Use of Repeated Blood Pressure and Cholesterol Measurements to Improve Cardiovascular Disease Risk Prediction: An Individual-Participant-Data Meta-Analysis

The added value of incorporating information from repeated blood pressure and cholesterol measurements to predict cardiovascular disease (CVD) risk has not been rigorously assessed. We used data on 191,445 adults from the Emerging Risk Factors Collaboration (38 cohorts from 17 countries with data encompassing 1962-2014) with more than 1 million measurements of systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol. Over a median 12 years of follow-up, 21,170 CVD events occurred. Risk prediction models using cumulative mean values of repeated measurements and summary measures from longitudinal modeling of the repeated measurements were compared with models using measurements from a single time point. Risk discrimination (Cindex) and net reclassification were calculated, and changes in C-indices were meta-analyzed across studies. Compared with the single-time-point model, the cumulative means and longitudinal models increased the C-index by 0.0040 (95% confidence interval (CI): 0.0023, 0.0057) and 0.0023 (95% CI: 0.0005, 0.0042), respectively. Reclassification was also improved in both models; compared with the single-time-point model, overall net reclassification improvements were 0.0369 (95% CI: 0.0303, 0.0436) for the cumulative-means model and 0.0177 (95% CI: 0.0110, 0.0243) for the longitudinal model. In conclusion, incorporating repeated measurements of blood pressure and cholesterol into CVD risk prediction models slightly improves risk prediction

Lafcadio Hearn (Koizumi Yakumo) His life, work and Irish background

A lecture given by S. G. Ronan, former Irish Ambassador to Japan (1984-1989), at Trinity College Dublin on 10 May 1990Available from British Library Document Supply Centre-DSC:99/39577 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Best practice No 162 The histological reporting of melanoma

The incidence of malignant melanoma has increased steadily over the past 30 years and this type of malignancy is the leading cause of death from cutaneous malignant disease. Cutaneous malignancies, including melanoma, can be detected at a very early stage and a cure is possible with prompt detection and treatment. In recent years, and mainly because of increased awareness of the early detection of melanoma, histopathologists have been exposed more and more to melanocytic lesions. Therefore, it is essential that histopathologists are able to provide a report to the clinician that conveys relevant information in a concise and precise manner. This paper provides a set of guidelines aimed at helping histopathologists with the gross and microscopic description and diagnosis of malignant melanoma. Key Words: melanoma • histological reporting • diagnosi

Physics and technology of the Next Linear Collider: a report submitted to Snowmass '96

We present the current expectations for the design and physics program of an e+e- linear collider of center of mass energy 500 GeV -- 1 TeV. We review the experiments that would be carried out at this facility and demonstrate its key role in exploring physics beyond the Standard Model over the full range of theoretical possibilities. We then show the feasibility of constructing this machine, by reviewing the current status of linear collider technology and by presenting a precis of our `zeroth-order' design