Waist-to-height ratio (WHtR) predicts abdominal fat and cardiometabolic risk. In children with obesity, the most adequate cut-off to predict cardiometabolic risk as well as its ability to predict ...risk changes over time has not been tested. Our aim was to define an appropriate WHtR cut-off to predict cardiometabolic risk in children with obesity, and to analyze its ability to predict changes in cardiometabolic risk over time.
This is an observational prospective study secondary to the OBEMAT2.0 trial. We included data from 218 participants (8-15 years) who attended baseline and final visits (12 months later). The main outcome measure was a cardiometabolic risk score derived from blood pressure, lipoproteins, and HOMA index of insulin resistance.
The optimal cut-off to predict the cardiometabolic risk score was WHtR ≥0.55 with an area under the curve of 0.675 (95% CI: 0.589-0.760) at baseline and 0.682 (95% CI: 0.585-0.779) at the final visit. Multivariate models for repeated measures showed that changes in cardiometabolic risk were significantly associated with changes in WHtR.
This study confirms the clinical utility of WHtR to predict changes in cardiometabolic risk over time in children with obesity. The most accurate cut-off to predict cardiometabolic risk in children with obesity was WHtR ≥0.55.
In children, there is no consensus on a unique WHtR cut-off to predict cardiometabolic risk. The present work provides sufficient evidence to support the use of the 0.55 boundary. We have a large sample of children with obesity, with whom we compared the previously proposed boundaries according to cardiometabolic risk, and we found the optimal WHtR cut-off to predict it. We also analyzed if a reduction in the WHtR was associated with an improvement in their cardiometabolic profile.
The aim of this study was the external validation of the updated logistic clinical SYNTAX score for two-year all-cause mortality after PCI in the GLOBAL LEADERS trial.
The GLOBAL LEADERS trial was an ...investigator-initiated, prospective randomised, multicentre, open-label trial comparing two strategies of antiplatelet therapy in 15,991 patients undergoing PCI. As a predefined analysis, we studied the first 4,006 consecutive patients enrolled between July 2013 and April 2014 for whom the anatomic SYNTAX scores were calculated by an independent core lab. The updated logistic clinical SYNTAX score was available in 3,271 patients. Patients were divided into quintiles according to the score. The C-statistic of the updated logistic clinical SYNTAX score for two-year all-cause mortality was 0.71 (95% confidence interval CI: 0.64-0.77). The updated logistic clinical SYNTAX score identified patients at very high risk for two-year all-cause mortality after PCI. Although it systematically overestimated two-year all-cause mortality, predicted and observed two-year all-cause mortality in the majority of the patients (four out of five quintiles) were in agreement.
Overall discrimination for two-year all-cause mortality of the updated logistic clinical SYNTAX score is either borderline acceptable or possibly helpful. Calibration in the majority of patients is appropriate. The score is potentially useful in selecting enriched high-risk populations.
This paper presents an improved asymmetric space vector modulation (ASVM) for two-level voltage source converters (VSCs) when the switching frequency is as low as nine times of line frequency. By ...adding two pulses in each line cycle when the fundamental voltage crosses zero, the total harmonic distortion (THD) of output current can be reduced significantly. The penalty of additional switching loss is very limited for high power factor operation. The applications of the improved ASVM in a single VSC or in two interleaved VSCs are shown, respectively. With the optimization of the duration and position of the additional pulses, the ac current THD can be reduced to as low as 50% for single VSC and even lower to less than 25% for interleaved VSCs systems. Such THD reduction has close relationship with space vectors' position, modulation index, and interleaving angle. Improved ASVM can also reduce the amplitude of circulating current in the interleaved VSCs, leading to smaller interphase inductors. Finally, the weights of total inductors needed to meet the same THD requirement are compared to demonstrate the benefits of improved ASVM when different pulsewidth modulation schemes are used. The analysis results are verified by experiments on a demo system.
