The Effect of Reproductive Factors on Coronary Artery Disease in Women

Abstract Introduction: There is a sex discrepancy in cardiovascular physiology. In this study, we aimed to investigate the effect of female reproductive factors on coronary artery disease (CAD) beyond the known CAD risk factors. Methods: In a case-control study, women referred to Tehran Heart Center for coronary artery angiography from 2012 to 2014 were enrolled. Of these, 80 premenopausal and 100 postmenopausal females with CAD in angiography were randomly selected as cases and 80 premenopausal and 100 postmenopausal females without CAD in angiography were selected as controls. A questionnaire including reproductive history and known CAD risk factors was filled for every subject. Analysis was performed separately for pre and postmenopausal women and a final adjustment for coronary artery disease risk factors was done. Results: Among reproductive factors, oligomenorrhea (OR= 6.72) was a significant risk factor for CAD in premenopausal women and history of oral contraceptive (OCP) use had a protective effect on CAD in pre and postmenopausal woman (OR= 0.24 and 0.20, respectively). Conclusions: Since oligomenorrhea has a strong association with insulin resistance and diabetes, a conventional risk factor of CAD, women with oligomenorrhea should be treated not only for cyclic irregularity but also for prevention of CAD

Assessing the adherence to the current guidelines in the management of syncope patients

  Background: There exist gaps in the implementation of guideline-recommended treatments and interventions to manage syncope. The present study aimed to investigate the adherence to the current guideline for the diagnosis and management of syncope patients referred to a tertiary center.  Methods: A cross-sectional study was carried out with the study group consisting of 324 consecutive patients, who were diagnosed with unexplained syncope with one or more attacks and were referred for head-up tilt table test (HUTT) between September 2009 and September 2011 to Tehran Heart Center. All the patients underwent a thorough evaluation, including a careful medical history and physical examination as well as a thorough history of all procedures performed before referral. The data collected was compared between patients with positive and negative HUTT results and also based on the referring physician, in order to assess the deviation from syncope guideline in their management. We compared the selected groups using a chi-square test for categorical variables and student t-test or analysis of variance (ANOVA) for continuous variables where appropriate.   Results: A total of 324 patients with a Mean (SD) age of 41.04 (17.74) years were enrolled in the study (158 patients, i.e. 48.8%, were male). HUTT was positive in 181 (55.8%) patients. Brain computed tomography scan and coronary angiography were performed more in the initial assessment of the patients with a negative HUTT compared with patients with negative HUTT (P=0.001 and P=0.01, respectively). Significantly higher rates of brain MRI (P=0.01), brain imaging (P=0.03), and electroencephalography (P=0.002) were observed among the neurologists' referrals while echocardiography (P<0.001), exercise tolerance test (P=0.001), electrocardiogram Holter monitoring (P<0.001), and coronary angiography (P=0.02) were significantly more performed in patients referred by a cardiologist.   Conclusion: We observed a noticeable deviation from the current guideline for the management of syncope although the patients underwent expensive tests with little benefit

Valiant\u27s Universal Circuit: Improvements, Implementation, and Applications

A Universal Circuit (UC) is a circuit that can simulate any circuit of a maximum size, given its description as input. In this work, we look back at Valiant\u27s universal circuit construction from Valiant (STOC 1976). Although it yields asymptotically optimal UC, and has implications for important problems in cryptography such as \u27\u27private function evaluation\u27\u27 (PFE) and \u27\u27cryptographic program obfuscation\u27\u27, somewhat surprisingly, no implementations of the construction exist. We provide a more approachable description, improve its constant factors, and put forth the first complete implementation. We observe that our improved implementation of Valiant\u27s UC performs better than estimated and in fact, is almost always smaller than UC construction of Kolesnikov and Schneider (FC 2008). The UC circuits generated by our implementation can be used for benchmarking MPC protocols, and provide a point of comparison for any future PFE. We also observe, for the first time, that the same construction can be adapted to yield size optimized \emph{universal arithmetic circuit} (UAC)

Orphan GPR26 Counteracts Early Phases of Hyperglycemia-Mediated Monocyte Activation and Is Suppressed in Diabetic Patients

