Blood pressure and LDL-cholesterol targets for prevention of recurrent strokes and cognitive decline in the hypertensive patient: design of the European Society of Hypertension-Chinese Hypertension League Stroke in Hypertension Optimal Treatment randomized trial.

BACKGROUND AND OBJECTIVES: The SBP values to be achieved by antihypertensive therapy in order to maximize reduction of cardiovascular outcomes are unknown; neither is it clear whether in patients with a previous cardiovascular event, the optimal values are lower than in the low-to-moderate risk hypertensive patients, or a more cautious blood pressure (BP) reduction should be obtained. Because of the uncertainty whether 'the lower the better' or the 'J-curve' hypothesis is correct, the European Society of Hypertension and the Chinese Hypertension League have promoted a randomized trial comparing antihypertensive treatment strategies aiming at three different SBP targets in hypertensive patients with a recent stroke or transient ischaemic attack. As the optimal level of low-density lipoprotein cholesterol (LDL-C) level is also unknown in these patients, LDL-C-lowering has been included in the design. PROTOCOL DESIGN: The European Society of Hypertension-Chinese Hypertension League Stroke in Hypertension Optimal Treatment trial is a prospective multinational, randomized trial with a 3 × 2 factorial design comparing: three different SBP targets (1, <145-135; 2, <135-125; 3, <125 mmHg); two different LDL-C targets (target A, 2.8-1.8; target B, <1.8 mmol/l). The trial is to be conducted on 7500 patients aged at least 65 years (2500 in Europe, 5000 in China) with hypertension and a stroke or transient ischaemic attack 1-6 months before randomization. Antihypertensive and statin treatments will be initiated or modified using suitable registered agents chosen by the investigators, in order to maintain patients within the randomized SBP and LDL-C windows. All patients will be followed up every 3 months for BP and every 6 months for LDL-C. Ambulatory BP will be measured yearly. OUTCOMES: Primary outcome is time to stroke (fatal and non-fatal). Important secondary outcomes are: time to first major cardiovascular event; cognitive decline (Montreal Cognitive Assessment) and dementia. All major outcomes will be adjudicated by committees blind to randomized allocation. A Data and Safety Monitoring Board has open access to data and can recommend trial interruption for safety. SAMPLE SIZE CALCULATION: It has been calculated that 925 patients would reach the primary outcome after a mean 4-year follow-up, and this should provide at least 80% power to detect a 25% stroke difference between SBP targets and a 20% difference between LDL-C targets.

Impact of a cis-associated gene expression SNP on chromosome 20q11.22 on bipolar disorder susceptibility, hippocampal structure and cognitive performance.

BackgroundBipolar disorder is a highly heritable polygenic disorder. Recent enrichment analyses suggest that there may be true risk variants for bipolar disorder in the expression quantitative trait loci (eQTL) in the brain.AimsWe sought to assess the impact of eQTL variants on bipolar disorder risk by combining data from both bipolar disorder genome-wide association studies (GWAS) and brain eQTL.MethodTo detect single nucleotide polymorphisms (SNPs) that influence expression levels of genes associated with bipolar disorder, we jointly analysed data from a bipolar disorder GWAS (7481 cases and 9250 controls) and a genome-wide brain (cortical) eQTL (193 healthy controls) using a Bayesian statistical method, with independent follow-up replications. The identified risk SNP was then further tested for association with hippocampal volume (n = 5775) and cognitive performance (n = 342) among healthy individuals.ResultsIntegrative analysis revealed a significant association between a brain eQTL rs6088662 on chromosome 20q11.22 and bipolar disorder (log Bayes factor = 5.48; bipolar disorder P = 5.85×10(-5)). Follow-up studies across multiple independent samples confirmed the association of the risk SNP (rs6088662) with gene expression and bipolar disorder susceptibility (P = 3.54×10(-8)). Further exploratory analysis revealed that rs6088662 is also associated with hippocampal volume and cognitive performance in healthy individuals.ConclusionsOur findings suggest that 20q11.22 is likely a risk region for bipolar disorder; they also highlight the informative value of integrating functional annotation of genetic variants for gene expression in advancing our understanding of the biological basis underlying complex disorders, such as bipolar disorder.

