Pressure Levels Research Articles

Effect of Risk Factors on Blood Pressure Using Multivariate Model amongst Adult Tribal Population in a District of India

Abstract Background: This research study uses multivariate model to analyse the effect of various risk factors on blood pressure (BP) levels amongst adults in the tribal communities. Materials and Methods: A community-based cross-sectional observational study with adult tribal population residing in Lohandiguda, Bastar district, Chhattisgarh, India. A multistage sampling was followed and the modified World Health Organization questionnaire for hypertensive patients was used. Results: Three hundred and thirty adults were included. Positive moderate-weak correlation in all three groups shown by body mass index (BMI) (0.208, 0.214 and 0.287) and waist–hip ratio (WHR) (0.223, 0.240 and 0.359) with systolic BP and (BMI = 0.223, 0.240 and 0.240; WHR = 0.166, 0.198 and 0.288) diastolic BP, respectively, was found. The Pearson correlation coefficient shows that the highest predictor of high BP was BMI (0.226) followed by WHR (0.198), age (0.182), number of bidi/cigarette use per day (0.131) and smokeless tobacco frequency per day (0.114). The multivariate general linear model is moderately distinguishable (0.529) amongst all study subjects and (0.543) amongst addicted study subjects with BP having strong significance (0.000) each for addicted and overall study subjects. Conclusion: These findings call for careful consideration in the development of dietary recommendations, quitting addictions, increased attention on physical activities and public health policies tailored to tribal communities.

Counseling and examination related to the prevention of hypertension and diabetes in the elderly

Aging brings various health challenges, including hypertension and diabetes mellitus, which can affect the quality of life of the elderly. This study aims to identify the prevalence of these two diseases in Kepatihan Village, Kaliwates District, Jember Regency, and evaluate the effectiveness of health education in managing them. Community service activities include initial examinations that show a high prevalence of hypertension and prediabetes among the elderly, with only a few having normal blood pressure and blood sugar levels. The program involves health examinations, disease prevention and control education, and re-examination two weeks after the education. The results showed that older adults with normal blood pressure increased from 3 to 8 people, and regular blood sugar levels increased from 5 to 21 people. A significant decrease in cases of prehypertension and diabetes indicates the success of the education in increasing participants' awareness and knowledge about managing their health. However, high initial health conditions and limited resources remain barriers. This program shows the effectiveness of education in reducing the prevalence of non-communicable diseases among the elderly but requires continued efforts to support more sustainable health improvements

Cardiovascular Risk Factors in Socioeconomically Disadvantaged Populations in a Suburb of the Largest City in Western Romania.

Background and Objectives: Cardiovascular disease (CVD) remains a major public health issue worldwide, disproportionately affecting socioeconomically disadvantaged populations due to the social determinants of health (SDOHs). In Western Romania, these populations are particularly vulnerable to CVD. This study aims to investigate the prevalence and impact of cardiovascular risk factors (CVRFs) among socioeconomically disadvantaged individuals in Western Romania and identify the primary CVRFs contributing to the high incidence of CVD within this population. Materials and Methods: A retrospective observational design was employed, utilizing data from the medical records of 1433 eligible individuals. The inclusion criteria were based on Eurostat's EU-SILC benchmarks, focusing on severe material deprivation, at-risk-of-poverty rates, and low work intensity. Data on demographics, familial and personal medical history, smoking status, blood pressure, glucose, cholesterol, triglycerides, and HbA1c levels were collected. Results: Of the 1433 subjects, 34.75% were male, with a median age of 52 years. Significant conditions included diabetes (7.39%), coronary disease (3.83%), arterial hypertension (35.58%), and dyslipidemia (21.28%). Median ages were higher for those with diabetes (65 vs. 51 years, p < 0.0001), coronary disease (64 vs. 51 years, p < 0.0001), arterial hypertension (65 vs. 43 years, p < 0.0001), and dyslipidemia (66 vs. 47 years, p < 0.0001). BMI (Body Mass Index) classifications showed 33.77% were overweight, 21.21% obese, and 15.07% morbidly obese. Smokers were younger than non-smokers (48 vs. 54 years, p < 0.0001). Conclusions: The findings highlight the significant prevalence of CVRFs among socioeconomically disadvantaged populations in Western Romania. Socioeconomically disadvantaged populations exhibit a significantly higher prevalence of cardiovascular risk factors such as diabetes, impaired glucose regulation, hypertension, and dyslipidemia compared to their before known status.

