Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK.

OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first and second CV-related hospitalisations (first event and second event cohorts). Within-person differences were used to estimate CV-related outcomes. SETTING: Patients in the UK who had their first CV event between January 2006 and March 2012. PARTICIPANTS: Patients ≥18 years who had a CV event and received at least 2 lipid-modifying therapy prescriptions within 180 days beforehand. PRIMARY AND SECONDARY OUTCOME MEASURES: Direct medical costs (2014 £) were estimated in 3 periods: baseline (pre-event), acute (6 months afterwards) and long-term (subsequent 30 months). Primary outcomes included incremental costs, resource usage and total costs per period. RESULTS: There were 24 093 patients in the first event cohort of whom 5274 were included in the second event cohort. The mean incremental acute CV event costs for the first event and second event cohorts were: coronary artery bypass graft/percutaneous transluminal coronary angioplasty (CABG/PTCA) £5635 and £5823, myocardial infarction £4275 and £4301, ischaemic stroke £3512 and £4572, heart failure £2444 and £3461, unstable angina £2179 and £2489 and transient ischaemic attack £1537 and £1814. The mean incremental long-term costs were: heart failure £848 and £2829, myocardial infarction £922 and £1385, ischaemic stroke £973 and £682, transient ischaemic attack £705 and £1692, unstable angina £328 and £677, and CABG/PTCA £-368 and £599. Hospitalisation accounted for 95% of acute and 61% of long-term incremental costs. Higher comorbidity was associated with higher long-term costs. CONCLUSIONS: Revascularisation and myocardial infarction were associated with the highest incremental costs following a CV event. On the basis of real-world data, the economic burden of CV events in the UK is substantial, particularly among those with greater comorbidity burden

Neural changes when actions change: Adaptation of strong and weak expectations

Repeated experiences with an event create the expectation that subsequent events will expose an analog structure. These spontaneous expectations rely on an internal model of the event that results from learning. But what happens when events change? Do experience-based internal models get adapted instantaneously, or is model adaptation a function of the solidity of, i.e., familiarity with, the corresponding internal model? The present fMRI study investigated the effects of model solidity on model adaptation in an action observation paradigm. Subjects were made acquainted with a set of action movies that displayed an altered script when encountered again in the scanning session. We found model adaptation to result in an attenuation of the premotor-parietal network for action observation. Model solidity was found to modulate activation in the parahippocampal gyrus and the anterior cerebellar lobules, where increased solidity correlated with activity increase. Finally, the comparison between early and late stages of learning indicated an effect of model solidity on adaptation rate. This contrast revealed the involvement of a fronto-mesial network of Brodmann area 10 and the ACC in those states of learning that were signified by high model solidity, no matter if the memorized original or the altered action model was the more solid component. Findings suggest that the revision of an internal model is dependent on its familiarity. Unwarranted adaptations, but also perseverations may thus be prevented

Rectification from Radially-Distorted Scales

This paper introduces the first minimal solvers that jointly estimate lens distortion and affine rectification from repetitions of rigidly transformed coplanar local features. The proposed solvers incorporate lens distortion into the camera model and extend accurate rectification to wide-angle images that contain nearly any type of coplanar repeated content. We demonstrate a principled approach to generating stable minimal solvers by the Grobner basis method, which is accomplished by sampling feasible monomial bases to maximize numerical stability. Synthetic and real-image experiments confirm that the solvers give accurate rectifications from noisy measurements when used in a RANSAC-based estimator. The proposed solvers demonstrate superior robustness to noise compared to the state-of-the-art. The solvers work on scenes without straight lines and, in general, relax the strong assumptions on scene content made by the state-of-the-art. Accurate rectifications on imagery that was taken with narrow focal length to near fish-eye lenses demonstrate the wide applicability of the proposed method. The method is fully automated, and the code is publicly available at https://github.com/prittjam/repeats.Comment: pre-prin

Magnitude of the Difference Between Clinic and Ambulatory Blood Pressures and Risk of Adverse Outcomes in Patients With Chronic Kidney Disease.

Background Obtaining 24-hour ambulatory blood pressure ( BP ) is recommended for the detection of masked or white-coat hypertension. Our objective was to determine whether the magnitude of the difference between ambulatory and clinic BP s has prognostic implications. Methods and Results We included 610 participants of the AASK (African American Study of Kidney Disease and Hypertension) Cohort Study who had clinic and ambulatory BPs performed in close proximity in time. We used Cox models to determine the association between the absolute systolic BP ( SBP ) difference between clinic and awake ambulatory BPs (primary predictor) and death and end-stage renal disease. Of 610 AASK Cohort Study participants, 200 (32.8%) died during a median follow-up of 9.9 years; 178 (29.2%) developed end-stage renal disease. There was a U-shaped association between the clinic and ambulatory SBP difference with risk of death, but not end-stage renal disease. A 5- to <10-mm Hg higher clinic versus awake SBP (white-coat effect) was associated with a trend toward higher (adjusted) mortality risk (adjusted hazard ratio, 1.84; 95% CI, 0.94-3.56) compared with a 0- to <5-mm Hg clinic-awake SBP difference (reference group). A ≥10-mm Hg clinic-awake SBP difference was associated with even higher mortality risk (adjusted hazard ratio, 2.31; 95% CI, 1.27-4.22). A ≥-5-mm Hg clinic-awake SBP difference was also associated with higher mortality (adjusted hazard ratio, 1.82; 95% CI, 1.05-3.15) compared with the reference group. Conclusions A U-shaped association exists between the magnitude of the difference between clinic and ambulatory SBP and mortality. Higher clinic versus ambulatory BPs (as in white-coat effect) may be associated with higher risk of death in black patients with chronic kidney disease

