Blood pressure control by home monitoring : meta-analysis of randomised trials

Objective To determine the effect of home blood pressure monitoring on blood pressure levels and proportion of people with essential hypertension achieving targets. Design Meta-analysis of 18 randomised controlled trials. Participants 1359 people with essential hypertension allocated to home blood pressure monitoring and 1355 allocated to the "control" group seen in the healthcare system for 2-36 months. Main outcome measures Differences in systolic (13 studies), diastolic (16 studies), or mean (3 studies) blood pressures, and proportion of patients achieving targets (6 studies), between intervention and control groups. Results Systolic blood pressure was lower in people with hypertension who had home blood pressure monitoring than in those who had standard blood pressure monitoring in the healthcare system (standardised mean difference 4.2 (95% confidence interval 1.5 to 6.9) mm Hg), diastolic blood pressure was lower by 2.4 (1.2 to 3.5) mm Hg, and mean blood pressure was lower by 4.4 (2.0 to 6.8) mm Hg. The relative risk of blood pressure above predetermined targets was lower in people with home blood pressure monitoring (risk ratio 0.90, 0.80 to 1.00). When publication bias was allowed for, the differences were attenuated: 2.2 ( − 0.9 to 5.3) mm Hg for systolic blood pressure and 1.9 (0.6 to 3.2) mm Hg for diastolic blood pressure. Conclusions Blood pressure control in people with hypertension (assessed in the clinic) and the proportion achieving targets are increased when home blood pressure monitoring is used rather than standard blood pressure monitoring in the healthcare system. The reasons for this are not clear. The difference in blood pressure control between the two methods is small but likely to contribute to an important reduction in vascular complications in the hypertensive population

Psychometric properties of the Polish version of the eight-item Morisky Medication Adherence Scale in hypertensive adults.

Low adherence to pharmacological treatment is often associated with poor blood pressure control, but identification of nonadherent patients in outpatient settings is difficult. The aim of the study was to translate and evaluate the psychometric properties of the Polish version of the structured self-report eight-item Morisky Medication Adherence Scale (MMAS-8) among patients with hypertension. The study was conducted in a family doctor practice between January and July 2015. After a standard "forward-backward" procedure to translate MMAS-8 into Polish, the questionnaire was administered to 160 patients with hypertension. Reliability was tested using a measure of internal consistency (Cronbach's α) and test-retest reliability. Validity was confirmed using known group validity. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); and 8 (high). Complete questionnaires were returned by 110 respondents (mean age: 60.7 years ±12.6; 54.6% were female). The mean number of pills taken daily was 3.61±4.31. The mean adherence score was 6.42± 2.0. Moderate internal consistency was found (Cronbach's α=0.81), and test-retest reliability was satisfactory (r=0.461-0.905; P<0.001). Reproducibility expressed by Cohen's κ coefficient =0.61 was good. In high-adherent patients, the percentage of well-controlled blood pressure was higher than in low-adherent patients (33.3% vs 19.1%, χ (2)=0.87, P=0.648). Psychometric evaluation of the Polish version of the MMAS-8 indicates that it is a reliable and valid measure tool to detect nonadherent patients. The MMAS-8 may be routinely used to support communication about the medication-taking behavior in hypertensive patients

On Nonregularized Estimation of Psychological Networks.

An important goal for psychological science is developing methods to characterize relationships between variables. Customary approaches use structural equation models to connect latent factors to a number of observed measurements, or test causal hypotheses between observed variables. More recently, regularized partial correlation networks have been proposed as an alternative approach for characterizing relationships among variables through off-diagonal elements in the precision matrix. While the graphical Lasso (glasso) has emerged as the default network estimation method, it was optimized in fields outside of psychology with very different needs, such as high dimensional data where the number of variables (p) exceeds the number of observations (n). In this article, we describe the glasso method in the context of the fields where it was developed, and then we demonstrate that the advantages of regularization diminish in settings where psychological networks are often fitted ( p≪n ). We first show that improved properties of the precision matrix, such as eigenvalue estimation, and predictive accuracy with cross-validation are not always appreciable. We then introduce nonregularized methods based on multiple regression and a nonparametric bootstrap strategy, after which we characterize performance with extensive simulations. Our results demonstrate that the nonregularized methods can be used to reduce the false-positive rate, compared to glasso, and they appear to provide consistent performance across sparsity levels, sample composition (p/n), and partial correlation size. We end by reviewing recent findings in the statistics literature that suggest alternative methods often have superior performance than glasso, as well as suggesting areas for future research in psychology. The nonregularized methods have been implemented in the R package GGMnonreg

