Antihypertensive treatment and risk factors for syncope in asymptomatic aortic stenosis patients with hypertension.

BACKGROUND: Evidence for treating hypertension in patients with asymptomatic aortic valve stenosis(AS) is scarce. OBJECTIVES: Given the paucity of data on the relationship between syncope and antihypertensive treatment in aortic stenosis. This study sought to investigate this association in patients admitted to our hospital. METHODS: A total of 158 patients with asymptomatic moderate or severe aortic stenosis were analyzed. Follow-up was conducted by clinic visit, telephone contact, or review of electronic medical records. Outcomes were syncope. RESULTS: Hypertension were documented in 90 of the 158 patients with moderate or severe AS, and 77 of them received antihypertensive medications. During an average 28 months follow-up period, the occurrence of syncope was observed in 13 patients. Among them, 8 were in antihypertensive group (n = 77) and 5 in normotensive group (n = 68). There was no significant difference in incidence of syncope between the two groups. Patients with treated hypertension and syncope had a lower stroke volume index (SVi), a higher valve arterial impedance (ZVA), a smaller SAC than those without. Kaplan-Meier analysis showed that there was no significant difference in syncope cumulative incidence between antihypertensive group and normotensive group (log rank P = .478). Multivariate cox regression analysis showed that both ZVA (hazard ratio:19.006, 95% confidence interval: 4.664 to77.448;P = .002) and LVMI (hazard ratio:1.484, 95% confidence interval: 1.427 to 5.157;P = .016) were associated with development of syncope, whereas hypertension were not related independently to syncope (hazard ratio:0.935, 95% confidence interval: 0.786 to3.173; P = .869). CONCLUSIONS: In patients with moderate or severe AS, concomitant hypertension, and antihypertensive treatment didn't increase the occurrence of syncope, whereas higher ZVA was independently associated with greater risk of syncope.

Critical Risk Indicators (CRIs) for the electric power grid: a survey and discussion of interconnected effects.

The electric power grid is a critical societal resource connecting multiple infrastructural domains such as agriculture, transportation, and manufacturing. The electrical grid as an infrastructure is shaped by human activity and public policy in terms of demand and supply requirements. Further, the grid is subject to changes and stresses due to diverse factors including solar weather, climate, hydrology, and ecology. The emerging interconnected and complex network dependencies make such interactions increasingly dynamic, posing novel risks, and presenting new challenges to manage the coupled human-natural system. This paper provides a survey of models and methods that seek to explore the significant interconnected impact of the electric power grid and interdependent domains. We also provide relevant critical risk indicators (CRIs) across diverse domains that may be used to assess risks to electric grid reliability, including climate, ecology, hydrology, finance, space weather, and agriculture. We discuss the convergence of indicators from individual domains to explore possible systemic risk, i.e., holistic risk arising from cross-domain interconnections. Further, we propose a compositional approach to risk assessment that incorporates diverse domain expertise and information, data science, and computer science to identify domain-specific CRIs and their union in systemic risk indicators. Our study provides an important first step towards data-driven analysis and predictive modeling of risks in interconnected human-natural systems.

Open Speech Platform: Democratizing Hearing Aid Research.

Hearing aids help overcome the challenges associated with hearing loss, and thus greatly benefit and improve the lives of those living with hearing-impairment. Unfortunately, there is a lack of adoption of hearing aids among those that can benefit from hearing aids. Hearing researchers and audiologists are trying to address this problem through their research. However, the current proprietary hearing aid market makes it difficult for academic researchers to translate their findings into commercial use. In order to abridge this gap and accelerate research in hearing health care, we present the design and implementation of the Open Speech Platform (OSP), which consists of a co-design of open-source hardware and software. The hardware meets the industry standards and enables researchers to conduct experiments in the field. The software is designed with a systematic and modular approach to standardize algorithm implementation and simplify user interface development. We evaluate the performance of OSP regarding both its hardware and software, as well as demonstrate its usefulness via a self-fitting study involving human participants.

