ECG Morphological Variability in Beat Space for Risk Stratification After Acute Coronary Syndrome

Background: Identification of patients who are at high risk of adverse cardiovascular events after an acute coronary syndrome (ACS) remains a major challenge in clinical cardiology. We hypothesized that quantifying variability in electrocardiogram (ECG) morphology may improve risk stratification post‐ACS. Methods and Results: We developed a new metric to quantify beat‐to‐beat morphologic changes in the ECG: morphologic variability in beat space (MVB), and compared our metric to published ECG metrics (heart rate variability [HRV], deceleration capacity [DC], T‐wave alternans, heart rate turbulence, and severe autonomic failure). We tested the ability of these metrics to identify patients at high risk of cardiovascular death (CVD) using 1082 patients (1‐year CVD rate, 4.5%) from the MERLIN‐TIMI 36 (Metabolic Efficiency with Ranolazine for Less Ischemia in Non‐ST‐Elevation Acute Coronary Syndrome—Thrombolysis in Myocardial Infarction 36) clinical trial. DC, HRV/low frequency–high frequency, and MVB were all associated with CVD (hazard ratios [HRs] from 2.1 to 2.3 [P<0.05 for all] after adjusting for the TIMI risk score [TRS], left ventricular ejection fraction [LVEF], and B‐type natriuretic peptide [BNP]). In a cohort with low‐to‐moderate TRS (N=864; 1‐year CVD rate, 2.7%), only MVB was significantly associated with CVD (HR, 3.0; P=0.01, after adjusting for LVEF and BNP). Conclusions: ECG morphological variability in beat space contains prognostic information complementary to the clinical variables, LVEF and BNP, in patients with low‐to‐moderate TRS. ECG metrics could help to risk stratify patients who might not otherwise be considered at high risk of CVD post‐ACS

The Geometry and Moduli of K3 Surfaces

These notes will give an introduction to the theory of K3 surfaces. We begin with some general results on K3 surfaces, including the construction of their moduli space and some of its properties. We then move on to focus on the theory of polarized K3 surfaces, studying their moduli, degenerations and the compactification problem. This theory is then further enhanced to a discussion of lattice polarized K3 surfaces, which provide a rich source of explicit examples, including a large class of lattice polarizations coming from elliptic fibrations. Finally, we conclude by discussing the ample and Kahler cones of K3 surfaces, and give some of their applications.Comment: 34 pages, 2 figures. (R. Laza, M. Schutt and N. Yui, eds.

Classical and quantum chaos in a circular billiard with a straight cut

We study classical and quantum dynamics of a particle in a circular billiard with a straight cut. This system can be integrable, nonintegrable with soft chaos, or nonintegrable with hard chaos, as we vary the size of the cut. We use a quantum web to show differences in the quantum manifestations of classical chaos for these three different regimes.Comment: LaTeX2e, 8 pages including 3 Postscript figures and 4 GIF figures, submitted to Phys. Rev.

Relationship between the unbinding and main transition temperatures of phospholipid bilayers under pressure

Using neutron diffraction and a specially constructed high pressure cell suitable for aligned multibilayer systems, we have studied, as a function of pressure, the much observed anomalous swelling regime in dimyristoyl- and dilauroyl-phosphatidylcholine bilayers, DMPC and DLPC, respectively. We have also reanalyzed data from a number of previously published experiments and have arrived at the following conclusions. (a) The power law behavior describing anomalous swelling is preserved in all PC bilayers up to a hydrostatic pressure of 240 MPa. (b) As a function of increasing pressure there is a concomitant decrease in the anomalous swelling of DMPC bilayers. (c) For PC lipids with hydrocarbon chains ≥13 carbons the theoretical unbinding transition temperature T* is coupled to the main gel-to-liquid crystalline transition temperature TM. (d) DLPC is intrinsically different from the other lipids studied in that its T* is not coupled to TM. (e) For DLPC bilayers we predict a hydrostatic pressure (&gt;290MPa) where unbinding may occur

A socioecological approach to children’s experiences of violence: Evidence from Young Lives

The scale and extent of violence towards children in different settings is increasingly well documented. However, few studies have attempted to draw on children’s perspectives to understand the linkages between forms of violence, as well as the factors that contribute to, and sustain, violence. We draw together findings from a collaborative project between UNICEF Office of Research–Innocenti and Young Lives, a 15-year longitudinal cohort study of children growing up in poverty in Ethiopia, India, Peru and Vietnam. This paper highlights findings relating to (1) the importance of understanding the contexts of children’s lives in relation to violence, (2) the ways in which violence is often underpinned by poverty that places pressure on families and communities, (3) the ways in which violence reflects and reinforces social norms and (4) how children’s experiences and their responses to violence are shaped by intersecting inequalities according to age, gender and the wider social and economic context

The association between family and community social capital and health risk behaviours in young people: an integrative review

