Daytime Values Research Articles

Association of Serum Uric Acid Level With Blood Pressure Variability in Newly Diagnosed Essential Hypertension.

Serum uric acid (UA) is independently associated with hypertension and blood pressure (BP) variability (BPV) is associated with cardiovascular events and mortality in hypertensive patients. The aim of the present study was to assess the association of serum UA with BPV in 300 untreated essential hypertension patients (mean age 57.3±13.6years). BPV was quantified as the standard deviation (SD) of the 24-hour, daytime, and nighttime mean values obtained by using ambulatory BP monitoring. In correlation analysis, log UA values were found to be positively correlated with 24-hour systolic BPV and nighttime systolic and diastolic BPV (Pearson coefficients of 0.246, 0.280, and 0.353, respectively; P<.001 for all). In multivariate analysis, log UA had an independent association with 24-hour systolic BPV and nighttime systolic and diastolic BPV. This study show for the first time that increased serum UA is independently associated with BPV in untreated essential hypertension patients.

Exercise augments the nocturnal prolactin rise in exercise-trained men.

The objective of this study was to profile over a 24 h period the prolactin responses of exercise-trained men on a day involving rest with no exercise in comparison to a day involving exercise training sessions. This is a quasi-experimental design study using repeated measures determination of 24 h prolactin responses in exercise-trained men (n = 16; age = 27.3± 3.3 years (mean ± standard deviation)). Blood samples were taken hourly over a 24 h period on a day involving two intensive exercise training sessions (ED), and on a separate control day (CD) with no exercise activity. The order of the ED and CD was randomized. Physical activity and diet were controlled and replicated for the ED and CD. Blood specimens were handled, prepared and analyzed utilizing appropriate standard clinical practices. The data were analyzed with the Friedman analysis of variance and Nemenyi post hoc statistical procedure for repeated measures. On the CD, prolactin displayed a typical circadian rhythm with daytime values of the hormone being less than the nocturnal rise once sleep had begun (p < 0.05; 16:00-20:00 h > all other times). On the ED, prolactin responses were noticeably different from those of the CD. The morning and afternoon exercise sessions included significant increases in prolactin immediately at the end of the exercise sessions, being greater than corresponding CD time points (p < 0.01; 01:00 h and 10:00 h); also for the second hour (2 h) following the morning exercise session. On the ED there was a displayed circadian nocturnal response in the hormone with 16:00-24:00 h being elevated above the all nonexercise effected values for that specific day (p < 0.01). Finally, the ED nocturnal elevation for prolactin for 16:00-24:00 h was significantly greater than the same respective hours on the CD (p < 0.05). Findings clearly demonstrated that nocturnal prolactin responses are augmented in exercise-trained men on days when they perform exercise. The mechanisms inducing this adaptive response are unclear but warrant further investigation.

Renal resistive index in patients with true resistant hypertension: results from the RESIST-POL study.

