What is the best management for patients with evidence of asymptomatic ischemia on exercise stress testing?

Patients with intermediate- or high-risk Duke Treadmill Score (DTS) on exercise stress testing (EST) should undergo myocardial perfusion imaging or exercise echocardiography, especially if they have abnormal values of Chronotropic Index or post-EST Heart Rate Recovery. For patients who have a low-risk DTS, the 4-year mortality is less than 1% to 2%; therefore, risk-factor reduction without further investigation is appropriate (strength of recommendation: B, based on cohort studies and consensus guideline)

Energy Choices and Environmental Constraints

This paper acknowledges the fact that there is no such thing as a free lunch - energy used is waste made. The paper reviews the environmental problems associated with two distinct classes of emerging energy technologies—solar and synfuels. Although the recent push towards synfuels has raised serious environmental concerns, it will be shown that developing the clean solar technologies also will demand sound environmental management practices. While changes in technology-use projections based on environmental constraints are not developed in this paper, it will be seen that some impacts could be quite significant; and still others could very well be showstoppers . Finally, the Federal regulatory scene is reviewed to determine what steps are being taken to prevent environmental damage without unnecessarily constraining, development of new energy technologies

Undernutrition and stage of gestation influence fetal adipose tissue gene expression

Funded by the Scottish Government’s Rural and Environment Science and Analytical Services Division (RESAS), including the Strategic Partnership for Animal Science Excellence (SPASE) and the U.S. National Institutes of Health (HD045784). None of the authors had any financial or personal conflicts of interest.Peer reviewedPostprin

A Hubble Space Telescope Imaging Survey of Nearby Active Glactic Nuclei

We obtained 500-second F606W WFPC2 images of 256 of the nearest (z<0.035) Seyfert 1,Seyfert 2, and starburst galaxies. Less than 10% show tidal features or multiple nuclei. The incidence of inner starburst rings is about 10% in both classes of Sy galaxies. In contrast, galaxies with H II region emission line spectra appear substantially more irregular because of their much higher specific rates of star formation. An unresolved central continuum source in our HST images is a virtually perfect indicator of a Sy1 spectrum. 52% of these Sy1 point sources are saturated in our images; we use their wings to estimate their magnitudes. The converse is not however true, as over a third of Sy's with direct spectroscopic evidence for broad Balmer wings show no nuclear point source. Like the Sy2's, they have central surface brightnesses consistent with those expected for the bulges of normal galaxies. The frequency of bars in Sy1's and 2's and non-Sys are the same. The Sy2 galaxies are significantly more likely to show nuclear dust absorption, especially in lanes and patches which are irregular or reach close to the nucleus. The difference cannot be explained by different average redshifts or selection techniques. This is confirmed by our morphology classifications, which show that Sy1 nuclei reside in earlier type galaxies than Sy2 nuclei. This intrinsic difference in host galaxy properties may undermine the strong unification hypothesis for Sy galaxies that they appear different due to the orientation of their central engine. The excess galactic dust we see in Sy2's may cause substantial absorption which obscures their hypothesized broad emission-line regions and central nonstellar continua. This galactic dust could produce much of the absorption in Sy2 nuclei which had instead been attributed to a thick dusty accretion torus.Comment: The text of the paper is 23 pages (ms.tex), there are 8 tables, and 9 figures. Figures 1, 2, and 3 are the image gallery (45 pages) and are NOT included here. They can be ftp'ed from ftp.astro.ucla.edu. Log in as anonymous and give your e-mail address as the password. The images are in the /pub/submit/vg/AGNgallery . Figures 4-9 are in eps format and are included here and can be printed using the lpr command in unix system

Research-based versus clinical serum creatinine measurements and the association of acute kidney injury with subsequent kidney function: findings from the Chronic Renal Insufficiency Cohort study.

Background:Observational studies relying on clinically obtained data have shown that acute kidney injury (AKI) is linked to accelerated chronic kidney disease (CKD) progression. However, prior reports lacked uniform collection of important confounders such as proteinuria and pre-AKI kidney function trajectory, and may be susceptible to ascertainment bias, as patients may be more likely to undergo kidney function testing after AKI. Methods:We studied 444 adults with CKD who participated in the prospective Chronic Renal Insufficiency Cohort (CRIC) Study and were concurrent members of a large integrated healthcare delivery system. We estimated glomerular filtration rate (eGFR) trajectories using serum creatinine measurements from (i) the CRIC research protocol (yearly) and (ii) routine clinical care. We used linear mixed effects models to evaluate the associations of AKI with acute absolute change in eGFR and post-AKI eGFR slope, and explored whether these varied by source of creatinine results. Models were adjusted for demographic characteristics, diabetes status and albuminuria. Results:During median follow-up of 8.5 years, mean rate of eGFR loss was -0.31 mL/min/1.73&nbsp;m2/year overall, and 73 individuals experienced AKI (55% Stage 1). A significant interaction existed between AKI and source of serum creatinine for acute absolute change in eGFR level after discharge; in contrast, AKI was independently associated with a faster rate of eGFR decline (mean additional loss of -0.67 mL/min/1.73&nbsp;m2/year), which was not impacted by source of serum creatinine. Conclusions:AKI is independently associated with subsequent steeper eGFR decline regardless of the serum creatinine source used, but the strength of association is smaller than observed in prior studies after taking into account key confounders such as pre-AKI eGFR slope and albuminuria

Cardiac Biomarkers and Risk of Atrial Fibrillation in Chronic Kidney Disease: The CRIC Study.

