Cost effectiveness analysis of different approaches of screening for familial hypercholesterolaemia

Objectives To assess the cost effectiveness of strategies to screen for and treat familial hypercholesterolaemia. Design Cost effectiveness analysis. A care pathway for each patient was delineated and the associated probabilities, benefits, and costs were calculated. Participants Simulated population aged 16­54 years in England and Wales. Interventions Identification and treatment of patients with familial hypercholesterolaemia by universal screening, opportunistic screening in primary care, screening of people admitted to hospital with premature myocardial infarction, or tracing family members of affected patients. Main outcome measure Cost effectiveness calculated as cost per life year gained (extension of life expectancy resulting from intervention) including estimated costs of screening and treatment. Results Tracing of family members was the most cost effective strategy (£3097 (&5066, $4479) per life year gained) as 2.6 individuals need to be screened to identify one case at a cost of £133 per case detected. If the genetic mutation was known within the family then the cost per life year gained (£4914) was only slightly increased by genetic confirmation of the diagnosis. Universal population screening was least cost effective (£13 029 per life year gained) as 1365 individuals need to be screened at a cost of £9754 per case detected. For each strategy it was more cost effective to screen younger people and women. Targeted strategies were more expensive per person screened, but the cost per case detected was lower. Population screening of 16 year olds only was as cost effective as family tracing (£2777 with a clinical confirmation). Conclusions Screening family members of people with familial hypercholesterolaemia is the most cost effective option for detecting cases across the whole population

Spin coherent quantum transport of electrons between defects in diamond

The nitrogen-vacancy color center in diamond has rapidly emerged as an important solid-state system for quantum information processing. While individual spin registers have been used to implement small-scale diamond quantum computing, the realization of a large-scale device requires development of an on-chip quantum bus for transporting information between distant qubits. Here we propose a method for coherent quantum transport of an electron and its spin state between distant NV centers. Transport is achieved by the implementation of spatial stimulated adiabatic Raman passage through the optical control of the NV center charge states and the confined conduction states of a diamond nanostructure. Our models show that for two NV centers in a diamond nanowire, high fidelity transport can be achieved over distances of order hundreds of nanometres in timescales of order hundreds of nanoseconds. Spatial adiabatic passage is therefore a promising option for realizing an on-chip spin quantum bus

Determining the fate of selenium in wheat biofortification: an isotopically labelled field trial study

Aims The principal aim of this research was to quantify retention of a single, realistic Se biofortification application (10 g ha-1) in contrasting soils over two growing seasons utilizing an enriched stable Se isotope (77Se) to discriminate between applied Se and native soil Se. Methods Isotopically enriched 77Se (Na2SeO4) was applied (10 g ha-1) to four replicate plots (2 m x 2 m) of winter wheat, on three contrasting soils on the University of Nottingham farm (UK), at early stem extension in May 2012. Labelled 77Se was assayed in soil and crop fractions by ICP-MS. Results Topsoil retained a proportion of applied Se at harvest (c. 15 – 31 %) with only minor retention in subsoil (2-4 %), although losses were 37 – 43 %. Further analysis of topsoil 77Se, the following spring, and at second harvest, suggested that labelled Se retained in soil was25 fixed and uptake by a following crop was negligible. Conclusions Prolonged biofortification leads to accumulation of Se in soil but the retained Se has very low bioavailability and mobility. The time required to double the soil Se content would be about 500 years. However, reincorporation of cereal straw could provide a residual source of Se for a following crop, depending on timing and management

The Relative Orientation of Nuclear Accretion and Galaxy Stellar Disks in Seyfert Galaxies

We use the difference (delta) between the position angles of the nuclear radio emission and the host galaxy major axis to investigate the distribution of the angle (beta) between the axes of the nuclear accretion disk and the host galaxy disk in Seyfert galaxies. We provide a critical appraisal of the quality of all measurements, and find that the data are limited by observational uncertainties and biases, such as the well known deficiency of Seyfert galaxies of high inclination. There is weak evidence that the distribution of delta for Seyfert 2 galaxies may be different (at the 90% confidence level) from a uniform distribution, while the Seyfert 1 delta distribution is not significantly different from a uniform distribution or from the Seyfert 2 delta distribution. The cause of the possible non-uniformity in the distribution of delta for Seyfert 2 galaxies is discussed. Seyfert nuclei in late-type spiral galaxies may favor large values of delta (at the ~96% confidence level), while those in early-type galaxies show a more or less random distribution of delta. This may imply that the nuclear accretion disk in non-interacting late-type spirals tends to align with the stellar disk, while that in early-type galaxies is more randomly oriented, perhaps as a result of accretion following a galaxy merger. We point out that biases in the distribution of inclination translate to biased estimates of beta in the context of the unified scheme. When this effect is taken into account, the distributions of beta for all Seyferts together, and of Seyfert 1's and 2's separately, agree with the hypothesis that the radio jets are randomly oriented with respect to the galaxy disk. The data are consistent with the expectations of the unified scheme, but do not demand it.Comment: To appear in the Astrophysical Journal, Vol 516 #1, May 1, 1999. Corrected figure placement within pape

