European Society of Cardiology: Cardiovascular Disease Statistics 2019

Aims The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. Methods and results In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5–23.1%] vs. 15.7% (IQR 14.5–21.1%)}, diabetes [7.7% (IQR 7.1–10.1%) vs. 5.6% (IQR 4.8–7.0%)], and among males smoking [43.8% (IQR 37.4–48.0%) vs. 26.0% (IQR 20.9–31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0–10.8) vs. 16.7% (IQR 13.9–19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655–8115)] compared with high-income [2235 (IQR 1896–3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. Conclusion A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest

Exploring the possibilities of speech synthesis with Dutch diphones

No abstract

Perception of familiar contrasts in unfamiliar positions

Contains fulltext : 55988.pdf (publisher's version ) (Open Access)This paper investigates the perception of non-native phoneme contrasts which exist in the native language, but not in the position tested. Like English, Dutch contrasts voiced and voiceless obstruents. Unlike English, Dutch allows only voiceless obstruents in word-final position. Dutch and English listeners' accuracy on English final voicing contrasts and their use of preceding vowel duration as a voicing cue were tested. The phonetic structure of Dutch should provide the necessary experience for a native-like use of this cue. Experiment 1 showed that Dutch listeners categorized English final /zee/-/ess/, /vee/-/eff/, /bee/-/pee/, and /dee/-/tee/ contrasts in nonwords as accurately as initial contrasts, and as accurately as English listeners did, even when release bursts were removed. In experiment 2, English listeners used vowel duration as a cue for one final contrast, although it was uninformative and sometimes mismatched other voicing characteristics, whereas Dutch listeners did not. Although it should be relatively easy for them, Dutch listeners did not use vowel duration. Nevertheless, they attained native-like accuracy, and sometimes even outperformed the native listeners who were liable to be misled by uninformative vowel duration information. Thus, native-like use of cues for non-native but familiar contrasts in unfamiliar positions may hardly ever be attained