The Association Between the Long-Term Change in Directly Measured Cardiorespiratory Fitness and Mortality Risk

Introduction: There is a strong inverse association between cardiorespiratory fitness (CRF) and mortality outcomes. This relationship has predominantly been assessed cross-sectionally, however low CRF is a modifiable risk factor, thus assessing this association using a single baseline measure may be sub-optimal. Purpose: To examine the association of the long-term change in CRF, measured using cardiopulmonary exercise testing (CPX) with all-cause and disease-specific mortality. Methods: Participants included 833 apparently healthy men and women (42.9±10.8 years) who underwent two maximal CPXs, the second CPX being ≥ 1 year following the baseline assessment. Participants were followed for 17.7 ± 11.8 years for allcause, cardiovascular disease (CVD), and cancer mortality. Cox-proportional hazard models were performed to determine the association between the change in CRF, computed as visit 1 (V1) peak oxygen consumption (VO2peak (ml·kg-1·min-1)) – visit 2 (V2) VO2peak, and mortality outcomes. Results: During follow-up, 172 participants died. Overall, the change in CPX-derived CRF was inversely related to all-cause, CVD, and cancer mortality (p\u3c0.05). Each 1 ml·kg-1·min-1 increase was associated with a 10.8, 14.7, and 15.9% reductions in allcause, CVD, and cancer mortality, respectively. The inverse relationship between CRF and all-cause mortality remained significant (p\u3c0.05) when men and women were examined independently, after adjusting for years since first CPX, baseline VO2peak, and age. Conclusion: Long-term changes in CRF were inversely related to mortality outcomes, and mortality was better predicted by CRF measured at subsequent examination than baseline CRF. These findings support the recent American Heart Association scientific statement advocating CRF as a clinical vital sign that should be assessed routinely in clinical practice, as well as support regular participation in physical activity to maintain adequate CRF levels across the lifespan

High order magnon bound states in the quasi-one-dimensional antiferromagnet α\alpha-NaMnO2_2

Here we report on the formation of two and three magnon bound states in the quasi-one-dimensional antiferromagnet $\alpha$-NaMnO$_2$, where the single-ion, uniaxial anisotropy inherent to the Mn$^{3+}$ ions in this material provides a binding mechanism capable of stabilizing higher order magnon bound states. While such states have long remained elusive in studies of antiferromagnetic chains, neutron scattering data presented here demonstrate that higher order $n>2$ composite magnons exist, and, specifically, that a weak three-magnon bound state is detected below the antiferromagnetic ordering transition of NaMnO$_2$. We corroborate our findings with exact numerical simulations of a one-dimensional Heisenberg chain with easy-axis anisotropy using matrix-product state techniques, finding a good quantitative agreement with the experiment. These results establish $\alpha$-NaMnO$_2$ as a unique platform for exploring the dynamics of composite magnon states inherent to a classical antiferromagnetic spin chain with Ising-like single ion anisotropy.Comment: 5 pages, 4 figure

Asymmetric forest transition driven by the interaction of socioeconomic development and environmental heterogeneity in Central America

Forest transitions (FT) have been observed in many developed countries and more recently in the developing world. However, our knowledge of FT from tropical regions is mostly derived from case studies from within a particular country, making it difficult to generalize findings across larger regions. Here we overcome these difficulties by conducting a recent (2001-2010) satellite-based analysis of trends in forest cover across Central America, stratified by biomes, which we related to socioeconomic variables associated with human development. Results show a net decrease of woody vegetation resulting from 12,201 km2 of deforestation of moist forests and 6,825 km2 of regrowth of conifer and dry forests. The Human Development Index was the socioeconomic variable best associated with forest cover change. The least-developed countries, Nicaragua and Guatemala, experienced both rapid deforestation of moist forests and significant recovery of conifer and dry forests. In contrast, the most developed countries, Panama and Costa Rica, had net woody vegetation gain and amore stable forest cover configuration. These results imply a good agreement with FT predictions of forest change in relation to socioeconomic development, but strong asymmetry in rates and directions of change largely dependent upon the biomewhere change is occurring. The FT model should be refined by incorporating ecological and socioeconomic heterogeneity, particularly inmulticountry and regional studies. These asymmetric patterns of forest change should be evaluatedwhen developing strategies for conserving biodiversity and environmental services.Fil: Redo, Daniel J.. Universidad de Puerto Rico; Puerto RicoFil: Grau, Hector Ricardo. Universidad Nacional de Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Aide, T. Mitchell. Universidad de Puerto Rico; Puerto RicoFil: Clark, Matthew L.. Sonoma State University; Estados Unido