Diabetes is the ninth leading cause of death, with an estimated 1.5 million deaths worldwide. Type 2 diabetes (T2D) results from the body's ineffective use of insulin and is largely the result of excess body weight and physical inactivity. T2D increases the risk of cardiovascular diseases, retinopathy, and kidney failure by two-to three-fold. Hyperglycemia, as a hallmark of diabetes, acts as a potent stimulator of inflammatory condition by activating endothelial cells and by dysregulating monocyte activation. G-protein couple receptors (GPCRs) can both exacerbate and promote inflammatory resolution. Genome-wide association studies (GWAS) indicate that GPCRs are differentially regulated in inflammatory and vessel cells from diabetic patients. However, most of these GPCRs are orphan receptors, for which the mechanism of action in diabetes is unknown. Our data indicated that orphan GPCR26 is downregulated in the PBMC isolated from T2D patients. In contrast, GPR26 was initially upregulated in human monocytes and PBMC treated with high glucose (HG) levels and then decreased upon chronic and prolonged HG exposure. GPR26 levels were decreased in T2D patients treated with insulin compared to non-insulin treated patients. Moreover, GPR26 inversely correlated with the BMI and the HbA1c of diabetic compared to non-diabetic patients. Knockdown of GPR26 enhanced monocyte ROS production, MAPK signaling, pro-inflammatory activation, monocyte adhesion to ECs, and enhanced the activity of Caspase 3, a pro-apoptotic molecule. The same mechanisms were activated by HG and exacerbated when GPR26 was knocked down. Hence, our data indicated that GPR26 is initially activated to protect monocytes from HG and is inhibited under chronic hyperglycemic conditions

Effect of opium on glucose metabolism and lipid profiles in rats with streptozotocin-induced diabetes

Wstęp: To eksperymentalne badanie przeprowadzono w celu określenia wpływu stosowania opium na profil lipidowy i metabolizm glukozy u szczurów z cukrzycą wywołaną podaniem streptozotocyny. Materiał i metody: Aby ocenić wpływ opium, 20 samców podzielono na dwie grupy: kontrolną (n = 10) i otrzymującą opium (n = 10). Po wywołaniu cukrzycy przez 35 dni codziennie mierzono stężenie glukozy we krwi zwierząt. Profil lipidowy i odsetek hemoglobiny A1c (HbA1c) określono na poczatku badania (przed wywołaniem cukrzycy) i w 35. dniu obserwacji. Wyniki: Poziom glikemii u szczurów, którym podawano opium i w grupie kontrolnej był podobny (544,8 ± 62,2 mg/dl v. 524,6 ± 50,0 mg/dl, P = 0,434). Ponadto, nie stwierdzono różnic między grupą leczoną i kontrolną w zakresie wartości HbA1c (6,5 ± 0,5% v. 6,6 ± 0,2%, P = 0,714). Również stężenia cholesterolu całkowitego, cholesterolu frakcji HDL, triglicerydów i lipoproteiny (a) były podobne w obu grupach. Wnioski: Stosowanie opium nie ma istotnego wpływu na metabolizm glukozy i profil lipidowy u szczurów z eksperymentalnie wywołaną cukrzycą.Background: This experimental study was performed to determine the impact of opium use on serum lipid profile and glucose metabolism in rats with streptozotocin-induced diabetes. Material and methods: To determine the effect of opium, 20 male rats were divided into control (n = 10) and opium-treated (n = 10) groups. After diabetes induction, the animals were investigated for daily glucose measurements for 35 days. Serum lipid profile and haemoglobin A1c (HbA1c) were assayed at the baseline (before induction of diabetes) and at 35-day follow-up. Results: The glycaemia levels in the rats treated with opium were similar to the levels measured in the control rats (544.8 ± 62.2 mg/dl v. 524.6 ± 50.0 mg/dl, P = 0.434). In addition, there was no difference between the opium-treated rats and control rats in HbA1c (6.5 ± 0.5% v. 6.6 ± 0.2%, P = 0.714). Compared to the control rats, the serum total cholesterol, high density lipoprotein (HDL), triglyceride and lipoprotein (a) in the test animals were similar. Conclusion: Opium use has no significant effect on glucose metabolism and serum lipid profile in rats with induced diabetes

