Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment

BACKGROUND: Uncontrolled hypertension (HT) is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community. METHOD: We used a 1 in 4 random selection of subjects who were ≥ 20 years of age. A questionnaire was administered and the blood pressure (BP) was measured by a doctor. HT was defined as diastolic blood pressure (DBP) ≥ 90 mm Hg ± systolic pressure (SBP) ≥ 140 mm Hg. Isolated systolic hypertension (ISH) was defined as SBP ≥ 160 mm Hg with DBP < 90 mm Hg. Subsequently, we reanalysed the data using current definition of ISH as SBP ≥ 140 mm Hg with DBP < 90 mm Hg. RESULTS: 2879 subjects ≥ 20 years of age were randomly selected of which 2415 (84%) participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives ≥ 60 years had ISH. CONCLUSION: This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community

Memory and Musical Expectation for Tones in Cultural Context

WE EXPLORED HOW MUSICAL CULTURE SHAPES ONE\u27S listening experience.Western participants heard a series of tones drawn from either the Western major mode (culturally familiar) or the Indian thaat Bhairav (culturally unfamiliar) and then heard a test tone. They made a speeded judgment about whether the test tone was present in the prior series of tones. Interactions between mode (Western or Indian) and test tone type (congruous or incongruous) reflect the utilization of Western modal knowledge to make judgments about the test tones. False alarm rates were higher for test tones congruent with the major mode than for test tones congruent with Bhairav. In contrast, false alarm rates were lower for test tones incongruent with the major mode than for test tones incongruent with Bhairav. These findings suggest that one\u27s internalized cultural knowledge may drive musical expectancies when listening to music of an unfamiliar modal system

Surgical Interventions and the Use of Device-Aided Therapy for the Treatment of Fecal Incontinence and Defecatory Disorders

The purpose of this clinical practice update expert review is to describe the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence (FI) and defecatory disorders. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). Best Practice Advice 1: A stepwise approach should be followed for management of FI. Conservative therapies (diet, fluids, techniques to improve evacuation, a bowel training program, management of diarrhea and constipation with diet and medications if necessary) will benefit approximately 25% of patients and should be tried first. Best Practice Advice 2: Pelvic floor retraining with biofeedback therapy is recommended for patients with FI who do not respond to the conservative measures indicated above. Best Practice Advice 3: Perianal bulking agents such as intra-anal injection of dextranomer may be considered when conservative measures and biofeedback therapy fail. Best Practice Advice 4: Sacral nerve stimulation should be considered for patients with moderate or severe FI in whom symptoms have not responded after a 3-month or longer trial of conservative measures and biofeedback therapy and who do not have contraindications to these procedures. Best Practice Advice 5: Until further evidence is available, percutaneous tibial nerve stimulation should not be used for managing FI in clinical practice. Best Practice Advice 6: Barrier devices should be offered to patients who have failed conservative or surgical therapy, or in those who have failed conservative therapy who do not want or are not eligible for more invasive interventions. Best Practice Advice 7: Anal sphincter repair (sphincteroplasty) should be considered in postpartum women with FI and in patients with recent sphincter injuries. In patients who present later with symptoms of FI unresponsive to conservative and biofeedback therapy and evidence of sphincter damage, sphincteroplasty may be considered when perianal bulking injection and sacral nerve stimulation are not available or have proven unsuccessful. Best Practice Advice 8: The artificial anal sphincter, dynamic graciloplasty, may be considered for patients with medically refractory severe FI who have failed treatment or are not candidates for barrier devices, sacral nerve stimulation, perianal bulking injection, sphincteroplasty and a colostomy. Best Practice Advice 9: Major anatomic defects (eg, rectovaginal fistula, full-thickness rectal prolapse, fistula in ano, or cloaca-like deformity) should be rectified with surgery. Best Practice Advice 10: A colostomy should be considered in patients with severe FI who have failed conservative treatment and have failed or are not candidates for barrier devices, minimally invasive surgical interventions, and sphincteroplasty. Best Practice Advice 11: A magnetic anal sphincter device may be considered for patients with medically refractory severe FI who have failed or are not candidates for barrier devices, perianal bulking injection, sacral nerve stimulation, sphincteroplasty, or a colostomy. Data regarding efficacy are limited and 40% of patients had moderate or severe complications. Best Practice Advice 12: For defecatory disorders, biofeedback therapy is the treatment of choice. Best Practice Advice 13: Based on limited evidence, sacral nerve stimulation should not be used for managing defecatory disorders in clinical practice. Best Practice Advice 14: Anterograde colonic enemas are not effective in the long term for management of defecatory disorders. Best Practice Advice 15: The stapled transanal rectal resection and related procedures should not be routinely performed for correction of structural abnormalities in patients with defecatory disorders

