Screening for Future Cardiovascular Disease Using Age Alone Compared with Multiple Risk Factors and Age

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Skyrmions in a ferromagnetic Bose-Einstein condensate

The recently realized multicomponent Bose-Einstein condensates provide opportunities to explore the rich physics brought about by the spin degrees of freedom. For instance, we can study spin waves and phase separation, macroscopic quantum tunneling, Rabi oscillations, the coupling between spin gradients and superfluid flow, squeezed spin states, vortices and other topological excitations. Theoretically, there have been already some studies of the ground-state properties of these systems and their line-like vortex excitations. In analogy with nuclear physics or the quantum Hall effect, we explore here the possibility of observing point-like topological excitations or skyrmions. These are nontrivial spin textures that in principle can exist in a spinor Bose-Einstein condensate. In particular, we investigate the stability of skyrmions in a fictitious spin-1/2 condensate of Rb87 atoms. We find that skyrmions can exist in this case only as a metastable state, but with a lifetime of the order of, or even longer than, the typical lifetime of the condensate itself. In addition to determining the size and the lifetime of the skyrmion, we also present its spin texture and finally briefly consider its dynamical properties.Comment: 4 pages (REVtex), 3 PDF figures. See also cond-mat/000237

The dose-response relationship between cigarette consumption, biochemical markers and risk of lung cancer.

The relationship between the number of cigarettes smoked per day and the incidence of lung cancer is linear but, from the multistage model of carcinogenesis, it should be quadratic (upwards curving). We investigated this anomaly in a study of 11,403 male never smokers and current smokers in whom carboxyhaemoglobin (COHb) was measured in all and serum cotinine in 1175. The relationship between the biochemical markers and the reported number of cigarettes per day was approximately linear up to 20 cigarettes per day as expected. But above 20 cigarettes per day the marker levels increased less steeply and were 35% lower than expected in men who smoked more than 40 cigarettes per day. Less smoke is inhaled from each cigarette by men with high daily cigarette consumption than by men with lower consumption. Allowance for this transforms the observed linear dose-response relationship into one consistent with the expected quadratic relationship. The anomaly is explained by the observation that heavier smokers inhale less smoke from each cigarette

Abortion Safety and Use with Normally Prescribed Mifepristone in Canada.

BACKGROUND: In the United States, mifepristone is available for medical abortion (for use with misoprostol) only with Risk Evaluation and Mitigation Strategy (REMS) restrictions, despite an absence of evidence to support such restrictions. Mifepristone has been available in Canada with a normal prescription since November 2017. METHODS: Using population-based administrative data from Ontario, Canada, we examined abortion use, safety, and effectiveness using an interrupted time-series analysis comparing trends in incidence before mifepristone was available (January 2012 through December 2016) with trends after its availability without restrictions (November 7, 2017, through March 15, 2020). RESULTS: A total of 195,183 abortions were performed before mifepristone was available and 84,032 after its availability without restrictions. After the availability of mifepristone with a normal prescription, the abortion rate continued to decline, although more slowly than was expected on the basis of trends before mifepristone had been available (adjusted risk difference in time-series analysis, 1.2 per 1000 female residents between 15 and 49 years of age; 95% confidence interval [CI], 1.1 to 1.4), whereas the percentage of abortions provided as medical procedures increased from 2.2% to 31.4% (adjusted risk difference, 28.8 percentage points; 95% CI, 28.0 to 29.7). There were no material changes between the period before mifepristone was available and the nonrestricted period in the incidence of severe adverse events (0.03% vs. 0.04%; adjusted risk difference, 0.01 percentage points; 95% CI, -0.06 to 0.03), complications (0.74% vs. 0.69%; adjusted risk difference, 0.06 percentage points; 95% CI, -0.07 to 0.18), or ectopic pregnancy detected after abortion (0.15% vs. 0.22%; adjusted risk difference, -0.03 percentage points; 95% CI, -0.19 to 0.09). There was a small increase in ongoing intrauterine pregnancy continuing to delivery (adjusted risk difference, 0.08 percentage points; 95% CI, 0.04 to 0.10). CONCLUSIONS: After mifepristone became available as a normal prescription, the abortion rate remained relatively stable, the proportion of abortions provided by medication increased rapidly, and adverse events and complications remained stable, as compared with the period when mifepristone was unavailable. (Funded by the Canadian Institutes of Health Research and the Women's Health Research Institute.)

Socioeconomic deprivation, urban-rural location and alcohol-related mortality in England and Wales

