

<p>Abstract</p> <p>Background</p> <p>Common conditions such as obesity and hypertension result in hemodynamic alterations that will induce remodeling of the left ventricle (LV). However, differences between the genders in the relationship of hemodynamics to LV geometry are not well known.</p> <p>The present study aims to investigate differences between the genders in this respect, in a sample of elderly persons.</p> <p>Methods</p> <p>Echocardiography and Doppler was performed in a population-based sample aged 70 - The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (n = 922).</p> <p>Hemodynamic patterns obtained by echocardiography and Doppler were evaluated in relation to four LV geometric groups (normal, concentric remodeling, eccentric hypertrophy and concentric hypertrophy).</p> <p>Results</p> <p>No significant difference between the genders was observed regarding the prevalence of the LV geometric groups.</p> <p>Mean values of most evaluated echocardiography and Doppler variables differed between men and women, such as LA, IVS, LVEDD and IVRT, but the relationship of hemodynamic variables to LV geometric groups did not differ between the genders.</p> <p>Conclusions</p> <p>Although mean values of many echocardiographic variables differed between men and women, the LV geometric adaptations to a given hemodynamic load appear similar in both genders.</p

Risk map as a library management information dashboard: a case study in adapting a configural display

In this paper, we report on our application of Cognitive Work Analysis to create an Abstraction Hierarchy model that helps librarians identify key functional relationships for managing the overall performance of a library. By themselves, functional relationships are not as useful in providing insights into the reasons for good or poor performance. However, when these functional relationships are set against the context of system invariants and constraints, they can provide library managers information useful for diagnosis and localization of problems. We propose the Risk Map visualization technique as an information dashboard to cognitively access these functional relationships. Furthermore, when these functional relationships are portrayed over time, trends and patterns can be detected with relative ease

Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs: A Randomized Clinical Trial

Importance: Hypertension is the leading risk factor for premature death worldwide. Multiple blood pressure-lowering therapies are available but the potential for maximizing benefit by personalized targeting of drug classes is unknown. Objective: To investigate and quantify the potential for targeting specific drugs to specific individuals to maximize blood pressure effects. Design, Setting, and Participants: A randomized, double-blind, repeated crossover trial in men and women with grade 1 hypertension at low risk for cardiovascular events at an outpatient research clinic in Sweden. Mixed-effects models were used to assess the extent to which individuals responded better to one treatment than another and to estimate the additional blood pressure lowering achievable by personalized treatment. Interventions: Each participant was scheduled for treatment in random order with 4 different classes of blood pressure-lowering drugs (lisinopril [angiotensin-converting enzyme inhibitor], candesartan [angiotensin-receptor blocker], hydrochlorothiazide [thiazide], and amlodipine [calcium channel blocker]), with repeated treatments for 2 classes. Main Outcomes and Measures: Ambulatory daytime systolic blood pressure, measured at the end of each treatment period. Results: There were 1468 completed treatment periods (median length, 56 days) recorded in 270 of the 280 randomized participants (54% men; mean age, 64 years). The blood pressure response to different treatments varied considerably between individuals (P <.001), specifically for the choices of lisinopril vs hydrochlorothiazide, lisinopril vs amlodipine, candesartan vs hydrochlorothiazide, and candesartan vs amlodipine. Large differences were excluded for the choices of lisinopril vs candesartan and hydrochlorothiazide vs amlodipine. On average, personalized treatment had the potential to provide an additional 4.4 mm Hg-lower systolic blood pressure. Conclusions and Relevance: These data reveal substantial heterogeneity in blood pressure response to drug therapy for hypertension, findings that may have implications for personalized therapy. Trial Registration: ClinicalTrials.gov Identifier: NCT02774460

Two-Dimensional Spectroscopy of Extended Molecular Systems: Applications to Energy Transport and Relaxation in an α-Helix

A simulation study of the coupled dynamics of amide I and amide II vibrations in an α-helix dissolved in water shows that two-dimensional (2D) infrared spectroscopy may be used to disentangle the energy transport along the helix through each of these modes from the energy relaxation between them. Time scales for both types of processes are obtained. Using polarization-dependent 2D spectroscopy is an important ingredient in the method we propose. The method may also be applied to other two-band systems, both in the infrared (collective vibrations) and the visible (excitons) parts of the spectrum.

