15,812 research outputs found
BP Reduction, Kidney Function Decline, and Cardiovascular Events in Patients without CKD.
BACKGROUND AND OBJECTIVES:
In the Systolic Blood Pressure Intervention Trial (SPRINT), intensive systolic BP treatment (target <120 mm Hg) was associated with fewer cardiovascular events and higher incidence of kidney function decline compared with standard treatment (target <140 mm Hg). We evaluated the association between mean arterial pressure reduction, kidney function decline, and cardiovascular events in patients without CKD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:
We categorized patients in the intensive treatment group of the SPRINT according to mean arterial pressure reduction throughout follow-up: <20, 20 to <40, and ≥40 mm Hg. We defined the primary outcome as kidney function decline (≥30% reduction in eGFR to <60 ml/min per 1.73 m2 on two consecutive determinations at 3-month intervals), and we defined the secondary outcome as cardiovascular events. In a propensity score analysis, patients in each mean arterial pressure reduction category from the intensive treatment group were matched with patients from the standard treatment group to calculate the number needed to treat regarding cardiovascular events and the number needed to harm regarding kidney function decline.
RESULTS:
In the intensive treatment group, 1138 (34%) patients attained mean arterial pressure reduction <20 mm Hg, 1857 (56%) attained 20 to <40 mm Hg, and 309 (9%) attained ≥40 mm Hg. Adjusted hazard ratios for kidney function decline were 2.10 (95% confidence interval, 1.22 to 3.59) for mean arterial pressure reduction between 20 and 40 mm Hg and 6.22 (95% confidence interval, 2.75 to 14.08) for mean arterial pressure reduction ≥40 mm Hg. In propensity score analysis, mean arterial pressure reduction <20 mm Hg presented a number needed to treat of 44 and a number needed to harm of 65, reduction between 20 and <40 mm Hg presented a number needed to treat of 42 and a number needed to harm of 35, and reduction ≥40 mm Hg presented a number needed to treat of 95 and a number needed to harm of 16.
CONCLUSIONS:
In the intensive treatment group of SPRINT, larger declines in mean arterial pressure were associated with higher incidence of kidney function decline. Intensive treatment seemed to be less favorable when a larger reduction in mean arterial pressure was needed to attain the BP target.info:eu-repo/semantics/publishedVersio
A Measurement of Secondary Cosmic Microwave Background Anisotropies with Two Years of South Pole Telescope Observations
We present the first three-frequency South Pole Telescope (SPT) cosmic microwave background (CMB) power spectra. The band powers presented here cover angular scales 2000 < ℓ < 9400 in frequency bands centered at 95, 150, and 220 GHz. At these frequencies and angular scales, a combination of the primary CMB anisotropy, thermal and kinetic Sunyaev-Zel'dovich (SZ) effects, radio galaxies, and cosmic infrared background (CIB) contributes to the signal. We combine Planck/HFI and SPT data at 220 GHz to constrain the amplitude and shape of the CIB power spectrum and find strong evidence for nonlinear clustering. We explore the SZ results using a variety of cosmological models for the CMB and CIB anisotropies and find them to be robust with one exception: allowing for spatial correlations between the thermal SZ effect and CIB significantly degrades the SZ constraints. Neglecting this potential correlation, we find the thermal SZ power at 150 GHz and ℓ = 3000 to be 3.65 ± 0.69 μK^2, and set an upper limit on the kinetic SZ power to be less than 2.8 μK^2 at 95% confidence. When a correlation between the thermal SZ and CIB is allowed, we constrain a linear combination of thermal and kinetic SZ power: D^(tSZ)_(3000) + 0.5D^(kSZ)_(3000) = 4.60 ± 0.63 μK^2, consistent with earlier measurements. We use the measured thermal SZ power and an analytic, thermal SZ model calibrated with simulations to determine σ_8 = 0.807 ± 0.016. Modeling uncertainties involving the astrophysics of the intracluster medium rather than the statistical uncertainty in the measured band powers are the dominant source of uncertainty on σ_8. We also place an upper limit on the kinetic SZ power produced by patchy reionization; a companion paper uses these limits to constrain the reionization history of the universe
Influence of SiC reinforcement particles on the tribocorrosion behaviour of Al–SiCp FGMs in 0.05M NaCl solution
The main aim of this work was to study and understand the influence of SiC particles on the corrosion and tribocorrosion of Al-matrix composite materials. For that, Al–SiCp functionally graded composites were produced by centrifugal casting and different SiCp contents were achieved. Their mechanical properties were improved by age-hardening heat treatments. The tribocorrosion behaviour was studied in 0.05M NaCl solutions using a reciprocating motion tribometer involving an alumina ball sliding against the Al-based samples. Above critical SiC particles' content the matrix alloy surface was found to be protected against wear by SiC particles protruding from the surface. Below this threshold content, the SiC reinforcement was inefficient and the wear rate of the composite was the same as the non-reinforced alloy.The research team was financially supported by the Portuguese Foundation for Science and Technology (FCT-Portugal) under a PhD scholarship (SFRH/BD/27911/2006). The authors also thank Dr Edith Ariza (University of Minho) and Pierre Mettraux (EPFL) for SEM analysis
