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Impact of diabetes mellitus on coronary artery plaque characteristics and outcomes in the SCOT-HEART trial
No full textBackgroundDiabetes mellitus is an established cardiovascular risk factor. We assessed the impact of diabetes mellitus on quantitative plaque and long-term outcomes in patients with and without diabetes mellitus in the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.MethodsCoronary artery calcium (CAC) was assessed on non-contrast computed tomography (CT). Coronary stenoses, visually assessed adverse plaque characteristics and quantitative plaque burdens (calcified, non-calcified, low attenuation and total, Autoplaque 2.5) were assessed on coronary CT angiography. Multivariable and survival analyses were performed. ResultsImages of 1769 patients were assessed (56% male, 58±9 years). Diabetes mellitus was present in 196 (11%) patients. Patients with diabetes mellitus had higher 10-year cardiovascular risk score (29 [interquartile range 21, 40] versus 15 [9, 21] %, p<0.001) and CAC score (71 [1, 447] versus 17 [0, 209] Agatston units, p<0.001), but were not more likely to have obstructive disease or visually assessed adverse plaque characteristics. Patients with diabetes mellitus had higher quantitatively assessed calcified, non-calcified, low attenuation and total plaque burdens. After adjustment for age and sex, diabetes mellitus was an independent predictor of calcified plaque burden (p=0.009), but not the other plaque types. During 8.7 [IQR 8, 9.6] years follow-up, diabetes mellitus was associated with an increased risk of fatal or non-fatal myocardial infarction, adjusted for age and sex (hazard ratio 1.85, 95% confidence interval 1.09 to 3.17, p=0.024). Conclusion Diabetes mellitus was an independent predictor of quantitatively assessed plaque burden, particularly calcified plaque, and was associated with an increased risk of myocardial infarction
Comparison of radiological interpretation made by veterinary radiologists and state-of-the-art commercial AI software for canine and feline radiographic studies
No full textINTRODUCTION: As human medical diagnostic expertise is scarcely available, especially in veterinary care, artificial intelligence (AI) has been increasingly used as a remedy. AI's promise comes from improving human diagnostics or providing good diagnostics at lower cost, increasing access. This study analyzed the diagnostic performance of a widely used AI radiology software vs. veterinary radiologists in interpreting canine and feline radiographs. We aimed to establish whether the performance of commonly used AI matches the performance of a typical radiologist and thus can be reliably used. Secondly, we try to identify in which cases AI is effective.METHODS: Fifty canine and feline radiographic studies in DICOM format were anonymized and reported by 11 board-certified veterinary radiologists (ECVDI or ACVR) and processed with commercial and widely used AI software dedicated to small animal radiography (SignalRAY ®, SignalPET ® Dallas, TX, USA). The AI software used a deep-learning algorithm and returned a coded abnormal or normal diagnosis for each finding in the study. The radiologists provided a written report in English. All reports' findings were coded into categories matching the codes from the AI software and classified as normal or abnormal. The sensitivity, specificity, and accuracy of each radiologist and the AI software were calculated. The variance in agreement between each radiologist and the AI software was measured to calculate the ambiguity of each radiological finding. RESULTS: AI matched the best radiologist in accuracy and was more specific but less sensitive than human radiologists. AI did better than the median radiologist overall in low- and high-ambiguity cases. In high-ambiguity cases, AI's accuracy remained high, though it was less effective at detecting abnormalities but better at identifying normal findings. The study confirmed AI's reliability, especially in low-ambiguity scenarios.CONCLUSION: Our findings suggest that AI performs almost as well as the best veterinary radiologist in all settings of descriptive radiographic findings. However, its strengths lie more in confirming normality than detecting abnormalities, and it does not provide differential diagnoses. Therefore, the broader use of AI could reliably increase diagnostic availability but requires further human input. Given the unique strengths of human experts and AI and the differences in sensitivity vs. specificity and low-ambiguity vs. high-ambiguity settings, AI will likely complement rather than replace human experts.</p
A new method to predict economic capital for the credit risk of a lending portfolio