A stochastic method for the energy management in hybrid electric vehicles

There are many approaches addressing the problem of optimal energy management in hybrid electric vehicles; however, most of them optimise the control strategy for particular driving cycles. This paper takes into account that the driving cycle is not a priori known to obtain a near-optimal solution. The proposed method is based on analysing the power demands in a given receding horizon to estimate future driving conditions and minimise the fuel consumption while cancelling the expected battery energy consumption after a defined time horizon. Simulations show that the proposed method allows charge sustainability providing near-optimal results. (C) 2014 Elsevier Ltd. All rights reserved.This research has been partially supported by Ministerio de Ciencia e Innovacion through Project TRA2010-16205 uDiesel and by the Conselleria de Educacio Cultura i Esports de la Generalitat Valenciana through Project GV/2103/044 AECOSPH.Payri González, F.; Guardiola, C.; Plá Moreno, B.; Blanco-Rodriguez, D. (2014). A stochastic method for the energy management in hybrid electric vehicles. Control Engineering Practice. 29:257-265. https://doi.org/10.1016/j.conengprac.2014.01.004S2572652

Sources of variation in cuticular hydrocarbons in the ant formica exsecta

Phenotypic variation arises from interactions between genotype and environment, although how variation is produced and then maintained remains unclear. The discovery of the nest-mate recognition system in Formica exsecta ants has allowed phenotypic variation in chemical profiles to be quantified across a natural population of 83 colonies. We investigated if this variation was correlated or not with intrinsic (genetic relatedness), extrinsic (location, light, temperature) or social (queen number) factors. (Z)-9-Alkenes and n-alkanes showed different patterns of variance: island (location) explained only 0.2% of the variation in (Z)-9-alkenes, but 21¬–29% in n-alkanes, whereas colony of origin explained 96% and 45–49% of the variation in (Z)-9-alkenes and n-alkanes, respectively. By contrast, within-colony variance of (Z)-9-alkenes was 4%, and 23–34% in n-alkanes, supporting the function of the former as recognition cues. (Z)-9-Alkene and n-alkane profiles were correlated with the genetic distance between colonies. Only n-alkane profiles diverged with increasing spatial distance. Sampling year explained a small (5%), but significant, amount of the variation in the (Z)-9-alkenes, but there was no consistent directional trend. Polygynous colonies and populous monogynous colonies were dominated by a rich C23:1 profile. We found no associations between worker size, mound exposure, or humidity, although effect sizes for the latter two factors were considerable. The results support the conjecture that genetic factors are the most likely source of between-colony variation in cuticular hydrocarbons

On the minimum transport required to passively suppress runaway electrons in SPARC disruptions

In [V.A. Izzo et al 2022 Nucl. Fusion 62 096029], state-of-the-art modeling of thermal and current quench (CQ) MHD coupled with a self-consistent evolution of runaway electron (RE) generation and transport showed that a non-axisymmetric (n = 1) in-vessel coil could passively prevent RE beam formation during disruptions in SPARC, a compact high-field tokamak projected to achieve a fusion gain Q > 2 in DT plasmas. However, such suppression requires finite transport of REs within magnetic islands and re-healed flux surfaces; conservatively assuming zero transport in these regions leads to an upper bound of RE current ~1 MA compared to ~8.7 MA of pre-disruption plasma current. Further investigation finds that core-localized electrons, within r/a < 0.3 and with kinetic energies 0.2-15 MeV, contribute most to the RE plateau formation. Yet only a relatively small amount of transport, i.e. a diffusion coefficient ~18 $\mathrm{m^2/s}$, is needed in the core to fully mitigate these REs. Properly accounting for (i) the CQ electric field's effect on RE transport in islands and (ii) the contribution of significant RE currents to disruption MHD may help achieve this