Addition of 24‐hour heart rate variability parameters to the Cardiovascular Health Study stroke risk score and prediction of incident stroke: The Cardiovascular Health Study

Background Heart rate variability (HRV) characterizes cardiac autonomic functioning. The association of HRV with stroke is uncertain. We examined whether 24‐hour HRV added predictive value to the Cardiovascular Health Study clinical stroke risk score (CHS‐SCORE), previously developed at the baseline examination. Methods and Results N=884 stroke‐free CHS participants (age 75.3±4.6), with 24‐hour Holters adequate for HRV analysis at the 1994–1995 examination, had 68 strokes over ≤8 year follow‐up (median 7.3 [interquartile range 7.1–7.6] years). The value of adding HRV to the CHS‐SCORE was assessed with stepwise Cox regression analysis. The CHS‐SCORE predicted incident stroke (HR=1.06 per unit increment, P=0.005). Two HRV parameters, decreased coefficient of variance of NN intervals (CV%, P=0.031) and decreased power law slope (SLOPE, P=0.033) also entered the model, but these did not significantly improve the c‐statistic (P=0.47). In a secondary analysis, dichotomization of CV% (LOWCV% ≤12.8%) was found to maximally stratify higher‐risk participants after adjustment for CHS‐SCORE. Similarly, dichotomizing SLOPE (LOWSLOPE <−1.4) maximally stratified higher‐risk participants. When these HRV categories were combined (eg, HIGHCV% with HIGHSLOPE), the c‐statistic for the model with the CHS‐SCORE and combined HRV categories was 0.68, significantly higher than 0.61 for the CHS‐SCORE alone (P=0.02). Conclusions In this sample of older adults, 2 HRV parameters, CV% and power law slope, emerged as significantly associated with incident stroke when added to a validated clinical risk score. After each parameter was dichotomized based on its optimal cut point in this sample, their composite significantly improved prediction of incident stroke during ≤8‐year follow‐up. These findings will require validation in separate, larger cohorts. Keywords: autonomic nervous system, clinical stroke risk model, heart rate variability, prediction, predictors, risk prediction, risk stratification, strok

"More is Less": The Tax Effects of Ignoring Flow Externalities

Using a model of nonlinear decay of the stock pollutant, and starting from the same initial conditions, the paper shows that an optimal tax that corrects for both stock and flow externalities may result in a lower tax, fewer cumulative emissions (less decay) and higher output at the steady state than a corrective tax that ignores the flow externality. The "more is less" result emphasises that setting a corrective tax that ignores the flow externality, or imposing a corrective tax at too low a level where there exists only a stock externality, may affect both transitory and steady state output, tax payments and cumulative emissions. The result has important policy implications for decision makers setting optimal corrective taxes and targeted emission limits whenever stock externalities exist.taxes,stock and flow externalities,nonlinear decay,climate change

Noisy Classical Field Theories with Two Coupled Fields: Dependence of Escape Rates on Relative Field Stiffnesses

Exit times for stochastic Ginzburg-Landau classical field theories with two or more coupled classical fields depend on the interval length on which the fields are defined, the potential in which the fields deterministically evolve, and the relative stiffness of the fields themselves. The latter is of particular importance in that physical applications will generally require different relative stiffnesses, but the effect of varying field stiffnesses has not heretofore been studied. In this paper, we explore the complete phase diagram of escape times as they depend on the various problem parameters. In addition to finding a transition in escape rates as the relative stiffness varies, we also observe a critical slowing down of the string method algorithm as criticality is approached.Comment: 16 pages, 10 figure

Absence of reflection as a function of the coupling constant

We consider solutions of the one-dimensional equation $-u'' +(Q+ \lambda V) u = 0$ where $Q: \mathbb{R} \to \mathbb{R}$ is locally integrable, $V : \mathbb{R} \to \mathbb{R}$ is integrable with supp$(V) \subset [0,1]$, and $\lambda \in \mathbb{R}$ is a coupling constant. Given a family of solutions $\{u_{\lambda} \}_{\lambda \in \mathbb{R}}$ which satisfy $u_{\lambda}(x) = u_0(x)$ for all $x<0$, we prove that the zeros of $b(\lambda) := W[u_0, u_{\lambda}]$, the Wronskian of $u_0$ and $u_{\lambda}$, form a discrete set unless $V \equiv 0$. Setting $Q(x) := -E$, one sees that a particular consequence of this result may be stated as: if the fixed energy scattering experiment $-u'' + \lambda V u = Eu$ gives rise to a reflection coefficient which vanishes on a set of couplings with an accumulation point, then $V \equiv 0$.Comment: To appear in Journal of Mathematical Physic

New Limits on Local Lorentz Invariance in Mercury and Cesium

We report new bounds on Local Lorentz Invariance (LLI) violation in Cs and Hg. The limits are obtained through the observation of the the spin- precession frequencies of 199Hg and 133Cs atoms in their ground states as a function of the orientation of an applied magnetic field with respect to the fixed stars. We measure the amplitudes of the dipole couplings to a preferred direction in the equatorial plane to be 19(11) nHz for Hg and 9(5) microHz for Cs. The upper bounds established here improve upon previous bounds by about a factor of four. The improvement is primarily due to mounting the apparatus on a rotating table. New bounds are established on several terms in the standard model extension including the first bounds on the spin-couplings of the neutron and proton to the z direction, <7e-30 GeV and <7e-29 GeV, respectively.Comment: 17 pages, 6 figure

