Summary Background Conventional coronary artery disease risk factors might potentially explain at least 90% of the attributable risk of coronary artery disease. To better understand the association ...between the pre-industrial lifestyle and low prevalence of coronary artery disease risk factors, we examined the Tsimane, a Bolivian population living a subsistence lifestyle of hunting, gathering, fishing, and farming with few cardiovascular risk factors, but high infectious inflammatory burden. Methods We did a cross-sectional cohort study including all individuals who self-identified as Tsimane and who were aged 40 years or older. Coronary atherosclerosis was assessed by coronary artery calcium (CAC) scoring done with non-contrast CT in Tsimane adults. We assessed the difference between the Tsimane and 6814 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). CAC scores higher than 100 were considered representative of significant atherosclerotic disease. Tsimane blood lipid and inflammatory biomarkers were obtained at the time of scanning, and in some patients, longitudinally. Findings Between July 2, 2014, and Sept 10, 2015, 705 individuals, who had data available for analysis, were included in this study. 596 (85%) of 705 Tsimane had no CAC, 89 (13%) had CAC scores of 1–100, and 20 (3%) had CAC scores higher than 100. For individuals older than age 75 years, 31 (65%) Tsimane presented with a CAC score of 0, and only four (8%) had CAC scores of 100 or more, a five-fold lower prevalence than industrialised populations (p≤0·0001 for all age categories of MESA). Mean LDL and HDL cholesterol concentrations were 2·35 mmol/L (91 mg/dL) and 1·0 mmol/L (39·5 mg/dL), respectively; obesity, hypertension, high blood sugar, and regular cigarette smoking were rare. High-sensitivity C-reactive protein was elevated beyond the clinical cutoff of 3·0 mg/dL in 360 (51%) Tsimane participants. Interpretation Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined. Funding National Institute on Aging, National Institutes of Health; St Luke's Hospital of Kansas City; and Paleocardiology Foundation.
Summary Background Atherosclerosis is thought to be a disease of modern human beings and related to contemporary lifestyles. However, its prevalence before the modern era is unknown. We aimed to ...evaluate preindustrial populations for atherosclerosis. Methods We obtained whole body CT scans of 137 mummies from four different geographical regions or populations spanning more than 4000 years. Individuals from ancient Egypt, ancient Peru, the Ancestral Puebloans of southwest America, and the Unangan of the Aleutian Islands were imaged. Atherosclerosis was regarded as definite if a calcified plaque was seen in the wall of an artery and probable if calcifications were seen along the expected course of an artery. Findings Probable or definite atherosclerosis was noted in 47 (34%) of 137 mummies and in all four geographical populations: 29 (38%) of 76 ancient Egyptians, 13 (25%) of 51 ancient Peruvians, two (40%) of five Ancestral Puebloans, and three (60%) of five Unangan hunter gatherers (p=NS). Atherosclerosis was present in the aorta in 28 (20%) mummies, iliac or femoral arteries in 25 (18%), popliteal or tibial arteries in 25 (18%), carotid arteries in 17 (12%), and coronary arteries in six (4%). Of the five vascular beds examined, atherosclerosis was present in one to two beds in 34 (25%) mummies, in three to four beds in 11 (8%), and in all five vascular beds in two (1%). Age at time of death was positively correlated with atherosclerosis (mean age at death was 43 SD 10 years for mummies with atherosclerosis vs 32 15 years for those without; p<0·0001) and with the number of arterial beds involved (mean age was 32 SD 15 years for mummies with no atherosclerosis, 42 10 years for those with atherosclerosis in one or two beds, and 44 8 years for those with atherosclerosis in three to five beds; p<0·0001). Interpretation Atherosclerosis was common in four preindustrial populations including preagricultural hunter-gatherers. Although commonly assumed to be a modern disease, the presence of atherosclerosis in premodern human beings raises the possibility of a more basic predisposition to the disease. Funding National Endowment for the Humanities, Paleocardiology Foundation, The National Bank of Egypt, Siemens, and St Luke's Hospital Foundation of Kansas City.
