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OBJECTIVES/SPECIFIC AIMS: To investigate the prognostic value of left ventricular mitral annular longitudinal displacement (LD) measured with color tissue Doppler imaging (TDI) in a large population suffering from acute coronary syndrome (ACS). METHODS/STUDY POPULATION: In total, 501 ACS patients underwent an echocardiography within 9 days after a percutaneous coronary intervention. Regional LD was obtained from the 6 mitral annular regions with TDI and GLD was calculated as an average. RESULTS/ANTICIPATED RESULTS: During a median follow-up time of 4.4 years 46 ACS patients suffered CVD. Mean value of GLD in the population was 8.11mm (±2.4). GLD and LD obtained from the inferior wall remained significant independent predictors after multivariate adjustment for clinical parameters, GLD (HR: 1.43, 95% CI: 1.12–1.82, p=0.014, per 1mm decrease), inferior LD (HR: 1.38, 95% CI: 1.14–1.66, p=0.001). Furthermore, inferior wall LD was the primary source of prognostic information in GLD since only inferior LD remained significant when both measures were included in the same model: GLD (HR: 0.95, 95% CI: 0.64–1.40, p=0.781); inferior LD (HR: 1.60, 95% CI: 1.15–2.22, p=0.005). Of all walls, only inferior wall LD remained as an independent predictor after multivariate adjustment. DISCUSSION/SIGNIFICANCE OF IMPACT: GLD provides independent prognostic information in ACS patients over and beyond all conventional echocardiographic measures. Regional inferior LD was the primary source of prognostic information gained from GLD. GLD proved to be a better predictor of cardiovascular events than conventional echocardiographic measures. This could lead to better risk stratification in the clinical setting and open up for earlier intervention in high-risk individuals.
Antipsychotics are associated with a polymorphic ventricular tachycardia, torsades de pointes, which, in the worst case, can lead to sudden cardiac death. The QT interval corrected for heart rate (QTc) is used as a clinical proxy for torsades de pointes. The QTc interval can be prolonged by antipsychotic monotherapy, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmaceutical treatment. Therefore, this study investigated the associations between QTc interval and antipsychotic monotherapy and antipsychotic polypharmaceutical treatment in schizophrenia, and measured the frequency of QTc prolongation among patients.
We carried out an observational cohort study of unselected patients with schizophrenia visiting outpatient facilities in the region of Central Jutland, Denmark. Patients were enrolled from January of 2013 to June of 2015, with follow-up until June of 2015. Data were collected from clinical interviews and clinical case records.
Electrocardiograms were available for 65 patients, and 6% had QTc prolongation. We observed no difference in average QTc interval for the whole sample of patients receiving no antipsychotics, antipsychotic monotherapy, or antipsychotic polypharmaceutical treatment (p=0.29). However, women presented with a longer QTc interval when receiving polypharmacy than when receiving monotherapy (p=0.01). A limitation of this study was its small sample size.
We recommend an increased focus on monitoring the QTc interval in women with schizophrenia receiving antipsychotics as polypharmacy.
The present study investigates the photobiont diversity of the boreal felt lichen, Erioderma pedicellatum. Previously sampled genetic data from Newfoundland were reanalyzed and new sequence data (16S rDNA, rbcLX) of the boreal felt lichen from Alaska (USA), Kamchatka (Russia), and North Trøndelag (Norway) were generated. The highest genetic diversity of the photobiont is found in Alaska and Kamchatka, indicating that these may be the primary sources of the species in the Northern Hemisphere. In Newfoundland, the photobiont of E. pedicellatum was screened on leaves of the symbiotic liverwort Frullania asagrayana and it was found to occur on trees where no other lichens were present, demonstrating that the geographical distribution, and possibly also the ecological requirement of the photobiont of E. pedicellatum, is wider than that of the lichen phenotype. Finally, a postulated association between the occurrence of the vegetatively reproducing Coccocarpia palmicola and the occurrence of the compatible photobiont of E. pedicellatum on the same tree could not be established.
