Reproducibility of peripheral arterial tonometry measurements in male cardiovascular patients

BACKGROUND Assessment of endothelial function of the microvasculature by peripheral arterial tonometry (EndoPAT(®)) has gained increasing popularity in patients with cardiovascular risk factors. Only limited knowledge about its reproducibility in patients with coronary artery disease (CAD) is available. We therefore aimed to quantify reproducibility of EndoPAT(®) parameters in patients with stable CAD. DESIGN EndoPAT(®) measurements were performed repeatedly in 78 male patients (age 66 ± 8 years) with CAD on stable medication. We calculated overall mean, standard deviation (SD), coefficient of variation (CV) and intraclass correlation coefficient (ICC) of the following parameters: reactive hyperemic index (RHI), PAT ratio of the postocclusion period 90-150 s as used for calculation of the RHI (PAT ratio90-150 s) and 90-120 s (PAT ratio90-120 s) as used for the often employed Framingham RHI (F-RHI), as well as PAT ratio of the peak hyperemic response (PAT ratiopeak response). Additionally, least significant changes (LSC) for individual subjects and minimum sample sizes for parallel and cross-over design studies were calculated. RESULTS Mean RHI was 1·84 (SD 0·36). For RHI, PAT ratio90-150 s , PAT ratio90-120 s , and PAT ratiopeak response the CVs were 17·0%, 25·4%, 26·1%, and 25·0%, respectively. The ICCs were 0·45, 0·49, 0·48 and 0·51, respectively, and LSC for RHI was 47·2%. CONCLUSIONS CV of RHI in our population was moderate; however, we consider this precision insufficient to monitor changes in individual patients, as they would need to exceed 47% to show a significant change. Further, the poor ICCs reflect the difficulty of detecting treatment effects in homogenous populations, such as patients with stable CAD.

Relation between Excitation Power Density and Er3+ Doping Yielding the Highest Absolute Upconversion Quantum Yield

The upconversion quantum yield (UCQY) is one of the most significant parameters for upconverter materials. A high UCQY is essential for a succesful integration of upconversion in many applications, such as harvesting of the solar radiation. However, little is known about which doping level of the rare-earth ions yields the highest UCQY in the different host lattices and what are the underlying causes. Here, we investigate which Er3+ doping yields the highest UCQY in the host lattices β-NaYF4 and Gd2O2S under 4I15/2 → 4I13/2 excitation. We show for both host lattices that the optimum Er3+ doping is not fixed and it actually decreases as the irradiance of the excitation increases. To find the optimum Er3+ doping for a given irradiance, we determined the peak position of the internal UCQY as a function of the average Er−Er distance. For this purpose, we used a fit on experimental data, where the average Er−Er distance was calculated from the Er3+ doping of the upconverter samples and the lattice parameters of the host materials. We observe optimum average Er−Er distances for the host lattices β-NaYF4 and Gd2O2S with differences <14% at the same irradiance levels, whereas the optimum Er3+ doping are around 2× higher for β-NaYF4 than for Gd2O2S. Estimations by extrapolation to higher irradiances indicate that the optimum average Er−Er distance converges to values around 0.88 and 0.83 nm for β-NaYF4 and Gd2O2S, respectively. Our findings point to a fundamental relationship and focusing on the average distance between the active rare-earth ions might be a very efficient way to optimize the doping of rare-earth ions with regard to the highest achievable UCQY.

Visible near infra-red (VisNIR) spectroscopy for predicting soil organic carbon in Ethiopia

Over the past few decades, the advantages of the visible-near infra-red (VisNIR) diffuse reflectance spectrometer (DRS) method have enabled prediction of soil organic carbon (SOC). In this study, SOC was predicted using regression models for samples taken from three sites (Gununo, Maybar and Anjeni) in Ethiopia. SOC was characterized in laboratory using conventional wet chemistry and VisNIR-DRS methods. Principal component analysis (PCA), principal component regression (PCR) and partial least square regression (PLS) models were developed using Unscrambler X 10.2. PCA results show that the first two components accounted for a minimum of 96% variation which increased for individual sites and with data treatments. Correlation (r), coefficient of determination (R2) and residual prediction deviation (RPD) were used to rate four models built. PLS model (r, R2, RPD) values for Anjeni were 0.9, 0.9 and 3.6; for Gununo values 0.6, 0.3 and 1.2; for Maybar values 0.6, 0.3 and 0.9, and for the three sites values 0.7, 0.6 and 1.5, respectively. PCR model values (r, R2, RPD) for Anjeni were 0.9, 0.8 and 2.7; for Gununo values 0.5, 0.3 and 1; for Maybar values 0.5, 0.1 and 0.7, and for the three sites values 0.7, 0.5 and 1.2, respectively. Comparison and testing of models shows superior performance of PLS to PCR. Models were rated as very poor (Maybar), poor (Gununo and three sites) and excellent (Anjeni). A robust model, Anjeni, is recommended for prediction of SOC in Ethiopia.

