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Jersey City, NJ, United States

Mitchell G.F.,Edgewater
Current Hypertension Reports | Year: 2015

Interest in relations between central aortic pressure and cardiovascular disease risk has increased markedly over the past two decades. Numerous studies have shown that higher pulse pressure is associated with increased risk. Further, pulse pressure differs variably and sometimes dramatically between the central aorta and the brachial artery, where blood pressure is generally measured. In light of the potential for variable misclassification of central systolic and pulse pressure by brachial measurements, central blood pressure has emerged as a potentially superior blood pressure measure. This brief review will examine the evidence supporting the use of central pressure to stratify risk and guide therapy in patients with hypertension. © 2015, Springer Science+Business Media New York. Source

Mitchell G.F.,Edgewater
Artery Research | Year: 2015

The heart, brain and kidneys are key targets of pulsatile damage in older people and in patients with longstanding hypertension. These central organs are exposed to central systolic and pulse pressures, which may differ from the corresponding peripheral pressures measured in the brachial artery. Studies employing the generalized transfer function as a means to estimate central pressure have demonstrated a large difference between central and peripheral systolic and pulse pressure that diminishes with age but remains substantial even in octogenarians. As a result of this persistent difference, some have advocated that central pressure may represent a more robust indicator of risk for target organ damage and major cardiovascular disease events. From the perspective of risk prediction, it is important to acknowledge that a new technique must add incremental predictive value to what is already commonly measured. Thus, in order to justify the added complexity and expense implicit in the measurement, central pressure must be shown to add significantly to a risk factor model that includes standard cardiovascular disease risk factors. A limited number of studies have shown marginally better correlations between central pressure pulsatility and continuous measures of target organ damage in the heart. A similarly limited number of prospective studies in unique cohorts have suggested that central pressure may provide marginally better risk stratification, although no reclassification analysis has been published. Thus, currently available evidence does not provide sufficient justification for widespread adoption and routine use of central pressure measurements in clinical practice. © 2014 Association for Research into Arterial Structure and Physiology. Source

Darzynkiewicz Z.,New York Medical College | Balazs E.A.,Edgewater
Aging | Year: 2012

Faithful preservation of genome integrity is the critical mission of stem cells as well as of germ cells. Reviewed are the following mechanisms involved in protecting DNA in these cells: (a) The efflux machinery that can pump out variety of genotoxins in ATP-dependent manner; (b) the mechanisms maintaining minimal metabolic activity which reduces generation of reactive oxidants, by-products of aerobic respiration; (c) the role of hypoxic niche of stem cells providing a gradient of variable oxygen tension; (d) (e) the presence of hyaluronan (HA) and HA receptors on stem cells and in the niche; (f) the role of HA in protecting DNA from oxidative damage; (g) the specific function of HA in protecting DNA in stem cells; (h) the interactions of HA with sperm cells and oocytes that also may shield their DNA from oxidative damage, and (e) mechanisms by which HA exerts the anti-oxidant activity. While HA has multitude of functions its anti-oxidant capabilities are often overlooked but may be of significance in preservation of integrity of stem and germ cells genome. © Darzynkiewicz and Balazs. Source

Kaess B.M.,Lung and Blood Institutes Framingham Heart Study | Kaess B.M.,University of Regensburg | Rong J.,Lung and Blood Institutes Framingham Heart Study | Larson M.G.,Boston University | And 9 more authors.
JAMA - Journal of the American Medical Association | Year: 2012

Context: Vascular stiffness increases with advancing age and is a major risk factor for age-related morbidity and mortality. Vascular stiffness and blood pressure pulsatility are related; however, temporal relationships between vascular stiffening and blood pressure elevation have not been fully delineated. Objective: To examine temporal relationships among vascular stiffness, central hemodynamics, microvascular function, and blood pressure progression. Design, Setting, and Participants: Longitudinal community-based cohort study conducted in Framingham, Massachusetts. The present investigation is based on the 2 latest examination cycles (cycle 7: 1998-2001; cycle 8: 2005-2008 [last visit: January 25, 2008]) of the Framingham Offspring study (recruited: 1971-1975). Temporal relationships among blood pressure and 3 measures of vascular stiffness and pressure pulsatility derived from arterial tonometry (carotid-femoral pulse wave velocity [CFPWV], forward wave amplitude [FWA], and augmentation index) were examined over a 7-year period in 1759 participants (mean [SD] age: 60 [9] years; 974 women). Main Outcome Measures: The primary outcomes were blood pressure and incident hypertension during examination cycle 8. The secondary outcomes were CFPWV, FWA, and augmentation index during examination cycle 8. Results: In a multivariable-adjusted regression model, higher FWA (β, 1.3 [95% CI, 0.5-2.1] mm Hg per 1 SD; P=.002) and higher CFPWV (β, 1.5 [95% CI, 0.5-2.6] mm Hg per 1 SD; P=.006) during examination cycle 7 were jointly associated with systolic blood pressure during examination cycle 8. Similarly, in a model that included systolic and diastolic blood pressure and additional risk factors during examination cycle 7, higher FWA (odds ratio [OR], 1.6 [95% CI, 1.3-2.0] per 1 SD; P<.001), augmentation index (OR, 1.7 [95% CI, 1.4-2.0] per 1 SD; P<.001), and CFPWV (OR, 1.3 [95% CI, 1.0-1.6] per 1 SD; P=.04) were associated with incident hypertension during examination cycle 8 (338 cases [32%] in 1048 participants without hypertension during examination cycle 7). Conversely, blood pressure during examination cycle 7 was not associated with CFPWV during examination cycle 8. Higher resting brachial artery flow (OR, 1.23 [95% CI, 1.04-1.46]) and lower flow-mediated dilation (OR, 0.80 [95% CI, 0.67-0.96]) during examination cycle 7 were associated with incident hypertension (in models that included blood pressure and tonometry measures collected during examination cycle 7). Conclusion: In this cohort, higher aortic stiffness, FWA, and augmentation index were associated with higher risk of incident hypertension; however, initial blood pressure was not independently associated with risk of progressive aortic stiffening. ©2012 American Medical Association. All rights reserved. Source

Gain variations during a packet can lead to significant performance degradation in communications systems that use high order quadrature amplitude modulation (QAM). A method and the associated apparatus track such variations in an OFDM system and completely eliminate any performance degradation. Gain estimation and compensation is employed with the use of pilot subcarriers in the payload of an OFDM data packet. Estimated pilot magnitude ratios are averaged, throughout the processing life of a packet, to yield accurate gain estimations. A gain compensation factor is used to adjust data carriers. An exclusion method is also employed to eliminate pilot carriers which contribute to noise.

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