BACKGROUND: Three daily portions of whole-grain foods could lower cardiovascular disease risk, but a comprehensive intervention trial was needed to confirm this recommendation. OBJECTIVES: We aimed ...to assess the effects of consumption of 3 daily portions of whole-grain foods (provided as only wheat or a mixture of wheat and oats) on markers of cardiovascular disease risk in relatively high-risk individuals. DESIGN: This was a randomized controlled dietary trial in middle-aged healthy individuals. After a 4-wk run-in period with a refined diet, we randomly allocated volunteers to a control (refined diet), wheat, or wheat + oats group for 12 wk. The primary outcome was a reduction of cardiovascular disease risk factors by dietary intervention with whole grains, which included lipid and inflammatory marker concentrations, insulin sensitivity, and blood pressure. RESULTS: We recruited a total of 233 volunteers; 24 volunteers withdrew, and 3 volunteers were excluded. Systolic blood pressure and pulse pressure were significantly reduced by 6 and 3 mm Hg, respectively, in the whole-grain foods groups compared with the control group. Systemic markers of cardiovascular disease risk remained unchanged apart from cholesterol concentrations, which decreased slightly but significantly in the refined group. CONCLUSIONS: Daily consumption of 3 portions of whole-grain foods can significantly reduce cardiovascular disease risk in middle-aged people mainly through blood pressure-lowering mechanisms. The observed decrease in systolic blood pressure could decrease the incidence of coronary artery disease and stroke by ≥15% and 25%, respectively. This trial was registered at clinicaltrials.gov as ISRCTN27657880.
Background and purpose
Parkinson’s disease (PD) reduces independence and quality of life through deterioration of upper limb motor function. Transcranial direct current stimulation (tDCS) may offer ...an alternative, adjunctive therapy for PD. However, the efficacy of tDCS for upper limb motor rehabilitation in PD is unknown. In this systematic review, evidence is compiled regarding the effects of tDCS on upper limb motor function in PD.
Methods
Studies of tDCS applied to PD patients that assessed upper limb motor function, conducted between January 2000 and November 2018, were screened for inclusion via a systematic search of Medline, Cochrane, PsycINFO, EMBASE, CINAHL, and Web of Science.
Results
Ten out of 606 studies were included and their findings synthesized into five categories regarding the effects of tDCS on: (1) Unified Parkinson’s Disease Rating Scale motor section (UPDRS III), (2) upper limb motor tasks, (3) manual dexterity, (4) reaction time, and (5) neurophysiology.
Conclusions
When applied to the primary motor cortex, tDCS may improve UPDRS III and the speed and force of movement. Considerable variation was found in tDCS parameters and further study is needed to clarify the long-term effects of tDCS on both simple and complex motor tasks and to compile relevant neurophysiological evidence.
Abstract Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that markedly elevates plasma low-density lipoprotein (LDL) cholesterol and causes premature ...coronary heart disease. There are at least 20 million people with FH worldwide, but the majority remain undetected and current treatment is often suboptimal. To address this major gap in coronary prevention we present, from an international perspective, consensus-based guidance on the care of FH. The guidance was generated from seminars and workshops held at an international symposium. The recommendations focus on the detection, diagnosis, assessment and management of FH in adults and children, and set guidelines for clinical purposes. They also refer to best practice for cascade screening and risk notifying and testing families for FH, including use of genetic testing. Guidance on treatment is based on risk stratification, management of non-cholesterol risk factors, and safe and effective use of LDL lowering therapies. Recommendations are given on lipoprotein apheresis. The use of emerging therapies for FH is also foreshadowed. This international guidance acknowledges evidence gaps, but aims to make the best use of contemporary practice and technology to achieve the best outcomes for the care of FH. It should accordingly be employed to inform clinical judgement and be adjusted for country-specific and local health care needs and resources.
