Profound influence of different methods for determination of the ankle brachial index on the prevalence estimate of peripheral arterial disease

BACKGROUND: The ankle brachial index (ABI) is an efficient tool for objectively documenting the presence of lower extremity peripheral arterial disease (PAD). However, different methods exist for ABI calculation, which might result in varying PAD prevalence estimates. To address this question, we compared five different methods of ABI calculation using Doppler ultrasound in 6,880 consecutive, unselected primary care patients ≥65 years in the observational getABI study. METHODS: In all calculations, the average systolic pressure of the right and left brachial artery was used as the denominator (however, in case of discrepancies of ≥10 mmHg, the higher reading was used). As nominators, the following pressures were used: the highest arterial ankle pressure of each leg (method #1), the lowest pressure (#2), only the systolic pressure of the tibial posterior artery (#3), only the systolic pressure of the tibial anterior artery (#4), and the systolic pressure of the tibial posterior artery after exercise (#5). An ABI < 0.9 was regarded as evidence of PAD. RESULTS: The estimated prevalence of PAD was lowest using method #1 (18.0%) and highest using method #2 (34.5%), while the differences in methods #3–#5 were less pronounced. Method #1 resulted in the most accurate estimation of PAD prevalence in the general population. Using the different approaches, the odds ratio for the association of PAD and cardiovascular (CV) events varied between 1.7 and 2.2. CONCLUSION: The data demonstrate that different methods for ABI determination clearly affect the estimation of PAD prevalence, but not substantially the strength of the associations between PAD and CV events. Nonetheless, to achieve improved comparability among different studies, one mode of calculation should be universally applied, preferentially method #1

Observation of discrete time-crystalline order in a disordered dipolar many-body system

Understanding quantum dynamics away from equilibrium is an outstanding challenge in the modern physical sciences. It is well known that out-of-equilibrium systems can display a rich array of phenomena, ranging from self-organized synchronization to dynamical phase transitions. More recently, advances in the controlled manipulation of isolated many-body systems have enabled detailed studies of non-equilibrium phases in strongly interacting quantum matter. As a particularly striking example, the interplay of periodic driving, disorder, and strong interactions has recently been predicted to result in exotic "time-crystalline" phases, which spontaneously break the discrete time-translation symmetry of the underlying drive. Here, we report the experimental observation of such discrete time-crystalline order in a driven, disordered ensemble of $\sim 10^6$ dipolar spin impurities in diamond at room-temperature. We observe long-lived temporal correlations at integer multiples of the fundamental driving period, experimentally identify the phase boundary and find that the temporal order is protected by strong interactions; this order is remarkably stable against perturbations, even in the presence of slow thermalization. Our work opens the door to exploring dynamical phases of matter and controlling interacting, disordered many-body systems.Comment: 6 + 3 pages, 4 figure

Avaliação e perspectivas da abordagem à conservação do patrimônio organístico no Brasil

Órgãos de tubos são construídos no Brasil, ou importados do exterior, desde as primeiras décadas do período colonial. Estes instrumentos, apesar de constituírem um conjunto relativamente exíguo, representam um testemunho histórico e musical de valor inestimável. No entanto, de um modo geral, encontram-se em condições precárias de funcionamento e, em parte, mais ou menos descaracterizados profundamente, quanto à sua estrutura e configuração original, às vezes em estado de abandono e, por incrível que pareça, ainda sujeitos ao risco de intervenções arbitrárias e desprovidas de bases técnicas e de preocupação histórica e musicológica. Neste artigo, busca-se percorrer o caminho que levou à atual situação e discutem-se os princípios e os critérios de processos de recuperação, manutenção e conservação preventiva desse patrimônio, partindo dos pressupostos do respeito à sua originalidade e do direito a restauros segundo os rigorosos cânones já definidos para objetos com plena condição de bem cultural, cujo reconhecimento para os órgãos de qualquer época deve ser urgentemente garantido.Pipe organs have been built in Brazil or imported from elsewhere since the very first decades of the colonial period. Albeit relatively small in number, such instruments have inestimable historical and musical value. Notwithstanding, they are generally in very poor working condition and some have lost much of their original structure and configuration; they are often found in a state of abandonment and, incredible as it may seem, still under the threat of arbitrary interventions performed with no technical expertise or any concern for their historical and musicological significance. This article is an effort to understand how this state of affairs came to be, and discusses principles and criteria for the restoration, maintenance and preventive conservation of this legacy, based on assumptions regarding its original conditions and entitlement to restoration in accordance with the stringent standards already set for artifacts that enjoy the full status of cultural assets, which should also be urgently granted to pipe organs of any time and age

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Prevalence estimates for PAD using different methods for ABI calculation

<p><b>Copyright information:</b></p><p>Taken from "Profound influence of different methods for determination of the ankle brachial index on the prevalence estimate of peripheral arterial disease"</p><p>http://www.biomedcentral.com/1471-2458/7/147</p><p>BMC Public Health 2007;7():147-147.</p><p>Published online 6 Jul 2007</p><p>PMCID:PMC1950873.</p><p></p> PAD was defined by an ABI value < 0.9 or clinical evidence of PAD . Clinical evidence of PAD included positive Rose questionnaire, intermittent claudication and peripheral vascular event

ROC curves for the association between ABI values (according to different methods for ABI calculation) and the history of cardiovascular events (myocardial infarction or coronary revascularisation)

<p><b>Copyright information:</b></p><p>Taken from "Profound influence of different methods for determination of the ankle brachial index on the prevalence estimate of peripheral arterial disease"</p><p>http://www.biomedcentral.com/1471-2458/7/147</p><p>BMC Public Health 2007;7():147-147.</p><p>Published online 6 Jul 2007</p><p>PMCID:PMC1950873.</p><p></p> , method #1; , method #2; , method #3; , method #4. The red dashed line represents the line of identity of tpr and fpr

Association between PAD and history of cardiac event using odds ratios (OR)

<p><b>Copyright information:</b></p><p>Taken from "Profound influence of different methods for determination of the ankle brachial index on the prevalence estimate of peripheral arterial disease"</p><p>http://www.biomedcentral.com/1471-2458/7/147</p><p>BMC Public Health 2007;7():147-147.</p><p>Published online 6 Jul 2007</p><p>PMCID:PMC1950873.</p><p></p> PAD was defined by an ABI value < 0.9 or clinical evidence of PAD, while history of cardiac event was evident after myocardial infarction or coronary revascularisation. OR, sensitivity and specificity are shown for the different modes of ABI calculation. Sensitivity and specificity are given for the 'detection' or 'exclusion', resp., of a history of cardiac events