Role of TSH and excess Heart Age in Predicting Atrial Fibrillation Recurrence Post-Ablation

Background: The association between atrial fibrillation (AF) and thyroid disease as defined by thyroid stimulating hormone (TSH) is established in literature. However, the relationship between TSH and recurrence of AF post ablation has not been established. Methods: We studied 207 patients (60.54±9.39yrs, 35.7% female) with persistent or paroxysmal AF who underwent either Cryo or RFA ablation between April 2011 and Jan 2015 at our center. Patients were stratified into hypothyroid (TSH \u3e \u3e4.5 U/mL), euthyroid (TSH 0.5-4.5 U/mL) and hyperthyroid (TSH \u3c 0.5 U/mL) based on pre procedure testing. Heart age was computed based on Framingham risk factors. Excess heart age was defined as the difference between actual age and heart age. Logistic regression and cox-proportional hazards model were implemented using R statistical software (v3.2.0). Results: There was a statistically significant lower rate of AF recurrence among male patients (OR 2.92, p=0.003). In univariate analysis, there was no statistically significant relationship between TSH and incidence of AF recurrence (OR 1.05, p=0.74). Cox proportional hazards models did not show an association between recurrence and TSH states (HR 0.85, p=0.74 for hypothyroid and HR 0.75, p=0.56 for hyperthyroid). Conclusions: This exploratory showed that TSH may not play a role in AF recurrence. While there is a tendency towards an association between TSH and AF recurrence, this was not statistically significant. We hypothesize that overt hyperthyroidism prior to ablation will not increase chance of recurrence. This was true after adjustment for Framingham risk factors. The limitation of this study was the small sample size of the patients with TSH in the hyperthyroid range. Further analysis using larger dataset is indicated

Triangle-free intersection graphs of line segments with large chromatic number

In the 1970s, Erdos asked whether the chromatic number of intersection graphs of line segments in the plane is bounded by a function of their clique number. We show the answer is no. Specifically, for each positive integer $k$, we construct a triangle-free family of line segments in the plane with chromatic number greater than $k$. Our construction disproves a conjecture of Scott that graphs excluding induced subdivisions of any fixed graph have chromatic number bounded by a function of their clique number.Comment: Small corrections, bibliography updat

Nieinsulinowa hipoglikemia trzustkowa u dorosłych — przegląd genetyki

  Hyperinsulinaemic hypoglycaemia (HH) is also classically referred to as “nesidioblastosis”. Heterogeneous clinical manifestation of the disease causes risk of late diagnosis or even misdiagnosis. In infants and children, it can lead to serious and permanent damage to the central nervous system, which leads to the manifesting mental retardation. HH is characterised by unregulated insulin secretion from pancreatic β-cells. This effect has been correlated with nine genes: ABCC8, KCNJ11, GCK, GLUD-1, HADH1, SLC16A1, HNF4A, HNF1A, and UCP2. Mutations in these genes were found in approximately 48% of cases. The genetic background of the remaining cases is unknown. Understanding the genetic basis of familial hyperinsulinism has changed the early look at the disease. It has allowed for the differentiation of specific types of the disease. Depending on which of the nine disease-associated loci bears a pathogenic mutation, they differ in phenotype and pattern of inheritance. This review provides a brief overview of the genetic mechanisms of HH and its possible clinical presentations. (Endokrynol Pol 2015; 66 (4): 344–354)    Hipogligemia hiperinsulinemiczna (HH) określana jest również terminem „nesidioblastoza”. Różnorodna kliniczna manifestacja choroby powoduje ryzyko późnej diagnozy, a nawet braku rozpoznania. U niemowląt i dzieci nesidioblastoza prowadzić może do ciężkich i trwałych uszkodzeń centralnego systemu nerwowego, manifestujących się w postaci niedorozwoju umysłowego. Hipogligemia hiperinsulinemiczna charakteryzuje się nieuregulowanym wydzielaniem insuliny przez komórki β trzustki. Efekt ten powiązany został z dziewięcioma genami: ABCC8, KCNJ11, GCK, GLUD-1, HADH1, SLC16A1, HNF4A, HNF1A i UCP2. Mutacje występujące w wymienionych genach znajdowane są u 48% chorych. Genetyczne podłoże pozostałych przypadków pozostaje nieznane. Zrozumienie genetycznej przyczyny rodzinnej postaci hiperisnulinizmu zmieniło sposób, w jaki postrzegano chorobę. Pozwoliło na wyróżnienie poszczególnych jej typów. W zależność od tego, w którym z dziewięciu zasocjowanych z chorobą loci występuje patogenna mutacja, typy różnią się fenotypem i sposobem dziedziczenia. Praca stanowi krótki przegląd genetycznych patomechanizmów choroby obserwowanych w HH oraz ich możliwych prezentacji klinicznych. (Endokrynol Pol 2015; 66 (4): 344–354)

