Guest Editorial Cardiovascular Health Informatics: Risk Screening and Intervention

Despite enormous efforts to prevent cardiovascular disease (CVD) in the past, it remains the leading cause of death in most countries worldwide. Around two-thirds of these deaths are due to acute events, which frequently occur suddenly and are often fatal beforemedical care can be given. New strategies for screening and early intervening CVD, in addition to the conventional methods, are therefore needed in order to provide personalized and pervasive healthcare. In this special issue, selected emerging technologies in health informatics for screening and intervening CVDs are reported. These papers include reviews or original contributions on 1) new potential genetic biomarkers for screening CVD outcomes and high-throughput techniques for mining genomic data; 2) new imaging techniques for obtaining faster and higher resolution images of cardiovascular imaging biomarkers such as the cardiac chambers and atherosclerotic plaques in coronary arteries, as well as possible automatic segmentation, identification, or fusion algorithms; 3) new physiological biomarkers and novel wearable and home healthcare technologies for monitoring them in daily lives; 4) new personalized prediction models of plaque formation and progression or CVD outcomes; and 5) quantifiable indices and wearable systems to measure them for early intervention of CVD through lifestyle changes. It is hoped that the proposed technologies and systems covered in this special issue can result in improved CVD management and treatment at the point of need, offering a better quality of life to the patient

Novel imaging and quality assurance techniques for ion beam therapy: a Monte Carlo study

Ion beams exhibit a finite and well defined range in matter together with an “inverted” depth-dose profile, the so-called Bragg peak. These favourable physical properties may enable superior tumour-dose conformality for high precision radiation therapy. On the other hand, they introduce the issue of sensitivity to range uncertainties in ion beam therapy. Although these uncertainties are typically taken into account when planning the treatment, correct delivery of the intended ion beam range has to be assured to prevent undesired underdosage of the tumour or overdosage of critical structures outside the target volume. Therefore, it is necessary to define dedicated Quality Assurance procedures to enable in-vivo range verification before or during therapeutic irradiation. For these purposes, Monte Carlo transport codes are very useful tools to support the development of novel imaging modalities for ion beam therapy. In the present work, we present calculations performed with the FLUKA Monte Carlo code and preliminary experimental studies

Evaluation of the surface strength of glass plates shaped by hot slumping process

The Hot Slumping Technology is under development by several research groups in the world for the realization of grazing-incidence segmented mirrors for X-ray astronomy, based on thin glass plates shaped over a mould at temperatures above the transformation point. The performed thermal cycle and related operations might have effects on the strength characteristics of the glass, with consequences on the structural design of the elemental optical modules and consecutively on the entire X-ray optic for large astronomical missions like IXO and ATHENA. The mechanical strength of glass plates after they underwent the slumping process was tested through destructive double-ring tests in the context of a study performed by the Astronomical Observatory of Brera with the collaboration of Stazione Sperimentale del Vetro and BCV Progetti. The entire study has been realized on more than 200 D263 Schott borosilicate glass specimens of dimension 100 mm x 100 mm and thickness 0.4 mm, either flat or bent at a Radius of Curvature of 1000 mm through the particular pressure assisted hot slumping process developed by INAF-OAB. The collected experimental data have been compared to non-linear FEM analyses and treated with Weibull statistic to assess the current IXO glass X-ray telescope design, in terms of survival probability, when subject to static and acoustic loads characteristic of the launch phase. The paper describes the activities performed and presents the obtained results.Comment: Accepted for publication in Optical Enginnering (Jun 26, 2014

Well-posedness of the Ericksen-Leslie system

In this paper, we prove the local well-posedness of the Ericksen-Leslie system, and the global well-posednss for small initial data under the physical constrain condition on the Leslie coefficients, which ensures that the energy of the system is dissipated. Instead of the Ginzburg-Landau approximation, we construct an approximate system with the dissipated energy based on a new formulation of the system.Comment: 16 page

ARTreat Project: Three-Dimensional Numerical Simulation of Plaque Formation and Development in the Arteries

Atherosclerosis is a progressive disease characterized by the accumulation of lipids and fibrous elements in arteries. It is characterized by dysfunction of endothelium and vasculitis, and accumulation of lipid, cholesterol, and cell elements inside blood vessel wall. In this study, a continuum-based approach for plaque formation and development in 3-D is presented. The blood flow is simulated by the 3-D Navier-Stokes equations, together with the continuity equation while low-density lipoprotein (LDL) transport in lumen of the vessel is coupled with Kedem-Katchalsky equations. The inflammatory process was solved using three additional reaction-diffusion partial differential equations. Transport of labeled LDL was fitted with our experiment on the rabbit animal model. Matching with histological data for LDL localization was achieved. Also, 3-D model of the straight artery with initial mild constriction of 30% plaque for formation and development is presented

