Physicians' estimates of the 10-year cardiovascular risk in hypertensive patients

RESUME L'objectif de cette étude est d'évaluer comment de jeunes médecins en formation perçoivent le risque cardiovasculaire de leurs patients hypertendus en se basant sur les recommandations médicales (« guidelines ») et sur leur jugement clinique. Il s'agit d'une étude transversale observationnelle effectuée à la Policlinique Médicale Universitaire de Lausanne (PMU). 200 patients hypertendus ont été inclus dans l'étude ainsi qu'un groupe contrôle de 50 patients non hypertendus présentant au moins un facteur de risque cardiovasculaire. Nous avons comparé le risque cardiovasculaire à 10 ans calculé par un programme informatique basé sur l'équation de Framingham. L'équation a été adaptée pour les médecins par l'OMS-ISH au risque perçu, estimé cliniquement par les médecins. Les résultats de notre étude ont montrés que les médecins sous-estiment le risque cardiovasculaire à 10 ans de leurs patients, comparé au risque calculé selon l'équation de Framingham. La concordance entre les deux méthodes était de 39% pour les patients hypertendus et de 30% pour le groupe contrôle de patients non hypertendus. La sous-estimation du risque. cardiovasculaire pour les patients hypertendus était corrélée au fait qu'ils avaient une tension artérielle systolique stabilisée inférieure a 140 mmHg (OR=2.1 [1.1 ;4.1]). En conclusion, les résultats de cette étude montrent que les jeunes médecins en formation ont souvent une perception incorrecte du risque cardiovasculaire de leurs patients, avec une tendance à sous-estimer ce risque. Toutefois le risque calculé pourrait aussi être légèrement surestimé lorsqu'on applique l'équation de Framingham à la population suisse. Pour mettre en pratique une évaluation systématique des facteurs de risque en médecine de premier recours, un accent plus grand devrait être mis sur l'enseignement de l'évaluation du risque cardiovasculaire ainsi que sur la mise en oeuvre de programme pour l'amélioration de la qualité.

New Estimates of Regional GDP in Spain, 1860-1930

This paper presents a new regional database on GDP in Spain for the years 1860, 1900, 1914 and 1930. Following Geary and Stark (2002), country level GDP estimates are allocated across Spanish provinces. The results are then compared with previous estimates. Further, this new evidence is used to analyze the evolution of regional inequality and convergence in the long run. According to the distribution dynamics approach suggested by Quah (1993, 1996) persistence appears as a main feature in the regional distribution of output. Therefore, in the long run no evidence of regional convergence in the Spanish economy is found.

Optimal Usage of De-Icing Chemicals when Scraping Ice, November 2003

One of the challenges that faces the winter maintainer is how much chemical to apply to the road under given conditions. Insufficient chemical can lead to the road surface becoming slick, and the road thus becoming unsafe. In all likelihood, additional applications will have to be made, requiring additional effort and use of resources. However, too much chemical can also be bad. While an excess of chemical will ensure (in most circumstances) that a safe road condition is achieved, it may also result in a substantial waste of chemical (with associated costs for this waste) and in ancillary damage to the road itself and to the surrounding environment. Ideally, one should apply what might be termed the “goldilocks” amount of chemical to the road: Not too much, and not too little, but just right. Of course the reality of winter maintenance makes achieving the “goldilocks” application rate somewhat of a fairy tale. In the midst of a severe storm, when conditions are poor and getting worse, the last thing on a plow operator’s mind is a minute adjustment in the amount of chemical being applied to the road. However, there may be considerable benefit and substantial savings to be achieved if chemical applications can be optimized to some degree, so that wastage is minimized without compromising safety. The goal of this study was to begin to develop such information through a series of laboratory studies in which the force needed to scrape ice from concrete blocks was measured, under a variety of chemical application conditions.

Optimal estimation of two-qubit pure-state entanglement

We present optimal measuring strategies for an estimation of the entanglement of unknown two-qubit pure states and of the degree of mixing of unknown single-qubit mixed states, of which N identical copies are available. The most general measuring strategies are considered in both situations, to conclude in the first case that a local, although collective, measurement suffices to estimate entanglement, a nonlocal property, optimally.

Progeny Trial Estimates of Genetic Parameters for Growth and Quality Traits in Scots Pine

Summary

New Estimates of Regional GDP in Spain, 1860-1930

This paper presents a new regional database on GDP in Spain for the years 1860, 1900, 1914 and 1930. Following Geary and Stark (2002), country level GDP estimates are allocated across Spanish provinces. The results are then compared with previous estimates. Further, this new evidence is used to analyze the evolution of regional inequality and convergence in the long run. According to the distribution dynamics approach suggested by Quah (1993, 1996) persistence appears as a main feature in the regional distribution of output. Therefore, in the long run no evidence of regional convergence in the Spanish economy is found.