Increased ultrasound Doppler renal resistive index (RRI) is a marker of atherosclerotic and hypertensive organ damage both at renal and systemic level. To evaluate RRI in patients with true resistant hypertension (TRHT) in the RESIST-POL study. From 204 patients diagnosed with TRHT in the RESIST-POL study, 151 patients (90 male, 61 female, mean age: 47.7 ± 10.4, range: 19-65 years) without secondary hypertension were included into the analysis. All patients were characterised by estimated glomerular filtration rate > 60 mL/min/1.73 m2 and no history of diabetes prior to the study. As a control group we included 50 age- and gender-matched patients (35 male, 15 female, mean age: 46.8 ± 10.4, range: 19-65 years) with primary well-controlled hypertension. The groups also did not differ in respect to the number of years of known history of hypertension. The RRIs were evaluated on the basis of the Doppler ultrasound examination. Increased RRI was defined as ≥ 0.7. Both groups did not differ in terms of renal function. Patients with TRHT were characterised by higher RRI as compared with the group with well-controlled hypertension (0.62 ± 0.05 vs. 0.60 ± 0.05, p < 0.05). In the TRHT group RRI correlated significantly with age, clinic and ambulatory blood pressure measurement, diastolic blood pressure (DBP) levels, as well as with clinic pulse pressure (PP) (r = 0.297; p = 0.001), with daytime (r = 0.355; p < 0.001) and nighttime (r = 0.313; p < 0.001) PP, and with fasting glucose concentration (r = 0.215; p = 0.008) and E/E’ ratio (r = 0.289; p = 0.001) on echocardiography. RRI values were significantly higher in TRHT patients with newly diagnosed diabetes as compared with TRHT patients without diabetes (0.65 ± 0.05 vs. 0.62 ± 0.05, p = 0.022). Age, daytime DBP, daytime PP, and E/E’ ratio but not fasting glucose concentration correlated independently with RRI in the model. Among patients with TRHT, patients with increased RRI were characterised by older age (52.2 ± 4.9 vs. 47.3 ± 10.6 years, p = 0.012), higher body mass index (32.8 ± 6.0 vs. 29.7 ± 4.5 kg/m2, p = 0.034), as well as lower daytime and nighttime DBP values and lower daytime and nighttime heart rate, as compared to patients with RRI < 0.7. The TRHT patients with increased RRI as compared to patients with RRI < 0.7 were characterised also by higher daytime and nighttime PP. Both groups did not differ in respect of renal function. Our study showed that the patients with TRHT were characterised by significantly higher RRI values as compared to the subjects with well-controlled hypertension. It may also be suggested that in the subjects with TRHT renal vascular resistance is related to blood pressure values, selected echocardiographic abnormalities, and some surrogate markers for metabolic and cardiovascular events, including fasting glucose plasma concentration and PP, respectively.

PP.31.11

Objective: The aim of our study was to determine the clinical profile, the prevalence of risk factors and the therapeutic use of patients treated for high blood pressure to detect patients at high cardiovascular risk and blood pressure control using ambulatory blood pressure monitoring. Design and method: This is a retrospective study of a population of 180 hypertensive patients who received ambulatory blood pressure monitoring to collect blood pressure readings several times an hour across a 24-hour period. We have studied and compared a systolic blood pressure and diastolic blood pressure with mean daytime and night-time values. We highlight the characteristics of the patients such cardiovascular risk factors, and the therapeutic strategies followed. Results: The mean age of patients was 60 years. Women represent 55% of the analyzed population. The combination of three risk factors was found in 30% of patients. A prevalence of diabetes in these hypertensive patients is 40%. Physical inactivity account for 50% of hypertensive patients. Only 20% of patients report lipid-lowering diet with a regular lipid control for their dyslipidemia. A quarter of patients followed with chronic renal failure. (CRF < 60 mL / minute). Only 36% of patients on treatment are optimized. In addition, we found a 40% nondipping and nocturnal hypertensives patients. Combination therapy was employed at 1/3 of patients. The most precise association is a calcium channel blocker with angiotensin converting enzyme. The use of quadruple therapy was found in 9% of patients. Non adherence to therapy is the first therapeutic resistance factor found. Conclusions: Awareness and education of hypertensive patient occupies a prominent place in blood pressure control. The various blood pressure categorization afforded by ambulatory blood pressure monitoring are valuable for clinical management of high blood pressure because they increase the accuracy for diagnosis of certain individuals who are not taking antihypertensive medication and the prediction of cardiovascular risk.