Constraints on B--->pi,K transition form factors from exclusive semileptonic D-meson decays

According to the heavy-quark flavour symmetry, the $B\to \pi, K$ transition form factors could be related to the corresponding ones of D-meson decays near the zero recoil point. With the recent precisely measured exclusive semileptonic decays $D \to \pi \ell \nu$ and $D\to K \ell \nu$, we perform a phenomenological study of $B \to \pi, K$ transition form factors based on this symmetry. Using BK, BZ and Series Expansion parameterizations of the form factor slope, we extrapolate $B \to \pi, K$ transition form factors from $q^{2}_{max}$ to $q^{2}=0$. It is found that, although being consistent with each other within error bars, the central values of our results for $B \to \pi, K$ form factors at $q^2=0$, $f_+^{B\to \pi, K}(0)$, are much smaller than predictions of the QCD light-cone sum rules, but are in good agreements with the ones extracted from hadronic B-meson decays within the SCET framework. Moreover, smaller form factors are also favored by the QCD factorization approach for hadronic B-meson decays.Comment: 19 pages, no figure, 5 table

Condensation of the roots of real random polynomials on the real axis

We introduce a family of real random polynomials of degree n whose coefficients a_k are symmetric independent Gaussian variables with variance = e^{-k^\alpha}, indexed by a real \alpha \geq 0. We compute exactly the mean number of real roots for large n. As \alpha is varied, one finds three different phases. First, for 0 \leq \alpha \sim (\frac{2}{\pi}) \log{n}. For 1 < \alpha < 2, there is an intermediate phase where grows algebraically with a continuously varying exponent, \sim \frac{2}{\pi} \sqrt{\frac{\alpha-1}{\alpha}} n^{\alpha/2}. And finally for \alpha > 2, one finds a third phase where \sim n. This family of real random polynomials thus exhibits a condensation of their roots on the real line in the sense that, for large n, a finite fraction of their roots /n are real. This condensation occurs via a localization of the real roots around the values \pm \exp{[\frac{\alpha}{2}(k+{1/2})^{\alpha-1} ]}, 1 \ll k \leq n.Comment: 13 pages, 2 figure

Automatic estimation of harmonic tension by distributed representation of chords

The buildup and release of a sense of tension is one of the most essential aspects of the process of listening to music. A veridical computational model of perceived musical tension would be an important ingredient for many music informatics applications. The present paper presents a new approach to modelling harmonic tension based on a distributed representation of chords. The starting hypothesis is that harmonic tension as perceived by human listeners is related, among other things, to the expectedness of harmonic units (chords) in their local harmonic context. We train a word2vec-type neural network to learn a vector space that captures contextual similarity and expectedness, and define a quantitative measure of harmonic tension on top of this. To assess the veridicality of the model, we compare its outputs on a number of well-defined chord classes and cadential contexts to results from pertinent empirical studies in music psychology. Statistical analysis shows that the model's predictions conform very well with empirical evidence obtained from human listeners.Comment: 12 pages, 4 figures. To appear in Proceedings of the 13th International Symposium on Computer Music Multidisciplinary Research (CMMR), Porto, Portuga