Beyond Pharmacotherapy: Investigating the Role of Classical Music in Preoperative Anxiety Management for Cesarean Sections

Preoperative anxiety is a prevalent concern among women undergoing cesarean sections (C-sections), potentially impacting maternal and neonatal outcomes. While pharmacotherapy is commonly used to manage anxiety, non-pharmacological interventions like music therapy offer a promising alternative or adjunct. This study aimed to investigate the efficacy of classical music in reducing preoperative anxiety levels in women scheduled for C-sections. A randomized controlled trial was conducted involving 100 women scheduled for elective C-sections. Participants were randomly assigned to either the intervention group (classical music listening) or the control group (standard care). Anxiety levels were assessed using the State-Trait Anxiety Inventory (STAI) before and after the intervention. Physiological parameters such as heart rate and blood pressure were also monitored. The intervention group demonstrated a significant reduction in both state and trait anxiety scores compared to the control group (p &lt; 0.05). Additionally, the intervention group exhibited lower heart rate and blood pressure levels post-intervention. In conclusion, classical music listening can be an effective non-pharmacological intervention for reducing preoperative anxiety in women undergoing C-sections. The findings suggest that integrating music therapy into standard preoperative care may enhance patient well-being and contribute to improved surgical outcomes.

Ethnic differences in knowledge, attitudes, and practices related to dietary salt intake and association with hypertension in Malaysia: a multi-centre cross-sectional study.

The association between high salt intake and elevated blood pressure levels has been well-documented. However, studies on how effectively this knowledge translates into actionable practices, particularly across different ethnic groups, remain limited. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) towards dietary salt intake across ethnicities and determine its association with hypertension. 5128 Malaysian adults recruited from a national blood pressure screening study completed questionnaires on demographics, and KAP related to dietary salt intake. There were 57.4% Malay, 23.5% Chinese, 10.4% Indian, and 8.7% individuals of other ethnic groups. Overall, more than 90% of the participants knew that a high salt intake causes serious health problems, but only around one-third knew the relationship between high salt intake and strokes and heart failure. Participants of different ethnic groups displayed significant differences in the KAP domains, where Indians generally exhibited better knowledge, attitudes, and reported better practices such as reading salt labels and using spices. Those who were unaware of the difference between salt and sodium and who reported not reading salt labels had higher odds of having elevated blood pressure. These findings demonstrate that while there is a suboptimal translation of salt knowledge into practice in Malaysia, with significant differences in KAP observed between ethnic groups, the potential of improving health outcomes by improving the clarity and awareness of salt labels is substantial. Tailored education promoting salt-label reading, minimizing processed foods intake and discretionary salt use should be ethnic-specific to better curb this escalating hypertension epidemic.

Statistical Metamodel of Liner Acoustic Impedance Based on Neural Network and Probabilistic Learning for Small Datasets

The main novelty of this paper consists of presenting a statistical artificial neural network (ANN)-based model for a robust prediction of the frequency-dependent aeroacoustic liner impedance using an aeroacoustic computational model (ACM) dataset of small size. The model, focusing on percentage of open area (POA) and sound pressure level (SPL) at a zero Mach number, takes into account uncertainties using a probabilistic formulation. The main difficulty in training an ANN-based model is the small size of the ACM dataset. The probabilistic learning carried out using the probabilistic learning on manifolds (PLoM) algorithm addresses this difficulty as it allows constructing a very large training dataset from learning the probabilistic model from a small dataset. A prior conditional probability model is presented for the PCA-based statistical reduced representation of the frequency-sampled vector of the log-resistance and reactance. It induces some statistical constraints that are not straightforwardly taken into account when training such an ANN-based model by classical optimizations methods under constraints. A second novelty of this paper consists of presenting an alternate solution that involves using conditional statistics estimated with learned realizations from PLoM. A numerical example is presented.

Proteinuric and Non-Proteinuric Diabetic Kidney Disease: Different Presentations of the Same Disease?

