Impact of Cuff Over Inflation on Blood Pressure Readings in Adults

Purpose Physical therapists regularly use blood pressure (BP) readings when making clinical decisions. Inaccuracies in BP readings may occur when not following standard procedure. False or missed diagnoses of hypertension (HTN) may lead to improper medical management. Objective To determine the effects of cuff over inflation on BP readings compared to the standardized 20 mmHg above the loss of Korotkoff sounds when taking manual BP in adults. Participants 109 adult participants recruited at the MN State Fair on August 28, 2019. Methods Data Collection Utilized American Heart Association (AHA) standardized positioning and procedures Baseline BP measurement taken using standard cuff inflation of 20 mmHg above loss of systolic Korotkoff sounds BP measured three subsequent times inflating the cuff to 40, 60, 80 mmHg above the lost of Korotkoff sounds in randomized order Data Analysis Friedman\u27s ANOVA performed to analyze differences in BP measurements Point biserial correlation performed to determine effects of demographics on change in BP measurements Results Significant difference found in systolic readings between standardized measurement and cuff inflation level of greater than or equal to 60 mmHg above loss of Korotkoff sounds Significant correlation found between body mass index (BMI) and BP change Conclusion Over inflating the blood pressure cuff created statistically significant differences in BP readings as compared to standard procedures Higher cuff inflation levels impact accuracy of clinical decisions Participants with higher BMI have a greater incidence of inaccurate readings with increasing cuff inflation level Clinical Relevance Over inflating the blood pressure cuff when manually taking an adult\u27s blood pressure may lead to significantly elevated systolic readings. Cuff inflation level for manual blood pressure assessment needs to be standardized. The determination of care being delivered can be significantly affected when standard procedures are not followed

Applying the Geostatistical Eigenvector Spatial Filter Approach into Regularized Regression for Improving Prediction Accuracy for Mass Appraisal

Prediction accuracy for mass appraisal purposes has evolved substantially over the last few decades, facilitated by the evolution in big data, data availability and open source software. Accompanying these advances, newer forms of geo-spatial approaches and machine learning (ML) algorithms have been shown to help improve house price prediction and mass appraisal assessment. Nonetheless, the adoption a of ML within mass appraisal has been protracted and subject to scrutiny by assessment jurisdictions due to their failure to account for spatial autocorrelation and limited practicality in terms of value significant estimates needed for tribunal defense and explainability. Existing research comparing traditional regression approaches has tended to examine unsupervised ML methods such as Random Forest (RF) models which remain more esoteric and less transparent in producing value significant estimates necessary for mass appraisal explainability and defense. Therefore, the purpose of this study is to apply the supervised Regularized regression technique which offers a more transparent alternative, and integrate this with a more nuanced geo-statistical technique, the Eigenvector Spatial Filter (ESF) approach, to more accurately account for spatial autocorrelation and enhance prediction accuracy whilst improving explainability needed for mass appraisal exercises. By undertaking such an approach, the research demonstrates the application of this method can be easily adopted for property tax jurisdictions in a framework which is more interpretable, transparent and useable within mass appraisal given its simple and appealing approach. The findings reveal that the integration of the ESFs improves model explainability, prediction accuracy and spatial residual error compared to baseline classical regression and Elastic-net regularized regression architectures, whilst offering the necessary ‘front-facing’ and flexible structure for in-sample and out-of-sample assessment needed by the assessment community for valuing the unsold housing stock. In terms of policy and practice, the study demonstrates some important considerations for mass appraisal tax assessment and for the improvement of taxation assessment and the alleviation of horizontal and vertical inequity

Dissecting complex transcriptional responses using pathway-level scores based on prior information

