Showing papers by "University of Miami published in 2003"
Boston University1, Rush University Medical Center2, University of Tennessee Health Science Center3, University of Michigan4, University at Buffalo5, University of Mississippi6, University of Miami7, University of Alabama at Birmingham8, Case Western Reserve University9, National Institutes of Health10
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Abstract: "The Seventh Report of the Joint National Committee on Prevention, Detection,
Evaluation, and Treatment of High Blood Pressure" provides a new guideline
for hypertension prevention and management. The following are the key messages(1) In persons older than 50 years, systolic blood pressure (BP) of
more than 140 mm Hg is a much more important cardiovascular disease
(CVD) risk factor than diastolic BP; (2) The risk of CVD, beginning at 115/75
mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive
at 55 years of age have a 90% lifetime risk for developing hypertension; (3)
Individuals with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80
to 89 mm Hg should be considered as prehypertensive and require health-promoting
lifestyle modifications to prevent CVD; (4) Thiazide-type diuretics should
be used in drug treatment for most patients with uncomplicated hypertension,
either alone or combined with drugs from other classes. Certain high-risk
conditions are compelling indications for the initial use of other antihypertensive
drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor
blockers, β-blockers, calcium channel blockers); (5) Most patients with
hypertension will require 2 or more antihypertensive medications to achieve
goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes
or chronic kidney disease); (6) If BP is more than 20/10 mm Hg above goal
BP, consideration should be given to initiating therapy with 2 agents, 1 of
which usually should be a thiazide-type diuretic; and (7) The most effective
therapy prescribed by the most careful clinician will control hypertension
only if patients are motivated. Motivation improves when patients have positive
experiences with and trust in the clinician. Empathy builds trust and is a
potent motivator. Finally, in presenting these guidelines, the committee recognizes
that the responsible physician's judgment remains paramount.
24,988 citations
TL;DR: In those older than age 50, systolic blood pressure of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP, and hypertension will be controlled only if patients are motivated to stay on their treatment plan.
Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.
14,975 citations
TL;DR: Results suggest that a conscious focus on blessings may have emotional and interpersonal benefits and exhibited heightened well-being across several, though not all, of the outcome measures across the 3 studies.
Abstract: The effect of a grateful outlook on psychological and physical well-being was examined. In Studies 1 and 2, participants were randomly assigned to 1 of 3 experimental conditions (hassles, gratitude listing, and either neutral life events or social comparison); they then kept weekly (Study 1) or daily (Study 2) records of their moods, coping behaviors, health behaviors, physical symptoms, and overall life appraisals. In a 3rd study, persons with neuromuscular disease were randomly assigned to either the gratitude condition or to a control condition. The gratitude-outlook groups exhibited heightened well-being across several, though not all, of the outcome measures across the 3 studies, relative to the comparison groups. The effect on positive affect appeared to be the most robust finding. Results suggest that a conscious focus on blessings may have emotional and interpersonal benefits.
2,587 citations
Harvard University1, Duke University2, Yale University3, Washington University in St. Louis4, University of North Carolina at Chapel Hill5, University of California, Los Angeles6, National Institutes of Health7, Stanford University8, Mayo Clinic9, University of Washington10, Rush University Medical Center11, University of Alabama at Birmingham12, University of Miami13
TL;DR: The intervention improved depression and social isolation, although the relative improvement in the psychosocial intervention group compared with the usual care group was less than expected due to substantial improvement in usual care patients.