Background: Diabetic kidney disease (DKD) is a leading cause of end-stage kidney disease (ESKD) worldwide. This review examines the potential differences in clinical presentation, outcomes, and management between individuals with proteinuric DKD (P-DKD) and non-proteinuric DKD (NP-DKD). Methods: We analyzed articles published globally from 2000 and 2024. Results: Individuals with NP-DKD generally have lower blood pressure levels and a more favorable lipid profile. In contrast, histological studies show that P-DKD is associated with more severe glomerulosclerosis, mesangial expansion, arteriolar hyalinosis, interstitial-fibrosis/tubular atrophy, and immune complex deposits. Additionally, those with P-DKD are more likely to develop diabetic retinopathy and have a higher risk of all-cause mortality and progression to ESKD. Strategies to slow DKD progression, applicable to both NP-DKD and P-DKD, include non-pharmacologic and pharmacologic interventions such as renin–angiotensin system blockers, sodium-glucose co-transporter-2 inhibitors, finerenone, and glucagon-like protein receptor agonists. Conclusions: NP-DKD and P-DKD represent different presentations of the same underlying disease.

Social pressures and their relationship to the achievement motivation of handball players in Jordan

This study aimed to assess the degree of social pressures and their relationship to sports achievement motivation among 51 randomly selected handball players from first-division clubs in Jordan. A descriptive approach was employed, and data were collected via a questionnaire, with analyses conducted using SPSS 26. The results showed that social pressure levels were moderate, with training pressures being the highest (M = 3.17; a relative importance of 63.40%), followed by family (M = 2.92; a relative importance of 58.40%) and public pressures (M = 2.32; a relative importance of 46.40%). No statistically significant differences were found in social pressures and sports achievement motivation among handball players based on experience (p &gt; 0.05). While family and public pressures were not significantly correlated with motivation (p&gt;0.05), training and overall pressures were positively correlated with motivation (p&lt;0.05). The study found moderate social pressure among handball players in Jordan, with low public-related pressures and no differences based on experience. Motivation for sports achievement was high, with training-related pressures positively linked to motivation.

An energy-based framework for predicting vehicle noise source intensity: From energy consumption to noise

The vehicle noise source strength prediction model is a crucial component in the field of traffic noise prediction. Despite the establishment of noise source strength localized models in various countries, the theoretical underpinnings of the sound power level models within these frameworks remains unclear. This study addresses this gap by analyzing the correlation between vehicle noise and energy consumption. An energy-based source strength model framework (E-SSIM) is proposed, focusing on developing nonlinear models for basic noise level. E-SSIM is built on acoustical principles and the energy flow of vehicles, integrating noise and energy consumption through the application of multivariate regression theory, characterized by a transient or simplified mathematical framework. Furthermore, sensitivity analysis and road experiments are conducted to validate the proposed framework. The findings reveal that E-SSIM effectively integrates vehicle energy flow and principles of acoustics, thereby providing a theoretical foundation for the logarithmic mathematical structure in classical noise source strength models. The study reveals that in low-speed driving conditions (17–40 km/h), the sensitivity of noise energy to aerodynamic drag energy consumption reaches its peak. Specifically, the sensitivity of E-SSIM, as assessed by the A-weighted sound level, progressively decreases with increasing speed. On the contrary, for the Z-weighted sound level, the sensitivity initially decreases before rising again, reaching its peak stability and robustness at a speed of 23.8 km/h. E-SSIM exhibits superior precision in predicting A/Z-weighted sound pressure levels. Compared to classic logarithmic structural prediction models, the mean absolute percentage error of E-SSIM was reduced by 4.19% and 0.07%. Compared to typical models such as ASJ developed by the Acoustical Society of Japan and CNOSSOS-EU used by the European Commission, E-SSIM yielded a mean absolute percentage error reduction of 68% and 67%. Interestingly, as vehicle internal energy consumption increases, the prediction deviations of E-SSIM, ASJ, and CNOSSOS-EU gradually decrease, possibly because vehicle operating conditions approach stability. E-SSIM can utilize abundant vehicle data to develop generic models, promoting the advancement of noise prediction.

