Use of the prevented fraction for the population to determine deaths averted by existing prevalence of physical activity: a descriptive study

Abstract Background: The disease or mortality burdens of unhealthy lifestyle behaviours are often reported. The positive side of the story, the burden that existing levels have averted, is rarely discussed. We present what we believe to be global application of the Prevented Fraction for the Population to obtain estimates of the percentage of premature mortality and number of premature deaths averted by total physical activity levels for 168 countries. Methods: We combined previously published activity prevalence data (2001-2016) and relative risks of mortality in Monte-Carlo simulations to estimate country-specific Prevented Fractions for the Population (percentage of mortality averted) and their 95% confidence intervals. Higher Prevented Fractions indicate a greater proportion of deaths averted due to physical activity. Using mortality data for 40-74 year olds, we estimated the number of premature deaths averted due to activity levels for all adults and by sex. We presented the median and range of the Prevented Fractions globally, by region, and by income classification. Results: The global median Prevented Fraction for the Population was 15.0% (range 6.6-20.5%), conservatively equating to 3.9 million (95% confidence interval: 2.5-5.6) premature deaths averted annually. The African region had the highest median (16.6%, range 12.1-20.5%), the Americas had the lowest (13.1%, range 10.8-16.6%). Low income countries tended to have higher median Prevented Fractions (17.9%, range 12.3-20.5%) than high income countries (14.1%, range 6.6-17.8%). Globally, the median Prevented Fraction was higher for men than women (16.0% (range 7.8-20.7% and 14.1% (range 5.0-20.4%), respectively). Interpretation: Existing physical activity levels have contributed to averting premature mortality across all countries. The Prevented Fraction for the Population has utility as an advocacy tool to promote healthy lifestyle behaviours as, by making the case of what has been achieved, it could demonstrate the value of current investment and services. This may be more conducive to political support.TS, SJS, and SB are funded by the UK Medical Research Council (MC_UU_12015/1 and MC_UU_12015/3). DD is funded by a Future Leader Fellowship by Heart Foundation Australia (No. 101234). At the time of this work, MT was a member of the Centre for Diet and Activity Research (MR/K023187/1), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, National Institute for Health Research (NIHR), and Wellcome Trust, under the auspices of the UKClinical Research Collaboration, is gratefully acknowledged. MT was also funded on the METAHIT project (Medical Research Council grant MR/P02663X/1)

First results from 2+1 dynamical quark flavors on an anisotropic lattice: light-hadron spectroscopy and setting the strange-quark mass

We present the first light-hadron spectroscopy on a set of $N_f=2+1$ dynamical, anisotropic lattices. A convenient set of coordinates that parameterize the two-dimensional plane of light and strange-quark masses is introduced. These coordinates are used to extrapolate data obtained at the simulated values of the quark masses to the physical light and strange-quark point. A measurement of the Sommer scale on these ensembles is made, and the performance of the hybrid Monte Carlo algorithm used for generating the ensembles is estimated.Comment: 24 pages. Hadron Spectrum Collaboratio

Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship

BACKGROUND AND OBJECTIVE: Walking and cycling have shown beneficial effects on population risk of all-cause mortality (ACM). This paper aims to review the evidence and quantify these effects, adjusted for other physical activity (PA). DATA SOURCES: We conducted a systematic review to identify relevant studies. Searches were conducted in November 2013 using the following health databases of publications: Embase (OvidSP); Medline (OvidSP); Web of Knowledge; CINAHL; SCOPUS; SPORTDiscus. We also searched reference lists of relevant texts and reviews. STUDY ELIGIBILITY CRITERIA AND PARTICIPANTS: Eligible studies were prospective cohort design and reporting walking or cycling exposure and mortality as an outcome. Only cohorts of individuals healthy at baseline were considered eligible. STUDY APPRAISAL AND SYNTHESIS METHODS: Extracted data included study population and location, sample size, population characteristics (age and sex), follow-up in years, walking or cycling exposure, mortality outcome, and adjustment for other co-variables. We used random-effects meta-analyses to investigate the beneficial effects of regular walking and cycling. RESULTS: Walking (18 results from 14 studies) and cycling (8 results from 7 studies) were shown to reduce the risk of all-cause mortality, adjusted for other PA. For a standardised dose of 11.25 MET.hours per week (or 675 MET.minutes per week), the reduction in risk for ACM was 11% (95% CI = 4 to 17%) for walking and 10% (95% CI = 6 to 13%) for cycling. The estimates for walking are based on 280,000 participants and 2.6 million person-years and for cycling they are based on 187,000 individuals and 2.1 million person-years. The shape of the dose-response relationship was modelled through meta-analysis of pooled relative risks within three exposure intervals. The dose-response analysis showed that walking or cycling had the greatest effect on risk for ACM in the first (lowest) exposure interval. CONCLUSIONS AND IMPLICATIONS: The analysis shows that walking and cycling have population-level health benefits even after adjustment for other PA. Public health approaches would have the biggest impact if they are able to increase walking and cycling levels in the groups that have the lowest levels of these activities. REVIEW REGISTRATION: The review protocol was registered with PROSPERO (International database of prospectively registered systematic reviews in health and social care) PROSPERO 2013: CRD42013004266

