A randomized trial of aggressive lipid reduction for improvement of myocardial ischemia, symptom status, and vascular function in patients with coronary artery disease not amenable to intervention

PURPOSE: To determine the effects of aggressive lipid lowering on markers of ischemia, resistance vessel function, atherosclerotic burden, and Symptom status in patients with symptomatic coronary artery disease. METHODS: Sixty consecutive patients with coronary artery disease that was unsuitable for revascularization were assigned randomly to either usual therapy of lipids for patients with a low-density lipoprotein (LDL) cholesterol target level <116 mg/dL, or to a, more aggressive lipid-lowering strategy involving up to 80 mg/d of atorvastatin, with a target LDL cholesterol level <77 mg/dL. The extent and severity of inducible ischemia (by dobutamine echocardiography), vascular function.(brachial artery reactivity), atheroma burden (carotid intima-media thickness), and symptom status were evaluated blindly at baseline and after 12 weeks of treatment. RESULTS: After 12 weeks of treatment, patients in the aggressive therapy group had a significantly greater decrease in mean (+/- SD) LDL cholesterol level than those in the usual care group (29 +/- 38 mg/dL vs. 7 +/- 24 mg/dL, P = 0.03). Patients in the aggressive therapy group had a reduction in the number of ischemic wall segments (mean between-group difference of 1.3; 95% confidence interval: 0.1 to 2.0; P = 0.04), flow-mediated dilatation (mean between-group difference of 5.9%; 95% confidence interval: 2.5% to 9.4%; P = 0.001), and angina score after 12 weeks. There were no significant changes in atherosclerotic burden in either group. CONCLUSION: Patients with symptomatic coronary artery disease who are treated with aggressive lipid lowering have improvement of symptom status and ischemia that appears to reflect improved vascular function but not atheroma burden. Am J Med. 2003;114:445-453. (C) 2003 by Excerpta Medica Inc.

Are thiazide diuretics preferred as first-line therapy for hypertension? An appraisal of The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)

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Lipid rafts and caveolae as portals for endocytosis: New insights and common mechanisms

Clathrin-coated pits and caveolae are two of the most recognizable features of the plasma membrane of mammalian cells. While our understanding of the machinery regulating and driving clathrin-coated pit-mediated endocytosis has progressed dramatically, including the elucidation of the structure of individual components and partial in vitro reconstitution, the role of caveolae as alternative endocytic carriers still remains elusive 50 years after their discovery. However, recent work has started to provide new insights into endocytosis by caveolae and into apparently related pathways involving lipid raft domains. These pathways, distinguished by their exquisite sensitivity to cholesterol-sequestering agents, can involve caveolae but also exist in cells devoid of caveolins and caveolae. This review examines the current evidence for the involvement of rafts and caveolae in endocytosis and the molecular players involved in their regulation.

Assessing forest fire as a potential PCDD/F source in Queensland, Australia

Forest fires are suggested as a potential and significant source of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs), even though no studies to date provide sufficient evidence to confirm forest fires as a source of PCDD/Fs. Recent investigations in Gueensland, Australia have identified a widespread contamination of PCDDs (in particular OND) in soils and sediments in the coastal region from an unknown source of PCDD/Fs. Queensland is predominately rural; it has few known anthropogenic sources of PCDD/Fs, whereas forest fires are a frequent occurrence. This study was conducted to assess forest fires as a potential source of the unknown PCDD/F contamination in Queensland. A combustion experiment was designed to assess the overall mass of PCDD/Fs before and after a simulated forest fire. The results from this study did not identify an increase in Sigma-PCDD/Fs or OCDD after the combustion process. However, specific non-2,3,7,8 substituted lower chlorinated PCDD/Fs were elevated after the combustion process, suggesting formation from a precursor. The results from this study indicate that forest fires are unlikely to be the source of the unknown PCDD contamination in Gueensland, rather they are a key mechanism for the redistribution of PCDD/Fs from existing sources and precursors.

