Prevalence and significance of alterations in cardiac structure and function in patients with heart failure and a preserved ejection fraction

<p><b>Background:</b> The purpose of this study was to examine the prevalence of abnormalities in cardiac structure and function present in patients with heart failure and a preserved ejection fraction (HFPEF) and to determine whether these alterations in structure and function were associated with cardiovascular morbidity and mortality.</p> <p><b>Methods and Results:</b> The Irbesartan in HFPEF trial (I-PRESERVE) enrolled 4128 patients; echocardiographic determination of left ventricular (LV) volume, mass, left atrial (LA) size, systolic function, and diastolic function were made at baseline in 745 patients. The primary end point was death or protocol-specific cardiovascular hospitalization. A secondary end point was the composite of heart failure death or heart failure hospitalization. Associations between baseline structure and function and patient outcomes were examined using univariate and multivariable Cox proportional hazard analyses. In this substudy, LV hypertrophy or concentric remodeling was present in 59%, LA enlargement was present in 66%, and diastolic dysfunction was present in 69% of the patients. Multivariable analyses controlling for 7 clinical variables (including log N-terminal pro-B–type natriuretic peptide) indicated that increased LV mass, mass/volume ratio, and LA size were independently associated with an increased risk of both primary and heart failure events (all P<0.05).</p> <p><b>Conclusions:</b> Left ventricular hypertrophy or concentric remodeling, LA enlargement, and diastolic dysfunction were present in the majority of patients with HFPEF. Left ventricular mass and LA size were independently associated with an increased risk of morbidity and mortality. The presence of structural remodeling and diastolic dysfunction may be useful additions to diagnostic criteria and provide important prognostic insights in patients with HFPEF.</p&gt

One-loop corrections to the metastable vacuum decay

We evaluate the one-loop prefactor in the false vacuum decay rate in a theory of a self interacting scalar field in 3+1 dimensions. We use a numerical method, established some time ago, which is based on a well-known theorem on functional determinants. The proper handling of zero modes and of renormalization is discussed. The numerical results in particular show that quantum corrections become smaller away from the thin-wall case. In the thin-wall limit the numerical results are found to join into those obtained by a gradient expansion.Comment: 31 pages, 7 figure

Identification of a Robust Methylation Classifier for Cutaneous Melanoma Diagnosis

Early diagnosis improves melanoma survival, yet the histopathological diagnosis of cutaneous primary melanoma can be challenging, even for expert dermatopathologists. Analysis of epigenetic alterations, such as DNA methylation, that occur in melanoma can aid in its early diagnosis. Using a genome-wide methylation screening, we assessed CpG methylation in a diverse set of 89 primary invasive melanomas, 73 nevi, and 41 melanocytic proliferations of uncertain malignant potential, classified based on interobserver review by dermatopathologists. Melanomas and nevi were split into training and validation sets. Predictive modeling in the training set using ElasticNet identified a 40-CpG classifier distinguishing 60 melanomas from 48 nevi. High diagnostic accuracy (area under the receiver operator characteristic curve = 0.996, sensitivity = 96.6%, and specificity = 100.0%)was independently confirmed in the validation set (29 melanomas, 25 nevi)and other published sample sets. The 40-CpG melanoma classifier included homeobox transcription factors and genes with roles in stem cell pluripotency or the nervous system. Application of the 40-CpG melanoma classifier to the diagnostically uncertain samples assigned melanoma or nevus status, potentially offering a diagnostic tool to assist dermatopathologists. In summary, the robust, accurate 40-CpG melanoma classifier offers a promising assay for improving primary melanoma diagnosis

A Way to Reopen the Window for Electroweak Baryogenesis

We reanalyse the sphaleron bound of electroweak baryogenesis when allowing deviations to the Friedmann equation. These modifications are well motivated in the context of brane cosmology where they appear without being in conflict with major experimental constraints on four-dimensional gravity. While suppressed at the time of nucleosynthesis, these corrections can dominate at the time of the electroweak phase transition and in certain cases provide the amount of expansion needed to freeze out the baryon asymmetry without requiring a strongly first order phase transition. The sphaleron bound is substantially weakened and can even disappear so that the constraints on the higgs and stop masses do not apply anymore. Such modification of cosmology at early times therefore reopens the parameter space allowing electroweak baryogenesis which had been reduced substantially given the new bound on the higgs mass imposed by LEP. In contrast with previous attempts to turn around the sphaleron bound using alternative cosmologies, we are still considering that the electroweak phase transition takes place in a radiation dominated universe. The universe is expanding fast because of the modification of the Friedmann equation itself without the need for a scalar field and therefore evading the problem of the decay of this scalar field after the completion of the phase transition and the risk that its release of entropy dilutes the baryon asymmetry produced at the transition.Comment: 19 pages, 3 figures; v2: minor changes, remark added at end of section 5 and in caption of figure 1; v3: references added, version to be publishe

Computation of the winding number diffusion rate due to the cosmological sphaleron

A detailed quantitative analysis of the transition process mediated by a sphaleron type non-Abelian gauge field configuration in a static Einstein universe is carried out. By examining spectra of the fluctuation operators and applying the zeta function regularization scheme, a closed analytical expression for the transition rate at the one-loop level is derived. This is a unique example of an exact solution for a sphaleron model in $3+1$ spacetime dimensions.Comment: Some style corrections suggested by the referee are introduced (mainly in Sec.II), one reference added. To appear in Phys.Rev.D 29 pages, LaTeX, 3 Postscript figures, uses epsf.st

