On Quantifying Qualitative Geospatial Data: A Probabilistic Approach

Living in the era of data deluge, we have witnessed a web content explosion, largely due to the massive availability of User-Generated Content (UGC). In this work, we specifically consider the problem of geospatial information extraction and representation, where one can exploit diverse sources of information (such as image and audio data, text data, etc), going beyond traditional volunteered geographic information. Our ambition is to include available narrative information in an effort to better explain geospatial relationships: with spatial reasoning being a basic form of human cognition, narratives expressing such experiences typically contain qualitative spatial data, i.e., spatial objects and spatial relationships. To this end, we formulate a quantitative approach for the representation of qualitative spatial relations extracted from UGC in the form of texts. The proposed method quantifies such relations based on multiple text observations. Such observations provide distance and orientation features which are utilized by a greedy Expectation Maximization-based (EM) algorithm to infer a probability distribution over predefined spatial relationships; the latter represent the quantified relationships under user-defined probabilistic assumptions. We evaluate the applicability and quality of the proposed approach using real UGC data originating from an actual travel blog text corpus. To verify the quality of the result, we generate grid-based maps visualizing the spatial extent of the various relations

Dyslipidemia: Treatment in Statin – Intolerant Patients

Statins are the mainstay of lipid-lowering therapy because of their well-established efficacy for reducing cardiovascular disease mortality and morbidity in various high risk populations. However, certain patients cannot avail themselves of these beneficial effects due to intolerance in these agents. Statin-induced myopathy is by far the most common side-effect. A less common side-effect of statin therapy is hepatic toxicity. Intolerance to statins is frequently encountered in clinical practice, mostly due to muscular symptoms and/or elevation of hepatic aminotransferases, which overall constitutes approximately two-thirds of reported adverse events during statin therapy. The first step in handling intolerant patients is to rule out any secondary causes of myopathy or liver toxicity. The second step is to determine whether the adverse effects are indeed related to statin therapy by statin dechallenge and rechallenge. Another option is to restart with the same statin at a lower dosage or to switch to another statin with defferent pathways of metabolism. If the symptoms are recurrent, different approaches should be considered, such as unconventional dosing (every other-day or weekly administration) of statins with longer half-life. Another option in patients who cannot tolerate statins is the use of non-lipid lowering drugs, such as ezetimibe, bile acids sequestrants (colesevelam) and fibrates, alone or in combination. Concerning low-risk individuals the use of herbal supplements effective in reducing LDL cholesterol may be considered

Novel Hypolipidemic Agents: the Role of PCSK9 Inhibitors

Hyperlipidemia is a major cause of cardiovascular disease despite the availability of first-line cholesterol lowering agents such as statins. Although statin therapy is very efficient to reduce cholesterol, nearly 10-20% of individuals on statins, experience side effects, such myopathy, which hinder the drugs ability to achieve target low-density lipoprotein (LDL) cholesterol (LDL-C) levels. Statin-intolerant patients require more effective therapies for lowering LDL-C. As proprotein convertase subtilisin kexin type 9 (PCSK9) promotes the degradation of the LDL receptor (LDLR) and prevents it from recycling to the membrane, a new therapeutic approach to lowering LDL-C acts by blocking LDL-receptor degradation by serum PCSK9. Humanized monoclonal antibodies which target PCSK9 and its interaction with the LDL receptor (REGN727/SAR23653, AMG145, and RN316), as well as agents that inhibit PCSK9 synthesis, such as ALN-PCS, are now in clinical trials. The latter is a small interfering RNA (siRNA) that directs sequence-specific messenger RNA for PCSK9 leading to reduced hepatocyte-specific synthesis of PCSK9. Ongoing phase III trials’ results are awaited with great interest in order to define these agents’ long-term safety, tolerability and efficacy for reducing cardiovascular events

Five-year incidence of type 2 diabetes mellitus among cardiovascular disease-free Greek adults: Findings from the ATTICA study

