Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m2), normal weight (18.5≤BMI<25.0 kg/m2), overweight (25.0≤BMI<30.0 kg/m2), and obese (BMI≥30.0 kg/m2). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ2=35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.

Safety and outcome of coronary interventions with special reference to anticoagulation and stent type

University of Turku, Faculty of Medicine, Department of Cardiology and Cardiovascular Medicine, Doctoral Programme of Clinical Investigation, Heart Center, Turku University Hospital, Turku, Finland Division of Internal Medicine, Department of Cardiology, Seinäjoki Central Hospital, Seinäjoki, Finland Heart Center, Satakunta Central Hospital, Pori, Finland Annales Universitatis Turkuensis Painosalama Oy, Turku, Finland 2015 Antithrombotic therapy during and after coronary procedures always entails the challenging establishment of a balance between bleeding and thrombotic complications. It has been generally recommended to patients on long-term warfarin therapy to discontinue warfarin a few days prior to elective coronary angiography or intervention to prevent bleeding complications. Bridging therapy with heparin is recommended for patients at an increased risk of thromboembolism who require the interruption of anticoagulation for elective surgery or an invasive procedure. In study I, consecutive patients on warfarin therapy referred for diagnostic coronary angiography were compared to control patients with a similar disease presentation without warfarin. The strategy of performing coronary angiography during uninterrupted therapeutic warfarin anticoagulation appeared to be a relatively safe alternative to bridging therapy, if the international normalized ratio level was not on a supratherapeutic level. In-stent restenosis remains an important reason for failure of long-term success after a percutaneous coronary intervention (PCI). Drug-eluting stents (DES) reduce the problem of restenosis inherent to bare metal stents (BMS). However, a longer delay in arterial healing may extend the risk of stent thrombosis (ST) far beyond 30 days after the DES implantation. Early discontinuation of antiplatelet therapy has been the most important predisposing factor for ST. In study II, patients on long-term oral anticoagulant (OAC) underwent DES or BMS stenting with a median of 3.5 years’follow-up. The selective use of DESs with a short triple therapy seemed to be safe in OAC patients, since late STs were rare even without long clopidogrel treatment. Major bleeding and cardiac events were common in this patient group irrespective of stent type. In order to help to predict the bleeding risk in patients on OAC, several different bleeding risk scorings have been developed. Risk scoring systems have also been used also in the setting of patients undergoing a PCI. In study III, the predictive value of an outpatient bleeding risk index (OBRI) to identify patients at high risk of bleeding was analysed. The bleeding risk seemed not to modify periprocedural or long-term treatment choices in patients on OAC after a percutaneous coronary intervention. Patients with a high OBRI often had major bleeding episodes, and the OBRI may be suitable for risk evaluation in this patient group. Optical coherence tomography (OCT) is a novel technology for imaging intravascular coronary arteries. OCT is a light-based imaging modality that enables a 12–18 µm tissue axial resolution to visualize plaques in the vessel, possible dissections and thrombi as well as, stent strut appositions and coverage, and to measure the vessel lumen and lesions. In study IV, 30 days after titanium-nitride-oxide (TITANOX)-coated stent implantation, the binary stent strut coverage was satisfactory and the prevalence of malapposed struts was low as evaluated by OCT. Long-term clinical events in patients treated with (TITANOX)-coated bio-active stents (BAS) and paclitaxel-eluting stents (PES) in routine clinical practice were examined in study V. At the 3-year follow-up, BAS resulted in better long-term outcome when compared with PES with an infrequent need for target vessel revascularization. Keywords: anticoagulation, restenosis, thrombosis, bleeding, optical coherence tomography, titanium

The Forecast Performance of Model-Free Implied Volatility: Evidence from DAX Index Options