PP.37.10

Objective: More than 50% of patients with sleep apnea have hypertension and about 30% of hypertensives have sleep apnea as demonstrated in numerous studies. Aim was to determine the prevalence of hypertension in this specific group of patients and the difference between values measure in office and by using ABPM. Design and method: Research included 100 patients who underwent polysomnograpic examination in UCC Kragujevac. According to apnea-hypopnea index (AHI) all patients were divided into 4 equal groups, 25 patients in each group (AHI < 5; 5–15; 15–30 and > 30). Data for history of hypertension and antihypertensive treatment were collected anamnestically, and office blood pressure was measured baseline. All patients underwent single 24-h ambulatory BP monitoring. We calculated 24-h, daytime and nighttime blood pressure values separately for systolic and diastolic BP. All data were statistically analyzed in the SPSS for Windows. Results: Study population consisted of 69% of male and 31% of female patients with mean age of 55.05 ± 11.16 years. Prior hypertension was present in 76% of patients (x2 = 27.04; p = 0.000) in total group, with 68% on antihypertensive therapy (x2 = 12.96; p = 0.000). Among patients with diagnosed sleep apnea-hypopnea 62% had hypertension (x2 = 7.31; p = 0.007). The mean office SBP and DBP were both higher than guideline recomendations (140.39 mmHg SBP, 85.24 mmHg DBP). Mean values of BP were in mmHg: dSBP-134.13 ± 18.44; nSBP-125.67 ± 20.43; 24h-SBP-130.67 ± 18.28; dDBP-83.20 ± 12.16; nDBP-74.31 ± 11.94; 24h-DBP-79.69 ± 11.30. There was a significant difference between BP measured in office and by using ABPM for both, systolic and diastolic blood pressure (t-test; p = 0.000 and p = 0.001). Conclusions: Hypertension is highly prevalent in patients with sleep apnoea-hypopnea syndrome, with the majority of patients treated with antihypertensive therapy. There was a significant difference between blood pressure values measured in office, at the baseline, and by using ABPM, with higher values at the office.

PP.05.26

Objective: Tight blood pressure control with a mean office blood pressure of 144/82 mmHg in patients with hypertension and type 2 diabetes achieves a clinically important reduction in hypertension related complications such as stroke (UKPDS). Further blood pressure reduction to an office blood pressure of 135/75 mmHg reduced cardiovascular mortality by 18% compared to placebo (140/75 mmHg) in the ADVANCE trial. The objective of the present registry study was to investigate the role of ambulatory-24-h-blood pressure measurement (ABPM) for the clinical management of hypertensive patients with type 2 diabetes in the general physician[Combining Acute Accent]s (GP) office. Design and method: 919 ABPM recordings of type 2 diabetic patients (age 64.4 + 12.3 years) with treated hypertension were obtained at 306 GPs using validated recorders. Hypertension management based on ABPM recordings of the 306 GPs was compared to a central, blinded and independent analysis of ABPM recordings in accordance with the recent ESH guidelines. Results: Mean office blood pressure was 151.7 ± 19.6/87.5 ± 11.5 mmHg. Mean ABPM daytime values were 141.3 ± 15.2/81.8 ± 10.2 mmHg and night-time values were 131.1 ± 18.3/72.6 ± 11.1 mmHg. The predominant form of hypertension based on ABPM was systolic/diastolic hypertension (58%) followed by isolated systolic hypertension (21%). Control rate of hypertension based on ABPM was estimated to be 64% by GPs. In contrast a control rate of 14% was calculated based on a central analysis according to ESH-ABPM guidelines. The GPs assessed the 10-year cardiovascular risk to be “very high” as to the definition of the ESH in 11% of their patients, while the estimated 10-year risk was “very high” in 892 patients (97%) based on the central, independent analysis. Despite 784 patients were deemed uncontrolled, antihypertensive therapy remained unchanged in 322 patients (41%). Conclusions: Blood pressure control was grossly overestimated in patients with hypertension and type-2 diabetes. This resulted in an underestimation of the total cardiovascular risk and a lack of efforts to control blood pressure more tightly. Whether a lack of therapeutic decision making of GPs was caused by inertia or a lack of knowledge of ABPM normal values remains to be determined.