Demosthenes B Panagiotakos1, Christos Pitsavos2, Yannis Skoumas2, Yannis Lentzas2, Christodoulos Stefanadis21Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece; 2First Cardiology Clinic, School of Medicine, University of Athens, Athens, GreeceObjective: We evaluated the 5-year incidence of diabetes in an adult population from Greece.Research design and methods: 3042 individuals (>18 years), free of cardiovascular disease, participated in the baseline examination (during 2001–2002). Of this sample, 1012 men and 1035 women were found alive at the time of follow-up, while 32 (2.1%) men and 22 (1.4%) women died during this period. The rest were lost to follow-up. Incidence of type 2 diabetes mellitus was evaluated in 1806 participants who did not have diabetes at baseline.Results: The age-adjusted 5-year incidence of diabetes was 5.5% (men, 5.8%; women, 5.2%). A linear trend was observed between diabetes incidence and age (5.6% increases in incidence per 1-year difference in age, p < 0.001). Multiple logistic regression analysis revealed that age (OR per 1 yr = 1.04, 95% CI 1.02–1.06), waist (OR per 1 cm = 1.02, 95% CI 1.01–1.003), physical activity (OR = 0.62, 95% CI 0.35–1.02) and family history of diabetes (OR = 2.65, 95% CI 1.58–4.53), as well as fasting glucose levels (OR per 1 mg/dl = 1.05, 95% CI 1.03–1.07), were the most significant baseline predictors for diabetes, after adjusting for various potential confounders. Additionally, presence of metabolic syndrome at baseline evaluation 2.95-fold the risk of diabetes (95% CI 1.89–4.61), and showed better classification ability than the model that contained the components of the syndrome (ie, correct classification rate: 94.5% vs. 92.3%).Conclusion: Our findings show that a 5.5% incidence rate of diabetes within a 5-year period, which suggests that the prevalence of this disorder in Greece is rising. Aging, heredity, and metabolic syndrome were the most significant determinants of diabetes.Keywords: diabetes, incidence, metabolic syndrom

Long-term prognostic value of LDL-C, HDL-C, lp(a) and TG levels on cardiovascular disease incidence, by body weight status, dietary habits and lipid-lowering treatment:the ATTICA epidemiological cohort study (2002–2012)

BACKGROUND: The link between blood lipids and cardiovascular disease (CVD) is complex. Our aim was to assess the differential effect of blood lipids on CVD risk according to age, sex, body weight, diet quality, use of lipid-lowering drugs and presence of hypercholesterolemia. METHODS: In this secondary analysis of the ATTICA prospective cohort study, serum blood lipids, i.e., total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and liproprotein(a) [Lp(a)], and sociodemographic, anthropometric, lifestyle and clinical parameters were evaluated at baseline (2001/2002) in 2020 CVD-free men and women. CVD incidence was recorded at the 10-year follow-up (2011/2012). RESULTS: All blood lipids assessed were univariately related to CVD risk; however, associations remained significant only for HDL-C and TG in multivariate models adjusted for age, sex, body mass index, smoking, Mediterranean Diet Score, physical activity, presence of hypercholesterolemia, hypertension and diabetes mellitus, use of lipid-lowering drugs, and family history of CVD [RR per 1 mg/dL (95% CI): 0.983 (0.967, 1.000) and 1.002 (1.001, 1.003), respectively]. In stratified analyses, TC and LDL-C predicted CVD risk in younger subjects, normal-weight subjects, and those not on lipid-lowering drugs, while HDL-C and TG were significant predictors in older subjects, those with low adherence to the Mediterranean diet, and hypercholesterolemic subjects; a significant effect on CVD risk was also observed for TG in males, overweight participants and lipid-lowering medication users and for Lp(a) in older subjects and females (all p ≤ 0.050). CONCLUSIONS: The impact of blood lipids on CVD risk differs according to several biological, lifestyle and clinical parameters

Adherence to the Mediterranean diet moderates the association of aminotransferases with the prevalence of the metabolic syndrome; the ATTICA study