<p>Abstract</p> <p>Background</p> <p>The genomewide pattern of changes in mRNA expression measured using DNA microarrays is typically a complex superposition of the response of multiple regulatory pathways to changes in the environment of the cells. The use of prior information, either about the function of the protein encoded by each gene, or about the physical interactions between regulatory factors and the sequences controlling its expression, has emerged as a powerful approach for dissecting complex transcriptional responses.</p> <p>Results</p> <p>We review two different approaches for combining the noisy expression levels of multiple individual genes into robust pathway-level differential expression scores. The first is based on a comparison between the distribution of expression levels of genes within a predefined gene set and those of all other genes in the genome. The second starts from an estimate of the strength of genomewide regulatory network connectivities based on sequence information or direct measurements of protein-DNA interactions, and uses regression analysis to estimate the activity of gene regulatory pathways. The statistical methods used are explained in detail.</p> <p>Conclusion</p> <p>By avoiding the thresholding of individual genes, pathway-level analysis of differential expression based on prior information can be considerably more sensitive to subtle changes in gene expression than gene-level analysis. The methods are technically straightforward and yield results that are easily interpretable, both biologically and statistically.</p

Mechanical Properties of Plant Underground Storage Organs and Implications for Dietary Models of Early Hominins

The diet of early human ancestors has received renewed theoretical interest since the discovery of elevated d13C values in the enamel of Australopithecus africanus and Paranthropus robustus. As a result, the hominin diet is hypothesized to have included C4 grass or the tissues of animals which themselves consumed C4 grass. On mechanical grounds, such a diet is incompatible with the dental morphology and dental microwear of early hominins. Most inferences, particularly for Paranthropus, favor a diet of hard or mechanically resistant foods. This discrepancy has invigorated the longstanding hypothesis that hominins consumed plant underground storage organs (USOs). Plant USOs are attractive candidate foods because many bulbous grasses and cormous sedges use C4 photosynthesis. Yet mechanical data for USOs—or any putative hominin food—are scarcely known. To fill this empirical void we measured the mechanical properties of USOs from 98 plant species from across sub-Saharan Africa. We found that rhizomes were the most resistant to deformation and fracture, followed by tubers, corms, and bulbs. An important result of this study is that corms exhibited low toughness values (mean = 265.0 J m-2) and relatively high Young’s modulus values (mean = 4.9 MPa). This combination of properties fits many descriptions of the hominin diet as consisting of hard-brittle objects. When compared to corms, bulbs are tougher (mean = 325.0 J m-2) and less stiff (mean = 2.5 MPa). Again, this combination of traits resembles dietary inferences, especially for Australopithecus, which is predicted to have consumed soft-tough foods. Lastly, we observed the roasting behavior of Hadza hunter-gatherers and measured the effects of roasting on the toughness on undomesticated tubers. Our results support assumptions that roasting lessens the work of mastication, and, by inference, the cost of digestion. Together these findings provide the first mechanical basis for discussing the adaptive advantages of roasting tubers and the plausibility of USOs in the diet of early hominins

Socioeconomic disparities in breast cancer survival: relation to stage at diagnosis, treatment and race

<p>Abstract</p> <p>Background</p> <p>Previous studies have documented lower breast cancer survival among women with lower socioeconomic status (SES) in the United States. In this study, I examined the extent to which socioeconomic disparity in breast cancer survival was explained by stage at diagnosis, treatment, race and rural/urban residence using the Surveillance, Epidemiology, and End Results (SEER) data.</p> <p>Methods</p> <p>Women diagnosed with breast cancer during 1998-2002 in the 13 SEER cancer registry areas were followed-up to the end of 2005. The association between an area-based measure of SES and cause-specific five-year survival was estimated using Cox regression models. Six models were used to assess the extent to which SES differences in survival were explained by clinical and demographical factors. The base model estimated the hazard ratio (HR) by SES only and then additional adjustments were made sequentially for: 1) age and year of diagnosis; 2) stage at diagnosis; 3) first course treatment; 4) race; and 5) rural/urban residence.</p> <p>Results</p> <p>An inverse association was found between SES and risk of dying from breast cancer (p < 0.0001). As area-level SES falls, HR rises (1.00 → 1.05 → 1.23 → 1.31) with the two lowest SES groups having statistically higher HRs. This SES differential completely disappeared after full adjustment for clinical and demographical factors (p = 0.20).</p> <p>Conclusion</p> <p>Stage at diagnosis, first course treatment and race explained most of the socioeconomic disparity in breast cancer survival. Targeted interventions to increase breast cancer screening and treatment coverage in patients with lower SES could reduce much of socioeconomic disparity.</p