Get PDFWe propose a method to compute the Value at Risk for a loan portfolio that involves predicting outstanding balance and repayment amounts, but not the probability of default directly. By modelling the behaviour of the borrowers in terms of repayments, balance and a default condition, we model the default occurrence more accurately than if we model the occurrence of default directly. We find that whilst including random effects increases the predictive accuracy of individual account performances, relatively simple structures give the most accurate predictions. We also find that, in terms of value at risk relative to expected loss, more complex random effects predict lower values at risk at more distant duration times whilst the omission of random effects leads to increasing values at risk over time. We compare the predicted amount of capital a bank should hold under our approach and under a standard approach and find that under certain circumstances, our approach indicates that considerably more capital should be held
Genome-wide characterization of 54 urinary metabolites reveals molecular impact of kidney function
Get PDFDissecting the genetic mechanisms underlying urinary metabolite concentrations can provide molecular insights into kidney function and open possibilities for causal assessment of urinary metabolites with risk factors and disease outcomes. Proton nuclear magnetic resonance metabolomics provides a high-throughput means for urinary metabolite profiling, as widely applied for blood biomarker studies. Here we report a genome-wide association study meta-analysed for 3 European cohorts comprising 8,011 individuals, covering both people with type 1 diabetes and general population settings. We identify 54 associations (p < 9.3 × 10-10) for 19 of 54 studied metabolite concentrations. Out of these, 33 were not reported previously for relevant urinary or blood metabolite traits. Subsequent two-sample Mendelian randomization analysis suggests that estimated glomerular filtration rate causally affects 13 urinary metabolite concentrations whereas urinary ethanolamine, an initial precursor for phosphatidylcholine and phosphatidylethanolamine, was associated with higher eGFR lending support for a potential protective role. Our study provides a catalogue of genetic associations for 53 metabolites, enabling further investigation on how urinary metabolites are linked to human health
Understanding the Potential of a Short-Term Participatory Video Project for Long-Term Change
Get PDFParticipatory video (PV) allows communities to explore issues of concern by making short videos. PV has been used in public health research by focusing the topic of video-making on a specific health issue in order to both raise awareness of this issue and to support communities to effect change with regard to this issue. Although evaluations of PV-in-health approaches yield positive findings in terms of community empowerment, it is difficult to measure changes in behaviour regarding the focal topic. This is important in the context of public health, as the impact of an intervention often determines its future usage. This study discusses a rare opportunity to consider the longer-term impacts of a PV project on the topic of antimicrobial resistance (AMR). Thematic analysis of a focus group discussion conducted with six PV participants demonstrates a retention of accurate knowledge about AMR over two years after original engagement. Participants reported changes in their own attitudes and practices around antibiotic and pesticide use, and described how they advocate for behaviour change in their wider communities. Findings also speak to the legacy of PV. While over time, videos may have impact through being viewed by others, participation in the project was also shown to have lasting legacy. Participants developed knowledge and changed attitudes on the topic, which continues to impact their behaviour. Beyond having co-produced the videos, participants are now experts in the video topic, and as such their opinions and actions represent a distinct, measurable impact of the PV process.</p
Anchors, archipelagos, and ports of departure:How resettlement shapes im/mobilities in Nyarugusu refugee camp, Tanzania
Get PDFThis article examines how the prospect of resettlement influences the migration plans and daily lives of encamped refugees. Using repeat surveys and interviews carried out with 77 refugee households in 2017-2023, we explore the consequences of the unfortunate ‘natural experiment’ of Nyarugusu refugee camp, where some Congolese refugees had substantial chances to be resettled while Burundian refugees were de facto barred from the opportunity. Participants depict resettlement as their favourite option in every single way; they are also acutely aware of their chance of being resettled and adjust their mobility plans accordingly. All feel stuck in the camp. Burundian refugees endure profound uncertainty and cast their hopes on moving to the ‘archipelago’ of refugee-hosting camps and cities in the region (yet rarely manage to do so). The possibility of resettlement anchors Congolese to the camp as they wait in a ‘port of departure’