A Method for Individual Source Brightness Estimation in Single- and Multi-band Data
We present a method of reliably extracting the flux of individual sources
from sky maps in the presence of noise and a source population in which number
counts are a steeply falling function of flux. The method is an extension of a
standard Bayesian procedure in the millimeter/submillimeter literature. As in
the standard method, the prior applied to source flux measurements is derived
from an estimate of the source counts as a function of flux, dN/dS. The key
feature of the new method is that it enables reliable extraction of properties
of individual sources, which previous methods in the literature do not. We
first present the method for extracting individual source fluxes from data in a
single observing band, then we extend the method to multiple bands, including
prior information about the spectral behavior of the source population(s). The
multi-band estimation technique is particularly relevant for classifying
individual sources into populations according to their spectral behavior. We
find that proper treatment of the correlated prior information between
observing bands is key to avoiding significant biases in estimations of
multi-band fluxes and spectral behavior, biases which lead to significant
numbers of misclassified sources. We test the single- and multi-band versions
of the method using simulated observations with observing parameters similar to
that of the South Pole Telescope data used in Vieira, et al. (2010).Comment: 11 emulateapj pages, 3 figures, revised to match published versio
Amphibia, Leptodactylidae, <i>Leptodactylus caatingae</i>: geographical distribution extension
Comment on Bress et al. Effect of Intensive Versus Standard Blood Pressure Treatment According to Baseline Prediabetes Status: A Post Hoc Analysis of a Randomized Trial. Diabetes Care 2017;40:1401-1408.
info:eu-repo/semantics/publishedVersio
Modelling of sanitary sewer systems integrating rainfall-derived infiltration and inflow
Wastewater utilities often have management difficulties when excessive wet-weather flow leads to serious impacts in public health and environment as well as disturbing operational conditions in wastewater treatment plants (WWTP). This phenomenon, resulting from rainfall-derived infiltration and inflow (RDII), occurs mainly due to defects in pipes and manholes (infiltration) and to illicit connections from downspouts, foundation drains or cross-connections with storm sewers (inflow), contributing to sanitary sewer overflows (SSOs). These difficulties related to SSOs negatively affect: (i) the capacity and operation of sanitary sewer collection; (ii) the performance and treatment efficiency of WWTP; (iii) the risk of a public health hazards and environmental contamination.
This well-known wastewater managerial problem is very difficult to locate and quantify in practice since the needed adequate measurement equipment often entails unsustainable costs for utilities. Wastewater flow mathematical modelling integrating a digital cadastral database using Geographic Information Systems (GIS) constitutes a sound methodology in predicting sanitary sewer systems performance which is a critical issue within SSOs reduction and remediation programs.
This paper presents the implementation of a methodology based on hydroinformatic tools to determine the contribution of RDII in complex municipal sewer systems in order to establish adequate urban wastewater management policies that will effectively mitigate SSOs. USEPA SWMM, and digital cadastral database with field verification were applied in a simulation study of the small scale sanitary sewer network of Espinho (Braga, Portugal) whose results will be used in a larger scale to create a city-wide model for wastewater systems management
Predicting success in weaning from mechanical ventilation in patients with and without cardiac disease
Modelling of Sanitary Sewer Systems integrating Rainfall-Derived Infiltration and Inflow
Municipal wastewater management difficulties may occur when excessive wet weather flow determine sanitary sewer overflows (SSOs) mainly caused by the contribution of rainfall-derived infiltration and inflow (RDII) into sanitary sewers. This excess of wet weather flow can lead to serious problems to public health and environment as well as to suboptimal operation of wastewater treatment plants. This paper presents the implementation of a methodology based on hydroinformatic tools to determine the contribution of RDII in complex municipal sewer systems in order to establish adequate urban wastewater management policies that will effectively mitigate SSOs. USEPA SWMM, and digital cadastral database with field verification were applied in a simulation study of a small scale sanitary sewer network whose results will be used in a larger scale to create a city-wide model for wastewater systems management
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