The peroxisome proliferator-activated receptor beta/delta agonist, GW501516, regulates the expression of genes involved in lipid catabolism and energy uncoupling in skeletal muscle cells

Lipid homeostasis is controlled by the peroxisome proliferator-activated receptors (PPARalpha, -beta/delta, and -gamma) that function as fatty acid-dependent DNA-binding proteins that regulate lipid metabolism. In vitro and in vivo genetic and pharmacological studies have demonstrated PPARalpha regulates lipid catabolism. In contrast, PPARgamma regulates the conflicting process of lipid storage. However, relatively little is known about PPARbeta/delta in the context of target tissues, target genes, lipid homeostasis, and functional overlap with PPARalpha and -gamma. PPARbeta/delta, a very low-density lipoprotein sensor, is abundantly expressed in skeletal muscle, a major mass peripheral tissue that accounts for approximately 40% of total body weight. Skeletal muscle is a metabolically active tissue, and a primary site of glucose metabolism, fatty acid oxidation, and cholesterol efflux. Consequently, it has a significant role in insulin sensitivity, the blood-lipid profile, and lipid homeostasis. Surprisingly, the role of PPARbeta/delta in skeletal muscle has not been investigated. We utilize selective PPARalpha, -beta/delta, -gamma, and liver X receptor agonists in skeletal muscle cells to understand the functional role of PPARbeta/delta, and the complementary and/or contrasting roles of PPARs in this major mass peripheral tissue. Activation of PPARbeta/delta by GW501516 in skeletal muscle cells induces the expression of genes involved in preferential lipid utilization, beta-oxidation, cholesterol efflux, and energy uncoupling. Furthermore, we show that treatment of muscle cells with GW501516 increases apolipoprotein-A1 specific efflux of intracellular cholesterol, thus identifying this tissue as an important target of PPARbeta/delta agonists. Interestingly, fenofibrate induces genes involved in fructose uptake, and glycogen formation. In contrast, rosiglitazone-mediated activation of PPARgamma induces gene expression associated with glucose uptake, fatty acid synthesis, and lipid storage. Furthermore, we show that the PPAR-dependent reporter in the muscle carnitine palmitoyltransferase-1 promoter is directly regulated by PPARbeta/delta, and not PPARalpha in skeletal muscle cells in a PPARgamma coactivator-1-dependent manner. This study demonstrates that PPARs have distinct roles in skeletal muscle cells with respect to the regulation of lipid, carbohydrate, and energy homeostasis. Moreover, we surmise that PPARgamma/delta agonists would increase fatty acid catabolism, cholesterol efflux, and energy expenditure in muscle, and speculate selective activators of PPARbeta/delta may have therapeutic utility in the treatment of hyperlipidemia, atherosclerosis, and obesity.

Faeces as a source of DNA for molecular studies in a threatened population of great bustards

With recent advances in molecular biology, it is now possible to use the trace amounts of DNA in faeces to non-invasively sample endangered species for genetic studies. A highly vulnerable population of approximately 100 great bustards (Otis tarda) exists in Morocco necessitating the use of non-invasive protocols to study their genetic structure. Here we report a reliable silica-based method to extract DNA from great bustard faeces. We found that successful extraction and amplification correlated strongly with faeces freshness and composition. We could not extract amplifiable DNA from 30% of our samples as they were dry or contained insect material. However 100% of our fresh faecal samples containing no obvious insect material worked, allowing us to assess the levels of genetic variation among 25 individuals using a 542 bp control region sequence. We were able to extract DNA from four out of five other avian species, demonstrating that faeces represents a suitable source of DNA for population genetics studies in a broad range of species.

