Atherogenic markers in predicting cardiovascular risk and targeting residual cardiovascular risk

Abstract Low-density lipoprotein (LDL) cholesterol (LDL-C) is the primary target in cardiovascular (CV) disease prevention and is commonly used in estimating CV risk; however, alternative markers may be needed when LDL-C is not an appropriate marker (e.g. in the presence of low LDL-C levels or elevated triglyceride [TG] levels). Non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B (apoB) are markers of atherogenic lipoproteins with evidenced associations with CV risk and are, therefore, recommended as secondary targets, appropriate for use in the presence of elevated TG levels. The reported strength of the associations of non-HDL-C and apoB in comparison to LDL-C is conflicting between studies, potentially due to discordance of the markers which can alter their predictive pattern. Although LDL-C levels are commonly managed with statin treatment, a residual risk of CV events still remains, and an abnormal lipid profile can persist. Combination therapy to further reduce LDL-C levels can be beneficial; a statin therapy combined with other LDL-C-lowering therapy further reduced the number of CV events. In addition, targeting other markers, including non-HDL-C, apoB, total cholesterol and TGs may also be beneficial, specifically in patients with low HDL-C and elevated TG levels. More clinical evidence is required before definitive recommendations can be made; however, a statin–fenofibrate combination demonstrated favourable reductions in major CV events in these specific patients

Pharmaceutical strategies for reducing LDL-C and risk of cardiovascular disease

Abstract A key strategy in preventing cardiovascular (CV) disease is the reduction of low-density lipoprotein cholesterol (LDL-C). Statins are a crucial therapy for achieving LDL-C reductions, with the highest tolerated dose often prescribed, especially for patients who are at the greatest risk of CV disease. However, statin intolerance, heterogeneous responses to statins and non-adherence make alternative therapies necessary in some cases. Statins can be combined with a multitude of therapies with synergistic mechanisms of action to effectively manage lipid profiles, while improving safety and tolerability profiles. Addition of a cholesterol absorption inhibitor, bile acid sequestrant or fibrate to statin therapy leads to greater numbers of patients achieving and maintaining LDL-C goals. Furthermore, combination therapies can alter the plasma profiles of other molecules involved in hypercholesterolaemia, including triglycerides and high-density lipoprotein cholesterol. An additional strategy is proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition therapy, for use in patients who are statin intolerant, patients with heterozygous or homozygous familial hypercholesterolaemia, and patients at very high CV risk, as a potential means for achieving large LDL-C reductions and maintaining LDL-C goals. Clinical trials have demonstrated that PCSK9 inhibition therapy is not only effective but can also be combined with statin therapy to ensure greater reductions in LDL-C. Current, ongoing studies are investigating the efficacy of novel therapies, including selective peroxisome proliferator-activated receptor (PPAR) alpha modulators, PCSK9-specific ribonucleic acid (RNA) interference and anti-inflammatory therapies

Measurement report: Plume heights of the April 2021 La Soufrière eruptions from GOES-17 side views and GOES-16–MODIS stereo views

We estimated geometric plume heights for the daytime eruptions of La Soufrière in April 2021 using visible red band geostationary side views and geostationary–polar orbiter stereo views. Most of the plumes either spread near the tropopause at 16–17 km altitude or penetrated the stratosphere at 18–20 km altitude. Overshooting tops reached heights of up to 23 km. These geometric heights were compared with radiometric heights corresponding to the coldest plume temperature, which usually represent ambiguous estimates within a wide range between a tropospheric and a stratospheric height match. The tropospheric lower bound of the radiometric height range always underestimated the geometric height by a couple of kilometers, even for smaller plumes. For plumes near or above the tropopause, the midpoint or the stratospheric upper bound of the radiometric height range was in reasonable agreement with the geometric heights. The geometric overshooting top height, however, was always above the radiometric height range. We also found that geometric plume heights can be estimated from infrared band side views too, albeit with increased uncertainty compared to the visible red band. This opens up the possibility of applying the side view method to nighttime eruptions

Dispersion and Aging of Volcanic Aerosols After the La Soufrière Eruption in April 2021

Volcanic aerosols change the atmospheric composition and thereby affect weather and climate. Aerosol dynamic processes such as nucleation, condensation, and coagulation modify the shape, size, and mass of aerosol particles, which influence their atmospheric lifetime and radiative properties. Nevertheless, most models omit these processes for ash particles. In this work, we explore the ash aerosol aging and sulfate production during the first 4 days following the 2021 La Soufrière (St. Vincent) eruption with the ICON-ART model (ICOsahedral Nonhydrostatic model with Aerosol and Reactive Trace gases). Online coupling of ICON-ART with a one-dimensional volcanic plume model calculates volcanic emission, which makes it possible to resolve the different eruption phases of the noncontinuous La Soufrière eruption. We compared our simulated aerosol distribution and composition with observations from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) instrument, the Multiangle Imaging SpectroRadiometer (MISR) Research Aerosol (RA) Algorithm, and the Barbados Cloud Observatory (BCO). We show that online coupling is essential to adequately model the emissions and plume development close to the volcano. The modeled aerosol aging is in very good agreement with observations from MISR near the emission source and with CALIOP at larger distances. Furthermore, particle aging occurs faster in the troposphere than in the stratosphere due to the availability of water vapor and OH, but a layer of coated ash appears at the plume top due to faster oxidation of SO$_2$ and lofting by aerosol-radiation interaction. This paper gives the first direct comparison of aerosol aging in volcanic eruption plumes between simulations and observations

Effect of formant frequency spacing on perceived gender in pre-pubertal children's voices