Resonance structure and mode transition of quarter‐wave ULF pulsations around the dawn terminator

AbstractQuarter‐wave modes are standing shear Alfvén waves supported along geomagnetic field lines in space. They are predicted to be generated when the ionosphere has very different conductance between the north compared with the south ionosphere. Our previous observation reported that the resonant frequency is sometimes very low around the dawn terminator and suggested these were due to quarter‐wave modes. In this paper, we examine the resonance structure that provides further evidence of the presence of quarter‐wave modes. Data from three magnetometers in New Zealand were analyzed. Four events are discussed which show extraordinarily low eigenfrequencies, wide resonance widths, and strong damping when the ionosphere above New Zealand was in darkness while the conjugate northern hemisphere ionosphere was sunlit. Later in the morning, the eigenfrequencies and resonance widths changed to normal daytime values. The wide resonance width and the strong damping of the quarter‐wave modes arise from strong energy dissipation in the dark side ionosphere. One event exhibited field line resonance structure continuously through a transition from very low frequency to the normal daytime values. The frequency change began when the dawn terminator passed over New Zealand and finished 1 h later when the ratio of the interhemispheric ionospheric conductances decreased and reached ~5. These observations are strong evidence of the presence of quarter‐wave modes and mode conversion from quarter‐ to half‐wave resonances. These experimental results were compared with the ULF wave fields obtained from a 2.5‐dimensional simulation model.

Decreased 6-Sulfatoxymelatonin Excretion in Male GH-Deficient Children and Adolescents

Aim: To evaluate melatonin secretion in a group of untreated and treated male growth hormone (GH)-deficient children and adolescents. Methods: We studied 44 male subjects: 8 untreated GH-deficient patients (GHDnt), 16 treated GH-deficient patients (GHDt) and 20 healthy children and adolescents as control group (CG). We measured urinary 6-sulfatoxymelatonin (6-SM) in total (24-hour samples), nocturnal (18.00-8.00 h) and diurnal samples (8.00-18.00 h). Levels of 6-SM were expressed as micrograms excreted per time interval and Δ values (difference between nighttime and daytime values). Results: Significant differences were observed among the 3 groups of pediatric subjects studied for total 6-SM (p < 0.0001), nocturnal 6-SM (p < 0.0001) and Δ values (p < 0.0001). Subsequent analysis showed significantly higher levels for total 6-SM, nocturnal 6-SM and nighttime-daytime Δ in the CG versus the GHDnt (p < 0.01) and in the CG versus the GHDt group (p < 0.01). No significant correlations were found between 6-SM excretion and insulin-like growth factor-1 values in the children and adolescents studied. Conclusions: GH-deficient patients showed lower levels of 6-SM. Our findings provide a different insight to a further understanding of some chronobiological disorders involved in GH deficiency in children.

Quantum efficiency of phytoplankton photochemistry measured continuously across gradients of nutrients and biomass in Lake Erie (Canada and USA) is strongly regulated by light but not by nutrient deficiency

Unattended sensor networks are a cost-effective strategy to enhance the resolution of environmental datasets and are required to understand how large aquatic ecosystems respond to complex stressors (e.g., climate change). We made unattended and continuous measurements of the quantum yield of photosystem II ([Formula: see text]) photochemistry in the surface mixed layer of Lake Erie during three lake-wide cruises to observe how phytoplankton physiology varied across nutrient and taxonomic gradients. Three prominent diel [Formula: see text] patterns were noted. The diel maximum consistently occurred at sunrise or sunset, nocturnal measurements were consistently lower than diel maxima, and daytime values were strongly diminished by nonphotochemical quenching. The diurnal pattern was modeled as a function of irradiance to a mean accuracy of 0.03 to 0.04. Contrary to previously published reports in Lake Erie, [Formula: see text] was largely insensitive to indices of nutrient deficiency through space and time. This finding was consistent with much recent literature about [Formula: see text] and suggests that Lake Erie phytoplankton, like many others, can tune their photosynthetic machinery to maintain relatively high efficiency of photochemistry in photosystem II even when deficient in phosphorus or nitrogen.