GUI Inspection from Source Code Analysis

Graphical user interfaces (GUIs) are critical components of todays software. Given their increased relevance, correctness and usability of GUIs are becoming essential. This paper describes the latest results in the development of our tool to reverse engineer the GUI layer of interactive computing systems. We use static analysis techniques to generate models of the user interface behaviour from source code. Models help in graphical user interface inspection by allowing designers to concentrate on its more important aspects. One particularly type of model that the tool is able to generate is state machines. The paper shows how graph theory can be useful when applied to these models. A number of metrics and algorithms are used in the analysis of aspects of the user interface's quality. The ultimate goal of the tool is to enable analysis of interactive system through GUIs source code inspection.

GUI Behavior from Source Code Analysis

When developing interactive applications, considering the correctness of graphical user interfaces (GUIs) code is essential. GUIs are critical components of today's software, and contemporary software tools do not provide enough support for ensuring GUIs' code quality. GUIsurfer, a GUI reverse engineering tool, enables evaluation of behavioral properties of user interfaces. It performs static analysis of GUI code, generating state machines that can help in the evaluation of interactive applications. This paper describes the design, software architecture, and the use of GUIsurfer through an example. The tool is easily re-targetable, and support is available to Java/Swing, and WxHaskell. The paper sets the ground for a generalization effort to consider rich internet applications. It explores the GWT web applications' user interface programming toolkit.

Extracting and verifying coordination models from source code

Current software development relies increasingly on non-trivial coordination logic for com- bining autonomous services often running on di erent platforms. As a rule, however, in typical non-trivial software systems, such a coordination layer is strongly weaved within the application at source code level. Therefore, its precise identi cation becomes a major methodological (and technical) problem which cannot be overestimated along any program understanding or refactoring process. Open access to source code, as granted in OSS certi cation, provides an opportunity for the devel- opment of methods and technologies to extract, from source code, the relevant coordination information. This paper is a step in this direction, combining a number of program analysis techniques to automatically recover coordination information from legacy code. Such information is then expressed as a model in Orc, a general purpose orchestration language

Analysis of computing open source systems

Graphical user interfaces (GUIs) are critical components of today's open source software. Given their increased relevance, the correctness and usability of GUIs are becoming essential. This paper describes the latest results in the development of our tool to reverse engineer the GUI layer of interactive computing open source systems. We use static analysis techniques to generate models of the user interface behavior from source code. Models help in graphical user interface inspection by allowing designers to concentrate on its more important aspects. One particular type of model that the tool is able to generate is state machines. The paper shows how graph theory can be useful when applied to these models. A number of metrics and algorithms are used in the analysis of aspects of the user interface's quality. The ultimate goal of the tool is to enable analysis of interactive system through GUIs source code inspection.

Characterization of verdete rock as a potential source of potassium

Potassium is a nutrient found at low levels in Brazilian soils, requiring large inputs of fertilizers to achieve satisfactory crop yields. Brazil has high external dependence and limited reserves of soluble K mineral, which is traditionally exploited for the production of fertilizers. On the other hand, it is common the occurrence in the country of potassium-rich silicate minerals which are not commercially exploited. This study aimed to characterize mineralogically and chemically samples of verdete rock separated into size fractions and evaluate its potential as potassium fertilizer. The mineral composition of verdete rock is based on glauconite, quartz and feldspar. The total K2O content in verdete rock ranged from 5.18 to 9.0 dag/kg. The K content extracted in water or 2% citric acid was 2.4% below the total of K, indicating low reactivity of verdete rock and limitations for direct use as K source. The processes of physical fractionation and sedimentation in water are inefficient to promote the concentration of K in the different verdete rock fractions. The total K content in some samples are considerable and may enable the use of this rock as raw material for production of more reactive potassium fertilizers.

New source-material for the socio-economic history of the Hindus of Goa

The Mhamai brothers were the suppliers of daily commodities / stationery to the viceroys / governors of Goa. Since late 18th century their agency house worked in partnership with several other trading houses all over the west coast of India. They also served as brokers for the French East India company in Goa during the critical period of anglo-french wars. The Mhamais were also revenue farmers, particularly customs and tobacco tax farming. I had the privilege of taking their family archives to the Xavier Centre of Historical Research in 1979 and making the history of the family known worldwide.