Excited State Nucleon Spectrum with Two Flavors of Dynamical Fermions

Highly excited states for isospin 1/2 baryons are calculated for the first time using lattice QCD with two flavors of dynamical quarks. Anisotropic lattices are used with two pion masses: 416(36) MeV and 578(29) MeV. The lowest four energies are reported in each of the six irreducible representations of the octahedral group at each pion mass. The lattices used have dimensions 24^3x64, spatial lattice spacing a_s = 0.11 fm and temporal lattice spacing a_t = 1/3 a_s. Clear evidence is found for a 5/2^-state in the pattern of negative-parity excited states. This agrees with the pattern of physical states and spin 5/2 has been realized for the first time on the lattice.Comment: 21 pages, 12 figure

What Maintains the SST Front North of the Eastern Pacific Equatorial Cold Tongue?

A coupled ocean–atmosphere regional model suggests a mechanism for formation of a sharp sea surface temperature (SST) front north of the equator in the eastern Pacific Ocean in boreal summer and fall. Meridional convergence of Ekman transport at 5°N is forced by eastward turning of the southeasterly cross-equatorial wind, but the SST front forms considerably south of the maximum Ekman convergence. Geostrophic equatorward flow at 3°N in the lower half of the isothermally mixed layer enhances mixed layer convergence. Cold water is upwelled on or south of the equator and is advected poleward by mean mixed layer flow and by eddies. The mixed layer current convergence in the north confines the cold advection, so the SST front stays close to the equator. Warm advection from the north and cold advection from the south strengthen the front. In the Southern Hemisphere, a continuous southwestward current advects cold water far from the upwelling core. The cold tongue is warmed by the net surface flux, which is dominated by solar radiation. Evaporation and net surface cooling are at a maximum just north of the SST front where relatively cool dry air is advected northward over warm SST. The surface heat flux is decomposed into a response to SST alone, and an atmospheric feedback. The atmospheric feedback enhances cooling on the north side of the front by 178 W m⁻², about half of which is due to enhanced evaporation from cold dry advection, while the other half is due to cloud radiative forcing.Keywords: Heat flux, Ekman pumping, Convergence, Fronts, Sea surface temperatur

Highly Variable Extinction and Accretion in the Jet-driving Class I Type Young Star PTF 10nvg (V2492 Cyg, IRAS 20496+4354)

We report extensive new photometry and spectroscopy of the highly variable young stellar object PTF 10nvg including optical and near-infrared time series data as well as mid-infrared and millimeter data. Following the previously reported 2010 rise, during 2011 and 2012 the source underwent additional episodes of brightening and dimming events including prolonged faint states. The observed high-amplitude variations are largely consistent with extinction changes having a 220 day quasi-periodic signal. Spectral evolution includes not only changes in the spectral slope but correlated variation in the prominence of TiO/VO/CO bands and atomic line emission, as well as anticorrelated variation in forbidden line emission which, along with H_2, dominates optical and infrared spectra at faint epochs. Neutral and singly-ionized atomic species are likely formed in an accretion flow and/or impact while the origin of zero-velocity atomic LiI 6707 in emission is unknown. Forbidden lines, including several rare species, exhibit blueshifted emission profiles and likely arise from an outflow/jet. Several of these lines are also seen spatially offset from the continuum source position, presumably in a shocked region of an extended jet. CARMA maps resolve on larger scales a spatially extended outflow in mm-wavelength CO. We attribute the observed photometric and spectroscopic behavior in terms of occultation of the central star as well as the bright inner disk and the accretion/outflow zones that renders shocked gas in the inner part of the jet amenable to observation at the faint epochs. We discuss PTF 10nvg as a source exhibiting both accretion-driven (perhaps analogous to V1647 Ori) and extinction-driven (perhaps analogous to UX Ori or GM Cep) high-amplitude variability phenomena.Comment: accepted to AJ - in press (74 pages

Automated interpretation of systolic and diastolic function on the echocardiogram:a multicohort study

