Non-Invasive Identification of Left Ventricular Hypertrophy (LVH)/ Cardiomegaly in US Firefighters

Background: Cardiovascular disease (CVD) causes 45% of firefighters’ on-duty deaths, but the risk of these events is limited to susceptible individuals. Left ventricular hypertrophy (LVH)/cardiomegaly increases arrhythmia, myocardial infarction, stroke and death risks, and is a condition which renders firefighters susceptible to CVD events. Autopsies demonstrate LVH/cardiomegaly in most firefighter CVD fatalities. If recognized beforehand, however, effective treatments are available. In this work we i) describe the state of the art knowledge on the definition of cardiac enlargement across imaging modalities, normalization techniques (indices) and reference ranges; ii) estimate the current prevalence of cardiac enlargement among the US firefighters; and iii) identify the significant predictors of LV mass (LVM). Methods: We conducted a literature review to compare measurements for heart size and mass by cardiac MRI (CMR), Echocardiograms (ECHO) and autopsies in healthy and diseased hearts in the general population (Chapter 1). We selected 400 participants by an enriched randomization sampling strategy from a population of active firefighters. All participants received a screening ECHO, followed by CMR. Prevalence estimates for LVH were derived among the active firefighters based on ECHO and CMR. Separate estimates were made by examining autopsies of other firefighters who suffered a noncardiac on-duty fatality (Chapter 2). Risk factors were evaluated as predictors for LVM normalized for height (Chapter 3). Results: The findings from Chapter 1 demonstrated a wide variance in LVH definitions and reference ranges; ECHO remains the most widely used diagnostic tool; and few direct comparisons exist between imaging and autopsies studies at this time. Chapter 2 showed a wide range of prevalence estimates of cardiac enlargement and body mass index (BMI) to be a major driver of heart weight. Chapter 3 identified BMI as the most significant and only consistent independent predictor of LVM indices. Conclusions: Standardization of cardiac enlargement definitions is needed. However, BMI drives LVM, heart weight and LV wall thickness. Therefore, reducing obesity will decrease the prevalence of LVH/cardiac enlargement in the fire service, which should in turn reduce CVD events

Chi è l'insegnante ideale? Greci insegnanti esprimono il loro parere per le caratteristiche del maestro "perfetto"

The purpose of the research is to identify the views of education department students (from elementary and pre-school education departments), namely potential teachers, on the ideal teacher. This study attempts to map diverse views on the role and image of the teacher inherent in social discourse as social experience, regardless of whether or not there is special knowledge. The authors asked 588 students from elementary education and pre-school education departments to write a text in which they would describe their views as to what makes a perfect teacher [What, in your opinion, makes an ideal educator?]. For the analysis of the texts, the authors used quantitative and qualitative content analysis (content analysis – classical thematic analysis). The findings of this research in accordance with previous studies, suggest that the teacher‘s role and his/her ―ideal‖ image, are two multidimensional concepts and cannot be defined with absolute precision.Lo scopo di questa ricerca è quello di identificare le opinioni di studenti universitari (da dipartimenti elementari e pre-scolastici) sul professore ideale. Questo studio si propone di dare le diverse opinioni sul ruolo e l'immagine del maestro nel discorso sociale come esperienza sociale. Gli autori hanno chiesto 588 studenti di istruzione elementare e l'istruzione pre-scuola per scrivere un testo in cui avrebbero descrivere il loro parere su ciò che rende un insegnante perfetto (Secondo suo parere, quali siano gli elementi che ci danno ‗il maestro ideale‘?]. Per l'analisi dei testi, gli autori hanno utilizzato l'analisi del contenuto quantitativa e qualitativa (analisi del contenuto - analisi tematica classica). I risultati di questa ricerca in accordo con gli studi precedenti, suggeriscono che il ruolo dell'insegnante e il suo immagine "ideale", sono due concetti multidimensionali e non possono essere definite con precisione assoluta

The relationship between Competition, Tourism and Sustainable Development: three interdependent topics

In recent years, there has been considerable interest in examining the relationship between tourism and sustainable development. For firms to act friendly against the environment, competition authorities (CA’s) must provide them with the appropriate legal certainty they need to make the necessary investments towards sustainability. Policy implications should be strengthened towards more installation of renewable energy and a convergence of environmental policies towards more efficient energy use among EU countries. Energy intensity flows must be kept up more closely since the empirical results point out its substantially positive contribution in terms of air pollution

Η έμμετρη μετάφραση των Ηρωίδων του Οβιδίου από τον Χρήστο Χρηστοβασίλη. Μεταγραφή, επεξεργασία, αποκατάσταση και σχολιασμός.