Abstract: CONTEXT Depression and low perceived social support (LPSS) after myocardial infarction (MI) are associated with higher morbidity and mortality, but little is known about whether this excess risk can be reduced through treatment. OBJECTIVE To determine whether mortality and recurrent infarction are reduced by treatment of depression and LPSS with cognitive behavior therapy (CBT), supplemented with a selective serotonin reuptake inhibitor (SSRI) antidepressant when indicated, in patients enrolled within 28 days after MI. DESIGN, SETTING, AND PATIENTS Randomized clinical trial conducted from October 1996 to April 2001 in 2481 MI patients (1084 women, 1397 men) enrolled from 8 clinical centers. Major or minor depression was diagnosed by modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and severity by the 17-item Hamilton Rating Scale for Depression (HRSD); LPSS was determined by the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Instrument (ESSI). Random allocation was to usual medical care or CBT-based psychosocial intervention. INTERVENTION Cognitive behavior therapy was initiated at a median of 17 days after the index MI for a median of 11 individual sessions throughout 6 months, plus group therapy when feasible, with SSRIs for patients scoring higher than 24 on the HRSD or having a less than 50% reduction in Beck Depression Inventory scores after 5 weeks. MAIN OUTCOME MEASURES Composite primary end point of death or recurrent MI; secondary outcomes included change in HRSD (for depression) or ESSI scores (for LPSS) at 6 months. RESULTS Improvement in psychosocial outcomes at 6 months favored treatment: mean (SD) change in HRSD score, -10.1 (7.8) in the depression and psychosocial intervention group vs -8.4 (7.7) in the depression and usual care group (P<.001); mean (SD) change in ESSI score, 5.1 (5.9) in the LPSS and psychosocial intervention group vs 3.4 (6.0) in the LPSS and usual care group (P<.001). After an average follow-up of 29 months, there was no significant difference in event-free survival between usual care (75.9%) and psychosocial intervention (75.8%). There were also no differences in survival between the psychosocial intervention and usual care arms in any of the 3 psychosocial risk groups (depression, LPSS, and depression and LPSS patients). CONCLUSIONS The intervention did not increase event-free survival. The intervention improved depression and social isolation, although the relative improvement in the psychosocial intervention group compared with the usual care group was less than expected due to substantial improvement in usual care patients.
1,792 citations
TL;DR: In patients with HBeAg-positive chronic hepatitis B, 48 weeks of 10 mg or 30 mg of adefovir dipivoxil per day resulted in histologic liver improvement, reduced serum HBV DNA and alanine aminotransferase levels, and increased the rates of H beAg seroconversion.
Abstract: Background In preclinical and phase 2 studies, adefovir dipivoxil demonstrated potent activity against hepatitis B virus (HBV), including lamivudine-resistant strains. Methods We randomly assigned 515 patients with chronic hepatitis B who were positive for hepatitis B e antigen (HBeAg) to receive 10 mg of adefovir dipivoxil (172 patients), 30 mg of adefovir dipivoxil (173), or placebo (170) daily for 48 weeks. The primary end point was histologic improvement in the 10-mg group as compared with the placebo group. Results After 48 weeks of treatment, significantly more patients who received 10 mg or 30 mg of adefovir dipivoxil per day than who received placebo had histologic improvement (53 percent [P<0.001], 59 percent [P<0.001], and 25 percent, respectively), a reduction in serum HBV DNA levels (by a median of 3.52 [P<0.001], 4.76 [P<0.001], and 0.55 log copies per milliliter, respectively), undetectable levels (fewer than 400 copies per milliliter) of serum HBV DNA (21 percent [P<0.001], 39 percent [P<0....
1,321 citations
Wake Forest University1, National Institutes of Health2, George Washington University3, Wayne State University4, University of Tennessee Health Science Center5, University of Chicago6, University of Alabama7, Columbia University8, University of Cincinnati9, University of Utah10, University of Texas Southwestern Medical Center11, University of Pittsburgh12, Ohio State University13, Thomas Jefferson University14, University of Texas at San Antonio15, University of Miami16, Brown University17, Case Western Reserve University18, University of Texas at Austin19, University of North Carolina at Chapel Hill20, Northwestern University21
TL;DR: In this paper, a double-blind, placebo-controlled trial involving pregnant women with a documented history of spontaneous preterm delivery was conducted, where women were enrolled at 19 clinical centers at 16 to 20 weeks of gestation.