Mindfulness, loving-kindness, and compassion-based meditation interventions and adult attachment orientations:A systematic map
Get PDFMeditation interventions have important benefits, including potentially helping those with higher attachment anxiety and avoidance enjoy better personal and relational growth. This preregistered and reproducible systematic map sought to identify the extent and scope of experimental evidence investigating the role of mindfulness, loving-kindness, and compassion-based multi-session meditation interventions in (a) moderating the effects of attachment orientations on outcomes over time and/or (b) changing attachment orientations over time. We conducted a systematic map, as the literature on meditation interventions and attachment is nascent. We searched 5 databases, screening 725 studies. We extracted data from four journal articles and one dissertation (five studies in total) which met our inclusion criteria. Four studies examined the effects of meditation interventions on buffering attachment insecurity and one examined attachment security enhancement. All five studies included a mindfulness meditation intervention, and one included a loving-kindness meditation intervention. All studies were conducted in Western cultures. Studies primarily found evidence for interventions benefitting those with higher attachment anxiety, although some evidence emerged for higher attachment avoidance. Our systematic map highlights a critical need for further application of meditation interventions in an attachment and personal growth context, given the promising nature of early work in this area
Sex-related hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axis adaptation during military training
Get PDFPeridotite xenoliths of Harrat ar-Rahah-Uwayrid alkaline basalts, NW Saudi Arabia: fragments of a multiply metasomatized Neoproterozoic mantle
Get PDFNumerous Upper Miocene to Quaternary harrats (basalt fields) litter western Saudi Arabia along the Red Sea between Jordan and Yemen and are related to the initial rifting of the Red Sea system at ~30–25 Ma. Many of these harrats contain alkaline scoria bombs and lesser lavas that bear mantle xenoliths, and one of these is Harrat Ar-Rahah-Uwayrid (HARU), which comprises a NW-SE oriented elongate volcanic field of ~7150 km2 and which extends for about ~230 km in NW Saudi Arabia. This study presents new whole-rock and mineral chemistry data of HARU mantle xenoliths to provide new insights into their petrogenesis and the nature of the subcontinental lithospheric mantle of Arabia. HARU xenoliths are mostly spinel lherzolite with lesser harzburgite and rare wehrlite. Xenoliths range from cm-scale to fist-size and are found primarily within Pleistocene basanite scoria bombs from cinder cones in the central HARU segment; others were recovered, for the first time, from the Upper Miocene alkali basalt and hawaiite lavas of the southern plateau. No distinctive features are apparent between peridotite xenoliths of the older and younger host rocks. Fo# of olivines from most of the HARU peridotite xenoliths ranges from 83.5 to 93.1, and spinel Cr# ranges widely from 0.09 to 0.59. Using F = 10 ln(spinel Cr#) + 24, estimated degrees of partial melting are low to high, ranging from 2% to 19%. On the basis of coexisting olivine-orthopyroxene-spinel pairs, oxygen fugacity ranges from −1.89 to −0.22 relative to FMQ, suggesting equilibration under reduced conditions. Thermobarometry calculations based on Ca in orthopyroxene suggest that the peridotite xenoliths equilibrated at temperatures of ~860–1000°C, at relatively shallow depths of ca. 35–42 km. Alike other harrats in Saudi Arabia, the host basalts are derived from partial melting of spinel lherzolite and garnet lherzolite. Overall, HARU peridotite xenoliths represent multiply metasomatized fragments of Neoproterozoic mantle
The Heirs of Avicenna:Philosophy in the Islamic East, 12–13th Centuries - Logic and Epistemology
Get PDFThis is the second in a series of sourcebooks charting the reception of Avicenna (Ibn Sīnā, d.1037) in the Islamic East (from Syria to central Asia) in the 12th-13th centuries CE. Moving on from the metaphysical and theological concerns covered in the first book, this volume looks at issues in logic and epistemology in the reception of Avicenna’s thought. Across dozens of authors and hundreds of passages, the translated material covers a wide range of topics including the subject matter of logic, the nature of knowledge and self-knowledge, questions in philosophy of language and syllogistic theory, and paradoxes
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