Decisão terapêutica na hipertensão: inquérito às atitudes dos médicos de família na região de Lisboa e Vale do Tejo

Objectives: This study was designed to characterize the attitudes of family physicians regarding clinical decision making in hypertension, including issues related to monitoring and treatment and to compare these attitudes with clinical recommendations available at the time of the study. Type of study: Cross-sectional study. Setting: Primary health care centers in Lisbon and Vale do Tejo, Portugal. Population: Family physician specialists and trainees in family medicine. Methods: Self-completed questionnaire assessing variables related to demographic characteristics, experience of treating hypertensive patients, measurement of blood pressure (BP), lifestyle changes, the decision to initiate antihypertensive drugs, and strategies used when assessing patient adherence. Bivariate analysis (Chi-square tests, α=0.05) was used to explore the associations between clinical decision-making and other variables. Results: The 60 participants (41 females) from 14 Primary Health Care Centers had a mean age of 52±8.6 years and a mean of 22±8.2 years experience in practice. All physicians considered lifestyle change to be useful. Acceptable ambulatory BP (ABPM) was 136/83mmHg for the daytime value. The BP values chosen for initiation of treatment were BP>140/90mmHg for patients without other risk factors. In the elderly, 77% of physicians agreed with accepting higher BP values, initiating treatment when BP>150/90mmHg. Physicians preferred to initiate therapy with only one drug. Most physicians (58%) believed that many patients can achieve control of BP with only one drug and physicians with over 20 years of experience in practice tended to agree more with this statement (p=0.043). Conclusions: The reported attitudes were in line with the national and European clinical guidelines available at the time of the study regarding the usefulness of lifestyle changes and the BP values chosen for initiating treatment. There was some heterogeneity regarding management of BP in the elderly and ABPM values. Updating of clinical recommendations requires continuous training of family physicians, in order to incorporate the best options for management of hypertension in clinical practice.

Nocturnal aerosol particle formation in the North China Plain

New particle formation is one of the major sources of atmospheric aerosol particles. Beside daytime nucleation, nocturnal new particle formation was also found in different regions around the world. Compared with daytime nucleation events, the understanding of nocturnal ones is still sparse. The variety of aerosol particle physico-chemical properties, including particle number size distribution, volatility and hygroscopicity were measured in the North China Plain during July–August 2013. During the observation period, rapid increase in ultrafine particle number concentration was attributed to new particle formation. The nocturnal new particle formation rate was 45 cm–3s–1, which is 1.25 times higher than an observed daytime value. Condensation sink was found to be 0.055 s–1.

Influence of atmospheric fine particulate matter (PM2.5) pollution on indoor environment during winter in Beijing

The objective of this study was to investigate the influence of atmospheric fine particulate matter (PM2.5) pollution on indoor environment. Time series of indoor and outdoor PM2.5 mass concentrations in a naturally ventilated building were monitored continuously and simultaneously in winter in Beijing when haze-fog episodes happen frequently. Relationships between indoor and outdoor PM2.5 mass concentrations were examined and discussed. Indoor and outdoor PM2.5 mass concentrations showed close correlation (R2 = 0.9104) when the windows are closed and there are no obvious indoor particle sources. The peak values of average indoor PM2.5 mass concentrations appeared at night, which were 1.5 times higher than the minimum values in daytime and showed an increasing trend from Monday to Friday in workdays. The indoor/outdoor PM2.5 mass concentrations ratios (I/O ratios) are closely correlated with outdoor wind speed and relative humidity. A prediction model was developed based on a method of mathematical statistics and it was applied to estimation of indoor PM2.5 mass concentrations by using outdoor PM2.5 mass concentrations and meteorological parameters as inputs. There is a good agreement between model results and the measured values with correlation coefficients of R2 = 0.95. The findings can provide meaningful reference to further research on influence of atmospheric PM2.5 on indoor environment and help further develop approaches to control outdoor originated indoor PM2.5 in the haze-fog episodes.