An Efficient Protocol for Oblivious DFA Evaluation and Applications

In this paper, we design an efficient protocol for \emph{oblivious DFA evaluation} between an input holder (client) and a DFA holder (server). The protocol runs in a single round, and only requires a small amount of computation by each party. The most efficient version of our protocol only requires $O(k)$ asymmetric operations by either party, where $k$ is the security parameter. Moreover, the client\u27s total computation is only linear in his own input and independent of the size of the DFA. We prove the protocol fully-secure against a \emph{malicious client} and \emph{private} against a malicious server, using the standard \emph{simulation-based} security definitions for secure two-party computation. We show how to transform our construction in order to solve multiple variants of the \emph{secure pattern matching} problem without any computational overhead. The more challenging variant is when parties want to compute the number of occurrences of a pattern in a text (but nothing else). We observe that, for this variant, we need a protocol for counting the number of accepting states visited during the evaluation of a DFA on an input. We then introduce a novel modification to our original protocol in order to solve the counting variant, without any loss in efficiency or security. Finally, we fully implement our protocol and run a series of experiments on a client/server network environment. Our experimental results demonstrate the efficiency of our proposed protocol and, confirm the particularly low computation overhead of the client

Family history of cardiovascular disease as a risk factor for coronary artery disease in adult offspring

Background and aims: There is controversy about the role of positive family history as an independent risk factor for coronary artery disease. The aim of this work was to investigate the influence of family history on presentation of coronary artery disease in adult offspring, and on its severity. Methods: In a retrospective cross-sectional study at Tehran Heart Center (University of Tehran Medical Sciences), 6399 patients with established coronary artery disease who underwent coronary angiography for standard indications were assessed. Coronary artery disease was defined as atherosclerotic involvement of more than 50% in at least one major coronary artery. Results: 953 patients (14.9%) had a verified positive family history of coronary artery disease, of whom 193 patients (20.2%) and 215 patients (22.5%) had paternal and maternal positive history, respectively. The mean age of clinical onset of ischemic heart disease in patients with a positive history was significantly lower than patients with no history (p < 0.001). Left main coronary lesion was significantly more frequent in patients with positive history (p = 0.017). Multivariate logistic regression analysis demonstrated that presentation of coronary artery disease in the form of acute coronary syndrome was significantly more prevalent in the background of positive family history (odds ratio, OR = 1.44, 95% confidence interval, CI: 1.14-1.83, p = 0.002), especially above 45 years old. Conclusion: These findings indicate that positive family history is a major risk factor for coronary artery disease which strongly predisposes to the atherosclerotic process at younger ages; therefore, these patients should be evaluated and managed more intensively for other risk factors

Private Set Operations from Oblivious Switching

Private set intersection reveals the intersection of two private sets, but many real-world applications require the parties to learn $\textit{only}$ partial information about the intersection. In this paper we introduce a new approach for computing arbitrary functions of the intersection, provided that it is safe to also reveal the cardinality of the intersection. In the most general case, our new protocol provides the participants with secret shares of the intersection, which can be fed into any generic 2PC protocol. Certain computations on the intersection can also be done even more directly and efficiently, avoiding this secret-sharing step. These cases include computing only the cardinality of intersection, or the ``cardinality-sum\u27\u27 application proposed in Ion et al. (ePrint 2017). Compared to the state-of-the-art protocol for computing on intersection (Pinkas et al., Eurocrypt 2019), our protocol has about $2.5-3\times$ less communication, and has faster running time on slower (50Mbps) networks. Our new techniques can also be used to privately compute the {\em union} of two sets as easily as computing the intersection. Our protocol concretely improves the leading private set union protocol (Kolesnikov et al., Asiacrypt 2020) by a factor of $2-2.5\times$, depending on the network speed. We then show how private set union can be used in a simple way to realize the ``Private-ID\u27\u27 functionality suggested by Buddhavarapu et al.~(ePrint 2020). Our protocol is significantly faster than the prior Private-ID protocol, especially on fast networks. All of our protocols are in the two-party setting and are secure against semi-honest adversaries

Prevalence, Awareness, Treatment, and Control of Hypertension among Adult Residents of Tehran: The Tehran Cohort Study.