Pattern recognition of estradiol, testosterone and dihydrotestosterone in children's saliva samples using stochastic microsensors

Stochastic microsensors based on diamond paste and three types of electroactive materials (maltodextrin (MD), α-cyclodextrin (α-CD) and 5,10,15,20-tetraphenyl-21H,23H porphyrin (P)) were developed for the assay of estradiol (E2), testosterone (T2) and dihydrotestosterone (DHT) in children's saliva. The main advantage of utilization of such tools is the possibility to identify and quantify all three hormones within minutes in small volumes of childen's saliva. The limits of quantification obtained for DHT, T2, and E2 (1 fmol/L for DHT, 1 pmol/L for T2, and 66 fmol/L for E2) determined using the proposed tools allows the utilization of these new methods with high reliability for the screening of saliva samples from children. This new method proposed for the assay of the three hormones overcomes the limitations (regarding limits of determination) of ELISA method which is the standard method used in clinical laboratories for the assay of DHT, T2, and E2 in saliva samples. The main feature of its utilization for children's saliva is to identify earlier problems related to early puberty and obesity

Polar curved polycyclic aromatic hydrocarbons in soot formation

© 2018 The Combustion Institute. In this paper, we consider the impact of polar curved polycyclic aromatic hydrocarbons (cPAH) on the process of soot formation by employing electronic structure calculations to determine the earliest onset of curvature integration and the binding energy of curved homodimers. The earliest (smallest size) onset of curvature integration was found to be a six ring PAH with at least one pentagonal ring. The σ bonding in the presence of pentagons led to curvature, however, the π bonding strongly favored a planar geometry delaying the onset of curvature and therefore the induction of a flexoelectric dipole moment. The binding energies of cPAH dimers were found to be of similar magnitude to flat PAH containing one or two pentagons, with an alignment of the dipole moments vectors. For the more curved structures, steric effects reduced the dispersion interactions to significantly reduce the interaction energy compared with flat PAH. Homogeneous nucleation of cPAH at flame temperatures then appears unlikely, however, significant interactions are expected between chemi-ions and polar cPAH molecules suggesting heterogeneous nucleation should be explored.This project is supported by the National Research Foundation (NRF), Prime Minister’s Office, Singapore under its Campus for Research Excellence and Technological Enterprise (CREATE) programme

3D Hand Movement Measurement Framework for Studying Human-Computer Interaction

In order to develop better touch and gesture user interfaces, it is important to be able to measure how humans move their hands while interacting with technical devices. The recent advances in high-speed imaging technology and in image-based object tracking techniques have made it possible to accurately measure the hand movement from videos without the need for data gloves or other sensors that would limit the natural hand movements. In this paper, we propose a complete framework to measure hand movements in 3D in human-computer interaction situations. The framework includes the composition of the measurement setup, selecting the object tracking methods, post-processing of the motion trajectories, 3D trajectory reconstruction, and characterizing and visualizing the movement data. We demonstrate the framework in a context where 3D touch screen usability is studied with 3D stimuli.Peer reviewe

A High Deuterium Abundance at z=0.7

Of the light elements, the primordial abundance of deuterium, (D/H)_p, provides the most sensitive diagnostic for the cosmological mass density parameter Omega_B. Recent high redshift (D/H) measurements are highly discrepant, although this may reflect observational uncertainties. The larger (D/H) values, which imply a low Omega_B and require the Universe to be dominated by non-baryonic matter (dynamical studies indicate a higher total density parameter), cause problems for galactic chemical evolution models since they have difficulty in reproducing the large decline down to the lower present-day (D/H). Conversely, low (D/H) values imply an Omega_B greater than derived from ^7Li and ^4He abundance measurements, and may require a deuterium abundance evolution that is too low to easily explain. Here we report the first measurement at intermediate redshift, where the observational difficulties are smaller, of a gas cloud with ideal characteristics for this experiment. Our analysis of the z = 0.7010 absorber toward 1718+4807 indicates (D/H) = 2.0 +/- 0.5 x 10^{-4} which is in the high range. This and other independent observations suggests there may be a cosmological inhomogeneity in (D/H)_p of at least a factor of ten.Comment: 6 pages, 1 figur

Joint Optical Flow and Temporally Consistent Semantic Segmentation

The importance and demands of visual scene understanding have been steadily increasing along with the active development of autonomous systems. Consequently, there has been a large amount of research dedicated to semantic segmentation and dense motion estimation. In this paper, we propose a method for jointly estimating optical flow and temporally consistent semantic segmentation, which closely connects these two problem domains and leverages each other. Semantic segmentation provides information on plausible physical motion to its associated pixels, and accurate pixel-level temporal correspondences enhance the accuracy of semantic segmentation in the temporal domain. We demonstrate the benefits of our approach on the KITTI benchmark, where we observe performance gains for flow and segmentation. We achieve state-of-the-art optical flow results, and outperform all published algorithms by a large margin on challenging, but crucial dynamic objects.Comment: 14 pages, Accepted for CVRSUAD workshop at ECCV 201