Background: Many causes of death are directly attributable to the toxic effects of alcohol and deaths from these causes are increasing in the United Kingdom. The aim of this study was to investigate variation in alcohol-related mortality in relation to socioeconomic deprivation, urban-rural location and age within a national context. Methods: An ecological study design was used with data from 8797 standard table wards in England and Wales. The methodology included using the Carstairs Index as a measure of socioeconomic deprivation at the small-area level and the national harmonised classification system for urban and rural areas in England and Wales. Alcohol-related mortality was defined using the National Statistics definition, devised for tracking national trends in alcohol-related deaths. Deaths from liver cirrhosis accounted for 85% of all deaths included in this definition. Deaths from 1999-2003 were examined and 2001 census ward population estimates were used as the denominators. Results: The analysis was based on 28,839 deaths. Alcohol-related mortality rates were higher in men and increased with increasing age, generally reaching peak levels in middle-aged adults. The 45-64 year age group contained a quarter of the total population but accounted for half of all alcohol-related deaths. There was a clear association between alcohol-related mortality and socioeconomic deprivation, with progressively higher rates in more deprived areas. The strength of the association varied with age. Greatest relative inequalities were seen amongst people aged 25-44 years, with relative risks of 4.73 (95% CI 4.00 to 5.59) and 4.24 (95% CI 3.50 to 5.13) for men and women respectively in the most relative to the least deprived quintiles. People living in urban areas experienced higher alcohol-related mortality relative to those living in rural areas, with differences remaining after adjustment for socioeconomic deprivation. Adjusted relative risks for urban relative to rural areas were 1.35 (95% CI 1.20 to 1.52) and 1.13 (95% CI 1.01 to 1.25) for men and women respectively. Conclusions: Large inequalities in alcohol-related mortality exist between sub-groups of the population in England and Wales. These should be considered when designing public health policies to reduce alcohol-related harm

Coherent spinor dynamics in a spin-1 Bose condensate

Collisions in a thermal gas are perceived as random or incoherent as a consequence of the large numbers of initial and final quantum states accessible to the system. In a quantum gas, e.g. a Bose-Einstein condensate or a degenerate Fermi gas, the phase space accessible to low energy collisions is so restricted that collisions be-come coherent and reversible. Here, we report the observation of coherent spin-changing collisions in a gas of spin-1 bosons. Starting with condensates occupying two spin states, a condensate in the third spin state is coherently and reversibly created by atomic collisions. The observed dynamics are analogous to Josephson oscillations in weakly connected superconductors and represent a type of matter-wave four-wave mixing. The spin-dependent scattering length is determined from these oscillations to be -1.45(18) Bohr. Finally, we demonstrate coherent control of the evolution of the system by applying differential phase shifts to the spin states using magnetic fields.Comment: 19 pages, 3 figure

Tempering The Enforcement With Law: A Model Of Diarchic Leadership For Ensuring Legalist Superintendence In Law Enforcement Agencies

Rule of law necessitates its due and precise enforcement without any excesses. This paper conceptually analyses the existing and prevalent system of law enforcement and the fallacies therein, including the post facto nature of remedies to violations. The structure of various law enforcement authorities is also considered including direct democratic leadership. The jurisprudence that has arisen with respect to policing reforms is specifically considered to analyse the direction in which a transformational systemic change can be envisioned. The fallacies in the post facto remedies offered through conventional fora like courts, ombudsmen, etc. are analysed to conceive an independent authority within the leadership itself for prevention of violations and excesses. It is proposed to suggest a juridical check to reduce the possibility and extent of misapplication and abuse of power by law enforcement agencies. The suggested remedy is to replace the monarchic politico-civil leadership with a diarchic leadership consisting of an executive officer and an independent judicial officer. The partial juridical superintendence of the law enforcement agency is expected to ensure the legal basis of operations as well as bettering the performance of the agency at large. Reliance is placed on the niche that the judiciary has carved up for itself in upholding the Rule of law, through a cadre of committed judicial servants. It is proposed to co-opt judicial servants into the management of law enforcement agencies. The possibility of conflicts within the diarchic executive is also considered and discussed, along with the possible limitations of the same. The Roman diarchic executive is modelled as an example for designing balanced leadership for law enforcement. The constructive friction that might arise out of diarchic executive is desirable to ensure balanced management and minimal violations of rule of law

Interpreting standardized and idiographic outcome measures in CAMHS: What does change mean and how does it relate to functioning and experience?

Patient Reported Outcome Measures (PROMs) are increasingly being used in Child and Adolescent Mental Health Services (CAMHS). The aim of the present research was to explore change in standardized and idiographic outcome measures in CAMHS using naturalistic, routinely collected data. We explored change in psychosocial difficulties and impact on daily life as evaluated by a broad standardised measure, the Strengths and Difficulties Questionnaire (SDQ) (Goodman, 1997), and progress toward goals as evaluated by a personalised idiographic measure, the Goal Based Outcomes tool (GBO) (Law, 2011) in a sample of N = 137 CAMHS attenders. Psychosocial difficulties and impact on daily life showed less change over the course of treatment than progress toward goals in the present study. Change in psychosocial difficulties and impact on daily life also showed fewer significant associations with change in clinician-reported functioning and satisfaction with care at time two than change in progress toward goals. Findings of the present research may support previous studies in which service users and clinicians report that idiographic measures are more capable than standardised measures of capturing relevant change for individuals

Analyzing Recent Coronary Heart Disease Mortality Trends in Tunisia between 1997 and 2009.

BACKGROUND: In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing. OBJECTIVE: To explain recent CHD trends in Tunisia between 1997 and 2009. METHODS: DATA SOURCES: Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys. ANALYSIS: Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (i)number of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina)(ii) uptake of specific medical and surgical treatments, and(iii) population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP), body mass index (BMI), diabetes and physical inactivity). RESULTS: CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98%) of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L) generated 440 additional deaths. In women, a fall (-0.43 mmol/L), apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg) generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI) (95 fewer deaths), initial AMI treatments (90), antihypertensive medications (80) and unstable angina (75). CONCLUSIONS: Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and cholesterol, BMI and diabetes. Current prevention strategies are mainly focused on treatments but should become more comprehensive