Obesity prevalence and associated risk factors in outdoor living domestic horses and ponies

Reasons for performing study. The prevalence of obesity in companion animals, including horses and ponies has risen drastically in recent years and risk factors have been little investigated. Horses are unique amongst companion animals in that many are outdoor-living and forage independently on pasture; they also have a dual utility and companionship role. The body condition of wild and free-living equines is known to vary seasonally, yet previous estimates of the prevalence of obesity and associated risk factors in domestic animals do not consider this. Most previous studies were conducted during the summer months when pasture quality is greater and obesity prevalence is likely to be highest. In addition, many previous estimates do not use validated body condition scoring methods and rely on owner reporting.Objectives. To examine the prevalence and risk factors predictive of equine obesity at both the end of winter and the end of summer, in a domestic population of leisure horses with daily access to pasture. Using validated body condition scoring methods and a single, trained observer.Methods. Body condition and belly girth measurements were taken at the end of winter and during the summer in a population of leisure horses (n = 96) with outdoor pasture access for ≥6 h per day. Risk factor information was obtained by two owner questionnaires and analysed statistically using a mixed effects logistic regression model. The dependent variable was obese (BCS ≥ 7/9) or non-obese (BCS < 7/9). Risk factors associated with seasonal change in belly girth were also explored using a mixed effects linear regression model.Results. Obesity prevalence rose significantly from 27.08% at the end of winter to 35.41% during summer (p < 0.001). Breed was the risk factor most strongly associated with obesity (p < 0.001). Supplementary feed was not a strong predictor and there was no association with low intensity structured exercise. As winter BCS increased, the percentage seasonal change in belly girth decreased.Conclusions. Obesity prevalence differed between winter and summer in domestic equines. Supplementary feed and low intensity structured exercise in equines living outdoors for ≥6 h per day had limited or no effect on obesity levels. Seasonal variation in body condition was lower in obese equines.Potential relevance. It is important to consider season when studying equine obesity and obesity-associated disorders. Risk factor analysis suggests preventative measures may need to be breed specific. The metabolic implications of a lessened seasonal change in body condition in obese animals, warrants investigation

Heart Rate Variability Measured Early in Patients with Evolving Acute Coronary Syndrome and 1-year Outcomes of Rehospitalization and Mortality

Objective: This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with �18 hours of sinus rhythm were selected for HRV analysis (number [N] �193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. Results: During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency �42 ms2 predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] �2.3; 95% confidence interval [CI] �1.4–3.8, P�0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power �8 ms2 ( HR �3.8; 95% CI �1.5–10.1; P�0.007) and troponin �0.3 ng/mL (HR �4.0; 95% CI �1.3–12.1; P�0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. Conclusion: HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study

Navigating the airport surface: Electronic vs. paper maps

Recent advances in the Differential Global Positioning System (DGPS) and ground/aircraft data-links provide a basis for the generation of an accurate cockpit navigational map display including data-linked ATC-cleared ground routes. Such an electronic map may have the potential to improve pilots' situation awareness and taxi performance and thereby lessen runway incursions. The objective of this simulator study was to assess the potential improvements in these areas when using an advanced electronic map (compared to using today's paper map) under two outside scene visibility levels. Results showed average taxi speed increased under both good and poor visibilities, by as much as 24 percent, due in part to eliminating the time used for orientation with the paper map. Pilots made only one-third as many errors as well and commented that they believed that the electronic map gave them better awareness

Prevalence and Prognostic Significance of Long QT Interval among Patients with Chest Pain: Selecting an Optimum QT Rate Correction Formula

Background: Little is known about the prevalence and prognostic significance of long QT interval among patients with chest pain during the acute phase of suspected cardiovascular injury. Objectives: Our aim was to investigate the prevalence and prognostic significance of long QT interval among patients presenting to the emergency department (ED) with chest pain using an optimum QT rate correction formula. Methods: We performed secondary analysis on data obtained from the IMMEDIATE AIM trial (N, 145). Data included 24-hour 12-lead Holter electrocardiographic recordings that were stored for offline computer analysis. The QT interval was measured automatically and rate corrected using seven QTc formulas including subject specific correction. The formula with the closer to zero absolute mean QTc/RR correlation was considered the most accurate. Results: Linear and logarithmic subject specific QT rate correction outperformed other QTc formulas and resulted in the closest to zero absolute mean QTc/RR correlations (mean ± SD: 0.003 ± 0.002 and 0.017 ± 0.016, respectively). These two formulas produced adequate correction in 100% of study participants. Other formulas (Bazett’s, Fridericia’s, Framingham\u27s, and study specific) resulted in inadequate correction in 47.6 to 95.2% of study participants. Using the optimum QTc formula, linear subject specific, the prevalence of long QTc interval was 14.5%. The QTc interval did not predict mortality or hospital admission at short and long term follow-up. Only the QT/RR slope predicted mortality at 7 year follow-up (odds ratio, 2.01; 95% CI, 1.02–3.96; p \u3c 0.05). Conclusions: Adequate QT rate correction can only be performed using subject specific correction. Long QT interval is not uncommon among patients presenting to the ED with chest pain