Emerging stability of forest productivity by mixing two species buffers temperature destabilizing effect

The increasing disturbances in monocultures around the world are testimony to their instability under global change. Many studies have claimed that temporal stability of productivity increases with species richness, although the ecological fundamentals have mainly been investigated through diversity experiments. To adequately manage forest ecosystems, it is necessary to have a comprehensive understanding of the effect of mixing species on the temporal stability of productivity and the way in which it is influenced by climate conditions across large geographical areas. Here, we used a unique dataset of 261 stands combining pure and two-species mixtures of four relevant tree species over a wide range of climate conditions in Europe to examine the effect of species mixing on the level and temporal stability of productivity. Structural equation modelling was employed to further explore the direct and indirect influence of climate, overyielding, species asynchrony and additive effect (i.e. temporal stability expected from the species growth in monospecific stands) on temporal stability in mixed forests. We showed that by adding only one tree species to monocultures, the level (overyielding: +6%) and stability (temporal stability: +12%) of stand growth increased significantly. We identified the key effect of temperature on destabilizing stand growth, which may be mitigated by mixing species. We further confirmed asynchrony as the main driver of temporal stability in mixed stands, through both the additive effect and species interactions, which modify between-species asynchrony in mixtures in comparison to monocultures. Synthesis and applications. This study highlights the emergent properties associated with mixing two species, which result in resource efficient and temporally stable production systems. We reveal the negative impact of mean temperature on temporal stability of forest productivity and how the stabilizing effect of mixing two species can counterbalance this impact. The overyielding and temporal stability of growth addressed in this paper are essential for ecosystem services closely linked with the level and rhythm of forest growth. Our results underline that mixing two species can be a realistic and effective nature-based climate solution, which could contribute towards meeting EU climate target policies.Emerging stability of forest productivity by mixing two species buffers temperature destabilizing effectpublishedVersio

Emerging stability of forest productivity by mixing two species buffers temperature destabilizing effect

The increasing disturbances in monocultures around the world are testimony to their instability under global change. Many studies have claimed that temporal stability of productivity increases with species richness, although the ecological fundamentals have mainly been investigated through diversity experiments. To adequately manage forest ecosystems, it is necessary to have a comprehensive understanding of the effect of mixing species on the temporal stability of productivity and the way in which it is influenced by climate conditions across large geographical areas. Here, we used a unique dataset of 261 stands combining pure and two-species mixtures of four relevant tree species over a wide range of climate conditions in Europe to examine the effect of species mixing on the level and temporal stability of productivity. Structural equation modelling was employed to further explore the direct and indirect influence of climate, overyielding, species asynchrony and additive effect (i.e. temporal stability expected from the species growth in monospecific stands) on temporal stability in mixed forests. We showed that by adding only one tree species to monocultures, the level (overyielding: +6%) and stability (temporal stability: +12%) of stand growth increased significantly. We identified the key effect of temperature on destabilizing stand growth, which may be mitigated by mixing species. We further confirmed asynchrony as the main driver of temporal stability in mixed stands, through both the additive effect and species interactions, which modify between-species asynchrony in mixtures in comparison to monocultures. Synthesis and applications. This study highlights the emergent properties associated with mixing two species, which result in resource efficient and temporally stable production systems. We reveal the negative impact of mean temperature on temporal stability of forest productivity and how the stabilizing effect of mixing two species can counterbalance this impact. The overyielding and temporal stability of growth addressed in this paper are essential for ecosystem services closely linked with the level and rhythm of forest growth. Our results underline that mixing two species can be a realistic and effective nature-based climate solution, which could contribute towards meeting EU climate target policies