Sex-specific estimates of dispersal show female philopatry and male dispersal in a promiscuous amphibian, the alpine salamander (Salamandra atra).

Amphibians display wide variations in life-history traits and life cycles that should prove useful to explore the evolution of sex-biased dispersal, but quantitative data on sex-specific dispersal patterns are scarce. Here, we focused on Salamandra atra, an endemic alpine species showing peculiar life-history traits. Strictly terrestrial and viviparous, the species has a promiscuous mating system, and females reproduce only every 3 to 4 years. In the present study, we provide quantitative estimates of asymmetries in male vs. female dispersal using both field-based (mark-recapture) and genetic approaches (detection of sex-biased dispersal and estimates of migration rates based on the contrast in genetic structure across sexes and age classes). Our results revealed a high level of gene flow among populations, which stems exclusively from male dispersal. We hypothesize that philopatric females benefit from being familiar with their natal area for the acquisition and defence of an appropriate shelter, while male dispersal has been secondarily favoured by inbreeding avoidance. Together with other studies on amphibians, our results indicate that a species' mating system alone is a poor predictor of sex-linked differences in dispersal, in particular for promiscuous species. Further studies should focus more directly on the proximate forces that favour or limit dispersal to refine our understanding of the evolution of sex-biased dispersal in animals.

Stereologic estimates of total spinophilin-immunoreactive spine number in area 9 and the CA1 field: Relationship with the progression of Alzheimer's disease

The loss of presynaptic markers is thought to represent a strong pathologic correlate of cognitive decline in Alzheimer's disease (AD). Spinophilin is a postsynaptic marker mainly located to the heads of dendritic spines. We assessed total numbers of spinophilin-immunoreactive puncta. in the CA I and CA3 fields of hippocampus and area 9 in 18 elderly individuals with various degrees of cognitive decline. The decrease in spinophilin-immunoreactivity was significantly related to both Braak neurofibrillary tangle (NFT) staging and clinical severity but not A beta deposition staging. The total number of spinophilin-immunoreactive puncta in CA I field and area 9 were significantly related to MMSE scores and predicted 23.5 and 61.9% of its variability. The relationship between total number of spinophilin-immunoreactive puncta in CA I field and MMSE scores did not persist when adjusting for Braak NFT staging. In contrast, the total number of spinophilin-immunoreactive puncta in area 9 was still significantly related to the cognitive outcome explaining an extra 9.6% of MMSE and 25.6% of the Clinical Dementia Rating scores variability. Our data suggest that neocortical dendritic spine loss is an independent parameter to consider in AD clinicopathologic correlations.

Potential-Scour Assessments and Estimates of Maximum Scour at Selected Bridges in Iowa, HR-344, 1995

This report presents the results of potential-scour assessments at 130 bridges and estimates of maximum scour at 10 bridges, in Iowa. All of the bridges evaluated in the study are constructed bridges (not culverts) that are sites of active or discontinued streamflow-gaging stations and peak-stage measurement sites. The period of the study was from October 1991 to September 1994. The potential-scour assessments were made using a potential-scour index developed by the U.S. Geological Survey for a study in Tennessee. Higher values of the index suggest a greater likelihood of scour-related problems occurring at a bridge. The estimates of maximum scour were made using scour equations recommended by the Federal Highway Administration. In this study, the long term aggradation or degradation that occurred during the period of streamflow data collection at each site was evaluated. Although the abutment-scour equation predicted deep scour holes at many of the sites, the only significant abutment scour that was measured was erosion of the embankment at the left abutment at one bridge after a flood.

Albedo and estimates of net radiation for green beans under polyethylene cover and field conditions

This paper describes the albedo (r) and estimates of net radiation and global solar irradiance for green beans crop (Phaseolus vulgaris L.), cultivated in greenhouse with cover of polyethylene and field conditions, in Botucatu, SP, Brazil (22º 54' S; 48º 27' W; 850 m). The solar global irradiance (Rg) and solar reflected radiation (Rr) were used to estimate the albedo through the ratio between Rr and Rg. The diurnal curves of albedo were obtained for days with clear sky and partially cloudy conditions, for different phenological stages of the crop. The albedo ranged with the solar elevation, the environment and the phenological stages. The cloudiness range have almost no influence on the albedo diurnal amount. The estimation of radiation were made by linear regression, using the global solar irradiance (Rg) and net short-waves radiation (Rc) as independent variables. All estimates of radiation showed better adjustment for specific phenological periods compared to the entire crop growing cycle. The net radiation in the greenhouse has been estimated by the global solar irradiance measured at field conditions.