Abstract: Background Women who have had a spontaneous preterm delivery are at greatly increased risk for preterm delivery in subsequent pregnancies. The results of several small trials have suggested that 17 alpha-hydroxyprogesterone caproate (17P) may reduce the risk of preterm delivery. Methods We conducted a double-blind, placebo-controlled trial involving pregnant women with a documented history of spontaneous preterm delivery. Women were enrolled at 19 clinical centers at 16 to 20 weeks of gestation and randomly assigned by a central data center, in a 2:1 ratio, to receive either weekly injections of 250 mg of 17P or weekly injections of an inert oil placebo; injections were continued until delivery or to 36 weeks of gestation. The primary outcome was preterm delivery before 37 weeks of gestation. Analysis was performed according to the intention-to-treat principle. Results Base-line characteristics of the 310 women in the progesterone group and the 153 women in the placebo group were similar. Treatment with 1...
1,314 citations
TL;DR: In a placebo-controlled trial, treatment with natalizumab led to fewer inflammatory brain lesions and fewer relapses over a six-month period in patients with relapsing multiple sclerosis.
Abstract: Background In patients with multiple sclerosis, inflammatory brain lesions appear to arise from autoimmune responses involving activated lymphocytes and monocytes. The glycoprotein α4 integrin is expressed on the surface of these cells and plays a critical part in their adhesion to the vascular endothelium and migration into the parenchyma. Natalizumab is an α4 integrin antagonist that reduced the development of brain lesions in experimental models and in a preliminary study of patients with multiple sclerosis. Methods In a randomized, double-blind trial, we randomly assigned a total of 213 patients with relapsing–remitting or relapsing secondary progressive multiple sclerosis to receive 3 mg of intravenous natalizumab per kilogram of body weight (68 patients), 6 mg per kilogram (74 patients), or placebo (71 patients) every 28 days for 6 months. The primary end point was the number of new brain lesions on monthly gadolinium-enhanced magnetic resonance imaging during the six-month treatment period. Clinica...
1,224 citations
TL;DR: The incidence of coagulation abnormalities, early after trauma, is high and they are independent predictors of mortality even in the presence of other risk factors.
Abstract: Background:Coagulopathy and hemorrhage are known contributors to trauma mortality; however, the actual relationship of prothrombin time (PT) and partial thromboplastin time (PTT) to mortality is unknown. Our objective was to measure the predictive value of the initial coagulopathy profile for trauma
1,121 citations
TL;DR: The association between religiousness and depressive symptoms was examined with meta-analytic methods across 147 independent investigations, indicating that greater religiousness is mildly associated with fewer symptoms.
Abstract: The association between religiousness and depressive symptoms was examined with meta-analytic methods across 147 independent investigations (N 98,975). Across all studies, the correlation between religiousness and depressive symptoms was –.096, indicating that greater religiousness is mildly associated with fewer symptoms. The results were not moderated by gender, age, or ethnicity, but the religiousness– depression association was stronger in studies involving people who were undergoing stress due to recent life events. The results were also moderated by the type of measure of religiousness used in the study, with extrinsic religious orientation and negative religious coping (e.g., avoiding difficulties through religious activities, blaming God for difficulties) associated with higher levels of depressive symptoms, the opposite direction of the overall findings.
1,076 citations
TL;DR: It is concluded that church/service attendance protects healthy people against death and some evidence that religion or spirituality impedes recovery from acute illness is found.
Abstract: Evidence is presented that bears on 9 hypotheses about the link between religion or spirituality and mortality, morbidity, disability, or recovery from illness. In healthy participants, there is a strong, consistent, prospective, and often graded reduction in risk of mortality in church/service attenders. This reduction is approximately 25% after adjustment for confounders. Religion or spirituality protects against cardiovascular disease, largely mediated by the healthy lifestyle it encourages. Evidence fails to support a link between depth of religiousness and physical health. In patients, there are consistent failures to support the hypotheses that religion or spirituality slows the progression of cancer or improves recovery from acute illness but some evidence that religion or spirituality impedes recovery from acute illness. The authors conclude that church/service attendance protects healthy people against death. More methodologically sound studies are needed.
