Comparing Strategies to Prevent Stroke and Ischemic Heart Disease in the Tunisian Population: Markov Modeling Approach Using a Comprehensive Sensitivity Analysis Algorithm.

Background. Mathematical models offer the potential to analyze and compare the effectiveness of very different interventions to prevent future cardiovascular disease. We developed a comprehensive Markov model to assess the impact of three interventions to reduce ischemic heart diseases (IHD) and stroke deaths: (i) improved medical treatments in acute phase, (ii) secondary prevention by increasing the uptake of statins, (iii) primary prevention using health promotion to reduce dietary salt consumption. Methods. We developed and validated a Markov model for the Tunisian population aged 35–94 years old over a 20-year time horizon. We compared the impact of specific treatments for stroke, lifestyle, and primary prevention on both IHD and stroke deaths. We then undertook extensive sensitivity analyses using both a probabilistic multivariate approach and simple linear regression (metamodeling). Results. The model forecast a dramatic mortality rise, with 111,134 IHD and stroke deaths (95% CI 106567 to 115048) predicted in 2025 in Tunisia. The salt reduction offered the potentially most powerful preventive intervention that might reduce IHD and stroke deaths by 27% (−30240 [−30580 to −29900]) compared with 1% for medical strategies and 3% for secondary prevention. The metamodeling highlighted that the initial development of a minor stroke substantially increased the subsequent probability of a fatal stroke or IHD death. Conclusions. The primary prevention of cardiovascular disease via a reduction in dietary salt consumption appeared much more effective than secondary or tertiary prevention approaches. Our simple but comprehensive model offers a potentially attractive methodological approach that might now be extended and replicated in other contexts and populations

Experimental evidence of accelerated seismic release without critical failure in acoustic emissions of compressed nanoporous materials

The total energy of acoustic emission (AE) events in externally stressed materials diverges when approaching macroscopic failure. Numerical and conceptual models explain this accelerated seismic release (ASR) as the approach to a critical point that coincides with ultimate failure. Here, we report ASR during soft uniaxial compression of three silica-based (SiO$_2$) nanoporous materials. Instead of a singular critical point, the distribution of AE energies is stationary and variations in the activity rate are sufficient to explain the presence of multiple periods of ASR leading to distinct brittle failure events. We propose that critical failure is suppressed in the AE statistics by dissipation and transient hardening. Some of the critical exponents estimated from the experiments are compatible with mean field models, while others are still open to interpretation in terms of the solution of frictional and fracture avalanche models.Comment: preprint, Main article: 7 pages, 3 figures. Supplementary material included in \anc folder: 6 pages, 3 figure

Inverse association between diabetes and altitude: a cross-sectional study in the adult population of the United States.

ObjectiveTo determine whether geographical elevation is inversely associated with diabetes, while adjusting for multiple risk factors.MethodsThis is a cross-sectional analysis of publicly available online data from the Behavioral Risk Factor Surveillance System, 2009. Final dataset included 285,196 US adult subjects. Odds ratios were obtained from multilevel mixed-effects logistic regression analysis.ResultsAmong US adults (≥20 years old), the odds ratio for diabetes was 1.00 between 0 and 499 m of altitude (reference), 0.95 (95% confidence interval, 0.90-1.01) between 500 and 1,499 m, and 0.88 (0.81-0.96) between 1,500 and 3,500 m, adjusting for age, sex, body mass index, ethnicity, self-reported fruit and vegetable consumption, self-reported physical activity, current smoking status, level of education, income, health status, employment status, and county-level information on migration rate, urbanization, and latitude. The inverse association between altitude and diabetes in the US was found among men [0.84 (0.76-0.94)], but not women [1.09 (0.97-1.22)].ConclusionsAmong US adults, living at high altitude (1,500-3,500 m) is associated with lower odds of having diabetes than living between 0 and 499 m, while adjusting for multiple risk factors. Our findings suggest that geographical elevation may be an important factor linked to diabetes

OH+ in astrophysical media: state-to-state formation rates, Einstein coefficients and inelastic collision rates with He

The rate constants required to model the OH$^+$ observations in different regions of the interstellar medium have been determined using state of the art quantum methods. First, state-to-state rate constants for the H$_2(v=0,J=0,1)$+ O$^+$($^4S$) $\rightarrow$ H + OH$^+(X ^3\Sigma^-, v', N)$ reaction have been obtained using a quantum wave packet method. The calculations have been compared with time-independent results to asses the accuracy of reaction probabilities at collision energies of about 1 meV. The good agreement between the simulations and the existing experimental cross sections in the $0.01-$1 eV energy range shows the quality of the results. The calculated state-to-state rate constants have been fitted to an analytical form. Second, the Einstein coefficients of OH$^+$ have been obtained for all astronomically significant ro-vibrational bands involving the $X^3\Sigma^-$ and/or $A^3\Pi$ electronic states. For this purpose the potential energy curves and electric dipole transition moments for seven electronic states of OH$^+$ are calculated with {\it ab initio} methods at the highest level and including spin-orbit terms, and the rovibrational levels have been calculated including the empirical spin-rotation and spin-spin terms. Third, the state-to-state rate constants for inelastic collisions between He and OH$^+(X ^3\Sigma^-)$ have been calculated using a time-independent close coupling method on a new potential energy surface. All these rates have been implemented in detailed chemical and radiative transfer models. Applications of these models to various astronomical sources show that inelastic collisions dominate the excitation of the rotational levels of OH$^+$. In the models considered the excitation resulting from the chemical formation of OH$^+$ increases the line fluxes by about 10 % or less depending on the density of the gas