Study of coronary artery calcium by multi-slice spiral CT as a tool for high risk cardiovascular screening

Background: Strong relationship has been demonstrated between the presence of occlusive CAD and coronary artery calcification (CAC) detected at autopsy, fluoroscopy and computed tomography (CT scan). CT scan quantifies the relative burden of CAC deposits as a marker of atherosclerosis. We explored utility of multi-slice spiral CT scan for detection of CAC as a tool for screening in asymptomatic high-risk cases above 40 years of age.Methods: Fifty-eight asymptomatic cardiovascular high-risk cases were included as per selection criteria. Detailed clinical history was recorded in every case regarding age, sex, history of risk factors for CAD like systemic hypertension, diabetes mellitus, smoking and family history of CAD. Every case was evaluated for fasting and postprandial blood sugar and fasting lipid profile. Body mass index (BMI) was calculated. An ECG was also recorded. Coronary artery calcium was estimated in each patient by multi -slice spiral CT scan. Fifty age and gender matched consenting participants were enrolled as controls and comparisons drawn.Results: Out of 58 cases scanned, 41 had no detectable CAC by multi-slice CT scan whereas in 17 cases (29.2%), calcium was detected. Mean CAC score was observed to increase as number of risk factors increased.Conclusions: Multi-slice CT scan is a useful tool for detection of coronary artery calcium (CAC) when utilised for high risk screening in older adults having one or more known cardiovascular risk factors

Self-Averaging, Distribution of Pseudo-Critical Temperatures and Finite Size Scaling in Critical Disordered Systems

The distributions $P(X)$ of singular thermodynamic quantities in an ensemble of quenched random samples of linear size $l$ at the critical point $T_c$ are studied by Monte Carlo in two models. Our results confirm predictions of Aharony and Harris based on Renormalization group considerations. For an Ashkin-Teller model with strong but irrelevant bond randomness we find that the relative squared width, $R_X$, of $P(X)$ is weakly self averaging. $R_X\sim l^{\alpha/\nu}$, where $\alpha$ is the specific heat exponent and $\nu$ is the correlation length exponent of the pure model fixed point governing the transition. For the site dilute Ising model on a cubic lattice, known to be governed by a random fixed point, we find that $R_X$ tends to a universal constant independent of the amount of dilution (no self averaging). However this constant is different for canonical and grand canonical disorder. We study the distribution of the pseudo-critical temperatures $T_c(i,l)$ of the ensemble defined as the temperatures of the maximum susceptibility of each sample. We find that its variance scales as $(\delta T_c(l))^2 \sim l^{-2/\nu}$ and NOT as $\sim l^{-d}. We find that$R_\chi$is reduced by a factor of$\sim 70$with respect to$R_\chi (T_c)$by measuring$\chi$of each sample at$T_c(i,l)$. We analyze correlations between the magnetization at criticality$m_i(T_c,l)$and the pseudo-critical temperature$T_c(i,l)$in terms of a sample independent finite size scaling function of a sample dependent reduced temperature$(T-T_c(i,l))/T_c$. This function is found to be universal and to behave similarly to pure systems.Comment: 31 pages, 17 figures, submitted to Phys. Rev.

Effective and Asymptotic Critical Exponents of Weakly Diluted Quenched Ising Model: 3d Approach Versus ϵ1/2\epsilon^{1/2}-Expansion

We present a field-theoretical treatment of the critical behavior of three-dimensional weakly diluted quenched Ising model. To this end we analyse in a replica limit n=0 5-loop renormalization group functions of the $\phi^4$-theory with O(n)-symmetric and cubic interactions (H.Kleinert and V.Schulte-Frohlinde, Phys.Lett. B342, 284 (1995)). The minimal subtraction scheme allows to develop either the $\epsilon^{1/2}$-expansion series or to proceed in the 3d approach, performing expansions in terms of renormalized couplings. Doing so, we compare both perturbation approaches and discuss their convergence and possible Borel summability. To study the crossover effect we calculate the effective critical exponents providing a local measure for the degree of singularity of different physical quantities in the critical region. We report resummed numerical values for the effective and asymptotic critical exponents. Obtained within the 3d approach results agree pretty well with recent Monte Carlo simulations. $\epsilon^{1/2}$-expansion does not allow reliable estimates for d=3.Comment: 35 pages, Latex, 9 eps-figures included. The reference list is refreshed and typos are corrected in the 2nd versio