Compressed representation of a partially defined integer function over multiple arguments

In OLAP (OnLine Analitical Processing) data are analysed in an n-dimensional cube. The cube may be represented as a partially defined function over n arguments. Considering that often the function is not defined everywhere, we ask: is there a known way of representing the function or the points in which it is defined, in a more compact manner than the trivial one

Personality trait development in midlife: exploring the impact of psychological turning points

This study examined long-term personality trait development in midlife and explored the impact of psychological turning points on personality change. Selfdefined psychological turning points reflect major changes in the ways people think or feel about an important part of their life, such as work, family, and beliefs about themselves and about the world. This study used longitudinal data from the Midlife in the US survey to examine personality trait development in adults aged 40–60 years. The Big Five traits were assessed in 1995 and 2005 by means of self-descriptive adjectives. Seven types of self-identified psychological turning points were obtained in 1995. Results indicated relatively high stability with respect to rankorders and mean-levels of personality traits, and at the same time reliable individual differences in change. This implies that despite the relative stability of personality traits in the overall sample, some individuals show systematic deviations from the sample mean-levels. Psychological turning points in general showed very little influence on personality trait change, although some effects were found for specific types of turning points that warrant further research, such as discovering that a close friend or relative was a much better person than one thought they were

A genome survey of Moniliophthora perniciosa gives new insights into Witches' Broom Disease of cacao

<p>Abstract</p> <p>Background</p> <p>The basidiomycete fungus <it>Moniliophthora perniciosa </it>is the causal agent of Witches' Broom Disease (WBD) in cacao (<it>Theobroma cacao</it>). It is a hemibiotrophic pathogen that colonizes the apoplast of cacao's meristematic tissues as a biotrophic pathogen, switching to a saprotrophic lifestyle during later stages of infection. <it>M. perniciosa</it>, together with the related species <it>M. roreri</it>, are pathogens of aerial parts of the plant, an uncommon characteristic in the order Agaricales. A genome survey (1.9× coverage) of <it>M. perniciosa </it>was analyzed to evaluate the overall gene content of this phytopathogen.</p> <p>Results</p> <p>Genes encoding proteins involved in retrotransposition, reactive oxygen species (ROS) resistance, drug efflux transport and cell wall degradation were identified. The great number of genes encoding cytochrome P450 monooxygenases (1.15% of gene models) indicates that <it>M. perniciosa </it>has a great potential for detoxification, production of toxins and hormones; which may confer a high adaptive ability to the fungus. We have also discovered new genes encoding putative secreted polypeptides rich in cysteine, as well as genes related to methylotrophy and plant hormone biosynthesis (gibberellin and auxin). Analysis of gene families indicated that <it>M. perniciosa </it>have similar amounts of carboxylesterases and repertoires of plant cell wall degrading enzymes as other hemibiotrophic fungi. In addition, an approach for normalization of gene family data using incomplete genome data was developed and applied in <it>M. perniciosa </it>genome survey.</p> <p>Conclusion</p> <p>This genome survey gives an overview of the <it>M. perniciosa </it>genome, and reveals that a significant portion is involved in stress adaptation and plant necrosis, two necessary characteristics for a hemibiotrophic fungus to fulfill its infection cycle. Our analysis provides new evidence revealing potential adaptive traits that may play major roles in the mechanisms of pathogenicity in the <it>M. perniciosa</it>/cacao pathosystem.</p