Comparison of energy expenditure, eating pattern and physical activity of grazing and zero-grazing dairy cows at different time points during lactation

An experiment was conducted to determine the effect of grazing versus zero-grazing on energy expenditure (EE), feeding behaviour and physical activity in dairy cows at different stages of lactation. Fourteen Holstein cows were subjected to two treatments in a repeated crossover design with three experimental series (S1, S2, and S3) reflecting increased days in milk (DIM). At the beginning of each series, cows were on average at 38, 94 and 171 (standard deviation (SD) 10.8) DIM, respectively. Each series consisted of two periods containing a 7-d adaptation and a 7-d collection period each. Cows either grazed on pasture for 16–18.5 h per day or were kept in a freestall barn and had ad libitum access to herbage harvested from the same paddock. Herbage intake was estimated using the double alkane technique. On each day of the collection period, EE of one cow in the barn and of one cow on pasture was determined for 6 h by using the 13C bicarbonate dilution technique, with blood sample collection done either manually in the barn or using an automatic sampling system on pasture. Furthermore, during each collection period physical activity and feeding behaviour of cows were recorded over 3 d using pedometers and behaviour recorders. Milk yield decreased with increasing DIM (P<0.001) but was similar with both treatments. Herbage intake was lower (P<0.01) for grazing cows (16.8 kg dry matter (DM)/d) compared to zero-grazing cows (18.9 kg DM/d). The lowest (P<0.001) intake was observed in S1 and similar intakes were observed in S2 and S3. Within the 6-h measurement period, grazing cows expended 19% more (P<0.001) energy (319 versus 269 kJ/kg metabolic body size (BW0.75)) than zero-grazing cows and differences in EE did not change with increasing DIM. Grazing cows spent proportionally more (P<0.001) time walking and less time standing (P<0.001) and lying (P<0.05) than zero-grazing cows. The proportion of time spent eating was greater (P<0.001) and that of time spent ruminating was lower (P<0.05) for grazing cows compared to zero-grazing cows. In conclusion, lower feed intake along with the unchanged milk production indicates that grazing cows mobilized body reserves to cover additional energy requirements which were at least partly caused by more physical activity. However, changes in cows׳ behaviour between the considered time points during lactation were too small so that differences in EE remained similar between treatments with increasing DIM.

Der allergische Notfall: Adrenalin das Mittel der Wahl bei der Anaphylaxie

Although allergic emergencies do not occur every day, they are as unpredictable as the course of the reaction, and require rapid treatment. Anaphylaxis is a life-threatening general reaction that usually manifests within a few minutes after a known or potential antigen contact. While sole cutaneous symptoms are not sufficient to diagnose anaphylaxis, an episode of acute bronchospasm or hypotension in rare cases may be the only symptom. Almost always two or more organ systems are affected and usually the skin and/or mucous membranes are involved. Epinephrine (adrenaline) is the most important and effective drug in the treatment of anaphylaxis. Since there is no absolute contraindication, epinephrine should be administered intramuscularly at the first signs of anaphylaxis. However, there is a gap between the international treatment guidelines and the daily practice in the treatment of acute allergic, particularly anaphylactic, reactions. This is due not least to the fact that anaphylaxis, the most severe form of allergy, is not sufficiently clear or uniformly defined. After a systemic allergic reaction, all patients should be equipped with emergency medications, appropriately instructed obtain a complete allergy work-up.

