5,691 research outputs found

    Reproducibility of arterial stiffness and wave reflections in chronic obstructive pulmonary disease: The contribution of lung hyperinflation and a comparison of techniques

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    SummarySignificant cardiovascular morbidity and mortality exists in chronic obstructive pulmonary disease (COPD). Arterial stiffness is raised in COPD and may be a mechanistic link. Non-invasive assessment of arterial stiffness has the potential to be a surrogate outcome measure, although no reproducibility data exists in COPD patients.Two studies (23 and 33 COPD patients) were undertaken to 1) assess the Vicorder reproducibility of carotid-femoral pulse wave velocity and Augmentation index in COPD; 2) compare it to SphygmoCor; and 3) assess the contribution of lung hyperinflation to measurement variability.There were excellent correlations and good agreement between repeat Vicorder measurements for carotid-femoral pulse wave velocity (r = 0.96 (p < 0.001); mean difference ±SD = −0.03 ± 0.36 m/s (p = 0.65); co-efficient of reproducibility = 4.02%; limits of agreement = −0.68–0.75 m/s). Augmentation index significantly correlated (r = 0.736 (p < 0.001); mean difference ±SD = 0.72 ± 4.86% (p = 0.48), however limits of agreement were only 10.42–9.02%, with co-efficient of reproducibility of 27.93%. Comparing devices, Vicorder values were lower but there was satisfactory agreement. There were no correlation between lung hyperinflation (as measured by residual volume percent predicted, total lung capacity percent predicted or the ratio of inspiratory capacity to residual volume) and variability of measurements in either study.In COPD, measurement of carotid-femoral pulse wave velocity is highly reproducible, not affected by lung hyperinflation and suitable as a surrogate endpoint in research studies. Day-to-day variation in augmentation index highlights the importance of such studies prior to the planning and undertaking of clinical COPD research

    Fast Ensemble Smoothing

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    Smoothing is essential to many oceanographic, meteorological and hydrological applications. The interval smoothing problem updates all desired states within a time interval using all available observations. The fixed-lag smoothing problem updates only a fixed number of states prior to the observation at current time. The fixed-lag smoothing problem is, in general, thought to be computationally faster than a fixed-interval smoother, and can be an appropriate approximation for long interval-smoothing problems. In this paper, we use an ensemble-based approach to fixed-interval and fixed-lag smoothing, and synthesize two algorithms. The first algorithm produces a linear time solution to the interval smoothing problem with a fixed factor, and the second one produces a fixed-lag solution that is independent of the lag length. Identical-twin experiments conducted with the Lorenz-95 model show that for lag lengths approximately equal to the error doubling time, or for long intervals the proposed methods can provide significant computational savings. These results suggest that ensemble methods yield both fixed-interval and fixed-lag smoothing solutions that cost little additional effort over filtering and model propagation, in the sense that in practical ensemble application the additional increment is a small fraction of either filtering or model propagation costs. We also show that fixed-interval smoothing can perform as fast as fixed-lag smoothing and may be advantageous when memory is not an issue

    Origin of interannual variability in global mean sea level

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    Author Posting. © National Academy of Sciences, 2020. This article is posted here by permission of National Academy of Sciences for personal use, not for redistribution. The definitive version was published in Proceedings of the National Academy of Sciences of the United States of America 117(25), (2020): 13983-13990, doi: 10.1073/pnas.1922190117.The two dominant drivers of the global mean sea level (GMSL) variability at interannual timescales are steric changes due to changes in ocean heat content and barystatic changes due to the exchange of water mass between land and ocean. With Gravity Recovery and Climate Experiment (GRACE) satellites and Argo profiling floats, it has been possible to measure the relative steric and barystatic contributions to GMSL since 2004. While efforts to “close the GMSL budget” with satellite altimetry and other observing systems have been largely successful with regards to trends, the short time period covered by these records prohibits a full understanding of the drivers of interannual to decadal variability in GMSL. One particular area of focus is the link between variations in the El Niño−Southern Oscillation (ENSO) and GMSL. Recent literature disagrees on the relative importance of steric and barystatic contributions to interannual to decadal variability in GMSL. Here, we use a multivariate data analysis technique to estimate variability in barystatic and steric contributions to GMSL back to 1982. These independent estimates explain most of the observed interannual variability in satellite altimeter-measured GMSL. Both processes, which are highly correlated with ENSO variations, contribute about equally to observed interannual GMSL variability. A theoretical scaling analysis corroborates the observational results. The improved understanding of the origins of interannual variability in GMSL has important implications for our understanding of long-term trends in sea level, the hydrological cycle, and the planet’s radiation imbalance.The research was carried out at JPL, California Institute of Technology, under a contract with NASA. This study was funded by NASA Grants NNX17AH35G (Ocean Surface Topography Science Team), 80NSSC17K0564, and 80NSSC17K0565 (NASA Sea Level Change Team). The efforts of J.T.F. in this work were also supported by NSF Award AGS-1419571, and by the Regional and Global Model Analysis component of the Earth and Environmental System Modeling Program of the US Department of Energy's Office of Biological & Environmental Research via National Science Foundation Grant IA 1844590. C.G.P. was supported by the J. Lamar Worzel Assistant Scientist Fund and the Penzance Endowed Fund in Support of Assistant Scientists at the Woods Hole Oceanographic Institution.2020-12-0

    Do topical repellents divert mosquitoes within a community? Health equity implications of topical repellents as a mosquito bite prevention tool.

