Exploring the Potential Role of Family History of Hypertension on Racial Differences in Sympathetic Vascular Transduction

The prevalence of hypertension in Non-Hispanic Black (BL) men surpasses all other racial groups. Our laboratory has previously demonstrated exaggerated vasoconstrictor and blood pressure (BP) responses to spontaneous bursts of muscle sympathetic nerve activity (MSNA; sympathetic vascular transduction) in young, healthy BL men compared to their Non-Hispanic White (WH) counterparts. Because a family history of hypertension (FHH) further compounds cardiovascular risk, we wanted to begin to explore the potential impact of a positive (+) FHH on sympathetic vascular transduction. Whether a +FHH influences sympathetic vascular transduction in WH and/or BL men remains unknown. PURPOSE: To begin to explore if +FHH influences sympathetic vascular transduction within and between racial groups. METHODS: 22 men, nine with a +FHH (4 BL men) and 13 without a FHH (-FHH; 6 BL men) were recruited. Beat-to-beat BP (Finometer), femoral artery blood flow (Doppler ultrasound), and MSNA were measured during a 20-minute quiet rest. The mean BP and leg vascular conductance (LVC; blood flow/mean BP) responses to spontaneous bursts of MSNA were quantified via a signal averaging technique. RESULTS: Resting heart rate, BP, and MSNA were not significantly different between groups (all p\u3e0.05). As previously demonstrated by our laboratory, the BL men exhibited an augmented sympathetic vascular transduction compared to the WH men (e.g., peak BP response, WH men: Δ4.1±0.3, BL men: Δ5.6±0.7 mmHg, p=0.04). When accounting for FHH within the groups, the peak BP (WH +FHH: Δ4.4±0.6 vs. WH -FHH: Δ3.8±0.4 mmHg, p=0.4) and nadir LVC responses (WH +FHH: Δ-0.5±0.07 vs. WH -FHH: Δ-0.5±0.09 ml·min-¹·mmHg-¹, p=0.7) were not significantly different between WH men +FHH and WH men –FHH. Likewise, the BL men +FHH exhibited similar peak BP (BL +FHH: Δ6.2±0.7 vs. BL -FHH: Δ5.3±1.1 mmHg, p=0.5) and nadir LVC (BL +FHH: Δ-1.1±0.44 vs. BL -FHH: Δ-0.6±0.10 ml·min-¹·mmHg-¹, p=0.2) responses to bursts of MSNA compared to the BL men –FHH. CONCLUSION: These preliminary findings do not support a role for +FHH in augmented sympathetic vascular transduction, therefore suggesting that racial differences in sympathetic vascular transduction are independent of FHH

Quantification of Sympathetic Transduction in Type 2 Diabetes Patients

Type 2 Diabetes patients (T2D) have been shown to have greater alpha­-adrenergic sensitivity. How this impacts the transduction of muscle sympathetic nerve activity (MSNA) to arterial blood pressure under resting conditions using spontaneous fluctuations in MSNA, as well as during stressors known to elicit sympatho­-excitation (e.g., cold pressor test (CPT)) is unclear. PURPOSE: We tested the hypothesis that T2D patients would exhibit greater sympathetic transduction compared to age­ and BMI­-matched, healthy controls. METHODS: MSNA (microneurography), heart rate (ECG), and beat­-to­-beat arterial blood pressure (finger photoplethysmography) were continuously recorded during a 10 minute baseline period, and in response to a 2­minute CPT in six T2D patients and six age­ and BMI­-matched, healthy controls (CON).To quantify sympathetic transduction at rest, normalized burst heights were divided into four quartiles (smallest to largest), related to the corresponding peak change in mean arterial pressure (MAP) within those quartiles and a slope was determined. To quantify sympathetic transduction in response to a stressor, the change in MAP was related to the change in MSNA from rest to the last minute of CPT. RESULTS: There were no differences in resting sympathetic transduction between groups (CON slope: 0.0103±0.0023 mmHg/AU, T2D slope: 0.0095±0.0016 mmHg/AU; p=0.78). Indeed, signal averaging of MSNA bursts indicated a similar peak increase in blood pressure in CON (+4.2±0.6 mmHg) and T2D (+4.0±0.9 mmHg) (p=0.66). Although the peak increase in blood pressure to CPT tended to be higher in T2D (T2D: +31.6±3.4 mmHg, CON: +21.4±3.7 mmHg; p=0.096), the Δ MAP/ Δ MSNA relationship during CPT was not different between groups (CON: 0.4158±0.21, T2D: 0.1862±0.05; p=0.36). CONCLUSIONS: Despite clear sympathetically-­mediated increases in blood pressure in T2D patients and healthy CON subjects both at rest and during the CPT, neither of the methodologies used to estimate sympathetic transduction, with respect to changes in arterial blood pressure, detected group differences

‘They Called Them Communists Then … What D'You Call ‘Em Now? … Insurgents?’. Narratives of British Military Expatriates in the Context of the New Imperialism