Ising model on 3D random lattices: A Monte Carlo study

We report single-cluster Monte Carlo simulations of the Ising model on three-dimensional Poissonian random lattices with up to 128,000 approx. 503 sites which are linked together according to the Voronoi/Delaunay prescription. For each lattice size quenched averages are performed over 96 realizations. By using reweighting techniques and finite-size scaling analyses we investigate the critical properties of the model in the close vicinity of the phase transition point. Our random lattice data provide strong evidence that, for the available system sizes, the resulting effective critical exponents are indistinguishable from recent high-precision estimates obtained in Monte Carlo studies of the Ising model and \phi^4 field theory on three-dimensional regular cubic lattices.Comment: 35 pages, LaTex, 8 tables, 8 postscript figure

An exploration of the use of simple statistics to measure consensus and stability in Delphi studies

<p>Abstract</p> <p>Background</p> <p>The criteria for stopping Delphi studies are often subjective. This study aimed to examine whether consensus and stability in the Delphi process can be ascertained by descriptive evaluation of trends in participants' views.</p> <p>Methods</p> <p>A three round email-based Delphi required participants (n = 12) to verify their level of agreement with 8 statements, write comments on each if they considered it necessary and rank the statements for importance. Each statement was analysed quantitatively by the percentage of agreement ratings, importance rankings and the amount of comments made for each statement, and qualitatively using thematic analysis. Importance rankings between rounds were compared by calculating Kappa values to observe trends in how the process impacts on subject's views.</p> <p>Results</p> <p>Evolution of consensus was shown by increase in agreement percentages, convergence of range with standard deviations of importance ratings, and a decrease in the number of comments made. Stability was demonstrated by a trend of increasing Kappa values.</p> <p>Conclusion</p> <p>Following the original use of Delphi in social sciences, Delphi is suggested to be an effective way to gain and measure group consensus in healthcare. However, the proposed analytical process should be followed to ensure maximum validity of results in Delphi methodology for improved evidence of consensual decision-making.</p

Building consensus about eHealth in Slovene primary health care: Delphi study

<p>Abstract</p> <p>Background</p> <p>Slovenia's national eHealth strategy aims to develop an efficient, flexible and modern health care informatics framework that would be comparable to the most successful EU countries. To achieve this goal, the gap between availability and usage of information and communication technology by primary care physicians needs to be reduced.</p> <p>As recent efforts show, consensus on information and communication technology purpose and usage in primary care needs to be established before any national information and communication technology solutions are developed.</p> <p>The aim of this study was to identify the most appropriate measures in implementation of Slovene national eHealth strategy and to suggest an appropriate model for success by using the three round Delphi study.</p> <p>Methods</p> <p>An e-mail based, three-round Delphi study was undertaken to achieve consensus from a selected sample of nationally recognized experts from the fields of primary health care and medical informatics. The aim of this study was to identify the most appropriate measures and key obstacles in implementation of eHealth in Slovene primary health care by using the Delphi study.</p> <p>Results</p> <p>High levels of consensus on the majority of suggested measures were achieved among all study participants, as well as between the subgroups of experts from primary health care and medical informatics. All aims of the three-round Delphi study on eHealth implementation in Slovenian primary health care were achieved.</p> <p>Conclusions</p> <p>The three round decision Delphi process has proven to be effective for developing outcomes, ranking key priorities in primary care eHealth development, and achieving consensus among the most influential experts in that field. This consensus is an important contribution to future national eHealth strategies in the field of primary health care.</p