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- Holmqvist, Fredrik, et al.
(författare)
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Heart rate is associated with progression of atrial fibrillation, independent of rhythm
- 2015
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Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 101:11, s. 894-899
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Tidskriftsartikel (refereegranskat)abstract
- Objective Atrial fibrillation (AF) often progresses from paroxysmal or persistent to more sustained forms, but the rate and predictors of AF progression in clinical practice are not well described. Methods Using the Outcomes Registry for Better Informed Treatment of AF, we analysed the incidence and predictors of progression and tested the discrimination and calibration of the HATCH (hypertension, age, TIA/stroke, chronic obstructive pulmonary disease, heart failure) and CHA(2)DS(2)VASc scores for identifying AF progression. Results Among 6235 patients with paroxysmal or persistent AF at baseline, 1479 progressed, during follow-up (median 18 (IQR 12-24) months). These patients were older and had more comorbidities than patients who did not progress (CHADS(2) 2.3 +/- 1.3 vs 2.1 +/- 1.3, p<0.0001). At baseline, patients with AF progression were more often on a rate control as opposed to a rhythm control strategy (66 vs 56%, p<0.0001) and had higher heart rate (72(64-80) vs 68 (60-76) bpm, p<0.0001). The strongest predictors of AF progression were AF on the baseline ECG (OR 2.30, 95% CI 1.95 to 2.73, p<0.0001) and increasing age (OR 1.16, 95% CI1.09 to 1.24, p<0.0001, per 10 increase), while patients with lower heart rate (OR 0.84, 95% CI 0.79 to 0.89, p<0.0001, per 10 decrease <= 80) were less likely to progress. There was no significant interaction between rhythm on baseline ECG and heart rate (p=0.71). The HATCH and CHA(2)DS(2)VASc scores had modest discriminatory power for AF progression (C-indices 0.55 (95% CI 0.53 to 0.58) and 0.55 (95% CI 0.52 to 0.57)). Conclusions Within 1.5 years, almost a quarter of the patients with paroxysmal or persistent AF progress to a more sustained form. Progression is strongly associated with heart rate, and age.
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2. |
- Lee, Whanhee, et al.
(författare)
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Mortality burden of diurnal temperature range and its temporal changes : a multi-country study
- 2018
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 110, s. 123-130
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Tidskriftsartikel (refereegranskat)abstract
- Although diurnal temperature range (DTR) is a key index of climate change, few studies have reported the health burden of DTR and its temporal changes at a multi-country scale. Therefore, we assessed the attributable risk fraction of DTR on mortality and its temporal variations in a multi-country data set. We collected time-series data covering mortality and weather variables from 308 cities in 10 countries from 1972 to 2013. The temporal change in DTR-related mortality was estimated for each city with a time-varying distributed lag model. Estimates for each city were pooled using a multivariate meta-analysis. The results showed that the attributable fraction of total mortality to DTR was 2.5% (95% eCI: 2.3-2.7%) over the entire study period. In all countries, the attributable fraction increased from 2.4% (2.1-2.7%) to 2.7% (2.4-2.9%) between the first and last study years. This study found that DTR has significantly contributed to mortality in all the countries studied, and this attributable fraction has significantly increased over time in the USA, the UK, Spain, and South Korea. Therefore, because the health burden of DTR is not likely to reduce in the near future, countermeasures are needed to alleviate its impact on human health.
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3. |
- Sunghee, Kim, et al.
(författare)
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Olfactory discrimination ability of South African fur seals (Arctocephalus pusillus) for enantiomers
- 2013
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Ingår i: Journal of Comparative Physiology A. Sensory, neural, and behavioral physiology. - : Springer. - 0340-7594 .- 1432-1351. ; 199:6, s. 535-544
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Tidskriftsartikel (refereegranskat)abstract
- Using a food-rewarded two-choice instrumentalconditioning paradigm we assessed the ability of SouthAfrican fur seals, Arctocephalus pusillus, to discriminatebetween 12 enantiomeric odor pairs. The results demonstratethat the fur seals as a group were able to discriminatebetween the optical isomers of carvone, dihydrocarvone,dihydrocarveol, menthol, limonene oxide, a-pinene,fenchone (all p\0.01), and b-citronellol (p\0.05),whereas they failed to distinguish between the (?)- and(-)-forms of limonene, isopulegol, rose oxide, and camphor(all p[0.05). An analysis of odor structure–activityrelationships suggests that a combination of molecularstructural properties rather than a single molecular featuremay be responsible for the discriminability of enantiomericodor pairs. A comparison between the discrimination performanceof the fur seals and that of other species testedpreviously on the same set of enantiomers (or subsetsthereof) suggests that the olfactory discrimination capabilitiesof this marine mammal are surprisingly well developedand not generally inferior to that of terrestrial mammalssuch as human subjects and non-human primates. Further,comparisons suggest that neither the relative nor the absolutesize of the olfactory bulbs appear to be reliable predictorsof between-species differences in olfactorydiscrimination capabilities. Taken together, the results ofthe present study support the notion that the sense of smellmay play an important and hitherto underestimated role inregulating the behavior of fur seals.
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