Background: Echocardiography is the diagnostic modality for assessing cardiac systolic and diastolic function to diagnose and manage heart failure. However, manual interpretation of echocardiograms can be time consuming and subject to human error. Therefore, we developed a fully automated deep learning workflow to classify, segment, and annotate two-dimensional (2D) videos and Doppler modalities in echocardiograms. Methods: We developed the workflow using a training dataset of 1145 echocardiograms and an internal test set of 406 echocardiograms from the prospective heart failure research platform (Asian Network for Translational Research and Cardiovascular Trials; ATTRaCT) in Asia, with previous manual tracings by expert sonographers. We validated the workflow against manual measurements in a curated dataset from Canada (Alberta Heart Failure Etiology and Analysis Research Team; HEART; n=1029 echocardiograms), a real-world dataset from Taiwan (n=31 241), the US-based EchoNet-Dynamic dataset (n=10 030), and in an independent prospective assessment of the Asian (ATTRaCT) and Canadian (Alberta HEART) datasets (n=142) with repeated independent measurements by two expert sonographers. Findings: In the ATTRaCT test set, the automated workflow classified 2D videos and Doppler modalities with accuracies (number of correct predictions divided by the total number of predictions) ranging from 0·91 to 0·99. Segmentations of the left ventricle and left atrium were accurate, with a mean Dice similarity coefficient greater than 93% for all. In the external datasets (n=1029 to 10 030 echocardiograms used as input), automated measurements showed good agreement with locally measured values, with a mean absolute error range of 9–25 mL for left ventricular volumes, 6–10% for left ventricular ejection fraction (LVEF), and 1·8–2·2 for the ratio of the mitral inflow E wave to the tissue Doppler e' wave (E/e' ratio); and reliably classified systolic dysfunction (LVEF <40%, area under the receiver operating characteristic curve [AUC] range 0·90–0·92) and diastolic dysfunction (E/e' ratio ≥13, AUC range 0·91–0·91), with narrow 95% CIs for AUC values. Independent prospective evaluation confirmed less variance of automated compared with human expert measurements, with all individual equivalence coefficients being less than 0 for all measurements. Interpretation: Deep learning algorithms can automatically annotate 2D videos and Doppler modalities with similar accuracy to manual measurements by expert sonographers. Use of an automated workflow might accelerate access, improve quality, and reduce costs in diagnosing and managing heart failure globally. Funding: A*STAR Biomedical Research Council and A*STAR Exploit Technologies

Damping of tropical instability waves caused by the action of surface currents on stress

Ocean eddies and fronts affect surface stress via two mechanisms: (1) ocean surface currents altering the relative motion between air and sea and, hence, the stress fields and (2) ocean sea surface temperature (SST) gradients forcing changes in stability and near-surface winds. In this paper, we quantify the first effect and how it impacts Tropical Instability Waves (TIW) in the eastern Pacific. High-resolution satellite data and a regional coupled model are used to distinguish between stress changes due to the surface currents and those due to the changes in stability and near-surface winds. It is found that both mechanisms affect the surface stress curl, but they do so at different latitudes, allowing for their effect on Ekman pumping to be distinguished. The Ekman pumping due to the surface current effect alone, leads to significant damping of the TIWs. In terms of the eddy kinetic energy, the inclusion of surface current in the stress leads to decay with an e-folding time comparable with the period of the TIWs. It is, thus, an important damping mechanism to be included in ocean and coupled ocean-atmosphere models

A Regional Ocean–Atmosphere Model for Eastern Pacific Climate: Toward Reducing Tropical Biases

The tropical Pacific Ocean is a climatically important region, home to El Niño and the Southern Oscillation. The simulation of its climate remains a challenge for global coupled ocean–atmosphere models, which suffer large biases especially in reproducing the observed meridional asymmetry across the equator in sea surface temperature (SST) and rainfall. A basin ocean general circulation model is coupled with a full-physics regional atmospheric model to study eastern Pacific climate processes. The regional ocean–atmosphere model (ROAM) reproduces salient features of eastern Pacific climate, including a northward-displaced intertropical convergence zone (ITCZ) collocated with a zonal band of high SST, a low-cloud deck in the southeastern tropical Pacific, the equatorial cold tongue, and its annual cycle. The simulated low-cloud deck experiences significant seasonal variations in vertical structure and cloudiness; cloud becomes decoupled and separated from the surface mixed layer by a stable layer in March when the ocean warms up, leading to a reduction in cloudiness. The interaction of low cloud and SST is an important internal feedback for the climatic asymmetry between the Northern and Southern Hemispheres. In an experiment where the cloud radiative effect is turned off, this climatic asymmetry weakens substantially, with the ITCZ migrating back and forth across the equator following the sun. In another experiment where tropical North Atlantic SST is lowered by 2°C—say, in response to a slow-down of the Atlantic thermohaline circulation as during the Younger Dryas—the equatorial Pacific SST decreases by up to 3°C in January–April but changes much less in other seasons, resulting in a weakened equatorial annual cycle. The relatively high resolution (0.5°) of the ROAM enables it to capture mesoscale features, such as tropical instability waves, Central American gap winds, and a thermocline dome off Costa Rica. The implications for tropical biases and paleoclimate research are discussed.Keywords: Ocean models, Cloud radiative effects, Model evaluation, Pacific Ocean, Climate predictionKeywords: Ocean models, Cloud radiative effects, Model evaluation, Pacific Ocean, Climate predictio