Comparing primary prevention with secondary prevention to explain decreasing Coronary Heart Disease death rates in Ireland, 1985-2000.

BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking

Registration of Ultrasound Images Using an Information-Theoretic Feature Detector

In this paper, we present a new method for ultrasound image registration. For each image to be registered, our method first applies an ultrasound-specific information-theoretic feature detector, which is based on statistical modeling of speckle and provides a feature image that robustly delineates important edges in the image. These feature images are then registered using differential equations, the solution of which provides a locally optimal transformation that brings the images into alignment. We describe our method and present experimental results demonstrating its effectiveness, particularly for low contrast, speckled images. Furthermore, we compare our method to standard gradient-based techniques, which we show are more susceptible to misregistration

An information-theoretic detector based scheme for registration of speckled medical images

Several studies dealt with medical ultrasound registration. Their similarity metrics relied on pixel-to-pixel intensity comparisons. Hence, they are not well suited to the case of speckled images. To better handle the speckle noise, our previous work proposed an information-theoretic feature detector-based registration approach. This work aims to extend it to the cases where the image speckle model is Rayleigh or normalized Fisher-Tippett distributed. Using speckle modeling based on these distributions, a speckle-specific information- theoretic feature detector is constructed and applied to provide feature images. Those feature images are then registered using differential equations, the solution of which provides a transformation to bring the images into alignment. Compared to standard gradient-based techniques, the experimental results demonstrate the effectiveness of our method, particularly for low contrast ultrasound images

Design and Realization of a Fully On-Chip High-Q Resonator at 15 GHz on Silicon

Cataloged from PDF version of article.We develop and demonstrate an on-chip resonator working at 15 GHz with a high quality factor (Q-factor) of 93.81 while only requiring a small chip size of 195 mu m x 195 mu m on Si by using our new design methodology. In our design, unlike previous approaches, we avoid the need for any external capacitance for tuning; instead, we utilize the film capacitance as the capacitor of the LC tank circuit and realize a fully on-chip resonator that shows a strong transmission dip of > 30 dB on resonance as required for telemetric-sensing applications. We present the design, theory, methodology, microfabrication, experimental characterization, and theoretical analysis of these resonators. We also demonstrate that the experimental results are in excellent agreement with the theoretical (both analytical and numerical) results. Based on our proof-of-concept demonstration, such high-Q on-chip resonators hold great promise for use in transmissive telemetric sensors

Waveguiding and photoluminescence in Er³⁺-doped Ta₂O₅ planar waveguides

The optimization of erbium-doped Ta2O5 thin film waveguides deposited by magnetron sputtering onto thermally oxidized silicon wafer is described. Optical constants of the film were determined by ellipsometry. For the slab waveguides, background losses below 0.4dB/cm at 633nm have been obtained before post-annealing. The samples, when pumped at 980nm yielded abroad photoluminescence spectrum (FWHM ~50 nm) centred at 1534nm, corresponding to 4 I 13/2 to the 4 I 15/2 transition of Er3+ ion. The samples were annealed up to 600 °C and both photoluminescence power and fluorescence lifetime increase with post-annealing temperature and a fluorescence lifetime of 2.4ms was achieved, yielding promising results for compact waveguide amplifier

First Report of the Simulation Optimization Group

This is the first report of the ATLAS Simulation Optimization Group, established in June of 2007. This article justifies the selected Geant4 version, physics list, and range cuts to be used by the default ATLAS simulation for initial data taking and beyond. The current status of several projects, including detector description, simulation validation, studies of additional Geant4 parameters, and cavern background, are reported

Amniotic fluid-derived stem cells for cardiovascular tissue engineering applications

Recent research has demonstrated that a population of stem cells can be isolated from amniotic fluid removed by amniocentesis that are broadly multipotent and non-tumorogenic. These amniotic fluid-derived stem cells (AFSC) could potentially provide an autologous cell source for treatment of congenital defects identified during gestation, particularly cardiovascular defects. In this review, the various methods of isolating, sorting and culturing AFSC are compared, along with techniques for inducing differentiation into cardiac myocytes and endothelial cells. Though research has not demonstrated complete and high yield cardiac differentiation, AFSC have been shown to effectively differentiate into endothelial cells and can effectively support cardiac tissue. Additionally, several tissue engineering and regenerative therapeutic approaches for the use of these cells in heart patches, injection after myocardial infarction, heart valves, vascularized scaffolds and blood vessels are summarized. These applications show great promise in the treatment of congenital cardiovascular defects, and further studies of isolation, culture, and differentiation of AFSC will help to develop their use for tissue engineering, regenerative medicine, and cardiovascular therapies

The importance of carotid artery stiffness and increased intima-media thickness in obese children

Background. Atherosclerosis that starts in childhood invariably advances during adulthood. Aim. We aimed to study the effect of obesity on main carotid artery intima-media thickness and arterial stiffness. Material and methods. A total of 78 children were studied from October 2010 to February 2011. They were divided into obese (42 – group 1) and normal (36 – group 2). All the children were subjected to physical examination, routine biochemical and haematological analysis, carotid ultrasonography and echocardiographic measurements. A detailed medical history was obtained. Body mass index (BMI) was calculated by dividing participants’ weight in kilograms by the square of their height in metres. Stiffness index β was calculated using blood pressure and diameter of the systolic and diastolic artery. Intima-media thickness was also measured. Results. The mean age of the obese and normal (control) groups were 10.12±2.12 years and 9.78±1.78 years respectively. Weight, BMI, and systolic and and diastolic blood pressure values were significantly higher in the obese group (all

Modelling Future Coronary Heart Disease Mortality to 2030 in the British Isles.

OBJECTIVE: Despite rapid declines over the last two decades, coronary heart disease (CHD) mortality rates in the British Isles are still amongst the highest in Europe. This study uses a modelling approach to compare the potential impact of future risk factor scenarios relating to smoking and physical activity levels, dietary salt and saturated fat intakes on future CHD mortality in three countries: Northern Ireland (NI), Republic of Ireland (RoI) and Scotland. METHODS: CHD mortality models previously developed and validated in each country were extended to predict potential reductions in CHD mortality from 2010 (baseline year) to 2030. Risk factor trends data from recent surveys at baseline were used to model alternative future risk factor scenarios: Absolute decreases in (i) smoking prevalence and (ii) physical inactivity rates of up to 15% by 2030; relative decreases in (iii) dietary salt intake of up to 30% by 2030 and (iv) dietary saturated fat of up to 6% by 2030. Probabilistic sensitivity analyses were then conducted. RESULTS: Projected populations in 2030 were 1.3, 3.4 and 3.9 million in NI, RoI and Scotland respectively (adults aged 25-84). In 2030: assuming recent declining mortality trends continue: 15% absolute reductions in smoking could decrease CHD deaths by 5.8-7.2%. 15% absolute reductions in physical inactivity levels could decrease CHD deaths by 3.1-3.6%. Relative reductions in salt intake of 30% could decrease CHD deaths by 5.2-5.6% and a 6% reduction in saturated fat intake might decrease CHD deaths by some 7.8-9.0%. These projections remained stable under a wide range of sensitivity analyses. CONCLUSIONS: Feasible reductions in four cardiovascular risk factors (already achieved elsewhere) could substantially reduce future coronary deaths. More aggressive polices are therefore needed in the British Isles to control tobacco, promote healthy food and increase physical activity