People form first impressions from facial appearance rapidly, and these impressions can have considerable social and economic consequences. Three dimensions can explain Western perceivers’ ...impressions of Caucasian faces: approachability, youthful-attractiveness, and dominance. Impressions along these dimensions are theorized to be based on adaptive cues to threat detection or sexual selection, making it likely that they are universal. We tested whether the same dimensions of facial impressions emerge across culture by building data-driven models of first impressions of Asian and Caucasian faces derived from Chinese and British perceivers’ unconstrained judgments. We then cross-validated the dimensions with computer-generated average images. We found strong evidence for common approachability and youthful-attractiveness dimensions across perceiver and face race, with some evidence of a third dimension akin to capability. The models explained ~75% of the variance in facial impressions. In general, the findings demonstrate substantial cross-cultural agreement in facial impressions, especially on the most salient dimensions.
First impressions of social traits, such as trustworthiness or dominance, are reliably perceived in faces, and despite their questionable validity they can have considerable real-world consequences. ...We sought to uncover the information driving such judgments, using an attribute-based approach. Attributes (physical facial features) were objectively measured from feature positions and colors in a database of highly variable “ambient” face photographs, and then used as input for a neural network to model factor dimensions (approachability, youthful-attractiveness, and dominance) thought to underlie social attributions. A linear model based on this approach was able to account for 58% of the variance in raters’ impressions of previously unseen faces, and factor-attribute correlations could be used to rank attributes by their importance to each factor. Reversing this process, neural networks were then used to predict facial attributes and corresponding image properties from specific combinations of factor scores. In this way, the factors driving social trait impressions could be visualized as a series of computer-generated cartoon face-like images, depicting how attributes change along each dimension. This study shows that despite enormous variation in ambient images of faces, a substantial proportion of the variance in first impressions can be accounted for through linear changes in objectively defined features.
Background Critically ill children with hemodynamic instability and acute kidney injury often develop fluid overload. Continuous renal replacement therapy (CRRT) has emerged as a favored modality in ...the management of such children. This study investigated the association between fluid overload and mortality in children receiving CRRT. Study Design Prospective observational study. Setting & Participants 297 children from 13 centers across the United States participating in the Prospective Pediatric CRRT Registry. Predictor Fluid overload from intensive care unit (ICU) admission to CRRT initiation, defined as a percentage equal to (fluid in L − fluid out L)/(ICU admit weight kg) × 100%. Outcome & Measurements The primary outcome was survival to pediatric ICU discharge. Data were collected regarding demographics, CRRT parameters, underlying disease process, and severity of illness. Results 153 patients (51.5%) developed < 10% fluid overload, 51 patients (17.2%) developed 10%-20% fluid overload, and 93 patients (31.3%) developed ≥ 20% fluid overload. Patients who developed ≥ 20% fluid overload at CRRT initiation had significantly higher mortality (61/93; 65.6%) than those who had 10%-20% fluid overload (22/51; 43.1%) and those with < 10% fluid overload (45/153; 29.4%). The association between degree of fluid overload and mortality remained after adjusting for intergroup differences and severity of illness. The adjusted mortality OR was 1.03 (95% CI, 1.01-1.05), suggesting a 3% increase in mortality for each 1% increase in severity of fluid overload. When fluid overload was dichotomized to ≥ 20% and < 20%, patients with ≥ 20% fluid overload had an adjusted mortality OR of 8.5 (95% CI, 2.8-25.7). Limitations This was an observational study; interventions were not standardized. The relationship between fluid overload and mortality remains an association without definitive evidence of causality. Conclusions Critically ill children who develop greater fluid overload before initiation of CRRT experience higher mortality than those with less fluid overload. Further goal-directed research is required to accurately define optimal fluid overload thresholds for initiation of CRRT.