Six years of OSI-SAF METOP-A AVHRR sea surface temperature

The Ocean and Sea Ice Satellite Application Facility (OSI SAF) has been producing full resolution global Sea Surface Temperature (SST) from the METOP-A Advanced Very High Resolution Radiometer (AVHRR) since July 2007. The SST operational processing and the validation scheme have remained unchanged for more than 6years. The global validation results against measurements are stable over time. Night-time METOP-A SSTs differ from drifting buoy SSTs by −0.05K in average with a standard deviation of 0.44K and the daytime values are respectively 0.09K and 0.56K.Seasonal statistics have been calculated on a global regular 5-degree grid for a 6-year period to review the main biases and their characteristics. There is evidence of regional and seasonal biases, indeed the multispectral regression algorithms are known (to a various degree depending upon specific implementation) to have limitations in handling the variety of atmospheric absorption conditions encountered over the global ocean. This problem has been solved for the OSI SAF geostationary SST chain by adopting a Numerical Weather Prediction (NWP) profile based correction method. The same approach has been tested on a prototype chain ingesting METOP-A data and gives encouraging results. It will be used in the new polar orbiter chain under development at OSI SAF, that will process METOP-B data.An application example of METOP-A SST time series is given by analyzing the inter-annual variability of Arctic Ocean SST in relation with the ice coverage variability in September. The METOP-A time series gives consistent results when compared to other observations or model outputs.

Observed Spatial Characteristics of Beijing Urban Climate Impacts on Summer Thunderstorms

AbstractThis study investigates interactive effects from the Beijing urban area on temperature, humidity, wind speed and direction, and precipitation by use of hourly automatic weather station data from June to August 2008–12. Results show the Beijing summer urban heat island (UHI) as a multicenter distribution (corresponding to underlying land-use features), with stronger nighttime than daytime values (averages of 1.7° vs 0.8°C, respectively). Specific humidity was lower in urban Beijing than in surrounding nonurban areas, and this urban dry island is stronger during day than night (maximum of −2.4 vs −1.9 g kg−1). Wind direction is affected by both a mountain–valley-breeze circulation and by urbanization. Morning low-level flows converged into the strong UHI, but afternoon and evening southerly winds were bifurcated by an urban building-barrier-induced divergence. Summer thunderstorms also thus bifurcated and bypassed the urban center because of the building-barrier effect during both daytime and nighttime weak-UHI (&lt;1.25°C) periods. This produced a regional-normalized rainfall (NR) minimum in the urban center and directly downwind of the urban area (of up to −35%), with maximum values along its downwind lateral edges (of &gt;15%). Strong UHIs (&gt;1.25°C), however, induced or enhanced thunderstorm formation (again day and night), which produced an NR maximum in the most urbanized area of up to 75%.

Temporal variation of radioactivity at NARL, Gadanki

The activity concentrations of radon were measured using AlphaGuard PQ-2000PRO along with meteorological parameters at NARL, Gadanki, India. The diurnal and monthly variations of activities of radon show maxima in the early morning hours when the turbulence mixing is minimum; whereas in the afternoon the turbulence mixing is maximum and concentrations exhibit minima. The arithmetic mean of radon concentration is 11.67 ± 2.4 Bq m-3 for the year 2012. The diurnal variations have reached the maximum concentration of 26 Bq m-3 in December 2012. Observations show an increase in the concentration of radon during nighttime compared to the daytime values. Also observed is the diurnal variation of radon that exhibits a positive correlation with the relative humidity and is negatively correlated with ambient temperature of the atmosphere

Open-Globe Eye Injuries and Choice of Muscle Relaxant: A Review of the Evidence

A goal of treatment of open-globe eye injuries is preventing rises in intraocular pressure and the resulting loss of vitreous humor fluid from the eye globe. Surgical repair of these injuries often requires general anesthesia and tracheal intubation. Normal intraocular pressure is 10-22 mm Hg, with variations between daytime and nighttime values. Factors such as eye muscle structure, fluid volume in the eye, overall hemodynamic status, blood acidity, and mechanical pressure collectively contribute to fluid pressure within the eye. One factor that has been shown to be strongly correlated with increased intraocular pressure is elevated venous pressure with physiological conditions during tracheal intubation (eg, straining, coughing, bucking). To determine intubation best practices, we reviewed the literature on succinylcholine, a depolarizing neuromuscular blocking agent, and nondepolarizing neuromuscular blocking agents. Research and case reports have not shown an association between the loss of ocular contents and succinylcholine administration. However, succinylcholine has been associated with increased intraocular pressure after administration and intubation. Nondepolarizing neuromuscular blocking agents, particularly rocuronium, administered before or instead of succinylcholine, have been found to attenuate the rise in intraocular pressure after induction and intubation.