With increasing site quality asymmetric competition and mortality reduces Scots pine (Pinus sylvestris L.) stand structuring across Europe

Heterogeneity of structure can increase mechanical stability, stress resistance and resilience, biodiversity and many other functions and services of forest stands. That is why many silvicultural measures aim at enhancing structural diversity. However, the effectiveness and potential of structuring may depend on the site conditions. Here, we revealed how the stand structure is determined by site quality and results from site-dependent partitioning of growth and mortality among the trees. We based our study on 90 mature, even-aged, fully stocked monocultures of Scots pine (Pines sylvestris L.) sampled in 21 countries along a productivity gradient across Europe. A mini-simulation study further analyzed the site-dependency of the interplay between growth and mortality and the resulting stand structure. The overarching hypothesis was that the stand structure changes with site quality and results from the site-dependent asymmetry of competition and mortality.First, we show that Scots pine stands structure across Europe become more homogeneous with increasing site quality. The coefficient of variation and Gini coefficient of stem diameter and tree height continuously decreased, whereas Stand Density Index and stand basal area increased with site index.Second, we reveal a site-dependency of the growth distribution among the trees and the mortality. With increasing site index, the asymmetry of both competition and growth distribution increased and suggested, at first glance, an increase in stand heterogeneity. However, with increasing site index, mortality eliminates mainly small instead of all-sized trees, cancels the size variation and reduces the structural heterogeneity.Third, we modelled the site-dependent interplay between growth partitioning and mortality. By scenario runs for different site conditions, we can show how the site-dependent structure at the stand level emerges from the asymmetric competition and mortality at the tree level and how the interplay changes with increasing site quality across Europe.Our most interesting finding was that the growth partitioning became more asymmetric and structuring with increasing site quality, but that the mortality eliminated predominantly small trees, reduced their size variation and thus reversed the impact of site quality on the structure. Finally, the reverse effects of mode of growth partitioning and mortality on the stand structure resulted in the highest size variation on poor sites and decreased structural heterogeneity with increasing site quality. Since our results indicate where heterogeneous structures need silviculture interventions and where they emerge naturally, we conclude that these findings may improve system understanding and modelling and guide forest management aiming at structurally rich forests

Emerging stability of forest productivity by mixing two species buffers temperature destabilizing effect

The increasing disturbances in monocultures around the world are testimony to their instability under global change. Many studies have claimed that temporal stability of productivity increases with species richness, although the ecological fundamentals have mainly been investigated through diversity experiments. To adequately manage forest ecosystems, it is necessary to have a comprehensive understanding of the effect of mixing species on the temporal stability of productivity and the way in which it is influenced by climate conditions across large geographical areas. Here, we used a unique dataset of 261 stands combining pure and two-species mixtures of four relevant tree species over a wide range of climate conditions in Europe to examine the effect of species mixing on the level and temporal stability of productivity. Structural equation modelling was employed to further explore the direct and indirect influence of climate, overyielding, species asynchrony and additive effect (i.e. temporal stability expected from the species growth in monospecific stands) on temporal stability in mixed forests. We showed that by adding only one tree species to monocultures, the level (overyielding: +6%) and stability (temporal stability: +12%) of stand growth increased significantly. We identified the key effect of temperature on destabilizing stand growth, which may be mitigated by mixing species. We further confirmed asynchrony as the main driver of temporal stability in mixed stands, through both the additive effect and species interactions, which modify between-species asynchrony in mixtures in comparison to monocultures. Synthesis and applications. This study highlights the emergent properties associated with mixing two species, which result in resource efficient and temporally stable production systems. We reveal the negative impact of mean temperature on temporal stability of forest productivity and how the stabilizing effect of mixing two species can counterbalance this impact. The overyielding and temporal stability of growth addressed in this paper are essential for ecosystem services closely linked with the level and rhythm of forest growth. Our results underline that mixing two species can be a realistic and effective nature-based climate solution, which could contribute towards meeting EU climate target policies