Αντικείμενο της παρούσας διδακτορικής διατριβής αποτελεί η ανάδειξη της πρώτης μετάφρασης στη νέα ελληνική του λατινικού έργου του Οβιδίου Ηρωίδες από τον Χρήστο Χρηστοβασίλη (ΧΧ) και η αποτίμηση της επιτυχίας της βάσει υφολογικών κριτηρίων. Η διατριβή δομείται σε δύο βασικά κεφάλαια ενώ συνοδεύεται από πλούσια παραρτήματα και εκτενή βιβλιογραφία. Το πρώτο κεφάλαιο συνιστά το πλαίσιο (γλωσσικό, κοινωνικό, μεταφραστικό) στο οποίο εργάστηκε ο ΧΧ παρέχοντας συνάμα βασικές πληροφορίες για τη ζωή και το έργο του. Στο παρόν κεφάλαιο την αναφορά στη μοναδική ολοκληρωμένη μετάφραση του έργου από τον μοναχό Πλανούδη τον 13ο αιώνα , ακολουθεί η διερεύνηση των αιτιών επιλογής της μορφής του δημοτικού τραγουδιού και της δημοτικής ως γλώσσας της μετάφρασης ενός λατινικού κειμένου. Παράλληλα γίνεται προσέγγιση των λόγων που ώθησαν τον ΧΧ να μεταφράσει το λατινικό κείμενο των Ηρωίδων. Το δεύτερο κεφάλαιο, το οποίο ως προς την έκταση καλύπτει και το μεγαλύτερο μέρος της παρούσας διατριβής, αποτελεί ενδελεχή παρουσίαση των μεταφραστικών επιλογών του ποιητή. Πιο συγκεκριμένα γίνεται αναφορά στις γλωσσικές του επιλογές, καθώς το έργο είναι γραμμένο στη δημοτική με αρκετές λαϊκές λέξεις, λέξεις της ηπειρώτικης ντοπιολαλιάς , επιβιώσεις της καθαρεύουσας και σύνθετες κατά το ομηρικό πρότυπο λέξεις αρμονικά συνδεδεμένες με νεολογισμούς του ποιητή για την επαρκή αποτύπωση του λατινικού κειμένου. Στη συνέχεια ακολουθούν οι στιχουργικές επιλογές καθώς ο ποιητής επιλέγει να μεταφράσει το ελεγειακό δίστιχο με ιαμβικό δεκαπεντασύλλαβο στίχο. Ο εμπλουτισμός και οι προσθήκες στο λατινικό πρότυπο με στόχο την κατανόηση του υπαινικτικού οβιδιανού ύφους δημιουργούν ένα μεταφραστικό κείμενο εκτενέστερο με το κάθε ελεγειακό δίστιχο να μεταφράζεται σε 4στιχο, 6στιχο ή 8στιχο δεκαπεντασύλλαβο στίχο. Οι γραμματικές και συντακτικές επιλογές του ποιητή διαφαίνονται μέσα από την αντιπαραβολή επιλεγμένων χωρίων της μετάφρασης με το λατινικό πρότυπο. Σε κάθε περίπτωση οι διαφοροποιήσεις υποκινούνται με στόχο την μετρική και νοηματική εξυπηρέτηση του μεταφρασμένου κειμένου. Υπό αυτή την οπτική ο μεταφραστής δεν ακολουθεί με απόλυτη συνέπεια τα σχήματα λόγου του Οβιδίου, επιλέγοντας κυρίως τα αντίστοιχα σχήματα που εμφανίζονται στο δημοτικό τραγούδι. Ως αποτέλεσμα ο ποιητής-μεταφραστής αναγεννά το λατινικό κείμενο δίνοντας εκ νέου στη μορφή της ελληνικής δημοτικής ποίησης φωνή στις ηρωίδες και τη διαχρονική προβληματική που έθεσαν για την ανθρώπινη φύση και συμπεριφορά. Τα Συμπεράσματα ολοκληρώνουν εποπτικά την έρευνα που πραγματοποιήθηκε αναδεικνύοντας τις εκφραστικές δυνατότητες της δημοτικής γλώσσας στη μετάφραση έργων της λατινικής ελεγειακής ποίησης, το μεταφραστικό έργο του συγκεκριμένου νεοέλληνα ποιητή, και τη διαμόρφωση κριτηρίων συνδυαστικά με τη Θεωρία της Νεοελληνικής Λογοτεχνίας για τη μελέτη και αποτίμηση ενός μεταφραστικού έργου. Στο Παράρτημα πραγματοποιείται η μεταγραφή της μετάφρασης του λατινικού κειμένου, παρουσιάζεται η πορεία των διορθώσεων και επεμβάσεων του έγκριτου φίλου του Χρήστου Χρηστοβασίλη , Μιχαήλ Κρίσπη, και γίνεται κριτική επιλογή των ορθών γραφών με βάση το κείμενο της Loeb.The aim of the present dissertation is the edition and in-depth study of the first translation of the Latin text of Ovids’ Heroides in modern Greek by Christos Christovassilis. The dissertation consists of two main chapters followed by appendices and an extensive bibliography. The first chapter focuses on the linguistic, social, and translational context of Christovassilis’ work, and provides basic information about his life and work. The chapter includes a comparative study of the Heroides translation made by Planudes in 13th century, the only complete translation of the Heroides until recently. In the same chapter, the use of folk song’s form and the vernacular language are presented and analyzed, and the reasons that prompted Christovassilis to translate the Latin text of the Heroides are explored. The second chapter, which covers the main body of the dissertation, is a thorough presentation of the poet's translation choices. The linguistic choices of the writer are reviewed and explained, as the work is written in the vernacular language, enriched with dialect types, words from the katharevousa or words invented and neologisms to correspond to similar linguistic devices observed in the Latin text. Regarding meter, the poet chooses to translate the elegiac couplet with the iambic verse of the Greek folk songs, which always contains fifteen syllables. The enrichment and additions to the Latin original in order to approach the allusive Ovidian style create a lengthier translation text, with each elegiac couplet being translated in 4-verse, 6-verse or 8-verse fifteen-syllable verse. The poet's grammatical and syntactic choices are identified through the comparison of selected passages of the translation with the Latin text. As a result, the Latin text is regenerated by the Greek poet; the Heroides come to life anew through Greek folk poetry. The Conclusions highlight the dynamism of the vernacular language in translating the works of Latin elegiac poetry, and the translational work of Christovassilis is emphasized. Lastly Christovassilis’s translation, is assessed on the basis of premised drawn from the Theory of Modern Greek Literary. The Appendix records in full the translation of the Latin text by Christovassilis, thus offering the first critical edition of the text, including the interventions made by his friend and a proposition for corrections based on Loeb’ text