Plant lignans are diphenolic compounds ingested with whole grains and seeds and converted to enterolignans by the colonic microbiota. In the present study, we investigated absorption and metabolism of plant lignans and enterolignans in vivo after consumption of cereal-based diets. Six pigs fitted with catheters in the mesenteric artery and portal vein and with a flow probe attached to the portal vein along with twenty pigs for quantitative collection of urine were used for this study. The animals were fed bread based on wheat flour low in plant lignans and three lignan-rich breads based on whole-wheat grain, wheat aleurone flour or rye aleurone flour. Plant lignans and enterolignans in plasma were monitored daily at fast after 0–3 d of lignan-rich intake, and on the 4th day of lignan-rich intake a 10-h profile was completed. Urine samples were collected after 11 d of lignan-rich diet consumption. The concentrations of plant lignans were low at fast, and was 1·2–2·6 nmol/l after switching from the low-lignan diet to the lignan-rich diets. However, on the profile day, the concentration and quantitative absorption of plant lignans increased significantly from 33 nmol/h at fast to 310 nmol/h 0–2·5 h after ingestion with a gradual increase in the following periods. Quantitatively, the absorption of plant lignans across diets amounted to 7 % of ingested plant lignans, whereas the urinary excretion of plant lignans was 3 % across diets. In conclusion, there is a substantial postprandial uptake of plant lignans from cereals, suggesting that plant lignans are absorbed from the small intestine.
The (usual) Caldero–Chapoton map is a map from the set of objects of a category to a Laurent polynomial ring over the integers. In the case of a cluster category, it maps reachable indecomposable objects to the corresponding cluster variables in a cluster algebra. This formalizes the idea that the cluster category is a categorification of the cluster algebra. The definition of the Caldero–Chapoton map requires the category to be 2-Calabi-Yau, and the map depends on a cluster-tilting object in the category. We study a modified version of the Caldero–Chapoton map which requires only that the category have a Serre functor and depends only on a rigid object in the category. It is well known that the usual Caldero–Chapoton map gives rise to so-called friezes, for instance, Conway–Coxeter friezes. We show that the modified Caldero–Chapoton map gives rise to what we call generalized friezes and that, for cluster categories of Dynkin type A, it recovers the generalized friezes introduced by combinatorial means in recent work by the authors and Bessenrodt.
Fortification with the essential trace element iodine is widespread worldwide. In the present study, results on iodine excretion and intake of iodine-rich foods from a cross-sectional study carried out in 2004–5, 4 to 5 years after the implementation of mandatory iodine fortification, were compared with data in a study carried out in 2008–10. The 2008–10 study was a follow-up of a cross-sectional study carried out before iodine fortification was implemented. Participants in the cross-sectional studies were randomly selected. Both studies were carried out in the cities of Aalborg and Copenhagen in Denmark. The median urinary iodine concentration decreased in women from 97 μg/l (n 2862) to 78 μg/l (n 2041) (P< 0·001). The decrease persisted after adjustment for age, city and education, and if expressed as estimated 24 h iodine excretion. The prevalence of users of iodine containing dietary supplements increased from 29·4 to 37·3 % (P< 0·001). The total fluid intake increased in women (P< 0·001), but the intake of other iodine-rich foods did not change. The median urinary iodine concentration did not change in men (114 μg/l (n 708) and 107 μg/l (n 424), respectively), while the total fluid intake decreased (P= 0·001). Iodine content was measured in milk sampled in 2000–1 and in 2013. The iodine content was lower in 2013 (12 (sd 3) μg/100 g) compared with that in 2000–1 (16 (sd 6) μg/100 g) (P< 0·001). In conclusion, iodine excretion in women has decreased below the recommended level. The reason might probably, at least partly, be a decreased content of iodine in milk.