Approach to equilibrium in adiabatically evolving potentials

For a potential function (in one dimension) which evolves from a specified initial form $V_{i}(x)$ to a different $V_{f}(x)$ asymptotically, we study the evolution, in an overdamped dynamics, of an initial probability density to its final equilibeium.There can be unexpected effects that can arise from the time dependence. We choose a time variation of the form $V(x,t)=V_{f}(x)+(V_{i}-V_{f})e^{-\lambda t}$. For a $V_{f}(x)$, which is double welled and a $V_{i}(x)$ which is simple harmonic, we show that, in particular, if the evolution is adiabatic, the results in a decrease in the Kramers time characteristics of $V_{f}(x)$. Thus the time dependence makes diffusion over a barrier more efficient. There can also be interesting resonance effects when $V_{i}(x)$ and $V_{f}(x)$ are two harmonic potentials displaced with respect to each other that arise from the coincidence of the intrinsic time scale characterising the potential variation and the Kramers time.Comment: This paper contains 5 page

Analytical Rebridging Monte Carlo: Application to cis/trans Isomerization in Proline-Containing, Cyclic Peptides

We present a new method, the analytical rebridging scheme, for Monte Carlo simulation of proline-containing, cyclic peptides. The cis/trans isomerization is accommodated by allowing for two states of the amide bond. We apply our method to five peptides that have been previously characterized by NMR methods. Our simulations achieve effective equilibration and agree well with experimental data in all cases. We discuss the importance of effective equilibration and the role of bond flexibility and solvent effects on the predicted equilibrium properties.Comment: 29 pages, 8 PostScript figures, LaTeX source. to appear in J. Chem. Phys., 199

The Order of Phase Transitions in Barrier Crossing

A spatially extended classical system with metastable states subject to weak spatiotemporal noise can exhibit a transition in its activation behavior when one or more external parameters are varied. Depending on the potential, the transition can be first or second-order, but there exists no systematic theory of the relation between the order of the transition and the shape of the potential barrier. In this paper, we address that question in detail for a general class of systems whose order parameter is describable by a classical field that can vary both in space and time, and whose zero-noise dynamics are governed by a smooth polynomial potential. We show that a quartic potential barrier can only have second-order transitions, confirming an earlier conjecture [1]. We then derive, through a combination of analytical and numerical arguments, both necessary conditions and sufficient conditions to have a first-order vs. a second-order transition in noise-induced activation behavior, for a large class of systems with smooth polynomial potentials of arbitrary order. We find in particular that the order of the transition is especially sensitive to the potential behavior near the top of the barrier.Comment: 8 pages, 6 figures with extended introduction and discussion; version accepted for publication by Phys. Rev.

Modifiable predictors of ventricular ectopy in the community

Background Premature ventricular contractions (PVCs) predict heart failure and death. Data regarding modifiable risk factors for PVCs are scarce. Methods and Results We studied 1424 Cardiovascular Health Study participants randomly assigned to 24-hour Holter monitoring. Demographics, comorbidities, habits, and echocardiographic measurements were examined as predictors of PVC frequency and, among 845 participants, change in PVC frequency 5 years later. Participants exhibited a median of 0.6 (interquartile range, 0.1-7.1) PVCs per hour. Of the more directly modifiable characteristics and after multivariable adjustment, every SD increase in systolic blood pressure was associated with 9% more PVCs (95% confidence interval [CI], 2%-17%; P=0.01), regularly performing no or low-intensity exercise compared with more physical activity was associated with ≈15% more PVCs (95% CI, 3-25%; P=0.02), and those with a history of smoking exhibited an average of 18% more PVCs (95% CI, 3-36%; P=0.02) than did never smokers. After 5 years, PVC frequency increased from a median of 0.5 (IQR, 0.1-4.7) to 1.2 (IQR, 0.1-13.8) per hour ( P&lt;0.0001). Directly modifiable predictors of 5-year increase in PVCs, described as the odds per each quintile increase in PVCs, included increased diastolic blood pressure (odds ratio per SD increase, 1.16; 95% CI, 1.02-1.31; P=0.02) and a history of smoking (OR, 1.31; 95% CI, 1.02-1.68; P=0.04). Conclusions Enhancing physical activity, smoking cessation, and aggressive control of blood pressure may represent fruitful strategies to mitigate PVC frequency and PVC-associated adverse outcomes

Stellar turbulence and mode physics

An overview of selected topical problems on modelling oscillation properties in solar-like stars is presented. High-quality oscillation data from both space-borne intensity observations and ground-based spectroscopic measurements provide first tests of the still-ill-understood, superficial layers in distant stars. Emphasis will be given to modelling the pulsation dynamics of the stellar surface layers, the stochastic excitation processes and the associated dynamics of the turbulent fluxes of heat and momentum.Comment: Proc. HELAS Workshop on 'Synergies between solar and stellar modelling', eds M. Marconi, D. Cardini, M. P. Di Mauro, Astrophys. Space Sci., in the pres