Seasonal trends, meteorological impacts, and associated health risks with atmospheric concentrations of gaseous pollutants at an Indian coastal city.

This study presents surface ozone (O3) and carbon monoxide (CO) measurements conducted at Bhubaneswar from December 2010 to November 2012 and attempts for the very first time a health risk assessment of the atmospheric trace gases. Seasonal variation in average 24 h O3 and CO shows a distinct winter (December to February) maxima of 38.98 ± 9.32 and 604.51 ± 145.91 ppbv, respectively. O3 and CO characteristics and their distribution were studied in the form of seasonal/diurnal variations, air flow patterns, inversion conditions, and meteorological parameters. The observed winter high is likely due to higher regional emissions, the presence of a shallower boundary layer, and long-range transport of pollutants from the Indo-Gangetic Plain (IGP). Large differences between daytime and nighttime O3 values during winter compared to other seasons suggest that photochemistry is much more active on this site during winter. O3 and CO observations are classified in continental and marine air masses, and continental influence is estimated to increase O3 and CO by up to 20 and 120 ppbv, respectively. Correlation studies between O3 and CO in various seasons indicated the role of CO as one of the O3 precursors. Health risk estimates predict 48 cases of total premature mortality in adults due to ambient tropospheric O3 during the study period. Comparatively low CO concentrations at the site do not lead to any health effects even during winter. This study highlights the possible health risks associated with O3 and CO pollution in Bhubaneswar, but these results are derived from point measurements and should be complemented either with regional scale observations or chemical transport models for use in design of mitigation policies.

Prospective measurement of blood pressure and heart rate over 24 h in women using combined oral contraceptives with estradiol

ObjectiveCombined oral contraceptives (COCs) containing ethinyl-estradiol are known to increase blood pressure (BP). We evaluated whether COCs containing estradiol (E2) influence 24-h ambulatory BP and heart rate (HR) in normotensive and normal-weight women. Study designTwenty-four-hour BP and HR were measured every 30 min with an ambulatory BP device in 18 normotensive healthy non-smoking women prior to (Days 3–6 of menstrual cycle) and after 6 months of use (Days 20–24 of cycle 6) of a COC containing either a quadriphasic combination of E2 valerate plus dienogest (n=11) or a monophasic association of micronized E2 plus nomegestrol acetate (n=7). ResultsMean age and body mass index of the final sample were 32.50±7.49 years and 22.87±4.08, respectively. E2-based COCs induced no modification of 24-h systolic BP (+1.65±8.34 mmHg; p=.41), diastolic BP (+0.04±7.36 mmHg; p=.98), mean BP (+0.64±6.42 mmHg; p=.68) or HR (−0.72±5.86 beats/min; p=.61). Differences were not observed even when daytime or nighttime values were separately considered. Though this was not a comparative study, we did not find differences between the effects of the two formulations (24-h mean BP; p=.699). ConclusionsThese data suggest a neutral effect of estradiol-based COCs on independent risk factors for cardiovascular diseases such as BP or HR. ImplicationsBP and HR of normotensive women are not increased by E2-based COCs.

Alterations in diurnal rhythmicity in patients treated for nonfunctioning pituitary macroadenoma: a controlled study and literature review.