Two single nucleotide polymorphisms (SNP TXNIP and SNP ARNT), both on chromosome 4, have been reported to be associated with roundworm (Ascaris suum) burden in pigs. In the present study, we selected pigs with two SNP TXNIP genotypes (AA; n = 24 and AB; n = 24), trickle-infected them with A. suum from 8 weeks of age until necropsy 8 weeks later, and tested the hypothesis that pigs with the AA genotype would have higher levels of resistance than pigs of AB genotype. We used different indicators of resistance (worm burden, fecal egg counts (FEC), number of liver white spots and A. suum-specific serum IgG antibody levels). Pigs of the AA genotype had lower mean macroscopic worm burden (2·4 vs 19·3; P = 0·06), lower mean total worm burden (26·5 vs 70·1; P = 0·09) and excreted fewer A. suum eggs at week 8 PI (mean number of eggs/g feces: 238 vs 1259; P = 0·14) than pigs of the AB genotype, as expected based on prior associations. The pigs were also genotyped at another locus (SNP ARNT) which showed a similar trend. This study provides suggestive evidence that resistant pigs may be selected using a genetic marker, TXNIP, and provides further support to the quantitative trait locus on chromosome 4.
Traditional Inuit dietary patterns have been found to be beneficial for CVD but have not been investigated in relation to glucose intolerance. We examined the association between dietary patterns and type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG).
Cross-sectional design with a priori derived dietary patterns from an FFQ resulted in five patterns: imported meat (n 196), traditional food (n 601), balanced diet (n 126), unhealthy diet (n 652) and standard diet (n 799).
Associations between dietary patterns and glucose-related outcomes were tested by linear and logistic regression analyses. Data included: dietary intake by FFQ, waist circumference, ethnicity, frequency of alcohol intake and smoking, physical activity, and oral glucose tolerance test results. Fasting participants and those without diagnosed T2DM were classified into normal glucose tolerance, IGT, IFG or T2DM. HOMA-IR (homeostatic model assessment–insulin resistance index) and HOMA-β (homeostatic model assessment of β-cell function) were calculated.
Data included 2374 Inuit, aged 18+ years.
Participants with a traditional dietary pattern had higher fasting plasma glucose (mean 5·73 (95 % CI 5·68, 5·78) mmol/l, P < 0·0001) and lowest HOMA-β (48·66 (95 % CI 46·86, 50·40), P < 0·0001). The traditional diet gave significantly higher odds for IFG and T2DM than the balanced diet, imported meat diet, standard diet and unhealthy diet.
Traditional food was positively associated with T2DM, IFG and fasting plasma glucose, and negatively associated with β-cell function, compared with a standard diet. The imported meat diet seemed the best in relation to glucose intolerance, with lowest fasting plasma glucose and lowest odds for IFG and T2DM.
Stability conditions on triangulated categories were introduced by Bridgeland as a ‘continuous’ generalisation of t-structures. The set of locally-finite stability conditions on a triangulated category is a manifold that has been studied intensively. However, there are mainstream triangulated categories whose stability manifold is the empty set. One example is Dc(k[X]/(X2)), the compact derived category of the dual numbers over an algebraically closed field k. This is one of the motivations in this paper for introducing co-stability conditions as a ‘continuous’ generalisation of co-t-structures. Our main result is that the set of nice co-stability conditions on a triangulated category is a manifold. In particular, we show that the co-stability manifold of Dc(k[X]/(X2)) is ℂ.
