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The Importance of Setting Treatment Goals for Cardiovascular Diseases

World Journal of Cardiovascular Diseases 2024年第1期14卷 10-15页

作者： David S. Schade Bramara Nagamallika Godasi Teodor Duro robert Philip eaton University of New Mexico Health Sciences Albuquerque USA

Background: Guidelines are issued by most major organizations that focus on a specific disease entity. Guidelines should be a significant help to the practicing physician who may not be up-to-date with the recent medical literature. Unfortunately, when conflicting guidelines for a specific disease are published, confusion results. Purpose: This article provides a suggested guideline outcome measure that would benefit the physician and patient. Methods: A review of 19 different guidelines for cardiovascular disease treatment is one example of the lack of specific outcomes that currently exist. The basic problem with most guidelines is that they do not state the expected end result (i.e., the benefit to the patient) if that guideline is followed. When guidelines use cardiovascular disease risk factors to dictate therapy, the end benefit is never stated so that the patient can make an appropriate choice of which (if any) guideline to follow. Results: A good example is guidelines published by the American Heart Association for reducing cardiovascular disease. These guidelines are risk factor based and only indicate that cardiovascular disease would be reduced if followed. No specific percentage in the reduction of the incidence of disease is given. In contrast, when elimination of the disease is the stated goal of the guideline, the end result is clear. To date, this goal has been stated by only one organization devoted to eliminating cardiovascular disease. Conclusion: Guidelines need to be written to provide the physician and the patient with a specific end point that is expected when the guideline is followed. Patient acceptance and compliance will be much improved if the patient knows the risk/benefit of following the guideline’s recommendations.

关键词： Guideline Goals for Cardiovascular Disease Prevention Cardiovascular Disease Risk Factors for Cardiovascular Disease Pooled Cohort equations

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Statistics of evolving Populations and Their Relevance to Flood Risk

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Journal of earth Science 2016年第1期27卷 2-8页

作者： robert e.Criss Department of earth and Planetary Sciences Washington University in St.Louis

Statistical methods are commonly used to evaluate natural populations and environmental variables, yet these must recognize temporal trends in population character to be appropriate in an evolving world. New equations presented here define the statistical measures of aggregate historical populations affected by linear changes in population means and standard deviations. These can be used to extract the statistical character of present-day populations, needed to define modern variability and risk, from tables of historical data that are dominated by measurements made when conditions were different. As an example, many factors such as climate change and in-channel structures are causing flood levels to rise, so realistic estimation of future flood levels must take such secular changes into account. The new equations provide estimates of water levels for ＂100-year＂ floods in the USA Midwest that are 0.5 to 2 m higher than official calculations that routinely assume population stationarity. These equations also show that flood levels will continue to rise by several centimeters per year. This rate is nearly ten times faster than the rise of sea level, and thus represents one of the fastest and most damaging rates of change that is documented by robust data.

关键词： flood risk statistical theory Mississippi River.

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Use of Geochemical and Geophysical Techniques to Characterize and Prospect for Geothermal Resources and Hydrothermal Ore Deposits

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Journal of earth Science 2015年第1期26卷 73-77页

作者： robert e.Criss Department of earth and Planetary Sciences Washington UniversitySt.Louis 63130USA

Fluid-rock interactions alter the geochemical, isotopic, petrographic and physical character of host rocks, producing a permanent record of hydrothermal activity. Maps of altered rock properties show regular variations that disclose master geologic controls and delineate likely sites for geothermal and mineral resources. In many cases, geochemical and stable isotope data re- veal the origins of thermal fluids, and they can also provide estimates of reservoir temperatures and identify zones of fluid recharge.

关键词： geothermal system hydrothermal system geophysical prospecting geochemicalprospecting Mt. Lassen oxygen isotope.

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Development of a classification system based on corneal biomechanical properties using artificial intelligence predicting keratoconus severity

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eye and Vision 2021年第3期8卷 203-213页

作者： robert Herber Lutz e.Pillunat Frederik Raiskup Department of Ophthalmology University Hospital Carl Gustav CarusUniversitätsklinikum Carl Gustav Carus an der Technischen Universität DresdenFetscherstraße 74TU 01307 DresdenGermany