1,049 citations
Seconda Università degli Studi di Napoli1, University of Graz2, University of Rome Tor Vergata3, University of Vienna4, University of Naples Federico II5, University of Regensburg6, University of Sydney7, University of L'Aquila8, University of Miami9, University of Ljubljana10, University of Tübingen11, University of Geneva12, University of Buenos Aires13, University of Florence14, Medical College of Wisconsin15, University of Connecticut16, Memorial Sloan Kettering Cancer Center17, Cornell University18, University of Lübeck19, University of Barcelona20, University of Siena21, Rutgers University22, Shinshu University23, University of Modena and Reggio Emilia24, Keio University25, Ludwig Maximilian University of Munich26, New York University27
TL;DR: The virtual Consensus Net Meeting on Dermoscopy represents a valid tool for better standardization of the dermoscopic terminology and, moreover, opens up a new territory for diagnosing and managing pigmented skin lesions.
Abstract: Background: There is a need for better standardization of the dermoscopic terminology in assessing pigmented skin lesions. Objective: The virtual Consensus Net Meeting on Dermoscopy was organized to investigate reproducibility and validity of the various features and diagnostic algorithms. Methods: Dermoscopic images of 108 lesions were evaluated via the Internet by 40 experienced dermoscopists using a 2-step diagnostic procedure. The first-step algorithm distinguished melanocytic versus nonmelanocytic lesions. The second step in the diagnostic procedure used 4 algorithms (pattern analysis, ABCD rule, Menzies method, and 7-point checklist) to distinguish melanoma versus benign melanocytic lesions. κ Values, log odds ratios, sensitivity, specificity, and positive likelihood ratios were estimated for all diagnostic algorithms and dermoscopic features. Results: Interobserver agreement was fair to good for all diagnostic methods, but it was poor for the majority of dermoscopic criteria. Intraobserver agreement was good to excellent for all algorithms and features considered. Pattern analysis allowed the best diagnostic performance (positive likelihood ratio: 5.1), whereas alternative algorithms revealed comparable sensitivity but less specificity. Interobserver agreement on management decisions made by dermoscopy was fairly good (mean κ value: 0.53). Conclusion: The virtual Consensus Net Meeting on Dermoscopy represents a valid tool for better standardization of the dermoscopic terminology and, moreover, opens up a new territory for diagnosing and managing pigmented skin lesions. (J Am Acad Dermatol 2003;48:679-93.) J Am Acad Dermatol 2003;48:679-93.
TL;DR: Transgenic and knockout studies have provided important mechanistic insights into the development of choroidal neovascularization, the principal cause of vision loss in age-related macular degeneration, and this in turn has culminated in preclinical and clinical trials of directed molecular interventions.
TL;DR: A progressive morphological filter was developed to detect nonground LIDAR measurements and shows that the filter can remove most of the nong round points effectively.
Abstract: Recent advances in airborne light detection and ranging (LIDAR) technology allow rapid and inexpensive measurements of topography over large areas. This technology is becoming a primary method for generating high-resolution digital terrain models (DTMs) that are essential to numerous applications such as flood modeling and landslide prediction. Airborne LIDAR systems usually return a three-dimensional cloud of point measurements from reflective objects scanned by the laser beneath the flight path. In order to generate a DTM, measurements from nonground features such as buildings, vehicles, and vegetation have to be classified and removed. In this paper, a progressive morphological filter was developed to detect nonground LIDAR measurements. By gradually increasing the window size of the filter and using elevation difference thresholds, the measurements of vehicles, vegetation, and buildings are removed, while ground data are preserved. Datasets from mountainous and flat urbanized areas were selected to test the progressive morphological filter. The results show that the filter can remove most of the nonground points effectively.
TL;DR: A systematic clinical working case definition for myalgic encephalomyelitis is presented and an Ex- pert Medical Consensus Panel representing treating physicians, teaching faculty and researchers are selected.
Abstract: Recent years have brought growing recognition of the need for clinical criteria for myalgic encephalomyelitis (ME), which is also called chronic fatigue syndrome (CFS). An Expert Subcommittee of Health Canada established the Terms of Reference, and selected an Ex- pert Medical Consensus Panel representing treating physicians, teaching faculty and researchers. A Consensus Workshop was held on March 30 to April 1, 2001 to culminate the review process and establish consensus for a clinical working case definition, diagnostic protocols and treatment protocols. We present a systematic clinical working case definition that
TL;DR: In this paper, a literature review of using photocatalytic oxidation (PCO) to destruct volatile organic compounds (VOCs) in indoor air is presented, and the dependence of reaction rate on some key influencing factors (moisture, light intensity, initial contaminant concentration) has been studied, and kinetic models have been developed to aid the optimal reactor design.
