Cardiovascular consequences of cortisol excess

Cushing's syndrome is a consequence of primary or, more commonly, secondary oversecretion of cortisol. Cardiovascular disease is the major cause of morbidity and mortality in Cushing's syndrome, and excess risk remains even in effectively treated patients. The cardiovascular consequences of cortisol excess are protean and include, inter alia, elevation of blood pressure, truncal obesity, hyperinsulinemia, hyperglycemia, insulin resistance, and dyslipidemia. This review analyses the relationship of cortisol excess, both locally and at tissue level, to these cardiovascular risk factors, and to putative mechanisms for hypertension. Previous studies have examined correlations between cortisol, blood pressure, and other parameters in the general population and in Cushing's syndrome. This review also details changes induced by short-term cortisol administration in normotensive healthy men

Renal artery stenosis and hypertension : whom and how to screen and treat

Renovascular disease is an underlying cause in a significant proportion of patients who have refractory hypertension. Aggressive medical therapy to lower cardiovascular risk is the first priority in these patients. Endovascular treatment is required in only a few carefully selected cases<br /

A Feature-Augmented Grammar for Automated Media Production

The IST Polymnia project is creating a fully automated system for personalised video generation, including content creation, selection and composition. This paper presents a linguistically motivated solution using context-free feature-augmented grammar rules to describe editing tasks and hence automate video editing. The solution is media and application independent

Establishment of Neural Networks Robust to Label Noise

Label noise is a significant obstacle in deep learning model training. It can have a considerable impact on the performance of image classification models, particularly deep neural networks, which are especially susceptible because they have a strong propensity to memorise noisy labels. In this paper, we have examined the fundamental concept underlying related label noise approaches. A transition matrix estimator has been created, and its effectiveness against the actual transition matrix has been demonstrated. In addition, we examined the label noise robustness of two convolutional neural network classifiers with LeNet and AlexNet designs. The two FashionMINIST datasets have revealed the robustness of both models. We are not efficiently able to demonstrate the influence of the transition matrix noise correction on robustness enhancements due to our inability to correctly tune the complex convolutional neural network model due to time and computing resource constraints. There is a need for additional effort to fine-tune the neural network model and explore the precision of the estimated transition model in future research.Comment: 11 pages, 7 figure

Durability of Motor Learning by Observation

Recent evidence suggests that neural representations of novel movement dynamics can be acquired by observing someone else experiencing them first-hand. Visual information about another person’s movement kinematics can be transformed into an adaptation of feedforward limb control for the observer; however, little is known about the durability of this adaptation. Despite the longevity of changes in the motor system being a defining characteristic of motor learning, studies to date have only examined observation-related effects shortly after observation has occurred, leaving unknown whether such effects are transient phenomena or products of learned, durable changes in neural systems. We measured human participants’ force generation patterns before and at various time points (1 minute – 24 hours) after they had either performed or observed movements that were perturbed by novel, robot-generated forces (i.e., a velocity-dependent force field). Like participants who had physically practiced, observers learned to predictively generate directionally- and temporally-specific compensatory forces during reaching. Although retention generally decayed with time, we found no evidence of an interaction between the effects of the passage of time and whether participants had performed or observed reaches in a force field, suggesting that the adaptation decayed similarly regardless of whether it was induced by observing someone else’s physical force field learning or feeling the force field for oneself. Notably, the adaptation of predictive limb control induced by observation was still detectable 24 hours later, demonstrating that visually-acquired representations of movement dynamics can be retained, and continue to influence behaviour, long after the initial training period is over. Our results suggest that observing can have lasting effects on the brain that are similar to those seen for physical practice

Approche économique et institutionnelle de l'influence des Aires Marines Protégées sur le développement durable des territoires en Méditerranée