Land Change in the Greater Antilles between 2001 and 2010

Land change in the Greater Antilles differs markedly among countries because of varying socioeconomic histories and global influences. We assessed land change between 2001 and 2010 in municipalities (second administrative units) of Cuba, Dominican Republic, Haiti, Jamaica, and Puerto Rico. Our analysis used annual land-use/land-cover maps derived from MODIS satellite imagery to model linear change in woody vegetation, mixed-woody/plantations and agriculture/herbaceous vegetation. Using this approach, we focused on municipalities with significant change (p ≤ 0.05). Between 2001 and 2010, the Greater Antilles gained 801 km2 of woody vegetation. This increase was mainly due to the return of woody vegetation in Cuba, and smaller increases in Puerto Rico and the Dominican Republic. Despite relatively similar environments, the factors associated with these changes varied greatly between countries. In Puerto Rico, Dominican Republic, and Jamaica, agriculture declined while mixed-woody vegetation increased, mostly in montane regions. In contrast, Cuba experienced an extensive decline in sugarcane plantations, which resulted in the spread of an invasive woody shrub species and the increase in woody vegetation in areas of high agricultural value. In Haiti, the growing population, fuelwood consumption, and increase in agriculture contributed to woody vegetation loss; however, woody vegetation loss was accompanied with a significant increase in the mixed woody and plantations class. Most regional analyses often treated the Greater Antilles as a homogeneous unit; our results suggest that historical and socio-economic differences among countries are crucial for understanding the variation in present day land change dynamics.Fil: Alvarez Berrios, Nora L.. Universidad de Puerto Rico; Puerto RicoFil: Redo, Daniel J.. Universidad de Puerto Rico; Puerto RicoFil: Aide, T. Mitchell. Universidad de Puerto Rico; Puerto RicoFil: Clark, Matthew L.. Sonoma State University; Estados UnidosFil: Grau, Hector Ricardo. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales e Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Consistent Surgeon Evaluations of Three-Dimensional Rendering of PET/CT Scans of the Abdomen of a Patient with a Ductal Pancreatic Mass.

Two-dimensional (2D) positron emission tomography (PET) and computed tomography (CT) are used for diagnosis and evaluation of cancer patients, requiring surgeons to look through multiple planar images to comprehend the tumor and surrounding tissues. We hypothesized that experienced surgeons would consistently evaluate three-dimensional (3D) presentation of CT images overlaid with PET images when preparing for a procedure. We recruited six Jefferson surgeons to evaluate the accuracy, usefulness, and applicability of 3D renderings of the organs surrounding a malignant pancreas prior to surgery. PET/CT and contrast-enhanced CT abdominal scans of a patient with a ductal pancreatic mass were segmented into 3D surface renderings, followed by co-registration. Version A used only the PET/CT image, while version B used the contrast-enhanced CT scans co-registered with the PET images. The six surgeons answered 15 questions covering a) the ease of use and accuracy of models, b) how these models, with/without PET, changed their understanding of the tumor, and c) what are the best applications of the 3D visualization, on a scale of 1 to 5. The six evaluations revealed a statistically significant improvement from version A (score 3.6±0.5) to version B (score 4.4±0.4). A paired-samples t-test yielded t(14) = -8.964,

The Association between the Change in Directly Measured Cardiorespiratory Fitness across Time and Mortality Risk