Effects of alternative sets of climatic predictors on species distribution models and associated estimates of extinction risk: a test with plants in an arid environment

Aim To evaluate the effects of using distinct alternative sets of climatic predictor variables on the performance, spatial predictions and future projections of species distribution models (SDMs) for rare plants in an arid environment. . Location Atacama and Peruvian Deserts, South America (18º30'S - 31º30'S, 0 - 3 000 m) Methods We modelled the present and future potential distributions of 13 species of Heliotropium sect. Cochranea, a plant group with a centre of diversity in the Atacama Desert. We developed and applied a sequential procedure, starting from climate monthly variables, to derive six alternative sets of climatic predictor variables. We used them to fit models with eight modelling techniques within an ensemble forecasting framework, and derived climate change projections for each of them. We evaluated the effects of using these alternative sets of predictor variables on performance, spatial predictions and projections of SDMs using Generalised Linear Mixed Models (GLMM). Results The use of distinct sets of climatic predictor variables did not have a significant effect on overall metrics of model performance, but had significant effects on present and future spatial predictions. Main conclusion Using different sets of climatic predictors can yield the same model fits but different spatial predictions of current and future species distributions. This represents a new form of uncertainty in model-based estimates of extinction risk that may need to be better acknowledged and quantified in future SDM studies.

A new classification of the Turkish terranes and sutures and its implication for the paleotectonic history of the region

The Turkish part of the Tethyan realm is represented by a series of terranes juxtaposed through Alpine convergent movements and separated by complex suture zones. Different terranes can be defined and characterized by their dominant geological background. The Pontides domain represents a segment of the former active margin of Eurasia, where back-arc basins opened in the Triassic and separated the Sakarya terrane from neighbouring regions. Sakarya was re-accreted to Laurasia through the Balkanic mid-Cretaceous orogenic event that also affected the Rhodope and Strandja zones. The whole region from the Balkans to the Caucasus was then affected by a reversal of subduction and creation of a Late Cretaceous arc before collision with the Anatolian domain in the Eocene. If the Anatolian terrane underwent an evolution similar to Sakarya during the Late Paleozoic and Early Triassic times, both terranes had a diverging history during and after the Eo-Cimmerian collision. North of Sakarya, the Küre back-arc was closed during the Jurassic, whereas north of the Anatolian domain, the back-arc type oceans did not close before the Late Cretaceous. During the Cretaceous, both domains were affected by ophiolite obduction, but in very different ways: north directed diachronous Middle to Late Cretaceous mélange obduction on the Jurassic Sakarya passive margin; Senonian synchronous southward obduction on the Triassic passive margin of Anatolia. From this, it appears that the Izmir-Ankara suture, currently separating both terranes, is composite, and that the passive margin of Sakarya is not the conjugate margin of Anatolia. To the south, the Cimmerian Taurus domain together with the Beydağları domain (part of the larger Greater Apulian terrane), were detached from north Gondwana in the Permian during the opening of the Neotethys (East-Mediterranean basin). The drifting Cimmerian blocks entered into a soft collision with the Anatolian and related terranes in the Eo-Cimmerian orogenic phase (Late Triassic), thus suturing the Paleotethys. At that time, the Taurus plate developed foreland-type basins, filled with flysch-molasse deposits that locally overstepped the lower plate Taurus terrane and were deposited in the opening Neotethys to the south. These olistostromal deposits are characterized by pelagic Carboniferous and Permian material from the Paleotethys suture zone found in the Mersin mélange. The latter, as well as the Antalya and Mamonia domains are represented by a series of exotic units now found south of the main Taurus range. Part of the Mersin exotic material was clearly derived from the former north Anatolian passive margin (Huğlu-type series) and re-displaced during the Paleogene. This led us to propose a plate tectonic model where the Anatolian ophiolitic front is linked up with the Samail/Baër-Bassit obduction front found along the Arabian margin. The obduction front was indented by the Anatolian promontory whose eastern end was partially subducted. Continued slab roll-back of the Neotethys allowed Anatolian exotics to continue their course southwestward until their emplacement along the Taurus southern margin (Mersin) and up to the Beydağları promontory (Antaya-Mamonia) in the latest Cretaceous-Paleocene. The supra-subduction ocean opening at the back of the obduction front (Troodos-type Ocean) was finally closed by Eocene north-south shortening between Africa and Eurasia. This brought close to each other Cretaceous ophiolites derived from the north of Anatolia and those obducted on the Arabian promontory. The latter were sealed by a Maastrichtian platform, and locally never affected by Alpine tectonism, whereas those located on the eastern Anatolian plate are strongly deformed and metamorphosed, and affected by Eocene arc magmatism. These observations help to reconstruct the larger frame of the central Tethyan realm geodynamic evolution.