Reactive halogens play a prominent role in the atmospheric chemistry of the
Arctic during springtime. Field measurements and modeling studies suggest
that halogens are emitted into the atmosphere ...from snowpack and reactions on wind-blown snow-sourced aerosols. The relative importance of snowpack and
blowing snow sources is still debated, both at local scales and regionally
throughout the Arctic. To understand the implications of these halogen sources on a pan-Arctic scale, we simulate Arctic reactive bromine chemistry in the
atmospheric chemical transport model GEOS-Chem. Two mechanisms are included:
(1) a blowing snow sea salt aerosol formation mechanism and (2) a snowpack
mechanism assuming uniform molecular bromine production from all snow
surfaces. We compare simulations including neither mechanism, each mechanism
individually, and both mechanisms to examine conditions where one process
may dominate or the mechanisms may interact. We compare the models using
these mechanisms to observations of bromine monoxide (BrO) derived from
multiple-axis differential optical absorption spectroscopy (MAX-DOAS)
instruments on O-Buoy platforms on the sea ice and at a coastal site in
Utqiaġvik, Alaska, during spring 2015. Model estimations of hourly and monthly average BrO are improved by assuming a constant yield of 0.1 %
molecular bromine from all snowpack surfaces on ozone deposition. The
blowing snow aerosol mechanism increases modeled BrO by providing more
bromide-rich aerosol surface area for reactive bromine recycling. The
snowpack mechanism led to increased model BrO across the Arctic Ocean with
maximum production in coastal regions, whereas the blowing snow aerosol
mechanism increases BrO in specific areas due to high surface wind speeds.
Our uniform snowpack source has a greater impact on BrO mixing ratios than
the blowing snow source. Model results best replicate several features of
BrO observations during spring 2015 when using both mechanisms in
conjunction, adding evidence that these mechanisms are both active during
the Arctic spring. Extending our transport model throughout the entire year leads to predictions of enhanced fall BrO that are not supported by
observations.
Zero trust assumes all points of trust will be questioned and mitigated, the individual resources are protected and there is no reliance on the network for protection. This has the goal of limiting ...threat mobility and containing damage. The presentation of rules for multifactor authentication and micro-segmentation are often cited as a Zero Trust Architecture (ZTA), but what is often missing in these so call architectures is what to do about major points of trust in the system. Zero trust is not achievable soley with theses approaches, and only minimal trust can be cultivated. Certain trust points are inevitable including Certificate Authorities, Policy evaluation and decision points and others. The more general Zero Trust Philosophy (ZTP) covers not only those architectural issues, but also the philosophical ones. The ZTP allows the network architect to examine each trust point and make a decision about verification and validation.
Purpose
To evaluate the response to nifedipine administration measured by changes in hepatic arterial (HA) flow on post-operative Doppler ultrasound (US) to predict short-term complications and ...long-term outcomes in liver transplant (LT) patients.
Methods
Patients who underwent LT with post-operative Doppler US within 3 days between 1 January 2005 and 31 December 2015 were included in this retrospective single center study. The patients who received and did not receive nifedipine during the Doppler US comprised the study and control groups, respectively. A positive response to nifedipine was defined as the detection of HA flow when none was present initially or a reduction in HA resistive index (RI) ≥ 0.1 after nifedipine administration. The rates of re-transplantation, re-operation, percutaneous intervention (PCI), and overall survival (OS) were recorded. Cox proportional hazards regression was used to evaluate the association of clinic-demographic variables and Doppler findings with the outcome measures.
Results
444 LT patients (305 M/139F, mean age 51.7 ± 17.4 years, mean interval between LT-Doppler US 1.12 ± 0.9 days) are presented. 220 patients comprised the nifedipine study group
n
= 157/220 (71.4%) responder,
n
= 63/220 (28.6%) nonresponder and 224 patients comprised the control group. There was no difference in re-transplantation or PCI rates between the groups (all
p
-values ≥ 0.2 and ≥ 0.08, respectively). The responder group had a lower rate of re-operation vs. the control group (15.9% vs. 24.1%,
p
= 0.03) and nonresponder group (15.9% vs. 31.8%,
p
= 0.004). 1-year and 2-year OS were similar between the groups (all
p
-values > 0.37).