Stand growth and structure of mixed-species and monospecific stands of Scots pine (Pinus sylvestris L.) and oak (Q. robur L., Quercus petraea (Matt.) Liebl.) analysed along a productivity gradient through Europe

19 Pág.Past failures of monocultures, caused by wind-throw or insect damages, and ongoing climate change currently strongly stimulate research into mixed-species stands. So far, the focus has mainly been on combinations of species with obvious complementary functional traits. However, for any generalization, a broad overview of the mixing reactions of functionally different tree species in different mixing proportions, patterns and under different site conditions is needed, including assemblages of species with rather similar demands on resources such as light. Here, we studied the growth of Scots pine and oak in mixed versus monospecific stands on 36 triplets located along a productivity gradient across Europe, reaching from Sweden to Spain and from France to Georgia. The set-up represents a wide variation in precipitation (456–1250 mm year−1), mean annual temperature (6.7–11.5 °C) and drought index by de Martonne (21–63 mm °C−1). Stand inventories and increment cores of trees stemming from 40- to 132-year-old, fully stocked stands on 0.04–0.94-ha-sized plots provided insight into how species mixing modifies stand growth and structure compared with neighbouring monospecific stands. On average, the standing stem volume was 436 and 360 m3 ha−1 in the monocultures of Scots pine and oak, respectively, and 418 m3 ha−1 in the mixed stands. The corresponding periodical annual volume increment amounted to 10.5 and 9.1 m3 ha−1 year−1 in the monocultures and 10.5 m3 ha−1 year−1 in the mixed stands. Scots pine showed a 10% larger quadratic mean diameter (p < 0.05), a 7% larger dominant diameter (p < 0.01) and a 9% higher growth of basal area and volume in mixed stands compared with neighbouring monocultures. For Scots pine, the productivity advantages of growing in mixture increased with site index (p < 0.01) and water supply (p < 0.01), while for oak they decreased with site index (p < 0.01). In total, the superior productivity of mixed stands compared to monocultures increased with water supply (p < 0.10). Based on 7843 measured crowns, we found that in mixture both species, but especially oak, had significantly wider crowns (p < 0.001) than in monocultures. On average, we found relatively small effects of species mixing on stand growth and structure. Scots pine benefiting on rich, and oak on poor sites, allows for a mixture that is productive and most likely climate resistant all along a wide ecological gradient. We discuss the potential of this mixture in view of climate change.The authors wish to thank the European Union for funding the project ?Mixed species forest management. Lowering risk, increasing resilience (REFORM)? (#2816ERA02S, PCIN2017-026) under the framework of Sumforest ERA-NET. All contributors thank their national funding institutions to establish, measure and analyse data from the triplets. The first author also thanks the Bayerische Staatsforsten (BaySF) for supporting the establishment of the plots and the Bavarian State Ministry for Nutrition, Agriculture, and Forestry for permanent support of the project W 07 ?Long-term experimental plots for forest growth and yield research? (#7831-22209-2013). The French site (FR-1) belongs to the OPTMix experimental site (https://optmix.irstea.fr), which is supported annually by Ecofor, Allenvi, and the French national research infrastructure ANAEE-F. Research on the Lithuanian triplets was made possible by the national funding institution Research Council of Lithuania (LMTLT), agreement No. S-SUMFOREST-17-1. Thanks are also due to Ulrich Kern for the graphical artwork. Finally, we thank two anonymous reviewers for their constructive criticism.Peer reviewe

Text area detection in handwritten documents scanned for further processing

In this paper we present an approach to text area detection using binary images, Constrained Run Length Algorithm and other noise reduction methods of removing the artefacts. Text processing includes various activities, most of which are related to preparing input data for further operations in the best possible way, that will not hinder the OCR algorithms. This is especially the case when handwritten manuscripts are considered, and even more so with very old documents. We present our methodology for text area detection problem, which is capable of removing most of irrelevant objects, including elements such as page edges, stains, folds etc. At the same time the presented method can handle multi-column texts or varying line thickness. The generated mask can accurately mark the actual text area, so that the output image can be easily used in further text processing steps