BAM framework for OMS using open source technologies

No início da década de 90, as empresas começaram a sentir a necessidade de melhorar o acesso à informação das suas actividades para auxiliar na tomada de decisões. Desta forma, no mundo da informática, emergiu o sector Business Intelligence (BI) composto inicialmente por data warehousing e ferramentas de geração de relatórios. Ao longo dos anos o conceito de BI evoluiu de acordo com as necessidades empresariais, tornando a análise das actividades e do desempenho das organizações em aspectos críticos na gestão das mesmas. A área de BI abrange diversos sectores, sendo o de geração de relatórios e o de análise de dados aqueles que melhor preenchem os requisitos pretendidos no controlo de acesso à informação do negócio e respectivos processos. Actualmente o tempo e a informação são vantagens competitivas e por esse mesmo motivo as empresas estão cada vez mais preocupadas com o facto de o aumento do volume de informação estar a tornar-se insustentável na medida que o tempo necessário para processar a informação é cada vez maior. Por esta razão muitas empresas de software, tais como Microsoft, IBM e Oracle estão numa luta por um lugar neste mercado de BI em expansão. Para que as empresas possam ser competitivas, a sua capacidade de previsão e resposta às necessidades de mercado em tempo real é requisito principal, em detrimento da existência apenas de uma reacção a uma necessidade que peca por tardia. Os produtos de BI têm fama de trabalharem apenas com dados históricos armazenados, o que faz com que as empresas não se possam basear nessas soluções quando o requisito de alguns negócios é de tempo quase real. A latência introduzida por um data warehouse é demasiada para que o desempenho seja aceitável. Desta forma, surge a tecnologia Business Activity Monitoring (BAM) que fornece análise de dados e alertas em tempo quase real sobre os processos do negócio, utilizando fontes de dados como Web Services, filas de mensagens, etc. O conceito de BAM surgiu em Julho de 2001 pela organização Gartner, sendo uma extensão orientada a eventos da área de BI. O BAM define-se pelo acesso em tempo real aos indicadores de desempenho de negócios com o intuito de aumentar a velocidade e eficácia dos processos de negócio. As soluções BAM estão a tornar-se cada vez mais comuns e sofisticadas.

Blood lipid associations in 18 year-old men

The association of cigarette smoking, physical activity at work, and social class with total cholesterol and with high and low density lipoprotein cholesterol were examined in a random sample of 238 males, of 18 years of age, of Rosario, Argerntina. The mean (mg/dl) total serum cholesterol of the whole sample was 174.7, the high density lipoprotein cholesterol 52.8, and the low density lipoprotein cholesterol 121.5. Black tobacco consumers, evenly distributed by social class, had higher levels of total and low density lipoprotein cholesterol. Total cholesterol was higher in the high social class, differently from what smokers' distribution by social class, would lead one to expect. While a highly negative association was found between social class and physical activity at work, there were no significant diferences in lipoprotein levels between manual and non-manual workers. It is possible that the nutritional differences by social class still prevail over the smoking habit in their influence on the lipoprotein levels in these subjects.

The source of the 1722 Algarve earthquake: evidence from MCS and tsunami data

The 27 December 1722 Algarve earthquake destroyed a large area in southern Portugal generating a local tsunami that inundated the shallow areas of Tavira. It is unclear whether its source was located onshore or offshore and, in any case, what was the tectonic source responsible for the event. We analyze available historical information concerning macroseismicity and the tsunami to discuss the most probable location of the source. We also review available seismotectonic knowledge of the offshore region close to the probable epicenter, selecting a set of four candidate sources. We simulate tsunamis produced by these candidate sources assuming that the sea bottom displacement is caused by a compressive dislocation over a rectangular fault, as given by the half-space homogeneous elastic approach, and we use numerical modeling to study wave propagation and run-up. We conclude that the 27 December 1722 Tavira earthquake and tsunami was probably generated offshore, close to 37 degrees 01'N, 7 degrees 49'W.