Modified Mediterranean Diet Score and Cardiovascular Risk in a North American Working Population

Introduction: Greater adherence to a Mediterranean diet is linked to lower risk for cardiovascular morbidity/mortality in studies of Mediterranean cohorts, older subjects, and/or those with existing health conditions. No studies have examined the effects of this dietary pattern in younger working populations in the United States. We investigated the effects of Mediterranean diet adherence on cardiovascular disease (CVD) biomarkers, metabolic syndrome and body composition in an occupationally active, non-Mediterranean cohort. Methods: A cross-sectional study in a cohort of 780 career male firefighters, ages 18 years or older, from the United States Midwest. No dietary intervention was performed. A modified Mediterranean diet score (mMDS) was developed for assessment of adherence to a Mediterranean dietary pattern from a previously administered life-style questionnaire that examined pre-existing dietary habits. Clinical data from fire department medical examinations were extracted and analyzed. Results: Obese subjects had significantly lower mMDS, and they reported greater fast/take-out food consumption (p<0.001) and intake of sweetened drinks during meals (p = 0.002). After multivariate adjustment, higher mMDS was inversely related to risk of weight gain over the past 5 years (odds ratio [OR]: 0.57, 95% confidence interval [CI]: 0.39–0.84, p for trend across score quartiles: 0.01); as well as the presence of metabolic syndrome components (OR: 0.65, 95% CI: 0.44–0.94, p for trend across score quartiles: 0.04). Higher HDL-cholesterol (p = 0.008) and lower LDL-cholesterol (p = 0.04) were observed in those with higher mMDS in linear regression after multivariate adjustment for age, BMI and physical activity. Conclusions: In a cohort of young and active US adults, greater adherence to a Mediterranean-style dietary pattern had significant inverse associations with metabolic syndrome, LDL-cholesterol and reported weight gain, and was significantly and independently associated with higher HDL-cholesterol. Our results support the potential effectiveness of this diet in young, non-Mediterranean working cohorts, and justify future intervention studies