Search for supersymmetry in events with large missing transverse momentum, jets, and at least one tau lepton in 20 fb⁻¹ of √s= 8 TeV proton-proton collision data with the ATLAS detector

A search for supersymmetry (SUSY) in events with large missing transverse momentum, jets, at least one hadronically decaying tau lepton and zero or one additional light leptons (electron/muon), has been performed using 20.3 fb−1 of proton-proton collision data at √s = 8TeV recorded with the ATLAS detector at the Large Hadron Collider. No excess above the Standard Model background expectation is observed in the various signal regions and 95% confidence level upper limits on the visible cross section for new phenomena are set. The results of the analysis are interpreted in several SUSY scenarios, significantly extending previous limits obtained in the same final states. In the framework of minimal gauge-mediated SUSY breaking models, values of the SUSY breaking scale ʌ below 63TeV are excluded, independently of tan β. Exclusion limits are also derived for an mSUGRA/CMSSM model, in both the R-parity-conserving and R-parity-violating case. A further interpretation is presented in a framework of natural gauge mediation, in which the gluino is assumed to be the only light coloured sparticle and gluino masses below 1090GeV are excluded.

Search for strong production of supersymmetric particles in final states with missing transverse momentum and at least three b-jets at √s= 8 TeV proton-proton collisions with the ATLAS detector

This paper reports the results of a search for strong production of supersymmetric particles in 20.1 fb−1 of proton-proton collisions at a centre-of-mass energy of 8TeV using the ATLAS detector at the LHC. The search is performed separately in events with either zero or at least one high-pT lepton (electron or muon), large missing transverse momentum, high jet multiplicity and at least three jets identified as originated from the fragmentation of a b-quark. No excess is observed with respect to the Standard Model predictions. The results are interpreted in the context of several supersymmetric models involving gluinos and scalar top and bottom quarks, as well as a mSUGRA/CMSSM model. Gluino masses up to 1340 GeV are excluded, depending on the model, significantly extending the previous ATLAS limits.

Search for supersymmetry at √8=8 TeV in final states with jets and two same-sign leptons or three leptons with the ATLAS detector

A search for strongly produced supersymmetric particles is conducted using signatures involving multiple energetic jets and either two isolated leptons (e or μ) with the same electric charge, or at least three isolated leptons. The search also utilises jets originating from b-quarks, missing transverse momentum and other observables to extend its sensitivity. The analysis uses a data sample corresponding to a total integrated luminosity of 20.3 fb−1 of ps = 8TeV proton-proton collisions recorded with the ATLAS detector at the Large Hadron Collider in 2012. No deviation from the Standard Model expectation is observed. New or significantly improved exclusion limits are set on a wide variety of supersymmetric models in which the lightest squark can be of the first, second or third generations, and in which R-parity can be conserved or violated.

Pollen dispersal properties of Poaceae and Cyperaceae: First estimates of their absolute pollen productivities

Pollen-trap results from the Swiss Alps 1996–2009 were used to assess the pollen dispersal–deposition properties of Poaceae (grasses) and Cyperaceae (sedges). Dispersal parameter values were investigated for a modified version of the Prentice–Sugita pollen dispersal–deposition model. Appropriate values (i.e. realistic in the field and allowing realistic modelling results) for wind speed are suggested to be in the range of 3–7 m s− 1 and for pollen an injection height of 0.03–0.1 m above the ground. The appropriate range of pollen injection height values for grasses and sedges differs from that of trees in the same area, suggesting different pollen dispersal properties between herbs and trees. In addition, logarithmic weighting of the vegetation was tested as an alternative to the modified Prentice–Sugita model. This yielded very similar results, suggesting that the use of such much simpler approximations of the pollen–vegetation relationship is a plausible alternative. Based on the modified Prentice–Sugita model, absolute pollen productivity for Poaceae was estimated to 7300 ± 400 grains cm− 2 year− 1 (1 SE). The data basis for Cyperaceae is smaller than for Poaceae, but the dispersal parameter values determined as appropriate for Poaceae yield good results. Absolute pollen productivity for Cyperaceae was estimated to 6300 ± 1100 grains cm− 2 year− 1 (1 SE).

