Managing the residual cardiovascular disease risk associated with HDL-cholesterol and triglycerides in statin-treated patients: A clinical update

Cardiovascular disease (CVD) is a significant cause of death in Europe. In addition to patients with proven CVD, those with type 2 diabetes (T2D) are at a particularly high-risk of CVD and associated mortality. Treatment for dyslipidaemia, a principal risk factor for CVD, remains a healthcare priority; evidence supports the reduction of low-density lipoprotein cholesterol (LDL-C) as the primary objective of dyslipidaemia management.While statins are the treatment of choice for lowering LDL-C in the majority of patients, including those with T2D, many patients retain a high CVD risk despite achieving the recommended LDL-C targets with statins. This ‘residual risk’ is mainly due to elevated triglyceride (TG) and low high-density lipoprotein cholesterol (HDL-C) levels. Following statin therapy optimisation additional pharmacotherapy should be considered as part of a multifaceted approach to risk reduction. Fibrates (especially fenofibrate) are the principal agents recommended for add-on therapy to treat elevated TG or low HDL-C levels. Currently, the strongest evidence of benefit is for the addition of fenofibrate to statin treatment in high-risk patients with T2D and dyslipidaemia. An alternative approach is the addition of agents to reduce LDL-C beyond the levels attainable with statin monotherapy.Here, addition of fibrates and niacin to statin therapy is discussed, and novel approaches being developed for HDL-C and TG management, including cholesteryl ester transfer protein inhibitors, Apo A-1 analogues, mipomersen, lomitapide and monoclonal antibodies against PCSK9, are reviewed.     

郑州地区初秋季节嗜尸性麻蝇生长发育规律的初步研究

目的：探讨郑州地区初秋季节嗜尸性麻蝇的生长发育规律,为该地区该季节人体死亡时间推断提供法医昆虫学较确切数据。方法：以人肝组织作为诱饵和培养物,观察郑州地区初秋季节嗜尸性麻蝇的生长演变过程及特点。结果：在郑州地区初秋季节,嗜尸性麻蝇首先飞临培养物产蛆,培养物放置4h见麻蝇幼蛆,幼蛆体长在幼蛆出生后的42h内与生长时间呈近似的线性关系。幼蛆出生后96h变蛹,16d变蝇。结论：在郑州地区初秋季节嗜尸性麻蝇的生长发育具有明显的规律性,实验结果可作为郑州地区推断人体死亡时间的较确切数据。     

Differential effects of advance semantic cues on grasping, naming, and manual estimation

In the three experiments reported here, we systematically investigated when and/or how prior semantic information about a target-object would affect the programming and execution of grasping movements. A name-length association was first created during a practice phase while participants performed one of the three tasks: grasping, naming, or manual estimation of an object’s length upon an auditory presentation of its name. In the subsequent test phase, in the majority of trials, these names correctly indicated the upcoming object for a grasping task or a control naming task (Experiment 1A and 1B), and a grasping task or a manual estimation of object length (Experiment 2). In both experiments, a name was occasionally incongruent or a neutral cue (a burst of white noise) was presented instead. Although in the grasping task, semantic cues (both congruent and incongruent) consistently facilitated movement-onset time (indicating a preparatory-set like effect), the impact of these cues on the formation of grasping aperture was less consistent or absent. The experiments also demonstrated that naming and perceptual estimation of object length were affected differently from grasping by the same semantic cues, with the congruent cues facilitating and the incongruent cues slowing down response onset. These findings reinforce and extend the proposal that the transformations of visual and semantic information for perceptually-driven tasks are quite different from the transformations of the same information for the programming and control of object-directed action.     

Effects of Various Parameters on Lateral Displacement Estimation in Ultrasound Elastography

Complementary to axial, lateral displacement and strain can provide important information on the biological soft tissues. In this paper, the effects of key parameters (i.e., lateral displacement, pitch, beamwidth, beam overlap and interpolation) on lateral displacement estimation were investigated, in simulations and homogeneous phantom experiments, using lateral rigid motion only to study its fundamentals separately from the effects of axial motion and 2-D deformation on lateral displacement estimation. The performance of the lateral motion estimator was evaluated by measuring its associated bias, jitter and correlation coefficient. Simulation results showed that the bias and jitter of the lateral displacement estimation and correlation coefficient of RF signals undergo periodic variations depending on the lateral displacement, with a period equal to the pitch. The performance of the lateral estimation was improved when a smaller pitch or a larger beamwidth, was used. The effect of the pitch on the lateral estimation on lateral displacement estimation was found to be greater than the beamwidth effect. Therefore, a smaller pitch is preferred when the beam overlap remains the same. The use of cubic spline, instead of linear interpolation, increases the correlation coefficient, and decreases the jitter, with the trade-off of increased bias. The results of the phantom experiments were shown in good agreement with the simulation findings, including the periodic variation of the performance with lateral displacement and effects of pitch, beamwidth and interpolation method on lateral displacement estimation. In conclusion, smaller pitch, wider beamwidth and spline interpolation were shown to be key in reducing the jitter error in the lateral displacement estimation. (E-mail: ek2191@columbia.edu)     

A method for estimating from thermometer sales the incidence of diseases that are symptomatically similar to influenza

Early detection and accurate characterization of disease outbreaks are important tasks of public health. Infectious diseases that present symptomatically like influenza (SLI), including influenza itself, constitute an important class of diseases that are monitored by public-health epidemiologists. Monitoring emergency department (ED) visits for presentations of SLI could provide an early indication of the presence, extent, and dynamics of such disease in the population.We investigated the use of daily over-the-counter thermometer-sales data to estimate daily ED SLI counts in Allegheny County (AC), Pennsylvania. We found that a simple linear model fits the data well in predicting daily ED SLI counts from daily counts of thermometer sales in AC. These results raise the possibility that this model could be applied, perhaps with adaptation, in other regions of the country, where commonly thermometer sales data are available, but daily ED SLI counts are not.     

居民主要食入蔬菜中210Po含量及所致公众内照射剂量估算

目的 为了调查市售蔬菜中²¹⁰Po的放射性水平,评价其对居民的影响。方法 通过市场购买叶菜类、果菜类等14种蔬菜,使用湿式消解与银片自沉积结合的方法测量各种蔬菜中²¹⁰Po活度浓度水平,与相关文献中的参考值进行对比,并进行内照射剂量估算。结果 此次研究所选取的14种蔬菜中,活度浓度范围在8.34×10^-3～1.27 Bq/kg（鲜）。菌类的香菇²¹⁰Po含量最高,为1.27 Bq/kg,高于其他几类蔬菜,叶菜类²¹⁰Po含量其次,范围在1.30×10^-2～1.74×10^-1 Bq/kg,根茎类的两种蔬菜活度浓度范围在1.77×10^-2～3.51×10^-2 Bq/kg,果菜类六种蔬菜范围在8.34×10^-3～6.19×10^-2 Bq/kg。经估算居民通过这14种蔬菜摄入²¹⁰Po的量为24.3 Bq/a,所致内照射剂量29.2 μSv/a。结论 此次调查的市售蔬菜中²¹⁰Po水平属于正常水平,不会对居民健康产生影响。