Mediterranean Diet and Workplace Health Promotion

Analytical and experimental studies confirm relationships between the consumption of certain foods and cardiovascular disease, diabetes, and cancer. Mediterranean diet patterns have long been associated with a reduced risk of major diseases and many favorable health outcomes. Data from observational, longitudinal, and randomized controlled trials have demonstrated that Mediterranean-style diets can improve body mass index and body weight, reduce the incidence of diabetes mellitus and metabolic syndrome risk factors, decrease cardiovascular morbidity and coronary heart disease mortality, as well as decrease all-cause mortality. Recently, efforts have attempted to improve dietary habits in the workplace, by modifying food selection, eating patterns, meal frequency, and the sourcing of meals taken during work. Evidence supporting the Mediterranean diet and the potential cardioprotective role of healthier diets in the workplace are reviewed here, and promising strategies to improve metabolic and cardiovascular health outcomes are also provided

Law enforcement duties and sudden cardiac death among police officers in United States: case distribution study

Objective: To assess the association between risk of sudden cardiac death and stressful law enforcement duties compared with routine/non-emergency duties. Design: Case distribution study (case series with survey information on referent exposures). Setting: United States law enforcement. Participants: Summaries of deaths of over 4500 US police officers provided by the National Law Enforcement Officers Memorial Fund and the Officer Down Memorial Page from 1984 to 2010. Main outcome measures Observed and expected sudden cardiac death counts and relative risks for sudden cardiac death events during specific strenuous duties versus routine/non-emergency activities. Independent estimates of the proportion of time that police officers spend across various law enforcement duties obtained from surveys of police chiefs and front line officers. Impact of varying exposure assessments, covariates, and missing cases in sensitivity and stability analyses. Results: 441 sudden cardiac deaths were observed during the study period. Sudden cardiac death was associated with restraints/altercations (25%, n=108), physical training (20%, n=88), pursuits of suspects (12%, n=53), medical/rescue operations (8%, n=34), routine duties (23%, n=101), and other activities (11%, n=57). Compared with routine/non-emergency activities, the risk of sudden cardiac death was 34-69 times higher during restraints/altercations, 32-51 times higher during pursuits, 20-23 times higher during physical training, and 6-9 times higher during medical/rescue operations. Results were robust to all sensitivity and stability analyses. Conclusions: Stressful law enforcement duties are associated with a risk of sudden cardiac death that is markedly higher than the risk during routine/non-emergency duties. Restraints/altercations and pursuits are associated with the greatest risk. Our findings have public health implications and suggest that primary and secondary cardiovascular prevention efforts are needed among law enforcement officers

Development of support vector machine learning algorithm for real time update of resource estimation and grade classification

This paper presents the development and implementation of a theoretical mathematical-statistical framework for sequential updating of the grade control model, based on a support vector machine learning algorithm. Utilising the Zambujal orebody within the Neves-Corvo Cu deposit in Portugal, parameters that can be measured in real time, used in visualisation, modelled for resource estimation, and used for process control visualisation and optimisation are considered. The methodology broadly comprises of three steps. Firstly, the provided dataset is used to develop a virtual asset model (VAM) representing the true 3D grade distribution in order to simulate the mining method. Then ore quality parameters are established simulating real time monitoring sensor installation at: (a) stope development and rock face monitoring (face imaging and drillholes); and (b) transport monitoring (muck pile, LHD/scooptram). Next, the acquired data was assimilated into the models as part of the sequential model update. Two different mining methods and the monitoring information that can be acquired during the ore extraction are analysed: (a) drift and fill mining and (b) bench and fill mining, which are widely implemented at the Neves-Corvo mine. Selected study zones were chosen such as to contrast mining through the high/low grade zones with different degrees of heterogeneity, which demonstrate the performance of resource estimation and classification models developed in heterogeneous mining stopes. The grade accuracy and error in the resource model, and high/low grade ore classification accuracy and error are evaluated as performance metrics for the proposed methods. In drift and fill mining, drillhole and face sampling data collection was simulated in a real-time manner and fed into the support vector machine (SVM) regressor to update the resource estimation model in both a high grade and low grade drift scenarios. In each scenario, six drift and fill mining steps were simulated sequentially and the posterior resource models, after integrating real time mining data, have shown significant improvement of bias correction in both updating planned resources and reconciling extracted ore. In bench and fill mining, grade classification based on random sampling data from muck pile was demonstrated, considering scoop by scoop derived monitoring data. Three different classifiers (mean, median, and Bayesian) were tested and shown very good performance. In the case study presented here, a sequence of 15 blasting steps was simulated with each step requiring 112 scooping operations to transport the blasted ore. Using the real time monitored information, it was shown that at each blasting step over 85% of the scoops can be labelled correctly using the proposed methods and with an accuracy of over 95%