Human pleural fluid is a potent growth medium for Streptococcus pneumoniae

Empyema is defined by the presence of bacteria and/or pus in pleural effusions. However, the biology of bacteria within human pleural fluid has not been studied. Streptococcus pneumoniae is the most common cause of pediatric and frequent cause of adult empyema. We investigated whether S. pneumoniae can proliferate within human pleural fluid and if growth is affected by the cellular content of the fluid and/or characteristics of pneumococcal surface proteins. Invasive S. pneumoniae isolates (n = 24) and reference strain recovered from human blood or empyema were inoculated (1.5×10⁶CFU/mL) into sterile human malignant pleural fluid samples (n = 11). All S. pneumoniae (n = 25) strains proliferated rapidly, increasing by a median of 3009 (IQR 1063-9846) from baseline at 24hrs in all pleural effusions tested. Proliferation was greater than in commercial pneumococcal culture media and concentrations were maintained for 48hrs without autolysis. A similar magnitude of proliferation was observed in pleural fluid before and after removal of its cellular content, p = 0.728. S. pneumoniae (D39 strain) wild-type, and derivatives (n = 12), each with mutation(s) in a different gene required for full virulence were inoculated into human pleural fluid (n = 8). S. pneumoniae with pneumococcal surface antigen A (ΔpsaA) mutation failed to grow (2207-fold lower than wild-type), p<0.001, however growth was restored with manganese supplementation. Growth of other common respiratory pathogens (n = 14) across pleural fluid samples (n = 7) was variable and inconsistent, with some strains failing to grow. We establish for the first time that pleural fluid is a potent growth medium for S. pneumoniae and proliferation is dependent on the PsaA surface protein and manganese.Natalia D. Popowicz, Sally M. Lansley, Hui M. Cheah, Ian D. Kay, Christine F. Carson, Grant W. Waterer, James C. Paton, Jeremy S. Brown, Y.C. Gary Le

Staggered versus overlap fermions: a study in the Schwinger model with Nf=0,1,2N_f=0,1,2

We study the scalar condensate and the topological susceptibility for a continuous range of quark masses in the Schwinger model with $N_f=0,1,2$ dynamical flavors, using both the overlap and the staggered discretization. At finite lattice spacing the differences between the two formulations become rather dramatic near the chiral limit, but they get severely reduced, at the coupling considered, after a few smearing steps.Comment: 15 pages, 7 figures, v2: 1 ref corrected, minor change

Do Relatively More Efficient Firms Demand Additional Audit Effort (Hours)?

We examine whether firms with higher relative efficiency (operational performance) require additional audit effort (hours) to signal audit quality to demonstrate that their financial reporting systems are robust. Therefore, we use a Korean sample of publicly listed firms because of the Korean audit hour policy which mandates that audit hour information be made available for market participants. We find that client firms with higher relative efficiency have higher audit hours, suggesting that management has an incentive to demand additional audit hours for signalling purposes, and that shareholders, amongst other stakeholders, have an incentive to demand external monitoring to reduce potential agency problems. The results show that relative efficiency is a unique measure of firm performance that can provide insights into a client firm's business and audit risk. We also find evidence suggesting that audit firms do not subject clients to a fee (fee per hour) premium based on relative efficiency, supporting our finding that client firms require audit effort for signalling purposes. Thus, our results have important implications for policymakers about audit effort demand

Do Relatively More Efficient Firms Demand Additional Audit Effort (Hours)?

We examine whether firms with higher relative efficiency (operational performance) require additional audit effort (hours) to signal audit quality to demonstrate that their financial reporting systems are robust. Therefore, we use a Korean sample of publicly listed firms because of the Korean audit hour policy which mandates that audit hour information be made available for market participants. We find that client firms with higher relative efficiency have higher audit hours, suggesting that management has an incentive to demand additional audit hours for signalling purposes, and that shareholders, amongst other stakeholders, have an incentive to demand external monitoring to reduce potential agency problems. The results show that relative efficiency is a unique measure of firm performance that can provide insights into a client firm's business and audit risk. We also find evidence suggesting that audit firms do not subject clients to a fee (fee per hour) premium based on relative efficiency, supporting our finding that client firms require audit effort for signalling purposes. Thus, our results have important implications for policymakers about audit effort demand

Science-Technology-Society (STS): a new paradigm in Science Education

publication-status: Publishedtypes: ArticleChanges in the past two decades of goals for science education in schools have induced new orientations in science education worldwide. One of the emerging complementary approaches was the science-technology-society (STS) movement. STS has been called the current megatrend in science education. Others have called it a paradigm shift for the field of science education. The success of science education reform depends on teachers' ability to integrate the philosophy and practices of current programs of science education reform with their existing philosophy. Thus, when considering the STS approach to science education, teacher beliefs about STS implementation require attention. Without this attention, negative beliefs concerning STS implementation and inquiry learning could defeat the reform movements emphasizing STS. This article argues the role of STS in science education and the importance of considering science teachers' beliefs about STS in implementing significant reforms in science education