University of Mississippi1, Boston University2, Howard University3, University of Miami4, Thomas Jefferson University5, Georgia Regents University6, University of North Carolina at Chapel Hill7, New York Methodist Hospital8, University of Toronto9, Emory University10, Rutgers University11, Mount Sinai St. Luke's and Mount Sinai Roosevelt12, University of Alabama13, Virginia Commonwealth University14, University of Pittsburgh15, Duke University16, University of Illinois at Chicago17, Children's Hospital Oakland Research Institute18, University of California, San Francisco19, National Institutes of Health20
TL;DR: In a long-term observational follow-up study of mortality in patients with SCA who originally participated in the randomized, double-blind, placebo-controlled Multicenter Study of Hydroxyurea in Patients with Sickle Cell Anemia (MSH), conducted in 1992-1995, to determine whether hydroxyuraxurea attenuates mortality in Patients With SCA as discussed by the authors.
Abstract: ContextHydroxyurea increases levels of fetal hemoglobin (HbF)
and decreases morbidity from vaso-occlusive complications in patients
with sickle cell anemia (SCA). High HbF levels reduce morbidity and
mortality.ObjectiveTo determine whether hydroxyurea attenuates mortality in
patients with SCA.DesignLong-term observational follow-up study of mortality in
patients with SCA who originally participated in the randomized,
double-blind, placebo-controlled Multicenter Study of Hydroxyurea in
Sickle Cell Anemia (MSH), conducted in 1992-1995, to
determine if hydroxyurea reduces vaso-occlusive events. In the MSH
Patients' Follow-up, conducted in 1996-2001, patients could continue,
stop, or start hydroxyurea. Data were collected during the trial and in
the follow-up period.SettingInpatients and outpatients in 21 sickle cell referral
centers in the United States and Canada.PatientsTwo-hundred ninety-nine adult patients with frequent
painful episodes enrolled in the follow-up. Follow-up data through
May 2001 were complete for 233 patients.InterventionIn the MSH, patients were randomly assigned to
receive hydroxyurea (n = 152) or placebo (n = 147).Main Outcome MeasureMortality, HbF levels, painful episodes,
acute chest syndrome, and blood cell counts. The randomized trial was
not designed to detect specified differences in mortality.ResultsSeventy-five of the original 299 patients died, 28% from
pulmonary disease. Patients with reticulocyte counts less than
250 000/mm3 and hemoglobin levels lower than 9 g/dL
had increased mortality (P = .002).
Cumulative mortality at 9 years was 28% when HbF levels were lower
than 0.5 g/dL after the trial was completed compared with 15% when HbF
levels were 0.5 g/dL or higher
(P = .03 ). Individuals who had acute
chest syndrome during the trial had 32% mortality compared with 18%
of individuals without acute chest syndrome
(P = .02). Patients with 3 or more
painful episodes per year during the trial had 27% mortality compared
with 17% of patients with less frequent episodes
(P = .06). Taking hydroxyurea was
associated with a 40% reduction in mortality
(P = .04) in this observational follow-up with
self-selected treatment. There were 3 cases of cancer, 1 fatal.ConclusionsAdult patients taking hydroxyurea for frequent painful
sickle cell episodes appear to have reduced mortality after 9 of years
follow-up. Survival was related to HbF levels and frequency of
vaso-occlusive events. Whether indications for hydroxyurea treatment
should be expanded is unknown.
TL;DR: The results showed that goal disengagement and goal reengagement can have interactive effects on subjective well-being and the importance of the findings for effective self-regulation and successful development is discussed.
