Dementia and Depression with Ischemic Heart Disease: A Population-Based Longitudinal Study Comparing Interventional Approaches to Medical Management

BACKGROUND: We compared the proportion of ischemic heart disease (IHD) patients newly diagnosed with dementia and depression across three treatment groups: percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical management alone (IHD-medical). METHODS AND FINDINGS: De-identified, individual-level administrative records of health service use for the population of Manitoba, Canada (approximately 1.1 million) were examined. From April 1, 1993 to March 31, 1998, patients were identified with a diagnosis of IHD (ICD-9-CM codes). Index events of CABG or PCI were identified from April 1, 1998 to March 31, 2003. Outcomes were depression or dementia after the index event. Patients were followed forward to March 31, 2006 or until censored. Proportional hazards regression analysis was undertaken. Independent variables examined were age, sex, diabetes, hypertension and income quintile, medical management alone for IHD, or intervention by PCI or CABG. Age, sex, diabetes, and presence of hypertension were all strongly associated with the diagnosis of depression and dementia. There was no association with income quintile. Dementia was less frequent with PCI compared to medical management; (HR = 0.65; p = 0.017). CABG did not provide the same protective effect compared to medical management (HR = 0.90; p = 0.372). New diagnosis depression was more frequent with interventional approaches: PCI (n = 626; hazard ratio = 1.25; p = 0.028) and CABG (n = 1124, HR = 1.32; p = 0.0001) than non-interventional patients (n = 34,508). Subsequent CABG was nearly 16-fold higher (p<0.0001) and subsequent PCI was 22-fold higher (p<0.0001) for PCI-managed than CABG-managed patients. CONCLUSIONS: Patients managed with PCI had the lowest likelihood of dementia-only 65% of the risk for medical management alone. Both interventional approaches were associated with a higher risk of new diagnosed depression compared to medical management. Long-term myocardial revascularization was superior with CABG. These findings suggest that PCI may confer a long-term protective effect from dementia. The mechanism(s) of dementia protection requires elucidation

A 16-b 10Msample/s Split-Interleaved Analog to Digital Converter

This work describes the integrated circuit design of a 16-bit, 10Msample/sec, combination ‘split’ interleaved analog to digital converter. Time interleaving of analog to digital converters has been used successfully for many years as a technique to achieve faster speeds using multiple identical converters. However, efforts to achieve higher resolutions with this technique have been difficult due to the precise matching required of the converter channels. The most troublesome errors in these types of converters are gain, offset and timing differences between channels. The ‘split ADC’ is a new concept that allows the use of a deterministic, digital, self calibrating algorithm. In this approach, an ADC is split into two paths, producing two output codes from the same input sample. The difference of these two codes is used as the calibration signal for an LMS error estimation algorithm that drives the difference error to zero. The ADC is calibrated when the codes are equal and the output is taken as the average of the two codes. The ‘split’ ADC concept and interleaved architecture are combined in this IC design to form the core of a high speed, high resolution, and self-calibrating ADC system. The dual outputs are used to drive a digital calibration engine to correct for the channel mismatch errors. This system has the speed benefits of interleaving while maintaining high resolution. The hardware for the algorithm as well as the ADC can be implemented in a standard 0.25um CMOS process, resulting in a relatively inexpensive solution. This work is supported by grants from Analog Devices Incorporated (ADI) and the National Science Foundation (NSF)

Lessons Learned from Fighting Against Inclusive Access: A Sociological Reflection

In this session, we will discuss the lessons learned from fighting against inclusive access using the sociological perspective of social movement and different authors such as Marx, Durkheim, or Bourdieu. We will start with the importance of being proactive, instead of reactive, in educating our audience and equipping the members of the OER and Open Pedagogy community with the tools necessary to organize the response to Inclusive Access. Then, we will focus on the importance of being brave, fearless, and at the same time realistic about the environment in which we operate. Next, we will conclude by presenting the importance of understanding the OER and Open Pedagogy community through the cultural lenses of obedience, alienation, but also emancipation and liberation. We will recognize the importance of empathy toward our peers and respect the different strategies, resources, and timelines of the members of our community. Finally, we will end this session with an open forum for individuals to share their own encounters with inclusive access struggles within their institutions, systems, or states. Join us as we unite in the fight against Inclusive Access, advocating for the openness that our democratic and educational institutions rightfully deserve