Long-term prognostic value of dobutamine-atropine stress echocardiography in 1737 patients with known or suspected coronary artery disease: A single-center experience

BACKGROUND--The purpose of this study was to assess the long-term value of dobutamine-atropine stress echocardiography (DSE) for prediction of late cardiac events in patients with proven or suspected coronary artery disease. METHODS AND RESULTS--Clinical data and DSE results were analyzed in 1734 consecutive patients undergoing DSE between 1989 and 1997. Seventy-four patients who underwent revascularization within 3 months of DSE and 1 patient lost to follow-up were excluded; the remaining 1659 (median age, 62 years; range, 14 to 99 years) were followed up for 36 months (range, 6 to 96 months). Wall motion abnormalities at rest and the presence and extent of stress-induced wall motion abnormalities (ischemia) were scored for each patient. Cardiac events were related to clinical and ECG data and DSE results. Four hundred twenty-eight cardiac events occurred in 366, documented cardiac death in 108 (total death, 247), nonfatal infarction in 128, and late revascularization in 192 patients. In a multivariable Cox proportional-hazards model, the ratio of documented cardiac death or (re)infarction was increased in the presence of stress-induced ischemia (hazard ratio, 3.3; 95% CI, 2.4 to 4.4) and extensive rest wall motion abnormalities (hazard ratio, 1.9; 95% CI, 1.3 to 2.6). The number of ischemic segments was predictive for late cardiac events. A normal DSE carried a relatively good prognosis, wit

Long-Term Prognostic Value of Dobutamine-Atropine Stress Echocardiography in 1737 Patients With Known or Suspected Coronary Artery Disease

Background—The purpose of this study was to assess the long-term value of dobutamine-atropine stress echocardiography (DSE) for prediction of late cardiac events in patients with proven or suspected coronary artery disease. Methods and Results—Clinical data and DSE results were analyzed in 1734 consecutive patients undergoing DSE between 1989 and 1997. Seventy-four patients who underwent revascularization within 3 months of DSE and 1 patient lost to follow-up were excluded; the remaining 1659 (median age, 62 years; range, 14 to 99 years) were followed up for 36 months (range, 6 to 96 months). Wall motion abnormalities at rest and the presence and extent of stress-induced wall motion abnormalities (ischemia) were scored for each patient. Cardiac events were related to clinical and ECG data and DSE results. Four hundred twenty-eight cardiac events occurred in 366, documented cardiac death in 108 (total death, 247), nonfatal infarction in 128, and late revascularization in 192 patients. In a multivariable Cox proportional-hazards model, the ratio of documented cardiac death or (re)infarction was increased in the presence of stress-induced ischemia (hazard ratio, 3.3; 95% CI, 2.4 to 4.4) and extensive rest wall motion abnormalities (hazard ratio, 1.9; 95% CI, 1.3 to 2.6). The number of ischemic segments was predictive for late cardiac events. A normal DSE carried a relatively good prognosis, with

Examining Periodic Solar Wind Density Structures Observed in the SECCHI Heliospheric Imagers

We present an analysis of small-scale, periodic, solar-wind density enhancements (length-scales as small as \approx 1000 Mm) observed in images from the Heliospheric Imager (HI) aboard STEREO A. We discuss their possible relationship to periodic fluctuations of the proton density that have been identified at 1 AU using in-situ plasma measurements. Specifically, Viall, Kepko, and Spence (2008) examined 11 years of in-situ solar-wind density measurements at 1 AU and demonstrated that not only turbulent structures, but also non-turbulent periodic density structures exist in the solar wind with scale sizes of hundreds to one thousand Mm. In a subsequent paper, Viall, Spence, and Kasper (2009) analyzed the {\alpha} to proton solar-wind abundance ratio measured during one such event of periodic density structures, demonstrating that the plasma behavior was highly suggestive that either temporally or spatially varying coronal source plasma created those density structures. Large periodic density structures observed at 1 AU, which were generated in the corona, can be observable in coronal and heliospheric white-light images if they possess sufficiently high density contrast. Indeed, we identify such periodic density structures as they enter the HI field of view and follow them as they advect with the solar wind through the images. The smaller periodic density structures that we identify in the images are comparable in size to the larger structures analyzed in-situ at 1 AU, yielding further evidence that periodic density enhancements are a consequence of coronal activity as the solar wind is formed.Comment: 15 pages, 12 figures. The final publication is available at http://www.springerlink.co