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    OBJECTIVES: Repellents do not kill mosquitoes--they simply reduce human-vector contact. Thus it is possible that individuals who do not use repellents but dwell close to repellent users experience more bites than otherwise. The objective of this study was to measure if diversion occurs from households that use repellents to those that do not use repellents. METHODS: The study was performed in three Tanzanian villages using 15%-DEET and placebo lotions. All households were given LLINs. Three coverage scenarios were investigated: complete coverage (all households were given 15%-DEET), incomplete coverage (80% of households were given 15%-DEET and 20% placebo) and no coverage (all households were given placebo). A crossover study design was used and coverage scenarios were rotated weekly over a period of ten weeks. The placebo lotion was randomly allocated to households in the incomplete coverage scenario. The level of compliance was reported to be close to 100%. Mosquito densities were measured through aspiration of resting mosquitoes. Data were analysed using negative binomial regression models. FINDINGS: Repellent-users had consistently fewer mosquitoes in their dwellings. In villages where everybody had been given 15%-DEET, resting mosquito densities were fewer than half that of households in the no coverage scenario (Incidence Rate Ratio [IRR]=0.39 (95% confidence interval [CI]: 0.25-0.60); p<0.001). Placebo-users living in a village where 80% of the households used 15%-DEET were likely to have over four-times more mosquitoes (IRR=4.17; 95% CI: 3.08-5.65; p<0.001) resting in their dwellings in comparison to households in a village where nobody uses repellent. CONCLUSIONS: There is evidence that high coverage of repellent use could significantly reduce man-vector contact but with incomplete coverage evidence suggests that mosquitoes are diverted from households that use repellent to those that do not. Therefore, if repellents are to be considered for vector control, strategies to maximise coverage are required

    Understanding Prediabetes Through Facebook: Pilot Study Protocol and Lessons Learned

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    Purpose/Background: Type 2 Diabetes is a serious contributor to mortality and morbidity. Rural populations (including those in Mountain West regions) exhibit greater health disparities than their urban counterparts for many conditions, including diabetes. It is therefore vital to address this important health issue, especially among rural populations. One way to address diabetes is with prevention, starting with enhanced detection of prediabetes. According to the CDC, more than 84 millions Americans (one in three adults) has prediabetes, but nine out of ten are not aware of their condition, which hampers prevention efforts. Infodemiology has been used successfully to track health information found on social media. Our project aims to find indicators of prediabetes through Facebook content, with a long-term goal of developing an effective social media screening tool for prediabetes. Materials & Methods: This study had an exploratory retrospective design (the study protocol has been published; Xu, Litchman, Geeet al., 2018 JMIR Research Protocols). Utilizing electronic medical records from a Mountain West region family medicine clinic, we recruited 17 patients diagnosed with prediabetes who were willing to share their Facebook posts. Participants completed a clinic session where they responded to a number of surveys (e.g., Facebook Intensity Scale, Prediabetes Online Community Engagement Scale, Computer-Mediated Social Support Scale) and provided us with their Facebook account information. We then accessed and coded all Facebook posts for the 6-month period surrounding their prediabetes diagnosis (3-months pre through 3-months post-diagnosis; see Figure 1). Coding included meta-data (e.g., time of post, post type), post text/visuals, social aspects of the post (e.g., comments, reactions, shares), and content of interest (e.g., health, physical symptoms, lifestyle factors, medical experiences, food etc.). Results: Descriptive information about participant demographics and their responses to surveys are provided (see Table 1). We are currently compiling the coded data and will use a mixed-method protocol for analyses. This includes both qualitative content analysis to identify themes as well as a quantitative approach to examine potential differences between the 3-months prediagnosis and the 3-months postdiagnosis for our participants. While we were able to code data for 17 patients, due to unanticipated barriers in recruitment and coding we did not meet our planned goal of 20 patients. To assist those planning on conducting this type of social media research, we will discuss some of these issues including the importance of having a large team of coders who can work simultaneously. Discussion/Conclusion: Data from this project should provide an initial taxonomy of prediabetes indicators indentifiable within a social media context. Future studies, with larger samples, can test the utility of the taxonomy on predicting prediabetes status from Facebook posts. We also hope that our lessons learned information will be helpful to other researchers working on social media health studies. The ultimate goal of our research is to develop an automated method to identify social media users who are likely to have prediabetes. This would be especially helpful for those who are unaware of their health condition, as identification can lead to efforts that can prevent the progression of prediabetes to diabetes

    Metabolic profiling of follistatin overexpression: a novel therapeutic strategy for metabolic diseases.

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    Background: Follistatin (Fst) promotes brown adipocyte characteristics in adipose tissues. Methods: Abdominal fat volume (CT scan), glucose clearance (GTT test), and metabolomics analysis (mass spectrometry) of adipose tissues from Fst transgenic (Fst-Tg) and wild type (WT) control mice were analyzed. Oxygen consumption (Seahorse Analyzer) and lipidomics (gas chromatography) was analyzed in 3T3-L1 cells. Results: Fst-Tg mice show significant decrease in abdominal fat content, increased glucose clearance, improved plasma lipid profiles and significant changes in several conventional metabolites compared to the WT mice. Furthermore, overexpression of Fst in 3T3-L1 cells resulted in up regulation of key brown/beige markers and changes in lipidomics profiles. Conclusion: Fst modulates key factors involved in promoting metabolic syndrome and could be used for therapeutic intervention. Diabetes Metab Syndr Obes 2018 Mar 26; 11:65-84
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