Background: The relationship between cardiorespiratory fitness (CRF) and mortality risk has typically been assessed using a single measurement, though some evidence suggests the change in CRF over time influences risk. This evidence is predominantly based on studies using estimated CRF (CRFe). The strength of this relationship using change in directly measured CRF over time in apparently healthy men and women is not well understood. Purpose: To examine the association of change in CRF over time, measured using cardiopulmonary exercise testing (CPX), with all-cause and disease-specific mortality and to compare baseline and subsequent CRF measurements as predictors of all-cause mortality. Methods: Participants included 833 apparently healthy men and women (42.9 ± 10.8 years) who underwent two maximal CPXs, the second CPX being ≥1 year following the baseline assessment (mean 8.6 years, range 1.0 to 40.3 years). Participants were followed for up to 17.7 (SD 11.8) years for all-cause-, cardiovascular disease- (CVD), and cancer mortality. Cox-proportional hazard models were performed to determine the association between the change in CRF, computed as visit 1 (CPX1) peak oxygen consumption (VO2peak [mL·kg−1·min−1]) – visit 2 (CPX2) VO2peak, and mortality outcomes. A Wald-Chi square test of equality was used to compare the strength of CPX1 to CPX2 VO2peak in predicting mortality. Results: During follow-up, 172 participants died. Overall, the change in CPX-CRF was inversely related to all-cause, CVD, and cancer mortality (p \u3c 0.05). Each 1 mL·kg−1·min−1 increase was associated with a ~11, 15, and 16% (all p \u3c 0.001) reduction in all-cause, CVD, and cancer mortality, respectively. The inverse relationship between CRF and all-cause mortality was significant (p \u3c 0.05) when men and women were examined independently, after adjusting for years since first CPX, baseline VO2peak, and age. Further, the Wald Chi-square test of equality found CPX2 VO2peak to be a significantly stronger predictor of all-cause mortality than CPX1 VO2peak (p \u3c 0.05). Conclusion: The change in CRF over time was inversely related to mortality outcomes, and mortality was better predicted by CRF measured at subsequent test than CPX1 CRF. These findings emphasize the importance of adopting lifestyle behaviors that promote CRF, as well as support the need for routine assessment of CRF in clinical practice to better assess risk

Cardiorespiratory Fitness and Mortality in Healthy Men and Women

Background There is a well-established inverse relationship between cardiorespiratory fitness (CRF) and mortality. However, this relationship has almost exclusively been studied using estimated CRF. Objectives This study aimed to assess the association of directly measured CRF, obtained using cardiopulmonary exercise (CPX) testing with all-cause, cardiovascular disease (CVD), and cancer mortality in apparently healthy men and women. Methods Participants included 4,137 self-referred apparently healthy adults (2,326 men, 1,811 women; mean age: 42.8 ± 12.2 years) who underwent CPX testing to determine baseline CRF. Participants were followed for 24.2 ± 11.7 years (1.1 to 49.3 years) for mortality. Cox-proportional hazard models were performed to determine the relationship of CRF (ml·kg-1·min-1) and CRF level (low, moderate, and high) with mortality outcomes. Results During follow-up, 727 participants died (524 men, 203 women). CPX-derived CRF was inversely related to all-cause, CVD, and cancer mortality. Low CRF was associated with higher risk for all-cause (hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 1.20 to 3.50), CVD (HR: 2.27; 95% CI: 1.20 to 3.49), and cancer (HR: 2.07; 95% CI: 1.18 to 3.36) mortality compared with high CRF. Further, each metabolic equivalent increment increase in CRF was associated with a 11.6%, 16.1%, and 14.0% reductions in all-cause, CVD, and cancer mortality, respectively. Conclusions Given the prognostic ability of CPX-derived CRF for all-cause and disease-specific mortality outcomes, its use should be highly considered for apparently healthy populations as it may help to improve the efficacy of the individualized patient risk assessment and guide clinical decisions

Latent ice recrystallization inhibition activity in nonantifreeze proteins : Ca2+-activated plant lectins and cation-activated antimicrobial peptides

Organisms living in polar regions have evolved a series of antifreeze (glyco) proteins (AFGPs) to enable them to survive by modulating the structure of ice. These proteins have huge potential for use in cellular cryopreservation, ice-resistant surfaces, frozen food, and cryosurgery, but they are limited by their relatively low availability and questions regarding their mode of action. This has triggered the search for biomimetic materials capable of reproducing this function. The identification of new structures and sequences capable of inhibiting ice growth is crucial to aid our understanding of these proteins. Here, we show that plant c-type lectins, which have similar biological function to human c-type lectins (glycan recognition) but no sequence homology to AFPs, display calcium-dependent ice recrystallization inhibition (IRI) activity. This IRI activity can be switched on/off by changing the Ca2+ concentration. To show that more (nonantifreeze) proteins may exist with the potential to display IRI, a second motif was considered, amphipathicity. All known AFPs have defined hydrophobic/hydrophilic domains, rationalizing this choice. The cheap, and widely used, antimicrobial Nisin was found to have cation-dependent IRI activity, controlled by either acid or addition of histidine-binding ions such as zinc or nickel, which promote its amphipathic structure. These results demonstrate a new approach in the identification of antifreeze protein mimetic macromolecules and may help in the development of synthetic mimics of AFPs