Abstract: Three studies examined associations between goal disengagement, goal reengagement, and subjective well-being. In Study 1, 115 undergraduates reported on the extent to which they were able to abandon unattainable goals and reengage their efforts in alternative goals. Study 2 examined the importance of goal disengagement and goal reengagement in groups of young adults and older adults (N = 120). In Study 3, a sample of parents of children with cancer and parents of medically healthy children was examined (N = 45). The findings confirmed that goal disengagement and goal reengagement can be associated with ratings of high subjective well-being. In addition, the results showed that goal disengagement and goal reengagement can have interactive effects on subjective well-being. The importance of the findings for effective self-regulation and successful development are discussed.
TL;DR: A seasonally resolved record of titanium shows that the collapse of Mayan civilization in the Terminal Classic Period occurred during an extended regional dry period, punctuated by more intense multi-year droughts centered at approximately 810, 860, and 910 A.D as mentioned in this paper.
Abstract: In the anoxic Cariaco Basin of the southern Caribbean, the bulk titanium content of undisturbed sediment reflects variations in riverine input and the hydrological cycle over northern tropical South America. A seasonally resolved record of titanium shows that the collapse of Maya civilization in the Terminal Classic Period occurred during an extended regional dry period, punctuated by more intense multiyear droughts centered at approximately 810, 860, and 910 A.D. These new data suggest that a century-scale decline in rainfall put a general strain on resources in the region, which was then exacerbated by abrupt drought events, contributing to the social stresses that led to the Maya demise.
TL;DR: It is demonstrated that lamivudine treatment for up to 6 years has an excellent safety profile in patients with HBeAg-positive compensated liver disease, but patients with long-standing lamivUDine-resistant mutations may experience worsening liver disease.
TL;DR: Three years of lamivudine therapy reduces necroinflammatory activity and reverses fibrosis (including cirrhosis) in most patients, therefore, extended-duration YMDD variants may require additional therapies to maintain the histological benefit of treatment.
TL;DR: There is reasonable evidence to suggest that cardiovascular reactivity can predict the development of some preclinical states and perhaps even new clinical events in some patients with essential hypertension or coronary heart disease.
Abstract: OBJECTIVE The objective of this review is to evaluate the evidence for the hypothesis that cardiovascular reactivity can predict the development of preclinical (elevated blood pressure, ventricular remodeling, carotid atherosclerosis) and/or clinical cardiovascular disease states. METHODS A review of the literature was conducted examining prospective studies. RESULTS Three large epidemiological studies with long-term follow-up periods (20 years or more) have found blood pressure responses to the cold pressor task to be predictive of subsequent essential hypertension in initially normotensive samples. Studies showing less consistent results have tended to use shorter-term follow-up periods. A larger body of literature demonstrates consistent associations between stress-related cardiovascular reactivity and blood pressure elevations in youth over the course of 1 to 6 years; such relationships have not been consistently shown among adult samples. Moderately consistent evidence points to a positive relationship between reactivity and other measures of subclinical disease (increased left ventricular mass and carotid atherosclerosis) among the few prospective studies that have examined these issues to date. A number of additional factors, however, such as baseline levels of disease risk and exposure to psychosocial stress, seem to moderate these relationships. Health status at baseline also seems to moderate the association between reactivity and clinical coronary heart disease in recent reports: two of three existing studies in initially healthy samples show no evidence of a relationship between reactivity and clinical outcomes, whereas three of four studies in samples with preexisting coronary heart disease or essential hypertension show a positive relationship between reactivity and subsequent disease states. CONCLUSIONS There is reasonable evidence to suggest that cardiovascular reactivity can predict the development of some preclinical states (eg, increased left ventricular mass and blood pressure) states and perhaps even new clinical events in some patients with essential hypertension or coronary heart disease. However, much more information is needed concerning moderating and potentially confounding variables before the robustness of the positive relationships can become clinically useful.
TL;DR: Angiogenesis, in response to tissue injury, is a dynamic process that is highly regulated by signals from both serum and the surrounding extracellular matrix (ECM) environment, which regulates angiogenesis by providing scaffold support and signaling roles.