Evaluation of maternal bromoform supplementation in late gestation on blood parameters of cows and their progeny

Bromoform supplementation has been successful in reducing enteric methanogenesis in ruminants; however, the impacts on the health of these animals are still limited. The current study evaluates the impact of maternal bromoform supplementation on the health of late-gestation cows and their progeny. Pregnant Angus cows (n = 42) were allocated into a control or bromoform group (n = 21 cows per treatment). Bromoform extracted from Asparagopsis armata (7,372 mg/kg) was supplemented once daily. Blood samples were collected from cows before supplementation (baseline). Within 24 h of parturition, blood and colostrum samples were collected from each cow and blood from neonates. Colostrum brix was measured to indicate immunoglobulin content. All data was analysed using the MIXED procedure in SAS.Supplementation of cows with bromoform resulted in increased blood urea to creatinine ratio (P = 0.048), base excess (P = 0.049), total carbon dioxide (TCO2; P = 0.048) and a decrease in blood glutamate dehydrogenase (GLDH; P = 0.031) compared to the control group. For cows in the bromoform group, a trend was observed for higher levels of partial pressure of carbon dioxide (pCO2; P = 0.070) and bicarbonate (HCO3-; P = 0.052), and lower levels of partial pressure of oxygen (pO2; P = 0.058) compared to the control group. Blood gamma-glutamyl transferase (GGT) was elevated in offspring of cows fed bromoform (P = 0.050). The lower blood pO2 of pregnant cows fed bromoform and elevated blood GGT levels in offspring are not well understood and highlight the need for further investigation. Additionally, the low-dose bromoform supplementation affected various blood gas parameters of cows and calves, demonstrating the importance of monitoring these parameters when using different doses of halogenated compounds in livestock.

Irruption of Network Analysis to Explain Dietary, Psychological and Nutritional Patterns and Metabolic Health Status in Metabolically Healthy and Unhealthy Overweight and Obese University Students: Ecuadorian Case.

The association between dietary nutritional patterns, psychological factors, and metabolic health status has not been investigated in university students. There are studies that include numerous variables to test hypotheses from various theoretical bases, but due to their complexity, they have not been studied in combination. The scientific community recognizes the use of Gaussian graphical models (GGM) as a set of novel methods capable of addressing this. To apply GGMs to derive specific networks for groups of healthy and unhealthy obese individuals that represent nutritional, psychological, and metabolic patterns in an Ecuadorian population. This was a quantitative, non-experimental, cross-sectional, correlational study conducted on a sample of 230 obese/overweight university students, selected through a multi-stage random sampling method. To assess usual dietary intake, a Food Frequency Questionnaire (FFQ) was used; to evaluate psychological profiles (anxiety, depression, and stress), the DASS-21 scale was employed; blood pressure and anthropometric data were collected; and insulin levels, lipid profiles, and glucose levels were determined using fasting blood samples. The International Diabetes Federation (IDF) criteria were applied to identify metabolically healthy and unhealthy individuals. Statistical analysis relied on univariate methods (frequencies, measures of central tendency, and dispersion), and the relationships were analyzed through networks. The Mann-Whitney U test was used to analyze differences between groups. In metabolically unhealthy obese individuals, GGMs identified a primary network consisting of the influence of waist circumference on blood pressure and insulin levels. In the healthy obese group, a different network was identified, incorporating stress and anxiety variables that influenced blood pressure, anthropometry, and insulin levels. Other identified networks show the dynamics of obesity and the effect of waist circumference on triglycerides, anxiety, and riboflavin intake. GGMs are an exploratory method that can be used to construct networks that illustrate the behavior of obesity in the studied population. In the future, the identified networks could form the basis for updating obesity management protocols in Primary Care Units and supporting clinical interventions in Ecuador.

Analysis of an evaporator with single horizontal circular micro-tube using FC-72 as working fluid for electronic cooling applications

Flow boiling in micro-channels is one of the most efficient methods for heat rejection in electronics, necessitating proper system design. Numerical simulations are the most suitable tool for this purpose, with most literature focusing on CHF situations, while few studies address conditions bellow it. This paper presents a parametric analysis of an evaporator with a horizontal circular micro-tube, maintaining a fixed outlet quality, using numerical simulation. The simulation employs a one-dimensional steady-state model with FC-72 as the working fluid, considering both subcooled liquid and two-phase lengths, computed using theoretical equations and correlations. The effects of inner tube diameter, heat flux, inlet pressure, and subcooling level on key evaporator design parameters are discussed in detail. Results indicate that to minimize hydraulic pumping power, fluid temperature difference, and inlet temperature are required, the evaporator should operate with the lowest heat flux (50kW∙m-2), the largest inner tube diameter (1.3mm), the highest subcooling level (30K), and the lowest inlet pressure (2bar). Under these conditions, hydraulic pumping power can be reduced by up to 86%. Furthermore, to achieve the minimum fluid temperature difference along the tube (approximately 4.9K) and avoid CHF situation, operation with the lowest subcooling level (5K) is necessary. Finally, the ratio of the heat flux to the critical heat flux, q"/CHF, increases with rising inlet pressure and subcooling level, and/or decreasing inner tube diameter. The minimum q"/CHF ratio of 43.9% was obtained at pin=2bar, q"=50kW∙m-2, D=0.9mm, and ΔTsub=5K. These findings provide insights into optimal design parameters for evaporators in micro-electronics cooling applications.