Proteomic profile of edible bird's nest proteins.

Edible bird's nest (EBN) is made of the swiftlets' saliva, which has attracted rather more attention owing to its nutritious and medical properties. Although protein constitutes the main composition and plays an important role in EBN, few studies have focused on the proteomic profile of EBN. The purpose of this study was to produce a proteomic map and clarify common EBN proteins. Liquid-phase isoelectric focusing (LIEF) was combined with two-dimensional electrophoresis (2-DE) for comprehensive analysis of EBN proteins. From 20 to 100 protein spots were detected on 2-DE maps of EBN samples from 15 different sources. The proteins were mainly distributed in four taxa (A, B, C, and D) according to their molecular mass. Taxa A and D both contained common proteins and proteins that may be considered another characteristic of EBN. Taxon A was identified using MALDI-TOF-TOF/MS and found to be homologous to acidic mammalian chitinase-like ( Meleagris gallopavo ), which is in glycosyl hydrolase family 18.

The effect of physician presence on blood pressure.

OBJECTIVES: To evaluate the effect of physician presence on blood pressure (BP) and the influencing factors. METHODS: This study included 600 adult outpatients, of whom 335 had hypertension and 265 did not have hypertension. An automated BP measurement device was used for all measurements of BP. After a 10-min rest, the first two readings were measured (BP1) in the presence of a physician, and then five BP readings were taken when the patient was left alone in the room and their average as automated office blood pressure (AOBP); finally, the second office BP (BP2) was measured (BP1) when the physician was present again. The differences in BP1 and BP2 with AOBP were calculated as ΔBP1 and ΔBP2. RESULTS: (a) Both BP1 and BP2 were significantly higher than AOBP (131±1/79±1 and 127±1/76±1 vs. 125±1/74±1 mmHg, both P<0.05). The hypertension detection rates on BP1 and on BP2 were 38.5 and 32.4%, but only 23.8% on AOBP (both P<0.05). (b) The ΔSBP1 was significantly higher than ΔSBP2 (6.8±9.3 vs. 2.0±7.7 mmHg, P<0.001), and ΔDBP1 was higher than ΔDBP2 (5.9±8.6 vs. 3.2±7.0 mmHg, P<0.001). (c) ΔSBP1, ΔSBP2, and ΔDBP were higher in the hypertension (EH) subgroup than in the nonhypertension (no-EH) subgroup. Meanwhile, in the no-EH group, the ΔSBP1 of the female subgroup were also significantly higher than that of the male subgroup. CONCLUSION: The presence of a physician, even the second time, is associated with an increase in BP. Hypertensive patients and females have higher BP reaction for physician presence.

One arm exercise induces significant interarm diastolic blood pressure difference.

OBJECTIVES: This study is designed to investigate the inducing effect of one arm exercise on interarm difference (IAD) in the blood pressure (BP). METHODS: Fifty healthy young participants were included in the study. Three-minute exercises of the right arm elbow flexion and extension were performed. The bilateral brachial BP was simultaneously measured with two automatic BP measurement devices before (basic) and immediately 0, 5, 10, 15, 20, and 30 min after exercise. The absolute difference in the systolic BP (SBP) and diastolic BP (DBP) between the left and right BP of at least 10 mmHg was recognized as sIAD and dIAD. RESULTS: The baseline data of the SBP and DBP in left and right arms revealed no significant difference (SBP: 110 ± 10 vs. 111 ± 11 mmHg; DBP: 66 ± 8 vs. 66 ± 9 mmHg, both not significant). The prevalence of dIAD was 2% at the baseline. However, this prevalence increased to 80% at 0 min, as right arm exercise induced the right DBP decrease and left DBP increase, and then the prevalence decreased gradually within a 30-min recovery period. The prevalence of sIAD was zero at the baseline and the maximal prevalence was 8% during the 20-min postexercise period. CONCLUSION: One arm exercise can lead to a significant IAD in DBP. Any arm exercise should be avoided before BP measurement.