Systematic Bias in Helioseismic Measurements of Meridional Circulation Arising from Nonlocal Averaging Kernels

Meridional circulation in the solar convection zone plays a profound role in regulating the interior dynamics of the Sun and its magnetism. While it is well accepted that meridional flows move from the equator towards the poles at the Sun's surface, helioseismic observations have yet to provide a definitive answer for the depth at which those flows return to the equator, or the number of circulation cells in depth. In this work, we investigate whether the discrepancies regarding the nature of the return flow are intrinsic to how helioseismic observations are made. We examine the seismic signature of possible meridional flow profiles by convolving time-distance averaging kernels with the mean flows obtained from 3-D hydrodynamic simulations of the solar convection zone. At mid and high latitudes, we find that weak flow structures in the deeper regions of the convection zone can be strongly obscured by signal from the much stronger surface flows. This contamination is the result of extended side lobes in the averaging kernels and generates a spurious equatorward signal of 2--3 m s$^{-1}$ at those latitudes, and at $\approx 70~\mathrm{Mm}$ depth. At low latitudes, however, the flows in the simulations tend to be stronger and multiple cells across the shell depth can produce a sufficiently strong seismic signal to survive the convolution process. The signal associated with the deep equatorward return flow in the Sun is expected to be weak and in the same sense as the contamination from the surface. Hence, the return flow needs to exceed $\sim 2$--$3~ \mathrm{m~s^{-1}}$ in magnitude for reported detections to be considered significant.Comment: Submitted to AAS Journal

'Bhavishya Shakti: Empowering the Future': establishing and evaluating a pilot community mobile teaching kitchen as an innovative model, training marginalised women to become nutrition champions and culinary health educators in Kolkata, India.

BACKGROUND: Malnutrition is a global emergency, creating an overlapping burden on individual, public and economic health. The double burden of malnutrition affects approximately 2.3 billion adults worldwide. Following 3 years of capacity building work in Kolkata, with assistance of local volunteers and organisations, we established an empowering nutrition education model in the form of a 'mobile teaching kitchen (MTK)' with the aim of creating culinary health educators from lay slum-dwelling women. AIMS: To evaluate the piloting of a novel MTK nutrition education platform and its effects on the participants, alongside data collection feasibility. METHODS: Over 6 months, marginalised (RG Kar and Chetla slums) women underwent nutrition training using the MTK supported by dietitians, doctors and volunteers. Preintervention and postintervention assessments of knowledge, attitudes and practices (KAP), as well as anthropometric and clinical nutritional status of both the women and their children were recorded. The education was delivered by a 'See One, Do One, Teach One' approach with a final assessment of teaching delivery performed in the final session. RESULTS: Twelve women were trained in total, six from each slum. Statistically significant improvements were noted in sections of KAP, with improvements in nutrition knowledge (+4.8) and practices (+0.8). In addition, statistically significant positive changes were seen in 'understanding of healthy nutrition for their children' (p=0.02), 'sources of protein rich food' (p=0.02) and 'not skipping meals if a child is ill' (p≤0.001). CONCLUSION: The MTK as a public health intervention managed to educate, empower and upskill two groups of lay marginalised women into MTK Champions from the urban slums of Kolkata, India. Improvements in their nutrition KAP demonstrate just some of the effects of this programme. By the provision of healthy meals and nutritional messages, the MTK Champions are key drivers nudging improvements in nutrition and health related awareness with a ripple effect across the communities that they serve. There is potential to upscale and adapt this programme to other settings, or developing into a microenterprise model, that can help future MTK Champions earn a stable income