A Machine Learning Approach for Deriving Atmospheric Temperatures and Typhoon Warm Cores From FY‐3E MWTS‐3 Observations

AbstractMachine learning has gained an increasing popularity in the fields of satellite retrieval and numerical weather modeling. In this study, machine‐learning (ML) neural‐network (NN) models are utilized to retrieve atmospheric temperatures from observations of brightness temperature from the Microwave Temperature Sounder‐3 (MWTS‐3) onboard the China's first dawn‐dusk polar‐orbiting satellite Fengyun (FY)‐3E, with the ERA5 reanalysis serving as training data sets. The root mean square errors of the ML‐retrieved temperatures at all pressure levels are smaller than those obtained by a previously used traditional linear regression method compared to the ERA5 reanalysis over global oceans as well as radiosonde observations over land. Less than a 1‐week period of training data is usually sufficient for an ML NN model to converge in less than 50–100 iterations. The shortest time period of training data is 3‐days right before the testing data period. While the horizontal patterns and temporal evolutions of the ML‐retrieved warm cores of Typhoon Malakas (2022) and Typhoon Haikui (2023) in the upper troposphere compared favorably with those obtained by traditional regression methods as well as the ERA5 reanalysis in the testing periods. The vertical structures of ML‐retrieved warm cores extend further down to the middle and lower troposphere while those from the traditional regression method are confined in the upper troposphere. A comparison among ML results with additional training data sets across different seasons confirms the above conclusion.

Marine compressed air source array acoustic field characterization from at-sea measurements: Long-range propagationa).

In 2007, the Littoral Acoustic Demonstration Center conducted a comprehensive experiment in the northern Gulf of Mexico to measure the three-dimensional acoustic field of a standard marine compressed-air source array used in seismic exploration. This study aims to enhance understanding of long-range acoustic propagation of the array signals, with focus on variations in received sound pressure levels and sound exposure levels (SELs) at various ranges from the source. These variations are influenced by factors, such as receiver depth, array orientation, and propagation conditions. The long-range measurements show that received peak pressure levels and SELs exhibit non-monotonic (oscillatory) behavior with range leading up to 10 dB increase in received levels at longer ranges. At ranges beyond 20 km, acoustic levels at the shallowest hydrophone consistently surpassed those at deeper ones by 3-10 dB, suggesting the impact of surface duct propagation effects. The results demonstrate that range-independent bathymetry leads to approximately 4 dB higher received acoustic levels than range-dependent propagation conditions. The measured long-range propagation acoustic metrics from controlled experiment provide a unique and critical dataset for validating both source and propagation model accuracy in predicting received sound pressure and SEL in the far-field of the source array.

P049 RENOVASCULAR HYPERTENSIVE RATS (2K1C) HAVE REDUCED INTRACRANIAL COMPLIANCE INDUCED BY RAISED VENTRICULAR VOLUME COMPARED TO NORMOTENSIVE RATS

Background and Objective: Intracerebroventricular (ICV) infusions of increased volumes of saline can be used to study intracranial compliance (ICC). Since the two-kidneys,1-clip (2K1C) rat model of renovascular hypertension has an enhanced baseline level of intracranial pressure (ICP), the present study aimed to verify the effect of ICV infusions of 0.15 M NaCl on ICP and ICC in 2K1C rats. Methods: Male Holtzman rats (180-210 g) were randomly separated to be normotensive (NT; sham surgery, n = 5) or with 2K1C (n = 5), done by a partial left renal artery occlusion. Six weeks after, rats were anaesthetized with urethane (1.2 g/kg body weight, i.v.), tracheostomized, placed under artificial ventilation, and had an ICP sensor and a needle inserted into the lateral ventricle for, respectively, ICP recording and ICV 0.15 M infusions (30, 60 and 90 μL, at 100 μL/min). There was a 20-minute interval between each infusion. ICC was calculated by the ratio of volume change to ICP change [ICC = ΔV (μL)/Δ ICP (mmHg)]. Results: Baseline MAP, ICP, and P2/P1 ratio of 2K1C rats (166 ± 6 mmHg; 15.7 ± 1.7 mmHg; 1.6 ± 0.1, respectively) were higher than the ones in NT rats (94 ± 5 mmHg; 10.1 ±1.4 mmHg; 0.7 ± 0.1 respectively; p&lt;0.05 vs 2K-1C). ICV infusions induced increased ICP in 2K1C rats (19 ±0.5; 42 ±1.2 and 55 ±5.5 mmHg, vs NT: 8 ±0.6; 25 ±3.2 and 36 ± 4.9 mmHg, respectively at 30, 60 and 90 μL infusion; p&lt;0.05). In addition, 2K1C rats presented a reduced ICC only at 30 μl infusion (5.6 ±1.4, vs NT: 11.4 ±0.9; p&lt;0.05). Conclusions: These findings suggest that renovascular hypertension impairs ICC to the well-documented increase in ICP. Support: FAPESP, CNPq.