Amylosucrase (E.C. 2.4.1.4) from
Neisseria polysaccharea catalyses a transglycosylation reaction using sucrose as a glucose donor to synthesise an insoluble (1→4)-α-glucan, releasing fructose in the ...solution. If glycogen is used as a glucosyl unit acceptor, amylosucrase elongates polymer branches from their non-reducing ends. Testing of a large series of acceptors with various molar masses, glycosidic linkages, branching degrees and solubilities showed that chain elongation occurred only on polymers with (1→4)-α- or (1→4)-α- and (1→6)-α- linkages. Synthesis yields were better for completely soluble polymers (1.45 glucosyl units grafted per glucosyl unit for polymers with (1→4)-α- and (1→6)-α- linkages), than for partially soluble polymers (0.27–0.97 glucosyl units grafted per glucosyl unit for polymers with either (1→4)-α- linkages or (1→4)-α- and (1→6)-α- linkages). Elongation occurred randomly at the non-reducing ends of some external chains. Elongation of soluble branched molecules led to rapid gel formation favourable to gelation control inside suspensions and solutions. These polymers showed resistant starch contents (22% (w/w) to 57%) after elongation with amylosucrase.
Approaching Artery Rigid Dynamics in IVUS Hernandez-Sabate, A.; Gil, D.; Fernandez-Nofrerias, E. ...
IEEE transactions on medical imaging,
11/2009, Letnik:
28, Številka:
11
Journal Article
Tissue biomechanical properties (like strain and stress) are playing an increasing role in diagnosis and long-term treatment of intravascular coronary diseases. Their assessment strongly relies on ...estimation of vessel wall deformation. Since intravascular ultrasound (IVUS) sequences allow visualizing vessel morphology and reflect its dynamics, this technique represents a useful tool for evaluation of tissue mechanical properties. Image misalignment introduced by vessel-catheter motion is a major artifact for a proper tracking of tissue deformation. In this work, we focus on compensating and assessing IVUS rigid in-plane motion due to heart beating. Motion parameters are computed by considering both the vessel geometry and its appearance in the image. Continuum mechanics laws serve to introduce a novel score measuring motion reduction in in vivo sequences. Synthetic experiments validate the proposed score as measure of motion parameters accuracy; whereas results in in vivo pullbacks show the reliability of the presented methodologies in clinical cases.
Abstract In many cases, numb chin syndrome (NCS) may represent a banal pathology. However, as it can be associated with malignant processes, its presence should alert the clinician of a possible ...occult disease. In patients already diagnosed with cancer, it often represents an ominous sign that indicates poor prognosis, due to the rapid progress of the disease. The case of a 62-year-old man diagnosed with synchronous lung and bladder cancer, who suddenly complained of numbness in the chin, is presented. The bone scan confirmed the suspicion of metastastic bone disease, and the patient died two months after the appearance of this sign.
Small-signal analysis of the phase-shifted PWM converter Vlatkovic, V.; Sabate, J.A.; Ridley, R.B. ...
IEEE transactions on power electronics,
1992-Jan., 1992, 1992-1-00, 19920101, Letnik:
7, Številka:
1
Journal Article, Conference Proceeding
Recenzirano
The specific circuit effects in the phase-shifted PWM (PS-PWM) converter and their impact on the converter dynamics are analyzed. The small-signal model is derived incorporating the effects of ...phase-shift control and the utilization of transformer leakage inductance and power FET junction capacitances to achieve zero-voltage resonant switching. The differences in the dynamic characteristics of the PS-PWM converter and its PWM counterpart are explained. Model predictions are confirmed by experimental measurements.< >
In many cases, numb chin syndrome (NCS) may represent a banal pathology. However, as it can be associated with malignant processes, its presence should alert the clinician of a possible occult ...disease. In patients already diagnosed with cancer, it often represents an ominous sign that indicates poor prognosis, due to the rapid progress of the disease. The case is presented of a 62-year-old man diagnosed with synchronous lung and bladder cancer, who suddenly complained of numbness in the chin. The bone scan confirmed the suspicion of metastastic bone disease, and the patient died two months after the appearance of this sign.
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