Electrocardiographic Left Ventricular Hypertrophy and Outcome in Hemodialysis Patients

BACKGROUND AND AIMS: Electrocardiography (ECG) is the most widely used initial screening test for the assessment of left ventricular hypertrophy (LVH), an independent predictor of cardiovascular mortality in patients with end-stage renal disease (ESRD). However, traditional ECG criteria based only on voltage to detect LVH have limited clinical utility for the detection of LVH because of their poor sensitivity. METHODS: This prospective observational study was undertaken to compare the prognostic significance of commonly used ECG criteria for LVH, namely Sokolow-Lyon voltage (SV) or voltage-duration product (SP) and Cornell voltage (CV) or voltage-duration product (CP) criteria, and to investigate the association between echocardiographic LV mass index (LVMI) and ECG-LVH criteria in ESRD patients, who consecutively started maintenance hemodialysis (HD) between January 2006 and December 2008. RESULTS: A total of 317 patients, who underwent both ECG and echocardiography, were included. Compared to SV and CV criteria, SP and CP criteria, respectively, correlated more closely with LVMI. In addition, CP criteria provided the highest positive predictive value for echocardiographic LVH. The 5-year cardiovascular survival rates were significantly lower in patients with ECG-LVH by each criterion. In multivariate analyses, echocardiographic LVH [adjusted hazard ratio (HR): 11.71; 95% confidence interval (CI): 1.57-87.18; P = 0.016] and ECG-LVH by SP (HR: 3.43; 95% CI: 1.32-8.92; P = 0.011) and CP (HR: 3.07; 95% CI: 1.16-8.11; P = 0.024) criteria, but not SV and CV criteria, were significantly associated with cardiovascular mortality. CONCLUSIONS: The product of QRS voltage and duration is helpful in identifying the presence of LVH and predicting cardiovascular mortality in incident HD patients

Mothers of Soldiers in Wartime: A National News Narrative

National news media represent mothers of US combat soldiers in the Iraq War as archetypal good mothers, that is, mothers who continue their maternal work even after their children are deployed. However, not all mothers are depicted as the archetypal patriotic mother, i.e., a good mother who is also stoic and silent about the war and her child\u27s role in it. Mothers of soldiers are portrayed as good mothers who sometimes also voice their attitudes about the war effort. The maternal attitudes ranged from complete support for the war to opposition to the war but support for the soldiers. The findings suggest a picture of wartime motherhood that is more nuanced than the historical image of the patriotic mother suggests

Estimation of the atmospheric flux of nutrients and trace metals to the Eastern Tropical North Atlantic Ocean

Atmospheric deposition contributes potentially significant amounts of the nutrients iron, nitrogen and phosphorus (via mineral dust and anthropogenic aerosols) to the oligotrophic tropical North Atlantic Ocean. Transport pathways, deposition processes and source strengths contributing to this atmospheric flux are all highly variable in space and time. Atmospheric sampling was conducted during 28 research cruises through the Eastern Tropical North Atlantic (ETNA) over a 12 year period and a substantial dataset of measured concentrations of nutrients and trace metals in aerosol and rainfall over the region was acquired. This database was used to quantify (on a spatial- and seasonal-basis) the atmospheric input of ammonium, nitrate, soluble phosphorus and soluble and total iron, aluminium and manganese to the ETNA. The magnitude of atmospheric input varies strongly across the region, with high rainfall rates associated with the Inter-tropical Convergence Zone contributing to high wet deposition fluxes in the south, particularly for soluble species. Dry deposition fluxes of species associated with mineral dust exhibited strong seasonality, with highest fluxes associated with winter-time low-level transport of Saharan dust. Overall (wet plus dry) atmospheric inputs of soluble and total trace metals were used to estimate their soluble fractions. These also varied with season and were generally lower in the dry north than in the wet south. The ratio of ammonium plus nitrate to soluble iron in deposition to the ETNA was lower than the N:Fe requirement for algal growth in all cases, indicating the importance of the atmosphere as a source of excess iron

Women We Loved: Paradoxes of public and private in the biographical television drama

Broadcast to critical acclaim and relatively large audiences for its niche channel, the Women We Loved season consisted of biographical dramatisations of three prominent female figures of 20th-century British culture. These dramas shared in common narratives that centre on the two aspects of ‘the public’ and ‘the private’: the tension between public career and personal life and the discrepancy between celebrity persona and private individual. Combining theoretical insights from feminist studies of biography with close textual analysis, this article analyses how performance, aesthetics and narrative express the ambivalent placement of their protagonists between public and private spheres

Global warming and the cosmopolitan political conception of justice

Within the literature in green political theory on global environmental threats one can often find dissatisfaction with liberal theories of justice. This is true even though liberal cosmopolitans regularly point to global environmental problems as one reason for expanding the scope of justice beyond the territorial limits of the state. One of the causes for scepticism towards liberal approaches is that many of the most notable anti-cosmopolitan theories are also advanced by liberals. In this paper, I first explain why one of the strongest expressions of liberal anti-cosmopolitanism cannot simply be dismissed because it may fail to support desired environmental ends. The political conception of justice represents one of the most important challenges to cosmopolitanism generally and is thus a serious challenge to viewing global environmental problems in terms of cosmopolitan justice. Second, I will show through the case of anthropogenic global warming that the political conception of justice under current conditions does have clear cosmopolitan implications despite its proponents' claims

Automated Risk Identification of Myocardial Infarction Using Relative Frequency Band Coefficient (RFBC) Features from ECG

Various structural and functional changes associated with ischemic (myocardial infarcted) heart cause amplitude and spectral changes in signals obtained at different leads of ECG. In order to capture these changes, Relative Frequency Band Coefficient (RFBC) features from 12-lead ECG have been proposed and used for automated identification of myocardial infarction risk. RFBC features reduces the effect of subject variabilty in body composition on the amplitude dependent features. The proposed method is evaluated on ECG data from PTB diagnostic database using support vector machine as classifier. The promising result suggests that the proposed RFBC features may be used in the screening and clinical decision support system for myocardial infarction