Transcranial direct current stimulation of the motor cortex in the treatment of chronic non-specific low back pain. A randomised, double-blind exploratory study

This exploratory study aimed to test the proof of principle that active anodal transcranial direct current stimulation (tDCS) applied to the motor cortex reduces pain significantly more than sham stimulation in a group of participants with chronic non-specific low back pain

Hippocampal theta activity during encoding promotes subsequent associative memory in humans

Hippocampal theta oscillations have been implicated in associative memory in humans. However, findings from electrophysiological studies using scalp electroencephalography or magnetoencephalography, and those using intracranial electroencephalography are mixed. Here we asked 10 pre-surgical epilepsy patients undergoing intracranial electroencephalography recording, along with 21 participants undergoing magnetoencephalography recordings, to perform an associative memory task, and examined whether hippocampal theta activity during encoding was predictive of subsequent associative memory performance. Across the intracranial electroencephalography and magnetoencephalography studies, we observed that theta power in the hippocampus increased during encoding, and that this increase differed as a function of subsequent memory, with greater theta activity for pairs that were successfully retrieved in their entirety compared with those that were not remembered. This helps to clarify the role of theta oscillations in associative memory formation in humans, and further, demonstrates that findings in epilepsy patients undergoing intracranial electroencephalography recordings can be extended to healthy participants undergoing magnetoencephalography recordings

Quantitative Three-dimensional Assessment of Knee Joint Space Width from Weight-bearing CT.

Background Imaging of structural disease in osteoarthritis has traditionally relied on MRI and radiography. Joint space mapping (JSM) can be used to quantitatively map joint space width (JSW) in three dimensions from CT images. Purpose To demonstrate the reproducibility, repeatability, and feasibility of JSM of the knee using weight-bearing CT images. Materials and Methods Two convenience samples of weight-bearing CT images of left and right knees with radiographic Kellgren-Lawrence grades (KLGs) less than or equal to 2 were acquired from 2014 to 2018 and were analyzed retrospectively with JSM to deliver three-dimensional JSW maps. For reproducibility, images of three sets of knees were used for novice training, and then the JSM output was compared against an expert's assessment. JSM was also performed on 2-week follow-up images in the second cohort, yielding three-dimensional JSW difference maps for repeatability. Statistical parametric mapping was performed on all knee imaging data (KLG, 0-4) to show the feasibility of a surface-based analysis in three dimensions. Results Reproducibility (in 20 individuals; mean age, 58 years ± 7 [standard deviation]; mean body mass index, 28 kg/m2 ± 6; 14 women) and repeatability (in nine individuals; mean age, 53 years ± 6; mean body mass index, 26 kg/m2 ± 4; seven women) reached their lowest performance at a smallest detectable difference less than ±0.1 mm in the central medial tibiofemoral joint space for individuals without radiographically demonstrated disease. The average root mean square coefficient of variation was less than 5% across all groups. Statistical parametric mapping (33 individuals; mean age, 57 years ± 7; mean body mass index, 27 kg/m2 ± 6; 23 women) showed that the central-to-posterior medial joint space was significantly narrower by 0.5 mm for each incremental increase in the KLG (threshold P < .05). One knee (KLG, 2) demonstrated a baseline versus 24-month change in its three-dimensional JSW distribution that was beyond the smallest detectable difference across the lateral joint space. Conclusion Joint space mapping of the knee using weight-bearing CT images is feasible, demonstrating a relationship between the three-dimensional joint space width distribution and structural joint disease. It is reliably learned by novice users, can be personalized for disease phenotypes, and can be used to achieve a smallest detectable difference that is at least 50% smaller than that reported to be achieved at the highest performance level in radiography. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Roemer in this issue

Radio Sources in Low-Luminosity Active Galactic Nuclei. I. VLA Detections of Compact, Flat-Spectrum Cores

We report a 0.2" resolution, 15 GHz survey of a sample of 48 low-luminosity active galactic nuclei with the Very Large Array. Compact radio emission has been detected in 57% (17 of 30) of LINERs and low-luminosity Seyferts, at least 15 of which have a flat to inverted radio spectrum (alpha > -0.3). The compact radio cores are found in both type 1 (i.e. with broad Halpha) and type 2 (without broad Halpha) nuclei. The 2 cm radio power is significantly correlated with the emission-line ([OI] lambda6300) luminosity. While the present observations are consistent with the radio emission originating in star-forming regions, higher resolution radio observations of 10 of the detected sources, reported in a companion paper (Falcke et al. 2000), show that the cores are very compact (= 10^8K) and probably synchrotron self-absorbed, ruling out a starburst origin. Thus, our results suggest that at least 50% of low-luminosity Seyferts and LINERs in the sample are accretion powered, with the radio emission presumably coming from jets or advection-dominated accretion flows. We have detected only 1 of 18 `transition' (i.e. LINER + HII) nuclei observed, indicating their radio cores are significantly weaker than those of `pure' LINERs.Comment: To appear in the Astrophysical Journal, October 20, 200