Background: Health risk behaviours known to result in poorer outcomes in adulthood are generally established in late childhood and adolescence. These ‘risky’ behaviours include smoking, alcohol and illicit drug use and sexual risk taking. While the role of social capital in the establishment of health risk behaviours in young people has been explored, to date, no attempt has been made to consolidate the evidence in the form of a review. Thus, this integrative review was undertaken to identify and synthesise research findings on the role and impact of family and community social capital on health risk behaviours in young people and provide a consolidated evidence base to inform multi-sectorial policy and practice.&lt;p&gt;&lt;/p&gt; Methods: Key electronic databases were searched (i.e. ASSIA, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Embase, Medline, PsycINFO, Sociological Abstracts) for relevant studies and this was complemented by hand searching. Inclusion/exclusion criteria were applied and data was extracted from the included studies. Heterogeneity in study design and the outcomes assessed precluded meta-analysis/meta-synthesis; the results are therefore presented in narrative form.&lt;p&gt;&lt;/p&gt; Results: Thirty-four papers satisfied the review inclusion criteria; most were cross-sectional surveys. The majority of the studies were conducted in North America (n=25), with three being conducted in the UK. Sample sizes ranged from 61 to 98,340. The synthesised evidence demonstrates that social capital is an important construct for understanding the establishment of health risk behaviours in young people. The different elements of family and community social capital varied in terms of their saliency within each behavioural domain, with positive parent–child relations, parental monitoring, religiosity and school quality being particularly important in reducing risk.&lt;p&gt;&lt;/p&gt; Conclusions: This review is the first to systematically synthesise research findings about the association between social capital and health risk behaviours in young people. While providing evidence that may inform the development of interventions framed around social capital, the review also highlights key areas where further research is required to provide a fuller account of the nature and role of social capital in influencing the uptake of health risk behaviours.&lt;p&gt;&lt;/p&gt

Assessing the psychometric and ecometric properties of neighborhood scales using adolescent survey data from urban and rural Scotland

This work was supported by NHS Health Scotland and the University of St Andrews.Background:  Despite the well-established need for specific measurement instruments to examine the relationship between neighborhood conditions and adolescent well-being outcomes, few studies have developed scales to measure features of the neighborhoods in which adolescents reside. Moreover, measures of neighborhood features may be operationalised differently by adolescents living in different levels of urban/rurality. This has not been addressed in previous studies. The objectives of this study were to: 1) establish instruments to measure adolescent neighborhood features at both the individual and neighborhood level, 2) assess their psychometric and ecometric properties, 3) test for invariance by urban/rurality, and 4) generate neighborhood level scores for use in further analysis. Methods:  Data were from the Scottish 2010 Health Behaviour in School-aged Children Survey, which included an over-sample of rural adolescents. The survey responses of interest came from questions designed to capture different facets of the local area in which each respondent resided. Intermediate data zones were used as proxies for neighborhoods. Internal consistency was evaluated by Cronbach’s alpha. Invariance was examined using confirmatory factor analysis. Multilevel models were used to estimate ecometric properties and generate neighborhood scores. Results:  Two constructs labeled neighborhood social cohesion and neighborhood disorder were identified. Adjustment was made to the originally specified model to improve model fit and measures of invariance. At the individual level, reliability was .760 for social cohesion and .765 for disorder, and between .524 and .571 for both constructs at the neighborhood level. Individuals in rural areas experienced greater neighborhood social cohesion and lower levels of neighborhood disorder compared with those in urban areas. Conclusions:  The scales are appropriate for measuring neighborhood characteristics experienced by adolescents across urban and rural Scotland, and can be used in future studies of neighborhoods and health. However, trade-offs between neighborhood sample size and reliability must be considered.Publisher PDFPeer reviewe

A general scheme for the effective-mass Schrodinger equation and the generation of the associated potentials

A systematic procedure to study one-dimensional Schr\"odinger equation with a position-dependent effective mass (PDEM) in the kinetic energy operator is explored. The conventional free-particle problem reveals a new and interesting situation in that, in the presence of a mass background, formation of bound states is signalled. We also discuss coordinate-transformed, constant-mass Schr\"odinger equation, its matching with the PDEM form and the consequent decoupling of the ambiguity parameters. This provides a unified approach to many exact results known in the literature, as well as to a lot of new ones.Comment: 16 pages + 1 figure; minor changes + new "free-particle" problem; version published in Mod. Phys. Lett.

Childrens friendships in super-diverse localities: Encounters with social and ethnic difference

This article explores how children make, manage, or avoid friendships in super-diverse primary school settings. We draw on interviews and pictorial data from 78 children, aged 8–9 years across three local London primary schools to identify particular friendship groupings and the extent to which they followed existing patterns of social division. Children in the study did recognise social and cultural differences, but their friendship perceptions, affections, conflicts and practices meant that the way in which difference impacted relationships was partial and unstable. Friendship practices in the routine settings of school involved interactions across difference, but also entrenchments around similarity

Ethical and methodological issues in engaging young people living in poverty with participatory research methods

This paper discusses the methodological and ethical issues arising from a project that focused on conducting a qualitative study using participatory techniques with children and young people living in disadvantage. The main aim of the study was to explore the impact of poverty on children and young people's access to public and private services. The paper is based on the author's perspective of the first stage of the fieldwork from the project. It discusses the ethical implications of involving children and young people in the research process, in particular issues relating to access and recruitment, the role of young people's advisory groups, use of visual data and collection of data in young people's homes. The paper also identifies some strategies for addressing the difficulties encountered in relation to each of these aspects and it considers the benefits of adopting participatory methods when conducting research with children and young people