Computer aided diagnosis for cardiovascular diseases based on ECG signals : a survey

The interpretation of Electroencephalography (ECG) signals is difficult, because even subtle changes in the waveform can indicate a serious heart disease. Furthermore, these waveform changes might not be present all the time. As a consequence, it takes years of training for a medical practitioner to become an expert in ECG-based cardiovascular disease diagnosis. That training is a major investment in a specific skill. Even with expert ability, the signal interpretation takes time. In addition, human interpretation of ECG signals causes interoperator and intraoperator variability. ECG-based Computer-Aided Diagnosis (CAD) holds the promise of improving the diagnosis accuracy and reducing the cost. The same ECG signal will result in the same diagnosis support regardless of time and place. This paper introduces both the techniques used to realize the CAD functionality and the methods used to assess the established functionality. This survey aims to instill trust in CAD of cardiovascular diseases using ECG signals by introducing both a conceptional overview of the system and the necessary assessment method

Isoscalar-isovector mass splittings in excited mesons

Mass splittings between the isovector and isoscalar members of meson nonets arise in part from hadronic loop diagrams which violate the Okubo-Zweig-Iizuka rule. Using a model for these loop processes which works qualitatively well in the established nonets, I tabulate predictions for the splittings and associated isoscalar mixing angles in the remaining nonets below about 2.5 GeV, and explain some of their systematic features. The results for excited vector mesons compare favorably with experiment.Comment: 8 RevTeX pages, including 1 LaTeX figure. CMU-HEP93-23/DOE-ER-40682-4

Exploring the QCD landscape with high-energy nuclear collisions

Quantum chromodynamics (QCD) phase diagram is usually plotted as temperature (T) versus the chemical potential associated with the conserved baryon number (\mu_{B}). Two fundamental properties of QCD, related to confinement and chiral symmetry, allows for two corresponding phase transitions when T and \mu_{B} are varied. Theoretically the phase diagram is explored through non-perturbative QCD calculations on lattice. The energy scale for the phase diagram (\Lambda_{QCD} ~ 200 MeV) is such that it can be explored experimentally by colliding nuclei at varying beam energies in the laboratory. In this paper we review some aspects of the QCD phase structure as explored through the experimental studies using high energy nuclear collisions. Specifically, we discuss three observations related to the formation of a strongly coupled plasma of quarks and gluons in the collisions, experimental search for the QCD critical point on the phase diagram and freeze-out properties of the hadronic phase.Comment: Submitted to the New Journal of Physics focus issue "Strongly Correlated Quantum Fluids: From Ultracold Quantum Gases to QCD Plasmas

Pioglitazone in early Parkinson\u27s disease: a phase 2, multicentre, double-blind, randomised trial

Background A systematic assessment of potential disease-modifying compounds for Parkinson\u27s disease concluded that pioglitazone could hold promise for the treatment of patients with this disease. We assessed the effect of pioglitazone on the progression of Parkinson\u27s disease in a multicentre, double-blind, placebo-controlled, futility clinical trial. Methods Participants with the diagnosis of early Parkinson\u27s disease on a stable regimen of 1 mg/day rasagiline or 10 mg/day selegiline were randomly assigned (1:1:1) to 15 mg/day pioglitazone, 45 mg/day pioglitazone, or placebo. Investigators were masked to the treatment assignment. Only the statistical centre and the central pharmacy knew the treatment name associated with the randomisation number. The primary outcome was the change in the total Unified Parkinson\u27s Disease Rating Scale (UPDRS) score between the baseline and 44 weeks, analysed by intention to treat. The primary null hypothesis for each dose group was that the mean change in UPDRS was 3 points less than the mean change in the placebo group. The alternative hypothesis (of futility) was that pioglitazone is not meaningfully different from placebo. We rejected the null if there was significant evidence of futility at the one-sided alpha level of 0.10. The study is registered at ClinicalTrials.gov, number NCT01280123. Findings 210 patients from 35 sites in the USA were enrolled between May 10, 2011, and July 31, 2013. The primary analysis included 72 patients in the 15 mg group, 67 in the 45 mg group, and 71 in the placebo group. The mean total UPDRS change at 44 weeks was 4.42 (95% CI 2.55-6.28) for 15 mg pioglitazone, 5.13 (95% CI 3.17-7.08) for 45 mg pioglitazone, and 6.25 (95% CI 4.35-8.15) for placebo (higher change scores are worse). The mean difference between the 15 mg and placebo groups was -1.83 (80% CI -3.56 to -0.10) and the null hypothesis could not be rejected (p=0.19). The mean difference between the 45 mg and placebo groups was -1.12 (80% CI -2.93 to 0.69)and the null hypothesis was rejected in favour of futility (p=0.09). Planned sensitivity analyses of the primary outcome, using last value carried forward (LVCF) to handle missing data and using the completers\u27 only sample, suggested that the 15 mg dose is also futile (p=0.09 for LVCF, p= 0.09 for completers) but failed to reject the null hypothesis for the 45 mg dose (p=0.12 for LVCF, p=0.19 for completers). Six serious adverse events occurred in the 15 mg group, nine in the 45 mg group, and three in the placebo group; none were thought to be definitely or probably related to the study interventions. Interpretation These findings suggest that pioglitazone at the doses studied here is unlikely to modify progression in early Parkinson\u27s disease. Further study of pioglitazone in a larger trial in patients with Parkinson\u27s disease is not recommended