First impressions made to photographs of faces can depend as much on momentary characteristics of the photographed image (within‐person variability) as on consistent properties of the face of the ...person depicted (between‐person variability). Here, we examine two important sources of within‐person variability: emotional expression and viewpoint. We find more within‐person variability than between‐person variability for social impressions of key traits of trustworthiness, dominance, and attractiveness, which index the main dimensions in theoretical models of facial impressions. The most important source of this variability is the emotional expression of the face, but the viewpoint of the photograph also affects impressions and modulates the effects of expression. For example, faces look most trustworthy with a happy expression when they are facing the perceiver, compared to when they are facing elsewhere, whereas the opposite is true for anger and disgust. Our findings highlight the integration of these different sources of variability in social impression formation.
Being able to identify trustworthy strangers is a critical social skill. However, whether such impressions are accurate is debatable. Critically, the field currently lacks a quantitative summary of ...the evidence. To address this gap, we conducted two meta-analyses. We tested whether there is a correlation between perceived and actual trustworthiness across faces, and whether perceivers show above-chance accuracy at assessing trustworthiness. Both meta-analyses revealed significant, modest accuracy (face level, r = .14; perceiver level, r = .27). Perceiver-level effects depended on domain, with aggressiveness and sexual unfaithfulness having stronger effects than agreeableness, criminality, financial reciprocity, and honesty. We also applied research weaving to map the literature, revealing potential biases, including a preponderance of Western studies, a lack of “cross-talk” between research groups, and clarity issues. Overall, this modest accuracy is unlikely to be of practical utility. Moreover, we strongly urge the field to improve reporting standards and generalizability of the results.
A large research literature details the powerful behavioral consequences that a trustworthy appearance can have on adult behavior. Surprisingly, few studies have investigated how these biases operate ...among children, despite the theoretical importance of understanding when these biases emerge in development. Here, we used an economic trust game to systematically investigate trust behavior in young children (5-8 years), older children (9-12 years), and adults. Participants played the game with child and adult "partners" that varied in emotional expression (mild displays of happiness and anger, and a neutral baseline), which is known to modulate perceived trustworthiness. Strikingly, both groups of children showed adult-like facial appearance biases when trusting others, with no "own-age bias." There were no developmental differences in the magnitude of this effect, which supports adult-like overgeneralization of these transient emotion cues into enduring trait impressions that guide interpersonal behavior from as early as 5 years of age. Irrespective of whether or not they were explicitly directed to do so, all participants modulated their behavior in line with the emotion cues: more generous and trusting with happy partners, followed by neutral, and then angry. These findings speak to the impressive sophistication of children's early social cognition and provide key insights into the causal mechanisms driving trait impressions, suggesting they are not necessarily contingent upon protracted social experience.
► We investigate first impressions from faces using a highly variable sample of 1000 face images. ► First impressions are shown to be consistent even when based on this highly variable face sample. ► ...We find that three dimensions subserve these first impressions, extending previous models.
Three experiments are presented that investigate the two-dimensional valence/trustworthiness by dominance model of social inferences from faces (Oosterhof & Todorov, 2008). Experiment 1 used image averaging and morphing techniques to demonstrate that consistent facial cues subserve a range of social inferences, even in a highly variable sample of 1000 ambient images (images that are intended to be representative of those encountered in everyday life, see Jenkins, White, Van Montfort, & Burton, 2011). Experiment 2 then tested Oosterhof and Todorov’s two-dimensional model on this extensive sample of face images. The original two dimensions were replicated and a novel ‘youthful-attractiveness’ factor also emerged. Experiment 3 successfully cross-validated the three-dimensional model using face averages directly constructed from the factor scores. These findings highlight the utility of the original trustworthiness and dominance dimensions, but also underscore the need to utilise varied face stimuli: with a more realistically diverse set of face images, social inferences from faces show a more elaborate underlying structure than hitherto suggested.
PDF