Vitamin A supplementation (VAS) at birth was not associated with improved survival in a randomised, placebo-controlled trial in Guinea-Bissau. However, a negative sex-differential effect, which became evident after diphtheria–tetanus–pertussis (DTP) vaccination, was noted; among girls who had received DTP, VAS at birth was associated with two-fold higher mortality than placebo. The objective of the present study was to investigate the immunological effects of VAS at birth within a subgroup of participants in the randomised trial. Guided by the mortality results, we further explored whether VAS had a differential effect according to sex and DTP status. At 6 weeks after randomisation and supplementation, we measured differential leucocyte counts and TNF-α, interferon-γ, IL-10, IL-13 and IL-5 production in a whole-blood culture assay. A total of 471 children were included. VAS compared with placebo at birth was associated with a higher proportion of monocytes (relative risk ratio 1·26, 95 % CI 1·07, 1·49, P= 0·04), while spontaneous TNF-α production was lower in the VAS group (geometric mean ratio 0·54, 95 % CI, 0·37, 0·78, P= 0·001). Stratified analysis showed that VAS was associated with lower TNF-α and IL-10 production for girls without DTP and boys with DTP, resulting in significant three-way interactions between VAS, sex and DTP vaccination status (P= 0·03 and P= 0·04, respectively) for spontaneous TNF-α and IL-10 production. The results substantiate the potential role of VAS as an immunomodulatory intervention, which has different effects depending on concomitant health interventions and the sex of the recipient.
The purpose of this article is to illustrate how the pension benefits a pension saver will (expect to) receive will depend on the type of pension scheme chosen. We compare three widely different pension savings products: the “traditional” with-profits scheme involving bonus entitlement (average interest rate product), a market-based Unit Link scheme and, finally, a formula based smoothed investment-linked annuity scheme – TimePension in short – which is on many points a cross between the two prior-mentioned types of savings products.
The three product types mentioned above have been analysed in previous literature, but those comparisons were based almost entirely on the values of pension savings accounts at the expiry of the accumulation period. This article will include the payout phase (decumulation phase) in the analysis, enabling us to analyse the size of paid-out pension benefits themselves as well as the possibilities of adjusting these benefits periodically. Compared to earlier articles, we have also improved the underlying model for the uncertainty of the underlying financial market.
The article demonstrates that expected pension benefits from the three schemes are an increasing function of the allocation to shares in the underlying investment portfolios. TimePension involves the highest allocation to shares and therefore offers, on average, the highest pension benefits, followed by the Unit Link scheme. In the third and last place comes the traditional with-profits scheme, which has a relatively low allocation to shares, but which, in return, also provides relatively safe and stable pension benefits. We also show, however, that the stability of pension benefits from a TimePension scheme is completely level with the stability of benefits from the traditional scheme. Unit Link-based pension benefits, on the other hand, vary far more, and pension savers in this product segment will experience much higher annual adjustments – in a both negative and positive direction – than savers in the other product segments.
Neutron powder diffraction studies of the layered compounds R1.2Sr1.8Mn2O7, (R = La,Pr, Nd), RSr2Mn2O7 (R = Pr,Nd),and La1.4Sr1.6Mn2O7 show that the degree of distortion of the MnO6 octahcdra do not correlate with the appearance of a metal-insulator (MI) transition in these compounds. Instead, the in-plane Mn-O bond length appears to be a better indicator of the electronic behavior. Detailed bulk magnetization studies on single crystal La1.2Sr1.8Mn2O7 show thai there are three magnetic regimes as a function of temperature: paramagnetic insulator, short-range ordered (SRO) fcrrromangct, and long-range ordered (LRO) fcrromagnct. Scaling analysis indicates that a 2D finite-size XY model is an appropriate description of the magnetic state in the SRO regime.
We define the symmetric Auslander category As(R) to consist of complexes of projective modules whose left- and right-tails are equal to the left- and right-tails of totally acyclic complexes of projective modules.
The symmetric Auslander category contains A(R), the ordinary Auslander category. It is well known that A(R) is intimately related to Gorenstein projective modules, and our main result is that As(R) is similarly related to what can reasonably be called Gorenstein projective homomorphisms. Namely, there is an equivalence of triangulated categories
where GMor(R) is the stable category of Gorenstein projective objects in the abelian category Mor(R) of homomorphisms of R-modules.
This result is set in the wider context of a theory for As(R) and Bs(R), the symmetric Bass category which is defined dually.