Background High levels of blood pressure (BP) remain undetected and poorly controlled in large segments of the population leading to an enormous burden in terms of disease and mortality. Objective We aimed to assess the prevalence, awareness, treatment, and control of hypertension in Tehran. Methods We used the data of 8,296 adults aged ≥35 years from the Tehran Cohort Study who were enrolled between May 2016 and February 2019. Hypertension was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg, self-report, and/or current antihypertensive medication use. The age- and sex-weighted prevalence of hypertension and high normal BP was calculated using the 2016 national census. Furthermore, awareness, treatment, and control of hypertension were analyzed. Results The mean age of the participants was 53.8 ±12.75 years, and 54.0% were women. The weighted prevalence of hypertension and high normal BP were 36.5% and 12.2%, respectively. Among hypertensive individuals, 68.2% were aware of hypertension, 53.3% were receiving medication, and 40.4% had adequate BP control. The awareness, treatment, and control of hypertension were significantly higher in women (72.2% vs. 63.4% [P < 0.001], 55.1% vs 51.1% [P = 0.020], and 42.7% vs. 37.7% [P = 0.004], respectively) and this gap considerably increased with advancing age. Hypertension was more prevalent in northern Tehran but with a better treatment rate and control in the same regions. Conclusion Despite the high prevalence of hypertension in the adult population of Tehran, the rates of awareness, treatment, and control of hypertension are unsatisfactory and demand comprehensive strategies to improve this situation, especially in younger men

Prevalence, awareness, treatment, and control of type 2 diabetes mellitus among the adult residents of tehran: Tehran Cohort Study.

BACKGROUND The prevalence of type 2 diabetes mellitus has increased in the past decades. We investigated the prevalence of diabetes and its awareness, treatment, and control among adult residents of Tehran. METHODS We used the recruitment phase data of the Tehran Cohort study, enrolling a random sample of adult residents of Tehran aged ≥35 years. Diabetes was defined as self-report, current use of glucose-lowering medications, and/or fasting plasma glucose (FPG) ≥126mg/dl. Impaired fasting glucose (IFG) was defined as an FPG of 100-125mg/dl. Awareness was defined as diabetes self-report, treatment as receiving glucose-lowering medications, and glycemic control as FPG <126mg/dl. The age- and sex-weighted estimates were calculated using the 2016 national census. Logistic regression models were used to determine the factors associated with diabetes awareness, treatment, and control. RESULTS A total of 8151 participants were included. Age- and sex-weighted prevalence of diabetes mellitus and IFG were 16.7% (95% CI: 15.1-18.4) and 25.1% (95% CI: 23.1-27.1), respectively. Diabetes was more prevalent in the eastern and central districts of Tehran. Advanced age (OR per 1-year increase: 1.026, 95% CI: 1.021-1.030), male sex (OR: 1.716, 95% CI: 1.543-1.909), higher BMI levels (OR for BMI ≥35 vs. <20 kg/m2: 4.852, 95% CI: 3.365-6.998), pre-existing hypertension (OR: 1.552, 95% CI: 1.378-1.747), dyslipidemia (OR: 1.692, 95% CI: 1.521-1.883), and chronic kidney disease (OR: 1.650, 95% CI: 1.019-2.673) were associated with an increased odds of diabetes mellitus. On the contrary, diabetes mellitus was less likely in current tobacco (OR: 0.872, 95% CI: 0.765-0.994) and alcohol users (OR: 0.836, 95% CI: 0.703-0.994) compared to non-users. Among diabetic individuals, 82.8% were aware of their condition, 71.9% received treatment, and 31.7% of treated patients had adequate glycemic control. Advanced age and pre-existing comorbidities, including hypertension and dyslipidemia, were associated with higher diabetes awareness and treatment. Furthermore, advanced age, higher levels of education, and female sex were determinants of better glycemic control among treated diabetic participants. CONCLUSION There is a high prevalence of diabetes and IFG among adult residents of Tehran. Additionally, more than two-thirds of treated diabetics living in Tehran remain uncontrolled