Low-contrast Pattern-reversal Visual Evoked Potential in Different Spatial Frequencies

Purpose: To evaluate the pattern-reversal visual evoked potential (PRVEP) in lowcontrast, spatial frequencies in time, frequency, and time-frequency domains. Methods: PRVEP was performed in 31 normal eyes, according to the International Society of Electrophysiology of Vision (ISCEV) protocol. Test stimuli had checkerboard of 5% contrast with spatial frequencies of 1, 2, and 4 cycles per degree (cpd). For each VEP waveform, the time domain (TD) analysis, Fast Fourier Transform(FFT), and discrete wavelet transform (DWT) were performed using MATLAB software. The VEP component changes as a function of spatial frequency (SF) were compared among time, frequency, and time–frequency dimensions. Results: As a consequence of increased SF, a significant attenuation of the P100 amplitude and prolongation of P100 latency were seen, while there was no significant difference in frequency components. In the wavelet domain, an increase in SF at a contrast level of 5% enhanced DWT coefficients. However, this increase had no meaningful effect on the 7P descriptor. Conclusion: At a low contrast level of 5%, SF-dependent changes in PRVEP parameters can be better identified with the TD and DWT approaches compared to the Fourier approach. However, specific visual processing may be seen with the wavelet transform

Structural-Interpretive Modeling Factors Affecting the Physical and Social Resilience of Shiraz to Natural Disasters of Flood

Objective: Flood is the most important natural disaster that has caused many casualties and damages in different parts of the country. Considering the possibility of floods in Shiraz and the importance of resilience, especially against floods, this study was planned with aim to model the most important factors affecting social and physical resilience of Shiraz against floods. Methods: Statistical society were selected through purposive sampling that consists of 50 university professors, experts and managers in the field of crisis management in Shiraz. After identifying the dimensions and primary factors, they were evaluated using Delphi method and also structural-interpretive modeling (ISM) method was used in order to analyze the data. Results:Based on the Mick Mac analysis, indicators of neighborhood status (C11), location of facilities and facilities (C8), capability and effectiveness (C10) and the degree of trust and solidarity (C9) have weak influence and dependence. Indicators of collective action and cooperation (C2), practice (C4), membership in groups and social networks (C13) have high influence, power and dependence. The variables of building strength (C1), access status (C7), type of attitude (C5) are more influenced by other factors and are effective and dependent elements. Awareness indicators (C3), acquired skills (C14), acquired knowledge (C6), procurement level (C12) are among the independent (key) variables that have a great impact on the process of physical and social resilience. Conclusion: The analysis of the resilience of human and environmental systems against natural disasters such as floods and in analyzing and reducing the vulnerability of cities and neighborhoods, we should not only emphasize the physical dimension and characteristics of communities, but also pay attention to social structures and dimensions to empower citizens and prepare for natural disaster

Advanced Analysis of PRVEP in Anisometropic Amblyopia

Introduction: to identify the pattern-reversal visual evoked potential (PRVEP) waveform descriptor by evaluating discrete wavelet transform (DWT) in order to optimize stimulus in the diagnosis of anisometropia amblyopia. Materials and Methods: The PRVEP testing was performedfor 31 normal individuals and 35 patients with amblyopia. The stimuli were consisted of spatial frequencies of 1, 2, and 4 cycles per degree (cpd) and contrast levels of 100%, 50%, 25%, and 5%. The results were analyzed in the dimensions of time and time-frequency. DWT descriptor were extracted at level 7 (7P descriptor) for Haar, Daubechies 2, Daubechies 4, Symlet 5, Biorthogonal 3.5, Biorthogonal 4.4, and Coiflet 5 wavelets for 12 stimuli and compared between the two groups.  The correlation between different spatial frequencies at the same contrast level and the similarities between reconstructed signals and original waveforms were evaluated. Results: There were a significant reduction in P100 amplitude and a significant elevation in latency among the patient group. In the patients with amblyopia, 7P descriptor decreased in all analysis except for the frequency of 4 cpd and the contrast of 5% using bior4.4. No significant correlation was observed between different frequencies at a special contrast; however, there was a significant correlation between reconstructed signals and the original ones. Conclusion: The 7P descriptor could be used to distinguish between normal and abnormal signals in anisometropia amblyopia. Considering the results, DWT with coif5, db4, bior4.4, and bior3.5 wavelets can be utilized as a good indicator for selecting optimum stimulus

Investigating Different Dimensions of Nomophobia among Medical Students: A Cross-Sectional Study