In the Mediterranean, a biodiversity Hotspot, Marine Protected Areas (MPAs) were introduced in the 1960s to protect biodiversity for ethical, cultural and functional reasons, as biodiversity contributes to the well-being. Today the AMP implementation is part of a formalized institutional environment at various levels: national, Mediterranean, European, and global with the Convention on Biological Diversity. In this promising context of environmental governance, protection cover by AMP yet remains below the commitments of riparian countries in the various governance bodies mentioned. Few resources are expanded and many MPAs are likely to be low effective. Given this disappointing finding the managers of Mediterranean MPA and their partners are gathering to strengthen efforts against the degradation of our common good that is marine and coastal biodiversity. The objective of this thesis is to contribute to this effort by enlightening elements favorable to the effectiveness and efficiency of MPAs.MPAs are intended to protect biodiversity and therefore establish rules related to the use of marine and coastal biodiversity and implement specific activities within their clearly defined space. This causes both constraints and opportunities for the sustainable development path especially that of territory environmentally and socio-economically connected to the MPA. This thesis aims to show that MPAs are institutional arrangements that are part of a social-ecological system. In this context, besides the mechanisms of ecosystem resilience, MPAs ability to generate benefits for the sustainable development of territories is based on the one hand on the ability of stakeholders to adapt to the change of rules, address the constraints and seize opportunities, and, on the other hand, on the ability of MPAs to rely on dense social networks to encourage behavior compliance and thus MPA’s effectiveness.The first part adopts an institutional approach that enables to consider MPAs in their socio-ecological system. It opens with the first chapter that defines the role attributed to AMP through the elaboration of this tool since the early twentieth century building on the construction at different levels nested of framework notions such as biodiversity, development sustainability and governance of the marine environment. The second chapter, looks over the current situation of MPAs in the Mediterranean in regard to their objectives of effectiveness and efficiency. A typology of Mediterranean MPAs is proposed to help the definition of differentiated strategies so as to strengthen existing and future MPAs in the basin. The third chapter, which ends the first part, analyzes the MPAs as institutional arrangements that enlighten on the one hand the nature of the effects and stakes related to the establishment of MPAs, and on the other hand, discusses the empirical forms of key success factors to facilitate MPAs.The second part, focusing on the integration of MPAs into the sustainable development of territories, opens with the fourth chapter which analyzes the formation of the benefits and costs generated by the Mediterranean MPAs on natural capital, human capital and social capital (and indirectly on physical capital) available in the territory. The last chapter shows that socio-economic assessment of the effects of MPAs can help strengthen MPAs, by going beyond the limits of economic valuation of particular benefits related to ecosystem services; and implementing complementary assessment methods and processes helping stakeholder engagement towards AMP.En Méditerranée, un Hotspot de biodiversité, des Aires Marines Protégées (AMP) ont été instaurées dès les années 1960 pour protéger la biodiversité marine pour des raisons éthiques, culturelles et fonctionnelles, du fait de la contribution au bien-être des individus. Aujourd’hui, la mise en œuvre des AMP s’inscrit dans un environnement institutionnel formalisé à différents échelons : national, méditerranée, européen, et global avec la Convention pour la Diversité Biologique (CDB). Dans ce contexte de gouvernance environnemental prometteur, le constat de la couverture de protection par les AMP demeure pourtant en-dessous des engagements pris par les pays riverains dans les différentes instances évoquées. Peu de moyens sont mis en œuvre et les AMP sont nombreuses à être peu effectives. Face à ce constat décevant les gestionnaires des AMP de Méditerranée ainsi que leurs partenaires se mobilisent pour le renforcement de la lutte contre la dégradation des biens communs que représente la biodiversité marine et côtière. L’objectif de cette thèse est de contribuer à cet effort en éclairant les éléments favorables à l’effectivité et l’efficacité des AMP. Les AMP, dont la finalité est la protection de la biodiversité, établissent des règles d’usages liés à la biodiversité marine et côtière et mettent en œuvre des activités spécifiques au sein d’un espace clairement défini. Ceci entraîne à la fois des contraintes et des opportunités pour la trajectoire de développement durable notamment celle du territoire écologiquement et socio-économiquement liée à l’AMP. Cette thèse vise à montrer que les AMP sont des dispositifs institutionnels qui s’inscrivent dans des systèmes socio-écologiques. Dans ce contexte, outre les mécanismes de résilience des écosystèmes, la capacité des AMP à générer des bénéfices pour le développement durable des territoires repose notamment, d’une part sur la capacité des parties prenantes à s’adapter au changement de règles, à faire face aux contraintes et à saisir les opportunités ; et, d’autre part, sur la capacité des AMP à s’appuyer sur des réseaux sociaux denses pour favoriser la conformité des comportements et donc l’effectivité de l’AMP. La première partie, centrée sur l’approche institutionnelle, permet de considérer les AMP au sein de leur système socio-écologique. Elle s’ouvre avec le premier chapitre qui définit le rôle attribué aux AMP à travers la construction de cet outil depuis le début du XXème siècle en s’appuyant sur la construction aux différents échelons imbriqués de notions cadre, telle que la biodiversité, le développement durable et la gouvernance du milieu marin. Le deuxième chapitre fait le bilan de la situation actuelle des AMP en Méditerranée face à leurs objectifs d’effectivité et d’efficacité. Une typologie réalisée à partir des AMP méditerranéennes est proposée afin de contribuer à la définition de stratégies différenciées pour renforcer des AMP existantes et à venir dans le bassin. Le troisième chapitre, qui clôt la Partie 1, analyse les AMP en tant que dispositifs institutionnels. Il éclaire la nature des effets et des enjeux liés à la création d’AMP, et discute la concrétisation de facteurs clés pour faciliter la réussite des AMP. La deuxième partie, centrée sur l’intégration des AMP dans le développement durable des territoires, s’ouvre avec le quatrième chapitre qui analyse la formation des bénéfices et des coûts générés par les AMP de Méditerranée sur le capital naturel, le capital humain et le capital social (et indirectement sur le capital physique) disponibles sur le territoire. Le dernier chapitre montre comment l’évaluation socio-économique des effets des AMP peut renforcer les AMP en dépassant les limites de l’évaluation économique concentrée sur certains bénéfices liés aux services écosystémiques ; par la réalisation de méthodes d’évaluation et des processus complémentaires qui encouragent l’engagement des parties prenantes auprès des AMP