Background We tested associations of cardiac biomarkers of myocardial stretch, injury, inflammation, and fibrosis with the risk of incident atrial fibrillation (AF) in a prospective study of chronic kidney disease patients. Methods and Results The study sample was 3053 participants with chronic kidney disease in the multicenter CRIC (Chronic Renal Insufficiency Cohort) study who were not identified as having AF at baseline. Cardiac biomarkers, measured at baseline, were NT-proBNP (N-terminal pro-B-type natriuretic peptide), high-sensitivity troponin T, galectin-3, growth differentiation factor-15, and soluble ST-2. Incident AF ("AF event") was defined as a hospitalization for AF. During a median follow-up of 8 years, 279 (9%) participants developed a new AF event. In adjusted models, higher baseline log-transformed NT-proBNP (N-terminal pro-B-type natriuretic peptide) was associated with incident AF (adjusted hazard ratio [HR] per SD higher concentration: 2.11; 95% CI, 1.75, 2.55), as was log-high-sensitivity troponin T (HR 1.42; 95% CI, 1.20, 1.68). These associations showed a dose-response relationship in categorical analyses. Although log-soluble ST-2 was associated with AF risk in continuous models (HR per SD higher concentration 1.35; 95% CI, 1.16, 1.58), this association was not consistent in categorical analyses. Log-galectin-3 (HR 1.05; 95% CI, 0.91, 1.22) and log-growth differentiation factor-15 (HR 1.16; 95% CI, 0.96, 1.40) were not significantly associated with incident AF. Conclusions We found strong associations between higher NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity troponin T concentrations, and the risk of incident AF in a large cohort of participants with chronic kidney disease. Increased atrial myocardial stretch and myocardial cell injury may be implicated in the high burden of AF in patients with chronic kidney disease

The Grizzly, October 20, 1978

Homecoming \u2778 Promises Color, Excitement • Judiciary Board Convicts Two • Shopping Center to Expand • On Personal Expression • Is Pledging All Fun and Games? • Ursinus\u27 Financial Aid Structure • SFARC Repairs Damage Policy • Gallagher Explores Amish • Springsteen & Dylan: Poet Laureates or Veritable Zeros? • The World\u27s Largest Hamburger • Paradise Lost: College Woods Gone Junkyard? • X-C: Dual Wins • Bears Fall Prey Again • Soccer Wins Five • News in Brief: Our New Look; Remember to Vote; Yom Kippur Celebration; Ursinus Announces Business Workshop; Library News Shortshttps://digitalcommons.ursinus.edu/grizzlynews/1003/thumbnail.jp

Vesta's Elemental Composition

Many lines of evidence (e.g. common geochemistry, chronology, O-isotope trends, and the presence of different HED rock types in polymict breccias) indicate that the howardite, eucrite, and diogenite (HED) meteorites originated from a single parent body. Meteorite studies show that this protoplanet underwent igneous differentiation to form a metallic core, an ultramafic mantle, and a basaltic crust. A spectroscopic match between the HEDs and 4 Vesta along with a plausible mechanism for their transfer to Earth, perhaps as chips off V-type asteroids ejected from Vesta's southern impact basin, supports the consensus view that many of these achondritic meteorites are samples of Vesta's crust and upper mantle. The HED-Vesta connection was put to the test by the NASA Dawn mission, which spent a year in close proximity to Vesta. Measurements by Dawn's three instruments, redundant Framing Cameras (FC), a Visible-InfraRed (VIR) spectrometer, and a Gamma Ray and Neutron Detector (GRaND), along with radio science have strengthened the link. Gravity measurements by Dawn are consistent with a differentiated, silicate body, with a dense Fe-rich core. The range of pyroxene compositions determined by VIR overlaps that of the howardites. Elemental abundances determined by nuclear spectroscopy are also consistent with HED-compositions. Observations by GRaND provided a new view of Vesta inaccessible by telescopic observations. Here, we summarize the results of Dawn's geochemical investigation of Vesta and their implications

Neural correlates of enhanced visual short-term memory for angry faces: An fMRI study

Copyright: © 2008 Jackson et al.Background: Fluid and effective social communication requires that both face identity and emotional expression information are encoded and maintained in visual short-term memory (VSTM) to enable a coherent, ongoing picture of the world and its players. This appears to be of particular evolutionary importance when confronted with potentially threatening displays of emotion - previous research has shown better VSTM for angry versus happy or neutral face identities.Methodology/Principal Findings: Using functional magnetic resonance imaging, here we investigated the neural correlates of this angry face benefit in VSTM. Participants were shown between one and four to-be-remembered angry, happy, or neutral faces, and after a short retention delay they stated whether a single probe face had been present or not in the previous display. All faces in any one display expressed the same emotion, and the task required memory for face identity. We find enhanced VSTM for angry face identities and describe the right hemisphere brain network underpinning this effect, which involves the globus pallidus, superior temporal sulcus, and frontal lobe. Increased activity in the globus pallidus was significantly correlated with the angry benefit in VSTM. Areas modulated by emotion were distinct from those modulated by memory load.Conclusions/Significance: Our results provide evidence for a key role of the basal ganglia as an interface between emotion and cognition, supported by a frontal, temporal, and occipital network.The authors were supported by a Wellcome Trust grant (grant number 077185/Z/05/Z) and by BBSRC (UK) grant BBS/B/16178