Background:To investigate machine-learning(ML)algorithms to differentiate corneal biomechanical properties between different topographical stages of keratoconus(KC)by dynamic Scheimpflug tonometry(CST,Corvis ST,Oculus,Wetzlar,Germany).In the following,ML models were used to predict the severity in a training and validation ***:Three hundred and eighteen keratoconic and one hundred sixteen healthy eyes were included in this monocentric and cross-sectional pilot *** corneal response(DCR)and corneal thickness related(pachymetric)parameters from CST were chosen by appropriated selection techniques to develop a ML *** stage of KC was determined by the topographical keratoconus classification system(TKC,Pentacam,Oculus).Patients who were classified as TKC 1,TKC 2 and TKC 3 were assigned to subgroup mild,moderate,and advanced *** patients were classified as TKC 1-2,TKC 2-3 or TKC 3-4,they were assigned to subgroups according to the normative range of further corneal indices(index of surface variance,keratoconus index and minimum radius).Patients classified as TKC 4 were not included in this study due to the limited amount of *** discriminant analysis(LDA)and random forest(RF)algorithms were used to develop the classification *** were divided into training(70%of cases)and validation(30%of cases)***:LDA model predicted healthy,mild,moderate,and advanced KC eyes with a sensitivity(S_(n))/specificity(S_(p))of 82%/97%,73%/81%,62%/83%and 68%/95%from a validation dataset,*** the RF model,a S_(n)/S_(p) of 91%/94%,80%/90%,63%/87%,72%/95%could be reached for predicting healthy,mild,moderate,and advanced KC eyes,*** overall accuracy of LDA and RF was 71%and 78%,*** accuracy for KC detection including all subgroups of KC severity was 93%in both ***:The RF model showed good accuracy in predicting healthy eyes and various stages of *** accuracy was superior with respec

关键词： Artificial intelligence Corneal biomechanics Corvis ST Grading Keratoconus Machine learning

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Dependence of Mean and Peak Streamflow on Basin Area in the Conterminous United States

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Journal of earth Science 2016年第1期27卷 83-88页

作者： William e.Winston robert e.Criss Department of earth and Planetary Sciences Washington University in St.Louis

Basin area is the primary control on both mean and peak streamflows, but relationships vary with regional meteorological conditions. Rich historical data sets permit deduction of these relationships for most areas of the United States, revealing both expected and unexpected correlations. On log-log plots, mean flows for most basins with 〉75 cm/y rainfall have unit slopes, with the y-intercept approximating the mean annual runoff. Lower slopes characterize regions where runoff is greatest at high topographic elevations, or where significant withdrawals for irrigation occur at lower elevations. Peak flows also correlate strongly with basin area, but the regressions for most regions have slopes ranging from 0.4 to 0.9, and y-intercepts that increase with increasing flood recurrence interval. The slopes on these log-log plots for peak flows are highest in cool regions with low sunshine and low evapotranspiration, and lowest where sunshine is abundant, evapotranspiration is high, and small convective storm cells are common. effects of relief are small and inconsistent. Peak flows of small watersheds are huge compared to their mean flows, commonly being several thousand times greater, particularly in the USA midcontinent where the slopes for peak flows are low.

关键词： floods GIS runoff rivers.

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River Management and Flooding: The Lesson of December 2015–January 2016, Central USA

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Journal of earth Science 2016年第1期27卷 117-122页

作者： robert e.Criss Mingming Luo Department of earth and Planetary Sciences Washington University in St.Louis School of environmental Studies China University of Geosciences

The huge winter storm of December 23-29, 2015 delivered heavy rainfall in a broad swath across the USA, deluging east-Central Missouri. Record high river levels were set at many sites, but damages were most pronounced in developed floodplain areas, particularly where high levees were built or river channels greatly narrowed. An average of 20 cm of rain that mostly fell in three days impacted the entire 10 300 km2 Meramec Basin. Compared to the prior record flood of 1982, the highest relative stage（＋1.3 m） on Meramec River occurred at Valley Park proximal to（1） a new levee,（2） a landfill in the floodway,（3） large floodplain construction fills, and（4） tributary creek basins impacted by suburban sprawl. even though only a small fraction of the 1.8 million km2 Mississippi River watershed above St. Louis received extraordinary rainfall during this event, the huge channelized river near and below St. Louis rapidly rose to set the 3rd-highest to the highest stages ever, exhibiting the flashy response typical of a much smaller river.

关键词： floods Mississippi River levees floodplain development.