Patients treated for nonfunctioning pituitary macroadenomas (NFMAs) have fatigue and alterations in sleep characteristics and sleep-wake rhythmicity frequently. As NFMAs often compress the optic chiasm, these complaints might be related to dysfunction of the adjacent suprachiasmatic nucleus (SCN). We aimed to explore whether indirect indices of SCN functioning are altered in the long term after surgery for NFMAs. We studied 17 NFMA patients in long-term remission after transsphenoidal surgery, receiving adequate and stable hormone replacement for hypopituitarism, and 17 control subjects matched for age, gender, and BMI. Indirect indices of SCN function were assessed from 24-h ambulatory recordings of skin and core body temperatures, blood pressure, and salivary melatonin levels. Altered melatonin secretion was defined as an absence of evening rise, considerable irregularity, or daytime values >3 pg/ml. We additionally studied eight patients treated for craniopharyngioma. Distal-proximal skin temperature gradient did not differ between NFMAs and control subjects, but proximal skin temperature was decreased during daytime (P=0.006). Core body temperature and non-dipping of blood pressure did not differ, whereas melatonin secretion was often altered in NFMAs (OR 5.3, 95% CI 0.9-30.6). One or more abnormal parameters (≥2.0 SDS of control subjects) were observed during nighttime in 12 NFMA patients and during daytime in seven NFMA patients. Similar patterns were observed in craniopharyngioma patients. Heterogeneous patterns of altered diurnal rhythmicity in skin temperature and melatonin secretion parameters were observed in the majority of patients treated for NFMAs. On a group level, both NFMA and craniopharyngioma patients showed a lower daytime proximal skin temperature than control subjects, but other group averages were not significantly different. The observations suggest altered function of central (or peripheral) clock machinery, possibly by disturbed entrainment or damage of the hypothalamic SCN by the suprasellar macroadenoma or its treatment.

Validation of remotely sensed surface temperature over an oak woodland landscape — The problem of viewing and illumination geometries

Satellite retrieved values of Land Surface Temperature (LST) over structured heterogeneous pixels generally depend on viewing and illumination angles as well as on the characteristics of the land cover. Here we present a method to quantify such dependencies on land surface characteristics, sun illumination and satellite position. The method uses a geometric model to describe the surface elements viewed by an air-borne sensor and relies on parallel-ray geometry to calculate the projections of tree canopies and sunlit and shaded ground: these are considered as basic surface elements responsible for most of the spatial variability of LST. For a woodland landscape we demonstrate that modeling the fractions of these basic surface elements within the sensor field-of-view allows us to quantify the directional effects observed on satellite LST with sufficient accuracy.Geometric models are an effective tool to upscale in situ measurements for the validation of LST over discontinuous canopies (e.g. forests). Here we present the application of a model to observations of brightness temperature from the LSA-SAF validation site in Évora (Portugal), an area of oak woodland, over the one-year period from October 2011 to September 2012. The resulting composite temperature is compared against LSA SAF LST products from the Spinning Enhanced Visible and InfraRed Imager (SEVIRI) onboard Meteosat as well as against MYD11A1/MOD11A1 (collection 5) products from the MODerate resolution Imaging Spectroradiometer (MODIS) onboard AQUA and TERRA. Comparisons with modeled ground LST show that SEVIRI LST has a bias of 0.26°C and a RMSE of 1.34°C, whereas MODIS LST (MYD11A1 and MOD11A1, collection 5) has a bias of −1.54°C and a RMSE of 2.37°C. Both MODIS and SEVIRI LST are closer to in situ values obtained with the geometric model than to those obtained when disregarding the effects of viewing and illumination geometry. These results demonstrate the need to consider the directional character of LST products, especially for validation purposes over heterogeneous land covers. For the new MODIS LST product (MOD21), which is based on the Temperature-Emissivity Separation (TES) algorithm, comparisons with in-situ LST show an improved bias of −0.81°C and a RMSE of 1.48°C (daytime values only). The TES based product presents lower emissivity values than those used for retrieving MYD11A1/MOD11A1 LST, which may partially explain the improved match with in-situ LST.Discrepancies between LST retrievals obtained from different sensors, especially those on different orbits can also be partly explained by their viewing/illumination geometries. In this study the geometric model is used to correct LST deviations between simultaneous MODIS and SEVIRI LST estimations related to those effects. When the model is used to correct the variable MODIS viewing geometry there is a reduction in standard deviation of about 0.5°C.