<div><p>Background</p><p>It is usually possible to identify the sex of a pre-pubertal child from their voice, despite the absence of sex differences in fundamental frequency at these ages. While it has been suggested that the overall spacing between formants (formant frequency spacing - ΔF) is a key component of the expression and perception of sex in children's voices, the effect of its continuous variation on sex and gender attribution has not yet been investigated.</p><p>Methodology/Principal findings</p><p>In the present study we manipulated voice ΔF of eight year olds (two boys and two girls) along continua covering the observed variation of this parameter in pre-pubertal voices, and assessed the effect of this variation on adult ratings of speakers' sex and gender in two separate experiments. In the first experiment (sex identification) adults were asked to categorise the voice as either male or female. The resulting identification function exhibited a gradual slope from male to female voice categories. In the second experiment (gender rating), adults rated the voices on a continuum from “masculine boy” to “feminine girl”, gradually decreasing their masculinity ratings as ΔF increased.</p><p>Conclusions/Significance</p><p>These results indicate that the role of ΔF in voice gender perception, which has been reported in adult voices, extends to pre-pubertal children's voices: variation in ΔF not only affects the perceived sex, but also the perceived masculinity or femininity of the speaker. We discuss the implications of these observations for the expression and perception of gender in children's voices given the absence of anatomical dimorphism in overall vocal tract length before puberty.</p></div

A Bayesian explanation of the 'Uncanny Valley' effect and related psychological phenomena

There are a number of psychological phenomena in which dramatic emotional responses are evoked by seemingly innocuous perceptual stimuli. A well known example is the ‘uncanny valley’ effect whereby a near human-looking artifact can trigger feelings of eeriness and repulsion. Although such phenomena are reasonably well documented, there is no quantitative explanation for the findings and no mathematical model that is capable of predicting such behavior. Here I show (using a Bayesian model of categorical perception) that differential perceptual distortion arising from stimuli containing conflicting cues can give rise to a perceptual tension at category boundaries that could account for these phenomena. The model is not only the first quantitative explanation of the uncanny valley effect, but it may also provide a mathematical explanation for a range of social situations in which conflicting cues give rise to negative, fearful or even violent reactions

How do you say ‘hello’? Personality impressions from brief novel voices

On hearing a novel voice, listeners readily form personality impressions of that speaker. Accurate or not, these impressions are known to affect subsequent interactions; yet the underlying psychological and acoustical bases remain poorly understood. Furthermore, hitherto studies have focussed on extended speech as opposed to analysing the instantaneous impressions we obtain from first experience. In this paper, through a mass online rating experiment, 320 participants rated 64 sub-second vocal utterances of the word ‘hello’ on one of 10 personality traits. We show that: (1) personality judgements of brief utterances from unfamiliar speakers are consistent across listeners; (2) a two-dimensional ‘social voice space’ with axes mapping Valence (Trust, Likeability) and Dominance, each driven by differing combinations of vocal acoustics, adequately summarises ratings in both male and female voices; and (3) a positive combination of Valence and Dominance results in increased perceived male vocal Attractiveness, whereas perceived female vocal Attractiveness is largely controlled by increasing Valence. Results are discussed in relation to the rapid evaluation of personality and, in turn, the intent of others, as being driven by survival mechanisms via approach or avoidance behaviours. These findings provide empirical bases for predicting personality impressions from acoustical analyses of short utterances and for generating desired personality impressions in artificial voices

Investigating the effects of handedness on the consistency of lateralization for speech production and semantic processing tasks using functional transcranial Doppler sonography

The left hemisphere is dominant for language in most people, but lateralization strength varies between different tasks and individuals. A large body of literature has shown that handedness is associated with lateralization: left handers have weaker language lateralization on average, and a greater incidence of atypical (right hemisphere) lateralization; but typically, these studies have relied on a single measure of language lateralization. Here we consider the relationships between lateralization for two different language tasks. We investigated the influence of handedness on lateralization using functional transcranial Doppler sonography (fTCD), using an existing dataset (N = 151 adults, 21 left handed). We compared a speech production task (word generation) and a semantic association task. We demonstrated stronger left-lateralization for word generation than semantic association; and a moderate correlation between laterality indices for the two tasks (r = 0.59). Laterality indices were stronger for right than left handers, and left handers were more likely than right handers to have atypical (right hemisphere) lateralization or inconsistent lateralization between the two tasks. These results add to our knowledge of individual differences in lateralization and support the view that language lateralization is multifactorial rather than unitary

The role of red yeast rice (RYR) supplementation in plasma cholesterol control: a review and expert opinion

International audienc

The polygenic nature of hypertriglyceridaemia: implications for definition, diagnosis, and management.

Plasma triglyceride concentration is a biomarker for circulating triglyceride-rich lipoproteins and their metabolic remnants. Common mild-to-moderate hypertriglyceridaemia is typically multigenic, and results from the cumulative burden of common and rare variants in more than 30 genes, as quantified by genetic risk scores. Rare autosomal recessive monogenic hypertriglyceridaemia can result from large-effect mutations in six different genes. Hypertriglyceridaemia is exacerbated by non-genetic factors. On the basis of recent genetic data, we redefine the disorder into two states: severe (triglyceride concentration >10 mmol/L), which is more likely to have a monogenic cause; and mild-to-moderate (triglyceride concentration 2-10 mmol/L). Because of clustering of susceptibility alleles and secondary factors in families, biochemical screening and counselling for family members is essential, but routine genetic testing is not warranted. Treatment includes management of lifestyle and secondary factors, and pharmacotherapy. In severe hypertriglyceridaemia, intervention is indicated because of pancreatitis risk; in mild-to-moderate hypertriglyceridaemia, intervention can be indicated to prevent cardiovascular disease, dependent on triglyceride concentration, concomitant lipoprotein disturbances, and overall cardiovascular risk