Volatility has a central role in various theoretical and practical applications in financial markets. These include the applications related to portfolio theory, derivatives pricing and financial risk management. Both theoretical and practical applications require good estimates and forecasts for the asset return volatility. The goal of this study is to examine the forecast performance of one of the more recent volatility measures, model-free implied volatility. Model-free implied volatility is extracted from the prices in the option markets, and it aims to provide an unbiased estimate for the market’s expectation on the future level of volatility. Since it is extracted from the option prices, model-free implied volatility should contain all the relevant information that the market participants have. Moreover, model-free implied volatility requires less restrictive assumptions than the commonly used Black-Scholes implied volatility, which means that it should be less biased estimate for the market’s expectations. Therefore, it should also be a better forecast for the future volatility. The forecast performance of model-free implied volatility is evaluated by comparing it to the forecast performance of Black-Scholes implied volatility and GARCH(1,1) forecast. Weekly forecasts for six years period were calculated for the forecasted variable, German stock market index DAX. The data consisted of price observations for DAX index options. The forecast performance was measured using econometric methods, which aimed to capture the biasedness, accuracy and the information content of the forecasts. The results of the study suggest that the forecast performance of model-free implied volatility is superior to forecast performance of GARCH(1,1) forecast. However, the results also suggest that the forecast performance of model-free implied volatility is not as good as the forecast performance of Black-Scholes implied volatility, which is against the hypotheses based on theory. The results of this study are consistent with the majority of prior research on the subject.

Evaluation of the in vitro glycemic index of a fiber-rich extruded breakfast cereal produced with organic passion fruit fiber and corn flour

The aim of this study was to determine the influence of process parameters and Passion Fruit Fiber (PFF) addition on the Glycemic Index (GI) of an extruded breakfast cereal. A 2³ Central Composite Rotational Design (CCRD) was used, with the following independent variables: raw material moisture content (18-28%), 2nd and 3rd barrel zone temperatures (120-160 ºC), and PFF (0-30%). Raw materials (organic corn flour and organic PFF) were characterized as to their proximate composition, particle size, and in vitro GI. The extrudates were characterized as to their in vitro GI. The Response Surface Methodology (RSM) and Principal Component Analysis (PCA) were used to analyze the results. Corn flour and PFF presented 8.55 and 7.63% protein, 2.61 and 0.60% fat, 0.52 and 6.17% ash, 78.77 and 78.86% carbohydrates (3 and 64% total dietary fiber), respectively. The corn flour particle size distribution was homogeneous, while PFF presented a heterogeneous particle size distribution. Corn flour and PFF presented values of GI of 48 and 45, respectively. When using RSM, no effect of the variables was observed in the GI of the extrudates (average value of 48.41), but PCA showed that the GI tended to be lower when processing at lower temperatures (<128 ºC) and at higher temperatures (>158 ºC). When compared to white bread, the extrudates showed a reduction of the GI of up to 50%, and could be considered an interesting alternative in weight and glycemia control diets.

Assessment of lettuce quality during storage at low relative humidity using Global Stability Index methodology

During postharvest, lettuce is usually exposed to adverse conditions (e.g. low relative humidity) that reduce the vegetable quality. In order to evaluate its shelf life, a great number of quality attributes must be analyzed, which requires careful experimental design, and it is time consuming. In this study, the modified Global Stability Index method was applied to estimate the quality of butter lettuce at low relative humidity during storage discriminating three lettuce zones (internal, middle, and external). The results indicated that the most relevant attributes were: the external zone - relative water content, water content , ascorbic acid, and total mesophilic counts; middle zone - relative water content, water content, total chlorophyll, and ascorbic acid; internal zone - relative water content, bound water, water content, and total mesophilic counts. A mathematical model that takes into account the Global Stability Index and overall visual quality for each lettuce zone was proposed. Moreover, the Weibull distribution was applied to estimate the maximum vegetable storage time which was 5, 4, and 3 days for the internal, middle, and external zone, respectively. When analyzing the effect of storage time for each lettuce zone, all the indices evaluated in the external zone of lettuce presented significant differences (p < 0.05). For both, internal and middle zones, the attributes presented significant differences (p < 0.05), except for water content and total chlorophyll.