Abstract: Angiogenesis is critical to wound repair. Newly formed blood vessels participate in provisional granulation tissue formation and provide nutrition and oxygen to growing tissues. In addition, inflammatory cells require the interaction with and transmigration through the endothelial basement membrane to enter the site of injury. Angiogenesis, in response to tissue injury, is a dynamic process that is highly regulated by signals from both serum and the surrounding extracellular matrix (ECM) environment. Vascular endothelial growth factor, angiopoietin, fibroblast growth factor, and transforming growth factor beta are among those most potent angiogenic cytokines in wound angiogenesis. The cooperative regulation of them is essential for wound repair. Migration of endothelial cells and development of new capillary vessels during wound repair is dependent on not only the cells and cytokines present but also the production and organization of ECM components both in granulation tissue and in endothelial basement membrane. The ECM regulates angiogenesis by providing scaffold support and signaling roles. They also serve as a reservoir and modulator for growth factors. Laminins are the major noncollagenous ECM of endothelial basement membrane. Two newly recognized laminins, 8 and 10, are the major laminins produced by human dermal microvascular endothelial cells. Laminin 10 is highly expressed in blood vessels around skin wounds. Laminin 8 promotes dermal endothelial cell attachment, migration, and tubule formation. Integrins with either beta 1 or alpha v subunits are the major cellular surface receptors for ECM molecules and mediate the interactions between cells and ECM during wound angiogenesis.
TL;DR: Patients with YMDD variants losing clinical response with a significant increase in the HBV DNA and ALT levels may require additional therapy.
Abstract: YMDD variants of hepatitis B virus (HBV) emerge in some patients with chronic hepatitis B who receive lamivudine. YMDD variants were examined in 794 patients in 4 controlled studies of 1 year's duration. The long-term effects of YMDD variants were examined in a subset of patients treated up to 4 years. YMDD variants were detected by polymerase chain reaction (PCR) and restriction fragment-length polymorphism assays. After 1 year, YMDD variants were detected in 81 (24%) of 335 patients. In these patients, the median serum HBV DNA concentration at 1 year was <20% of the baseline level, and serum alanine transaminase (ALT) levels and liver histologic findings had significantly improved. In patients with YMDD variants who were treated for up to 4 years, median HBV DNA and ALT levels showed improvements. Sex, baseline body mass index, and HBV DNA level were associated with emergence of YMDD variants. Patients with YMDD variants losing clinical response with a significant increase in the HBV DNA and ALT levels may require additional therapy.
TL;DR: In this paper, the authors show that firms and industries with lower market model R 2 statistics exhibit higher association between current returns and future earnings, indicating more information about future earnings in current stock returns.
Abstract: Roll [1988] observes low R 2 statistics for common asset pricing models due to vigorous firm-specific return variation not associated with public information. He concludes that this implies “either private information or else occasional frenzy unrelated to concrete information” [p. 56]. We show that firms and industries with lower market model R 2 statistics exhibit higher association between current returns and future earnings, indicating more information about future earnings in current stock returns. This supports Roll’s first interpretation: higher firm-specific return variation as a fraction of total variation signals more information-laden stock prices and, therefore, more efficient stock markets.
TL;DR: In this paper, the authors investigated the large-scale control on the climate of the South American Altiplano using local observations, reanalysis data and general circulation model experiments and found that the climatic conditions on the Altiplano are closely related to the upper-air circulation, with an easterly zonal flow aloft favoring wet conditions and westerly flow causing dry conditions.
TL;DR: In this paper, the effects of different operating parameters on the performance of PEM fuel cells have been studied experimentally using pure hydrogen on the anode side and air on the cathode side.
Proceedings Article•
01 Jan 2003TL;DR: A novel scheme that uses robust principal component classifier in intrusion detection problems where the training data may be unsupervised and outperforms the nearest neighbor method, density-based local outliers (LOF) approach, and the outlier detection algorithm based on Canberra metric is proposed.