Objective: To investigate the relationship between physical fitness and work integration following stroke. Design: Single-group study, measurement of physical fitness pre and post physical training, measurement of employment status in a follow-up assessment 2 to 36 months after rehabilitation. Setting: Interdisciplinary outpatient rehabilitation program. Participants: 58 stroke survivors (62% male, mean age at program start 46.7 years, mean time since stroke 1.1 years) who were consecutively referred to the program. Intervention: 1½ hours of intensive training of cardiorespiratory fitness and muscle strength 1–3 times weekly as part of the 3-month program. Measures: Physical fitness was measured with a modified Harvard Step Test, the Åstrand Cycling Test, and walking/running speed. The type of participants' employment as well as the amount of working hours was registered. Results: Good physical fitness as measured by the Harvard Step test, but not the Åstrand Cycling Test and walking/running speed, was related to return to competitive, full-time employment. Test results from training tended to predict work reintegration better than test results from training start. Improvement of physical fitness as measured by the Harvard Step Test was also related to follow-up employment. Conclusions: The results imply a relationship between physical fitness and work integration following stroke and should be confirmed with a randomised controlled study design.
The effects of wheat and rye breads made from whole-wheat grain (WWG), wheat aleurone flour (WAF) or rye aleurone flour (RAF) on net portal absorption of carbohydrate-derived nutrients (glucose, SCFA and lactate) and apparent insulin secretion were studied in a model experiment with catheterised pigs. The breads were similar in dietary fibre (DF, 120–125 g/kg DM) but differed in arabinoxylans (50–62 g/kg), β-glucans (4–9 g/kg) and content of soluble DF (13–29 g/kg). Six pigs in a repeated 3 × 3 crossover design were fitted with catheters in the portal vein and the mesenteric artery and a portal flow probe. Pigs were fed three meals daily (at 09.00, 14.00 and 19.00 hours), and blood profiles were collected repeatedly from 08.30 until 19.00 hours once weekly. Net portal absorption of glucose was similar among breads and between meals. In contrast, insulin secretion was lowest (P < 0·05) in pigs fed RAF bread (3·9 nmol/h), intermediate in pigs fed WAF bread (5·4 nmol/h) and highest in pigs fed WWG bread (5·9 nmol/h), indicating that RAF bread improved insulin economy. Portal concentrations of propionate, butyrate and valerate were high, intermediate and low (P < 0·05) when pigs were fed RAF, WAF and WWG breads, respectively. Insulin secretion was higher (P < 0·001), and portal absorption of SCFA was lower (P < 0·05) after the first daily meal than after the second daily meal (8·8 v. 4·4 nmol/h). A low insulin response was associated with high portal absorption of SCFA. In conclusion, RAF bread was able to improve insulin economy compared to WWG bread.
Triangulated categories were introduced in the mid 1960's by J.L. Verdier in his thesis, reprinted in . Axioms similar to Verdier's were independently also suggested in . Having their origins in algebraic geometry and algebraic topology, triangulated categories have by now become indispensable in many different areas of mathematics. Although the axioms might seem a bit opaque at first sight it turned out that very many different objects actually do carry a triangulated structure. Nowadays there are important applications of triangulated categories in areas like algebraic geometry (derived categories of coherent sheaves, theory of motives) algebraic topology (stable homotopy theory), commutative algebra, differential geometry (Fukaya categories), microlocal analysis or representation theory (derived and stable module categories).
It seems that the importance of triangulated categories in modern mathematics is growing even further in recent years, with many new applications only recently found; see B. Keller's article in this volume for one striking example, namely the cluster categories occurring in the context of S. Fomin and A. Zelevinsky's cluster algebras which have been introduced only around 2000.
In this chapter we aim at setting the scene for the survey articles in this volume by providing the relevant basic definitions, deducing some elementary general properties of triangulated categories, and providing a few examples.
Certainly, this cannot be a comprehensive introduction to the subject.