Changing distribution of the east coast of Scotland bottlenose dolphin population and the challenges of area‐based management

MAC received funding from the Department of Energy and Climate Change (DECC) (now Department for Business, Energy and Industrial Strategy) UK, and the MASTS (Marine Alliance for Science and Technology for Scotland) pooling initiative. MASTS is funded by the Scottish Funding Council (grant reference HR09011) and contributing institutions. Annual surveys were funded by DECC, Scottish Natural Heritage (SNH), Beatrice Offshore Windfarm Ltd., Moray Offshore Renewables Ltd, Marine Scotland, The Crown Estate, Highlands and Islands Enterprise and the Universities of St Andrews and Aberdeen. All fieldwork was carried out under SNH Animal Scientific Licences to PMT and PSH. The authors have no conflict of interest to declare. We thank John Baxter for helpful discussions about the implications for conservation and management while drafting this manuscript, and Morven Carruthers for her advice on the site condition monitoring for the Moray Firth SAC. This manuscript benefited from the helpful comments of two anonymous reviewers.Peer reviewedPostprin

Predictors of surgical, general and follow-up complications in lumbar spinal stenosis relative to patient age as emerged from the Spine Tango Registry

Published opinions regarding the outcomes and complications in older patients have a broad spectrum and there is a disagreement whether surgery in older patients entails a higher risk. Therefore this study examines the risk of surgery for lumbar spinal stenosis relative to age in the pooled data set of the Spine Tango registry

Reduced level of arousal and increased mortality in adult acute medical admissions: a systematic review and meta-analysis

Abstract Background Reduced level of arousal is commonly observed in medical admissions and may predict in-hospital mortality. Delirium and reduced level of arousal are closely related. We systematically reviewed and conducted a meta-analysis of studies in adult acute medical patients of the relationship between reduced level of arousal on admission and in-hospital mortality. Methods We conducted a systematic review (PROSPERO: CRD42016022048), searching MEDLINE and EMBASE. We included studies of adult patients admitted with acute medical illness with level of arousal assessed on admission and mortality rates reported. We performed meta-analysis using a random effects model. Results From 23,941 studies we included 21 with 14 included in the meta-analysis. Mean age range was 33.4 - 83.8 years. Studies considered unselected general medical admissions (8 studies, n=13,039) or specific medical conditions (13 studies, n=38,882). Methods of evaluating level of arousal varied. The prevalence of reduced level of arousal was 3.1%-76.9% (median 13.5%). Mortality rates were 1.7%-58% (median 15.9%). Reduced level of arousal was associated with higher in-hospital mortality (pooled OR 5.71; 95% CI 4.21-7.74; low quality evidence: high risk of bias, clinical heterogeneity and possible publication bias). Conclusions Reduced level of arousal on hospital admission may be a strong predictor of in-hospital mortality. Most evidence was of low quality. Reduced level of arousal is highly specific to delirium, better formal detection of hypoactive delirium and implementation of care pathways may improve outcomes. Future studies to assess the impact of interventions on in-hospital mortality should use validated assessments of both level of arousal and delirium

Probe the QCD phase diagram with \phi-mesons in high energy nuclear collisions

High-energy nuclear collision provide a unique tool to study the strongly interacting medium. Recent results from the Relativistic Heavy Ion Collider (RHIC) on \phi-meson production has revealed the formation of a dense partonic medium. The medium constituents are found to exhibit collective behaviour initiated due to partonic interactions in the medium. We present a brief review of the recent results on \phi production in heavy-ion collisions at RHIC. One crucial question is where, in the phase diagram, does the transition happen for the matter changing from hadronic to partonic degrees of freedom. We discuss how \phi-meson elliptic flow in heavy-ion collisions can be used for the search of the QCD phase boundary.Comment: Plenary talk at Strange Quark Matter 2008, Beijing China, 6-10 October 2008. To appear in proceedings of SQM200