Symmetry of Nonparametric Statistical Tests on Three Samples

Problem statement: Many different nonparametric statistical procedures can be used to analyze ranked data. Inconsistencies among the outcomes of such procedures can occur when analyzing the same ranked data set. Understanding why these peculiarities can occur is imperative to providing an accurate analysis of the ranking data. In this context, this study addressed why inconsistent outcomes can occur and which types of data structures cause the different procedures to yield different outcomes. Approach: Appropriate properties were identified and developed to explain why different methods can define different rankings of three samples with the same data. The approach identifies certain symmetry structures that are implicitly contained within the data and analyzes how the procedures utilize these structures to produce an outcome. Results: We proved that all possible differences among the nonparametric rules are caused because different rules place different levels of emphasis on the specified symmetry configurations of data. Our findings explain and characterize why different procedures can output different results using the same data set. Conclusion: This study therefore served as crucial step in deciding which nonparametric procedure to use when analyzing ranked data. In addition, it serves as the building block to defining new techniques to analyze rankings. Because different procedures use different aspects of the data in different ways, then one may determine the choice of analysis procedure based on what parts of the data one deems important

Over-expressing the C3 photosynthesis cycle enzyme Sedoheptulose-1-7 Bisphosphatase improves photosynthetic carbon gain and yield under fully open air CO2fumigation (FACE)

Abstract Background Biochemical models predict that photosynthesis in C3 plants is most frequently limited by the slower of two processes, the maximum capacity of the enzyme Rubisco to carboxylate RuBP (Vc,max), or the regeneration of RuBP via electron transport (J). At current atmospheric [CO2] levels Rubisco is not saturated; consequently, elevating [CO2] increases the velocity of carboxylation and inhibits the competing oxygenation reaction which is also catalyzed by Rubisco. In the future, leaf photosynthesis (A) should be increasingly limited by RuBP regeneration, as [CO2] is predicted to exceed 550 ppm by 2050. The C3 cycle enzyme sedoheptulose-1,7 bisphosphatase (SBPase, EC 3.1.3.17) has been shown to exert strong metabolic control over RuBP regeneration at light saturation. Results We tested the hypothesis that tobacco transformed to overexpressing SBPase will exhibit greater stimulation of A than wild type (WT) tobacco when grown under field conditions at elevated [CO2] (585 ppm) under fully open air fumigation. Growth under elevated [CO2] stimulated instantaneous A and the diurnal photosynthetic integral (A') more in transformants than WT. There was evidence of photosynthetic acclimation to elevated [CO2] via downregulation of Vc,max in both WT and transformants. Nevertheless, greater carbon assimilation and electron transport rates (J and Jmax) for transformants led to greater yield increases than WT at elevated [CO2] compared to ambient grown plants. Conclusion These results provide proof of concept that increasing content and activity of a single photosynthesis enzyme can enhance carbon assimilation and yield of C3 crops grown at [CO2] expected by the middle of the 21st century. </jats:sec

The Histone Deacetylase Complex (HDC) 1 protein of Arabidopsis thaliana has the capacity to interact with multiple proteins including histone 3-binding proteins and histone 1 variants

Intrinsically disordered proteins can adopt multiple conformations thereby enabling interaction with a wide variety of partners. They often serve as hubs in protein interaction networks. We have previously shown that the Histone Deacetylase Complex (HDC) 1 protein from Arabidopsis thaliana interacts with histone deacetylases and quantitatively determines histone acetylation levels, transcriptional activity and several phenotypes, including ABA-sensitivity during germination, vegetative growth rate and flowering time. HDC1-type proteins are ubiquitous in plants but they contain no known structural or functional domains. Here we explored the protein interaction spectrum of HDC1. In addition to binding histone deacetylases, HDC1 directly interacted with core histone H3-binding proteins and co-repressor associated proteins, but not with H3 or the co-repressors themselves. Surprisingly, HDC1 was also able to interact with variants of the linker histone H1. Truncation of HDC1 to the ancestral core sequence narrowed the spectrum of interactions and of phenotypic outputs but maintained binding to a H3-binding protein and to H1. The results indicate a potential link between H1 and histone modifying complexes

Nutrient loading and meteorological conditions explain interannual variability of hypoxia in Chesapeake Bay

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109879/1/lno20145920373.pd

A Comparative Analysis Of Audit Service Supply Using Desk And Working Paper Reviews

The Texas Education Agency (TEA) performs extensive reviews of audit working papers for selected Texas school district audits to evaluate the quality of audit services rendered by independent accountants. These reviews are referred to as Quality Control Reviews (QCRs). The TEA also conducts desk reviews of all audited financial statements issued by Texas independent school districts. During the desk review process, the TEA performs a limited check of the accuracy of financial statement amounts, completeness of financial disclosures, and existence of proper audit output. Prior research suggests that desk reviews and quality control reviews both measure audit quality (Colbert and O&rsquo;Keefe 1995; Copley et al. 1994; Deis and Giroux 1992, 1996; Giroux et al. 1995; O&rsquo;Keefe and Westort 1992; O&rsquo;Keefe et al. 1994). The purpose of the paper is to determine if desk reviews capture the same audit quality information as quality control reviews. If so, regulators should focus resources on desk reviews since they are more timely and economical than QCRs. The results of the study, however, indicate that desk reviews and quality control reviews do not measure the same constructs. The findings suggest that desk reviews measure the industry specific knowledge of the auditor, which is only one aspect of audit quality. Moreover, it was observed that some audits passing the desk review were graded low in quality by the working paper review. This finding suggests that low audit quality may be more prevalent than generally suspected and that steps to improve audit quality and auditor credibility are warranted