Improving the cost effectiveness equation of cascade testing for Familial Hypercholesterolaemia (FH)

Purpose of Review : Many International recommendations for the management of Familial Hypercholesterolaemia (FH) propose the use of Cascade Testing (CT) using the family mutation to unambiguously identify affected relatives. In the current economic climate DNA information is often regarded as too expensive. Here we review the literature and suggest strategies to improve cost effectiveness of CT. Recent findings : Advances in next generation sequencing have both speeded up the time taken for a genetic diagnosis and reduced costs. Also, it is now clear that, in the majority of patients with a clinical diagnosis of FH where no mutation can be found, the most likely cause of their elevated LDL-cholesterol (LDL-C) is because they have inherited a greater number than average of common LDL-C raising variants in many different genes. The major cost driver for CT is not DNA testing but of treatment over the remaining lifetime of the identified relative. With potent statins now off-patent, the overall cost has reduced considerably, and combining these three factors, a FH service based around DNA-CT is now less than 25% of that estimated by NICE in 2009. Summary : While all patients with a clinical diagnosis of FH need to have their LDL-C lowered, CT should be focused on those with the monogenic form and not the polygenic form

Biases in prime factorizations and Liouville functions for arithmetic progressions

We introduce a refinement of the classical Liouville function to primes in arithmetic progressions. Using this, we discover new biases in the appearances of primes in a given arithmetic progression in the prime factorizations of integers. For example, we observe that the primes of the form $4k+1$ tend to appear an even number of times in the prime factorization of a given integer, more so than for primes of the form $4k+3$. We are led to consider variants of P\'olya's conjecture, supported by extensive numerical evidence, and its relation to other conjectures.Comment: 25 pages, 6 figure

Development of an improved protective cover/light block for multilayer insulation

The feasibility of using a scrim-reinforced, single metallized, 4-mil Tedlar film as a replacement for the Teflon coated Beta-cloth/single metallized 3-mil Kapton film presently used as the protective cover/light block for multilayer insulation (MLI) on the Orbiter, Spacelab, and other space applications was demonstrated. The proposed Tedlar concept is lighter and potentially lower in cost. Thermal analysis with the proper concept was much simpler than with the present system. Tests have already demonstrated that white Tedlar has low alpha (adsorption) degradation in space from U.V. The proposed concept was 4400 percent cheaper with nominal weight savings of 50 percent

Sounds Like a Spy Story : The Espionage Thrillers of Alfred Hitchcock in Twentieth-Century English and American Society, from The Man Who Knew Too Much (1934) to Topaz (1969)

Throughout a career that lasted for almost half a century, Sir Alfred Hitchcock (1899-1980) directed fifty-three feature films, many of which are still watched and regarded today as epitomes of classic English and American film. One of his most revisited genres is the espionage thriller, which compromises twelve out of the fifty-three films he directed in England and the United States and includes two short films. In analyzing fourteen films, beginning with the English-made The Man Who Knew Too Much (1934) and concluding with the American Topaz (1969), this paper argues that Hitchcock\u27s spy thrillers are products of their time and reflect the sentiments and fears of English and American societies before and during World War II, as well as during the Cold War. However, although the espionage thrillers reinforce and utilize the politics of their times, they are not one-sided in their politics or ideals, and they speak to bigger questions of human morality

Leveraged ETFs: The Trojan Horse Has Passed the Margin-Rule Gates

What do the Great Depression, the Great Recession, and the demise of Lehman Brothers and Bear Sterns all have in common? One word: leverage. The misuse of leverage, in all its forms, contributed greatly to all of these events. Yet even today, common investors can purchase a leveraged exchange-traded fund (leveraged ETF), a complex product that uses leverage to increase returns, without triggering applicable laws designed to regulate the use of leverage. This Comment articulates the basics surrounding the functions and operations of leveraged ETFs and margin rules in order to assess the compatibility of the two. The Comment argues that leveraged ETFs should be limited or prohibited because they contravene the purposes of the long-established margin rules set in place to protect the market and investors

Improving the tensile strength of carbon nanotube spun yarns using a modified spinning process

A modified process for the dry spinning of carbon nanotube (CNT) yarn is reported. The approach gives an improved structure of CNT bundles in the web drawn from the CNT forest and in the yarn produced from the twisted web leading to improved mechanical properties of the yarn. The process enables many different mechanical and physical treatments to be applied to the individual stages of the pure CNT spinning system, and may allow potential for the development of complex spinning processes such as polymer–CNT-based composite yarns. The tensile strength and yarn/web structure of yarn spun using this approach have been investigated and evaluated using standard tensile testing methods along with scanning electron microscopy. The experimental results show that the tensile properties were significantly improved. The effect of heat treatments and other yarn constructions on the tensile properties are also reported