BACKGROUND: Today, mobile phones are recognised as an inseparable part of our daily lives, facilitating communication between users. Based on the studies, addiction to cell phones can lead to several complications including depression, anxiety, anger, and aggression. AIM: This study aimed to investigate nomophobia (no mobile phone phobia) among medical students of Islamic Azad University, Tehran Branch. METHODS: This descriptive cross-sectional study was conducted on 100 students studying in different majors of medical sciences in Islamic Azad University, Tehran Branch, from 2016 to 2017. Demographic data of all participants were recorded in a data sheet. In the next stage, a questionnaire was designed by the researcher to evaluate the effect of age, gender, education, and the duration of using cell phone variables on discomfort, anxiety, and insecurity due to lack of access to cell phone or other related issues. Raw data were analysed using SPSS statistical software version 21. The significance level was considered P < 0.05. RESULTS: The results of the study showed that participants with lower mean age felt more discomfort, anger, anxiety, and insecurity due to lack of access to mobile phones and other related issues compared to other people. However, no variable was statistically significant (P-value > 0.05). Except anxiety, results showed that longer duration of mobile phone use might lead to a significant decrease in discomfort, anger, and insensibility variables among users (P-value > 0.05). The incidence of nomophobia (with its different aspects) was significantly lower in females (P-value > 0.05). Also, in participants with higher educational status, the nomophobia was recorded to be more frequent (P-Value > 0.05). CONCLUSION: Understanding the pattern of nomophobia occurrence among cell phone users can facilitate our path to prevent its harms including discomfort, anger, anxiety, and feeling of insecurity among users of technology

The Effect of Concomitant Ethanol and Opium Consumption on Lipid Profiles and Atherosclerosis in Golden Syrian Hamster’s Aorta

Background: Cardiovascular disease (CVD) is the main cause of mortality in the world and is normally argued as the third cause of all mortalities. Opium and alcohol every day consumption can cause people to have many health problems. The present study aimed to assess the effect of ethanol and opium consumption on lipid profiles and atherosclerosis in aorta. Methods: Twenty four male golden Syrian hamsters were randomly divided into four treatment groups (n = 6): Control, addicted (40 mg/kg), alcohol (6.0 g/kg) and combination of opium and alcohol. All of the hamsters were scarified and their livers were removed immediately and fixed in formalin solution 10%. The plasma levels of the lipid profiles were measured enzymatically. Aorta sections were examined by a pathologist. Findings: The amount of the total cholesterol significantly increased in ethanol (P < 0.05) and combination (P < 0.05) groups, while it had a non-significant decrease in opium group. Serum triglyceride significantly increased in ethanol (P < 0.05) and combination (P < 0.001) groups, as well as this parameter increased in opium group but it was not significant. Low-density lipoprotein cholesterol (LDL-C) markedly increased in the combination group (P < 0.05). No significant difference was observed in serum LDL-C among other treatment groups. Levels of high-density lipoprotein cholesterol had a significant rise only in ethanol group. Change in aorta histology was not significant. Conclusion: The results showed that consumption of opium plus alcohol has harmful effects on lipid profile; however, it had no effect on aorta histology that was maybe due to the short period of the treatment. Keywords: Opium, Ethanol, Cholesterol, Atherosclerosis, Aort

Vericiguat in patients with atrial fibrillation and heart failure with reduced ejection fraction:insights from the VICTORIA trial

Aims We evaluated the relation between baseline and new-onset atrial fibrillation (AF) and outcomes, and assessed whether vericiguat modified the likelihood of new-onset AF in patients with worsening heart failure (HF) with reduced ejection fraction in VICTORIA. Methods and results Of 5050 patients randomized, 5010 with recorded AF status at baseline were analysed. Patients were classified into three groups: no known AF (n = 2661, 53%), history of AF alone (n = 992, 20%), and AF on randomization electrocardiogram (n = 1357, 27%). Compared with those with no AF, those with history of AF alone had a higher risk of cardiovascular death [adjusted hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.01-1.47] without excess myocardial infarction or stroke; neither type of AF was associated with a higher risk of the primary composite outcome (time to cardiovascular death or first HF hospitalization), HF hospitalizations, or all cause-death. The beneficial effect of vericiguat on the primary composite outcome and its components was evident irrespective of AF status at baseline. Over a median follow-up of 10.8 months, new-onset AF occurred in 6.1% of those with no AF and 18.3% with history of AF alone (P < 0.0001). These events were not influenced by vericiguat treatment (adjusted HR 0.93, 95% CI 0.75-1.16; P = 0.51), but were associated with an increase in the hazard of both primary and secondary outcomes. Conclusions Atrial fibrillation was present in nearly half of this high-risk population with worsening HF. A history of AF alone at baseline portends an increased risk of cardiovascular death. Neither type of AF affected the beneficial effect of vericiguat. Development of AF post-randomization was associated with an increase in both cardiovascular death and HF hospitalization which was not influenced by vericiguat

Comparison of Platelet Function Guided Versus Unguided Treatment With P2Y12 Inhibitors in Patients With Acute Myocardial Infarction (from the Hungarian Myocardial Infarction Registry)

L

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049