This paper addresses the question of the extent to which the colonial past provides material for contemporary actors' understanding of difference. The research from which the paper is drawn involved interview and ethnographic work in three largely white working-class estates in an English provincial city. For this paper we focus on ten life-history interviews with older participants who had spent some time abroad in the British military. Our analysis adopts a postcolonial framework because research participants' current constructions of an amorphous 'Other' (labelled variously as black people, immigrants, foreigners, asylum-seekers or Muslims) reveal strong continuities with discourses deployed by the same individuals to narrate their past experiences of living and working as either military expatriates or spouses during British colonial rule. Theoretically, the paper engages with the work of Frantz Fanon and Edward Said. In keeping with a postcolonial approach, we work against essentialised notions of identity based on 'race' or class. Although we establish continuity between white working-class military emigration in the past and contemporary racialised discourses, we argue that the latter are not class-specific, being as much the creations of the middle-class media and political elite

Simple geometrical interpretation of the linear character for the Zeno-line and the rectilinear diameter

The unified geometrical interpretation of the linear character of the Zeno-line (unit compressibility line Z=1) and the rectilinear diameter is proposed. We show that recent findings about the properties of the Zeno-line and striking correlation with the rectilinear diameter line as well as other empirical relations can be naturally considered as the consequences of the projective isomorphism between the real molecular fluids and the lattice gas (Ising) model.Comment: 7 pages, 2 figure

Patients' attitudes towards cost feedback to doctors to prevent unnecessary testing: a qualitative focus group study

© 2020 The Authors Objectives: There is a need to improve efficiency in healthcare delivery without compromising quality of care. One approach is the development and evaluation of behavioural strategies to reduce unnecessary use of common tests. However, there is an absence of evidence on patient attitudes to the use of such approaches in the delivery of care. Our objective was to explore patient acceptability of a nudge-type intervention that aimed to modify blood test requests by hospital doctors. Study design: Single-centre qualitative study. Methods: The financial costs of common blood tests were presented to hospital doctors on results reports for 1 year at a hospital. Focus group discussions were conducted with recent inpatients at the hospital using a semi-structured question schedule. Discussions were transcribed and analysed using qualitative content analysis to identify and prioritise common themes explaining attitudes to the intervention approach. Results: Three focus groups involving 17 participants were conducted. Patients were generally apprehensive about the provision of blood test cost feedback to doctors. Attitudes were organised around themes representing beliefs about blood tests, the impact on doctors and their autonomy, and beliefs about unnecessary testing. Patients thought that blood tests were important, powerful and inexpensive, and cost information could place doctors under additional pressure. Conclusion: The findings identify predominantly positive beliefs about testing and negative attitudes to the use of financial costs in the decision-making of hospital doctors. Public discussion and education about the possible overuse of common tests may allow more resources to be allocated to evidence-based healthcare, by reducing the perception that such strategies to improve healthcare efficiency negatively impact on quality of care

Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies

Unintentional poisoning is a significant child public health problem. This systematic overview of reviews, supplemented with a systematic review of recently published primary studies synthesizes evidence on non-legislative interventions to reduce childhood poisonings in the home with particular reference to interventions that could be implemented by Children's Centres in England or community health or social care services in other high income countries. Thirteen systematic reviews, two meta-analyses and 47 primary studies were identified. The interventions most commonly comprised education, provision of cupboard/drawer locks, and poison control centre (PCC) number stickers. Meta-analyses and primary studies provided evidence that interventions improved poison prevention practices. Twenty eight per cent of studies reporting safe medicine storage (OR from meta-analysis 1.57, 95% CI 1.22–2.02), 23% reporting safe storage of other products (OR from meta-analysis 1.63, 95% CI 1.22–2.17) and 46% reporting availability of PCC numbers (OR from meta-analysis 3.67, 95% CI 1.84–7.33) demonstrated significant effects favouring the intervention group. There was a lack of evidence that interventions reduced poisoning rates. Parents should be provided with poison prevention education, cupboard/drawer locks and emergency contact numbers to use in the event of a poisoning. Further research is required to determine whether improving poison prevention practices reduces poisoning rates

Earthquake Forecast via Neutrino Tomography

We discuss the possibility of forecasting earthquakes by means of (anti)neutrino tomography. Antineutrinos emitted from reactors are used as a probe. As the antineutrinos traverse through a region prone to earthquakes, observable variations in the matter effect on the antineutrino oscillation would provide a tomography of the vicinity of the region. In this preliminary work, we adopt a simplified model for the geometrical profile and matter density in a fault zone. We calculate the survival probability of electron antineutrinos for cases without and with an anomalous accumulation of electrons which can be considered as a clear signal of the coming earthquake, at the geological region with a fault zone, and find that the variation may reach as much as 3% for $\bar \nu_e$ emitted from a reactor. The case for a $\nu_e$ beam from a neutrino factory is also investigated, and it is noted that, because of the typically high energy associated with such neutrinos, the oscillation length is too large and the resultant variation is not practically observable. Our conclusion is that with the present reactor facilities and detection techniques, it is still a difficult task to make an earthquake forecast using such a scheme, though it seems to be possible from a theoretical point of view while ignoring some uncertainties. However, with the development of the geology, especially the knowledge about the fault zone, and with the improvement of the detection techniques, etc., there is hope that a medium-term earthquake forecast would be feasible.Comment: 6 pages, 4 figures, 1 tabl