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effect of losing a fight on later agonistic behavior toward unfamiliar conspecifics in male Syrian hamsters

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Current Zoology 2011年第4期57卷 449-452页

作者： Javier DeLBARCO-TRILLO robert e. JOHNSTON Comell University Department of Psychology Uris Hall Ithaca NY 14853 USA

In many species, agonistic interactions result in social relationships that are stable over time. In Syrian hamsters, two unfamiliar males that are placed together will fight vigorously and a clear winner/loser relationship is usually established. In subsequent interactions, the loser will flee soon after detecting the familiar winner. Here we tested the hypothesis that losing a fight with a conspecific will affect future agonistic interactions not only toward that individual （i.e., the familiar winner） but also toward unfamiliar conspecifics. To test this hypothesis we paired two Syrian hamster males in three trials on one day in which the loser had tile opportunity to escape the winner. The next day the loser was paired with an unfarniliar male, also for three trials. If he lost again, he was tested on a third day with a third unfamiliar male. Subjects were those males that were losers on all three days. The latency to escape on the first trial on Days 2 and 3 was significantly shorter than on the first trial on Day l, indicating that losing against the first male affected the response toward unfamiliar males. However, the latency to escape on the first trial on Days 2 and 3 was significantly longer than that on the third trial on the preceding day, indicating that a loser treats unfamiliar males differently than a familiar winner. These results suggest that a defeat during an interaction with one male affects later agonistic behavior towards other, unfamiliar males [Current Zoology 57 （4）： 449-452, 2011].

关键词： Agonistic behavior Loser Hamsters Mesocricetus

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The impact of macroalgae on mean and turbulent flow fields

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Journal of Hydrodynamics 2015年第3期27卷 427-435页

作者： THOMAS robert e. MCLeLLAND Stuart J. Department of Geography Environment and Earth Sciences University of Hull

In this paper, we attempt to quantify the mean and turbulent flow fields around live macroalgae within a tidal inlet in Norway. Two Laminaria digitata specimens - 0.50 m apart were selected for detailed study and a profiling ADV was used to collect 45 velocity profiles, each composed of up to seven 0.035 m-high profiles collected for 240 s at 100 Hz, at a streamwise spacing of 0.25 m and cross-stream spacing of 0.20 m. To quantify the impact of the macroalgae, measurements were repeated over a sparser grid after the region had been completely cleared of algae and major roughness elements.

关键词： dealiasing laminaria digitata turbulence vectrino profiler velocity profile

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Discharge-Stage Relationship on Urban Streams evaluated at USGS Gauging Stations,***,Missouri

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Journal of earth Science 2020年第6期31卷 1133-1141页

作者： robert e.Criss David L.Nelson Department of earth and Planetary Sciences Washington UniversitySt.Louis MO 63130USA Columbia Cir Pasadena CA 91105USA

extensive USGS data tables and detailed,1 m2 Li DAR surveys are used to determine the optimal power n that relates discharge(Q)to stage(h*)above channel bottom(ho)at 39 gauging stations on small streams in the ***,Missouri area,all of which have catchments of 0.6 to 220 *** different methodologies are employed to determine both n and ho:(1)optimizing linearity in a plot of Q1/n *** stage(hL)using USGS field measurements at each site;(2)optimizing linearity in a plot of Q1/n *** using USGS rating tables at each site;(3)a mathematical inverse method applied to the same USGS rating tables;(4)use of Li DAR data on channel geometry to determine the power dependences of channel area A and hydraulic radius H on h*,combined with the Manning and rational equations to predict *** these methods,only methods 2 and 3 compare favorably,and these values compare poorly with Method 1 based on field data,and with method 4 based on theoretical and empirical *** Method 4 is predictive,it provides a useful alternative to methods 1–3 that are based on USGS field measurements,which are heavily weighted toward low *** conclude that the apparent values of n in the USGS rating tables are systematically too low for small streams.

关键词： stream gauging Li DAR topography urban flooding discharge hydrology

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Cardiac troponins in the elderly:interpretation of elevated levels

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Journal of Geriatric Cardiology 2007年第3期4卷 188-192页

作者： robert e Fromm Baylor College of Medicine Senior IntensivistVISICUinc. 2219 Dorrington Street HoustonTX 77030USA Jr

elderly patients with myocardial infarction commonly present with symptoms other than chest pain. The clinician evaluation of the elderly may rely on laboratory methods more so than in younger patients. Fortunately,advances in laboratory science have brought newer biomarkers of cardiac injury to the clinical arena including cardiac troponins I and T(cTnI,cTnT) . These regulatory components of the contractile apparatus are sensitive indicators of myocardial injury. Their central role in the current definition of acute myocardial infarction highlights their utility in the diagnosis of acute myocardial ischemic syndromes. The troponins are also released in some clinical situations where thrombotic complications of coronary artery disease and resultant acute myocardial infarction have not occurred. examples of these conditions include conditions like myocarditis,pulmonary embolism,sepsis,and acute stroke. elevated troponins in these conditions are thought to emanate from injured myocardial cells and in most circumstances have been associated with adverse outcomes. Interpretation of elevated troponin in the elderly requires consideration of other possible conditions.

关键词： acute myocardial infarction thrombolysis elderly

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