Hävittäjäohjaajan kognitiivisen kuormituksen tason mittaaminen NASA-Task Load Index ja Modified Cooper-Harper -mittareilla F/A-18 virtuaalisimulaattorissa

F/A-18-monitoimihävittäjän ohjaajan tehtävän kognitiiviset vaatimukset ovat korkeat. Kognitiivisen kuormituksen taso vaikuttaa hävittäjäohjaajan suoritustasoon ja subjektiivisiin tun-temuksiin. Yerkesin ja Dodsonin periaatteen mukaisesti erittäin matala tai erittäin korkea kuormituksen taso laskee suoritustasoa. Optimaalinen kuormituksen taso ja suoritustaso saa-vutetaan jossain ääripäiden välillä. Hävittäjäohjaajan kognitiivisen kuormituksen tasoon vaikuttaa lentotehtävän suorittamiseen vaadittava henkinen ponnistelu. Vaadittavan ponnistelun taso riippuu tehtävien vaatimustasosta ja määrästä, tehtäviin käytettävissä olevasta ajasta sekä yksilöllisistä ominaisuuksista. Tutkimuksessa mitattiin kognitiivisen kuormituksen tasoa subjektiivisen arvioinnin menetelmällä NASA-TLX (National Aeronautics and Space Administration - Task Load Index) ja MCH (Modified Cooper-Harper) -mittareilla. Tutkimuksessa selvitettiin mittareiden havaintoarvojen muutosta, sensitiivisyyttä ja yhdenmukaisuutta kognitiivisen kuormituksen tason muuttuessa. Tutkimuksen mittauksiin osallistui 35 Suomen ilmavoimien aktiivisessa palveluksessa olevaa F/A-18-monitoimihävittäjäohjaajaa. Koehenkilöiden lentotuntien keskiarvo F/A-18-monitoimihävittäjällä oli 598 tuntia ja keskihajonta 445 tuntia. Koehenkilöiden tehtävänä oli lentää F/A-18-virtuaalisimulaattorilla 11 ILS (Instrument Landing System) -mittarilähestymistä eri aloitusetäisyyksiltä kiitotien kynnyksestä. Kognitiivisesti kuormitta-van mittarilähestymistehtävän aikana kuormituksen tasoa nostettiin lisätehtävillä ja vähentä-mällä tehtäviin käytettävissä olevaa aikaa. Koehenkilöitä pyydettiin ponnistelemaan mahdollisimman paljon tehtävien suorittamisen aikana hyvän suoritustason ylläpitämiseksi. Tulosten perusteella mittareiden havaintoarvot muuttuivat kognitiivisen kuormituksen tason muuttuessa. Käytettävissä olevan ajan vaikutus kognitiivisen kuormituksen tasoon oli tilastollisesti erittäin merkitsevä. Mittarit olivat sensitiivisiä kognitiivisen kuormituksen tason muutokselle ja antoivat yhdenmukaisia havaintoarvoja.

Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”), guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluated are healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruits causing early glycemic peak and the fruits with moderated GI (coconut water and custard apple).

Index librorum & tractatuum &c. &c. (cura [et] sumptibus J. G. d. ep. Ab.) Variis locis & temporibus, maximam partem recentioribus annis, in usum ecclesiae & scholarum in magno ducatu Finlandiae, editorum

Arkit: A2 B.

Index librorum & tractatuum &c. &c. (cura [et] sumptibus J. G. d. ep. Ab.) Variis locis & temporibus, maximam partem recentioribus annis, in usum ecclesiae & scholarum in magno ducatu Finlandiae, editorum

Arkit: A2 B1.

Index philosophique : philosophie et sciences annexes : biologie, neurologie, psychiatrie : publication de la Revue de philosophie / par N. Vaschide,... et von Buschan,...

1903 (A2).

Index philosophique : philosophie et sciences annexes : biologie, neurologie, psychiatrie : publication de la Revue de philosophie / par N. Vaschide,... et von Buschan,...

Périodicité : Annuel

Index philosophique : philosophie et sciences annexes : biologie, neurologie, psychiatrie : publication de la Revue de philosophie / par N. Vaschide,... et von Buschan,...

1902 (A1).