A cyber security architecture for military networks using a cognitive network approach

Cyber security is one of the main topics that are discussed around the world today. The threat is real, and it is unlikely to diminish. People, business, governments, and even armed forces are networked in a way or another. Thus, the cyber threat is also facing military networking. On the other hand, the concept of Network Centric Warfare sets high requirements for military tactical data communications and security. A challenging networking environment and cyber threats force us to consider new approaches to build security on the military communication systems. The purpose of this thesis is to develop a cyber security architecture for military networks, and to evaluate the designed architecture. The architecture is described as a technical functionality. As a new approach, the thesis introduces Cognitive Networks (CN) which are a theoretical concept to build more intelligent, dynamic and even secure communication networks. The cognitive networks are capable of observe the networking environment, make decisions for optimal performance and adapt its system parameter according to the decisions. As a result, the thesis presents a five-layer cyber security architecture that consists of security elements controlled by a cognitive process. The proposed architecture includes the infrastructure, services and application layers that are managed and controlled by the cognitive and management layers. The architecture defines the tasks of the security elements at a functional level without introducing any new protocols or algorithms. For evaluating two separated method were used. The first method is based on the SABSA framework that uses a layered approach to analyze overall security of an organization. The second method was a scenario based method in which a risk severity level is calculated. The evaluation results show that the proposed architecture fulfills the security requirements at least at a high level. However, the evaluation of the proposed architecture proved to be very challenging. Thus, the evaluation results must be considered very critically. The thesis proves the cognitive networks are a promising approach, and they provide lots of benefits when designing a cyber security architecture for the tactical military networks. However, many implementation problems exist, and several details must be considered and studied during the future work.

Helsingin matkailijakartta = Turistkarta över Helsingfors = Helsinki : Touristenkarte = Helsinki : tourist map = Helsinki : plan touristique

Kartta kääntöpuolella

Map of Helsinki-Helsingfors

Kääntöpuolella kannessa: Finland Travel Bureau Ltd Esplanade 19, Branch Office Stockmanns Department Stores

Helsingin matkailijakartta = Turistkarta över Helsingfors = Helsinki : Touristenkarte = Helsinki : tourist map = Helsinki : plan touristique

Kartta kääntöpuolella

Nieuwe paskaart voor een gedeelte van de Oost-Zee = Nouvelle carte hydrographique d'une partie de la Mer Baltique = Nya pass cort öfwer yen dehl af Oster-Siöön = The new sea map of the second of the East-Sea

Sisältää myös kartakkeet: Pastkaartje van de Noord Bodem, Suomenlahden itäosa ja Laatokka

Nieuwe paskaart voor een gedeelte van de Oost-Zee = Nouvelle carte hydrographique d'une partie de la Mer Baltique = Nya pass cort öfwer yen dehl af Oster-Siöön = The new sea map of the second of the East-Sea

Sisältää myös kartakkeet: Pastkaartje van de Noord Bodem, Suomenlahden itäosa ja Laatokka

Lancelot du Lac [par GAUTIER MAP].

Commençant par : «... nois negée et si li out aparellée à sa chevalerie robe blanche de samit, cote et mantel... » et finissant par : «... conquier, damoisele, nos en aurons... helmes et cil chevaliers a... » . Incomplet an commencement et à la fin ; le dernier feuillet est en partie effacé.

Roman de Lancelot du Lac, Quête du S. Graal et mort d'Artus, par GAUTIER MAP.

Contient : «... l'assemblée qui lors i fu la veille de Pantecouste. Explicit. Ci fenist mestre Gautier Map son livre et commance le Galaad. (Fol. 152.) A la veille de Pantecouste quant li compaignon de la Table ronde... » (Incomplet. de la fin.) — Miniatures

Master Plan Map

Master Plan Phase 2. Map of the original 1964 master plan showing the planned campus layout and distances from the centre of campus (ie. the Tower).

Master Plan Map

Master Plan Phase 2. This overhead map of the original 1964 Master Plan shows the planned campus layout along the escarpment.

Land Use Map

This map shows the entire campus master plan and details what each area of land would be used for.