Local muscle pressure stimulates the principal receptors for proprioception

Proprioception plays a crucial role in motor coordination and self-perception. Muscle spindles are the principal receptors for proprioception. They are believed to encode muscle stretch and signal limb position and velocity. Here, we applied percutaneous pressure to a small area of extensor muscles at the forearm while recording spindle afferent responses, skeletal muscle activity, and hand kinematics. Three levels of sustained pressure were applied on the spindle-bearing muscle when the hand was relaxed and immobile ("isometric" condition) and when the participant's hand moved rhythmically at the wrist. As hypothesized to occur due to compression of the spindle capsule, we show that muscle pressure is an "adequate" stimulus for human spindles in isometric conditions and that pressure enhances spindle responses during stretch. Interestingly, release of sustained pressure in isometric conditions lowered spindle firing below baseline rates. Our findings urge a re-evaluation of muscle proprioception in sensorimotor function and various neuromuscular pathologies.

Green fund investors and ESG performance: Evidence from China

Using the ESG scores from the Bloomberg Database and the manually filtered green fund investor data, we study the influence of green fund investors on the Chinese A-shares' ESG performance. As we have found, the holding of fund investors who pay attention to sustainable development can improve the firm's ESG performance, and this improvement is more pronounced in state-owned enterprises, heavily polluting industries, and after the green policy announcement. Our findings are robust after considering the reverse causality endogeneity concern and sample selection bias. In addition, the holdings of green fund investors favor the company's status as a green index constituent and its long-term financial performance. Further, the mechanism test reveals the influencing channel of this improvement and supports that it is long-term green fund investors themselves improving the firms' ESG performance and can improve a firm's ESG performance by attracting other long-term investors and new mutual fund investors, and increasing the level of media scrutiny pressure. Our paper contributes to figuring out the impact of institutional holding on ESG development and further points out the source of this influence.

Stimulation of the internal superior laryngeal nerve as a potential therapy for obstructive sleep apnea in a porcine model.

Impaired pharyngeal sensing of negative pressure (NP) can lead to a blunted response of the upper airway dilator muscles and contribute to the development of obstructive sleep apnea (OSA). This response is modulated by the nerve fibers in the internal branch of the superior laryngeal nerve (iSLN), mediating negative pressure sensation. Artificial excitation of these fibers could be a potential treatment target for OSA. To evaluate this, electrostimulation of the iSLN was performed in a porcine-isolated upper airway model. Artificial obstructions were induced by varying the levels of negative pressure, and the ability of the animal to resolve these obstructions was evaluated. The pressure at which the animal was still able to resolve the obstruction was quantified as "Resolvable Pressure." Thereby, the effects on pharyngeal patency (n = 35) and the duration of the therapeutic effect outlasting the stimulation (n = 6) were quantified. Electrostimulation before the introduction of an artificial obstruction improved the median resolvable pressure from -28.3 cmH2O [IQR: -45.9; -26.1] to -92.6 cmH2O [IQR: -105.1; -78.6]. The median therapeutic effect was found to outlast the last stimulation burst applied by 163 s when five stimulation bursts were applied in short succession [IQR: 58; 231], 58 s when two were applied [IQR: 7; 65], and 6 s when one was applied [IQR: 0; 51]. Stimulation of the iSLN increased electromyography (EMG) in the genioglossus (GG). The proposed treatment concept can improve pharyngeal patency in the model. Transfer of the results to clinical application could enable the development of a new neuromodulation therapy for OSA.NEW & NOTEWORTHY Electrostimulation before the introduction of an artificial obstruction to induce artificial sleep apnea in the pig model improves the response of the upper airway to negative pressure (NP). The electrostimulation creates a sustained therapeutic effect that outlasts the initial electrostimulation. The use of this therapy in clinical practice has the potential to treat obstructive sleep apnea (OSA).