<p>Abstract</p> <p>Background</p> <p>Elevated liver enzymes are markers of liver steatosis and metabolic syndrome. We aimed to investigate the association of Mediterranean diet on the relationship between aminotransferases (i.e., AST, ALT, gGT) and the metabolic syndrome.</p> <p>Methods</p> <p>The ATTICA study has randomly enrolled 1514 adult males (18–87 yrs) and 1528 females (18–89 yrs) from the greater area of Athens. Adherence to Mediterranean diet was assessed through the MedDietScore. According to NCEP III criteria, participants were classified into those with or without the metabolic syndrome.</p> <p>Results</p> <p>Women with metabolic syndrome had higher γGT (p = 0.02) and lower AST/ALT levels (p = 0.018) than those without, and men with metabolic had a lower AST/ALT ratio (p = 0.01) compared to those without metabolic syndrome. The AST/ALT ratio was also positively correlated with MedDietScore (rho = 0.17, <it>p </it>< 0.001), while higher MedDietScore was associated with lower likelihood of having the metabolic syndrome in a multi-adjusted analysis (OR = 0.34, 95% CI: 0.16–0.73). Stratified analysis by the level of adherence to the Mediterranean diet, revealed that only in subjects away or with moderate adherence to the Mediterranean diet, an increase in the AST/ALT ratio was associated with lower likelihood of having the metabolic syndrome (OR = 0.33, <it>p </it>< 0.05 and OR = 0.34, <it>p </it>< 0.09, respectively); however, when we focused in those with greater adherence to the Mediterranean diet, AST/ALT ratio was not associated with the presence of the syndrome (OR = 0.51, <it>p </it>= 0.55). These findings remained similar in both genders, and even when the quantity of alcohol drinking was taken into account.</p> <p>Conclusion</p> <p>Aminotransferases ratio constitutes a marker of the metabolic syndrome among healthy adults; however, this relationship is moderated when individuals are close to the Mediterranean dietary pattern.</p

Abdominal obesity, blood glucose and apolipoprotein B levels are the best predictors of the incidence of hypercholesterolemia (2001–2006) among healthy adults: the ATTICA Study

<p>Abstract</p> <p>Objective</p> <p>In this work we evaluated the 5-year incidence of hypercholesterolemia, in a sample of cardiovascular disease free adult men and women from Greece. We also evaluated the association of several socio-demographic, dietary and lifestyle habits on the incidence of this disorder.</p> <p>Methods</p> <p>1514 men and 1528 women (>18 y) without any clinical evidence of cardiovascular disease, living in Attica area, Greece, were enrolled in the ATTICA study from May 2001 to December 2002. The sampling was random, multi-stage, and included information about various socio-demographic, lifestyle (diet, exercise, smoking etc), biological (lipids, and inflammatory markers), and clinical characteristics of the participants. In 2006, a group of experts performed the 5-year follow-up through telephone calls or personal visits (941 of the 3042 (31%) participants were lost to follow-up). Hypercholesterolemia, among people who had normal blood lipids at initial examination, was defined as fasting total cholesterol levels > 200 mg/dl or use of lipids lowering agents (NCEP ATPIII).</p> <p>Results</p> <p>The 5-year incidence of hypercholesterolemia was 23.7% (n = 127) in men and 17.7% (n = 110) in women (p for gender differences < 0.001). Multi-adjusted logistic regression analysis which revealed that increased age (odds ratio = 1.05, p < 0.001), waist circumference (odds ratio = 1.02, p = 0.03), fasting blood glucose (odds ratio = 1.01, p = 0.08) and apolipoprotein B (odds ratio = 1.02, p = 0.001) levels, were the most significant baseline predictors of developing hypercholesterolemia within a 5-year period.</p> <p>Conclusion</p> <p>Incidence of hypercholesterolemia was high in both genders, emphasizing the burden of this disorder at population level. Aging, increased waist circumference, fasting blood glucose and apolipoprotein B levels were the most significant baseline predictors of hypercholesterolemia.</p