Abstract: : This paper proposes a novel scheme that uses robust principal component classifier in intrusion detection problems where the training data may be unsupervised Assuming that anomalies can be treated as outliers, an intrusion predictive model is constructed from the major and minor principal components of the normal instances A measure of the difference of an anomaly from the normal instance is the distance in the principal component space The distance based on the major components that account for 50% of the total variation and the minor components whose eigenvalues less than 020 is shown to work well The experiments with KDD Cup 1999 data demonstrate that the proposed method achieves 9894% in recall and 9789% in precision with the false alarm rate 092% and outperforms the nearest neighbor method, density-based local outliers (LOF) approach, and the outlier detection algorithm based on Canberra metric
TL;DR: Neurofibrillary tangles are more numerous in medial temporal lobe regions associated with memory function and show a relationship to performance on memory tests in nondemented individuals, suggesting that NFTs may constitute a pathological substrate for memory loss not only in AD but also in normal aging and MCI.
Abstract: Background Large numbers of neurofibrillary tangles (NFTs) and amyloid plaques are diagnostic markers for Alzheimer disease (AD), but lesser numbers of these lesions are also seen in nondemented elderly individuals. Much of the existing literature suggests that the NFTs of AD have a closer correlation with cognitive function than do amyloid plaques. Whether a similar relationship exists in normal aging and mild cognitive impairment (MCI), a condition that frequently reflects a preclinical stage of AD, remains unknown. Objective To determine the distribution patterns of beta-amyloid plaques and NFTs and the association of these lesions with memory performance in nondemented individuals. Methods We investigated regional distributions and neuropsychological correlates of NFTs and amyloid plaques in cognitively normal elderly persons and subjects with MCI who received neuropsychological testing before death. Subjects Eight nondemented subjects who volunteered to receive annual neuropsychological testing and agreed to brain donation were studied. Five subjects showed no cognitive impairment, and 3 were diagnosed with MCI. Results Distribution of NFTs followed a rigorous and hierarchical pattern, but distribution of amyloid plaques varied among individuals. Subjects with MCI displayed higher NFT densities than did nonimpaired subjects. In addition, NFT density in the temporal lobe correlated with memory scores, whereas density of amyloid plaques did not. Conclusions Neurofibrillary tangles are more numerous in medial temporal lobe regions associated with memory function and show a relationship to performance on memory tests in nondemented individuals. These results suggest that NFTs may constitute a pathological substrate for memory loss not only in AD but also in normal aging and MCI.
TL;DR: Positive feelings are considered within the framework of a general model of origins and functions of affect, which treats affect as reflecting the error signal of a feedback loop managing rate of incentive-seeking behaviour.
Abstract: Positive feelings are considered within the framework of a general model of origins and functions of affect. This model treats affect as reflecting the error signal of a feedback loop managing rate of incentive-seeking (and threat-avoidant) behaviour. In this view, positive feelings represent a sign that things are going better than necessary and are presumed to induce coasting. A tendency to coast is seen as facilitating the shift of attention and effort to other behavioural domains, where they may be needed more or where unforeseen opportunities have arisen. Such a function for positive feelings would permit the person both to maintain satisfactory standing with regard to multiple goals and to take advantage of unforeseen opportunities, thus providing adaptive value. Comparisons are made to other recently developed ideas concerning the functions of positive feelings.
TL;DR: Data is summarized regarding the role of the vasculature, leukocytes, blood-brain barrier, macrophages, and microglia after experimental and clinical stroke.
Abstract: Inflammation has been implicated as a secondary injury mechanism following ischemia and stroke. A variety of experimental models, including thromboembolic stroke, focal and global ischemia, have been used to evaluate the importance of inflammation. The vasculature endothelium promotes inflammation through the upregulation of adhesion molecules such as ICAM, E-selectin, and P-selectin that bind to circulating leukocytes and facilitate their migration into the CNS. Once in the CNS, the production of cytotoxic molecules may facilitate cell death. The macrophage and microglial response to injury may either be beneficial by scavenging necrotic debris or detrimental by facilitating cell death in neurons that would otherwise recover. While many studies have tested these hypotheses, the importance of inflammation in these models is inconclusive. This review summarizes data regarding the role of the vasculature, leukocytes, blood-brain barrier, macrophages, and microglia after experimental and clinical stroke.