Quantifying structural racism in cohort studies to advance prospective evidence

Calls-to-action in health research have described a need to improve research on race, ethnicity, and structural racism. Well-established cohort studies typically lack access to novel structural and social determinants of health (SSDOH) or precise race and ethnicity categorization, contributing to a loss of rigor to conduct informative analyses and a gap in prospective evidence on the role of structural racism in health outcomes. We propose and implement methods that prospective cohort studies can use to begin to rectify this, using the Women's Health Initiative (WHI) cohort as a case study. To do so, we evaluated the quality, precision, and representativeness of race, ethnicity, and SSDOH data compared with the target US population and operationalized methods to quantify structural determinants in cohort studies. Harmonizing racial and ethnic categorization to the current standards set by the Office of Management and Budget improved measurement precision, aligned with published recommendations, disaggregated groups, decreased missing data, and decreased participants reporting “some other race”. Disaggregation revealed sub-group disparities in SSDOH, including a greater proportion of Black-Latina (35.2%) and AIAN-Latina (33.3%) WHI participants with income below the US median compared with White-Latina (42.5%) participants. We found similarities in the racial and ethnic patterning of SSDOH disparities between WHI and US women but less disparity overall in WHI. Despite higher individual-level advantage in WHI, racial disparities in neighborhood resources were similar to the US, reflecting structural racism. Median neighborhood income was comparable between Black WHI ($39,000) and US ($34,700) women. WHI SSDOH-associated outcomes may be generalizable on the basis of comparing across race and ethnicity but may quantitatively (but not qualitatively) underestimate US effect sizes. This paper takes steps towards data justice by implementing methods to make visible hidden health disparity groups and operationalizing structural-level determinants in prospective cohort studies, a first step to establishing causality in health disparities research

Ecological Invasion, Roughened Fronts, and a Competitor's Extreme Advance: Integrating Stochastic Spatial-Growth Models

Both community ecology and conservation biology seek further understanding of factors governing the advance of an invasive species. We model biological invasion as an individual-based, stochastic process on a two-dimensional landscape. An ecologically superior invader and a resident species compete for space preemptively. Our general model includes the basic contact process and a variant of the Eden model as special cases. We employ the concept of a "roughened" front to quantify effects of discreteness and stochasticity on invasion; we emphasize the probability distribution of the front-runner's relative position. That is, we analyze the location of the most advanced invader as the extreme deviation about the front's mean position. We find that a class of models with different assumptions about neighborhood interactions exhibit universal characteristics. That is, key features of the invasion dynamics span a class of models, independently of locally detailed demographic rules. Our results integrate theories of invasive spatial growth and generate novel hypotheses linking habitat or landscape size (length of the invading front) to invasion velocity, and to the relative position of the most advanced invader.Comment: The original publication is available at www.springerlink.com/content/8528v8563r7u2742

A direct search for the CP-violating decay Ks->3p^0 with the KLOE detector at DAFNE

We have searched for the decay Ks->3p^0 with the KLOE experiment at DAFNE using data from e^+ e^- collisions at a center of mass energy W= m(phi) for an integrated luminosity L=450 pb^-1. The search has been performed with a pure Ks beam obtained by tagging with Kl interactions in the calorimeter and detecting six photons. We find an upper limit for the branching ratio of 1.2x10^-7 at 90% C.L.Comment: 15 pages, 6 figures. To be submitted to Physics Letter