P217 MAY MEASUREMENT MONTH 2019: BLOOD PRESSURE VARIABILITY IN RELATION TO AGE AND SEX

Background and Objective: Within-visit blood pressure variability (BPV) is predictive of cardiovascular events independent of mean blood pressure (BP) levels and may serve as marker of cardiovascular aging. This study aimed to explore changes in BPV by age, and sex in May Measurement Month (MMM) 2019 survey participants. Methods: Adults (≥18 years) were surveyed opportunistically from 92 countries and up to three standardized seated BP readings were recorded. This analysis included all participants who were not taking BP-lowering medication and with complete data on age, sex, and three valid BP recordings. Three indices of BPV were compared: the standard deviation (SD), coefficient of variation (CV), and variation independent of the mean (VIM). A linear regression model was created for each index. Models were adjusted for mean BP, age, sex, and an interaction between age and sex. Age and mean BP were each included as natural cubic splines with 11 and 5 knots, respectively, to allow for flexibility with modelling relationships. Results: Data from 842,356 participants were included. The mean age was 42.9 (SD 15.9) years and 51.5% were female. Patterns of BPV from 18-90 years and by sex were consistent across BPV indices. Systolic BPV was higher in female than male participants between the ages of 30 and 80. In female participants, systolic BPV declined with age from 18-25, after which systolic BPV increased with age. In male participants, systolic BPV declined with age from 18-45, after which systolic BPV increased with age. Diastolic BPV was highest at the youngest and oldest ages, and lowest between 45 and 55 in both sexes. Conclusions: There was a highly consistent pattern amongst three commonly used indices of BPV in their relationships with age and sex. The BPV of screened adults was lower in males than females and varied non-linearly with age, with markedly higher BPV at younger and older ages, with distinct patterns of variation observed between systolic and diastolic BPV.

P093 PLASMA PROTEINS PROFILE AND THERAPEUTIC RESPONSIVENESS IN PATIENTS WITH PREECLAMPSIA

Preeclampsia (PE) is a hypertensive syndrome of pregnancy, characterized by target organ damage, related to a high incidence of cardiovascular sequelae. PE requires antihypertensive drug therapy, however, about 40% of patients do not respond to this treatment, leading to worse clinical outcomes. Through the proteomic strategy, we 1) compared the profile of circulating proteins expressed in 10 responsive (R-PE) and 10 non-responsive to antihypertensive therapy (NR-PE), besides 10 healthy pregnant (HP); 2) investigated which proteins are differentially expressed between the groups and 3) found out which signaling pathways are altered between them. The study followed the Declaration of Helsinki and was approved by the Research Ethics Committee of the Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP, protocol code CAAE-37738620.0.0000.5440). We performed plasma protein quantification using mass spectrometry, the obtained data underwent bioinformatics analyses based on Uniprot, PatternLab for Proteomics, String and MetaboAnalyst softwares. Considering a fold change of 1.5, three proteins showed as significantly differentially expressed between HP and R-PE, one downregulated (transtyretin) and two upregulated (apolipoprotein C1 and hemoglobin subunit beta). Between HP and NR-PE, there were six, two downregulated (clusterin and plasmin heavy chain A) and four upregulated (apolipoprotein A-IV; heparin cofactor II; complement C4B and haptoglobin related protein). Between R-PE and NR-PE there were four, one downregulated (fibronectin) and three upregulated (pregnancy-specific beta-1-glycoprotein 1 (PSG1); complement C4B (C4B) and complement C4A (C4A). Regarding PE, C4A and C4B intensity peaks were correlated with blood pressure and creatinine levels. Both, together with PSG1, showed significant correlations with the newborn's weight and gestational week (all p&lt; 0.05). These findings help to understand the pathophysiological mechanisms between the two subgroups of the disease, since the under regulated circulating proteins act in the blood pressure modulation and the upregulated may occur as compensatory mechanisms due to an inflammatory scenario. These data give insights to explain the complexity and clinical consequences of this disorder.