The impact of absolute importance and processing overlaps on prospective memory performance

Prospective memory is the ability to remember an intention at an appropriate moment in the future. Prospective memory tasks can be more or less important. Previously, importance was manipulated by emphasizing the importance of the prospective memory task relative to the ongoing task it was embedded in. This resulted in better prospective memory performance but also ongoing task costs. In the present study, we simply instructed one group of participants that the prospective memory task was important (i.e., absolute importance instruction) and compared them to a group with relative importance instructions and a control group. The results showed that absolute importance lead to an increase in prospective memory performance without enhancing ongoing task costs, whereas relative importance resulted in both increased prospective memory performance and ongoing task costs. Thus, prospective memory can be enhanced without ongoing task costs, which is particularly crucial for safety-work contexts.

Modeling absolute differences in life expectancy with a censored skew-normal regression approach.

Parameter estimates from commonly used multivariable parametric survival regression models do not directly quantify differences in years of life expectancy. Gaussian linear regression models give results in terms of absolute mean differences, but are not appropriate in modeling life expectancy, because in many situations time to death has a negative skewed distribution. A regression approach using a skew-normal distribution would be an alternative to parametric survival models in the modeling of life expectancy, because parameter estimates can be interpreted in terms of survival time differences while allowing for skewness of the distribution. In this paper we show how to use the skew-normal regression so that censored and left-truncated observations are accounted for. With this we model differences in life expectancy using data from the Swiss National Cohort Study and from official life expectancy estimates and compare the results with those derived from commonly used survival regression models. We conclude that a censored skew-normal survival regression approach for left-truncated observations can be used to model differences in life expectancy across covariates of interest.

Effect of Health Risk Assessment and Counselling on Health Behaviour and Survival in Older People: A Pragmatic Randomised Trial.

BACKGROUND Potentially avoidable risk factors continue to cause unnecessary disability and premature death in older people. Health risk assessment (HRA), a method successfully used in working-age populations, is a promising method for cost-effective health promotion and preventive care in older individuals, but the long-term effects of this approach are unknown. The objective of this study was to evaluate the effects of an innovative approach to HRA and counselling in older individuals for health behaviours, preventive care, and long-term survival. METHODS AND FINDINGS This study was a pragmatic, single-centre randomised controlled clinical trial in community-dwelling individuals aged 65 y or older registered with one of 19 primary care physician (PCP) practices in a mixed rural and urban area in Switzerland. From November 2000 to January 2002, 874 participants were randomly allocated to the intervention and 1,410 to usual care. The intervention consisted of HRA based on self-administered questionnaires and individualised computer-generated feedback reports, combined with nurse and PCP counselling over a 2-y period. Primary outcomes were health behaviours and preventive care use at 2 y and all-cause mortality at 8 y. At baseline, participants in the intervention group had a mean ± standard deviation of 6.9 ± 3.7 risk factors (including unfavourable health behaviours, health and functional impairments, and social risk factors) and 4.3 ± 1.8 deficits in recommended preventive care. At 2 y, favourable health behaviours and use of preventive care were more frequent in the intervention than in the control group (based on z-statistics from generalised estimating equation models). For example, 70% compared to 62% were physically active (odds ratio 1.43, 95% CI 1.16-1.77, p = 0.001), and 66% compared to 59% had influenza vaccinations in the past year (odds ratio 1.35, 95% CI 1.09-1.66, p = 0.005). At 8 y, based on an intention-to-treat analysis, the estimated proportion alive was 77.9% in the intervention and 72.8% in the control group, for an absolute mortality difference of 4.9% (95% CI 1.3%-8.5%, p = 0.009; based on z-test for risk difference). The hazard ratio of death comparing intervention with control was 0.79 (95% CI 0.66-0.94, p = 0.009; based on Wald test from Cox regression model), and the number needed to receive the intervention to prevent one death was 21 (95% CI 12-79). The main limitations of the study include the single-site study design, the use of a brief self-administered questionnaire for 2-y outcome data collection, the unavailability of other long-term outcome data (e.g., functional status, nursing home admissions), and the availability of long-term follow-up data on mortality for analysis only in 2014. CONCLUSIONS This is the first trial to our knowledge demonstrating that a collaborative care model of HRA in community-dwelling older people not only results in better health behaviours and increased use of recommended preventive care interventions, but also improves survival. The intervention tested in our study may serve as a model of how to implement a relatively low-cost but effective programme of disease prevention and health promotion in older individuals. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number: ISRCTN 28458424.