Multiscale - Patient-Specific Artery and Atherogenesis Models

In this work, we present a platform for the development of multiscale patient-specific artery and atherogenesis models. The platform, called ARTool, integrates technologies of 3-D image reconstruction from various image modalities, blood flow and biological models of mass transfer, plaque characterization, and plaque growth. Patient images are acquired for the development of the 3-D model of the patient specific arteries. Then, blood flow ismodeled within the arterial models for the calculation of the wall shear stress distribution (WSS). WSS is combined with other patient-specific parameters for the development of the plaque progression models. Real-time simulation can be performed for same cases in grid environment. The platform is evaluated using both animal and human data

Genetic Variants of the Renin-Angiotensin-Aldosterone System and Reverse Remodeling After Cardiac Resynchronization Therapy

Background: Reverse remodeling (RR) after cardiac resynchronization therapy (CRT) is associated with favorable clinical outcomes in heart failure (HF). The renin-angiotensin-aldosterone system (RAAS) is involved in the remodeling process. Methods and Results: We assessed the association between RR and 8 common RAAS gene variants, which were determined by TaqMan assays, in 156 outpatients with chronic HF. RR was defined as a O15% decrease in left ventricular end systolic volume (LVESV) at 9 (interquartile range 7e12) months after CRT. We matched 76 patients who did not show RR (RR) to 80 RR? control subjects by age, sex, HF etiology, New York Heart Association (NYHA) functional class and left ventricular ejection fraction (LVEF). The frequency of the minor allele of the NR3C2 gene (rs5522 C/T), encoding the mineralocorticoid receptor, was higher in RR than in RR (24/126 vs 10/150; P value after false discovery rate correction: <.0193). Conversely, LVESV decreased significantly less after CRT in carriers of the NR3C2 minor C allele (P 5 .02). After adjustment for age, sex, NYHA functional class, previous myocardial infarction, atrial fibrillation, and LVEF, RR remained independently associated with NR3C2 C allele carriage (odds ratio 3.093, 95% confidence interval 1.253e7.632). Conclusions: The association of RR after CRT with a common polymorphism in the mineralocorticoid receptor gene involved in aldosterone signaling suggests a possible role for variants in RAAS genes in progressive LV function decline, despite apparently effective CRT

Elective Open Suprarenal Aneurysm Repair in England from 2000 to 2010 an Observational Study of Hospital Episode Statistics

Background: Open surgery is widely used as a benchmark for the results of fenestrated endovascular repair of complex abdominal aortic aneurysms (AAA). However, the existing evidence stems from single-centre experiences, and may not be reproducible in wider practice. National outcomes provide valuable information regarding the safety of suprarenal aneurysm repair. Methods: Demographic and clinical data were extracted from English Hospital Episodes Statistics for patients undergoing elective suprarenal aneurysm repair from 1 April 2000 to 31 March 2010. Thirty-day mortality and five-year survival were analysed by logistic regression and Cox proportional hazards modeling. Results: 793 patients underwent surgery with 14% overall 30-day mortality, which did not improve over the study period. Independent predictors of 30-day mortality included age, renal disease and previous myocardial infarction. 5-year survival was independently reduced by age, renal disease, liver disease, chronic pulmonary disease, and known metastatic solid tumour. There was significant regional variation in both 30-day mortality and 5-year survival after risk-adjustment. Regional differences in outcome were eliminated in a sensitivity analysis for perioperative outcome, conducted by restricting analysis to survivors of the first 30 days after surgery. Conclusions: Elective suprarenal aneurysm repair was associated with considerable mortality and significant regional variation across England. These data provide a benchmark to assess the efficacy of complex endovascular repair of supra-renal aneurysms, though cautious interpretation is required due to the lack of information regarding aneurysm morphology. More detailed study is required, ideally through the mandatory submission of data to a national registry of suprarenal aneurysm repair

Different gene expression modulation is the major effect fue to shear stress and stent application in huvecs model: preliminary results

Although it is known that disturbed shear stress may cause endothelial damage, the mechanism by which a stent procedure may affect the endothelium is not yet fully clarify. We present the preliminary data on gene expression analysis of human endothelial cells in a laminar flow bioreactor (LFB) system submitted to different physical (flow changes) and/or mechanical (stent application) stimuli. Our preliminary results show that low shear stress together with stent procedure are the experimental conditions that mainly modulate the highest number of genes in human endothelial model. Those genes belong to pathways specifically involved in the endothelial dysfunctio