Conclusion
Short-term complication rates and long-term outcomes for patients with liver transplant who responded to nifedipine administration on Doppler US are similar to those who did not require nifedipine administration. A lack of response to nifedipine was associated with a higher re-operation rate.
Action observation is often conceptualized in a bottom-up manner, where sensory information activates conceptual (or motor) representations. In contrast, here we show that expectations about an ...actor's goal have a top-down predictive effect on action perception, biasing it toward these goals. In 3 experiments, participants observed hands reach for or withdraw from objects and judged whether a probe stimulus corresponded to the hand's final position. Before action onset, participants generated action expectations on the basis of either object types (safe or painful, Experiments 1 and 2) or abstract color cues (Experiment 3). Participants more readily mistook probes displaced in a predicted position (relative to unpredicted positions) for the hand's final position, and this predictive bias was larger when the movement and expectation were aligned. These effects were evident for low-level movement and high-level goal expectancies. Expectations bias action observation toward the predicted goals. These results challenge current bottom-up views and support recent predictive models of action observation.
Atomic chlorine (Cl) is a strong atmospheric oxidant that shortens the lifetimes of pollutants and methane in the springtime Arctic, where the molecular halogens Cl2 and BrCl are known Cl precursors. ...Here, we quantify the contributions of reactive chlorine trace gases and present the first observations, to our knowledge, of ClNO2 (another Cl precursor), N2O5, and HO2NO2 in the Arctic. During March – May 2016 near Utqiaġvik, Alaska, up to 21 ppt of ClNO2, 154 ppt of Cl2, 27 ppt of ClO, 71 ppt of N2O5, 21 ppt of BrCl, and 153 ppt of HO2NO2 were measured using chemical ionization mass spectrometry. The main Cl precursor was calculated to be Cl2 (up to 73%) in March, while BrCl was a greater contributor (63%) in May, when total Cl production was lower. Elevated levels of ClNO2, N2O5, Cl2, and HO2NO2 coincided with pollution influence from the nearby town of Utqiaġvik and the North Slope of Alaska (Prudhoe Bay) Oilfields. We propose a coupled mechanism linking NO x with Arctic chlorine chemistry. Enhanced Cl2 was likely the result of the multiphase reaction of Cl– (aq) with ClONO2, formed from the reaction of ClO and NO2. In addition to this NO x -enhanced chlorine chemistry, Cl2 and BrCl were observed under clean Arctic conditions from snowpack photochemical production. These connections between NO x and chlorine chemistry, and the role of snowpack recycling, are important given increasing shipping and fossil fuel extraction predicted to accompany Arctic sea ice loss.
Cosmic hylomorphism Simpson, William M. R.
European journal for philosophy of science,
2021/3, Letnik:
11, Številka:
1
Journal Article
Odprti dostop
The primitive ontology approach to quantum mechanics seeks to account for quantum phenomena in terms of a distribution of matter in three-dimensional space (or four-dimensional spacetime) and a law ...of nature that describes its temporal development. This approach to explaining quantum phenomena is compatible with either a Humean or powerist account of laws. In this paper, I offer a powerist ontology in which the law is specified by Bohmian mechanics for a global configuration of particles. Unlike in other powerist ontologies, however, this law is not grounded in a
structural power
that is instantiated by the global configuration. Instead, I combine the primitive ontology approach with Aristotle’s doctrine of hylomorphism to create a new metaphysical model, in which the cosmos is a hylomorphic substance with an
intrinsic power
to choreograph the trajectories of the particles.
Live Twin Ectopic Pregnancy Pek, Jen Heng; Simpson, William L.; Owen, Jane ...
The Journal of emergency medicine,
August 2020, 2020-Aug, 2020-08-00, 20200801, Letnik:
59, Številka:
2
Journal Article
PDF