The clinical utility of routine urinalysis in pregnancy: A prospective study

Objectives: To determine whether routine urinalysis in the antenatal period facilitates diagnosis of pre-eclampsia. Can routine urinalysis during pregnancy be discontinue in women with normal results of dipstick urinalysis and microscopy at the first antenatal visit? Design: Prospective observational study. Setting: A metropolitan public hospital and a private hospital in Sydney (NSW). Participants: One thousand women were enrolled at their first antenatal visit (March to November 1999), and 913 completed the study. Outcome measures: The primary outcome was a diagnosis of de novo hypertension (gestational hypertension, pre-eclampasia, or pre-eclampsia superimposed on chronic hypertension). Results: Thirty-five women had dipstick proteinuria at the first antenatal visit. In 25 (71%) of these women, further dipstick proteinuria was detected during pregnancy, and two (6%) were diagnosed with pre-eclampsia. Of the 867 without dipstick proteinuria at the first visit, 338 (39%) had dipstick proteinuria (> 1+) at some time during pregnancy. There were no statistically significant differences in the proportion of women with and without dipstick proteinuria at their first visit who developed hypertension during pregnancy. Only six women developed proteinuria before the onset of hypertension. Women who had an abnormal result of a midstream urine test at their first visit, compared with women with a normal result, were more likely to have a urinary tract infection diagnosed during pregnancy; however, the numbers were small. Conclusion: In the absence of hypertension, routine urinalysis during pregnancy is a poor predictor of pre-eclampsia. Therefore, after an initial screening urinalysis, routine urinalysis could be eliminated from antenatal care without adverse outcomes for women

College Football Television and Attendance: The Problem with Selection Bias

Television coverage\u27s impact on college football attendance is a topic of debate. Between 2005 and 2019, annual growth in athletic department revenues for Football Bowl Subdivision (FBS) schools from media rights, postseason football, and National Collegiate Athletic Association (NCAA) conference distributions far exceed revenue growth in ticket sales revenue. This study re-evaluates the substitution or complementarity of television coverage and stadium attendance in college football with updated data while controlling for selection bias through endogenous treatment regression. Although initial results reveal a positive correlation between television coverage and attendance, national coverage and attendance appear to be substitutes after controlling for selection bias. That said, from an attendance maximizing perspective, national coverage is preferable to lower-tiered coverage if a game is to be televised

Preeclampsia-Associated Cardiovascular Risk Factors 6 Months and 2 Years After Pregnancy: The P4 Study

BACKGROUND: Increased cardiovascular risk following preeclampsia is well established and there are signs of early cardiovascular aging 6 months postpartum. This study assessed whether blood pressure (BP) and other cardiovascular measures are abnormal 2 years postpartum in the same cohort to determine ongoing risk markers. METHODS: Six months and 2 years postpartum, BP was measured using sphygmomanometry, 24-hour ambulatory BP monitoring, and noninvasive central BP. Anthropometric measures, blood, and urine biochemistry were performed. Cross-sectional comparisons between preeclampsia and normotensive pregnancy (NP) groups and longitudinal comparisons within each group were made at 6 months and 2 years. RESULTS: Two years postpartum, 129 NP, and 52 preeclampsia women were studied who also had 6 months measures. At both time points, preeclampsia group had significantly higher BP (office BP 2 years, 112±12/72±8 versus 104±9/67±7 mm Hg NP; [P120/80 mm Hg) classified 25% versus 8% (P<0.002), as did our reference range threshold of 122/79 mm Hg. American Heart Association criteria classified 60% post-preeclampsia versus 16% after NP with above-normal ambulatory BP monitoring (P<0.001). Other cardiovascular risk markers more common 2 years post-preeclampsia included higher body mass index (median 26.6 versus 23.1, P=0.003) and insulin resistance. CONCLUSIONS: After preeclampsia, women have significantly higher BP 6 months and 2 years postpartum, and have higher body mass index and insulin-resistance scores, increasing their future cardiovascular risk. Regular cardiovascular risk screening should be implemented for all who have experienced preeclampsia