Measurements of Direct CP Violation, CPT Symmetry, and Other Parameters in the Neutral Kaon System

We present a series of measurements based on K -> pi+pi- and K -> pi0pi0 decays collected in 1996-1997 by the KTeV experiment (E832) at Fermilab. We compare these four K -> pipi decay rates to measure the direct CP violation parameter Re(e'/e) = (20.7 +- 2.8) x 10^-4. We also test CPT symmetry by measuring the relative phase between the CP violating and CP conserving decay amplitudes for K->pi+pi- (phi+-) and for K -> pi0pi0 (phi00). We find the difference between the relative phases to be Delta-phi = phi00 - phi+- = (+0.39 +- 0.50) degrees and the deviation of phi+- from the superweak phase to be phi+- - phi_SW =(+0.61 +- 1.19) degrees; both results are consistent with CPT symmetry. In addition, we present new measurements of the KL-KS mass difference and KS lifetime: Delta-m = (5261 +- 15) x 10^6 hbar/s and tauS = (89.65 +- 0.07) x 10^-12 s.Comment: Submitted to Phys. Rev. D, August 6, 2002; 37 pages, 32 figure

The influence of thermal cycles on the microstructure of grade 92 steel

The microstructure in the heat-affected zone (HAZ) of welds made from the 9 wt pct chromium martensitic Grade 92 steel is complex and has not yet been completely understood. There is a lack of systematic microstructural investigations to define the different regions of the microstructure across the HAZ of Grade 92 steel welds as a function of the welding process. In this study, the microstructure in the HAZ of an as-fabricated single-pass bead-on-plate weld on a parent metal of Grade 92 steel was systematically investigated by using an extensive range of electron and ion-microscopy-based techniques. A dilatometer was used to apply controlled thermal cycles to simulate the microstructures in the different regions of the HAZ. A wide range of microstructural properties in the simulated materials were then characterized and compared with the experimental observations from the weld HAZ. It was found that the microstructure in the HAZ of a single-pass Grade 92 steel weld can be categorized as a function of a decreasing peak temperature reached as (1) the completely transformed (CT) region, in which the original matrix is completely reaustenitized with complete dissolution of the pre-existing secondary precipitate particles; (2) the partially transformed (PT) region, where the original matrix is partially reaustenitized along with a partial dissolution of the secondary precipitate particles from the original matrix; and (3) the overtempered (OT) region, where the pre-xisting precipitate particles coarsen. The PT region is considered to be the susceptible area for damage in the commonly reported HAZ failures in weldments constructed from these types of steels

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results

Jet size dependence of single jet suppression in lead-lead collisions at sqrt(s(NN)) = 2.76 TeV with the ATLAS detector at the LHC

Measurements of inclusive jet suppression in heavy ion collisions at the LHC provide direct sensitivity to the physics of jet quenching. In a sample of lead-lead collisions at sqrt(s) = 2.76 TeV corresponding to an integrated luminosity of approximately 7 inverse microbarns, ATLAS has measured jets with a calorimeter over the pseudorapidity interval |eta| < 2.1 and over the transverse momentum range 38 < pT < 210 GeV. Jets were reconstructed using the anti-kt algorithm with values for the distance parameter that determines the nominal jet radius of R = 0.2, 0.3, 0.4 and 0.5. The centrality dependence of the jet yield is characterized by the jet "central-to-peripheral ratio," Rcp. Jet production is found to be suppressed by approximately a factor of two in the 10% most central collisions relative to peripheral collisions. Rcp varies smoothly with centrality as characterized by the number of participating nucleons. The observed suppression is only weakly dependent on jet radius and transverse momentum. These results provide the first direct measurement of inclusive jet suppression in heavy ion collisions and complement previous measurements of dijet transverse energy imbalance at the LHC.Comment: 15 pages plus author list (30 pages total), 8 figures, 2 tables, submitted to Physics Letters B. All figures including auxiliary figures are available at http://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/HION-2011-02