Heart Rate Variability Measurement and Clinical Depression in Acute Coronary Syndrome Patients: Narrative Review of Recent Literature

Aim: We aimed to explore links between heart rate variability (HRV) and clinical depression in patients with acute coronary syndrome (ACS), through a review of recent clinical research literature. Background: Patients with ACS are at risk for both cardiac autonomic dysfunction and clinical depression. Both conditions can negatively impact the ability to recover from an acute physiological insult, such as unstable angina or myocardial infarction, increasing the risk for adverse cardiovascular outcomes. HRV is recognized as a reflection of autonomic function. Methods: A narrative review was undertaken to evaluate state-of-the-art clinical research, using the PubMed database, January 2013. The search terms “heart rate variability” and “depression” were used in conjunction with “acute coronary syndrome”, “unstable angina”, or “myocardial infarction” to find clinical studies published within the past 10 years related to HRV and clinical depression, in patients with an ACS episode. Studies were included if HRV measurement and depression screening were undertaken during an ACS hospitalization or within 2 months of hospital discharge. Results: Nine clinical studies met the inclusion criteria. The studies’ results indicate that there may be a relationship between abnormal HRV and clinical depression when assessed early after an ACS event, offering the possibility that these risk factors play a modest role in patient outcomes. Conclusion: While a definitive conclusion about the relevance of HRV and clinical depression measurement in ACS patients would be premature, the literature suggests that these measures may provide additional information in risk assessment. Potential avenues for further research are proposed

Nasa's Launch Communications Ground Segment for the 21st Century Florida Spaceport

The National Aeronautics and Space Administration (NASA) Near Earth Network (NEN) Project is implementing a new launch communications ground segment to provide services for the next generation of human and robotic space exploration systems. It will deliver unique and advanced capabilities to accelerate the transformation of Kennedy Space Center into a multi-user spaceport in cooperation with the United States Air Force (USAF). The project has leveraged commercial technologies and remote operations concepts matured in NASAs orbiting satellite ground systems to achieve dramatic lifecycle cost efficiencies as compared to the space shuttle-era ground segment. The purpose of this paper is to discuss the development history, capabilities and anticipated use cases of the NEN Launch Communications Segment (NEN LCS).The NASA Kennedy Space Center is co-located with the USAF Eastern Launch Range at Cape Canaveral, Florida. The USAF operates two launch communications ground stations, but they are not designed to transmit voice, commands or other data to the launch vehicle or astronauts. The bi-directional uplink-downlink communications responsibility for human missions has historically resided with the Goddard Space Flight Center in Greenbelt, Maryland. Several market analyses and feasibility studies investigating concepts to provide NASAs next generation launch communications services were performed during the Constellation Program prior to its cancellation in 2009, and as part of the Kennedy Space Centers follow-on efforts to transform itself into a 21st century multi-user spaceport. In 2012, the Kennedy Space Center and the USAF 45th Space Wing jointly led a study to analyze the market needs of current and future launch systems and assess the operational deficiencies of the Eastern Range infrastructure. The study team issued several recommendations, two of which ultimately became driving operational capability requirements for the NEN LCS: increased telemetry data rates of at least 20 Mbps, and S-band uplink capability. Additional capabilities identified in the requirements development process include spread spectrum modulation support, LDPC 12 and 78 error correction codes, support for IRIG-106 and CCSDS data formats, automated best source selection, and Space Link Extension (SLE) services for data distribution. The NEN LCS is comprised of two permanent ground stations, the new Kennedy Uplink Station (KUS) and refurbished Ponce de Leon (PDL) station. Both stations are remotely operated from the Global Monitor and Control Center at Wallops Flight Facility. This core architecture is extensible through host-tenant arrangements with the U.S. Air Force and deployable assets, enabling agile, tailored and robust solutions to meet the needs of civil, commercial or military customers. The NEN LCS has three use cases:1.To provide agile, tailored and robust launch communications solutions to Florida spaceport customers2.To provide orbital communications services to near-earth customers 3.To provide an experimental proving ground for Space Mobile Network concepts and technologies The NEN LCS driving mission is to support the bi-directional link with the Orion crew capsule and two 20 Mbps telemetry links from the Space Launch System core stage on Exploration Mission-1, the first integrated flight of NASAs flagship human exploration systems